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SLE - 22/2/2011By Dr. Omar almsnad

COLLECTED AND TRIED TO BE ANSWERD AND SENT BY

DR.ABULMALIK ALBAKER 2011 MED_ST99@HOTMAIL.COM

Q1/ 2 months old child complaining of spitting of food , abd examination soft lax , occult

bloodve , what you will do ?

Reassure the parents

Abd CT

Q2/ baby with streptococcus pharyngitis start his ttt after two days he improved, Full course

of streptococcus pharyngitis treatment with amoxicillin is

10 days ( 9-11 days )

7days

14 days

If GAS is suspected, begin empiric antibiotic therapy with penicillin 10 days.Cephalosporins, amoxicillin, and azithromycin are alternative options. Symptom relief can be

attained with fl uids, rest, antipyretics, and salt-water gargles.

Q3/ Uncomplicated UTI ttt

TMP-SMX for 3 days

Ciprofloxacin 5 days

Q4/ Facial injury suturing remove after?

24h

35 days ( most likely )

710 days

14 days

Q5/ Post streptococcus pharyngitis pt present with RBC cast in urine analysis to confirm this

post streptococcus glomerulonephritis with single test ?

Low C3

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High blood pressure

Q6/ Lichen planus most common site ?

Scalp

Neck

Knee

Buttocks

As far as I know the common site will be near the wrist and the ankle but those sites

were not one of the choices ?

Q7/ Child with loss hair in the temporal area with microscopic finding Dx

Alopecia

Q8/ One of the following condition does not cause hypokalemia

Metabolic alkalosis

Furosemide

Hyperaldosteronism

Acute tubular necrosis

Diarrhea

Q9/ Condition not associated with increase alpha feto protein

Breech presentation

Down syndrome

Gastroschisis

Q10/ Pt came with trauma to left eye by tennis ball examination shows anterior chamber

hemorrhage you must exclude ?

Conjunctivitis

Blepharitis

Foreign body ( most likely )

keratitis

Q11/ Acute angle glaucoma , you can use all this drug except?

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B blocker

Acetazolamide

Pilocarpine

I do not remember the last one which is I think is the correct choice because all the

previous three can be used

Q12/ Pt talking to doctor and the pt look to his right side most of the time, when the doctor

asked him why is that? He said that his mother is there but in fact no one is there, after

asking the pt family they said that the mother died when he is child Dx?

Visual hallucination (Or may be the doctor is blind )

Auditory hallucination

psychosis

Q13/ Child after his father died start to talk to himself , walk in the street naked when the

family asked him he said that his father asked him to do that , he suffer from those things 3

days after that he is now completely normal and he do not remember much about what he

did Dx

Schizophrenia

Schizoaffective

Schizophreniform

Psychosis

There was a fifth choice I do not remember it, I think they make from his father

death a cause.

+ve symptoms: Hallucinations (most often auditory), delusions, disorganizedspeech,bizarre behavior, and thought disorder.

-ve symptoms: Flat affect, emotional reactivity, poverty of speech, lackof purposefulactions, and anhedonia.

Schizophreniform disorder: Symptoms of schizophrenia with a duration of < 6

months.

Schizoaffective disorder: Combines the symptoms of schizophrenia with a major

affective disorder (major depressive disorder or bipolar disorder).

Axis I: Psychiatric disorders.

Axis II: Personality disorders and mental retardation.

Axis III: Physical and medical problems.

Axis IV: Social and environmental problems/ stressors.

Axis V: The Global Assessment of Functioning (GAF).

Delusion: A fixed false idiosyncratic belief.

Hallucination: Perception of an object or event without an existing external

stimulus.

Illusion: False perception of an actual external stimulus.

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Evolution of EPS :

4 hours: Acute dystonia , 4 days: Akinesia , 4 weeks: Akathisia , 4 months: Tardive

dyskinesia

Q14/ Pt with erectile problem which antidepressants contraindicated

SSRI

TCA

Buspirone

MOA

Q15/ Pt taking ttt for TB came with imbalance, hearing loss which drug?

INH

Strept

Rifampin

Ethambutol

Pyrazinamide

all causes hepatitis except streptomycin

isoniazide causes peripheral neuritis

rifampicin causes thrombocytopenia and pink orange color of urine and ocp are inafective if

used with it

ethambutol causes reversible optic neuritis

pyrazinamide causes gout

streptomycin 8th nerve damage , nephrotoxicity

Q16/ Pt smoker and alcoholic come with difficult swallowing and neck mass Ivx?

Indirect laryngoscope ????????????

Neck CT

Head CT

Biopsy ???

aspiration

Q17/ Pt with foreign body sensation in the eye , after the removal of the foreign body it was

insect ttt?

Local antibiotic

Local steroid

Systemic antibiotic

Systemic steroid

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Q18/ Child 9 month hx of congenital heart disease , central and peripheral cyanosis Dx?

Tetralogy of fallot

Coarctation of aorta

Truncus arteriosus

PDA

Q19/ Pt k/c endocarditis will do dental procedure prophylaxis?

2 g amoxicillin before procedure 1 h

1 g amoxicillin after procedure

2 g clindamycine before procedure 1 h

1 g clindamycine after procedure

Q20/ Drug (strange name ) use to quit smoking absolute contraindication indicated in ?

Seizure

There was other medical diseases

Q21/ In kwashakor

Low protein low carbohydrate

Low protein high carbohydrate

High protein high carbohydrate

High protein low carbohydrate

Q22/ Child with white yellow mouth lips lesion in erythmatous base with gingivitis Dx?

HSV ( most likely )

EBV

CMV

Q23/ Pregnant never did check up before, her baby born with hepatosplenomegaly and

jaundice

Rubella

CMV

HSV

Toxoplasmosis

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Q24/ Best Invx to Dx GERD is

History only

History + upper GI endo

History + barium study

Q25/ Pregnant with hyperthyroidism T4 high free T4 high , thyroid nodule , ttt

Antithyroid drug

Iodine

Surgery

Q26/ Pregnant did TFT result , high T4 normal free T4 normal TSH high TBG Dx

Pregnancy

Thyroiditis

Graves

Q27/ Female with vaginal infection (chlamydia) not pregnant best ttt

Doxycycline

Azithromycin

metronidazole

Doxycycline 100 mg PO BID 7 days or azithromycin 1 g PO 1 day. Use erythromycin in pregnant

patients. Treat sexual partners, and maintain a low threshold to treat for N. gonorrhoeae.

Q28/ Child fall from stairs came with mild injury to the nose, no bleeding, and edema in the

nasal sputum ttt

Refer to ENT

Reassure

Analgesia

Nasal packing

Q29/ Old Pt with abnormal ear sensation and fullness, hx of vertigo and progressive hearing

loss , invx low frequency sensorial hearing loss Dx

Acoustic neuroma Neuritis

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Menieres disease

Mnires Disease :

o A cause of recurrent vertigo with auditory symptoms that affects at least 1 in 500 in

the United States. More common among females.o Hx/PE: Presents with recurrent episodes of severe vertigo, hearing loss, tinnitus, or

ear fullness, often lasting hours to days. Nausea and vomiting are typical. Patients

progressively lose low-frequency hearing over years and may become deaf on the

affected side.

Q30/ Relation of indirect hernia to spermatic cord

Superior medial

Superior lateral

Inferior medial Inferior lateral

Q31/ The most difficult mode of transmission to prevent is

Person to person

Air droplet

Vector

Q32/ about primary prevention in anemia all true except

Giving iron during pregnancy

Health education about food rich with iron

Reduce giving the baby cow milk before 12 months

Q33/ about secondary prevention in breast cancer

Q34/ about how to prevent asthma in child via advice mother to do ?

Wash close with hot water

Prevent dust

Change blanket

Q35/ The most effective way in health education is

Mass media

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Group discussion BEST IS FACE TO FACE

Q36/ Old pt complaining of back pain on walking on examination there was stiffness of the

muscle and there was some finding on the X-Ray best effective ttt

Physiotherapy

NSAID

Surgery

Q37/ Pt took high dose of acetaminophen C/O nausea vomiting Lab increase alkaline

phosphatase and bilirubin which organ is affected?

Liver

Brain

Gastro

Q38/ Old pt with knee pain increase with walking , crepitus Dx?

Osteoarthritis

Rheumatoid arthritis

Q 39/ Pt came with deep injury on the wrist site, the nerve that has high risk to be injured

will manifest as?

Can not oppose thumb to the other finger

Claw hand

Drop hand

Q40/ Child present with URTI , lymphadenopathy , splenomegaly ttt

Amoxicillin

Supportive ttt only

Clindamycine

Q41/ Newborn with clavicle fx

Mostly brachial injury occur

Mostly heal without complication

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Need 8 figur sling for 6 weeks

Occur in the premature infant commonly

Q42/ Female pt with hypothyroidism, TSH high But he did not give the total T4 nor free ,pulse normal BP normal she is in thyroxin what you will do?

Increase thyroxin follows after 6 months

Increase thyroxin follows after 3 months

Decrease thyroxin follows after 6 months

Decrease thyroxin follows after 3 months

Q43/ Pt work most of the time on the computer came with wrist pain , positive tinel sign you

will do cast for the hand so the hand position should be in

Dorsxiflexion

Planter flexion

Ulnar deviation

Best diagnostic test is phalen's test

Q44/ What is standard deviation?

Measure central tendency or variability

Measure extreme value Measure validity

Q45/ Old pt with cramp abd pain , nausea , vomiting , and constipation but no tenderness Dx

Diverticulitis

Colon cancer

Obstruction

Q46/ Pt treating for the cancer disease with chemo and radio , came with congested neck

veins Dx

Inf vena cava obstruction

Sup vena cava obstruction

Arch of aorta

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Q47/ Which vitamin that should be given to the baby at birth to prevent bleeding

Vit E

Vit C

Vit K

Q48/ Pt with BMI 28 newly diagnosed with HTN the most effective thing will reduce blood

pressure is

Salt restriction

Weight reduction

Exercise

Q49/ Pt G3 P3 all her deliveries were normal except after the second one she did D&C , Labs

all normal except: high FSH, high LH, low estrogen Dx

Ovarian failure

Asherman syndrome

Q50/ Pt with polycethemia vera the cause of bleeding in this pt is

Increase viscosity

Low platelets

Q51/ Child with mild Truman develop hemoarthrosis , in past hx similar episode Dx

Platelets dysfunction

Clotting factor deficiency

Q52/ Pt k/c of SCA , the doctor planning to give him pneumococcal vaccine which true ?

Pt need antibiotic when there is hx of contact even with vaccine ( most likely )

Q53/ Child after an URTI he develop knee swelling

Rheumatic fever

Juvenile idiopathic arthritis

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Q54/ 50 years old pt complaining of episodes of erectile dysfunction , hx of stress attacks

and he is now in stress what you will do ?

Follow relaxation strategy

Viagra

Ask for invx include testosterone

Q55/ Pt with bilateral breast cancer which type ?

Lobulated

Invasive ductal

Q56/ All are live vaccine except

Polio

BCG

VZV

HBV

Q57/ Pregnant pt want to take varicella vaccine , what you will tell her ?

That it is alive vaccine

It is ok to take it

Q58/ Old pt with painful erythema in the leg , the pain increase in dependent position ,

decrease pedis puls

Cellulites

Arterial insufficiency

Q59/ Child with enuresis, what is the most important single test you will do ?

Urine analysis

IVP

US

Blood culture

Q60/ Old male pt came with fever, abd pain, diarrhea , loss of weight , + ve occult blood ,Labs shows that the pt infected with streptococcus bovis , what you will do ?

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Give antibiotic

ORS

Abd X-Ray

Colonoscopy

Metronidazole

Q61/ Mallory weiss syndrome

Mostly need surgery

Mostly the bleeding stops spontaneously

Associated with high mortality

Q62/ Female pt around 35 years old, hx of thromboembolic disease, what type of reversible

contraceptive she can use

OCP

Mini pills

IUCD

Q63/ Best method to prevent plague is

Hand wash

Kill rodent

Q64/ Wound, with greenish discharge, Gram + ve in long chain?

Streptococcus

Proteus

Chlamydia

Q65/ Female pt present with dysuria, urine analysis shows epithelial cast

Contaminated sample

Chlamydia urethritis

Kidney disease

Cervical disease

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Q66/ Female pt came to you post ovarian cancer surgery one month ago, you did x-ray for

her and you found metallic piece, what you will do

Tell her and refer her to surgery

Do not tell her

Call the surgeon

Q67/ Anemia of chronic disease will show

high ferritin high iron low TIBC

Low ferritin low iron high TIBC

high ferritin low iron low TIBC ( this Q may come with ferritin or without )

Low ferritin high iron low TIBC

Q68/ Iron deficiency anemia will show

Low ferritin low iron low TIBC

Low ferritin low iron high TIBC

high ferritin low iron low TIBC

Low ferritin high iron low TIBC

Q69/ Dental caries associated with

Vit A

Fluoride

Zinc

Q70/ Child has URTI , after days you find out that the organism is meningiococcal when you

contact the family they tell you that the child is ok, what you will do ?

No need for ttt ( most likely )

Amoxicillin

clindamycine

Q71/ Patient after accident, there was a part on his left chest moving inward during

inspiration and outward during expiration Dx

Pneumothorax

Rib fx

Flail chest

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Rib dislocation

Q72/ Hypertensive pt using sildenafil, in his case it is contraindicated to take

CCB

B blocker

Nitrate

Diuretics

Q73/ Pt K/C of uncontrolled asthma moderate persistent on bronchodilator came with

exacerbation and he is now ok, what you will give him to control his asthma

Systemic steroid Inhaler steroid

Ipratropium

Q74/ Patient complaining of pain more in the night and increase when he elevate his arm,

associated with tingling Dx

Brachial plexus neuropathy

Shoulder impingement syndrome ( most likely )

Brachial artery thrombophlebitis Thoracic outlet problem

Dr. Omar almsnad

Please do not forget to pray for me

COLLECTED AND TRIED TO BE ANSWERD AND SENT BY

DR.ABULMALIK ALBAKER 2011 MED_ST99@HOTMAIL.COM

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