For rahaf

lady mised period which most appropriate time of us A. 11-13 weeks B. 16 - 18 weeks C. 18 - 22 weeks

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

9 month old child presented with rash noticed by parents , both parents had eczema before What is the typical site according the child age ? A- upper back B- diaper area C- scalp , cheeks, forehead D - dorsum of feet

C

Pt finish tx of h pylori today after 2 weeks using ppi when to do urea test A-After 2 weeks B-After 4 weeks

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- I forget but it’s suggestive for chronic limb ischemia B- intermittent claudication C- rest pain D- scar for iliofemoral bypass in left leg

C

12 y boy presented with 2 days of tenderness in upper pole of right testis with right scrotal inflammation (redness …),the testis is in longitudinal position (no high riding testis) diagnosis? A-Testicular torsion B-Appendicular torsion C-Cry..orchitis D- Hydrocele

B

12 y boy presented with 2 days of tenderness in upper pole of right testis with right scrotal inflammation (redness …),the testis is in longitudinal position (no high riding testis) diagnosis? A-Testicular torsion B-Appendicular torsion C-Cry..orchitis D- Hydrocele

B 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.

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

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

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 .

Baby came with clear picture of UTI and urine analysis showed UTI. Mum said she had these symptoms multiple times. What to do? A-Renal US B-Voiding cystourethrogram C-Renal US and cystourethrogram D-I think the last one was reassurance

c

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

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

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

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

20-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

B

A patient with DVT with ankle-brachial index 0.3 and occlusion size 3 cm. Treatment ? A- Embolectomy B- Stent C- tPA D- amputation

this question is weird, as ABI is used for PAD and is not indicated for DVT, anyways in dvt w would tart DOAC or VKA and in case of PAD Endovascular or surgical revascularization. If you have a better recall pleae share

Sle with neurological symptoms (the patient in the question was already in steroid) Cyclophosphamide ✅ azathrioprine mycophenolate

For rare patients in whom an acute inflammatory etiology such as CNS vasculitis is strongly suspected or confirmed, immunosuppressive therapies such as high-dose intravenous ("pulse") glucocorticoids and intravenous cyclophosphamide

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

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.