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1. Mr H a 56 yr old diabetic for 10 yrs. Presented with fever, cough, SOB for 5 days.

Respi xm revealed rt lower zone consolidation. Below are specific staining expected result a. Gram positive cocci in clusters T b. Gram positive cocci in chains T c. Gram negative cocci in clusters F d. AFB positive F e. Gram negative rods T 2. Which of the following causes clubbing a. Bronchiectasis T b. COPD T c. HOCM F d. Inflam. Bowel dz T e. Pulmonary fibrosis T 3. Mrs M 40 yr old lady, diabetic for 8 years. was rushed to casualty with sx of SOB, orthopnoea, PND, n bilateral lower limb swelling for 1 day. What sign would help in the dx? a. JVP > 5cm T b. Irregularly irregular pulse T c. Apex beat at 5th ICS midclavicular line F d. Bruit over goitre T e. Third heart sound 4. Mr M 75 yr old diabetic n hypertensive for 20 years. on examination, power of R upper and lower limb were only 2/5. Following symptoms are correspond to their respective circulation. a. Dizziness- anterior circulation F b. Difficulty walking posterior circulation T c. Unable to recognise right from left anterior circulation T d. Tend to fall on right anterior circulation F e. Unable to see on the right eye anterior circulation T 5. Puan S is an 85 yr old housewife, previously well. Presented to ED with sudden LOC. She also had palpitation and sweating. When arrived, she was fully awake and wanted to go home, however halfway during interview, she fitted. What ix should be done to reach the above dx? a. CT of brain b. ECG c. LFT d. RP e. RBS 6. The statement r true regarding anemia: a. Pancytopenia can occur in megaloblastic anemia T (sbb common cause of it are b12 n folate deficiency. So dua condition ni can occur when ada bone marrow suppression. Dats y dapat pancytopenia.) b. Anemia with enlarged LN may suggestive for haematological malignancy T c. TIBC is low in iron deficiency anemia F d. Bone marrow aspiration is the 1st step to confirm the cause of anemia F e. Presence of reticulocytosis indicates increased production or erythrocytes T (reticulocytosis usually increase in acute loss of blood)

7. 18 yr old lady presented with jaundice n pallor to health clinic. Possible causes include: a. viral hepatitis F (hepatitis cause jaundice but not pallor. Jaundice + pallor is due to HEMOLYSIS) b. Non alcoholic steatohepatitis F (dia just impair some liver fx but tak cause jaundice or pallor) c. Thalassemia T d. Hereditary spherocytosis T e. Paroxysmal Nocturnal Hemoglobinuria T 8. Which r the following pairs are correct? a. Facial puffiness nephrotic syndrome T b. Bilateral LL swelling DVT F c. Orthopnoea and PND- Rt Ventricular failure F d. Chest pain during inspiration- pleuritis T e. Vomiting and blurring of vision brain tumour T 9. Complication of DM a. Autonomic Neuropathy T (so pt boleh dapat postural hypotension, giddiness, alternate bowel habit usually diarhea due to autonomic neuropathy) b. Dermatitis herpetiforme F (benda ni ada dlm celiac dz) c. Cataract T d. Recurrent skin infx T e. Charcots joint T 10. 25 yr old lady c/o periorbital swelling , facial puffiness and bilateral LL swelling. No sy of orthopnoea, PND. Following ix can lead to dx: a. serum ALT F b. Anti nuclear antibody T c. USG KUB F d. Urine for contrast study T (test ni utk tgk morphology of RBC. Kalau dia ad SLE so blh nmpak red cell cast dlm urine tuh) e. ESR F 11. Following r true regarding thyrotoxicosis a. Active sx include increase weight and forgetful F b. There are association with autoimmune T c. Active sign include lid lag and hyperreflexia T d. Initial ix should include serum thyroglobulin F (bnda ni just kita check if pt post thyroidectomy or post radioiodine. Bear in mind that thyroglobulin is not thyroid binding globulin. TBG is used for transportation of thyroid hormone in the blood while thyroglobulin(Tg) is used for synthesis of thyroid hormone. Patient yg ada autoimmune dz such as hashimoto thyroiditis or grave dz ada antibody against thyroglobulin.) e. PTU is given in pregnancy T

12. Following are true regarding peptic ulcer dz a. Associated with stressful working environmnt T b. Prednisolone is associated with ulcer formation F (pelik juge knapa F, tp dr rahman pn x sure knapa jawapn yg dberi kt kertas soaln dia F) c. PR examination is unnecessary F d. Bleeding episode r associated with increased urea level T (bila bleed dlm perut, blood will be absorbed into the circulation, so urea akn high sbb blood tukan akn dimetabolized n akhirnya jd urea)

e. Treatment of choice H2 antagonist F (PPI) 13. Following r true regarding dengue fever a. Incubation period may last to 2 weeks F (up to 10 days shj) b. Is an RNA virus T c. Transmitted by anopheles spp mosquito F d. There are 3 serotypes F e. There are vaccines for the virus F 14. These dz carries excellent prognosis a. Wilson dz F b. Dubin johnson T c. Rotor syndrome T d. Sclerosing cholangitis F e. Gilbert syndrome T