SLE - 22/2/2011

By 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
blood ve , 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
3 5 days ( most likely )
7 10 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

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?

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 purposeful
actions, 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.

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

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

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

Menieres disease

Mnires Disease :
o
o

A cause of recurrent vertigo with auditory symptoms that affects at least 1 in 500 in
the United States. More common among females.
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

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

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

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

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 ?

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

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

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