SLE 2010COLLECTED AND TRIED TO BE ANSWERD AND SENT BY

DR.ABULMALIK ALBAKER 2011 MED_ST99@HOTMAIL.COM

22- Pt with scoliosis, you need to refer him to the ortho when the degree is:- 5% - 10% 10% ENOGH TO CONFIRM DIAGNOSIS- 15%-. 20%

Scoliosis

Definition :lateral curvature of spine with vertebral rotation Epidemiology : age: 10-14 years more frequent and more severe in females Treatment based on degree of curvature : <20% : observe for changes >20% or progressive: bracing (many types) >40% , cosmetically unacceptable or respiratory problems: surgical correction (spinal

fusion)

23- 5 y.o child with history of fever and swelling of the face anterior to the both ears (parotid gland enlargement) what is the most common complication:

- Labrynthitis - meningitis - encephalitis - orchitis

The most common complication in children is the inflammation of the brain (meningitis aspect).

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 nextn. FNA with cytologyo. Mammogramp. Biopsyq. Follow up for next cycleObservation

25 -pt with salpingitis and there is swelling in pelvis in posterior fornex and it is fluctuant m:

-colpotomy - Laproscopic - continouse oral theraby

Culdocentesis refers to the extraction of fluid from the rectouterine pouch posterior to the vagina through a needle > The Rectouterine Pouch is often reached through the posterior fornix of the vagina . The process of creating the hole is called "colpotomy" if a scalpel incision is made to drain the fluid rather than using a needle..- Drainage of a tubo-ovarian/pelvic abscess is appropriate if the mass persists after antibiotic treatment; the abscess is > 4–6 cm; or the mass is in the cul-de-sac in the midline and drainable through the vagina.

-If the abscess is dissecting the rectovaginal septum and is fixed to the vaginal membrane, colpotomy drainage is appropriate.

- If the patient’s condition deteriorates, perform exploratory laparotomy.

26- child swallowing battery in the oesophegus m:-broncoscoby- insert foly catheter- observation

28 : In the appendisits the histology is: -leukocyte in muscle- lymphoid aggregation in mascular layer-tumor-plasma cell in mascular layer

29 - water in the body:- 40% of total body wight- diffrence depend on age and sexwater makes 60% of body weight in adult male (18% protein, 15% fat, 7% minerals) , Depending on age,sex and lean body mass

30 _clavicular fracture m:- If displaced need open surgery_arm sling and figer 8 is equal in efficncy

Clavicular fracture : The most commonly fractured long bone in children. May be birth related (especially in large infants) and can be associated with brachial nerve palsies. ttt : Figure-of-eight sling vs. arm sling.

31 _corneal ulcer ttt:-ab and cycloplagia is mydrasis and refer to ophthalmologyincluding topical cycloplegics like

32 -regarding drainge of the abcess one of the following is true:-curbuncle and frunculosis need draing -usually give cephtriaxon and penicillin post draing

Boil (FURUNCLE) is a staphylococcal infection of a hair follicle or sebaceous gland with perifolliculitis, which usually proceeds to suppuration and central necrosis.ttt : subsides without suppuration

FURUNCULOSIS: Multiple recurrent boils may occur in hairy areas. ttt : Ab

Carbuncle is an infective gangrene of the subcutaneous tissues caused by Staphylococcus aureus. It is especially common with diabetes, nephritis and malnutrition

33 _salpingitis and PID on penicillin but not improve the most likely organism is :-chlamydia- Neisseria gonorrhoeae-SYPHLIS- HSV

Outpatient regimens :

- Regimen A: Ofloxacin or levofloxacin × 14 days +/– metronidazole × 14 days.- Regimen B: Ceftriaxone IM × 1 dose or cefoxitin plus probenecid plus

doxycycline × 14 days +/– metronidazole × 14 days. Inpatient antibiotic regimens:

- Cefoxitin or cefotetan plus doxycycline × 14 days.- Clindamycin plus gentamicin × 14 days.

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 & analgesia2. 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

definitive diagnosis requires a demonstration of depleted body iron stores by performing a bone marrow aspiration, with the marrow stained for iron

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. Labrynthitis2. meningitis3. encephalitis4. orchitis

39. Mother who is breast feeding and she want to take MMR vaccine what is your advice:1. can be given safely during lactation2. contain live bacteria that will be transmitted to the baby3. stop breast feeding for 72 hrs after taking the vaccine

40. which of the following is a disease improving drug for RA:1. NSAID2. Hydroxychloroquine3- STEROIDS

o disease modifying anti-rheumatic drugs (DMARDs)o DMARDs include methotrexate, sulfasalazine, leflunomide , etanercept ,

infliximab , adalimumab , abatacept , rituximab , anakinra , antimalarials, gold salts, d-penicillamine, cyclosporin A, cyclophosphamide and azathioprine .

o only DMARD agents have been shown to alter the disease course and improve radiographic outcomes.

41- Greatest risk of stroke: DMElevated blood pressureFamily history of stroke HyperlipedemiaSmooking

42- SCA complications in adultsCerebral infarctionCerebral hemorrhage

43- Child with large periorbital hemangioma , if this hemangioma cause obstruction to vision , when will be permenant decrease in visual acuityAfter obstruction by one dayBy 1 weekBy 3 monthsBy 6 months

44- What is the most common treatment for juvenile rheumatoid arthritisIntraarticular injection of steroidOral steroidParacetamolD-penicillamineAsprine

Aspirin is no longer a first choice in JRA because of its side effects. The side effects can be (but rarely are) serious, especially those in the digestive tract and liver.

The major emphasis of treatment for JIA is to help the child regain normal level of physical and social activities. This is accomplished with the use of physical therapy, pain management strategies and social support.

Most children are treated with non-steroidal anti-inflammatory drugs and intra-articular corticosteroid injections.

-when the wound cleanScar formation

45 -adolescence 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 vaccineSmoking stopOral steroidB 2 agonist

49 _pt with congenital hip dislocation :-abducting at flexed hip can causes click or tali

o Barlow’s maneuver: Pressure is placed on the inner aspect of the abducted thigh, and the hip is then adducted, leading to an audible “clunk” as the femoral head dislocates posteriorly.

o Ortolani’s maneuver: The thighs are gently abducted from the midline with anterior pressure on the greater trochanter. A soft click signifi es reduction of the femoral head into the acetabulum.

o Allis’ (Galeazzi’s) sign: The knees are at unequal heights when the hips and knees are fl exed (the dislocated side is lower).

o Asymmetric skin folds and limited abduction of the affected hip are also

50-colon cancer with stage 3 give the chemotherapy:As soon as possible

Stage IV: Distant metastases :ttt : Chemotherapy for metastatic disease

51-SCA give prophlaxis:Penicillin Iron month

52-diagnosis of thalassimiaminor: not clear question -Hb a2 and HbF- Microcytosis

β-thalassemia minor : 1/2 β :Patients are asymptomatic, but their cells are microcytic and hypochromic on peripheral smear.

α-thalassemia trait : 2/4 α Patients have low MCV but are usually asymptomatic.

α -thalassemia Carrier : Microcytic anemia , MVC <78fl, MCH<27pg ,

HbA2>3.5% . - α -thalassemia-Abnormal Hbs : Hb Bart’s (g2g2) , Hb H (β2 β2 ) .

53- 56 y old present with vasomotor rhinitisLocal anti histamineLocal decongestionLocal steroid Systemic ab

Non-allergic rhinitis refers to runny nose that is not due to allergy. Non-allergic rhinitis can be classified as either non-inflammatory or inflammatory rhinitis. One very common type of non-inflammatory, non-allergic rhinitis that is sometimes confused with allergy is called vasomotor rhinitis . in which certain non-allergic triggers such as smells, fumes, smoke, dusts, and temperature changes, cause rhinitis.

ttt : Nasal antihistamines, such as azelastine, have a labeled indication for the treatment of vasomotor rhinitis.

54 - Hepatitis b ab and ag on the curvey

55-strongest risk factor for strok:-HTN-a fibrillation

56 - Anemia of Chronic Infection :

All are correct : Low Serum Iron - Low TIBC - High Serum ferritin

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

COLLECTED AND TRIED TO BE ANSWERD AND SENT BY DR.ABULMALIK ALBAKER 2011

MED_ST99@HOTMAIL.COM

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