2010-APRIL 1. 5 years old c/o limping in ct there is a v necrosis ttt is: -surgery -splent -physiotherpy 2.

Hepatitis b ab and ag on the curve 3. -Pt have dm and renal impairment when he had diabeti nephropathy:there is curve for albumin -5y -10y -20y -25y 4. -Pt has alzahimar disease and halusination and delusion ttt: Halopridole 5. Generalize antxity disorder best ttt: _Ssri -tricyclic a d 6. Major depression management: Intial therapy even sever 7. Psychiatric pt with un compliance of drugs ttt: -depro halopredol 8. strongest risk factor for strok: -htn -a fibrillation 9. most risk factor: -htn 10. -pt with salpingitis and there is swelling in pelvis in posterior fornex and it is fluctuant m: -colpotomy Laproscopic 11-child swallowing battery in the oesophegus m: -broncoscoby 12_mild diarrhea m: -ors 13. In the appendisits the histology is: -leukocyte in muscle -layer lymphoid

-tumor -plasma cell 14-water in the body: -40% -diffrence depend on age and sex 15_clavicular fracture m: If displaced need open surgery _arm sling and figer 8 is equal in efficncy 16_corneal ulcer ttt: -ab and cycloplagia is mydrasis and refer to ophthalmology 17-regarding dringe of the abcess one of the following is true: -curbuncle and frunculosis need draing -usually give ciphtriaxon and penicillin post draing 18_salpingitis and pid on penicillin but not improve the most likely organism is : -chlamydia -nessiria 19-wound at end inflammatory phase when: Epithelial tissue formation -angiogenisis -when the wound clean Scar formation 20-juvenile ra ttt: Aspirine Steroid Penicillamine Hydrocloroquin 21-adlosence with osteoporosis ttt: Ca folic acid 22_pt has hemorrhoid with 4 degree ttt: Exsion surgery 23_pt come with history of tinia capitis ttt: -tar shampoo _fluconazol 24_pt with history of copd the most action to prevent complication is: Pnemoccoccal vaccine Smoking stop Oral steroid

B 2 agonist 25_pt with congenital hip dislocation : -abducting at flexed hip can causes click or tali 26-colon cancer with stage 3 give the chemotherapy: As soon as possible I month 27-56 y old present with vasomotor rhinitis Local anti histamine Local decongestion Local steroid Systemic ab 28-sca give prophlaxis: Penicillin Iron 29-diagnosis of thalasimia minor: -hb a2 and hgf Microcytosis 30-pt with mcv decrease and reticulocyt decrease iron deficiency anaemia investigation: Ferritin level and tibc and serum iron Born bcg 1month hepatitis b oral polio dpt 2month s 3month s 9 to 12 month mmr :::( Body mass index) ... - - ( ) :::( rh. fever) ( DMARD).. :::ttt of acute gouty arthritis :::radiological finding in lateral view for elbow dislocation ::: most common cause of ch. renal failure Worldwide :: ( ...( Hallucination or ...))

Delusion thinking) Hallucination .. ::::( myosis and Respiratory depression) ( Cocaine or opiate).. In battered women which is true: 1. mostly they come from poor socioeconomic area 2. usually they marry a second violent man 3. mostly they come to the E/R c/o.. 4. mostly they think that the husband respond like this because they still have strong feeling for them

46) 17 y.o,she missed her second dose of varecila vaccine,the first one about 1 y ago what you'll do: a. give her double dose vaccine b. give her the second dose only c. revaccinate from start d. see if she has antibody and act accordingly

1- Pt with hodgicn lymphoma , and red strunberg cell in pathology and there is esinophil lycocyte in blood so pathological classification is 2- 62 y male with DVT and IVC obstruction deu to thrombosis so most like dd is -neohrotic syndrome -SLE -Chirstm disease 3-Pt with hbdominal pain heamatutea , HTN, and have abnormalty in chromosm 16 , diagnosis is _ POLY CYCTIC KIDNEY 4- 17 year pt with dyspnea Po2 , PCO2 ,Xray normal PH increase so dd is - acute attack of asthma -PE - pneumonia -pnemothrax 5- A long scenario about patient with polydipsia ad polyuria. Serum osmolrity high . desmoprsin inductin no change urine omolarity and plasma osmolrity so dd is _ nphrognic type _ central tupe 6- 50 year old Man presented to ER with sudden headach, blurred of vision and eye pain. The diagnosis is: a. Acute glaucoma b. Acute conjunctivitis c. Corneal ulcer d. ----7- RTA with hip dislocation and shock so causes of shock is - blood lose - urtheral injery -nryrogenic 8- most common causes of hand infection - truma - imunocrombromise 9- ttt of cholestatoma is - surgery - antibiotic - steroid -Grommet tube

10 twins one male and other female . his father notice that femle become puberty before male so what you say to father - female enter puberty 1-2 year before male -female enter puberty 2-3 year before male -female enter puberty at the same age male 11- in devolping countery to prevent dental carise , it add to water - florid - zink - copper - iodide 12- 10. 12 y.o boy c/o abdominal pain after plauing football,he denied any h/o trauma ,the pain is in the Lt paraumbilical region what inx you want to do: 1. CXR 2. ultrasound kidney 13- pt child with back pain that wake pt from sleep So diagnosis - lumber kyphosis - osteoarthritis - RA - Scoliosis 14- child with papule vesical on oropharnx and rash in palm and hand so dd - CMV - EBV - MEASLS - ROBELLA 15- chid with dental caries and history of bottle feading So dd - nurse milk caris

5years old c/o limping in ct there is a v necrosis ttt is: -16 -surgery total hip replacement-splent -physiotherpy 17 -Pt have dm and renal impairment when he had diabetic

nephropathy:there is curve for albumin -5y -10y -20y -25y 18 -Pt has alzahimar disease and halusination and delusion ttt: Halopridole Antipsychotic drugs are modestly useful in reducing aggression and psychosis in Alzheimer's patients with behavioural problems Generalize antxity disorder best ttt: -19 _Ssri -tricyclic a d -MAOI Major depression management: -20 - - Intial MONOTHERABY even sever sever deprisson - Ttt should be change if no response during 2wk psychotherapy, medication, and electroconvulsive therap Psychiatric pt with un compliance of drugs ttt: -21 -depro halopredol injection - oral colonazepam 22- Pt with scoliosis, you need to refer him to the ortho when the degree is: e. 5 10% ENOGH TO CONFIRM DIAGNOSIS f. 10 g. 15 h. 20 i. 23- 5 y.o child with h.o fever and swelling of the face ant to the both ears (parotid gland enlargement) what is the most common complication: j. Labrynthitis k. meningitis l. encephalitis m. orchitis 24- 35 y Woman with cyclic bilateral nodularity in her breast since 6 month, on examination there is 3 cm tender mobile mass in her breast : what you will do next n. FNA with cytology o. Mammogram p. Biopsy q. Follow up for next cycle Observation 25 -pt with salpingitis and there is swelling in pelvis in posterior fornex and it is fluctuant m:

-colpotomy : Culdocentesis refers to the extraction of fluid from the rectouterine pouch[1] posterior to the vagina through a needle > The Rectouterine Pouch is often reached through the posterior fornix of the vagina. -Laproscopic - continouse oral theraby 26- child swallowing battery in the oesophegus m: -broncoscoby - insert foly catheter - observation 27 _mild diarrhea m: -ors - IVF - oral antibiotic In the appendisits the histology is: -28 -leukocyte in muscle - lymphoid aggregation mascular layer -tumor -plasma cell in mascular layer 29 -water in the body: -40% of total body wight -diffrence depend on age and sex 30 _clavicular fracture m: - If displaced need open surgery _arm sling and figer 8 is equal in efficncy Treatment usually involves resting the affected extremity and supporting the arm with the use of a sling. In older practice, a figure-8 brace was used 31 _corneal ulcer ttt: -ab and cycloplagia is mydrasis and refer to ophthalmology including topical cycloplegics like 32 -regarding dringe of the abcess one of the following is true: -curbuncle and frunculosis need draing -usually give ciphtriaxon and penicillin post draing 33 _salpingitis and pid on penicillin but not improve the most likely organism is : -chlamydia -nessiria -SYPHLIS - HSV 34 -wound at end inflammatory phase when: Epithelial tissue formation -angiogenisis

35. male pt developed corneal ulcer in his Rt eye after trauma what is the Mx: 1. topical Ab & analgesia 2. topical steroid - antibiotic +cycloplgia + refferd to opthalm

36 -pt with mcv decrease and reticulocyt decrease iron deficiency anaemia investigation to confirm diagnosis: Ferritin level and tibc and serum iron - BONE MARROW IRON STAIN - -prephral smear - -elctrphorosis 37-. 6 mths baby with crying episodes+current jelly stool,looks slightly pale,signs of obstruction wht is your Mx: 1. barium enema 2. immediate surgery 3. I.v fluid & wait for resolution 38. 5 y.o child with h.o fever and swelling of the face ant to the both ears (parotid gland enlargement) what is the most common complication: 1. Labrynthitis 2. meningitis 3. encephalitis 4. orchitis 39. Mother who is breast feeding and she want to take MMR vaccine what is your advice: 1. can be given safely during lactation 2. contain live bacteria that will be transmitted to the baby 3. stop breast feeding for 72 hrs after taking the vaccine 40. which of the following is a disease improving drug for RA: 1. NSAID 2. Hydroxychloroquine 3 41- Greatest risk of stroke: DM Elevated blood pressure Family history of stroke Hyperlipedemia Smooking 42- SCA complications in adults Cerebral infarction Cerebral hemorrhage 43- Child with large periorbital hemangioma , if this hemangioma cause obstruction to vision , when will be permenant decrease in visual acuity After obstruction by one day

By 1 week By 3 months By 6 months 44- What is the most common treatment for juvenile rheumatoid arthritis Intraarticular injection of steroid Oral steroid Paracetamol D-penicillamine Asprin -when the wound clean Scar formation 45 -adlosence with osteoporosis ttt: Ca folic acid 46 _pt has hemorrhoid with 4 degree ttt: Exsion surgery 47 _pt come with history of tinia capitis ttt: -tar shampoo _fluconazol oral terbinafine, itraconazole, and fluconazole 48_pt with history of copd the most action to prevent complication is: Pnemoccoccal vaccine Smoking stop Oral steroid B 2 agonist 49 _pt with congenital hip dislocation : -abducting at flexed hip can causes click or tali 50-colon cancer with stage 3 give the chemotherapy: As soon as possible 51-sca give prophlaxis: Penicillin Iron month 52-diagnosis of thalasimia minor: -hb a2 and hgf Microcytosis 53-56 y old present with vasomotor rhinitis Local anti histamine Local decongestion Local steroid Systemic ab 54 - Hepatitis b ab and ag on the curvey 55-strongest risk factor for strok: -htn -a fibrillation

- 9-most risk factor: -htn , atropine 56-

to get more information from the pt -open end question 2- gingivits most likely cause -HSV 3-watery discharge from eye , conjunctivitis treated by - topical corticosteroid 4-blow out fracture eyelid swelling , redness other syptoms - present air fluid level - enopthalmos its enophaloms and other name of blow out fracture orbital floor fracture 5-drinking of dirty water causes -heptitis A -B -C -D i think its heptitis A 6- giemsa stained blood film - malaria 7-regarding peritonitis -can be caused by chemical erosions 8-mid- clavicaular fracture treatment -arm sling and finger 8 is equal in effiency 9-fraucture of humerus associated with - radial N injury 10-there is case i cant remember they asked about diagnosis of acute lymphocytic leukemia ALL 11-diagnosis of hemochromatosis -serum ferritin 12-kawasaki disease associated with -strawberry tongue 13-most common tumor in children -wilms tumor 14- pt c/o of hypopigmentful skin , nerve thicking diagnosis -leprosy 15-regrading COPD to reduce complication we should give

- theophyline - pneumococcal vaccin i think its pneumococcal vaccin 16- pseud-gout its -CACO3 -CACL3 its CACO3 17-man with history of alcohol assocation with - high MCV -folic acid deficiency -B12 deficieny - hepatitis i think its high MCV 18-neanate 9 days on breast fed develop jandice - breast fed jandice 19-newborn we should given to prevent bleeding -vit k 20- pregnant lady 16 wks u/s shows snowstorm appearance - complete hydatiform mole 21-lady c/o headche bandlike pain - tension headache 22-regarding breast screening - self breast examination early detection of tumor - mamogram 23-19 yrs old c/o abdo pain within menestration for last 6 years diagnosis - primary dysmenorrhea -secondary dysmenorrhea 24-bilateral breast mass diagnosis - ductal carcinoma -pagets disease 25- beriberi cause of deficiency - VIT B1 - VIT B2 - VIT B3 its VIT B1 thiamine 26-chronic uses of estrogen assciation 27- Asystole

- adrenalin - atropin asystol has only 3 durgs epinephrine-vasopressine-atropin 28-pt has diarrhea , dermatitis and dementia diagnosis pellagra 29-regarding injectable progestron -can cause skin prob 30-sencodary prevention is -coronary bypass gaft 31-22 yrs old c/o insomina/ sleep disturb treatment -SSRI 32-celluitis in children most commin causes - group A steptoccus 33- antideprssants associated with hypertensive crisis treatment -MAOI 34-pt his MBI = 24 kg he is - norama weight -over weight - morbid weight - mild weight 35-baby c/o fever , chills , rigors and head rigidity +ve kurnings sign rash on his lower limb diagnosis - meningoccal meninigits 36-48 yrs pt with abdo pain , neusea, vominting tenderness in right hypochondrial - acute cholecysitis 37-29 pt c/o dysurea his microscopic showed G -ve organism is - legonealla 38- 30 yrs pt c/o feeling heaviness in the lower abdomen having pulge papable at the top scrotum that was reducible and icreasing in valsalva maneuver diagnosis - hydrocele -variocele -indirect inguinal hernia -direct inginal hernia 39- 27 yrs girl wih breathing heavily she had numbness and tingling sensation around the mouth and tip of the fingers you will do -let her breat to in a bag

40-anticoagulation prescrib for - one month - 6 months - 6 weeks - one year 41-cushing syndrome best single test to confirm - palsma cortison -ATCH 42-23 yrs old history of URTI then he developed ecchomysis best treated -local AB -local antiviral -steroid 43-chronic psycotic disorder manged by -heloperidol 44-29 yrs old lady B-HSG 160 c/o vomiting , abdomenal pain which is more accurate to diagnosis -BHCG serial -pelvic US -laprascopy 45-70 yrs old man c/o fever , vesicular rash over forehead mangement -IV AB -IV antiviral 46-celiac disease involves -proximal part of small intestin -distal part of small intestin -proximal part of large intesin -distal part of large intensin 47-6 yes old pt cyanosis past history of simillar attack 6 month ago u will do for him -PFT -CxR -secure airway -CBC 48-side affect of diazepam 49-lady 28 yrs G3+3 C/O infertility -uterin fibroid -endemic means