For rahaf

25 years old Patient came to ER with SOB after exercise, he had history of intermittent SOB, on exam there are wheezing in all chest, most appropriate treatment? A-inhaled salmeterol B-inhaled fulticasone C-IV cortisone D-IV magnesium sulfate

this patient came to the er, he hasn’t been diagnosed with asthma nor is he taking any medication for it, A and B are LABA and we wouldn’t give iv steroid as first line. First thing we do is give O2 and SABA(albuterol) and oral corticosteoids if no response

Patient with cushing syndrome will go for surgery for adrenal tumor, what you will give before surgery? A-IV hydrocortisone B- IV fludrocortisone

A

Patient came for routine f/u and did CT scan,accidentally found 1 cm lung nodule , he’s smoker. The mass was 1cm with sharp borders. No symptoms A- Biopsy B- Surgery C- No follow up D- Follow up ct 3 to 6 mo

a

35 years old female her father has colon cancer when he was 55 and her mom had breast cancer when she was 43, asking about screening? A.She should do mammogram annually B.Start mammogram at 40 C.Start mammogram at 40 and colonoscopy at 55 D.Colonoscopy at 50

A

Male patient came to ER with right femur shaft fracture, Hemodynamically stable, no other injuries. what is your priority? D.Pain management B. Blood control C.Maintaining function D.Decrease soft tissue trauma

B

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

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

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

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

Case of hydated cyst and ask about definitive treatment? A- albendazole B- surgical deroofing C- percutaneous drainage D- liver resection

B

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 D-Furosemide

C

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

30-What type of polyp with highest risk of cancer? A. Villous B. Tubular C. Tubulovillous

A

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 had chemo session then developed signs of infection diagnosed as deep aspergillosis What is the treatment of choice for aspergillosis? A.voriconazole B-meropenem

A

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

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

6 m boy presented with abnormal movement and yellowish discoloration for 1 week. He is exclusively breast feeding 2 week ago his mother started to introduce fruit and fruit juice, since that, pt started vomiting, irritable, On examination: Hepatosplenomegaly, Distended abdomen Generalized jaundice * Urine: positive reducing substances (normal is negative). Dx? A Tyrosinemia B galactosemia C Alpha 1 anti trypsin def D congenital fructose intolerance

D

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

Pt came with signs and symptoms of TB fever hemoptysis and so on… You did x-ray and found cavitation What will you do next? A-sputum AFB B-start INH, rifampin, ethambutol and pyrazinamid

a.