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SMLE - ALL
| A 14-year-old boy with progressive lower limb weakness and tingling 10 days after a viral illness. What is the most likely diagnosis? | A. Polymyositis | B. Multiple sclerosis | C. Acute poliomyelitis | D. Guillain-Barré syndrome | D. Guillain-Barré syndrome |
| A 5-year-old boy had a seizure after fever and cough. What is the most appropriate treatment? | A. Phenytoin | B. Diazepam | C. Amoxicillin | D. Paracetamol | D. Paracetamol |
| Which measure decreases the incidence of Sudden Infant Death Syndrome? | A. Pacifier at bedtime | B. Sleep in prone position | C. Soft mattress | D. Sleep support device | A. Pacifier at bedtime |
| In which condition should circumcision be avoided? | A. Phimosis | B. Hypospadias | C. Unilateral Cryptorchidism | D. Posterior urethral valve | B. Hypospadias |
| A 6-year-old girl develops dystonic reactions after taking metoclopramide. What is the appropriate treatment? | A. Tizanidine | B. Epinephrine | C. Cyproheptadine | D. Diphenhydramine | D. Diphenhydramine |
| A 4-month-old boy presents with rash over the neck for 3 days. What is the most likely diagnosis? | A. Cellulitis | B. Candidal intertrigo | C. Erythema multiforme | D. Seborrheic dermatitis | B. Candidal intertrigo |
| A 3-year-old boy with blood in diapers for 2 days, pale and dry mucosa. What is the most likely diagnosis? | A. Juvenile polyp | B. Intussusception | C. Hirschsprung disease | D. Meckel’s diverticulum | D. Meckel’s diverticulum |
| A 6-year-old boy with frequent eye blinking episodes for 2 weeks. What is the most likely diagnosis? | A. Tic disorder | B. Petit mal seizure | C. Dry eye syndrome | D. Tourette syndrome | A. Tic disorder |
| A 2-week-old girl with persistent vomiting since birth, epigastric mass. Best investigation? | A. Barium swallow | B. Abdominal X-ray | C. CT scan | D. Ultrasound | D. Abdominal ultrasound |
| A 13-year-old boy with fatigue, cough, low-grade fever, night sweats, and hemoptysis. Diagnosis? | A. Tuberculosis | B. Bronchiectasis | C. Lung neoplasm | D. Mycoplasma pneumonia | A. Tuberculosis |
| A 6-year-old with fever, conjunctivitis, coryza, cough, and maculopapular rash starting on face. Diagnosis? | A. Toxic shock syndrome | B. Gonococcal bacteremia | C. Measles | D. Rubella | C. Measles |
| A 40-year-old primigravida with previous DVT — appropriate management? | A. Aspirin | B. Heparin | C. Enoxaparin | D. No anticoagulation | D. No anticoagulation |
| A 29-year-old G4 P3 at 12 weeks with BP 150/95 mmHg, trace protein. Best therapy? | A. Methyldopa | B. Atenolol | C. Captopril | D. Losartan | A. Methyldopa |
| During a difficult forceps delivery, the blade crushed the left facial nerve. Expected defect? | A. Inability to close left eyelid | B. Reduced blood supply to ear | C. Loss of facial sensation | D. Loss of anterior tongue taste | A. Inability to close left eyelid |
| A 34-year-old G4 P3 at 32 weeks with tonic-clonic convulsions. Best drug to control seizures? | A. Magnesium sulfate | B. Hydralazine | C. Phenytoin | D. Diazepam | A. Magnesium sulfate |
| A 27-year-old primigravida abnormal GTT. Next step? | A. Random glucose | B. HbA1c | C. Adjust diet | D. Repeat GTT | C. Adjust diet |
| A 35-year-old G2 P1 at 30 weeks with uncontrolled gestational diabetes on diet. Best medication? | A. Pioglitazone | B. Metformin | C. Glyburide | D. Insulin | D. Insulin |
| A 35-year-old woman on prolactinemia treatment. When is pituitary imaging indicated? | A. Prolactin twice normal | B. Persistent galactorrhea | C. Blurred vision | D. Pregnancy | B. Persistent galactorrhea |
| A 40-year-old woman on tamoxifen has thickened endometrium. Next step? | A. Endometrial sampling | B. CA-125 | C. Pelvic CT | D. FSH/LH | A. Endometrial sampling |
| A 24-year-old obese woman with irregular menses, acne, hirsutism, ↑LH/↓FSH. Diagnosis? | A. Turner | B. Exogenous obesity | C. Premature ovarian failure | D. PCOS | D. Polycystic ovary syndrome |
| A 25-year-old breastfeeding mother with fever and painful right breast. Pathogen? | A. E. coli | B. Staph aureus | C. H. influenzae | D. β-hemolytic strep | B. Staphylococcus aureus |
| A 22-year-old woman with ovarian cysts, hirsutism, insulin resistance. Diagnosis? | A. Gynecomastia | B. Kallmann | C. Klinefelter | D. Stein-Leventhal syndrome | D. Stein-Leventhal syndrome |
| A 28-year-old HCV-treated woman, pregnant, asks about breastfeeding. When contraindicated? | A. Lack of vaccines | B. Neonatal thrush | C. Maternal anemia | D. Cracked nipples | D. Cracked nipples |
| A 22-year-old woman with normal exam but pre-menstrual breast tenderness. Screening test? | A. Breast ultrasound | B. Pap smear | C. HPV test | D. GBS culture | B. Papanicolaou smear |
| A 30-year-old 10-weeks pregnant with hyperemesis and ketonuria. Finding confirms diagnosis? | A. Leukocytes | B. Glucose | C. Ketones | D. Protein | C. Ketones |
| A 25-year-old 10 days postpartum, red tender breast lump, fever 39 °C. Diagnosis? | A. Fibrocystic disease | B. Inflammatory carcinoma | C. Puerperal sepsis | D. Breast abscess | D. Breast abscess |
| A 35-year-old woman with greenish-yellow purulent vaginal discharge and spotted rash lesions. Diagnosis? | A. Candidiasis | B. Bacterial vaginosis | C. Atrophic vaginitis | D. Trichomoniasis | D. Vaginal trichomoniasis |
| A 65-year-old postmenopausal woman with vaginal bleeding. Essential investigation? | A. MRI | B. Ultrasound | C. Endometrial biopsy | D. Tumor markers | C. Endometrial biopsy |
| A 67-year-old woman with lichen sclerosus, new vulvar mass. Histopathology finding? | A. Adenosquamous carcinoma | B. Squamous cell carcinoma | C. Adenocarcinoma | D. Melanoma | B. Squamous cell carcinoma |
| A 29-year-old woman with thin grayish fishy vaginal discharge, pH 5.5. Treatment? | A. Metronidazole | B. Fluconazole | C. Tetracycline | D. Doxycycline | A. Metronidazole |
| A 57-year-old menopausal woman with endometrial hyperplasia + atypia. Best treatment? | A. Myomectomy | B. Progesterone | C. Embolization | D. Total hysterectomy | D. Total abdominal hysterectomy |
| A 55-year-old woman with urinary leakage before reaching bathroom. First step in evaluation? | A. Cystoscopy | B. IV pyelogram | C. Urethral pressure profile | D. Urine analysis and culture | D. Urine analysis and culture |
| A postpartum 3 months woman with fecal incontinence + vaginal flatus. Diagnosis? | A. Hemorrhoids | B. Puerperal sepsis | C. Perineal tear | D. Rectovaginal fistula | D. Recto-vaginal fistula |
| A 60-year-old ASC-US twice after estrogen therapy. Next investigation? | A. Repeat Pap 6 months | B. Endometrial biopsy | C. HPV test | D. Colposcopy | D. Colposcopy |
| A 25-year-old woman with painless 3 cm cystic labial mass 7 o’clock. Diagnosis? | A. Bartholin cyst | B. Vulvar myoma | C. Vaginal adenosis | D. Skene duct cyst | A. Bartholin cyst |
| A 33-year-old woman with thick odorless white cottage-cheese discharge after antibiotics. Diagnosis? | A. Chlamydia | B. Candidiasis | C. Gardnerella | D. Trichomoniasis | B. Candidiasis |
| A 48-year-old woman with recurrent curd-like discharge, yeast on microscopy. Associated condition? | A. Sarcoidosis | B. Tuberculosis | C. Diabetes mellitus | D. Lupus erythematosus | C. Diabetes mellitus |
| A 56-year-old postmenopausal woman with pea-sized labial lump, bleeding discharge. Diagnosis? | A. Bartholin cyst | B. Cystic adenosis | C. Bartholin gland carcinoma | D. Vulvar SCC | D. Squamous cell carcinoma of vulva |
| A 21-year-old woman with diffuse abdominal pain, dyspareunia, cervical tenderness. Diagnosis? | A. PID | B. Cholecystitis | C. Appendicitis | D. Cervicitis | A. Pelvic inflammatory disease |
| A 23-year-old woman with watery brown discharge after IUD insertion. Diagnosis? | A. Uterine rupture | B. Bacterial vaginosis | C. Twisted ovarian mass | D. PID | D. Pelvic inflammatory disease |
| A 21-year-old woman with thick white curdy discharge, pseudohyphae, pH 4.0. Diagnosis? | A. Trichomoniasis | B. Bacterial vaginosis | C. Physiologic discharge | D. Vulvovaginal candidiasis | D. Vulvovaginal candidiasis |
| A young woman unresponsive to ceftriaxone for PID. Likely pathogen? | A. Adenovirus | B. Herpes virus | C. Neisseria gonorrhea | D. Chlamydia trachomatis | D. Chlamydia trachomatis |
| A 34-year-old woman Pap ASC-US, history of HPV warts. First step? | A. Repeat Pap | B. Hysterectomy | C. Colposcopy | D. HPV testing | D. HPV testing |
| A woman with cyclic pelvic pain before menses. Diagnostic method for endometriosis? | A. MRI | B. Diagnostic laparoscopy | C. Biopsy | D. Ultrasound | B. Diagnostic laparoscopy |
| A 67-year-old woman with vaginal atrophy and burning, negative wet prep. Initial treatment? | A. Steroid cream | B. Metronidazole gel | C. Vinegar douche | D. Estrogen vaginal cream | D. Estrogen vaginal cream |
| A 16-year-old girl with primary amenorrhea, normal breast, absent uterus. Diagnosis? | A. Turner syndrome | B. Kallmann syndrome | C. Androgen insensitivity | D. Asherman syndrome | C. Androgen insensitivity syndrome |
| A 28-year-old woman with secondary amenorrhea, history of D&C. Diagnosis? | A. PCOS | B. Turner syndrome | C. Asherman syndrome | D. Hypothalamic amenorrhea | C. Asherman syndrome |
| A 22-year-old woman with amenorrhea, galactorrhea, negative pregnancy test. Diagnosis? | A. Pituitary tumor | B. PCOS | C. Ovarian failure | D. Hypothalamic dysfunction | A. Pituitary tumor (prolactinoma) |
| A 30-year-old woman with infertility and hirsutism, LH:FSH = 3:1. Diagnosis? | A. PCOS | B. Cushing | C. Hypothyroidism | D. Adrenal tumor | A. Polycystic ovary syndrome |
| A 27-year-old woman with hirsutism and clitoromegaly. Cause? | A. PCOS | B. Adrenal tumor | C. Cushing | D. Ovarian failure | B. Adrenal tumor |
| A 35-year-old woman with heavy menses and irregular cycles. Most likely cause? | A. Anovulation | B. Endometriosis | C. Adenomyosis | D. Fibroids | A. Anovulation |
| A 30-year-old woman with heavy menses, firm enlarged uterus. Diagnosis? | A. Adenomyosis | B. Leiomyoma | C. Fibroid polyp | D. Endometrial carcinoma | B. Leiomyoma |
| A 42-year-old woman with dysmenorrhea, heavy bleeding, uniformly enlarged uterus. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. Fibroids | D. Polyp | B. Adenomyosis |
| A 35-year-old woman with cyclic pelvic pain, infertility, nodular uterosacral ligament. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PID | D. Fibroid | A. Endometriosis |
| A 45-year-old woman with hot flashes, irregular menses, FSH ↑. Diagnosis? | A. Hypothyroidism | B. Premature ovarian failure | C. Menopause | D. Hyperprolactinemia | C. Menopause |
| A 50-year-old postmenopausal woman with vaginal bleeding. Next step? | A. Pap smear | B. Endometrial biopsy | C. CT scan | D. Hysteroscopy | B. Endometrial biopsy |
| A 40-year-old woman with postcoital bleeding. Investigation? | A. Pap smear | B. TVS | C. Endometrial biopsy | D. Hysteroscopy | A. Pap smear |
| A 28-year-old pregnant woman with painless vaginal bleeding, soft uterus, no pain. Diagnosis? | A. Placenta previa | B. Abruption placenta | C. Vasa previa | D. Cervical polyp | A. Placenta previa |
| A 28-year-old woman at 34 weeks with painful vaginal bleeding, tender uterus. Diagnosis? | A. Placenta previa | B. Abruption placentae | C. Uterine rupture | D. Vasa previa | B. Abruptio placentae |
| A 30-year-old primigravida with gush of fluid at 34 weeks. Test to confirm? | A. Nitrazine test | B. Pap smear | C. Biophysical profile | D. CTG | A. Nitrazine test |
| A 32-year-old woman with PROM, fever, uterine tenderness. Diagnosis? | A. Endometritis | B. Chorioamnionitis | C. Sepsis | D. UTI | B. Chorioamnionitis |
| A 29-year-old woman with fever, uterine tenderness 3 days postpartum. Diagnosis? | A. Endometritis | B. Mastitis | C. Septic abortion | D. Retained placenta | A. Endometritis |
| A 24-year-old woman at 36 weeks with headache, blurred vision, BP 160/110, 3+ proteinuria. Diagnosis? | A. Gestational HTN | B. Chronic HTN | C. Pre-eclampsia | D. Eclampsia | C. Pre-eclampsia |
| A 30-year-old woman with preeclampsia, seizure, unconscious. Diagnosis? | A. Stroke | B. Epilepsy | C. Eclampsia | D. Hypertensive crisis | C. Eclampsia |
| A 25-year-old woman at 32 weeks, BP 170/110, urine protein 4+. Next step? | A. Deliver immediately | B. Antihypertensives and magnesium sulfate | C. Observe | D. Steroids only | B. Start magnesium sulfate and control BP |
| A 35-year-old G2P1 with GDM on insulin, at 38 weeks. Next step? | A. Induce labor | B. Cesarean | C. Wait till 41 weeks | D. Stop insulin | A. Induce labor at 38 weeks |
| A 28-year-old woman with pruritus and jaundice in pregnancy. Diagnosis? | A. Viral hepatitis | B. Intrahepatic cholestasis | C. Acute fatty liver | D. Preeclampsia | B. Intrahepatic cholestasis of pregnancy |
| A 25-year-old G2P1 with previous C-section, at 39 weeks, wants VBAC. Contraindication? | A. Transverse lie | B. One previous C-section | C. Term pregnancy | D. Vertex presentation | A. Transverse lie |
| A 25-year-old woman at 10 weeks with vaginal bleeding, open os. Diagnosis? | A. Threatened abortion | B. Inevitable abortion | C. Incomplete abortion | D. Missed abortion | B. Inevitable abortion |
| A 30-year-old woman 14 weeks, vaginal bleeding, closed os, fetal heart present. Diagnosis? | A. Threatened abortion | B. Inevitable abortion | C. Missed abortion | D. Complete abortion | A. Threatened abortion |
| A 26-year-old woman with positive pregnancy test, spotting, adnexal tenderness. Diagnosis? | A. Ovarian cyst | B. Ectopic pregnancy | C. Threatened abortion | D. Appendicitis | B. Ectopic pregnancy |
| A 28-year-old woman with ectopic pregnancy, BP 80/50. Management? | A. Methotrexate | B. Salpingostomy | C. Laparotomy | D. Observation | C. Emergency laparotomy |
| A 24-year-old woman with missed abortion, mild bleeding. Best management? | A. Expectant | B. Surgical evacuation | C. Misoprostol | D. Oxytocin | B. Surgical evacuation |
| A 30-year-old woman 10 weeks with multiple vesicular structures on ultrasound. Diagnosis? | A. Missed abortion | B. Molar pregnancy | C. Multiple gestation | D. Twin pregnancy | B. Hydatidiform mole |
| A 32-year-old woman post-molar evacuation, hCG plateau for 6 weeks. Diagnosis? | A. Complete mole | B. Invasive mole | C. Choriocarcinoma | D. Normal regression | B. Invasive mole |
| A 30-year-old woman with molar pregnancy, after evacuation follow-up test? | A. hCG weekly | B. CT abdomen | C. MRI pelvis | D. Ultrasound | A. Weekly serum hCG |
| A 32-year-old woman with high β-hCG, multiple snowstorm pattern. Diagnosis? | A. Partial mole | B. Complete mole | C. Multiple gestation | D. Ectopic pregnancy | B. Complete hydatidiform mole |
| A 35-year-old woman with postpartum heavy bleeding, boggy uterus. Diagnosis? | A. Retained placenta | B. Uterine atony | C. Laceration | D. Coagulopathy | B. Uterine atony |
| A 30-year-old woman with firm uterus, heavy bleeding, vaginal tear. Diagnosis? | A. Uterine rupture | B. Laceration | C. Placenta accreta | D. Uterine inversion | B. Vaginal laceration |
| A 26-year-old woman with prolonged labor, sudden pain, fetal bradycardia. Diagnosis? | A. Placenta previa | B. Abruption | C. Uterine rupture | D. Cord prolapse | C. Uterine rupture |
| A 32-year-old woman after delivery, inverted uterus. Management? | A. Replace uterus manually | B. Hysterectomy | C. Uterotonics | D. Oxytocin | A. Manual replacement of uterus |
| A 29-year-old woman 2 days postpartum, red tender breast, fever 39 °C. Organism? | A. Staph aureus | B. Strep pyogenes | C. E. coli | D. Pseudomonas | A. Staph aureus |
| A 28-year-old woman with postpartum psychosis. Management? | A. Hospitalization | B. Antidepressants | C. ECT | D. Family support | A. Hospitalization and antipsychotics |
| A 23-year-old woman with green vaginal discharge, strawberry cervix. Diagnosis? | A. Candida | B. Trichomonas | C. Bacterial vaginosis | D. Chlamydia | B. Trichomonas vaginalis |
| A 26-year-old woman with clue cells on wet mount, pH >4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Gonorrhea | B. Bacterial vaginosis |
| A 28-year-old woman with yellow discharge, intracellular diplococci on smear. Diagnosis? | A. Gonorrhea | B. Chlamydia | C. BV | D. Candida | A. Gonorrhea |
| A 23-year-old woman with cervicitis, Giemsa stain shows inclusion bodies. Diagnosis? | A. BV | B. Candida | C. Gonorrhea | D. Chlamydia | D. Chlamydia trachomatis |
| A 25-year-old woman with painful vesicles on vulva. Diagnosis? | A. HPV | B. HSV | C. Trichomonas | D. Candida | B. Herpes simplex virus |
| A 26-year-old woman with cauliflower-like genital warts. Diagnosis? | A. HSV | B. HPV | C. BV | D. Chlamydia | B. Human papillomavirus infection |
| A 30-year-old woman with painless genital ulcer and firm nodes. Diagnosis? | A. Syphilis | B. Chancroid | C. Lymphogranuloma venereum | D. HSV | A. Primary syphilis |
| A 27-year-old woman with painful genital ulcer and tender inguinal nodes. Diagnosis? | A. Syphilis | B. Chancroid | C. LGV | D. HSV | B. Chancroid |
| A 28-year-old woman with multiple shallow painful ulcers, grouped vesicles. Diagnosis? | A. HSV | B. Chancroid | C. LGV | D. Syphilis | A. Herpes simplex virus |
| A 30-year-old woman with bubo and groove sign. Diagnosis? | A. HSV | B. LGV | C. Syphilis | D. Chancroid | B. Lymphogranuloma venereum |
| A 40-year-old woman with hot flashes and mood changes, FSH high, LH high. Diagnosis? | A. Hypothyroidism | B. Premature menopause | C. PCOS | D. Addison’s | B. Premature menopause |
| A 48-year-old woman with heavy bleeding, uterus 12-week size. Investigation? | A. US pelvis | B. Hysteroscopy | C. MRI | D. CT | A. Ultrasound pelvis |
| A 35-year-old woman with severe pelvic pain during menstruation, infertility, tender nodules in posterior fornix. Diagnosis? | A. PID | B. Endometriosis | C. Adenomyosis | D. Fibroid | B. Endometriosis |
| A 45-year-old woman with cyclic menorrhagia, boggy uterus. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. Fibroid | D. Endometrial polyp | B. Adenomyosis |
| A 30-year-old woman with infertility, bilateral adnexal masses, chocolate cysts. Diagnosis? | A. Endometriosis | B. Fibroid | C. PID | D. Ovarian tumor | A. Endometriosis |
| A 45-year-old woman with painless postmenopausal bleeding, thickened endometrium on ultrasound. Next step? | A. D&C | B. MRI pelvis | C. TVS | D. Biopsy | D. Endometrial biopsy |
| A 32-year-old woman on OCP presents with mild right lower abdominal pain, ovarian cyst on ultrasound. Likely type? | A. Dermoid cyst | B. Follicular cyst | C. Endometrioma | D. Serous cystadenoma | B. Follicular cyst |
| A 25-year-old woman with right ovarian cyst containing hair and teeth. Diagnosis? | A. Dermoid cyst | B. Endometrioma | C. Serous cystadenoma | D. Mucinous cystadenoma | A. Dermoid cyst (Mature teratoma) |
| A 30-year-old woman with cystic ovarian mass, thick capsule, bilateral. Likely diagnosis? | A. Mucinous cystadenoma | B. Serous cystadenoma | C. Dermoid cyst | D. Endometrioma | B. Serous cystadenoma |
| A 40-year-old woman with multilocular mucin-filled ovarian cyst. Diagnosis? | A. Mucinous cystadenoma | B. Serous cystadenoma | C. Endometrioma | D. Dermoid cyst | A. Mucinous cystadenoma |
| A 35-year-old woman with virilization and solid ovarian mass. Diagnosis? | A. Granulosa cell tumor | B. Sertoli-Leydig tumor | C. Theca cell tumor | D. Dysgerminoma | B. Sertoli-Leydig tumor |
| A 40-year-old woman with endometrial hyperplasia and adnexal mass. Likely tumor? | A. Dysgerminoma | B. Granulosa cell tumor | C. Yolk sac tumor | D. Serous cystadenoma | B. Granulosa cell tumor |
| A 20-year-old woman with right adnexal mass, elevated LDH. Diagnosis? | A. Dysgerminoma | B. Yolk sac tumor | C. Choriocarcinoma | D. Teratoma | A. Dysgerminoma |
| A 25-year-old woman with adnexal mass, AFP high. Diagnosis? | A. Dysgerminoma | B. Yolk sac tumor | C. Choriocarcinoma | D. Teratoma | B. Yolk sac tumor |
| A 22-year-old woman with adnexal mass, β-hCG elevated, not pregnant. Diagnosis? | A. Dysgerminoma | B. Yolk sac tumor | C. Choriocarcinoma | D. Teratoma | C. Choriocarcinoma |
| A 60-year-old woman with bilateral ovarian masses, ascites, pleural effusion. Diagnosis? | A. Krukenberg tumor | B. Serous carcinoma | C. Mucinous cystadenoma | D. Fibroma | A. Krukenberg tumor |
| A 45-year-old woman with ovarian fibroma, ascites, pleural effusion. Diagnosis? | A. Krukenberg | B. Meigs syndrome | C. Serous carcinoma | D. Brenner tumor | B. Meigs syndrome |
| A 50-year-old woman with postmenopausal bleeding and adnexal mass. Tumor marker? | A. CA 19-9 | B. CA 125 | C. AFP | D. β-hCG | B. CA-125 |
| A 28-year-old woman with recurrent UTIs, dysuria, sterile urine culture. Likely cause? | A. Interstitial cystitis | B. Nephrolithiasis | C. Pyelonephritis | D. Urethritis | A. Interstitial cystitis |
| A 25-year-old woman with stress incontinence. Initial management? | A. Surgery | B. Kegel exercises | C. Catheterization | D. Anticholinergics | B. Pelvic floor (Kegel) exercises |
| A 45-year-old woman with continuous dribbling urine after hysterectomy. Diagnosis? | A. Stress incontinence | B. Urge incontinence | C. Vesicovaginal fistula | D. Overflow incontinence | C. Vesicovaginal fistula |
| A 30-year-old woman with sudden urge to void, can’t reach toilet. Diagnosis? | A. Stress incontinence | B. Urge incontinence | C. Overflow incontinence | D. Fistula | B. Urge incontinence |
| A 60-year-old woman with loss of urine with cough or sneeze. Diagnosis? | A. Stress incontinence | B. Overflow incontinence | C. Urge incontinence | D. Functional | A. Stress incontinence |
| A 70-year-old woman with continuous leakage and post-void residual >300 mL. Diagnosis? | A. Stress | B. Urge | C. Overflow | D. Fistula | C. Overflow incontinence |
| A 55-year-old woman with cystocele, dragging sensation. Treatment? | A. Pelvic floor exercises | B. Ring pessary | C. Hysterectomy | D. Kegel only | B. Ring pessary |
| A 50-year-old woman with second-degree uterine prolapse, doesn’t want surgery. Treatment? | A. Pessary | B. Pelvic exercises | C. Estrogen cream | D. Repair | A. Pessary |
| A 45-year-old woman with foul vaginal discharge after delivery, tender uterus. Diagnosis? | A. PID | B. Endometritis | C. Retained products | D. UTI | B. Endometritis |
| A 25-year-old woman with incomplete abortion, heavy bleeding, open os. Management? | A. Expectant | B. Surgical evacuation | C. Methotrexate | D. Observe | B. Surgical evacuation |
| A 26-year-old woman at 35 weeks, painless vaginal bleeding, no pain, normal fetal HR. Diagnosis? | A. Placenta previa | B. Abruption | C. Vasa previa | D. Uterine rupture | A. Placenta previa |
| A 32-year-old woman at 36 weeks with abdominal pain, bleeding, tender uterus, fetal distress. Diagnosis? | A. Placenta previa | B. Abruptio placentae | C. Uterine rupture | D. Cord prolapse | B. Abruptio placentae |
| A 29-year-old woman at 39 weeks, previous cesarean, severe pain, absent fetal heart. Diagnosis? | A. Abruption | B. Uterine rupture | C. Placenta previa | D. Cord prolapse | B. Uterine rupture |
| A 35-year-old woman after delivery with hypotension and no response to fluids. Diagnosis? | A. PPH | B. Sheehan syndrome | C. DIC | D. Retained placenta | B. Sheehan syndrome |
| A 28-year-old woman postpartum, failure of lactation, amenorrhea. Diagnosis? | A. Sheehan | B. Pituitary tumor | C. PCOS | D. Thyroiditis | A. Sheehan syndrome |
| A 30-year-old woman with retained placenta, hemorrhage, hypotension. Next step? | A. Manual removal | B. Oxytocin | C. D&C | D. Observation | A. Manual removal of placenta |
| A 32-year-old woman with PPH, uterus not contracting. Next management? | A. Oxytocin | B. Misoprostol | C. Ergometrine | D. All | D. All uterotonics |
| A 27-year-old woman after delivery, perineal tear to anal sphincter. Degree? | A. 1st | B. 2nd | C. 3rd | D. 4th | C. Third-degree tear |
| A 30-year-old woman with third-degree tear. Management? | A. Repair sphincter | B. Observation | C. Ligation | D. Antibiotics only | A. Surgical repair under anesthesia |
| A 25-year-old woman postpartum with fever, tender uterus, foul lochia. Diagnosis? | A. Endometritis | B. Retained products | C. Sepsis | D. UTI | A. Endometritis |
| A 24-year-old woman with previous molar pregnancy, now high hCG and lung metastases. Diagnosis? | A. Invasive mole | B. Choriocarcinoma | C. Complete mole | D. Partial mole | B. Choriocarcinoma |
| A 30-year-old woman with choriocarcinoma. Best treatment? | A. Methotrexate | B. Surgery | C. Radiotherapy | D. Observation | A. Methotrexate chemotherapy |
| A 32-year-old woman with complete mole, hCG plateau for 8 weeks. Diagnosis? | A. Invasive mole | B. Choriocarcinoma | C. Normal regression | D. Partial mole | A. Invasive mole |
| A 30-year-old woman post-molar evacuation, hCG rises again. Diagnosis? | A. Choriocarcinoma | B. Invasive mole | C. Normal regression | D. Partial mole | A. Choriocarcinoma |
| A 25-year-old woman with molar pregnancy. Best contraceptive for follow-up? | A. OCP | B. IUCD | C. Barrier | D. None | A. Oral contraceptive pills |
| A 30-year-old woman with twins, discordant growth, oligohydramnios in one sac. Diagnosis? | A. TTTS | B. Discordant twins | C. Fetal anomaly | D. Placenta previa | A. Twin-to-twin transfusion syndrome |
| A 28-year-old woman with fundal height > expected, high hCG, polyhydramnios. Likely? | A. Twin pregnancy | B. Anemia | C. IUGR | D. Oligohydramnios | A. Twin pregnancy |
| A 26-year-old woman with previous stillbirth, now Rh-negative. Next step? | A. Rh antibody screen | B. Coombs test | C. RhIg at 28 weeks | D. All | D. All of the above |
| A 25-year-old Rh-negative woman, 32 weeks, indirect Coombs positive. Management? | A. RhIg | B. No action | C. Monitor titers | D. Induce | C. Monitor antibody titers |
| A 26-year-old Rh-negative woman delivered Rh-positive baby, no prior RhIg. Next step? | A. Nothing | B. RhIg within 72 hours | C. RhIg at 6 weeks | D. Observe | B. Give Rh immunoglobulin within 72 hours |
| A 22-year-old woman, 30 weeks pregnant, reports decreased fetal movement. Next step? | A. Ultrasound | B. Non-stress test | C. CTG | D. Kick count | B. Non-stress test |
| A 32-year-old woman, 38 weeks, reactive non-stress test. Interpretation? | A. Normal fetus | B. Fetal distress | C. Hypoxia | D. Preterm labor | A. Normal fetal status |
| A 28-year-old woman, 39 weeks, decelerations and decreased variability on CTG. Management? | A. Reposition mother | B. Oxygen | C. Stop oxytocin | D. All | D. All of the above |
| A 25-year-old woman at 36 weeks, fundal height small. Investigation? | A. Ultrasound Doppler | B. CTG | C. NST | D. Biophysical profile | A. Doppler ultrasound for IUGR |
| A 30-year-old woman, IUGR, abnormal Doppler with absent end-diastolic flow. Next step? | A. Continue monitoring | B. Immediate delivery | C. Increase nutrition | D. Reassure | B. Immediate delivery |
| A 24-year-old primigravida with headache, visual disturbances, BP 170/110, urine +++. Diagnosis? | A. Gestational HTN | B. Preeclampsia | C. Eclampsia | D. Chronic HTN | C. Eclampsia |
| A 26-year-old pregnant woman, BP 160/100, no proteinuria. Diagnosis? | A. Chronic HTN | B. Gestational HTN | C. Preeclampsia | D. Eclampsia | B. Gestational hypertension |
| A 28-year-old woman with pregnancy-induced HTN, seizures. Drug of choice? | A. Diazepam | B. Phenytoin | C. Magnesium sulfate | D. Phenobarbital | C. Magnesium sulfate |
| A 30-year-old woman with eclampsia, RR 10/min, absent reflexes. Next step? | A. Stop MgSO₄ | B. Continue same dose | C. Increase dose | D. Give calcium gluconate | A. Stop MgSO₄ and give calcium gluconate |
| A 25-year-old woman at 30 weeks, itching palms and soles, bile acids high. Diagnosis? | A. Viral hepatitis | B. Intrahepatic cholestasis | C. Fatty liver | D. HELLP | B. Intrahepatic cholestasis of pregnancy |
| A 29-year-old woman with epigastric pain, jaundice, hypoglycemia, late pregnancy. Diagnosis? | A. Preeclampsia | B. HELLP | C. Acute fatty liver | D. Cholestasis | C. Acute fatty liver of pregnancy |
| A 35-year-old woman with preeclampsia, low platelets, high AST/ALT. Diagnosis? | A. DIC | B. HELLP syndrome | C. Acute fatty liver | D. Sepsis | B. HELLP syndrome |
| A 27-year-old woman, preeclampsia, severe headache, visual loss, hyperreflexia. Next step? | A. Deliver | B. Labetalol | C. MgSO₄ | D. All | D. All (stabilize and deliver) |
| A 22-year-old woman with UTI at 28 weeks. Safe antibiotic? | A. Ciprofloxacin | B. Ampicillin | C. Tetracycline | D. Sulfonamide | B. Ampicillin |
| A 30-year-old woman with asymptomatic bacteriuria in pregnancy. Management? | A. No treatment | B. Treat with antibiotics | C. Repeat culture | D. Observe | B. Treat with antibiotics |
| A 28-year-old woman with pyelonephritis in pregnancy. Management? | A. IV antibiotics | B. Oral antibiotics | C. Observation | D. Surgery | A. IV antibiotics |
| A 25-year-old woman with GDM, random glucose 12 mmol/L. Next step? | A. Diet | B. Oral agents | C. Insulin | D. Observe | C. Start insulin therapy |
| A 26-year-old woman at 10 weeks, fasting glucose 7.0 mmol/L. Diagnosis? | A. Gestational DM | B. Type 2 DM | C. Type 1 DM | D. Impaired fasting glucose | B. Type 2 diabetes mellitus (pre-existing) |
| A 30-year-old woman with polyhydramnios, macrosomia, fetal distress. Cause? | A. Preeclampsia | B. GDM | C. Rhesus isoimmunization | D. Twin pregnancy | B. Gestational diabetes |
| A 40-year-old woman with GDM, controlled on diet. Best fetal assessment? | A. NST weekly | B. Ultrasound growth | C. Kick count | D. All | D. All of the above |
| A 22-year-old woman with preterm labor at 30 weeks. Tocolytic? | A. Oxytocin | B. Nifedipine | C. Ergometrine | D. Methylergometrine | B. Nifedipine |
| A 28-year-old woman with preterm labor. Drug to accelerate lung maturity? | A. Oxytocin | B. Betamethasone | C. MgSO₄ | D. Misoprostol | B. Betamethasone |
| A 24-year-old woman, PROM at 32 weeks, afebrile. Management? | A. Expectant | B. Induce labor | C. Cesarean | D. Antibiotics only | A. Expectant management with antibiotics |
| A 29-year-old woman at 39 weeks, ruptured membranes 24 h ago, afebrile. Next step? | A. Induce labor | B. Expect | C. C-section | D. Reassure | A. Induce labor |
| A 28-year-old woman with cord visible at introitus, fetal bradycardia. Management? | A. Push cord in | B. Elevate presenting part | C. C-section | D. All | D. All of the above immediately |
| A 30-year-old woman with shoulder dystocia. First maneuver? | A. Suprapubic pressure | B. Fundal pressure | C. Woods screw | D. McRoberts | D. McRoberts maneuver |
| A 25-year-old woman with cord around neck, fetal distress. Best step? | A. Cut cord | B. Slip over head | C. Continue labor | D. Push back | B. Slip cord over the head gently |
| A 30-year-old woman, PPH after delivery. Uterus firm. Cause? | A. Atony | B. Trauma | C. Coagulopathy | D. Retained placenta | B. Genital tract trauma |
| A 32-year-old woman, PPH, uterus boggy. First step? | A. Massage uterus | B. Call help | C. Oxytocin | D. All | A. Uterine massage |
| A 28-year-old woman, PPH unresponsive to uterotonics. Next step? | A. Bakri balloon | B. Ligation | C. Hysterectomy | D. All sequentially | A. Balloon tamponade |
| A 30-year-old woman with DIC after abruption. Lab findings? | A. ↑PT/↓fibrinogen | B. ↓PT/↑fibrinogen | C. Normal PT | D. ↑Platelets | A. Increased PT, decreased fibrinogen |
| A 26-year-old woman post-cesarean, sudden dyspnea, hypotension, DIC. Diagnosis? | A. PE | B. AFE | C. Sepsis | D. MI | B. Amniotic fluid embolism |
| A 25-year-old woman, 3 days postpartum, painful leg swelling. Diagnosis? | A. DVT | B. Cellulitis | C. Lymphedema | D. Thrombophlebitis | A. Deep vein thrombosis |
| A 32-year-old woman with severe perineal pain, fever, foul lochia. Diagnosis? | A. Endometritis | B. Necrotizing fasciitis | C. Vaginitis | D. Retained products | B. Necrotizing fasciitis |
| A 24-year-old woman postpartum with perineal infection, crepitus. Management? | A. Debridement | B. Antibiotics only | C. Observe | D. Dressing | A. Surgical debridement |
| A 25-year-old woman with fever, tender leg vein postpartum. Diagnosis? | A. Superficial thrombophlebitis | B. DVT | C. Cellulitis | D. Lymphedema | A. Superficial thrombophlebitis |
| A 28-year-old woman postpartum, chest pain, tachypnea, hypoxia. Diagnosis? | A. MI | B. PE | C. AFE | D. Pneumonia | B. Pulmonary embolism |
| A 26-year-old woman with cesarean wound discharge, fever. Management? | A. Open wound | B. Antibiotics | C. Debridement | D. All | D. All of the above |
| A 32-year-old woman with mastitis, fluctuant mass. Next step? | A. Continue feeding | B. Stop feeding | C. Incision and drainage | D. Change breast | C. Incision and drainage |
| A 23-year-old woman breastfeeding with cracked nipples, mastitis. Organism? | A. Staph aureus | B. Strep | C. E. coli | D. Candida | A. Staphylococcus aureus |
| A 22-year-old woman with PPH and hematuria after delivery. Cause? | A. Uterine rupture | B. Bladder injury | C. Urethral tear | D. Vaginal tear | B. Bladder injury |
| A 30-year-old woman post-delivery, unable to void urine. Cause? | A. Bladder atony | B. UTI | C. Retention | D. Perineal edema | A. Bladder atony |
| A 24-year-old woman with postpartum depression, crying, insomnia. Management? | A. Supportive | B. Antidepressants | C. ECT | D. Hospitalize | A. Supportive reassurance |
| A 26-year-old woman with postpartum psychosis, hallucinations. Management? | A. Hospitalize | B. ECT | C. Antipsychotics | D. All | D. All (urgent hospitalization and treatment) |
| A 30-year-old woman, 6 weeks postpartum, fever, tender uterus, foul discharge. Diagnosis? | A. Endometritis | B. Retained products | C. Sepsis | D. PID | A. Endometritis |
| A 25-year-old woman, postpartum, excessive bleeding, failure to lactate. Diagnosis? | A. Sheehan | B. DIC | C. Retained placenta | D. Sepsis | A. Sheehan syndrome |
| A 30-year-old woman with infertility and bilateral hydrosalpinx. Cause? | A. PID | B. Endometriosis | C. TB | D. Fibroid | A. Pelvic inflammatory disease |
| A 28-year-old woman with pelvic pain, fever, adnexal tenderness. Diagnosis? | A. Endometriosis | B. PID | C. Ectopic | D. Ovarian cyst | B. Pelvic inflammatory disease |
| A 25-year-old woman with PID, unresponsive to ceftriaxone. Organism? | A. Gonorrhea | B. Chlamydia | C. Trichomonas | D. Candida | B. Chlamydia trachomatis |
| A 22-year-old woman with lower abdominal pain, vaginal discharge, and fever. Treatment? | A. Ceftriaxone + doxycycline | B. Ampicillin + gentamicin | C. Azithromycin | D. Ciprofloxacin | A. Ceftriaxone and doxycycline |
| A 26-year-old woman with salpingitis. Common complication? | A. Ectopic pregnancy | B. Infertility | C. Chronic pain | D. All | D. All of the above |
| A 28-year-old woman, tubo-ovarian abscess. Management? | A. IV antibiotics | B. Surgery | C. Drainage | D. Observe | A. IV broad-spectrum antibiotics |
| A 24-year-old woman with infertility, dysmenorrhea, dyspareunia. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PID | D. PCOS | A. Endometriosis |
| A 30-year-old woman with cyclic pelvic pain and infertility. Gold standard diagnosis? | A. Ultrasound | B. MRI | C. Laparoscopy | D. CT | C. Diagnostic laparoscopy |
| A 28-year-old woman with retroverted uterus, painful periods, infertility. Diagnosis? | A. Adenomyosis | B. PID | C. Endometriosis | D. PCOS | C. Endometriosis |
| A 35-year-old woman with uterine tenderness, heavy periods, enlarged uterus. Diagnosis? | A. Adenomyosis | B. Fibroid | C. Endometriosis | D. PID | A. Adenomyosis |
| A 40-year-old woman with irregular bleeding, intermenstrual spotting. Investigation? | A. TVS | B. Endometrial biopsy | C. Pap smear | D. MRI | B. Endometrial biopsy |
| A 45-year-old woman with menorrhagia and intermenstrual bleeding. Common cause? | A. Fibroid | B. Adenomyosis | C. Polyp | D. Endometrial carcinoma | A. Uterine fibroid |
| A 32-year-old woman with heavy bleeding and fibroid uterus. Medical treatment? | A. GnRH agonist | B. OCP | C. NSAIDs | D. All | D. All of the above |
| A 40-year-old woman with infertility, multiple fibroids, anemia. Best treatment? | A. Myomectomy | B. Hysterectomy | C. Embolization | D. Observe | A. Myomectomy |
| A 50-year-old postmenopausal woman with fibroid. Management? | A. Observe | B. Hysterectomy | C. Myomectomy | D. GnRH | B. Hysterectomy |
| A 35-year-old woman with infertility and anovulation. Best initial test? | A. Serum progesterone (Day 21) | B. FSH/LH | C. Estradiol | D. Prolactin | A. Serum progesterone on day 21 |
| A 28-year-old woman with galactorrhea, amenorrhea, normal TSH. Investigation? | A. MRI pituitary | B. Prolactin | C. β-hCG | D. FSH | B. Serum prolactin |
| A 27-year-old woman with prolactinoma on bromocriptine, pregnant. Management? | A. Stop drug | B. Continue same | C. Increase dose | D. Switch to cabergoline | A. Stop bromocriptine during pregnancy |
| A 26-year-old woman with infertility, normal tubes, normal sperm, anovulation. Management? | A. Clomiphene | B. FSH | C. IVF | D. Surgery | A. Clomiphene citrate |
| A 30-year-old woman with failure to conceive after 2 years, normal ovulation, patent tubes, normal semen. Diagnosis? | A. Unexplained infertility | B. Endometriosis | C. Tubal block | D. PCOS | A. Unexplained infertility |
| A 29-year-old woman with recurrent pregnancy loss, anticardiolipin antibodies positive. Diagnosis? | A. Lupus | B. Antiphospholipid syndrome | C. Thrombophilia | D. Factor V Leiden | B. Antiphospholipid syndrome |
| A 30-year-old woman with antiphospholipid syndrome. Management? | A. Aspirin + heparin | B. Warfarin | C. Clopidogrel | D. Steroids | A. Aspirin and heparin |
| A 33-year-old woman with infertility, tubal blockage. Next step? | A. IVF | B. Clomiphene | C. IUI | D. Myomectomy | A. In vitro fertilization |
| A 35-year-old woman with amenorrhea, hot flashes, FSH high. Diagnosis? | A. Hypothalamic | B. Pituitary | C. Ovarian failure | D. Thyroid | C. Premature ovarian failure |
| A 22-year-old woman with delayed puberty, anosmia, low FSH/LH. Diagnosis? | A. Turner | B. Kallmann | C. PCOS | D. Sheehan | B. Kallmann syndrome |
| A 16-year-old girl with primary amenorrhea, webbed neck, short stature. Diagnosis? | A. Klinefelter | B. Turner | C. Kallmann | D. AIS | B. Turner syndrome |
| A 17-year-old girl with primary amenorrhea, normal breast, absent uterus. Diagnosis? | A. AIS | B. MRKH | C. Turner | D. PCOS | B. Müllerian agenesis (MRKH) |
| A 25-year-old woman with secondary amenorrhea after D&C. Diagnosis? | A. PCOS | B. Asherman | C. Sheehan | D. Hypothyroidism | B. Asherman syndrome |
| A 28-year-old woman with heavy periods, infertility, and fibroid uterus. Diagnosis? | A. Submucous fibroid | B. Endometriosis | C. Adenomyosis | D. Polyp | A. Submucous fibroid |
| A 45-year-old woman with heavy periods, pelvic fullness. Best imaging? | A. TVS | B. MRI | C. CT | D. X-ray | A. Transvaginal ultrasound |
| A 48-year-old woman with fibroid uterus and anemia, not fit for surgery. Management? | A. GnRH agonist | B. Myomectomy | C. Embolization | D. Observe | A. GnRH agonist therapy |
| A 32-year-old woman with ovarian cyst, 5 cm, simple, no symptoms. Management? | A. Observe | B. Surgery | C. Chemotherapy | D. Aspiration | A. Observe |
| A 45-year-old woman with adnexal mass, solid, fixed, ascites. Next step? | A. CA-125 | B. US | C. Laparotomy | D. Biopsy | A. CA-125 tumor marker |
| A 50-year-old woman with bilateral ovarian masses, ascites. Likely diagnosis? | A. Ovarian carcinoma | B. Serous cystadenoma | C. Endometrioma | D. Teratoma | A. Ovarian carcinoma |
| A 55-year-old woman with ovarian cancer. Most common histologic type? | A. Serous cystadenocarcinoma | B. Mucinous | C. Endometrioid | D. Brenner | A. Serous cystadenocarcinoma |
| A 30-year-old woman with large ovarian cyst, papillary projections, ascites. Diagnosis? | A. Malignant tumor | B. Benign cyst | C. Endometrioma | D. Teratoma | A. Malignant epithelial ovarian tumor |
| A 25-year-old woman with dysgerminoma. Marker? | A. LDH | B. AFP | C. β-hCG | D. CA-125 | A. LDH |
| A 28-year-old woman with yolk sac tumor. Marker? | A. LDH | B. AFP | C. β-hCG | D. CA-125 | B. AFP |
| A 24-year-old woman with choriocarcinoma. Marker? | A. LDH | B. AFP | C. β-hCG | D. CA-125 | C. β-hCG |
| A 50-year-old woman with granulosa cell tumor. Marker? | A. Inhibin | B. LDH | C. AFP | D. β-hCG | A. Inhibin |
| A 60-year-old woman with adnexal mass, ascites, omental cake. Diagnosis? | A. Ovarian carcinoma | B. Krukenberg tumor | C. Fibroma | D. Serous cystadenoma | A. Ovarian carcinoma |
| A 40-year-old woman with mucinous ovarian tumor and pseudomyxoma peritonei. Diagnosis? | A. Mucinous cystadenoma | B. Mucinous carcinoma | C. Serous carcinoma | D. Krukenberg tumor | B. Mucinous cystadenocarcinoma |
| A 25-year-old woman with dermoid cyst. Complication? | A. Torsion | B. Rupture | C. Malignant change | D. All | D. All of the above |
| A 28-year-old woman with acute lower abdominal pain, ovarian cyst on ultrasound. Likely complication? | A. Torsion | B. Rupture | C. Infection | D. Hemorrhage | A. Ovarian torsion |
| A 32-year-old woman with ovarian torsion. Best management? | A. Laparoscopy detorsion | B. Laparotomy | C. Observe | D. Aspiration | A. Laparoscopic detorsion |
| A 30-year-old woman with right adnexal pain, ovarian cyst, mild fever. Diagnosis? | A. Endometrioma | B. PID | C. Tubo-ovarian abscess | D. Corpus luteum cyst | C. Tubo-ovarian abscess |
| A 27-year-old woman with tubo-ovarian abscess unresponsive to antibiotics. Next step? | A. Drainage | B. Observe | C. Continue same | D. Hysterectomy | A. Surgical drainage |
| A 30-year-old woman with recurrent miscarriage, uterine septum found on imaging. Management? | A. Hysterectomy | B. Septal resection | C. IVF | D. Hormone therapy | B. Hysteroscopic septal resection |
| A 25-year-old woman with infertility, hysterosalpingogram shows bilateral block at fimbrial end. Cause? | A. PID | B. Endometriosis | C. TB | D. Adhesions | C. Genital tuberculosis |
| A 28-year-old woman with infertility and positive chlamydia IgG. Likely cause? | A. Ovulatory | B. Tubal | C. Uterine | D. Cervical | B. Tubal factor infertility |
| A 32-year-old woman with infertility, progesterone low on day 21. Diagnosis? | A. Anovulation | B. Luteal insufficiency | C. PCOS | D. Ovarian failure | A. Anovulation |
| A 30-year-old woman with PCOS. Best drug for ovulation induction? | A. Clomiphene | B. FSH | C. GnRH | D. Bromocriptine | A. Clomiphene citrate |
| A 28-year-old woman with infertility and hyperprolactinemia. Drug of choice? | A. Bromocriptine | B. Cabergoline | C. Pergolide | D. Dopamine | A. Bromocriptine |
| A 35-year-old woman with recurrent miscarriage, antiphospholipid antibodies. Treatment? | A. Low-dose aspirin | B. Heparin | C. Both | D. Steroids | C. Aspirin + heparin |
| A 26-year-old woman with infertility and normal investigation. Next management? | A. Expectant | B. Clomiphene | C. IUI | D. IVF | C. Intrauterine insemination |
| A 34-year-old woman with tubal block. Management? | A. Clomiphene | B. HSG | C. IVF | D. IUI | C. In-vitro fertilization |
| A 30-year-old woman with luteal phase defect. Treatment? | A. Progesterone | B. Clomiphene | C. Estrogen | D. GnRH | A. Progesterone support |
| A 28-year-old woman with premature ovarian failure. Hormone profile? | A. FSH↑ LH↑ E2↓ | B. FSH↓ LH↓ | C. FSH normal | D. FSH↑ E2↑ | A. High FSH & LH, low estrogen |
| A 27-year-old woman with Kallmann syndrome. Finding? | A. Anosmia | B. Galactorrhea | C. Hirsutism | D. Amenorrhea with high FSH | A. Anosmia |
| A 16-year-old girl with amenorrhea, normal breast, absent uterus. Diagnosis? | A. AIS | B. MRKH | C. Turner | D. Kallmann | B. Müllerian agenesis (MRKH) |
| A 17-year-old girl with tall stature, sparse pubic hair, 46 XY. Diagnosis? | A. Klinefelter | B. AIS | C. Turner | D. MRKH | B. Androgen insensitivity syndrome |
| A 30-year-old woman with cyclic pelvic pain, tender nodules posterior fornix. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. PID | D. Fibroid | B. Endometriosis |
| A 40-year-old woman with heavy periods, boggy uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. PID | A. Adenomyosis |
| A 45-year-old woman with heavy bleeding, enlarged irregular uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial carcinoma | D. Polyp | A. Uterine fibroid |
| A 30-year-old woman with submucous fibroid, menorrhagia. Treatment? | A. Hysteroscopic resection | B. Myomectomy | C. Hysterectomy | D. Embolization | A. Hysteroscopic myomectomy |
| A 50-year-old postmenopausal woman with fibroid. Management? | A. Observe | B. Hysterectomy | C. GnRH | D. Myomectomy | B. Hysterectomy |
| A 35-year-old woman with 3 cm endometrial polyp. Management? | A. Polypectomy | B. Observe | C. Hysterectomy | D. Curettage | A. Hysteroscopic polypectomy |
| A 45-year-old woman with postcoital bleeding, contact bleeding on exam. Diagnosis? | A. Cervical cancer | B. Polyp | C. PID | D. Ectropion | A. Cervical carcinoma |
| A 30-year-old woman with abnormal Pap (HSIL). Next step? | A. Repeat Pap | B. Colposcopy | C. Hysterectomy | D. HPV test | B. Colposcopy |
| A 28-year-old woman Pap = ASC-US, HPV positive. Management? | A. Colposcopy | B. Repeat Pap | C. Biopsy | D. Hysterectomy | A. Colposcopy |
| A 32-year-old woman Pap = LSIL, HPV negative. Management? | A. Repeat Pap in 6 mo | B. Colposcopy | C. Cone | D. LEEP | A. Repeat cytology in 6 months |
| A 35-year-old woman Pap = HSIL, biopsy CIN 3. Treatment? | A. Cryotherapy | B. LEEP | C. Hysterectomy | D. Observe | B. LEEP or cone excision |
| A 40-year-old woman post-cone biopsy with negative margins. Follow-up? | A. Pap at 6 mo | B. Yearly | C. No follow-up | D. HPV test only | A. Pap smear in 6 months |
| A 55-year-old woman with postmenopausal bleeding. Investigation? | A. TVS | B. Endometrial biopsy | C. Pap smear | D. Hysteroscopy | B. Endometrial biopsy |
| A 60-year-old woman with endometrial thickness > 10 mm. Diagnosis? | A. Carcinoma | B. Hyperplasia | C. Polyp | D. Atrophy | B. Endometrial hyperplasia |
| A 58-year-old woman with atypical endometrial hyperplasia. Management? | A. Hysterectomy | B. Progesterone | C. Observe | D. D&C | A. Total abdominal hysterectomy |
| A 25-year-old woman with greenish vaginal discharge, pH > 4.5, motile protozoa. Diagnosis? | A. BV | B. Candida | C. Trichomonas | D. Gonorrhea | C. Trichomonas vaginalis infection |
| A 27-year-old woman with thin gray discharge, fishy odor, clue cells. Diagnosis? | A. BV | B. Candida | C. Trichomonas | D. Chlamydia | A. Bacterial vaginosis |
| A 26-year-old woman with thick white curdy discharge, itching. Diagnosis? | A. BV | B. Candida | C. Trichomonas | D. Gonorrhea | B. Vulvovaginal candidiasis |
| A 23-year-old woman with painful vesicular genital lesions. Diagnosis? | A. HSV | B. HPV | C. Syphilis | D. LGV | A. Herpes simplex virus infection |
| A 25-year-old woman with painless ulcer, firm lymphadenopathy. Diagnosis? | A. Syphilis | B. Chancroid | C. HSV | D. LGV | A. Primary syphilis |
| A 26-year-old woman with painful ulcer, soft base, tender nodes. Diagnosis? | A. Chancroid | B. Syphilis | C. HSV | D. LGV | A. Chancroid |
| A 28-year-old woman with groove sign, bubo, lymphadenopathy. Diagnosis? | A. LGV | B. HSV | C. Chancroid | D. Syphilis | A. Lymphogranuloma venereum |
| A 30-year-old woman with cauliflower-like genital warts. Diagnosis? | A. HPV | B. HSV | C. Syphilis | D. Trichomonas | A. Human papillomavirus infection |
| A 45-year-old woman with postmenopausal vulvar itching, white plaques. Diagnosis? | A. Lichen sclerosus | B. Psoriasis | C. Candidiasis | D. VIN | A. Lichen sclerosus |
| A 55-year-old woman with lichen sclerosus develops mass. Likely malignancy? | A. SCC | B. Adeno | C. Melanoma | D. Sarcoma | A. Vulvar squamous cell carcinoma |
| A 30-year-old woman with vulvar pain, 3 cm cystic swelling at 4 o’clock. Diagnosis? | A. Bartholin cyst | B. Skene duct cyst | C. Gartner cyst | D. Lipoma | A. Bartholin gland cyst |
| A 33-year-old woman with recurrent Bartholin abscess. Treatment? | A. Word catheter | B. Incision only | C. Hysterectomy | D. Antibiotic only | A. Word catheter insertion |
| A 25-year-old woman with firm, fixed vulvar mass, age > 40. Concern? | A. Carcinoma | B. Fibroid | C. Lipoma | D. Abscess | A. Bartholin gland carcinoma |
| A 60-year-old woman with postmenopausal bleeding and enlarged uterus. Diagnosis? | A. Endometrial carcinoma | B. Cervical cancer | C. Fibroid | D. Polyp | A. Endometrial carcinoma |
| A 55-year-old woman with endometrial cancer, stage IA. Management? | A. Total hysterectomy + BSO | B. Radiotherapy | C. Chemotherapy | D. Observe | A. Total abdominal hysterectomy with bilateral salpingo-oophorectomy |
| A 60-year-old woman with endometrial carcinoma, deep myometrial invasion. Add therapy? | A. Radiotherapy | B. Chemotherapy | C. Both | D. None | A. Post-operative radiotherapy |
| A 50-year-old woman with postcoital bleeding, ulcerated cervix. Diagnosis? | A. Cervical cancer | B. Polyp | C. Endometrial carcinoma | D. PID | A. Cervical carcinoma |
| A 35-year-old woman Pap = HSIL, biopsy = CIN III. Treatment? | A. Cryotherapy | B. LEEP | C. Conization | D. Hysterectomy | B. LEEP or cone excision |
| A 40-year-old woman with invasive cervical carcinoma, confined to cervix. Stage? | A. IA | B. IB | C. IIA | D. IIB | B. Stage IB |
| A 42-year-old woman cervical cancer extending to upper vagina. Stage? | A. I | B. IIA | C. IIB | D. III | B. Stage IIA |
| A 50-year-old woman cervical cancer with parametrial invasion. Stage? | A. IIA | B. IIB | C. III | D. IVA | B. Stage IIB |
| A 55-year-old woman cervical carcinoma with pelvic wall involvement. Stage? | A. II | B. III | C. IVA | D. IVB | B. Stage III |
| A 60-year-old woman cervical carcinoma invading bladder mucosa. Stage? | A. III | B. IVA | C. IVB | D. IIIB | B. Stage IVA |
| A 45-year-old woman cervical carcinoma with distant lung metastases. Stage? | A. III | B. IVA | C. IVB | D. IIB | C. Stage IVB |
| A 50-year-old woman stage IIB cervical carcinoma. Treatment? | A. Radical hysterectomy | B. Radiotherapy + chemo | C. Cone biopsy | D. Observe | B. Combined chemoradiation |
| A 35-year-old woman stage IA1 cervical carcinoma. Treatment? | A. Conization | B. Hysterectomy | C. Radiotherapy | D. Chemo | A. Conization |
| A 28-year-old woman with carcinoma in situ of cervix. Treatment? | A. LEEP | B. Cone biopsy | C. Hysterectomy | D. Observe | A. Excision (LEEP/cone) |
| A 60-year-old woman with cervical carcinoma. Most common histologic type? | A. Squamous cell | B. Adeno | C. Small cell | D. Clear cell | A. Squamous cell carcinoma |
| A 40-year-old woman with cervical cancer. Main risk factor? | A. HPV 16 & 18 | B. HSV | C. EBV | D. CMV | A. High-risk HPV 16 and 18 infection |
| A 25-year-old woman with genital warts. Prevention? | A. HPV vaccine | B. Pap smear | C. Condoms only | D. Antibiotics | A. HPV vaccination |
| A 30-year-old woman with vaginal bleeding after intercourse. Screening test? | A. Pap smear | B. Biopsy | C. HPV | D. Ultrasound | A. Pap smear |
| A 45-year-old woman with persistent watery vaginal discharge, negative Pap. Diagnosis? | A. Vaginal carcinoma | B. Cervical polyp | C. Endometrial cancer | D. Fibroid | A. Primary vaginal carcinoma |
| A 65-year-old woman with vulvar itching, ulcerated lesion. Diagnosis? | A. Vulvar carcinoma | B. VIN | C. Lichen planus | D. Psoriasis | A. Vulvar squamous cell carcinoma |
| A 40-year-old woman with Paget’s disease of vulva. Histology finding? | A. Adenocarcinoma cells | B. Squamous cells | C. Melanocytes | D. Lymphocytes | A. Adenocarcinoma cells in epidermis |
| A 60-year-old woman with pelvic mass, ascites, CA-125 elevated. Diagnosis? | A. Ovarian carcinoma | B. Endometrial | C. Cervical | D. GI tumor | A. Ovarian carcinoma |
| A 55-year-old woman with bilateral adnexal masses. Histology shows serous papillae. Diagnosis? | A. Serous cystadenocarcinoma | B. Mucinous | C. Endometrioid | D. Brenner | A. Serous cystadenocarcinoma |
| A 45-year-old woman with ovarian tumor and endometrial hyperplasia. Diagnosis? | A. Granulosa cell tumor | B. Dysgerminoma | C. Thecoma | D. Serous carcinoma | A. Estrogen-secreting granulosa cell tumor |
| A 25-year-old woman with right ovarian mass and elevated LDH. Diagnosis? | A. Dysgerminoma | B. Yolk-sac | C. Teratoma | D. Choriocarcinoma | A. Dysgerminoma |
| A 23-year-old woman with ovarian mass, AFP elevated. Diagnosis? | A. Yolk-sac tumor | B. Dysgerminoma | C. Choriocarcinoma | D. Teratoma | A. Yolk-sac tumor |
| A 27-year-old woman with ovarian mass, β-hCG elevated, not pregnant. Diagnosis? | A. Choriocarcinoma | B. Dysgerminoma | C. Endometrioid | D. Teratoma | A. Choriocarcinoma |
| A 30-year-old woman with ovarian fibroma, ascites, pleural effusion. Diagnosis? | A. Meigs syndrome | B. Krukenberg | C. Brenner | D. Serous | A. Meigs syndrome |
| A 50-year-old woman with bilateral mucinous ovarian tumors, signet-ring cells. Diagnosis? | A. Krukenberg tumor | B. Meigs | C. Brenner | D. Teratoma | A. Krukenberg metastasis |
| A 55-year-old woman with ovarian carcinoma. Tumor marker? | A. CA-125 | B. AFP | C. β-hCG | D. LDH | A. CA-125 |
| A 40-year-old woman with mucinous cystadenoma. Complication? | A. Pseudomyxoma peritonei | B. Rupture | C. Torsion | D. All | D. All of the above |
| A 30-year-old woman with dermoid cyst. Histology shows? | A. Ectodermal tissue | B. Endodermal | C. Mesodermal | D. None | A. Ectodermal derivatives (hair, teeth) |
| A 35-year-old woman with postmenopausal bleeding, thickened endometrium. Next step? | A. Endometrial biopsy | B. TVS | C. Pap smear | D. D&C | A. Endometrial biopsy |
| A 60-year-old woman with adnexal mass, omental cake. Diagnosis? | A. Ovarian carcinoma | B. Endometrial | C. Cervical | D. GI metastasis | A. Advanced ovarian carcinoma |
| A 25-year-old woman with molar pregnancy. Follow-up test? | A. Weekly β-hCG | B. Ultrasound | C. CA-125 | D. FSH | A. Serial weekly β-hCG until negative |
| A 28-year-old woman with molar pregnancy, high hCG after evacuation. Diagnosis? | A. Invasive mole | B. Choriocarcinoma | C. Normal regression | D. Partial mole | A. Invasive mole |
| A 30-year-old woman with molar pregnancy and metastasis to lung. Diagnosis? | A. Choriocarcinoma | B. Invasive mole | C. Complete mole | D. Partial mole | A. Choriocarcinoma |
| A 32-year-old woman with choriocarcinoma, no metastasis. Treatment? | A. Methotrexate | B. Surgery | C. Radiation | D. Observe | A. Methotrexate chemotherapy |
| A 35-year-old woman with hydatidiform mole. Chromosome type? | A. 46 XX paternal | B. 69 XXX | C. 46 XY maternal | D. 47 XXY | A. Diploid 46 XX paternal origin (complete mole) |
| A 28-year-old woman with partial mole. Karyotype? | A. 69 XXY | B. 46 XX | C. 46 XY | D. 45 XO | A. Triploid 69 XXY (partial mole) |
| A 25-year-old woman post-mole evacuation, contraception recommended. Duration? | A. 6 months | B. 12 months | C. 3 months | D. None | B. Avoid pregnancy ≥ 12 months |
| A 27-year-old woman with complete mole, snowstorm USG. Diagnosis confirmed by? | A. β-hCG | B. Biopsy | C. CT | D. MRI | A. Very high β-hCG |
| A 25-year-old woman with choriocarcinoma, metastasis to lungs. Management? | A. Chemotherapy | B. Surgery | C. Radiation | D. Observe | A. Chemotherapy (methotrexate-based) |
| A 2-day-old newborn has poor feeding, jaundice, and hepatomegaly. Mother is HBsAg positive. What should be done? | A. Observe | B. HBIG only | C. HB vaccine + HBIG | D. HB vaccine only | C. Administer HBIG and hepatitis B vaccine immediately |
| A 1-day-old infant with single umbilical artery. What should be investigated? | A. Cardiac anomalies | B. Renal anomalies | C. GI anomalies | D. Skeletal anomalies | B. Congenital renal anomalies |
| A 3-day-old newborn, not passed meconium, distended abdomen. Diagnosis? | A. Hirschsprung disease | B. Meconium ileus | C. Imperforate anus | D. Duodenal atresia | A. Hirschsprung disease |
| A 1-day-old newborn with bilious vomiting, double bubble on X-ray. Diagnosis? | A. Jejunal atresia | B. Pyloric stenosis | C. Duodenal atresia | D. Volvulus | C. Duodenal atresia |
| A 2-week-old infant with projectile non-bilious vomiting, palpable olive in epigastrium. Diagnosis? | A. Pyloric stenosis | B. Duodenal atresia | C. GERD | D. Volvulus | A. Congenital hypertrophic pyloric stenosis |
| A 1-month-old infant with non-bilious vomiting and metabolic alkalosis. Treatment? | A. Surgery after correction | B. Surgery immediate | C. Observation | D. Metoclopramide | A. Correct electrolytes then pyloromyotomy |
| A newborn with excessive salivation and coughing during feeding. Diagnosis? | A. Laryngomalacia | B. TE fistula | C. Choanal atresia | D. GERD | B. Tracheoesophageal fistula |
| A neonate with meconium-stained liquor, respiratory distress. Diagnosis? | A. Meconium aspiration syndrome | B. Pneumonia | C. TTN | D. RDS | A. Meconium aspiration syndrome |
| A preterm baby with grunting, nasal flaring, intercostal retraction. Diagnosis? | A. TTN | B. Pneumonia | C. RDS | D. Pneumothorax | C. Respiratory distress syndrome |
| A newborn with RDS. Deficiency of which substance? | A. Surfactant | B. Albumin | C. Hemoglobin | D. Bilirubin | A. Surfactant deficiency |
| A 1-day-old neonate with tachypnea, clear lungs, resolves in 48 h. Diagnosis? | A. TTN | B. RDS | C. Pneumonia | D. Sepsis | A. Transient tachypnea of the newborn |
| A 1-day-old preterm baby with ground-glass appearance on chest X-ray. Diagnosis? | A. RDS | B. TTN | C. Meconium aspiration | D. Pneumonia | A. Hyaline membrane disease (RDS) |
| A 2-day-old newborn with jaundice within 12 hours of birth. Cause? | A. Physiologic | B. Hemolytic | C. Breast milk | D. Infection | B. Hemolytic disease of the newborn |
| A 3-day-old term baby with jaundice, unconjugated bilirubin 10 mg/dL. Diagnosis? | A. Physiologic | B. Hemolytic | C. Sepsis | D. Breast milk | A. Physiologic jaundice |
| A 7-day-old baby with jaundice, direct bilirubin 4 mg/dL. Diagnosis? | A. Physiologic | B. Breast milk | C. Biliary atresia | D. Hemolytic | C. Neonatal cholestasis (biliary atresia) |
| A newborn with prolonged jaundice, pale stool, dark urine. Diagnosis? | A. Hemolysis | B. Hypothyroidism | C. Biliary atresia | D. Sepsis | C. Biliary atresia |
| A 2-day-old newborn with severe jaundice, positive Coombs test. Cause? | A. ABO incompatibility | B. Rh incompatibility | C. G6PD | D. Sepsis | B. Rh incompatibility |
| A newborn with unconjugated hyperbilirubinemia, reticulocytosis, negative Coombs. Diagnosis? | A. G6PD deficiency | B. Rh disease | C. Biliary atresia | D. Sepsis | A. G6PD deficiency |
| A newborn with high indirect bilirubin, poor feeding, lethargy, hypotonia. Diagnosis? | A. Kernicterus | B. Sepsis | C. Hypoglycemia | D. RDS | A. Kernicterus |
| A newborn with meconium plug, abdominal distension, cystic fibrosis suspected. Next step? | A. Rectal biopsy | B. Sweat chloride test | C. Barium enema | D. Genetic test | B. Sweat chloride test |
| A 2-year-old with recurrent chest infections, steatorrhea, failure to thrive. Diagnosis? | A. Celiac | B. Cystic fibrosis | C. Immunodeficiency | D. Asthma | B. Cystic fibrosis |
| A newborn with absent anal opening, gas in urinary bladder on X-ray. Diagnosis? | A. Low ARM | B. High ARM | C. Hirschsprung | D. Meconium plug | B. High anorectal malformation |
| A 1-month-old boy with vomiting, dehydration, palpable olive. Investigation? | A. USG abdomen | B. Barium swallow | C. CT | D. MRI | A. Abdominal ultrasound |
| A 2-week-old baby with bilious vomiting, distension, X-ray shows air-fluid levels. Diagnosis? | A. Small bowel atresia | B. Volvulus | C. Duodenal atresia | D. Meconium ileus | A. Jejunoileal atresia |
| A newborn with Down syndrome and vomiting since birth. X-ray: double bubble. Diagnosis? | A. Pyloric stenosis | B. Duodenal atresia | C. Hirschsprung | D. Volvulus | B. Duodenal atresia |
| A 2-day-old term baby with abdominal distension, no meconium, spasm on rectal exam. Diagnosis? | A. Hirschsprung | B. Meconium ileus | C. Atresia | D. Imperforate anus | A. Hirschsprung disease |
| A 1-week-old infant with bile-stained vomiting and X-ray showing triple bubble. Diagnosis? | A. Duodenal atresia | B. Jejunal atresia | C. Volvulus | D. Meconium ileus | B. Jejunal atresia |
| A 3-day-old neonate with bilious vomiting, abdominal distension, malrotation. Investigation? | A. Upper GI contrast | B. Barium enema | C. CT | D. USG | A. Upper GI contrast study |
| A 4-year-old boy with painless rectal bleeding. Diagnosis? | A. Juvenile polyp | B. Meckel’s diverticulum | C. IBD | D. Hemorrhoid | B. Meckel’s diverticulum |
| A 2-year-old boy with palpable olive, projectile vomiting. Electrolyte abnormality? | A. Hypochloremic alkalosis | B. Hyperkalemia | C. Acidosis | D. Hyponatremia | A. Hypochloremic metabolic alkalosis |
| A 5-year-old boy with hematuria, hearing loss, family history. Diagnosis? | A. PSGN | B. Alport syndrome | C. IgA nephropathy | D. Nephrotic syndrome | B. Alport syndrome |
| A 7-year-old boy with periorbital edema, proteinuria, no hematuria. Diagnosis? | A. PSGN | B. Nephrotic syndrome | C. IgA nephropathy | D. HUS | B. Minimal change nephrotic syndrome |
| A 5-year-old child post-sore throat, cola-colored urine, RBC casts. Diagnosis? | A. PSGN | B. IgA nephropathy | C. HUS | D. Nephrotic | A. Post-streptococcal glomerulonephritis |
| A 4-year-old with periorbital edema, ascites, proteinuria 4+, no hematuria. Diagnosis? | A. Minimal change disease | B. FSGS | C. PSGN | D. IgA nephropathy | A. Minimal change nephrotic syndrome |
| A 6-year-old boy with nephrotic syndrome, no response to steroids. Diagnosis? | A. FSGS | B. Minimal change | C. Membranous | D. MPGN | A. Focal segmental glomerulosclerosis |
| A 10-year-old with edema, HTN, RBC casts, low C3. Diagnosis? | A. PSGN | B. IgA nephropathy | C. Lupus | D. HUS | A. Acute post-streptococcal GN |
| A 3-year-old with acute renal failure, microangiopathic hemolytic anemia, thrombocytopenia. Diagnosis? | A. HUS | B. TTP | C. PSGN | D. DIC | A. Hemolytic uremic syndrome |
| A 4-year-old with recurrent UTIs. Investigation? | A. MCU | B. IVP | C. Ultrasound | D. CT | A. Micturating cystourethrogram |
| A 6-year-old boy with daytime wetting, continuous dribbling. Diagnosis? | A. Neurogenic bladder | B. Ectopic ureter | C. UTI | D. Enuresis | B. Ectopic ureter |
| A 5-year-old with intermittent fever, flank pain, pyuria, and hydronephrosis. Diagnosis? | A. VUR | B. Pyelonephritis | C. Obstruction | D. Stones | A. Vesicoureteric reflux |
| A 4-year-old boy with painless scrotal swelling, transillumination positive. Diagnosis? | A. Hydrocele | B. Hernia | C. Varicocele | D. Epididymitis | A. Congenital hydrocele |
| A 10-year-old boy with scrotal pain, high-riding testis, absent cremasteric reflex. Diagnosis? | A. Epididymitis | B. Torsion | C. Varicocele | D. Hernia | B. Testicular torsion |
| A 6-year-old boy with painless scrotal mass, bag of worms feel. Diagnosis? | A. Hydrocele | B. Hernia | C. Varicocele | D. Torsion | C. Varicocele |
| A 2-year-old boy with undescended testis. Best age for orchiopexy? | A. <1 year | B. 1–2 years | C. 3–5 years | D. After puberty | B. Between 1–2 years |
| A 5-year-old boy with UTI, left hydronephrosis, dilated ureter. Cause? | A. PUJ obstruction | B. VUR | C. Posterior urethral valve | D. Calculus | C. Posterior urethral valve |
| A 5-year-old child with barking cough, stridor, and hoarseness. Diagnosis? | A. Croup | B. Epiglottitis | C. Asthma | D. Bronchiolitis | A. Viral croup (laryngotracheobronchitis) |
| A 3-year-old with drooling, high fever, muffled voice, tripod position. Diagnosis? | A. Epiglottitis | B. Croup | C. Retropharyngeal abscess | D. Asthma | A. Acute epiglottitis |
| A 1-year-old with wheezing, cough, difficulty breathing after RSV infection. Diagnosis? | A. Bronchopneumonia | B. Bronchiolitis | C. Asthma | D. Croup | B. Bronchiolitis |
| A 2-year-old with recurrent wheezing, nocturnal cough, and family history of atopy. Diagnosis? | A. Asthma | B. Bronchiolitis | C. Croup | D. Pneumonia | A. Bronchial asthma |
| A 5-year-old child with fever, tachypnea, chest indrawing, crepitations. Diagnosis? | A. Asthma | B. Pneumonia | C. Bronchiolitis | D. Croup | B. Community-acquired pneumonia |
| A 6-year-old with chronic cough, clubbing, and foul-smelling sputum. Diagnosis? | A. Bronchiectasis | B. Asthma | C. Cystic fibrosis | D. TB | A. Bronchiectasis |
| A 7-year-old with fever, weight loss, night sweats, chronic cough. Diagnosis? | A. TB | B. Bronchitis | C. Pneumonia | D. Cystic fibrosis | A. Pulmonary tuberculosis |
| A 1-year-old child with pneumonia not improving after antibiotics. Next step? | A. Look for TB | B. Change antibiotic | C. CT chest | D. Bronchoscopy | A. Rule out tuberculosis |
| A 3-year-old with barking cough, inspiratory stridor, and steeple sign. Diagnosis? | A. Croup | B. Epiglottitis | C. Asthma | D. Bronchiolitis | A. Croup (parainfluenza virus) |
| A 4-year-old with fever, drooling, sitting forward, inflamed epiglottis on X-ray. Diagnosis? | A. Epiglottitis | B. Croup | C. Retropharyngeal abscess | D. Diphtheria | A. Epiglottitis (H. influenzae type b) |
| A 2-year-old child with expiratory wheezing, cyanosis, tachypnea. Diagnosis? | A. Bronchiolitis | B. Croup | C. Asthma | D. Pneumonia | A. Acute bronchiolitis |
| A 6-month-old infant with cough, difficulty feeding, retractions, and wheeze. Diagnosis? | A. RSV bronchiolitis | B. Asthma | C. Pneumonia | D. Croup | A. Respiratory syncytial virus bronchiolitis |
| A 5-year-old with sudden respiratory distress while playing with peanuts. Diagnosis? | A. Asthma | B. Foreign body aspiration | C. Bronchitis | D. Croup | B. Foreign body aspiration |
| A 2-year-old with unilateral decreased breath sounds and hyperinflated chest. Diagnosis? | A. Pneumothorax | B. Aspiration | C. Pneumonia | D. Bronchitis | B. Foreign body aspiration |
| A 3-year-old child with inspiratory stridor, drooling, and toxic look. Immediate management? | A. Intubate | B. Nebulized epinephrine | C. Secure airway | D. Antibiotics | C. Secure airway (suspect epiglottitis) |
| A 6-year-old with recurrent pneumonia in same lobe. Cause? | A. Bronchial obstruction | B. TB | C. Cystic fibrosis | D. Asthma | A. Bronchial obstruction (foreign body) |
| A 2-year-old with poor feeding, lethargy, and dehydration after diarrhea. Best indicator of severity? | A. Skin turgor | B. Sunken eyes | C. Urine output | D. Thirst | C. Decreased urine output |
| A 1-year-old child with watery diarrhea, no blood, and dehydration. Cause? | A. Rotavirus | B. Shigella | C. E. coli | D. Salmonella | A. Rotavirus |
| A 3-year-old with bloody diarrhea and seizures. Likely cause? | A. Shigella | B. E. coli | C. Salmonella | D. Campylobacter | A. Shigella infection |
| A 5-year-old with rice-water stool, dehydration, sunken eyes. Diagnosis? | A. Cholera | B. Rotavirus | C. E. coli | D. Shigella | A. Cholera |
| A 4-year-old with foul-smelling greasy stool, bloating, weight loss. Diagnosis? | A. Celiac disease | B. Cystic fibrosis | C. Giardia infection | D. Lactose intolerance | C. Giardiasis |
| A 2-year-old with failure to thrive, distension, foul stool, after weaning. Diagnosis? | A. Celiac disease | B. Giardia | C. CF | D. Cow milk intolerance | A. Celiac disease |
| A 3-year-old with steatorrhea and positive anti-tTG antibodies. Diagnosis? | A. Celiac | B. CF | C. Crohn | D. Giardia | A. Celiac disease |
| A 2-year-old with diarrhea after milk, bloating, flatulence. Diagnosis? | A. Lactose intolerance | B. Celiac | C. IBS | D. Giardia | A. Lactose intolerance |
| A 4-year-old child with abdominal pain, currant jelly stool, and sausage mass. Diagnosis? | A. Intussusception | B. Appendicitis | C. Meckel | D. Volvulus | A. Intussusception |
| A 3-year-old with intermittent colicky pain, vomiting, and red currant stool. Investigation? | A. Ultrasound | B. CT | C. Barium swallow | D. X-ray | A. Abdominal ultrasound (“target sign”) |
| A 2-year-old with bilious vomiting, abdominal distension, and malrotation. Diagnosis? | A. Volvulus | B. Atresia | C. Intussusception | D. Pyloric stenosis | A. Midgut volvulus |
| A 5-year-old with periumbilical pain, fever, tenderness at McBurney’s point. Diagnosis? | A. Appendicitis | B. Mesenteric adenitis | C. Intussusception | D. Gastroenteritis | A. Acute appendicitis |
| A 3-year-old with intermittent abdominal pain, red currant jelly stool, palpable mass. Next step? | A. Air enema | B. Surgery | C. US | D. Observe | A. Air/contrast enema reduction |
| A 6-year-old with jaundice, RUQ pain, palpable mass. Diagnosis? | A. Choledochal cyst | B. Hepatitis | C. Biliary atresia | D. Cholelithiasis | A. Choledochal cyst |
| A 10-year-old with fever, hepatomegaly, jaundice, ↑ALT/AST. Diagnosis? | A. Hepatitis A | B. Hepatitis B | C. Hepatitis C | D. Leptospirosis | A. Hepatitis A virus infection |
| A 5-year-old with clay-colored stool, dark urine, tender liver. Diagnosis? | A. Hepatitis A | B. Hepatitis B | C. Hepatitis E | D. Cholestasis | A. Acute viral hepatitis A |
| A 9-year-old boy with prolonged jaundice, splenomegaly, spherocytes. Diagnosis? | A. Thalassemia | B. HS | C. Sickle cell | D. G6PD | B. Hereditary spherocytosis |
| A 6-year-old with pallor, jaundice, bone pain, and hepatosplenomegaly. Diagnosis? | A. Sickle cell disease | B. Thalassemia major | C. G6PD | D. HS | B. β-Thalassemia major |
| A 5-year-old boy with dactylitis, pain crises, and hemoglobin S. Diagnosis? | A. Sickle cell disease | B. HS | C. Thalassemia | D. Leukemia | A. Sickle cell anemia |
| A 4-year-old child with anemia, jaundice, Heinz bodies. Diagnosis? | A. G6PD deficiency | B. Thalassemia | C. Sickle | D. HS | A. G6PD deficiency |
| A 7-year-old child with pancytopenia, short stature, abnormal thumbs. Diagnosis? | A. Fanconi anemia | B. Diamond-Blackfan | C. Aplastic anemia | D. Thalassemia | A. Fanconi anemia |
| A 5-year-old with microcytic hypochromic anemia, low ferritin. Diagnosis? | A. IDA | B. Thalassemia | C. Sideroblastic | D. Lead | A. Iron deficiency anemia |
| A 3-year-old child with severe anemia, splenomegaly, bone deformities. Diagnosis? | A. Thalassemia major | B. Sickle cell | C. Leukemia | D. Aplastic | A. β-Thalassemia major |
| A 6-year-old boy with fatigue, pallor, bone pain, hepatosplenomegaly. Diagnosis? | A. Leukemia | B. Lymphoma | C. Aplastic anemia | D. Thalassemia | A. Acute lymphoblastic leukemia |
| A 7-year-old boy with fever, lymphadenopathy, night sweats, weight loss. Diagnosis? | A. Hodgkin lymphoma | B. TB | C. Leukemia | D. HIV | A. Hodgkin lymphoma |
| A 5-year-old with generalized lymphadenopathy, gum bleeding, anemia. Diagnosis? | A. ALL | B. AML | C. Lymphoma | D. ITP | A. Acute lymphoblastic leukemia |
| A 3-year-old child with purpura, platelet count 15,000, normal coagulation. Diagnosis? | A. ITP | B. DIC | C. TTP | D. Leukemia | A. Immune thrombocytopenic purpura |
| A 4-year-old child with fever, joint pain, rash, elevated ASO titer. Diagnosis? | A. Rheumatic fever | B. Kawasaki | C. JIA | D. SLE | A. Acute rheumatic fever |
| A 5-year-old child with fever, conjunctivitis, strawberry tongue, rash, lymphadenopathy. Diagnosis? | A. Kawasaki disease | B. Scarlet fever | C. Measles | D. Toxic shock | A. Kawasaki disease |
| A 3-year-old with Kawasaki disease. Most serious complication? | A. Myocarditis | B. Pericarditis | C. Coronary aneurysm | D. Endocarditis | C. Coronary artery aneurysm |
| A 2-year-old with fever, erythematous rash starting on face then spreading. Diagnosis? | A. Measles | B. Rubella | C. Scarlet fever | D. Roseola | A. Measles (rubeola) |
| A 3-year-old with low-grade fever, lymphadenopathy, maculopapular rash from face to trunk. Diagnosis? | A. Rubella | B. Measles | C. Roseola | D. Varicella | A. Rubella |
| A 1-year-old with high fever for 3 days followed by rash after defervescence. Diagnosis? | A. Roseola | B. Rubella | C. Measles | D. Varicella | A. Roseola infantum (HHV-6) |
| A 6-year-old with fever, sore throat, sandpaper rash, strawberry tongue. Diagnosis? | A. Scarlet fever | B. Kawasaki | C. Rubella | D. Measles | A. Scarlet fever (Strep pyogenes) |
| A 5-year-old with slapped-cheek rash followed by lacy body rash. Diagnosis? | A. Parvovirus B19 | B. Measles | C. Rubella | D. Roseola | A. Erythema infectiosum (Parvovirus B19) |
| A 3-year-old with vesicular rash in crops, different stages. Diagnosis? | A. Varicella | B. Smallpox | C. Herpes | D. Measles | A. Chickenpox (Varicella) |
| A 7-year-old with painful vesicular rash along dermatomal distribution. Diagnosis? | A. Varicella | B. Zoster | C. HSV | D. Measles | B. Herpes zoster |
| A 6-year-old unvaccinated child with lockjaw, spasticity, risus sardonicus. Diagnosis? | A. Tetanus | B. Diphtheria | C. Botulism | D. Meningitis | A. Tetanus |
| A 3-year-old with sore throat, gray membrane over tonsils, bull neck. Diagnosis? | A. Diphtheria | B. Tonsillitis | C. Mono | D. Epiglottitis | A. Diphtheria |
| A 2-year-old with whooping cough, post-tussive vomiting. Diagnosis? | A. Pertussis | B. Croup | C. Bronchiolitis | D. Asthma | A. Pertussis (Bordetella pertussis) |
| A 5-year-old with swelling of parotid glands, fever, and orchitis. Diagnosis? | A. Mumps | B. Rubella | C. Measles | D. EBV | A. Mumps |
| A 4-year-old with Koplik spots, cough, coryza, conjunctivitis, rash. Diagnosis? | A. Measles | B. Rubella | C. Roseola | D. Scarlet fever | A. Measles |
| A 7-year-old with sore throat, strawberry tongue, and desquamating rash. Diagnosis? | A. Scarlet fever | B. Kawasaki | C. Measles | D. Rubella | A. Scarlet fever |
| A 2-year-old with petechiae, hypotension, and DIC. Organism? | A. Meningococcal | B. Pneumococcal | C. H. influenzae | D. Staph | A. Neisseria meningitidis |
| A 1-year-old with bulging fontanelle, fever, neck stiffness. CSF: high protein, low glucose. Diagnosis? | A. Bacterial meningitis | B. Viral | C. TB | D. Fungal | A. Bacterial meningitis |
| A 3-year-old with meningitis, CSF lymphocytes, normal glucose. Diagnosis? | A. Viral | B. Bacterial | C. Fungal | D. TB | A. Viral meningitis |
| A 4-year-old with fever, altered sensorium, neck stiffness, Kernig’s positive. Diagnosis? | A. Meningitis | B. Encephalitis | C. Sepsis | D. Epilepsy | A. Acute meningitis |
| A 2-year-old with recurrent otitis media and pneumonia, low IgG and IgA. Diagnosis? | A. CVID | B. IgA deficiency | C. SCID | D. XLA | D. X-linked agammaglobulinemia |
| A 5-month-old boy with recurrent infections, absent thymic shadow. Diagnosis? | A. DiGeorge | B. SCID | C. HIV | D. CVID | B. Severe combined immunodeficiency |
| A 1-year-old with tetany, low calcium, absent thymus, low PTH. Diagnosis? | A. DiGeorge syndrome | B. SCID | C. Hypoparathyroidism | D. Rickets | A. DiGeorge syndrome |
| A 2-year-old with recurrent pneumonia, catalase-positive infections. Diagnosis? | A. CGD | B. SCID | C. HIV | D. Neutropenia | A. Chronic granulomatous disease |
| A 10-year-old boy with recurrent sinusitis, bronchiectasis, situs inversus. Diagnosis? | A. Kartagener syndrome | B. CF | C. Asthma | D. Bronchitis | A. Kartagener syndrome |
| A 4-year-old with recurrent infections and partial albinism. Diagnosis? | A. Chediak-Higashi | B. CGD | C. SCID | D. Wiskott-Aldrich | A. Chediak-Higashi syndrome |
| A 2-year-old with eczema, thrombocytopenia, and recurrent infections. Diagnosis? | A. Wiskott-Aldrich | B. SCID | C. DiGeorge | D. CGD | A. Wiskott-Aldrich syndrome |
| A 5-year-old with polyuria, polydipsia, dehydration, weight loss. Diagnosis? | A. Type 1 DM | B. Type 2 DM | C. DI | D. Cushing | A. Type 1 diabetes mellitus |
| A 6-year-old with growth retardation, short stature, and webbed neck. Diagnosis? | A. Turner | B. Klinefelter | C. Down | D. Noonan | A. Turner syndrome |
| A 15-year-old tall boy with small testes, gynecomastia, XXY. Diagnosis? | A. Klinefelter | B. Turner | C. Marfan | D. Noonan | A. Klinefelter syndrome |
| A newborn with hypotonia, upslanting palpebral fissures, single palmar crease. Diagnosis? | A. Down syndrome | B. Edwards | C. Patau | D. Turner | A. Down syndrome (Trisomy 21) |
| A neonate with clenched fists, rocker-bottom feet, low-set ears. Diagnosis? | A. Edwards | B. Down | C. Patau | D. Turner | A. Edwards syndrome (Trisomy 18) |
| A neonate with cleft lip/palate, polydactyly, microcephaly. Diagnosis? | A. Patau | B. Down | C. Edwards | D. Turner | A. Patau syndrome (Trisomy 13) |
| A 2-year-old with obesity, hypogonadism, small hands/feet, developmental delay. Diagnosis? | A. Prader-Willi | B. Angelman | C. Down | D. Noonan | A. Prader-Willi syndrome |
| A 3-year-old with happy puppet face, ataxia, seizures. Diagnosis? | A. Angelman | B. Prader-Willi | C. Rett | D. Down | A. Angelman syndrome |
| A 2-year-old girl with regression of milestones, hand-wringing, microcephaly. Diagnosis? | A. Rett | B. Angelman | C. Autism | D. CP | A. Rett syndrome |
| A 4-year-old with poor eye contact, repetitive behavior, speech delay. Diagnosis? | A. Autism spectrum disorder | B. ADHD | C. Rett | D. Conduct disorder | A. Autism |
| A 7-year-old boy with inattention, hyperactivity, impulsivity. Diagnosis? | A. ADHD | B. Autism | C. ODD | D. Conduct disorder | A. Attention-deficit hyperactivity disorder |
| A 5-year-old with aggression, rule-breaking, fights, theft. Diagnosis? | A. Conduct disorder | B. ODD | C. ADHD | D. Autism | A. Conduct disorder |
| A 4-year-old child with motor and vocal tics for 2 years. Diagnosis? | A. Tourette syndrome | B. OCD | C. ADHD | D. Anxiety | A. Tourette syndrome |
| A 2-year-old with seizure, hypoglycemia, hepatomegaly. Diagnosis? | A. von Gierke | B. McArdle | C. Pompe | D. Gaucher | A. von Gierke disease (GSD I) |
| A 4-year-old with coarse facies, hepatosplenomegaly, developmental delay. Diagnosis? | A. Hurler | B. Hunter | C. Gaucher | D. Tay-Sachs | A. Hurler syndrome |
| A 3-year-old with hepatosplenomegaly, bone pain, Erlenmeyer flask deformity. Diagnosis? | A. Gaucher | B. Niemann-Pick | C. Hurler | D. Tay-Sachs | A. Gaucher disease |
| A 2-year-old with cherry-red macula, no hepatosplenomegaly. Diagnosis? | A. Tay-Sachs | B. Niemann-Pick | C. Gaucher | D. Hurler | A. Tay-Sachs disease |
| A 2-year-old with cherry-red macula, hepatosplenomegaly. Diagnosis? | A. Niemann-Pick | B. Tay-Sachs | C. Gaucher | D. Hurler | A. Niemann-Pick disease |
| A 1-year-old with severe hypoglycemia, seizures after fasting. Diagnosis? | A. Glycogen storage | B. MCAD | C. Fructose intolerance | D. Galactosemia | D. Galactosemia |
| A neonate with cataracts, jaundice, vomiting after milk. Diagnosis? | A. Galactosemia | B. Fructose intolerance | C. PKU | D. MCAD | A. Galactosemia |
| A 2-year-old with musty odor urine, developmental delay, seizures. Diagnosis? | A. PKU | B. Maple syrup urine | C. Homocystinuria | D. Tyrosinemia | A. Phenylketonuria |
| A 1-year-old with seizures, hypoglycemia, hepatomegaly, hyperuricemia. Diagnosis? | A. von Gierke | B. Pompe | C. McArdle | D. Cori | A. von Gierke disease |
| A neonate with floppy baby, tongue fasciculations, absent reflexes. Diagnosis? | A. SMA | B. DMD | C. Myasthenia | D. Cerebral palsy | A. Spinal muscular atrophy (Werdnig–Hoffmann) |
| A 3-year-old with seizures, developmental delay, ash leaf spots. Diagnosis? | A. Tuberous sclerosis | B. Neurofibromatosis | C. Sturge-Weber | D. Lennox-Gastaut | A. Tuberous sclerosis |
| A 6-year-old with café-au-lait spots, axillary freckles, Lisch nodules. Diagnosis? | A. NF type 1 | B. NF type 2 | C. Tuberous sclerosis | D. Sturge-Weber | A. Neurofibromatosis type 1 |
| A 4-year-old with port-wine stain on face, seizures, glaucoma. Diagnosis? | A. Sturge-Weber | B. NF | C. Tuberous sclerosis | D. Lennox-Gastaut | A. Sturge-Weber syndrome |
| A 7-year-old with multiple seizures, developmental delay, and EEG with hypsarrhythmia. Diagnosis? | A. Infantile spasm | B. Absence | C. Lennox-Gastaut | D. Febrile seizure | C. Lennox-Gastaut syndrome |
| A 9-month-old with sudden flexion spasms, developmental regression. Diagnosis? | A. Infantile spasm | B. Febrile seizure | C. Tonic seizure | D. Atonic seizure | A. Infantile spasms (West syndrome) |
| A 10-year-old with blank stares, lip smacking, no postictal confusion. Diagnosis? | A. Absence | B. Partial | C. Myoclonic | D. Atonic | A. Absence seizure (petit mal) |
| A 5-year-old with generalized tonic-clonic seizures, normal development. First-line drug? | A. Valproate | B. Phenytoin | C. Diazepam | D. Levetiracetam | A. Sodium valproate |
| A 2-year-old with high fever, single generalized seizure <15 min. Diagnosis? | A. Febrile seizure | B. Epilepsy | C. Meningitis | D. Encephalitis | A. Simple febrile seizure |
| A 3-year-old with recurrent febrile seizures >15 min, focal features. Diagnosis? | A. Complex febrile seizure | B. Simple | C. Epilepsy | D. Nonepileptic | A. Complex febrile seizure |
| A 6-year-old with ataxia, tremor, intention dysmetria. Lesion site? | A. Cerebellum | B. Basal ganglia | C. Cortex | D. Brainstem | A. Cerebellar lesion |
| A 1-year-old with hypotonia, delayed milestones, frog-like posture. Diagnosis? | A. Cerebral palsy | B. SMA | C. DMD | D. Myasthenia | A. Cerebral palsy (spastic type) |
| A 2-year-old with developmental delay, spastic diplegia, preterm birth. Diagnosis? | A. Cerebral palsy | B. Autism | C. Rett | D. DMD | A. Spastic cerebral palsy |
| A 5-year-old with Gowers sign, calf hypertrophy, and elevated CPK. Diagnosis? | A. DMD | B. Becker | C. SMA | D. Myasthenia | A. Duchenne muscular dystrophy |
| A 10-year-old boy with mild weakness, ambulatory, later onset than DMD. Diagnosis? | A. Becker muscular dystrophy | B. DMD | C. SMA | D. Myotonic dystrophy | A. Becker muscular dystrophy |
| A 3-year-old with hypotonia, weakness, absent reflexes, tongue fasciculations. Diagnosis? | A. SMA type 1 | B. Myasthenia | C. DMD | D. CP | A. Spinal muscular atrophy type 1 |
| A 12-year-old with weakness improving with rest, ptosis, positive edrophonium test. Diagnosis? | A. Myasthenia gravis | B. Lambert-Eaton | C. SMA | D. DMD | A. Myasthenia gravis |
| A 6-year-old with generalized edema, proteinuria, low albumin. Diagnosis? | A. Nephrotic syndrome | B. PSGN | C. HUS | D. IgA nephropathy | A. Minimal change disease (nephrotic) |
| A 10-year-old with polydipsia, polyuria, hypernatremia, dilute urine. Diagnosis? | A. DI | B. DM | C. SIADH | D. Nephrotic | A. Diabetes insipidus |
| A 9-year-old with obesity, striae, moon face, HTN. Diagnosis? | A. Cushing syndrome | B. Hypothyroidism | C. GH deficiency | D. DM | A. Cushing syndrome |
| A 7-year-old with short stature, delayed bone age, normal intelligence. Diagnosis? | A. Constitutional delay | B. Hypothyroidism | C. GH deficiency | D. Turner | A. Constitutional growth delay |
| A 3-year-old with coarse facies, protruding tongue, umbilical hernia. Diagnosis? | A. Congenital hypothyroidism | B. Cretinism | C. Hypopituitarism | D. Rickets | A. Congenital hypothyroidism (cretinism) |
| A 10-year-old with weight gain, fatigue, cold intolerance, slow growth. Diagnosis? | A. Hypothyroidism | B. Cushing | C. DM | D. Turner | A. Juvenile hypothyroidism |
| A 12-year-old with hypertension, hypokalemia, metabolic alkalosis. Diagnosis? | A. Conn syndrome | B. Addison | C. Cushing | D. Pheochromocytoma | A. Primary hyperaldosteronism |
| A 7-year-old with palpitations, sweating, episodic hypertension. Diagnosis? | A. Pheochromocytoma | B. Cushing | C. Thyrotoxicosis | D. Anxiety | A. Pheochromocytoma |
| A 9-year-old with bone pain, bowing of legs, low calcium, low phosphate, high ALP. Diagnosis? | A. Rickets | B. Scurvy | C. Hypoparathyroidism | D. Osteogenesis imperfecta | A. Nutritional rickets |
| A 2-year-old with delayed walking, frontal bossing, rachitic rosary. Cause? | A. Vitamin D deficiency | B. Calcium deficiency | C. Hypophosphatemia | D. Renal failure | A. Vitamin D deficiency rickets |
| A 5-year-old with swollen knees, bleeding gums, perifollicular hemorrhage. Diagnosis? | A. Scurvy | B. Rickets | C. Hemophilia | D. ITP | A. Vitamin C deficiency (scurvy) |
| A 3-year-old with bone pain, hepatosplenomegaly, anemia, Erlenmeyer flask bone. Diagnosis? | A. Gaucher | B. Thalassemia | C. Leukemia | D. Hurler | A. Gaucher disease |
| A 6-year-old with easy bruising, prolonged PTT, normal platelet count. Diagnosis? | A. Hemophilia A | B. ITP | C. DIC | D. vWD | A. Hemophilia A |
| A 5-year-old girl with prolonged bleeding time, normal PT, prolonged PTT. Diagnosis? | A. vWD | B. Hemophilia | C. DIC | D. ITP | A. von Willebrand disease |
| A 10-year-old with recurrent fractures, blue sclerae, hearing loss. Diagnosis? | A. Osteogenesis imperfecta | B. Rickets | C. Scurvy | D. Marfan | A. Osteogenesis imperfecta |
| A 12-year-old tall boy with long limbs, lens dislocation, aortic regurgitation. Diagnosis? | A. Marfan syndrome | B. Klinefelter | C. Homocystinuria | D. Ehlers-Danlos | A. Marfan syndrome |
| A 6-year-old with tall stature, thromboembolism, lens dislocation downward. Diagnosis? | A. Homocystinuria | B. Marfan | C. Ehlers-Danlos | D. Klinefelter | A. Homocystinuria |
| A 5-year-old with hyperextensible joints, fragile skin, easy bruising. Diagnosis? | A. Ehlers-Danlos | B. Marfan | C. Homocystinuria | D. Osteogenesis imperfecta | A. Ehlers-Danlos syndrome |
| A 2-year-old with developmental regression, loss of motor skills, cherry-red macula. Diagnosis? | A. Tay-Sachs | B. Niemann-Pick | C. Gaucher | D. Hurler | A. Tay-Sachs disease |
| A 4-year-old with macrocephaly, developmental delay, seizures, subependymal nodules. Diagnosis? | A. Tuberous sclerosis | B. NF | C. Sturge-Weber | D. Lennox-Gastaut | A. Tuberous sclerosis |
| A 3-year-old with hemangioma, seizures, tram-track calcification. Diagnosis? | A. Sturge-Weber | B. NF | C. Tuberous sclerosis | D. VHL | A. Sturge-Weber syndrome |
| A 6-year-old child with port-wine stain in trigeminal area, seizures. Diagnosis? | A. Sturge-Weber | B. NF | C. Tuberous sclerosis | D. Hemangioma | A. Sturge-Weber syndrome |
| A 7-year-old with ataxia, telangiectasia, recurrent infections. Diagnosis? | A. Ataxia-telangiectasia | B. Friedreich | C. SMA | D. CP | A. Ataxia-telangiectasia |
| A 12-year-old with progressive ataxia, scoliosis, cardiomyopathy. Diagnosis? | A. Friedreich ataxia | B. Ataxia-telangiectasia | C. SMA | D. CP | A. Friedreich ataxia |
| A 9-year-old with chronic progressive proximal muscle weakness, Gowers sign. Diagnosis? | A. DMD | B. Becker | C. SMA | D. Myasthenia | A. Duchenne muscular dystrophy |
| A 2-year-old with recurrent infections, albinism, neuropathy. Diagnosis? | A. Chediak-Higashi | B. CGD | C. SCID | D. Wiskott-Aldrich | A. Chediak-Higashi syndrome |
| A 55-year-old man with exertional chest pain relieved by rest. Diagnosis? | A. Unstable angina | B. Stable angina | C. NSTEMI | D. STEMI | B. Stable angina pectoris |
| A 58-year-old man with chest pain at rest, no ST elevation, troponin negative. Diagnosis? | A. Stable angina | B. Unstable angina | C. NSTEMI | D. Pericarditis | B. Unstable angina |
| A 60-year-old man with chest pain, ST depression, troponin positive. Diagnosis? | A. Stable angina | B. NSTEMI | C. STEMI | D. Prinzmetal angina | B. Non-ST elevation myocardial infarction |
| A 59-year-old man with ST elevation in II, III, aVF. Diagnosis? | A. Anterior MI | B. Lateral MI | C. Inferior MI | D. Posterior MI | C. Inferior wall myocardial infarction |
| A 62-year-old man with chest pain, hypotension, JVD, clear lungs. Diagnosis? | A. LV infarct | B. RV infarct | C. Pulmonary embolism | D. Pericarditis | B. Right ventricular infarction |
| A 55-year-old man with chest pain radiating to arm, sweating, elevated troponin. Management? | A. Aspirin + clopidogrel | B. Morphine + oxygen | C. Beta-blocker | D. All | D. All of the above (MONA-B) |
| A 60-year-old post-MI patient — drug proven to improve survival? | A. ACE inhibitor | B. CCB | C. Diuretic | D. Nitrate | A. ACE inhibitor |
| A 57-year-old with MI complicated by pulmonary edema. Treatment? | A. Furosemide + morphine | B. Beta-blocker | C. IV fluid | D. Digoxin | A. IV furosemide and morphine |
| A 58-year-old with MI — contraindication to beta-blockers? | A. Bradycardia | B. Hypertension | C. Diabetes | D. Smoking | A. Bradycardia or heart block |
| A 70-year-old hypertensive patient with ankle edema due to medication. Drug? | A. Amlodipine | B. Losartan | C. Atenolol | D. Enalapril | A. Calcium channel blocker (Amlodipine) |
| A 50-year-old with hypertension, dry cough, started on ACE inhibitor. Alternative drug? | A. ARB | B. Beta-blocker | C. Diuretic | D. CCB | A. Angiotensin receptor blocker (ARB) |
| A 65-year-old diabetic with hypertension and proteinuria. Preferred drug? | A. ACE inhibitor | B. Beta-blocker | C. Diuretic | D. CCB | A. ACE inhibitor |
| A 70-year-old with isolated systolic hypertension. Best treatment? | A. Thiazide diuretic | B. Beta-blocker | C. ACE inhibitor | D. CCB | D. Calcium channel blocker |
| A 60-year-old with malignant hypertension. Drug of choice? | A. Nitroprusside | B. Hydralazine | C. Captopril | D. Labetalol | A. IV nitroprusside |
| A 55-year-old with pulsus paradoxus, JVD, muffled heart sounds. Diagnosis? | A. Pericardial effusion | B. Cardiac tamponade | C. Constrictive pericarditis | D. RV infarct | B. Cardiac tamponade |
| A 45-year-old man with chest pain relieved by leaning forward, diffuse ST elevation. Diagnosis? | A. MI | B. Pericarditis | C. PE | D. GERD | B. Acute pericarditis |
| A 60-year-old man with Kussmaul sign, pericardial knock, JVP elevation. Diagnosis? | A. Cardiac tamponade | B. Constrictive pericarditis | C. RV failure | D. PE | B. Constrictive pericarditis |
| A 70-year-old man with severe tearing chest pain radiating to back, unequal BP in arms. Diagnosis? | A. MI | B. Aortic dissection | C. PE | D. Tamponade | B. Aortic dissection |
| A 65-year-old smoker with chronic cough, sputum, cyanosis. Diagnosis? | A. Chronic bronchitis | B. Emphysema | C. Asthma | D. Bronchiectasis | A. Chronic bronchitis |
| A 60-year-old with barrel chest, pursed-lip breathing, hyperinflated lungs. Diagnosis? | A. Emphysema | B. Asthma | C. Chronic bronchitis | D. Bronchiectasis | A. Emphysema |
| A 45-year-old man with episodic wheeze, cough, reversible obstruction. Diagnosis? | A. Asthma | B. COPD | C. Bronchiectasis | D. PE | A. Bronchial asthma |
| A 30-year-old asthmatic using β2-agonist daily with symptoms at night. Next step? | A. Add inhaled corticosteroid | B. Add theophylline | C. Add LABA | D. Stop treatment | A. Add inhaled corticosteroid |
| A 55-year-old man with COPD, chronic hypercapnia. Oxygen therapy caution? | A. May suppress respiratory drive | B. Causes acidosis | C. Irrelevant | D. None | A. Can depress hypoxic drive |
| A 60-year-old chronic smoker with weight loss and clubbing. Diagnosis? | A. Bronchogenic carcinoma | B. COPD | C. TB | D. Bronchiectasis | A. Lung cancer |
| A 45-year-old with hemoptysis, night sweats, weight loss, apical infiltrates. Diagnosis? | A. TB | B. Pneumonia | C. Cancer | D. Abscess | A. Pulmonary tuberculosis |
| A 35-year-old with productive cough, fever, rusty sputum. Diagnosis? | A. Pneumococcal pneumonia | B. Atypical pneumonia | C. TB | D. Bronchitis | A. Streptococcus pneumoniae infection |
| A 28-year-old with cough, myalgia, diffuse infiltrates, cold agglutinins positive. Diagnosis? | A. Mycoplasma pneumonia | B. Viral pneumonia | C. TB | D. Chlamydia | A. Atypical (Mycoplasma) pneumonia |
| A 30-year-old with pneumonia and diarrhea, hyponatremia. Organism? | A. Legionella | B. Strep pneumo | C. Klebsiella | D. Mycoplasma | A. Legionella pneumophila |
| A 40-year-old alcoholic with cavitating pneumonia in upper lobe. Organism? | A. Klebsiella | B. Staph | C. TB | D. Pseudomonas | A. Klebsiella pneumoniae |
| A 50-year-old man with sudden pleuritic pain, dyspnea, tachycardia, D-dimer positive. Diagnosis? | A. PE | B. Pneumonia | C. MI | D. COPD | A. Pulmonary embolism |
| A 45-year-old with DVT and SOB, CT shows saddle embolus. Treatment? | A. Heparin | B. Warfarin | C. Thrombolysis | D. Oxygen | C. Thrombolysis (massive PE) |
| A 60-year-old man with pleural effusion, exudate, high LDH. Diagnosis? | A. TB effusion | B. CHF | C. Cirrhosis | D. Nephrotic | A. Tuberculous exudative effusion |
| A 40-year-old woman with dry cough, bilateral hilar lymphadenopathy. Diagnosis? | A. Sarcoidosis | B. TB | C. Lymphoma | D. COPD | A. Sarcoidosis |
| A 50-year-old man with hematuria, hemoptysis, anti-GBM antibodies. Diagnosis? | A. Goodpasture | B. Wegener | C. PAN | D. SLE | A. Goodpasture syndrome |
| A 60-year-old man with nasal ulcer, hematuria, c-ANCA positive. Diagnosis? | A. Wegener granulomatosis | B. PAN | C. SLE | D. Goodpasture | A. Granulomatosis with polyangiitis (Wegener’s) |
| A 40-year-old man with HTN, uveitis, erythema nodosum, bilateral hilar lymphadenopathy. Diagnosis? | A. Sarcoidosis | B. TB | C. RA | D. SLE | A. Sarcoidosis |
| A 35-year-old with hemoptysis, cavitating lesion, c-ANCA positive. Diagnosis? | A. Wegener | B. TB | C. Cancer | D. Goodpasture | A. Granulomatosis with polyangiitis |
| A 45-year-old man with chronic cough, hemoptysis, clubbing, purulent sputum. Diagnosis? | A. Bronchiectasis | B. TB | C. Cancer | D. COPD | A. Bronchiectasis |
| A 50-year-old man with polyuria, polydipsia, fasting glucose 160 mg/dL. Diagnosis? | A. Type 1 DM | B. Type 2 DM | C. Diabetes insipidus | D. Stress hyperglycemia | B. Type 2 diabetes mellitus |
| A 25-year-old man with polyuria, polydipsia, weight loss, ketones in urine. Diagnosis? | A. Type 1 DM | B. Type 2 DM | C. DI | D. Cushing | A. Type 1 diabetes mellitus |
| A 40-year-old diabetic with fruity breath, Kussmaul breathing. Diagnosis? | A. DKA | B. HONK | C. Lactic acidosis | D. Hypoglycemia | A. Diabetic ketoacidosis |
| A 60-year-old diabetic with hyperosmolar coma, no ketones. Diagnosis? | A. DKA | B. HONK | C. Lactic acidosis | D. Hypoglycemia | B. Hyperosmolar nonketotic coma |
| A 55-year-old diabetic with HbA1c 9%. Indicates? | A. Poor control | B. Good control | C. Normal | D. Hypoglycemia | A. Poor glycemic control |
| A 40-year-old diabetic with microalbuminuria. Next step? | A. ACE inhibitor | B. Loop diuretic | C. ARB | D. Both A and C | A. Start ACE inhibitor therapy |
| A 60-year-old diabetic with neuropathy and absent ankle reflexes. Diagnosis? | A. Peripheral neuropathy | B. Myopathy | C. Nephropathy | D. Retinopathy | A. Diabetic peripheral neuropathy |
| A 55-year-old man with retinopathy and nephropathy. Type of diabetes complication? | A. Microvascular | B. Macrovascular | C. Acute | D. None | A. Microvascular complication |
| A 50-year-old diabetic with MI and stroke. Type of complication? | A. Microvascular | B. Macrovascular | C. Neuropathic | D. None | B. Macrovascular complication |
| A 45-year-old with hypoglycemia, high insulin, low C-peptide. Cause? | A. Exogenous insulin | B. Insulinoma | C. Sulfonylurea | D. Addison | A. Exogenous insulin use |
| A 40-year-old with fasting hypoglycemia, high insulin and C-peptide. Diagnosis? | A. Insulinoma | B. Addison | C. Factitious | D. GH tumor | A. Insulinoma |
| A 35-year-old woman with palpitations, weight loss, tremor, heat intolerance. Diagnosis? | A. Hypothyroidism | B. Thyrotoxicosis | C. Pheochromocytoma | D. Anxiety | B. Hyperthyroidism (thyrotoxicosis) |
| A 30-year-old woman with exophthalmos and pretibial myxedema. Diagnosis? | A. Graves disease | B. Toxic adenoma | C. Hashimoto | D. Thyroiditis | A. Graves disease |
| A 45-year-old woman with weight gain, cold intolerance, dry skin. Diagnosis? | A. Hypothyroidism | B. Hyperthyroidism | C. Cushing | D. Addison | A. Hypothyroidism |
| A 50-year-old woman with painless goiter and hypothyroidism. Diagnosis? | A. Hashimoto | B. Graves | C. De Quervain | D. Subacute thyroiditis | A. Hashimoto thyroiditis |
| A 40-year-old man with painful thyroid enlargement following viral infection. Diagnosis? | A. De Quervain | B. Graves | C. Hashimoto | D. Riedel | A. Subacute granulomatous (De Quervain) thyroiditis |
| A 55-year-old woman with hard woody thyroid, fixed to trachea. Diagnosis? | A. Riedel thyroiditis | B. Hashimoto | C. Graves | D. De Quervain | A. Riedel thyroiditis |
| A 45-year-old woman with thyroid nodule, cold on scan. Next step? | A. FNAC | B. Observe | C. Radioiodine | D. Surgery | A. Fine-needle aspiration cytology |
| A 60-year-old woman with thyroid nodule, amyloid on biopsy, calcitonin elevated. Diagnosis? | A. Medullary carcinoma | B. Papillary | C. Follicular | D. Anaplastic | A. Medullary thyroid carcinoma |
| A 40-year-old woman with thyroid cancer and psammoma bodies. Diagnosis? | A. Papillary | B. Follicular | C. Medullary | D. Anaplastic | A. Papillary thyroid carcinoma |
| A 50-year-old woman with thyroid cancer invading capsule, hematogenous spread. Diagnosis? | A. Follicular carcinoma | B. Papillary | C. Medullary | D. Anaplastic | A. Follicular carcinoma |
| A 70-year-old with rapidly enlarging thyroid, compressive symptoms. Diagnosis? | A. Anaplastic carcinoma | B. Medullary | C. Papillary | D. Hashimoto | A. Anaplastic carcinoma of thyroid |
| A 45-year-old with fatigue, weight gain, hypotension, hyponatremia, hyperkalemia. Diagnosis? | A. Addison | B. Cushing | C. Conn | D. SIADH | A. Addison’s disease (primary adrenal insufficiency) |
| A 35-year-old woman with truncal obesity, moon face, striae, HTN. Diagnosis? | A. Cushing | B. Addison | C. Conn | D. PCOS | A. Cushing syndrome |
| A 40-year-old woman with Cushing syndrome. Best screening test? | A. Overnight dexamethasone suppression | B. ACTH level | C. Cortisol AM | D. CT adrenals | A. Low-dose dexamethasone suppression test |
| A 45-year-old man with HTN, hypokalemia, metabolic alkalosis. Diagnosis? | A. Conn syndrome | B. Addison | C. Cushing | D. Pheochromocytoma | A. Primary hyperaldosteronism (Conn syndrome) |
| A 50-year-old man with episodic headache, sweating, palpitations, HTN. Diagnosis? | A. Pheochromocytoma | B. Cushing | C. Thyrotoxicosis | D. Anxiety | A. Pheochromocytoma |
| A 45-year-old woman with MEN 2A. Tumors involved? | A. Medullary thyroid + Pheo + Parathyroid | B. Pituitary + Pancreas + PTH | C. Pheo + Insulinoma + GH | D. Adrenal + Pancreas | A. Medullary thyroid carcinoma, pheochromocytoma, hyperparathyroidism |
| A 60-year-old man with galactorrhea and low libido. Diagnosis? | A. Prolactinoma | B. GH adenoma | C. ACTH tumor | D. Cushing | A. Pituitary prolactinoma |
| A 40-year-old man with large hands, jaw, high GH. Diagnosis? | A. Acromegaly | B. Gigantism | C. Cushing | D. Prolactinoma | A. Acromegaly |
| A 42-year-old with acromegaly. Screening test? | A. IGF-1 level | B. GH after glucose | C. MRI | D. TSH | A. Elevated IGF-1 |
| A 45-year-old with central obesity, purple striae, HTN, high cortisol, low ACTH. Diagnosis? | A. Adrenal adenoma | B. Cushing disease | C. Ectopic ACTH | D. Steroid use | A. Adrenal adenoma (ACTH-independent Cushing) |
| A 60-year-old woman with confusion, Na+ 118, osmolality low. Diagnosis? | A. SIADH | B. DI | C. Addison | D. Cushing | A. Syndrome of inappropriate ADH secretion |
| A 30-year-old man with polyuria, polydipsia, hypernatremia, urine osmolality low. Diagnosis? | A. DI | B. DM | C. SIADH | D. Cushing | A. Diabetes insipidus |
| A 25-year-old woman with amenorrhea, galactorrhea, visual field defect. Diagnosis? | A. Prolactinoma | B. Craniopharyngioma | C. Cushing | D. GH tumor | A. Pituitary prolactinoma |
| A 45-year-old man with hyperpigmentation, hypotension, hyperkalemia. Diagnosis? | A. Addison | B. Cushing | C. Conn | D. SIADH | A. Addison’s disease |
| A 55-year-old man with proximal weakness, hypokalemia, metabolic alkalosis. Diagnosis? | A. Conn | B. Addison | C. Cushing | D. Pheochromocytoma | A. Primary hyperaldosteronism |
| A 40-year-old woman with HTN, episodic headache, sweating. Diagnosis? | A. Pheochromocytoma | B. Cushing | C. Conn | D. Addison | A. Pheochromocytoma |
| A 30-year-old woman with polyuria, low urine osmolality, normal glucose. Diagnosis? | A. Diabetes insipidus | B. DM | C. SIADH | D. Addison | A. Diabetes insipidus |
| A 60-year-old man with edema, proteinuria, hypoalbuminemia. Diagnosis? | A. Nephrotic syndrome | B. Nephritic syndrome | C. Glomerulonephritis | D. CKD | A. Nephrotic syndrome |
| A 55-year-old man with periorbital edema, frothy urine, hyperlipidemia. Diagnosis? | A. Minimal change | B. FSGS | C. Membranous nephropathy | D. Diabetic nephropathy | C. Membranous nephropathy |
| A 45-year-old woman with SLE, proteinuria, RBC casts. Diagnosis? | A. Lupus nephritis | B. PSGN | C. FSGS | D. Amyloidosis | A. Lupus nephritis |
| A 35-year-old man with hematuria, cola-colored urine, post-sore throat. Diagnosis? | A. PSGN | B. IgA nephropathy | C. MPGN | D. Lupus | A. Post-streptococcal glomerulonephritis |
| A 25-year-old with recurrent hematuria, after URI, normal complement. Diagnosis? | A. IgA nephropathy | B. PSGN | C. Lupus | D. HSP | A. IgA nephropathy (Berger disease) |
| A 40-year-old man with nephrotic range proteinuria and Congo red positivity. Diagnosis? | A. Amyloidosis | B. FSGS | C. Membranous | D. MPGN | A. Renal amyloidosis |
| A 55-year-old diabetic with progressive renal failure, proteinuria. Diagnosis? | A. Diabetic nephropathy | B. Amyloidosis | C. PSGN | D. FSGS | A. Diabetic nephropathy |
| A 65-year-old hypertensive with small shrunken kidneys. Diagnosis? | A. Chronic kidney disease | B. Acute renal failure | C. Nephrotic syndrome | D. Amyloidosis | A. Chronic kidney disease |
| A 70-year-old man with CKD. Common cause of death? | A. Cardiovascular disease | B. Uremia | C. Anemia | D. Hyperkalemia | A. Cardiovascular complications |
| A 45-year-old man with hematuria, flank pain, palpable mass. Diagnosis? | A. RCC | B. PKD | C. Pyelonephritis | D. Stone | A. Renal cell carcinoma |
| A 50-year-old man with painless hematuria, smoker. Diagnosis? | A. Bladder carcinoma | B. RCC | C. Stone | D. Cystitis | A. Transitional cell carcinoma (bladder cancer) |
| A 55-year-old man with hematuria, flank pain, family history of kidney cysts. Diagnosis? | A. ADPKD | B. ARPKD | C. RCC | D. Hydronephrosis | A. Autosomal dominant polycystic kidney disease |
| A 60-year-old woman with acute renal failure, low urine Na+, high BUN/Cr. Diagnosis? | A. Prerenal | B. Intrinsic | C. Postrenal | D. CKD | A. Prerenal azotemia |
| A 50-year-old with muddy brown casts, BUN/Cr <15. Diagnosis? | A. ATN | B. Prerenal | C. Postrenal | D. CKD | A. Acute tubular necrosis |
| A 40-year-old with eosinophilia, rash, recent antibiotic use. Diagnosis? | A. Interstitial nephritis | B. ATN | C. Glomerulonephritis | D. Rhabdomyolysis | A. Drug-induced interstitial nephritis |
| A 65-year-old man with flank pain, hematuria, stone on X-ray. Type? | A. Calcium oxalate | B. Uric acid | C. Cystine | D. Struvite | A. Calcium oxalate stone |
| A 45-year-old woman with recurrent UTI and staghorn calculi. Stone type? | A. Struvite | B. Uric acid | C. Calcium | D. Cystine | A. Struvite (magnesium ammonium phosphate) stones |
| A 50-year-old man with gout, radiolucent renal stones. Type? | A. Uric acid | B. Calcium | C. Struvite | D. Cystine | A. Uric acid stones |
| A 60-year-old with polyuria, polydipsia, high calcium, bone pain, renal stones. Diagnosis? | A. Hyperparathyroidism | B. Sarcoidosis | C. Malignancy | D. Vit D toxicity | A. Primary hyperparathyroidism |
| A 55-year-old man with fatigue, bone pain, fractures, normal calcium, low phosphate, high ALP. Diagnosis? | A. Osteomalacia | B. Osteoporosis | C. Paget | D. HyperPTH | A. Osteomalacia |
| A 70-year-old man with bone pain, elevated ALP, normal calcium, mosaic bone pattern. Diagnosis? | A. Paget disease | B. Osteoporosis | C. Osteomalacia | D. Metastasis | A. Paget’s disease of bone |
| A 65-year-old woman with chronic joint pain, Heberden nodes. Diagnosis? | A. OA | B. RA | C. Gout | D. Pseudogout | A. Osteoarthritis |
| A 40-year-old woman with morning stiffness >1 hr, small joints, RF positive. Diagnosis? | A. Rheumatoid arthritis | B. OA | C. Gout | D. SLE | A. Rheumatoid arthritis |
| A 35-year-old woman with malar rash, photosensitivity, proteinuria. Diagnosis? | A. SLE | B. RA | C. Dermatomyositis | D. Vasculitis | A. Systemic lupus erythematosus |
| A 45-year-old woman with dry eyes, dry mouth, parotid enlargement. Diagnosis? | A. Sjögren syndrome | B. SLE | C. RA | D. Dermatomyositis | A. Sjögren syndrome |
| A 40-year-old woman with proximal muscle weakness, heliotrope rash, Gottron papules. Diagnosis? | A. Dermatomyositis | B. Polymyositis | C. SLE | D. RA | A. Dermatomyositis |
| A 50-year-old with proximal muscle weakness, no rash, elevated CK. Diagnosis? | A. Polymyositis | B. Dermatomyositis | C. SLE | D. Myasthenia | A. Polymyositis |
| A 55-year-old with dysphagia, sclerodactyly, telangiectasia. Diagnosis? | A. Systemic sclerosis | B. Dermatomyositis | C. SLE | D. RA | A. Systemic sclerosis (CREST syndrome) |
| A 60-year-old man with recurrent oral ulcers, genital ulcers, uveitis. Diagnosis? | A. Behçet disease | B. SLE | C. RA | D. Vasculitis | A. Behçet syndrome |
| A 25-year-old man with back pain, morning stiffness, HLA-B27 positive. Diagnosis? | A. Ankylosing spondylitis | B. RA | C. OA | D. Psoriatic arthritis | A. Ankylosing spondylitis |
| A 35-year-old man with urethritis, conjunctivitis, arthritis. Diagnosis? | A. Reactive arthritis | B. Gout | C. SLE | D. RA | A. Reactive arthritis (Reiter syndrome) |
| A 40-year-old man with acute monoarthritis, needle-shaped crystals, negative birefringence. Diagnosis? | A. Gout | B. Pseudogout | C. Septic arthritis | D. RA | A. Gout |
| A 60-year-old with knee pain, rhomboid crystals, positive birefringence. Diagnosis? | A. Pseudogout | B. Gout | C. OA | D. RA | A. Calcium pyrophosphate deposition (pseudogout) |
| A 50-year-old woman with Raynaud’s phenomenon, anti-centromere antibodies. Diagnosis? | A. Limited scleroderma | B. Diffuse sclerosis | C. SLE | D. CREST | A. CREST (limited scleroderma) |
| A 40-year-old woman with dysphagia, skin thickening, anti-Scl-70 positive. Diagnosis? | A. Diffuse scleroderma | B. CREST | C. Dermatomyositis | D. RA | A. Diffuse systemic sclerosis |
| A 60-year-old man with fever, weight loss, purpura, neuropathy, HBV+. Diagnosis? | A. Polyarteritis nodosa | B. Wegener | C. HSP | D. SLE | A. Polyarteritis nodosa |
| A 12-year-old with purpura, arthralgia, abdominal pain, hematuria. Diagnosis? | A. HSP | B. SLE | C. PAN | D. ITP | A. Henoch–Schönlein purpura |
| A 40-year-old woman with hematuria, hemoptysis, anti-GBM positive. Diagnosis? | A. Goodpasture | B. Wegener | C. PAN | D. SLE | A. Goodpasture syndrome |
| A 55-year-old with asthma, eosinophilia, neuropathy. Diagnosis? | A. Churg–Strauss | B. Wegener | C. PAN | D. SLE | A. Eosinophilic granulomatosis with polyangiitis |
| A 45-year-old woman with fatigue, pruritus, high ALP, antimitochondrial antibody. Diagnosis? | A. PBC | B. PSC | C. Cirrhosis | D. Hepatitis | A. Primary biliary cholangitis |
| A 40-year-old man with UC and beaded intrahepatic ducts. Diagnosis? | A. PSC | B. PBC | C. Cirrhosis | D. Cholangiocarcinoma | A. Primary sclerosing cholangitis |
| A 50-year-old alcoholic with hepatomegaly, AST > ALT. Diagnosis? | A. Alcoholic hepatitis | B. Viral hepatitis | C. Cirrhosis | D. NASH | A. Alcoholic hepatitis |
| A 45-year-old man with chronic HBV and cirrhosis, AFP elevated. Diagnosis? | A. HCC | B. Cholangiocarcinoma | C. PSC | D. Adenoma | A. Hepatocellular carcinoma |
| A 60-year-old with painless jaundice, palpable gallbladder. Diagnosis? | A. Carcinoma head of pancreas | B. Cholangiocarcinoma | C. Gallstones | D. PSC | A. Carcinoma of pancreas (Courvoisier sign) |
| A 25-year-old man after road traffic accident with hypotension, tachycardia, flat neck veins. Diagnosis? | A. Hypovolemic shock | B. Cardiac tamponade | C. Tension pneumothorax | D. Septic shock | A. Hypovolemic shock |
| A trauma patient with hypotension, distended neck veins, muffled heart sounds. Diagnosis? | A. Cardiac tamponade | B. Tension pneumothorax | C. Hemothorax | D. PE | A. Cardiac tamponade |
| A 30-year-old man after chest trauma with absent breath sounds, hyperresonance, trachea deviated. Diagnosis? | A. Tension pneumothorax | B. Hemothorax | C. Flail chest | D. PE | A. Tension pneumothorax |
| A 35-year-old with blunt chest trauma, multiple rib fractures, paradoxical chest movement. Diagnosis? | A. Flail chest | B. Pneumothorax | C. Hemothorax | D. Contusion | A. Flail chest |
| A 28-year-old trauma patient with BP 80/40, HR 140, cool extremities. Class of shock? | A. Class I | B. Class II | C. Class III | D. Class IV | C. Class III hemorrhagic shock |
| A trauma patient with airway obstruction and facial burns. Management? | A. Early intubation | B. Tracheostomy | C. Observe | D. Cricothyrotomy | A. Early endotracheal intubation |
| A 35-year-old with abdominal trauma, free fluid on FAST. Next step? | A. Laparotomy | B. CT scan | C. Observation | D. Diagnostic peritoneal lavage | A. Emergency laparotomy |
| A 30-year-old with penetrating abdominal injury, hypotension, distended abdomen. Next step? | A. Exploratory laparotomy | B. CT scan | C. Ultrasound | D. Observe | A. Immediate laparotomy |
| A 25-year-old with blunt abdominal trauma, left shoulder pain, hypotension. Diagnosis? | A. Splenic rupture | B. Liver injury | C. Pancreatic injury | D. Kidney trauma | A. Splenic rupture (Kehr’s sign) |
| A 40-year-old with right upper quadrant injury, hypotension. Organ injured? | A. Liver | B. Spleen | C. Pancreas | D. Kidney | A. Liver laceration |
| A 45-year-old man after RTA, blood at urethral meatus, high-riding prostate. Diagnosis? | A. Urethral injury | B. Bladder rupture | C. Renal trauma | D. Rectal tear | A. Posterior urethral injury |
| A 32-year-old with pelvic fracture, unable to pass urine. Next investigation? | A. Retrograde urethrogram | B. CT | C. Cystoscopy | D. USG | A. Retrograde urethrogram before catheterization |
| A 25-year-old with suspected bladder rupture. Best test? | A. Cystogram | B. IVP | C. USG | D. CT | A. Retrograde cystogram |
| A 35-year-old with penetrating neck wound, active bleeding. First step? | A. Secure airway | B. Direct pressure | C. CT angiography | D. Observe | A. Secure airway and control bleeding |
| A 40-year-old with peritonitis after trauma. Next step? | A. Laparotomy | B. CT scan | C. Observe | D. FAST | A. Exploratory laparotomy |
| A 50-year-old with post-op fever on day 1. Most likely cause? | A. Atelectasis | B. Wound infection | C. UTI | D. DVT | A. Atelectasis (wind) |
| A 50-year-old with fever on day 5 post-op. Likely cause? | A. Wound infection | B. Pneumonia | C. DVT | D. Sepsis | A. Wound infection |
| A 55-year-old with fever on day 7 post-op. Likely cause? | A. DVT | B. UTI | C. Pneumonia | D. Wound infection | A. Deep vein thrombosis (walk) |
| A 45-year-old with sudden shortness of breath post-op, chest pain, tachycardia. Diagnosis? | A. PE | B. Pneumonia | C. MI | D. Pneumothorax | A. Pulmonary embolism |
| A 50-year-old post-surgery with abdominal distension, no bowel sounds. Diagnosis? | A. Ileus | B. Obstruction | C. Volvulus | D. Adhesion | A. Postoperative paralytic ileus |
| A 40-year-old man with fever, RLQ pain, guarding. Diagnosis? | A. Appendicitis | B. Cholecystitis | C. Perforation | D. Renal colic | A. Acute appendicitis |
| A 25-year-old woman with RLQ pain, tenderness, fever. Best initial test? | A. Ultrasound | B. CT | C. MRI | D. X-ray | A. Abdominal ultrasound |
| A 50-year-old with fever, RUQ pain, Murphy’s sign. Diagnosis? | A. Acute cholecystitis | B. Cholangitis | C. Hepatitis | D. Peptic ulcer | A. Acute calculous cholecystitis |
| A 60-year-old with fever, jaundice, RUQ pain. Diagnosis? | A. Ascending cholangitis | B. Cholecystitis | C. Hepatitis | D. Cirrhosis | A. Charcot’s triad – Ascending cholangitis |
| A 45-year-old obese woman with postprandial pain, gallstones. Diagnosis? | A. Cholelithiasis | B. Cholecystitis | C. Choledocholithiasis | D. Pancreatitis | A. Symptomatic cholelithiasis |
| A 55-year-old alcoholic with epigastric pain radiating to back, ↑amylase/lipase. Diagnosis? | A. Acute pancreatitis | B. Cholecystitis | C. PUD | D. MI | A. Acute pancreatitis |
| A 45-year-old with history of gallstones, elevated bilirubin, dilated bile ducts. Diagnosis? | A. Choledocholithiasis | B. Cholangitis | C. Cholecystitis | D. Pancreatitis | A. Choledocholithiasis |
| A 50-year-old with severe epigastric pain, vomiting, free air under diaphragm. Diagnosis? | A. Perforated peptic ulcer | B. Pancreatitis | C. SBO | D. Gastritis | A. Perforated peptic ulcer |
| A 60-year-old with upper GI bleed, history of NSAID use. Cause? | A. Peptic ulcer | B. Gastritis | C. Varices | D. Mallory-Weiss | A. Peptic ulcer disease |
| A 55-year-old with hematemesis and cirrhosis. Cause? | A. Esophageal varices | B. PUD | C. Mallory-Weiss | D. Gastritis | A. Bleeding esophageal varices |
| A 45-year-old alcoholic with vomiting, then hematemesis, tear at GE junction. Diagnosis? | A. Mallory-Weiss tear | B. PUD | C. Varices | D. Erosive gastritis | A. Mallory-Weiss tear |
| A 65-year-old with dysphagia to solids then liquids, weight loss. Diagnosis? | A. Esophageal cancer | B. Achalasia | C. Stricture | D. Plummer-Vinson | A. Esophageal carcinoma |
| A 30-year-old woman with dysphagia to both solids and liquids, bird-beak on barium. Diagnosis? | A. Achalasia | B. Stricture | C. Cancer | D. Web | A. Achalasia cardia |
| A 55-year-old with painful swallowing, mid-esophageal pouch. Diagnosis? | A. Diverticulum | B. Zenker | C. Stricture | D. Achalasia | A. Epiphrenic diverticulum |
| A 70-year-old with epigastric pain relieved by food. Diagnosis? | A. Duodenal ulcer | B. Gastric ulcer | C. GERD | D. Gastritis | A. Duodenal ulcer |
| A 65-year-old with epigastric pain worsened by food, weight loss. Diagnosis? | A. Gastric ulcer | B. Duodenal | C. GERD | D. Pancreatitis | A. Gastric ulcer |
| A 50-year-old with hematemesis, melena, cirrhosis. Initial management? | A. IV fluids + octreotide | B. Antibiotics | C. Endoscopy | D. Balloon tamponade | A. Fluid resuscitation and octreotide |
| A 45-year-old with acute abdomen, rigid board-like, free air under diaphragm. Diagnosis? | A. Perforated ulcer | B. Pancreatitis | C. SBO | D. Appendicitis | A. Perforated peptic ulcer |
| A 50-year-old man with recurrent vomiting, visible peristalsis, succussion splash. Diagnosis? | A. Gastric outlet obstruction | B. Duodenal ulcer | C. Gastritis | D. Achalasia | A. Gastric outlet obstruction |
| A 65-year-old with painless hematochezia, anemia, change in bowel habits. Diagnosis? | A. Colon cancer | B. Diverticulosis | C. Hemorrhoids | D. UC | A. Colorectal carcinoma |
| A 40-year-old with LLQ pain, fever, leukocytosis. Diagnosis? | A. Diverticulitis | B. UC | C. Crohn | D. IBS | A. Acute diverticulitis |
| A 45-year-old woman with painless breast lump, irregular hard, fixed to skin. Diagnosis? | A. Fibroadenoma | B. Breast carcinoma | C. Fibrocystic | D. Abscess | B. Invasive ductal carcinoma |
| A 25-year-old woman with mobile, firm, non-tender breast lump. Diagnosis? | A. Fibroadenoma | B. Fibrocystic disease | C. Abscess | D. Carcinoma | A. Fibroadenoma |
| A 35-year-old woman with cyclic mastalgia, nodular breast. Diagnosis? | A. Fibrocystic disease | B. Carcinoma | C. Abscess | D. Fibroadenoma | A. Fibrocystic change |
| A 50-year-old woman with eczematous nipple changes and underlying lump. Diagnosis? | A. Paget disease | B. Fibrocystic | C. Mastitis | D. DCIS | A. Paget’s disease of the breast |
| A 60-year-old with peau d’orange breast and axillary nodes. Diagnosis? | A. Inflammatory carcinoma | B. Ductal carcinoma | C. Paget | D. Sarcoma | A. Inflammatory breast carcinoma |
| A 25-year-old lactating woman with fever, breast pain, tender swelling. Diagnosis? | A. Mastitis | B. Abscess | C. Carcinoma | D. Galactocele | A. Acute lactational mastitis |
| A 30-year-old lactating woman with fluctuant breast swelling, fever. Diagnosis? | A. Abscess | B. Mastitis | C. Fibrocystic | D. Carcinoma | A. Breast abscess |
| A 40-year-old woman post-breast surgery with arm swelling. Cause? | A. Lymphedema | B. Thrombosis | C. Infection | D. Cellulitis | A. Post-mastectomy lymphedema |
| A 55-year-old woman with breast cancer, bone metastasis. Common site? | A. Vertebrae | B. Lungs | C. Liver | D. Brain | A. Vertebral metastasis |
| A 60-year-old woman with lump in breast, no nodes, <2 cm. Stage? | A. I | B. II | C. III | D. IV | A. Stage I breast cancer |
| A 50-year-old man with nipple discharge, mass under areola. Diagnosis? | A. Male breast carcinoma | B. Gynecomastia | C. Fibroadenoma | D. Abscess | A. Male breast carcinoma |
| A 60-year-old man with symmetric enlargement of both breasts. Diagnosis? | A. Gynecomastia | B. Carcinoma | C. Cyst | D. Lipoma | A. Gynecomastia |
| A 45-year-old woman with solitary thyroid nodule, cold on scan. Next step? | A. FNAC | B. Observe | C. Surgery | D. Suppression therapy | A. Fine-needle aspiration cytology |
| A 35-year-old woman with diffuse goiter, exophthalmos. Diagnosis? | A. Graves | B. Hashimoto | C. Toxic adenoma | D. Multinodular goiter | A. Graves disease |
| A 40-year-old man with solitary thyroid nodule, solid, cold, male. Risk? | A. Malignancy | B. Benign | C. Thyroiditis | D. Cyst | A. Malignancy risk |
| A 45-year-old woman with thyroid nodule, calcitonin elevated. Diagnosis? | A. Medullary carcinoma | B. Papillary | C. Follicular | D. Anaplastic | A. Medullary thyroid carcinoma |
| A 55-year-old man with rapidly enlarging neck mass, hoarseness, dysphagia. Diagnosis? | A. Anaplastic thyroid carcinoma | B. Medullary | C. Lymphoma | D. Papillary | A. Anaplastic carcinoma |
| A 40-year-old man with midline neck swelling moving with tongue protrusion. Diagnosis? | A. Thyroglossal cyst | B. Dermoid | C. Lymph node | D. Goiter | A. Thyroglossal duct cyst |
| A 30-year-old man with lateral neck cyst, anterior to SCM. Diagnosis? | A. Branchial cyst | B. Thyroglossal | C. Dermoid | D. Lipoma | A. Branchial cyst |
| A 25-year-old man with neck swelling after URTI, tender, fluctuant. Diagnosis? | A. Abscess | B. Branchial cyst | C. Lymphoma | D. TB | A. Deep neck abscess |
| A 40-year-old man with epigastric swelling, increases on cough. Diagnosis? | A. Epigastric hernia | B. Umbilical | C. Incisional | D. Inguinal | A. Epigastric hernia |
| A 30-year-old woman with swelling at umbilicus, reducible. Diagnosis? | A. Umbilical hernia | B. Paraumbilical | C. Incisional | D. Spigelian | A. Umbilical hernia |
| A 50-year-old obese woman post-laparotomy with scar swelling. Diagnosis? | A. Incisional hernia | B. Umbilical | C. Paraumbilical | D. Spigelian | A. Incisional hernia |
| A 25-year-old man with groin swelling above inguinal ligament, reducible. Diagnosis? | A. Indirect inguinal hernia | B. Direct | C. Femoral | D. Hydrocele | A. Indirect inguinal hernia |
| A 60-year-old man with groin bulge medial to inferior epigastric vessels. Diagnosis? | A. Direct inguinal hernia | B. Indirect | C. Femoral | D. Obturator | A. Direct inguinal hernia |
| A 55-year-old woman with swelling below inguinal ligament, tender, irreducible. Diagnosis? | A. Femoral hernia | B. Direct | C. Indirect | D. Incisional | A. Femoral hernia |
| A 45-year-old man with irreducible hernia and obstruction. Management? | A. Emergency surgery | B. Elective repair | C. Truss | D. Observe | A. Emergency hernia repair |
| A 40-year-old woman with right flank pain, hematuria, colicky pain. Diagnosis? | A. Renal stone | B. Pyelonephritis | C. Tumor | D. Cyst | A. Ureteric calculus |
| A 55-year-old man with painless hematuria, smoker. Diagnosis? | A. Bladder cancer | B. RCC | C. Stone | D. Cystitis | A. Transitional cell carcinoma |
| A 60-year-old man with painless scrotal swelling, transilluminates. Diagnosis? | A. Hydrocele | B. Varicocele | C. Hernia | D. Epididymitis | A. Hydrocele |
| A 25-year-old man with scrotal pain, high-riding testis, absent cremasteric reflex. Diagnosis? | A. Torsion testis | B. Epididymitis | C. Hernia | D. Hydrocele | A. Testicular torsion |
| A 30-year-old man with bag-of-worms feel, left side, infertility. Diagnosis? | A. Varicocele | B. Hydrocele | C. Hernia | D. Epididymitis | A. Varicocele |
| A 65-year-old man with LUTS, enlarged firm prostate, PSA 12. Diagnosis? | A. BPH | B. Prostate cancer | C. Prostatitis | D. Stone | B. Carcinoma prostate |
| A 60-year-old man with nocturia, hesitancy, weak stream, smooth prostate. Diagnosis? | A. BPH | B. Carcinoma | C. Prostatitis | D. Urethral stricture | A. Benign prostatic hyperplasia |
| A 50-year-old man with acute retention. Initial management? | A. Catheterization | B. Surgery | C. Drugs | D. Observe | A. Bladder catheterization |
| A 55-year-old man with perianal swelling, pain, fever. Diagnosis? | A. Perianal abscess | B. Fistula | C. Hemorrhoid | D. Fissure | A. Perianal abscess |
| A 40-year-old man with chronic anal discharge, external opening near anus. Diagnosis? | A. Fistula-in-ano | B. Fissure | C. Abscess | D. Hemorrhoid | A. Anal fistula |
| A 35-year-old woman with painful bleeding after defecation, tear in anoderm. Diagnosis? | A. Anal fissure | B. Fistula | C. Hemorrhoids | D. Abscess | A. Anal fissure |
| A 45-year-old man with painless rectal bleeding, prolapse during defecation. Diagnosis? | A. Internal hemorrhoids | B. Fissure | C. Polyp | D. Cancer | A. Internal hemorrhoids |
| A 50-year-old man with rectal bleeding, tenesmus, mass on DRE. Diagnosis? | A. Rectal cancer | B. Hemorrhoid | C. Fissure | D. Fistula | A. Rectal carcinoma |
| A 25-year-old man fell on outstretched hand, pain over anatomic snuffbox. Diagnosis? | A. Scaphoid fracture | B. Colles fracture | C. Smith fracture | D. Lunate dislocation | A. Scaphoid fracture |
| A 60-year-old woman fell on outstretched hand, dorsal angulation distal radius. Diagnosis? | A. Colles fracture | B. Smith fracture | C. Barton | D. Monteggia | A. Colles fracture |
| A 45-year-old man with volar angulation distal radius. Diagnosis? | A. Smith fracture | B. Colles | C. Barton | D. Galeazzi | A. Smith fracture |
| A 30-year-old man with ulnar fracture and radial head dislocation. Diagnosis? | A. Monteggia fracture | B. Galeazzi | C. Colles | D. Smith | A. Monteggia fracture-dislocation |
| A 25-year-old with radial fracture and distal radioulnar dislocation. Diagnosis? | A. Galeazzi fracture | B. Monteggia | C. Colles | D. Barton | A. Galeazzi fracture |
| A 40-year-old with shoulder pain after fall, arm externally rotated, abducted. Diagnosis? | A. Anterior shoulder dislocation | B. Posterior | C. Fracture clavicle | D. Rotator cuff tear | A. Anterior shoulder dislocation |
| A 45-year-old with shoulder deformity, unable to abduct arm after dislocation. Nerve injured? | A. Axillary | B. Radial | C. Median | D. Ulnar | A. Axillary nerve injury |
| A 30-year-old man with midshaft humerus fracture. Nerve injured? | A. Radial | B. Ulnar | C. Median | D. Axillary | A. Radial nerve |
| A 60-year-old man with supracondylar humerus fracture, wrist drop. Nerve injured? | A. Radial | B. Ulnar | C. Median | D. Axillary | A. Radial nerve |
| A 10-year-old with supracondylar fracture, loss of thumb opposition. Nerve? | A. Median | B. Ulnar | C. Radial | D. Axillary | A. Median nerve |
| A 30-year-old with elbow injury, claw hand deformity. Nerve? | A. Ulnar | B. Radial | C. Median | D. Axillary | A. Ulnar nerve injury |
| A 25-year-old with wrist laceration, cannot oppose thumb. Nerve? | A. Median | B. Ulnar | C. Radial | D. Axillary | A. Median nerve injury |
| A 45-year-old with pelvic fracture, unable to dorsiflex foot. Nerve? | A. Common peroneal | B. Femoral | C. Sciatic | D. Tibial | A. Common peroneal nerve injury |
| A 50-year-old with posterior hip dislocation. Nerve injured? | A. Sciatic | B. Femoral | C. Obturator | D. Peroneal | A. Sciatic nerve |
| A 70-year-old woman with hip fracture, shortened externally rotated limb. Diagnosis? | A. Neck of femur fracture | B. Intertrochanteric | C. Shaft fracture | D. Dislocation | A. Fracture neck of femur |
| A 65-year-old with subtrochanteric fracture after minor fall. Likely cause? | A. Osteoporosis | B. Metastasis | C. Paget | D. OA | A. Osteoporotic fragility fracture |
| A 30-year-old with pain, swelling tibia, fever, high ESR. Diagnosis? | A. Osteomyelitis | B. Osteosarcoma | C. Ewing | D. Cellulitis | A. Acute osteomyelitis |
| A 14-year-old boy with diaphyseal bone lesion, onion-skin periosteal reaction. Diagnosis? | A. Ewing sarcoma | B. Osteosarcoma | C. Osteomyelitis | D. Chondrosarcoma | A. Ewing sarcoma |
| A 17-year-old boy with metaphyseal lesion around knee, sunburst pattern. Diagnosis? | A. Osteosarcoma | B. Ewing | C. Chondroblastoma | D. Giant cell tumor | A. Osteosarcoma |
| A 25-year-old woman with epiphyseal lytic lesion, soap-bubble appearance. Diagnosis? | A. Giant cell tumor | B. Chondroblastoma | C. Ewing | D. Osteosarcoma | A. Giant cell tumor (osteoclastoma) |
| A 35-year-old with chronic knee pain, morning stiffness <30 min. Diagnosis? | A. Osteoarthritis | B. RA | C. Gout | D. Septic | A. Osteoarthritis |
| A 20-year-old athlete with knee pain after twist, positive Lachman test. Diagnosis? | A. ACL tear | B. PCL | C. Meniscus | D. Collateral | A. ACL rupture |
| A 25-year-old athlete with knee locking, joint line tenderness. Diagnosis? | A. Meniscal tear | B. ACL | C. PCL | D. OA | A. Meniscal tear |
| A 30-year-old man with posterior dislocation knee, weak dorsalis pedis. Vessel? | A. Popliteal artery | B. Femoral | C. Tibial | D. Peroneal | A. Popliteal artery injury |
| A 60-year-old smoker with calf pain on walking, relieved by rest. Diagnosis? | A. Intermittent claudication | B. DVT | C. Varicose veins | D. Cellulitis | A. Peripheral arterial disease |
| A 65-year-old man with rest pain, absent pulses, ulcer on toe. Diagnosis? | A. Critical limb ischemia | B. DVT | C. Varicose | D. Cellulitis | A. Critical limb ischemia |
| A 40-year-old woman with dilated tortuous leg veins, aching pain. Diagnosis? | A. Varicose veins | B. DVT | C. Lymphedema | D. Thrombophlebitis | A. Varicose veins |
| A 55-year-old with leg ulcer above medial malleolus, painless. Cause? | A. Venous ulcer | B. Arterial | C. Neuropathic | D. Pressure | A. Venous ulcer |
| A 65-year-old diabetic with foot ulcer on sole, loss of sensation. Diagnosis? | A. Neuropathic ulcer | B. Arterial | C. Venous | D. Pressure | A. Diabetic neuropathic ulcer |
| A 70-year-old with painful black toe, absent pulses. Diagnosis? | A. Arterial ulcer | B. Venous | C. Neuropathic | D. Pressure | A. Arterial ischemic ulcer |
| A 25-year-old with deep laceration leg, absent distal pulses, cold limb. Management? | A. Vascular repair | B. Fasciotomy | C. Observe | D. Amputation | A. Immediate vascular repair |
| A 35-year-old with crush injury, severe pain, paresthesia, pallor, tight limb. Diagnosis? | A. Compartment syndrome | B. DVT | C. Arterial occlusion | D. Cellulitis | A. Acute compartment syndrome |
| A 40-year-old man with electric burn, myoglobinuria. Management? | A. IV fluids + alkalinization | B. Antibiotics | C. Observe | D. Amputation | A. Aggressive IV fluids and urine alkalinization |
| A 30-year-old with circumferential full-thickness burn, distal pulses absent. Management? | A. Escharotomy | B. Fasciotomy | C. Grafting | D. Amputation | A. Escharotomy |
| A 50-year-old with 40% flame burns, singed nasal hairs, hoarseness. Next step? | A. Intubate early | B. Observe | C. Oxygen only | D. Fluids | A. Early airway intubation |
| A 25-year-old with 30% burns. Fluid requirement first 24h? | A. Parkland formula | B. Holliday-Segar | C. Maintenance | D. Evans | A. Parkland formula (4 mL × %BSA × weight) |
| A 40-year-old with chemical burn. Immediate management? | A. Copious water irrigation | B. Neutralize | C. Cover | D. Antibiotic | A. Copious irrigation with water |
| A 50-year-old with electrical burn and rhabdomyolysis. Best indicator renal failure? | A. Myoglobinuria | B. Oliguria | C. CK | D. Hyperkalemia | A. Myoglobinuria |
| A 60-year-old with postoperative wound dehiscence, bowel visible. Management? | A. Cover with saline gauze + surgery | B. Dress | C. Observe | D. Drain | A. Cover wound and urgent re-suturing |
| A 45-year-old post-op day 5, fever, erythema, pus discharge. Diagnosis? | A. Wound infection | B. Seroma | C. Hematoma | D. Dehiscence | A. Surgical site infection |
| A 70-year-old diabetic with foul-smelling necrotic wound, crepitus. Diagnosis? | A. Gas gangrene | B. Cellulitis | C. Abscess | D. Necrosis | A. Clostridial gas gangrene |
| A 50-year-old smoker with chronic nonhealing ulcer, rolled everted edges. Diagnosis? | A. SCC | B. BCC | C. Melanoma | D. Keratoacanthoma | A. Marjolin’s ulcer (SCC) |
| A 60-year-old farmer with pearly nodular lesion, central ulceration. Diagnosis? | A. Basal cell carcinoma | B. SCC | C. Melanoma | D. Keratoacanthoma | A. Basal cell carcinoma |
| A 55-year-old man with pigmented irregular lesion, changes in size and color. Diagnosis? | A. Melanoma | B. BCC | C. SCC | D. Seborrheic keratosis | A. Malignant melanoma |
| A 45-year-old man with head injury, brief loss of consciousness, lucid interval, then coma. Diagnosis? | A. Epidural hematoma | B. Subdural | C. SAH | D. Contusion | A. Epidural hematoma |
| A 60-year-old with gradual headache, confusion, after minor trauma. Diagnosis? | A. Chronic subdural hematoma | B. Epidural | C. SAH | D. Contusion | A. Chronic subdural hematoma |
| A 35-year-old with sudden severe headache, neck stiffness, photophobia. Diagnosis? | A. Subarachnoid hemorrhage | B. Meningitis | C. Migraine | D. ICH | A. Subarachnoid hemorrhage |
| A 50-year-old man with hypertension, sudden hemiplegia, coma. Diagnosis? | A. Intracerebral hemorrhage | B. SAH | C. Stroke infarct | D. Tumor | A. Hypertensive intracerebral hemorrhage |
| A 65-year-old with sudden right-sided weakness, aphasia, carotid bruit. Diagnosis? | A. Ischemic stroke | B. Hemorrhage | C. SAH | D. TIA | A. Ischemic stroke |
| A 70-year-old man with stroke, BP 160/90, glucose 110. Next step? | A. CT brain | B. MRI | C. Thrombolysis | D. Aspirin immediately | A. CT brain before thrombolysis |
| A 65-year-old with stroke, CT shows no bleed, within 2 hours. Management? | A. IV tPA | B. Aspirin | C. Heparin | D. Observe | A. Thrombolysis with IV tPA |
| A 70-year-old with stroke 8 hours ago. Management? | A. Aspirin | B. Thrombolysis | C. Surgery | D. Observe | A. Antiplatelet (aspirin) |
| A 60-year-old man with facial droop, drooling, forehead spared. Diagnosis? | A. Stroke | B. Bell’s palsy | C. Myasthenia | D. Guillain-Barré | A. Upper motor neuron facial palsy (stroke) |
| A 35-year-old woman with sudden facial weakness, cannot close eye, taste loss. Diagnosis? | A. Bell’s palsy | B. Stroke | C. Myasthenia | D. GBS | A. Lower motor neuron facial palsy (Bell’s) |
| A 25-year-old with ascending weakness after viral illness. Diagnosis? | A. Guillain-Barré syndrome | B. Myasthenia | C. Polio | D. Transverse myelitis | A. Guillain-Barré syndrome |
| A 30-year-old with double vision, fatigability, improves with rest. Diagnosis? | A. Myasthenia gravis | B. Lambert-Eaton | C. GBS | D. MS | A. Myasthenia gravis |
| A 28-year-old woman with diplopia, fatigue, thymic mass. Diagnosis? | A. Myasthenia gravis | B. MS | C. GBS | D. Thyroid eye disease | A. Myasthenia gravis with thymoma |
| A 40-year-old woman with optic neuritis, internuclear ophthalmoplegia, relapsing symptoms. Diagnosis? | A. Multiple sclerosis | B. GBS | C. MG | D. CVA | A. Multiple sclerosis |
| A 35-year-old man with tremor at rest, rigidity, bradykinesia. Diagnosis? | A. Parkinson disease | B. Huntington | C. Wilson | D. Essential tremor | A. Parkinson disease |
| A 40-year-old woman with intention tremor, worsens on action, improves with rest. Diagnosis? | A. Essential tremor | B. Parkinson | C. Wilson | D. Dystonia | A. Essential tremor |
| A 20-year-old man with tremor, rigidity, KF rings, low ceruloplasmin. Diagnosis? | A. Wilson disease | B. Parkinson | C. Hepatitis | D. ALS | A. Wilson’s disease |
| A 60-year-old with progressive memory loss, disorientation, apraxia. Diagnosis? | A. Alzheimer’s | B. Parkinson | C. Vascular dementia | D. Depression | A. Alzheimer’s disease |
| A 65-year-old hypertensive with stepwise memory decline. Diagnosis? | A. Vascular dementia | B. Alzheimer’s | C. Lewy body | D. Parkinson | A. Vascular dementia |
| A 70-year-old with visual hallucinations, fluctuating cognition, Parkinsonism. Diagnosis? | A. Lewy body dementia | B. Alzheimer’s | C. Vascular | D. Frontotemporal | A. Dementia with Lewy bodies |
| A 55-year-old with personality change, disinhibition, preserved memory. Diagnosis? | A. Frontotemporal dementia | B. Alzheimer’s | C. Vascular | D. Lewy | A. Frontotemporal dementia |
| A 40-year-old man with choreiform movements, family history. Diagnosis? | A. Huntington disease | B. Wilson | C. Parkinson | D. MS | A. Huntington’s chorea |
| A 60-year-old man with sudden vision loss, temple tenderness, high ESR. Diagnosis? | A. Temporal arteritis | B. Optic neuritis | C. Glaucoma | D. Migraine | A. Giant cell arteritis |
| A 35-year-old with severe unilateral periorbital headache, lacrimation, rhinorrhea. Diagnosis? | A. Cluster headache | B. Migraine | C. Tension | D. Sinusitis | A. Cluster headache |
| A 25-year-old woman with unilateral throbbing headache, photophobia, aura. Diagnosis? | A. Migraine | B. Cluster | C. Tension | D. SAH | A. Migraine |
| A 30-year-old woman with bilateral band-like headache, stress-related. Diagnosis? | A. Tension headache | B. Migraine | C. Cluster | D. Neuralgia | A. Tension-type headache |
| A 50-year-old with facial pain triggered by touch, lasts seconds. Diagnosis? | A. Trigeminal neuralgia | B. Cluster | C. Migraine | D. TMJ disorder | A. Trigeminal neuralgia |
| A 25-year-old with seizure, EEG 3-Hz spike-and-wave. Diagnosis? | A. Absence seizure | B. Tonic-clonic | C. Myoclonic | D. Focal | A. Absence seizure |
| A 20-year-old with generalized tonic-clonic seizure. First-line therapy? | A. Valproate | B. Phenytoin | C. Levetiracetam | D. Diazepam | A. Sodium valproate |
| A 30-year-old with focal seizure, temporal lobe aura. Drug of choice? | A. Carbamazepine | B. Valproate | C. Diazepam | D. Ethosuximide | A. Carbamazepine |
| A 28-year-old woman with absence seizure. Drug of choice? | A. Ethosuximide | B. Valproate | C. Carbamazepine | D. Phenytoin | A. Ethosuximide |
| A 35-year-old epileptic woman on valproate, pregnant. Risk? | A. Neural tube defect | B. Cleft palate | C. Cardiac defect | D. Hydrocephalus | A. Neural tube defects (spina bifida) |
| A 60-year-old hypertensive with right hemiparesis, expressive aphasia. Vessel? | A. Left MCA | B. Right MCA | C. ACA | D. PCA | A. Left middle cerebral artery infarct |
| A 55-year-old man with left leg weakness, urinary incontinence. Vessel? | A. ACA | B. MCA | C. PCA | D. Basilar | A. Anterior cerebral artery infarct |
| A 50-year-old with visual field defect, occipital lobe infarct. Vessel? | A. PCA | B. MCA | C. ACA | D. Basilar | A. Posterior cerebral artery infarct |
| A 65-year-old with vertigo, diplopia, ataxia, crossed signs. Diagnosis? | A. Brainstem stroke | B. MS | C. Vestibular neuritis | D. Migraine | A. Brainstem stroke |
| A 25-year-old man with trauma, flaccid paralysis below injury, absent reflexes. Diagnosis? | A. Spinal shock | B. Cord transection | C. GBS | D. Hemisection | A. Spinal shock |
| A 30-year-old with ipsilateral motor loss, contralateral pain loss. Diagnosis? | A. Brown-Sequard | B. Cord transection | C. Anterior syndrome | D. Central | A. Brown-Sequard syndrome |
| A 70-year-old man with postural tremor, cogwheel rigidity, shuffling gait. Diagnosis? | A. Parkinson disease | B. Wilson | C. Essential tremor | D. Huntington | A. Parkinson disease |
| A 45-year-old man with head injury, brief loss of consciousness, lucid interval, then coma. Diagnosis? | A. Epidural hematoma | B. Subdural | C. SAH | D. Contusion | A. Epidural hematoma |
| A 60-year-old with gradual headache, confusion, after minor trauma. Diagnosis? | A. Chronic subdural hematoma | B. Epidural | C. SAH | D. Contusion | A. Chronic subdural hematoma |
| A 35-year-old with sudden severe headache, neck stiffness, photophobia. Diagnosis? | A. Subarachnoid hemorrhage | B. Meningitis | C. Migraine | D. ICH | A. Subarachnoid hemorrhage |
| A 50-year-old man with hypertension, sudden hemiplegia, coma. Diagnosis? | A. Intracerebral hemorrhage | B. SAH | C. Stroke infarct | D. Tumor | A. Hypertensive intracerebral hemorrhage |
| A 65-year-old with sudden right-sided weakness, aphasia, carotid bruit. Diagnosis? | A. Ischemic stroke | B. Hemorrhage | C. SAH | D. TIA | A. Ischemic stroke |
| A 70-year-old man with stroke, BP 160/90, glucose 110. Next step? | A. CT brain | B. MRI | C. Thrombolysis | D. Aspirin immediately | A. CT brain before thrombolysis |
| A 65-year-old with stroke, CT shows no bleed, within 2 hours. Management? | A. IV tPA | B. Aspirin | C. Heparin | D. Observe | A. Thrombolysis with IV tPA |
| A 70-year-old with stroke 8 hours ago. Management? | A. Aspirin | B. Thrombolysis | C. Surgery | D. Observe | A. Antiplatelet (aspirin) |
| A 60-year-old man with facial droop, drooling, forehead spared. Diagnosis? | A. Stroke | B. Bell’s palsy | C. Myasthenia | D. Guillain-Barré | A. Upper motor neuron facial palsy (stroke) |
| A 35-year-old woman with sudden facial weakness, cannot close eye, taste loss. Diagnosis? | A. Bell’s palsy | B. Stroke | C. Myasthenia | D. GBS | A. Lower motor neuron facial palsy (Bell’s) |
| A 25-year-old with ascending weakness after viral illness. Diagnosis? | A. Guillain-Barré syndrome | B. Myasthenia | C. Polio | D. Transverse myelitis | A. Guillain-Barré syndrome |
| A 30-year-old with double vision, fatigability, improves with rest. Diagnosis? | A. Myasthenia gravis | B. Lambert-Eaton | C. GBS | D. MS | A. Myasthenia gravis |
| A 28-year-old woman with diplopia, fatigue, thymic mass. Diagnosis? | A. Myasthenia gravis | B. MS | C. GBS | D. Thyroid eye disease | A. Myasthenia gravis with thymoma |
| A 40-year-old woman with optic neuritis, internuclear ophthalmoplegia, relapsing symptoms. Diagnosis? | A. Multiple sclerosis | B. GBS | C. MG | D. CVA | A. Multiple sclerosis |
| A 35-year-old man with tremor at rest, rigidity, bradykinesia. Diagnosis? | A. Parkinson disease | B. Huntington | C. Wilson | D. Essential tremor | A. Parkinson disease |
| A 40-year-old woman with intention tremor, worsens on action, improves with rest. Diagnosis? | A. Essential tremor | B. Parkinson | C. Wilson | D. Dystonia | A. Essential tremor |
| A 20-year-old man with tremor, rigidity, KF rings, low ceruloplasmin. Diagnosis? | A. Wilson disease | B. Parkinson | C. Hepatitis | D. ALS | A. Wilson’s disease |
| A 60-year-old with progressive memory loss, disorientation, apraxia. Diagnosis? | A. Alzheimer’s | B. Parkinson | C. Vascular dementia | D. Depression | A. Alzheimer’s disease |
| A 65-year-old hypertensive with stepwise memory decline. Diagnosis? | A. Vascular dementia | B. Alzheimer’s | C. Lewy body | D. Parkinson | A. Vascular dementia |
| A 70-year-old with visual hallucinations, fluctuating cognition, Parkinsonism. Diagnosis? | A. Lewy body dementia | B. Alzheimer’s | C. Vascular | D. Frontotemporal | A. Dementia with Lewy bodies |
| A 55-year-old with personality change, disinhibition, preserved memory. Diagnosis? | A. Frontotemporal dementia | B. Alzheimer’s | C. Vascular | D. Lewy | A. Frontotemporal dementia |
| A 40-year-old man with choreiform movements, family history. Diagnosis? | A. Huntington disease | B. Wilson | C. Parkinson | D. MS | A. Huntington’s chorea |
| A 60-year-old man with sudden vision loss, temple tenderness, high ESR. Diagnosis? | A. Temporal arteritis | B. Optic neuritis | C. Glaucoma | D. Migraine | A. Giant cell arteritis |
| A 35-year-old with severe unilateral periorbital headache, lacrimation, rhinorrhea. Diagnosis? | A. Cluster headache | B. Migraine | C. Tension | D. Sinusitis | A. Cluster headache |
| A 25-year-old woman with unilateral throbbing headache, photophobia, aura. Diagnosis? | A. Migraine | B. Cluster | C. Tension | D. SAH | A. Migraine |
| A 30-year-old woman with bilateral band-like headache, stress-related. Diagnosis? | A. Tension headache | B. Migraine | C. Cluster | D. Neuralgia | A. Tension-type headache |
| A 50-year-old with facial pain triggered by touch, lasts seconds. Diagnosis? | A. Trigeminal neuralgia | B. Cluster | C. Migraine | D. TMJ disorder | A. Trigeminal neuralgia |
| A 25-year-old with seizure, EEG 3-Hz spike-and-wave. Diagnosis? | A. Absence seizure | B. Tonic-clonic | C. Myoclonic | D. Focal | A. Absence seizure |
| A 20-year-old with generalized tonic-clonic seizure. First-line therapy? | A. Valproate | B. Phenytoin | C. Levetiracetam | D. Diazepam | A. Sodium valproate |
| A 30-year-old with focal seizure, temporal lobe aura. Drug of choice? | A. Carbamazepine | B. Valproate | C. Diazepam | D. Ethosuximide | A. Carbamazepine |
| A 28-year-old woman with absence seizure. Drug of choice? | A. Ethosuximide | B. Valproate | C. Carbamazepine | D. Phenytoin | A. Ethosuximide |
| A 35-year-old epileptic woman on valproate, pregnant. Risk? | A. Neural tube defect | B. Cleft palate | C. Cardiac defect | D. Hydrocephalus | A. Neural tube defects (spina bifida) |
| A 60-year-old hypertensive with right hemiparesis, expressive aphasia. Vessel? | A. Left MCA | B. Right MCA | C. ACA | D. PCA | A. Left middle cerebral artery infarct |
| A 55-year-old man with left leg weakness, urinary incontinence. Vessel? | A. ACA | B. MCA | C. PCA | D. Basilar | A. Anterior cerebral artery infarct |
| A 50-year-old with visual field defect, occipital lobe infarct. Vessel? | A. PCA | B. MCA | C. ACA | D. Basilar | A. Posterior cerebral artery infarct |
| A 65-year-old with vertigo, diplopia, ataxia, crossed signs. Diagnosis? | A. Brainstem stroke | B. MS | C. Vestibular neuritis | D. Migraine | A. Brainstem stroke |
| A 25-year-old man with trauma, flaccid paralysis below injury, absent reflexes. Diagnosis? | A. Spinal shock | B. Cord transection | C. GBS | D. Hemisection | A. Spinal shock |
| A 30-year-old with ipsilateral motor loss, contralateral pain loss. Diagnosis? | A. Brown-Sequard | B. Cord transection | C. Anterior syndrome | D. Central | A. Brown-Sequard syndrome |
| A 70-year-old man with postural tremor, cogwheel rigidity, shuffling gait. Diagnosis? | A. Parkinson disease | B. Wilson | C. Essential tremor | D. Huntington | A. Parkinson disease |
| A 55-year-old man with weakness of all four limbs, UMN signs, no sensory loss. Diagnosis? | A. ALS | B. MS | C. GBS | D. Myasthenia | A. Amyotrophic lateral sclerosis |
| A 35-year-old woman with optic neuritis, paresthesia, relapsing course. Diagnosis? | A. Multiple sclerosis | B. Myasthenia | C. GBS | D. SLE | A. Multiple sclerosis |
| A 40-year-old man with proximal weakness, small-cell lung cancer. Diagnosis? | A. Lambert-Eaton syndrome | B. Myasthenia | C. GBS | D. ALS | A. Lambert–Eaton myasthenic syndrome |
| A 70-year-old man with resting tremor, rigidity, shuffling gait. Diagnosis? | A. Parkinson disease | B. Essential tremor | C. Huntington | D. Wilson | A. Parkinson disease |
| A 30-year-old woman with hand tremor when holding a cup, relieved by alcohol. Diagnosis? | A. Essential tremor | B. Parkinson | C. Wilson | D. Dystonia | A. Essential tremor |
| A 20-year-old man with chorea, KF rings, psychiatric changes. Diagnosis? | A. Wilson disease | B. Huntington | C. Parkinson | D. Sydenham | A. Wilson disease |
| A 45-year-old woman with pain and stiffness in shoulder, ESR high. Diagnosis? | A. Polymyalgia rheumatica | B. RA | C. Osteoarthritis | D. SLE | A. Polymyalgia rheumatica |
| A 70-year-old woman with headache, jaw claudication, tender temporal artery. Diagnosis? | A. Temporal arteritis | B. Polymyalgia | C. Migraine | D. RA | A. Giant cell arteritis |
| A 30-year-old man with fatigue, pallor, glossitis, neurologic signs. Diagnosis? | A. B12 deficiency | B. Folate | C. Iron | D. Thalassemia | A. Vitamin B12 deficiency anemia |
| A 40-year-old vegetarian with macrocytosis, hypersegmented neutrophils. Diagnosis? | A. Megaloblastic anemia | B. Iron deficiency | C. Sideroblastic | D. Hemolytic | A. Megaloblastic anemia (B12/Folate) |
| A 60-year-old man with pallor, koilonychia, microcytosis. Diagnosis? | A. Iron deficiency anemia | B. Thalassemia | C. Anemia of chronic disease | D. Sideroblastic | A. Iron deficiency anemia |
| A 25-year-old woman with menorrhagia, low Hb, low MCV, high TIBC. Diagnosis? | A. Iron deficiency anemia | B. Thalassemia | C. Chronic disease | D. Hemolytic | A. Iron deficiency anemia |
| A 30-year-old man with microcytosis, target cells, normal iron. Diagnosis? | A. Thalassemia | B. Iron deficiency | C. Sideroblastic | D. Chronic disease | A. Thalassemia trait |
| A 50-year-old with fatigue, weight loss, splenomegaly, basophilia, t(9;22). Diagnosis? | A. CML | B. AML | C. CLL | D. Polycythemia vera | A. Chronic myeloid leukemia |
| A 70-year-old man with lymphocytosis, smudge cells, generalized lymphadenopathy. Diagnosis? | A. CLL | B. CML | C. AML | D. NHL | A. Chronic lymphocytic leukemia |
| A 40-year-old man with blasts, Auer rods, DIC. Diagnosis? | A. AML | B. ALL | C. CML | D. CLL | A. Acute myeloid leukemia (M3 variant) |
| A 5-year-old child with lymphoblasts, bone pain, hepatosplenomegaly. Diagnosis? | A. ALL | B. AML | C. CML | D. Lymphoma | A. Acute lymphoblastic leukemia |
| A 30-year-old man with painless lymphadenopathy, Reed–Sternberg cells. Diagnosis? | A. Hodgkin lymphoma | B. NHL | C. Leukemia | D. TB | A. Hodgkin lymphoma |
| A 50-year-old man with painless lymphadenopathy, B symptoms, multiple nodes. Diagnosis? | A. Non-Hodgkin lymphoma | B. Hodgkin | C. CLL | D. TB | A. Non-Hodgkin lymphoma |
| A 60-year-old man with bone pain, anemia, renal failure, lytic lesions. Diagnosis? | A. Multiple myeloma | B. Lymphoma | C. Osteoporosis | D. Paget | A. Multiple myeloma |
| A 55-year-old man with recurrent infections, M spike on electrophoresis. Diagnosis? | A. Multiple myeloma | B. MGUS | C. Waldenström | D. Lymphoma | A. Multiple myeloma |
| A 65-year-old man with hyperviscosity, IgM monoclonal spike. Diagnosis? | A. Waldenström macroglobulinemia | B. MM | C. MGUS | D. Lymphoma | A. Waldenström macroglobulinemia |
| A 40-year-old man with easy bruising, petechiae, low platelets, normal PT/PTT. Diagnosis? | A. ITP | B. DIC | C. TTP | D. Hemophilia | A. Immune thrombocytopenic purpura |
| A 35-year-old woman with fever, anemia, thrombocytopenia, renal failure, neuro signs. Diagnosis? | A. TTP | B. HUS | C. DIC | D. ITP | A. Thrombotic thrombocytopenic purpura |
| A 5-year-old child post-diarrhea with anemia, thrombocytopenia, renal failure. Diagnosis? | A. HUS | B. TTP | C. DIC | D. ITP | A. Hemolytic uremic syndrome |
| A 55-year-old with sepsis, bleeding, low platelets, high PT/aPTT. Diagnosis? | A. DIC | B. ITP | C. TTP | D. HUS | A. Disseminated intravascular coagulation |
| A 60-year-old man with splenomegaly, high Hb, low EPO, pruritus after hot bath. Diagnosis? | A. Polycythemia vera | B. Secondary polycythemia | C. CML | D. PV deficiency | A. Polycythemia vera |
| A 50-year-old man with fatigue, pruritus, high eosinophils, high ALP. Diagnosis? | A. Myeloproliferative disorder | B. Lymphoma | C. CML | D. Allergic reaction | A. Chronic myeloproliferative disease |
| A 30-year-old woman with migratory thrombophlebitis and pancreatic cancer. Diagnosis? | A. Trousseau syndrome | B. DVT | C. Factor V Leiden | D. DIC | A. Trousseau’s migratory thrombophlebitis |
| A 45-year-old man with recurrent DVT, normal PT/PTT. Cause? | A. Factor V Leiden | B. Protein C deficiency | C. Antithrombin deficiency | D. All | D. All of the above thrombophilias |
| A 60-year-old man with anemia, high ferritin, low TIBC, chronic disease. Diagnosis? | A. Anemia of chronic disease | B. Iron deficiency | C. Thalassemia | D. Sideroblastic | A. Anemia of chronic disease |
| A 55-year-old with bone pain, punched-out skull lesions. Diagnosis? | A. Multiple myeloma | B. Metastasis | C. Osteosarcoma | D. Paget | A. Multiple myeloma |
| A 50-year-old woman with hypercalcemia, low phosphate, high PTH. Diagnosis? | A. Primary hyperparathyroidism | B. Secondary | C. Tertiary | D. Malignancy | A. Primary hyperparathyroidism |
| A 60-year-old man with hypercalcemia, low PTH. Cause? | A. Malignancy | B. Primary HPT | C. Tertiary | D. Vit D | A. Malignancy-associated hypercalcemia |
| A 40-year-old woman with fatigue, low calcium, high phosphate, low PTH. Diagnosis? | A. Hypoparathyroidism | B. Vitamin D deficiency | C. CKD | D. Pseudohypoparathyroidism | A. Hypoparathyroidism |
| A 45-year-old man with hypertension, low potassium, high aldosterone. Diagnosis? | A. Conn | B. Addison | C. Cushing | D. Pheochromocytoma | A. Conn syndrome |
| A 50-year-old man with paroxysmal hypertension, palpitations, headache. Diagnosis? | A. Pheochromocytoma | B. Cushing | C. Conn | D. Addison | A. Pheochromocytoma |
| A 35-year-old woman with generalized hyperpigmentation, hypotension, low cortisol. Diagnosis? | A. Addison | B. Cushing | C. Conn | D. SIADH | A. Addison’s disease |
| A 30-year-old man with obesity, striae, moon face, truncal fat. Diagnosis? | A. Cushing | B. Addison | C. Hypothyroidism | D. Conn | A. Cushing syndrome |
| A 40-year-old man with hypertension, truncal obesity, buffalo hump. Diagnosis? | A. Cushing | B. Conn | C. Addison | D. Pheochromocytoma | A. Cushing syndrome |
| A 50-year-old man with polyuria, low urine osmolality, high Na+. Diagnosis? | A. Diabetes insipidus | B. SIADH | C. DM | D. Addison | A. Diabetes insipidus |
| A 45-year-old woman with hyponatremia, low serum osmolality, concentrated urine. Diagnosis? | A. SIADH | B. DI | C. Addison | D. Hypothyroidism | A. Syndrome of inappropriate ADH secretion |
| A 55-year-old man with chest pain relieved by rest, normal ECG. Diagnosis? | A. Stable angina | B. Unstable angina | C. NSTEMI | D. STEMI | A. Stable angina |
| A 58-year-old man with chest pain at rest, ST depression, normal troponin. Diagnosis? | A. Unstable angina | B. NSTEMI | C. STEMI | D. Prinzmetal | A. Unstable angina |
| A 60-year-old man with ST elevation in anterior leads, chest pain 2 hours. Management? | A. Thrombolysis | B. Aspirin | C. PCI | D. All | D. All (PCI preferred if <12h) |
| A 65-year-old with inferior MI, hypotension, clear lungs. Diagnosis? | A. RV infarction | B. LV failure | C. Tamponade | D. Shock | A. Right ventricular infarction |
| A 50-year-old post-MI, harsh systolic murmur at apex radiating to axilla. Diagnosis? | A. MR | B. TR | C. VSD | D. AS | A. Papillary muscle rupture → Mitral regurgitation |
| A 60-year-old man with chest pain, pericardial rub, diffuse ST elevation. Diagnosis? | A. Pericarditis | B. MI | C. PE | D. Angina | A. Acute pericarditis |
| A 55-year-old man with BP 180/120, papilledema. Diagnosis? | A. Hypertensive emergency | B. Urgency | C. Crisis | D. Normal | A. Hypertensive emergency |
| A 60-year-old man with tearing chest pain radiating to back, unequal pulses. Diagnosis? | A. Aortic dissection | B. MI | C. PE | D. Tamponade | A. Aortic dissection |
| A 65-year-old man with chronic cough, sputum 3 months/year for 2 years. Diagnosis? | A. Chronic bronchitis | B. Emphysema | C. Asthma | D. TB | A. Chronic bronchitis |
| A 50-year-old smoker with progressive dyspnea, barrel chest, decreased breath sounds. Diagnosis? | A. Emphysema | B. COPD | C. Asthma | D. Bronchiectasis | A. Emphysema |
| A 45-year-old with episodic wheezing, cough, reversible obstruction. Diagnosis? | A. Asthma | B. COPD | C. Bronchiectasis | D. PE | A. Asthma |
| A 35-year-old woman with nonproductive cough, bilateral hilar lymphadenopathy. Diagnosis? | A. Sarcoidosis | B. TB | C. Lymphoma | D. COPD | A. Sarcoidosis |
| A 40-year-old man with hematuria, hemoptysis, anti-GBM antibody. Diagnosis? | A. Goodpasture | B. Wegener | C. PAN | D. SLE | A. Goodpasture syndrome |
| A 50-year-old with nasal ulcers, sinusitis, renal failure, c-ANCA positive. Diagnosis? | A. Wegener granulomatosis | B. PAN | C. Churg-Strauss | D. TB | A. Granulomatosis with polyangiitis |
| A 45-year-old asthmatic with eosinophilia and vasculitis. Diagnosis? | A. Churg-Strauss | B. PAN | C. Wegener | D. Goodpasture | A. Eosinophilic granulomatosis (Churg-Strauss) |
| A 60-year-old man with chronic cough, foul sputum, clubbing. Diagnosis? | A. Bronchiectasis | B. COPD | C. Asthma | D. TB | A. Bronchiectasis |
| A 50-year-old man with acute dyspnea, tachycardia, pleuritic pain, D-dimer high. Diagnosis? | A. PE | B. Pneumonia | C. MI | D. COPD | A. Pulmonary embolism |
| A 65-year-old with sudden dyspnea after long flight, clear lungs. Diagnosis? | A. PE | B. Pneumothorax | C. MI | D. Asthma | A. Pulmonary embolism |
| A 70-year-old man with orthopnea, basal crackles, S3 gallop. Diagnosis? | A. Left heart failure | B. Right HF | C. COPD | D. PE | A. Left-sided heart failure |
| A 60-year-old man with peripheral edema, hepatomegaly, JVP raised. Diagnosis? | A. Right heart failure | B. Left HF | C. Tamponade | D. Cirrhosis | A. Right-sided heart failure |
| A 65-year-old man with syncope, angina, ejection murmur radiating to carotids. Diagnosis? | A. Aortic stenosis | B. MR | C. AS | D. TR | A. Aortic stenosis |
| A 55-year-old with early diastolic murmur, wide pulse pressure, head bobbing. Diagnosis? | A. Aortic regurgitation | B. MS | C. MR | D. TR | A. Aortic regurgitation |
| A 45-year-old with diastolic murmur at apex, opening snap. Diagnosis? | A. Mitral stenosis | B. Aortic regurgitation | C. MR | D. TR | A. Mitral stenosis |
| A 60-year-old with pansystolic murmur radiating to axilla. Diagnosis? | A. MR | B. TR | C. VSD | D. AS | A. Mitral regurgitation |
| A 50-year-old with pansystolic murmur increasing on inspiration. Diagnosis? | A. Tricuspid regurgitation | B. MR | C. VSD | D. AS | A. Tricuspid regurgitation |
| A 30-year-old with fixed split S2, pulmonary flow murmur. Diagnosis? | A. ASD | B. VSD | C. PDA | D. TOF | A. Atrial septal defect |
| A 5-year-old with harsh pansystolic murmur at LLSB. Diagnosis? | A. VSD | B. ASD | C. PDA | D. TOF | A. Ventricular septal defect |
| A 10-year-old with continuous machinery murmur. Diagnosis? | A. PDA | B. ASD | C. VSD | D. TOF | A. Patent ductus arteriosus |
| A 3-year-old with cyanosis, clubbing, squatting episodes. Diagnosis? | A. Tetralogy of Fallot | B. TGA | C. VSD | D. PDA | A. Tetralogy of Fallot |
| A 60-year-old hypertensive with flash pulmonary edema. Drug? | A. Furosemide | B. ACE inhibitor | C. Beta-blocker | D. CCB | A. IV furosemide |
| A 55-year-old with systolic heart failure. Drug improving survival? | A. ACE inhibitor | B. Beta-blocker | C. Spironolactone | D. All | D. All of the above |
| A 60-year-old man with AF, irregularly irregular pulse. Initial management? | A. Rate control + anticoagulate | B. Shock | C. Rhythm convert | D. Observe | A. Rate control with beta-blocker and anticoagulation |
| A 65-year-old with AF, INR 1.5, on warfarin. Target INR? | A. 2–3 | B. 1–2 | C. 3–4 | D. <1 | A. 2–3 |
| A 55-year-old with paroxysmal SVT. Acute management? | A. Vagal + adenosine | B. Amiodarone | C. Beta-blocker | D. DC shock | A. Vagal maneuvers + IV adenosine |
| A 60-year-old man with wide complex tachycardia, stable BP. Management? | A. Amiodarone | B. Adenosine | C. Shock | D. Beta-blocker | A. IV amiodarone |
| A 70-year-old with VT, pulse absent. Next step? | A. Defibrillation | B. CPR | C. Amiodarone | D. Lidocaine | A. Immediate defibrillation |
| A 65-year-old man with sudden chest pain, tachypnea, ECG shows S1Q3T3. Diagnosis? | A. Pulmonary embolism | B. MI | C. Pneumothorax | D. Aortic dissection | A. Acute pulmonary embolism |
| A 55-year-old man with chronic productive cough, cyanosis, overweight. Diagnosis? | A. Chronic bronchitis | B. Emphysema | C. Asthma | D. Bronchiectasis | A. Blue bloater – chronic bronchitis |
| A 65-year-old with thin build, dyspnea, minimal cough, hyperinflated lungs. Diagnosis? | A. Emphysema | B. Bronchitis | C. Asthma | D. TB | A. Pink puffer – emphysema |
| A 30-year-old woman with dry cough, erythema nodosum, hilar lymphadenopathy. Diagnosis? | A. Sarcoidosis | B. TB | C. Lymphoma | D. COPD | A. Sarcoidosis |
| A 50-year-old with cough, weight loss, hemoptysis, apical infiltrate. Diagnosis? | A. Pulmonary TB | B. Lung cancer | C. Bronchiectasis | D. Pneumonia | A. Pulmonary tuberculosis |
| A 40-year-old man with chronic cough, sputum, clubbing, coarse crepitations. Diagnosis? | A. Bronchiectasis | B. COPD | C. TB | D. Pneumonia | A. Bronchiectasis |
| A 25-year-old with pleuritic chest pain, tall thin male, sudden dyspnea. Diagnosis? | A. Spontaneous pneumothorax | B. PE | C. Asthma | D. Pneumonia | A. Primary spontaneous pneumothorax |
| A 60-year-old with dullness, decreased breath sounds, stony percussion. Diagnosis? | A. Pleural effusion | B. Pneumothorax | C. Consolidation | D. Collapse | A. Pleural effusion |
| A 65-year-old man with bronchial carcinoma, pleural effusion. Fluid type? | A. Exudate | B. Transudate | C. Chylous | D. Empyema | A. Exudative pleural effusion |
| A 50-year-old woman with frothy sputum, orthopnea, basal crepitations. Diagnosis? | A. Pulmonary edema | B. Pneumonia | C. COPD | D. Asthma | A. Pulmonary edema (heart failure) |
| A 60-year-old with basal crackles, JVP raised, ankle edema. Diagnosis? | A. Congestive heart failure | B. COPD | C. Cirrhosis | D. PE | A. Congestive heart failure |
| A 65-year-old man with sudden dyspnea, hypotension, muffled heart sounds. Diagnosis? | A. Cardiac tamponade | B. PE | C. Pneumothorax | D. MI | A. Cardiac tamponade |
| A 70-year-old with orthopnea, S3, bilateral basal crepitations. Diagnosis? | A. LV failure | B. RV failure | C. COPD | D. PE | A. Left ventricular failure |
| A 60-year-old man with ankle edema, ascites, raised JVP. Diagnosis? | A. RV failure | B. LV failure | C. Cirrhosis | D. Nephrotic | A. Right-sided heart failure |
| A 45-year-old woman with systolic murmur, radiating to axilla. Diagnosis? | A. Mitral regurgitation | B. Aortic stenosis | C. MR | D. TR | A. Mitral regurgitation |
| A 50-year-old man with diastolic murmur, opening snap. Diagnosis? | A. Mitral stenosis | B. Aortic regurgitation | C. TR | D. MR | A. Mitral stenosis |
| A 55-year-old with ejection systolic murmur radiating to carotids. Diagnosis? | A. Aortic stenosis | B. MR | C. TR | D. ASD | A. Aortic stenosis |
| A 60-year-old man with early diastolic murmur, collapsing pulse. Diagnosis? | A. Aortic regurgitation | B. MS | C. MR | D. TR | A. Aortic regurgitation |
| A 50-year-old man with pansystolic murmur increasing with inspiration. Diagnosis? | A. Tricuspid regurgitation | B. MR | C. VSD | D. ASD | A. Tricuspid regurgitation |
| A 30-year-old woman with fixed split S2, pulmonary murmur. Diagnosis? | A. ASD | B. VSD | C. PDA | D. TOF | A. Atrial septal defect |
| A 5-year-old with harsh pansystolic murmur, LLSB. Diagnosis? | A. VSD | B. ASD | C. PDA | D. TOF | A. Ventricular septal defect |
| A 10-year-old with continuous machinery murmur. Diagnosis? | A. PDA | B. ASD | C. VSD | D. TOF | A. Patent ductus arteriosus |
| A 3-year-old cyanotic child, squatting relieves dyspnea. Diagnosis? | A. TOF | B. TGA | C. VSD | D. PDA | A. Tetralogy of Fallot |
| A 65-year-old hypertensive with renal bruit. Cause? | A. Renal artery stenosis | B. PCKD | C. Nephrotic | D. CKD | A. Renal artery stenosis |
| A 60-year-old with flank mass, hematuria, polycythemia. Diagnosis? | A. RCC | B. PKD | C. Pyelonephritis | D. Stone | A. Renal cell carcinoma |
| A 55-year-old diabetic with high creatinine, proteinuria. Diagnosis? | A. Diabetic nephropathy | B. Nephritic | C. FSGS | D. Amyloidosis | A. Diabetic nephropathy |
| A 40-year-old woman with butterfly rash, oral ulcers, arthritis, proteinuria. Diagnosis? | A. SLE | B. RA | C. Dermatomyositis | D. PAN | A. Systemic lupus erythematosus |
| A 35-year-old woman with dry mouth, dry eyes. Diagnosis? | A. Sjögren syndrome | B. SLE | C. RA | D. CREST | A. Sjögren syndrome |
| A 25-year-old man with back pain, morning stiffness, improved with exercise. Diagnosis? | A. Ankylosing spondylitis | B. RA | C. OA | D. Gout | A. Ankylosing spondylitis |
| A 40-year-old man with acute big toe pain, needle-shaped crystals. Diagnosis? | A. Gout | B. Pseudogout | C. OA | D. RA | A. Gout (monosodium urate) |
| A 60-year-old woman with knee pain, rhomboid crystals, positive birefringence. Diagnosis? | A. Pseudogout | B. Gout | C. RA | D. OA | A. Pseudogout (CPPD) |
| A 50-year-old with proximal weakness, heliotrope rash, Gottron papules. Diagnosis? | A. Dermatomyositis | B. Polymyositis | C. SLE | D. RA | A. Dermatomyositis |
| A 45-year-old with proximal weakness, no rash, high CK. Diagnosis? | A. Polymyositis | B. Dermatomyositis | C. RA | D. Myasthenia | A. Polymyositis |
| A 55-year-old woman with Raynaud’s, sclerodactyly, telangiectasia. Diagnosis? | A. Systemic sclerosis | B. Dermatomyositis | C. SLE | D. RA | A. Limited scleroderma (CREST) |
| A 45-year-old man with cough, hemoptysis, anti-GBM antibodies. Diagnosis? | A. Goodpasture | B. Wegener | C. PAN | D. SLE | A. Goodpasture syndrome |
| A 40-year-old man with chronic cough, weight loss, apical cavity. Diagnosis? | A. TB | B. Cancer | C. Bronchiectasis | D. Sarcoidosis | A. Pulmonary tuberculosis |
| A 55-year-old with fever, productive cough, rusty sputum. Diagnosis? | A. Pneumococcal pneumonia | B. Klebsiella | C. TB | D. Legionella | A. Streptococcus pneumoniae infection |
| A 45-year-old alcoholic with upper lobe cavitating pneumonia. Diagnosis? | A. Klebsiella | B. Staph | C. Pseudomonas | D. TB | A. Klebsiella pneumonia |
| A 50-year-old man with fever, hyponatremia, pneumonia. Organism? | A. Legionella | B. Strep | C. Klebsiella | D. Mycoplasma | A. Legionella pneumophila |
| A 30-year-old man with cough, myalgia, patchy infiltrate, cold agglutinins. Organism? | A. Mycoplasma | B. Chlamydia | C. Legionella | D. Pneumococcus | A. Mycoplasma pneumoniae |
| A 40-year-old with recurrent sinusitis, hematuria, c-ANCA positive. Diagnosis? | A. Wegener | B. PAN | C. Goodpasture | D. SLE | A. Granulomatosis with polyangiitis (Wegener) |
| A 35-year-old woman with pleuritic chest pain, pericardial rub, diffuse ST elevation. Diagnosis? | A. Pericarditis | B. MI | C. PE | D. Angina | A. Acute pericarditis |
| A 60-year-old with ejection systolic murmur radiating to carotid. Diagnosis? | A. Aortic stenosis | B. MR | C. TR | D. ASD | A. Aortic stenosis |
| A 45-year-old woman with early diastolic murmur, collapsing pulse. Diagnosis? | A. Aortic regurgitation | B. MS | C. MR | D. TR | A. Aortic regurgitation |
| A 30-year-old woman with diastolic murmur, opening snap. Diagnosis? | A. Mitral stenosis | B. Aortic regurgitation | C. MR | D. TR | A. Mitral stenosis |
| A 60-year-old man with pansystolic murmur radiating to axilla. Diagnosis? | A. MR | B. TR | C. VSD | D. AS | A. Mitral regurgitation |
| A 40-year-old with pansystolic murmur increasing on inspiration. Diagnosis? | A. TR | B. MR | C. VSD | D. ASD | A. Tricuspid regurgitation |
| A 60-year-old man with chest pain, fever, pericardial rub, diffuse ST elevation. Diagnosis? | A. Pericarditis | B. MI | C. PE | D. Angina | A. Acute pericarditis |
| A 55-year-old man with chest pain, ST elevation, hypotension, clear lungs. Diagnosis? | A. RV infarction | B. LV failure | C. PE | D. Tamponade | A. Right ventricular infarction |
| A 65-year-old with tearing chest pain radiating to back, unequal BP in arms. Diagnosis? | A. Aortic dissection | B. MI | C. PE | D. Tamponade | A. Aortic dissection |
| A 70-year-old man with chronic cough, sputum, cyanosis. Diagnosis? | A. Chronic bronchitis | B. Emphysema | C. Asthma | D. TB | A. Chronic bronchitis |
| A 50-year-old man with barrel chest, dyspnea, pursed-lip breathing. Diagnosis? | A. Emphysema | B. COPD | C. Bronchiectasis | D. Asthma | A. Emphysema |
| A 30-year-old woman with nonproductive cough, bilateral hilar lymphadenopathy. Diagnosis? | A. Sarcoidosis | B. TB | C. Lymphoma | D. COPD | A. Sarcoidosis |
| A 40-year-old man with hemoptysis, weight loss, cavitary lesion upper lobe. Diagnosis? | A. TB | B. Cancer | C. Bronchiectasis | D. Pneumonia | A. Pulmonary tuberculosis |
| A 50-year-old with fever, rusty sputum, lobar consolidation. Diagnosis? | A. Pneumococcal pneumonia | B. Klebsiella | C. TB | D. Legionella | A. Streptococcus pneumoniae |
| A 45-year-old alcoholic with upper lobe pneumonia, currant jelly sputum. Diagnosis? | A. Klebsiella | B. Staph | C. TB | D. Pneumococcus | A. Klebsiella pneumoniae |
| A 60-year-old with fever, diarrhea, hyponatremia, pneumonia. Organism? | A. Legionella | B. Pneumococcus | C. Mycoplasma | D. Klebsiella | A. Legionella pneumophila |
| A 25-year-old with dry cough, patchy infiltrates, cold agglutinins positive. Diagnosis? | A. Mycoplasma pneumonia | B. Chlamydia | C. Legionella | D. TB | A. Mycoplasma pneumoniae |
| A 50-year-old with recurrent hematuria, hemoptysis, c-ANCA positive. Diagnosis? | A. Wegener | B. Goodpasture | C. PAN | D. SLE | A. Granulomatosis with polyangiitis (Wegener) |
| A 45-year-old man with asthma, eosinophilia, neuropathy. Diagnosis? | A. Churg–Strauss | B. Wegener | C. PAN | D. Goodpasture | A. Eosinophilic granulomatosis (Churg–Strauss) |
| A 60-year-old man with peripheral edema, JVP raised, hepatomegaly. Diagnosis? | A. Right heart failure | B. Left heart failure | C. Cirrhosis | D. PE | A. Right-sided heart failure |
| A 65-year-old with orthopnea, S3 gallop, basal crackles. Diagnosis? | A. Left heart failure | B. Right heart failure | C. COPD | D. PE | A. Left-sided heart failure |
| A 70-year-old with severe dyspnea, frothy sputum, crackles. Diagnosis? | A. Pulmonary edema | B. COPD | C. Pneumonia | D. PE | A. Pulmonary edema |
| A 60-year-old with fixed split S2, pulmonary murmur. Diagnosis? | A. ASD | B. VSD | C. PDA | D. TOF | A. Atrial septal defect |
| A 50-year-old with continuous machinery murmur. Diagnosis? | A. PDA | B. ASD | C. VSD | D. TOF | A. Patent ductus arteriosus |
| A 5-year-old child with cyanosis, clubbing, squatting episodes. Diagnosis? | A. Tetralogy of Fallot | B. TGA | C. VSD | D. PDA | A. Tetralogy of Fallot |
| A 45-year-old with syncope, angina, ejection murmur radiating to carotid. Diagnosis? | A. Aortic stenosis | B. MR | C. MS | D. TR | A. Aortic stenosis |
| A 60-year-old man with early diastolic murmur, wide pulse pressure. Diagnosis? | A. Aortic regurgitation | B. MS | C. MR | D. TR | A. Aortic regurgitation |
| A 40-year-old woman with diastolic murmur at apex, opening snap. Diagnosis? | A. Mitral stenosis | B. MR | C. AR | D. TR | A. Mitral stenosis |
| A 55-year-old with pansystolic murmur radiating to axilla. Diagnosis? | A. MR | B. TR | C. VSD | D. AS | A. Mitral regurgitation |
| A 50-year-old man with pansystolic murmur increasing with inspiration. Diagnosis? | A. TR | B. MR | C. VSD | D. ASD | A. Tricuspid regurgitation |
| A 60-year-old with fatigue, pallor, glossitis, neuropathy. Diagnosis? | A. B12 deficiency | B. Folate deficiency | C. Iron deficiency | D. Sideroblastic | A. Vitamin B12 deficiency |
| A 35-year-old vegetarian with macrocytosis, hypersegmented neutrophils. Diagnosis? | A. Megaloblastic anemia | B. Iron deficiency | C. Thalassemia | D. Chronic disease | A. Megaloblastic anemia |
| A 45-year-old woman with menorrhagia, low Hb, microcytosis, high TIBC. Diagnosis? | A. Iron deficiency anemia | B. Thalassemia | C. Chronic disease | D. Hemolytic | A. Iron deficiency anemia |
| A 55-year-old man with weight loss, splenomegaly, basophilia, t(9;22). Diagnosis? | A. CML | B. AML | C. CLL | D. PV | A. Chronic myeloid leukemia |
| A 70-year-old man with lymphocytosis, smudge cells. Diagnosis? | A. CLL | B. CML | C. AML | D. ALL | A. Chronic lymphocytic leukemia |
| A 50-year-old man with anemia, bone pain, lytic lesions, M spike. Diagnosis? | A. Multiple myeloma | B. Lymphoma | C. Metastasis | D. Leukemia | A. Multiple myeloma |
| A 60-year-old man with hyperviscosity, IgM spike. Diagnosis? | A. Waldenström macroglobulinemia | B. MM | C. MGUS | D. Lymphoma | A. Waldenström macroglobulinemia |
| A 40-year-old man with fever, anemia, thrombocytopenia, renal failure, neuro signs. Diagnosis? | A. TTP | B. HUS | C. DIC | D. ITP | A. Thrombotic thrombocytopenic purpura |
| A 5-year-old child with anemia, thrombocytopenia, renal failure after diarrhea. Diagnosis? | A. HUS | B. TTP | C. DIC | D. ITP | A. Hemolytic uremic syndrome |
| A 60-year-old with sepsis, low platelets, prolonged PT/aPTT. Diagnosis? | A. DIC | B. ITP | C. TTP | D. HUS | A. Disseminated intravascular coagulation |
| A 55-year-old with pruritus after hot bath, high Hb, low EPO. Diagnosis? | A. Polycythemia vera | B. Secondary polycythemia | C. CML | D. PV deficiency | A. Polycythemia vera |
| A 65-year-old with anemia, high ferritin, low TIBC. Diagnosis? | A. Anemia of chronic disease | B. Iron deficiency | C. Thalassemia | D. Sideroblastic | A. Anemia of chronic disease |
| A 45-year-old man with recurrent DVT, normal PT/PTT. Cause? | A. Factor V Leiden | B. Protein C deficiency | C. Antithrombin III deficiency | D. All | D. All (inherited thrombophilias) |
| A 25-year-old man after road traffic accident, hypotensive, flat neck veins. Diagnosis? | A. Hypovolemic shock | B. Cardiac tamponade | C. Tension pneumothorax | D. Septic shock | A. Hypovolemic shock |
| A trauma patient with distended neck veins, muffled heart sounds, hypotension. Diagnosis? | A. Cardiac tamponade | B. Tension pneumothorax | C. Hemothorax | D. PE | A. Cardiac tamponade |
| A 35-year-old man after chest trauma, absent breath sounds, trachea deviated. Diagnosis? | A. Tension pneumothorax | B. Hemothorax | C. Flail chest | D. PE | A. Tension pneumothorax |
| A 40-year-old man with blunt chest trauma, paradoxical chest movement. Diagnosis? | A. Flail chest | B. Pneumothorax | C. Hemothorax | D. Contusion | A. Flail chest |
| A 25-year-old trauma patient with hypotension, tachycardia, cool extremities. Type of shock? | A. Hypovolemic | B. Septic | C. Cardiogenic | D. Neurogenic | A. Hypovolemic shock |
| A patient with spinal cord injury, hypotension, bradycardia, warm skin. Diagnosis? | A. Neurogenic shock | B. Hypovolemic | C. Septic | D. Cardiogenic | A. Neurogenic shock |
| A 45-year-old with chest trauma, BP 70/40, JVP elevated, muffled heart sounds. Diagnosis? | A. Cardiac tamponade | B. Tension pneumothorax | C. Hemothorax | D. PE | A. Cardiac tamponade |
| A 30-year-old man with blunt abdominal trauma, Kehr’s sign positive. Organ injured? | A. Spleen | B. Liver | C. Pancreas | D. Kidney | A. Splenic rupture |
| A 50-year-old man after RTA, RUQ pain, hypotension. Organ injured? | A. Liver | B. Spleen | C. Pancreas | D. Stomach | A. Liver laceration |
| A 45-year-old with pelvic fracture, blood at urethral meatus. Next step? | A. Retrograde urethrogram | B. Catheterization | C. Cystoscopy | D. CT scan | A. Retrograde urethrogram before catheterization |
| A 25-year-old with lower abdominal pain, distension, no urine output. Diagnosis? | A. Bladder rupture | B. Urethral injury | C. Renal trauma | D. Bowel injury | A. Bladder rupture |
| A 60-year-old with peritonitis after perforated ulcer. Management? | A. Exploratory laparotomy | B. CT | C. Observe | D. Antibiotics only | A. Emergency laparotomy |
| A 35-year-old post-op day 5, fever, erythema, purulent wound. Diagnosis? | A. Wound infection | B. Seroma | C. Hematoma | D. Dehiscence | A. Surgical site infection |
| A 60-year-old diabetic with foul-smelling necrotic tissue, crepitus. Diagnosis? | A. Gas gangrene | B. Cellulitis | C. Abscess | D. Necrosis | A. Clostridial gas gangrene |
| A 70-year-old with black gangrene of toes, absent pulses. Diagnosis? | A. Arterial gangrene | B. Venous | C. Neuropathic | D. Pressure | A. Arterial ischemic gangrene |
| A 55-year-old with chronic ulcer above medial malleolus. Cause? | A. Venous insufficiency | B. Arterial | C. Neuropathic | D. Pressure | A. Venous ulcer |
| A 65-year-old diabetic with ulcer on sole, painless. Diagnosis? | A. Neuropathic ulcer | B. Arterial | C. Venous | D. Pressure | A. Diabetic neuropathic ulcer |
| A 40-year-old man with severe leg pain, pallor, paresthesia, tense calf. Diagnosis? | A. Compartment syndrome | B. DVT | C. Arterial occlusion | D. Cellulitis | A. Acute compartment syndrome |
| A 25-year-old with full-thickness circumferential burn, absent distal pulses. Management? | A. Escharotomy | B. Fasciotomy | C. Amputation | D. Grafting | A. Escharotomy |
| A 50-year-old with flame burns 30% TBSA. Fluid calculation? | A. Parkland formula | B. Maintenance | C. Evans | D. Holliday-Segar | A. Parkland formula (4 mL × %BSA × weight) |
| A 45-year-old with breast lump, hard, irregular, fixed. Diagnosis? | A. Carcinoma | B. Fibroadenoma | C. Fibrocystic | D. Abscess | A. Invasive ductal carcinoma |
| A 25-year-old woman with mobile, firm breast lump. Diagnosis? | A. Fibroadenoma | B. Fibrocystic | C. Abscess | D. Carcinoma | A. Fibroadenoma |
| A 30-year-old woman with cyclic breast pain, nodularity. Diagnosis? | A. Fibrocystic disease | B. Carcinoma | C. Fibroadenoma | D. Mastitis | A. Fibrocystic disease |
| A 55-year-old woman with eczematous nipple lesion. Diagnosis? | A. Paget disease | B. DCIS | C. Fibrocystic | D. Abscess | A. Paget’s disease of breast |
| A 60-year-old with peau d’orange breast and axillary nodes. Diagnosis? | A. Inflammatory carcinoma | B. Ductal carcinoma | C. Paget | D. Fibrosis | A. Inflammatory breast carcinoma |
| A 35-year-old lactating woman with fever, painful breast swelling. Diagnosis? | A. Mastitis | B. Abscess | C. Carcinoma | D. Galactocele | A. Acute mastitis |
| A 30-year-old with fluctuant tender breast lump, pus discharge. Diagnosis? | A. Breast abscess | B. Mastitis | C. Carcinoma | D. Fibrocystic | A. Breast abscess |
| A 50-year-old man with nipple discharge, subareolar mass. Diagnosis? | A. Male breast carcinoma | B. Gynecomastia | C. Abscess | D. Lipoma | A. Male breast carcinoma |
| A 60-year-old man with bilateral breast enlargement, non-tender. Diagnosis? | A. Gynecomastia | B. Carcinoma | C. Cyst | D. Lipoma | A. Gynecomastia |
| A 40-year-old woman with solitary thyroid nodule, cold on scan. Next step? | A. FNAC | B. Observe | C. Surgery | D. Suppression therapy | A. Fine-needle aspiration cytology |
| A 50-year-old with hard fixed thyroid mass, dysphagia. Diagnosis? | A. Anaplastic carcinoma | B. Medullary | C. Papillary | D. Follicular | A. Anaplastic thyroid carcinoma |
| A 35-year-old woman with thyroid nodule, calcitonin high. Diagnosis? | A. Medullary carcinoma | B. Papillary | C. Follicular | D. Anaplastic | A. Medullary thyroid carcinoma |
| A 45-year-old woman with papillary structures, psammoma bodies. Diagnosis? | A. Papillary thyroid carcinoma | B. Follicular | C. Medullary | D. Anaplastic | A. Papillary thyroid carcinoma |
| A 55-year-old man with solitary nodule, capsular invasion, hematogenous spread. Diagnosis? | A. Follicular carcinoma | B. Papillary | C. Medullary | D. Anaplastic | A. Follicular carcinoma |
| A 25-year-old man with groin swelling above inguinal ligament, reducible. Diagnosis? | A. Indirect inguinal hernia | B. Direct inguinal hernia | C. Femoral hernia | D. Hydrocele | A. Indirect inguinal hernia |
| A 60-year-old man with groin swelling medial to inferior epigastric vessels. Diagnosis? | A. Direct inguinal hernia | B. Indirect | C. Femoral | D. Spigelian | A. Direct inguinal hernia |
| A 55-year-old woman with swelling below inguinal ligament, irreducible. Diagnosis? | A. Femoral hernia | B. Inguinal | C. Incisional | D. Umbilical | A. Femoral hernia |
| A 40-year-old woman with swelling at umbilicus, reducible. Diagnosis? | A. Umbilical hernia | B. Paraumbilical | C. Incisional | D. Epigastric | A. Umbilical hernia |
| A 50-year-old woman post-laparotomy with bulge at scar. Diagnosis? | A. Incisional hernia | B. Umbilical | C. Paraumbilical | D. Spigelian | A. Incisional hernia |
| A 35-year-old with swelling in epigastric region, increases on coughing. Diagnosis? | A. Epigastric hernia | B. Umbilical | C. Spigelian | D. Paraumbilical | A. Epigastric hernia |
| A 45-year-old man with irreducible hernia, vomiting, distension. Diagnosis? | A. Obstructed hernia | B. Strangulated | C. Reducible | D. Incisional | A. Obstructed hernia |
| A 40-year-old man with irreducible tender hernia, toxic, obstruction. Diagnosis? | A. Strangulated hernia | B. Obstructed | C. Incarcerated | D. Reducible | A. Strangulated hernia |
| A 50-year-old man post-hernia repair with groin swelling again. Diagnosis? | A. Recurrent hernia | B. Seroma | C. Hematoma | D. Infection | A. Recurrent hernia |
| A 25-year-old with right iliac fossa pain, fever, guarding. Diagnosis? | A. Acute appendicitis | B. Cholecystitis | C. Diverticulitis | D. UTI | A. Acute appendicitis |
| A 30-year-old woman with RLQ pain, vomiting, tenderness at McBurney’s point. Next step? | A. Ultrasound | B. CT | C. Observe | D. Laparotomy | A. Abdominal ultrasound |
| A 60-year-old man with fever, RUQ pain, Murphy’s sign. Diagnosis? | A. Acute cholecystitis | B. Cholangitis | C. Hepatitis | D. Ulcer | A. Acute calculous cholecystitis |
| A 65-year-old with jaundice, fever, RUQ pain. Diagnosis? | A. Ascending cholangitis | B. Cholecystitis | C. Hepatitis | D. Cirrhosis | A. Charcot’s triad → Ascending cholangitis |
| A 45-year-old woman with postprandial pain, gallstones. Diagnosis? | A. Symptomatic cholelithiasis | B. Cholecystitis | C. Choledocholithiasis | D. Pancreatitis | A. Gallstones (chronic cholelithiasis) |
| A 55-year-old alcoholic with severe epigastric pain radiating to back. Diagnosis? | A. Acute pancreatitis | B. Cholecystitis | C. PUD | D. MI | A. Acute pancreatitis |
| A 50-year-old with fever, jaundice, elevated ALP, dilated ducts. Diagnosis? | A. Choledocholithiasis | B. PSC | C. PBC | D. Hepatitis | A. Common bile duct stones |
| A 60-year-old with sudden severe epigastric pain, free air under diaphragm. Diagnosis? | A. Perforated peptic ulcer | B. Pancreatitis | C. SBO | D. Appendicitis | A. Perforated duodenal ulcer |
| A 55-year-old with hematemesis, history of NSAID use. Cause? | A. Peptic ulcer disease | B. Mallory-Weiss | C. Varices | D. Gastritis | A. Peptic ulcer disease |
| A 50-year-old alcoholic with vomiting, then hematemesis. Diagnosis? | A. Mallory-Weiss tear | B. Varices | C. PUD | D. Erosive gastritis | A. Mallory-Weiss tear |
| A 65-year-old with painless jaundice, palpable gallbladder. Diagnosis? | A. Carcinoma head of pancreas | B. Cholangiocarcinoma | C. Stones | D. Cirrhosis | A. Pancreatic cancer (Courvoisier sign) |
| A 60-year-old man with dysphagia to solids then liquids, weight loss. Diagnosis? | A. Esophageal carcinoma | B. Achalasia | C. Web | D. Stricture | A. Esophageal cancer |
| A 35-year-old woman with dysphagia to solids and liquids, bird-beak on barium. Diagnosis? | A. Achalasia | B. Stricture | C. Web | D. Cancer | A. Achalasia cardia |
| A 50-year-old man with vomiting, visible peristalsis, succussion splash. Diagnosis? | A. Gastric outlet obstruction | B. PUD | C. GERD | D. Cancer | A. Gastric outlet obstruction |
| A 70-year-old with epigastric pain relieved by food. Diagnosis? | A. Duodenal ulcer | B. Gastric ulcer | C. GERD | D. Gallstones | A. Duodenal ulcer |
| A 65-year-old with pain worse after food, weight loss. Diagnosis? | A. Gastric ulcer | B. Duodenal | C. GERD | D. PUD | A. Gastric ulcer |
| A 50-year-old with upper GI bleed, cirrhosis. Diagnosis? | A. Esophageal varices | B. Mallory-Weiss | C. PUD | D. Gastritis | A. Bleeding esophageal varices |
| A 45-year-old with acute abdomen, rigid board-like, air under diaphragm. Diagnosis? | A. Perforated ulcer | B. Pancreatitis | C. SBO | D. Appendicitis | A. Perforated peptic ulcer |
| A 60-year-old with recurrent vomiting, visible peristalsis. Diagnosis? | A. Gastric outlet obstruction | B. PUD | C. GERD | D. IBS | A. Gastric outlet obstruction |
| A 55-year-old with lower GI bleed, painless hematochezia, anemia. Diagnosis? | A. Colon cancer | B. Diverticulosis | C. Hemorrhoid | D. UC | A. Colorectal carcinoma |
| A 40-year-old with LLQ pain, fever, constipation. Diagnosis? | A. Diverticulitis | B. Appendicitis | C. UC | D. IBS | A. Acute diverticulitis |
| A 45-year-old with perianal pain, fever, swelling. Diagnosis? | A. Perianal abscess | B. Fistula | C. Hemorrhoid | D. Fissure | A. Perianal abscess |
| A 40-year-old man with chronic discharge, external opening near anus. Diagnosis? | A. Fistula-in-ano | B. Abscess | C. Fissure | D. Hemorrhoid | A. Anal fistula |
| A 35-year-old with painful bleeding after defecation. Diagnosis? | A. Anal fissure | B. Fistula | C. Hemorrhoids | D. Abscess | A. Anal fissure |
| A 50-year-old with painless rectal bleeding, prolapse on defecation. Diagnosis? | A. Internal hemorrhoids | B. Fissure | C. Cancer | D. Polyp | A. Internal hemorrhoids |
| A 55-year-old with tenesmus, rectal mass, bleeding. Diagnosis? | A. Rectal carcinoma | B. Hemorrhoids | C. Fissure | D. Fistula | A. Rectal cancer |
| A 40-year-old man with painful swelling in scrotum, high-riding testis, absent cremasteric reflex. Diagnosis? | A. Testicular torsion | B. Epididymitis | C. Hydrocele | D. Hernia | A. Testicular torsion |
| A 25-year-old man with scrotal pain, fever, tender epididymis, normal cremasteric reflex. Diagnosis? | A. Epididymitis | B. Torsion | C. Varicocele | D. Hydrocele | A. Epididymitis |
| A 30-year-old man with painless scrotal swelling that transilluminates. Diagnosis? | A. Hydrocele | B. Varicocele | C. Hernia | D. Epididymitis | A. Hydrocele |
| A 35-year-old man with bag-of-worms feel in scrotum, infertility. Diagnosis? | A. Varicocele | B. Hydrocele | C. Hernia | D. Epididymitis | A. Varicocele |
| A 65-year-old man with LUTS, enlarged firm prostate, PSA 12. Diagnosis? | A. Carcinoma prostate | B. BPH | C. Prostatitis | D. Urethral stricture | A. Prostate carcinoma |
| A 60-year-old man with nocturia, hesitancy, smooth enlarged prostate. Diagnosis? | A. BPH | B. Prostate cancer | C. Prostatitis | D. Cystitis | A. Benign prostatic hyperplasia |
| A 55-year-old man with acute urinary retention. Initial management? | A. Catheterization | B. Surgery | C. Observe | D. Alpha-blocker | A. Urinary catheterization |
| A 50-year-old man with fever, dysuria, tender prostate. Diagnosis? | A. Acute prostatitis | B. BPH | C. Cancer | D. Retention | A. Acute bacterial prostatitis |
| A 45-year-old with flank pain, hematuria, renal colic. Diagnosis? | A. Ureteric stone | B. Pyelonephritis | C. Cystitis | D. Tumor | A. Ureteric calculus |
| A 60-year-old with painless gross hematuria, smoker. Diagnosis? | A. Bladder cancer | B. RCC | C. Stone | D. Cystitis | A. Transitional cell carcinoma (bladder) |
| A 55-year-old man with right flank mass, hematuria, polycythemia. Diagnosis? | A. RCC | B. PKD | C. Stone | D. Infection | A. Renal cell carcinoma |
| A 40-year-old woman with fever, flank pain, CVA tenderness. Diagnosis? | A. Pyelonephritis | B. Cystitis | C. Stone | D. Tumor | A. Acute pyelonephritis |
| A 60-year-old woman with incontinence on coughing and sneezing. Diagnosis? | A. Stress incontinence | B. Urge | C. Overflow | D. Functional | A. Stress urinary incontinence |
| A 70-year-old man with dribbling, distension, high residual urine. Diagnosis? | A. Overflow incontinence | B. Urge | C. Stress | D. Functional | A. Overflow incontinence |
| A 45-year-old with sudden urge to void, frequent urination. Diagnosis? | A. Urge incontinence | B. Stress | C. Overflow | D. Functional | A. Urge incontinence |
| A 25-year-old man with midshaft humerus fracture, wrist drop. Nerve injured? | A. Radial nerve | B. Ulnar | C. Median | D. Axillary | A. Radial nerve injury |
| A 45-year-old with shoulder dislocation, unable to abduct arm. Nerve injured? | A. Axillary | B. Radial | C. Median | D. Ulnar | A. Axillary nerve |
| A 30-year-old man with supracondylar fracture, loss of thumb opposition. Nerve injured? | A. Median | B. Ulnar | C. Radial | D. Axillary | A. Median nerve |
| A 40-year-old with elbow injury, claw hand. Nerve injured? | A. Ulnar | B. Radial | C. Median | D. Axillary | A. Ulnar nerve |
| A 25-year-old with pelvic fracture, foot drop. Nerve injured? | A. Common peroneal | B. Femoral | C. Tibial | D. Sciatic | A. Common peroneal nerve |
| A 70-year-old woman with hip fracture, limb shortened and externally rotated. Diagnosis? | A. Neck of femur fracture | B. Intertrochanteric | C. Shaft fracture | D. Dislocation | A. Fracture neck of femur |
| A 25-year-old with fracture tibia, severe pain, tense compartment. Diagnosis? | A. Compartment syndrome | B. DVT | C. Arterial occlusion | D. Infection | A. Acute compartment syndrome |
| A 60-year-old man with chronic leg ulcer above medial malleolus. Cause? | A. Venous ulcer | B. Arterial | C. Diabetic | D. Pressure | A. Venous ulcer |
| A 65-year-old diabetic with ulcer on sole, painless. Diagnosis? | A. Neuropathic ulcer | B. Arterial | C. Venous | D. Pressure | A. Diabetic neuropathic ulcer |
| A 50-year-old smoker with black toe, absent pulses. Diagnosis? | A. Arterial gangrene | B. Venous | C. Neuropathic | D. Pressure | A. Arterial ischemic gangrene |
| A 30-year-old woman with tortuous leg veins, aching after standing. Diagnosis? | A. Varicose veins | B. DVT | C. Lymphedema | D. Cellulitis | A. Varicose veins |
| A 60-year-old man with rest pain, absent pulses, ulcer on toe. Diagnosis? | A. Critical limb ischemia | B. DVT | C. Venous ulcer | D. Cellulitis | A. Critical limb ischemia |
| A 40-year-old man with crush injury, severe pain, paresthesia, pallor. Diagnosis? | A. Compartment syndrome | B. DVT | C. Arterial occlusion | D. Cellulitis | A. Compartment syndrome |
| A 35-year-old with severe burns to 40% BSA. First step in management? | A. Airway + fluid resuscitation | B. Antibiotics | C. Dressing | D. Surgery | A. Airway management and IV fluids |
| A 25-year-old with chemical burn. Immediate management? | A. Copious irrigation with water | B. Neutralize | C. Cover | D. Ointment | A. Copious water irrigation |
| A 50-year-old with flame burn, hoarseness, singed nasal hairs. Management? | A. Early intubation | B. Observe | C. Oxygen only | D. Fluid | A. Early intubation |
| A 60-year-old man with postoperative wound gaping, bowel visible. Management? | A. Cover with saline gauze + surgery | B. Dress | C. Observe | D. Drain | A. Cover wound and urgent closure |
| A 55-year-old with chronic ulcer with rolled everted edges. Diagnosis? | A. SCC | B. BCC | C. Melanoma | D. Keratoacanthoma | A. Squamous cell carcinoma |
| A 60-year-old man with pearly nodular lesion, central ulceration. Diagnosis? | A. BCC | B. SCC | C. Melanoma | D. Keratoacanthoma | A. Basal cell carcinoma |
| A 50-year-old man with pigmented lesion, irregular borders, color change. Diagnosis? | A. Melanoma | B. BCC | C. SCC | D. Keratoacanthoma | A. Malignant melanoma |
| A 40-year-old farmer with parotid swelling, facial nerve palsy. Diagnosis? | A. Parotid malignancy | B. Pleomorphic adenoma | C. Infection | D. Cyst | A. Parotid carcinoma |
| A 35-year-old woman with firm, painless parotid mass, mobile, no nerve palsy. Diagnosis? | A. Pleomorphic adenoma | B. Warthin tumor | C. Mucoepidermoid | D. Cyst | A. Pleomorphic adenoma |
| A 60-year-old man with recurrent parotid swelling, smoker. Diagnosis? | A. Warthin tumor | B. Pleomorphic | C. Mucoepidermoid | D. Cyst | A. Warthin tumor (papillary cystadenoma lymphomatosum) |
| A 25-year-old man with midline neck swelling moving with tongue protrusion. Diagnosis? | A. Thyroglossal cyst | B. Branchial cyst | C. Dermoid | D. Lymph node | A. Thyroglossal duct cyst |
| A 30-year-old man with cystic swelling anterior to sternocleidomastoid. Diagnosis? | A. Branchial cyst | B. Thyroglossal | C. Dermoid | D. Lipoma | A. Branchial cyst |
| A 40-year-old man with soft fluctuant swelling at back of neck. Diagnosis? | A. Lipoma | B. Sebaceous cyst | C. Abscess | D. Fibroma | A. Lipoma |
| A 35-year-old man with dome-shaped swelling with punctum, cheesy discharge. Diagnosis? | A. Sebaceous cyst | B. Lipoma | C. Abscess | D. Lymph node | A. Sebaceous cyst |
| A 60-year-old man with lateral neck mass, firm, fixed, ulcerated. Diagnosis? | A. Metastatic lymph node | B. Lymphoma | C. TB | D. Cyst | A. Metastatic lymph node |
| A 50-year-old with painless ulcer on lateral tongue, indurated edges. Diagnosis? | A. SCC of tongue | B. Aphthous ulcer | C. TB | D. Cyst | A. Squamous cell carcinoma |
| A 45-year-old smoker with hoarseness, throat pain, weight loss. Diagnosis? | A. Laryngeal carcinoma | B. Vocal cord polyp | C. TB | D. Pharyngitis | A. Carcinoma of larynx |
| A 60-year-old man with difficulty swallowing, regurgitation, neck swelling. Diagnosis? | A. Zenker diverticulum | B. Achalasia | C. Web | D. Cancer | A. Pharyngoesophageal (Zenker) diverticulum |
| A 40-year-old with epigastric pain radiating to back, elevated amylase. Diagnosis? | A. Acute pancreatitis | B. PUD | C. Cholecystitis | D. Gastritis | A. Acute pancreatitis |
| A 55-year-old man with chronic pancreatitis, steatorrhea, diabetes. Cause? | A. Alcohol | B. Gallstones | C. Trauma | D. Viral | A. Alcohol abuse |
| A 45-year-old with painless jaundice, palpable gallbladder. Diagnosis? | A. Carcinoma head of pancreas | B. Choledocholithiasis | C. Cirrhosis | D. Cholangiocarcinoma | A. Pancreatic head cancer |
| A 60-year-old woman with jaundice, palpable gallbladder, weight loss. Diagnosis? | A. Cholangiocarcinoma | B. Pancreatic carcinoma | C. Cirrhosis | D. PSC | A. Carcinoma of biliary tract (cholangiocarcinoma) |
| A 50-year-old man with recurrent oral ulcers, genital ulcers, uveitis. Diagnosis? | A. Behçet disease | B. SLE | C. RA | D. Vasculitis | A. Behçet syndrome |
| A 40-year-old with intermittent claudication, rest pain, absent pulses. Diagnosis? | A. Peripheral arterial disease | B. DVT | C. Varicose veins | D. Lymphedema | A. Peripheral arterial occlusive disease |
| A 65-year-old smoker with pulsatile abdominal mass. Diagnosis? | A. Abdominal aortic aneurysm | B. Renal cyst | C. Lipoma | D. Tumor | A. AAA |
| A 70-year-old with sudden back pain, hypotension, pulsatile mass. Diagnosis? | A. Ruptured AAA | B. Renal colic | C. MI | D. Pancreatitis | A. Ruptured abdominal aortic aneurysm |
| A 40-year-old woman with recurrent varicose veins, ulcer over medial malleolus. Diagnosis? | A. Venous insufficiency | B. Arterial | C. Neuropathic | D. Pressure | A. Chronic venous insufficiency |
| A 55-year-old diabetic with gangrene of toe, foul discharge. Diagnosis? | A. Wet gangrene | B. Dry gangrene | C. Gas gangrene | D. Necrosis | A. Wet gangrene |
| A 60-year-old man with black mummified toe, clear line of demarcation. Diagnosis? | A. Dry gangrene | B. Wet | C. Gas | D. Necrosis | A. Dry gangrene |
| A 45-year-old man with rapidly spreading infection, crepitus, foul smell. Diagnosis? | A. Gas gangrene | B. Wet gangrene | C. Cellulitis | D. Abscess | A. Clostridial gas gangrene |
| A 30-year-old man with deep laceration, swelling, pain, paresthesia, tense compartment. Diagnosis? | A. Compartment syndrome | B. DVT | C. Arterial occlusion | D. Infection | A. Acute compartment syndrome |
| A 50-year-old man with open fracture tibia, soft tissue loss. Management? | A. Debridement + external fixation | B. Cast | C. Internal fixation | D. Observe | A. Surgical debridement and external fixation |
| A 70-year-old woman with wrist fracture, dorsal angulation. Diagnosis? | A. Colles fracture | B. Smith | C. Barton | D. Monteggia | A. Colles fracture |
| A 45-year-old man with fracture radius and distal radioulnar dislocation. Diagnosis? | A. Galeazzi fracture | B. Monteggia | C. Smith | D. Colles | A. Galeazzi fracture |
| A 30-year-old with ulnar fracture and radial head dislocation. Diagnosis? | A. Monteggia fracture | B. Galeazzi | C. Colles | D. Smith | A. Monteggia fracture |
| A 40-year-old woman with shoulder dislocation, arm abducted and externally rotated. Diagnosis? | A. Anterior shoulder dislocation | B. Posterior | C. Fracture | D. Subluxation | A. Anterior shoulder dislocation |
| A 50-year-old woman with breast cancer, lymphedema arm. Cause? | A. Lymphatic obstruction | B. Venous thrombosis | C. Infection | D. Trauma | A. Post-mastectomy lymphatic obstruction |
| A 35-year-old man with chronic sinus discharge, foreign body in bone. Diagnosis? | A. Chronic osteomyelitis | B. TB | C. Sarcoma | D. Abscess | A. Chronic osteomyelitis |
| A 15-year-old with diaphyseal lesion, onion-skin appearance. Diagnosis? | A. Ewing sarcoma | B. Osteosarcoma | C. Osteomyelitis | D. Fibroma | A. Ewing’s sarcoma |
| A 17-year-old with metaphyseal lesion around knee, sunburst appearance. Diagnosis? | A. Osteosarcoma | B. Ewing | C. Chondroblastoma | D. Giant cell tumor | A. Osteosarcoma |
| A 25-year-old woman with epiphyseal lytic lesion, soap-bubble appearance. Diagnosis? | A. Giant cell tumor | B. Osteosarcoma | C. Chondroblastoma | D. Fibrous dysplasia | A. Giant cell tumor (osteoclastoma) |
| A 60-year-old man with bony pain, elevated ALP, normal calcium. Diagnosis? | A. Paget disease | B. Osteoporosis | C. Osteomalacia | D. Metastasis | A. Paget’s disease of bone |
| A 40-year-old woman with loss of bone density, fragility fractures. Diagnosis? | A. Osteoporosis | B. Osteomalacia | C. Paget | D. Myeloma | A. Osteoporosis |
| A 70-year-old man with spinal tenderness, anemia, lytic skull lesions. Diagnosis? | A. Multiple myeloma | B. Metastasis | C. Osteoporosis | D. Paget | A. Multiple myeloma |
| A 30-year-old man with small bowel obstruction, previous surgery. Cause? | A. Adhesions | B. Hernia | C. Volvulus | D. Intussusception | A. Post-operative adhesions |
| A 50-year-old man with sigmoid volvulus. X-ray finding? | A. Coffee-bean sign | B. Air-fluid levels | C. Free air | D. String sign | A. Coffee-bean sign |
| A 65-year-old man with pain out of proportion, peritonitis, AF history. Diagnosis? | A. Mesenteric ischemia | B. Perforation | C. Obstruction | D. Pancreatitis | A. Acute mesenteric ischemia |
| A 25-year-old woman presents with amenorrhea for 6 weeks and positive pregnancy test. Next step? | A. Ultrasound | B. β-hCG | C. Pelvic exam | D. Wait and repeat test | A. Transvaginal ultrasound to confirm intrauterine pregnancy |
| A 30-year-old pregnant woman with vaginal bleeding, closed cervix. Diagnosis? | A. Threatened abortion | B. Inevitable | C. Incomplete | D. Missed | A. Threatened abortion |
| A. Incomplete abortion | B. Inevitable | C. Threatened | D. Missed | A. Incomplete abortion | |
| A 35-year-old woman with absent fetal heart, closed cervix, retained products. Diagnosis? | A. Missed abortion | B. Complete | C. Inevitable | D. Threatened | A. Missed abortion |
| A 40-year-old woman with repeated pregnancy loss at 8–10 weeks. Cause? | A. Luteal phase defect | B. Cervical incompetence | C. Infection | D. Thrombosis | A. Luteal phase defect |
| A 25-year-old woman with amenorrhea, lower abdominal pain, shoulder pain, and positive pregnancy test. Diagnosis? | A. Ectopic pregnancy | B. Abortion | C. PID | D. Ovarian cyst | A. Ruptured ectopic pregnancy |
| A 30-year-old woman with ectopic pregnancy, hemodynamically stable. Management? | A. Methotrexate | B. Laparotomy | C. Observation | D. D&C | A. Medical management with methotrexate |
| A 32-year-old G2P1 with vaginal bleeding, uterus larger than gestational age, snowstorm on US. Diagnosis? | A. Molar pregnancy | B. Missed abortion | C. Twin pregnancy | D. Fibroid | A. Hydatidiform mole |
| A 28-year-old post-evacuation of mole, β-hCG remains high. Diagnosis? | A. Choriocarcinoma | B. Twin | C. Persistent mole | D. Ectopic | A. Gestational trophoblastic neoplasia (choriocarcinoma) |
| A 24-year-old with hyperemesis, hypertension, uterus > gestational age. Diagnosis? | A. Molar pregnancy | B. Ectopic | C. Missed abortion | D. Pre-eclampsia | A. Hydatidiform mole |
| A 26-year-old at 30 weeks with BP 160/110, proteinuria, edema. Diagnosis? | A. Pre-eclampsia | B. Eclampsia | C. Chronic HTN | D. Gestational HTN | A. Severe pre-eclampsia |
| A 27-year-old woman with convulsions, hypertension, and proteinuria. Diagnosis? | A. Eclampsia | B. Epilepsy | C. Pre-eclampsia | D. Stroke | A. Eclampsia |
| A 28-year-old woman with pre-eclampsia. Drug for seizure prophylaxis? | A. Magnesium sulfate | B. Diazepam | C. Phenytoin | D. Midazolam | A. Magnesium sulfate |
| A 32-year-old primigravida with BP 150/95 after 20 weeks, no proteinuria. Diagnosis? | A. Gestational hypertension | B. Chronic | C. Pre-eclampsia | D. Eclampsia | A. Gestational hypertension |
| A 35-year-old woman with painless vaginal bleeding at 32 weeks. Diagnosis? | A. Placenta previa | B. Abruption | C. Vasa previa | D. Preterm labor | A. Placenta previa |
| A 28-year-old at 34 weeks with painful bleeding, tender uterus. Diagnosis? | A. Placental abruption | B. Placenta previa | C. Rupture | D. Preterm labor | A. Placental abruption |
| A 29-year-old woman in labor with vaginal bleeding, fetal distress, and loss of station. Diagnosis? | A. Uterine rupture | B. Abruption | C. Placenta previa | D. Cord prolapse | A. Uterine rupture |
| A 30-year-old woman with cord visible at introitus, fetal bradycardia. Diagnosis? | A. Cord prolapse | B. Uterine rupture | C. Abruption | D. Placenta previa | A. Umbilical cord prolapse |
| A 28-year-old woman with preterm labor, no cervical dilation, irregular contractions. Diagnosis? | A. False labor | B. True labor | C. Placenta previa | D. Abruption | A. False labor |
| A 30-year-old at 39 weeks with regular contractions and cervical dilation. Diagnosis? | A. True labor | B. False labor | C. Abruption | D. Placenta previa | A. True labor |
| A 25-year-old primigravida at 40 weeks with prolonged labor, fetal distress. Management? | A. Emergency C-section | B. Induction | C. Observe | D. Forceps | A. Emergency cesarean section |
| A 30-year-old with head not descending, caput formation, molding. Diagnosis? | A. Cephalopelvic disproportion | B. Malpresentation | C. Obstructed labor | D. Prolonged labor | A. Cephalopelvic disproportion |
| A 25-year-old with retained placenta after 30 minutes, bleeding. Management? | A. Manual removal | B. Oxytocin | C. Wait | D. Massage | A. Manual removal of placenta |
| A 32-year-old woman with postpartum hemorrhage due to uterine atony. Management? | A. Uterine massage + oxytocin | B. Manual removal | C. Antibiotic | D. Surgery | A. Massage and uterotonic agents |
| A 28-year-old woman with postpartum hemorrhage not controlled by drugs. Next step? | A. Uterine artery ligation | B. Hysterectomy | C. Balloon tamponade | D. Observe | C. Balloon tamponade or surgical ligation if refractory |
| A 35-year-old woman with fever, foul lochia after delivery. Diagnosis? | A. Puerperal sepsis | B. Endometriosis | C. UTI | D. Mastitis | A. Puerperal sepsis |
| A 25-year-old woman with painful breast swelling during lactation. Diagnosis? | A. Mastitis | B. Abscess | C. Galactocele | D. Carcinoma | A. Lactational mastitis |
| A 28-year-old lactating woman with fluctuant tender lump, pus. Diagnosis? | A. Breast abscess | B. Mastitis | C. Fibrocystic | D. Carcinoma | A. Breast abscess |
| A 26-year-old woman with excessive bleeding, uterus large after delivery. Diagnosis? | A. Retained products | B. Uterine atony | C. Trauma | D. Coagulopathy | A. Retained products of conception |
| A 30-year-old woman with tender uterus, foul-smelling lochia, fever. Diagnosis? | A. Endometritis | B. Mastitis | C. Retained placenta | D. Wound infection | A. Puerperal endometritis |
| A 29-year-old woman 3 months postpartum with inability to breastfeed, amenorrhea. Diagnosis? | A. Sheehan syndrome | B. PPH | C. Asherman | D. Pituitary adenoma | A. Sheehan’s syndrome (pituitary necrosis) |
| A 35-year-old woman with infertility, amenorrhea after D&C. Diagnosis? | A. Asherman syndrome | B. PCOS | C. Pituitary failure | D. Sheehan | A. Intrauterine adhesions (Asherman) |
| A 25-year-old woman with secondary amenorrhea, galactorrhea, headache. Diagnosis? | A. Prolactinoma | B. PCOS | C. Sheehan | D. Hypothyroidism | A. Pituitary prolactinoma |
| A 30-year-old woman with irregular menses, hirsutism, obesity, infertility. Diagnosis? | A. PCOS | B. Hypothyroidism | C. Hyperprolactinemia | D. CAH | A. Polycystic ovary syndrome |
| A 26-year-old woman with dysmenorrhea, dyspareunia, infertility. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PID | D. Fibroid | A. Endometriosis |
| A 35-year-old woman with heavy painful menses, enlarged tender uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. PID | A. Adenomyosis |
| A 40-year-old woman with heavy painless bleeding, irregular enlargement of uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial cancer | D. DUB | A. Uterine fibroids (leiomyoma) |
| A 30-year-old woman with irregular menses, acne, hirsutism, and infertility. Diagnosis? | A. PCOS | B. Cushing | C. CAH | D. Thyroid disorder | A. Polycystic ovary syndrome |
| A 25-year-old woman with amenorrhea, low FSH/LH, normal prolactin. Diagnosis? | A. Hypothalamic amenorrhea | B. PCOS | C. Premature ovarian failure | D. Sheehan | A. Hypothalamic amenorrhea |
| A 35-year-old woman with hot flashes, amenorrhea, high FSH/LH. Diagnosis? | A. Premature ovarian failure | B. Sheehan | C. PCOS | D. Hypothyroid | A. Premature ovarian failure |
| A 28-year-old woman with primary infertility, regular cycles, open tubes. Next step? | A. Semen analysis | B. Ovulation test | C. HSG | D. Laparoscopy | A. Semen analysis (first-line test in infertility) |
| A 32-year-old woman with secondary infertility, HSG shows tubal block. Management? | A. IVF | B. Clomiphene | C. IUI | D. Ovarian drilling | A. In vitro fertilization |
| A 25-year-old woman with vaginal discharge, “strawberry cervix.” Organism? | A. Trichomonas | B. Candida | C. Gardnerella | D. Chlamydia | A. Trichomonas vaginalis |
| A 30-year-old woman with curdy white vaginal discharge, itching. Diagnosis? | A. Candidiasis | B. Trichomonas | C. BV | D. Chlamydia | A. Vulvovaginal candidiasis |
| A 28-year-old woman with thin fishy discharge, clue cells on microscopy. Diagnosis? | A. Bacterial vaginosis | B. Trichomonas | C. Candida | D. Gonorrhea | A. Bacterial vaginosis (Gardnerella vaginalis) |
| A 24-year-old woman with mucopurulent discharge, cervical motion tenderness. Diagnosis? | A. PID | B. BV | C. Candida | D. Trichomonas | A. Pelvic inflammatory disease |
| A 26-year-old woman with lower abdominal pain, fever, adnexal tenderness. Diagnosis? | A. PID | B. Ectopic | C. Ovarian torsion | D. Endometriosis | A. Pelvic inflammatory disease |
| A 35-year-old woman with adnexal mass, twisting pain, vomiting. Diagnosis? | A. Ovarian torsion | B. Ectopic | C. PID | D. Fibroid | A. Ovarian torsion |
| A 30-year-old woman with sudden unilateral lower abdominal pain mid-cycle. Diagnosis? | A. Mittelschmerz | B. Ectopic | C. Ovarian torsion | D. PID | A. Mittelschmerz (ovulation pain) |
| A 40-year-old woman with cyclic pelvic pain, dyspareunia, infertility. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PID | D. Fibroid | A. Endometriosis |
| A 45-year-old woman with heavy painful menses, tender bulky uterus. Diagnosis? | A. Adenomyosis | B. Fibroid | C. Endometriosis | D. DUB | A. Adenomyosis |
| A 35-year-old woman with menorrhagia, irregularly enlarged uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial CA | D. Polyp | A. Uterine fibroid (leiomyoma) |
| A 45-year-old woman with intermenstrual bleeding, endometrial thickness > 12 mm. Diagnosis? | A. Endometrial hyperplasia | B. Cancer | C. Polyp | D. DUB | A. Endometrial hyperplasia |
| A 55-year-old postmenopausal woman with vaginal bleeding. Next step? | A. Endometrial biopsy | B. Pap smear | C. US | D. Hysteroscopy | A. Endometrial sampling to rule out malignancy |
| A 60-year-old woman with vulvar itching, white patches, loss of architecture. Diagnosis? | A. Lichen sclerosus | B. Lichen planus | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus (atrophic vulvitis) |
| A 35-year-old woman with post-coital bleeding, friable cervix. Next step? | A. Pap smear | B. HPV test | C. Colposcopy | D. Biopsy | A. Pap smear for screening |
| A 40-year-old woman with abnormal Pap smear showing HSIL. Next step? | A. Colposcopy and biopsy | B. Repeat Pap | C. HPV vaccine | D. Observe | A. Colposcopy with directed biopsy |
| A 30-year-old woman with ASC-US Pap smear. Next step? | A. HPV testing | B. Colposcopy | C. Repeat Pap in 6 months | D. Cone biopsy | A. HPV testing for triage |
| A 28-year-old woman with multiple painful vesicles on vulva. Diagnosis? | A. HSV infection | B. HPV | C. Syphilis | D. Chancroid | A. Genital herpes (HSV type 2) |
| A 26-year-old woman with painless genital ulcer, indurated edges. Diagnosis? | A. Syphilis | B. Chancroid | C. HSV | D. LGV | A. Primary syphilis (chancre) |
| A 24-year-old woman with painful ulcer, ragged edges, tender nodes. Diagnosis? | A. Chancroid | B. Syphilis | C. HSV | D. LGV | A. Chancroid (Haemophilus ducreyi) |
| A 30-year-old woman with painless ulcer, later buboes. Diagnosis? | A. Lymphogranuloma venereum | B. Chancroid | C. Syphilis | D. HSV | A. LGV (Chlamydia L1-L3) |
| A 25-year-old woman with cauliflower-like growth on vulva. Diagnosis? | A. Genital warts | B. Syphilis | C. Chancroid | D. HSV | A. Condyloma acuminata (HPV 6, 11) |
| A 50-year-old woman with abdominal mass, ascites, CA-125 elevated. Diagnosis? | A. Ovarian cancer | B. Fibroid | C. Endometrial CA | D. Cyst | A. Epithelial ovarian carcinoma |
| A 55-year-old woman with postmenopausal bleeding, high CA-125. Diagnosis? | A. Ovarian CA | B. Endometrial CA | C. Cervical CA | D. Vaginal CA | A. Ovarian carcinoma |
| A 45-year-old woman with contact bleeding, foul discharge, ulcerative cervix. Diagnosis? | A. Cervical cancer | B. Endometrial CA | C. PID | D. Erosion | A. Cervical carcinoma |
| A 60-year-old woman with vaginal bleeding, enlarged uterus, high estrogen history. Diagnosis? | A. Endometrial carcinoma | B. Cervical CA | C. Ovarian CA | D. Vaginal CA | A. Endometrial adenocarcinoma |
| A 55-year-old woman with vulvar mass, itching, ulcer. Diagnosis? | A. Vulvar carcinoma | B. Bartholin cyst | C. Lichen planus | D. Condyloma | A. Squamous cell carcinoma of vulva |
| A 40-year-old woman with post-coital bleeding, Pap smear normal. Next step? | A. Colposcopy | B. Repeat Pap | C. HPV test | D. Observe | A. Colposcopic evaluation |
| A 30-year-old woman wanting contraception, also for dysmenorrhea. Choice? | A. Combined OCP | B. Barrier | C. Copper IUD | D. DMPA | A. Combined oral contraceptive pills |
| A 25-year-old postpartum woman breastfeeding, wants contraception. Choice? | A. Progestin-only pill | B. Combined OCP | C. Copper IUD | D. Barrier | A. Progestin-only (minipill) |
| A 28-year-old woman G3P3 wants permanent contraception. Method? | A. Tubal ligation | B. Cu-T | C. Vasectomy | D. Implant | A. Tubal ligation |
| A 30-year-old man wants permanent contraception. Method? | A. Vasectomy | B. Condom | C. Implant | D. Pill | A. Vasectomy |
| A 25-year-old woman with heavy menstrual bleeding, normal uterus on US. Diagnosis? | A. DUB | B. Fibroid | C. Adenomyosis | D. Polyp | A. Dysfunctional uterine bleeding (anovulatory) |
| A 35-year-old woman with infertility, chocolate cysts on ovary. Diagnosis? | A. Endometriosis | B. PCOS | C. Fibroid | D. Adenomyosis | A. Endometriosis |
| A 30-year-old woman with vaginal itching, curdy discharge, pH < 4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Chlamydia | A. Candidiasis |
| A 25-year-old woman with primary amenorrhea, normal breast, absent uterus. Diagnosis? | A. Mayer-Rokitansky syndrome | B. Androgen insensitivity | C. Turner | D. Hypogonadism | A. Müllerian agenesis (Mayer-Rokitansky-Küster-Hauser syndrome) |
| A 18-year-old girl with primary amenorrhea, tall, scanty hair, testes palpable. Diagnosis? | A. Androgen insensitivity | B. MRKH | C. CAH | D. Turner | A. Androgen insensitivity (testicular feminization) |
| A 16-year-old girl with short stature, webbed neck, streak gonads. Diagnosis? | A. Turner syndrome | B. Klinefelter | C. CAH | D. MRKH | A. Turner syndrome (45,XO) |
| A 22-year-old woman with ambiguous genitalia, high 17-hydroxyprogesterone. Diagnosis? | A. Congenital adrenal hyperplasia | B. Androgen insensitivity | C. PCOS | D. Turner | A. CAH (21-hydroxylase deficiency) |
| A 25-year-old with secondary amenorrhea, hot flushes, high FSH/LH. Diagnosis? | A. Premature ovarian failure | B. PCOS | C. Hypothyroid | D. Sheehan | A. Premature ovarian insufficiency |
| A 30-year-old with oligomenorrhea, hirsutism, obesity, normal prolactin. Diagnosis? | A. PCOS | B. Cushing | C. CAH | D. Thyroid | A. Polycystic ovary syndrome |
| A 28-year-old woman with galactorrhea, amenorrhea, high prolactin. Diagnosis? | A. Prolactinoma | B. Sheehan | C. PCOS | D. Hypothyroid | A. Pituitary prolactinoma |
| A 35-year-old woman with infertility, hysterosalpingogram shows bilateral block. Next step? | A. IVF | B. IUI | C. Clomiphene | D. Ovarian drilling | A. IVF (in-vitro fertilization) |
| A 25-year-old with mid-cycle pain, normal exam. Diagnosis? | A. Mittelschmerz | B. Ovarian torsion | C. PID | D. Ectopic | A. Mittelschmerz |
| A 28-year-old woman with tender unilateral mass, fever, adnexal tenderness. Diagnosis? | A. PID | B. Ovarian torsion | C. Endometrioma | D. Ectopic | A. Pelvic inflammatory disease |
| A 30-year-old woman with sudden severe pelvic pain, vomiting, adnexal mass. Diagnosis? | A. Ovarian torsion | B. Ectopic | C. PID | D. Endometriosis | A. Ovarian torsion |
| A 35-year-old woman with chocolate cysts on ovary, infertility. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PCOS | D. Fibroid | A. Endometriosis |
| A 40-year-old with heavy bleeding, enlarged irregular uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial CA | D. Polyp | A. Leiomyoma (uterine fibroid) |
| A 45-year-old with heavy menses, uniformly enlarged tender uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. PID | A. Adenomyosis |
| A 28-year-old with thin fishy discharge, clue cells. Diagnosis? | A. Bacterial vaginosis | B. Trichomonas | C. Candida | D. Gonorrhea | A. Bacterial vaginosis |
| A 25-year-old with curdy white discharge, pH < 4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Chlamydia | A. Vulvovaginal candidiasis |
| A 27-year-old with frothy green discharge, strawberry cervix. Diagnosis? | A. Trichomonas | B. BV | C. Candida | D. Gonorrhea | A. Trichomonas vaginalis infection |
| A 22-year-old with mucopurulent discharge, cervical motion tenderness. Diagnosis? | A. PID | B. BV | C. Trichomonas | D. Candida | A. Pelvic inflammatory disease |
| A 30-year-old woman with post-coital bleeding, friable cervix. Next step? | A. Pap smear | B. Colposcopy | C. Biopsy | D. HPV test | A. Pap smear |
| A 45-year-old with abnormal Pap showing HSIL. Next step? | A. Colposcopy and biopsy | B. Repeat Pap | C. HPV vaccine | D. Observe | A. Colposcopy with directed biopsy |
| A 30-year-old with ASC-US Pap result. Next step? | A. HPV test | B. Repeat Pap | C. Colposcopy | D. Cone biopsy | A. High-risk HPV testing |
| A 40-year-old with ulcerative cervix, contact bleeding. Diagnosis? | A. Cervical cancer | B. Erosion | C. Polyp | D. PID | A. Cervical carcinoma |
| A 55-year-old with postmenopausal bleeding, CA-125 normal. Diagnosis? | A. Endometrial cancer | B. Ovarian CA | C. Cervical CA | D. DUB | A. Endometrial adenocarcinoma |
| A 50-year-old with abdominal mass, ascites, CA-125 elevated. Diagnosis? | A. Ovarian carcinoma | B. Fibroid | C. Endometrial CA | D. Cyst | A. Epithelial ovarian cancer |
| A 60-year-old with vulvar itching, white patches, loss of architecture. Diagnosis? | A. Lichen sclerosus | B. Vulvar CA | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus |
| A 65-year-old woman with vulvar ulcer, bleeding, hard edges. Diagnosis? | A. Vulvar carcinoma | B. Lichen planus | C. Infection | D. Bartholin cyst | A. Squamous cell carcinoma of vulva |
| A 28-year-old woman with cauliflower-like growth on vulva. Diagnosis? | A. Genital warts (HPV 6, 11) | B. Syphilis | C. HSV | D. Chancroid | A. Condyloma acuminata |
| A 30-year-old woman on combined OCP for 3 years, comes with HTN and migraine. Next step? | A. Stop COC | B. Continue | C. Switch to Cu-T | D. Add DMPA | A. Discontinue OCP and switch to non-estrogen method |
| A 25-year-old breastfeeding mother wants contraception. Choice? | A. Progestin-only pill | B. COC | C. IUD | D. Barrier | A. Progestin-only (minipill) |
| A 30-year-old woman with IUD, missed period, abdominal pain. Diagnosis? | A. Ectopic pregnancy | B. Molar | C. Threatened | D. Missed | A. Ectopic pregnancy |
| A 27-year-old with pre-eclampsia. Drug for seizure prophylaxis? | A. Magnesium sulfate | B. Diazepam | C. Phenytoin | D. Phenobarbital | A. Magnesium sulfate |
| A 29-year-old with postpartum bleeding uncontrolled by oxytocin. Next step? | A. Balloon tamponade | B. Hysterectomy | C. Uterine massage | D. Uterine artery ligation | A. Balloon tamponade or surgical ligation if needed |
| A 30-year-old with retained placenta after delivery. Next step? | A. Manual removal | B. Oxytocin | C. Massage | D. Observe | A. Manual removal of placenta |
| A 32-year-old postpartum woman with amenorrhea, inability to breastfeed. Diagnosis? | A. Sheehan syndrome | B. Asherman | C. PCOS | D. Prolactinoma | A. Pituitary necrosis (Sheehan’s syndrome) |
| A 25-year-old primigravida at 39 weeks presents with regular contractions and cervical dilation. Diagnosis? | A. True labor | B. False labor | C. Placenta previa | D. Preterm labor | A. True labor |
| A 28-year-old woman at 36 weeks with irregular contractions and no cervical change. Diagnosis? | A. False labor | B. True labor | C. Abruption | D. Preterm labor | A. False labor |
| A 32-year-old woman with painful contractions and cervix dilated at 30 weeks. Diagnosis? | A. Preterm labor | B. False labor | C. Threatened abortion | D. Incompetent cervix | A. Preterm labor |
| A 29-year-old woman with history of second-trimester losses, painless dilation. Diagnosis? | A. Cervical incompetence | B. Preterm labor | C. Abruption | D. Threatened abortion | A. Cervical incompetence |
| A 28-year-old woman at 28 weeks with BP 150/100, proteinuria, edema. Diagnosis? | A. Pre-eclampsia | B. Gestational HTN | C. Eclampsia | D. Chronic HTN | A. Pre-eclampsia |
| A 30-year-old woman with seizures, hypertension, and proteinuria. Diagnosis? | A. Eclampsia | B. Pre-eclampsia | C. Epilepsy | D. Stroke | A. Eclampsia |
| A 32-year-old woman with eclampsia. Drug of choice? | A. Magnesium sulfate | B. Diazepam | C. Phenytoin | D. Midazolam | A. Magnesium sulfate |
| A 35-year-old woman with BP 160/110 and headache at 34 weeks. Management? | A. Hospitalize + magnesium + delivery | B. Observe | C. Delay delivery | D. Antihypertensive only | A. Control BP, magnesium sulfate, plan delivery |
| A 26-year-old at 33 weeks with painless vaginal bleeding, soft uterus. Diagnosis? | A. Placenta previa | B. Abruption | C. Vasa previa | D. Preterm labor | A. Placenta previa |
| A 30-year-old at 36 weeks with painful bleeding, tender uterus, fetal distress. Diagnosis? | A. Placental abruption | B. Placenta previa | C. Uterine rupture | D. Cord prolapse | A. Abruptio placentae |
| A 29-year-old in labor with sudden pain, loss of fetal station, maternal shock. Diagnosis? | A. Uterine rupture | B. Abruption | C. Cord prolapse | D. Placenta previa | A. Uterine rupture |
| A 28-year-old with visible umbilical cord at introitus, fetal bradycardia. Diagnosis? | A. Cord prolapse | B. Uterine rupture | C. Abruption | D. Placenta previa | A. Umbilical cord prolapse |
| A 30-year-old with retained placenta and bleeding 30 min after delivery. Management? | A. Manual removal | B. Wait | C. Massage | D. Oxytocin | A. Manual removal of placenta |
| A 32-year-old woman with postpartum hemorrhage, uterus soft. Diagnosis? | A. Uterine atony | B. Trauma | C. Retained placenta | D. Coagulopathy | A. Uterine atony |
| A 35-year-old woman with postpartum hemorrhage unresponsive to uterotonics. Next step? | A. Balloon tamponade | B. Uterine artery ligation | C. Hysterectomy | D. Observe | A. Balloon tamponade or surgical ligation if needed |
| A 25-year-old woman with fever, foul-smelling lochia after delivery. Diagnosis? | A. Puerperal sepsis | B. Endometritis | C. UTI | D. Mastitis | A. Puerperal sepsis |
| A 28-year-old woman postpartum with tender uterus, foul lochia, fever. Diagnosis? | A. Endometritis | B. Mastitis | C. Retained placenta | D. Wound infection | A. Puerperal endometritis |
| A 27-year-old woman 2 weeks postpartum with painful breast swelling. Diagnosis? | A. Lactational mastitis | B. Abscess | C. Galactocele | D. Fibrocystic | A. Mastitis |
| A 28-year-old lactating woman with fluctuant tender lump and pus. Diagnosis? | A. Breast abscess | B. Mastitis | C. Fibrocystic | D. Carcinoma | A. Breast abscess |
| A 29-year-old woman 3 months postpartum with failure to lactate, amenorrhea. Diagnosis? | A. Sheehan syndrome | B. Asherman | C. PCOS | D. Hypothyroid | A. Pituitary necrosis (Sheehan’s syndrome) |
| A 32-year-old woman with infertility, amenorrhea after D&C. Diagnosis? | A. Asherman syndrome | B. PCOS | C. Sheehan | D. Hyperprolactinemia | A. Intrauterine adhesions (Asherman) |
| A 25-year-old woman with galactorrhea, amenorrhea, headache. Diagnosis? | A. Prolactinoma | B. PCOS | C. Sheehan | D. Hypothyroidism | A. Pituitary prolactinoma |
| A 30-year-old woman with irregular cycles, obesity, hirsutism. Diagnosis? | A. PCOS | B. Hypothyroidism | C. Cushing | D. CAH | A. Polycystic ovary syndrome |
| A 28-year-old woman with infertility, chocolate cyst on ovary. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. Fibroid | D. PID | A. Endometriosis |
| A 35-year-old woman with heavy bleeding, bulky tender uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. DUB | A. Adenomyosis |
| A 40-year-old woman with irregular heavy bleeding, enlarged irregular uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial CA | D. Polyp | A. Leiomyoma (fibroid) |
| A 55-year-old woman with postmenopausal bleeding. Next step? | A. Endometrial biopsy | B. Pap smear | C. USG | D. Observe | A. Endometrial sampling |
| A 45-year-old woman with post-coital bleeding, friable cervix. Next step? | A. Pap smear | B. Colposcopy | C. HPV test | D. Biopsy | A. Pap smear |
| A 50-year-old with Pap smear HSIL. Next step? | A. Colposcopy and biopsy | B. Repeat Pap | C. HPV vaccine | D. Observe | A. Colposcopy with biopsy |
| A 35-year-old woman with intermenstrual bleeding, endometrial thickness 14 mm. Diagnosis? | A. Endometrial hyperplasia | B. Endometrial cancer | C. DUB | D. Polyp | A. Endometrial hyperplasia |
| A 60-year-old woman with vulvar itching, white patches, loss of vulvar architecture. Diagnosis? | A. Lichen sclerosus | B. Vulvar CA | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus |
| A 65-year-old woman with vulvar ulcer, indurated edges. Diagnosis? | A. Vulvar carcinoma | B. Lichen planus | C. Infection | D. Bartholin cyst | A. Squamous cell carcinoma |
| A 25-year-old woman with cauliflower-like growth, HPV 6 and 11. Diagnosis? | A. Condyloma acuminata | B. HSV | C. Syphilis | D. Chancroid | A. Genital warts |
| A 40-year-old woman on OCP, comes with HTN and migraine. Next step? | A. Stop OCP | B. Continue | C. Switch to Cu-T | D. DMPA | A. Stop OCP and change to non-estrogen method |
| A 26-year-old breastfeeding woman seeking contraception. Best choice? | A. Progestin-only pill | B. Combined OCP | C. Cu-T | D. Condom | A. Progestin-only (minipill) |
| A 30-year-old woman wants long-term reversible contraception. Option? | A. Copper IUD | B. Barrier | C. Pill | D. Injection | A. Copper IUD |
| A 30-year-old woman with IUD and missed period. Next step? | A. Pregnancy test | B. Remove IUD | C. USG | D. Observe | A. Urine pregnancy test to rule out ectopic |
| A 25-year-old woman wants permanent contraception. Option? | A. Tubal ligation | B. Cu-T | C. Vasectomy | D. Implant | A. Tubal ligation |
| A 35-year-old man wants permanent contraception. Option? | A. Vasectomy | B. Condom | C. Implant | D. Pill | A. Vasectomy |
| A 30-year-old primigravida with breech presentation at 37 weeks. Next step? | A. External cephalic version | B. C-section | C. Wait | D. Induce labor | A. Attempt external cephalic version at 37 weeks if no contraindication |
| A 28-year-old woman with transverse lie in labor. Management? | A. Cesarean section | B. Version | C. Forceps | D. Observe | A. Cesarean section |
| A 25-year-old at 32 weeks with multiple pregnancies, uterine size larger than expected. Diagnosis? | A. Twin pregnancy | B. Molar | C. Polyhydramnios | D. Fibroid | A. Twin gestation |
| A 29-year-old with polyhydramnios. Associated fetal anomaly? | A. Esophageal atresia | B. Renal agenesis | C. Cardiac defect | D. Anencephaly | A. Esophageal atresia or anencephaly |
| A 30-year-old woman with oligohydramnios. Associated condition? | A. Renal agenesis | B. TEF | C. Anencephaly | D. Cardiac defect | A. Bilateral renal agenesis |
| A 27-year-old G2P1 with macrosomia, polyhydramnios, glucose intolerance. Diagnosis? | A. Gestational diabetes | B. PIH | C. Pre-eclampsia | D. Twin | A. Gestational diabetes mellitus |
| A 32-year-old diabetic pregnant woman with large baby, shoulder dystocia. Complication? | A. Brachial plexus injury | B. Uterine rupture | C. Cord prolapse | D. Placenta previa | A. Erb’s palsy (brachial plexus injury) |
| A 25-year-old woman in labor with excessive bleeding after delivery, soft uterus. Diagnosis? | A. Uterine atony | B. Retained placenta | C. Trauma | D. Coagulopathy | A. Uterine atony |
| A 35-year-old with postpartum bleeding, uterus firm, laceration present. Diagnosis? | A. Genital tract trauma | B. Atony | C. Retained placenta | D. DIC | A. Genital tract laceration |
| A 30-year-old woman with postpartum hemorrhage not responding to uterotonics. Next step? | A. Balloon tamponade | B. Uterine artery ligation | C. Hysterectomy | D. Observe | A. Balloon tamponade, if fails → surgical ligation |
| A 29-year-old woman with persistent postpartum bleeding, uterus well-contracted. Diagnosis? | A. Retained products | B. Atony | C. Trauma | D. Coagulopathy | A. Retained products of conception |
| A 27-year-old woman with fever, foul lochia, uterine tenderness. Diagnosis? | A. Puerperal endometritis | B. Mastitis | C. Retained placenta | D. Sepsis | A. Postpartum endometritis |
| A 25-year-old postpartum woman with painful breast lump, erythema, fever. Diagnosis? | A. Mastitis | B. Abscess | C. Fibroadenoma | D. Cancer | A. Lactational mastitis |
| A 30-year-old woman with breast abscess, fluctuance, pus. Management? | A. Incision and drainage | B. Antibiotics only | C. Observe | D. Needle aspirate | A. Surgical drainage + antibiotics |
| A 32-year-old with postpartum inability to lactate and amenorrhea. Diagnosis? | A. Sheehan syndrome | B. PCOS | C. Asherman | D. Hypothyroidism | A. Pituitary necrosis (Sheehan’s) |
| A 29-year-old with secondary amenorrhea, infertility after D&C. Diagnosis? | A. Asherman syndrome | B. PCOS | C. Sheehan | D. Prolactinoma | A. Asherman syndrome (intrauterine adhesions) |
| A 24-year-old woman with primary amenorrhea, normal breasts, absent uterus. Diagnosis? | A. MRKH | B. Androgen insensitivity | C. Turner | D. Hypothalamic | A. Müllerian agenesis (MRKH) |
| A 18-year-old girl with tall stature, sparse hair, testes palpable. Diagnosis? | A. Androgen insensitivity | B. Turner | C. MRKH | D. CAH | A. Testicular feminization syndrome |
| A 16-year-old with short stature, webbed neck, streak gonads. Diagnosis? | A. Turner | B. MRKH | C. CAH | D. Hypogonadism | A. Turner syndrome |
| A 26-year-old with infertility, high FSH/LH, low estrogen. Diagnosis? | A. Premature ovarian failure | B. PCOS | C. Hypothalamic | D. Sheehan | A. Premature ovarian failure |
| A 30-year-old woman with hirsutism, obesity, anovulation. Diagnosis? | A. PCOS | B. CAH | C. Cushing | D. Thyroid | A. Polycystic ovary syndrome |
| A 35-year-old woman with hot flashes, FSH > 40, LH high. Diagnosis? | A. Premature ovarian failure | B. Menopause | C. PCOS | D. Hypogonadism | A. Premature ovarian insufficiency |
| A 50-year-old woman with vaginal dryness, hot flashes, and amenorrhea. Diagnosis? | A. Menopause | B. Premature ovarian failure | C. Hypothyroidism | D. PCOS | A. Menopause |
| A 55-year-old postmenopausal woman with vaginal bleeding. First step? | A. Endometrial biopsy | B. Pap smear | C. USG | D. Observe | A. Endometrial sampling to rule out malignancy |
| A 45-year-old woman with irregular bleeding, thick endometrium. Diagnosis? | A. Endometrial hyperplasia | B. Cancer | C. DUB | D. Polyp | A. Endometrial hyperplasia |
| A 60-year-old woman with postmenopausal bleeding, high estrogen exposure. Diagnosis? | A. Endometrial carcinoma | B. Cervical CA | C. Ovarian CA | D. Vaginal CA | A. Endometrial adenocarcinoma |
| A 45-year-old woman with contact bleeding, foul discharge, ulcerated cervix. Diagnosis? | A. Cervical cancer | B. PID | C. Erosion | D. Polyp | A. Cervical carcinoma |
| A 50-year-old woman with postmenopausal bleeding, mass in ovary, CA-125 elevated. Diagnosis? | A. Ovarian carcinoma | B. Fibroid | C. Endometrial CA | D. Cyst | A. Epithelial ovarian carcinoma |
| A 60-year-old woman with vulvar itching, white patch, lichenified skin. Diagnosis? | A. Lichen sclerosus | B. Vulvar CA | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus |
| A 65-year-old woman with ulcerated vulvar mass, indurated edges. Diagnosis? | A. Vulvar carcinoma | B. Lichen planus | C. Bartholin cyst | D. HSV | A. Squamous cell carcinoma of vulva |
| A 30-year-old woman with cauliflower-like genital growth. Diagnosis? | A. HPV condyloma | B. HSV | C. Syphilis | D. Chancroid | A. Condyloma acuminata (HPV 6, 11) |
| A 28-year-old with painful vesicular genital lesions. Diagnosis? | A. HSV infection | B. Syphilis | C. Chancroid | D. LGV | A. Genital herpes simplex infection |
| A 26-year-old with painless ulcer, indurated edges, serous discharge. Diagnosis? | A. Syphilis | B. Chancroid | C. HSV | D. LGV | A. Primary syphilis (chancre) |
| A 24-year-old with painful ulcer, ragged edges, tender nodes. Diagnosis? | A. Chancroid | B. Syphilis | C. LGV | D. HSV | A. Chancroid (H. ducreyi) |
| A 30-year-old with painless ulcer, then inguinal buboes. Diagnosis? | A. Lymphogranuloma venereum | B. Chancroid | C. Syphilis | D. HSV | A. LGV (C. trachomatis L1-L3) |
| A 25-year-old woman with dysuria, vaginal discharge, clue cells. Diagnosis? | A. Bacterial vaginosis | B. Candida | C. Trichomonas | D. Chlamydia | A. Bacterial vaginosis |
| A 27-year-old woman with thick curdy discharge, intense itching, pH < 4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Gonorrhea | A. Vulvovaginal candidiasis |
| A 30-year-old with frothy discharge, strawberry cervix, motile organisms on wet mount. Diagnosis? | A. Trichomonas | B. BV | C. Candida | D. HSV | A. Trichomonas vaginalis |
| A 26-year-old woman with mucopurulent discharge, cervical motion tenderness. Diagnosis? | A. PID | B. BV | C. Candida | D. Trichomonas | A. Pelvic inflammatory disease |
| A 60-year-old man with chest pain radiating to jaw and arm, relieved by rest. Diagnosis? | A. Unstable angina | B. Stable angina | C. NSTEMI | D. STEMI | B. Stable angina |
| A 58-year-old man with chest pain at rest, normal ECG, troponin negative. Diagnosis? | A. Unstable angina | B. NSTEMI | C. STEMI | D. Prinzmetal | A. Unstable angina |
| A 60-year-old with ST elevation in V1–V4 and raised troponin. Diagnosis? | A. Anterior MI | B. Inferior MI | C. Posterior MI | D. Lateral MI | A. Anterior wall STEMI |
| A 65-year-old with ST elevation in II, III, aVF. Diagnosis? | A. Anterior MI | B. Inferior MI | C. Lateral MI | D. Posterior MI | B. Inferior wall STEMI |
| A 60-year-old post-MI patient develops pansystolic murmur at apex. Diagnosis? | A. Papillary muscle rupture | B. VSD | C. MR | D. TR | A. Papillary muscle rupture causing acute MR |
| A 55-year-old man with ST-depression in V2–V3, tall R waves in V1. Diagnosis? | A. Posterior MI | B. Anterior MI | C. Lateral MI | D. Inferior MI | A. Posterior wall MI |
| A 60-year-old with crushing chest pain, hypotension, JVP elevated, clear lungs. Diagnosis? | A. RV infarction | B. LV failure | C. Tamponade | D. PE | A. Right ventricular infarction |
| A 55-year-old man with systolic murmur radiating to carotids. Diagnosis? | A. Aortic stenosis | B. Mitral regurgitation | C. VSD | D. ASD | A. Aortic stenosis |
| A 60-year-old with early diastolic murmur and wide pulse pressure. Diagnosis? | A. Aortic regurgitation | B. MS | C. MR | D. TR | A. Aortic regurgitation |
| A 45-year-old woman with mid-diastolic murmur, opening snap at apex. Diagnosis? | A. Mitral stenosis | B. AR | C. MR | D. TR | A. Mitral stenosis |
| A 50-year-old with pansystolic murmur radiating to axilla. Diagnosis? | A. MR | B. TR | C. VSD | D. AS | A. Mitral regurgitation |
| A 55-year-old man with murmur increasing on inspiration. Diagnosis? | A. Tricuspid regurgitation | B. MR | C. AS | D. VSD | A. Tricuspid regurgitation |
| A 25-year-old with continuous machinery murmur. Diagnosis? | A. PDA | B. ASD | C. VSD | D. TOF | A. Patent ductus arteriosus |
| A 5-year-old with harsh pansystolic murmur LLSB. Diagnosis? | A. VSD | B. ASD | C. PDA | D. TOF | A. Ventricular septal defect |
| A 30-year-old woman with fixed split S2, pulmonary flow murmur. Diagnosis? | A. ASD | B. VSD | C. PDA | D. TOF | A. Atrial septal defect |
| A 3-year-old child with cyanosis, clubbing, squatting relief. Diagnosis? | A. TOF | B. TGA | C. VSD | D. PDA | A. Tetralogy of Fallot |
| A 40-year-old man with systolic BP 180, diastolic 120, papilledema. Diagnosis? | A. Hypertensive emergency | B. Urgency | C. Crisis | D. Stable HTN | A. Hypertensive emergency |
| A 65-year-old with tearing chest pain radiating to back, unequal pulses. Diagnosis? | A. Aortic dissection | B. MI | C. PE | D. Tamponade | A. Aortic dissection |
| A 55-year-old man with chronic cough, sputum for >3 months in 2 years. Diagnosis? | A. Chronic bronchitis | B. Emphysema | C. Asthma | D. Bronchiectasis | A. Chronic bronchitis |
| A 60-year-old smoker with dyspnea, barrel chest, pursed-lip breathing. Diagnosis? | A. Emphysema | B. COPD | C. Asthma | D. Bronchiectasis | A. Emphysema |
| A 40-year-old man with episodic wheeze and reversible airflow obstruction. Diagnosis? | A. Asthma | B. COPD | C. Bronchiectasis | D. PE | A. Asthma |
| A 60-year-old man with foul purulent sputum, clubbing. Diagnosis? | A. Bronchiectasis | B. COPD | C. Asthma | D. TB | A. Bronchiectasis |
| A 45-year-old man with hemoptysis, night sweats, weight loss. Diagnosis? | A. TB | B. Cancer | C. Pneumonia | D. Abscess | A. Pulmonary tuberculosis |
| A 35-year-old with pneumonia, hyponatremia, diarrhea. Organism? | A. Legionella | B. Strep pneumo | C. Klebsiella | D. Mycoplasma | A. Legionella pneumophila |
| A 25-year-old with dry cough, patchy infiltrates, cold agglutinins. Diagnosis? | A. Mycoplasma pneumonia | B. Chlamydia | C. Legionella | D. Viral | A. Mycoplasma pneumoniae |
| A 60-year-old with pleuritic pain, dyspnea, tachycardia, D-dimer high. Diagnosis? | A. PE | B. Pneumonia | C. MI | D. Asthma | A. Pulmonary embolism |
| A 65-year-old man with chronic cough, weight loss, clubbing, mass on X-ray. Diagnosis? | A. Bronchogenic carcinoma | B. TB | C. COPD | D. Bronchiectasis | A. Lung cancer |
| A 40-year-old man with dry cough, bilateral hilar lymphadenopathy. Diagnosis? | A. Sarcoidosis | B. TB | C. Lymphoma | D. COPD | A. Sarcoidosis |
| A 60-year-old man with hematuria, hemoptysis, anti-GBM positive. Diagnosis? | A. Goodpasture | B. Wegener | C. PAN | D. SLE | A. Goodpasture syndrome |
| A 45-year-old man with sinusitis, hematuria, c-ANCA positive. Diagnosis? | A. Wegener granulomatosis | B. PAN | C. Goodpasture | D. SLE | A. Granulomatosis with polyangiitis (Wegener) |
| A 50-year-old man with HTN, proteinuria, edema. Diagnosis? | A. Chronic renal disease | B. Nephrotic | C. Nephritic | D. AKI | A. Chronic kidney disease |
| A 35-year-old man post-sore throat, cola-colored urine, edema. Diagnosis? | A. PSGN | B. IgA nephropathy | C. Lupus | D. Diabetic | A. Post-streptococcal glomerulonephritis |
| A 25-year-old with recurrent hematuria after URI, normal complement. Diagnosis? | A. IgA nephropathy | B. PSGN | C. Lupus | D. HSP | A. IgA nephropathy (Berger) |
| A 55-year-old diabetic with proteinuria, retinopathy, CKD. Diagnosis? | A. Diabetic nephropathy | B. Amyloidosis | C. FSGS | D. Lupus | A. Diabetic nephropathy |
| A 50-year-old man with hematuria, flank mass, polycythemia. Diagnosis? | A. RCC | B. PKD | C. Stone | D. Pyelonephritis | A. Renal cell carcinoma |
| A 60-year-old man with smoking history, painless hematuria. Diagnosis? | A. Bladder cancer | B. RCC | C. Stone | D. Infection | A. Transitional cell carcinoma of bladder |
| A 40-year-old woman with malar rash, arthritis, proteinuria. Diagnosis? | A. SLE | B. RA | C. Dermatomyositis | D. PAN | A. Systemic lupus erythematosus |
| A 45-year-old woman with dry mouth, dry eyes, parotid swelling. Diagnosis? | A. Sjögren | B. SLE | C. RA | D. Dermatomyositis | A. Sjögren syndrome |
| A 30-year-old woman with heliotrope rash, Gottron papules, proximal weakness. Diagnosis? | A. Dermatomyositis | B. Polymyositis | C. SLE | D. RA | A. Dermatomyositis |
| A 45-year-old woman with proximal muscle weakness, no rash, ↑ CK. Diagnosis? | A. Polymyositis | B. Dermatomyositis | C. RA | D. SLE | A. Polymyositis |
| A 40-year-old with Raynaud’s, sclerodactyly, telangiectasia. Diagnosis? | A. Systemic sclerosis | B. Dermatomyositis | C. SLE | D. RA | A. Limited systemic sclerosis (CREST) |
| A 30-year-old man with urethritis, conjunctivitis, arthritis. Diagnosis? | A. Reactive arthritis | B. RA | C. AS | D. SLE | A. Reiter syndrome (Reactive arthritis) |
| A 25-year-old man with back pain, morning stiffness, HLA-B27 positive. Diagnosis? | A. Ankylosing spondylitis | B. RA | C. OA | D. Gout | A. Ankylosing spondylitis |
| A 40-year-old with big-toe pain, needle-shaped crystals, negative birefringence. Diagnosis? | A. Gout | B. Pseudogout | C. RA | D. OA | A. Gout |
| A 60-year-old with knee pain, rhomboid crystals, positive birefringence. Diagnosis? | A. Pseudogout | B. Gout | C. RA | D. OA | A. Calcium pyrophosphate deposition disease (Pseudogout) |
| A 60-year-old man with anemia, bone pain, and lytic skull lesions. Diagnosis? | A. Multiple myeloma | B. Metastasis | C. Osteoporosis | D. Paget | A. Multiple myeloma |
| A 65-year-old with recurrent infections, M-spike on electrophoresis. Diagnosis? | A. Multiple myeloma | B. MGUS | C. Waldenström | D. Lymphoma | A. Multiple myeloma |
| A 70-year-old man with lymphocytosis, smudge cells. Diagnosis? | A. CLL | B. CML | C. AML | D. ALL | A. Chronic lymphocytic leukemia |
| A 50-year-old with basophilia, splenomegaly, t(9;22). Diagnosis? | A. CML | B. AML | C. CLL | D. PV | A. Chronic myeloid leukemia |
| A 5-year-old child with anemia, bone pain, hepatosplenomegaly. Diagnosis? | A. ALL | B. AML | C. CML | D. Lymphoma | A. Acute lymphoblastic leukemia |
| A 40-year-old man with blasts and Auer rods. Diagnosis? | A. AML | B. ALL | C. CML | D. CLL | A. Acute myeloid leukemia |
| A 35-year-old man with painless lymphadenopathy, Reed–Sternberg cells. Diagnosis? | A. Hodgkin lymphoma | B. NHL | C. CLL | D. TB | A. Hodgkin lymphoma |
| A 55-year-old man with B-symptoms and multiple nodes. Diagnosis? | A. Non-Hodgkin lymphoma | B. Hodgkin | C. CLL | D. TB | A. Non-Hodgkin lymphoma |
| A 60-year-old with anemia, renal failure, hypercalcemia. Diagnosis? | A. Multiple myeloma | B. MGUS | C. Lymphoma | D. CML | A. Multiple myeloma |
| A 65-year-old with IgM spike, hyperviscosity. Diagnosis? | A. Waldenström macroglobulinemia | B. MM | C. MGUS | D. Lymphoma | A. Waldenström macroglobulinemia |
| A 40-year-old woman with petechiae, low platelets, normal PT/PTT. Diagnosis? | A. ITP | B. TTP | C. DIC | D. HUS | A. Immune thrombocytopenic purpura |
| A 35-year-old with fever, anemia, thrombocytopenia, renal failure, neurologic symptoms. Diagnosis? | A. TTP | B. HUS | C. DIC | D. ITP | A. Thrombotic thrombocytopenic purpura |
| A 5-year-old post-diarrhea child with anemia, thrombocytopenia, renal failure. Diagnosis? | A. HUS | B. TTP | C. DIC | D. ITP | A. Hemolytic uremic syndrome |
| A 60-year-old septic patient with bleeding, prolonged PT/aPTT. Diagnosis? | A. DIC | B. TTP | C. HUS | D. ITP | A. Disseminated intravascular coagulation |
| A 55-year-old man with pruritus after hot bath, Hct ↑, EPO ↓. Diagnosis? | A. Polycythemia vera | B. Secondary polycythemia | C. CML | D. PV deficiency | A. Polycythemia vera |
| A 45-year-old with migratory thrombophlebitis and pancreatic mass. Diagnosis? | A. Trousseau syndrome | B. DVT | C. Factor V Leiden | D. DIC | A. Trousseau’s migratory thrombophlebitis |
| A 60-year-old with DVT and normal PT/PTT. Likely cause? | A. Factor V Leiden | B. Protein C deficiency | C. Antithrombin III deficiency | D. All | D. Inherited thrombophilia |
| A 40-year-old with microcytosis, target cells, normal iron. Diagnosis? | A. Thalassemia | B. IDA | C. Sideroblastic | D. ACD | A. Thalassemia trait |
| A 30-year-old woman with menorrhagia, low Hb, high TIBC. Diagnosis? | A. Iron deficiency anemia | B. Thalassemia | C. ACD | D. Hemolytic | A. Iron deficiency anemia |
| A 50-year-old vegetarian with macrocytosis, hypersegmented neutrophils. Diagnosis? | A. Megaloblastic anemia | B. IDA | C. ACD | D. Thalassemia | A. Megaloblastic anemia (B12/folate deficiency) |
| A 60-year-old man with pallor, glossitis, paresthesia. Diagnosis? | A. B12 deficiency | B. Folate | C. Iron | D. Chronic disease | A. Vitamin B12 deficiency |
| A 55-year-old man with fatigue, weight loss, hepatosplenomegaly, Hb ↑. Diagnosis? | A. Myelofibrosis | B. CML | C. PV | D. Leukemia | A. Myeloproliferative disorder (PV/myelofibrosis variant) |
| A 40-year-old woman with polyuria, polydipsia, fasting glucose > 126 mg/dL. Diagnosis? | A. Type 2 DM | B. Type 1 DM | C. DI | D. Stress hyperglycemia | A. Type 2 diabetes mellitus |
| A 20-year-old with polyuria, weight loss, ketones in urine. Diagnosis? | A. Type 1 DM | B. Type 2 DM | C. DI | D. Cushing | A. Type 1 diabetes mellitus |
| A 50-year-old diabetic with polyuria, polydipsia, glucose 600, no ketones. Diagnosis? | A. HONK | B. DKA | C. Lactic acidosis | D. Hypoglycemia | A. Hyperosmolar non-ketotic coma |
| A 25-year-old type 1 diabetic with fruity breath, Kussmaul breathing. Diagnosis? | A. DKA | B. HONK | C. Lactic acidosis | D. Uremia | A. Diabetic ketoacidosis |
| A 55-year-old with HbA1c 9%. Interpretation? | A. Poor control | B. Good control | C. Normal | D. Low | A. Poor glycemic control |
| A 50-year-old diabetic with microalbuminuria. Next step? | A. ACE inhibitor | B. ARB | C. Loop diuretic | D. CCB | A. Start ACE inhibitor |
| A 60-year-old diabetic with absent ankle reflexes. Diagnosis? | A. Peripheral neuropathy | B. Nephropathy | C. Retinopathy | D. Myopathy | A. Diabetic peripheral neuropathy |
| A 55-year-old with retinopathy and nephropathy. Type of complication? | A. Microvascular | B. Macrovascular | C. Neuropathic | D. None | A. Microvascular |
| A 60-year-old with MI and stroke. Complication type? | A. Macrovascular | B. Microvascular | C. Acute | D. Neuropathic | A. Macrovascular |
| A 45-year-old with hypoglycemia, ↑ insulin, ↓ C-peptide. Diagnosis? | A. Exogenous insulin use | B. Insulinoma | C. Sulfonylurea | D. Addison | A. Exogenous insulin administration |
| A 40-year-old with ↑ insulin and C-peptide during hypoglycemia. Diagnosis? | A. Insulinoma | B. Addison | C. Factitious | D. GH tumor | A. Pancreatic insulinoma |
| A 30-year-old woman with weight loss, heat intolerance, tremor, palpitations. Diagnosis? | A. Hyperthyroidism | B. Hypothyroidism | C. Anxiety | D. Pheochromocytoma | A. Hyperthyroidism |
| A 28-year-old with exophthalmos, pretibial myxedema. Diagnosis? | A. Graves disease | B. Hashimoto | C. Thyroiditis | D. Toxic adenoma | A. Graves disease |
| A 45-year-old woman with cold intolerance, weight gain, dry skin. Diagnosis? | A. Hypothyroidism | B. Cushing | C. Addison | D. PCOS | A. Primary hypothyroidism |
| A 50-year-old with painful thyroid post-viral infection. Diagnosis? | A. De Quervain thyroiditis | B. Graves | C. Hashimoto | D. Riedel | A. Subacute (De Quervain) thyroiditis |
| A 55-year-old woman with hard woody thyroid fixed to trachea. Diagnosis? | A. Riedel thyroiditis | B. Hashimoto | C. Graves | D. De Quervain | A. Riedel thyroiditis |
| A 45-year-old woman with painless goiter and hypothyroidism. Diagnosis? | A. Hashimoto | B. Graves | C. Subacute | D. Riedel | A. Hashimoto thyroiditis |
| A 40-year-old woman with solitary thyroid nodule, cold on scan. Next step? | A. FNAC | B. Observe | C. Surgery | D. Radioiodine | A. Fine-needle aspiration cytology |
| A 50-year-old woman with thyroid nodule, calcitonin elevated. Diagnosis? | A. Medullary carcinoma | B. Papillary | C. Follicular | D. Anaplastic | A. Medullary thyroid carcinoma |
| A 40-year-old with papillary structures and psammoma bodies. Diagnosis? | A. Papillary carcinoma | B. Follicular | C. Medullary | D. Anaplastic | A. Papillary thyroid carcinoma |
| A 55-year-old with solitary thyroid nodule, capsular invasion, hematogenous spread. Diagnosis? | A. Follicular carcinoma | B. Papillary | C. Medullary | D. Anaplastic | A. Follicular carcinoma |
| A 70-year-old with rapidly enlarging thyroid, compressive symptoms. Diagnosis? | A. Anaplastic carcinoma | B. Medullary | C. Papillary | D. Follicular | A. Anaplastic carcinoma |
| A 45-year-old woman with fatigue, weight gain, hypotension, hyperpigmentation. Diagnosis? | A. Addison disease | B. Cushing | C. Conn | D. SIADH | A. Primary adrenal insufficiency (Addison’s disease) |
| A 35-year-old woman with moon face, truncal obesity, striae, HTN. Diagnosis? | A. Cushing syndrome | B. Addison | C. Conn | D. PCOS | A. Cushing syndrome |
| A 40-year-old man with HTN, hypokalemia, metabolic alkalosis. Diagnosis? | A. Conn syndrome | B. Addison | C. Cushing | D. Pheochromocytoma | A. Primary hyperaldosteronism (Conn’s) |
| A 50-year-old man with episodic headache, sweating, palpitations, HTN. Diagnosis? | A. Pheochromocytoma | B. Cushing | C. Conn | D. Addison | A. Pheochromocytoma |
| A 45-year-old woman with MEN 2A. Involved tumors? | A. Medullary thyroid + Pheo + Parathyroid | B. Pituitary + Pancreas + PTH | C. Pheo + GH | D. Adrenal + Pancreas | A. Medullary thyroid carcinoma, pheochromocytoma, and hyperparathyroidism |
| A 60-year-old woman with confusion, Na 118, osmolality low, concentrated urine. Diagnosis? | A. SIADH | B. DI | C. Addison | D. Cushing | A. Syndrome of inappropriate ADH secretion |
| A 30-year-old man with polyuria, polydipsia, hypernatremia, dilute urine. Diagnosis? | A. Diabetes insipidus | B. SIADH | C. DM | D. Addison | A. Central diabetes insipidus |
| A 40-year-old man with fatigue, weakness, hyperkalemia, low cortisol. Diagnosis? | A. Addison disease | B. Conn | C. Cushing | D. SIADH | A. Addison’s disease |
| A 35-year-old woman with truncal obesity, HTN, purple striae. Diagnosis? | A. Cushing | B. Addison | C. Conn | D. PCOS | A. Cushing syndrome |
| A 50-year-old woman with central obesity, buffalo hump, high cortisol, low ACTH. Diagnosis? | A. Adrenal adenoma | B. Cushing disease | C. Ectopic ACTH | D. Steroid use | A. Adrenal adenoma (ACTH-independent Cushing) |
| A 60-year-old man with galactorrhea, low libido. Diagnosis? | A. Prolactinoma | B. GH tumor | C. ACTH adenoma | D. Cushing | A. Pituitary prolactinoma |
| A 40-year-old man with large hands, jaw enlargement, elevated IGF-1. Diagnosis? | A. Acromegaly | B. Gigantism | C. Cushing | D. GH deficiency | A. Acromegaly |
| A 45-year-old woman with central obesity, amenorrhea, HTN, glucose intolerance. Diagnosis? | A. Cushing syndrome | B. PCOS | C. Addison | D. Conn | A. Cushing syndrome |
| A 30-year-old woman with amenorrhea, galactorrhea, visual field defect. Diagnosis? | A. Prolactinoma | B. Craniopharyngioma | C. Cushing | D. GH tumor | A. Pituitary microadenoma (Prolactinoma) |
| A 35-year-old man with polyuria, dilute urine, hypernatremia. Diagnosis? | A. Diabetes insipidus | B. SIADH | C. DM | D. Addison | A. Diabetes insipidus |
| A 50-year-old man with high calcium, low phosphate, high PTH. Diagnosis? | A. Primary hyperparathyroidism | B. Secondary | C. Tertiary | D. Malignancy | A. Primary hyperparathyroidism |
| A 60-year-old man with hypercalcemia, low PTH. Cause? | A. Malignancy | B. Primary HPT | C. Tertiary | D. Vit D | A. Hypercalcemia of malignancy |
| A 40-year-old with fatigue, low calcium, high phosphate, low PTH. Diagnosis? | A. Hypoparathyroidism | B. Vit D deficiency | C. CKD | D. Pseudohypoparathyroidism | A. Hypoparathyroidism |
| A 55-year-old man with proximal weakness, hypokalemia, metabolic alkalosis. Diagnosis? | A. Conn | B. Addison | C. Cushing | D. Pheo | A. Primary hyperaldosteronism |
| A 35-year-old woman with hypertension, episodic headache, sweating. Diagnosis? | A. Pheochromocytoma | B. Conn | C. Cushing | D. Addison | A. Pheochromocytoma |
| A 45-year-old woman with hot flashes, FSH high, LH high, estrogen low. Diagnosis? | A. Menopause | B. PCOS | C. POF | D. Hypothyroid | A. Natural menopause |
| A 25-year-old woman with amenorrhea, galactorrhea, normal TSH. Diagnosis? | A. Prolactinoma | B. Sheehan | C. PCOS | D. Hypothyroid | A. Pituitary prolactinoma |
| A 28-year-old woman with obesity, hirsutism, irregular menses. Diagnosis? | A. PCOS | B. Cushing | C. CAH | D. Hypothyroidism | A. Polycystic ovary syndrome |
| A 30-year-old with amenorrhea, normal estrogen, normal FSH, normal LH. Diagnosis? | A. Hypothalamic amenorrhea | B. PCOS | C. Premature ovarian failure | D. Sheehan | A. Hypothalamic amenorrhea |
| A 35-year-old woman with hot flashes, premature amenorrhea, high FSH. Diagnosis? | A. Premature ovarian failure | B. Menopause | C. PCOS | D. Sheehan | A. Premature ovarian insufficiency |
| A 50-year-old woman with vaginal dryness, dyspareunia, hot flashes. Diagnosis? | A. Menopause | B. Hypothyroidism | C. PCOS | D. Sheehan | A. Menopause |
| A 45-year-old man with weight gain, central obesity, glucose intolerance. Diagnosis? | A. Metabolic syndrome | B. Cushing | C. Hypothyroidism | D. PCOS | A. Metabolic syndrome |
| A 60-year-old man with obesity, glucose intolerance, dyslipidemia, HTN. Diagnosis? | A. Metabolic syndrome | B. DM | C. Obesity | D. Hypothyroid | A. Metabolic syndrome (Syndrome X) |
| A 40-year-old man with BMI 33, OSA, HTN. Diagnosis? | A. Obesity hypoventilation | B. OSA | C. COPD | D. Restrictive | A. Obesity hypoventilation (Pickwickian syndrome) |
| A 50-year-old with excessive daytime sleepiness, loud snoring. Diagnosis? | A. Obstructive sleep apnea | B. Obesity hypoventilation | C. COPD | D. CHF | A. Obstructive sleep apnea |
| A 65-year-old man with bradykinesia, tremor, rigidity. Diagnosis? | A. Parkinson’s disease | B. Wilson | C. Essential tremor | D. Huntington | A. Parkinson disease |
| A 25-year-old with ascending paralysis post viral infection. Diagnosis? | A. Guillain–Barré syndrome | B. Myasthenia | C. MS | D. Polio | A. Guillain–Barré syndrome |
| A 30-year-old woman with diplopia, weakness, thymic mass. Diagnosis? | A. Myasthenia gravis | B. Lambert–Eaton | C. GBS | D. MS | A. Myasthenia gravis with thymoma |
| A 35-year-old woman with relapsing visual loss, paresthesia. Diagnosis? | A. Multiple sclerosis | B. GBS | C. MG | D. CVA | A. Multiple sclerosis |
| A 40-year-old man with tremor at rest, shuffling gait. Diagnosis? | A. Parkinson disease | B. Huntington | C. Essential tremor | D. Wilson | A. Parkinson disease |
| A 25-year-old man after a road traffic accident, BP 80/50, pulse 120, cold clammy skin. Diagnosis? | A. Hypovolemic shock | B. Cardiogenic shock | C. Septic shock | D. Neurogenic shock | A. Hypovolemic shock |
| A trauma patient with distended neck veins, muffled heart sounds, hypotension. Diagnosis? | A. Cardiac tamponade | B. Tension pneumothorax | C. Hemothorax | D. PE | A. Cardiac tamponade |
| A 30-year-old with chest trauma, trachea deviated away, absent breath sounds, hyperresonant chest. Diagnosis? | A. Tension pneumothorax | B. Hemothorax | C. Contusion | D. Flail chest | A. Tension pneumothorax |
| A 40-year-old with blunt chest trauma, paradoxical movement of chest wall. Diagnosis? | A. Flail chest | B. Pneumothorax | C. Hemothorax | D. Contusion | A. Flail chest |
| A 35-year-old trauma patient, absent pulses in leg, cold limb. Diagnosis? | A. Arterial injury | B. Venous injury | C. Compartment | D. DVT | A. Arterial injury |
| A 25-year-old man with severe leg pain, pallor, paresthesia, and tense swelling. Diagnosis? | A. Compartment syndrome | B. DVT | C. Cellulitis | D. Crush injury | A. Acute compartment syndrome |
| A 40-year-old man with upper GI bleed after vomiting, mucosal tear at GE junction. Diagnosis? | A. Mallory–Weiss tear | B. Boerhaave | C. Varices | D. PUD | A. Mallory–Weiss syndrome |
| A 60-year-old alcoholic with severe epigastric pain radiating to back. Diagnosis? | A. Acute pancreatitis | B. Perforated ulcer | C. Gallstones | D. PUD | A. Acute pancreatitis |
| A 55-year-old woman with right upper quadrant pain, fever, Murphy’s sign. Diagnosis? | A. Acute cholecystitis | B. Cholangitis | C. Pancreatitis | D. Ulcer | A. Acute calculous cholecystitis |
| A 65-year-old with fever, jaundice, right upper quadrant pain. Diagnosis? | A. Ascending cholangitis | B. Cholecystitis | C. Hepatitis | D. Cirrhosis | A. Charcot triad → Ascending cholangitis |
| A 45-year-old woman with postprandial RUQ pain, normal LFT. Diagnosis? | A. Chronic cholecystitis | B. Acute | C. Choledocholithiasis | D. Pancreatitis | A. Symptomatic gallstones |
| A 60-year-old man with sudden severe epigastric pain, free air under diaphragm. Diagnosis? | A. Perforated peptic ulcer | B. Pancreatitis | C. SBO | D. Appendicitis | A. Perforated peptic ulcer |
| A 55-year-old man with hematemesis and melena, history of NSAID use. Diagnosis? | A. Peptic ulcer disease | B. Varices | C. Mallory-Weiss | D. Gastritis | A. Bleeding peptic ulcer |
| A 50-year-old alcoholic with vomiting then hematemesis. Diagnosis? | A. Mallory-Weiss tear | B. Varices | C. Gastritis | D. Ulcer | A. Mallory–Weiss tear |
| A 60-year-old man with chronic liver disease and hematemesis. Diagnosis? | A. Esophageal varices | B. Mallory-Weiss | C. Ulcer | D. Gastritis | A. Bleeding varices |
| A 45-year-old with acute abdomen, rigid board-like, air under diaphragm. Diagnosis? | A. Perforated duodenal ulcer | B. Pancreatitis | C. Appendicitis | D. SBO | A. Perforated ulcer |
| A 40-year-old man with generalized peritonitis after trauma. Management? | A. Emergency laparotomy | B. Observe | C. CT scan | D. Fluids only | A. Exploratory laparotomy |
| A 25-year-old man with periumbilical pain shifting to right lower quadrant, fever. Diagnosis? | A. Acute appendicitis | B. Cholecystitis | C. Diverticulitis | D. UTI | A. Acute appendicitis |
| A 30-year-old woman with RLQ tenderness, guarding, rebound. Diagnosis? | A. Appendicitis | B. PID | C. Ovarian cyst | D. UTI | A. Acute appendicitis |
| A 65-year-old man with abdominal distension, vomiting, air-fluid levels. Diagnosis? | A. Small bowel obstruction | B. Large bowel | C. Paralytic ileus | D. Pseudo-obstruction | A. SBO (likely adhesions) |
| A 50-year-old with sigmoid volvulus. X-ray finding? | A. Coffee-bean sign | B. Double bubble | C. Air-fluid | D. Free air | A. Coffee-bean sign |
| A 45-year-old man with LLQ pain, fever, constipation. Diagnosis? | A. Diverticulitis | B. Appendicitis | C. UC | D. IBS | A. Acute diverticulitis |
| A 55-year-old with painless rectal bleeding, altered bowel habits, anemia. Diagnosis? | A. Colorectal cancer | B. Hemorrhoid | C. Polyp | D. UC | A. Colorectal carcinoma |
| A 50-year-old man with acute anal pain and bleeding during defecation. Diagnosis? | A. Anal fissure | B. Hemorrhoid | C. Fistula | D. Abscess | A. Anal fissure |
| A 45-year-old with perianal pain, swelling, fever. Diagnosis? | A. Perianal abscess | B. Fistula | C. Fissure | D. Hemorrhoids | A. Perianal abscess |
| A 40-year-old with chronic perianal discharge and external opening. Diagnosis? | A. Fistula-in-ano | B. Abscess | C. Fissure | D. Hemorrhoid | A. Anal fistula |
| A 50-year-old with painless rectal bleeding and prolapse during defecation. Diagnosis? | A. Internal hemorrhoids | B. Fissure | C. Cancer | D. Polyp | A. Internal hemorrhoids |
| A 60-year-old man with jaundice, palpable gallbladder. Diagnosis? | A. Carcinoma head of pancreas | B. Cirrhosis | C. Stone | D. Hepatitis | A. Pancreatic head carcinoma (Courvoisier’s sign) |
| A 40-year-old man with swelling in groin above inguinal ligament, reducible. Diagnosis? | A. Indirect inguinal hernia | B. Direct | C. Femoral | D. Hydrocele | A. Indirect inguinal hernia |
| A 60-year-old man with groin bulge medial to epigastric vessels. Diagnosis? | A. Direct inguinal hernia | B. Indirect | C. Femoral | D. Umbilical | A. Direct inguinal hernia |
| A 55-year-old woman with groin swelling below inguinal ligament. Diagnosis? | A. Femoral hernia | B. Direct | C. Indirect | D. Umbilical | A. Femoral hernia |
| A 45-year-old woman with midline abdominal bulge after surgery. Diagnosis? | A. Incisional hernia | B. Umbilical | C. Epigastric | D. Femoral | A. Incisional hernia |
| A 50-year-old with umbilical swelling, reducible. Diagnosis? | A. Umbilical hernia | B. Paraumbilical | C. Incisional | D. Epigastric | A. Umbilical hernia |
| A 35-year-old with swelling above umbilicus, not reducible. Diagnosis? | A. Epigastric hernia | B. Paraumbilical | C. Umbilical | D. Incisional | A. Epigastric hernia |
| A 25-year-old man with painful swelling in scrotum, absent cremasteric reflex. Diagnosis? | A. Testicular torsion | B. Epididymitis | C. Hydrocele | D. Varicocele | A. Testicular torsion |
| A 30-year-old man with scrotal swelling, transillumination positive. Diagnosis? | A. Hydrocele | B. Varicocele | C. Hernia | D. Epididymitis | A. Hydrocele |
| A 35-year-old man with bag-of-worms feel, infertility. Diagnosis? | A. Varicocele | B. Hydrocele | C. Torsion | D. Epididymitis | A. Varicocele |
| A 60-year-old man with firm nodular prostate, PSA elevated. Diagnosis? | A. Prostate cancer | B. BPH | C. Prostatitis | D. UTI | A. Adenocarcinoma prostate |
| A 55-year-old man with smooth enlarged prostate, no nodules. Diagnosis? | A. BPH | B. Cancer | C. Prostatitis | D. Stricture | A. Benign prostatic hyperplasia |
| A 50-year-old man with fever, dysuria, tender prostate. Diagnosis? | A. Acute prostatitis | B. BPH | C. Cancer | D. Retention | A. Acute bacterial prostatitis |
| A 40-year-old man with hematuria, flank pain, mass. Diagnosis? | A. RCC | B. Stone | C. Cystitis | D. PKD | A. Renal cell carcinoma |
| A 45-year-old woman with flank pain, fever, CVA tenderness. Diagnosis? | A. Pyelonephritis | B. Cystitis | C. Stone | D. Tumor | A. Acute pyelonephritis |
| A 60-year-old smoker with painless gross hematuria. Diagnosis? | A. Bladder cancer | B. RCC | C. Cystitis | D. Stone | A. Transitional cell carcinoma |
| A 25-year-old man with fracture midshaft humerus, wrist drop. Nerve injured? | A. Radial nerve | B. Ulnar | C. Median | D. Axillary | A. Radial nerve |
| A 40-year-old man with shoulder dislocation, loss of abduction. Nerve injured? | A. Axillary | B. Radial | C. Median | D. Ulnar | A. Axillary nerve |
| A 30-year-old man with supracondylar humerus fracture, loss of thumb opposition. Nerve injured? | A. Median | B. Ulnar | C. Radial | D. Axillary | A. Median nerve |
| A 40-year-old man with elbow injury, claw hand deformity. Nerve injured? | A. Ulnar | B. Median | C. Radial | D. Axillary | A. Ulnar nerve |
| A 25-year-old with pelvic fracture and foot drop. Nerve injured? | A. Common peroneal | B. Femoral | C. Tibial | D. Sciatic | A. Common peroneal nerve |
| A 70-year-old woman with hip fracture, leg shortened and externally rotated. Diagnosis? | A. Neck of femur fracture | B. Intertrochanteric | C. Shaft fracture | D. Dislocation | A. Fracture neck of femur |
| A 25-year-old with tibial fracture and severe pain, tense compartment. Diagnosis? | A. Compartment syndrome | B. DVT | C. Arterial occlusion | D. Infection | A. Acute compartment syndrome |
| A 40-year-old smoker with black toe, absent pulses. Diagnosis? | A. Arterial gangrene | B. Venous | C. Neuropathic | D. Pressure | A. Arterial ischemic gangrene |
| A 65-year-old diabetic with painless plantar ulcer. Diagnosis? | A. Neuropathic ulcer | B. Venous | C. Arterial | D. Pressure | A. Diabetic neuropathic ulcer |
| A 60-year-old with ulcer above medial malleolus, edema, pigmentation. Diagnosis? | A. Venous ulcer | B. Arterial | C. Pressure | D. Neuropathic | A. Venous ulcer |
| A 30-year-old woman with tortuous leg veins, aching on standing. Diagnosis? | A. Varicose veins | B. DVT | C. Lymphedema | D. Cellulitis | A. Primary varicose veins |
| A 65-year-old man with rest pain, absent pulses, nonhealing toe ulcer. Diagnosis? | A. Critical limb ischemia | B. DVT | C. Venous ulcer | D. Cellulitis | A. Peripheral arterial disease (critical limb ischemia) |
| A 45-year-old with crush injury, severe pain, paresthesia, pallor. Diagnosis? | A. Compartment syndrome | B. DVT | C. Arterial occlusion | D. Infection | A. Acute compartment syndrome |
| A 25-year-old man with 40% flame burns. Immediate management? | A. Airway + fluid resuscitation | B. Antibiotic | C. Dressing | D. Surgery | A. Airway control and IV fluids |
| A 50-year-old with facial burns, hoarseness, singed nasal hairs. Management? | A. Early intubation | B. Observe | C. Oxygen only | D. Fluids | A. Early airway intubation |
| A 30-year-old man with chemical burn to arm. Immediate management? | A. Copious irrigation with water | B. Neutralize acid | C. Ointment | D. Dress | A. Irrigate thoroughly with water |
| A 40-year-old with circumferential full-thickness limb burn, absent pulse. Management? | A. Escharotomy | B. Fasciotomy | C. Amputation | D. Grafting | A. Escharotomy |
| A 55-year-old with full-thickness burns over 30% body surface. Fluid therapy? | A. Parkland formula | B. Maintenance | C. Evans | D. Holliday-Segar | A. Parkland formula (4 mL × %BSA × wt) |
| A 60-year-old with chronic ulcer with everted rolled edges. Diagnosis? | A. SCC | B. BCC | C. Melanoma | D. Keratoacanthoma | A. Squamous cell carcinoma |
| A 55-year-old with pearly nodular lesion, central ulceration. Diagnosis? | A. Basal cell carcinoma | B. SCC | C. Melanoma | D. Keratoacanthoma | A. Basal cell carcinoma |
| A 45-year-old with pigmented lesion, irregular border, color variation. Diagnosis? | A. Melanoma | B. BCC | C. SCC | D. Keratoacanthoma | A. Malignant melanoma |
| A 40-year-old woman with firm, mobile, nontender breast lump. Diagnosis? | A. Fibroadenoma | B. Fibrocystic | C. Abscess | D. Carcinoma | A. Fibroadenoma |
| A 35-year-old woman with cyclical mastalgia, nodularity. Diagnosis? | A. Fibrocystic disease | B. Carcinoma | C. Fibroadenoma | D. Abscess | A. Fibrocystic change |
| A 55-year-old woman with hard irregular fixed breast lump. Diagnosis? | A. Carcinoma | B. Fibroadenoma | C. Abscess | D. Fibrocystic | A. Invasive ductal carcinoma |
| A 50-year-old woman with eczematous nipple lesion, discharge. Diagnosis? | A. Paget disease | B. DCIS | C. Fibrocystic | D. Abscess | A. Paget’s disease of breast |
| A 60-year-old woman with peau d’orange skin and axillary nodes. Diagnosis? | A. Inflammatory carcinoma | B. Ductal | C. Paget | D. Fibrocystic | A. Inflammatory breast carcinoma |
| A 25-year-old lactating woman with fever, tender breast lump. Diagnosis? | A. Mastitis | B. Abscess | C. Galactocele | D. Fibroadenoma | A. Acute mastitis |
| A 30-year-old with fluctuant breast lump, pus discharge. Diagnosis? | A. Breast abscess | B. Mastitis | C. Carcinoma | D. Fibrocystic | A. Breast abscess |
| A 50-year-old man with subareolar mass, nipple retraction. Diagnosis? | A. Male breast carcinoma | B. Gynecomastia | C. Abscess | D. Lipoma | A. Male breast cancer |
| A 60-year-old man with bilateral breast enlargement, soft. Diagnosis? | A. Gynecomastia | B. Carcinoma | C. Cyst | D. Lipoma | A. Gynecomastia |
| A 35-year-old man with midline neck swelling moving with tongue. Diagnosis? | A. Thyroglossal cyst | B. Branchial cyst | C. Dermoid | D. Lipoma | A. Thyroglossal duct cyst |
| A 30-year-old man with cystic swelling anterior to sternocleidomastoid. Diagnosis? | A. Branchial cyst | B. Thyroglossal | C. Lipoma | D. Abscess | A. Branchial cyst |
| A 40-year-old man with soft, fluctuant swelling on back of neck. Diagnosis? | A. Lipoma | B. Sebaceous cyst | C. Abscess | D. Lymph node | A. Lipoma |
| A 35-year-old with dome-shaped swelling with punctum and cheesy discharge. Diagnosis? | A. Sebaceous cyst | B. Lipoma | C. Abscess | D. Lymph node | A. Sebaceous cyst |
| A 60-year-old with firm fixed neck mass, ulcerated skin. Diagnosis? | A. Metastatic lymph node | B. Lymphoma | C. TB | D. Cyst | A. Secondary metastasis to cervical node |
| A 50-year-old with painless ulcer on lateral tongue, indurated edges. Diagnosis? | A. SCC | B. Aphthous | C. TB | D. Syphilis | A. Squamous cell carcinoma of tongue |
| A 45-year-old smoker with hoarseness, throat pain, weight loss. Diagnosis? | A. Laryngeal carcinoma | B. Vocal cord polyp | C. Pharyngitis | D. Laryngitis | A. Laryngeal carcinoma |
| A 60-year-old man with dysphagia, regurgitation, neck swelling. Diagnosis? | A. Zenker diverticulum | B. Achalasia | C. Web | D. Cancer | A. Pharyngoesophageal (Zenker’s) diverticulum |
| A 40-year-old with pulsatile abdominal mass. Diagnosis? | A. Abdominal aortic aneurysm | B. Lipoma | C. Tumor | D. Cyst | A. AAA |
| A 70-year-old with sudden back pain, hypotension, pulsatile mass. Diagnosis? | A. Ruptured AAA | B. Renal colic | C. MI | D. Pancreatitis | A. Ruptured abdominal aortic aneurysm |
| A 60-year-old man with chronic venous insufficiency and ulcer. Location? | A. Medial malleolus | B. Lateral malleolus | C. Heel | D. Sole | A. Over medial malleolus |
| A 55-year-old man with varicose veins, ulcer, pigmentation. Cause? | A. Venous hypertension | B. Arterial | C. Lymphatic | D. Diabetic | A. Venous hypertension |
| A 60-year-old man with epigastric pain radiating to back, elevated amylase. Diagnosis? | A. Acute pancreatitis | B. PUD | C. Cholecystitis | D. Gastritis | A. Acute pancreatitis |
| A 55-year-old with chronic pancreatitis, steatorrhea, diabetes. Cause? | A. Alcohol | B. Gallstones | C. Trauma | D. Viral | A. Chronic alcohol use |
| A 50-year-old man with painless jaundice, palpable gallbladder. Diagnosis? | A. Pancreatic head carcinoma | B. Cholangiocarcinoma | C. PSC | D. Cirrhosis | A. Carcinoma of pancreatic head (Courvoisier sign) |
| A 60-year-old woman with jaundice, weight loss, palpable GB. Diagnosis? | A. Cholangiocarcinoma | B. Pancreatic CA | C. PSC | D. Gallstones | A. Cholangiocarcinoma |
| A 40-year-old woman with RUQ pain after fatty meal, US: stones. Diagnosis? | A. Cholelithiasis | B. Cholecystitis | C. Choledocholithiasis | D. Cholangitis | A. Gallstones (chronic calculous cholecystitis) |
| A 65-year-old with fever, jaundice, hypotension. Diagnosis? | A. Ascending cholangitis | B. Cholecystitis | C. Pancreatitis | D. Cirrhosis | A. Suppurative cholangitis (Charcot + Reynolds pentad) |
| A 70-year-old with dysphagia to solids then liquids, weight loss. Diagnosis? | A. Esophageal carcinoma | B. Achalasia | C. Web | D. Stricture | A. Esophageal cancer |
| A 35-year-old woman with dysphagia to both solids and liquids, bird-beak sign. Diagnosis? | A. Achalasia cardia | B. Stricture | C. Web | D. Cancer | A. Achalasia of esophagus |
| A 50-year-old man with vomiting, visible peristalsis, succussion splash. Diagnosis? | A. Gastric outlet obstruction | B. PUD | C. GERD | D. Cancer | A. Gastric outlet obstruction |
| A 70-year-old man with epigastric pain relieved by food. Diagnosis? | A. Duodenal ulcer | B. Gastric ulcer | C. GERD | D. Gallstones | A. Duodenal ulcer |
| A 60-year-old man with epigastric pain worse after food. Diagnosis? | A. Gastric ulcer | B. Duodenal | C. GERD | D. PUD | A. Gastric ulcer |
| A 45-year-old with hematemesis and melena, cirrhosis. Diagnosis? | A. Esophageal varices | B. Mallory-Weiss | C. PUD | D. Gastritis | A. Bleeding esophageal varices |
| A 50-year-old man with long-standing GERD, intestinal metaplasia. Diagnosis? | A. Barrett esophagus | B. Stricture | C. Ulcer | D. Cancer | A. Barrett’s esophagus |
| A 45-year-old man with mass in parotid, no facial palsy. Diagnosis? | A. Pleomorphic adenoma | B. Warthin tumor | C. Mucoepidermoid | D. Cyst | A. Pleomorphic adenoma |
| A 60-year-old man with parotid mass and facial nerve palsy. Diagnosis? | A. Parotid malignancy | B. Pleomorphic | C. Warthin | D. Cyst | A. Malignant parotid tumor |
| A 65-year-old smoker with parotid cystic tumor, bilateral. Diagnosis? | A. Warthin tumor | B. Pleomorphic | C. Mucoepidermoid | D. Cyst | A. Papillary cystadenoma lymphomatosum (Warthin tumor) |
| A 50-year-old woman with hard thyroid mass, compressive symptoms. Diagnosis? | A. Anaplastic carcinoma | B. Medullary | C. Papillary | D. Follicular | A. Anaplastic thyroid cancer |
| A 35-year-old woman with thyroid nodule, psammoma bodies. Diagnosis? | A. Papillary carcinoma | B. Follicular | C. Medullary | D. Anaplastic | A. Papillary thyroid carcinoma |
| A 45-year-old woman with thyroid nodule, calcitonin ↑. Diagnosis? | A. Medullary carcinoma | B. Papillary | C. Follicular | D. Anaplastic | A. Medullary thyroid carcinoma |
| A 55-year-old with thyroid nodule and capsular invasion. Diagnosis? | A. Follicular carcinoma | B. Papillary | C. Medullary | D. Anaplastic | A. Follicular thyroid carcinoma |
| A 40-year-old man with generalized weakness, Na ↓, K ↑, pigmentation. Diagnosis? | A. Addison | B. Cushing | C. Conn | D. SIADH | A. Primary adrenal insufficiency (Addison) |
| A 50-year-old woman with moon face, central obesity, HTN. Diagnosis? | A. Cushing | B. Conn | C. Pheo | D. Addison | A. Cushing syndrome |
| A 45-year-old man with episodic headache, palpitation, HTN. Diagnosis? | A. Pheochromocytoma | B. Cushing | C. Conn | D. Addison | A. Pheochromocytoma |
| A 60-year-old man with truncal obesity, high glucose, purple striae. Diagnosis? | A. Cushing | B. Metabolic syndrome | C. Conn | D. Addison | A. Cushing syndrome |
| A 30-year-old man with trauma, BP 70/40, muffled heart sounds, JVP ↑. Diagnosis? | A. Cardiac tamponade | B. Tension pneumothorax | C. Hemothorax | D. Shock | A. Cardiac tamponade |
| A 25-year-old with Kehr’s sign after trauma. Organ injured? | A. Spleen | B. Liver | C. Pancreas | D. Kidney | A. Splenic rupture |
| A 50-year-old man after RTA with RUQ pain and hypotension. Organ injured? | A. Liver | B. Spleen | C. Pancreas | D. Stomach | A. Liver laceration |
| A 25-year-old woman with positive pregnancy test, abdominal pain, shock. Diagnosis? | A. Ruptured ectopic pregnancy | B. Miscarriage | C. Ovarian cyst | D. PID | A. Ruptured tubal pregnancy |
| A 30-year-old woman with amenorrhea, spotting, β-hCG ↑, empty uterus on US. Diagnosis? | A. Ectopic pregnancy | B. Threatened abortion | C. Molar | D. Normal | A. Unruptured ectopic pregnancy |
| A 26-year-old with uterus larger than dates, β-hCG ↑↑, snowstorm US. Diagnosis? | A. Hydatidiform mole | B. Twins | C. Abortion | D. Fibroid | A. Molar pregnancy |
| A 25-year-old after molar evacuation, β-hCG remains high. Diagnosis? | A. Choriocarcinoma | B. Persistent mole | C. Ectopic | D. Normal | A. Gestational trophoblastic neoplasia |
| A 28-year-old with hyperemesis and BP 160/100 at 12 weeks. Diagnosis? | A. Molar pregnancy | B. Pre-eclampsia | C. Ectopic | D. Twins | A. Hydatidiform mole |
| A 25-year-old woman with amenorrhea 6 weeks and positive pregnancy test. Next step? | A. Ultrasound | B. β-hCG | C. Pelvic exam | D. Wait and repeat test | A. Transvaginal ultrasound to confirm intrauterine pregnancy |
| A 30-year-old with vaginal bleeding, cervix closed. Diagnosis? | A. Threatened abortion | B. Inevitable | C. Incomplete | D. Missed | A. Threatened abortion |
| A 32-year-old with open cervix, products in cervical canal. Diagnosis? | A. Incomplete abortion | B. Inevitable | C. Threatened | D. Missed | A. Incomplete abortion |
| A 35-year-old woman with retained fetal tissue and no FHR. Diagnosis? | A. Missed abortion | B. Complete | C. Inevitable | D. Threatened | A. Missed abortion |
| A 40-year-old woman with ≥ 3 pregnancy losses at 8–10 weeks. Cause? | A. Luteal-phase defect | B. Cervical incompetence | C. Infection | D. Thrombophilia | A. Luteal-phase deficiency |
| A 26-year-old with amenorrhea, abdominal pain, shoulder pain, +β-hCG. Diagnosis? | A. Ectopic pregnancy | B. Abortion | C. PID | D. Cyst | A. Ruptured ectopic pregnancy |
| A 30-year-old stable ectopic pregnancy. Treatment? | A. Methotrexate | B. Laparotomy | C. D&C | D. Observe | A. Medical methotrexate therapy |
| A 32-year-old with uterus > dates, β-hCG high, snow-storm US. Diagnosis? | A. Molar pregnancy | B. Missed abortion | C. Twin | D. Fibroid | A. Hydatidiform mole |
| A 28-year-old post-molar evacuation, β-hCG remains elevated. Diagnosis? | A. Choriocarcinoma | B. Persistent mole | C. Ectopic | D. Normal | A. Gestational trophoblastic neoplasia |
| A 24-year-old with hyperemesis, HTN, uterus > dates. Diagnosis? | A. Molar pregnancy | B. Ectopic | C. Abortion | D. Twins | A. Hydatidiform mole |
| A 26-year-old G1P0 at 32 weeks with BP 150/100 and proteinuria. Diagnosis? | A. Pre-eclampsia | B. Gestational HTN | C. Eclampsia | D. Chronic HTN | A. Pre-eclampsia |
| A 27-year-old woman with seizures, HTN, proteinuria. Diagnosis? | A. Eclampsia | B. Pre-eclampsia | C. Epilepsy | D. Stroke | A. Eclampsia |
| A 30-year-old with pre-eclampsia. Drug for seizure prophylaxis? | A. Magnesium sulfate | B. Diazepam | C. Phenytoin | D. Phenobarbital | A. Magnesium sulfate |
| A 33-year-old primigravida at 36 weeks with BP 160/110, protein +, edema. Diagnosis? | A. Severe pre-eclampsia | B. Mild | C. Chronic HTN | D. Gestational HTN | A. Severe pre-eclampsia |
| A 32-year-old primigravida with BP 140/90 after 20 weeks, no proteinuria. Diagnosis? | A. Gestational hypertension | B. Chronic HTN | C. Pre-eclampsia | D. Eclampsia | A. Gestational hypertension |
| A 35-year-old woman at 32 weeks with painless bleeding, non-tender uterus. Diagnosis? | A. Placenta previa | B. Abruption | C. Rupture | D. Vasa previa | A. Placenta previa |
| A 28-year-old at 34 weeks with painful bleeding, tender uterus. Diagnosis? | A. Placental abruption | B. Placenta previa | C. Rupture | D. Cord prolapse | A. Abruptio placentae |
| A 29-year-old in labor with sudden pain, loss of station, shock. Diagnosis? | A. Uterine rupture | B. Abruption | C. Placenta previa | D. Cord prolapse | A. Uterine rupture |
| A 30-year-old in labor with cord visible at introitus, fetal bradycardia. Diagnosis? | A. Cord prolapse | B. Uterine rupture | C. Abruption | D. Previa | A. Umbilical cord prolapse |
| A 28-year-old at 30 weeks with regular contractions, cervix unchanged. Diagnosis? | A. False labor | B. True labor | C. Preterm | D. Threatened | A. False labor |
| A 30-year-old at term with regular painful contractions, cervical dilation. Diagnosis? | A. True labor | B. False labor | C. Abruption | D. Previa | A. True labor |
| A 25-year-old in labor with head not descending, caput and molding. Diagnosis? | A. Cephalopelvic disproportion | B. Malpresentation | C. Prolonged labor | D. Obstruction | A. Cephalopelvic disproportion |
| A 27-year-old woman with prolonged labor, fetal distress. Management? | A. Emergency C-section | B. Forceps | C. Observe | D. Induce | A. Emergency cesarean section |
| A 30-year-old with bleeding 30 min post-delivery, placenta retained. Next step? | A. Manual removal | B. Oxytocin | C. Massage | D. Observe | A. Manual removal of placenta |
| A 32-year-old with postpartum hemorrhage, soft boggy uterus. Diagnosis? | A. Uterine atony | B. Retained products | C. Trauma | D. Coagulopathy | A. Uterine atony |
| A 35-year-old with PPH not controlled by oxytocin. Next step? | A. Balloon tamponade | B. Uterine artery ligation | C. Hysterectomy | D. Observe | A. Balloon tamponade (then ligation if fails) |
| A 25-year-old with fever, foul lochia after delivery. Diagnosis? | A. Puerperal sepsis | B. Endometritis | C. UTI | D. Mastitis | A. Puerperal sepsis |
| A 28-year-old postpartum woman with tender uterus, foul discharge. Diagnosis? | A. Endometritis | B. Mastitis | C. Retained products | D. Wound infection | A. Puerperal endometritis |
| A 27-year-old woman 2 weeks postpartum with painful breast swelling. Diagnosis? | A. Mastitis | B. Abscess | C. Galactocele | D. Fibrocystic | A. Lactational mastitis |
| A 28-year-old lactating woman with fluctuant tender lump, pus. Diagnosis? | A. Breast abscess | B. Mastitis | C. Fibrocystic | D. Carcinoma | A. Breast abscess |
| A 29-year-old woman 3 months postpartum with failure to lactate, amenorrhea. Diagnosis? | A. Sheehan syndrome | B. Asherman | C. PCOS | D. Pituitary adenoma | A. Pituitary necrosis (Sheehan’s syndrome) |
| A 32-year-old woman with amenorrhea, galactorrhea, headache, and visual defect. Diagnosis? | A. Prolactinoma | B. PCOS | C. Sheehan | D. Hypothyroid | A. Pituitary prolactinoma |
| A 30-year-old woman with irregular menses, hirsutism, obesity, infertility. Diagnosis? | A. PCOS | B. Cushing | C. CAH | D. Hypothyroidism | A. Polycystic ovary syndrome |
| A 28-year-old woman with infertility and chocolate cyst on ovary. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. Fibroid | D. PID | A. Endometriosis |
| A 35-year-old woman with heavy painful menses and bulky tender uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. DUB | A. Adenomyosis |
| A 40-year-old woman with heavy painless bleeding and irregular uterine enlargement. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial CA | D. Polyp | A. Uterine fibroid (leiomyoma) |
| A 25-year-old woman with secondary amenorrhea, infertility after D&C. Diagnosis? | A. Asherman syndrome | B. Sheehan | C. PCOS | D. Premature ovarian failure | A. Intrauterine adhesions (Asherman’s syndrome) |
| A 30-year-old woman with secondary amenorrhea, hot flashes, high FSH/LH. Diagnosis? | A. Premature ovarian failure | B. PCOS | C. Hypothyroid | D. Sheehan | A. Premature ovarian insufficiency |
| A 35-year-old woman with infertility, bilateral tubal block on HSG. Next step? | A. IVF | B. Clomiphene | C. IUI | D. Ovarian drilling | A. In vitro fertilization |
| A 25-year-old woman with primary infertility, regular cycles, open tubes. Next step? | A. Semen analysis | B. Ovulation test | C. HSG | D. Laparoscopy | A. Husband semen analysis (first-line test) |
| A 30-year-old woman with strawberry cervix and green frothy discharge. Organism? | A. Trichomonas | B. Candida | C. Gardnerella | D. Chlamydia | A. Trichomonas vaginalis |
| A 25-year-old woman with curdy white discharge, itching, pH < 4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Gonorrhea | A. Vulvovaginal candidiasis |
| A 28-year-old woman with thin fishy discharge, clue cells on microscopy. Diagnosis? | A. Bacterial vaginosis | B. Trichomonas | C. Candida | D. Chlamydia | A. Gardnerella vaginalis (bacterial vaginosis) |
| A 24-year-old woman with mucopurulent discharge, cervical motion tenderness. Diagnosis? | A. PID | B. BV | C. Candida | D. Trichomonas | A. Pelvic inflammatory disease |
| A 30-year-old woman with severe lower abdominal pain, adnexal tenderness, fever. Diagnosis? | A. PID | B. Ovarian torsion | C. Endometriosis | D. Ectopic | A. Acute pelvic inflammatory disease |
| A 35-year-old woman with adnexal mass, twisting pain, vomiting. Diagnosis? | A. Ovarian torsion | B. PID | C. Cyst rupture | D. Ectopic | A. Ovarian torsion |
| A 28-year-old woman with mid-cycle pelvic pain, normal US. Diagnosis? | A. Mittelschmerz | B. PID | C. Ovarian torsion | D. Endometriosis | A. Ovulation (Mittelschmerz) |
| A 45-year-old woman with postcoital bleeding and friable cervix. Next step? | A. Pap smear | B. Colposcopy | C. Biopsy | D. HPV test | A. Pap smear for cervical screening |
| A 40-year-old woman with HSIL on Pap smear. Next step? | A. Colposcopy and biopsy | B. Repeat Pap | C. HPV test | D. Observe | A. Colposcopy with directed biopsy |
| A 30-year-old woman with ASC-US on Pap smear. Next step? | A. HPV testing | B. Colposcopy | C. Repeat Pap | D. Cone biopsy | A. High-risk HPV testing |
| A 45-year-old woman with contact bleeding, ulcerated cervix, foul discharge. Diagnosis? | A. Cervical cancer | B. Erosion | C. PID | D. Polyp | A. Cervical carcinoma |
| A 55-year-old postmenopausal woman with bleeding. Next step? | A. Endometrial biopsy | B. Pap smear | C. USG | D. Observe | A. Endometrial sampling |
| A 40-year-old woman with heavy menstrual bleeding, thickened endometrium. Diagnosis? | A. Endometrial hyperplasia | B. Endometrial cancer | C. DUB | D. Polyp | A. Endometrial hyperplasia |
| A 60-year-old woman with vaginal bleeding, high estrogen exposure. Diagnosis? | A. Endometrial carcinoma | B. Cervical CA | C. Ovarian CA | D. Vulvar CA | A. Endometrial adenocarcinoma |
| A 50-year-old woman with abdominal mass, ascites, CA-125 ↑. Diagnosis? | A. Ovarian carcinoma | B. Fibroid | C. Endometrial CA | D. PID | A. Epithelial ovarian carcinoma |
| A 60-year-old woman with vulvar itching, white patch, loss of architecture. Diagnosis? | A. Lichen sclerosus | B. Lichen planus | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus |
| A 65-year-old woman with ulcerated vulvar mass, indurated edges. Diagnosis? | A. Vulvar carcinoma | B. Lichen planus | C. Infection | D. Cyst | A. Squamous cell carcinoma of vulva |
| A 25-year-old woman with cauliflower-like genital growth. Diagnosis? | A. Condyloma acuminata | B. HSV | C. Syphilis | D. Chancroid | A. HPV genital warts (types 6, 11) |
| A 28-year-old woman with painful vesicular genital lesions. Diagnosis? | A. HSV | B. Syphilis | C. Chancroid | D. LGV | A. Genital herpes (HSV-2) |
| A 26-year-old woman with painless genital ulcer, indurated edges. Diagnosis? | A. Syphilis | B. Chancroid | C. HSV | D. LGV | A. Primary syphilis (chancre) |
| A 24-year-old woman with painful ulcer, ragged edges, tender nodes. Diagnosis? | A. Chancroid | B. Syphilis | C. HSV | D. LGV | A. Chancroid (Haemophilus ducreyi) |
| A 30-year-old woman with painless ulcer followed by buboes. Diagnosis? | A. Lymphogranuloma venereum | B. Chancroid | C. Syphilis | D. HSV | A. LGV (Chlamydia trachomatis L1–L3) |
| A 30-year-old woman on OCP develops migraine and HTN. Next step? | A. Stop OCP | B. Continue | C. Switch to Cu-T | D. Barrier | A. Discontinue OCP and switch to non-estrogen method |
| A 25-year-old breastfeeding mother seeking contraception. Best choice? | A. Progestin-only pill | B. Combined OCP | C. Cu-T | D. Barrier | A. Progestin-only (minipill) |
| A 30-year-old woman wanting long-term reversible contraception. Choice? | A. Copper IUD | B. Barrier | C. Pills | D. Injection | A. Copper T IUD |
| A 25-year-old woman requesting permanent contraception. Option? | A. Tubal ligation | B. Cu-T | C. Vasectomy | D. Implant | A. Tubal ligation |
| A 30-year-old man requesting permanent contraception. Option? | A. Vasectomy | B. Condom | C. Implant | D. Pill | A. Vasectomy |
| A 35-year-old woman with heavy menstrual bleeding, normal uterus. Diagnosis? | A. DUB | B. Fibroid | C. Adenomyosis | D. Polyp | A. Dysfunctional uterine bleeding (anovulatory) |
| A 1-day-old newborn with delayed meconium passage and abdominal distension. Diagnosis? | A. Hirschsprung disease | B. Meconium ileus | C. Intussusception | D. Volvulus | A. Hirschsprung disease |
| A 2-day-old neonate with failure to pass meconium, cystic fibrosis history. Diagnosis? | A. Meconium ileus | B. Hirschsprung | C. Atresia | D. NEC | A. Meconium ileus |
| A 1-day-old baby with bilious vomiting, double bubble on X-ray. Diagnosis? | A. Duodenal atresia | B. Pyloric stenosis | C. Malrotation | D. Volvulus | A. Duodenal atresia |
| A 3-week-old infant with non-bilious projectile vomiting, palpable olive. Diagnosis? | A. Pyloric stenosis | B. Duodenal atresia | C. GERD | D. Malrotation | A. Hypertrophic pyloric stenosis |
| A 6-month-old infant with currant jelly stools and sausage-shaped mass. Diagnosis? | A. Intussusception | B. Volvulus | C. Hirschsprung | D. Meckel | A. Intussusception |
| A 2-year-old with painless rectal bleeding, normal exam. Diagnosis? | A. Meckel’s diverticulum | B. Intussusception | C. Polyp | D. Fissure | A. Meckel diverticulum |
| A premature neonate with abdominal distension, bloody stool, pneumatosis intestinalis. Diagnosis? | A. NEC | B. Sepsis | C. Volvulus | D. Atresia | A. Necrotizing enterocolitis |
| A 2-day-old newborn with respiratory distress, scaphoid abdomen, bowel sounds in chest. Diagnosis? | A. Congenital diaphragmatic hernia | B. TEF | C. RDS | D. Pneumothorax | A. Bochdalek hernia (CDH) |
| A newborn with excessive drooling, choking with feeds, unable to pass NG tube. Diagnosis? | A. Tracheoesophageal fistula | B. Choanal atresia | C. CDH | D. Cleft palate | A. TEF with esophageal atresia |
| A 1-week-old newborn with cyanosis relieved by crying. Diagnosis? | A. Choanal atresia | B. Tetralogy | C. Laryngomalacia | D. RDS | A. Bilateral choanal atresia |
| A 1-day-old baby with continuous murmur and wide pulse pressure. Diagnosis? | A. PDA | B. ASD | C. VSD | D. TOF | A. Patent ductus arteriosus |
| A 3-day-old neonate with cyanosis not improving with O₂. Diagnosis? | A. Transposition of great arteries | B. TOF | C. ASD | D. PDA | A. Transposition of great arteries (TGA) |
| A 5-day-old neonate with systolic murmur, bounding pulses. Diagnosis? | A. PDA | B. ASD | C. VSD | D. TOF | A. Patent ductus arteriosus |
| A 2-week-old infant with cyanosis and squatting episodes. Diagnosis? | A. TOF | B. TGA | C. VSD | D. ASD | A. Tetralogy of Fallot |
| A 6-month-old with harsh pansystolic murmur at LLSB. Diagnosis? | A. VSD | B. ASD | C. PDA | D. TOF | A. Ventricular septal defect |
| A 3-year-old with fixed split S2 and systolic murmur. Diagnosis? | A. ASD | B. VSD | C. PDA | D. TOF | A. Atrial septal defect |
| A 5-year-old with continuous machinery murmur. Diagnosis? | A. PDA | B. VSD | C. ASD | D. TOF | A. Patent ductus arteriosus |
| A 1-week-old with cyanosis, single S2, boot-shaped heart. Diagnosis? | A. TOF | B. TGA | C. VSD | D. Truncus | A. Tetralogy of Fallot |
| A 1-month-old baby with poor feeding, sweating during feeds, murmur. Diagnosis? | A. Heart failure | B. Sepsis | C. Hypoglycemia | D. Colic | A. Congestive heart failure |
| A 3-month-old with harsh murmur, failure to thrive, recurrent pneumonia. Diagnosis? | A. VSD | B. ASD | C. PDA | D. TOF | A. Ventricular septal defect |
| A 2-year-old with barking cough, inspiratory stridor, hoarseness. Diagnosis? | A. Croup | B. Epiglottitis | C. Bronchiolitis | D. Asthma | A. Viral croup (laryngotracheobronchitis) |
| A 4-year-old with high fever, drooling, tripod position, no cough. Diagnosis? | A. Epiglottitis | B. Croup | C. Foreign body | D. Bronchiolitis | A. Epiglottitis (H. influenzae type b) |
| A 1-year-old with fever, wheezing, tachypnea, RSV positive. Diagnosis? | A. Bronchiolitis | B. Pneumonia | C. Asthma | D. Croup | A. Bronchiolitis (RSV) |
| A 2-year-old with stridor, sudden onset while playing. Diagnosis? | A. Foreign body aspiration | B. Croup | C. Epiglottitis | D. Asthma | A. Foreign body aspiration |
| A 6-year-old with chronic cough, steatorrhea, recurrent infections. Diagnosis? | A. Cystic fibrosis | B. Asthma | C. TB | D. Bronchiectasis | A. Cystic fibrosis |
| A 10-year-old with productive cough, clubbing, coarse crepitations. Diagnosis? | A. Bronchiectasis | B. CF | C. Asthma | D. Pneumonia | A. Bronchiectasis |
| A 3-year-old with wheezing, nighttime cough, reversible obstruction. Diagnosis? | A. Asthma | B. Bronchiolitis | C. Pneumonia | D. CF | A. Childhood asthma |
| A 1-year-old with cough, high fever, crackles, bronchial breathing. Diagnosis? | A. Pneumonia | B. Bronchiolitis | C. Asthma | D. CF | A. Pneumonia (lobar) |
| A 2-year-old with fever, sore throat, pseudomembrane in throat. Diagnosis? | A. Diphtheria | B. Strep throat | C. Viral pharyngitis | D. Mono | A. Diphtheria |
| A 1-year-old with paroxysmal cough ending with whoop. Diagnosis? | A. Pertussis | B. Croup | C. Asthma | D. Bronchiolitis | A. Whooping cough (Bordetella pertussis) |
| A 2-year-old unimmunized child with trismus, rigidity, arching. Diagnosis? | A. Tetanus | B. Meningitis | C. Seizure | D. Hypocalcemia | A. Neonatal tetanus |
| A 1-year-old with high fever, conjunctivitis, Koplik spots, and rash. Diagnosis? | A. Measles | B. Rubella | C. Roseola | D. Scarlet fever | A. Measles (rubeola) |
| A 5-year-old with low-grade fever, postauricular lymphadenopathy, maculopapular rash. Diagnosis? | A. Rubella | B. Measles | C. Roseola | D. Varicella | A. Rubella |
| A 2-year-old with fever, vesicular rash in crops. Diagnosis? | A. Chickenpox | B. Measles | C. Rubella | D. Roseola | A. Varicella (chickenpox) |
| A 1-year-old with high fever for 3 days, then rash appears. Diagnosis? | A. Roseola infantum | B. Rubella | C. Measles | D. Scarlet fever | A. Roseola (HHV-6 infection) |
| A 6-year-old with sore throat, sandpaper rash, strawberry tongue. Diagnosis? | A. Scarlet fever | B. Measles | C. Rubella | D. Kawasaki | A. Scarlet fever |
| A 4-year-old with fever, conjunctivitis, cracked lips, red palms and soles. Diagnosis? | A. Kawasaki disease | B. Measles | C. Scarlet fever | D. Rubella | A. Kawasaki disease |
| A 2-year-old with painful swelling of parotid gland. Diagnosis? | A. Mumps | B. Measles | C. Rubella | D. Mono | A. Mumps parotitis |
| A 5-year-old with jaw swelling, trismus, history of dental infection. Diagnosis? | A. Ludwig angina | B. Mumps | C. Cellulitis | D. Abscess | A. Ludwig’s angina |
| A 3-year-old with dysuria, frequency, fever. Diagnosis? | A. UTI | B. Nephrotic | C. Glomerulonephritis | D. Stones | A. Urinary tract infection |
| A 5-year-old with periorbital edema, frothy urine, proteinuria. Diagnosis? | A. Nephrotic syndrome | B. Glomerulonephritis | C. HUS | D. AKI | A. Minimal change nephrotic syndrome |
| A 6-year-old post-sore throat, cola-colored urine, edema. Diagnosis? | A. PSGN | B. IgA nephropathy | C. HUS | D. Lupus | A. Post-streptococcal glomerulonephritis |
| A 3-year-old with edema, proteinuria, hyperlipidemia. Diagnosis? | A. Nephrotic syndrome | B. Nephritic | C. CKD | D. AKI | A. Nephrotic syndrome |
| A 5-year-old with edema, hypertension, hematuria. Diagnosis? | A. Nephritic syndrome | B. Nephrotic | C. AKI | D. CKD | A. Nephritic syndrome |
| A 4-year-old child with pallor, bone pain, hepatosplenomegaly, lymphadenopathy. Diagnosis? | A. Acute lymphoblastic leukemia | B. AML | C. Aplastic anemia | D. Lymphoma | A. Acute lymphoblastic leukemia (ALL) |
| A 6-year-old boy with chronic anemia, hepatosplenomegaly, target cells. Diagnosis? | A. Thalassemia major | B. Iron deficiency | C. Sickle cell | D. Aplastic | A. Beta thalassemia major |
| A 3-year-old with pallor, jaundice, high reticulocytes, splenomegaly. Diagnosis? | A. Hemolytic anemia | B. Aplastic | C. Iron deficiency | D. Megaloblastic | A. Hereditary hemolytic anemia |
| A 2-year-old with sickle cell disease presents with acute splenic sequestration. Management? | A. Blood transfusion | B. Splenectomy | C. Iron | D. Observe | A. Urgent blood transfusion |
| A 5-year-old with recurrent infections, severe anemia, thrombocytopenia. Diagnosis? | A. Aplastic anemia | B. Leukemia | C. ITP | D. Fanconi | A. Aplastic anemia |
| A 10-year-old boy with recurrent epistaxis, petechiae, low platelets, normal PT/PTT. Diagnosis? | A. ITP | B. TTP | C. DIC | D. HUS | A. Immune thrombocytopenic purpura |
| A 3-year-old with prolonged bleeding after dental extraction, high aPTT, normal PT. Diagnosis? | A. Hemophilia A | B. Hemophilia B | C. vWD | D. DIC | A. Hemophilia A (Factor VIII deficiency) |
| A 5-year-old with mucosal bleeding, prolonged bleeding time, normal platelets. Diagnosis? | A. Von Willebrand disease | B. ITP | C. Hemophilia | D. DIC | A. von Willebrand disease |
| A 2-year-old child with recurrent infections, albinism, neuropathy. Diagnosis? | A. Chediak-Higashi | B. CGD | C. SCID | D. Wiskott-Aldrich | A. Chediak–Higashi syndrome |
| A 1-year-old with eczema, thrombocytopenia, recurrent infections. Diagnosis? | A. Wiskott–Aldrich | B. SCID | C. CGD | D. DiGeorge | A. Wiskott–Aldrich syndrome |
| A 4-year-old with recurrent bacterial and fungal infections, negative NBT test. Diagnosis? | A. Chronic granulomatous disease | B. SCID | C. LAD | D. Chediak | A. CGD (NADPH oxidase defect) |
| A 2-month-old with persistent candidiasis, recurrent viral infections. Diagnosis? | A. SCID | B. CGD | C. LAD | D. Chediak | A. Severe combined immunodeficiency (SCID) |
| A 5-year-old with hypocalcemia, tetany, absent thymus. Diagnosis? | A. DiGeorge syndrome | B. SCID | C. CGD | D. Wiskott | A. DiGeorge syndrome (22q11 deletion) |
| A 6-year-old with obesity, hypertension, polyuria, polydipsia. Diagnosis? | A. Type 2 diabetes mellitus | B. Type 1 DM | C. DI | D. Cushing | A. Type 2 diabetes mellitus (childhood obesity) |
| A 7-year-old with short stature, webbed neck, shield chest. Diagnosis? | A. Turner syndrome | B. Noonan | C. Down | D. Klinefelter | A. Turner syndrome (45,X) |
| A 12-year-old boy with tall stature, gynecomastia, small testes. Diagnosis? | A. Klinefelter syndrome | B. Marfan | C. Fragile X | D. Noonan | A. Klinefelter syndrome (47,XXY) |
| A 6-year-old with short stature, webbed neck, and normal intelligence. Diagnosis? | A. Noonan syndrome | B. Turner | C. Down | D. Achondroplasia | A. Noonan syndrome (male Turner phenotype) |
| A 1-year-old with hypotonia, upslanting palpebral fissures, single palmar crease. Diagnosis? | A. Down syndrome | B. Edwards | C. Patau | D. Fragile X | A. Down syndrome (trisomy 21) |
| A newborn with rocker-bottom feet, clenched fists, low-set ears. Diagnosis? | A. Edwards syndrome | B. Patau | C. Down | D. Turner | A. Edwards syndrome (trisomy 18) |
| A newborn with microcephaly, cleft lip, polydactyly. Diagnosis? | A. Patau syndrome | B. Edwards | C. Down | D. Turner | A. Patau syndrome (trisomy 13) |
| A 10-year-old tall boy with long limbs, hyperextensible joints, lens subluxation upward. Diagnosis? | A. Marfan syndrome | B. Homocystinuria | C. Klinefelter | D. Ehlers-Danlos | A. Marfan syndrome |
| A 6-year-old with similar features but lens subluxation downward. Diagnosis? | A. Homocystinuria | B. Marfan | C. Klinefelter | D. Ehlers-Danlos | A. Homocystinuria |
| A 5-year-old with mental retardation, eczema, musty odor urine. Diagnosis? | A. Phenylketonuria | B. Maple syrup urine disease | C. Homocystinuria | D. Galactosemia | A. PKU (phenylketonuria) |
| A 3-day-old infant with vomiting after milk, jaundice, cataracts. Diagnosis? | A. Galactosemia | B. PKU | C. MSUD | D. G6PD | A. Classic galactosemia (GALT deficiency) |
| A 2-day-old neonate with poor feeding, maple syrup smell urine. Diagnosis? | A. Maple syrup urine disease | B. PKU | C. Tyrosinemia | D. Galactosemia | A. Maple syrup urine disease |
| A 5-year-old child with café-au-lait spots, Lisch nodules. Diagnosis? | A. Neurofibromatosis type 1 | B. Tuberous sclerosis | C. Sturge-Weber | D. Von Hippel-Lindau | A. NF1 (von Recklinghausen disease) |
| A 6-year-old with hypopigmented macules, seizures, cardiac rhabdomyoma. Diagnosis? | A. Tuberous sclerosis | B. NF | C. Sturge-Weber | D. VHL | A. Tuberous sclerosis complex |
| A 2-year-old with port-wine stain in trigeminal area, seizures. Diagnosis? | A. Sturge-Weber syndrome | B. Tuberous sclerosis | C. NF | D. VHL | A. Sturge-Weber syndrome |
| A 3-year-old boy with ataxia, telangiectasia, recurrent infections. Diagnosis? | A. Ataxia telangiectasia | B. Wiskott | C. SCID | D. NF | A. Ataxia-telangiectasia (DNA repair defect) |
| A 2-year-old child with mental retardation, flapping hands, large ears. Diagnosis? | A. Fragile X syndrome | B. Down | C. Rett | D. Angelman | A. Fragile X syndrome |
| A 3-year-old girl with developmental regression, hand-wringing. Diagnosis? | A. Rett syndrome | B. Fragile X | C. Angelman | D. Down | A. Rett syndrome (MECP2 mutation) |
| A 5-year-old with inappropriate laughter, seizures, wide mouth. Diagnosis? | A. Angelman syndrome | B. Rett | C. Prader-Willi | D. Fragile X | A. Angelman syndrome |
| A 7-year-old with obesity, small hands/feet, hypogonadism. Diagnosis? | A. Prader–Willi syndrome | B. Angelman | C. Fragile X | D. Down | A. Prader–Willi syndrome |
| A 2-year-old with developmental delay and coarse facial features. Diagnosis? | A. Hurler syndrome | B. Hunter | C. Gaucher | D. Niemann-Pick | A. Hurler syndrome (MPS I) |
| A 3-year-old with hepatosplenomegaly, anemia, bone crisis. Diagnosis? | A. Gaucher disease | B. Niemann-Pick | C. Tay-Sachs | D. Hurler | A. Gaucher disease |
| A 1-year-old with hypotonia, cherry-red spot, hepatosplenomegaly. Diagnosis? | A. Niemann-Pick disease | B. Tay-Sachs | C. Gaucher | D. Krabbe | A. Niemann-Pick disease |
| A 6-month-old with hypotonia, seizures, cherry-red spot, no hepatomegaly. Diagnosis? | A. Tay-Sachs | B. Niemann-Pick | C. Gaucher | D. Krabbe | A. Tay-Sachs disease |
| A 2-year-old with developmental delay, angiokeratomas, renal failure. Diagnosis? | A. Fabry disease | B. Gaucher | C. Krabbe | D. Hurler | A. Fabry disease (X-linked lysosomal disorder) |
| A 3-year-old with regression, spasticity, optic atrophy. Diagnosis? | A. Krabbe disease | B. Tay-Sachs | C. Niemann-Pick | D. Metachromatic leukodystrophy | A. Krabbe disease |
| A 4-year-old with ataxia, developmental regression, metachromatic granules. Diagnosis? | A. Metachromatic leukodystrophy | B. Krabbe | C. Tay-Sachs | D. NF | A. Metachromatic leukodystrophy |
| A 3-year-old child presents with seizures, developmental delay, and port-wine stain. Diagnosis? | A. Sturge-Weber syndrome | B. Tuberous sclerosis | C. NF | D. Angelman | A. Sturge-Weber syndrome |
| A. Duchenne muscular dystrophy | B. Becker | C. Myotonic | D. SMA | A. Duchenne muscular dystrophy (X-linked dystrophin mutation) | |
| A 10-year-old boy with proximal weakness, cardiomyopathy, slow progression. Diagnosis? | A. Becker muscular dystrophy | B. Duchenne | C. SMA | D. Myotonic | A. Becker muscular dystrophy |
| A 2-year-old with regression, flaccid paralysis, absent reflexes, preserved sensation. Diagnosis? | A. Spinal muscular atrophy | B. GBS | C. CP | D. Duchenne | A. Werdnig–Hoffmann disease (SMA type 1) |
| A 1-year-old child with developmental delay and persistent primitive reflexes. Diagnosis? | A. Cerebral palsy | B. SMA | C. Autism | D. Muscular dystrophy | A. Spastic cerebral palsy |
| A 3-year-old with poor eye contact, repetitive behavior, language delay. Diagnosis? | A. Autism spectrum disorder | B. ADHD | C. Rett | D. MR | A. Autism spectrum disorder |
| A 6-year-old with inattention, hyperactivity, impulsivity at school. Diagnosis? | A. ADHD | B. Autism | C. ODD | D. Anxiety | A. Attention-deficit/hyperactivity disorder |
| A 2-year-old with lack of speech and difficulty in social interaction. Diagnosis? | A. Autism | B. Hearing loss | C. CP | D. MR | A. Autism spectrum disorder |
| A 9-month-old not sitting without support. Gross motor delay age? | A. 9 months | B. 6 months | C. 12 months | D. 18 months | A. 9 months – should sit without support |
| A 1-year-old can stand with support but not walk alone. Milestone? | A. Normal for 12 months | B. Delayed | C. Early | D. Regression | A. Normal developmental milestone |
| A 2-year-old can climb stairs and combine 2 words. Diagnosis? | A. Normal development | B. Delayed | C. Autism | D. ADHD | A. Normal development for 2 years |
| A 4-year-old can hop on one foot, copy cross, know colors. Milestone? | A. Normal | B. Delayed | C. Precocious | D. Regression | A. Normal for 4 years |
| A 5-year-old can skip, tie shoelaces, tell stories. Milestone? | A. Normal | B. Delayed | C. Autism | D. ADHD | A. Normal 5-year-old development |
| A 6-month-old not holding head steady. Delay type? | A. Gross motor | B. Fine motor | C. Language | D. Social | A. Gross motor delay |
| A 9-month-old not transferring objects hand to hand. Delay type? | A. Fine motor | B. Gross motor | C. Language | D. Social | A. Fine motor delay |
| A 1-year-old says no words, does not respond to name. Delay type? | A. Language | B. Social | C. Gross motor | D. Cognitive | A. Language delay |
| A 2-year-old child not recognizing mother, indifferent to people. Delay type? | A. Social/adaptive | B. Language | C. Gross motor | D. Fine motor | A. Social/adaptive delay |
| A 3-year-old malnourished child with edema, moon face, flaky paint skin. Diagnosis? | A. Kwashiorkor | B. Marasmus | C. Rickets | D. PEM | A. Kwashiorkor |
| A 1-year-old severely underweight, muscle wasting, no edema. Diagnosis? | A. Marasmus | B. Kwashiorkor | C. Rickets | D. PEM | A. Marasmus |
| A 2-year-old with bow legs, wrist widening, delayed dentition. Diagnosis? | A. Rickets | B. Scurvy | C. Marasmus | D. Kwashiorkor | A. Nutritional rickets (vitamin D deficiency) |
| A 1-year-old with irritability, bleeding gums, corkscrew hairs. Diagnosis? | A. Scurvy | B. Rickets | C. Anemia | D. Marasmus | A. Vitamin C deficiency (Scurvy) |
| A 3-year-old with corneal xerosis, Bitot spots. Diagnosis? | A. Vitamin A deficiency | B. Rickets | C. Scurvy | D. Night blindness | A. Vitamin A deficiency |
| A 6-year-old with bone pain, frontal bossing, dental caries. Diagnosis? | A. Vitamin D deficiency | B. Vitamin A | C. Vitamin C | D. Iron | A. Rickets |
| A 2-year-old with anemia, pica, pallor. Diagnosis? | A. Iron deficiency anemia | B. Thalassemia | C. Sideroblastic | D. Chronic disease | A. Iron deficiency anemia |
| A 3-month-old with lethargy, bulging fontanelle, fever. Diagnosis? | A. Meningitis | B. Hydrocephalus | C. Encephalitis | D. Sepsis | A. Acute bacterial meningitis |
| A 2-year-old with fever, vomiting, convulsion. Next step? | A. Lumbar puncture | B. CT | C. MRI | D. Observe | A. Lumbar puncture after stabilization |
| A 6-year-old with petechial rash, hypotension, altered sensorium. Diagnosis? | A. Meningococcal sepsis | B. Viral meningitis | C. Encephalitis | D. Dengue | A. Meningococcal septicemia (Waterhouse–Friderichsen syndrome) |
| A 2-year-old with inspiratory stridor, drooling, high fever. Diagnosis? | A. Epiglottitis | B. Croup | C. Foreign body | D. Asthma | A. Epiglottitis |
| A 1-year-old with barking cough, hoarseness, mild fever. Diagnosis? | A. Croup | B. Epiglottitis | C. Bronchiolitis | D. Asthma | A. Viral croup |
| A 2-year-old with seizure, high fever, normal CSF. Diagnosis? | A. Febrile seizure | B. Epilepsy | C. Encephalitis | D. Meningitis | A. Simple febrile seizure |
| A 5-year-old with continuous seizure >30 minutes. Diagnosis? | A. Status epilepticus | B. Febrile | C. Absence | D. Focal | A. Status epilepticus |
| A 3-year-old with loss of consciousness, tonic-clonic movements, frothing. Diagnosis? | A. Generalized seizure | B. Focal | C. Febrile | D. Atonic | A. Generalized tonic-clonic seizure |
| A 7-year-old with blank staring spells, no postictal phase. Diagnosis? | A. Absence seizure | B. Complex partial | C. Focal | D. Myoclonic | A. Absence seizure (petit mal) |
| A 5-year-old child with recurrent UTIs, vesicoureteral reflux grade III. Management? | A. Prophylactic antibiotics | B. Surgery | C. Observe | D. IV fluids | A. Long-term antibiotic prophylaxis |
| A 6-year-old with enuresis, normal UA, no stressor. Management? | A. Behavioral therapy | B. Desmopressin | C. Anticholinergic | D. Observe | A. Behavioral therapy (first line) |
| A 10-year-old boy with knee pain, fever, swelling, positive cultures. Diagnosis? | A. Septic arthritis | B. JIA | C. Osteomyelitis | D. Cellulitis | A. Septic arthritis |
| A 12-year-old with chronic joint pain, morning stiffness, ANA+. Diagnosis? | A. Juvenile idiopathic arthritis | B. RA | C. SLE | D. Post-strep | A. Juvenile idiopathic arthritis |
| A 5-year-old with petechiae, hematuria, abdominal pain after sore throat. Diagnosis? | A. Henoch–Schönlein purpura | B. ITP | C. PSGN | D. DIC | A. IgA vasculitis (Henoch–Schönlein purpura) |
| A 7-year-old with fever, conjunctivitis, rash, strawberry tongue. Diagnosis? | A. Kawasaki disease | B. Scarlet fever | C. Measles | D. Rubella | A. Kawasaki disease |
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