Medicine FCPS 2, IMM PREP

🩺 CASE 10 – IMM FAVORITE (CONNECTIVE TISSUE DISEASE)

A 30-year-old female presents with joint pain, oral ulcers and photosensitivity.
Labs: ANA positive, anti-dsDNA positive.

👉 Questions:

1.Diagnosis?
2.One marker of disease activity?
3.Drug of choice in pregnancy?

🩺 CASE 9 – NEPHROTIC SYNDROME

A 25-year-old male with generalized edema.
Urine protein 5 g/day
Serum albumin 2.2 g/dL

👉 Questions:

1.Most likely pathology?
2.Indication for renal biopsy?
3.One thrombotic complication?

🩺 CASE 8 – ENDOCRINE EMERGENCY

A 40-year-old woman presents with palpitations, fever, agitation and diarrhea.
Pulse 140/min.

👉 Questions:

1.Diagnosis?
2.First drug to give?
3.Scoring system used?

🩺 CASE 7 – TB OR NOT TB?

A 35-year-old male with chronic cough and weight loss.
CXR: Right upper zone fibrosis.
Sputum AFB negative ×2.

👉 Questions:

1.Can you label this TB?
2.Next best diagnostic step?
3.Examiner’s red flag mistake here?

🩺 CASE 6 – CHRONIC LIVER DISEASE

A 50-year-old male with jaundice, ascites and spider nevi.
History of blood transfusion 20 years ago.

👉 Questions:

1.Most likely etiology?
2.One investigation to confirm?
3.Screening for which complication is mandatory?

🩺 CASE 5 – CHEST PAIN (EXAM TRAP)

A 45-year-old diabetic male presents with chest pain for 2 hours.
ECG: ST elevation in II, III, aVF.

👉 Questions:

1.Diagnosis?
2.Immediate management step?
3.One absolute contraindication to thrombolysis?

⚠️ IMM exam loves contraindications.

🩺 CASE 4 – IMM CLASSIC (VASCULITIS)

A 28-year-old woman presents with fever, weight loss, hematuria and purpura.
BP 160/100 mmHg
Urine: RBC casts

👉 Questions:

1.Probable diagnosis?
2.Best initial screening test?
3.Role of biopsy?

🩺 CASE 3 – HYPONATREMIA

A 55-year-old female admitted with confusion.
Serum Na⁺ = 118 mmol/L
Serum osmolality low
Urine osmolality high

👉 Questions:

1Likely diagnosis?
2.Cause?
3.Correct rate of sodium correction? (very important)

⬇️ FCPS candidates, answer carefully.
Answer in comments – FCPS style.

2.ca

Answer in comments – FCPS style.🩺 CASE 2 – SHORTNESS OF BREATH (VIVA FAVORITE)

A 60-year-old smoker presents with progressive dyspnea and cough.
CXR shows bilateral interstitial markings.
SpO₂ 88% on room air.

👉 Questions:

1.Differential diagnosis?
2.One investigation to confirm diagnosis?
3.Management priority?

⚠️ Examiner tip: Don’t say COPD without justification.
Answer in comments – FCPS style

2.one

Answer in comments – FCPS style🩺 CASE 1 – PYREXIA OF UNKNOWN ORIGIN

A 32-year-old male presents with fever for 6 weeks, weight loss and night sweats.
Examination: mild pallor, no lymphadenopathy, no organomegaly.

Initial labs:
Hb 9.8 g/dL | ESR 85 mm/hr | CRP high
Blood cultures ×3 negative

👉 Questions (FCPS-2 level):

1.Define PUO (exam definition).
2.Top 3 differentials in Pakistan?
3.Single most important next investigation?

Answer in comments – FCPS style

403 Forbidden

IMM Recall:
Examiner asked:
Why NOT TB in this case?

Key lesson:
Never say TB unless you justify it clinically.

A 45-year-old male presents with weight loss, fever and hepatosplenomegaly.

▶ What are your top 3 differentials?
▶ What single investigation will you order first?
Answer in comments.