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Question 1

Recurrent cellulitis in the limbs causing skin thickness

Answer 1

Chronic lymphedema

Question 2

When to screen for ladies for breast cancer

Answer 2

From 50-70 every two year

Question 3

Common organism causing otitis externa

Answer 3

Pseudomonas, staph

Question 4

When patient comes with alter mental status and high glucose >600 , high osmolairatity , and normal bicarbonate and anion gap ,,,, preceded by infection , steroid,

Answer 4

Think of HHS

Question 5

Hypercalcemia and metabolic alkalosis with hx of anti acid

Answer 5

Malik alike syndrome

Question 6

Women with osteoporosis >65 . Should be started on

Answer 6

Biphospante with dietary supplement , and to stop it after 5 year

Question 7

How to diagnose Cushing syndrome

Answer 7

Low dose dexa suppression test
24 hr urine cortisol excreation
Late night salivary cortisol assey

Question 8

Patient his DM not controlled has early satiety (gastroparesis)

Answer 8

Give him metclopromide

Question 9

Patient on ocp or pregnant shows high thyroid hormones why

Answer 9

Due to increased thyroid binding globulin

Question 10

Patient postpartum present with hyperthyroidism what’s is the treatment

Answer 10

Beta blocker only

Question 11

Patient started on anti hyperthyroidism meds after one week presented with fever what’s next

Answer 11

Stop the meds and check WBC

Question 12

Hyperthyroidism with normal radiouptake scans ?

Answer 12

Painless thyroditis

Question 13

Patient from 35-70 year with BMI >25

Answer 13

Should be screened for DM

Question 14

Patient diagnosed with syphilis and started on treatment and presented within 48 hr with fever rigors and myalgias

Answer 14

Acute reaction post treatment (jarxsh hexicular reaction )

Question 15

Prolonged and profuse travel diarrhea caused by

Answer 15

Cryptosporidium parfumerie , cyclospora , Gardia

Question 16

Solid organ transplant should be receive prophylactic ABX ?

Answer 16

Bactrim

Question 17

Episodic flushing , chronic diarrhea, tricuspid regurgitation, bronchospasm , telanagioectesia

Answer 17

Carcinoid syndrome

Question 18

Fatigue and priuritis in IBD patient next step

Answer 18

MRCP to R/O PSC

Question 19

Patient came with osteoarthritis on clinical exam next step

Answer 19

Nothing (no need for x ray )

Question 20

If you highly suspect cartel tunnel syndrome, with negative tinsel and phalanx test next step

Answer 20

Nerves conducting study

Question 21

Patient you suspected polyarthritis rhumatica (symptoms of hips and shoulders pain and stiffness in elderly next step?

Answer 21

Nothing (except if patient symptoms of giant cell do biopsy)

Question 22

Patient with shiny skin , telangiectesi, came with high bp and confusion found to have high creatinine?

Answer 22

This scleroderma renal crisis which treated by ACE inhibitors

Question 23

Possible complications of giant cells artritis is

Answer 23

Aortic anyuresm

Question 24

Before starting methotrexate screen for

Answer 24

Hep B , c

Question 25

If you suspected RA also think of viral infection , with short period of time and exposure to childrens , patient usually a symptomatic with normal EST

Answer 25

Like P19

Question 26

Erythema nodosum without other complaints next step

Answer 26

CXR(to R/O sarcoidosis)

Question 27

Dermatomyocytitis associated with

Answer 27

Malignancy (adenocarcinoma)

Question 28

Knee pain with quiderceps atrophy .¿

Answer 28

Patella femoral pain syndrome

Question 29

Elderly with irritative urinary symptoms with microscopic hematouria

Answer 29

Bladder cancer , should be role out

Question 30

Transfuse high amount of blood in patient and patient develop hyper reflex ia , and numbness. ?

Answer 30

Due to hypocalcemia

Question 31

In case of tympanic membrane rupture nex step

Answer 31

Wait it will heal with weeks

Question 32

Any hematoma should be

Answer 32

Evacuated due to risk of infection

Question 33

Patient with mass in the tonsils causing you should suspect malignancy even in young which associated

Answer 33

With Hpv

Question 34

If you suspect tension pneumothorax next step?

Answer 34

Needle decompression before cxr

Question 35

Budding yeasts in the blood cultures,

Answer 35

candidiasis albicans Should be treated empirically as all , and remove the central line if it available, to do opthalmic evaluation for septi Foch , and may consider echo

Question 36

Patient came with hypotension , acidosis

Answer 36

You should suspect sepsi give aggressive Iv fluids and I’ve abx

Question 37

Burn wound infection treatment?

Answer 37

Vancomycin and meropenm or tazocin to cover pseudomonas and staph

Question 38

Cystic hepatic lesion with eggshells calcifications

Answer 38

Hydatid cyst

Question 39

Common organisms for puncture wound

Answer 39

Staph , pseudomonas

Question 40

Which abx should be avoided in patient known case of aortic aneurysms

Answer 40

Flouroquinolons

Question 41

Someone healthy after starting Anasthesia become hypotensive and unresponsive to fluid

Answer 41

Think of adrenal insufficiency

Question 42

High fever and distant heart sound and diffuse st elevation, ?

Answer 42

Purulent pericardial effusion