QUESTION: 1

A 38-year-old man presents with acute infection of skin in the leg. Diagnosis of cellulitis has been made. What should be prescribed?

Ceftriaxone + Flucloxacillin
Vancomycin + Metronidazole
Metronidazole + Erythromycin
Ceftriaxone + Terbinafine
Penicillin + Flucloxacillin

Answer(s): E

Explanation:

Penicillin + Flucloxacillin. Cellulitis is usually caused by bacteria, such as staphylococci or streptoc are commonly present on the skin. So Penicillin + Flucloxacillin should be given.

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A 28-year-old man presents with a 2 hours' history of rapid palpitations. He feels a little light headed but is other exam: pulse=170 bpm and regular, BP=100/68 mmHg. He has had 2 similar episodes in the past.
What is the most disturbance?

SVT
VF
A-fibrillation
VT
Ventricular-ectopic

Answer(s): A

Explanation:

Palpitation, light headedness with a tachycardia of 170 bpm that is regular are most likely a SVT.

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QUESTION: 3

A 29-year-old lady who is a bank manager is referred by the GP to the medical OPC due to a long history of tin in the joints. An autoimmune screen result showed smooth muscle antibodies positive.
What is the most appropriate investigation?

Jejunal biopsy
Thyroid function test
Liver function test
Serum glucose
ECG

Answer(s): C

Explanation:

Autoimmune hepatitis. Definitive investigation is liver biopsy Steroid [start with high dose prednisolone]. Azathioprine is commonly added with steroid to reduce its dose as more side effects than azathioprine.

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QUESTION: 4

A 65-year-old man presents with significant weight loss and complains of cough, SOB and chest pain. Exam constricted, drooping of left eyelid.
What is the most likely diagnosis?

Thoracic outlet syndrome
Cervical rib
Bronchogenic carcinoma
Pancoast tumor
Pneumonia

Answer(s): D

Explanation:

Pancoast tumor. Pancoast tumour is the apical lung cancer that is associated with destructive lesion thoracic inlet and involvement of the brachial plexus and cervical sympathetic nerves (the stellate ganglion) le horner's syndrome.

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