TOACS ( FCPS – II ) January 28,2019 1. Picture of a girl with bilateral ptosis Questions asked were, What is the diagnosis? How would you investigate her? What are the treatment options? What is Lambert Eaton syndrome? 2. A young girl diagnosed case of Rheumatoid arthritis has been taking NSAIDs with no response, how would you manage her Questions asked were ( after telling him that would like to start on DMARDs with doses What are the side effects of DMARDs ? What are the complications of Rhuematoid arthritis? How would you follow this patient? 3. CT Scan Brain very poor film ( Empty delta sign ) Scenario : 34 weeks pregnant lady presented with bilateral lower limb weakness along with vomits, What is the diagnosis? How would you treat her? For how long will you anticoagulate her? 4. Middle aged lady presenting to OPD with weight loss, progressively worsening exertional shortness of breath and pallor, also now having hemiplegia, on examination S1 is soft with mid diastolic rumbling murmur over mitral area, What are the differentials and what is the diagnosis ? Why is this not Infective Endocarditis and why not MS? How would you treat her ? 5. A middle aged male with previous history of blood transfusions, presenting to OPD with ascites, What is the diagnosis How would you investigate and then viva on Hepatitis C guidelines 6. A middle aged girl with weight loss despite having good appetite and heat intolerance presented to you, What is the diagnosis? What signs would you look for in her? How would you investigate her? How will you manage 7. A middle aged male with the hx of Asthma on steroids presented to you with worsening shortness of breath, on examination there is widespread wheeze all over, on labs IgE is 1000u/l and eosinophilia What is the diagnosis? What features are suggestive? How would you further investigate him? How would you treat him? If itraconazole isn’t working then what are the options What is the role BAL 8. A middle aged male presented to you with vague abdominal pain, on examination BP 155/100mmHg, Bilateral mass palpable in the loin, What is the diagnosis? What is the criteria to diagnose ADPKD ? What features are suggestive? What are the complications of this disease? How would you manage him? What is the indication of MRI brain? What are the newer drugs to prevent the progression of this disease? 9. A young unmarried girl presented to you with right lower leg swelling, on examination its hot and red and tender to touch, she gives past history of similar 2 episodes What do you think is going on? How would you investigate her? What questions would you ask her? For how long will you anticoagulate her? What are the treatment options? Why do you give enoxaparin and for how long do you give it? What are the newer drugs 10. A chest xray with mitral valve visible, CT scan showing IC bleed, what is it? What other etiologies may give rise to these finding 11. A. ECG showing inferior wall MI with 1st degree block b. Ventricular extrasystoles, Atrial fibrillations, what may be the etiology 12. A middle aged diabetic male for last 15 years, came to you with impotence, early satiety, BP 130/80mmHg on supine position and 90/60mmHg on standing, What do you think is going on? What are the other clinical signs which you can elicit How would you mange him? What are the other indication of sildenafil
