16-july-2011 Paediatrics

1)Fallapy baby 4 hours after birth:check Blood Sugar 2)Aboriginal boy with external ear pain, redness an little purulent discharge Ear toilet Antibiotic C) Paracetamal. 3)A 2 year old aboriginal boy present with his mother complain of a thick material comes out of his air and nose, and boy only say 4-5 words what is the complication could be seen?
A) B)

Cholesteatoma Hearing loss C) Otosclerosis 4)A premature infant, born at 28 weeks of gestational age. Now presenting with tachypnea, tachycardia, and chest wall retractions.
A) B)

A) hyaline membrane disease 5)A 5 year old boy is presented by his mother because of fever and ear pain during the last 24 hours,in your physical examination his body T:38/6 and his right tympanic membrane is redden ang bulged outside.which one of the following is the best appropriate next step in management? A)IV ampicillin B)PO paracetamol C)PO amoxicillin 6)A 6 year old boy is presented by his mother complaining he is very naughty,she claimed I am unable to control him to sit and he is always jumping and can not sit infront of TV,she said that I am forced to keep him in his room for long time but it doesnt still work,which one of the following is the best appropriate management? A)methyl phenydate B)psychiatric counseling with her son C)competent parent course 7) You see late deceleration in CTG of a 25 year old woman at her 43 weeks of gestation during induction. Apart from cessation of oxytocin which one of the following is the most appropriate next step in management? A)C/S

B)Fetal scalp monitoring C)repeat CTG in the next 30 8)Which one of the following can be an alarming sign in a 2 m infant? A) unable to change from prone to supine B) unable to follow her mom when she is walking in front C) unable to turn to her mums voice D) unable to lift head to 90 while prone 9)An 18 months boy is presented with inspiratory stridor and subcostal recession, He had experienced and episode of URTI 2 weeks ago. Which one of the following is the best way to manage his current problem? A)IV hydrocortisone B)nebulised salbutamol C)IV adrenaline D)nebulised adrenaline 10)A child with 2 does DTP, at 2.4 years old he falls over and there is a superficial lesion. After the debridement, what will you do? A)Toxoid + local antibiotics B)Toxoid + IV antibiotics C)Toxoid + Ig D)DTP + Ig 11)A 6 year old girl with BMI 85% and hight 75%.with breast development stage 1 taner. scanty pubic hair and no axillary hair. What will you do? 1-GH 2-FSH AND LH 3-MRI brain 4-review in 6 months 12)Child with history of jaundice in infancy . with splenomegaly, best management Spleenectomy 13)Child brought by his mum, say he can walk, but now cannot walk, you arrange a CT for him, but at the day they didnt come, what will you do? A)Contact child protect agency B)Wait 14 days

C)Call the mother to follow up D)Leave it 14)Ascites with malignant, what will you find? A)A nodule when perform digital exam B)Hepatomegaly C)Cervical LN 15)A 8 weeks old infant, acyanotic with left upper sterna systolic murmur A)ASD B)VSD C)PDA 16)Which will you be interested in 8 weeks old boy? A)Cannot smile B)Cannot hold the head C)Cannot move the head to the sound 17) A 16-year-old boy presented to your clinic for assessment. His height at the 5th percentile and weight is 50th centile. His development of secondary sexual characteristics is of Tanner stage 2 What is the most likely cause? A)Constitutionally delayed puberty B)Klinefelter syndrome 18) A teenager is active in sports. He presented with point tenderness and a lump at the tibial tuberosity. What is the most appropriate advice? A) His condition will go away after 1-2 years B) If the lump is persistent he will need investigations 19) What can a normal 2-year-old child do? A) Feed self with spoon B) Name a few colours C) Tell surname D) Combine 2 words and make a sentence E) Knows 3 words with 4 syllabus 20)A newborn developed jaundice at 12 hours after birth. What is the most likely cause of the jaundice?

A) Biliary atresia B) Hemolytic disease

21) A 4 year-old boy presented to your clinic with bilateral conjunctivitis, fever, redness of the tongue and lips, peeling of the palms and soles. What is the most appropriate management? A) Intravenous immunoglobulin and aspirin B) Paracetamol C) Penicillin D) Prednisolone 22) A boy has a 3rd episode of nephrotic syndrome. He is treated with prednisolone but his recovery is slower than expected. He also has hematuria. Blood pressure is 120/80mmHg. What is the cause? A)Superimposed post-streptococcal glomerulonephritis B)Renal calculi C)Focal segmental glomerulosclerosis D)Renal tubular acidosis 23) A girl was found to have 2 vaginas and 2 cervices after an ultrasound scan. What is the next most appropriate investigation? A) FSH and LH levels B) Estrogen level C) CT abdomen and pelvis D) Hysterosalpingogram 24)Parent of a 5 months old infant was rushed to the ED. 5 months old infant with a history of intermittent screaming and drawing up his knees. He has vomited twice and appears to be pale clammy and tired. Abdominal examination is normal. What is your diagnosis? A. Intussusception B. UTI C. Pyloric stenosis D. Gastroenteritis 25) Baby eats detergent and brought by father to you. The most appropriate initial treatment A. milk B. Charcoal

26) A preterm baby with weight 1.6kg at birth and 6 months later her mother brings her to you To see if she grows normally with current weight 5.1kg A. The baby pick up weight well B. she is low weight C. she is overweight D. grows up normally E. she is obese 27) New born baby is unwell. Vomiting and having difficulty in feeding. Urinary analysis shows leucocytes 100,000. What is the most appropriate management? A. Amoxycillin B. Sulphonamide C. Suprapubic aspiration 28) An 18 year old boy presented with ear pain. On examination, his tympanic membrane was found to be normal. There was a congested area over the gingival mucosa behind the molar. Orthopantogram shows an impacted unerupted molar. What is the next step? A. B. C. D. Oral antibiotics I/v antibiotics Refer to an orthodontist Refer to a maxillofacial surgeon pustules or papular

29) Parents bring their 10 day old child with multiple pustules lesions over body. What is the most likely diagnosis? A. B. C. D. Meningococcal infection Erythema toxicum Drug reaction Pyoderma

30) 3 weeks old baby presented with features of meningitis. What is the most likely causative organism? A. B. C. D. Meningococci E coli Group B streptococcus Staphylococci

31) 3 years old child going to the child care. the child of that child care is affected by pertussis. the mother present with child with 2 days cough and runny nose. the child is uptodate of all vaccine. what is the management for this child?

a)give booster dose DTP and tell not to go child care untill infection is stop. b)give antibiotic erythromycin and tell them not to go child care untill infection is stop. 32) 13.6 month old child with UTI. what is the treatment? a)amoxycilin and gentamycin b)cephalexin c)ceftriaxon d)trimethoprim 33) A boy with first day jaundice. There was blood picture. (I think that was G6PD). What the chance of affected for sibling? a.50% of all sibling affected b.100% of all sibling affected c.50 % boy only affected d.25% all sibling affected e.25% boy only affected. 34) Patient presents with haematuria, hypertention, and palpable mass of bilateral kidneys. Asks for Diagnosis. A. Renal tumor B. Wilm's tumor C. Neuroblastoma D. PCKD Child with bronchiolitis Kawasaki

Surgery
1)A patient comes with orthostatic hypotension and pulse rate of 120 and acute bleeding. What is the estimated percentage of blood loss? 10% 15% 20%

25% 30% 2)which one is absent in pseudobulbar palsy? Decreased gag reflex

3)Patient with swelling of left scrotum. management? sono 4) Picture which submandibular swelling and redness. What is the first step in management? sono 5)A patient with acute upper GI bleeding what is most important? Injection of adrenalin in the ulcer through endoscopy 6)A patient with venous ulcer which is the most predisposing condition? DVT 7)Patient with elevated TSH what is the best test to determine the cause of the condition? A)T3 and T4 B)homogenouse increase uptake of iodine in the gland 8)Patient comes with h/o anxious, tremor, sweating and loss of body weight. O/e pt has high heart rate, TFT shows TSH 0.01 (normal 0.04-??). Which of the following results could lead to diagnosis? A)High T3, T4 B)Increased radioiodine uptake scan C)Cold nodule in radioiodine uptake scan 9)Same scenario as above, what is the initial management after giving propranolol A)carbamazepine 10)melanoma stage 2. Excised with border of 2mm. what do you do? Reexcise 11)Urge incontinency: A)Pelvic floor exercise B)Bladder re-training C)Pessary

D)Surgery 12)Picture of breast: Intra ductal papilloma

A)

Ductectomy

13)A ECG shown atrial fibrillation. Patient came in with h/o of abdominal pain, what is the diagonosis A)mesenteric ischemia B)pancreatitis C)biliary colic 14)Patient on warfarin, CT abdomen showed as below, what is the diagnosis Rectus sheath haematoma 15)On Aspirin and given the CT scan of rectus sheath hematoma 16)MVA (or some other trauma) in ED. Multiple rib fracture, patient is tachypnoea, tachycardia, and paradoxical breath pattern, what is the next management A)Strain chest B)Paralyse, intubate and ventilate 17)Patient- Achalasia esophageus , operation 5 years ago. One month ago has hoarseness of voice- presenting with 2 weeks of dysphasia. He is a smoker. Lesion is in vocal cord where could be the mets? SCC B) Bronchial CA C) CA larynx 18)Colles fractures the plaster (Repeat recall)
A)

Back slab Cylinder plaster 19)The patient coming with ST-elevation he has chest pain one hour ago, tertialry hospital 4 hours time, what do next?
A) B)

Iv Streptokinase
A) B) C) D)

rTPA PCI DC shock GTN

20)A man from NT, presented with a lesion on his hand its the lesion increasing in size what is the diagnosis (picture)
A) B) C)

BCC SCC Melanoma

21)A 45 year old woman is presented with abrupt left eye blindness and right hemiparesis (the stem was not that clear but the patient is symptomatic)Right carotid Doppler shows 50% stenosis and left side shows 60% stenosis. What is the next appropriate management? A)left carotid endarterectomy B)ASA C)warfarin 22)A case was presented by femoral hernia(from the pic)which one of the following is the most appropriate next step in management? A)urgent surgical referral B)observe for 24 hours C)refer in the next 2 days to surgeon D)discharge and follow up 23)A pt is presented with bilateral visual blurring and crossed sensory loss and left ptosis and miosis, which one of the following vessels involvement is responsible for his presentation? A)left post communicating artery B)left vertebral stenosis C)middle cerebral artery D)left carotid artery 24)A 52 year old heavy smoker is presented by productive cough and SOB, you put him on 12 L 100% oxygen, after a while his LOC is decreased, which one f the following can be his ABG finding? A)pao2:62 paco2:102 PH:7.29 B)pao2:114 paco2:35 PH:7.35 25)You are the ED physician 4 year old girl is brought by paramedics after a house burn, her vital signs is stable now and in physical exam the lungs are clear. the only positive finding is presence of soot in her sputum. What is the most appropriate next step in management? A)Nasal cannula O2 B)O2 by mask

C)endotracheal intubation D)observe her for 6 hours 26)pt with tarry stool what is the first management? A)gastroscopy B)colonoscopy

27)CXR and history of 2 months cough, low fever, malaise, night sweating and green sputum and blood in sputum. What do you do? A)12 months tetracycline B)reassure and 6 months later do Chest X-Ray C)TB therapy D)report to health service 28)Old patient with abdominal pain, constipation, what is the cause? X-Ray is given (you can see the gallbladder stone) A)Mechanic bowel obstruction B)Sigmoid volvulus C)Pseudo obstruction 29)(pic of BCC) Treatment? A)Local incision + LN clearance B)Wide local incision C)Local incision 30)Patient ovary mass, biopsy shows metastasis, which could be the primary? A)Kidney B)Breast C)Pancrease D)Liver (no bowel or stomach) 31)A picture of a lesion on the nail for a long time A)Wedge incision

B)Biopsy C)Local incision 32)DVT patient A)Inpatient and compress the leg+heparin B)Inpatient and elevate the leg+heparin C)Outpatient and compress the leg+heparin D)Outpatient and elevate the leg+heparin 33)Patient has symptoms of stroke, BP 180/100 left carotid 40-50% stenosis, right side 50-60% stenosis. How can you lower the risk A)Anti Platelets B)Anti HTN C)Surgery 34)A young girl syncope, someone do CPR to her, father suddenly died 25 years ago. What is causing the symptom? A)HOCM B)Drugs C)Cerebral problem 35)A patient with 39 degree temperature, sputum vitals normal. X-Ray given (shows left upper lobe cavity and fluid level)/ A)Lung abscess B)HIV C)Tumour 36)24 hour post operation gastric cancer, patient with upper abdominal pain, a chest X-ray given. A)CTPA B)Antibiotics C)O2

D)Painkiller 37)A pic of Venous ulcer what is the cause? A)Long history of smoking B)Family history of melanoma C)History of tibial fracture 38)A patient 20 weeks pregnant with hyperthyroidism A)PTU B)Pronolol C)Carbimazole D)Observe 39)Painless jaundice, itchy a palpable mass in RUQ what is the diagnosis? A)Pancreatic Cancer B)CBD stone C)Gall bladder stone D)Hep B E)Hep A 40)Patient with lab data all normal Cr and BUN and Calcium raised. A woman with falling down and fatigue. What is the diagnosis? A) Pagets B) malignancy induced hypercalcemia C) primary hyperparathyroidism D) Vitamin D toxicity 41)A patient with appendicitis after appendectomy pathology shows acute appendicitis and carcinoid tumour .what is the treatment: Right hemicolectomy 42)Bout of vomiting, patient has sudden chest pain. O/e dullness on the left side, what is the most appropriate initial investigation Contrast-enhanced CT Endoscopy

43) Same scenario, what is the most appropriate management A)Needle aspiration B)Contrast-enhanced CT C)Endoscopy D)Chest tube 44)X-ray of the young nurse working in rural area, presented with sweating fever to me was like TB asking what the diagnosis is. TB B) CLL C) ALL 45)A 59 year old man is presented 3 days after cholecystectomy by decreased LOC, which one of the following is the most likely cause of his confusion? A)hyponatremia B)alcohol withdrawal C)infection D)delirium
A)

A 54 year old man was brought to the Emergency department with multiple fractures after an automobile accident. He underwent emergency surgery. On the third post operative day, he complained of seeing people coming to his room with the intention of harming him, which you know is not true. What is the reason for the hallucination? A. B. C. D. Fat embolism Alcohol withdrawal Complication of Anesthesia Cerebrovascular accident

46) Patient with colon cancer, metastasis to LN, what can help after the operation? A)5FU B)Tamoxifen 47) A lady in her 20s is newly diagnosed with lateral epicondylitis. What is the first step in management? A) Oral steroids for 1 week B) Lateral epicondylectomy C) Brace below the elbow D) Splint for the fingers of the affected arm

E) Brace immobilizing the affected elbow 48) Which is the following is the most characteristic sign of chronic limb ischaemia? A) Pain relieved by walking B) Rubor C) Colour of the limb improved after hanging the limb at the end of the bed D) Numbness

49) Toxic shock syndrome caused by Staphylococcus Aureus is associated with: A) Super-absorbent sanitary pad B) Endotoxin production 50) A 20 year old man presented with weakness of the left arm. On examination the left arm is oedematous. There is tenderness over the inner aspect of his left arm. His left axillary lymph nodes are enlarged but not tender. He also reported that his pet cat is unwell. What is the cause? A) Cellulitis b) Axillary vein thrombosis C) Cat Scratch fever 51) A patient had a subtotal thyroidectomy 2 days ago. She developed shortness of breath and stridor. What is the most appropriate management? A) Give Oxygen B) Nebulized salbutamol C) Remove the superficial sutures D) Remove all sutures in the ward E) Call the operation theatre 52) An adult with polycystic kidney also has multiple liver cysts. What is the least likely association? A) History of flank pain B) Berry aneurysm C) Abnormal liver function test D) Hematuria 53) A man alleged a major car accident. He presented to the emergency department with hoarseness of voice. Chest X-ray showed widened mediastinum and loss of aortic knuckle. What is the next step in management? A) Pericardiocentesis B)Intubation and ventilation C) Oxygen D) CTPA

54) What is the most common cause of isolated 4th nerve palsy? A)Multiple Sclerosis B)Diabetes Mellitus C)Neuroma of the trochlear nerve

55) A man alleged a trauma few days ago after falling down from the bicycle and his helmet was split into half. He did not lose consciousness and did not have amnesia. Now he presents to the emergency department with headache. What is the most likely diagnosis? A) Post-trauma headache B) Subarachnoid haemorrhage C) Subdural hematoma D) Extradural hematoma 56) A man in his 30s developed back pain after carrying heavy load. Neurological examination showed weakness in dorsiflexion, plantar flexion, inversion and eversion of the ankle. Knee reflex is present and normal; the ankle reflex is absent. Which nerve is most likely to be involved? A) L4 B) L5 C) Sciatic nerve D) Tibial nerve E) Common peroneal nerve 57)A middle age woman presents with two years of amenorrhea and recently has galactorrhea. No headache or visual disturbance. Long history with hypertension which is treated by Verapamil. Investigation revealed prolactin higher than normal level. Most likely cause A. macroadenoma of the pituitary B. microadenoma of the pituitary C. verapamil D. primenopausual state E. craniopharyngioma 58) The best way to estimate a significant blood loss in a patient who has GI bleeds A. estimate the volume of loss by history B. monitor changes in resting heart rate C. assessing BP with positional change D. measure hematocrit change 59) A 55 year old lady with right upper quadrant pain, jaundice and dark urine. She has cholecystectomy 7 years ago and your next appropriate investigation? A. USG

B. Abdominal CT C. Laparoscopy D. ERCP E. Oral cholecystogram 60) Which of the following are the causes of mechanical dysphasia EXCEPT A. B. C. D. E. amygdalitis reflux esophagitis Schatzki ring Myasthenia gravis exceeding enlargement of thyroid gland

61) An 80 year old male presented with absolute constipation, pain and distension of abdomen. On examination, abdomen was found to be markedly distended and the rectum was found to be empty. What is the most likely cause? A. B. C. D. Colorectal Carcinoma Sigmoid volvulus Mesenteric vascular occlusion Adhesions

62) Picture of a middle aged man with a submandibular swelling. He has the swelling for the past one year. It increases in size while taking orange juice. What is the diagnosis? A. B. C. D. Submandibular sialolithiasis Parotid tumour Lymphadenopathy Branchial cyst

63) CT scan of the brain showing dark areas; Lateral ventricle seen to be displaced and there is (?)midline shift. Patient gives h/o lung resection one year back for malignant tumor. A. Infarction B. Metastatic lesion? 64) 50 year old golfer comes with an ulcer in the pinna. It bleeds on scratching. (Picture of posterior part of pinna with a reddish,non pigmented ulcer. There are deeply sun-tanned areas around the lesion) . What is the diagnosis? A. B. C. D. SCC BCC Malignant melanoma Bowenss disease

65) 38 year old female nurse from a rural hospital comes with complaints of cough and fever. She is a heavy smoker. On examination, she has coarse crackles at the left apex. Chest x-ray is given ( Left apical field, there is a cavity-same as the one given in blue book). What is the diagnosis? A. Tuberculosis B. Malignancy C. Sarcoidosis D. Pulmonary embolism 66) Parents of a young boy brings the son to emergency department as he felt a sudden stinging sensation while cycling through a grass land. Examination was normal. But suddenly he developed diplopia. Which of the following is the best way to detect the type of venom? A. B. C. D. Urine Swab from the wound Skin scrapings Clothes

67) 80 year old man presented with dyspepsia and vomiting. Barium swallow of the patient is given. (There is dilatation of esophagus.....like an achalasia cardia. But there are two constrictions......one for the esophageal sphincter and second at the level of diaphragmatic opening......Likely to be a hiatus hernia+/- achalasia). What should be the best management? A. B. C. D. Esomeprazole Pneumatic dilatation Laproscopic cardiomyotomy Surgery for hiatus hernia

68) A 50 year old female who returned after a long air flight from England, now presents with fever, chest pain, cough and diarrhea. o/e, she has widespread inspiratory crackles. What is the likely diagnosis? A. Pneumonia B. Pulmonary embolism C. H1N1 infection 69) Picture of a pinna. There is a brownish pigmented lesion on the helix. What is the best way for biopsy? A. Excision biopsy B. Incision biopsy C. Shave biopsy

D. Punch biopsy E. Cryocautery 70) 40 year female who is a known case of polycystic kidneys and congenital liver cysts. Which of the following is least likely? A. B. C. D. Abnormal liver enzymes Hematuria Two of her five brothers having polycystic kidney Developing subarachnoid hemorrhage

71) 86 year old female from Egypt, who had undergone CT scan abdomen for some other complaints, was found to have a large mass in the liver (mass shows dense calcification circumferentially around the circular dark mass). What is the best step in management? A. B. C. D. Reassure and do nothing Laparoscopic biopsy of the mass laparotomy and excision of the mass MRI of abdom

72) Picture of pyogen Granuloma Mx? A. local excision B. wide excision C. cryotherapy D. do nothing 73) Case of middle aged men with symptoms of acute appendicitis. A surgery was ordered with success. Pathology of the appendix shows mucous carcinoid. What is the next management? A. No need for other treatment B. adjuvant therapy C. chemotherapy D. radiotherapy 74) Before/after of a Picture of a man change into extremely red face. No symptoms except for the flushing. Asks for investigation. (not pemberton since the arms were not raised) A. 5-HIAA 75) An 70 year old lady, case of lethargy and weakness. Blood picture was given. LOW iron, ferretin, MCV, HB. Asks for most appropriate next management? A. oral Iron supplement B. colonoscopy C. Dexa scan

D. reassure 76) 49 year old woman with history of jaundice with dark urine and mass was presented in the right upper abdomen which moves with respiration has no history of alcohol intake, no history of pancreatitis. What is the most probable cause? A. cholangitis B. cholycysitis C. mucocele of gall bladder D. choledocholithiasis 77) 1 day after operation patient is agitated and confusion what you will do? blood gas analysis. Cpr: COMPRESION RATE 100 picture of chronic breast abcess Patient with bitemporal hemianopia what is the causes? X-Ray of surgical neck of humerus fracture. Diagnosis Carcinoma of upper oesophagus Treatment for DVT (outpatient or in patient?) Psoriasis picture (pic of the eye shows conjunctivitis) patient with itch discomfort, tears. Treatment? (pic of fundoscopy, flame shape) diagnose? Hypertension A picture of psoriasis on the leg, treatment? Plain X-ray of abdomen showing dilated large bowel loops. S/o Sigmoid volvulus. Asking for diagnosis

Medicine
1)A patient comes in with fever, lower abdominal rigidity, and diarrhoea and one month ago patient went to south East Asia during the trip patient experienced (some symptoms of acute appendicitis) whats the cause of the current presentation? Acute appendicitis Pancreatitis C) Gall stone 2)Atrial Fibrillation young patient what is the initial management?
A) B)

Aspirin B) Warfarin C) Digoxin D) Amiodarone E) Cardioversion 3)Patient with AF what do you do for rate control? A)Digoxin
A)

4) An 80 year old woman came to you with fever and cough. On examination the pt has wheeze and stridor. In CXR she has infiltration of left lower lobe. What is you treatment? A) azithromycin B) ceftriaxone C) penecilline D) dicloxacillin 5)An 80 year old diabetic comes to you with acute lower limb pain. The pt has swelling and tenderness and redness in his left leg. He can not move his knee and sensation below the knee is impaired. Which one is your treatment? A) dicloxacillin B) gentamicine 6)Picture of red eye and history of rhematic disease.treatment? Prednisolone 7) Which of the following is not a risk factor of primary open angle glaucoma?

A. B. C. D. E.

DM Steroid Hypermetropia Family history age>40

8)ECG of SVT: Carodit massage 9)ECG of torsade pointes 10)Patient with WPW and came with VT what do you do? Amiodaron 11)A Patient from Sudan with Chest X-Ray of TB, what is the treatment? A)multiple drug TB therapy 12) pt with symptoms of hyper thyroidism 13) Patient with joint pain and jaundice. No pruritus. What is the diagnosis? 1-HB 2-hcv 3-Hav 4-gall stone 5-cholangitis 14)

An ECG (V1) is shown as above. Patient is young and hemodynamic stable, what is the initial management A)beta blocker B)cardioversion C)amiodarone D)vasalvaga E)vasovagal maneuver 15)ECG-SVT gives adenoma. Patient has allergy. What to give next?

Verapamil B) Amiodaron C) Thiazide D) Digoxin 16)ECG of 9 year old boy complaining of palpitation (my heart is racing) his pulse is 240B/M what is the initial management
A)

Adenosine B) Valsava maneuver C) Verapamil D) Cardio version 17)COPD patient, after giving 24% oxygen, ABG showed as below
A)

pH 7.2 PaO2 80 mmHg PaCO2 60 mmHg What is the next most appropriate management? A)High flow oxygen B)Low flow oxygen D)CPAP 18)Splenectomy- patient after 6months comes with infection Vaccination B) Amoxicillin C) Pneumococcal vaccination. D) Ceftriaxone 19)Patient with abdominal pain and jaundice. All the liver function tests are very high. Especially AST ALT >10 times. GGT and ALP is very high as well. No particular travel history was given, and a mass can be palpated 3cm below corstal margin on the right side.
A) A) B) C) D) E)

Hep A Hep B Hep C CMV EBV

20)A patient with MM, blood sample shows Hb 85 g/L, ureic acid high, Cr high. A)Blood transfusion

B)Iron supplement C)Oral phosphate D)Dialysis

21)A ECG given vitals stable, shows VT A)Atenolol B)Amiodarone C)Adenosine D)Verapamil 22)A old patient with chest pain at home, especially when inspiration, EKG given (shows prolonged PR interval what is your diagnose? A)PE B)Pericarditis C)Dissection D)HOCM 23)Patient becomes unstable after carotid palpation, ECG showed AV blocking, what is the most important thing in the next management A)Warfarin B)Digoxin C)Aspirin D)Stop carotid palpation 24)A truck driver, BMI 42. H/o hypertension, diabetes and etc. Present with daytime sleepiness. Occasionally fall sleep while waiting at the traffic light. O/e blood glucose level of high (but just slightly high). What is the next most appropriate management A)Overnight sleep pattern assessment B)Start insulin C)Diet management

25)Pic of fundoscopy (looks normal) asking for sudden aura of blindness

A) B) C)

Retinal artery occlusion Carotid artery occlusion. Retinal vein occlusion

26)A 50 year old lady, hypertension, DM, come to the clinic, complaining of an episode of blur vision, said there is shimmering light which spread over her left eye for a 10 min period and leave her with blurred vision and completely resolved with in 30 mins what is the diagnosis? Migraine Aura B) TIA C) Epilepsy D) Retro bulbar neuritis. 27)An ophthalmology case with feeling of a large spot in visual field, in retina you could see something like haemorrhage and the rest was normal. A)diabetic retinopathy B)hypertensive retinopathy C)macular degeneration
A)

28) A patient presented with generalized abdominal pain and tenderness. ECG was done. (ECG was given which showed irregularly irregular R-R interval) What is most likely diagnosis? a. Peritonitis b. Bowel obstruction due to adhesions c. Pancreatitis d. Mesenteric ischaemia e. Diverticulitis 29) A 40 year old lady has pain in the hand joints bilaterally. The following are the investigation results. Which is the most appropriate long term management? ANA: Positive (1:160 titre) Anti-Ro (SSA) positive Anti-double stranded DNA: 4 IU/mL (Normal 0 5 IU/mL) Anti-CCP: Negative Rhematoid factor: Positive

A) Hydroxycholoroquine B) Naproxen C) Prednisolone D) Methotrexate

E) Azathioprine

30) A picture of visual field was shown. Where is the lesion most likely to be?

A) Optic chiasm B) Optic nerve C) Parietal lobe D) Temporal lobe E) Cortex 31) A patient presented with generalized abdominal pain and tenderness. ECG was done. (ECG was given which showed irregularly irregular R-R interval) What is most likely diagnosis? A) Peritonitis B) Bowel obstruction due to adhesions C) Pancreatitis D) Mesenteric ischaemia E) Diverticulitis

32) On disorders of coagulation and immune system that cause DVT except WOF A. B. C. D. E. Anticardiolipin antibodies (ACA) Factor VIII Factor V INR Protein S

33) A child with IDDM at his school in the playground. What is the most appropriate next in management? A. B. C. D. E. 34) IV glucose check blood sugar level assess his neurological test test urine ketones Insulin Injection

This is the field of vision of a patient with complaint of visual defects. Where is the site of the lesion? A. B. C. D. Optic Nerve Optic chiasma Parietal lobe Temporal lobe

35) All are features of temporal arthritis, except? A. sudden blindness B. fever C. elevated ESR D. Pain in the head and shoulder area 36) An old lady presented with flashers and floaters, difficulty seeing in bright light, and on red light reflex, black particles were seen. What is the most likely diagnosis?. A. glaucoma B. retinal detachment C. uveitis D. keratitis E. cataract 37) 60 years old man with dyspnoea presented in ED. he was fine before which one could be his ECG change? 5 ECG stems a)AF b)heart block c)atrial flutter d)VT e)SVT

38) A nurse came from a rural area with sputum (forgot the color) and intermittent haemoptysis. her temp is 39.5 what is the management for her.(there was a x-ray of lung abscess). a.antibiotic for 12 months b.drainage c.start anti TB drug 39) The chief surgical risk to which patients with polycythaemia vera are exposed is that due to a. Anemic disturbances b. Hemorrhage c. Infection d. Renal dysfunction e. Cardiopulmonary complications

Sjogren disease (pic of the the same as 2010 July recall) about age, sex, smoker, lipid level. multiple question on distinguishing between IgA nephropathy, Hemolytic-uremic syndrome HUS, minimal change disease, Focal segmental glomerulosclerosis (FSGS ) what is most likely for HIV? pic of swan neck deformity. pic of hypertensive retinopathy pic of cherry red spot. Fundoscopic picture of CRVO. Diagnosis?

OBGYN
1)Secondary menorrhoea lab results FSH increased LH increased (FSH: LH 1:1) Estradiol reduced (slightly lease than lower margin) Ultrasound sowing 3-4 follicles in the ovary Dx? Premature Ovarian Failure B) PCO 2)Which one is true about Bartholin's cyst? A)It can be caused by gonococal infection
A)

3)A patient with CIN 3 and evidence of malignancy in colposcopy what do you do? A)cone biopsy B)LEEP 4)A woman with long lasting PCO. What do you screen? Endometrial cancer 5)Term .came with intrauterine fetal death. Mother RH negative and coombs test was negative in screening during pregnancy. What is the main cause? A)Fetomaternal hemorrhage B) Idiopathic 6)An Rh-negative mother come to ER complaining of pain (38 weeks), she was in labour but baby is dead what the cause of babys death is? A)Feto maternal hemorrhage B)Unexplained death 7) Which one of the followings is the contraindication of tocolysis(Actually the question was a case but at the end they asked which one of the features in this woman is a cont indication of tocolysis ) A)placenta previa B)CHF in mother C)preeclampsia

8)A woman is coming at her 17 weeks of gestation with right abdominal pain, in your physical exam you find his uterus 3 cm below the umbilicus. in her 8 weeks sonography you can see a fibroid mass located in right side of her uterus. Which one of the following is the most likely cause of her abdominal pain? A)placenta abruption B)red degeneration of fibroid C)Appendicitis 9)Apart from folic acid which one of the following options is advised to administer in pregnancy to reduce the subsequent neurological malformation? A)iodine B)magnesium C)beta carotene D)copper 10) A lady with Vagina candidiasis was treated by clotrimazole and the symptoms persisted what is the next management? Fluconazole Metronidazole C) Clindamycin D) Ceftriaxone 11)GA 22w came with 18 hours history of lower abdominal colicky pain. RLQ pain no rebound. With N/V. U/A normal. A)red degeneration of previous fibroid B)UTI C)round ligament pain D)luteal cyst torsion
A) B)

12)Pregnant mother, complain of his 1st child chickenpox, the 1 st anenatal exam of this pregnancy. Shows IgG (-) what is the treatment? A)Repeat the IgG ( No IgM given) B)Give immunoglobin C)Reassure 13)A 18 year young on OCP, suffered heavy menstrual period from 6 month ago. What is the cause? A)Begin ovulate 6 months ago B)Cervix tumour C)Metriosis

14)Women on OCP for 10 years which risk rises? A)Breast B)Cervix C)Uterus 15)A womens pap smear CIN II do ablation 3 years ago. Did abdominal hysterectomy because of fibroids, before the surgery everything is normal. When shall her repeat pap smear? A)No need B)2 yearly C)Yearly 16) 16 weeks pregnant with abdominal pain she did appendix surgery when 19 years old. Now vital stable, what is the cause? A) round ligament Stretch B) threatened abortion C) ectopic pregnancy 17)A 14 weeks pregnant women lower abdominal pain BP 80/50, hour 129 bpm, what is the cause? A) Threatened abortion B) Incomplete abortion C) Ectopic pregnancy D) Degeneration of fibroids 18) Patient 32w with mild vaginal bleeding. Cervix is closed and fetal heart is normal. What do you do? Transvaginal US 19)GA:18 w first visit. Unplanned pregnancy .previous pap smear normal. Came with vaginal discharge that is clear. what do u do? A)repeat pap B)culture of low vaginal swab 20) A pregnant lady presented to the antenatal clinic at 12 weeks with fever and flu-like symptoms. Her first visit at 4-weeks gestation revealed positive CMV IgM. What is the appropriate management? A) Fetal ultrasound at 18 weeks B) Check her CMV IgG at 4-weeks gestation

C) Perform blood test for CMV IgG and IgM now D) Amniocentesis 21) A 24-year-old lady is confirmed to be pregnant after serum beta HCG was done. The gestational age is 10 weeks. Which of the following investigation will alter the management of this gestation? A) Varicella antibodies B) Parvovirus antibodies C) Blood glucose D) Rubella antibodies E) HIV test 22) A 38 year old lady is pregnant. What is the chance of having a baby with Downs syndrome? A) 1:1000 B) 1:500 C) 1:250 D) 1:100 E) 1:50 23)18 weeks pregnant lady diagnosed with DVT and before treatment what investigation need to be done? Select the antibiotic most frequently associated with fetal side effects. A.Tetracycline B. Streptomycin C. Nitrofurantoin D. Chloramphenicol E. Sulfonamides 24) The third-trimester fetus of a mother with a balanced 13;13 translocation would have what likelihood of having an abnormal chromosome karyotype? a. 2% b. 10% c. 25% d. 50% e. 100% 25) 52 year old female has noticed a swelling of 2cm diameter appearing at her introitus everytime she defecates. The swelling disappears after defecation. She doesnt have any urinary symptoms. What is the likely pathology? A. Rectocoele B. Cystocoele

C. Bartholin gland cyst D. Wolfian duct cyst 26) 31 weeks gestation women come to health check, she wants to confirm her EDC(expected date of childbirth). Which of the following is most reliable? A. USG at 18 weeks B. USG at 34 week 27) Picture of CTG shows variable deceleration what is the management ? a)observation b)LUCS c)amniotomy 28) What is the true for bartholin cyst? a)it can be asymptomatic for long time b)if infected then treat by antibiotic. (forgot other options. read bartholin)

HRT: Estrogen 0.625 Female with DVT what OCP do we prescribe? Treatment for CINII cervical cancer Billings method of contraception.

Pharmacology
1)DM + hypertension patient developed hypoglycaemic shock. Which drug mostly causing his symptom? ACE Inhibitor B) Beta-blocker C) CCB D) Thiazide 2)Which is not the side effects of steroids?
A) A) B)

Leukopenia Osteomalacia

3)Amitriptyline overdose, what is the management sodium bicarbonate, ventilation 4)Which drug has negative inotropic effect? A)digoxin B)diltiazem C)dopamine D)dobutamine 5)A 55 year old man is presented by lt hemiplegia on warfarin(A CT scan Q:an ICH in CT is evident)which one of the following is the most appropriate next step in management?(INR:5.9) A)Vit K B)FFP C)Stop warfarin until INR <5 D)skip warfarin 6)A lady came in with femoral neck fracture, history of oesophagitis, was noted to have osteoporosis what is the best management? Alendronate Calcium C) Vitamin D D) Raloxifen E) Calcitonin 7)A patient with Right leg weakness + painful. He is on ACEI, statin, anti-platelets. The neurological exam normal. Physical examination: right are and leg tenderness, what is the next step in management?
A) B)

A)Do US B)Stop Statin C)Painkiller 8) Young patient after orthopaedic surgery??, and is on patient-controlled analgesia. Morphine is set as 1mg /bolus injection and the interval is set as 5 min. Patient is drowsy now. What is the next most appropriate management? A)Give paracetamol 6 hourly B)Reduce morphine to 0.5 mg 9) A pregnant lady has migraine. What is the most appropriate drug combination? a. Paracetamol + Codeine b. Metoclopramide + Aspirin

c. Sumatriptan + ? d. Morphine + ? e. Morphine + ? 10) Picture CT with typically rectus sheath hematoma and patient has a long history of taking warfarin and now INR : 2.9 and feels uncomfortable in abdomen, ask for the most appropriate initial treatment A. Drainage B. Decompression C. FFP D. Iv fluid 11) Which one of the drugs is considered unsafe in the last 4 weeks of pregnancy: A.Warfarin B.Cotrimoxazole C.Paracetamol D.Tetracycline 12) The appropriate antibiotic to prescribe while awaiting specific culture verification is a. Penicillin b. Erythromycin c. Tetracycline d. Azathioprine e. Cloxacillin 13) A patient had MI before 2 years with a drug eluting stent was on clopidogrel. Now he has come for presurgery evaluation for ligation of varicose vein. What should be the advice? A. B. C. D. Avoid surgery Stop the drug for one month Post pone the surgery for one month and do the surgery Stop drug for 10 days before surgery

14) CT of an abdomen with mass in the anterior border. Patient on Wafarin, was found to have a mass in the abdomen. A. Rectus sheath haematoma. 15) 50 years old taking unfractionated heparin before hip arthroplasty. after going home 10 days later again develop DVT. her platelet is 30,000. what your management? a)unfractionated

b)FFP c)another type heparin 16) Side effect of sodium valproate? a.thrombocytopenia b.obesity

Public Health & Psychiatry

1) Man machine controller and he said he sometimes feel tiredness on Monday on history he always drink about 3-6 drinks 4-6 drinks on sat and Sunday whats your management? tell him not to operate machine anymore tell him to drink no more than 2-3 drinks per day C) show him information about the risk or hazard of alcoholism 2) Patient with ankle fracture after drinking. He says he is not alcoholic because he does not drink on weekdays after 6. His friends say he drinks at least 4 drinks a day. What is you initial management?
A) B)

A)Keep a diary of drinking B)Tell him he has no problem C)Sent him for alcoholic withdrawal programs 3) Patient with serious condition can not speak and swallowing and with advanced directive no tube whats your management? parenteral nutrition Euthanasia B) palliative treatment/ Compassion support C) Small amount of water given to mouth 4) Patient with ALS says doesnt want NG feeding. She has a CVA and doesnt have gag and is unconscious. What do you do?
A)

A)Central line for parenteral feeding B)Gastrostomy 5)After TIA patient fully recovered Eye test with corrected lens shows 6/9 and patient also has hemi temporal vision loss patient is driver of home business whats your most appropriate management?

Report to licence authority B) Tell patient not to drive. C) Tell patient he can drive after 3 months D) Tell the patient he can drive after 6 months. 6)You have a new patient that has been transferred to your state recently. The pt is a known case of bipolar disorder being treated with Lithium. On examination the pt has no signs of the illness nor toxicity of lithium. What is the interval by which you will check Lithium for this pt? A)3 months B)6 months C)12 months D)1month
A)

7)Patient on lithium for over 20 years. Symptoms have been well controlled and have no problem with the medication. Recently moved from overstate. How frequently do you monitor of lithium level A)1 month B)3 month C)6 month D)9 month E)Yearly A man in his 40s has been taking lithium for around 20-years and he is stable. How frequent would you monitor the lithium levels? a. Every 1 month b. Every 3 months c. Every 6 months d. Every 1 year e. Every 2 years 8)A boy with BMI 85% . both parents are fat. They are conserved what to do? The main aspect is maintenance of current weight 9)Which kind of study is least important in medicine? A)Case report

10)Asking about least important study? A)Case control

B)Cohort C)Case report D)RCT

11)A woman with history of insomnia and excessive house cleaning. Excessive alcohol intake and flirting. Gets aggressive too. What is your diagnosis? Hypomania

12)20th visit in 12 months period after his wifes death. Worrying about significant dangerouse diseases that he doesnt have. What is the diagnosis? A)Abnormal grief B)Hypochondriasis

13)What does P value mean? 14)What does incidence mean?

15)An old patient in serious condition. His wife requests you to give up resuscitation and his son does not want to. The most appropriate response should be? A)Do as the wife B)Do as the son C)Refer to guardianship court

16)Men travelling overseas, comes to doctor, asking advise to prevent him from schistosomiasis what is the most appropriate advice to give him Avoid taking bath in streams. B) Avoid walking barefoot on grass or ground C) Avoid keeping outside D) Use mosquito repellents 17)Aboriginal 22 years comes from a check up family history DM after one year from recheck. What do you bother about?
A)

FBS B) HBA1C C) Cholesterol, TG D) FBC 18)Factitious disorder

A)

19)Histrionic personality 20)After treating a patient for a few months you feel interested in her,you feel she has got some similar feeling to you,which one of the following is the best approach to towards this circumstance? A)stop her treatment and arrange a date outside B)continue her treatment and apologize politely cause you are not allowed to make any relationship with your patients C)stop her treatment and send her to one of your colleagues.

21)you have been candidated to visit an old lady living in a nursing house as nursing staffs say they have just detecting some odds behaviour about masturbation in her. What is the most appropriate management? A)Old care unit B)psychiatric counselling C)talking to her family about her behaviour

22)A 45 year old man complaining of dry cough and shortness of breath. In your physical exam you can see red spots on his both lower limb. Which one of the following is the best way to diagnose his problem? A)biopsy from his spots B)Chest CT scan C)CXR

23)A girlss school performance is going down, she takes shower till mid-night and say that the neighbour always makes noise to interrupt her what is your diagnose?

24)A women 52 year, her aunt diagnosed Breast cancer 78 years old, how to follow up? A)Mammography 2 yearly B)Mammography + US 2 yearly

C)Mammography yearly D)Mammography + US yearly

25)A 54 year old man comes, his father colon cancer at 55 years old, died because of metastasis. A) Colonoscopy now B) FOBT C) Sigmoidoscopy 26)Woman comes asking about hemochromatosis screening for herself and her two children (5 and 7 years old).her brother has recently been diagnosed. What do you do? screen them now

27) Young woman with sister and mother with CA breast (44 and 45 years old) what is the chance of her getting the disease? 25-50%

28) A 47 year old woman BMI 30 what is the best screening program? A)GTT every 2 years B)Random glucose every 2 years C)FBS every year

29)A 84 year old man is presented by his neighbours complaining about his recent forgetfulness and some strange behaviour, they have heard about some bodies wants to enter his house, he said. Which one of the following is the most likely cause? A)recent stroke B)Alzheimer disease C)Lewy body dementia D)delusional disorder E)schizophrenia

30) A patient with right knee pain is given a walking stick. What is the correctly way to use it? A) Hold it with right hand, and move with the left leg. B) Hold it with left hand, and move with the left leg C) Hold it with right hand, and move with the right leg. D) Hold it with left hand, and move with the right leg.

31) An elderly is terminally ill. However he does not have a will. His wife is the legal guardian. On what basis should she be while making the decision? A) His previous wishes b) Weighing the pros and cons

32) What is the most common cause of death among patients with beta-thalassemia major? A) Renal failure B) Heart failure C) Liver failure D) Sepsis

33) A man comes to you as he will be travelling to Fiji. He already has vaccination against hepatitis A and typhoid. What other vaccinations should be recommended? A) Tetanus, diphtheria and whooping cough B)Yellow Fever C) Hepatitis B D) Polio

34) A male patient has history of depression. He will be travelling to Papua New Guinea and he inquired about malaria prophylaxis. Which of the following drug would be most appropriate? A) Chloroquine B) Chloroquine + Proguanil C) Mefloquine D) Mefloquine if febrile E) Doxycycline

35) As a GP in rural area you notice that recently more cases of Hepatitis C has been diagnosed and you want to do some research on the incidence of Hepatitis C in your community with population around 9000.How could you get all the information you have A. All cases diagnosed as Hep C positive the last 5 years B. All patient with Hep C antigen positive C. All patient with Hep C antibody positive 36) A patient whom you are treating for a long time invites you for a dinner with clear romantic intentions. You also think that you feel attracted towards her. What is the best possible approach to the situation? A. B. C. D. Accept her invitation and continue treating her Postpone the dinner Accept the invitation and refer her to another doctor for further treatment Reject the invitation and stop treating her

37) A 25 year old aborigine comes to you with c/o tearfulness and suicidal ideation. He says he hear the voices of his dead ancestors talking to him. He also tells that his mother has died one month back. But from the reports, she died before one year. What is the diagnosis? A. B. C. D. Abnormal grief reaction Depression with psychosis Mania Marijuana toxication

38) Picture of the CT scan of brain (couldnt make the diagnosis.....luckily question was not based on diagnosis....)This is the CT brain of a 70 year old man with h/o dementia and now in coma. His wife didnt want to treat him further. But his son wants you to give the best treatment for him. What you should do? A. B. C. D. Do as his wife asks Do as his sons wish Report to hospital ethical committee Apply to Guardianship court

39) 93 year female who is getting treatment from you for osteoarthritis. Now she is on Paracetamol 1000mg 3 times daily and Paracetamol 500mg+ Codeine at night for pain. She said as she was not getting relief with this, her friend used to inject her morphine, which was given for her palliative care. Now the friend died and she wants you to prescribe morphine for her. What is the best step? A. B. C. D. Prescribe her morphine. Refuse her request. Refer her to an Orthopedic surgeon. Increase the dose of paracetamol

E. Inform authorities about her drug seeking behaviour 40) An 86 year old female in a nursing home with h/o dementia. The nursing staff reports you that she was found masturbating in her room. What is the best step? A. B. C. D. E. Shift her to a room with four other inmates Tell nursing staff that it is her privacy Call a family meeting to discuss this problem with her family members Send a social counselor to assess the problem Tell her that it is not an appropriate behaviour

41) You are called to the ward to mediate a fight between a patient and nursing staff. The patient was getting admitted for a varicose vein surgery. She is highly demanding and is asking for a special room with TV and airconditioner, because she thinks she deserves it which nursing staff cannot oblige. Seeing you, she says I have private health insurance. Being a doctor, you know what I mean. But these silly nurses dont understand. What defence mechanism is she using? A. B. C. D. E. Projection Denial Splitting Isolation Intellectualisation

42) 53year old female comes requesting for a Ca 125 marker study as her friend was diagnosed to have ovarian carcinoma. On examination, the abdomen and pelvis were normal. What is the next step? A. Do a CEA test B. Do ultrasound C. Do CEA and Ca-125

43) A patient who was taking phenytoin for the past 10 years for epilepsy used to get 2-3 episodes of seizures every month. Two months back, he was changed over to carbamazepine, after which he didnt have any seizures. Now he comes to you asking for permission to drive. What should be the minimum interval before he starts driving? A. B. C. D. 6months 3months 1 year 2 years

44) A female patient is violent in the emergency department. Tells that she is prophetress, that all the staff in the hospital are imposters and that all the patients getting admitted are going to get killed today. What is the appropriate thing to do A. B. C. D. Call police Call security Give her biscuit and tea Take a short history

45) A single mother comes with her 13 year old daughter complaining that she is very disobedient now a days and that she shouts at the mother. The girl is well dressed in her school uniform. What is the best way to talk to the girl? A. B. C. D. Tell her she should not behave this way Ask about her interests Give her a questionnaire to be filled Ask if she has a boyfriend

46) A 78year old man with dementia, and Mini mental status examination score of 10/30 is admitted in hospital. When he was healthy, he had given the authority of decision to his wife. While taking any decisions for him, which of the following should the wife give most importance to? A. His principle and values B. His previously expressed wishes C. His physical status 47) 48 year female comes to the clinic. Her mother had Ca Breast at the age of 72. Her father had Ca colon at the age of 76, her brother had diabetes mellitus at age 60. Her sister had gall stone at age of 50!!!!! What is your advice on screening? A. B. C. D. E. Colonoscopy every year Mammography every year Abdomen ultrasound every year Blood sugar assay every year No screening in particular

48) A 25year old female who has a one month old child comes to you asking for advice about stopping breast feeding as she has to go for work. What is the appropriate thing to do?

A. B. C. D.

Tell her to discuss with her husband Refer her to lactation consultant to advice about stopping breast feeding. Convince her to continue breast feeding. Advise her to stop working.

49) A young patient came to your clinic asking advice about prostate cancer. His dad died of prostate cancer, his uncle was diagnosed colon cancer. What is your next management? A. reassure B. PSA C. PR exam D. colonoscopy 50) If both parents are schizophrenic what is the chance of a child acquiring the condition? A. Not inherited B. <1% C. Approximately one third D. 100% 51) A lady comes to your clinic, she just been prescribed with anti-depressant medication. She wants to know how long she needs to be on this medication? A. 1month B. 3months C. 6months D. 1 year 52) You are doing a test. the test is 10% false negative and 30% false positive.what is the true positivity of that test in 100%? a)0% b)50% c)70% d)90% e)100%

53) Bitemporal haemianopia when he can drive gain? a.never b.after 6 months c.after 1 year

bitemporal haemianopia and vision is 6/12 when he can drive?

a)never b)after 6 months c.after 1 year 54) Nurse did something mistake where you will report? a)incidental report b)nurse manager