All q Flashcards
1
Q
Old patient, parkinsonism , visual hallucinations
A
Lewy body dementia
2
Q
Young male patient, DM has UTI + mrsa , which medication?
A
Vancomycin
3
Q
Most nephrotoxic anti tb
A
Rifampicin
4
Q
Most hepatotoxic anti tb
A
Inh
5
Q
Soldier go south region, what malaria prophylaxis to give?
A
Atovaquone/ proguanil
6
Q
Case of chronic diarrhea, blood culture shows c.diff
A
Oral vancomycin
7
Q
Pt with Htn and progressive memory lost and decrease cognitive function. MRI shows hyperintense lesion.
A
Vascular dementia
8
Q
Sharp, shooting pain of neck radiating to shoulder and jaw, what’s the diagnosis?
A
Cervical disk prolapse
9
Q
16 year old girl with acute migraine headache and nausea and aura. What’s the acute management?
A
Triptans
10
Q
Headache that is throbbing and unilateral aggravating with light and movement
A
Migraines
11
Q
Extraintestinal symptom of crohn disease
A
Erythema nodosum
12
Q
Interstitial pneumonitis causes
A
Viral pneumonia
13
Q
NF1 mode of inheritance?
A
AD
14
Q
Parameter that indicate LV function?
A
Bnp
15
Q
40 year old, diabetic female. Hx pruritis, vulva erythematous with white - grey odourless discharge. What’s the likely diagnosis?
A
Candida albicans
16
Q
In iron deficiency anemia which of the following will be high
A
TIBC( total iron binding capacity)
17
Q
Osteoporosis screening
A
65
In another Q,
Answer is 65-69
18
Q
Child throws ball at you, draws a straight line and stacks few cubes on each other. What is the age?
A
24 months
19
Q
child that can raise his head slightly when prone and
smiles. He turns his head
180 degrees and has head lag when you pull him to sit. How old is
he?
A
8 weeks
20
Q
Child can sit without support, cruises around furniture,
uses chair to stand, say
dada, crawl stairs. What is the age of this child ?
A
10 months
21
Q
baby can smile at which age
A
2 months
22
Q
child ride tricycle, but can’t copy square what is the age
A
3 years
23
Q
child can know color but with difculty in making
square
A
3 year
24
Q
Baby wave his hand bye bye which developmental
milestone reflect ???
A
9 month
25
what is the age of child should be know few word ?
12month/ 1 year
26
child can support his head when sit and loving when
stare to him or cooing
4 months
27
Developmental milestones 5 words, hop on one leg ?
48 month/4 years
28
Milestone, baby pull him self to stand crawl without
difficulty, which age
10 months
29
ER Child can roll over, sit triploid, attempt to take
object
Which month?
6 month
30
Child tells stories runs and plays father -role.. What's
the age?
4 years
31
Baby setting in mother’s lap unsupported, when the
doctor spoke the baby turned
around and laughed and babbled to the doctor, baby’s age?
6 month
32
18 months baby says baba mama what you will do for
him
Developmental assessment
33
Baby can walk when he held by one hand and good
pincer grasp but he can not put things in the bottle What is his age:
12 months
34
milestone baby can hold his head and when he looks
at his flying hand he laughs and coos ?
4 months
35
milestone said baba and walk holding furniture and a
lot of other features
12 month
36
infant sit in tripod position , role from prone to supine ,
reach object
6 month
37
Can't sit without support , coos and laughs
3 months
38
child can Know the color when you point at them, ride
tricycle but cannot copy
square what is his age ?
3 years
39
4 month child which developmental milestone ?
A- try to crawling
B- roll over from side to side
C- sit without support
✨ D- complete fixation of the head
40
development child walk alone & build three cup ?
18 month/1.5 year
41
Child say few words what age
12 months
42
child etc ... Can Not take the object in 2 fingers .. How
old is he?
6 month
43
milestone baby can hold his head and when he looks
at his flying hand he laughs
and coos
4 months
44
milestone said baba and walk holding furniture and a lot
of other features
10 months / 12/ not sure
45
4 y.o child , language development
Tell a story
46
child in the hospital play and come to his parents say
stories , draw head and hands
and legsط what is the age of this
child:
4 years or 5?
47
Child can walk without support ,crawling ,build 3
cubes point to something he interested in , so what is the age of the child ?
15 months
48
Say few words at the age of which ?
12 month
49
milestone > baby healthy run to the doctor play a role
model as his father can’t
complete a sentence can't eat with spoon
Run so should be more than 15 months?
50
child sit and support his head , laughing and cooing :
4 months or 6 , NS
51
baby sit briefly, crawl , move object from hand to hand ,
but no pencil grasp.
7 month
52
baby said hi when he entered the clinic, imitates his
mother, feeds his doll, refers to
himself “ME” and say “eye”:
18 months
53
A child that can raise his head slightly when prone
and smiles . He turns his head
180 degrees and has head lag when you pull him to sit. How many
old is he?
8 weeks?
54
Pencil grasp develops at
9 months
55
4 month child with developmental milestone ?
roll over from side to side
56
baby can sit roll from prone to supine and back play
handle object but can't pick things b/2 fingersage
6 months
57
Child can roll over ,sit tripod ,attempt to take object
Which month?
6 month
58
Milestone at 6 months
Rolls prone to supine
59
Smoking increase risk of ischemia by/
Risk of MI in a smoker compared to a non-smoker
2 times
60
Physical activity in adult
1/2 hour in 5 days
61
Rheumatic fever prophylaxis
carditis prophylaxis is for 10 years or until 21 years old whichever is longer
62
Lipid goal
Total cholesterol < 200 Triglycerides < 150 LDL < 100 HDL ≥ 60
63
Daily requirement of vit D
400 IU/ml
64
Mammogram can detect breast cancer before clinical examination by how many years
2
65
Smoking withdrawal peak
3-5 days
66
Colon cancer screen recommended grad A which age group
50 - 75
67
Colon cancer screen recommended grad A which age group
50 - 75
68
Colon cancer screen recommended grad A which age group
50 - 75
69
Colon cancer screen recommended grad A which age group
50 - 75
70
Colon cancer screen recommended grad A which age group
50 - 75
71
COPD O2 indications
SO 2 <90% or Pao2 ≤ 55 mm Hg
72
Brucellosis treatment duration →
6-8 weeks
73
Neurobrucellosis treatment duration →
6 months
74
Cancer of lung in smoker →
20-37 folds
75
screening of the uveitis in JIA
+ve ANA > 3 months. N.B: -ve > 6 months.
76
Best time to examine red reflex
birth or 6 weeks
77
HCV genotype in KSA
4
78
Intercostal space
Tension pneumothorax: 2nd mid clavicular line (using NEEDLE THORACOSTOMY)
® Chest tube: 5th
® Live need biopsy: 7th
® Thoracentesis: 8th-10th mid axillary line.
79
What are the sleeping hours associated with obesity→
< 5H or less 6 hours?
80
What is the percentage of smokers in Saudi Arabia
37% All, M only 21 %.
81
After colectomy due to colorectal cancer, how many months you follow up
3 m
82
Post-partum hemorrhage →
vaginal more than 500 → CS more then 1000
83
Ulcerative colitis when will do colonoscopy →
8y after diagnosis
84
Fecal incontinence which level is affected
Below T12
85
The degree of obesity in women based on the BMI, height 154cm weight 150kg
Obese grade 3
86
Confirm the h pylori eradication →
4 weeks
87
How long does a whooping cough vaccine last for →
10 years
88
Steeping reflex for baby disappears →
2 months
89
Overall deaths percentage due to postpartum hemorrhage →
25%
90
Blood bank storage →
Whole blood at 1°- 6°C (4°C). Platelet 20°-24°C (22°C).
91
Minimum volume of blood to do a culture is →
10 -20 ml
92
Peutz-Jegher syndrome (PJS) Familial adenomatous polyposis or Gardner syndrome
(FAP) screening time?
FAP annually → PJS start at age of 8 and every 3 years
93
HTN when to do screening at what age →
18 years
94
For how long you avoid airplane in Postural hypotension that caused by BB
2 weeks
95
Apgar score, at which score do you do resuscitation→
0-3
96
Pregnant women on chemo, at which age the child can get vaccination →
6 months
97
Infantile colic onset
Start at 6 weeks of age and goes away by 6 months of age
98
What time taken for patches on x ray of Lobar pneumonia to disappear →
6 weeks
99
What is the best time to do US to confirm GA →
11/14 or 14/16
100
How long should meningitis patient stay in isolation after antibiotics started →
12 hours
101
How long do you follow up an old patient with appendicular mass which was treated
Colonoscopy 6 weeks
102
When to screen for hyperlipidemia in low risk males →
low risk male 35, female 45.
→ High risk both gender 25.
103
Lung cancer risk increases with smokers for how many folds→
20
104
Boy has genital hair + scrotal darkening, what type of tanner stage →
4
Learn stages from gallery
105
Incidence of Down Syndrome with maternal age
® 40 ∼ 1:100
® 45 ∼ 1:30
® 50 ∼ 1:6
106
Vaccine at birth
- BCG
- Hepatitis B
BaBy
107
Vaccination at 2 months
- Hepatitis B
- Dtap
- Rota
- Hib
- IPV
- PCV
BIRD PH 2
108
Vaccination at 4 months
- Hepatitis B
- Dtap
- Rota
- Hib
- IPV
- PCV
BIRDPH 4
109
6 months
- Hepatitis B
- Dtap
- OPV
- Hib
- IPV
- PCV
BODHIP
110
9 months
- Measles
- MCV 4
M&M
111
12 months
- PCV
- OPV
- MMR
- MCV4
POMM 1 year
112
Vaccination at 18 months
- Hib
- OPV
- Varicella
- MMR
- Hepatitis A
- Dtap
HOVMAD
113
Vaccine at 2 years
- Hepatitis A
It's just A
114
Vaccine at 4 - 6 years
- Varicella
- MMR
- OPV
- DTap
**VMOD**
115
Live attenuated vaccine
Varicella
BCG
Rota
MMR
OPV
Very Big RoOM
116
Killed attenuated vaccine
Hepatitis A
DTaP
Hepatitis B
Hib
PCV
PH BAD
117
Best test for critical limb ischemia/ best to confirm ischemic arterial disease
- CT angio
118
Pt with picture of pcos what could be the cause for infertility?
Increased testosterone
Ovulatory dysfunction
119
Female pt came with pancreatitis picture then she was treated few days later she came with palpable epigastric mass (pseudocyst) what is the Mx?
- observation
- drainage
120
Least risk factor for gallstones
Nulliparity
121
Picture of trichomonalis infection how to treat?
Metronidazole
122
Couples came for fertility work up female has regular period what test you want to do?
21 progesterone
123
Picture of Turner syndrome with amenorrhea , the mother asks for simple test to do ?
LH/FSH
124
In the middle of an operation (do not remember but I think colon) pt started to bleed the surgeon called vascular surgery and he clamped an artery to stop the bleeding which artery?
Infrarenal
125
which of the following is an absolute contraindications for thrombolytic therapy?
-intracranial hemorrhage in the past 2 years
126
which of the following is contraindicated for Dtap vaccine?
- seizure
- encephalopathy
127
The site of thoracocentesis?
8th to 10th mid axillary line
128
Female pt with picture of preeclampsia which of the following would increase her risk for fetal
growth restriction?
GDM
129
pt with preeclampsia developed seizure what is the next step?
MgSO4
130
Pt with preeclampsia which of the following is a complication?
Fetal growth restriction
131
A female who is divorced had sickle cell child from first marriage, She is getting married what is the next step in premarital screening?
-Hb electrophoresis for the mother
-Hb electrophoresis for the husband
-Genetic testing for the mother
132
Pregnant smoker , best method for smoking cessation?
-Behavioral therapy/CBT
133
What is the most common cause of biliary colic?
Gallbladder stone
134
Farmer came to ER with severe abdominal pain and have green discharge after being hit by a wooden stick with . What is the most appropriate management?
Abdomen CT
135
Pic of sole hand spots and said in the q also he have same in sole of foot ask about the diagnosis?
Palmoplantar pustulosis
136
18 month have cystic fibrosis confirmed and the doctor suggest that he needs intubation, the family refused but other doctors suggest same.
Intubate
Same other q , but boy should be put in the?
Pedia care unit
137
Vaginal yellow discharge diagnosis?
Trichomoniasis
138
Female diabetic, what's the most probably vaginal infection?
Candida
139
Pregnant delivered at home, the newborn have some ecchymosis
Neonatal hemorrhagic dis
140
When the rooting reflex disappear?
4 month
141
66 y old male with low grade yof esophagus
Follow up after 6m + ppi
142
TTl with 32000 PLT, what's the management?
Plasma exchange
143
Pt with go to surgery and he has 85000 ply count , normal others like PT, Patti, INR what to do before surgery?
Give hydration only
144
The most indicative of systemic perfusion?
Central line
145
What could make the condition of cystic fibrosis worsening?
Post pertussis infection
146
Female planning to be pregnant this winter, what vaccine should take?
Influenza
Rubella before conception
147
Obgyne infections( Candida, tricho, BV , Chlamydia, gonorrhea)
Learnnn
148
Large abscess, PID case, how to manage?
Antibiotics
149
Lots of pedo surgery qns
Learn intussuception, duodenal atrecia , hirshprung
150
Young man wants to be soldier came with bilateral inguinale hernia
Laparoscopic with mesh
151
Girl she have headache tight like bands?
Tension
152
Child have asthma and father smoker
Inform father smoking effect in child
On other q, parents refuses to listen about quitting smoking - inform child protection
153
Hydatid cyst treatment but no albendazol in answers
Surgical resection
Refer notes rn
Hydatid cyst:
5 cm or less 👉🏻 metro or albenazole
More than 5 cm 👉🏻puncture aspiration injection re-aspiration
Large with daughter cells 👉🏻 surgical deroofing
Large calcified 👉🏻 observe
154
Ebola patient wants to go out of hospital and refuse to stay?
Call security
155
Turner syndrome
Webbed neck, daughter 17 no period
156
SLE with UTI, drug contraindicated?
Sulfamethoxazole
157
SLE on Hydroxychloroquine Gtt and indirect high, AST: 700 ALT: 700 AlP: high Bright
echogenicity Liver, They did a Biopsy and they find (interface hepatitis with plasma cell)
what is management?
Prednisolone
158
Criteria of SLE
Autoimmune hemolytic anemia
159
Pregnant abdominal pain and vaginal bleeding on ex abdomen tender , uterus not palpable?
Missed abortion
Ns
160
Retrosternal and epigastric pain and regurgitation and heart burn did barium x-ray showed dilation of esophagus and lower esophagus stenosis, and there is multiple contraction in it, no esophageal movement was the diagnosis?
Achalasia cardia
161
Aspiration conium treatment?
Surfactant
162
Known case of polymyalgia rheumatic presents with malignancy symptoms (weight loss and other non specific constitutional symptoms) Labs showed anemia, low platelets and increase WBC lymphocytes.
What is the diagnosis?
CLL
163
12 yard old male with testicular pain (horizontally lined, mildly elevated no swelling or erythema of Scratoum)
What to do next?
Pediatric, 11 yo male, came to the ER with severe scrotal pain , swelling , redness , absent cremasteric reflex
, light exam showed transillumination and something about cremasteric reflex. What is your next step ??
Surgical exploration
164
5 years old child found to have 1 testes in the scrotum and other in the inguinal area what to do?
5 Y/O boy, his parents noticed that he has
undescended testis, on P/E unilateral
descended testis, the other was in the
inguinal, management?
Orchiopexy
165
What indicates adequate systemic perfusion?
Mixed venous O2 saturation
166
Crohn disease with fistula in steroids and pentosa, what tt?
Infliximab
167
Rapid progressive glomerulonephritis, what's pathophysiology?
Crescent formation in bowman's capsule
168
Side effects of chemotherapy in electrolytes?
Find answer
169
Man with jaundice came to doctor to discuss the normal blood test he said it was abnormal in bilirubin in last previous test what's your diagnosis?
Healthy man came with icterus , indirect bilirubin high dx?
Gilbert's syndrome
170
Vaccine contraindicated for pregnancy
Zoster
Rubella
171
Old women vaginal fish smell tt?
Metronidazole
172
Aedes aegyptu, which can carry dengue fever, when is the favourite time for this mosquito to bite?
Early morning
173
Clear case of malaria in sudan, what's the treatment?
Artemisinin combination therapy
174
What gives the highest diagnostic value in asthma?
Methacholine challenge test
175
Atypical complex endometrial hyperplasia tx?
Oral progestin
If she is postmenopausal then it should be TAH & BSO
176
Hx abortion + DVT, Dx?
Anti phospholipid syndrome
177
Sick patient low O2, despite 100% O2
Adult respiratory distress syndrome
178
Bilateral scrotal redness and swelling, non tender , dx?
Idiopathic scrotal edema
179
Additional precaution for meningitis belt countries other than quadruple vaccine
Oral ciprofloxacin chemoprophylaxis
180
Acute pancreatitis dx
US
181
Old PT came with sudden severe lower back pain started coughing, x-ray showed lumbar compression fracture, next step?
Start iv acetaminophen
182
Came by ambulance from a burning building, semi confused o/e aligned nasal hair, otherwise stable, what to do?
Elective intubation
183
Female had a previous history of varicose veins, came now c/0 painful cord like. What is the initial Mx?
NSAID
184
Diarrhea for 5 days, vomiting 3 days and in PT in hypovolemic state, what lab abdnormality do you expect?
Hypernatremia
185
Trauma patient, came to ER after RTA , he was driving 130 and wearing his seat belt , he was alert, conscious, what is the next step?
US abdomen
186
Diabetic patient with central chest pain occur after exercise and last 15 minutes relieved by rest. ECG was given with depressed ST segment in lead v1 and V3?
Refer to cardiologist
187
Common valvular heart disease in down syndrome
Endocardial cushion defect
188
Investigation of down syndrome
High bhcg, high inhipin ,low AFP , low estradiol
HBI , LAE
189
Slanting eyes , short fingers , single crease palm of hand , dx?
Down syndrome
190
Prominence occipital, rocker bottom feet, cardiac
Edwards syndrome
191
17 years old hypertensive not menstruating heat at clinic by her parents, she is short stature , short neck. Most appropriate diagnosis /
16 yo F short stature< 5th percentile, short neck, low hairline and hypertension, both parents short, what's the dx?
Turner syndrome
192
Child 9yrs old came with his mother because she thinks he is short stature. mother is short. When hand bone examined revealed age of 7 years Investigation All normal including
growth hormone. Except insulin like growth hormone was 18 low, What is diagnosis?
Growth hormone deficiency
193
Pediatric with egg allergy contraindication and needs to be referred to an immunologist before given?
Yellow fever
194
Kawasaki case asking about which of the following is one of the criteria:
Injection conjunctivitis with no exudate
195
child took tablets, came with black vomiting, most likely material ingested?
Iron
196
child ingest iron tablets and come with symptoms=
IV deferoxamine
197
Face Rash with conjunctivitis spread later to the trunk:
Rubella
198
Developmental milestones q: 5 words, hop on one leg
48 months/ 4 years
199
Picture of intussusception : nausea and vomiting Which statement regarding
Diagnosis
Presence of sausage shape in palpation
200
Baby 3 hours of life. His brother died of immune condition
Do not give bcg and only give hepatitis vaccine
201
Child with strabismus
Cover eye test
202
home delivery baby with umbilical bleeding after day 5, dx:
Factor x deficiency
203
Beriberi
Vit b1 deficiency
204
Honey crust lesion ask about diagnosis?
Impetigo
Google pictures
205
Case of child studies given microcytic anemia he has high Hba2 on electrophoresis
what type of anemia
Beta thalassemia minor
206
pediatric patient have meningitis, with close contact to his brother recently, Asking for
what to give to his brother
Rifampicin
Other question, younger brother, give oral rifampicin
207
34 years old nulliparity with previous hx of DVT, drugs will give this patient?
No need treatment
208
-Young female presented with dyspnoea, low grade fever and arthralgia. On examination there was tender erythematous nodules on her shin. And on auscultation basal crackles. Whaic is best nexts step in management?
Chest Xray
209
29years old woman complaining of dysuria and urgency , allergic to penicillin, shell fish and TMX . What to give
Nitrofurantoin
210
Case of gun shot, raised JVP and no heart sounds , best appropriate management?
Pericardiocentesis
Another Q, If it is cardiac tamponade , initially give IV fluids
211
Stab wound in chest. Came with weak thread pulse , raised JVP even what's the diagnosis?
Cardiac tamponade
212
Child with stab wound in the lower right chest, he is hypotensive and tachycardias, what is the most appropriate thing to do?
Thoracotomy
213
Pt with CHF and afib. What will you use to control his cardiac rhythm?
Amiodarone
Rate control- BB, CCB or digoxin
Rhythm control - amiodarone, sotalll, flacinide
214
18 Y has ALL. 17 days after chemo he develops fever around 38.7 C. No focus of infection found. Labs shows: low WBC 0.6 (normal was 4-10x..), Neutrophil level 60% (normal 40-60%), i’m not sure if he has low platelets as well, what you’ll do:
Blood, urine, ... Culture and Iv abx
215
IBS patient advice
Avoid lentils
216
Which if the following is true regarding intussuception
Shock is the most common complication
217
which one of the dipeptidyl peptidase-4 inhibitors used without limitation
Linagliptin( can be given without monitoring in CKD)
218
Patient you suspect chronic thromboembolic what’s the highest diagnostic test ?
Spiral CT with contrast
219
- 28 years old male presented with attacks of bloody stool for 2 months. Colonoscopy shows diffuse polyps in rectum and colon. Multiple biopsies were taken.
Familial adenomatous polyposis
220
Honey coloured crusts on face and extremities ( impetigo), asking about the organism
Group A streptococcus
Revise other causative organism
221
A baby with recurrent vomiting in between and after feeding, wheezing, cough, dystonic neck posturing( he described sandifer syndrome), dx or cause?
GERD
222
Pediatric Girl 4-5 years with uncomplicated cystitis , Mx?
Oral amoxicillin,
Rest of options were IV
223
Pt with bronchogenic carcinoma, presented with progressive SOB, on P/E
there’s elevated jvp, clear lung and quiet heart sounds. What will confirm your
dx:
ECHO
Dx is cardiac tamponade
224
Mode of inheritance of neurofibromatosis
Autosomal dominant inheritance
225
4 year old child with a morning limb and knee arthritis and (-) ANA.When should see the ophthalmologist to check for uveitis?
6 months
Dx: juvenile idiopathic arthritis
226
when do you recommend mammography for female patients aged between 50-75
annually
Every 2 years
227
Case scenario describes pertussis presentation , ask about the diagnostic test :
Nasopharyngeal sample culture
Learn pertussis symptoms
228
1 year old boy is brought to the clinic for failure to thrive, recurrent oral thrust and hepatosplenomegaly, he had a brother who died at the age of 3 years old with sever infection and septic shock, which of the following vaccine must be avoided until a diagnosis is made?
Varicella
229
celiac diseasel lost follow up , has bossing , distal phalanges erosion , what diagnostic for the condition:
X-ray hand cupping
230
Pt with humeral and ulnar fracture of the left arm, surgery done and after surgery cant extend forearm, wrist and fingers
Which nerve is affected :
Radial nerve at spiral groove
231
Child had a viral illness 2 weeks ago, has symmetric weakness in the extremities and face. Reflexes in lower limbs absent. Ascending paralysis. Also has fluctuations in respiratory effort, sometimes becoming tachypneic. Whatʼs the diagnosis?
GBS
232
A scenario of a boy with recurrent infections. His brother died when he was 3 years old. He has 2 sisters who are alive and well. Previous investigations done at an outside clinic show low levels of all immune markers except for T cells which are normal What does he have?
X linked agammaglobulinemia
233
Residents have order from consultant that he should proscribed penicillin but the pharmacy told the pt have allergy from this the consultant insist:
Refuse to give gently
234
Known case of polymyalgia rheumatic presents with malignancy symptoms (weight loss and other non specific constitutional symptoms) Labs showed anemia, low platelets and increase WBC lymphocytes.
What is the diagnosis?
Chronic lymphocytic leukemia
235
Anal fissure with skin tag Mx?
Internal lateral sphincterotomy
236
How to effectively decrease the risk of children intoxication?
Advice about legalization of strong cap of hazardous medication
237
PTH high, ca high phosphate 1.2 slightly low treatment?
Hydration, diuretic with bisphosphonate ✅
238
Case about patient with cancer on chemotherapy asking about Side effect in electrolytes ?
Hypocalcemia
239
Ectopic pregnancy presentation, what is the source of bleeding?
Fallopian tube
240
What's the most commonly occured minor side effects after DTap vaccination?
Local erythema
241
pediatric patient with umbilical hernia, bulging out when he cries, and reduced when he is sleeping, whats your managment:
Observation
242
child has attention problem at school , day dreaming , starting brief sudden lapses of consciousness “seizure” (less than 30 seconds) , EEG (generalized 3-Hz spike-and-wave activity Treatment :
Ethosuxamide(absence seizure)
243
Asymptomatic child scheduled for a dental procedure, on examination found to have a murmur that changes with position, what to do?
Innocent murmur
244
2 months old baby wakes at night and cries for 1-2 hrs was happening several times he’s fine and growing well the mother concerned how to assures her ?
Infantile colic
245
Pt did CT with contrast and develop AKI few days later.. What is the mechanism?
Acute tubular necrosis
246
Elderly (70s) patient with progressive hand tremors, she was unable to feed herself by spoon + unable to write Now she started to notice her voice is changed.
Propranolol
247
Q about when ovulation happen? ( With pic)
36 hrs after LH peak
36 hrs after LH surge
248
Ask about role of Metformin in PCOS
Decrease insulin resistance
249
couple came to infertility clinic the wife had PID 2 year ago and got traded , the husband semen was normal . what is the appropriate step?
?
Couples came to infertility clinic the wife had PID 2 years ago with chlamydia inf and got treated
the husband semen was normal what is the appropriate step
IVF
250
Child can sit without support, cruises around furniture
10 month
251
pregnant with twins. One twin is breech, and other cephalic , US show bicornate uterus . what is CI for ECV?
Bicornuate uterus
252
asthma on albuterol, complained of symptoms and 2/week night symptoms . the most appropriate mx?
Long action beta 2 agonist and ics
253
COPD
Smoking cessation
254
Pt was found to have cavity on x-ray in upper lobe
Airborne
255
Abruption of placenta , what is the mx?
A reassurance
B call multi disciplinary team and rrt
Answer not known
256
smoker has chronic GERD, endoscopy done show high grade dysplasia. What is mx?
Endoscopic mucosal resection
257
Impetigo ask about Mx?
Abx
258
feral with breech presentation flexion hip and knee :
Complete breech
259
baby 3 hrs of life. His brother died of immune condition ?
Don't give bcg
260
Drugs should be avoided in pregnancy?
Ciprofloxacin
261
female G3p2 had previous C/S due to breach and one vaginal delivery. Shes at 34
weeks and fetus is breach, she wants to do ECV. US: anterior low lying placenta and amniotic fluid
of 4 Digital exam: “normal” Whats the contraindication for ECV?
Us findings
262
Contraindication of IUFD(intra uterine fetal demise)
Child death due to IUFD
263
Per vaginal examination/ digital vaginal exam is contraindicated in
Placenta previa
Def- abnormal implantation of placenta over the internal cervical os
Dx- transabdominal us , then transvaginal us ( confirmatory test)
264
Contraindications vaccine during pregnancy
Live vaccines
265
Which of the following is an absolute contraindication for thrombolytic therapy?
Intracerebral hemorrhage 2 years ago
266
?Pregnant in her 38 week and 2 weeks ago she was admitted and ECV was done for her.
Currently the fetus position is in linear (or lateral not sure) with amniotic fluid index 12. What’s the
contraindication for ECV in her condition?
Fetal position
267
Women diabetic controlled developed dysuria and frequency urine analysis nitrate, creatinine
high. Which drug is contraindicated?
Septrin
268
Pregnant UTI which drug contraindicated?
Ciprofloxacin
269
pt came to clinic want to get pregnant she has a history of epilepsy 6 years and not compliance
on medication what best initial management?
Review all medication
270
ECV in 34 weeks pregnant absolute contraindication?
Ultrasound finding of low lying placenta( type of placenta previa)
Low lying placenta
Def- placenta that is implanted in the lower segments of the uterus but not covering the internal cervical os( more than 0 cm but less than 2 cm away)
271
Contraindication to external cephalic version
Bicornate uterus
272
Female use paroxetine with history of suicidal attempts and depressions pregnant what to do
Discontinue
SSRIs are generally considered an option
during pregnancy, including citalopram , fluoxetine and sertraline .?
Some studies have indicated using paroxetine during pregnancy may increase your risk for
miscarriage. In addition, there may be an increased risk of your newborn experiencing heart
defects if you use Paxil while pregnant.
273
Preeclampsia management in mild BP> 140/ 90mm Hg
At term - induce delivery
Preterm
1. Betamethasone - mature fetus lungs
2. Magnesium sulphate- seizure prophylaxis
274
Preeclampsia management in severe BP> 160/110
1. Prevent eclampsia - magnesium sulphate
2. Control BP- Labetalol, hydralazine
3. Delivery- Term
4. For preterm delivery- give betamethasone for mature fetus lungs and magnesium sulphate for seizure prophylaxis
275
Pregnant with blurred vision, headache and ... BP 170/ What to do ?
stabilize and give MG and deliver
276
Mgso4 toxicity ?
Discontinue MGso4
277
Primigravida 32 came with mild headache with no abdominal pain, or visual disturbance, Blood
pressure 150/90, urine analysis +3 protien, appropriate management?
Admission and observe
278
Pregnant 32 GA, with 150/90 BP and protinuria +3. Whats next
Admit and observe
279
Pregnant , 10 weeks with HTN never went to doctor before (chronic HTN) what is the complication?
Preeclampsia
280
Pregnant present in 38 weeks in labor , BP 150/90 and elevated proteins /creatinine ratio.
Preeclampsia
281
Preeclampsia presentation
Without severe features
HT > 140/ 90
Proteinuria dipstick+1, +2 ; 24h urine > 300 mg
With severe features
HT> 160/110
Proteinuria not necessary
Mental status changes present
Vision changes present
Ruq pain present( due to swelling if Glisson capsule)
282
39 week, women with proteinuria Bp 140/90 , ur action:
Labour induction
283
Pregnant with pre-eclampsia mild 140/40 with abdominal pain .platelet and, uricaerd what
indicate severity
Abdominal pain
284
Case of preeclampsia on labetalol she’s 32 weeks, fundal height 28. what will commonly occur with IUGR:
Oligohydramnios
285
IUGR( intra uterine growth restriction ), witch one of the following can be the cause?
Oligohydramnios
286
about Pre-eclampsia : 32 weeks other case ; 34wks has hypertension and proteinuria, management?
Admit and observe
Delivery is the only cure for preeclampsia.
Patients with preeclampsia without severe features are induced after 37 weeks' gestation. Before this, the patient is usually hospitalized and monitored carefully for the development of
worsening preeclampsia or complications of preeclampsia, and the immature fetus is treated with
expectant management with corticosteroids to accelerate lung maturity in preparation for early
delivery.
In patients with preeclampsia with severe features, induction of delivery should be considered
after 34 weeks' gestation. In these cases, the severity of disease must be weighed against the risks of infant prematurity. In the emergency setting, control of BP and seizures should be priorities.
287
?Pregnant 34 week with preeclampsia, high BP 170 /100 what to give ?
Stabilize , MgSo4 and admistion
288
?preeclampsia what drug to give to prevent convulsions
MgSo4
289
?Pregnant 34 wx, vaginal bleeding open cervix 6, preeclampsia Fetal bradycardia:
MgS04 and deliver
290
pregnant in 32 weeks with pre eclampsia what to do?
Admit to observation
291
?34 wk pre eclamsia pt came with epigastric pain, headache, bullerd vision .. non stress test
reassuring mx ?
MgS04 and delivery
292
?Magnisium sulfate given to HTN pregnant to
Prevent the attack eclampsia
293
Pregnant, now bp 140/90, platelets 90, hx of previously severe preeclampsia. What indication here of severe preeclampsia?
Platelets
294
?Preganat c/o sever abd pain and uterine cotractions she was given 6mg Mg sulfate and the e
contractions become normal then decrease the dose to 4mg Then complained of shortness of
breath What to do
after stop Mg sulfate give the Ca gluconate✅
295
Case of preeclampsia with very low plt and high urea what indicators that is preeclampsia:
Low platelets
296
pregnant with seizure take 6 .. mg sulphate then decrease to 4 , There is
absent deep tendon reflex
Stop mg sulphate > THEN GIVE CA GLUCONATE
297
Patient on oxytocin and MgS04, preeclampsia. Her CTG: absence variability. What's the cause?
Another question CTG of child is non reactive
MgSO4 toxicity
298
pt at 32 week presented with seizure and high blood pressure, what is the next
appropriate 'There was no medication for seizure
magnesium sulfate
299
Severe preeclampsia, acute management of HTN drug?
Hydralazine
300
GDM type F with nephritis + and controlled HTN, She is pregnant now what’s most
complications will occur ?
Pre eclampsia
301
pathophysiology of GDM
Placental hormones(lactogene)
Human placental lactogene(HPL) aka somatomammotropin is a hormone produced by placenta, peaks at 24 - 28 week and decrease maternal insulin sensitivity
302
When is ultrasound done to confirm gestational age best done?
14-16 week
Another Q 11-13 week
303
Pt with preterm symptoms ( contractions and cervical changes before 34 wks) the best test to
confirm your diagnosis is
Continues CTG
304
Gestational diabetes at what week screening?
Gestational age diabetes screening?
24 weeks
24 - 28 weeks
305
K/c of cervical incompetence came for antenatal care. When to do surgery?
12 to 14 weeks
Cervical incompetence do not have a hx of contractions , but painless dilation if cervix
306
married women came to routine antenatal care most important thing?
most significant examination in gyne for general check up in newly married women:
Pelvic examination
307
What's the minimum number of days should do muscle strengthening activities
Secondary pregnancy
308
55 years old female done mammogram now, when to do it again
Other q, 50 y women no family Hx of breast ca , mammogram normal When to do next mammogram ?
After 2 years/ every other year
Screening of breast Ca - 50 to 74
309
Mammography screening for 50 yr
Every 2 year
Less than 50 year old, every 1 year
310
solid mass of ovary+ca125 high
Gynaecologist oncology referral
311
pregnant 1st visit at 10 weeks what is the most important to be done on 1st visit
CBC for anemia
312
Pic of anembryonic pregnancy and asks about the Dx an embryonic tx:
Follow up to 4 week
Pic will show empty fluid-filled structure, called a gestational sac, with no embryo inside it.
313
Pregnant at 22 weeks gestational age oral glucose challenge test after one hr high after 2 hrs high
after three hrs high.. What is next?
HgA1c✅✅✅
314
Female came with left leg pain and swelling with red streak, what is the causative organisms?
Streptococcus pyogenes
315
Female used herbal cream in vagina then started to have Redness and itching :
Contact dermatitis
316
Female pt with her husband for fertility counselling. BMI and All labs are good, Regular menses.
Your advice:
Eat less fast food
317
Couple came to OBGYN clinic, need to check infertility, what to assess first?
General appearance
General appearance of the couple might help you to reach diagnosis, for example:
*Hirsutism on the female supports , Lymphadenopathy or parotid enlargement in male
318
Couple come by infertility after investigation done show bilateral fallopian tube obstruction
what will do
Tell couple
319
Infertility and cysts in ovary what is the problem?
Ovulation
320
couple seeking infertility clinic after 3 months what is ur advise?
Try more
After how many months you will start call a couple infertile?12 months
Wife with down syndrome husband try to conceive for 3m? try more and come back after
complete 1 year✅
Couple present with 3months infertility, next step: nothing
321
Couple after 2 years failed to get pregnant, husband sperm normal what is the cause of infertility
after excluding male factors we should look for ovulation cuases✅
322
Female complain of infertility since 2 years, regular period, normal semen analysis, monophasic
basal body temperature. What the cause of her infertility?
Anovulation
323
woman in her 30s with irregular cycles and anovulatory cycles since several years endometrial
biopsy was done and showed atypical hyperplasia what is the best treatment
Oral progestin
Management of endometrial hyperplasia includes surveillance, progestin therapy or hysterectomy
324
Couple present to infertility clinic everything normal after taking history and doing examination
which first investigation to start?
Serum analysis
325
Female with regular menses come for infertility evaluation?
21 progesterone
326
Couple came to you, with infertility issues. Upon investigation, wife has bilateral tubal
blockage (not sure). Who should you inform?
Both
327
Couples present with infertility for 3y, what you will order:
Sperm analysis
328
Pt came to infertility clinic, wife ha ha of PID everything else is normal, what to do?
Hysterosalpingogram
329
pregnant lady, G4p3 ,35yo, 34GA came complaining of bleeding 2hours ago, what question will
you ask next?
Intercourse
330
F Hx of chlamydia infection, wants to get pregnant, best next step?
Hysterosalpingography
331
Woman had adhesion in pelvis and peritoneum and signs of obstruction what is the organism?
Chlamydia
Ttt : azithro + doxy
332
Pt with history of PID (pelvic infection dis) and treated for it is now coming in the clinic because of
infertility despite regular sexual activity what investigation will you do first:
Hysterosalpingography (adhesions)
came with feature of PID what is the investigation: Hysterosalpingo
333
Which bacterial infection is associated with intrauterine device in PID ?
Actinomycosis
334
most common cause of ectoplc pregnancy ( no hx of anything )
PID
Most common risk factor of ectopic is PID
Most significant factor is previous ectopic
Couples use condom which type of infection - PID
335
Chlamdiya + pregnant woman, what is the most commonly infected part of the neonate:
Eyes
Ophthalmia neonatorum
336
Pelvic adhesion causes
Chlamydia
337
Strawberry cervix with yellowish to grey discharge
Trichomonas vaginalis
Ttt metronidazole for both?
338
case of 20 yrs old with GTD ( grossly abnormal mass on cervical examination) with
hemoptysis, What is the next in management ?
Admitted for staging and chemo
339
Vaginal discharge under microscope flagellate what dx ?
Trichomonas vaginalis
340
Yellow green vaginal discharge
Trichomoniasis
341
Vaginal discharge pseudohyphae cell under microscope what treatment?
Fluconazole
342
A woman with smiley vaginal discharge and itching..her husband has a Hx of
urethral discharge, asking about ttt?
Ceftriaxine
343
Female her previous pregnancy is stellbirth and now she want to pregnant and ask the doctor
about all the vaccines that she is need before consumption and
.reduce the stillbirth
Rubella
344
vaginal infection that can cause incompetency
Bacterial vaginitis
345
Patients with sx of bacterial vaginitis. What's the test?
Gram stain
Fish like odor discharge without pruritus
346
Clinical scenario of (painless genital ulcer + skin rash). What is the dx?
Secondary syphilis
1⁰ syphilis- painless genital ulcer with healed up indurated edges
2⁰ syphilis - rash( palms & soles, alopecia areata, mucous patches, condylomata Lata
3⁰ syphilis - neurosyphilis, aortitis , gummas( bone & skin lesions)
Dx: dark field microscopy
FTA or MHA- TP( confirmatory)
Tx: single dose of intramuscular benzathine penicillin
Doxycycline if penicillin allergic
347
Post - op fever
0-2days: atelectasis or pneumonia.
3-5 days> UTI
5-7 days > DVT / thrombophlebitis of the IV access lines
7 day - wound infection / cellulitis
8 -15 day - drug fever or deep abscess
348
Pregnant came because his son has infection, What to give her? .
Influenza
349
Vaccine in pregnancy
Influenza, Dtap
350
Pregnant with Rh-negative blood type her baby have Rh-positive blood type present with
jaundice ask about Pathophysiology
autoantibodies against fetal RBCs (Mother’s
antibodies attack fetus RBCs?
351
Mother A negative Newborn o positive, what to do ?
Give Rh
Anti rhesus, Rh immunoglobulin
?when to give inti D? if mother rh ve- and child rh ve+.
352
?Pregnant 28 wk primigravida came for routine check up and she mentioned that
she is -RH and her husband is +RH what next
Give her anti D in this visit
353
Femal has cottage like vaginal white discharge, what could this Pt suffer from?
DM
354
hyphae in urine microscopy?
Candida
355
female with white-gray vaginal secretion , odorless, adherents to vaginal wall
in microscope there’s spore , what’s the dx:
Vaginal candidiasis
356
?budding yeast cells and pseudohyphae in vaginal discharge
Vaginal Candadia treat by
fluconazole ?
357
?woman presented with itchiness and white patchy vaginal lesions. There were
thick white secretions but she denied them being foul smelling. What is the most
appropriate treatment
Topical itraconazole
358
Pt with vaginal itching and bad smell the microscopic is flatellaprazite
Trichomoniasis
359
Trichomonas vaginalis
Profuse green frothy discharge.
360
Female had hx of two pregnancies loss , she tried to conceive but she didn’t succeeded , she want
improved her immunity....etc what vaccines appropriate in her case ?
Rubella
361
Female with painful genital ulcer, rash, conjunctivitis, there was a test done and was +ve
called anti coccal something antigen, diagnosis?
Gonorrhea
362
pt with infected HBV husband concerned about sexual
Couple came to your clinic for counseling of their sexual relationship, the wife was
worried as.her husband is Hep B +ve and she’s Hep B -ve, what are you gonna tell them:
Wear condom
363
When detecting pregnant women is infected with HBV, what kind of prevention?
Secondary
364
Mother with HBV. Baby delivered 12 hours ago. What to give baby?
HBV Vaccine and IG
365
female with fishy smell discharge and itching , on vulva scratch mark tx:
Metronidazole tablet
366
Female with Thin gray vaginal discharge wiff test positive and Ph above 5 treatment?
Metronidazole
367
Bacterial vaginosis
Fishy odor without pruritis
Metronidazole
368
Patient with symptoms and signs of Bacterial vaginosis we took a sample and analysed it what
will be there:
Granular epithelial cells
369
Pic of clue cells diagnosis?
Bacterial vaginosis
370
Female come with grayish vaginal discharge + PH Dx, bacterial vaginosis what is ttt?
Sx of vaginal discharge when examined by microscopy: motile flagilla what is the treatment for the
husband?
treatment of Trichmonas vaginalis
Metronidazole
371
Female with vaginal discharge Cheese segment What will you give the husband?
No need for ttt
372
Vaginitis
BV
Pathogen- gardnerella
Sx: vaginal discharge with fishy odour, grey white
Dx: saline wet mount shows clue cells , epithelial cells covered with bacteria
Tx- metronidazole or clindamycin
Candidiasis
Pathogen- Candida albicans
Sx- white , clumpy vaginal discharge
Dx- KOH shows pseudohyphae
Tx- miconazole or clitrinazole, fluconazole or Nystatin
Trichomonas ( MC non viral STD)
Sx-profuse , green , frothy vaginal discharge
Dx- saline wet mount shows motile flagellates
Tx- treat both patient and partner with metronidazole
373
HbsAg positive mothers , baby vaccine
Should receive hepatitis B immunoglobulin (HBIG) + hepatitis B
374
Pregnant lady complaints of foul smelling vaginal discharge. What to give?
Metronidazole
375
Pregnant lady with term baby had recapture of membrane 1 h ago but she had history of
multiple vaginal herpes attacks what you will did next:
Pregnant came with rupture of membranes and history shows herpes lesions previously what
will u do?
Pregnant came with rupture of membranes and history shows herpes
lesions previously what will u do?
Pelvic speculum exam
376
?*Active herpes?* CS*Previous history of recurrent herpes?*
Acyclovir
377
painful vesicles in labia and cervix( HSV) management?
Acyclovir
Herpes simplex virus presents with vesicles prior to ulcer and painful
Dx- PCR( accurate) or viral/ culture
Tx- acyclovir, valacyclovir, foscarnet for acyclovir resistant herpes
378
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?
Cervix uterus
Genital warts(condylomata acuminata)
Dx- visual appearance
Tx- cryotherapy with liquid nitrogen, sx for large ones, laser or melting them with podophyllin or tca
Imiquimod is locally applied immunostimulant that leads to sloughing off the lesion.
379
Hx of Genital warts and treated, after 2 years she complain of bleeding after intercourse, where
is the lesion?
Uterine cervix
380
Screening of cervical CA
21
381
pregnant women in 26 weeks GA has large vulvar warts how you will treat her:
Cryotherapy
382
pic of female genitalia with warts , Pt have history of multiple sexual
partners, what you are suspect the dx
Condylomata acuminata
Genital warts present as skin coloured growths, painless, tender , itching , burning sensation, bleeding with intercourse
383
Warts which organism
Condylomata acuminata, HPV 6 and 11
384
A female patient came to the clinic complaining of a mass on a vagina she has a history of
repeated unprotected intercourse with multiple partners, upon examination. she has a wart in
the vagina, the causative agent is
female pt with small papule on genital area with central pitting, h/o unprotected sexual
intercourse with multiple partners.
Molluscum contagiosum
Has central pitting
Fluid filled like, properly round
385
22 years old, female married never done Pap smear before when to do it
Immediately
386
pap smear screening
From 21 years
Every 3 year
Married woman pap smear screening start at? A. 20-24
After age 30, pap smear alone every 3 years or pap smear with HPV co testing every 5 years
387
23 yo female came complain of breast tenderness before period and all history is negative an
she plan to be pregnant in 2 years, What screening recommended for this patient
Pap smear
388
40 y Female with hx of Wart 7 or 10 years back, last pap smear normal, what is investigation u went to do in this visit?
Repeat pap smear with hepatitis B
389
27 year old female came for follow up she is asymptomatic last Pap smear was 3 years ago and
it showed unconcerned squamous cell, what to do:
Repeat pap smear with cytology
390
Female with cervical lesion measuring 11mmx12mm with irregular borders, pap
was done, no results yet, what to do ?
Biopsy
391
Abnormal pap results
Atypical glandular cells- colposcopy with endometrial sampling
Atypical endometrial cells- endometrial and endocervical sampling
392
Female patient Pap smear done before 7 years ago result was atypical hyperplasia Now came to
clinic what to do
CT
393
Pregnant lady with suspicious cervical changes , next step =
Pregnant female with suspicious lesion in the cervix on exam what's the next step?
56yrs postmenopausal her pap smear hx was normal except one month ago revealed ASCUs,
then given local estrogen for one month then pap smear. Repeated reveale dintra epithelia lesion. Next step is?
Pap test came with high dysplasia, next step is?
30y old female came for pap screening, all her past results were negative, now
results show low grade squamous epithelial lesion. What's the appropriate next step?
Case of postmenopausal women, on pap smear found ASC-US. Pap was repeated 6 months
after that & found same resu Its. you do next
60 year old with pap smear showing ASCUS. Doctor gave her estrogen, and after one months
repeated pap smear showed also ASCUS. What will you do?
Colposcopy
394
How to do a Pap smear =
From transformation Zone (endocervix)
395
40y/o female patient underwent PaP smear histopathology showed ASCUS, your next step?
Do HPV test
21-25 yr ascus- repeat cytology in 1 year
25-65 yr - order HPV, if +ve do colposcopy and ECC, if -ve repeat pap in 3 years
396
Ascus positive twice in 45 yrs what to do next
Colposcopy
397
Case of 34 year women have ASCUS what to do next?
female with the result of cervical biopsy by microscopic is ASCUS what next?
HPV test
398
females with abnormal Pap smear and colposcopy show invasive carcinoma :
Clinical staging
399
27 years old female she did Pap smears before 3 years it was normal what is your advice for
her?
Pap smear with cytology
400
Mother comes around 2 weeks postpartum complaining of clear discharge that is positive for
leukocytes and epithelial cells?
Reassure that it's normal
401
Post partum and cesarean section fever?
Endometritis
?
Postpartum endometritis is an infection of the lining of the womb which can occur up to six
weeks after childbirth. It is much more common after caesarean section birth
402
Female was delivered by C-section. Presents with vaginal bleeding 15 days later. She has a fever.
What is the dx?
Retained product of placenta
403
women come to ER 15 days after CS complain of persistent vaginal bleeding.
BP 110/70 , HR 85 , T 38.1 . What’s Dx ?
Endometritis
404
Pt marriage 33 years complain of mastitis /redness /tenderness what’s treatments?
Amoxicillin
405
Campylobacter jejuni treatment ?
Azithromycin
406
C.diffile tx
Oral vancomycin
407
7 weeks gestation, she presented with vaginal bleeding and brown discharge
Observe
408
Familial Mediterranean Fever which drug to avoid
Amoxicillin
FMF sx - mefv gene,recurrent episodes of abdominal pain , tenderness and fever
Dx - ear,crp, WBC and fibrinogen levels elevated
Tx- colchicine
409
Pregnant women with pneumonia, her Immune systems respond for this condition by ig
production What type of immunity should baby take in this infection?
Passive natural
410
Pregnant 35w came with sever headache,abdominal pain and feel dizzy
give mg salfate and admission for delivery
411
lady presents to your clinic after cardiac event. Which of the is true about her condition?
ACE inhibitors are indicated indefinitely for heart failure ✅
412
Pregnant KC of hyperthyroidism 28 weeks GA on 15mg carbimazole came with Sx of
hyperthyroidism, labs: low TSH high t4, what's the most appropriate management ?
increase carbi dose to 20mg ✅
PTU in the first trimester, methimazole in second and third trimester
413
Pregnant with hyperthyroidism , what to give
6 week pregnant lady came with diarrhea, heat intolerance and another sign of hyperthyroidism i forgot it, Lab show low TSH, high free T4 and positive thyroid
antibody Ask about management
PTU
Hyperthyroidism presentation
Tachycardia, weight loss, heat intolerance, fever, diarrhea
414
What is true about hydroxychloroquine?
Reduced efficacy with smoking
415
Asthmatic pregnant what to told her about her medication?
Safe take all your medication
416
Pregnant lady, just delivered and she's known to have bronchial asthma. Which of the following
uterotonic medications you would avoid giving?
?Pregnant lady,justdelivered and she's known to have bronchialasthma.Which of
thefollowing uterotonic medicationsyou would avoid giving?
Carboprost f2 alpha
417
how to prevent hypercalciuria that causes stones:
In case of hypercalcemia the most effective way to decrease stone formation in the case of hypercalciuria:
Thiazide
418
?G3 P2 GA20 weeks presented with history of preterm delivery twice on examination
cervical is 30mm. what is the management?
Progesterone
Progesterone Supplementation and the Prevention of Preterm Birth :
progesterone supplementation during pregnancy to reduce the risk of recurrent preterm birth in
women with a history of at least one prior spontaneous preterm delivery. This is the first time that
the FDA has approved a medication for the prevention of preterm birth.
419
Mom just eat polished rice, what is the deficiency?
Vit B1 deficiency
420
?females want to get pregnant what supplements she should use
?Patient had seizures. uncontrolled. now came to women health clinic wants
to get pregnant what to do:
Folic acid
421
woman in her 30s with irregular cycles and anovulatory cycles since several years endometrial
biopsy was done and showed atypical hyperplasia best treatment?
Oral progestin
422
Pregnant with dysuria studies showed 20 wbcs in urine treatment
?Pregnant with dysuria studies showed 20 wbcs in urine treatment
nitrofurantoin Note : If third avoid nitro > cephalaxin or amoxicillin
423
Pregnant ( with anti-thyroxine medication for 10 years not controlled what to do :
Increase the dose
424
long history of pregnant lady received IV mgso4. What drug reverse the action?
Ca Gluconate✅✅
425
pregnant with symptoms of hyperthyroidism asking about management =
A-Probothuracil (( FIRST Trimester)) B-Carbamezole (second Trimester Depend on which trimester
426
?Bleeding diagnosed with Ovulatory dysfunction treatment?
Ocp
427
?Pregnent type of estrogen=
Estriol E 3
Estrone: during post menopause Estradiol: childbearing age Estriol: pregnancy
Abundant estrogen in pregnant lady?
?E1 Estrone >> Menapouse
?E2 Estradiol>> Reproductive age
?E3 Estriol>> Pregnancy
428
?most important immunoglobulin in breast milk?
IgA
429
?HIV mother on HIV medication what you will tell her regarding her disease?
She can't breast feed her baby✅
430
?Which mother can give breastfeeding to her son?
expressed milk TB mother ✅
431
?Pregnant lady known case of HIV, she wants to know the HIV transmission to her baby?
Treatment of the mother during pregnancy decrease the rate of transmission✅
432
Breastfeeding mother after 7 days of delivery, asymptomatic, culture sensitive to cipro, nitro,
amoxicillin Wbc high 10K maybe (it was borderline of wbc
No treatment
433
Postpartum 2 weeks woman lactating asymptomatic, came for follow up, urine
cx showed 100,000 e coli, ttt?
No need for treatment
434
?Mother just delivered she has +ve hbv, child was given hbv vaccination and immunoglobulin
What is true regarding breastfeeding :
Encourage breastfeeding
435
ingested 2 pack of paracetamol after a fight with her mother come after a day of
ingestion with RUQ pain in which stage of toxicity she is:
Stage 2
436
Asthma pt with 6-8 times night symptoms. She is on SABA. What to add?
Inhaled corticosteroid
437
45 years old man had MVA presented with isolated head injury and coma for 5 days
in ICU , which of the following is best initial way of feeding?
Nasogastric injury
438
case of urinary incontinence and weak pelvic muscles: TTT?
Pelvic exercise
439
Which of the following should the asymptomatic people do screen for:
Colorectal cancer
440
Patient with memory loss and change in behavior
Front temporal dementia
(Emotional and social appropriateness are lost first, memory deteriorate later, no special therapy beyond acetylcholine medication)
441
Painless penile ulcer
Syphilis
442
SLE pt what vaccine can take?
Influenza
443
Case of copd it is severe and full secretion
Invasive MV
COPD is sob from lung destruction decreasing elastic recoil of lungs
Decrease in fev1 and fvc with Inc in total lung capacity TLC.
444
Patient had a long flight then admitted complaining of SOB , on examination patient
is tall , investigation showed pneumothorax, what is the appropriate management
Chest tube
445
STEMI in lead I avL v5 v6?
Lateral
446
Most common organism causing lobar pneumonia?
Strept pneumoniae✅
447
Patient i remember in his early 20s or 18, came with paroxysmal cough and many
others (most likely they are hinting for pertusses), which of the following is a fact on
the vaccine for this disease?
immunity lasts for 10 years ✅
448
Hyponatremia euvolemia with decrease sensorium mangmment :
Hypertonic Saline✅
449
young male patient 30 y.o who devoloped over 1 hr sudden unilateral facial nerve
palsy, asking about Mx
Steroid
450
Central obesity , striae , round face?
Cushing syndrome
451
Most common organism causing gastroenteritis:
Campylobacter
452
which one of the dipeptidyl peptidase-4 inhibitors used without limitation
Linagliptin
453
Know hcv pt came to the ER with massive esophageal varices hemoptesis, on
p/e he is found to have tender ascitis. Labs: hb is 8 , bp/ 100/90 What will
reduce life mortality
IV ceftriaxone
454
SAAG low level indicate
Tb
455
Poisoning case with garlic oder
Organophosphate
456
Treatment of CAP ?
Azithromycin
457
9 y.o man known to have DM , present to ER with 4 days of production cough and
tachycardia, on examination , orianted to TPP , chest examination revealed right
lower lobe creptation. RR 23/min Tmp 38.5 Wbc 12 Urea 5 Chest x ray : right
lower lobe infiltrate Which of the following most appropriate management
start oral abx and seen in outpatient in7 days✅
458
28 years old male presented with attacks of bloody stool for 2 months.
Colonscopy shows diffuse polyps in rectum and colon. Multiple biopsies were
taken. What is the dx?
Familial adenomatosis polyposis
459
which one is a minor Jones criteria:
polyathreligia
460
Pt having prograssive arm and leg weakness, absent tendon reflex I don’t
remember the rest but this is the most important information asking about dx
Polymyositis✅
461
Endomatrial hyperplasia case (given in the question), what contribute to that?
unopposed estrogen.✅
462
Postpartum breast feeding and best methods of contraceptive
depo-provera injectable ✅ Note: If post-partum and less
than 4-6 weeks >> progesterone injection only
463
35 years old with Bilateral inguinal hernia with swelling and pain positive
cough ,,not tender or erythema mangment :
bilater laparoscopic mesh repair ✅
464
HIV pregnancy which is correct ?
- c-s to reduce transmission ✅
465
Infant is hypoglycemia from diabetic mother , route of glucose intake by ?
central line ✅ because in ex the write they need 20% concentration
Note
Maximal concentration of glucose in
peripheral IV is D12.5.
-If infant requires IV dextrose concentrations >12.5%, insert central venous
catheter.
466
35old Patient has behavior change and get irritate ,has problem of initial
speech ,and he has pause during conversation
Which is Diagnosis?
frontal temporal dementia ✅
467
Pregnant smoker what will help her stop?
behavioral therapy ✅
468
Turner syndrome ask about hormone that effect on patient?
FSH
469
#Differentiations between osteoporosis and osteomalcia and osteopenia and
Paget diseas
Ans find
470
60 yrs female with watery odorless secretions, caused by :
Atrophic vaginitis
471
Pregnant + did OGTT post 1hrs 8.1mmol What is the risk of infection
Bv
472
Female with 2 history of preterm labour now she pregnant in 20week cervical
length 30 What you will do for her??
Progesterone
473
Signs and symptoms of PCOS and ask diagnosis
Stein leventhal syndrome ✅
474
During labor episotomy done, tear reachs the anal mucosa, what degree of tear:
Fourth
475
pregnant 10 weeks complaining of recurrent biliary colic in the past 5 weeks Mx
??
laparoscopic cholecystectomy in second trimester ✅ ✅
476
Pt I think in her fourties with picture of ectopic pregnancy and BHCG >5000.
And US no intrauterine sac.The pt lives far away. What will make you choose the
surgical tx
Her social history
477
PPH case asked about most or gold standard ttt
Oxytocin
478
Most common valvular malignancy
SCC
479
TSH was very very low and T4 was 21 ( high) ... in US report they revealed two
solid thyroid nodule and ask about the most appropriate next step management
Thyroid scan
480
Q about thyroid nodule , investigation and treatment
Find answer
481
Case of perianal swelling, per rectal bleeding, on examination: there is 1 cm mass
from anal verge, biopsy shows adenocarcinoma, mx
Abdominal perianal
resection
482
Neck mass biopsy showed normal follicular thyroid cells
Refer
483
Pt with hip fracture, what prophylactic should be given?
Elderly female with pelvic fx + obese what to give as DVT prophylaxis?
Enoxaparin sc bid
2nd Q answer: enoxaparin 40 SC daily
484
Patient with DM and HTN presented with ingrown toenail, what is the thing you
must do before the operation:
Check peripheral pulses
485
What is the best mesh used in Ventral hernia repair?
Sublay mesh
486
Female post gastric bypass surgery (i think 8 weeks) complaining of recurrent
vomiting and bad mood, all labs normal, CT scan normal, what’s your next step:
Reassure
487
exudative light criteria ✅
488
#BIRSDS 3 probably Benign
Short follow up
489
#spleen injuries G3 , stable
490
Grade 3,4,5 > operative management :
491
*Stable > preserving surgery (splenorrhaphy) ✅
492
*Unstable > splenectomy
493
Fever throat pain tonisls coverd with whaite membrane lymphoadenopathy
organism
EBV
494
Case of Kawasaki and given IVIG, what is an indicator of poor response ?
High CRP
495
A 9-year-old girl come to ER complaining of fatigue and lethargy physical
examinations she is pale she has hepatomegaly and splenomegaly 6 cm below
coastal area hemoglobin low 50 sickle cell positive she had seam attack 2 times
before what’s your best management
Blood transfusions
496
Pt after viral infection presented with jaundice - indirect bilirubin was high,
other labs no–mal
Gilbert syndrome
497
Child fever 5 days con}rowth}t}is rash and diagnosed Kawasaki.. what
investigation you will perform to check his coronary arteries ?
Echo
498
child with eczema and recurrent respiratory infection and his uncle and his
cousin also have the same complain what is the dx?
Wiskott aldrich
syndrome✅
499
15 month Meningitis gram +ve cocci what to give ?
Vancomycin ceftriaxone
500
A young boy complaining of coca cola colored urine, upon examination you
noticed he is slightly feverish and with a congested throat, labs were similar to
the ones above and also no mention of iga:
IgA nephropathy
501
when to consider a nephrotic syndrome is a cortisone resistant?
4 weeks of daily cortisone✅
502
3 days old boy his mother reported that his 3 years brother died due to chest
infection with primary low immunity what’s your action
Don't give BCG vaccine
503
HSP mx?
Supportive management
504
Late deceleration >
Metabolic acidosis
505
variable deceleration
Respiratory acidosis
506
false positive BNP=
Obesity
507
Flat T wave
Hypokalemia
508
Lethargy with past hx of Polymyalgia rheumatica and ischemic heart disease, what is the cause?
CLL
509
In my exam the labs showed 60% lymphocytes and slightly low platelets.?
510
Vitiligo pathophysiology (same as previous months):
In my exam the correct choice was “autoimmune lymphocytic attack against melanocytes”
511
COPD elderly patient presented to the ER distress and full of secretion how you will manage:
Mechanical ventilation
512
Old with 4 meds for HTN, still high BP, Dx
Renal artery stenosis
513
13yr girl with primary dysmenorrhea, what is the best treatment?
NSAIDS
514
32 years old female came with leg swelling and pain with denial of travelling or surgery for past 6 years
and no medication use. What question should you ask the patient? (OCP not in option)
Smoking
In my exam she was 19 or 18 ? and choices included “Hx of OCPs use” I think it’s the correct choice.
515
Lab findings of HBsAg +ve
Active infection
516
Female , GA 7 weeks present to ER with vaginal bleeding , no tissue passage , OS closed , brownish
discharge from the vagina. US: crown bump 7 cm:
Threatened abortion
517
Known case of TB he still has one month to finish the medication course he starts to have some pricks in his
fingertips which are increasing, what to do?
Give him pyridoxine
518
Pt in tb drug have peripheral neuropathy which give him
Pt on 1st line anti tb medication complains of numbness and paresthesia. What should be admistered to him?
Pyridoxine b6
519
Couple known case of infertility and they talk with you about surrogacy, and you know it is not allowed in
your hospital clinic, but you donʼt know if it allowed in KSA or no, whatʼs your action?
Tell them it’s not allowed in your hospital.
520
Patient have jaundice direct bilirubin high , ct abdomen 70% replacement of normal
parenchymal liver what to do?
Colonoscopy
521
A 9 y/o girl, her mother is concerned , she is pale, dizzy, she is a picky eater and she has 2 brothers with the
same sx Lab show : microcytic hypochromic anemia, Low ferritin. What is the dx?
Iron deficiency anemia
522
Ectopic pregnancy after methotrexate high BHCG (meaure BHCG weekly?)
give other dose if not contraindicated
523
Diabetic patient with central chest pain occur after exercise and last 15 minutes relieved by rest. ECG was
given with depressed ST segment in lead v1 & v3 ?
refer to cardiologist / treadmill ECG not sure
524
Pic of clue cells diagnosis?
C. BV (bacterial vaginosis).
The answer is: C
Sooooo many Qs about these, they mentioned different scenarios and all kinds of discharges they ask about
Dx and Rx.
525
Rh positive partner when to al Rh negative pregnant lady when to give ? Or don’t give ?
Give Rh if mother negative and husband positive
Answer is: A
Another theoretical Q: Rh -ve mother and Rh +ve child, they gave choices of mechanism of complication if Rh
not give. Fetal Vs maternal antibodies / RBCs agglutination happens to fetus by maternal abs? I forgot choices
526
Female with polycystic ovary, obese ,acne, insulin resistance and hirsutism what is the diagnosis ?
Stein leventhal syndrome
527
Typical scenario of ectopic pregnancy, female bleeding after intercourse what is the place of bleeding ?
Ectopic pregnancy >> fallopian tube
528
Lady gestational week 8 aborted, Hx of two abortion in second trimester due to cervical
incompetence, cause for this abortion?
Chromosomal abnormalities
529
What is true regarding infantile colic?
Resolves after the first 2 m of life.
530
70 yrs old man k/c of IHD, central abdominal pain vitally stable, amylase 600, WBC normal, abdominal x
ray: dilated small bowl with thickened wall: what’s the dx:
mesenteric vascular occlusion
531
Congenital diaphragmatic hernia, after stabilization, management is:
Immediate surgical repair.
532
Pregnant had warts, what will you do?
cryotherapy.
Answer: A, No TCA in choices.
533
Child is treated with chemotherapy due leukemia or lymphoma not sure which of them. 17 days after that
he developed fever. No focus of Infection. Investigation revealed platelets 20000, WBC low. Temperature 38
point something. What is the best management?
Septic workup and IV broad spectrum antibiotics
is a case of febrile neutropenia
534
Case scenario of a female patient discovered to have malignant Phylloid tumor of the breast measuring
12*13 cm. What is the best next step in management?
Wide local incision
535
Pt with fever ,cervical lymphadenopathy swollen tonsils (without?) patch, Possible complication?
Scarlet fever
536
Smoker has chronic GERD , upper scope was done and showed high grade dysplasia what is the
management:
Refer for possible esophagectomy.
537
Boy c/o rash description as vesicles surrounded by redness , start from head and neck then spread to
extremities. Mother said he has same complaint 1 week ago and she worries about her brother as brother is
immunosuppressed ?
A. Give Immunoglobulin to immunocompromised boy.
B. Give acyclovir to immunocompromised boy.
Answer not sure
538
A 15-month-old patient with recurrent chest infections; with a family hx of brother with similar condition
who passed away at the age of 10 months. Which of the following vaccines do you defer until he is seen by
an immunologist?
Varicella
539
A case of crohn disease came w/ 1 cm stricture near the ileocecal valve. What’s the best management ?
Stricturoplasty
540
ALL patients after treatment , asking about lab abnormalities:
hypocalcemia (tumor lysis syndrome)
541
Child with JIA and -ve ANA when to screen for uveitis
6 m
542
Meeting with pt family and discussing the condition the doctor talked about the disease pathophysiology,
complication and treatment, what he did:
Summarising
543
What is the first test you’d order for a woman presenting to the ER with abdominal pain?
Pregnancy test
544
Esophageal metaplasia, diagnosis?
Barret's esophagus
545
Stubborn child, how can the mother deal with him?
Time out
546
Case of gout with erosion +Tophi what drug is contraindicated:
Allopurinol
547
Patient with TTP scenario and labs. What’s the management ?
Plasma transfusion
TTl with 32000plt, what's the management? Plasma exchange
548
Pic of fragmented RBC with hx of fever and headache and raised ESR only:
TTP
549
Male pt with esophagitis symptoms (heart burt, regurege, metal taste, but no dysphagia) on ppi and Mild
improve What next
Food change, modification
550
Ulcerative colitis patient came with severe diarrhea and lower abdominal pain , Abd xray was performed
(description of toxic megacolon) mx:
IV steroid
551
15 years old pt going to surgery what to do:
Both consent from PT and parent
552
Bradycardia (40 bpm) during laparoscopic procedure Is due to:
Rapid expansion of parietal peritoneum
553
Old age pt with chronic diseases planned for major surgery what to give to prevent the complication?
40 mg, SC, Enoxaparin.
554
A 60 years old patient come with sudden onset of upper abdominal pain after a few bouts of vomiting.
Examination confirm sick patient with tenderness in epigastrium and supraclavicular subconscious
emphysema . What’s Dx ?
boerhaave's syndrome
555
A 5 y/o child. Bilateral inguinal hernia with swelling in inguinal scrotal line :
Laparoscopic hernia repair with mesh
556
Anal fissure Rx:
Lateral internal. sphincterotomy
557
Minimal minutes for children exercise:
60 min
558
Couple of post sleeve casese.
559
Case of absence seizure, ask about Rx
ethosuximide.
560
Alot of vascular investigations q + stab neck wound at zone 1 with soft sign.
561
2 milestone Qs. Pedia has murmur + anemia. What to do?
Correct anemia then reassess?
562
S& s of Stress incontinence Rx?
Keegle Vs surgery
Kegel given in 1
563
Hepatitis C needle stick injury, chance of transmission?
3%
564
Contraindication of ECV
Low lying placenta
565
Child with controlled bronchial asthma , her mother concerned about the prognosis of her
child disease?
it’s mostly will get out in children
566
Tonsils exudate, fever, cervical lymphadenopathy
Rapid antigen test
567
Normal pregnancy
palaple over Symphysis pubis
568
Many scenarios of ob case + CTG, they ask about management.
569
Case about pseudocyst scenario, asks about Dx.
570
Case about Left rectus palsy, asks about affected nerve
6th cranial nerve
571
PCKD how to screen for sibling
Us
572
Vulvar CIS, Rx
573
3rd day post op fever → most likely infection of UTI/pneumonia/wound/DVT ?
I think uti
574
Question about the injury with exposed vasculature →
Secondary closure
575
Baby with fever + couph + wheezing + splenomegaly or hepatomegal im not sure
Lab show 38 .. wbcs High
X ray show increased vasculuter + bilateral patch
Ask about Dx
VSD
Next
Ask about Mx:
Furisamad
576
asking about which of the following Malaria drugs Highly resistant ?
Depend on the area mostly chloroquine
577
Mile stone for child 15 month and 24 months
Self study??
578
man has HTN and his family father and 2 sister have HTN, medically free before, O/E and
invesX all with normal limits, his bmi 27 and his blood pressure is 160/100, high creatinine
And high blood urea nitrogen level.
what is the appropriate management?
ACEI
579
child has abdominal pain and destination ( i think) and very very bad smell stool, what else in
examination you will find?
Nasal polyp??
580
CXR showing plural effusion to the middle lobe, what would do?
Chest tube
581
child fall down of stairs and hit her head, blood coming out from ear, perforation of tympanic
membrane?
Basel skull fracture
582
doctor gathered with parents child for his illness, the doctor said we will go back and explain
with happen to your child's, and the end i ll answer all your questions. what the doctor is doing?
Agenda setting
583
Q/ man did inguinal hernial repair with mush, after few days, he has pain and numbness at the
mush side, no sign of inflammation at all ? What is the appropriate mangment ?
Remove the mush
Nerve block
Other option? Give non steroidal
Ns
584
Q/ obese child come with his parents, his bmi 30,
Dietary modification
585
man c/o unilateral knee pain, medical free before, lab show high PMNs, and postive for clot ( i
think wifn clot something like this), what is the Dx?
Septic arthritis
Other recall:
Patient in his 30s with right knee swelling Joint aspiration showed
Yellow, turbid, positive mucin clot test , 15000 WBC, 90% PMN (no mention of
crystals) What’s the most likely diagnosis?
A. septic arthritis
586
Q/ man has severe pain in metatarsophalangeal joint, for couple of days, it's was red and tender,
what is Most likely Dx
Ca crystal (psudogout)
Uric crystal
✅
( gout)
587
mother not will to give her child medical support because of wrong idea, the doctor explained
to her why her child need the treatment and ended saying, ( everything is making sense now?) to
the mother, what the doctor trying to do?
Making sure she mother understand
588
Case of hypochondriasis
589
Testicular torsion
Learn
590
Man with short bowel syndrome on perantal nutrition which of the following abnormality
you will find :
If he had a weakness its hypo phosphotemia
591
Pregnant on term after examination everything normal except brusis in left thigh and
increase PT and APTT in lab results what is the cause ?
A. ITP
B. Neonatal hemorrhage
C. Factor X
D. Hemophilia
Answer find
592
Old Menepusal wamen with bleeding and protruding mass occur after stand up and cough
―I think case of uterine displacement " the question is how to examine the patient?
with speculum
593
Two poisoning questions ask for management first question 6 hours after ingested aspirin he
came to ER and another question bleach poisoning after few hours " i forgat duration but it's
short and less than 6 hours " he came to ER
______________________________________
594
Pregnant with history of stillbirths what vaccine she take to prevent recurrant stillbirths?
Influenza
595
Women with amenorrhea after history of curettage
What endometrial layer effected ?
Basal layer
596
Mother came with her child who has asthma she concern about her child asking is the
asthma will continue to adulthood or not?
Asthma is a chronic disease
597
Term newborn with diaphragmatic hernia after Resuscitation and stabilization what's the
most appropriate next step?
Surgical repair
598
In a study done with 10000 exposed and 10000 controlled 750 of the exposed got infected
while 150 of the controls got infected what’s the incidents rate?
For exposed group: 7.5%
For control group: 1.5%
Both: 4.5%
599
Fanconi anemia mood of inheritance?
Autosomal recessive
600
Numbness sensation in the back of thumb?
Radial nerve
601
Question about tennis elbow which ligament is injured?
Lateral
602
Infection post breast abscess what is the organism?
603
Pan systolic murmur heard in left second intercostal space?
Mitral regurg
604
Patient came for vaccination what allergy is important to ask about
Eggs
605
Patient diagnosed with Meckel’s diverticulum where will the surgeon find the fistula?
60 CM proximal to the ileocecal valve
606
Where is the most common site of fibroids?
Submucosal
607
Scenario with factor 8 what will you see in the labs?
Ppt increase
608
Asthma patient complaining of using the Saba 4 or 3 times a week and once a week wakes up at night with sob what medications you give him.
609
K/c of all present to with fever mx?
A) refer to onco
B) IV ceftriaxone
Ns
610
Down syndrome have bilateral ventricular enlargement rt axis deviation
AVSD
611
61) What is the most common cause of vomiting in children?
UTI ???
612
Pediatric Case of bloody diarrhea w/o Constipation nothing else, No obstruction?
A) Juvenile polyp
B) Intussusception
C) Diverticulosis
613
63) Pt pedia with status epileptics with an IV line? Give lorazepam?
A) IV
B) Rectal
C) oral
614
64) 7 years old child had an upper respiratory tract infection since birth with a generalized joint pain aches. His uncle and uncle have the same condition, labs show high creatinine and BUN and +VE urine protein?
A) Idiopathic fibrosis
B) Autoimmune
615
65) Pregnant with recurrent UTI how to investigate?
A) Cystoscopy
B) Ultrasound
Us if there is no cystoscopy in the choices
616
66) 40 years old patient presented to clinic complains of abnormal uterine bleeding, her menstrual period is regular every 30 days associated with blood clots what’s the diagnosis?
Adenomyosis
617
Pt with asymptomatic fibroid how to manage Mx?
Follow up
618
68) Pt with 2ry amenorrhea what to order?
LH, FSH
619
69) Pt post menopause with AUB?
A) Biopsy
B) u/s
620
Pediatric pt. with itching and Vaginal bleeding Dx?
A) Foreign body
B) Candida
621
Os closed just PV bleeding?
Answer is threatened
622
2) 10 week pregnant and had previous colic pain when she was 5 week How to manage?
A) Lap chole in 2nd tri
623
) Colic pain she is 20 week pregnant mx?
A) Conservative
B) Lap choli
624
74) Pt female has submucosal fibroid. She didn't complete her family yet. How manage?
A. laparoscopic myomectomy
B. hysteroscopy resection
625
COPD with mouth full of secretion Mx?
Intubation
626
76) Pt CP with respiratory failure? Asking about type is it labs show just decrease o2 saturation!
A-Neurologicnic respiratory failure
B-hypoxic respiratory failure
C-hypercabnic
627
Pt with IM in ECG what is most appropriate mx after resuscitation in ER?
PCA
628
8) Pt now just diagnosis with type 1 DM suffering from hypoglycemia all day mornings and post prandial mx? D
Decrease with insulin
629
Obese pt bmi 28 I think, failed to lose weight with exercises and diet? How to manage now
olistat
-surgery
630
65 years with lesion on his face (long case) and part of the biopsy report is dx Melanoma. He is
Known to be noncompliance. How would you make him now a compliance pt?
C. Talk to him slowly step by step to make him understand you
631
Patient old with end stages cancer disease complaining of severe pain and his children ask you
To give him stronger pain killers you respect theirs wishes but you told them that the pain
Killers may fasten the death of their father question in this case what the doctor do?
Principle of double effect
632
What are the 4 principles for effective reporting in child abuse?
. observe, document, report, self-protection
633
Patient presented to ER by police, bruised in her cheek, chest and back. Looked sad with tears in her eyes, how to approach?
Invest time in her clinical presentation
634
Anal fissure with skin tag mx?
A. Internal lateral sphincterotomy
External lateral sphincterotomy
B. Curettage of fissure with removal of skin tag
635
ECG with 2nd degree heart black type 2 TX?
Pacemaker
636
Least common mutation of trisomy 21
Mosaicism
637
a pregnant patient 34 GA fall down the satires with no abdominal pain, no bleeding except for little dark colored spots, Fetal movement stopped for 45 minutes after the incident then improved, CTG reactive and assuring, Cervix dilated, contractions every 3-4 minutes, what’s most likely the Dx?
Latent labour phase
638
0) C.difficile infection, no hx of antibiotic intake, which of the following is risk factor for the infection?
A.Ferrous sulphate
B. omeprazole
C. ca carbonate
639
2) k/c of crohns, on infliximab, came with Perianal fistula discharge, with induration and low grade fever for 3 weeks what is the best management?
A. Increase Infliximab dose and decrease frequency
B. Broad spectrum antibiotic
C. Swab from discharge
640
Female k/c of IHD and Polymyalgia rheumatic, complain from fatigue for 2 (weeks or months)
Labs: WBC 21, lymphocyte 60% plt 144 what is the cause?
A. Lymphoma
B. Chronic lymphocytic leukemia
641
Case scenario with Reactive arthritis, medication?
A. sulfasalazine
B .methotrexate
Don’t remember other choices
642
Hx of myomectomy pain relived by simple analgesia, heavy bleeding
A. Adenonyosis
B. uterine fibroid
C. Endometrial hyperplasia
643
2month old baby, Pan systolic murmur low sternal border poor feeding cough wheeze, x-ray showed: cardiomegaly bilateral palm infiltrate what to do?
A. Medical treatment
B. refer for surgical repair
C. Admit to ICU for management
644
Child capable of putting 6 cube above each other, hop on 1 foot dress with minimal assistance understand proposition, age?
A.48 months
B.36 months
C.24 moths
D.15 months
645
98) Child able to put 3 cube above each other, hop on 2 foot, crawl stair point to object he wants, understand 2 words command, Draw line with crayon
A.9 months
B.12 months
C.15 months
D.24 months
646
Female came with discharge with Fishy odor what do you except to see on wet mount
647
Pregnant with pyelonephritis and hx of 2 previous uti during this pregnancy
What investigation you will do?
A. Urinary tract us
B. Ureteric Scope
648
59 post menopause last mens was 12 years ago, came with hx of abnormal uterine bleeding for 8 month wants admission for hysterectomy, what will you do?
A. Calm her down, take detailed hx and to explore her options
B. refer to oncology and explain high risk of malignancy due to age
649
) to cases of Febrile seizure
Control fever (paracetamol, antipyretic) vs diazepam?
In both cases baby came looks normal active
650
Prim gravid, cervix is 3 cm dilated, 50% effacement fetal head stage 0, what to do?
A. induce labor by artificial amniotic rupture
B. Induce by oxytocin
(Study labor stage and arrest well)
651
Prim Gravid membrane ruptured 20 hr ago, 80 effacement 6 cm dilated induced by oxytocin ,baby was reactive , after 1 hr fetal hr 80 contraction last for 2 min?
A.CS
B. give antibiotic
C. Stop oxytocin
652
12 y.o girl with uti, fever vomiting suprapubic tenderness, looks unwell vomiting unwell? A. admit for IV antibiotic
B. Discharge with oral antibiotic
653
Couples came to fertility clinic, female had hx of chlamydia PID 2 years ago
Hysterosalpingo gram showed normal uterus without free spillage out the tube (I think), regarding pregnancy:
A. Ivf with intrauterine implantation
B. Ivf with intrauterine somatization
C. Normal pregnancy
D. Forgot the choice
654
Pregnant female week 5 came with vaginal bleeding with clots, diagnosed with cervical incompetence due to 2 prev. Pregnancy loss in 2nd trimester, hx of d&c The cause of her fetal abortion now is?
A. Asherman syndrome
B. chromosomal abnormality
655
Pregnant with twins, screening showed increased nuchal thickness in one fetus this can be increased risk factor for?
A. Increased risk for cardiac defect.
B. increase in risk factor for neural tube defect
656
109) How to effectively decrease the risk of children intoxication?
A. educate day cares
B. educate parents
C. Advice about legalization of strong cap of hazardous medication
657
Female with regular period, try to conceive for 6 months, which is investigation?
A. TSH level
B. prolactin level
C. urinary fsh/lh
D. 21 day progesterone
658
45-50 y.o female, did total abdominal hysterectomy with bilateral salpingo- oophorectomy
Hormonal replacement?
A. cyclic estrogen and progesterone
B. Estrogen patch
C. Intra uterine progesterone
D. Another combined hormone
659
Bilateral tube ovarian abscess treatment:
A. IV antibiotic
B. Laparoscopy
C. Laparotomy
D. Drainage
660
Baby with ambiguous genitalia, hypotension hyponatremia and hyperkalemia, accumulated 21 enzyme deficiency?
A. 21 b hydroxylase (hypotension)
B. 17 a hydroxylase (hypertension)
C. 11 b hydroxylase (hypertension)
661
Septic shock VA sepsis in children 6 y.o , fever ,sick tachycardia , tachypnea BP 63/44 , capillary refill time 4 sec?
A) Sepsis
B) Septic shock
662
Cancer screening test best to be?
A) Specific
B) Sensitive
C) Cheap
D) Easy to conduct
663
Hot thyroid nodule 3x3 was removed by thyroid lobectomy , 8mm papillary will defined focus was found distant to the lesion, what is the appropriate?
A. Complete thyroidectomy
B. Follow up 3 months
C. RAI
664
Lateral neck mass, painless, percutaneous biopsy showed Lymph node with follicular next?
A normal reassure
B. f/u 3 month
C. excise full LN
665
Malignant phylloid tumor 1st step?
A. Ct chest
B. wle
C. PET scan
666
PTH high, ca high phosphate 1.2 slightly low treatment?
A. hydration and diuretic
B. Hydration, diuretic with bisphosphonate
667
120) 25 y.o female, fhx of breast ca, came with Ill-defined mass 1st step?
A. Fna
B. core needle biopsy
C. bilateral mammo
668
popliteal and distal pulse is absent?
A. thrombolysis
B. Thromboembolectomy
C. heparin+ observe
669
Asthmatic child with wheeze and hypoxia?
A. nebulizer + IV fluid or
B. nebulizer + systemic steroid
670
Patient with sign of obstruction, water splash, hyperactive bowel sound periumbilical tenderness colicky abdominal pain, repeated vomiting, general abdominal distension initial imp. Step in management:
A. Ct abdomen
B. abdomen us,
C. exploratory laparotomy
D .groin exam
671
tonsillitis with exudate membrane like?
A .Ebv
B. corona
C .influenza
672
125) Child with spinal atrophy severe illness need intubation family refusing because of fear of losing their child?
A .Ethical committee
B. ignore and intubate
673
Signs of liver cirrhosis or cancer, next step?
A.Triphasic
B. AFP
674
7) Sca Pale low plt low hb, hepatosplenomegaly
A. Transfusion
B. Ivig
675
A case of classic triad of situs inversus, recurrent sinusitis, and bronchiectasis ask about diagnosis?
Kartenger syndrome
676
pt with retrosternal chest, pain became continuous even at rest or bedtime, type of angina
Unstable
677
Pt did upper GI endoscopy with multiple biopsy of ulcer in stomach shows metastasis adenocarcinoma what is next?
Ct of chest and abdomen and pelvis
Laparoscopy
Abdominal US
678
MRSA management?
Vancomycin
679
Hcv percentage of transmission
3%
680
Most-important sign to now progression or prognosis (not sure) in inhalation injury :
Hoarseness of voice
681
HbsAG +ve and hbcAG ( igG +ve ) the rest is negative dx ?
Chronic infection
682
SLE with seizure what is the treatment ?
SLE on Prednisone with neurological manifestations, what add?
Cyclophosphamide
If active seizures- benzodiazepine
683
Male with epigastric fullness and tenderness on palpitation next to order ?
Amylase
684
Long case with STONY DULLNESS in chest dx?
Pleural effusion
685
Case of male with obstructive sleep apnea ( symptoms ) how to ventilate ?
Same q above but ask about investigation we do
Nasal CPAP
Polysomnography
686
Male with hx of cardiomyopathy 65years old , c/o sudden abdominal pain for 8 h , tenderness , abnormal bowel sound ,high amylase dx?
Mesenteric ischemia
687
Scenario male with sudden sever retrosternal pain radiating to back and delay femoral pulse dx?
Coarctation of aorta
688
Pediatric pt with Cerebral pulsy ABG normal even po2 , and oxygen saturation is 95 , what type of respiratory failure ?
Neurogenic respiratory f
689
S&s of sever asthma what to do ?
Iv magnesium – iv aminophylline
690
Case of inflamed joint and wbc 55,000 dx ?
Septic arthritis
691
Cluster headache s$s ( lacrimation eye ) what prevent it ?
Verapamil
692
When to stop metformin ?
If GFR less than 30 ✅
693
Case of contrast allergy , first thing to do ?
Epinephrine
694
Low risk dyslipidemja screening age in male?
35
695
baby came with family, nurse inform doctor that patient never was vaccinated in the file since birth, the parents refuse vaccines and say “ vaccines damages the baby brain) what is the appropriate action?
Explain about the vaccine and the great side of it
696
6 years vaccination
MMR
Varicella
DTaP
OPV
697
Child not vaccinated c/o right eye proptosis , erythema , can’t move his eye
What we will do to him next
CT to see extended –MRI– fundoscopy to see if there is foreign body
Another Q same the above one but ask dx : periorbital cellulitis – orbital cellulitis – periorbital myositis
baby can elevate his head off the exam table, smile and cooing when doctor plays with him, follow object with head, age?
6 months
698
how would a 12 years old child reacts according to his developmental stage to parents illness
hard time expressing directly their feelings ( fussiness .. ✅
699
years old his mother compline of wet in bed at night , the pt had fever and urine analysis show high wbc , nitrate present with cloudy urine she concern cuz las time wet him self at 5 long time ago what your diagnosis
UTI
700
Ped pt with fever and dark urine, lion pain , she has constipation, dx?
Bp 125/86
Urine : high wbc , protein ++ , high erythrocytes
Acute pyelonephritis
701
Case of maningitis treatmentmore than 2 months baby ?
Ceftriaxine and vancomycin
702
Case barking cough, stridor dx?
Croup
703
Child with healthy 2 sisters one brother died when he was 10 months , he have recurrent infections dx ?
x- linked agammaglobulinemia( wiskot aldrich syndrom ) ✅
704
Hemolytic anemia indication?
Unconjugated bilirubin
705
Unvaccinated boy with runny nose and fever , maculopapular rash dx?
Rubella
706
Parking and whooping cough ?
Pertussis
707
6 years old white white vesicles on moth gingiva مااتذكر الباقي ? Dx
Herpes
Coxa
Rubella
708
You attended the surgery theater as an intern, ( some renal surgery ) and the surgeon was preparing to do the surgery on the right side, but you knew from the history that the diseased kidney is the left one. What should you do?
Tell the surgeon
709
Case about Thenar eminence atrophy but sensation is intact on palm surface, which nerve is affected ?
Medial-radial-ulnar-axillary
710
Child with bilateral reducible hernia?
Herniotomy
711
elderly female with pelvic fx + obese what to give as DVT prophylaxis?
Enoxaparin 40 SC daily
712
RUQ pain ct shows hydate cyst with daughter cyst
non- Calcified Rx?
De roofing
713
Elderly female during annual checkup found to have small asymptomatic femoral hernia
Laparoscopic repair
714
Elderly Pt presented with appendicitis managed conservatively discharged after 7 days. On imaging appendical mass with no collection
Colonoscopy after 6 weeks
Other recall:
appendicular abscess, treated conservatively and the patient improve , what you will do for him ?
A-lap appendectomy after 12 weeks
B-Open appendectomy after 12 weeks
C-Colonoscopy after 6 weeks
if he is elderly choose C if not choose A ✅
715
Pt did roux-Y. Came with fever chill and left shoulder pain
CT with contract
716
Old Pt HTN smoker IHD came with sudden abdominal pain in left side with tenderness and vomiting , constipation and he pale and dehydrated what the diagnosis ?
Mesntric ischamia
Perforated viscous
Incomplete choices but if there was diverticulitis it will be the most likely answer .
717
Case of anterior thigh stabbed wound 10 cm in depth next step ?
Apply direct pressure on the wound
718
Child with Testicular swilling not painfull and (positive) trasillumination ?
Hydrocele
719
Scrotal pain + asymmetry testes + absent cremastric reflex ?
Testicular torsion
720
Testicular pain ( horizontally lying , mildly elevated no swilling or erythema of scrotum next to do?
Surgical exploration
721
Child unilateral scrotal swilling (negative) transillumination next step ?
US and think about surgery
Herniotomy
722
Most common or useful not sure for ventral hernial mesh repair?
Onlay – inlay – sublay ✅
723
Baby need to do inguinal hernia and his mother abounded him
The baby need consent , appropriate next ?
Call the ethical committee
724
Female with varicose in her leg came with swilling pulses intact , test to do ?
Venous us or venous Doppler us
725
Pt after RTA stable but left leg swilling and pain paresthesia bt toes RX?
External fixation with multiple fasciotomies ✅
726
What is hard sound for vascular injury?
Bruit
727
Pregnant lady was working all day and came due to decreased fetal movement. No abdominal pain, no vaginal bleeding, What’s the next step?
Non stress test
Other recoil stress test was done it’s reassuring and biophysical profile done and it was 8
Next step : repeat it after weak ✅
728
Patient want to take hormonal therapy, but you are sure that it is not suitable for her, and she decided to complain against you, what is your action ? In other recall Hormonal therapy in post-menopausal woman In other recall gyn explain to the pt that HRT will not help her menopausal symptom at this stage but the pt insist to have it what should doctor do?
Don't give to her ( refuse)
729
third- and fourth-degree perineal tears due to
Restrained legs and use of forceps and other metallic instruments هذي اجابت
730
Pregnant lady 14 weeks Suprapubic pain os close fundal hight 16 cm dx:
Threatened abortion - missed abortion
731
Breastfeeding lady with painfal breast mass erythema RX
I& D
Could be abscess or mastitis??
732
atypical ductal hyperplasia management
mastectomy- excision – follow up 🤷🏽♀️
733
White odourless discharge
Candida
734
Water like odourless discharge
Atrophy
735
Case of ss of ectopic pregnancy bhcg 2000 . Rx?
Methotrexate
736
Ectopic pregnancy defect in?
Implantation
737
Pic of CTG of early deceleration ask the cause
Fetal head compression
738
Pic of sinusoidal pattern ,cause ?
Fetal anemia
739
Pic of variable deceleration ask about abnormality come with it ?
Respiratory acidosis
Be carful if the pic of late dec. choose metabolic acidosis
740
Pregnant in 10 weeks came with v. Bleeding abdomen gestational age 11-12 bhcg high dx?
Hydatidiform or molar pregnancy
741
UTI in pregnant Rx?
Nitro
742
Diastolic rumble low pitched heard best at apex (mitral stenosis) with Decrescendo
diastolic murmur (3/6) heard best At left sternal border with low pulse pressure,
diagnosis: (no radiation in question)?
Aortic regurgitation
743
13 years old child with SLE, she is complaining of neck stiffness and arthritis and stiffness
in hand joint at morning with malaria rash Which of the following associated with
American clinical criteria of SLE
A. Malar rash
B. arthritis or joint involvement
C. positive ANA
D. hemolytic anemia with RBC
744
Child with fever, vomiting and diarrhea ABG:Normal pco2~Normal bicarb
~Base access -4 “normal range from -2 to 2” Ph 7.3~What type of shock does he
have? A. early compensated shock B. late compensated shock C. early uncompensated
shock D. late uncompensated shock
Answer is: C
745
systolic murmur radiated to the apex, with left parasternal heave
Congenital pulmonary stenosis✅
746
case of gun shot , Raised JVP and no heart sounds , best appropriate management
Pericardiocentesis
747
Murmur increase with handgrip and decrease with valsalva
Mitral regurgitation
Also aortic regurgitation increase with handgrip
Hocm and MVP - decreased with handgrip
748
Young man in 20s with sudden chest pain and dyspnea, on examination decrease in resonance, tactile fremitus and decrease in lung sounds and decrease in breath sounds
Pulmonary embolism
749
Patient has bleetand loss 25% ?
What would be the first thing affected?
Pulse pressure
750
Diabetic insipidus
High blood osmolality ,Low urine osmolarity
High Na / hypernatremia
Low Na in urine
Excessive thirst
Less serum volume
High urine volume
If PT not responding to desmopressin then it's nephrotic DI
751
Painful vesicular lesions in hand , feet , mouth and tongue
Hand , foot and mouth disease
Disease subside in few days
752
Ulcerated lesions in soft palate and uvula causing anorexia, pain on swallowing and fever
Herpangina
severe case need iV fluid and analgesia
753
Vesicular lesions in lips, gum, and ant surface if tongue and hard palate.
10 month to 3 year child usually
High fever and child miserable
Gingivostomatitis
754
10 month child came with mother complaining of vesicles. Rash on his tongue and hard palate. Child looks dehydrated. Can't eat well, no fever
Answer not sure
Given herpes impetigo?
755
PT sign and symptoms of meniycsf sensitive for +be cocci. What the tx?
Ceftriaxone+ vanco
756
12 year old boy diagntwuth growing pains, has bilateral leg pain during the night
Refer to ortho. Aspirin for pain relief and reassure
757
Young male medically freem history of fragility fracture .sparse facial and axillary hair .what investigation?
Testosterone and gonadotropin level
758
RUQ pain , CT shows hydatid cyst with daughter cyst, non calcified. Rx?
De roofing
759
Pregnant in 10 weeks came with vaginal bleeding, abdomen ga 11 -12 bhcg high, dx?
Hydatidiform or molar pregnancy??
760
Pregnant with placenta abrupt and developed dic and her fetus died, Mx?
Cs??
761
Patient with primary hypothyroidism lab tsh 15 T4 is low. , asymptomatic, Mx?
Start levothyroxine
762
Woman with itchy lesion on vulva with suspicion of psoriasis, how to dx?
Clinical is enough
763
Pregnant( not mentioned primi or multi) in second stage of labor. She has spend 3h and she didn't receive epidural anesthesia. Cervix is fully dilated, station is +2, baby heart is normal or 170bpm ns .Mx?
Ventose?
764
COPD with pneumothorax 2cm. Asymptomatic, Mx?
Chest tube
765
Rheumatic American criteria?
Erythema marginatun
766
Child with coryza, conjunctivitis, cough and rash starting from head and then spread to extremities, dx?
Rubella
767
Decrease mortality in hf?
Enalapril
768
Patient with CHF and DM and Htn not tolerating ACEI .what to switch it with?
Arbs ( lorestan)
769
Which one is the only approved in helping quit smoking?
Varenicline
770
Travels diarrhea came back with watery diarrhea+ triphozoites
Gardia
771
COPD with mouth full of secretion.mx?
Intubation
772
Young female patient came with palpitations and signs of hyperthyroidism ( I think sweating)
She complained of neck discomfort
HR 110
Tsh low T4 high esr high
Subacute thyroiditis
773
PT with RUQ pain and tenderness and mass. Investigation showed entamoeba histolytica. And there is abscess 12x 14 cm I think, what is your first step in ttt?
Percutaneous drainage
774
Pt w hx of open repair of right inguinal hernia
Now he has right reducible inguinal hernia
Laparoscopic repair with mesh
775
45 years with 2ndry dysmenorrhea and heavy
menses with clots, on examination found not
palpable, on us : show small bulky uterine. Pt
had hx of myomectomy .. Dx?
Adenomyosis
776
a pregnant patient 34 GA fall down the staires
with no abdominal pain, no bleeding except
for little dark colored spots, Fetal movement
stopped for 45 minutes after the incident then
improved, CTG reactive and assuring, Cervix
dilated, contractions every 3-4 minutes, whats
most likely the Dx?
Latent labour phase
777
Pregnant lady came with facial rash, oral ulcer
and painful hand joints, on examination there
was a tender car hand joints, which of the
following is the most likely diagnosis?
SLE
778
Patient with family hx of type 2 DM came with
polyurea labs shows FBS of 7.0, HbA1c of
7.1. Dx?
DM type 2
779
elderly with lower gi bleeding , both upper and
lower endoscopy r normal
Next investigqtion
Capsule
780
Femal with suprapupic abdominal pain
In Viginal exam Uterine fornix tendenerss Dx
Acute salpingitis
781
4-year-old child presented with several
episodes of passage of frequent bloodless
stool and
vomiting after contact with sick children at
school. Management?
Supportive management
782
Patient with duodenal ulcer had an
endoscopic clipping of the ulcer he is doing
well , what to give him?
Iv PPI for 72 hours then oral PPI
783
Male with colicky upper abdominal pain
aggravated by morphine and its derivatives,
US shows mildly dilated CBD (I think it was 9
mm not sure) and dilated intrahepatic ducts,
what’s the Dx?
Sphincter of oddi dysfunction
784
60 years old patient complaining of dull
aching swelling non tender found to have a
retro-peritoneal mass of a 20×20 cm size, and
multiple masses in the liver. Most likely
diagnosis:
Liposarcoma
785
Unclear Q about patient who came with
nausea and vomiting and pain LRQ , what is
the pathophysiology in this case :
Obstruction
786
Patient of ALL post chemo develops
headache and dry mouth what is the
electrolyte derangement?
Hypocalcemia
787
68-60 yrs female with watery odorless
secretions, spores caused by :
Atrophic vaginitis, ns
788
Pregnant lady presents with cough of
white sputum then cough increased in
severity and she developed SOB she is
allergic to dust, mites and pollens what
is the most imp investigation?
Spirometry
789
Pregnant women complaining of severe
abdominal pain, has Hx of pre-eclampsia, her
blood pressure is 140/90, lab are decreased
in platelet,very very high uric acid, which of
the following of her condition indicates severe
pre-eclampsia?
Platelet
790
ECG elevation in all lead what is mangement
Ibuprofen
791
Patient with hyperlipidemia started on anti
lipid then developed facial flushing, the
doctors prescribed to him aspirin to relive this
adverse effect:
Niacin
792
Pregnant with high blood pressure in 15 weeks?
Essential htn
More than 20 weeks - gestational Htn
With symptoms or protenuria- preclampsia
793
PT with heavy bleeding and hx of uterine surgery, uterus is bulky?
Adenomyosis
794
PT with painful bleeding and hx of smoking
Placental abruption
795
Svt what to give?
Stable - IV adenosine
Stable Initially - carotid massage
Unstable - cardioversion
796
Elderly with pyonephritis got pe( typical symptoms+ confirmed by imaging)
Heparin
797
Elderly (70s) patient with progressive hand tremors, she was unable to feed herself by spoon + unable
to write
Now she started to notice her voice is changed
What medication should we give
(Sorry i don't remember choices
If rest tremor- parkinsonism - levodopa
If essential tremor- BB ( propranolol)
In this case voice is changed so mostly essential
798
Elderly have severe pneumonia and she is *confused*, she is with her son
The sun refused to give her the medication because he believe it's harmful for her
Talk to the son in the presence of the consultant
799
CTG for fetal anemia
800
Round 5 cm Stromsl GI tumor with defined borders treatment
WLE
801
Patient came with high velocity MVA
No breath sound on right lung + hyper resonant right lung
The patient GCS is mentioned (8)
What is immediate step in management
-intubation
-needle thoracosentesis
802
Female 22y in routine follow up with no problem
Only she mentioned that her breast become tender in her third day of period
Breast exam negative
She wishes to be pregnant in the next 2 years
What screening should you do for her before pregnancy
-group B strept
-HPV
-papensious smear (it was written like this)
803
Post op fever
0-2 days atelectasis or pneumonia
3-5 days uti
5-7 days DVT
7 day wound infection
804
Vaccine in pregnancy
Influenza, dtap
805
Female genitalia warts picture, hx of multiple sexual partners
Condyloma lata- flat papules- secondary syphilis
Can be HPV 6-11 or treponema pallidun
806
Smalla papule on genital area with central pitting, hx unprotected sex with multiple partners
Molluscum contagiosum
807
Athlete female with delayed breast development compared to classmates and amenorrhea
Hypogonadotropic hypogonadism
808
Breast development, coarse pubic hair , no mens , high testosterone
Mullarian agenesis/ Mayer rokitansky Hauser syndrome/ vaginal agensis
Failure of mullarian ducts to develop so no ux and upper 2/3 of vagina
809
Pregnant come for her natal care there is mid systolic murmur radiate to carotid with displaced apex, no diastolic murmur, what is the cause of murmur?
Aortic stenosis
810
Multiple repeated Qs about COPD and asthma *management* and pleural
effusion (exudative)
811
Patient with A.F with significant history of TIA, he use warfarin and
other drugs, what to do?
Stop warfarin
Keep warfarin + add aspirin
-55 age diabetic patient with lab
812
55 age diabetic patient with labs ( indicate he is controlled very well!
) with metformin for his diabetes, blood pressure 149/90, what do ?
Add BB
Add ACE
ADD sulfonylurea
Nothing
813
child with diarrhea that is sometimes bloody, since 3 month, he lost
some weight, he has joint pain! Labs: HG is 8, high WBC ,, DD?
US
Crohn
Celiac
Chronic dysentery
814
2 weeks history of diarrhea, now present with severe dehydration,
what is his ABG ? ( NO results were provide ) !
M.acidosis
Non combinsated M.acidosis
815
Patient after thyroid removal develop hematoma with stridor, what
to do ?
Tracheostomy
Bed side evacuation
816
Painful perianal vesicular lesion, with some systemic symptoms (
fever and like that ), DD ?
G.warts
G.HSV
817
female with history of appendectomy, come with severe abdominal
pain and vomiting, LMP about 2 month, what is the first thing you
need to exclude?
E.P
Ovarian torsion
818
sudden infant death syndrome, why it’s decrease now?
Baby sleep in his back
No smoking in his bedroom
819
pregnant 38, HTN : 149/90! T.C.Seizure ! what to give
Diazepam
M.Sulphate
820
case about preeclampsia, ask what from the following associated
with IUGR?
DM
Polyhydramnios
oligohydramnio
821
patient after appendicitis, 20h he has severe pain with purulent
discharge, 38.8c
, what to do?
Dressing
AB
Wound explore
822
patient after appendicitis, he has severe pain with purulent
discharge, redness around wound and tender, fever : 38
IV AB
Exploratory laparotomy
CT scan
823
that famous question about patient after rectal surgery, but they
mentioned “he was slowly recover’ , not in recovery room!!
Heparin
IVC
824
14 boy with hx of eczema M.C.Site at this age?
a. Antecubital fossa
b. Popliteal fossa
825
supracondylar fracture, absent pulse, ( nothing about limb perfusion
condition 😔 ), most appropriate step ?
k wire
surgical explore
826
Pediatric patient has yellow stool and jundice after 3ed day was
dignose with physlogical jundice and now the labs shown high direct
and total billurben what is the dignosis?
Biliary atresia
827
Primimother worried about her 6week baby , he stepping all the
formula since birth , what most likely. ask about the next step ?
burping the baby and semi setting while feeding
828
Case of Kawasaki, what is The best treatment of Kawasaki disease?
Aspirin if no ivig in options
829
Patient came with fever, tonsils covered with white membrane and
lymphadenopathy, what is the most complication :
Scarlet fever
830
child with fever and left knee pain and swelling. Most important single
investigation?
Joint aspiration
831
Newborn circumcision , chordee and hooded foreskin + hypospadias
,how to manage:
Refer to pedia surgeon
832
child with gum bleeding and knee swelling ( hemarthrosis) after
surgery. what is the dx ?
Hemophilia
Hemophilia A-factor VIII
Hemophilia B-factor ix
833
4 year old child with a morning limb and knee arthritis and (-) ANA.
When should see the ophthalmologist to check for uveitis?
6 months
834
18 months old with cerebral palsy had episodes of vomiting and
unable to breathe. Then he was moved
to ICU. He was on 100% FIO2. ABG showed NORMAL PH AND CO2 but
LOW O2. what is the diagnosis?
Hypoxic respiratory failure
835
baby with Ejection systolic murmur with click heard in the left second
intercostal and left parasternal heave distended JVP and ejection
systolic murmur increase with inspiration:
Congenital pulmonary stenosis
836
child was playing football and he fell on his knee and develop swelling
in his tibia
osgood-schlatter disease
837
Baby developed SOB , whezzing DR start to give broncodilator then no
response, think of laryngomalacia dx test is ?
a-Bronchocsopy
answer :a
Pediatric male pt presented with sign of “ laryngomalacia “ what’s the
TTT:
reassure and wait for 1 year
838
Parents came with their preterm infant, it lived for a few months then
died. On history, the patient had lung problems and was sleeping with
his parents in the same room. Parents are heavy smokers. Likely cause
of death?
Sudden infant death syndrome
839
infant presented with cough, sneezing, circuoral cyanosis, secretions
in the mouth,On chest exam there is crackles i think.
Bronchiolitis
840
Baby born with severe hypoglycemia. And they want to give 20%
concentration which route?
Central line
841
Pediatric had gastroenteritis and she took metoclopramide that leads
to involuntary movement facial grimace and tongue protruding what
to give:
Diphenhydramine
842
3 months boy came with fever and hx of circumcision you take a urine
culture and it was 80.000 E Coli and sensitive to TMX/Sulfa you gave him
abx for 10 days and discharged after two days the mother said his fever
improved
Do US
843
15 m old baby with sign of meningitis on csf analysis you found gram
positive diplococcai what is the treatment
vancomycin with ceftriaxone
ampicillin with gentamicin- 1 to 3 months
844
Case of neonate after ventouse there bulging in head under periosteum
within line of head sutures :
cephalohematoma
845
Pt with Hx of TOF repair present with murmur in parasternal area it
increase with inspiration
Pulmonary regurgitation
846
Child with nephrotic syndrome on steroid 6 months. What is true
about vaccine
stop steroid one month then take vaccine
Immunise one month before starting corticosteroids or atleast 1 month after stopping corticosteroids
847
Pt female has submucosal fibroid. She didn't complete her family yet. How manage?
Hysteroscopy resection
848
Learn ECG of heartblocks
849
Diastolic rumble low pitched heard best at apex (mitral stenosis) with Decrescendo diastolic murmur (3/6) heard best At left sternal border with low pulse pressure, diagnosis: (no radiation in question)?
Mitral stenosis?
850
Pt with Dm, has ptosis on his right eye, can't adduct, elevate and depress
Diabetic 3rd nerve neuropathy
851
systolic murmur radiated to the apex.
Aortic stenosis
852
56 years old dm and hypertension on thiazide and still his htn not controlled what to add? A.
Acei
853
Increase Hb A2?
Thalassemia trait
854
Patient with painful bilateral inguinal lesion, vesicles, most common cause?
HSV
855
Child with periorbital edema, lower limb edema,sacral edema, high Ast and amylase
Nephrotic syndrome
856
77 year on 3 Htn medication, not controlled. Us asymmetric kidney size
Renal artery stenosis
857
Gbs
Painless weakness that is more distal than proximal, PT have hx of infection or vaccine received 2 weeks ago
858
Type of precaution for both meningitis and pneumonia
Droplets
859
Frontal sinus headache , how to reach dx
Full hx and examination
860
chronic alcohol drinker, cant remember the symptoms but the labs showing
• low copper
• low serum ceruloplasmin
• High 24 hour urine copper
diagnosis: wilson’s disease
− treatment: penicillamine ✅
861
TTP peripheral blood smear pic + aptt and tp were normal in the scenario
TTP review picture
862
(diabetic patient with vitiligo) vary direct scenario about b 12 deficiency and labs showing high mcv
with low b 12. asking about the treatment
Im B12
863
COPD male patient with SOB, hepatomegaly,… with all edema sx. On la)bs
O2 saturation 86%
High bicarbonate, low oxygen.
NEXT?
- Diuretics
- Oxygen
Oxygen?
864
59 year old male patient with HTN and BPH what med to give ?
A- BB
B- CCB
NO Alpha blocker in the chices
865
Old female with many sx not related to each other (dizzy when stand up from
bed, lightheadnsess. Flush, Skin itchy, cold extremity, abdominal pain)
examination clear
Labs normal.
Stool test normal
Next step?
A us abdomem/ pelvic
B 24-hour urinary 5-HIAA
866
young patient with sx of meningitis and rash on the lower limbs. Most likely
diagnosis:
A meneingo meningitis
B pnemococal meningitis
Meningo meningitis
867
64 years man with DM, HTN. AFB
A aspirin
B warfarin
868
Pt with absent distal pulses, palpable popliteal pulses, diminished
sensation, altered motor response, What is your most appropriate
action?
A. Upper knee amputation B. Catheter thrombolysis.
C. Heparinization and wait D. Maybe imaging?
869
Number of effective minutes in aerobic exercise
A 15
B 10
C 15
D 20
870
Patient with RTA>> tention phenmothorax, GCS 8 next?
A intubate
B needle decompression
871
Child lab showed microcytic and hypochoromic anemia with
reticulocyte count high (3%) , ferritin low, and his 2 siblings
have the same presentation what is the diagnosis ? A. Sickle
cell disease B. IDA C. Alpha Thalassemia trait
872
Patient with Sarcoidosis with the labs showing: high
ferritin, what is the diagnosis?
A.IDA
B.Sideroblastic anemia
C.Anemia of chronic disease
873
39 years old primagravida, 39 GA in second stage of labor for 2 hr.
full dilated fully effaced, fetus +2, palpable fetal head from abdomen 1/5
cs
ventose
re evaluate in 2 hours
874
13 years old child with SLE, she is complaining of neck stiffness and arthritis and stiffness
in hand joint at morning with malaria rash Which of the following associated with
American clinical criteria of SLE
A. Malar rash
B. arthritis or joint involvement
C. positive ANA
D. hemolytic anemia with RBC
875
Old PT with DM and HTN, presented with neck pain and sweating for 1H, he has a previous Hx of recurrent chest pain which resolve spontaneously after resting, ECG done and shows non-spesific ST segment and T wave changes, Troponin test are negative, what is your next step? A. Repeat troponin after 6H B. Discharge PT C. Do stress ECG test D. Give aspirin and nitroglycerin
876
Child with fever, vomiting and diarrhea ABG:Normal pco2~Normal bicarb ~Base access -4 “normal range from -2 to 2” Ph 7.3~What type of shock does he have? A. early compensated shock B. late compensated shock C. early uncompensated shock D. late uncompensated shock Answer is: C
Child with fever, vomiting and diarrhea ABG:Normal pco2~Normal bicarb ~Base access -4 “normal range from -2 to 2” Ph 7.3~What type of shock does he have? A. early compensated shock B. late compensated shock C. early uncompensated shock D. late uncompensated shock Answer is: C
Explain this
Sources
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Answer
The child has early uncompensated shock (answer C). Here's why:
The arterial blood gas (ABG) shows a pH of 7.3, which indicates metabolic acidosis. The normal range for pH is 7.35-7.45, so a pH of 7.3 is acidic.
The pCO2 is normal, which suggests the lungs are trying to compensate by blowing off CO2 to raise the pH.
However, the bicarbonate (HCO3) is normal and the base excess (BE) is -4, which is below the normal range of -2 to +2. This indicates the kidneys have not had time to compensate by retaining bicarbonate.
In early uncompensated shock, there is inadequate tissue perfusion leading to lactic acidosis. The lungs try to compensate by increasing respiratory rate, but the kidneys have not yet had time to retain bicarbonate
877
patient was diagnosed with generalized anxiety disorder and has difficulty sleeping. the following is used for management?
Alprazolam
878
patient presented with insomnia 2 months post myocardial infarction. What is the recommended treatment for this patient?
Zolpidem ( with heart disease ✅) Diazepam ( with no pervious heart disease
879
Pt with malar rash, chest infection, autoimmune Hemolytic anemia, renal impairment protienuria and high creatinine and urea, what's the dx: lupus nephritis All lab normal except low c3 , c4 or c2 Ask about treatment: A-Methotrexate and hydroxychlorine B-Methotrexate and cyclophosphamide C-Methotrexate and MMF D-Azithromycin No steriod in And in other recall No (MTX + Cyolophsophmide ) Was in choice: (MTX – Cycolsproin) NOTE: MMF for renal Cycol for CNS?
880
HIV case with neurological MRI findings, tx? Rifampicin+ Ab Another AB combination Sulfa+ other drug 2 drugs (not Ab) what brain lesion ist ??????? HIV can be associated with specific cns mass lesion as Toxoplasmosis, cns lymphoma or brain abscess.. or it can have non-mass lesion like encephalitis of any viral or bacterial cause) ** since the options are most likely pointing towards Toxoplasmosis, most likely answer is sulfadiazine + pyrimethamine
881
Alzheimer’s came with severe agitation what is ttt:
Olanzepine
882
Pansystolic murmur to left lower sternal border
VSD
883
low pitch Mid diastolic murmur, rumbling in character heard best at apex?
Mitral stenosis
