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This is one of the previous papers of DHA exam. I have solved to the best of my Knowledge.
Q1.Pregnant 10 weeks with hypertension and diabetis mellitus. she is on insulin but not
controlled .
O/E
Bp: 150/95
FBS: 190
Urine +3
Managment:
1.ACEi
2.hemodialysis
3.Pregnancy termination
4. IV Mg sulphates
Answer: Pregnancy termination
Explanation: This lady may go into eclampsia if pregnancy not terminated on time. We could
use Mg sulphates but if the patient was in eclampsia.
Tip: Urinary proteins less than 300 mg is not detectable by Urine dipstick.
Q3- A thin patient complaining of cough, wheezes and has upper chest patchy opacities ,he
lives in over crowded town.what should be done for prophylaxsis to he contacts:
1.Himopalus influenza b (Hib)
2.Meningococcal vaccine
3.Brucella
4.Bacillus calmate-guerin
Answer: Bacillus calmate-guerin (BCG)
Explanation: This is a thrid class question.This is typical case of PTB but BCG is done
after birth.BCG is basically for primary prevention.Here option should have included INH.So
we can give INH to the contacts.
Q4- 8 years old Child with leukemia and she is on chemotherapy ,came with fever,apathy
and severely dehydrated. Labs showed:
Na: 140
K: 3.6
Plaltlet count 47,000
Managment:
1.Lumbar puncture
2. Refer to oncology
3. IV ceftriaxone
4. Platlet transfusion
Answer: IV ceftriaxone
Explanation: This child probably has gone into septicemia (DIC),that is comm with
AML3,Promyelocytic leukemia so must be treated with IV Antibiotics. Platelets transfusion is not
warranted as patient is not bleeding actively.So mere platelets transfusion will not relieve her fever and
septicemia.At this amount of platelets as bleeding and subdural spinal hematoma is a chance
So i would not prefer Lumbar Puncture(LP).
Q10-What is the initial management for a middle age patient newly diagnosed knee
osteoarthritis.
a) Intra-articular corticosteroid.
b) Reduce weight
c) Exercise.
d) Strengthening of quadriceps muscle.
Answer: Reduce weight
Q13- 8 year old boy weight and hight above 95th centile.His BMI is 30what to do:
1.surgery
2.medication
3.observation for 12 month
4.life style modification
Answer: life style modification
Explanation: This child is obese and it will improve with life style modification.
Q25-female patient BMI 16 has fine hair all over the body and has amenorrea and refuse to
eat:
Diagnosis:
1.Anorexia nervousa
2.Bullimia
3.Body dismorphic disorder
Answer: Anorexia nervousa
Q26-HBA1c in diabetic should be:
1.8
2.6
3.7
4.4
Answer: 6
Explanation: The goal is to keep HBA1c less than
6.5
Q27-Asymptomatic patient and said he is an IVdrug abuser.
what is important to investigate:
1.Staph Aureus
2.HIV
3.Viral HB
4.HCV
Answer: HIV
Explanation: Most of the people here too make mistake of clicking HCV but HIV is
more important than HCV as HIV will spread like that and there is no treatment.
HCV has a treatment. IV drug abusers are mostly HIV postive.
Tip: It is a Public hazard.
Q29-pt complaining of epilepsy and facial twitches on taping the facial area
Parathormone level 8 (high)
Calcium :low
Creatinine: High
Diagnosis:
1.Digeorge syndrome
2.Pseudohypoparathyrodism
3.CRF
4.Osteoporosis
Answer: Pseudohypoparathyrodism
Explanation: Most people are confused that it is CRF but in CRF seum calcium is
usually normal.although initially serum calcium is low. Secondly Epilepsy is the
clue to diagnosis as Pseudohypoparathyroidism is associated with certain
disorders involving the brain and there is resistance to TSH and patients are
usually Hypothyroid not responding to Thyroxine. Creatinine may be high. There
are many types and the most common is Type1,also called Albright renal
Osteodystrophy. Probably this is this one.
This is the most repeated Question in DHA. I was having the same question in my
paper which i will upload soon.
Q31-54 years old patient ,farmer,coming complaining of dry eye,he is smoker for 20 years
and smokes 2 packs/ day.
your recommendation advise him:
a-exercise
b-stop smoking
c-wear sunscreen
Answer: stop smoking
Q32-clinical picture of fever,sore throat and enlarged spleen & liver EBV +ve:
Diagnosis:
Answer: It is Infectious Mononucleosis
Q33-pt hypertensive and diabetic he is on hydrochlorothizize ,but not controlled
Treatment:
1.Double the dose of hydrochlorothizide
2.Add BB
3.Add ACEi
Answer: Add ACEi
Explanation: Best drug in DM type 1. RENAAL studies.
Tip: For type 2 DM the best drug is ARB
Q34-pregnant came with fever and gum bleeding, O/E spleen is palpable 5 cm below left
costal margin, uterus is palpable at the symphsis pubis, platelets count 50,000.
Diagnosis:
a- Gestational thrombocytopenia
b- HEELP syndrome
c- Idiopathic thrombocytopenic purpura
Answer: ITP
Explanation: Another culprit for making mistake in this Q. I have seen mostly they think
that splenomegaly is not the feature of ITP. But remember splenomegaly also doesnt
exclude ITP.HEELP syndrome is characterized by Hemolytic anemia,Elevated liver
enzymes and Low platelets. Here no such things available to establish a diagnosis.
Gestational Thrombocytopenia is a possibilty but that does not present with fever and
splenomegaly.
Tip: ITP is aggravated by infection like in this case Fever is a clue to infection. ITP is
also fales upin Pregnancy.
Q35-pt has a problem in delivering speech in the work,but other wise he is good in working
in his job: Diagnosis:
1.Specific Phobia
2.GAD
3.Depression
4.Social Phobia
5.Performance anxiety
Answer: Performance anxiety
Q46-child complain of weakness that began in the lower limb then extend up wards ,history
of recent respiratory infection:
Answer is Gian-baree syndrome (GBS)
Q47-6 months boy with fever you should give antipyretic to decrease risk of:
a) Febrile convulsion
b) Epilepsy
Answer: Febrile Convulsion. Very easy Q