Ethics Alaa Questions and Notes for Smle 2019

ask about history and the pts want to express his feeling and concerns:
let him express
‫ يعني يقولك المريض دخل المشاعر الشخصية بالتاريخ المريض ايش مفروض نسوي معاه ؟؟ ال نقاطع المريض نخليه يكمل تعبير مشاعره‬.
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patient has cancer you told him he responded this mistake. what is this:
denial
‫ ربط سرطان = رفض = االمراض السرطانية دايم عالجها مرفوض حتى االن‬.

consent for CS the pt refuse to do CS, what will you do?

Respect her wish or call hospital admin
‫ ماتبغى تعمل عملية = مانغصبها وال نكلم زوجها ناخذ الموافقة منه نحترم قرارها ولو مافي باالختيارات اختاروا انه نكلم مدير المستشفى‬.
Child came to ER because of asthma attack and when you talk to father about not smoking in the home he seems not
interested, what to do:
A. inform child protection✅
B. ignore the father and focus on treating the child
‫ واضح انه االب مهمل وال يهمه ضرر الطفل = فخالص الزم نكلم مسؤولين حماية الطفل‬.

Another same case but first attack of asthma and father smoking what to do = cauenclling the father about risk of
smoking on child
‫هذا واضح انه ابوه مايعرف خطورة التدخين ف اول شيء = نعلمه خطورة التدخين‬
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Parents came with their son who was recently diagnosed with lung problem, dr informed the parent that now ((he
will explain the case to them, go through management) and then he will answer their questions, what is this called ?
A. probing B. agenda setting✅
‫الموقف هذا يسمى ب ايش ؟‬.‫ ثم يجيب على اسالتهم‬manag ‫يعني الدكتور قال لالباء انه راح يشرح ل الحالة ابنهم لكن كلم‬
= managmant = setting ‫ربط‬
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Patient got pulmonary TB and treated accordingly, got liver failure from the treatment and admitted to ICU. Son is
angry and want to suit the doctor. What is your response?
((Calm)) him and tell him the case will be investigated.
‫ و ولده غاصب من الدكتور كيف نرد على ولده ؟‬TB ‫سار له فشل بالكبد بسبب ادوية‬
. ‫ ونقول له راح نتحقق من الي سار‬Calm ‫اهم شيء نهديه‬
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child with abdominal pain during school days, what to do?
Positive reinforcement
= Postive + reinforcement‫ربط = مدرسة = الزم يكون شاطر و قوي بالدراسة‬
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couple came in the fertility clinic, husband found to have HIV.

A. -tell the husband
‫ النها اسرار‬. ‫ نخبر صاحب المرض فقط‬، ‫ الن شيء شخصي‬، ‫اي احد مصاب بمرض مانخبر احد من اهله‬
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Couple came to the infertility clinic wife found to have (blocked tubes) what will you do?
A. -tell wife B. -tell husband
D. -tell couple✅
‫ الن شيء يتعلق بالحمل فالزوج والزوجة الزم يعرفوا‬.
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Child immunocompromise mother refuse intubation because her previous child dead in the same way:
ignore and intubate
‫ نتجاهل االم ونعمل‬intbe ‫ وكمان حالته طارئة مايحتاج موافقة من احد‬. ‫ الن هذا حياة الطفل وليس حياتها الشخصية‬، ‫للمريض‬
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female asking HRT= refuse
‫ مو اي احد يطلب عالج للهرمون ونعطيه الن خطر بيعمل‬cancer
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couple asking about (surogacy) and you are not sure :
give another appointment and read
‫ ف عادي عطيهم موعد ثاني واقرء عنه‬، ‫طلبوا تأجير الرحم = وانت ما تعرف هل مسموح وال ال‬
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Pt threatened u for complaining if you don’t do the surgery
A. consult physician
B. call social worker
C. do it
D. ethical committee
Answer : Refer the patient or B
‫ وليس‬. ‫ هنا انت ال تعالجه حوله ل دكتور ثاني او اطلب سوشيال يتفاهمون معه‬، ‫واحد يهددك لو ماعالجته كويس راح يشتكي عليك ويسوي لك مشاكل‬
. ‫اخالقيات ال تخربطون‬
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Patient primigravida was trying to get pregnant for 10 years and she finally got pregnant reached 10 weeks. Then
developed complete abortion. She and her husband are so emotional and sad. The doctor try to bring togetherthe
reason the management and tried to address their emotions to bring them together.
What communication skills did the doctor === Reflection.
= reflection ‫حاولوا عشر سنوات يحملوا وبعد حملت سقطت كيف اتعامل معها‬
.‫ربط = مصيبة زي كذا تحتاج اكشن = ريفليشكن‬
.....
Pt come to do cardiac catherzation but pt have concerns what to do ?
A. Explain to her and tell her the complication
B. explain to her and tell her the complication with alternative✅
‫الزم نشرح لها المضاعفات مع البدائل‬
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Consultant prescribed drug for pt and the pharmacist tells you that pt has allergy from drug , but the doctor insists to
give, what to do?
A. write it and let the doctor sign it
B. refuse gently✅
‫عنده حساسية من دواء ال تفكر تعطيه بيده ارفض‬
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12 y old female, acne , menorrhea , and 29 BMI , Agitated, not cooperative in examination You have considered:
A. Mood B. Behavior✅
C. Substance use D. Anxiety
‫ربط = وحدة غير متعاونة بالفحص = سلوكها و اخالقا سيء‬
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Child with multiple congenital Anomaly came needing intubation
A. respect the mother wish
B. Contact hospital ethics committee
C. Ignore the mother request and intubate
It depends on the age
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Infant 2 months found dead his mother denied any fever NO sign for fracture or skin bruise Which part of hx will to
complete and help in reach dx ?
A. social Hx✅
B. allergic Hx
C. blood transfusions Hx
D. medication Mather takes in pregnancy
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-Mother refused to sign for abortion ( 22 weeks): ?
A. husband sign
B. respect her ✅

Doctor decided CS for a pregnant lady due to ((fetal distress)) but , mother refused.. asking: who should sign the
informed consent?
A. husband
B. doctor
C. mother
Answer is: C or ethical community✅
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A young man has been admitted after being diagnosed with (Ebola,) and he is threatening to leave the hospital if you
do not discharge him.
A. Call committee B. Security✅ C.DAMA
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Surgeon forget after appendectomy a gauze and foreign body showed in image , What should a surgeon do ??
A. tell the patient✅
B. tell hospital committee
C. not tell anyone

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You can get helpful ((information)) from the patient , as a consultant what you will do ??
A. ask open questions✅
B. tell the patient waiting outside
C. you are busy don’t have time
‫السؤوال المفتوح يعطيك (معلومات) كثيرة‬
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Angry man came to your clinic with her son who want goo with school team but her mom refused and told you her
wife asked me to tell you refuse and write my son not fit for sport , As consultant what you will do
A. tell me what happened✅
B. what you will do if you are a doctor
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Female pregnant smoking,, abortion ,As doctor on consultation,,
A. ask her to stop smoking✅
B. smoking increase 10 times IUFD
‫تدخن = توقف التدخين‬

Patient refuse CS , consent from who =

A. patient✅ B. husband C. ethical committee
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90 yrs male with severe symptoms of respiratory symptoms and thoracic surgeon decide to a surgery to improve his
symptoms but with high risk?
A. explain to the patient and signed high risk consent
‫من العنوان هاي ريزك مع هاي رزك‬
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Patient has incomplete abortion and refused D&C, her husband ask if he can sign instead of her , who has the right :
A. Patient✅ B. Husband C. Hospital committee
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Child came to ER because of asthma attack and when you talk to father about not smok in home he seems(( not
interested(( , what to do:
A. Inform Child protection✅
B. Ignore the father and focus on treating the child
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Women pregnant with ovarian cyst torsion refuse emergency laparotomy from whom to take consent:
A. Respect wife✅ B. husband consent
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43- Pt underwent tonsillectomy and the procedure take long time due to bleeding and patient recover will after the
operation but concern why it took long time :
A. Reassure and tell the pt what happen
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44- Child came to the ED with gastroenteritis, U discharge him home after telling him to eat healthy food and come
to the hospital if there is warning symptom. The doctor doing??
A – safety Netting✅
B- mirroring
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Pregnant with fetal distress and refused to do CS: -
A- allow vaginal delivery ✅
B- her husband decision
C- ethical committee ‫االخالقيات مالهم عالقة‬
D- Do CS force

Patient came to u buz she is afraid from developed cancer diagnosed with endometriosis. what is the appropriate
counseling to tell this pt in this situation:-
A- not related to cancer.
B- protect against cancer.
C- associated with ovarian cancer✅
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Child with asthma and his mother also she (had poor technique ) for inhaler use the child have extirpation despite
the treatment what is the cause:
A- no compliance
B- poor technic✅
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An ethical scenario in which parents brought their child for a health check. Child has not had any vaccinations
because px's don't believe in it. What should you do?*
A-Accept their decision
B-Refer them to social services,
C-Refer them to another Physician
D-Counsel them about the benefits of immunization and correct their misconceptions ✅

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Case about man interruption the clinic and concern about his disease what do for him :

A. Tell him the clinic is full of pt and come again.

B. listen to his complain with open ended complete question ✅

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Patient is worried and talking much and take from your time:
A. Politely interrupt him and ask close ended Q. ✅
‫اخذ وقتي الزم اقطعه واسال اسالة جوابها بسيط‬
B. Tell him there is mor pt outside
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Pt admit for tonsillectomy but surgery prolonged bc bleeding, the surgery successfully done , after pt ask why
surgery prolonged?

A. reassure pt and don’t tell him about bleeding

B. tell another doctor to see him
C. ethics committee
D. reassure pt and tell him what✅ happened
‫الزم اقوله بالحقيقه هذا جسده الزم يعرف ايش سار‬
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A pregnant woman in labour with fetal distress. You counselled her for surgery but she is refusing bluntly. What is
the appropriate action?
A-Refer to another hospital,
B-Inform the hospital ethics committee,
C-Get consent from husband,
D- Allow vaginal delivery based on her✅
‫ العالج والتدخل الطبي يخص المريض وحده وعلي الطبيب إيجاد البدائل‬،‫ فقط يرسل المريض لقسم األخالقيات إذا كان غير مدرك على اتخاذ القرار‬----
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A woman came for routine ANC and smokes about half a pack of cigarettes daily. She had 2 normal children
previously and doesn't believe smoking is harmful in pregnancy. How do you manage?
A- Accept her beliefs,
B- Refer her to mental health services,
C- Counsel that her child is at risk of intrauterine growth restriction,✅

7 years old child brought to the ER with DKA. What is the best to do after ER treatment to make pt more compliance
for ttt??
A- Listen to his concerns about DKA and its management
B- Supply child and family with a written plan of care✅
C- Send the Child to special care services
‫ لذلك دور الوالدين له دور فعال في نجاح العالج‬، ‫الطفل في هذا العمر غير مدرك لتفاصيل األمراض الطبية ومضاعفتها وإن تم تبسيطها‬
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Mother of baby with Fetal congenital anomaly ask u don’t Resuscitation , what to do ?
A- Honor her wish
B- ethical committee
C- Resuscitation
Answer is: Same as above question
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A pt with IUFD , what is the best thing tell pt at this moment :-
A- console the couple for early follow up visit after a few days
B- let the mother spend some time with her dead child✅
C- give medication during her think to induce termination
D- u can’t let her go home to think
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Cause of domestic violence
A. Martia distasfied ✅B. Smoking
‫سبب العنف المنزلي = الزوجة الثانية‬
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A mother had IUFD and blames herself for smoking 5 cigarettes a day as a cause of the death of her baby. What will
you tell her?
A. Smoking is not associated with fetal demise
B. Tell her to stop smoking for future pregnancies ✅
C. Tell her that further investigation needs to be done to know the cause
D. Tell her that smoking 5 cigarettes a day increases the risk by 10 folds
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Mom is complaining she can’t leave the house because her son is using a nublizer which needs electricity, what do
you suggest?
A. stop nubilzer and give inhaler✅
B. suggest portable nubelizer
C. someone stays home with him
D. all family stay home cuz it’s important
Answer is: A or B (A more correct based on consultant answer )
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Ashmatic child his family stat that thy can not go out becouse the nebuluzer machine need electicity, what u wll do
to help them?
A•Tell them they are right.
B•Provide them with nebulizer with battery.
C•Clearly instruct the inhaler and tell them to stop the nebulizer.✅
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pt come to the doctor and he have Malignant Melanoma :
A. send him to other doctor
B. he can trusted you b/c you are good doctor
C. give more detail about his condition so he can trusted you ✔️
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Ethic csae about serrugaty and the doctor know that it’s not allowed at his hospital but doesn’t know about SA role?
Till them that it’s not allowed at his hospital.
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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?
A- call the chef intern
B- tell the surgent ✅
C - do nothing
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Patient old with end stages cancer disease complining of sever 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 there father
question in this case what the doctor do ?
principles of double effects
‫ = دبل دوز‬pain killer = ‫ربط‬
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Dr want to explain family cystic fibrosis from a to z wts call?
A. Summartion ✅B. Paraphrasing
(explanation better answer than paraphrasing
.‫ يكون افضل‬exoplanch ‫لو فيه اختيار‬
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Female has ovarian torsion, dr. explained to the patient about surgery and got consent from the husband, but the
patient refused doing surgery:
A. Do surgery
B. Tell someone of the relative
C. DAMA✅
D. Husband consent is enough
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Female pt going for breast examination but she wants female doctor to examine her what you will do: A. refuse B.
respect✅
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During abdominal examination the intern forget to close the curtain what he broke:
A. principal of dignity
B. principal of privacy✔️
Close = privacy
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You want to do surgery to a 15 y old , from where take the consent ;
A. Parents alone
B. Patient alone
C. Both of them
Answer is Parents’ consent and ass the child✅✅
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Women want to take ocp and husband no want take ocp ?
A. empathy B. follow wife
C. follow husband D. Both✅
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A pt want to quit smoking and he saied well do it next year what this is called
A-prepration
B-precontemplation
C-contemplation✅
. ‫ = كنت اريد اوقف التدخين السنة الجاية‬cont = ‫ربط‬
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Patient came for surgery, after finishing it was discovered that the surgeon assistant forgot infected sponge (or
something like that) inside the patient. The patient was taken urgently back to OR to be reported and to take out the
infected sponge. Your action should be?
A-Inform the consultant
B. Inform the patient and apologies✅
C. Inform hospital ethics committee
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patient was diagnosed with generalized anxiety disorder and has difficulty sleeping. the following is used for
management?
A. Alprazolam ✅
B. Bupropion
C. Hallopridol
‫ = ربط‬alpra = alarm = sleep
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elderly + metastatic cancer his son ask yo to not tell his father about the diagnosis:
A-Tell he patient✅
B-consult legal committee
B-consult ethical committee
‫اشك بالحل هذا‬
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doctor give instruction to patients about symptoms if happen patient need further medical help:
A-safety netting✅
... ‫شرح له اعراض معينة اذا حصلت له نقول له يرجع للمشفى‬
‫ = نت = انترنت = نبحث فيه عن اعراض المرض واذا نفس اعراضنا نروح للمشفى‬netting = ‫ربط‬
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Pt ask strangers inappropriate questions and he is not aware and not respond when they try to tell him?
A-flight of ideas
B- loose of associ
Answer is Perseveration
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When you screen a Rare disease in a population, what is highest positive result:
A-False positive✅
B-True positive
Rare = fals
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• Sensitivity Answer is for screening
......
examine patient and forget close curtains? A. privacy
NOTES (Clothes = dignity) ( Curtain = privacy )
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Patient for surgery but has a persistent cough for 6 months and you didn't book him for surgery, he is angry and
threatened to report you if you didn't book him for surgery:
A. do the surgery to get his respect
B. Report him to hospital social worker
C. Consult a physician
D. Report him to the administratio✅
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A child with multiple bruises brought by parents. What should Dr. do?
A. Question parents about it
B. Refer the child
C. Inform child protection services✅
‫ربط = ضرب = حماية‬protection .
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Scenario of an elderly with an advanced cancer. Anaesthetist thinks operation not advised but surgeon wants to
operate. What should you do?
A. Take a high risk consent,✅
B. The surgeon should operate with another anaesthetist,
C. Inform hospital ethics committee,
D. Refer patient to another facility.
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Question about early identification of disease, what type of prevention was it? 2ry screening
Early = scondry
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Wife refused who got the right to decide= Patient.
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Old pt you diagnose her with atrophic vaginitis but didn't seem convinced she told you she wanted another
consultation
A. Tell her u r sure that us not necessary
B. Write report and refer✅
C. Refuse
………………………………………………………………………………….
15 years old for surgery from where you get consent?
A. parents✅B. child C. both D. social
Consent the parent Ascent the child
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pregnant lady came to hospital with broken arm after her husband beat her, whats the most likely time increase
violence?
A. after retirement
B. after family visit
C. Holidays✅
D. at work
‫الوقت االكثر احتماالت لزيادة العنف‬
Answer is: C ( pregnancy first then if not there , go with holidays )

ther of newly diagnosed child with DM1 she didn’t give him medication cuz she said he will be normal
A. Denial✅ B. Neglect C. anxietya
D*m* ‫ = مع‬D*enil* ‫ربط‬
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Bilateral ovarian abscess in a pregnant with 20 weeks who refused the surgery what to do?
A. Accept her decision✅
B. consent from husband
C. tell a relative
D. inform social or medical advisor
Answer is: A and let her sign that she refused
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Meningitis suspected pt's SON refuse iv antibiotic to be given to his father what to do?
A. Respect the son's decision.
B. Ask patient opinion✅
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elderly with end-stage cancer in unbearable pain his family ask u to give him what to do? Give him
.....
pt doesn’t want to know the details, the surgeon appreciated that , but the anesthsic dr insist?
‫المريض ال يريد معرفة تفاصيل العملية ولكن طبيب التخدير يصر انه يقول للمريض‬
Tell the pt the decision of the anasthesia dr.✅
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pt were inappropriate clothes and speeks( I know language to nurse) in sudective way to the dr what should he do?
A. Shout on her (scream).
B. Call security.
C. Get nurse who speak same language.✅
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65 years with lesion on his face ( long case ) and part of the biopsy report is dx‫ز‬melanoma. He is known to be non
compliance. How would you make him now a compliance pt?
A. Tell him about the serious sign and symptoms
B. Show him how brilliant of a doctor you are
C. Talk to him slowly step by step to make him understand you✅
Answer is C
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Pt dx to have squamous cell cancec. How to break the news to him?
A- Dont waste time and tell him his options
A. Reassurance , tell him not to worry
B. Dont tell him at all , hide the dx
C. Tell him by small step in different times✅
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Female on 38 weeks long case confirmed fetal death in utero no cause identified. They asked about Mother options
by the dr?
A. Induce labour now immediately
B. She still have time to go home✅
.....
Pregnant with HIV what will you tell her =
A. She can breast feed
B. To do CS to avoid transmitting to child via vaginal ✅
C. No need to give the child vaccine after birth
D. Tell her she is cute mother regardless HIV
.....
baby with hernia mother left him and pediatric surgeon want to do the surger now from who you take the consent =
ethical committee
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Wife came to with bruise due to his husband hit her what is the most common cause of violation against female ?
A. Socioeconomic B. cultural✅
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What determines the prevalence of a disease?
A. sensitivity B. Specificity
C. predictive value

⚘prevalence= predictive value⚘.

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The doctor explains to the mother about vaccination and if the child did not take it what will happen for the him ,
what do you call this= counseling
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Parents refuse to vaccinate their child what will u do :
A. Scocial service✅
B. Ethics department
C. Vaccinate him
D. Tell them about advantages of vaccines Answer is : A
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Forget guze in abdomen of post operative patient . What to do :
A. Dont tell the patient
B. Tell the patient apologize and get it out Answer is : B
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Case of amputation, pt refused. What to do?
A. Refer
B. discharge because he refused Answer is: B
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87 years old boy presents with measles, he have never been vaccinated since his father
think it's bad, what to do?
A. Explain to the father
B. Call child protection services
C. Refuse to treat the patient
D. Treat the patient and let him go
Answer is A
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160- Female with incomplete abortion, her husband wants to sign for surgery, and she is refuse.. Who should sign
for a consent?
a) Husband
b) Family Patient Doctor
Answer is the Patient
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scenario during surgery you injured CBD and the pt is ok what to do ?
informs the pt
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couples Post coital ( after intercours) bleeding , they are sad ,
Answer is Acknowledge their emotions
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senario of suspicion Appendicitis and durning surgery appendix is normal , but you have to remove it even thow its
normal , what to do ?
Tell the pt
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senario of end cancer how sign DNR and after he died, his son is angery why you didn't resuscitated his father ?
tell them you respect his wife
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while you came to the clinic late the pt is angry ?
explore the reason of being angry
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Mother with appeared with some mental retardation Parents want to take hime back home:
a-Called child protection
b-contact ethic✅
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Elderly with endstage cancer in unbearable pain his family ask u to give him stronger pain killer?
a- Give him stronger analgesic
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pt man result came back HIV +ve who came prior for infertility assessment:
a- Tell the patient first ✅
b- tell wife #
c- tell both together
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dr after explaining to pt what is next mx and explore there emotion went through the main points again.What did he
do is:
- Summarizations
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pt with complete abortion while waiting for admission were tearfulness and husband was emoitinally distress what
to do :
a- Explore and reflect to thire emotions
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A fetus was discovered to be dead at one of the antenatal visits. The mother is crying. Her husband is upset. What is
your role?
A-discuss the possibility of future fetal malformations
B-explore, identify their emotions, empathize.
C-explore, recognize their emotions, find solutions
D-empathy is sufficient
Answer is: C, B maybe also a correct answer
……………………………………………………………………………………………………………………………
You were late pt start to shout and angry: Acknowledge his anger
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pt don’t belive this is the correct dx and wants another dr opinion:
a- Give her report as this is her right ✅
B- refer #
C- ethical committee
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consent in case of IUD to be taken consent from:
A- wife
B- husband
C- mutual from both✅
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Case of child newborn abanded by his mother as he result from out of marriage relatioship .Child is in the hospital he
has hernia and pediatric surgeon said he need repair for his hernia now How u will act :
A. Reveiw ethics section in hospital ✅>> should be court or the ethical comity
B. Do the surgery without consen
t C. Refuse to do it as no one to sign
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You was talking to patient to get details on the history but the patient interrupted u and start to talk about his point
of veiw regarding his diagnosis and the reason of his disease . How u would act :
A. Refer him to another doctor
B. Let him finish his point of view✅
c. Apologize to him and start with close ended questions
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Patient need operation dr start to tell the patient about the positive and possible complications but patient refuse to
hear that but the anesthesia doctor insiseted that the patient should know the complications . How u will act
A. cancel the operation
B .Get another anaesthesia doctor
C tell the patient what anaesthesia doctor want✅
D.let the anesthesia doctor deal with the patient
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Best way to stop smoking in pregnant is :
a. Behavioral way✅
b. bupropion
c. Electronic smoking
d. Alternative to smoke
------------------------------------------------------------------------------------------------------------------------
67 y old man felt dawn complain of pain on hip and knee assessment releved no fractures foly catheter inserted on
first day as he was unable to move with analgesic after 5 days he discharged to nursing home with unchanged foly
catheter now complain of fever urine analysis show full wbc in urine with bacteria , this could be prevented by
a. Prophylactic antibiotics
a. Prophylactic antibiotics
b. Increase iv fluid intake
c. Daily review for the need of foley catheter✅
d. Change foley catheter before discharge .
-------------------------------------------------------------------------------------------------------------------------
12y old attitude toward parent illness:
a. Can't comprehensive the concept of disease treatment prognosis
b. Depression withdrawal response
c. Forget

Refractory behaviour: fussing,

violences
Children may react to the imposed stressor by isolating themselves, feeling guilty and worrying about changes in
parental health.
……………………………………………………
internal medicine resident did diabetic foot examination but she forget to close curtains when she expose pt
abdomen what the ethical principles she is broke? privacy
......
A woman brought with the police with bruises how to deal with her condition ?
• Call a Social service of the hospital
• Not examines her without her husband
• Enter to her with a large smile and begin examination
• tries to console her, she knows the cause of the bruising, and then begins the examination✅
--------------------------------------------------------------------------------------------------------------------------
Patient admitted with stroke hemiplegia on 2nd day start to having 1st degree bed sores the physicin verbally tell
the nurse to change patient position every 1 hr to avoid bed sores . Nurse forget to write this . 3 days later patient
had fever on examination he had infected grade 3 bed sores . Where is the defect :
A. Communication between the doctor and the nurse inadequate way✅
------------------------------------------------------------------------------------------------------------------------
The mother refused the cs that is will save the baby.
A. Refer the pt
B. Repect her wish✅
C. Take the husband concent
D. Do vaginal delevary
E. Do cs against her wish
……………………………………………………….
24 week preterm delivered, mother she is a doctor and she asked not to Resuscitate her baby, what you will do ?
a. Ignore the mother and Resuscitate ✅
b. Tell social services
c. respect her wishes
-------------------------------------------------------------------------------------------------------------------
A woman brought with the police with bruises how to deal with her condition ?
• Call a. Social service of the hospital
• Not examines her without her husband
• Enter to her with a large smile and begin examination
• tries to console her, she knows the cause of the bruising, and then begins the examination
Answer is D
----------------------------------------------------------------------------------------------------------------------------------
Patient admitted with stroke hemiplegia on 2nd day start to having 1st degree bed sores the physicin verbally tell
the nurse to change patient position every 1 hr to avoid bed sores . Nurse forget to write this . 3 days later patient
had fever on examination he had infected grade 3 bed sores . Where is the defect :
A. Communication between the doctor and the nurse inadequate way
----------------------------------------------------------------------------------------------------------------------------------
The mother refused the cs that is will save the baby.
A. Refer the pt
B. Repect her wish✅
C. Take the husband concent ( not sure)
D. Do vaginal delevary
E. Do cs against her wish
…………………………………………………………….
Copd elderly admitted exuberation at night became aggressive disoriented what the nurse should do first:
a. Call the duty dr for lorazepam iv
b. Restrain her
c. Call family sit beside her
d. Elevate the head of bed put nasal oxygen try to orient her about place✅ and time
--------------------------------------------------------------------------------------------------------------------------
7 year old sick baby, not complinet to his medication your job as a doctor is to?
A. Explain to the parents the importance of medication compliance ✅
B. call the police
C. involve the parents and the child in the medical plan
D.refer them to the Ethics Committee
--------------------------------------------------------------------------------------------------------------------------
women got pregnant after trying 10 years, now she is 10 week pregnant, she has abdomen pain and vaginal bleed,
she went to the ER , the dr said the was not fetal heart sound and this is abortion ( they were shocked ) what the
doctor should do ?
A.Sympathy✅
B.Admission after evacu#ation as post partum care
C.Search for cause of abortion
------------------------------------------------------------------------------------------------------------------------
75 years old has terminal lung cancer , he can’t breathe , he can’t make decisions very well, the doctor wants to do
debulking of cancer to help him breathing well, and the success of this operation will improve his live , but the dr
also knows that can develop the complication of the operation and the anesthesia. What the dr should do?
A.go ahead surgery
B.informed consent pt
C.search alternative decision maker consent ✅
-------------------------------------------------------------------------------------------------------------------------
Reviewed the case and it was a hernia, he recommended to do surgery now, what should you do?
A-Refuse to do surgery without consent
B-Consult ethics committee in hospital
C-Do surgery without consent
D-4th option can not remember it Answer: If is emergency C if not A
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Child has flu brought by his mother for vaccinations and mother wants to postpone because he is sick, on ex mild
flow, child is active what to do
A. Reschedule in 2 wks
B. Ignor
best answer is explain to the mother then give him
----------------------------------------------------------------------------------------------------------------------------------
Pregnant wants to quote smoking best way
A. CBT✅
B. Nicotine rep#lacement
C. Buprine
----------------------------------------------------------------------------------------------------------------------------------
34 years P4G3 GA 32 she is not came to ANC visit never, what the cause?
A- visit is expensive B- Ignorance
C- scaring from visit Answer: B
----------------------------------------------------------------------------------------------------------------------------------
If patient is HIV ve+, tell him and tell him to till his wife but the doctor should tell the authorities. But If pt say plz
don't tell my wife, then what you will do?
a) You shouldn't tell her
b) Tell health authority's only
Note: Tell patient first and ask him to inform the partner , otherwise she will be informed legally
----------------------------------------------------------------------------------------------------------------------------------
Pregnant with rupture of membrane Elderly female discovered to have cancer. Her sons said to you don't tell her she
has cancer. What to do?
A. Tell pt
B. Don't tell pt #
C. Consult health authority Answer: A
-----------------------------------------------------------------------------------------------------------------------------
cystic fibrosis or celiac pt sit with the dr to know how to deal with the disease and its prognosis what does this
session called
A- summarisation
B- verbal communication
Answer: B
----------------------------------------------------------
a mother knows that her child has diabetes and was giving him insulin then she suddenly stops giving him insulin by
saying his pancreas r working and he has no disease anymore?
A anxiety B neglect C denial✅
----------------------------------------------------------------------------------------------------------------------------------
a young child newly diagnosed asthmatic mother also asthmatic father is a chain smoker
A stop smoking in the house✅
B give short acting beta agonist to the child
----------------------------------------------------------------------------------------------------------------------------------
pt newly dx with HTN and doctor tell him about disease and complication and medication what doctor did?
A-give informational case✅
B-build bonding with p
----------------------------------------------------------------------------------------------------------------------------------
parents come with child not vaccinated because they think it is bad for him what you will do?
A-consult child support
B-explains to parents about wrong myth and it is good for child
--------------------------------------------------------------------------------------
Doctor who is leader for a team is doing CPR for a patient. The doctor's role in providing protection for the patient is:
A. Put another nurse instead of him
B. Put a resident instead of him
C. Providing more practice for the team
D. Make communication more between the team Answer is D (CPR = Team )
--------------------------------------------------------------------------------------------
Screening in low prevalence community Positive result with be ?
● True +
● True-
● False +
● False -
false postive‫ربط خطا و صح‬
---------------------------------------------------------------------------------
Abundant baby, doctor said do inguinal repair now :
A. Do it without consent
B. Take consent from ethical committee ✅✅
Abundant baby = ethical committee
---------------------------------------------------------------------
Surgeon is doing OP for patients with Hepatitis C and suddenly he was injured by an injection. What is the
percentage of getting infection? 3%
--------------------------------------------------------------------
Volunteers give lectures for public about preventive measures ((during eating and drinking and cleaning)). Type of
prevention?
A. primary prevention -
B. premodal prevention
C. secondary prevention
D. tertiary prevention
‫ = ربط= قبل االكل الزم نغسل يدنا اول شي نسويه هو غسل اليد‬primary
---------------------------------------------------------------------------------
Doctor tell nurse to move bedridden pt nurse forget to tell other
A - poor communication ✅
Forget == poor
----------------------------------------------------------------------------------------------------------------------------------
Long scenario: Radiologist asked by the treating team to do Ct guided Fluid aspiration, Who should get the informed
consent?
A- Radiologist
----------------------------------------------------------------------------------------------------------------------------------
Resident was in operation room with the consultant and during the operation the consultant did unnecessary
intervention but the patient was fine . What should the residents do?
A. Tell the patient
B. Tell the administration
C. Write what happened in surgery report✅
D. Consider nothing happened because the patient was fine
----------------------------------------------------------------------------------------------------------------------------------
Doctor told the nurse to give the patient a medicine that is intravenously but the nurse by mistake gave the patient
lidocaine because it was beside the wanted drug and the patient died. What is this case?
A. the same medicine
B. mistake in prescription and administer
C. disconnection between doctor and nurse✅✅
D. unlike medicine
----------------------------------------------------------------------------------------------------------------------------------
You want to break bad news. What should u do?
A. Tell the patient and family
B. Ask the patient if he wants his family with him C. Tell him only with empath✅✅
----------------------------------------------------------------------------------------------------------------------------------
Female patient needs kidney transplantation and the husband agree but the patient refused. What should u do?
A. Husband's acceptance is enough
B. Make the patient sign on DAMA✅
---------------------------------------------------------------------------------------------------------------
Baby preterm, with ALS needs intubation, family refused. What to do?
A- Respect
B- Ignore and intubate✅
‫ مانسمع كالمهم‬25‫ ممكن نسمع كالم الوالدين بعد ال‬25 ‫لو كان قبل االسبوع‬
----------------------------------------------------------------------------------------------------------------------------------
Patient with irregular cycle and take OCP before marriage. After marriage the husband wants a baby, but she
refused. What’s correct?
Mutual consent on ocp
---------------------------------------------------------------------------------------------------------------------------
7y girl appears underweight and neglected when asking the mother she complains that she has other younger
children to look after that she is busy with.......
A.Contact social worker✅
B.Refer mother to psychiatrist
C.Other opions
------------------------------------------------------------------------------------------------------------------------
Best Advices to traveled man:
• just eat in clean restaurant✅
• just drink
• government water avoid rice
---------------------------------------------------------------------------------------------------------------------------
Female come to ER complaining from her neighbor (abuse her) and talk with him even he is not with her in ER.
Diagnosis?
Delusions and hallucinations✅
----------------------------------------------------------------------------------------------------------------------------------
Smocking decreasing life expectancy by how many years?
5 year
10 years✅
15 years
20 years
Answer: B
---------------------------------------------------------------------------------------
Population screening program?
Colon Ovary
----------------------------------------------------------------------------------------------------------------------------------
Pregnant patient with language barrier came to the ER for preterm labor or PROM (I don’t remember) and she’s
concerned as her 7 years old son was preterm. What should you do?
A. show that you understand her concern✅
B. Ignore her due to language barrier
------------------------------------------------------------------------------------------------------------------------------
Father angry because his daughter insists to enter gym. What is appropriate?
A. Explore why he angry ✅
B. Agree with them
..................
Mother brought her child 8 years that looks not clean, failure to thrive and she was anxious about taking care of her
other children:
A. Refer to psychology
B. Refer to social worker✅
-----------------------------------------------------------------------------------------------------------------------
Patient diagnosed as melanoma to ensure compliance with treatment what should you do?
A. say it’s a serious disease and he might die
B. Explain pathophysiology and management options✅
-------------------------------------------------------------------------------------------------------------
Pt took antiTb he is old he developed liver failure admitted to the ICU HES SON IS ANGERY VERY ANGERY:
a. tell him
b. It could happen to any one Doctor did the best management
c. Calm the son and tell that you want to investigate✅
----------------------------------------------------------------------------------------------------------------------------------
Screening tool should be :
A. Easy and fast✅
B. For rare disease
C. For dz unknown pathophysiology Highly specifice
D. No high sensitive in choices
-------------------------------------------------------------
Patient known case of SMA (spinal myotoni atrophy), develops respiratory muscle fatigue and needs intubation ,
mother refuses as one of her children died of the same condition what will you do?
A. consult ethical commitee
B. intubate her✅
=================================
patient underwent tonsillectomy, during the surgery surgeon faced with difficulty in control bleeding. He toke him
....... it end without complications. Next day the patient ask why it take this long time. What surgery should replay?
a- don’t tell him what happens
b- Tell him and reassure him now that is no complication ✅✅
C- tell Hospital ethics
---------------------------------------------------------------------------------------------------------------------------
Most important step in managing asthma child to ensure compliance to treatment?
A. Listen to child and answer his concerns
B. Write a plan✅
C. Send nurse to check compliance
----------------------------------------------------------------------------------------------------------------------
Elderly man with end stage Ca lung, intensivist label do not resuscitate, surgeon plan a debulk surgery that may have
little benefit. Ask about?
A- go ahead with surgery with another anaesthetist
B- take high risk consent✅
C- involve the family in decision # D-involve hospital ethics committee
---------------------------------------------------------------------------------------------------------------------------
Mother with IUFD counselled prior to delivery of liveless baby, postdelivery mother insisted to stillborn should be
admitted in NICU. Asked about the action?
A- Denial✅
B- Acting out #
C- two other options
-------------------------------------------------------------------------------------------------------------------------------
42 yrs old female came to your clinic with heavy uterine bleeding on us thereuterine hyperplasia, biopsy should
taken what you should do?!
A- Verbal consent✅
B- Call the anaesthesia #
C- Prepare the pt for immediate biopsy
----------------------------------------------------------------------------------------------------------------------------------
child refuse to walk with his mother.. Always thriw his toys. The way to deal with him
A- Time out✅
B- Verbal warning and s#hout at him
C- Sparkling D-Scodli
----------------------------------------------------------------------------------------------------------------------------
What are the 4 principles for effective reporting in child abuse?
A-observe, document, report, self protection✅
B-observe, document, referrals, follow up
C- Document, confirm, report, conference
----------------------------------------------------------------------------------------------------------------------------------
Pt aborted (Ethics) what to do next
a- show empathy and talk about management
B- show empathy and explore emotion ✅
----------------------------------------------------------------------------------------------------------------------------------
40 y.o female 24 weeks gastation had fever couple of days ago but didn't seek medical advice, whats the most likely
cause ?
a- afraid from physician✅
b- neglect
----------------------------------------------------------------------------------------------------------------------------Person asking random
people inappropriate questions what psychiatric symptom is this?
A-Perseveration✅
B-Flight of ideas
----------------------------------------------------------------------------------------------------------------------------------
- about alcohol addiction, which one is related assessment of addiction?
-------------------------------------------------------------------------------------------
Do you feel (guilty) because you are alcoholic✅
‫هل تحس بالذنب ؟‬
Do you think you are alcoholic
--------------------------------------------------------------------------------
eldery with pneumonia and doctor ask to start IV antibiotics but his son refuse what you will do ?
A-ignore his son and start Abx
B-take the pt opinion✅
----------------------------------------------------------------------------------------------------------------------------------
Lady who have malnuratiod baby , with low socioeconomic status .. what to do with her ?
A. -Close end question and send to social worker. ✅
B. psychiatry consultation
-----------------------------------------------------------------------------------------------------------------------------------------------------------
A case of infertility for 10years,with irregular menses n the woman came with bleeding n after ultrasound is
incomplete miscarriage. What will do after evaluation.
A.show empathy n sympathy.
B.empathy should be enough.
C.show empathy and console the couples emotions✅

infertility for 10years= console the couples

-------------------------------------------------------------------------------------------------------------------
DNR and family refuse doctor arrogance meeting with family to : A. Justify✅ B. inform
----------------------------------------------------------------------------------------------------------------------------------
pregnant 10 wk diagnosed with ovarian ca she need for abortion what to do :
A. inform hospital ethics committee B. search in website of Saudi law # C. ask your college

- abortion = ethics
--------------------------------------------------------------------------------------------------------------------
Female came to ER with sign and symptoms of appendicitis , appendectomy was done , surgeon discover the
appendix was normal , what surgeon should be do ?
a- Tell pt what happened and that was routine and no complication✅
b- Not tell the pt
c- - Write report about what happened and give it to hospital committee
----------------------------------------------------------------------------------------------------------------------------
How to inform the society about poisons dangerous ?
a- through media
b- u will do camp and talk about it
c- tell fathers and mothers about it
d-do awareness campaigns and explain the danger of it✅
Danger = danger
----------------------------------------------------------------------------------------------------------------------------------
patient has intra operative common bile duct injury but controlled :
a- tell the patient and reassure him✅
b- Reassure him but dot tell him about what happen.
---------------------------------------------------------------------------------------------------------------------------
physician telling patient : ( I will be discussing with you the diagnosis of your child disease and the outcomes the I will
be answering your questions)
a- assess understanding
b- Setting Agend ‫جدول االعمال‬. ✅
c- Setting ....
d- Probing
----------------------------------------------------------------------------------------
women has sexual harassment at work usually from who?
A-employee B-co-worker C- supervisor✅✅
----------------------------------------------------------------------------------------------------------------------------------
U were late and pt start to shout and angry. What to do?
A- Explain to him why u r
B- Acknowledge his feelings. ✅
shout and angr === feelings
pt came to sign consent for hysterectomy
a-Give her details about surgery ✅b-Make documentation clear
----------------------------------------------------------------------------------------------------------------------------------
normal bereavement case?
a- Sadness
b- 2-3 months
C- not exceeding 12 months ✅
----------------------------------------------------------------------------------------------------------------------------------
Pt with history of asthma on SABA, need to go 2nd step but she refuse that, what you do?
A- increase does of SABA
B- add LABA
C- tell pt how take steroid and benefit✅
----------------------------------------------------------------------------------------------------------------------------------
Elderly not compliant to medications. What to do?
A. worry him about carelessness B. tell family to carry of him ✅ eldry = carry
----------------------------------------------------------------------------------------------------------------------------------
13 years child with bilateral legs burn and father said it is due being in hot path. On
exam you found another lesion due to carelessness. What to do according to Child protection protocol?
A. inform documents and report✅ B. follow up
----------------------------------------------------------------------------------------------------------------------------------
227 Child with Cafe au late sopts , mother said that this is birth mark in her family.?
A- send for more genetic education
B- send for genetic to health education about neurofibromatosis
C- counseling on neurofibromatosis type 1
Answer: Café au lait spots are associated with some syndromes such as neurofibromatosis type 1 and McCune–
Albright syndrome so C first to confirm the Dx then educate the patient. A and B are the same
---------------------------------------------------------------------------------------------------------------------------------- ----------------------
Pt with charcot leg the treating doctor decide to do amputation but pt refused what to do ?
A. Refer to another doctor
B. Respect his wishes✅✅
C. Sign for discharge
----------------------------------------------------------------------------------------------------------------------------------
A nurse came to work with transparent uniform, and was talking to you in a seductive way.
A.walk her out that minute n bring another.
B.report her to the Md.✅
C.leave the office.
----------------------------------------------------------------------------------------------------------------------------------
During heads assesment of adolescent psychiatry who should attend the session
a.parents should be present b.with adolescent alone✅
c.with adolescent and his parents Answer:B
----------------------------------------------------------------------------------------------------------------------------------
A type 2 DM pt has an appointment in the clinic at 11 o'clock, the doctor came at 12:30 because there was a serious
case in the hospital, the pt was angry, what will you do as a doctor ?
A-Apologize and expect that.
Answer: Explore his anger✅
----------------------------------------------------------------------------------------------------------------------------------
If patient that you treated gave an expensive watch as a gift, what will you do?
A-Accept it and tell to not do it again B-Refuse it✅
C-Accept it
Answer: B
----------------------------------------------------------------------------------------------------------------------------------
A doctor is going to present in hypertension conference. Company that produced new drug suggested to sponsor his
trip. What he is supposed to do:
A-Disclose that he’s sponsored
B-Avoid mentioning the new drug at all
C-Reject the offer.✅✅‫ال نقبل الرشاوي‬
----------------------------------------------------------------------------------------------------------------------------------
mother brought her child to hospital. Surgeon discovered hernia and decided to do surgery immediately. Mother
refused. What to do?
A-Do surgery whatever mother decision!!! Here if emergency which hernia is not
B-Inform hospital police!!!
C- Don't do surgery!!! D- explain to the mother✅

‫ لكن الي ارسلته شامل ان شاء هللا‬، ‫ ملف االيثيك تبع جلوري كثير اسالة بنفس الملف مكررة‬.