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Final Year Viva Questions - Medicine Professional Exam 2012

Final Year Viva Questions - Medicine Professional Exam

Compiled by Class of 2012

Components of Med Viva
2 Short Cases
1 Long Case

Easy.Overall medicine ka viva subse comfortable hota hai.Maximum 2pm tk sub farigh ho jaty hain.Do bedside achi tarah, long case parh lenay ka time mil jaye ga, osce krwa dety hn, short case chill h in east, bedside part asking just.
Class of 2013 Questions



1)ETT: Identify, indications, name of the instrument used to pass an ETT.
2) Councilling station (council a 24 yr old salesman with DKA being discharged)

3)Scanario DKA: diagnosis, investigations, treatment
4)Interactive session for BP measurement.
5)Scenario of upper GI bleed caused by chronic NSAID use: diagnosis, investigations, treatment.
6)Photo of xanthoma on upper eyelid: Identify, which condition is it found in?
7)CT scan of intracranial hemorrhage.
8)Salbutamol: The class of drugs it belongs to and its indications.
9)ECG A-Fib.
10)Photo of distended abdomen with prominent abdominal veins. Likely diagnosis and 3 underlying diseases.


pulmonary embolism scenario
lung abscess xray

LP needle..uses
which diseases spread through needle prick?
counslng of CLD patient in decompensated stage
pneumonia scenario
pyogenic meningitis
MI ecg
DKA scenario

Long case: Iscaemic stroke
Extrnal: what's your diagnosis? What are his risk factors (Diabetic and smoker). What other hazards smoking can cause? (COPD, Bronchogenic CA) How'll you manage CVA in emergency? when i said we'll treat B.P only when it's above 220/110, she asked what if 218? (Ans: tb nahi kren gay).

Long case(sir shahid): Paraplegia (every1 helps u in long case) sir asked reason? localise lesion,test u wud do 4 it?(sensory sensations) inves?(MRI)causes(deg dis of sc,Tb of spine,tumor,trauma) wat is pott's dis, wat is transverse myelitis? ATT therapy? drugs? ethambutol S/E? which vision is lost(color visison) and tb drugs causing hepatotoxicity? (its only ur luck if u get a Cns case like this ques can be a lil tough)

Long case (East) DKA
External: Listened to history and asked for presumptive diagnosis. Didn't ask me to examine. Pathogenesis of DK. Cardinal features. Relation of acidosis with potassium levels. Treatment.
If, during Rx, oedema develops, why does it occur only in the brain? (Brain cells don't depend on insulin for glucose metabolism. They use glucose independently of the rest of the body.)

Long case...west sr tariq wseem....acute cornary syndrome.....hstry....diagnosis...managmnt of pulmonary edeme?wt features of hrt failure r present in ur patient?how wl u cntrol htn in ur ptnt ? Wt r side effcts of ace inhibitrs? How wl u dfrntiate ur case 4m cardiomyopathy?

Long case, viral encephalitis. Differential diagnosis. How will you differentiate it from meningitis. investigation of choice. Findings on Lp which will differentiate it from meningitis. Most common causative agent. Treatment. Apart from Lp other investigations. One non invasive investigation. (EEG)

Long case CVA...sir Irshaad...chkd ward cards of all years...listened to history to of comatosed patient...treatment of ischemic stroke...wen to give thrombolytic...which(alteplase) kitni dair mai ( I said 3 hours n sir agreed to this)

long case MI+ history of recent CVA+ hypertension
he listened to the complete history. asked the clinical findings? treatment of hypertension in this patient? what r the cut off values in a stroke patient for treating hypertension? for how long u won't lower B.P? nice guidelines.?side effects of ACE inhibitors and ARBs. drus to treat hypertension in pregnancy... name antiplatelets, mechanism of action of clopidogrel...

Short case 1: LMN type of facial nerve palsy
External: He asked to examine again in front of him. what are your findings? what's crossed hemiplegia? If he had loss of taste sensations and hyperacusis, where will be the lesion? What's hyperacusis, it's mechanism? What's Ramsay hunt syndrome?

Short case 2:Palpate the precordium(parasternal heave was +ve)
findings? How do you check the heave? wht does it mean(Right ventricular hypertrophy). What are the causes? What are the peripheral signs? How'll you differentiate b/w ascites due to cirrhosis and CCF (CCF men pehle ankle oedema ata hai bad mn ascites, vice versa in cirrhosis)
Short Case 1: gave a series of commands:(check ankle jerk, pedal edema, palmar erythema and neck rigidity, palpate dorsalis pedis) viva gave scenario of chest pain (MI) manage?say history( pain), inves ECG, cardiac enzymes n then treatment) ...........................................

 Short case 2 (sir irshad): gave command "palpate and percuss "the abdomen phir dusre short case pe chale gaye n then came back and said to "examine for free fluid" i did shifting dullness(neg) and fluid thrill (+ve) so diag (tense ascites asked causes? one diagnostic test? / invest,diff b/w cardiac n cld ascites (By JVP) SBP?, Findings, manage treat?

Short Case 1: Elicit triceps jerk, palpate postserior tibial artery and look for clubbing. GI-related causes of clubbing and extra-colonic manifestations of ulcerative colitis.

Short Case Dr. Irshad:Palpate and auscultate precordium.
Qs: What manoeuvre did you use to look for AR's murmur? Peripheral signs of AR. Management of STEMI.
Short case 1 dr irshad: palpate n percuss abdomen
findings(ascites). ascites? SBP? its criteria n ttreatmnt? upper gi bleed causes managmnt in emergncy?

ext: extremely sarial
do ankle jerk? what is pin rolling tremors ? perform its
hypokalemia causes? treatmnt of sys HTN

short case 2 :examine precordium.tmc asked AS murmur,its radiation,heart sound in as,pulse,pulse pressure,clinical features management,treatment of pyogenic meningitis.
examine back of chest: findings in middle n lower zone,consolidation n pleural effusion difrentiate on percussion n auscultation.dka
long case:dr irshad upper git bleed d/d,clinical exam findings of cld,managemnt,sbp criteria

Short case1..extrnal... .do upper lmb reflexes?do plantar reflex?wt is grading of reflexes? sajid..pleural effusion....findings on examination?wt r cardinal rules of prcussion?wt wl b there on pleural effusion on auscultation?types o
f crepitations?
short case, external. examine the pulses. do carotid pulse of left side. Which condition leads to radioradial delay. which condition leads to radiofemoral delay. Physical finding of coartaction of Aorta. What murmur will it produce.
Short case
sir sajjid. Palpate the abdomen. shifting dullness and fluid thrill. Causes of hepatomegaly.How will you investigate Malaria. Drugs used in treatment of malaria.treatment ofAnemia in malaria. new version of halofantrine is.

Short case sir Shahid...ascultate the chest... since I didn't appreciate any murmur I just told normal on heaving apex beat? causes? ms ka murmur...cause...diagnosis of rheumatic fever...prophylaxis ...for joints as well...doses...stenosis can lead to??
short case external... gpe...patient had jaundice...related examination for cld khud hi kr lain to betr hai I spider nevi...hepatispleenomegaly etc...cvs n git causes of clubbing...differential clubbing....hypertrophic pulmonary osteoarthopathy...treatment...pruritis kis jaundice mai hoga...cause...stool mai findings in obstructive jaundice...y pale y bulky...if pt prolonged how to control...vit k given parenterel I think

short case dr. bilquees:
command: examine lower limb.
do deep tendon n superficial reflexes! what r the causes of absent reflexes.

short case with dr. tariq waseem:
command: examine precordium and do the relevant
findings?if pansystolic murmur of MR in this patient,what side of heart usually fails in such scenario? what features of RHF u found in this patient? clinical difference between MR & TR murmur.
Class of 2012 Questions

Imp SHORT CASES & Commands:
Examne hand/palm
Demonstrate clubbng
Exmne cervical nodes. Demonstrate edema 
Name sites 4 cyanosis.
Pulses, JVP,apex beat,auscultate precordium, demonstrate signs o Chronic ischemia.
Resp palpate trachea,chest expansion,vocal fremitus,percuss chest, auscultate chest.

inspect abdomen,palpate abd for liver,spleen,kidneys,check ascites by fluid thrill,shifting dullness,sites 4 hep,renal,aortic bruit,splenic rub.

 =assess higher mental functionCNs 3,4,6,7 r commonly asked examine motor system?Chk bulk,tone,power,reflexes,coordination,involuntary movements gait.Commonly askd reflexes n Root value Knee,ankle,biceps,plantar,conjuctival,corneal reflexes
Cerebellum function test.check cortical sensations?Show signs of meningeal irritation

Easy. They tell the osce answers to 1st roll number so ask him before going in. And short case mam tahira : precordium exam.MS murmur explain plus investigations and treatment o MS.external .: 
percussion auscultate diff btw pleural effusion and consolidation on exam. MR auscultation findings. Long case viva on DM control and hypoglycemia s/s and treatment.DM follow up
Baki ascitis li treatment AS ko treatment. DKA treatment cirhosis complications etc
Ftma,sajid!osce me mcq th,udar e bta rae th sb wo log,long hepatic encep,bilkul basic,def,t.t,varices,enceph,mtlb bedsyd main krni,long b wahan tyar o jta,to bs short e khud krna hta
Thek hua.criteria of nephrotic.causes of nephrotic. Crf treatment.cause of anemia in uremia. Elicit sighns of hypocalcemia.malignant htn.

Yar short case tha CNs of motor system exam wd grading of power and shrt case of clubbing apex beat localisation edema chek palpat dorsalis pedis artry plus causes of ascites long case of pleural effusion its differential and treatmnt of hep encephalpthy
bht acha ho gya chronic renal failur long case ful viva abt cause management investigation short case murmurs radiation cause nd cld ascites cause saag
ALHUMDULILLAH sai hogya. . . .short case MR. . .n ascitis. . .Tx of a.fib. .in o.p.d n emergency. . .causes of ascitis,SAAG. . .long case TBM. . .skin changes in D.M n hypo n hyperthyroidism. . .dif of carbuncle n boil. . .ankle jerk. .causes of depressed. .causes of brady n tachycardia

Do bedside achi tarah, long case parh lenay ka time mil jaye ga, osce krwa dety hn, short case chill h in east, bedside part asking just. N mi,heart failure tx.
Mi ka treatment, scenario crf,cld,needle stick injury

Loud s1 causes Pt of aortic stenosis Examine treatment of MR Pt of hemiplegia absent ankle jerk causes ascites pt exudate transudate? SAAG ?jaundice Dkho why bruises? cause Cld long case Alcohnlic liver disease featrez?ascites examine kro.osce mai help hue

Short case :1st wid an external she was a bit saryall case was of ascites.examine the abdomen.asked about causes .fluid thrill was positive..will it b +ve if theres 650 ml of fluid? 
2nd one wid irshad hussain..palpate and auscultate the front of was of left sided pleural effusion.asked abt findings nd causes of red vocal resonance..palpate the trachea..rx of acute M.I..streptokinase contra mention hem stroke!woh ziada pasand hai unhay!
Long case M.I

Aoa. Today's viva,,my combination was short case n osce by dr irshaD, n long case TMC..osce was mcqs n 1 counselng section,, pehle he bta diye gae the sare mcqs...2 short cases., my comand was ascultate d Aoritic area, n odr comand do motor systm ov lower limb,, qs to b askd were mananagement ov acute MI,, localization ov leison,3 actionz ov morphine,,emergncy treatment ov malignant htn,, drugz causing aplastic anemia,, featrz ov MR, LONG CASE was acute coronary syndrome, qs were, cmplicationz ov MI,treatment ov arythmias, n treatment ov acute asthama.
L0ng case was of encephalitis.dr.irshad listnd t0 the hst0ry a bit,then askd p0sitiv findng,askd me 2 do signs of meningeal iritati0n,diag,treatment...osce was so simpl,9 stati0nz c0ntaind mcqz n 10th c0unseling of patient with ascites n of luck...

Short case 1 with dr. irshad: examine anterior chest.. pt had right sided pleural effusion, picked up very easily, plus they'd informed already! causes of bronchial breath sounds. management of MI. Sir is found in good mood :) Short case 2 with external: GPE! patient had ascites and other stuff.. was performing flapping tremors when ma'am came up and asked what are you doing and why? give two precipitants of hepatic enceph. Osce: we weren't told, sorry :P but it was all mcqs so wasn't bad. counselling: patient with ascites, dupuytren's contracture and spleenomegaly.. discuss prognosis.. Dr. Shandana is a very educated patient, she wants to know all about child pugh score :) Long case: CLD. viva with Dr. Tahira Murtaza: very sweet examiner. Ascites appears in compensated or decompensated liver failure? Again, Child pugh scoring. One complication of Hep C infection apart from cirrhosis? CSF findings in viral meningites?
Stay focused and calm.. everybody's co-operative. Best of luck!

aoa... west medicine ward.
short case xternal..... examine the last 5 cranial nerves.umn leion n lower of hypoglossal..findings,,differences...tongue appearance in both.
dr.fatima short case...measure JVP...causes of massively raised JVP.hepatojugular to chek pulsatile liver.causes of pulsations in suprasternal notch n epigastrium.expansile n transmitted pulsations.pembertens sign
long case dr.sajid... MI case... acute complicaions of MI. ventricular fibillation presentation n managemet.causes of acute dysnea..... GooD LUCK

short case ext: auscultate mitral area..findings..features of MS..treatment of MI..clinical features of IE
short case sir irshad: examine pure motor nerves.. examine facial nerve..
treatment of acute pulmonary oedema..

long case ext from tmc ward: case of chronic diarrhoea..D/D.. causes of malabsorption syndrome.. treatment and investigations of celiac disease.. electrolyte disturbance in celiac disease..

(Long Case Dr. Sajid Abaidullah, Short Case Dr. Fatima, External Grim Reaper)
Short Case
External: Examine Sensory System. Elicit knee jerk, ankle jerk. How do you test proprioception and vibration sense.
Dr. Fatima: Palpate precordium and report findings. Viva involved questions about murmurs and a detailed discussion of hypertrophic cardiomyopathy.
Long Case
External: (CRF) Causes of shortness of breath in CRF (pulm. edema, anemia). Why does CRF cause anemia?

  • Class of 2011 Questions
Madam tahira murtaza cheema is the best female in medicine profession i have seen yet.. She is the best!

table 9....identify injection(lingocain) nd its uses..
.tabee10...examiner sitting with senerio on table hving a case of hcv pt u will counsel him for rx if he is reluctant..
.table 1..munir sb with case of plt 25000,epistaxis nd periorbital...discuss.
.table ....identify injec lasix nd write its two complications....,
larngoscope identification with its two uses....
DKA diagnosis nd which first two drugs u will give.
..a 65 yr old man on getting up in morning hvng weakness of left half body nd mouth deviate to the left while he is smiling...tell its diagnosis nd site of lesion,
,pleural effusion xray identify nd tell its two causes,
foleys identification with its two complication....
 Lasix side effects
,folleys complications,
lignocaine uses,
pleural effusion...what r its renal causes
,laryngoscope uses,
stroke scenario,
one station of hep c,
one station of dengue fever,
DKA drugs
 mid diastolic murmur (mitral stenosis) And investigation for it.
osce adrenalin,sodium bicarbonate,foleys catheter,pleural effusion on xray,two photographs one of a postauricular swelling,second of blue discolouration of tips of fingers of both hands,true false ques related to all of these,totally helped by the doctors there they told us each n every answer..

Ps:osce:1. heparin was written over there and 5 true false had to b solved about it. Like during heparin thepapy aptt is is given intra muscularly. T/fit causes thrombocytopenia. T/f2. ETT3. Pic of a patient wid goiter4. Pic of a pt wid cor pulmonale5. I dnt remember.
2)"Imp. Things 4 OSCE"

¤ Xrays¤ Foleys Cath (indicatns)¤ N.G tube (Indic)¤ Ambu Bag¤ L.P needle (indic , position,C.I)¤ Clubbing (pic of fingrs placd on table) causes?¤ Oropharyngeal airway (indic)¤ ETT (indic, method)¤ Suction tube (nelton tube)¤ CVP line (indic)¤ Double lumen cathetr¤ Laryngoscop¤ Sangstaken blakemor tube...

1)"Imp Thngs in Short Cases". . .In CNS¤ Examin Motr Systm of lowr limb,¤ Examin Cranial nerve 7 ,3 ,4,5,6¤ examin position sense,POWER,TONEQs.* Dif. b/w UMN & LMN lesion* Root value of knee & other imp jerks. . .

In CVS¤ examin precodium, chek Apex beat, pulse, JVPQs. .* abt murmur, pulse, apex beat, JVP, MI. .

In RESpo.¤ mostly Pt. of pleural ef.¤ examin back of chestQs.* DD of dull note* Breathng typs* about pleural ef. TB,COPD,ASthma. .

In GIT¤ Pt of ascites, spleno or hepatomegalyQs. .* about Ascites, hepato & splenomegaly, CLD

Dr. Irshad
dr irshad is very nice i was asked to auscultate precordium viva on aortic regurgitaion and pulmonary edema

east medicine long case tetanus mam tmc asked differentials investigations and treatment (HOs help u prepare ur entire case and viva and help in osce)

Dr. Fatima
Dr Fatima likes abdominal reflexes.she asked me to examine 3rd nerve,when jaw jerk is brisk n when absent ,then askd pseudo bulbar palsy,asked me to perform abdominal reflexes when they are absent(multipara,old,obese) or exaggerated and physiologically when they are absent.then in the end she asked any condition in which abdominal muscle hypertrophy occurs....
 She also asked about beehver sign
Dr. Sajid Ubaidullah

external aunti extreme sarial kuch bhi kara sakti hai asked me to check hydration status of patient (forehead pe turgor kiu nai check kia aaaarghhhh :s) aur hypoglycemia pe pura viva lia 

External prof zafar: pulses when narrow pulse pressure,management of dengue shock syndrome,wide pulse pressure aortic regurgitation and how to listen
South medicine short case external: examine facial nerve .. what is the lesion? where is the lesion? Treatment of status asthmaticusshort case Dr.Irshad \m/ GPE of patient. what are the findings ( Jaundice & pallor) cause of this . lab findings in haemolytic anaemia .. treatment of acute anaphylaxis

Long case TBM Dr.Mushtaq haroon how can you diagnose TBM on history .Diagnosis of TBM in lab..Complications of TBM . difference between treatment of pulmonary and meningeal TB ... which drug should be substituted in ATT and with what . tuberculoma
murmur of AR

Short Casesexternal: radial pulse, dependant edema, Post. tibial. causes of A. Fibrillation name antithyroid drugs and any side effectdr.M Haroon: shifting dullness. diff btwn exudative and transudative ascites, causes of tender hepatomegaly, causes of pulsus bisferiens, cause of cannon a waves in jvpLong CaseExternal: causes of Peptic ulcer, H pylori eradication therapy, upper GI bleed management, HB level at which transfusion should be performed...Very nice and helpful staff in OSCE, short cases, and long case.All the best...!

now, about the osce: i didnt bother to read the questions, as the help system was 100% efficient; altho i remember there being a LP needle & an xray showing free air under diaphragm. No pic

short case1(TMC)- hemiplegia- explain findings, what is importance of gait(i missed that initially), hemiplegic gait, 2(xtrnl)pleural effusion- explain findings, why is this not consolidation/collapse/pneumothorax? coz he did not have bronchial breathing or hyper resonance

long case: madam bilqis: bacterial meningitisQuestion no 1: whats wrong with ur patient? (i was completely lost at this question; is she asking the presenting complaint or the diagnosis or is she just irritated)meningism, PUO, & another question i dont remember but i did respond with a blunt NO to that one

analysis of examiners: maam TMC is an extremely good examiner, very slow tempo of questions, more like baby steps. the external wasnt bad, maam bilqis didnt allow u to answer any question that u know, & kept pestering u on those that u dont know

HO's & MO's were extremely cooperative & prepared all of us for both the short case & long case

best of luck

Lng case:cor pulmonale ques by sir mushtaq Harun:prim pulm htn,sec pulm htn,investigation,dd of cor pulmonale,single inv to diagnose pulm htn,pulm fibrosis,treatment of pulm htn,treatment of cor pulmonale,tricuspid regurgeextrnal short case:mitral stenosiswt is apex beat,auscult findings in ms,treatment of pulm edema,resp accentuation in mssir irshad short case:palpate abdomenfindings,causes of hepatomegaly,findings in ccf,amebic abscess of liver,its treatment,cmplications,dose of mtz.
 Yes I just checked wikipedia. Swan Ganz Catheter provides the most definitive diagnosis of Pulmonary Hypertension
 FDA has approved Epoprostenol, Bosentan and Sildenafil (I'm not kidding, check FDA's website) for treatment of Pulmonary Hypertension. Other drugs have virtually no efficacy.

a)ext:examine cervical lymph nodes,jaundice & dorsalis nephrotic syndrome,causes;causes of fulminant liver failure.b)dr.mushtaq:examine lower motor system,coordination,features of raised intra cranial pressure and all treatment modalaties,pulsus paradoxus & causes,AR.long case:dr.irshad:case was CLD;causes of cld,various forms and causes of ascities,portal hypertension,hepatic encephalopathy etc.It was easy.Good Luck.

East Medicine 

OSCE: X-ray which had air under diaphragm and hilar opacities (cause? safe option: write causes of both) lignocaine, clubbig pic, LP needle, furosemide. (true/false.. HOs will tell u everything)

Short case, Extrnal Aunty: examine pallor, radial pulse. ques: complications of pneumonia, COMMON causes of jaundice, what is diabetes mellitus 

Short case, Sir Mushy: patient had right hemiparesis, had to examine motor system in limbs. but when he came to me he asked which sensations will u check. which tract carries touch sensations (ant. spinothalamic, posterior column. the HOs and SR there didnt know, sir told me 'yai abi kachay kheeray hein. in ko paka kerna hai :D )) hoffman sign (when u flex the middle finger, flip it so that it goes into extension itself, dont force it into extension) 

Long case (prof irshad) pt had encephalitis/meningitis. checked all ward cards. asked the history. examination findings. elicit brudzinski. 3rd condition where there can be similar findings; headache, vomiting, neck stiffness etc (SAH) causes of encephalitis, clinical difference between encephalitis and meningitis (most imp: seizures) investigations (in emergency will u do CT first or LP?) treatment of TBM.

Lng case, COPD..P/C risk factrs in hstry,wt r findings?accessory ms. Reasn of intr costal recessn..Rx of acute copd, type n features of resp.failure, y lw dose oxyen is given..

Osce... Nothing much to tell except that you will be helped alotShort case and Table viva...Prof. Zafarullah... Weber syndrome, anacrotic pulse, clinical features of pontine haemorrhageMadam Bilquees... SIADH, Polycythemia causes, paraneoplastic features of small cell CA Long caseNothing special just the usual questions

South Medicine Ward

OSCE NO help :(X-ray which had air under diaphragm, hilar opacities, increased lucency AND elongated heart: most imp cause!!!!! lignocaine, clubbig pic, LP needle, furosemide, blood picture of anemia, [probably it was B12 def anemia] (true/false)

short case external (prof akbar ch)right sided pleural effusion, asked to percuss+auscultate, Findings. Diagnosis. Why is it not consolidation? Treatment of pulmonary edema.

short case prof irshadexamine 2nd & 3rd cranial nerves (pt had 3rd nerve palsy), findings, localise the lesion, Rx of acute severe asthma.

long case nephrotic syndrome by prof mushtaq haroonhistory, DD, investigations, Rx, which type best responds to steroids? (minimal change), name of nephrotic syndrome in diabetics? (Kimmelstiel-Wilson syndrome, or nodular diabetic glomerulosclerosis)

North medicine

OSCE: You get to know all. 

Short case, Prof Zafarullah: Check cervical nodes. Which groups have you checked? Causes of enlargement of supra clavicular nodes. Secondaries come from which organs in supra clavicular nodes. What is anacrotic pulse, pulsus bigeminus, pulsus alternans 

Short case, Dr. Bilqees: Perform GPE relevant to GIT. Findings? GPE findings in a patient of CLD. Three findings in eyes. Causes of cirrhosis. 

Table viva, Prof Zafarullah: Manifestations of chronic alcoholism, what happens to brain

Table viva, Dr. Bilqees: What is pheochromocytoma? signs, symptoms, investigations. How to lower BP in pheo. Why alpha blocker? What is diabetic amyotrophic neuropathy? What is diabetic autonomic neuropathy

Long case, external. Case CVA: Is it hemorrhagic or ischemic? Types of ischemic? Is your patient thrombotic or embolic? How to know clinically? Sources of embolism? Site of lesion?

Short case, Prof Irshad. Palpate and percuss abdomen. Hepatomegaly. Causes. Normal liver span. Signs of congestive hepatomegaly. Emergency treatment of upper GI bleed.

Short case, External. Percuss and auscultate back of abdomen. Right sided pleural effusion. Findings. Diagnosis. Why is it not consolidation? Treatment of pulmonary edema.

Long case, Prof Mushtaq. CVA. Presenting complaints, diagnosis, site of lesion, treatment, complications, risk factors of stroke.

No help with OSCE in South Medicine.

west medical ward.short cases.Prof tahira murtaza chema..lower limb motor system..findings..types of clonus...stroke n its investigations.external..percus n auscultate back..wt is difference between dull n stony dull percussion note,wat wd b de difference in findings in case of consolidation, wat is mechanismlong case...diabetese,crf, ccf..dr.bilquis..hyperkalemia n its management,complications of insulin,if antibodies r dere wat wd u do..(she ws smiling while asking dis question..n her smile became more prominent wn i said corticosteroids which is not right:)..)

north medicine

short case: maam bilqees gpe in relation to git....dr.zafarullah gpe of TOF patient....table viva maam bilqees ITP and its t/m....VC multiple sclerosis and its t/m....

long case TMC (amazing....really nice) hemiplegia with motor aphasia...t/m...tyes of stroke...tia....Rind....

West Medical Ward:Dr Tahira: Examine motor system of lower limb. Patient had hemiplegia. Qs: Diff b/w UMNL and LMNL, define hemiplegia and paraplegia, causes of hemi n paraplegia.External: percuss and auscultate back of chest, Types of percussion notes, Diff b/w dull n stony dull note. Causes of bronchial breathing, Name the conditions causing collapse (with patent bronchus and obstructed bronchus), clinical findings of consolidation.Dr Bilqees! Diff b/w NSTEMI ans STEMI, Angina and MI, cardiac enzymes, ECG leads, indications and contraindications of SK, time duration when SK can b given and PCI.OSCE: Free gas under rt hemidiaphragm, lignocaine, LP needle, Hypersegmented neutrophils were shown in pic, clubbing , Furesemide.BEST OF LUCK :)

east medicine 0SCE : all our senoir H/0s of east med r so co-oderate :pshort case Rr. Mushtaq examine motor system of upper limb examine 3rd cranial nerve, examine coordination, check nystagmus, Dilutional hyponatremia, management, normal sodium levels, third cr nerve palsy, Bulbar palsy, pseudobulbar palsy Dr. ExternalCheck radial pulse, jaundiceCause of AF n irregularly irregular pulseLong case: COPDHow will u rule out CCF on history, precipitating factors, investigations, management, wich antibiotic, common organisms name viruses, atypical organisms,..Best of luck

prof. zafarullah !sle and its clinical criteria, treatment, cases of clubbing, tof and its features, wide pressure pulse, mumurs and their radiations,jvp, causes of left parasternal heave, 

Dr. bilqees !ascities, dipping method of palpation of liver, causes of isolated left lobe enlargement,dka its features and its treatment, RA,insulin and its types.

External Aunty !!long case! ccf and its causes, ascities, jvp, murmurs etc etc.

lots of luck !! sub ho jaya ga inshallah ! otherwise ya haseebo's the trick !!!!

short caseExt: elicit signs of CO2 retention.cozes of peripheral cyanosis.findings in hand in RA.jaundice causes.Dr mushtaq: examine abdomen, pt had ascites.features of portal hypertension.clinical features of hep enceph.constructional apraxia.Long caseupper git bleed CLD. ext asked abt history,risk factors n treatment for hep enceph,treatment of hematemesis.indications of blood transfusion.

Ans to CO2 warm periphery, bounding pulse, flapping tremors, papiledema, altered consciousnes, myoclonic twitchng

(taken by Dr. Tahira Murtaza)SHORT CASE 1: Examine abdomen(pt was having ascites)Questions: (1) Why there is shifting dullness(2) Reason for free fluid accumulation(3) How to differentiate b/w exudative and transudative causes of ascites

SHORT CASE 2: Examine precordium(pt was having systolic murmur of MR)Questions:(1) Explain your findings(2) Grades of murmurs(3) Radiation of murmur(which according to TMC was radiating to axilla)(4) Relation with posture and respiration

LONG CASE: CRF(taken by Prof. Dr. Zafrullah Khan)Questions:(1) What is your diagnosis(2) Palpate trachea(3) Examine motor part of 5th cranial nerve(4) If rt medial pterygoid is damaged; where will be the lesion

East Medicine:Short case External: Radial pulse, signs of endocarditis in hands, causes of clubbing, pedal edema, causes of edema, nephrotic syndrome definition.Short case Dr.mushtaq haroon: Patient of ascities, correct method of dipping palpation (with both hands one on top of other),percuss upper border of liver, hydatid thrill, difference b/w amoebic n pyogenic liver abscess clinically.Long case Dr. Irshad: CLD patient, case history, positive findings, treatment, SBP diagnostic criterion.

North Medicine:long case:CLD(external:Dr Saleema)ques:*what are the causes of hepatic encephalopathy in this patient?My patient had gastroenteritis which precipitated hepatic enceph*what are the clinical findings of hep encephalopathy?*what is the treatment plan?*what precitates hepatic encephalopathy?*protein restriction in such a pt how much will you allow per day?Short case 1:Prof ZafarullahPatient with TOF(command:GPE)Ques:what are the causes of clubbing?GIT causes,CVS causes.esophageal causes of clubbing.Short case 2:Dr BilqeesPatient with massive ascitesQues:causes of distended abdomenhow do you check vena caval obstruction method?SAAG,what tests are done on ascitic fluidwhat are the causes of ascitesTable viva:DKA and its management.What is the most common complication in type 1 diabetic 14 yr old who presents to emergency unconsciousSLE its causes,clinical criteria,management.Good luck everyone:))
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short cases: exter: look for anemia and cervical lymph..causes of bot...what is aplastic anmeia nd drugs causing it dr mushtaq: 5methods for spleen examination, causes of splenomegaly, significance of umbilicus and its clinilac variations, signs of AR long case: most probable diagnosis, Rx of hypoglycemic coma, neurological complications of HTN, treatment of hypertensive encephalopathy, and clinical assessment in a patient of alterest sensorium..:)

Short case (prof Tahira) case was of mitral stenosis. command was to examine the precordium...Q:findings in that patient, auscultatory findings in aortic stenosis, treatment of rheumatic fever

Short case (external) case was of ascites. command was to examine the patient...Q: causes of decreased bowel sounds, causes of increased bowel sounds, causes of paralytic ileus, causes of hypokalemia, K loss more in diarrhea or vomiting. 

Long case (Dr.Bilquis) case of dysentery...Q: types of dysentery, Investigations, Treatment, complication of amebic dysentery, complication of amebic liver abscess

Dr M.haron shrt case,rt. hemipresis, motr sys.of lower limb..check deep sensatns..tracts in whch they pas..wt happens in basal ganglia lesion, rigidity n spasticty n rigidty...mam xtrnal..chck anmia, dorsalis pedis irregulrly irregulr pulse,pulsus defcit

east medicine:short case external: look for cyanosis,percuss upper part of lung..(she just pointed tht percuss over here)..palmar erythema..clinical signs of acute asthma,causes of pleural effusion,complications of of ascites..wt is ur diagnosis?why?..askd about appendicectomy scar and umblicus..if pigmentation aroud umblicus?(cullens sign) pigmentation in flanks? site of ascitic tap? most comon site? (mid line but not done these daz coz pt has to b in knee elbow position for a long time)..hw to assess small amount of ascitis? (puddle sign)..when to label a pt diabetic on post prandial sugar level?..long case dr.irshad: ccf..history,positive findings,labs,treatment...

Short case mam bilquis ascites examin abdomen, causes of massiv splenomegaly, how wil u diagnose cml, findings other than splenomegaly in cml, rh fever criteria, nd treatment, cld child gradin. Prof. Zafarullah findings in hand clubing, def cyanosis, how 2 see pistol shot pulse and capilary pulsations, sle features and treatment.Long case mam tahira, bleeding episodes frm nose, mouth with rash, wats likely diagnsis, wat are investigations nd treatment of itp.

short case wid dr mushtaq: examine abdomen case was of ascites Q. findings do diping method i did it 1st wid both hands he said aisy to nae hoti then i did wid q hand he said ab theek hai. signs of hepatic failure in hands. wat is tapping apex beat? seen in? normal area of mitral valve? critical stenosis mei kitna ho jata hai?LONG CASE was of ischemic heart disease: external askd wat is diagnosis? how did u reach d diagnosis? wat investigations will u do? if pt of myocardial infarction comes in 6 hrs which enzymes will you do? cpk and troponin. management of acute myocardial infarction

West MedInt Maam Tahira (real nice)Ex VC and Maam Bilqees for long case

Short:MS, ascites, resp with no findings, CVA.sesnory and cerebellum bhi karaya. 

Long:ITP, CRF (lots of cases here), MI, Peptic ulcer, EncephalitisZafarullah: Q: Diabetic nephropathy, how wud u diagnose? microalbuminuria? draw jvp waveform and explain its partslevelsangiography ki indications, define wheeze, where bilirubin produced? Gilberts syndrome, features of crfMaam Bilqees: levels of urea creatinine, indications for n types of dialysis, management of crf in emergency and ward

East medicine ward..short case prof mushtaq haroon,examine motor system of limbs,show me the different gaits(hemiplegic,parkinsonian n cerebellar),show chorea kaisa hota ha? tone inc or dec in chorea?( decreased) two more lesions where tone is decreased and lesion in the cranium(cerebellar,parietal lobe)short case external, examine apex beat,auscultate apex, examine pedal edema..wat is osteomalacia,osteoporosis n pagets disease.long case,prof.irshad hussainac.excacerbation of copd..general ques, +ve findings? investigations,management? why patient breathes thru pursed to differentiate bw asthma n copd on basis of spirometry(reduced FEV1 nFVC of asthma is reversible after bronchodilator therapy.)

west medicine:short cases...ext..lower limb motor system...asked root values of reflexes..another short case..examine back of chest..que asked status astmaticus...long case..hepatic enceph...mam bilquis asked..grades of of lactulose...

causes of malnutrition,causes of clubbing,how to differentiate btween different types of chest pain,what is monrokellie doctrine,what is obst jaundice,stool colour in it,celiac disease,treatment.sob in its causes,sunset sign,murmurs,ulcerativ n crohns differences,localization of lesion,specificity of internal capsule lesion <answer dense hemiplegia>,normal urea levels<which i forgot lols>,prinzmetal angina n its treatmet.
Monro kellie hypothesis:The pressure-volume relationship between ICP, volume of CSF, blood, and brain tissue, and cerebral perfusion pressure (CPP) is known as the Monro-Kellie doctrine or the Monro-Kellie hypothesis.
The Monro-Kellie hypothesis states that the cranial compartment is incompressible, and the volume inside the cranium is a fixed volume. The cranium and its constituents (blood, CSF, and brain tissue) create a state of volume equilibrium, such that any increase in volume of one of the cranial constituents must be compensated by a decrease in volume of another.
Setting-sun sign refers to the downward deviation of an infant’s or a young child’s eyes as a result of pressure on cranial nerves III, IV, and VI.

Long Case: Got a patient with COPD. External took my Viva. What is COPD? Define its components, types of respiratory failure, causes, Investigations to differentiate between the two,its management.

Short case with Dr. Mushtaq Haroon. The patient had left sided Pleural Effusion.Asked me to examine the back of the chest. Then he asked me about the positive findings. Cardiac Causes of Clubbing, types of percussion notes, conditions in which they are found, what do u look for when u are examining chest movements at the apex, how do u know the movements are reduced at apex? treatment of Pyogenic meningitis, what will u give before administrating antibiotics and why?

Short Case with external: Examine Clubbing, posterior tibial artery.Treatment of Acute MI, contraindications of Streptokinase

Short case with dr. tahira cheema.. examination of precordium. patient had MR.Short case with External.. patient had ascites.. asked to demonstrate shifting dullnessLong case with prof. zafarullah.. Upper GI Bleed.. asked the management,investigations, assessment of blood loss, assessment of hematemesis nd hemoptysis nd their difference etc..

first short case dr.tahira:inspect back of chest,diagnosis?left sided pleural effusion,causes of effusion,most common connective tissue disorder in which pleural effusion occurs?SLE due to serositis.

second short case pissed off external aunty:motor system of lower limb,elicit ankle clonus,side of lesion ,causes of bilateral UMN lesion.

long case Dr. Zafarullah:diabetic patient of MI presenting as pancreatitis:S..heard history,gray turner and cullen sign?,causes,findings of ascitic fluid analyisis in patient of pancreatitis.

first short case dr.tahira:inspect back of chest,diagnosis?left sided pleural effusion,causes of effusion,most common connective tissue disorder in which pleural effusion occurs?SLE due to serositis.

second short case pissed off external aunty:motor system of lower limb,elicit ankle clonus,side of lesion ,causes of bilateral UMN lesion.

long case Dr. Zafarullah:diabetic patient of MI presenting as pancreatitis:S..heard history,gray turner and cullen sign?,causes,findings of ascitic fluid analyisis in patient of pancreatitis.

first short case dr.tahira:inspect back of chest,diagnosis?left sided pleural effusion,causes of effusion,most common connective tissue disorder in which pleural effusion occurs?SLE due to serositis.

second short case pissed off external aunty:motor system of lower limb,elicit ankle clonus,side of lesion ,causes of bilateral UMN lesion.

long case Dr. Zafarullah:diabetic patient of MI presenting as pancreatitis:S..heard history,gray turner and cullen sign?,causes,findings of ascitic fluid analyisis in patient of pancreatitis.

first short case dr.tahira:inspect back of chest,diagnosis?left sided pleural effusion,causes of effusion,most common connective tissue disorder in which pleural effusion occurs?SLE due to serositis.

second short case pissed off external aunty:motor system of lower limb,elicit ankle clonus,side of lesion ,causes of bilateral UMN lesion.

long case Dr. Zafarullah:diabetic patient of MI presenting as pancreatitis:S..heard history,gray turner and cullen sign?,causes,findings of ascitic fluid analyisis in patient of pancreatitis.

first short case dr.tahira:inspect back of chest,diagnosis?left sided pleural effusion,causes of effusion,most common connective tissue disorder in which pleural effusion occurs?SLE due to serositis.

second short case pissed off external aunty:motor system of lower limb,elicit ankle clonus,side of lesion ,causes of bilateral UMN lesion.

long case Dr. Zafarullah:diabetic patient of MI presenting as pancreatitis:S..

heard history,gray turner and cullen sign?,causes,findings of ascitic fluid analyisis in patient of pancreatitis.

short case..mam eternal,examine motor system of the lower limb and tel the findings..........short case..mam tahira,examine the back of chest,findings,diff bw exudate and transudate,what type of fluid in tb.......long case..mam bilqees,MI,tell findinds,what r cardiac enzymes,when raised,treatment of mi,contra indications of streptokinase........

short case:mushtaq haroon _1.aortic beat character,murmur,radiation, how to diagnose ankylosing spondylitis?external_patient had spleenomegaly.mam asked to xamine anemia,jaundice,pedal she asked was drugs tht cause aplastic anemia.long case:prof.irshad_peptic ulcer disease..sir asked d/d,investigations,management.

Today's exam (prof irshad's unit)short cases: 1. 3rd nerve palsy. The questions which he asked were site of lesion, crossed n uncrossed hemiplegia, webber syndrome, horner syndrome. 1 Q which was nt related to case like management of hep enceph, pul edema etc2. Ascites3. Pleural effusion(ext conducted the exam here. Questions he asked were simple like causes of bronchial breath sounds, how it sounds like)4. mit regurgno one was concerned about ur method. They just asked findings and related Questions.good luck everyone

last post 4 medicine (last yr viva)¤ Causes of infectious hemolytic anemia (malaria, parvo virus, kalazar)¤ Polynuropathy causes¤ POLIO treatmnt¤ Drugs causing polyneuropathy (Vincristine,INH) ¤ Most comn cause of transudativ & exudatv ascites ? (cirhosis& TB)¤ indic. of thrapeutic tap¤ acute complic. of ascites ?¤ Y SBP s called spontaneus ?¤ child pugh criteria 4 prognosis n cirhosis¤ gradng of hepatc enceph.¤ Ix & tr. of CoPD¤ where s lesion if crossd hemiplegia with 7th Nerv

Sir sajid: motor system xamination. Ellicit ankle jerk. Wen is babinski positive.

External: examine apex beat. he asked me site. N asked y is it displaced.i sed cardiomegaly. He asked why? N thn asked to auscultate apex beat n tell findings bus

short case... dr irshad... palpate nd ascultate prcordium... murmur of ms nd ar... Rx of MI..... EXTERNAL MADAM... do gpe nd cyanosis pay cmnt.. tracheal shift... causes... plural effusin percusn... Rx of DKA.. SE of insulin..
LONG CASE.... case was ccf... askd bt causes .. ppt factrz.. invstigatnz nd findngs on thm... clincl findgz... Rx.
ma'am fatima asked what are reversible causes of clubbing........differ b/w arterial n venous pulsations.......causes of visible pulsations in suprasternal notch.....command palpate precordium.-------------------------south medicine . OSCE .....they will tell u all before going Short case Pgs will tell u before going in the findings External maam SMW .....I was standing on left side of pateint , so maam said "are u left handed ? " I said yes :P , then she said percuss chest . asked findings ........was pleural effusion , RX of DKASir Irshad ........palapate n percuss abdomen , diff bet . spleen n kidney on palpation , treatment of upeer GI bleed , saw ward cards of all three years Long case .......TMC external was CLD , investigations , treatment , hepatic encep. treatment .  
Sir Sajid: nephrotic syndrome criteria, causes in children and adults, treatment of ascites
EXT Madam : criteria of nephrotic synd, prim n sec ns, psgn, drugs causing ns


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