Give you all an idea of the reason for my close to fixed flexion deformity of left third metacarpophalangeal joint… and all the smoke and flames merrily burning in the exam hall… haha…

1. 60yo lady, came in for fall. lives alone, independent in ambulation.
has a h/o previous fall, hypertension, Parkinson’s disease, and sth else…
- list 4 most likely causes of her fall
- 6 signs you would look out for at PE
- she has a dexa scan showing osteopenia, how would you manage her?
- what would she require in the discharge plans?

2. 75yo male, with extensive RA, with h/o IHD, comes in with a Hb of 7.5g/dL. on the following drugs: aspirin, prednisolone, MTX, sulfasalazine. on examination, synovitis of finger, wrist, elbow, shoulder joints.
- list 4 possible causes of his Hb level
- what lab tests would you do to discern the underlying cause? give expected results.
- how would his IHD influence your acute mx of his anaemia?
- how would his IHD influence your mx of his RA?

3. 45yo male comes into clinic c/o 1mth tiredness. his casual capillary glucose is 12.5mmol/L. he has no other PMH of note.
- what is his diagnosis?
- lab tests to assess his condition? (sth like that)
- how would you plan the initial and further management of this patient with regards to the target goals?

4. 7yo child comes to your clinic with parents, complaining of acute onset central abdo pain associated with vomitting x1. has been having recurrent central abdo pain and vomitting, resulting in being absent from school. has a low grade fever on PE. no other significant findings on PE.
- what are your differential diagnoses?
- what other information would you look out for in the history and PE to help diagnose?

5. A child p/w anaemia and was diagnosed with thalassaemia. His parents are now in your clinic.
counsel the parents with respect to:
- the types of thalassaemia syndromes
- the incidence and racial distribution of various thalassaemia syndromes
- lab tests and expected results to differentiate btwn the syndromes
- antenatal diagnosis of the condition

My panic level just rose from q1 to q5. sigh.