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6 YO known case of congestive heart failure , present in ER with SOB after playing , HR : 200 other examination normal , ask about apportiate mangment : ⁃ iv fursamide ⁃ observation as symptom expected of ⁃ his diagnos .

A

 

pregnant with diffuse goiter not mentioned tsh and t4 , us showed bilateral nodule one solid 0.5x0.8 and one 2x3 most appropiate management? A. FNA both B. FNA large C. Follow up D. Thyroid scan
B
Case of stroke and complain of weakness in the arm leg and face, intact speech and sensation where’s the damage? A. Middle cerebral artery B. Anterior cerebral artery C. Mid basilar artery D. Vertebral artery
a, based on votes
A scenario of patient came to clinic with preeclampsia without severe features ( I think at 32 or 33 weeks). What you do? A- Admission for observation B- Give appointment at outpatient clinic after 1 week
B
Patient with a history of Hashimoto's disease for 25 years presented now with a rapid growing tumor of the thyroid and weight loss (100% sure) what is it most likely diagnosis: A. Papillary B. Medullary C. Anaplastic D. Thyroid Lymphoblastic
d

60 YO male patient k/c of DM and HTN presented to ER with: neck pain and sweating for one hour. He has a previous history of recurrent chest pain which resolve spontaneously after resting. ECG done and showed non-specific ST segment and T wave changes. Troponin is normal. What is your next step? •A. Repeat troponin after 6 hours •B. Discharge the patient •C. Do stress ECG test •D. Give aspirin and nitroglycerin

a um alqura

Child sit unsupported, smiles coos and points to his mouth with his finger A. 2 months B. 5 months C. 7 months D. 10 months
c
Child 4 years , her mother told you she is always yelling and say NO and hitting , what is the diagnosis? ⁃ Anxiety disorder ⁃ Depression ⁃ Mental retardation ⁃ Temper tantrum
d
12 years old boy asymptomatic came for routine f/u was found to have irregular pulse heart rate :80 vitals:stable and normal Hight > 90 sentile Wt 25 sentile Most likely prognosis: A.heart block B .normal development C.syncopal episode D.Myocardial dysfunction
B
Child with stab wound in the lower right chest and free fluid in the andomen ,most appropriate thing to do A/thoracotomy B/thoracostomy C/exploratory laboratomy
c
SLE case case arthritis and malar rash no renal \ CNS\ CVS symptoms, tt:- 1- HQC+azathioprim 2-HQC+ methotrexate 3-HQC+ MMF 4-HQC+ cyclophosphamide
b
patient came to the clinic for a check - up , he has some abdominal pain , endoscopy done for him revealed multiple ulcers . The biopsies were taken and showed positive H.pylori and mucosa - associated lymphoid tissue ( MALT lymphoma ) . The management should be ? A. H.pylori eradication ✅ B. Surgical resection C. Chemotherapy D. Anti - acid medication
A
An 8 year old girl with persistent and continuous diarrhea, she drinks 3 pints of goat milk per day and is a fussy eater. Which of the following conditions explain her presentation? Labs: Hb Low, MCV Low and MCHC High A) psychological Deprivation B) Giardiasis Parasitic Infection C) Aplastic Anaemia D) Hypothyroidism
a, survey
Weman her husband has gonorrhea what’s the most diagnostic for her A- anogenital swap B- high vaginal swap C- endocervical swap D- urine culture جاني هذا بس الخيارات غير كانت كذا Male suspected gonorrhea: A. urethral swab B. vesicular cx ' C. urine cx
C, A
A case of young male asymptomatic presented abnormal LFT. He is a smoker and drinks alcohol in the weeknds. Labs showed high AST ALT Tbilli and slightly high iron and TIBC and very high ferritin (450). What is the cause of his abnormal LFT A-hemochromatosis B-alcoholic hepatitis C-cholangitis
A
vertex presentation deliver by 1 forceps delivery 2 spontaneous delivery 3 CS 4 ventose
B
type of polyp with highest risk of cancer? A. Villous B. Tubular C. Tubulovillous
A
43 years come to your clinic to check,, only Hba1c 6.9 Ask about management? ما ذكر عنده سمنة او مرض مزمن فقط جا العيادة يفحص ولقينا التراكمي كذا 1- metformin 2- life style 3- low Carbohydrate 4- insulin
b
a case of rheumatoid arthritis came for follow up, he is well controlled on steroid and hydroxychloroquine Labs all normal except high fasting blood glucose and A1C What to do? A- stop steroid and start methotrexate B- stop steroid and start ibuprofen C- continue same treatment
steroids shouldn’t be initiated for long term since this patient has controlled symptoms. Methotrexate is given to patients with moderate to severe disease activity. Ibuprofen can be given to relieve symptoms but this patint has none, but by exclusion it seems the best choice.
27 Y.O with history of confusion for 2 days and seizure for 5 hours. He is not oriented to time, place and person. He has history of unprotected sex for 6 years. Serum cryptococcal antigen positive, what is the most appropriate next step? A. HIV serology. B. SF Toxoplasmosis testing. C. CSF Syphilis serology. D. Herpes simplex testing
A
patient who had right big toe pain and because of that “written like this” he was diagnosed with gout and treated with allopurinol. He’s a known case of psoriasis. He presented now with right big toe pain, right ankle pain and bilateral knee pain and there was no improvement with allopurinol. Labs shows high uric acid What’s the diagnosis? A- active pseudo-gout arthritis B- active gout arthritis C- psoriasis arthritis D- Osteoarthritis
C
Patient diagnosed with persistent afib. HTN & DM. Has no contraindications to any anti-thrombotic. What’s the first line anti-thrombotic? A. Aspirin B. Clopidogrel C. Aspirin + Clopidogrel D. Warfarin
d
28 male with lower back pain ,erythmatous and B/L knee jointLabs were of insignificant values ,how to dx? * HLB27 * MRI SPINE * CT SPINE * JOINT Aspiration
B
Patient underwent lap chole for multiple gallstones 7 days ago, presents with vague abdominal pain. On US there is fluid around the gallbladder (something like that) and the CBD is 9 mm. What is the most likely diagnosis or cause? A - CBD injury B - Retained stone in CBD C - Sub-hepatic collection D- slipped clips
a

Pediatric patient came with fever and sore throat, the tonsils were congested and he had papular lesion with erythematous base on his mouth and gingivitis: HSV EBV Coxsackie

A

Pt had fibroid myomectomy, risk of placenta accreta? A) Decrease B) Increased C) Unknown D) No risk
B
30 year women complained of dry cough very sever comes in attack that she can not complete talking intial dx as alergic rhinitis took intranasal steroid but no improvemt ..they mentioned that she has allergy to dust .on exam slight nasal congesion. FEV1/FVC <70 and improved by 20% with bronchodilator ..what you want to do: A- Chest ct B- Skin allergy test C- IgE antibody level D- Methacholline chalenge test
C
Patient coming from an endemic area for malaria. Later on, he was admitted to the hospital with Heart failure. Doctor did not ask the patient about travel or medication history. Thus, he ordered the nurse to give digoxin. Who is at fault? A) Computerized drug prescription system B) Nurse failed to write drug formularies C) Pharmacist who failed to check prescription D) Patient who did not bring his medicine pack/ report his medicines
A
DM with hx of pad, had pain when he walks 300m and relieved by rest what will you do A- CTA B- vascular ultrasound C- conventional Angio D- MRA
Next? B ✅ Best or Gold standard or most diagnostic? C ✅
45yo Women , has abdominal distention . Imaging shows moderate ascites , pleural effusion & bilateral ovarian masses . Ca 125 is elevated 90something . What is the dx? A- Epithelial ovarian cancer B- sex cord tumor C- germ cell tumor
A
Patient after cholangitis intervention with the following WBCs 9, RR 18, HR 80 (exactly 80 not 90), normal BP, Temp: 38 exactly 38). What is the cause: - sepsis - SIRS - bactermia - septic shock
C

pt from India with sign and symptoms of Meningitis , labs wbc : lymphocytes , high protein .. A- TB meningitis  B-viral meningitis C-Bacterial meningitis

more info

Pt had fibroid myomectomy, risk of placenta accreta? A) Decrease B) Increased C) Unknown D) No risk
B
Morbidly obese man with hiatal hernia and GERD grade 3, what’s the best procedure? A. Ring B. Sleeve gastrectomy C. Roux en Y gastric bypass D. balloon
C
2. Pt with history of diarrhea, weight loss, and fatigue. ESR high. CT scan: findings of crohn but I can’t remember exact wording ( something terminal ilum and strictures in jejunum). Hgb is low. What else are you going to find in your physical examination? 1. Nail pitting 2. Splenomegaly 3. Perianal dissease 4. Erythema marginatum
3
Child (new born) with forceful vomiting, already not detected any anomaly what the cause? Pyloric stenosis Necrotizing enterocolitis Atresia Something for the heart
A
45 years old male with history of constipation, with family history of colon cancer , came to u , colonscopy report shows normal colon, which of the following most likely protective for colon cancer ( or highest one that decrease his chance of having cancer or most protective something like this ) Maintaining healthy weight and excersize Annual colonoscopy Low fiber diet Other irrlevant
a
Smoker has acute cough with yellowish sputum and had red streak in sputum for 2 days , high fever, CXR: right lower lobe lung infiltration ? A) community acquired pneumonia B) acute bronchitis C) TB
a
prophylactic antibiotic for appendicitis duration A. Preoperative then stop immediately B. Preoperative then stop 3 days after surgery C. Preoperative then stop 5 days after surgery D. Preoperative then stop 7 days after surgery
A
Young SLE female pt on treament. Developed urinary incontinence, hypereflexia, paraplegic or paresthesia. (Sx mostly neuro) what the most important test to do immediately? Lumber puncture & MRI brain Lumbar puncture & ct brain Lumbar puncture & MRI spine LP, MRI, MRA, and MRV of the brain
C. Answer is LP and MRI of the spine. This is a case of Transverse myelitis as a neurological complication of SLE. Management is IV steroid and Cyclophosphamide.
90-year-old Female patient with with long standing incisional hernia, came to ER with abdominal pain and fecalith discharge, her hernia is strangulated with ulcers and necrotic all vital are normal, what will u do ? A. Dressing B. Laparoscopy C. MRI D. Lapratomy abdomen
D
Femal after a choly developed fever rigor T 38 WBC 11 BB 110/70: SIRS bacteremia Sepsis Severe Sepsis
B
Female after a chole developed fever rigor T 38 WBC 11 BB 110/70: SIRS bacteremia Sepsis Severe Sepsis
B
Worse headache of life with neck pain. In physical examination pupil poor reactive to light. CT negative. What do next? A- lumbar puncture B- MRI neck C- MRI brain
A
Chest gunshot wound. Entry was lateral to left nipple and exit point below left scapula, patint suddenly become worse w/ raised JVP and muffled heart sound, your action? A- Pericardiocentesis B- Immediate thoractomy C- CT
a
Young women with depression (and other symptoms) prior to her cycle every month it is effecting her work what to give her A- ssri B- medroxyprogesterone C- progesterone D- estrogen
A
Which diuretic prevent reaccumulation of ascites - loop, thiazide, aldosterone antagonist
C
65-year-old heavy smoker is coming for a general examination. What is the best screening test for him? A. Osteoporosis B. Colon cancer C. Abdominal Aortic Aneurism
b
Patient with lung cancer and has hypercalcemia, what is the type ? -Squamous cell carcinoma -small cell lung cancer
A
Female with multiple small ovarian cyst , androgen production high , insulin resistance , anovulation and HTN ( exactly like this ) what is the diagnosis ? 1- gycecomstia 2- kallman syndrome 3- kllifnter 4- Stein-Leventhal syndrome
4
Typical case of hemolytic anemia and blood film show spherocytosis,Hb:8, MCV MCHC normal range, WBC: 3, PLT: 500, LDH AST ALT high, low haptoglobin most appropriate treatment? A-blood transfusion B-corticosteroids C-hydroxyurea
B
Which of the following is the best contaception in pt w a history of PE? A-IUD B- permenat steriilization C-levonorgestrel D- condom
A
Case of pylori stenosis na 130 bicarb decreased a little bit i forger how much What to give: Npo Ng tube Iv na Iv bicarb
IVNS
25 year old woman had severe pelvic inflammatory disease 2 years ago that was treated by intravenous antibiotics. The isolated organism was clamydia. Since then the patient was trying for pregnancy but failed. She had normal regular period and normal seminal analysis. A. Ultrasound monitoring of her ovulaion B. Magnetic resonance image of the pelvis C. Hysterosalpingogram
c

14 y female complain of vaginal bleeding in interval of 3 weeks to 2 months, she has normal development and normal secondary features, every thing normal What to do? A- Reassure B- OCP C- Order FSH and prolactin

a

Elderly man presented to the ER with rigid distended abdomen prepared for laparotomy with hypotension and fever (38) X ray showed free air under diaphragm What is the best initial resuscitation option ? A- intubation and ionotropes B-Broad spectrum Abx C-Colloid via central line D-Crystalloid fluid via peripheral line 

d

 

Child with RLQ pain anorexia and fatigue who look ill with mass in RLQ, leukocytosis with left shift:- 1- US 2- CT
a
6 m/o infant present to ER with sudden apnea & color change. Mother gave history of recurrent vomiting and multiple chest infections. On exam he looks failing to thrive with dystonic neck posturing while crying. Which of the following considers as high risk case for the above disease? A- Obese baby B- Preterm infant C- Post pertussis infection D- Following inguinal hernia repair
B
56 years old patient had an upper Gl bleeding due to esophageal varices and was given IV fluid. Which of the following should be given to reduce mortality? A. Vasopressin B. Octreotide C. Nadolol D. Ceftriaxone
D
146. Pregnant 37 week with BP 160/110 every thing else was normal Her BP during pregnancy was 120/90 no protinurea ? A.Gestational HTN B.Preeclampsia C.Eclampsia
A
A 35 years old male has repeated attacks of hematemesis. On examination, he has spider angioma and bilateral gynecomastia with splenomegaly. Labs showing high liver enzymes. What is the most appropriate next atep after initial resuscitation with IV fluid? A. Abdominal X-Ray. B. Upper GI endoscopy. C. Nasogastric tube insertion. D. Give antibiotics.
D
3 y old child has asthma best way to diagnose? chest xray PFT and spiromymetry detailed history,physical examination and improvment post dialator therapy
C
Open fracture 
jpj
Male patient came from India RUQ pain .. on and off fever for 3 weeks . raised LFT , high WBC (Neurtrophol 70% Lymphocytes 20%) . image showed homogenous hypoechoic mass in the liver. a) hydatid cyst b) TB abscess c) amebic abscess d) pyogens abscess
C
Patient with cushing syndrome will go for surgery for adrenal tumor, what you will give before surgery? A-IV hydrocortisone B- IV fludrocortisone
A
PRESCHOOL VACCINATION
A
70 years old, menopause, came seeking hormonal replacement therapy, and you explained that there is no benefit in her case, but she insisted, what you will do? A) Refer her to another gynaecologist B) Prescribe her the medication C) Refuse her the medication D) Consult the ethics department
c
Young man with palpitation only, comes Suddenly lasts for 5-10 mins Everything was normal ECG normal rhythm What is the most appropriate? Initial invx? Holter Echo Excercize ecg
A
Patient with long term history of DM type1 in12 weeks of gestation. HbA1C 12. Which of the following complication is most likely to happen? A. Preeclampsia B. Polyhydroamnios C. Congenital malformation D. IUGR Explanation:
C
Q37 - Pathophysiology regarding patient with appendicitis complicated by appendicular mass (Abscess), patient was feverish (38.7)? A - Peripheral Vasoconstriction B - Decreased Cardiac Index C - Redistribution of Blood D - Bradycardia
`C
19 yrs old dysmenorrhea resolve on 3rd day and resolve after few , Sxs associated with sever pain radiated to upper thigh, she had this for several years and getting worse A- Primary dysmenorrhea B- premenstrual C- secondary dysmenorrhea D- endometriosis
A Physical Sx and the presentation is typical for Primary, the only exception is that it’s getting worse. جاني في نوڤمبر وحطيت A.
15 month boy came to ER complaining of abdominal discomfort, emesis, stool with blood and mucus on phisycal examination he has increase abdominal sound X-ray report shows obstractive bowel ( written like this ) A- give antibiotic B- Go to OR and do surgery C- Barium enema D- bowel rest, IV hydration and wait until symptoms gone
C
What cause ripening to the cervix? A) oxitocin B) prostaglandin
B
Patient present with “ring in his eyes” what is most likely diagnosis A. Wilson's Disease ✅ B. Hemochromatosis
a
An old patient with symptoms of fever and productive cough admitted to isolation as a case of T.B, then next day results came out showing him having HIV. What shall you do now? A. Start anti-HIV immediately B. Start anti T.B for 3 months then anti-HIV C. Consider Pneumocystis Carinii D. Start both ant T.B and anti-HIV
B
Young male came afrer RTA and FSAT was order Which of the following most probably to found? - pneumothorax -subdural hematoma -hallo viscous injury -interpertoneal free fluid
D

28 year old female presented following radiation of neck with neck swelling. Ultrasound showed swelling in the left lobe of the thyroid of 3x4cm of papillary thyroid cancer. Which of the following is the best management? A) Left Lobectomy B) Left Lobectomy with Isthmusectomy C) Subtotal Thyroidectomy D) Total Thyroidectomy

D

Which of the following antidepressants causes constipation? A- SSRI B- Snri C- Tca D- Moa
C
Patient undergoing laprascopic cholecystectomy, as they were inserting the tubes "laprascopy equipment" patient developed severe bradycardia 40 min/hr What could be the cause? A. Cold air inflation B. Streching of the preitoneum
B
15 year old girl has sparse pubic hair not reaching the mons pubis, breast budding with areolar enlargement, but with no clear distinction between breast and areola. No contour of breast was seen. What Tanner stage is she? a. Tanner I b. Tanner II c. Tanner III d. Tanner IV
B

about child present with projectile vomiting , on abdminal examination , olive like mass , what is the mx ? Pyleromytomy

Observation

A

vaccination at birth? Hep B, Dtap MMR, BCG MMR, Hep B BCG

D

family notices that their grandfather is starting to gradually forget important events and basic things in his life, like the directions in his house and the name of his children. The family is concerned he might have Alzheimers. What is the most likely diagnosis of this patient's presentation? 1. Benign forgetfulness 2• Alzheimers 3. Vascular dementia 4. Lewy Body dementia
b
post delivery 10 days or weeks came with fever and chills, there is swelling and tender with cracked nipple and lymphadenopathy 1- puerporal sepsis 2- breast abscess 3- cardiomypathy
B
38 weeks with placental aprubtion baby and IUFD cervix Is 5 cm dailted what to do "no vitals " Observe Cs Augmentation of labor No IOL in the choices, no vitals, no hours
C
Type of anemia with with sarcoidosis IDA, anemia of chronic disease, hemolytic anemia
B
35 female diabetic smoker history of sub fertility What concern u in this pregnancy A- hx of fertility B- smoker hx C- maternal age D- dm
D
SLE PT came for follow up, labs reveal slightly elevated crt. +bun , biopsy was indicated and showed (minimal change) grade 1 , BP :150/90 what is next ? A- give steroid B-observe C- treat HTN
A
Neoborn with tachypnea , tachycardia and difficulty feeding , on oscultation there was parasternal heave and single S1 heart sound , what is the essential part of the initial management? A-NSAID B-Diuretics C-Dopamine D-Prostaglandine
d, based on votes
34 weeks pregnant in active labor, abdomen is contracting every 5 minutes, Station - 3, 4 cm dilated, membrane intact, CTG is reactive, everything else is normal as far as I remember, what is your next step? A) C-section B) Ventose C) Rupture of membrane D) Tocolytic
c
60 y/o Patient was discharged from icu after 2 weeks of having mi, the patient have another appointment with elective cholecystectomy. When should he do it? A. Upon discharge B. 6 weeks C. 6 months D. Until symptoms resolve
B
Patient smoker on chest x ray there was a nodule which of the following will make you suspect malignancy? A- Size more than 1(not say 2.5 ) B- Hypercalcemia C.smoking D.....iam not remember
c
8 years old boy. Mother complained of poor training to bathroom which muscles is targeted in therapy? A- Perianal B- Pelvic floor C- Rectus muscle D- Detrusor
D
Scenario suspect endometriosis, most appropriate way to diagnose? US Laparascopy MRI Biopsy
B
Women with uncomplicated pyelonephritis ( the diagnosis was given like this ) , what Antibiotics would you give her : A - Ciprofloxacin B - One of the Macrolides ( I forgot which one ) C - ceftriaxone
A
Female with ovarian tumor, ascites Then ask ho to stage her tumor ? A. Paracentases B. CT abdomen pelvis and chest c. surgical staging
c
Crhon’s disease on prednisolone and mesalamine , presenting with perianal fistula … abdominal symptoms controlled with no diarrhea , management ? A- methotroxate B- Budesomide C- Azythromycin D- Odalizumab or influximab
D

Child with viarl infection not improving with 2 inhaled saba:- 1- cough suppressant 2- leukotrine 3-ICS 4- oral beta agonist

C

 

Patient came with Diarrhoea, culture came as shigella, what is the antibiotic of choice? Ceftriaxone Azithromycin Amoxicillin
B
A 72 year old man presented with an episode of right sided weakness that lasted 10 minutes and fully resolved and he is clinically stable, he has no other medical illness. On examination: BP 110/70, HR 95, T 36.6 Which of the following is the most appropriate next step in the management? A.Aspirin. B. Warfarin, INR 3-4 C. Warfarin, INR 2-3 D. No additional drug treatment
A
Delayed bone age but normal growth velocity:- 1- reassurance 2- basic tests ( CBC,TSH…etc)
a

after using PPI when to do urea test? -2weeks -4weeks

2weeks ppi

4 weeks antibiotic

Folic acid quantity for a healthy lady wants to conceive and with no prior diseases or disorders A) 1 mg B) 5 mg C) 10 mg D) 15 mg
A

pic of spherocytosis

LOOKS LIKE A RED BALL NOT CONCAVE

Child with face swelling and sacral edema with abnormal liver test and proteinuria Dx? A-CHF B-Chronic liver disease C-Nephrotic syndrome D- Low protein diet
C
History of obese diabetic female with irregular menstruation every 8-9wks , presented with heavy uterine bleeding since last menstraul cycle which was 15days ago and still … Dx ? A- chronic an-ovulation B- Submucosal fibroid C- Uterine atrophy
A
Patient came after 3 days after Roux-En-Y surgery complaining of fever chill and left shoulder pain, best diagnostic investigation? A. CT with contrast B. Endoscy C. Laparoscopy D. Exploratory laparatomy
A
Patient came with lesions on the groin, get inflamed frequently with Nontender, skin-colored, on the level of the skin, dome-shaped papules with central umbilication - skin tag - molluscum contagiosum - furnucle ?puncule شيء زي كذا
b
case of a patient with a large amount of fluid in the pouch of douglas A- laparotomy B- suction and evacuation
A
Women with worsening dysphagia for 9 months for both liquid and solids, she recently have ill defined central chest pain, no other past history. Clinical examination was unremarkable, labs was unremarkable, except of ESR = 13 ( the normal was up to 10 ), what is the diagnosis? A. Pharyngeal pouch B. Achalasia C. Esophageal web D. Squamous cell carcinoma of the esophagus
B
Post menopausal women present with itchiness and oderless discharge with vaginal excoriation what is the dx A- Candidiasis B- triachomniasis C- vagnosis D- atrophied vaginitis
D
Female patient pregnant with history of previous 4 C-section presented with mild bleeding and hypotension, what is the most likely cause of her presentation “This is the full scenario no further details” A- cord prolapse B- Uterine rupture C- abruptio placentae D- fetal vessel rupture
B
Pt after splenectomy surgery presented with with multiple episodes of intestinal obstruction Now complianing of abdominal destination pain rigidity sluggish bowel sounds Vitality stable X ray air fluid level What is the intial management? A- Paracentesis B- gastrografin enema C- expl laparotomy D- NGT , analgesic, bowel rest
d
Scenario of critical limb ischemia, what’s the most diagnostic investigation? A- CTA B- MRA C- Conventional angiography D- ultrasound
C Peripheral Arterial Disease ( PAD ) Investigations: 1st ( Start By simple ) Laboratory tests: CBC, Hgb, RBS, Lipid profile, RFTs. 2nd ( Vascular Labs ): - Doppler US to detect the pulse by Sound. - Ankle-Brachial Index at rest and exercise if drop > 20% —> ischemia - Segmental pressure measurement: to find the location of stenotic artery. 3rd ( Imaging ) If Asked Next? Start by Duplex US If asked the Gold standard or best investigation to detect PAD? Choose Conventional Angiography. Usually we start by US if not diagnostic we use CTA If the patient have renal impairment and we cannot use CTA due to the contrast usually we go for MRA. If none of the above is Diagnostic? Conventional Angio is the gold standard for theraputic and diagnostic purposes. Note: If the patient have PAD then presented suddenly with leg pain and suspicion of Acute ischemia? Give Heparin. Heparinization immediately required.
Vaccination of 2 months? IPV, HBV, rota virus, Hib, PCV13, DTaP or bcg, hep b or mcv4
a
Patient had a fracture and is being treated, he developed severe pain and swelling, what which of the following signs, indicates the earliest damage? Decrease pulse Parasthesia Discoloration Foot drop
b
patient came with hx of appendectomy 2 years ago came with s&s of bowel obstruction, vitally stable and bowel sound are exaggerated with minimal diffuse tenderness. WBC: 11.5, Xray shows multiple air fluid levels: A- Echo B- Ultrasound C- CT abdomen D- laparotomy
C

What is the age in month of child talk 6-10 words, know 2 body parts, immature pencil grasp? A-17 B-19 C-12 D-24

(C) 1.5 yrs or 18 months . We expect 18 month’s milestones more from a 19 months old than 17 .

70s female complaining of dysuria, frequency, urgency. On examination there is a Grade 2 anterior wall and vaginal prolapse. What is the most appropriate next step in management? A- vaginal hysterectomy B- anterior repair C- Urinalysis
C

Condulioma lata 

 wart-like lesions on the genitals.

 

A full term born came with respiratory distress and chest X ray showed fluid in the fissures. He is born by cesarean section. Most likely diagnosis A-Transient tachypnea of newborn B-Sepsis C- Meconium aspiration D-Hyaline membrane disease
A
Alcoholic, right hypochondriac pain and i think weight loss alpha fetoprotein is high No other labs Image: CT showed multiple lesion in liver and cirrhosis A-Hepatocellular carcinoma B-pancreatic cancer
A
Heroin addict want to start a program to eliminate the addiction, which drug would you choose? A- Naloxone B-Methadone
B, OVERDOSE GIVE NALOXONE

Why ACIs is Contraindicated during pregnancy : fetal anomaly Renal impairment of the fetus

B

Female obese,HTN, hypercholesterolemia ,smoking BMI:38 What is direct related to Stroke ? -HTN -obese -hypercholesterolemia -smoking
a
30 year women complained of dry cough very sever comes in attack that she can not complete talking intial dx as alergic rhinitis took intranasal steroid but no improvemt ..they mentioned that she has allergy to dust .on exam slight nasal congesion FEV1/FVC <70 and improved by 20% with bronchodilator ..what you want to do: Chest ct Skin allergy test IgE antibody level Methacholline chalenge test
C
A 3-year-old child was brought by his mother for a regular check-up. The child behaved badly, continued to shout “NO!” and throw toys. His mother tried to stop him but he continued to ignore his mother. Which of the following would you advise this mother? A) Ignorance B) Counselling C) Positive reinforcement D) Punish the child
c
Pregnant in 39 or 38 weeks came to hospital starting labora in fwe hours cervix 6 cm , spontaneous rupture of membrane 20 hours ago ctg shows fetal bradycardia what is most appropriate management? A- Stop oxytocin B- CS
B
34 y after rta … open eye with pain , makes sounds , localized pain 8 9 10 11
9
Child with 3 degree burn and 1% of genitalia surface affected: A- Refer to burn unit B- sterile wound ointment C- antibiotic ointment D- dressing and discharge
Answer is A Burns involving the face, hands, feet, genitalia, perineum, or major joints are an indication of referral to burn unit. Ref: Schwartz.
Patient coming from an endemic area for malaria. Later on, he was admitted to the hospital with Heart failure. Doctor did not ask the patient about travel or medication history. Thus, he ordered the nurse to give digoxin. Who is at fault? A) Computerized drug prescription system B) Nurse failed to write drug formularies C) Pharmacist who failed to check prescription D) Patient who did not bring his medicine pack/ report his medicines
a
Case of pylori stenosis na 130 and low Cl much What to give: Npo Ng tube Iv NS 0.9 Iv bicarb
c
Pt with episodes of vomiting and hematemesis , EGD was done and it showed intestinal like metaplasia in distal esophagus: A- Esophagitis B- Plummer Vinson C- Mallory weiss D- Barret esophagus
D
Patient give birth to Rh positive baby, she took anti-D immune globulin during pregnancy, how much will give her after birth A. 300 B. 1000 C. 2000 D. No need
A
Child came with painfull red swollen hemiscrotum. On examination, mass was palpated with -ve cough impulse. The mass was tender and extended to the inguinal area. Left testes cannot be palpable. Which of the following is the most likely diagnosis? A- testicular torsion B- Epidydomorchitis C- Incarcerated inguinal hernia D- Testicular appendicular torsion
C
Patient had liver laceration and the patient is hemodynamically unstable. What to do? A- Right hepatectomy B- Perihepatic packing done C- Right hepatic artery ligation D- Ligation of the involved vessels
B
Ct hydatid cyst , ask about (most appropriate initial mx )? Ceftriaxone, surgery, albendazole
albendazole
Q- female patient k/c Renal failure + DM+ HTN, complaining of chest pain and SOB Lab: potassium 6 , what expected ECG changes ? 1- peaked T wave 2- peaked P wave 3- short PR interval 4- narrow QRS
a
Pediatric age pt presented with his mom to ED she said that her child ingested large amount of paracetamol (i think) the pt was healthy no signs of any toxicity on presentation, they observed the pt for 4 hours with no any change in health no signs and symptoms of toxicity, the mom then mentioned that she found some of the drug was spilled on his clothes and in the floor, what is next? A. Reassure B. Watch for another 4 hours C. Give antidote IV D. Gastric lavage
C
8 years old boy previously healthy, Presented with fever, bruising and pain on both legs. On exam he is pale, has ecchymosis & petechiae all over his trunk, neck & face. His labs: HgB 67 (low) WBC 28 (very high) Plt 40 (low) What is the appropriate diagnostic test? A- Bone Marrow Biopsy B- Coagulation profile C- Liver US (or CT liver not sure) D- forgot i think some blood test maybe C3 levels not sure
A
Thyroid nodule with High levels of calcitonin Associated with which tumor -medullary -papillary -lymphoma
A
Typical case of hemolytic anemia and blood film show spherocytosis,Hb:8, MCV MCHC normal range, WBC: 3, PLT: 500, LDH AST ALT high, low haptoglobin most appropriate treatment? A-blood transfusion B-steroids C-hydroxyurea
B

Baby sit briefly, crawl , move object from hand to hand , but can't do pincer grasp , age ? A. 4 month B. 6 month C. 7 month  D. 9 month

C

Pregnant lady 26 weeks gestation presented with large genital wart how you gonna manage? A)Cryotherapy B)Thermal C)Intralesional immuno … injection D) podophyllin
A
3 year old came to clinic with lethargy and failure to thrive Hg 88 Mcv 65 Normal RBCs Reticulocyte 5 Mch low What is the most appropriate management : A. Blood transfusion B. Im iron C. Oral ferrous sulfate D. Fortified formela
c

Co-morbid patient was admitted for some reason, was on salbutamol, spironolactone, aspirin, statin and metformin. K level: 2.5. What medication causes this lab finding: A- salbutamol. B- spironolactone. C- statin. D- Aspirin.

A Salbutamol reduces serum potassium levels by increasing the shift of extracellular potassium into the intracelluar space.

pf after PE stared on heparin ..labs show prolong PT and PTTT 1-stop and give …?!(i forget the drug name but start with L!) 2-continue 3-switch to theraputic dose of enoxaprin 4- stop and !!!
C
Croup case ( dignosis is not written) in ER + barking cough + Fever so norepinephrine nebulizer was given and temporary improved , what to add ? 1. Bronchdilation 2. Antibiotic 3. Steroids 4. Antipyretic ( not sure + no repeat norepinephrine dose)
C
Pregnant at 13 weeks of gestation with history or spontaneous fetal loss at 20 week. What is the most appropriate action to do? A- Regular F/U without specific intervention B- Cervical cerclage now
B
Child came with a potentially toxic dose of paracetamol. The physician requests an “Acetaminophen level”. The lab technician calls to report results. He says: “two” stops and pauses and then says ”one, three”. The nurse mistakenly writes it as “2.13” while the real result was “213”. The patient went into irreversible liver damage, which of the following explain the error that has happened? A) Doctor did not check B) Lack of communication C) Technician didn't check if the nurse got the number correctly D) Mishandling from the nurse.
b
Which of the following is true regarding single umbilical artery? A) Associated with maternal diabetes B) Major malformation in 80% of cases C) Low fetal mortality D) Associated with african race
A
Baby born on 35th week of gestation . His mother bring him for vaccination. which of the following is true: A) give the vaccine at time as schedule B) delay his vaccination 2 month C) give the vaccine at time but half the dose
a
Female patient with unilateral nipple dryness, crust and oozing discharge..bilateral breast ultrasound and mammography are normal. what is the next step? A. Follow up US in 6 month. B. Prescribe steroid ointment. C. Nipple biopsy D. Referral to dermatology
c
Patient K/C of cirrhotic liver disease with severe hematemesis. He is drowsy and disoriented. There is blood coming out of his mouth. What do to next? A - Intubation B - Octerotide C - IV fluid D- Endoscopy
A

Case of pancreatic cyst for 5 Ws with collection was 18 cm x 24 cm how to manage? A- Percutaneous drainage B- Endoscopic drainage C- Surgical drainage

b

5 years old girl with history of recurrent vomiting. What is the next initial management: -Notmal Saline -Ringer Lactate -Potassium Chloride
A

Plt were low, PT&PTT&INR all normal, high bilirubin and reticulocytes and low Hb (indicates hemolysis), creatinine was normal, your management: A.Steroids and IVIG B. Exchanged transfusion C. Platelet transfusion D. I don’t remember

B 

Our case is Most likely TTP

Managment is

1- supportive. ( Iv fluid if indicated, correct Acid base imbalance and

electrolyte ).

2- Pex ( Plasma exchange ) and steroid.

 

RBCs transfusion if Hb is less or equal to 7.

Platlets transfusion only for severe bleeding or going for invasive procedure.

70-year-old male K/C of HTN with progressive decline in cognitive state, MRI showed Periventricular white matter Hyperintensities, what is the diagnosis? A- Vascular dementia B- Alzheimer disease
A

25 weeks pregnent ,sero-ve for rubella , when take vaccicine? A- now B- postpartum  C- no need D- 3d trimester

b

Patient in a coma for 5 days. Initial method for feeding A- Gastrostomy B- NGT C- Central something (There was no Jejunostomy in the choices)
B

4 months* old girl, during Pneumatic otoscope unilateral non-purulent effusion and decrease tympanic membrane motility , no fever pr other symptoms, and no hx of previous infectious diseases, breast feeding very well and no use of pacifier , What’s the best next step? - use amoxicillin tx - use of amoxicillin and clavulanate - Observe and F/U for 48hrs - Refer for ENT to evaluation for tympanostomy tube (للاسف الشديد هذا السؤال جاء نسخ لصق تكرر كثير بالاشهر الماضية وكنت اعتقد انه bad recall )

D

Female has headache, mastalgia, and behavioral changes 10 days before her periods, and she is asymptotic for the rest of the cycle. What is the Dx? A. premenstrual tension syndrome B. pelvic congestion syndrome
A
Healthy female with perianal discharge at 3 and 7 oclock ( no mass, no vitals ), what are you going to order? A- MRI B- Colonoscopy
B
Which of a following is a cause of precocious puberty? • A-Addison disease • B-Hyperthyroidism • C-Congenital adrenal hyperplasia • D-DM • E-Turner syndrome
C
Patient after bariatric surgery presented to you with fever and mild abdominal pain, on examination you found abd tenderness, HR: 116, BP: normal. What is the possible cause for this presentation: Dehydration Leak Inadequate analgesia
B
Case about child with UTI طبعاً بس معطيك الفايندينق ماقاله What makes you suspect UTI? A. fever. B. leukocyte C. nitrite
C
Pediatric patient with shigella treatment: A. Amoxicillin B. Azithromycin C. Ceftriaxone
B
May present with abrupt cognitive decline and stepwise deterioration Asymmetric or focal deficits (e.g., hemiparesis) CT/MRI: multiple cortical and lacunar infarcts, white matter lesions
vascular dementia
Female 37 y/o did papa smear before 3 years ago and result was normal Regarding pap smear when she can do it? Annual pap smaer Pap smear for 5 years 3 negative result then no need pap smear Reassure and no more screening
b
Pt have melena fatigue in history he have dental tooth extraction for which he using iboprofen on ex pale Labs🧪: hb 8 maroon stool colour, management ? A-Normal saline B-Somthing with crytalloid flood C-Blood transfusion
a
5 years old boy picky eater and aggressive behavior. Came from low socioeconomic status. The mother mentioned that both his siblings have the same symptoms. (I'm sure) Labs: Hb: low MCV:low Lead: high Ferritin: low ...(Other labs) What's the diagnosis: -IDA -Thalassemia minor "trait" -hediatert spherocytosis
A
Child with posterior urethral valve what is the preferable diagnostic test: VCUG Iv pylogram
a
12 year old with testicular pain for 2 days. Vertical testes, tender apex, with skin changes. Most likely diagnosis? A-Epididymo-orchitis, B-torsion of testicular appendix C- testicular torsion
B
Child with productive cough, fever with stony dullness and crepation What is the diagnosis? Pleural effusion Lung colapse Bronchopneumonia
C
Old, forgetting famous figures, friends names, wife worried about AD, everything else normal: AD Benign forgetfulness
B
Bowel obstruction case , due to adhesion after surgery and she devolped it many times before all treated conservative but now there is genrlized tenderness and rigidity with metabolic acedosis and increase lactate:- 1- laparotomy 2- bowel rest and hydration
a
30 years old male ve diarrhea since 10 months no blood in the stool and the loss of weight 10 kg lab shows that microcytic anemia and thrombocytosis What’s best management for him 1-PPI 2-Loperamide 3-free gluten diet 4-Omeprazole
C
Child present with periumblical pain nausea and vomiting in the morning related to school and separation anaxity 1 stop school fo 3 month 2 involve the child with peers activity 3 start citalopram 4 othe psycho med
B
Thoracic tube insertion after 15 min 2L blood A) thoractomy B) chest tube
A
Sore throat + enlarged lymph node vaccinated up to date, organism ? A- Streptococcus pyogens B- H. Influenza
A
Child had a Contact with a person with flu-like symptoms, they did strep swab and it was negative what will you do while waiting for culture:- 1- Po steroid 2- Amoxicillin 3- supportive 3- ceftrixone
c
Psycho: Pt brought by his wife saying he is too sad, 3 months ago he bought expensive car and said he is rich, tx? Lithium Olanzipine
ab

Lab technician give a result to nurse through the phone, said 2 then pause after that proceed 3 5 and the nurse wrote 2.35 but the correct one is 235, the patient had irreversible liver damage by this mistake, Cause of this condition ? A- Doctor did not check B- Lack of communication  C- Technician didn’t check if the nurse got the number correctly D- Mishandling from the nurse

b

A six year old girl presenting to the pediatric emergency department with unstable gait and progressive difficulty climbing the stairs over the last 10 days the parents reported that the child has been “choking on her own saliva” the symptoms began was prickly sensation in the fingers and toes that developed to ascending and symmetrical there is a history of viral gastroenteritis three weeks before physical examination confirms the absence of the knee-jerk reflex CSF analysis of weighted protein concentration with normal cell count, nerve conduction test reduced velocity which off the following is most appropriate treatment: A.plasma exchange B.IVIG C.MTX D.steroids
B

9 y/o pt his mom complaining about he is wetting his bed since one month. He used to be dry since 7 years. The urine is foul smelling His lab showing high wbs and turbid in colour and showed nitrate Diagnosis ? A- UTI  B- normal for his age C- nocturnal enuresis

A

36 with le- neck mass, 2x2xm in posterior angle of mandible US: normal thyroid, le- large LN with cysTIc component FNA: all smear shows follicular thyroid A- Metastatic thyroid cancer B- Apparent thyroid C- Ectopic thyroid D- Thryoglossal cyst
a
Child his parents moved him to another school and now he has difficulty making friends: -Dysthymia -Adjusment disorder -Hypomania
B

Female c/o urine leakage with cough, sneezing, exercise and with urgency. What type of incontinence does she have? A. Urge incontinence B. Stress incontinence C. Mixed incontinence  D. Overflow incontinence

c

Nisseria meningitidis precaution a- droplet b- contact c- airborne d- cannot remember, maybe no precaution
A
Long case of COPD patient with oxygen saturation 88% and PHTN is 50 What improve survival? A) Long term oxgen B)oral steroid C) over night pulse oximeter
a
35 year old male have sudden SOB and chest pain was shifted to ICU, diagnosed with Massive PE (no vitals were mentioned) what is the next initial step: Heparin infusion TpA
B
Young Patient with abnormal uterine bleeding, diagnosed fibroid , Hb 7 What is the next step? - blood transfusion - Myomectomy
A
barking cough that is so severe causing cyanosis and the patient feels exhausted in between coughs , Post tussive vomiting. Dx: A- Bortedella pertussis ✅ How to diagnos? Nasopharyngeal swab ✅
احفظ
Patient with symptoms of MI presented to the ER in tertiary hospital. What is the most appropriate management? (No time mentioned) A: PCI B: thrombolytics
A

Patient presented with neck swelling, she is completely asymptomatic, neck US was done reveal a solid mass of 7 mm with regular margins, which of the following is the most appropriate next step? A. FNA cytology B. Thyroid scintigraphy C. Check TSH

C

Patient had a sigmoid polyp removed. They found on histopathology well differentiated adenocarcinoma and the margins are free from cancer. No lymph node or extention to muscularis. What is the. best next step? -Observation -Segmoidectomy -Segmental colectomy -Fulguration of the polyp site
A
After resection of a pedunculated polyp the results was benign adenoma and patient has no family history of colon cancer what to advice for reduction of colon cancer? A- Prophylactic sigmoidoscopy B- Prophylactic colectomy C- Annual colonoscopy D- Life style modification (healthy diet and exercise)
D
stop him but he continued to ignore his mother. Which of the following would you advise this mother? A) Ignorance B) Counselling C) Positive reinforcement D) Punish the child
C
Patient with hypertension, heavy bleeding and anemia, what contraceptive she can use? A. Tube ligation B. IUCD mirena C. Condom D. OCP
B
Pt after mastectomy she has numbness in inner side of the arm, with nerve affected? a- Long thoracic nerve b- Intercostal brachial c- Medial pectoral d-Thoracodorsal
A
61 years old male patient came for routine check up, his Echo showed constrictive LV hypertrophy and severely stenotic aortic valve. His ejection fraction is Normal. ECG is unremarkable. He is symptomatic. What is the most appropriate next step ? A-ballon valvuplasty B-ace inhibitor C-AV replacement D-follow up in 6 months
c
Female presented to The clinic with velvety, hyperpigemented lesions over her neck and axilla, she gave history of 2 years of trying to conceive but failed despite regular sexual intercourse, her periods where irregular. Which of the following is the cause of her hyperpigmented lesion? A. Acanthosis nigricans. B. melasma C. lichen planus
Acanthozia nigricans
Pregnant with hx of recurrent uti, asthma on SABA, she is on labour, what is the drug that should be administered during labour and delivery? A- Bethamethasone B- Ampicllin Forget the rest..
B
Pt with back pain and groins his pain is severe that he cannot stay still and keep rolling, he has hematuria urine analysis has blood and epithelial cells " no other investigations” , whats the diagnosis? الله يسعد اللي كتبه - uretre stone - appendicitis - pancreatitis - cholecystitis
A
New drug is being studied for it's effecacy, which of the following is the the highest evedence study? A. Randomized controlled trials (RCT) B. Systematic review c. cohort
B

A 4-month-old uncircumcised boy. He has low-grade fever. Many negative symptoms. He looks well and changed diaper multiple times. Temp: 39.1 Urine analysis: High WBC. Positive nitirte. Posiitve leukocyte. What is the most appropriate management? A. Oral cephalexin. B. Oral azithromycin. C. IV ceftriaxone. D. IV cefuroxime.

A, YOU CHECKED IT TWICE, ITS CORRECT

38- Patient with chronic limb ischemia, presented with sudden leg pain, diminished popliteal and distal pulses in right leg, and diminished distal pulse with intact popliteal in the left, what's the appropriate next action? A. Heparin B. CT angio C. US D. conventional angio
A
Pediatric age 6 years old Case about lower GI Bleeding with blood seen coming from ileocecal valve during colonoscopy A. Angiodysplasia B. Crohns C. Meckle diverticulum
C Painless lower GI bleeding is the most common symptom of Meckle’s diverticulum. Another Q: Best diagnostic tool? Nuclear scan as Radioisotope scan
Patient with Hip Fracture underwent Hip fixation repair surgery. What anticoagulant to give to prevent DVT? A) Enoxaparin Subcutaneous (SC) 40 mg daily B)Heparin 1000 units BID
A
16 YO came to ER after vomiting once with blood , she had recurrent N/V before her period in the last time there was slight blood with vomiting , after 4-6 hours they mention also ,all labs and exams are normal what you should so? A- admit her for observation B- reassure and ask to come if it recur again C- prepare for urgent EGD D- Discharge
C
Chronic kidney disease picture of iron def anemia and and high ferritin what is the treatment ? A Oral iron B erythropoietin C IV iron
b
24y/o male presented after chemotherapy for the treatment of colorectal cancer what electrolytes abnormality would you suspect? A- hypokalemia B- hypocalcemia C- hyponatremia D- hypomagnesemia
b
Old pt have painless heamaturia whats is most appropriate investigation 1 cystoscopy 2 us 3 ct
a
Primigravid come with labor for 4h Dilated 5 cm, effaced 80%, station +1 after 5h there is no change in cervix, and contraction occur every 3 min. and stay for 60 sec. What to do? A. Instrument use B. C/S C. IV oxytocin D. Wait for 2h
D

woman with dyspareunia and spotting fresh blood after intercourse . She had a history of warts on vulva with cryotherapy done 2 yrs back what is the site of the bleeding? a. valva b. vagina c. cervix uterus d. body of uterus

YOUR FOCUS TEAM SAYS C

Pt with vesicles and maculopapular rash in the right chest, how to diagnose? A- Blood culture B- Skin biopsy C- Skin swab for culture D- No further tests required
جاني في نوڤمبر الكيس كانت واضحة انها shingles No further tests required unless there’s a neurological symptoms in which we use PCR to diagnose it. ماكان فيه Neurological Symptoms. الاجابة D.

Patient smokes 20 cigarettes and vital signs show BP 140/92 Which of the following is the most considerable risk factor for MI ? A) Hypertension B) Smoking  C) Age

b

HIV patient presented with neurological manifestation and diagnosed with toxoplasmosis, most appropriate management? -pyrimethamine and sulfadiazine -Doxycycline and clindamycin -Ceftriaxon and azithromycin
a
diabetic patient with gout. Which of the following drugs aggravates his arthritis? A: Lasix B: Plavix C: Aspirin D: Metformin
a
A surgeon conducting a research regarding new procedures. But before submitting he edited the results so it shows higher success rates. What is this action called? -Fabrication -Falcification -Plagiarism -Ghost writing
B
35 yrs pregnant,smoker,Hx of diabetes in family, the most important risk factor for her pregnancy: Age Smoking Diabetes
A\

Pediatric patient presented with generalized seizure, hypoglycemia, ketones in the urine with characteristic odor. What is the dx? A. Galactosemia. B. Phenylketonuria. C. Maple syrup urine disease.  D-Fatty acid oxidation defect

c

17y female with uterine bleeding, recurrent every 6to8 w,examined all things are normal what is ur management 1-reassurance 2-OCP 3-hystrectomy
A
46 Y/O G3P1 at 34 weeks’ gestation presented to antenatal clinic for regular check-up, she has unremarkable medical hx and uncomplicated pregnancy Braxton Hicks and non-pruritic cervical discharge. Her pre-pregnancy weight was 54.4 on examination cervical length was 33 mm. VS were given & I believe they were normal. Current weight: 52 Rubella AB: -ve ( Normal range is positive ) HBsAg: -ve Blood type: O+ Which of the following is the most appropriate next step? A. F/U after 2 weeks B. OGGT test C. Do rubella Ab test D. Give anti-D Ab
a
Many studies were done to test the outcome of something(i forgot), but the sample size is small, so a study was done collecting these data for a larger sample size to analyze them A. Cohort B. Meta analysis C. Cross section
B
Warfarin was not stopped by patient despite of the clear instructions, the nurse in the OR noticed that the patient did not stop the drug as instructed and informed the surgeon, so the surgeon postponed the operation: A) Adverse event B) Medical negligence C) Near miss D) Principle of totality
C

Typical case of intussusception asking about next initial step: A-NPO B-NGT decompression C-Iv hydration D-Surgery

C

Couple having infertility request surrogacy 1- inform couple hospital doesn’t provide the services 2- give appointment after few weeks and read about topic 3- illegal in saudi arbia 4- referal
2

couples with infertility ask about surrogate pregnancy which not allowed in ur hospital and u are not sure wither allowed in saudi or not? A. Warn them might not be allowed in ksa. B. appointment to check yourself and then tell them. C. Referral to colleague who can help to do it. 

b

39 years old female who has three children and completed her family diagnosed as endometrioma which was removed 2 years ago, right ovary cyst she presented to the clinic with mild to moderate dysmenorrhea and dyspareunia during intercourse and chronic lower abdominal pain. Pelvic ultrasound shows: Left ovary endometrioma cyst 6x7 in size. A. Removal of cyst more than 10 in size B. Aspiration of cyst content under ultrasound guidance C. Immediate hysterectomy and salpingectomy oophorectomy D. Removal of cyst by laparoscopic ablation of endometrioma spots.
c
Female had breast cancer and did surgery for it, now wants to get pregnant What is the minimum time after breast cancer surgery to wait before getting pregnant? A- 3m B- 6m C- 2 years D- 5 years
C
Uncircumcised boy has fever which of the following is the most significant factor for UTI diagnosis? -uncircumcised -fever 38 -male
a
Elderly woman with left hip fracture What to do to prevent DVT? enoxaprin Asprin
A
39 years old female who completed her family, presented with abdominal pain with irregular periods. She had a history of right endometriosis of the right ovary 2 years ago which was managed with right oophorectomy. Imaging now shows 3 × 4 left ovarian cyst. What is the most appropriate management for her case? -Laparoscopic cyst drainage -Left oophorectomy -Total hysterectomy with bilateral salpingectomy and left oophorectomy
C
Pt came 4 days after hernia repair, with mild swelling and tenderness in the wound, with no more Sx or labs DX? A- Seroma B- Hematoma C- recurrent D- Wound infection
A

664-10 Yo female presented with RUO.pain for one week. Associated with jaundice, vomiting and diarrhea, she has a recent Mx of eating from outside, She has no Hx of drug. Which of the following test wil contirm her infectin ? A. HAV IgM B. HAV IgG C. HBSAg D. HCV RNA

A-Confirmatory testing

  • ↑ Anti-HAV IgM antibodies: present in patients with active infection 
    • Usually detectable 5–10 days after exposure and 5–10 days before clinical symptoms develop
A child with typical celiac disease symptoms (weight loss, abdominal bloating, flattening of buttocks) , what is the most appropriate step? A- anti endomysial antibody B- duedenal biopsy C- other irrelevant (No anti Tga antibody)
a
Patient has grandiose delusions and hallucinations, what does he have ? Neurosis Psychosis
b
A 25 year old primigravida at 36 weeks gestation presented with feeling fatigue and unwell. She shortly developed shortness of breath and died. XRAY showed Enlargement of the cardiac silhouette What is the likely cause of her presentation? A) Amniotic Fluid Embolism B) Peripartum Cardiomyopathy
B
Sign of Rh alloimmunization A-Low middle cerebral artery peak systolic velocity B-skin edema and ascites
B
Pregnant lady 35 weeks gestation Known case of Bicornute uterus in leopoid manouver you found globally soft structure in 1&2 grib Fetal heart in the level of the umbilicus of the mother Fetal kicking felt in lower abdomen How you will deliver this baby? A) CS B) Normal vaginal C) Ventose D) Forceps
A
Carcinoid ulcer photo 
JPG
Pregnant women in her 14 W , DM, HTN came to clinic ( no complain she’s coming for follow up) what to do Start folate Refer to dietitian Review her medication Don’t remember
C
Long scenario of elderly female that has back and she is stooping and bending her back while she walks to relieve the pain. What is the diagnosis? A- Lumbar spine stenosis ✅ B- Degenerative Lumbar spine
A
Pregnant female GA22, presented with bleeding, on examination there was soft dilated cervix, U/S showed normal fetal heart rate. Which of the following is the diagnosis? A. Threatened abortion B. Incomplete abortion C. Cervical incompetence
C
Young , obese , hirsiutim with irregular cycles next step ? A- Life style modification B- metformen
a
Famale have irregular periods diagnosed with PCOS what is the most sensitive test? A- testeron B-ACTH C-sex hormone binding globulin D-17-hydroxyprogsteron
A

Calculate the cerberal perfusion pressure of intercerinal of 15 and mean pressure of 65: -40 -50  -60 -70

b

COPD indication for oxygen therapy 2 reading of <7.3 ✅
A
Stage 3 renal disease, which of the following can be prescribe? A-nitrofuronation B-metformin C-lithium D-Warfarin
D, all other drugs are contraindicated in CKD
71 yo male came to clinic with 2 years’ history of slow progressive memory loss. Patient is able to perform activity of daily living such as dressing himself. He was kind but previous 3 months he was agitated and aggressive. The neurological and cardiovascular examinations were not done yet. What is the likely diagnosis for this presentation? A- Lewy Body dementia. B- Alzheimer’s disease. C- Multi-infarcts dementia.
c
Patient in labor, received MgSo4 and Epidural anesthesia. Fetus at -1 station. CTG picture showed minimal variation. What is the cause? A. MgSo4 B. Epidural C. Fetal head station
A
bleeding with and after defecation associated with discomfort and itching :- 1- anal fissure 2- hemorrhoid
a
Young Patient presented with migratory polyarthritis and subcutaneous nodules. What will confirm the diagnosis? A- High ESR B- High CRP C- blood culture D- ASO titer antistripsin
D
10 days, lethargic, with absent femoral pulse Dx Ballon Prostaglandin Ventricular septem.. Surgery
b

Pregnant 20 weeks with with two previous histories of preterm labor. Her current pregnancy is uneventful and her cervix is closed, cervical length is 30 mm and Positive fibronectin.

What will you do?

Immediate cerclage

Progesterone supplement

B

Patient came with vaginal discharge she have done CS with episiotomy 10 days ago , the obstetrician diagnosed her with UTI and described Abx , but she did not improve then she went to another obstetrician and he found infected vaginal swab , What is the medical error done by the first obstetrician? A. let the midwife assist him and depend on her B. doctor failed to follow the surgical safety protocol in the OR C. No communication between the 1st and 2nd obstetrician D. Genuine different assessment or diagnosis of patient case

B

Female underwent gyne surgery, massive bleeding occurred intraop and the doctor and his colleague decided she needs emergency hysterectomy to save her life What to do? A. Get consent from husband B. Do it without consent  C. Ethical committee consent

b

RTA, GCS 8, decrease rt side air entry, intubated cervical emphysema, penumomediastinum, pneumothorax What is the Diagnosis Open or tension pneumothorax Tracheobroncial injury

Tracheobroncial injury

Marfan features what investigation to do to rule out life threatening complications Echo Eeg Ecg
A
Pt after fell down from hight present with open fracture and dirty , what the most appropriate next step in the management ? A- oral antibiotic B- open fixation C- surgical debridement D- external fixation
Answer is C. Remember the Management of Open fracture very well and also in sequence: 1- ATLS protocol and control the bleeding. 2- IV Antibiotics and Tetanus Toxoid. 3- Closed reduction and immobilization by a cast or splint. 4- ER Irrigation, Debridement and external fixation. Once the infection controlled and patient stabilized you can now go for OR to do: 5- Definitive Management by Open Reduction and Internal Fixation ( ORIF ) by IM nail or screws. This sequence is Very important. Whichever comes in the choices first choose it. Oral Antibiotics is not recommended it should be given Peripherally by IV line.

60 years old male patient k/c of hemorrhagic stroke 2 years ago presented to ER with crushing chest pain for 2 hours. ECG: ST elevation in lead Il, lead Ill, aVF. What is the most appropriate management? A. Aspirin B. PCI  C. Unfractionated heparin D. thrombolytics

B

year-old women medically free with no personal or family history of cancer. Asking about when to to start colon cancer screening? A- no need for screening for her case B- Start now and every 5 years C- Start at 50 years with annual colonoscopy D- Strat at 50 with annual Fecal occult blood
D Recommended colon cancer screening tests for average risk patients: 1- Colonoscopy every 10 years 2- flexible Sigmoidoscopy, Air contrast barium enema every 5 years 3- Annual Fecal Occult blood Test ( FOBT ).

5 years old with stab wound in lower chest, has abdominal distension Fast shows free fluid in abdomen All vitals normal except O2 90 What is the most appropriate management: Thoracotomy Tube thoracostomy Expl lapratomy Angioembolization

c, badran says so shut up

7 years old girl with pubic hair and no other manifestation of puberty - normal - early puberty
A
Female presented complaining of low mood, feeling of worthlessness and other manifestations of depression. Which reuptake inhibitor should be prescribed? A. DOPA B. GABA C. Serotonin D. Acetylcholine
C
9-month Hx of MI came to clinic for smoking cessation he was in respiratory distress raised JVP nicotine tear in his hand what is the most appropriate drug? - A. Nicotine replacement therapy - B. Varenicline - C. Bupropion
B: 1- Most important initial step in smoking cessation is Motivational support to the patient. 2- Most effective drug is Varenicline and it’s also Safe in Cardiac Patients 3- If written in the Q ( Hospitalized patient ) Best option is Nicotine replacement therapy.
old man post op (i think colectomy) day 6, he has all the signs and symptoms of PE including sudden shortness of breath, hemoptysis, and others. ABG: results provided was showing respiratory alkalosis ECG: Right bundle branch block CXR: Slight atelactasis in the lower part of the left lung (not sure if it was right or left lung) What will you do? A- Echocardiogram B- CT angiogram
B
Man driving and hit his chest to the dash when stopped to avoid accident now he has a wide mediastinum:- 1- aortic rupture 2- pneumothorax 3- hemothorax
a
Case of wilson disease typically : A_ penicillamine B_ deferoxamine
A
COPD acute exacerbation. Quick drug to administer? A- Salmeterol B- Albuterol C- Ipratrobium D- Inhaled corticosteroid
B
Child with vesicles on trunk and back - Varicella - HSV
a
A case of Pancreatitis 5 weeks ago. Now she has epigastric tenderness and cannot tolerate food with vomiting each time. By ultrasound, you found large about 12X10 mass with thick wall and fluid inside which is heterogenous and non-liquefied. Labs: 346 amylase, Wbc 15k. What is the diagnosis? A. Pancreatic Pseudocyst B. Pancreatic Abscess C. Walled off pancreatic necrosis
C LESS THAN 4 WEEKS IF HETEROGENOUS ITS ACUTE NECROTIC COLLECTION, IF HOMOGENOUS ITS PERIPNCREATIC COLLECTION. IF MORE THAN 4 WEEKS HETEROGENOUS ITS WALLED OFF NECROSIS IF HOMOGENOUS ITS PSEUDOCYST
Deep inhury to calf muscles whuch nerve 1- tibial 2- siatic 3- common fibular
a
Pic of abrupto placenta with deceleration wants the mangment? CS
A
Patient presented to clinic with dry cough and exertional SOB after exercise, did spirometry and was normal, what to do? A- Repeat spirometry B- Methacholine challenge test FEV1 decrease to more than 20% C- Arterial blood gases D- Peak expiratory flow
B
Uncontrolled asthma patient present to the ER with asthma exacerbation, his last many reading of PEF was <450. Which of the following indicates severe asthma exacerbation? A-Respiratory rate >25 B-PEF <350 C-Heart rate > 100 bpm
a
45 years old female with retrosternal chest pain, dysphasia to liquids more the solids. What is best diagnostic method ? A-barium swallow B-oesophageal sphincter manometry C-endoscopy
b
11 month old boy presented due to massive amount of urine volume, and sever thirst. There were 3 episodes of dehydration NOT related to vomitting and diarrhea. Boys in his family have similar complain and symptoms. What is the most likely diagnosis? 1- Diabetes mellitus 2- Diabetes insipidus 3- Water intoxication 4- Nephrotic syndrome
2
pregnant women diagnosed with cardiomyopathy complains of mild symptoms that are not limiting her daily activity whats her NYHA class? 1 2 3 4
2
viral csf management
STOP EMPIRIC ABX AND GO SUPPORTIVE
Female patient with jaundice and pruritus and elevated AST and ALT, liver biopsy shows interphase hepatitis. What is the treatment ? -prednisone -Ursideoxycolic acid.
A
What is the age in month of child talk 6-10 words, know 2 body parts, immature pencil grasp? A-17 B-19 C-12 D-24
Answer is B. This Question came in my Nov. exam. The scenario was ( Points ) to 2 body parts not ( Know ) and another milestone of a 18m but I can’t recall.
Obese woman with infertility lab results within normal range except prolactin was 2000 A- IVF B- IUI C- bromocriptine D- clomid
C
Mother Para 1, Her child has sickle cell disease, she divorced and married again Came asking for counseling. - Multiple marker screening - Parental chromosomal study - Parental electrophoresis ✅ - Maternal electrophoresis
C
A patient with Anterior chest trauma with bruising in the sternum. Patient vitally stable, clear cardiac and respiratory exam, except for pounding pulse. ECG: Arrhythmia X-ray: Sternal Fracture. Echo: Normal What is the diagnosis: A. Pneumothorax B. Cardiac contusion C. Cardiac Tamponade D. Ventricular rupture
B: Arrhythmia on ECG and Sternal fracture Plus Non-complete Beck’s triad Makes the answer more with Cardiac contusion Triad JVP Muffled heart sound Hypotension
Pt in his 60’s came with flank pain and hematuria, tender mass in lumber region his vital BP= 160/90 What’s the most diagnostic investigation ? A-US B-CT abdomen ✅ C-MRI D-Radionuclides
B
case of interstitial pneumonitis most commonly associated with? A-Viral pneumonia B- Lobar pneumonia C- Bronchopneumonia D-Secondary tuberculosis
a
child with pica,pale,low socioeconomic state,low-haemoglobin,hand lead was 2 , iron profile was normal, x-ray report dense metaphyseal bands , what is the treatment? A. vit-K B. D-penicillamine C. Iron
B
36 Years old female came with sudden pain for 12 in right iliac fossa and periumbilical , there’s tenderness over right iliac fossa and suprapubic no rebound tenderness. In the lab there’s High WBCs what you will do? A. Transvaginal US. B. CT abdomen C. emergent appendectomy
a
Patient knowing for DM And HTN and history of right leg pain increased by exertion, on examination absent popliteal pulse on right leg Which one of the following indicates acute limb ischemia: A-intermittent claudication B-rest pain C-scar for iliofemoral bypass in left leg D-swelling
B
Patient with lung cancer and has SVC syndrome, what is the type ? -small cell lung cancer -squamous cell carcinoma
A

4 days Post op pt of AAA with low BP despite 2L NS. BP still low. (-/40). HR normal. Periphery warm. Type of shock ? - no other parameters are given- A. Hemorrhagic B. Septic C. Anaphylactic D. Neurogenic

b

8 years old girl presented with shortness of the breath , exercise intolerance and weight (not mention increase or decrease!!) Vital sign RR 40 HR 160 ECG OR ECH: normal (Question exactly like this no more info!!!) What’s the best test? -CBC -VBG -electrolytes -TFT
D
9 year old girle came with bloody diarrhoea dx as shigea what is antibiotic of choice: A. Azithromycin B. Ceftrixon C. Metronidazol
A
Young pt k/c of myeloid leukemia c/o fever for 1 Days PE unremarkable urine analysis normal blood culture and stool still pending, Vitaly stable Fever: 38.8 All lap within normal except Wbc: (1) Plt: (20 ) sure No other findings, What is the most appropriate management? A-Iv antibiotics B-Close observation C-iv antibiotic and viral agent D-Oral antibiotic and antifungal
A First Scenario is missing important info which is WBC is 1 ( Low ) that makes the scenario is about ( Neutropenic fever ). Neutropenic fever is managed by IV Antibiotics usually Meropenem and septic workup which is culture from every possible site of infection like, blood, urine, sputum, Csf.
Patient on NSAID developed perforated ulcer and repaired, after the repair he became agitated (he was hypoxic hypercapnic ) management? A- start him on 100 O2 B- Intubate and hyperventilate
A
Patient with sjogren syndrome which type of RTA: + Labs: Shows low K Normal Na A. RTA| B. RTAII C. RTA II D. RTA IV
A

Patient was sympathetic + old she did Pap smear and it shows invasive lesion. Best diagnostic value? - colposcopy - biopsy

B 

If Next step > A

Best diagnostic > B

Baby term delivery (didn't specify CS or SVD). 4 hours later complaining from SOB , Tachypnea, Tachycardia with grunting A- Hyaline membrane disease preterm B- pulmonary "something". C- Meconium Aspiration syndrome D-Transient Tachypnea of the New born ✅
d
Pregnant 28 weeks came with bilateral breast mass it was movable and the size was3x4 cm, most appropriate next step? A-reassurance and follow up after delivery B- bilateral breast ultrasound C-Bilateral breast mammogram D-MRI
B, pregnancy doesn’t mean we don’t image the breast mass
Hyperthyroidism pt had 2 nodules, One is hot the other is cold. Most importantly immediate management! A- Antithytoid med B- Radioactive ablation C- lobectomy D- Total thyrodectomy
A
Anal pain and discharg, no visible mass or bulge, upon DRE there was palpable mass inside, which of the following is the most likely diagnosis? A) perianal fistula B) inter-sphincteric abscess
B
patient has appendicular abscess large 10*15 reaching the right flank there is also fecalith on the US what should u do A. Laparoscopic appendectomy B. Open appendectomy C. Percutanous drainage
C
Patient involved in motor vehicle accident. When paramedics first arrived, patient was oriented to time and place, GCS was 15. Soon after, patient lost consciousness. At the hospital, head x-ray showed temporal fracture. What the diagnosis? A. Subdural B. Epidural C. Basal fracture D. AV malformation rupture
B
9 m/o with eczema and has positive family history for eczema what is the most common site: A: upper back B: dorsalis of foot C: scalp, checks and forhead
C
Child with rash with cervical and occipital lymphadenopathy? Rubella Measles
A
28 years old patient with a family history of diabetes came for checkup. labs: Fasting blood glucose: 7.4 HbA1c: 6.3 what are you going to do? ⁃ repeat A1c in 6 weeks ⁃ repeat fasting ⁃ reassure ⁃ 75 OGTT
d
Elderly 70 years old with chest pain for 2 hours given aspirin, clopidogrel, Showing ECG: St elevation in leads V1-V5 A. Posterior mi ECG B. LBBB C. RBBB D. Ventricle tachycardia
B
husband has 2 siblings with SCD the wife not mentioned , what is the likelihood of affecting his children to be diagnosed with SCD? A. Very high B. Not at risk C. Low risk if mother negative ✅ D. Advice not to have children
c
46 yo female known to have varicose veins for 6 years presented with bilateral leg swelling and pain after prolonged standing No hx of claudication After examination there’s various veins in the great sephonus vein territory What is the investigation of choice: A. CT venography B. Venous duplex C. venous plethysmography D. No investigation required
B
Female Patient on icu urosepsis and septic shock, did not respond to ressisatuve mesures, he was started on norepinephrine but no response. Check labs below Right atrial pressure: Normal PCWP: Slightly high CO: Normal SVR: Normal What is the cause of her deterioration A-Adult respiratory distress syndrome B-Volume overload C-Cardiogenic edema
a
Pregnant lady came for check up at 20 weeks gestation High hba1c baby at risk of? Congenital malformations Chromosomal abnormality
A
patient with palpitation HR 265 ecg done show narow complex tachy cardia (no pic)? atrial fibrillation atrial fluter super ventricular tachy cardia ventricular tachycardia
c
Pregnant 9 weeks come with sever bleeding she says that there was gush of fluid and part on examination os is open and tissue is seen (incomplete abortion)what's most appropriate step? A-Expectant B-D&C
B
Neonate found to have ambiguous genitalia with high 17-Hydroxyprogesterone, where is the deficiency? A. 17-hydroxylase deficiency B. 21-hydroxylase deficiency C. 11-hydroxylase deficiency
B
Seasonal allergy, tearing eye, red, rhinitis, take anti histamine as needed, what do you want to add w saba: Daily oral anti histamine Laba and ics Ics
C
Pregnant 14 weeks GA, came to the clinic for booking she Is Diabetic and HTNsive, what would you do? Review medication Give Folic acid
a
Rectal . Bleeding, colonscopy revealed 1.3 adenoma,, Excition done revealed Tubular complete Excition.. Colonscopy follow up 3-6 3 years 5 years 10 years
b
A patient presents with a knife injury to the hand. On examination, the laceration reached the tendon and nerve. How will you repair this injury? A- Primary repair to injury structures B- Debridement with primary closure C- Debridement with secondary intention D- Debridement with Vacuum assisted closure (VAC
B
55 years old male, presented with exertional dyspnea and syncope, on examination he was found to have systolic ejection murmur that radiates to the carotids, on ECG there is left ventricular hypertophy. How would you manage this patient? A- antihypertensives with tight BP control B- refer for surgical correction C- give vasodilator D- give diuretic
B
when does stepping reflex disappear? 2 m 4 m 6 m 2 weeks
A
A patient with epigastric pain admitted to hospital, U/S shows gallstones with dilated CBD. Now he is stable and labs are normal except high amylase 250. What is the appropriate next step? A. ERCP B. CT abdomen C. cholecystectomy now D. cholecystectomy after 6 months
A
Long case of IBD, investigation show non continous lesion? A.crohns ✅ B.ulserative C.h.pylorai
A
Patient with rash on cheeks and white spots on inside cheek - mumps, measles
B

patient female elderly with symptoms of Orthopnea SOB PND, JVP, Bilateral basal crackles. S3. what is the diagnosis A- Pulmonary edema B- MI C- Mitral regurgitation D- Right sided heart failure

C badran says so

Newborn/infant with stridor worse when prone improves when supine, mother is concerned, what todo? A Start laser treatment B tell her it will resolve on its own by first birthday C Tell her it will get worse D-Do Laryngoscope
B
Patient involved in motor vehicle accident. When paramedics first arrived, patient was oriented to time and place, GCS was 15. Soon after, patient lost consciousness. At the hospital, head x-ray showed temporal fracture. What the diagnosis? A. Subdural B. Epidural C. Basal fracture D. AV malformation rupture
B
A 73 year old woman is brought to ER after a fall at home. She is diagnosed with left hip fracture (see lab results) Weight 82 kg Sodium 136 (normal) Potassium 4.2 (normal) Creatinine 68 (normal) What is the best order by the admitting orthopedic surgeon to prevent deep vein thrombosis? A. Aspirin 81 mg PO daily B. Enoxaparin 40 mg SC daily ✅ C. Fondaparinux 10 mg SC daily D. Heparin sulfate 10,000 units IV BID
b
Pregnant complain of recurrent stillbirth and positive pregnancy test which vaccine can give her! A- Rubella B- Influenza C- Measles D- Varicella
B
50-year old heavy smoker presented to the clinic for a regular checkup. He showed no interest in quitting smoking at all. Which of the following is the most appropriate action? A) Offer smoking cessation classes B) Nicotine replacement therapy C) Set a deadline to quit smoking D) Offer personalized advice Answer: D,
d
low CO and elevated CWP type of shock ? Cardiogenic, hypovolemic
A
Child with absent red reflex 1- mri brain 2- reassurance 3- eye examination under sedation
c
15 month boy came to ER complaining of abdominal discomfort, emesis, stool with blood and mucus on phisycal examination he has increase abdominal sound X-ray report shows obstractive bowel ( written like this ) A- give antibiotic B- Go to OR and do surgery C- Barium enema D- bowel rest, IV hydration and wait until symptoms gone
C
Patient with barking , flared nostrils, muscle retraction. etc. initial treatment? A. Fluid resuscitation 2. Epinephrine + steroid
B
Most imp in hx taking with pt complains of dysmenorrhea? Medical Surgical Family Menstural
D

CTG w/ prrolongrd decelation. Most appropriate to do? A) emergency CS  B) hydration, reposition and assess in 20 mints

b

baby with noisy breathing and wheezing that improves when prone and increases when supine. What is the diagnosis? A. Laryngomalacia B. Tracheomalacia
a
51 yrs old women with symptoms and signs of meningitis Lab low glucose high ptn High wbcs بس ماحدد مين البري دومننت What’s the cuause ? Listera Strept pneumonia
a
30 weeks gestamon , she has lower abdominal pain with no bleeding or leaking if we suspect preterm labor , which of the following will confirm preterm labor ? A- History will be enough to confirm preterm labor B- Presence of contracaons C- SERIAL Pelvic examinaaon D- cervix length measurement
d
Asymptomatic (no constipation no urinate problems) pt with utrine prolapse grade discovered incidentally ttt? Observe Repair
A
41 weeks pregnant given pethidine and Phenagran. Cervix is dilated 9 cm. Meconium stained liquor is draining. CTG shown in the Picture: ( Not the same Pic but it was Prolonged Late deceleration ). Which of the following is the most appropriate next step in management? A- Give naloxone B- Watch and reassess after 30 mins C- change mothers position D- Increase oxytocin infusion.
Answer is C. This is non-reassuring CTG which requires uterofetal resuscitation measures the first one is to change the mother’s position.
Patient RTA with spine injury back pain , finding on examination : spine injury can not be ruled out , nurosurgary consultation done and waiting for them Question about most imports until the patient is fully assed ? 1- urgent full spine CT 2- maintain full spine immobilization
B
You are doing a thoracosentesis for a patient, at which level in mid axillary line you will place the needle? A- At 4th intercostal space B- At 5th intercostal space C- Between 6th and 7th intercostal space D- Between 8th and 10th intercostal space
D
28 year old female have neuropsychiatric SLE asking about the appropriate treatment: High dose steroid +cyclophosphamide High dose steroid + mycophonolate
A
High velocity trauma, pt hypotensive despite giving IV fluids. X-ray showed open book fracture. What is the most appropriate next step? A. Pelvic binder
A
RTA pt with maltipule mandbular fracutere with severe bleeding, uncontious, no vitales menstioned How would you mange his Airway? A. Laryngial mask B. Orotracheal C. nasotracheal D.Cricothyrotomy
D
Q-parkland formale 70kg with both lowerlimb burrn how to calcute? الخيارات كانت Ringer lactate 200ml/24 Normal saline 116/24houre Ringer lacte 5ml/6hours ,6ml/16h Ringer lactate 6ml/6h,5ml/16h
C, (70*36*4)/2= 5040ml 5040/2= 2520 ml ——1st 8 hours 2520/8= 315 ml/ hour 315/60 min/hour = 5.25ml/minute
Hypothyroidism clear Hx and labs with low Na (it was 129) normal 134 What to do next ? 1. Levothyroxine 2. treat the hyponatremia with hyper Na fluid
1
Pregnant with SC trait.complication ? -IUGR -UTI
UTI, the complications of SC trait isnt confirmed yet.
Elderly healthy medically free came for vaccines ? A. pneumococcal B. Meningococcal C. MMR
a
Neonatal jaundice, blood film was attached,,, i think i saw Bite cell What is test you will order to confirm?! Osmlarity fragility test G6PD..
G6PD enzyme analysis
Pt had RTA in er, only has a bruises in lower abdomen and abdominal pain, what is the most appropriate nest step ? Bp : 110/80 Temperature : 37.2 HR : 88 RR : 19 A. CT B. Fast C. Initial assessment and resuscitation D. Exploratory laboratory
C
lady mised period which most appropriate time of us A-11-13 weeks B-16 - 18 weeks C-18 - 22 weeks
A

Patient presented to you with goiter and signs of hyperthyroidism and TFT was like this: TSH: LOW, T4,3: High, thyroid antibodies are negative, what is the most probable cause: Primary TSH secreting adenoma Graves disease Multinodular goiter

C because antibodies are negative

Pt with systemic sclerosis ..comes with fatigue and dizziness Bp188/90 Renal impairment. What medications to add? A.Lisinopril B.Amilodipin C. BB
A
Old, post meno bleed, had 5cm fibroid in the past now having the same findings on us  no chanege, what next? Observe Hystrectomy✅ Myomectomy Endometrial biopsy
B
Patient came after 3 days after Roux-En-Y surgery complaining of fever chill and left shoulder pain, best diagnostic investigation? A. CT with contrast B. Endoscy C. Laparoscopy D. exploratory laparotomy
A
Pt pain less defication, Blood in th stool. Biles reduced spontanius in 3 areas 3.7...._ Hb very low, Dx hemmorriid was given which of the following is Definitive management ? A. conservative manag B. fiber diet C. rubber band ligation D. hemorroidectomv
C
pregnant woman presented with massive vaginal bleeding from the abruption placenta and her Hgb: 8.6, BP 84\40, HR140. What is the best management to save her life? A- Admit to ICU B- Immediate Transfusion of 2 packs FF C- Call multidisciplinary and rapid response team (RRT)..✅
C
Hyperkalemia 6.5 in CKD patient, Most appropriate next step? (They put a pic of an ECG) A. Calcium gluconate B.insulin and salbutamol C. Dialysis
A
Patient presented with exercise intolerance and fatigue she was diagnosed with celiac disease 7 years ago, however she’s not complaint to gluten free diet. She started to take oral iron supplements 12 weeks ago after she was diagnosed with iron deficiency anemia. On examination the patient looks very thin, she have pale conjuctiva and nail beds and systolic murmur 2/6. Lab results iron low, ferritin low. How would manage this patient A- continue the same medications B- give oral iron on liquid preparations C- give IV iron preparations D- give oral iron tablets 3 times per day
C
Hx of asthma in labor with pph doctor did massage but didnt help she stil in bleeding Which of the following contraindications is the most appropite managment to her at this stage ? A- oxytocin B-misoprstol C-methylergonovine D- Carboprost
d
Case scenario about asthmatic child with resp distress with ABG before&after ttt The ph was 7.6 then become 7.3 I can't remember other reading what's ur management 1-intubate in ER 2_refer to PICU
A
patient with mitral stenosis what is the targete international normalized ratio? <1 1-1.5 2-3 >3
c
baby with drooling, aspiration after feeding , Coild NG tube in esophageal pouch: A- Hiatus hernia B- another answer but no esophageal atresia C- Tracheoesophageal fistula D- Choanal atresia
c
8 year old female with Heliotrope Rash and Nodules in Phalanges. Diagnosis? A) Juvenile Dermatomyositis ✅ B) Oligoarthritic JIA C) Systemic JIA
a
Old age pt with cardiomegaly. he's asymptomatic Echo showed: EF 40%. what is the best Mx A- digoxin B- Lisinopril ✅ C- echo after 6 months D- frusemide
b
Coca cola urine + rash + had congestion throat and lymphadenopathy (didn't specify the duration) Vitals (fever 38, Tachy) Likely dx? IgA nephropathy Acute glumornephritis Acute cholecystitis Not remembered
A
Couple came to the infertility clinic. Semen analysis was normal, cervical exam not done yet. The wife has regular menstrual cycles every 36-40 days. Investigations show monophasic basal temperature. What is the cause of infertility? A. Coital B. Vaginal C. PID D. Anovulatory
D
Child diagnosed of epelipsy on medication, what is true regarding his vaccincation? A- Give all. B- Don’t give live vaccincation. C- Hold Dtap.
A
39 year old female complaints of heartburn and regurgitations for 6 months burning is primary after eating and occasionally has chest pain, not associated with weight loss or lifestyle changes. the patient mentioned that she eats dinner 2 hours before going to bed and complains of heartburn primarily at night.. She's taking omeprazole 20 mg per day did endoscopy . She had distal esophagitis. her BMI is 28 What is the appropriate next step? A. add antacids twice per day B. ranitidine before bed C. advice weight loss D. refer for nissen fundoplicati
C
2 yr old child presented with facial swelling, sacral edema and labs shows hypo albumin + high cholesterol (protein uria not mentioned !) what ur diagnoses ? A-nephrotic synd B-protein malnutrition D and c are irrelvant
A
Male dr wants to examine a female patient and he asked the nurse to come with him what did the doctor practice ? A- privacy B- justice C- Nonmaleficence
a
A case with right leg embolism where you suspect it source: 1- right atrium 2- right ventricle 3-abdominal aorta
left atrium or ventricle. Right will go to heart
Pt after embryo transplant by 4 wks present with abdominal pain , what is the most likely cause ? Ectopic pregnancy
A
55 years old male, presented with exertional dyspnea and syncope, on examination he was found to have systolic ejection murmur that radiates to the carotids, on ECG there is left ventricular hypertophy. How would you manage this patient ? A- antihypertensives with tight BP control B- refer for surgical correction C- give vasodilator D- give diuretic
B
There was a case about elderly diabetic pt with 2 day history of abdominal pain , bloody diarrhea imaging was done showed thickning of descending and sigmoid colon with thumb appearance , what is the dx? A- uc B-crohn disease C-ischemic colitis D-acute diverticulitis
c
head trauma and coma for 5days best early way for feeding A. NGT B. central nutrition C. parental nutrition D. Gastrostomy
A
Brest lump solid irregular family history of cancer ? A) core needle biopsy B) FNA C) bilateral US
A
Patient known case of ITP who is currently pregnant. After the delivery she developed Postpartum hemorrhage. What to give the patient? A. Cryoceptate B. Fresh frozen plasma C. Packed RBCs
B
Another recall: Pregnant with recurrent UTI what to do? A- X ray B- US C- ureteroscopy D- cystoscopy and RET's
B
Case for sudden pain in the left leg associated with reduce sensation and color change? A-US B- Ct angio C- conventional radio ✅
b??
A female get high energy accident (high velocity), with seat belt sign, on X ray have chance fracture. What will associated with this fracture? A- Duodenal perforation B- Gastric perforation C- Jejunum perforation D- Vena cava perforation
a
A 55 years old male Known case of chronic peptic ulcer. Came with multiple vomiting attacks. On imaging there is a mass from ulcer obstructing gastric outlet. On Examination the Patient is Dehydrated. Which of the following is most common manifestation? A- High urinary K B- Hypokalemia C- Respiratory alkalosis C- Metabolic acidosis
B wrote this Question from my September exam. Answer is Hypokalemia. Gastric Outlet Obstruction can result in Hypokalemia, Hypochoremia, Metabolic alkalosis. Ref: UTD.
38 years old man presented with severe epigastric pain that worse with food, relived slightly by antacid Hg 12 Urea 8.4 Platelet 450 The rest unremarkable What is the most appropriate to establish diagnosis: A. Upper gi endoscopy B. H pylori antibody C. Ct abdominal D. Not sure ( barium )
A
45 years old female presented 1 week post operation of cholecystectomy with abdominal pain and mild jaundice. Labs: LVT: slightly elevated WBCs: high US: CBD: 9 mm What is the cause? -Something space bile leakage (not sure) -Intra-hepatic bile leakage (not sure) -Slipped clip of CBD
C
Which of the following indicate acute sever asthma ? A- ox less than 90 B- HR more than 100 C- pEF <200 ml D- can’t complete sentences in one breath (exactly like this)
C
Patient underwent left lower parathyroidectomy for primary hyperparathyroidism (adenoma). He presented 4 months later with depressed mood and fatigability. Both parathyroid hormone and calcium were high, what is the most common cause? A. Parathyroid hyperplasia B. Missed adenoma C. New adenoma D. Parathyroid cancer
b
Women came with severe abdominal pain radiating to the shoulder with abdominal tenderness. What is the best management? Pelvic MRI CT abdomen ✅ Liver function test
B
3m old, sneezing and runny nose, his bro had same symptoms: Rcv Influenza Para influenza
B
A doctor is ordering 75 OGT for a pregnant patient. Why did he order it? A- History of GDM In previous pregnancy B- age 25
a
1003- Calculate child pugh score: Albumin 30, INR 1.9, Bilirubin 30, Confused 1 week, Ascites A-Child A B-Child B C-Child C
c
Infant 8 month old with recurrent chest infection with Hx of vomiting.. And upon examination Dr so infant with arched back Asking about the most common cause? Obesity Prematurity Aspiration Forget
its gerd
55yo, dm controlled, 20 min loss of vision, normal vital: Ms Tia
tia
What anti diabetic medication can reduce mortality in DM patients A. Metformin B. Gliflozin C. Glipizide D. Acarbose
b
A 53 year old Male, known to have schizophrenia on medication, presented to ER with recurrent abdominal distention and constipation. Was normal on examination and vitally stable. Abdominal Xray: dilated colon lumen 10cm CT: No obstruction Best management? a-Decompression colonoscopy with rectal tube. b-emergency colectomy. c-Lt side colostomy. d-lower barium enema.
A
48 yo lady with diffuse goiter, high T4 low TSH, US show bilateral thyroid nodules , right 3x4 in size , left is 1x2 size what to do? A. FNA both B. FNA the larger one C. total thyroidectomy
A
Elderly 70 years old with chest pain for 2 hours given aspirin, clopidogrel .... Showing ECG: St elevation in leads V1-V5 A. Posterior mi ECG B. LBBB C. RBBB] D. Ventricle tachycardia
B
Inform infectious authorities with which infection? Mono Chlamydia Pneumonia Bac vaginosis
b, repeated
Female with vaginal discharge Grey, fishy odor , smear : show clue cells, diagnosis? A. Trichomoniasis B. Bacterial vaginosis C. Candida
B
pt with clamidia.tretment? Azithromicine penicillin amoxicillin
A
Another recall: 33yo male with painless swelling in the posterior triangle of his neck. On US thyroid is normal and the swelling has cystic component. FNA shows complete follicular cells. What is the most likely diagnosis? A. Apparent thyroid B. Metastatic cancer C. Ectopic thyroid D. Thyroglossal cyst
b
smell & positive ketone Diagnosis? A. Phenylketonuria B. maple syrup urine disease✅ C. Galactosemia
B
Child got pertussis infection, has two siblings 3 and 5 yrs, both up to date in vaccination: A: Give them both booster vaccine B: Chemo prophylaxis by Macrolide C: Give booster only if high risk D: close observation for signs and symptoms of infection
B
Took 3 doses of HB and never infected of HBV, what will his hepatitis b serology show? HBsAb, HBsAg
a
Typical case on nephrotic syndrome, ask about highly diagnostic test ( no renal biopsy ) A. Serum albumin B. US C. Urine total protein D. Electrolytes
C
patient on ibuprofen for RA now has severe epigastric pain erect xray show air under diphgram treatment? laprotomy or laproscopy (can't remember)
a
Patient after SVD found placenta failed to deliver and cannot extract. The patient refused hysterectomy. It was managed by ligating the placenta and started on Methotrexate therapy, whats the complication of this case? a. Bleeding b. Infection c. DIC
A
pt with maltipule mandpular fracuter with sever bleeding, uncontious, no vitales menstioned How would you mange his Airway? A. Laryngial mask B. Orotracheal C. nasotracheal D.Cricothyrotomy✅
d
Male, Smoker, diffuse wheezing, normal chest x-ray, what is the diagnosis? A- Pulmonary fibrosis B- Interstitial lung disease C- COPD D- Occupational lung disease
C
3m boy exclusive breastfeeding, mother worry about Iron deficiency anemia,U give her medical advice when to start oral iron prophylaxis After how month from now 1m 2m 6m
A
Typical case of preeclampsia, asking about which of the following clinical findings with this condition? A-elevated mother liver enzymes B-oligohydroamnios C-polyhydroamnios
A refer to Criteria for the diagnosis of preeclampsia in utd
16 year old , amenorrhea for 2 months and galactorrhea for 3 months , what is the most important investigation ? A-Prolactin B-Progesterone C-Oestrogen D-LH
a
Vessels effected in epidural hematoma: ⁃ Middle meningeal artery
a
8 years old child with lax joints and fingers Arachnodactyly what is the investigation that will protect him from life threatening condition? A. Echo B. Ecg C. Chest ct D. Brain mri
a
15 month boy came to ER complaining of abdominal discomfort, emesis, stool with blood and mucus on phisycal examination he has increase abdominal sound X-ray report shows obstractive bowel ( written like this ) A- give antibiotic B- Go to OR and do surgery C- Barium enema ✅ D- bowel rest, IV hydration and wait until symptoms gone
C
Female, p6, feel heaviness and discomfort on her pelvic region, exam showed mass coming from introitus , dx? A- Rectocle B- Cystocele C- Uterine prolapse D- Enterocoele
C
Child with Sand paper rash, sparing mouth. Most likely organism? A-Staph aureus B-parvovirus b19 C- herpes simplex virus 6 D-strept pyogenes
d, Scarlet fever = strep pyo
Pregnant with low risk pregnancy at 32 weeks came with vaginal bleeding, diagnosed as placenta abruption and managed conservatively , most appropriate next step? A- remain in hospital B- reclasify as high risk and f/u with US for fetal growth C-apply as low risk with f/u outpatient clinic D-apply as low risk and f/u with US for vaginal bleeding
B
Young male came afrer RTA and FSAT was order Which of the following most probably to found? A-pneumothorax B-subdural hematoma C-Hollow viscous injury D-interpertoneal free fluid
D
Pt sad I think then he diagnosed with cirrhosis who will tell the pt about his diagnosis? A- family B- nurse C- hospital administrator D- doctor
d
COPD patient with SOB in ER , only finding is PH 7.3 and he already took 1 dose of bronchodilator with no improvement what to do next ? Non invasive mechanical ventilation ✅ Give another dose of bronchodilator Give inhaled steroid (100% sure no choice mechanical ventilation )
A
patient with paracetamol toxicity came to ED after one day atidote N acetyle cystein no need in this stage
N acetylcestiene
diabetic pregnant with HbA1c 12 whats is commenst complication? congenital malformation polyhdraminos preeclampsia
A
Pregnant Patient Presents with Cottage Cheese Discharge. What is the Treatment of Choice? A. Oral Anti Fungal B. Topical Anti Fungal✅ C. Oral Antibiotic D. Topical Antibiotic
B
11 year old girl with exercise intolerance and weight (did not mention loss or gain) Hx is unremarkable and PE is normal bp:160/100 HR:130 T:36.6 O2: 95 ECHO shows normal heart function and anatomy. What is the most appropriate ? managment? 1- ABG 2-electrolyte level 3-CBC ??? (anemia ) 4-TFT????
4
i spy with my little eye: Slowly progressive, over ∼ 8–10 years Episodic impairment of memory Characteristic order of language impairment: naming → comprehension → fluency is a clinical diagnosis MRI Diffuse cortical atrophy Hippocampal atrophy CSF ↓ Beta amyloid ↑ Phosphorylated tau Neuritic plaques (amyloid beta peptides, mainly accumulating extracellularly) Neurofibrillary tangles (abnormally phosphorylated tau protein, which accumulates intracellularly)
Alzeheimers disease

10 y old girl complain of abdominal pain since *14* days On examination you found bruises over the abdominal and asked her what is these she told you she fall from bicycle … A- ct abdomen B- us abdomen C- laparotomy D- laparoscopic

B

Known case of GERD on 20 mg omperazole; partial improvement of the pain, but she had worsening of the symptoms at night. She was obese. Endoscopy showed esophagitis. Next step? A. Add antacid BID B. Ranitidine at bedtime C. Advice to lose weight D. Refer for fundoplication (plz focus this from the past, in my exam she wasn’t obese her BMI was 27, maybe consider over weight? anyways i still think C is the answer)
C
Mother came with her child for preschool Vaccination Which of the following is important Vaccine to give : A-RV B-OPV C-Meningococcal ( MCP4 ) D-Hib
B
Pediatric with recurrent infection with pyogenic bacteria pneumonia and otits media and recurrent dirrhea most important diagnostic test? - C1 inhibitors - Immunoglobulin
b
Child pt with decreased IQ, pica (eat dirt) < they wrote it :) With Hepatosplenomegaly ! Labs showed *Hypochromic microcytic anemias. What is the highest diagnostic labs? A- blood lead levels B- CBC with blood smear (they already do it ) C- Iron studies
Answer is A. This Q came to my exam in November. There was no Iron studies in the choices!! I don’t remember the Q exactly but the choices were wrong except for A which is diagnostic for lead poisoning since the child is Eating dirt and have low IQ.
boy circumcised mother said urine smell foul fever 39 for 1d what indicated uti in this pt A.Fever duration B.Being a male C.Fever 39 D.Age
C
60 y/o male,, progressive Ascites, fever, loss of weight, low SAAG.. This is the complete Q.. Dx 1.HF 2 liver chirrosis 3 pretonial TB 4 vaso oclusive
c
SLE pt on medication and present to the ER with urinary incontinence and lower limb weakness during examination you found hyperreflexia and paraplegia, what you will order ? -LP + MRI brain -LP + MRI spine -LP + CT brain -LP + MRI MRA MRV brain
B. Answer is LP and MRI of the spine. This is a case of Transverse myelitis as a neurological complication of SLE. Management is IV steroid and Cyclophosphamide.
Doctor did lap for appendicitis appendix not inflamed but removed as part of common practice, dr didn’t inform patient about this in pre op consent: Tell patient its part of standard procedure✅ Ask other dr to tell Dont tell Ask the ethics
A
32y female present with 4cm fibroadenoma with hyperplasia and atypia What is the most signeficant risk factor for breast cancer? A. Her age B. Present of hyperplasia C. Present of atypia D. Fibroadenoma size
C\
Elderly has problem in urination ,back pain elevated PSA DX? A -Prostatic CANCER B- incontinence C- UTI
A
Elderly with abdominal pain amd abdominal distention, He shows signs of obstruction, on imaging there is air fluid levels and pneumobilia (air in biliary ducts), What's the next step in investigation? A- Gastrograffin test B- Barium swallow C- Abdominal CT ✅ D- US
C
Case about gun shot and the pt had pneumothorax. Tube thoracostomy was inserted after 15min there was blood in the under water seal drain (2L), what is the most appropriate thing to do? A - thoracotomy B- Tube thoracostomy C- CT chest
A
Baby jaundice, cataract, hepatomegaly how to confirm? Urine reducing✅ Hida Alpha 1 antitrypsin
A
Term Female came for labour , her prenatal history was urine culture (not vaginal swab for culture) positive 100000 GBS and asthma wich is managed by SABA , now what to give during labor and delivery? -Ampicillin ✅ -betamethasone
a
A celiac patient with skin rash. What is the most likely associated diagnosis? • A Psoriasis • B Dermatitis herpetiformis • C-Chicken pox • D-Pemiphagus vulagris
B
Fungal infection in pregnant lady how to treat? A. Oral antifungal B. Topical antifungal
B
Severe pain when going downhill but improve when bending forward ? Spinal stenosis ? Osteoarthritis
A
55+ M Known HTN Came with heart murmur radiating to carotid region.. What’s the best diagnostic method? A/ trans esophageal echo B/ ct angiography C/ cardiac catheterization D/ ecg
A
old patient came with subdural hematoma with signs of lateralization imaging revealed 13 mm shifting. his GCS 7/15 then was intubated and resuscitated what to do next A- iv mannitol B- elevate head of bed C-hyperventilate D- urgent craniotomy
D
12 years old with myopia, pectus excavate, congenital heart disease, Height > 90th percentile weight <50th percentile, Normal IQ. what's your diagnosis A- Marfan Syndrome B-Homocystinuria C-Soto's D-Alexander
A
Mother with child born premature 23 weeks and needs intubation and resuscitation but she refused. What to do? A. respect her wish B recuscitate
a
Vertex presentations.. How to diver Vavum CS Forcebs NVD
d

40 something year old female with menorrhagia What is you diagnosis? - endometrial polyp - submucosal fibroid

A a picture of homogynous US will come with this

newborn, w/ family Hx of primary immune deficiency: what to do? A- give BCG B- dont give BCG C- Give vaccine when he become adolescent D- give immunoglobulin
B
5 year old male presented with a history of URTI 2 weeks ago, now he complains of RUQ abdominal pain, no rebound tenderness. There is splenomegaly. HB: 7 Retics: High WBC: 16 Blood film: Normocytic normochromic anemia with target cells and inclusion bodies What is the most likely diagnosis? A- IDA B- Lead poisoning C- Acute appendicitis D- GI Infarction E- scd
survey
17 yrs Senario of primary dysmenorrhea severe pain affect on life and school attendance. She was on NSAID and pain become less severe, she able to go school and do her life activities.. most appropriate next step? 1-OCP 2-counseling and education of self care
B
12 Weeks pregnant, what will her blood test show? A. Decrease in serum creatinine B. Increase in plasma sodium C. Increase in plasma BUN D. Decrease in BUN
A

36 Year old male patient diagnosed with WPW and he is on BB but still uncontrolled. What to do? A- Add CCB B- Increase the dose. C- Give amiodarone. D- Radiofrequency ablation 

d

Patient fell on outstretched hand, pain at anatomical sniff box, which bone fracture is it? A) Colles B) Scaphoid
b
47 yo woman came for screening: Pap Fecal occult Glucose Ct
A
patient presents with pain and an itchy anus after defecation, as well as painful defecation with streaks of blood in his s tool. What is the most likely diagnosis? A. Abscess B. Anal Fissure C. Thrombosed piles D. Fistula
B

Case of 3 years old he has breathing hold, no inspiratory stridor and monophasic wheeze and barking cough ? A- bronchiolitis B- Tracheomalacia C- Laryngomalacia D- Bronchial asthma

B

47 year old lady known to have hypertension, came for clinic, what screening test to do? Pap smear Fasting blood glucose ✅ Colon cancer

she is not obese, i would go for pap smear

12 years old boy came with supracondylar fracture and abscent of distal pulse , most appropriate mangment : Early k wire Elevate hands watchful waiting Surgical exploration ( sure there is no closes reduction )
d

Pt with sjograns disease , ask what causes HYPERKALEMIA in this pt? A- RTA 1 B- RTA 2 C- RTA 3 D- RTA 4

sjogren causes RTA TYPE 1,  hyperkalemia present i RTA type 4

A male patient with Ulcerative colitis had several episodes of diarrhea for 7 days. Not associated with vomiting. Which of the following is the best fluid to give him ? A- Half Normal saline B- Ringers lactate C- Colloid
B
patient comes with cough, hemoptysis What is the initial action? a. Acid fast bacilli b. Chest X-Ray c. Isolation in a negative pressure room
c
Diabetic patient with pseudo hyper epithelialization in situ, what you should do: A. Amputate toe B. ulcer Debridement C. follow up D. Repeat biopsy
D
Patient underwent total hysterectomy with bilateral oophorectomy what to give her? A-Estrogen patch B-lUD C-OCP (Progesterone and estrogen) D- Progesterone only pills
A
A boy was playing football and felt sudden pain in his groin while kicking the ball or aiming to the goal smth like that, there is a swelling at the groin but no cough impulse and not reducible, vitals showed fever and wbcs were high, whats ur management? A. aspiration to rule out hematoma B. give analgesics and check after 8 hrs C. surgical exploration for hernia D. force reduction manually or smth like that
c

A pregnant patient GA around 37 or 38 weeks came with labour , with contractions and cervix dilated and effaced. A picture of urinalysis showing positive ketones and Proteinuria and glucose. No vitals mentioned, the did not mention if she has gestational diabetes or not. What is the most appropriate management? A- Induction of labour B- Discharge and follow as outpatient

📝📌Note to remember

When to deliver in case of Diabetes Mellitus? (ACOG)

-  At 39+0 to 39+6 weeks if well-controlled glucose levels and no vascular disease;

-  At 36+0 to 38+6 weeks if poorly controlled glucose levels or vascular disease (even earlier if severity of complications warrants earlier delivery)

-  Expectant management beyond 40+0 weeks is not recommended

 

 

Delivery before maternal stabilization should be avoided!!

 

For this patient the correct answer is to manage the DKA (by insulin and hydration) and stabilize the mother!

-> Then induction of labor after correction of her status.!!

 

If IV insulin and hydration in the choices I would choose it. If not? IOL

حليتها على أساس ان قصدهم من كلمه the most appropriate  انه وش مفروض اسوي بعد ما اعالج ارتفاع السكر؟ هل اتركها ولا اولدها؟ والجواب توليد

والاصح طبعا اني اعالج السكر المرتفع!!

 

Dr.wafa

Patient with signs and symptoms of hyperthyroidism , painful goiter , labs shows ESR : 58 , diagnosis : Subacute thyroiditis Sick euthyorid Others irrelvant
a

A Elderly patient with left lowr quadrant abdominal pain for few days associated with constipation and fever. What is the most appropriate next step? A- sigmoidoscopy B- colostomy with anastomoses C- explaratory laparotomy

If its diverticulitis case then CT
If volvulus then reduction by sigmoidoscopy

Ecg of hyperkalemia and the scenario mentioned the level of hyperkalemia asking about initial thing to give ? A- ca gluconate B- Insulin C- na bicarbonate

a

Case of croup what appropriate mx: Dexamethasone Predsnoloe Racemic epinephrine
A
14 YO male presented to ER with history of diarrhea for 3 months. Associated with abdominal bloating and loss of subcutaneous fat. What is the best treatment? A. Hydrolyzed diet B. Gluten free diet C. High caloric diet
B
33 ga came with fever , rigor loin, rigor and has had 2 uti this pregnancy what will you do ? mri pelvis x ray spetic screening
C
Hyperthyroid symptoms for 10 days, labs show high ESR 58, what is the most appropriate management? A-Methimazole B-Steroid C-PTU D-Radioactive Iodine
C
Female presented with the current attacks of palpitation / sweating and fear of Family gathering with another Sx ( I think social phobia) Management? 1-benzodiazepines 2-TCA 3-SSRI
C
Middle-aged female palpitaion and weight loss. On examination, there was irregularly irregular pulse and fine tremor. ECG showed Atrial fibrillation. Which of the following is Important investigation? A. Thyroid function tests B. CBC
A
pregnant in labour on at term. OE (describe breech . As head in funds and filix both hip and knee ) spine pf baby parrele to spine of mother. What is the lie.( Atention ask for lie not presentaion)??? A.longitudinall B.transverse. C.breach D.cephalic
A
Patient with renal impairment has the following findings (on dialysis I think) K 6.4or6.5 but definitely 6 ECG: Tented T wave A. Immediate hemodialysis B. Ca gluconate
B
patient complaining of chest pain, diaphoresis and other symptoms of Ml that started 2 hours ago. He has a history of ischemic stroke (2 months ago). what would you give him next? ] - Thrombolytic Therapy - Aspirin – PCI – Statin
C
42 man came to hospital complain of SOP, fever and fatigue for few days, physical examination rise JPV pulsus paradoxus And distant heart sound Which involve? A. Valves B. Pericardium C. Myocardium D. Coronary artery
B
Sickle cell trait, what’s the most common complication during pregnancy? A- IUGR B- Chest infection C- Preeclampsia D- UTI
d
25-year-old man presented to the Emergency Department with severe pain during and after defecation for 3 days associated with passage of a small amount of fresh blood after defecation. Physical examination confirmed an acute posterior anal fissure. Digital and proctoscopic examination were not performed due to the anal pain. Which of the following is the most appropriate management? A. examination under anaesthesia B. lateral internal anal sphincterotomy C. chemical sphincterotomy with diltiazem D. botulinus toxin paralysis of anal sphincter
C-Schwartz: first line management of Anal fissures is usually to minimize the trauma incidence by bulk agents, stool softeners, warm baths and analgesic cream. CCB ( as Diltiazem ) helps to heal the fissures and have fewer side effects. Failed Medical therapy? Lateral internal sphincterotomy is recommended.
Pt with high cholesterol, triglycerides and TSH. T4 was normal. What is the best medication for her Dyslipidemia? - Statin - Thyroxin - Niacin
A
Man with HCV and cirrosis presented with ascites , and his WBCs is high (>20 thousand ) the patient was unstable his BP is low what is your next step? -ABx -labroscopy -ex laboratomy
a
23-year-old Primigravida, 30 GA admitted as a case of threatened preterm labour. In which she received corticosteroids. What’s the rationale of giving it? A. VII injury B. Pneumothorax formation C. Incidence of hypoglycemia D. Respiratory distress syndrome
d
Case of child falling with open femoral fracture : A_ external fixation B_ internal fixation C_ surgical debridement D_forget 🤷🏻‍♂️
C
36 year-old female presented with left neck mass 2x2cm in posterior angle of mandible. US: Normal thyroid, left large LN with cystic component. FNA: All smear shows follicular thyroid What is the most likely diagnosis? A. Metastatic thyroid cancer B. Apparent thyroid C. Ectopic thyroid (in the pathway of thyroid ) D. Thryoglossal cyst
A

32 male patient, develop sever hypovolumic shock due to traumatic splenic injury, managed by splenectomy. In the operation he received 8 unit of blood, then transferred to the ICU. On the 3rd day he became febrile. Blood culture : positive for gram negative bacilli What is the most probable source of infection ? A- contaminated blood B- respiratory tract infection C- urinary tract infection D- from intestinal source

C Gram negative bacilli can be E.coli so UTI

45 year old male smoker had an adenoma removed from his colon. Pathology report shows a benign lesion. What advice should you give this patient to prevent him from getting colon cancer? A. Eat a low-fibre diet B. Eat a high-protein diet C. Colonoscopy every year D. Stop smoking and start exercising
D
After resection of a pedunculated polyp the results was benign adenoma and patient has no family history of colon cancer what to advice for reduction of colon cancer? A. Prophylactic sigmoidectomy B. Prophylactic colectomy C. Annual colonoscopy D. Lifestyle modification (healthy diet and exercise)
D
Tracheal deviation to the left and dullness on the right side:- 1-pleural effusion 2- pneumonia 3- pneumothorax
a
Patient with excessive vomiting electrolyte changes -hypokalemia -increase K in urine -metabolic acidosis -respiratory alkalosis
A
Male patient came with scalp open wound, after 6h assault, what wound management? A. Secondary closure B. Debridement with Primary closure C. Debridement with granulation D. Leave it for granulation
b

Patient came with new onset of LBBB ( given dx ) what to the most appropriate next step ? ⁃ Give carvidolol ⁃ Give warfarin ⁃ Give thrombolytic ⁃ Wait for the cardiac biomarkers results

D

What is true about celiac disease? A biopsy has no role in diagnosis B can’t affect adults C simple blood serology can confirm diagnosis D successful treatment of gluten free diet consider diagnostic
a gluten free diet shoud not be facilitated ithout proper diagnosis, biopsy HAS a role in ddx and it can affect adults, c by exclusion
Long case of patient flank pain. US of the kidney showed Hypoechoic acoustic shadow. Diagnosis? A. Blood clot B. Uric acid stone C. Renal papilloma (Didn’t catch the full name)
B

Child with Sx of tracheomalacia How to confirm the diagnosis? A) chest XR B) bronchoscopy C) Fluoroscopy

B

recurrent pregnancy loss in 1st. Trimester with Hx of theomebolism A- warfarin life long B- enoxaparin life long C- aspirin life long D- fandiprix life long

A.

If pregnant or planning to get pregnant switch to enoxaprin

Pt with rheumatoid arthritis and got infected I think it was pneumonia Then after treatment pt have deteriorating kidney function with blood in urine What is the cause of deterioration of the kidney function pt was given cefuroxime for treatment of an infection 1) renal vasculitis 2) prerenal failure 3) immunecomplex glumriolonephritis 4) I think interstitial nephritis
D

A doctor used the Foceps, place it in wrong position and injured the stylomastoid bone, what is the result? A.Baby cannot close his left eyes B.Loss of taste in anterior ⅔\

This Q was repeated a lot.

 

Stylomastoid foramen is the place where the fibers of the facial nerve passes.

 

Responsible for ( Taste ) of the Ant 2/3 of the tounge.

Responsible of ms that closes the eye.

 

The recaller may have missed some important details in the Q.

If choice B says ( Sensation ) of the tounge not the taste it will be wrong. And the answer will be A.

 

If The injuried foramen is the left and choice A was Right eye it will be wrong because it’s ipsilateral and answer will be B.

 

Or: maybe it’s not a bad recall and both are correct.

3 months boy circumcised presented with febrile UTI … what the most appropriate management? 1-Renal US 2-MCUG
A

A diabetic lady presenting to the clinic asking about travelers diarrhea prophylaxis. Mild Cr Elevation, BUN is high, urea is high. What prophylaxis to give? A.Fluoroquinolones B. No need ✅ C. Probiotics D. Bismuth

b 

If renal impairment with severe dehydration the answer is A.

 

Mild renal impairment is not an indication for travelers prophylaxis.

5 years old girl with history of recurrent vomiting. What is the next initial management: -Notmal Saline -Ringer Lactate -Potassium Chloride
A
A healthy young lady just delivered a baby 6 months ago. However, she tells you that she does not want to get pregnant for the next 2 years. What method of contraception will you recommend? a. Combined OCP b. Depo Provera injection C) male condom D ) vaginal ring
B
What the best way to reduce weight? 1-excessive exercise 2-low carb diet 3-life style modification 4-bariatric surgery
C
Elderly with Long history of diverticulosis, with sudden pain Ct showed thickend sigmoid fluid collection and air in peritoneum Stable Most important management? Colonscopy Exploratory lap Diagnostic lap Ct guided drain
B
elderly, epigastric pain for 3m, wt loss, jaundice and dark urine There was dilatation of intrahepatic and extrahepatic duct Labs: cholestatic picture (They did not mention if the gallbladder is palpable or shrunk :) ) A. Klatskin tumor B. Gall bladder cancer C. Ampullary cancer
C
patient diagnosed with schizophrenia and started treatment , what is true about his prognosis ? 5% have remission Most will have remission? 70% will have good quality of life 33% will reduce ssx
d

Highest risk factor for ednodemtrial ca?

untreated pcos, 

40 YO female has heavy menstrual bleeding, came to the clinic and she was diagnosed as a dysfunctional uterine bleeding. what is the treatment -OCP -D&C - Hysterectomy

A The answer is OCP .. She came to clinic not ER , D&C will be the last option

38 YO female presents to the clinic after finding of hilar lymphadenopathy on CXR. She has on and off cough, but denies any fever, headache, n/v, weight loss all negative. Labs insignificant except for X-ray shows confirmed bilateral hilar lymphadenopathy CT guided biopsy shows noncaseating granuloma What is the best next step in management (They wrote “all labs were normal” and didn’t mention hypercalcemia) A. Observe B. Start prednisolone C. Start azithromycin D. Start anti TB medication

A

Male presents with peptic ulcer resistant to medications, with positive secretin stimulation test, what is the diagnosis? a) VIPoma b) Glucagonoma c) Gastrinoma
C
epidemiology of dengue fever which region is the highest western eastern northern
A
4 years old child came post URTI 2 days ago complaining of SOB Wheezing, RR 33, HR 100, O2 82% other vitals normal (not sure). Parents said that he had multiple previous hospitilization due to same reason . What is mangment ? A. ABx and systemic steroid B. IV fluid and ventolin C. Ventolin and systemic steroid D. ABx with something (I don’t think it was Ventolin)
C
Pregnant women Last menstrual period 7th of May, she has regular period and is sure about it. What is the Expected date of delivery? A. 10 February next year B. 10 December same year C. 25 December next year D. 30 February next year
a
Recommended frequency of pap smear for cervical cancer ? A- every 2 year B- every 3 year
B
Elderly with a lot of comorbidities her A1C is currently 7 but she was between 8-9 in the previous years so we had to add insulin above metformin that she was taking. She is presenting with distal symmetrical neuropathy. She is taking glargine, aspart, and lisinopril. What should be done/given? (No labs were given) A- tighter A1C control B- vitamin B12 C- amitriptyline
C

Patient with thyroid mass measuring 2*3 on one lobe, patient is asymptomatic, TSH and T4 are normal, Bethesda 4, what’s next step in management? A. Hemithyroidectomy  B. Nodule excision C. Total thyroidectomy

a

Patient with Low TSH and high T3 and T4 Symptoms: palpitation and heat intolerance What’s the diagnosis ? 1- Thyrotoxicosis 2- sick euthyroid syndrome 3- Primary Hypothyroidism 4- something unrelated
a
DIC with: Uterine rupture Placenta privea Placenta abruption
C
hematemesis with abdominal pain first time no previous symptoms no medical hx no medication , all lab normal, dx? Gastritis , peptic ulcer, immune hepatitis, mallory weiss
b
Patient presented with abdominal pain for 1 day intermittent, right sided pain and fullness and rigidity Pregnancy test is negative (she was hypotensive and had fever) A- Appendicitis B- Ectopic pregnancy C- Ovarian tors
C

child came post URTI 2 days ago complaining of SOB Wheezing, RR 33, HR 100, O2 90%, other vitals normal (not sure). What’s most appropriate management? A. ABx and systemic steroid B. IV fluid and ventolin C. Ventolin and systemic steroid D. ABx with something (I don’t think it was Ventolin)

c

 

Case of native valve endocarditis what is best empirical treatment? A) Gentamicin B) Vancomicin C) Ceftriaxone D) Ceftriaxone and vancomicin
D
24 years old with history of appendectomy 5 years ago presented with abdominal pain, distention and vomiting for 3 days, CT scan revealed signs of intestinal obstruction & peritonitis. What agent is contraindicated in this patient ? A-propafol B-nitrous oxide C-sevoflurine D-ketamine
b
32y female present with 4cm fibroadenoma with hyperplasia and atypia What is the most signeficant risk factor for breast cancer? A. Her age B. Present of hyperplasia C. Present of atypia D. Fibroadenoma size
C
A long scenario of a female (26 Y.o) came with right lower quadrant pain with no rebound. WBC: High U/S: Inclusive What will you do next? A- Abdominal CT B- Diagnostic laparoscopy C- Open Appendectomy
A
Drug that decrease the incidence of diabetes ? -metformin -Liraglutide
A
patient on 4 anti hypertensive meds yet his BP is high Renal imaging Asymmetrical kidneys Choices -primary hyperaldosteronisim -renal stenosis -adult poly cyctic disease
B
6 years old child with long history of multiple lower respiratory infection and rhinitis admitted with respiratory symptoms bronchoscope done, sputum collection done and culture was positive for pneudomonus aergunosa and ? What is the cause 1-primary ciliary dyskinesia 2-cystic fibrosis 3-bronchial asthma 4-!
b
23 years old male, have proteinuria & was diagnosed with nephrotic syndrome 2ndry to minimal change in glomerulonephritis (written exactly like this). What is the most appropriate treatment to decrease protein levels in the urine? A- Prednisone B- ACEi C- No treatment needed D- forgot but irrelevant
A
pediatric patient came with pain and redness in Rt hemiscrotum , on examination , there is bulging or something like that extended from scrotum to inguinal area , tender , red , Rt testes not palpable , what is the Dx? A-testicular torsion B-testicular appedoges torsion C-epidydemoorchitis D-incarcerated inguinal hernia
D 4 Diseases that usually comes together in the choices Epididymo-orchitis Testicular torsion Appendicular torsion Inguinal hernia How Can I differentiate? Let’s take them one by one. ◻️ Epididymo-orchitis: - Gradual pain in the scrotum Usually >24h. - Tender edematous cord - Red scroutm - Fever, Dysuria, urethral discharge can be present - High WBCs and inflammatory markers. Mx: Antibiotics. ◻️Testicular torsion: - Scrotal pain less than 12 hours ( مهم ) لانه بعد ١٢ ساعه يصير Necrosis ومايحس بالالم. - Previous episode or trauma. - High riding testis ( Horizontal ) - negative phren sign and absent cremasteric reflex. - Low doppler flow Mx: Surgical exploration ASAP. ◻️Appendicular torsion: - Tenderness over the upper pole - Vertical ( Longitudinal ) testis - Blue dot sign Mx: NSAIDs and Rest. ◻️Inguinal hernia: - Mass extended to the groin.
60y old lady present with lower genital bleeding, she described it as Scanty and barely stain the pad , what is the source of bleeding A- Fallopian tube B- Ovary C- Uterus D- Genital tract
C
Pt have unilateral neck pain that increase and become like electeric shock from neck radiate to shoulder also develop weakness in the arm Whats cause? 1 cervical disc prolapse 2 polymyalgia rheumatica
a
Married for 3 years, off contraceptive since 18 months and still didn’t get pregnant A. IVF B. Induction ovulation C. Infertility investigation for both wife and husband D. Continue trying
c
Young female has a history of multiple miscarriages, came to complaining that she want to conceive and want to receive all types vaccinations. Her B-HCg is positive. What to give her? Measles Rubella Influenza
C
81 year old male presenting with memory loss and difficulty remembering grandsons name, medically free apart from occasional alcohol intake. What is the likely diagnosis of his presentation? A) Multi Infract Dementia B) Alzahimers Disease C) Alcohol Induced encephalopathy D) Parkinsonism with Dementia
B
CKD 2nd stage scenario, lab show LOW HB + <80MCV WHAT IS APPROPRIATE TEST TO DO IRON LEVEL Erythropoietien Bone marrow Reticulocyte
a

Female came to ER with sign and symptoms of appendicitis, appendectomy was done , surgeon discover the appendix was normal , what surgeon should be do ? A. Tellptwhathappenedandthatwasroutineandnocomplication B. Not tell the pt C. Write report about what happened and give it to hospital committee

a

Pregnant lady K/O SLE controlled on HQ, mycophenolate motefil. Asking about what drugs adjustment should be done? — stop Mycophenolate and give methotrexate — stop Mycophenolate and give azathioprine
B
The goverment is aiming for "Health for all" (not sure) with 2030 vision by decreasing the mortality rates among 5 years old children and younger. And that is achieved by: -Health education -Immunisations
B
37 weeks in active labor dialted 4cm intact membrane. CTG is normal except for recurrent variable deceleration. Next step? A. CS B. ROM C. Observe D. Give tocoloytics
c
Case of Malignant phyllodes tumor (Dx is writen). Mass size was 10x12 cm What is the most appropriate? Wide local excision Chemotherapy CT chest * with * contrast Radiotherapy
A
Chronic non bloody diarrhea+fatigue+microcytic anemia+thrombocytosis+wt loss 10 kg and no fever, tt? (That is it, no hints of any disease that I could find) 1- glutin free 2-metronidazole 3-ppi 4-loperamide
a
A young female on labor GA 38/40. Her pregnancy was normal, uneventful, with normal fetal development. The labor was normal but the was difficulty delivering the placenta which complicated with uterine inversion accompanied with vaginal bleeding 1200cc. Which of the following is the source of her bleeding? A- Trauma blood vessels B- Muscular injury and laceration C- Uterine muscles fail to contract
c
female with ovarian cyst what kind of oral contraceptive a-OCP b-progesterone only c-male condom d-vaginal ring
A
Female had gastroenteritis and she took metoclopramide that leads to involuntary movement facial grimace and tongue protruding what to give how to manage ? A. Diphenhydramine B. Epinephrine C. Cyproheptadine D. Tizanidine
A

Child with Supracondylar fracture, he has absent pulse, Next step? A, K-wire Fixation  B, Explore

First step is Urgent reduction

If Hot and warm — K wire.

If Cold and pale — Exploration.

 

Here the answer is A.

8 weeks baby presented with fever, feeding difficulty, dyspnea and tachypnea for two weeks, she was healthy prior to her presentation apart from a pansystolic murmur, xray shows cardiomegaly and increased pulmonary vascular markings. What is the initial/next step? A- refer for surgical correction B- manage medically with diuritics C- icu with full course of abx?
B
Sickle cell trait, what is the most common complication during pregnancy? A-IUGR B-Chest infection C-Preeclampsia D-UTI
d
Elderly patient presented with retroperitoneal haemorrhage. History of Hodgkin lymphoma. What’s the diagnosis? A. Lymphosarcoma B. Liposarcoma C. Sarcoma
B
55 y.o Patient k/c smoker only. Presents with signs and symptoms of MI. ECG shows lead II,III,AVF depression. Hist vitals are: BP: 150/92 Pulse: 99 Which of the following is the most considerable risk factor for MI in this case? A. HTN B. Smoking✅ C. Age
B
Pregnant 20 weeks with with two previous histories of preterm labor. Her current pregnancy is uneventful and her cervix is closed, cervical length is 30 mm and Positive fibronectin. What will you do? Immediate cerclage Progesterone supplement
B

Pt k/z DM present with perianal painful swelling and us fever, T 38 on DR exam you found posterior fullness with mimimal discharge, Dx ? A-Abcess  B-Perianal fistula C. Thromposed pile

A

Man come to the ER for poly Trauma and he was intubated after resuscitation admitted to the ICU what is the best approach to exclude cervical spine injury and remove neck collar? A. MRI neck B.Ap and lateral x-ray neck C. Clinical judgment D. Ct neck 

d

scenarios about a child 2 years old with SOB and Expiratory wheeze and other respiratory symptoms he had a viral illness 2 days ago A.Respiratory monitoring for hypoxia B. Inhaled epinephrine and steroids C. Intubation and antibiotics D. SABA

A

19 yrs old dysmenorrhea resolve on 3rd day and resolve after few , Sxs associated with sever pain radiated to upper thigh, she had this for several years and getting worse A- Primary dysmenorrhea B- premenstrual C- secondary dysmenorrhea D- endometriosis
A
Pt in his 60’s came with flank pain and hematuria, tender mass in lumber region his vital BP= 160/90 What’s the most diagnostic investigation ? A-US B-CT abdomen C-MRI D-Radionuclides
B
39.Female with vaginal discharge, examination reveals straw cells s A- BV B- CHLamydia C- Trichomonas vaginalis.
C
37-Patient after Motor vehicle accident at ER, on examination showed generalized tenderness What is the Most Appropriate management? A.CT B.FAST C.DPL D.Laparotomy
B,
Pt present with constipation small intestine obstruction, imaging showed 3 stricture on the proximal ilium, Dx ? A-Crohns B-GI Stromal tumor C-Intestinal lymphoma
A
Child with low grade fever and sudden onset of stridor: A: epiglottis B: tracheitis C: tonsillitis
A
11 month old child, brought by his parents they reported a 1 day history of fresh blood in stool associated with foul smell and dark brown stool on examination the child was pale (they didn’t mention pain or any abdominal examination), What’s the best diagnostic tool: A- barium enema B- barium meal C- radioisotope scan D- US abdomen
C Painless lower GI bleeding is the most common symptom of Meckle’s diverticulum. Another Q: Best diagnostic tool? Nuclear scan as Radioisotope scan
Middle aged female patient with history of myomectomy. in operation note: they enter uterine cavity during surgery. What is the most likely developed in future pregnancy? A. Placenta previa B. Placenta acreta C. Placenta Increta D. Placenta percreta
b
Kayser-Fleischer Ring … ask about mx > D-penicillamine, MGSo4, iron supplement
A
65 years old man admitted for elective ventral hernia repair, K/C of hypertension and BA, upon examination bilateral crepitation, ascites and bilateral edema, what to do? A- Proceed with hernia repair. B- Don’t repair unless obstruction has occurred C- Delay until situation is controlled.
ذا جاني فالاختبار.. طيب عشان تفهمون ليش حطيت B ركزوا معي Smoking Obesity Diabetes COPD Asthma Congestive heart failure All of these are relative contraindications to elective ventral hernia repair. Relative contraindications means: You don’t repair the hernia unless incarcerated or strangulated. As elaborated in this case patient has asthma and signs of congestive heart failure. DrThawabah also agrees with this answer ✅.
78 YO post-op contaminated surgery. Admitted to ICU and given 6 L of crystalloid IVF and 1 PRBC in the last 12 h. Broad spectrum antibiotics were given. , CVP is 40”over fluid treatet = no hypoVoluimia” 8-12 Vitals: BP 70/45 HR: 125 T: 38.6 O2: 93% Labs: WBC 8 Most appropriate IV intervention: A-albumin B-2 L crystalloid fluid C-norepinephrine C-frusemide
C
Child with recurrent infections did chloride sweat test and it was positive, which complication is common in this condition? A- malignancy B- bronchiectasis C- lung emphysema
B
30 week GA pregnant woman had pprom 3 days ago, now presented with fever and abdominal pain, what is the mangement? A- gentamicin, ampicillin, deliver B- gentamicin, ampicillin, observe C- observe D- find the cause of fever and treat accordingly
a
2 week history of epigastric pain, fever and jaundic with BP 90/60 and amylase is 1400:- 1- pancreatitis 2- cholngitis
a]
45 year old female is having amenorrhea since 6 months and want to get pregnant what is the appropriate test: FSH Endometrial biopsy US
A
Case of baby with Acetaminophen toxicity with s/s came after 1 day what to do ? A-Nac B-Charcoal
A
8 years old boy. Mother complained of poor training to bathroom which muscles is targeted in therapy? A- Perianal B- Pelvic floor C- Rectus muscle D- Detrusor
D , repeated
Mangmenent of polynephritis in pregnant Admission and Iv antibiotic, oral
A
8 years old boy previously healthy, Presented with fever, bruising and pain on both legs. On exam he is pale, has ecchymosis & petechiae all over his trunk, neck & face. His labs: HgB 67 (low) WBC 28 (very high) Plt 40 (low) What is the appropriate diagnostic test? A- Bone Marrow Biopsy B- Coagulation profile C- Liver US (or CT liver not sure) D- forgot i think some blood test maybe C3 levels not sure
A
At which age can we give peanuts and eggs to babies to prevent the risk of getting allergic? A. 10 months B. 14 months C. 18 months D. 24 months
A
11 month old child, brought by his parents they reported a 1 day history of fresh blood in stool associated with foul smell and dark brown stool on examination the child was pale (they didn’t mention pain or any abdominal examination), What’s the best diagnostic tool: A- barium enema B- barium meal C- radioisotope scan D- US abdomen
C
5 years old boy dehydrated Sunken eye , skin turgor , delayed capillary refill etc.. the doctor establish IV access and take blood samples for electrolytes What your management? A- NS 20ml per Kg bolus B- start fluid maintenance waiting for electrolytes
a
10 weeks pregnant complaining of biliary colic for the past 5 weeks. What is the most appropriate management A - Laparoscopic cholecystectomy now B - Laparoscopic cholecystectomy after delivery C - Laparoscopic cholecystectomy in second trimester D - Laparoscopic cholecystectomy in third trimester
C : Biliary and Pregnancy: - If the pregnant women had first episode of “ Biliary colic” the Management is Conservative. - if the pregnant women had recurrent attack of biliary colic the management is Lap chole at the 2nd trimester. - If the pregnant women had first attack of “ Acute cholecystitis “ the management is Lap chole at the 2nd trimester. 1st trimester is always conservative management. If in 3rd trimester delay the procedure after the delivery.
Female just gave birth 2 weeks ago and was having GDM and family history of DM type2 and came for screening HBA1C was 5.5 Fasting was normal And she is obese What drug to give? Metformin Acrobose Glucagon-like peptide-1 Insulin
c

Diabetes millitus Risk ratio is 0.83 among patients who drink green tea (exposed) and patients who drink black tea (unexposed). A- green tea drinkers have lower risk of dm  B- black tea drinker have higher risk of dm C- getting dm among both groups is unrelated/accidental D- no different between both are the same