٢٠٢١ ‫االسئلة املتكرره شهر فبراير ومارس‬

‫دعواتـــكم‬
‫أفنان مقبل‬

Femal pt menopause start vaginal bleeding. She is on conjugated estrogen. Ask about
management?
Progestin pills only
Stop conjugated estrogen❤ ️
COP

: pregnant with SCA at risk of what of the following?

A- chest infection
B- UTI
C- IUGR❤ ️

A patient present in the ER with burning in the back, in the inspection the clothes
were adherent to the skin and there was powder martial in the burn site, after
removing the clothes what should be done
- Irrigation for 30 min
- Surgical debridement and coverage❤ ️
- Forget the other options

2. young patient did pap smear in screening and showed HISL, the biopsy showed
carcinoma insitue, she wants to conserve her fertility
A. cold knife
B. electrosurgical loop (LEEP)❤ ️
C. cryotherapy
D. laser
Female pregnant patient she received anti-D at 20 weeks of gestation, what is the next does
50 yo old lady with regular follow up regarding her renal disease in the clinic.Her
Kidney function test is deteriorating and the doctor decided to
start her on
hemodialysis soon? ( I’m sure was written soon not given a
specific period). What is
the most preferred method to use?
⁃ AV graft
⁃ AV fistula❤ ️
⁃ Non tunneled central catheter
⁃ Tunneled central catheter
Si i think av fistula

polyhydramnios risk factors ?

A- Post term B- Anencephaly
????
B

type of cancer in case of hashimotos thyroiditis?

Papillary
Medullary
Lymphoma❤ ️

Old age female DM HTN admitted to ICU due to urosepsis

and septic shock Vitals low PB
SpO2 84 temp 38 HR 120 given O2 and not improve
Cardiac examination is clear High WBCs
X Ray shows bilateral lung infiltrate what is the case of her respiratory problem ?

A. ARDS.❤ ️
B. Cardiogenic shock.
C. Hypovolemic shock
D. Fluid overload

Pt presented with stabbed wound after wound exploration you found anterior
abdominal fascia penetration, (his vitals were stable) what's your next step?
CT abdomen❤ ️
MRI abdomen
Exploratory laparotomy
Diagnostic laparoscopy

Epigastric pain stable suddenly sever pain and back pain pulstie mass?
Us❤ ️
Ct
Surgery

Case of child I think 6 years his parent brought him because of absent of right testis
on examination left testis was in scrotom but right in inguinal what to d ?o
(1wait tell puberty
(2orchiopexy
(3orchioectomy ❤ ️bc undescended testicle (> 2 years(

-Female patient 46 years old, had heartburn for long time she was taking medication by
her own , now presented with dysphasia in the retrosternal area , whats the most
important investigation to do ?
Endoscopy
Urea breath test

-Patient talkative and bought expensive car, his wife mentioned history of
depression what is the best medication?
Lithium
Bupropion
E.g. of SSRIs

Pregnant 38 wk with polyhydramnios, presents with rupture of membrane and severe abdominal
pain, CTG show fetal bradycardia, whats the diagnosis :
A- vasa previa
B- cord prolapse
C- placental abruption❤ ️

Female pregnant received anti-D at 20 weeks of gastination what is the next does?
A. 300 mcg❤ ️
B. 1000 mcg
C. 2000 mcg
D. No need for further dose
Usually at 28 n postpartum
The dose same 300

Warm like strongyloides

4
Rice like Enterobious
 Mediterranean
ummm
Fever Doxcycline Rifampin
which drug to avoid Amoxicillinor 11 1 streptomycin
arogast
scarlet fever oral penicillin

Dengue fever fluid Acetaminophen

hemorrhagic BloodTransfusion

- Female in 20s has diabetic present with confusion. The patient has a long history of type 1
diabetes. She also complains of periorbital swelling, rhinorrhea and black necrotic spot over the
face. labs show glucose 600 mg/ dl and ketones. Ct scan shows obliteration of all the sinuses.
Which of the following is the causative organism?

A. Rhizopus oryzae ❤ ️

B. Candida albicans

C. Moraxella catarrhalis

D. Staph. Aureus
A
Mucormycosis

45-48 y/o with grade 3 hemorrhoids at 3 and 11 o’clock

What is the best next step?
Colonoscopy
Hemorrhoidectomy
Band ligation❤ ️

Patient admitted to ICUwith progressive sob, cough and fever

O2 saturation 80% RR 33
CXR show sign of ARDS
Most likely causitive organism?
Streptococcus pneumonia
- Staph aureous
- pseduonomas pyogen❤ ️
308.Surgeon is doing OP for patients with Hepatitis C and suddenly he was injured by an
injection. What is the percentage of getting infection?
A. 30%
B. 3%❤ ️
C. 0.3%
D. 0.03%

Mom with DM , her baby after delivery was having respiratory d istress (lots of details and labs,
glucose was not given)
A- Intubate and mechanical ventilate
B- Admission no NICU with glucose administration and observation❤ ️

107) 59 Y.O. female Patient diagnosed with MI and was treated at the hospital, upon her discharge
she asked you what is the best way to prevent reinfarction?
A) Use of antiplatelet for short duration.❤ ️
B) Use of Calcium channel blocker indefinitely.
C) Use of ACEI if she develops heart failure to prevent cardiac changes
D) Use of spironolactone for longduration

pt with high fever tender cervical lymphadenopathy exudate tonsil next month?
-swab culture
-rapid antigen detection test❤ ️
Looks like pharyngitis
Group A beta streptococcus is the cause
That's why doing rapid antigen test

Patient came for HRT that will not help her menopausal
symptom
at her stage but the pt insist to have it what should doctor
do??
A. Don’t give it to her refuse
B. give her
C. refer her❤ ️

-nurse work in pulmonary clinic with Productive Cough

and fever in 🚩 🚩 x ray > patchy infiltrate > and not
respond to AB the organism:
streptococcus pneumonia
strepto group b
strepto group a
Mycoplasma pneumonia
Hemophilus influenza pneumonia ❤ ️
.Nurse work in pulmonary clinic C/O with fever, productive cough. She is not responding to AB (🚩
🚩 Xray show opacity left upper lobe)
A- Streptococcus pneumoniae
B- Hemophilus pneumonia
C-Mycobacterium❤ ️

3 yrs old with sudden blood with defecation PE doctor told them its a preventable condition .Dx?
preventable condition .Dx?
Hemorrhoids
Intissuption
Familial polyp
Fissure❤ ️

Drug Not given to asthmatic pregnant woman?

Answer is: Carboprost
----------------
pregnant lady, just delivered and she's known to have bronchial asthma. Which of the
following uterotonic medications you would avoid giving?
A. misoprostol
B. carboprost F2 alpha ❤ ️
C. Oxytocin
D. Methylergonovine
Answer is: B
___________

Pt known case of asthma which drug is contraindicated ?!

A. misoprostol
B. Prostaglandin F2 alpha ❤ ️
C. Oxytocin
D. Methylergonovine

pregnant around 30 something week who is a case of Rh alloimmunization, fetus was found to have
anemia, management?
A- deliver immediately
B- Duplex
C- fetal blood transfusion❤ ️

-45 years old male or female , has a mass 5 cm in right upper limb, (MRI shows a
mass from triceps) what to do next?
incisional biopsy
excisional biopsy !!
core needle biopsy
PET scan

2. 35 y/o female k/c of SLE on Corticosteroid 40 mg and Hydroxychloroquine 200 mg presenting

with lower limb weakness and urinary incontinence, PE showed that patient is paraplegic with
absences of deep tendon reflex. What you will order for her ?

A) Lumber puncture+Ct brain

B) Lumber puncture+MRI brain

C) Lumber puncture+spinal cord MRI❤ ️

D) Lumber puncture+MRI and MRA brain

-55 female with breast ulceration scaling oozing no mass in examination Mammogram show no
mass nothing What is the appropriate next step ?

Derma consult F/u within 6 month Nipple biopsy❤ ️

-45 years female with 1 week hx of fatigue nausea, jaundice, no other symptoms, AST ↑ ALT ↑:

GGT ↑: 60 ↑ total bili what is the cause of her condition?

A-vital hepatiti❤ ️
B-Autoimmune hepatitis
C-hemochrombtosis
D-Non-Alcoholic SteatoHepatitis

healthy lady with Preterm labor what to give her ?

-indomethacin❤ ️

-magnesium sulfate

-nifedipine

-the third choice is ether terbutaune or nitroglycerin

Post partum three months, came with hx of something that protruded from the cervix bleeding on
touch, mx:

- immediate D&C❤ ️
- measue hcg after 1 week

- Biopsy

- Tests for metastasis

pregnant lady came for a checkup. Her baby was found to have hydrops fetalis. What is responsible
for such a condition?

Ans: Anti-Kell Antibodies❤ ️

make truck driver with painful swelling between his gluteal fold. What is the most likely diagnosis:
Rectoischial abcess
Pilonodal cyst
Hidradenitis suppurativa❤ ️

mother with gestational diabetes, what is the hormone that is responsible for her diabetes?
Lactogen hormone from placenta.❤ ️
Progesterone hormone from placenta.
Estradiol hormone from placenta

2 days old baby brought to the hospital because of reluctant to feed and seizure since last night. On
exam the baby weight is 3Kg, inactive, has a generalized increased tone. CSF: clear, Glucose 3
mmol (normal 2.8-5), protein 0.22 (normal 0.22-0.33), cells 10 (normal up to 10).

Which of the following is the most likely diagnosis?

A. neonatal sepsis
B. neonatal tetanus ( correct bcz hypertonich)❤ ️
C. Hypoxic ischemic encephalopathy (will present with seizures in the first 24hr of birth and
hypotonic baby initially then will become spastic with aging) 🤔
D. Pyogenic infection

Patient with hyperthyroidism symptoms, asking what should be measured first:

A. T3

B. T4❤ ️

C. Tsh

Pt with multiple vomiting What do you expect of Na level :

A- high ❤ ️
B- Low
C- Normal
Pt feels that she has a gluten allergy , as she expierience abdominal bloating with gluten Bx done
showed Total villous atrophy ..

What to tell her :

A- Biopsy is a normal finding

B- She has no gluten allergy

C- gastroenterolgy referral ❤ ️

D- Make her to eat gluten diet and repear biopsy after

C
Villous atrophy indicate celiac

Pregnant in 1st trimester develop vaginal

bleeding and LL quadrant pain, she denied any
passage of tissue U/S shows :
No sac either intrauterine or extrauterine Dx ?

1- Ovarian ectopic

2- Complete abortion

3- missed abortion

4- Pregnancy of unknown location❤ ️

Case of severe menorragea in 40s old female found to have uterine mass in US ( The scenrio was
litteraly like that ) , Dx :
1- parasitic fibroid

2-subserosal fibroid

3-submucosal fibroid❤ ️

10days old newborn boy every thing is fine expert on physical examining his lower
back there as a tuft of hair, Which investigation should be ordered now:
-U/S
-CT
-MRI❤ ️
-CSF
pediatric with cough and enlarged lymph nodes and rash behind the ear face neck and upper
trunk.?

a) measles❤ ️
b) mumps
c) rubella
d) chickenpox

Child who is lethargic and losing his concentration, hgb is 10.5 what to give.
A. im iron
B. Oral ferrus sulphate
IM iron

15. Female k/c IDDM pregnant at 12 week of gestation, her ha1c was 12%, she have a high risk
of developing which of the following?
!! A) preeclampsia
B) polyhydramnios !!
C) Congenital anomaly❤ ️

young, sexually active women who present with lower abdominal pain and adnexal motion
tenderness , asked about highest diagnostic test value ?
A. US
B. HSG
C.Laparoscopic ❤ ️
D.Exploratory

407. 18 months baby says baba mama only , what you will do for him ?
A. Developmental assessment
B. Bone age
C. hearing assessment❤ ️
D. Something not related

29-Female patient complaining of headache and myalgia for 5 day, 2 days ago she
had fever and rash on her face, 10 day ago she was in Jeddah, how would you treat
her?
A) steroid
B) IV antiviral
C) IV antibiotic
D) supportive management ❤ ️

R
75-Pt have hypok what change in ECG: P
A
-Peak p wave❤ ️
-Peak T wave
-Wide QRS R

peakeapware
p
a
a proungalian s

88-Post menepause with dyschazia LMP before 15 months what

give?
Depo vera injection❤ ️
Conjecated estrogen pill
Congecated estrogen pill
OCP

A 66-year-old man, who was undergoing maintenance haemodialysis through a subcutaneous

tunnelled catheter, presented with fever, chills and rigors during haemodialysis.
On examination, his temperature was 38.6°C, his pulse was 105 beats per minute and his blood
pressure was 100/60 mmHg. Examination of his respiratory and cardiovascular systems was
normal.
What is the most likely cause of his infection?
Answers
• A: Escherichia coli
• B: Pseudomonas aeruginosa
• C: Staphylococcus epidermidis❤ ️
• D: Streptococcus pneumoniae
• E: Streptococcus viridans

SLE pt with hx of 3 consecutive abortion what is anticoagulant prophylactic to give:

.1Long term warfarin
.2long termUFH
.3long term Enoxooarin❤ ️
.4I can't remember

Old lady follow up incidentally found grade 3 pelvic organ prolapse and she has no
complaint what to do?
A. Surgical repair
B. Ring❤ ️
C. No need for intervention
D. Forgot
Eye symptoms on thyrotoxicosis is due to?
Male
Free T4 T3
Not responding to medication
Smoking❤ ️

50year old with family history of breast cancer came with right upper outer mass,
atypical ductal hyperplasia. What to do?
A. Simple mastectomy

B. Wire localization excision

• Wide ❤ ️

Women with history of insomnia and crying for 5 days due to sibling death what’s
the quick drug to us ?e
A-lorazepam❤ ️
B-fluoxetine (case insomnia

Female patient in her 30s her last menstrual cycle was 7 weeks ago, what is the first
investigation to order.
A. Pelvic Ultrasound
B. TFT
C. B-HCG❤ ️
D. FLH

Patient present to ER after RTA, with SOB, in examination the tracheal shifted to
the right side, in chest X-ray, the lungs are expanded and winded mediastinum.
What is the diagnosis.
A. Tension pneumothorax
B. Cardiac tamponade
C. Plural effusion
D. Raptured esophagea

Scenario of a child with celiac disease, +ve anti-endomysial antibodies and Anti- transglutaminase
antibodies (ATA), biopsy shows villous atrophy what to do?
A-gluten free diet❤ ️
B-gluten free diet for 6 months and then do biopsy again
what of this not important in nephrotic criteria
A. hypertension❤ ️
B. Proton urea
C. Serum albumin level
D. Odema

Newborn with microcephaly and hepatospleenomegaly what best investigation?

A. Chromosomal
B. congenital infection screening❤ ️

45 y.o. asymptomatic pateint, on pelvic ultrasound that was 2*3(not sure about the size) uterine
fibroid at the fundus. What is the next best appropraite plan of managment?
A-immediate hysterectomy
B-immediate myomectomy
C-follow up with yealy U/S
D-follow up with serial U/S and CBC every 2 month

14 y o girl with irregular massive bleeding then 6 months without period

What your management??!
A. Reassure❤ ️
B. Hormones FSH prolactin
C. Comption OCP
D. Metformin

ICU pt elderly develop sacral ulcer with discharge and necrosis area & fat exposed
• Primary-closer
• debridement with primary-closer
• debridement with skin graft
• debridement with VAC❤ ️

- snow storm appearance??

A-Molar pregnancy❤ ️

antihypertensive in multiple sclerosis

A. Bb
B. ACEi❤ ️
C. ARBs
D. CCB
 GREEN.DISCHARGE BILATERAL MAMO AND US DUCT DILATATION WHATS NEXT
TEST??
A-MRI
B-BIOPSY❤ ️

Case of knee injury The tibia contradicts to femur What is the ligament get injured?*

anterior ligament
• posterior ligament
- lateral collateral ligament
- medial collateral ligament❤ ️

A lady who is smoking 20 cigarettes a day comes with IUFD. What is the factor
that led to fetal demise?
a. Chromosomal anomaly
b. 20 cigarettes a day ❤ ️
c. There is no identifiable cause

Anemic and hypertensive female wants contraception method what to give her

ocp
IUD mirena❤ ️
depoprvera
Tubal ligation

An old man presents with abdominal pain, distension, constipation and vomiting.
Digital rectal examination reveals an empty rectum. Abdominal X-ray was done
and showed a Y-shaped colon with distended bowel. What is the next best step?
a. Surgical resection ❤ ️
b. Colonoscopy
c. Fleet enema
d. Observation

How to check the compliance in pt with celiac disease

Biposy
Anti endo mysel
TtG antibody❤ ️
fully dilated and fully effaced +3 +4 contractions 4 every 10 mins

- Ventose❤ ️

- Oxytocin Cs

- Reevaluate 2 hrs

Male victim of gunshot to the thigh, pale and unconscious, BP 90/60 pulse 130, next?

- orotracheal intubation❤ ️
- blood transfusion
- shift to OR
- RL infusion

RTA victim, multiple trauma; free fluid in abdomen and spleen lacerations +
thoracic aortic injury?

- thoracotomy
- laparotomy❤ ️
- ct scan

-A long-time smoker with cyanosis and a raised JVP wants to quit smoking. What will you give him
to help him achieve this?
a. Bupropion❤ ️
b. Varenicline
c. Nicotine replacement therapy

PDA which nerve affected during surgery?

1. Lt Vagus N
2. Phrenic N
3. Superficial N of the heart
4. PDA operation. Recurrent laryngeal❤ ️

Patient with post partum hemorrhage that was not controlled by oxytocin or bimanual massage.
They asked about the next step?
A- Hystrectom
B- Embolization
C- Bakri balloon ❤ ️
D- Forge the forth one but it was not
medication
-pt with uterine cancer in the funds u deicide to do hysterectomy with lymph node dissection which
lymph node will be excised?
A. Inguinal
B. Femoral
C. Para aortic ❤ ️
D.iliac

90 yr old female, htn and dm ,Admitted to the hospital as a case of HF and was treated with
medication,There was incidintal finding of uterine procedentia, when taking hx from pt , she said it
has been for 10 year and never bothered her ,Seh used to push her uterus back when urinate and
pass stoolWhat is your management
A-vaginal pessary❤ ️
B-vaginal hysterectomy
C-Radical hysterectomy
D-lap hysterectomy with sacro-spinous suspension

old female with pelvic organ prolapse grade 3 how to manage:

A.pessary❤ ️
B.sacrohysteropexy
C.La fort technic (colpoclesis)

in case of 4 th grade prolapse we go with la fort technique

Women present with vaginal bleeding, gynecologist ordered Hysteroscopy, What is the
complication of doing hysteroscopy ?
a- infection
b- hemorrahge❤ ️

38 y/o female at her 20th week of gestation presenting with vaginal spotting with no hx of trauma
her blood group is O-, she is vitally stable. US showed normal size fetus with long cervix.
What you will do for her ?

A) Give anti-D❤ ️
B) Discharge home
C) observation
D) continue on her multivitamins

28 y/o female, pregnant 35 GA presenting with decreased fetal movement, CTG was reassuring with
fetal HR 130, then 1 hr later CTG showing good variability. What is the best management for her ?

A) Observe for 24 hr🙇 🏻 ‍♀ ️

B) Induction of labor
C) C/S
D) Discharge her with fetal kic🙇 🏻 ‍♀ ️
between A and D
most likely A

129. Screening of HBV during pregnancy?

A) Primary❤ ️
B) Secondary

Most reassuring biophysical profile?

A) 8/10
B) 9/10❤ ️
C) 12/12
D) 7/10

Woman who tried IVF and got ectopic pregnancy. On imaging there was tubal pregnancy on the
right and hydrosalpinx on the left. What is the management?
- Salpingotomy on the right only
- Salpingectomy on the right only
- Removal of both tubes❤ ️
- Methotrexate

tocolytic SE
A) Oliguria
B) Palptation❤ ️
C) Abdominal pain
D) Vaginal bleeding

50. Highest value test to asset IUGR

ultra sound❤ ️

104. risk factor for preeclampsia

A) Maternal age❤ ️
B) Gestational age
C) Multiple pregnancy

105. risk for miscarriage.

A) Maternal age❤ ️
B) Gestational age
C) Pre existing conduction HTN and diabetes

1. Pregnant women with 2 hx of preterm labour, presented with vaginal spotting What to give her:
A) Estrogen
B) Progesterone❤ ️
C) indomethacin
D) mg sulphate

Pt with intermenstraul bleeding. What is the most appropriate investigation

A) CBC
B) TFT
C) B-HCG
D) US❤ ️

60 y/o female did Pap smear and showed ( ASC-US ), her treating physician prescribe for her
topical vaginal estrogen for 1 month, she came back after that and Pap smear repeated and it was
also ( ASC -US ). What you will do for her

A) Colposcopy❤ ️
B) Punch biopsy
C) No further investigations

Pregnant in labour, she takes heparin, post delivery she has heavy bleeding? What to give?
A) FFP❤ ️ since it’s heavy bleeding
B) Portmine sulphate
C) Vit K

Pregnant lady everything was normal but she complain of itching and had elevated liver enzyme,
what is the dx?

A) Viral hepatitis
B) Pregnancy cholestasis❤ ️

105. Pregnant lady ,41 GA in labor on epidural analgesia, mg sulfate for pre-eclampsia and
oxytocin. CTG showed prolonged decelera,on and the mother was hypotensive, most likely cause of
the CTG finding:

A) Mg sulfate
B) Oxytocin
C) Epidural analgesia❤ ️

Pregnant in 27 GA, came with minimal bleeding, us showed Placenta totalis. What is the most imp
mx ?

A) abx
B) Tocolytics
C) Steroid❤ ️
35 year old female, smokes 12-14/day. Came to antenatal clinic .. what is the greatest risk factor for
sub fer,lity?

A) smoking
B) Maternal age❤ ️

15. Young female pregnant in her 28th week, pregnancy test was done at home. She presented with
mild bleeding loss of fetal movement. She denied any passage of ,ssue or abdominal pain.
Transvaginal US was done and showed pregnancy of 18 weeks and no heart beat. (No other
informa,on was provided about the cervix). What is your diagnosis?

A) Fetal Demise ❤ ️
B) Missed Abor,on
C) Incomplete abor,on

8) Physiological changes in pregnancy that can lead to heart failure in patient with mitral stenosis

A- increase minute ventilation

B- increase RBC mass ❤ ️
C- increase renal plasma flow

Sca pt pregnant, antenatal complications associated with her condi,on?

A) Low birth weight

B) Chest infection
C) UTI

Patient presents with palpitations and irritability. Thyroid-stimulating Antibodies are negative. T4 is
high. What is the most likely diagnosis?

a. Hashimoto
b. Graves
c. Toxic multinodular goitre❤ ️

Patient with sore throat fatigue and shortness of breath and productive cough with whitish sputum,
sometimes there's bloody streaks. X-ray: normal with no conselidation.
What's the diagnosis?
A-Hereditary telangtesia
B-Good pasture syndrome
C-Pleural edema
D-Bronchitis

patient presents with irregular periods and low T4. What test will you do next?

a. TSH level

b. Prolactin level

c. Pelvic US

d. Serum FSH and LH

patient was extubated after thyroid surgery and immediately developed shortness of breath and
respiratory distress. Examination reveals that both vocal cords are in a semi-closed position. How
will you secure the airway?

a. Cricothyroidotomy
b. Tracheostomy tube
c. Re-intubate the patient

A patient presents with a knife injury to the hand. On examination, the laceration reached the tendon
and nerve. How will you repair this injury?

a. Primary repair
b. Debridement with primary closure
c. Debridement with secondary intention❤ ️
d. Debridement with Vacuum assisted closure (VAC

An male patient who is a known alcoholic for many years presents with abdominal pain, vomiting
and hematemesis. He was recently managed as a case of perforated peptic ulcer. On exam, there is
epigastric tenderness. Liver enzymes are normal. What is the most likely diagnosis?

a. Acute pancreatitis
b. Chronic pancreatitis
c. Varices
d. Mallory-weiss❤ ️

A patient with chronic Hepatitis B presents with jaundice and fatigue. Labs show elevated liver
enzymes. What is your next step?

a. Liver biopsy
b. Anti-delta antibodies❤ ️
c. Interferon
d. Repeat tests

female presents with jaundice and elevated liver enzymes. Hepatitis B serology showed Positive
HBsAg, Positive HBcAb (IgG), Positive HBeAg, and Negative Anti-HBs. What does this patient
have?

a. Acute Hepatitis B infection

b. Chronic Hepatitis B infection❤ ️
c. Resolving Hepatitis B infection
d. Immunity by vaccination

A newly married woman has been on her honeymoon for 1 week and is now complaining of dysuria
and frequency. How will you manage?

a. Ampicillin
b. Nitrofurantoin
c. Ciprofloxacin
d. Cephtriaxone

A post-term baby with meconium aspiration syndrome presents with severe respiratory distress,
cyanosis, and intercostal retractions. The difference between his Preductal and Postductal O2 Sat is
greater than 10. What should you give this baby?

a. Oxygen

b. Inhaled NO❤ ️

c. Surfactant lavage

man from India presents with jaundice and a hypoechoic mass on ultrasound. What is the most
likely diagnosis?

a. Echinococcus❤ ️

b. Granulomatous TB of the liver

known case of liver cirrhosis secondary to Hepatitis C has completed treatment. Hepatitis C RNA is
negative. How will you follow up this patient?
a. Regular screening with AFP

b. Regular screening with ultrasound

c. Liver biopsy

d. No follow up is required❤ ️

pregnant female of 10 weeks gestation comes for a regular checkup. US shows an intrauterine
gestational sac with no viable heartbeat. The cervical os is closed and she denies any vaginal
bleeding. What is the most likely diagnosis?

a. Ectopic pregnancy
b. Threatened abortion
c. Inevidable abortion
d. Baby of uncertain viability

A 37 year old woman comes to you with infertility. Semen analysis of the husband is normal and the
woman has normal, regular cycles and normal FSH and LH levels. However, US revealed many
fibroids disrupting the uterine cavity. What is the best way to restore her fertility?

a. Surgical removal of the fibroid❤ ️

b. Reassurance
c. GnRH to help shrink the fibroid
What indicates a chest tube in a parapneumonic effusion?

a. Negative culture
b. Serosangeous effusion
c. Glucose > 60
d. pH <7.2 indicates

PPH not responding to oxytocin and massage what you will do next :
A. B lynch❤ ️
B. Hysterectomy
C. Uterine Vessel ligations
D. Angoi embolization

Case of n/v with abdominal pain umbilical site

Labs normal exapt high amylase 700
Report: cyst 10x15
What is the appropriate drainages?
Laparoscopic
Open
continuous
Endoscopic

Which of the following medication affect work of warfarin:

SSRI
B- digoxin ❤ ️
C- sulfamethoxazole
D- steroid
Elderly KC of DM and uncontrolled hypertensive, history of chest tightness with exertion, he is on
insulin, ACE, nitroglycerin, what to add?

A.metoprolol.❤ ️
B.diltiazem.
C.nifedipine.
D.Amlodipine

73 years old male with high BP recorded at home for 1 week and in hospital before his surgery
200/190 . He is on 3 antihypertensive medication what is the cause of his high BP

A. NSAID
B. Pseudoephedrine❤ ️

Please can you tell me about ttt of acute attack of migraine??????

Aspirin
Ttiptan❤ ️

Rheumatic fever question asking about what of the following is most related to it, choices of main
SSx of different diseases. Only one that goes with Rheumatic fever was:
A. Sydenham chorea and polyarthralgia.

13 yo coming with her mom complaining of menstrual pain. Hx unremarkable. Best treatment?
A. NSAIDs.
B. OCP.

Lady coming to general ob gyn clinic, for check up, no complaints. Highest value?
A. General examination.
B. Vaginal exam.
C. Pelvic exam.

Pregnant with previous preterm, doing US. Which of the following would indicate cerclage?
A. Dilation less than 35mm.
B. Dilation less than 5 mm.
C. Dilation less than 25mm.❤ ️

Newborn with microcephaly and distended abdomen exam showing hepatosplenomegaly, I think
mother was diabetic. Labs showing pancytopenia and elevated LFTs (AST/ALT). Next ?
A. Chromosomal analysis.
B. Congenital infection screening.
C. US abdomen.
D. CT abdomen.

RTA patient, blood at the meatus, did retrograde urethrogram showed membranous urethra injury.
Next ?
A. Foley catheter.
B. Supra pubic catheter.❤ ️
C. Immediate repair.

Lady with abdominal pain and I think vaginal bleeding. Exam she is febrile, with a normal looking
vagina and cervix no adnexal masses, and motion excitation. Dx?
A. PID.
B. Acute appendicitis.
C. Cervicitis.

The child (2 months I think) with inguinal hernia and undescended testis. Management?
Choices didn’t include anything regarding the undescended testis, only one reasonable choice was
about the hernia.

Patient with blunt chest injury resulted in fracture in 3rd, 4th and 5th ribs in more than one site. What
is the initial treatment ?
A. Intubation
B. Assisted ventilation
C. IV fluid.
No analgesia in the choices.

Lady with urinary incontinence during sneezing, coughing, exercising and when urged to void. Dx?
A. Urge incontinence.
B. Mixed.
C. Stress.

30 yo lady with endometriosis, tried NSAIDs with no improvement. Next?

A. Oral progesterone.
B. Combined oral contraceptives.
C. laparoscopic fulguration.
D. Hysterectomy with bilateral salpingoophorectomy.

Lady with treated breast carcinoma. Didn’t mention treatment given to her. When can she get
pregnant?
A. 2 years.
B. 9 months.
C. 3 months.
D. 5 years.

Young age male, previously well, presenting with 2 days Hx of SOB started after landing from an
airplane. You notice he is a tall man (with other characteristics I forgot them), CXR showing right
pneumothorax (in a report with no image, and not telling the size). Management?
A. Observation.
B. Chest thoracostomy.

Case of MI and asking about the most considerable risk for MI?
A. Age
B. HTN
C. Smoking

Long scenario of a child I think 12 y/o with Hx of PUD treated with H.Pylori clarithromycin triple
therapy after confirmation by urea breath test. Asking about the way you will monitor response to
treatment (not confirm eradication)?
A. Urea breath test.❤ ️
B. Clinical improvement.

32 y/o lady with bloody nipple discharge, examination normal. What is the next investigation?
A. Mammogram.
B. US.
C. MRI.

Case of molar pregnancy with very high B-Hcg, treated and following up with her every week. B-hcg
level given weekly, dropping until week 5 it was 1. What will you do?
A. Next week B-hCG.
B. Next month B-hCG.❤ ️
C. Discharge.
D. Give methotrexate.

DKA protocol goal:

A. To decrease blood glucose 3mmol/hour
B. To decrease blood glucose 6mmol/hour ❤ ️
C. To aim blood glucose 18mmol.

Pregnant 34 weeks, backache rigors and fever I think, and hypotensive. What is the immediate
action that must be taken?
A. Give betamethasone for fetal lung maturity.
B. Admit and give IV abx.
C. Admit and observe.

A 14 y/o child hasn't been vaccinated against chickenpox. What to do?

A. 2 Varicella doses, 4 weeks apart.
B. 3 varicella doses 6 months apart.

PPH. Rx?
A. Oxytocin 20 unit mixed with 500 ml D5 IV.
B. 0.5 mg ergo IM.
C. 0.2 mg ergo IV.

Pregnant lady, and a mass. What to do?

A. Colposcopy.
B. Pap smear.
C. Cone Bx.
Old man with 2 h presentation of stroke. Hx of a non-hemorrhagic stroke 2 months ago. CT stroke
non hemorrhagic. Rx?
A. PCI.❤ ️
B. Thrombolytics.
C. heparin.

Long senario, asks about Asthma test:

-Methcholine challenge Test❤ ️
-skin allergy test

COPD on Oxygen 3L, saturation 93%, labs and pft provided(forgot them),
-decrease oxygen
-increase oxygen
-intubate
Granulamatosis with polyangiits(wegners granulamatosis)

Patient post operative 7 days(I’m not sure)has not passed stool, complains of vomiting and nausea.
Labs show Low K
What is next investigation?
Stool K
Urine K❤ ️
EEG
ECG
New

20 male diagnosed with DMT1 after DkA upon discharge what is best Rx?
-insulin bouls
-baseline bolus with glargine once daily
- Rapid acting with meals with no long acting

Child with controlled asthma who use inhaled corticosteroid regularly without washing his mouth
after, came complain of white patches in the mouth and foul smelling, how do you treat?
1- Amphotericin B ❤ ️
2- Cant remember the other choices.
Gargling with a 1:50 dilution of amphotericin B is effective in treating oral candidiasis of asthmatic
patients treated with inhaled steroids.

Alcholic patient came to the ED complain of abdominal pain with vomiting and hematesis
(hematesis from the first episode he didn’t get hematesis after few episode of vomiting = they wrote
it exactly like this) they just provide me with hemoglobin investigation and it was low, whats your
diagnosis?
1- Acute pancreatitis
2- Esophageal varices
3- Peptic ulcer perforation ❤ ️

What do you find in celiac biopsy?

1- Villous atrophy ❤ ️

Preganant known of a sickle cell anemia, you want to give her folic acid, what is the right
prescription for her?
1- 5 mg folic acid till 12 week
2- 5 mg folic acid till she gave birth ❤ ️
3- 5 μg folic acid till 12 week
4- 5 μg folic acid till she gave birth

Fever of unknown origin in pediatrics by days:

A- 7 (8❤ ️)
B- 14
C- 21
D- 28

An 82 years old male with very painful micturition and week urination. What is the most appropriate
management?

A. ABx for UTI

B. Foley catheter and ABx❤ ️
C. Cystoscopy and TURP

137-34 y/o female 30 gestation with painless vaginal bleeding, did vaginal examination found
suspicious mass (see report) Report: US shows that the fetus corresponds to the Gestational age
Next step:

A. Colposcopy❤ ️
B. Cone biopsy
C. Pap smear
D. Endocervical curettage

Complainong of Red and render shin lesion for 3 days, was prescribed Abx and (1 DAY later) he had
severe diarhea Diagnosis ?

A. Salmonilla
B. Allergy to Abx
C. Diabetic gastroparesis
D. C. Difficele❤ ️

51-preterm 30 week, 80% effacement, 2 cm dilatation, stable mom and fetus. Admitted to labor.
What to do?

- call NICU and labor

- give dexamethasone, GBS swab, nifedipine and labor
- give dexamethasone and labor
- this is false labor

47-Admitted to the labor room. Patient received prostaglandin. patient massively bleed with stop in
uterine contraction. What is the cause of her condition?

1- placenta previa
2- utrine rapture❤ ️
3- placenta abruption
4- prostaglandin hypersensitivity

-Electrolyte abnormalities Suspected in TPN -

Hypokalemia🙇 🏻 ‍♀ ️
hypamagnesemia🙇 🏻 ‍♀ ️

Pt 5 days after delivery change in mood ( I think Symptoms of depression) What’s the mangemant ?

Ssri
Benzodiazepines
Flow up 1 week❤ ️

Case they wrote the diagnosis (osteoarthritis). How to confirm your DX:

A- MRI
B- X-ray❤ ️

1. Case of appendicitis (sharp central abdominal pain, radiate to RIF), Managed by surgery, AB
should be given ?

- 30 m pre-op -❤ ️
Pre-op + post-op for 3 days
- Pre-op + post-op for 5 days
- Pre-op + post-op for 7 days

Female withe Ovarian cyst, what type of contraceptive:

A-male condom
B-Compined pills ❤ ️
C- progestin only

Obese patient wants to do as surgery to reducehisweightwhatisthe

appropriate investigation to decide the type of procedureforhim?
A-Endoscopy. ❤ ️
B- US.
C- Bariumswollen
D- CTabdomen

mother coming for the first visit with an Rh positive father and a baby and a mother with an
unknown RH status. WHAT IS THE NEXT most appropriate STEP?

A) TEST THE MOTHER❤ ️

B) Amniocentesis

Pt with SLE, anti phospholipids, multi miscarriages > what to give

A) LMWH❤ ️
B) aspirin
C) warfarin

Primigravid come with active phase for 4h Dilated 5 cm, effaced 80%, station +1 after 5h there
is no change in cervix, and contraction occur every 3 min. and stay for 60 sec . What to do?
A. Instrument use
B. C/S ❤ ️
C. IV oxytocin
D. Wait for 2h

Pregnant with vomiting and oral thrush what to do to confirm diagnosis

A. Urine glucose❤ ️
B. Urine ketones
(answer: urine protein?)
I go with A
diabetes with pregnancy
If DKA must be give it's symptoms
Pregnant in 20w with HTN 160/90 what is the appropriate antihypertensive
drug for her?
A- Labetalol
B-Hydralazine
C-Methyldopa❤ ️

K/C ITP, her delivery complicated by PPH, what to give?

- PRBC
- FFP
- PLATELET ❤ ️
- CREP

PROM NEXT STEP?

A) Sterile speculum examina,on❤ ️
B) Abx
C) chemical testing

Preterm delivered by CS developed respiratory distress and grun,ng.

A) Transient Tachypnea of The newborn
B)RDS❤ ️

23-Clear case of pancreatitis ask which of the following to assess severity or prognosis ?
ESR
CRP❤ ️
ALT
PROCLACITONIN

A 34 year old man presents with slow progressive dysphagia. He has been using H2 blockers for the
last year because of retrosternal discomfort. He has not noticed any weight loss. A haemoglobin
level was done a month ago which reads 13.3g/dL.
What is the SINGLE most likely diagnosis?
— A. Foreign body
— B. Plummer-Vinson syndrome
— C. Pharyngeal pouch
— D. Peptic stricture❤ ️
— E. Esophageal Cancer
Peptic strictures have an association with gastro-oesophageal reflux disease and can cause
dysphagia. The fact that there is no weight loss and haemoglobin is normal points towards a benign
cause. Esophageal cancer at this age group is also uncommon.
Pt k c of crohns after surgery developed severe diarrhea what will you give
Mesalamin
Cholystaimne❤ ️
cholystarmine ~After surgery to allow reabsorption of bile salts and prevent diarrhea
mesalamine ~before surgery to improve symptoms if diarrhea

Pic of down syndrom trisomy

21❤ ️
23
13
18

Pic of air under diaphragm

Pt past HX of alcoholic come ē abd pain in PX abd tenderness and regadety dx

Perforated duodenal ulcer
Acut pancreatitis
Acut cholangitis
Acute appendix

neonate come after dilvery by respiratory distres and absent femorl pulse what to do
Surgical repair
Ballon
Prostaglindin infusion❤ ️

Inducated of Successful ttt of ectopic p after methotrexate f/u

Answer weekly hbcg till -ve then monthly for 6 month❤ ️

Pt hemodynimaicl unstable Rx DC

Told report of ECG narrowing of QRS and HR 230 asking about DX

Sit to inter the thoracocintasis at 9th intercostal spice mide clavical line

What is the best manage of lumber spine stenosis?

A- Laminectomy ❤ ️
B-Conservative
C- spinal fusion surgery

To Prevent First attack of Acute rheumatic fever after acute group A strep. Pharyngitis ' appropriate
antibiotic therapy should be instituted before
A- 3rd day of illness
B- 5th day of illness
C- 7th day of illness
D- 9th day of illness❤ ️
E- 11th day of illness

45 yrs female, her last pregnancy was 15 years ago, she came with Hx of 7 months amenorrhea,
pregnancy test was -ve. She wants to get pregnant, what is the most appropriate inv. to do:
A. Endometrial sample
B. FSH and LH levels❤ ️
C. TSH levels
D. Hysterosalpingography

93. Which of the following is not true regarding Osteomyelitis:

a) Puomyositis
b) Epiphyseal plate destruction
c) Septic arthritis (it can develop due to osteomylitis) “not sure”
d) Septicemia❤ ️
e) After bone growth

trauma with hypotension , x-ray : trachea shifted to the right , expanded lungs and widened
mediastinum. What is the dx ?
Massive haemothorax
Pneumothorax
Thoracic aorta rupture❤ ️
Spontaneous pneumothorax

28. 6 m boy presented with abnormal movement and yellowish discoloration for 1 week. He is
exclusively breast feeding, 2 week ago his mother started to introduced fruit and fruit juice, since
that , pt started vomiting, irritable,
On examination: Hepatospleenomegaly, Distended abdomen, Generalised jaundice
Urine: positive reducing substances( normal is negative)
Dx?
A) Tyrosinemia
B) galactosemia
C) Alpha 1 anti trypsin def
D) conginital fructose intolerance❤ ️

● Female with infertility, prolactin high, TSH high, Cause of infertility?

A. hypothyroidism ❤ ️
B. hyperprolactinemia
C. hypopituitarism
milestone said baba and walk holding furniture and a lot of other features
A. 12M
B. 10M❤ ️

22 years female known case of severe depression ، suicidal attempts, she is controlled on
paroxetine. Now, she is pregnant. What to do:

A. Stop paroxetine because of fetal malformation

B. Continue paroxetine and control her depression
C. Decrease dose❤ ️

young male came to well baby clinic, upon examination his right testis was
palpable in the inguinal canal and small in size and easily moved to
scrotum, the left is normal, what is the cause?
-ectopic testis
-undescended testis
-testicular torsion
-Retractile testis❤ ️

42.months baby came to ER with acute attack of seizure he’s on antiepileptics. What to do
regarding vaccination:
A) defer all vaccines
B) Defer live vaccine
C) Defer DTaP❤ ️
D) Give IPV instead of OP

New born seizure after delivery with hypoglycemia, management

- vit k
- glucose❤ ️
- diazepam
- antibiotic

2-Pregnant with IUGR on 2 occasion >> what is the best to confirm >
serial us❤ ️
stress test
kick chart
ctg
Tb case what to do next? Female from sourh asia with cavitation and infiltration
- Sputum culture for acid fast bacilli ❤ ️
- Start Medication (rifamicin , isoniazid... etc)

2- Depressed female her spouse is asking for most risk of suicidal thoughts?
- age
- Gender
- Social isolation❤ ️

Lady with abdominal pain and I think vaginal bleeding. Exam she is febrile, with a normal looking
vagina and cervix no adnexal masses, and motion excitation. Dx?
A. PID. ❤ ️
B. Acute appendicitis.
C. Cervicitis.

8 days old baby full term, his mother knows case of DM, present with bluish discoloration
of mouth, SOB dx:
- polycythemia❤ ️?
- RDS
- Pulmonary HTN
It’s B as complication of DM

Lady presenting with vaginal bleeding (+ fever I think) after 15 days of CS, most likely Dx?
A. Wound infection.
B. Retained products of conception.
C. Endometritis.❤ ️

A diabetic lady presenting to the clinic asking about travelers diarrhea prophylaxis. Cr high, BUN
high, urea high. What prophylaxis to give?
A. Fluoroquinolones.
B. No need. ❤ ️
C. Probiotics.
D. Bismuth.

LCIS tx ?
Chemo,
radio, screen
high risk,
mastectomy❤ ️

patient with high ICP (I think it was due to a brain tumor), which of the following nerves is most likely
to be affected?
1. Trochlear
2. Cranial
3. Optic ❤ ️
4. Facial

Patient came to u her mother and her sister diagnosed with breast cancer, cam for counseling, what
to do now?

1. BRCA ❤ ️
2. MRI
3. PET scan

years old lady, found a lump in the upper outer area of her right breast, it was large, firm with
irregular border, not tender, no palpable lymph node, what should you do?

1. FNA. ❤ ️
2. Lumpectomy and radiation.
3. Mastectomy.
2 q about vaccine

4 month come for vaccination but mother give hx about admation by anaphylaxis shock at last vist
of vaccination
Daily all
Give all
Wiat result of elargy❤ ️
Give axcept DTaP *

Hx of kwasaka under ivig.came to vaccination what to give safe ?

MMR
Verasil
Opv
DTap*❤ ️

Pregnancy 15 w past hx of HTN came ē hx of headache and N/V for 5w .

Preeclampsia
G_HTN
Primary HTN❤ ️

Pregnant 25w came by s/s of HTN BP high 155/90

Soult and water restriction
Oral labtulol ❤ ️
Sprin

6-female postpartum 2 weeks , she is breastfeeding, what contraception method ?

A) POP ( progesterone only pills )❤ ️

B) medroxyprogesterone acetate
C) COC
D) IUD

Vaginal discharge dx as PPRM , tx :??

Ampicilin + oxytocin
Dexa + nphidipine
Dexa + magnesium
sulphate Dexa + erythromycin + ampicilin❤ ️

Pregnant on epidural and oxytocin suddenly contractions stopped (pic of variable decelerations)
what would you do?

stop oxytocin and immediate delivery

stop epidural increase oxytocin
change to lateral position and recheck after 20 mins❤ ️

An infant suspected to have colic Which of the following is the

most effective management
A- Behavioral change
B-Improving feeding technique ❤ ️?
C-Ghareeb Water
D-Change formula

Left stylomastoid foramen injury by forceps blade during delivery:

A. Cannot open left eye >> if cannot close left eye
B. decrease blood supply to ear
C. loss ant 2/3 tongue sensation >> if tounge taste taste
D. loss half face sensation >> if motor

Paeudoepithelialization hyperplasia : ??
 Repeate biposy❤ ️
Amputation of first toe
Negative pressure dressing
Surgical debridement

Pt with diarrhea did colonoscopy and found erosion extended to the splenic flexure, what is the
management?

A. Mesalamine suppositories
B. Mesalamine oral and suppository❤ ️
C. Mesalamine enema
D. Mesalamine oral and enema

45-year-old woman complains to her primary care physician of nervousness,

sweating, tremulousness, and weight loss. The thyroid scan reveals a single focus of
increased isotope uptake. Which of the following is the most likely disorder?
A. Hypersecreting adenoma
B. Graves’ disease❤ ️
C. Multinodular goiter
D. Papillary carcinoma of thyroid

pt. with MI came to hospital after 2 hours and PCI was contraindicated
What’s is the mangment ? (I think was NSTE MI
A-ASA streptokinase nitroglycerin and bb
B-ASA streptokinase heparin and bb

2 years old patient asymptomatic came for follow up, Echo showing conentric LVH with
normal EF and severly stenosed aortic valve. What is the appropriate management?

A. Aortic valve replacement❤ ️

B. Follow up after 6 months
C. ACEi

Patients with unstable angina (UA) are at a higher risk of developing which of the following?
Low risk
NSTEMI❤ ️
Stroke
STEMI

Stool analysis of vibrio cholera ?

Osmotic 300
Osmotic 410
Osmo gab 30❤ ️
Osmo gab 110

Mom comes with her boy who drinks cow milk and solid food complaining of fatigue. His labs
showed only high RDW, no iron study whats your diagnosis ?
- thalassemia trait
- iron deficiency anemia❤ ️

A study was done about the effects of green tea vs black tea on a certain disease risk ratio of the
effect of green tea in comparison to black tea is 0.85 whats your interpretation?
- green tea is better than black tea
- black tea is better than green tea
- there’s no difference ❤ ️
- the result happened by chance

ONE MONTH BOY CAME FOR VACCINE. HIS OLDER SISTER (6YEARS OLD) HAD
RENAL TRANSPLANT AND NOW SHE IS ON IMMUNOSUPPRESSIVE MEDICATION.
WHICH VACCINE IS CONTRAINDICATED FOR BOY?
MMR
ORAL POLIO❤ ️
VARICELLA
INFLUENZA

70 something age patient present with sudden abdominal tenderness do U/S normal and normal
examination HB low ask about what next ?
-Occult stool❤ ️
-Endoscopy and colonoscopy
-2 remaining Others not significant

Flush hot in post menopausal women :

A-Low estrogen ❤ ️
B-Low progestrone
C-High LH and FSH

Type of insulin for DKA

A-Sliding insulin SC
B-Iv insulin + long acting insulin
C-Insulin BID
D-Fixed rate IV insulin’s❤ ️
what is the MOA of emergency contraceptives?

prevent implantation
prevent fertilization❤ ️
prevent anovualtion
delays fertilisation

A 60 y old man admitted to coronary care unit with an acute myocardial infarction his
hemodynamics parameter 2 h later are

Blood pressure 80/50

Heart rate 40
Which of the following would be the appropriate management

A:normal saline infusions

B: iv dobutamine ❤ ️
C: iv isopropanol

Recurrence rate of ectopic pregnancy?

- 10%❤ ️
- 30%

BA +rthf associated with laud s2?

A- Ar
B- Tr
C- Pr
D- Ar

A 2 year old child wasbrought by his mother with swelling on the right side of his neck extending
from the angle of the mouth to the middle one third of the sternocleidomastoid muscle. The
swelling is on the anterolateral side of the sternocleidomastoid muscle. On examination, the mass is
partially compressible, when subjected to light test is brilliantly translucent.
What is the SINGLE most likely diagnosis?

— A. Lymphangioma❤ ️
— B. Branchial cyst
— C. Thyroglossal cyst
— D. Ranula
— E.Grave’s disease

3. Child presented with his parents complain of walk on tip of his foot he start to walk
by age 13 month and he had normal development. His young brother died with
disease of muscles and his mother now pregnant and its a boy. what is the chance of
brother to get the same disease. Lab result: creatinine kinase 300 (high)?
(Duchenne muscle dystrophy inheritance):
a-12%
b-20%
c-50%❤ ️
d-75%

Patient with hirsutism, low estrogen, high fsh and lh, what should be investigated:
A. Glucose tolerance and lipid profile
B. Thyroid profile
C. Testosterone level❤ ️

Most common cause of PPH?

- atony❤ ️
- Iatrogenic
- Placenta

child with nephrotic ( diagnosis made after you read the report/ proteinuria +4)and progressive
edema over days.
What to give him?
- steroids ❤ ️
- Furosemide

Ectopic pregnancy. Start methotrexate weak ago I think 30

Follow up result
D1 : BHCG 1000
D4: BHCG 1200
D7: BHCG 2200
Next step ?
A- Immediately laparotomy
B- Second dose methotrexate ❤ ️
C- Multiple dosemethotrexate
Elderly Pt presented with appendicitis managed conservatively discharged after 7 Ds. On imaging
appendical mass with no collection

A. No further intervention
B. Open appendectomy after 12W
C. Laparoscopic appendectomy after 12W❤ ️

CP child came with respiratory distress

O saturation = 95%
Co2 = 35
ABG NORMAL
Whats the cause of his respiratory failure?
- Hypoxic type
- Hypercapnia
- Hypocapnia ❤ ️
- Neurogenic

Low salt diet

A- Primary
B- Secondary
C- Primordial❤ ️

Young pt with stab wound in center of abdomen vitally stable what the most appropiate next step?

- FAST
- DPL
-CT❤ ️
- Expolartory laproyomy

1-A woman bas intoncentince when jumping. What is the next most appropriate test to do?
a. Q-tip test
b. Cough test❤ ️

2. In the year 2030, the government makes it a goal to protect children’s lives. How will they do so?
a. Vaccinations❤ ️
b. Early testing of diseases
c. More physical activity on schools
3. What is the point of a multidisciplinary team in oncology?
a. Compassion
b. Patient treatment optimization❤ ️
c. Judgement-free discussions

4- Female present for regular check up in clinic, she didn't remember when was her last menstrual
period, what is the most accurate way to calculate the gastrointestinal age?
A-History and examination of utrus funds length
B. Bitemporal lengths
C - Femur lenght
D. fetal crown-rump length (CRL)❤ ️

5-Mother bring her Infant (3week old ?) had fever no cough or SOB what to do ?
A.Admission for the fever and observed if afebrile send them home
B.admission and do blood and urine culture ❤ ️
C.send home advice the mother to head to ER if seizure occurs

6- a young female with sob and cough mainly a respiratory system, and ECHO was normal what’s
next mangment?
A- CBC
B- ABG blood gases❤ ️
C- Electrolyte
D- thyroid function test

7-Elderly female newly diagnosed with HTN started on medications, according to the JNC 8
guidelines whats the target BP reading for her?
- Less then 120
- Less then 130
- Less then 140
- Less then 150❤ ️

Pregnant women in 10 weeks , came to antenatal care as the first visit , which vaccine is
recommended for the mother in this time ?
A- influnza ❤ ️
B- ( toxoid vaccine ) DTap
C- MMR

Pt asymptomatic start on anti TB medication and during follow up liver enzyme was slightly elevated
( only elevated 2x of normal range ) :
A- stop all Anti tb
B- stop only INH
C- continuation of anti tb
D- follow up after 1 week

Atrial fib , DM , post PCI , came with sever abdominal pain , the pain was 10/10 , on ex : abdomin
was rigid and sever tenderness , next ?
- colonscopy
- exploratomy
- Abdomin x ray
- US ❤ ️
No CT in choice

Pt with A.fib , best appropriate drugs as antithromboitic for long use is :

-asprin
- Clopdegril
- warfarin❤ ️

DM type 2 pt , no other chronic illness, what is the first line ttt :

A-Bingunide ❤ ️
B-SGL-P
C-DDP-4 inhibitor
D-Second generation of sulphonylurea

Pt with liver hemangioma, what will advice him ?

A- avoid excessive exercise ❤ ️

Sever Pain as shock and tenderness in neck radiated to arm and shoulder :
A-Cervical disc prolapse❤ ️
B- Polymyelgia rheumatica

Pregnant came last few days with PROM , then came with fever and abdominal pain :
A- appendicitis
B-chorioamnionitis❤ ️

Women came fever and lower abdominal pain and tenderness , discharge with slightly blood ,
adnexal painful with cervical motion :
A-Appendicitis
B- PID ❤ ️
C- cystitis
Scd 1-2 attack per year now pregnant hg 9 , Systolic murmur grade 2/6
simple blood transfusion ❤ ️
Start hydroxyurea Close
followup during pregnancy
Blood exchange

t RTA co left side chest pain and SOB, he is couscous alert, examination: decreased air entry in left
side and resonant What is best next step in management?

A. left needle decomposition❤ ️

B. Left chest tube
C. PA, lateral chest x ray

6. Prepregnant lady at 32 weeks gestation comes for a checkup. Her pre-pregnancy weight was
54.4 kg, while her current weight is 52.2 kg. Rubella Antibody is negative. STI infection screen is
negative. What will you do for her?

A. Repeat rubella screen

B. Perform a glucose tolerance test❤ ️

23. A patient presents with bilateral cataract, ketones, and raised liver enzymes. How will you
diagnose this case?

a. Abdominal US
b. Liver biopsy
c. Abdominal CT