1 . Female pt 8 wks postpartum,not smoker diagnosed to hae asthma,her
asthma was not controlled she attended E! " times last month,on #2 agonist and oral steroid,she came c$o whee%ing and s.o.& mildl' c'anosed using her intercostal muscles,whee%' chest,#()1*0$100 ()120 (+2),2 (EF)"*,there is oedema in her -oot up to the knee,the most likel' diagnosis ) 1 . .+(/ 2 . pulmonar' em&olism " . 0cute asthma attack 1 . 0ngioedema 2 . Female pt deeloped sudden loss o- ision(&oth e'es) while she was walking down the street,also c$o num&ness and tingling 2n her -eet ,there is discrepanc' &$w the complaint and the -inding , +$E re-le3es and ankle 2erks presered,there is decrease in the sensation and weakness in the lower muscles not going with the anatom',what is 'our action ) 1 . .all ophthalmologist 2 . .all neurologist " . call ps'chiatrist 1 . reassure her and ask her a&out the stressors " . same scenario in 4.2 what is the diagnosis ) 1 . .onersion disorder 2 . Somato-orm disorder 1 . male pt deeloped corneal ulcer in his !t e'e a-ter trauma what is the 53 ) 1 . topical 0& 6 analgesia 2 . topical steroid 7 . -emale pt with !t e'e pain and redness with water' discharge,no h.o trauma,itching,+$E there is di--use congestion in the con2unctia and water' discharge what 'ou8ll do ) 1 . gie 0& 2 . gie antihistamine " . topical steroid 1 . re-er her to the ophthalmologist * . Epidemic disease in poor sanitation areas a--ecting children and 'oung adults ) 1 . hep 0 2 . # " . . 1 . / , . * mths &a&' with cr'ing episodes9current 2ell' stool,looks slightl' pale,signs o- o&struction wht is 'our 53 ) 1 . &arium enema 2 . immediate surger' " . :. -luid 6 wait -or resolution 8 . 1, '.o adolescent, athletic ,with h$o !t -oot pain planter sur-ace,diagnosis is ) 1 . planter -asciaitis 2 . alu3 ;; " . alu3 ..; < . pregnant lad' 1* wks presented with aginal &leeding ,enlarged a&domen,omiting ,her uterus is smaller than e3pected -or the gestational age,#h.= 80,>$S snowstorm appearance,diagnosis ) 1 . complete h'dati-orm mole 2 . partial h'dati-orm mole 10 . 12 '.o &o' c$o a&dominal pain a-ter plauing -oot&all,he denied an' h$o trauma ,the pain is in the Lt paraum&ilical region what in3 'ou want to do ) 1 . .?! 2 . ultrasound kidne' 11 . 7 '.o child with h.o -eer and swelling o- the -ace ant to the &oth ears (parotid gland enlargement) what is the most common complication ) 1 . La&r'nthitis 2 . meningitis " . encephalitis 1 . orchitis 12 . what is the meaning o- di--icult' &reathing ) 1 . d'spnia 2 . tach'cardia 1" . -emale pt complaining that she alwa's isuali%e that snakes crowling to her &a&' cri&,and this is a--ecting her marriage,diagnosis is ) 1 . @allucination 11 . -emale pt c$o seer migraine that a--ecting her work,she mentioned that she was improed in her last pregnanc',to preent that ) 1 . &io-eed&ack 2 . propranolol 17 . 0&out /5 in AS0 ) 1 . a&out B 10 C 2 . 5ost o- the pt o- insulin dependant t'pe " . -emale more a--ected with t'pe 2 /5 1 . most o- D://5 are o&ese 1* . Flu accine not gien to the &a&' who is allergic to ) 1 . egg 1, . (t with as'mptomatic Erichomniasis ) 1 . treat her an'wa' regardless 2 . treat her i- she is s'mptomatic onl' 18 . 1, '.o,she missed her second dose o- arecila accine,the -irst one a&out 1 ' ago what 'ou8ll do ) 1 . gie her dou&le dose accine 2 . gie her the second dose onl' " . see i- she has anti&od' and act accordingl' 1< . pt with gonorrhea in-ection what else 'ou want to check -or 1 . .lam'dia trachomatis 20 . -emale pt with 0ortic stenosis,she deeloped s'ncope while she was in the class and she recoered immediatel',what is the cause o- s'ncope ) 1 . alular rupture 2 . s'stemic h'potension 21 . dia&etic pt well controlled,she came with h.o di%%iness and sweating a-ter taking a medication #S)*0 what drug that ca'se her pro& ) 22 . male pt with acute urine retention what is 'our action ) 1 . insert -oll'8s cath and ask him to come &ack to the clinic . 2" . :n &attered women which is true ) 1 . mostl' the' come -rom poor socioeconomic area 2 . usuall' the' marr' a second iolent man " . mostl' the' come to the E$! c$o ..;;; 1 . mostl' the' think that the hus&and respond like this &ecause the' still hae strong -eeling -or them 21 . smoking withdrawal s'mptoms peak at ) 1 . 1F2 da's 2 . 2F1 da's " . 7., da's 1 . 10F11 da's 27 . 5other who is &reast -eeding and she want to take 55! accine what is 'our adice ) 1 . can &e gien sa-el' during lactation 2 . contain lie &acteria that will &e transmitted to the &a&' " . stop &reast -eeding -or ,2 hrs a-ter taking the accine 2* . male pt c$o pain in his !t el&ow,he said that he is using the hummer a lot in his work diagnosis ) 1 . lateral epichond'litis 2, . 70 '.o male with di--icult' swallowing -ood with wt loss ) 1 . +esophageal cancer 28 . 'oung -emale with pain in her el&ow(lateral epichond'litis) &est treatment is ) 1 9.;;;; . DS0:/ 2 . electric ..;;;; 2< . what drug that improe the surial in .@F 1 . digo3in 2 . @'drala%in " . diuretic (can8t remem&er the name ) "0 . old man with &ilateral knee pain and tenderness that increase with walking and relieed &' rest G 1 . !0 2 . +0 "1 . !egarding peritonitis ) 1 . .omplicated appendectom' the cause is anero&e organism 2 . rigidit' and the cause is paral'tic ileus " . can &e caused &' chemical erosions 1 ..;;;; . 7 .;;;;; . "2 . regarding 5: all e3cept ) 1 . unsta&le angina,longer duration o- pain and can occur een at rest . 2 . sta&le angina,shorter duration and occur with e3certion " . there should &e H wae in 5: 1 . een i- there is er' pain-ul unsta&le angina the cardiac en%'mes will &e normal 7 ;;;;;; . "" . (t with scoliosis, 'ou need to re-er him to the ortho when the degree is ) 1 . 7 2 . 10 " . 17 1 . 20 "1 . * mths &a&' with undescending testis which is true ) 1 . till the mother that he need s'rger' 2 . in most o- the cases spontaneous descent a-ter 1 'ear " . surger' indicated when he is 1 'ears 1 . unlikel' to &ecome malignant "7.21 '.o (t with as'mptomatic congenital inguinal hernia ) 1 . immediate surger' 2 . surger' indicated when he is I"7 ' " . electie surger' i- it is reduci&le 1 ..;;;; . "* . the most e--ectie thing regarding counseling ) 1 . -amil' rapport 2 . well ad2usted appointment &e-ore counseling " .;;;;;; . ", . :n a certine stud' the' are selecting the 10th -amil' in each group,ahat is the t'pe o- stud' ) 1 . s'stemic stud' 2 . non randomi%ed stud' " .;;;;;; . "8 . /eep laceration in the ant aspect o- the wrist,causing in2ur' to the median nere,the result is ) 1 . claw hand 2 . drop hand " . ina&ilit' to oppose the thum& to other -ingrs "< . 70 '.o male with num&ness in the little -inger and he has degeneratie cericitis with restriction in the neck moement,also there is num&ness in the ring -inger and atroph' o- the thenar muscle9compression in the el&ow,what 'ou8ll do ) 1 . surgical decompression 2 . .0E scan -or surical spine " ;;; . 1 ;;;; . 10 . 'oung pt with lier cirrhosis and ascitis what diuretic to gie ) 1 . spironolactone 2 ..;;;; . " .;;;; . 11 . *0 '$o male with hematuria and &ladder calculi what organism mostl' inoled ) 1 . schistosoma hematopium 2 ..;;;;; 12 . (t with cough ,? ra'showed upper lo&e ;;;.9-i&rosis and he is working in a crowded area(case o- E# : guess) Jhat 'ou8ll gie the -amil' contact ) 1 . #acilli ;;;;; 2 ..;;;; . 1" . &a&' with -ace cellulitis and er'thema what is the causatie organism ) 1 . @ in-luen%a t'pe & Staph I strept I @ in-luen%a ( in children) strept I Staph ( in adult) 11 . the &est indicator -or progression o- la&our ) 1 . descent o- the head 2 . uterine contractions 17 . &a&' with white papules in his -ace what is 'our action ) 1 . reassure the mother and it will resole spontaneousl' 2 . gie her anti&iotic " ;;;;; . 1* . old man with generali%ed a&dominal pain E)"8.2,a&scent &owel sound,3 ra')dilated small &owel and part o- the transerse colon,no no -luid leel ) 1 . pancreatitis 2 . per-orated peptic ulcer " . &acterial colitis 1 .;;; . 1, . pt with pepti ulcer using anti acid,presented with -orce-ul omiting that contains -ood particle ) 1 . gastric outlet o&struction 2 .;;;;;; . 18 . pregnant lad' with cardiac disease presented in la&our,'ou8ll do all e3cept ) 1 . epidural anesthesia 2 . .$S " . diuretic 1 . digitalis 7 . +2 1< . 0nti&iotic -or communit' acHuired pneumonia 1 . =entamicin90mo3icillin 2 . Er'throm'cin " .;;;;; . 70 . &a&' presented with skin lesion in his shoulder since &irth ) 1 . straw&err' ;;;; 2 ;;;;;; . 71 . pt with rheumatic -eer a-ter untreated strep in-ection a-ter man' 'ears presented with 5itral regurge,the cause o- massie regurge is dilatation o- ) 1 . !t atrium 2 . !t entricle " . Lt atrium 1 . Lt entricle 72 . old -emale with pu&ic itching with &lood' discharge,then she deeloped pea shaped swelling in her la&ia,most likel' ) 1 . #artholin c'st 2 . #artholin gland carcinoma " . #artholin a&scess 7" . male pt with @ED on medication,wel controlled,the pt is using garlic water and he is conenced that it is the reason -or #( control,what 'ou8ll do as his ph'sician ) 1 . tell him to continue using it 2 . to stop the medication and continue using it " . tell him that he is ignorant 1 . to stop using garlic water 71 . -orcing the child to go to the toilet &e-ore &edtime and in the morning,'ou8ll contro the pro&lem o- G 1 . enuresis 2 ;;; . 77 . the wound will heal when ) 1 . &ecome sterile 2 . -ormation o- epithelium " ..;;; . 7* . which o- the -ollowing is a disease improing drug -or !0 ) 1 . DS0:/ 2 . @'dro3'chloroHuine " ;;;;; 7, . adolescent -emale came to 'ou in the clinic 2ust -or -ollowup what 'ou8ll gie her ) 1 . .a9-olic acid 2 . .a9 %inc " . -olic acid9%inc 1 ..;;; . 78 . 70 '.o male with rectal &leeding,+$E there is e3ternal hemorrhoid,'our action ) 1 . E3cision o- the hemorrhoid 2 . rigid sigmoidoscop' and e3cision o- the hemorrhoid " 9..;;;;; . colonscop' 1 .;;;; . 7< . &a&' with tonic clonic conulsions,what drug 'ou8ll gie the mother to take home i- ther is another sei%ure ) 1 . /ia%epam 2 . phen'toin " . pheno&ar& *0 . -emale pt with /5 well controlled and she wants to get pregnant,and she asked 'ou a&out the risk o- congenital a&normalit',to aoid this dia&etes control should start in ) 1 . &e-ore pregnanc' 2 . 1st trimester " . 2nd trimester 1 . "rd trimester *1 . pregnant lad', she wants to do a screening tests,she insist that she doesn8t want an' inasie procedure,'ou8ll do ) 1 . >$S 2 . amniosenteses " ;;;;; . *" . pt complaining that urine is coming out -rom her agina,the cause is ) 1 . esico aginal -istula 2 . esico cutaneous -istula " ;;;; . *1 . a mother &rought her 10 '$o o&ese &o' to the -amil' practice clinic ,what is 'our adice ) 1 . same dietr' ha&&its onl' e3ercise 2 . -at -ree diet " . multi-actorial interentions 1 .;;;; . *7 . male pt with a c'anotic heart disease;;;;;.(incomplete 4) 1 . 0S/ 2 . KS/ " . (/0 1 . truncus arteriosus ** . pt c$o pain when moing the e'e,-undoscop')normal ) 1 . optic neuritis 2 . papillodema " .;;;;;;; . 1 ;;;;;; . i remem&er one H case o- sudden death in athlete ans is ) o&structie h'pertophic cardiom'opath' SLE march 2010(prometric) E.histol'tica c'st is destro'ed &' ) Free%ing #oiling :odine treatment .hlorine (atient a-ter accident , the le-t ri&cage moe inward during inspiration and outward during e3piration ) Flial chest =reatest risk o- stroke ) /5 Eleated &lood pressure Famil' histor' o- stroke @'perlipedemia Smooking .hild has pallor , eats little meat , &' inestigation )microc'tic h'pochromic anemia . what will 'ou do ) Erial o- iron therar' 5ultiitamin with iron dail' Ereatment o- mania that doesnot cause hepatoto3icit' Lithium S.0 patient , the macula is cherr' red , and a&sence o- a--erent papillar' light re-le3 !etinal arter' o cclusion :n-lammator' &owel disease is idiopathic &ut one o- -ollowing is possi&le underl'ing cause :mmunological (atient present with high &lood pressure (s'stolic 200) , tach'cardia 5'driasis , sweating . what is the to3icit' ) 0ntichlenergic S'mpathomemitic Eric'clic antidepressant +rganophosphorous compounds i think the answer is s'mpathomimetic Ereatment o- .hlam'dia with pregnan' ) 0%ithrom'cin Er'throm'cin &ase the ma3imum &od' lenght will &e reached a-ter menarch &' * months 1 'ear 2 'ears (atient deeloped sudden loss o- ision &ilaterall' while she was walking in the street , -ollowed &' num&ness , the su&2ectie s'mptoms are di--erent -rom o&2ectie , and does not match anatomical , what is 'our diagnosis ) .onersion s'ndrome(i think this is the answer 0-ter in-lammator' phase o- wound , there will &e wound healing &' ) :- the wound is clean 0ngiogenesis Epithelial tissue +ld male with tender knee , pain , crepitus . the diagnosis ) +steorhritis 0nk'losin spond'litis !heumatoid 5other has &a&' with cle-t palate and asks 'ou what is the chance o- haing a second &a&' with cle-t palate or cle-t lip , 27C 70C C1 1C i think the answer is 27 1 liter -luid de-icit eHuals 1 kg 0-ter accident patient with tach'cardia , h'potension , what will &e 'our initial step !apid :KF cr'stalloid .E .;; * ' child was &orn to @#S positie mother is @#S positie , he was onl' accinated &' #.= a-ter &irth , what 'ou will gie him now ) @#K 9 oral polio 9 /E( 9 hi& @#K 9 oral polio 9 dt 9 55! 9hi& @#K 9 oral polio 9 /t 9 55! Ereatment o- non in-lammator' acne !etinoic acid Treatment of comedones: Topical retinoids . 2 . Treatment of papules or pustules: Topical benzoyl peroxide plus topical antibiotics, mainly clindamycin or erythromycin . 3 . In severe cases, intralesional steroid injection or oral antibiotics, such as tetracycline or erythromycin may be added . Jhich is not true :n emergenc' management o- stroke =ie :KF to aoid /7 70C =ie dia%epam in conulsions 0nticonulsants not needed in i- sei%ures 5ust correct electrol'tes Ereat eleated &lood pressure S.0 complications in adults .ere&ral in-arction .ere&ral hemorrhage Ehe most common risk -or intracere&ral stroke @'pertension .;;; ;;;; Ehe antidepressant used -or secondar' depression that cause se3ual d's-unction Sertatlie 0m'pramine Leo-lu3ine (reiousl' health' -emale patient presented to E! with d'snea , ane3iet' , tremor , and she &reath heail' , the s'mptoms &egan 20 minutes &e-ore she came to E! , in the hospital she deeloped num&ness perior&ital and in her -ingers , what 'ou will do 0sk her to &reath into a &ag Eake &lood sample to look -or alcohol to3icit' Jhat is the most important in councling E3clude ph'sical illness Esta&lishing ra&&ot Famil' Schedule appointement :n &reaking &ad news Find out how much the patient know Find out how much the patient wants to know (atient with chest pain that aggreated&' couphing, there is added sound on le-t sternal &order .in ecg 'ou will -ind St changes (r prolongation @'peroltage Ehe most common site -or isceral hemangioma is Lier .hild with large perior&ital hemangioma , i- this hemangioma cause o&struction to ision , when will &e permenant decrease in isual acuit' 0-ter o&struction &' one da' #' 1 week #' " months #' * months Ehe s'mptoms o- so-t tissue sarcoma (rogressie enlarging mass "7 'ear -emale with &ilateral &reat pain , that decrease a-ter menstruation , the &reast is nodular with prominent " cm mass su&areolar , a3illar' l'mph nodes are not enlarged , what 'ou will do 5ammograph' -ollowed &' us See her ne3t c'cle Fine needle &iops' -ollowed &' tissue studies (regnant with &leeding -or 12 hours and tissue , the ceri3 is 1 cm .omplete a&ortion :ncomplete a&ortion 5olar pregnanc' 2 month in-ant with omiting a-ter each meal , he is in 70 centile , @e passed meconium earl' and stool , diagnosis is 5idgut olulus 5econium ileus @ischsprung disease (atient with d'sphagia to solid and liHuid , and regurg , &' &arium there is non peristalsis dilatation o- osophagus and airF-luid leel and tapering end . diagnosis is +sophageal spasm 0chalasia +sophageal ca Ehe most common cause o- cough in adults is 0sthma =erd (ostnasal drip =irl with amenorrhea -or man' months . &mi is 20 and is sta&le oer last 7 'ears . diagnosis Eating disorder (ituitar' adenoma +ld -emale with itching o- ula , &' e3amination there is pale and thin agina , no discharge . what is management Estrogen cream .orticosteroid cream Flucona%ole (atient with d'suria , -reHuenc' , urgenc' , &ut no -lank pain , what is the treatment .ipro-lo3acin po od -or "F7 da's Dor-ocin po od -or , L 11 da's (atient with -lank pain , -eer , omiting , treatment is @ospitali%ation and intraenous anti&iotics and -luid (atient present with mid -ace pain , erethematous lesions and esicles on perior&ital and -orehead , the pain ia at nose , nose is er'thematous . what is diagnosis !oseola @s @erpes %oster 5ale with itching in groin er'thematous lesions and some hae clear centers , what is diagnosis ) (soriasis Einea curis Er'thrasma Kasoconstrictie nasal drops complication !e&ound phenomenon Ehe use-ul e3curcise -or osteoarthritis in old age to maintain muscle and &one Low resistance and high repetion weight training .onditioning and low repetion weight training Jalking and weight e3ercise ..;;;;;;;;;; >nilateral worsening headach , nausea , e3cacer&eted &' moement and aggreated &' light in 1, old girl 5igraine .luster /iet supplement -or osteoarthritis =inger +ld male with a&dominal pain , nausea , w&c , . what is true a&out appendicitis in elderl' .t not use-ull -or diagnosis J&c is o-ten normal !upture is common :- there is no -eer the diagnosis o- appendicitis is unlikel' 0nemia is common +ld patient with &ilateral enlarged knee , no histor' o- trauma , no tenderness , normal esr and cFreactie proteins . the diagnosis is +steoarthritis =out :n-ectous arthritis (atient has decrease isual acuit' &ilateral , &ut more in rt side , isual -ield is not a--ected , in -undus there is irregular pigmentations and earl' cataract -ormation . what 'ou will do !e-er to ophthalmologist -or laser therap' !e-er to ophthalmologist -or cataract surger' Jhat is the most common treatment -or 2uenile rheumatoid arthritis :ntraarticular in2ection o- steroid +ral steroid (aracetamol /Fpenicillamine 0sprin which o- the -ollowing decrease mortalit' a-ter 5: metoprolol nitrogl'cerine thia%ide morphine the cardiac arrest in children is uncommon &ut i- occur it will &e due to primar' respirator' arrest h'poolemic shock neurogenic shock old -emale with recurrent -racture , it d insu-ecienc' and smoker . which e3ogenous -actor has the gretest e3ogenous side e--ect on osteoporosis old age smoking vit d insufeciency continue smoking recurrent -racture patient presented with sudden chest pain and d'snea , tactile ocal -remitus and chest moeme&t is decreased , &' 3Fra' there is decreased pulmonar' marking in le-t side , diagnosis atelectasis o- le-t lung spontaneous pneumothora3 pulmonar' em&olism &o' a-ter running -or hours , has pain in knee and mass on upper sur-ace o- ti&ia osgood scatter disease ilioti&ial &and Osood!"chlatter disease Osood!"chlatter #say: $oz!ood shlot!ter$% disease is one of the most common causes of &nee pain in youn athletes. It causes s'ellin, pain and tenderness just belo' the &nee, over the shin bone #also called the tibia%. Osood!"chlatter commonly affects boys 'ho are havin a ro'th spurt durin their pre!teen or teenae years. One or both &nees may be affected . pancreatitis am'lase is slowl' rising &ut remain -or da's am'lase is more speci-ic &ut less sensitie than lipase ranson criteria has seerit' (predictie) in acute pancreatitis pain is increased &' sitting and relieed &' l'ing down contraceptie pills is associated patient has -eer , night sweating , &lood' sputum , weight loss , ppd test was positie . 3Fra' show in-iltrate in ape3 o- lung , ppd test is now reactionar' , diagnosis actiation o- primar' t# sarcoidosis case control is &ackward stud'