A 32-year-old woman has stage III choriocarcinoma with lung metastases and a WHO prognostic score of 10. What is the most appropriate treatment?
A) Total hysterectomy alone
B) Observation with serial hCG measurements
C) Methotrexate monotherapy
D) Multiagent chemotherapy
A) Total hysterectomy alone
B) Observation with serial hCG measurements
C) Methotrexate monotherapy
D) Multiagent chemotherapy
A patient has lower-GI bleeding. Upper GI endoscopy is normal. What is the most likely cause?
A) Diverticulosis
B) Angiodysplasia
C) Cancer
D) Haemorrhoids
A) Diverticulosis
B) Angiodysplasia
C) Cancer
D) Haemorrhoids
A patient with an unprovoked deep vein thrombosis has completed 3 months of warfarin. What is the most appropriate management?
A) Stop warfarin
B) Continue warfarin indefinitely
C) Continue warfarin till completing 6 months
D) Switch to aspirin
A) Stop warfarin
B) Continue warfarin indefinitely
C) Continue warfarin till completing 6 months
D) Switch to aspirin
A middle-aged hypertensive male who smokes has an LDL of 4.3 mmol/L and total cholesterol of 6.1 mmol/L with normal triglycerides; what is the appropriate treatment?
A) High intensity statin
B) Lifestyle modification and recheck
C) Moderate intensity statin
D) Smoking cessation only
A) High intensity statin
B) Lifestyle modification and recheck
C) Moderate intensity statin
D) Smoking cessation only
A patient came to the ER with a stab wound in the right thigh. He is drowsy with a GCS of 9/15. What is the initial management?
A) IV fluid
B) Control bleeding
C) Apply tourniquet
D) Endotracheal intubation
A) IV fluid
B) Control bleeding
C) Apply tourniquet
D) Endotracheal intubation
A patient presents with signs and symptoms of fluid overload, including bilateral lower limb edema, ascites, and distended jugular veins. Laboratory investigations show low serum sodium. What type of hyponatremia is most likely?
A) Euvolemic hyponatremia
B) Hypervolemic hyponatremia
C) Hypovolemic hyponatremia
D) Pseudohyponatremia
A) Euvolemic hyponatremia
B) Hypervolemic hyponatremia
C) Hypovolemic hyponatremia
D) Pseudohyponatremia
A young male who is asymptomatic presented with abnormal LFTs. He is a smoker and drinks alcohol on the weekends. Labs showed high AST, ALT (2:1 ratio), total bilirubin and slightly high iron TIBC and very high ferritin (450). What is the cause of his abnormal LFTs?
A) Hemochromatosis
B) Alcoholic hepatitis
C) Cholangitis
D) Primary biliary cirrhosis
A) Hemochromatosis
B) Alcoholic hepatitis
C) Cholangitis
D) Primary biliary cirrhosis
Five days after right thigh surgery, a man has pain and swelling around the wound. The dressing is saturated with foul-smelling green discharge. Which organism is the most likely cause?
A) Staphylococcus aureus
B) Clostridium perfringens
C) Streptococcus pyogenes
D) Pseudomonas aeruginosa
A) Staphylococcus aureus
B) Clostridium perfringens
C) Streptococcus pyogenes
D) Pseudomonas aeruginosa
November 2026
A patient presents with 12 hours of lower limb weakness. All vital signs are normal. Coagulation profile and platelet count are normal. Imaging shows a small to moderate ischemic core with proximal anterior circulation occlusion. What is the most appropriate management?
A) tPA
B) Manual embolectomy
C) tPA and embolectomy
D) Observe
A patient presents with 12 hours of lower limb weakness. All vital signs are normal. Coagulation profile and platelet count are normal. Imaging shows a small to moderate ischemic core with proximal anterior circulation occlusion. What is the most appropriate management?
A) tPA
B) Manual embolectomy
C) tPA and embolectomy
D) Observe
November 2026
A patient underwent laparoscopic cholecystectomy and presents to the ER with vague abdominal pain. A CT scan shows a collection in the subhepatic area. Which of the following is the most appropriate next step?
A) Operative drainage
B) Laparoscopic drainage
C) Ultrasound-guided drainage
D) MRCP (Magnetic Resonance Cholangiopancreatography)
A patient underwent laparoscopic cholecystectomy and presents to the ER with vague abdominal pain. A CT scan shows a collection in the subhepatic area. Which of the following is the most appropriate next step?
A) Operative drainage
B) Laparoscopic drainage
C) Ultrasound-guided drainage
D) MRCP (Magnetic Resonance Cholangiopancreatography)
November 2026
A 25-year-old male presents with rectal bleeding and abdominal pain. Both his sibling and mother have the same condition. The guaiac stool test is positive. What is the most likely diagnosis?
A) Diverticulosis
B) Ulcerative colitis
C) Peutz-Jeghers syndrome
D) Familial adenomatous polyposis
A 25-year-old male presents with rectal bleeding and abdominal pain. Both his sibling and mother have the same condition. The guaiac stool test is positive. What is the most likely diagnosis?
A) Diverticulosis
B) Ulcerative colitis
C) Peutz-Jeghers syndrome
D) Familial adenomatous polyposis
November 2026
A man in his 60s with a BMI of 25 has no complaints except two elevated blood pressure readings. All laboratory investigations are normal. What is the most appropriate next step?
A) Ambulatory blood pressure monitoring for 1 week
B) Renal ultrasound to assess for renal artery stenosis
C) Echocardiography
D) Start an ACE inhibitor now
A man in his 60s with a BMI of 25 has no complaints except two elevated blood pressure readings. All laboratory investigations are normal. What is the most appropriate next step?
A) Ambulatory blood pressure monitoring for 1 week
B) Renal ultrasound to assess for renal artery stenosis
C) Echocardiography
D) Start an ACE inhibitor now
November 2026
A postoperative patient on day 4 after surgery presents with fever as the only complaint. What is the most appropriate next step in management?
A) Order complete blood count
B) Send urine culture
C) Assess the surgical site
D) Review current medications
A postoperative patient on day 4 after surgery presents with fever as the only complaint. What is the most appropriate next step in management?
A) Order complete blood count
B) Send urine culture
C) Assess the surgical site
D) Review current medications