SMLE 2019

th
26 OF DECEMBER

Glory Team

Please don't hesitate to contact us if you have any correction, comments or

suggestions.

Teamglory2020@gmail.com

Medicine: 2-11
Surgery: 12-14
Pediatrics: 15-19
OB/GYN: 20-22
Glory Team 26th of December

Medicine
● Pt old with gag reflex not working; not feeding because he is sick; how to
establish feeding
A. NGT
B. jejunostomy
C. Duodenostomy
Answer is: A

● Pt old female with septic shock hypotension given IV challenge fluid still ​hypo
then developed bilateral lungs crackles (or something). The reason for lung
problem is
A. ARDS
B. IV challenge
Answer is: A

● Pt presenting with central obesity; prominent buffalo hump. What is the

diagnosis?
A. Cushing’s
Answer is: A

● What is the highest screening in asymptomatic adults?

A. Breast
B. Colon
C. Uterus
D. Bladder
Answer is: B

● Question about ​fasciculation​ with weakness

A. Lower motor neuron
B. Myasthenia gravis
Answer is: A
In another recall, the question was as follows:

● ♥ A woman presents with left sided facial twitching and spasticity throughout her
body; she also has unilateral tongue fasciculation. The most likely diagnosis is
A. myasthenia gravis
B. Myasthenic syndrome
C. Mononeuropathy
D. Motor neuron disease
Answer is: D
Glory Team 26th of December
● ♥ Question about loss of sensation in ear pinna ... after injury which nerve
affected.
A. great auricular
Answer is: A

● Smoker with changes in esophagus like intestine cells ?

A. Barrett’s​ esophagus
Answer is: A

● Smoker with dysplasia what is the mx?

A. Endoscopic resection
Answer is: if High grade A

● +ve cryptococcal
A. HIV
Answer is: A

● ♥ Pt came from india with diarrhea, most common organism?

A. e coli
Answer is: A

● clear case of guillain barre :

A. IV-Ig
Answer is: A

● ♥ Endocarditis post 1 month of valve replacement.. organism?

A. epidermis
Answer is: A

● meningitis ( csf : +ve bacilli, hem catalase +ve .. ttt?

A. ampicillin
Answer is: A if neonate

● meningitis + seizure
Answer is: vanco+ceftriaxone +steroid

● viral meningitis ( csf : lymphocyte 90% ) mx?

A. acyclovir
Answer is: Supportive, acyclovir might be considered in encephalitis.

● ​Most appropriate diagnosis for AAA ..

A. abd us
Glory Team 26th of December
B. cta
Answer is: A

● Hyperkalemia ..
A. give iv ca gluc
Answer is: A if indicated,

● ♥ pleural effusion thoracentesis

A. indication .. <60 gluc
Answer is: A

● acute gout attack case scenario, What us the drug ​CI​ in this situation ??
Answer is: Allopurinol

● Two Q about 2 y/o female with fever and constipation , dark urine, investigation
Shown, High WBC in Both urine and serum In urine reach 17,000 Hematuria high
Proteinuria +2 First Q about management?
A. Steroid
B. antibiotic
C. Reassure
Answer is: B

● Second Q ABOUT diagnosis

A. acute pyelonephritis
B. acute glomerulonephritis
C. nephrotic syndrome
D. HUS
Answer is: A

● Long Case about man present with ​hemoptysis​ and ​hematuria

Diagnosis?
Answer is: ​Goodpasture syndrome
Wagner same plus + sinusitis

● Pt with loss of sensorium since 2 days And neck rigidity CSF analysis: Turbid,
Lymphocytes 70%, neutrophils35%, Protein high, Glucose normal. Diagnosis?
A. TB meningitis
B. viral meningoencephalitis
Answer is: B

● Reactive arthritis case so clear was taking NSAID for a long time with no
improvement, what to give:
A. sulfasalazine
Glory Team 26th of December
B. methotrexate
Answer is: Steroids if not in choices > A

● Patient after cardiac bypass has abd pain with hypotension and tachy ​central
venous pressure 15 (​please know the normal range they didn’t mention it) and
increased CO, no other information:
A. septic shock
B. hypovolemic
C. cardiogenic
Answer is: A ​SVP​ ​increase in cardiogenic and septic

● Pt with RTA with hypotension and tachy Distant heart sounds, Normal chest
exam, they did CT ( not sure) showed ​cardiomegaly​, Diagnosis?
A. cardiac tamponade
B. hypovolemic due to internal bleeding
Answer is: A

● ♥ there was q about RA​ case.. pt was on ​methotrexate and NSAIDs ​but still his
symptoms not controlled then ask which drug will you add?
A. hydroxychloroquine
B. Adalimumab
Answer is: B
Methotrexate ( add 2 DAMARDs or single biological )
- hydroxy - sulfate - azithro > dmards
- Mab > biologic

● Patient with ​hypotension​ and ​bradycardia​ gave him IV atropine no response what
to do next:
A. dopamine
B. temporary pacemaker
( didn’t mention dose of atropine and no other atropine in choices)
Answer is: B
Bradycardia > atropine
Cardiogenic shock > dobutamine

● Case of orbital cellulitis so clear he didn’t receive vaccines what to do next:

A. Fundus exam for inclusion body
B. Ct to check extent of infection
Answer is: B

● Post hernia with mesh complaining of paresthesia and neuro symptoms what is
mx :
A. nerve block
Glory Team 26th of December
B. systemic inflammatory mx
C. remove mesh
Answer is: B

● ♥ hyperparathyroidism, hypercalcemia, renal stones investigation?

A. Sestamibi scan > for hyperp>> only before the surgery
Answer is: ​urinary calcium if not in choices > A

● Pt allergic to penicillin, Shellfish, Sulfa. Present with UTI (not sure). Which ABX to
give?
Answer is: ​nitro

● Obese with snoring at night and hypertension best investigation?

A. Polysomnography
Answer is: A

● Known case of chronic hep b, presented with confusion asterixis and abdominal
distention, asterixis analysis 400 ​neutrophils​, management?
A. Lactulose and iv ceftriaxone
Answer is: A

● Acetaminophen toxicity 24 hrs ago with ​RUQ pain w

​ hich stage?
A. 2
Answer is: A

● Male with Pectus excavatum and scoliosis and other congenital features. With
height percentile above 95 and weight percentile less than 25
A. Marfan
Answer is: A

● Young man with presentation of ​ulcerative colitis​; In PEx what do expect to find
A. perianal diseases
B. erythema marginatum
Answer is: B

● Pt , take 3 doses of vaccine against HCV , and never get exposed what serology he
will have :
A. sAb
B. Abc
Answer is: A, surface antibody

● Patient who has hyponatremia and asking about fluid type yo be given
A. Hypertonic
Glory Team 26th of December
B. Half saline
C. Normal saline
Answer is: C, if severe hyponatremia > A

● Young smoker healthy who plays football presents with episode of 3cm
pneumothorax which was treated. After two weeks we did x ray showed resolved
pneumothorax. Best single advice to prevent future pneumothoraces?
A. Stop smoking
B. Avoid travel for 12m
C. Avoid exercise for 12m
D. Schedule regular physiotherapy for lung
Answer is: A

● DM type 1 insulin management:

A. NPH twice daily
B. Basal once daily with glargine once daily
Answer is: B

● Asymptomatic man presport, EF is 40%.

A. Give ACEI
B. Follow up after 6 months
Answer is: B

● Elderly HTN on two medications came to the clinic develops basal crackles and
mild lower limb edema. What to do?
A. Give furosemide
B. ACEI
Answer is: A

● Elderly abdominal pain, jaundice, gallbladder palpable but no tender?

A. Liver cancer
B. Pancreatic cancer
C. Primary Choledocholithiasis
D. Secondary Choledocholithiasis
Answer is: B

● What drug cause tongue and facial swelling​:

A. Verpliam
B. Ramipril
Answer is : B

● prophylactic for cluster headache

A. oxygen
Glory Team 26th of December
B. triptans
C. calcium channel blockers*verapamil*
Answer is: C

● Also question about Mg2 toxicity. What is the best next step?
A. Stop Mg2
B. Start calcium cog
Answer is: A

● Old age with high liver enzyme and high bilirubin , in the US there is lesion 5x6 cm
in right loop what investigations to do ,,
A. triphasic CT for the abdomen
B. a- fetoprotein
Answer is: B as initial step > A as the best investigation

● ♥ Pt with vascular malformation, which one is indicated for intervention?

A. pain
B. claudication
C. congenital heart disease
Answer is: Congestive heart failure

● Patient k/c of DM HTN came with unstable angina treated with statin , aspirin , b
blocker , heparin , nitrate What to add ?
A. Candesartan
B. Clopidogrel
C. CCB
Answer is: B

● Management of moderate asthma with night symptoms 6/ month

A. LDICS.
B. ICS + LABA
Answer is: B

● Case of inferior MI present with ​clear lung sound, JVP ​,hypotension not mentioned
muffled sound and no murmur
A. Papillary muscle rupture (new murmur, cracklse….)
B. Right ventricular infarction
C. Cardiac tamponade
Answer is: B

● Rheumatic, what kind of valvular dis?

A. Mitral.
Answer is: A regurgitation
Glory Team 26th of December
● Case of Cn3 palsy with intact and reactive pupils, etiology?
A. posterior communicating aneurysms
B. Diabetic cranial nerve 3 palsy
C. Cavernous sinus thrombosis
Remember if pupil is reactive ➡ Micro vascular disease ( B)
If not reactive then A
Answer is:

● Systolic murmer that decreases by valsva maneuver and increases by hand grip
A. AS
B. MR
C. MS
D. AR
Answer is: B

● Osteoporosis is one of extraintestinal manifestations of Crohn’s disease, which of

the following will increase its risk if associated with CD?
A. age 20-40
B. premenopausal
C. long term steroids
D. extensive bowel involvement
Answer is: C

● ♥ Known case of GERD on PPI, symptoms only mild improvement, endoscopy

done: esophagitis, what's the most important next step?
A. repeat Endoscopy in 6m.
B. nissen fundoplication.
C. esophageal manometry.
D. ambulatory PH monitoring.
Answer is: D, if he was on maximum PPI dose > B

● Case of daughter cells Treatment?

A. Surgery
B. PAIR
C. Albinadazole
Answer is: A deroffing ♥

● Case of obstruction symptoms, disk x-ray which showed air-fluid level What is the
most appropriate investigation?
A. CT
B. Diagnostic laparoscopy
C. Us
Glory Team 26th of December
Answer is: A

● Case of patient complains of abdominal pain, exam tenderness and. Pulsatile

mass above Umbilicus, What is the most appropriate investigation ?
A. US
B. CTA
C. angiography
Answer is: A

● Nerve sensation of pinna go external ear?

A. Great auricular nerve
B. less occipital nerve
Answer is: A

● CAH.with high 17 ,hydroxyglutamte is due to

A. 17 hydroxylase deficeny
B. 21 deficiency
C. 11 deficiency
Answer is: B

● patient present LL pain with difficulty in walking down the hill but relieved when
she goes up
What is the cause of her case?
A. venous insufficiency
B. lymphadenopathy
C. lumbar spinal stenosis
Answer is: C

● smoker patient with recurrent cough attacks, spirometry shows restrictive pattern,
what is the cause?
A. pulmonary fibrosis
B. asthma
C. COPD
Answer is: A, interstitial lung disease

● patient with HF, looks dehydrated with dry mouth, what is the best ​initial​ thing to
do?
A. careful administration of normal saline
B. give BB
C. give spironolactone
Answer is: A
Glory Team 26th of December
● patient with progressive dysphagia, presented with weight loss, what is the Dx?
A. Gastritis
B. pancreatitis
C. esophageal cancer
Answer is: C in ole recall we're ** feeling of fulness**

● patient presented with ​bitter​ taste when lying down, what’s the dx
A. Esophagitis
B. gastritis
C. Peptic ulcer disease
Answer is: A

● patient present with elevation in lead 2,3,aVf; And in V1 till V6 “they brought ECG
picture”... What is the diagnosis:
A. inferior wall MI
B. lateral wall MI
C. acute coronary syndrome with unstable angina
Answer is: A

● patients on antihypertensive medications lisinopril, she develop dry cough, what

alternative drug that she can use?
A. propranolol
B. Enalpril
C. Losartan
Answer is: C
Glory Team 26th of December
Surgery
● Sclerotherapy to treat which type of hemorrhoids?
A. external hemorrhoids.
B. internal hemorrhoids
C. prolapsed hemorrhoids.
Answer is: B

● Old man with small bowel obstruction, vitally stable. No history of previous
surgery. Hemoglobin normal. CT done and it shows small bowel dilatation
and something about fat stippling? WBC 12000
Next step in management:
A. observe
B. diagnostic laparoscopy
C. exploratory laparotomy
D. Colonoscopy
Answer is: D

● leg numbness + absent of sm thing pulse or sensation

Answer is: fasciotomy

● birads V with ​mets to lymph mx​?

A. radical mastectomy
Answer is: A

● multiple vomits, then vomit fresh blood

Answer is: mallory weiss tear>> conservative treatment

● Abdominal trauma with anterior fascia penetration next step?

A. Diagnostic laparoscopy
Answer is: A

● Inguinal intractable pain with hyperaesthesia with pain radiating to thigh 3 weeks
post inguinal hernia with mesh, upon physical exam, no recurrence or surgical
site infection, what's the mx: anonymous poll
A. Nerve block
B. Systemic Anti-Inflammatory
C. Neurectomy with mesh removal
D. mesh removal
Answer is: B

● Barret's esophagus with low grade dysplasia management?

A. Surgical resection.
B. Antacids.
C. Surveillance every 6-12m
D. PPI and rescope every 6-12 m
Answer is: D
Glory Team 26th of December
● 60 old man with cardiac bypass surgery; Had severe Abd pain. ​Increase cardiac
output,​ Decrease vascular resistance ; And sth cardiac increased can’t remember
Hypotension. What is the type of this shok
A. Cardiac
B. Septic
C. Hypovolemic
Answer is: B

● Pt with neck lump, TFT: decreased TSH and increased T3,T4 Us isolated nodule
Scan hot nodule but the rest of the gland cold Mx?
A. total thyroidectomy
B. Rt hemithyroidectomy
C. iodine ablation
Answer is: C if there is antithyroid better

● Burn patient 2nd degree in both arm, age 70kg calculate fluid using Parkland
formula:
A. Ringers lactate 200ml/hr
B. Normal saline 120ml/hr
Answer is: Self study

● Regarding PPI after endoscopy

A. take for 24 hr
B. 36 hr
C. 48 hr
D. 72 hr
Answer is: D

● ♥♥ Child with case of blunt trauma, laceration of spleen 2 cm , Hb 11, HD stable

what is treatment?
A. Two units of pRBCs
B. Non operative
C. Splenectomy
D. Splenic preservation survey
Answer is: B, ​any stable child even if grade 100 injury >> conservative; because overwhelming
post splenectomy sepsis is a killer

● Case of splenic trauma Grade 3, HD stable, treatment?

A. splenic preservation surgery
B. Observation ☑
C. Splenectomy
Answer is: B

● Most common indication for surgery in Graves’ disease?

A. No response to medications
B. Eye symptoms
Answer is: B
Glory Team 26th of December
● Trauma patient with a wound on his thigh, subcutaneous fat is lost and
vasculature underneath is exposed what provides the best management?
A. Debridement with primary closure
B. Primary repair
C. Debridement with secondary closure
D. Debridement with ​vacuum​ assisted closure
Answer is: D, if there’s debridement with dressing more accurate

● ♥ Case of small bowel obstruction with abdominal distention, tympanic on

percussion. CT: multiple small bowel dilatation with transition point at distal small
bowel. Mesenteric fat something*
A. observation
B. colonoscopy
C. diagnostic laparoscopy
D. exploratory laparotomy
Answer is : B

● 54 year old woman known case of DM did cholecystectomy 2 years ago,She has
been using NSAID to relieve RA symptomsShe develop HTN, what do think the
cause of HTN
A. Essential hypertension
B. pheochromocytoma
C. NSAID induced HTN
answer: A, C if it was with hyperK

● Patient came with abdominal pain and vomiting after the gastric sleeve:
A. Adhesion
B. Perforation
C. Intussusception
Answer is: A
Glory Team 26th of December

Pediatrics
● Pt with hypotonia, simian crease, protruded tongue, and VSD. What is the
diagnosis?
A. Down’s syndrome
B. Turner’s syndrome
Answer is: A

● 2 week child brought by the mother with poor oral intake for 2 days; on
examination, there’s mouth thrush and diaper dermatitis tx
A. Oral antifungal for 7 days
B. Topical antifungal for 5 days
C. Systemic antifungal for 5 days
D. Oral and topical antifungal for 5 days
Answer is: D

● Little kid has a brown yellow discoloration and caries :

A. Local antibiotics
B. Systemic fluoride supplements
C. Antiseptic mouthwash
D. Diet modification
Answer is: D

● Case of conjunctivitis +rash start in face then spread rapidly to all body
A. EBV
B. Coxsackie
C. Rubella
Answer is: C

● During delivery forceps blade on baby left ​stylomastoid​ foramen which

Neurological effect the baby
A. Can't open left eye❌ if can't open ok
B. Decrease blood supply to ear
C. Loss anterior 2/3 tongue sensation
D. Loss half face sensation
Answer is: C, by exclusion
Because motor and sensory fibers of the facial nerve leaves the skull through the stylomastoid
foramen; compression of these fibers would lead to ​drooping of the corners of the mouth,

❌
inability to close the eye, inability to wrinkle the forehead and loss of the blink reflex.
Taste fibers and preganglionic parasympathetic axons exit the facial nerve in the greater
petrosal n and in the chorda tympani in the facial canal proximal to stylomastoid foramen; so
taste and glandular function such as lacrimation should not be affected.
Glory Team 26th of December
● A child complains of a recurrent headache that was tied to his head. Its like
pressure that came more than a week. He had stress in school. What is the type of
headache?
A. Migrane headache
B. Stress headache
Answer is: B

● child with inc urine output, heavy thirst .. mother says that there is a similar
condition in the family ..
A. DM
B. DI
C. water intoxication
D. Something like drinking a lot of water
Answer is: B

● ​Baby with diarrhea..

A. give all vaccines
Answer is: if ​4m give all, if 6m delay OPV

● hyperphagia, obese, ​facial​ dysmorphic

Answer is: ​prader​ willi syndrome

● ♥ TOF finding :
A. Pulmonary stenosis
Answer is: A

● Down syndrome quad test :

A. Elevated Hcg, elevated inhibin A, decreased AFP and decrease estroil
Answer is: A

● 2 years girl coming to ER with thirst and polyurea , Sign of dehydration

" DKA case", With high glucose , Q ABOUT how to confirm diagnosis?
A. Glycinate hemoglobin
B. complete blood count
C. HLA-DR3 antigen
D. Urine dipstick
Answer is: D

● ♥♥ Pt diagnosed with DM type 1 after came with DKA, stabilized now BS normal
What insulin you give for discharge:
A. NPH twice daily
B. bolus base + once daily glarine
C. rapid before meals without long acting.
Answer is: rapid before meals and one dose long acting
Glory Team 26th of December
● Pedia with unilateral lower lid swelling with erythema and pain, mother said no
diplopia no change in vision,
A. cellulitis ( only no pre orbital or orbital )
B. hematoma
C. allergy
Answer is: A

● When should pediatric enuresis be worrying?

A. 5
B. 6
C. 7
D. 8
Answer is: 6 up to 5 normal and acceptable

● Heart block and patent ductus arteriosus in neonate 24 hours age. What is the
maternal factor?
A. Rubella
B. Sle
Answer is: B if only PDA choose A if only heart block choose B if salata choose B

● Baby with signs of gastroenteritis and dehydration What you will do to confirm the
dx?
A. viral serum culture
B. Serum antibody
C. stool leukocytes
D. stool antigen
Answer is: D

● 3 months boy came with fever and hx of circumcision you take a urine culture and
it was 80.000 E Coli and sensitive to TMX/Sulfa you gave him abx for 10 days and
discharged after two days the mother said his fever improved
A. complete course of Abx for 10 and no need for further action
B. do US
C. repeat urine culture
Answer is: B

● Infant 2 months comes with her mother crying at night, her cries for 2-3 times per
week that lasts for 1-2 hours. What is diagnosis?
A. infantile colic
B. cystic fibrosis
C. temper tantrum
Answer is: A
Glory Team 26th of December
● 13yr girl with primary dysmenorrhea, what is the best treatment?
A. OCP
B. NSAIDs
C. Medroxyprogesterone
D. Acetaminophen
Answer is: B first life style

● Sickle cell child, hgb 51. What to do?

A. Steroids
B. Blood transfusion
Answer is: B 5 Is very low ‫ﺑﯿﻤﻮت‬

● Pediatric patient with murmer found in routine visit with grade 3 in intensity,
increases in supine and it is vibratory in quality
A. Still murmer
B. VSD
C. ASD
Answer is:: A

● Case 3 weeks neonate presents with severe vomiting, dehydration signs K is high,
Na is low, glucose is low, What is the appropriate treatment?
A. IV fluid
B. Steroid and hormone replacement
C. Antibiotic
Answer is: B

● patient came with pertussis and cough attacks, he got norepinephrine and 3 hours
later he has repeated attacks what to do?
A. observation
B. give another dose of norepinephrine
Answer is: B I think it’s croup

● patient with pertussis and his two siblings 3 years age and 5 years age already
received pertussis vaccine; What to do for them as precaution now?
A. give them booster vaccine
B. close observation
C. booster vaccine after 1 month
Answer is: B if they received complete doses

● child with vesicular lesions on chest upper limb and face. What antigen will you
find?
A. VZV igM
B. HSV 1 igM
C. HSV 2 igM
D. HIV igM
Answer is:: A
Glory Team 26th of December
● Child fell on his head, N/V twice, normal neurological exam. What to do?
A. Consult neurology
B. Observe
C. CT
Answer is: B

● A boy came with right, non-tender, no light transillumination, not reducible

A. Testicular torsion
B. Hydrocele
C. Inguinal hernia
D. Orchitis
Answer is: C

● 12y\o girl with one side pain that provoked by light what type of headache
A. Cluster
B. Migraine
Answer is: B

● Turner syndrome; Edward syndrome

How to diagnose?
Answer is: ​Karyotyping
 Ob/Gyn
● Which of the following is the best in PPH?
A. Oxytocin
B. Carboprost
Answer is: A

●
2 hours Labor .. pt exhausted, head 4/5, station -3 cervical 100% dilated (fully) ..
next step
A. cs
B. forceps
C. vacuum
D. wait for another 2 hours sm thing like this
Answer is: A

●
Pregnant with asymptomatic UTI more than 100,000 e.coli; What is best
management:
A. Ciprofloxacin
B. Trimethoprim-sulfamethoxazole
C. Nitrofurantoin
D. No ttt needed
Answer is: D, if pregnant > C

● Most common complication of uterine evacuation?

A. Pneumonia
B. Amniotic embolism
C. Uterine ​perforation
Answer is: bleeding if not in choices > C

● most acceptable test to diagnose endometriosis?

Answer is: laparoscopy

● And another one hcg 2500 Also was stable

Answer is: MTX

● pph + asthma, contraindicated drug?

A. carboprost
Answer is: A

● lichen planus associated with

A.ssc
Answer is: A

● Case about women paragravida in 38 weeks, Present with manifestation of heart

failure, Previously was Healthy , Diagnosis?
A. peripartum cardiomyopathy
Answer is:A
Glory Team 26th of December
● Gestational DM Due to :
A. placenta estradiol
B. placenta ​lactogen
C. placenta inhibin
Answer is: B

● Same Q of C/S and when to give IV antibiotics:

A. Pre op
B. After cord clamp
Answer is: A

● women with amenorrhea for 8 months. All her lab are normal except high FSH and
LH (estrogen and progesterone were no mentioned)
A. she is at risk for endometrial cancer
B. she is at risk for ovarian cancer
C. she is at risk for osteoporosis
Answer is: C

● 48 years old female patient with ASCUS; 3 month later did Pap smear again:
Found ASCUS, what to do?
A. Pap smear after 1 year
B. colposcopy
Answer is: B

● 32 year old menopause at risk of what?

A. Osteoporosis
Answer is: A

● Pregnant with recurrent UTI. What to do?

A. Ultrasound of the renal system
B. Cystogram
Answer is: Cystoscope

● pregnant woman with vaginal bleeding in her 34 GA l, what to do?

A. administer Indomethacin
B. oxytocin
C. dexamethasone
Answer is: US

● patient with AUB post menopause, what is the best next step?
A. pelvic MRI
B. endometrial sample
C. US
Answer is: B

● recurrent miscarriages?
Answer is: antiphospholipid syndrome
Glory Team 26th of December
● Elderly women came to clinic frightened because of endometrial hyperplasia and
want you to book her for hysterectomy. What to do?
A. Do what she asks for
B. Refer to gyne oncology because the risk of malignancy
C. Calm her down and hear her thoughts
Answer is: C

● Case of ectopic pregnancy with fluid in Cul de sac, treatment ?

A. Salpingectomy
B. Salpingectomy
C. MTX
Answer is:: C if not contraindicated

● Pregnant lady present with twisted her arm when violent can increase between
couple
A. Holiday
B. Pregnancy
C. Afterfamily visit
Answer is: B

● cervical polyp what to do:

A. Excision in the clinic
B. admission
Answer is: A

● vitiligo in vulva, what is the Pathophysiology

A. tumor “increasing in cell division”
B. recurrent use of allergens
C. Autoimmune lymphocytes attacking melanocytes
Answer is: C

Ethics & Biostatistics

● Pediatric pt come with severe asthma in ER and his father is a heavy smoker, and
you have told the father many times to quit, what will you do ??
A. leave the father and concentrate with the kid.
B. tell the social committee in the hospital
Answer is: A

● Pt 70 years diagnosed with cancer, family asked you not to tell him what you
should do?
A. tell him
B. ask ethical advice department in hospital
C. don’t tell him
Answer is: A
Topics & Pics
❖ Wiskott–Aldrich syndrome (WAS)​ is a rare X-linked recessive disease
characterized by ​eczema​, ​thrombocytopenia​ (low platelet count), immune deficiency,
and bloody diarrhea
❖ 2 cases of kawasaki dx and mx
❖ peripartum cardiomyopathy
❖ good pasture syndrome
❖ Multiple Q ABOUT physiological Gastroesophegeal reflex Diagnosis + managment
❖ Down syndrome sx
❖ :cushion defect
❖ Thoracocenthesis of TB >>> WBCs > 1000 , LDH > 100
❖ Cauda equena symptoms
❖ Old with abdominal pulsatile mass what impo test to do >>>> CL level , calcium
level , Amylase level
❖ Cardiac tamponade
❖ Bronchogenic carcinoma >>> Cardiac tamponade
❖ Compartment syndrome
❖ RTA>>>
❖ Pic of colles fracture what to do <<< reduction with forearm cast
❖ - Gout - in flare how to treat
❖ - Septic shock , sepsis , septic shock syndrome
❖ Most common site injury to the aortic
❖ Undescended testis at age 5 years what is the management ?
❖ ​Which food consider low potassium diet ? Tomato
❖ Stomach varicocele before endoscopy what to give? Octeoride
❖ Achalasia treatment?
❖ Angiodysplasia treatment?
❖ Vtach ECG.
❖ Dm and HTn? Acei
❖ COPD exacerbation and he is in coma, what to do? mechanical ventilation
❖ Emphysema spirometey.
❖ Case of old smoker c/o cough, loss of nail bed angle? beonchogenic carcinoma
❖ Iron overload is managed within 8 hours ? -Deferoxamine
❖ Tow q of spleenectemy? One ITP one thrombosed vein.
❖ TTP treatment ? Plasma exchange
❖ Parents with tb , child 10mm ? Positive
❖ First thing to do tb? Isolation.
❖ 2nd degree burn in both legs. His weight is 70 kg(Calculate fluid refinement )
❖ Calculate Brain pressure perfusion ​(Give Mean Arterial pressure)
❖ *Typical case of Vascular dementia*
❖ Pictures:
➢ Perforated duodenal ulcer
➢ Heart block
➢ Distal radial and ulnar#
➢ Anembryonic sac
➢ Ground Glass appearance
➢ Many CTG
Glory Team 26th of December

● women with lesions over inguinal line, usually asymptomatic, but with trauma
become scratchy and blue purple, diagnosis:
A. condyloma lata
B. chondyloma acumnata
C. skin tag
Answer is:: C