1- ectopic

2-abdominal distention+shifting dullness...........ascitis

3-pt complaining from thrist +intractable vomiting+investigation increase
calcium .....next step
a-frusemide

b-hydration

4-manifestation of pulmonary congestion+mitral valve disease .....diagnosis

increased left atrial pressure lead to pulmonary congestion

a-lt side heart failure

b-rt side heart failure

c-aortic stenosis

5-history of strep pharygitis +rh fever .....risk of recurrance of rh fever

a-100%
b-the same as. those without history
those without history

c-5times more than

6- study ..... sensetivity

7-study started 1980 about alcohol consumption 1000pt in 2005 development of
hepatitis is tested.......type of study
a-retrospective cohort

b-concurrent cohort

case control

8-child 4years old decrease head growth +social skills +language

delay.......diagnosis
a-autism

b-rett"s syndrome

9accentuated pulmonary componant of second sound +increase jugular venous

pressure on sitting +chest pain two days after surgery ECHO show tricusped
regurge
no symptoms or sign of pulmonary embolism next step.....
.
cardiac tamponade
Ttt neuro axial anathesia
a-Bbloker

b-complete rest

c-anti coagulant

10-45minutes after commit suicide by over dose of acetaminophen .....what to

do?
a-give n-acetyl cysteine
liver enzyme

b-chek level of acetaminophen

11-how to treat pt with non compliace the chronic ttt

a-IV haloperdol
12 ........flight of idea

c- chek

13-side effect of prolonged steriod eye drops use...............cataract

14-systemic side effect of prolonged steriod use...................osteoprosis
15-pt ttake steroid for inflammatory condtion and develop sinusitis what to do
beside ttt of sinusitis
1-stop stetiod

b-continue

c- decrease dose

16-para nasal sinusites with hemophlus influnsa ......ttt

a-nasal decongestant+ antibiotic +nasal steriod
+antiinflammatory+antibiotic

b-topical steriod

17-35 years old take phynetion since 29 years old for seizure now she fell well
but complaining of hirsutism she want to stop it
what will you tell her
continue use
b-take new anticonvulsant
of39 years old
d-stop

c-take it till age

18-pt take warfarin what food interfere with it? Spinach

Kale Spinach Brussels sprouts Parsley Collard greens
Mustard greens Chard Green tea

beef liver,soy beans,green leafy vegetables,asparagus, avocados, dill pickles, green peas,
green tea, canola oil, margarine, mayonnaise, olive oil, and soybean oil
19-type of food contraindecated with increase cholesterol
a-egg white

b-chicken

c-liver

d-tuna

20-type of excersise improve osteoporosis

According to the National Osteoporosis Foundation, the
best exercises for building and maintaining bone density are weight-bearing
exercise as walking and strength training exercise
21-.....................................osteoarthritis
Exercises that will help you if you have osteoarthritis include:
Aerobic activity such as walking, biking, swimming, and water aerobics.
Strength exercises, such as lifting light weights or dumbbells or using elastic
tubing, at home or in a gym.
Range-of-motion exercises that help keep you flexible, such as stretching or
exercises that target a certain joint.
22......................................body fittness and decrease risk of cardiovascular
disease
a-yoga

b-weight liffting

c-resistance excrsise

Aerobic exercises include: walking, jogging, jumping rope, bicycling, skiing,

skating, rowing, and aerobics.Strengthening exercises are repeated muscle
contractions (tightening). They help tone muscles, improve strength, and
increase your metabolism.
23- hemptosis+red urine+episodes of fever.........................wegeners granulomas
fever.........................wegeners granulomas
First ;good pasture syndrome consists of lower respiratory tract affection"
hemeoptysis cough abnormal chest x ray" + kidney affection "heamaturia" AND
THE CONDITION IS AUTO IMMUNE SECOND:
wagners is vasculitis so it is inflammatory in nature affecting many systems like
kidney"heamaturia"+upper respiratory "sinusitis and otitis media ""and this us
the key diagnosis"+lower respiratory "hemeoptysis and cough"+other organs
like brain and joint
24chilh with red utine+dysuria...........investgation
a-microscopic examin of urine
pyrophyrin

b-culture of the sedimnt

c-quantitative

25-pregnant +pulmonary empolism..............investigation.............v/q scan

26-child best investigation
a-IVpyelograph

b-renal ultrasond

c-isonucloitide scan

27-pt take insulin to control diabetus and he will go to do surgery ....doctor

advise him to fasting from mid night what about his insulin
a-take half of the dose at night and the other half in the morring
b-take his usaul dose
c- take half of the dose
28-ttt of post partum hemorrage
a-uterine sedation

b-uterine contractalant

c- uterine relaxant

29-ttt of post partum infection

a-ampicillin +clavualunic
+oxacillin

b-metronidazole +fluconazole

30-picture of varicella need diagnosis

31-erythma of the gum+macules+vesicles....diagnosis
a-candida

b-herpes simplex

32-tobacco +alcohol+ulcer on the lateral border of the tongue

c-ampicillin

a-leukoplekia

b-aphthus ulcer

c-sq cell carcinoma

33-GERD+grade 4 barret esophgus ttt

a-anti reflex sugery

b-baritiat surgery

c- follow up`

34-sedorric dermatitisof scalp+nasal fold+dehind the ear ttt....nizoral cream

35-young age female with familial conductive hearing loss..........otosclerosis
36-old age pt with sensorineural hearing loss +loss of high frequency sound first
a-age related hearing loss

b-otosclerosis

c-noise induce deafness

37-pt with decrease hearing from right ear but he hear his sound very loud
a-otitis media

b-otitis externa

c-furuncle of ear canal

38-6years old child with +HBsAg his mother+HBsAg not vaccinated

a-td,mmR ,polio .HBv .Hib
b-Dtp, mmR ,polio ,HBV,Hib
c-TD ,mmR ,polio ,HBv
39-senil chart and ask if the pt can read the third line
a-20/100 b-20/70

c-20/50

40-acase of polycystic ovary

41-infirtility+hirsutism

this due to

a-increase androgens

b-increase esrtogen

c- non

42-case of polycysemia mechanism of flushing

a-increase seensitivity to histamine

b-abnormal histamine release

43-incease leucocytes+anemia+thromcytopenia +blast cells ....leumphocytes

a-acute lymphocytic leukemia
b-acute myloid
c- lymphoma
44-case of COPD take B2 agonist for 2weeks but still symptomatic and there is
only 15%improvment what will you do
a-change B2 agonist
tpratropium

b-add steriod

c-add phynytion

d-add

45-case of COPD with severe hypoxia during rapid phase of sleep at night
will you do
a-positive pressure ventilation during night
oxygen at night

what

b-give concentrated

46-pt with dementia +gait disorder + picture of CT show dilated ventricles+ LP

show normal CSF pressure this due to
a- decrease absorption of CSF
c- un resolved sub dural hematoma

B-congenital degenerative condition

47-pt with ceiliac dis which food safe to him...............rice

48- +anti mitocondorial antibodies.................primary biliary cirrhosis
49-best ttt of specific phobia
a-SSRIs

b-psycotherapy

50-pt with recurrent attack of abdominal pian +ERCP show multiple stone
step
............cholecystectomy

next

51-case of ankylosing spondiolitis

52-pt with osteoarthritis develop knee swelling +with erythema+limitation of
movement
next step
a-diagnostic arthrocentesis

b-incision and driange

c-X-ray

53-doctors use NSAID in ttt of dysmenorria because it ..............decrease

prostaglandin synthesis
54-female 24 years old need to use IUD as contraceptian

what willyou tell her

a- it cause irregular uterine bleeding b-can cause perforation

55-female take anticovulsant for ttt of epelipsy she want to be pregnant the risk
of congenital anomalies in this case due to..........
a- attacks of epelipsy

b-side effect of anticonvalsant drug