IFOM Recalls 2025

Any explanation?

A 72-year-old man presents with dyspnea on exertion, orthopnea, and bilateral lower extremity edema. He has a history of hypertension and type 2 diabetes mellitus. Physical examination reveals an S3 heart sound, jugular venous distension, and bilateral basilar crackles. Echocardiography shows a left ventricular ejection fraction (LVEF) of 35%. He is started on guideline-directed medical therapy.

Channel name was changed to «IFOM Recalls 2025»

Channel name was changed to «IFOM Recalls 2024»

-IFOM-CSE- Cairo center 22.8.2023 *Inguinal hernia (small bulge increase with strain and disappear with lying down) cause- patent processes vaginalis *OCD *Patient had burns what is the first step to do ? Intubation *Patient had splenectomy received before pnemuccocal polysachride - now he should recieve pneumococcal conjugate *Incarcerated inguinal hernia - emergency surgery *Bronchitis- FEV1 decreased and the ratio also decreased? *Asthmatic patient on SABA only she had increased in symptoms severity- check the step up treatment for asthma *Pneumonia CAP MCC - strep pneumonia *Patient had arthroplasty someting related to femur surgery before and now presented with rash( over the thorax and typical symptoms of embolism- FAT EMBOLISM *Another question symptoms of DVT and PE - CT angio *Typical symptoms of cushing *Pleural effusion it showed an exudate most probably - empyema/parapnemonic effussion - whats the next step *DKA *Patient had normal TSH on US , 1.5 cm no history of anything that causes high-risk ... - RAIU or FNA ?  *Patient with hyperthyroidism typical symptoms- TSH will be low and RAIU will be high ? * Acute gout attack treatment- NSAIDs * High ALP and an xray picture- paget disease *Rheumatoid arthritis typical scenario; know how the mechanism of it *Ankylosing spondylitis cvs complication- i dont know *High ESR and CK levels with shoulder pain - polymyalgia rehumtica *At the hospital showed ECG showed ST elevation, patient was playing then lost his conciousness - Ventricular tachyarrythmia *Orthostatic hypotension is due to- peripheral alpha blockade *IV drug user had a mid-diastolic mumur - tricuspid stenosis my answer *Neonate was born with plethoric facies - what to check for ? Glucose levels/electrolytes/ echo/ xray *18 months milestones- know whats its normal or abnormal *Meconium aspiration, what to do? I don’t remember the options *Pregnant lady that drink alot of alcohol- alcohol fetal syndrome know its mechanism *Typical kawshiorkor symptoms (edema, protubernt belly) - caused by inadequate amount of proteins *Alzheimer disease: amyloid plaques *Typical Parkinson’s symptoms 3. Patient loss the sensation on the outside part of the thigh- Lateral femoral cutaneous nerve *Patient had a hit on his head and then lost his consciousness- i think epidural hematoma Back pain cases *Stroke cases  * Typical scabies pictures *Melanoma picture *Actinic keratosis *Psoriasis mechanism of action *Patient had piercing presented with a bump what is the cause- pseudomonas arginosa *Harsh cough, inspiratory stridor in child what is the organism - *Dengue fever typical symptoms *Patient pregnant previously lived in cameron and she says that she had got her prohylaxis before against malaria, what to do she want to travel back to cameron after 2 weeks - i chose chemoprophylaxis now and continues *Study STDs and GYNE discharges- *PPH cause - uterine atony *Preeclampsia patient typical symptoms at 37 weeks what to do- induce labor *breast mass, appear dense on mammogram, firm, mobile, 2 cm - whats is the next step? I think core needle biopsy ? * breast masses doesn’t change with mensuration, non tender, mobile mass- fibroadenoma *Patient had high grade squamous intraepithelial lesion on pap smear- HPV positive? Colonoscopy? *Athletes, BMI 19  cause of amenorrhea- decreased FSH and LH  *12 years old, no breast no menstruation yet the mother is worried what to do next ?   *. Barothioln cyst that is symptomatic- Incison and drainage *Ectopic pregnancy BHCG was 2,500- repeat after 48 hours/ Transvaginal US ? *GERD symptoms went endoscopy (showed thickness, erythema) what drug to give? Pantorazole / ranitidine *Right lower quadrant pain started at the navel (which is the umbilicus, then changed to RLQ - appendicitis

Uworld step2 ck 2023, For reversion purpose. Q: A 74-year-old man is brought to the emergency department due to confusion. His daughter states that over the past 2 weeks, the patient has been increasingly confused and has decreased oral intake. She shares that he won't stop screaming, "someone stop the ringing!" he has chronic bilateral osteoarthritis of the knees and hands, hypertension and chronic kidney disease with a baseline creatinine of 2.2g/dl. He uses topical methyl salicylate for his arthritis because he does not like taking pills. Temperature is 37.8 C, blood pressure is 100/60 mm Hg, pulse is 112/min and respiration is 30/min. Pulse oximetry shows 89% on room air. The patient is awake but disoriented and agitated. Mucous membranes are dry. There is no jugular venous distention, heart sounds are normal, lung auscultation reveals bilateral crackles. There is no peripheral edema. Neurological examination is nonfocal. Laboratory results as follows: Sodium 140 mEq/L Potassium 4.6 mEq/L Chloride 102 mEq/L Bicarbonate 14 mEq/L Blood urea nitrogen 44 mg/dl Creatinine 2.4 mg/dl Glucose 85 mg /dl

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25/10 -AMD know the difference bet. the wet type and dry type and not just on fundoscopy but the actual changes in vision ( the qn gave signs of inability of seeing straight lines and the qn was about the pathophysiology: choices included both: 1)neovascularizatiin 2)deposits in the retina ) -Extropia -blunt eye trauma - ecg with st elevation asking about the artery involved - contraception for a pt with migraine -blunt abdominal trauma -a qn about a mass between the symphysis pubis and the umbilicus -prolapsed neck veins and distant heart sounds -cardiogenic shock parameters PCWP and others asking about the cause -a painful swelling in the perineal area of a female pt who is unable to sit or walk -carpenter presented with a left leg pain after a small penetration during work -symptoms of broncheiectesis asking about the pathogenesis -an immigrant from Sudan with a mantoux test of more than 15cm induration otherwise healthy how to treat? -Teen pt concerned about STDs due to oral sex -Malignant milanoma pic rx -BCC pic dx -pt with hypopigmented lesions in a linear distribution how to treat? -baby with a scalp cyst not sure about the requirement whether rx or dx. -NNT -RRR -sensitivity - 2 qns asking to explain a study result. - other 4 biostats’ qns so don’t ignore biostats and epidemiology PLEASE!! -an MRCP of a pt with a distended CBD came with jaundice and RUQ pain that increased in severity, she had a cholicystectoma 4 yrs ago what is your management? -blunt abdominal trauma pt with hypotension -Alcohol withdrawal -2 qns about head trauma don’t remember the details -3 qns about anaphylaxis, urtecaria and their pathogenesis -common organism causing diarrhea in HIV pts -Homosexual pt concerned about STDs using condoms what would you advise them? -2 qns about bleeding disorders -DKA Asthma management pt already on Salbutamol per need yet had several attack

- Pt FEV 60%  with productive cough works as mechanic dx ? bronchitis - Pericardial tamponad asking about parameters - VWD diagnosis by coagulation profile - Famished refugee thin hair face fullness ( I think it’s kwash )what is deficient ? Protein other options vit c /vit b12 /calories - Prostate nodules next step ? Biopsy - Exotropia - UTI (+ve nitrite ) organism ? Ecoli - Mechanism of aki in pt with rhabdomyelitis ? - Saturday night palsy in alcoholic which nerve damage? Radial - Epiglottis kid how to prevent? H influenza B vaccine - Erythematus mass in vulva pt can’t walk and sit because of pain next step? I think it’s a partholin abscess so I chose incision and drainage - Number needed to treat - Absolute risk reduction - Sensitive and specificity - Nap and ppp - Ethical question about vaccine trial done on infants asking about what’s wrong with the study Notes : time management is the key

IFOM CSE recalls 2022: 20/10 -Pericarditis after viral infection , tx? prednisone (NSAID nor colchicine was not option ) -Inferior wall mi given the leads and presentation by abdominal disturbance ,which artery ? Both RCA and LCX was in the options - side effect of statin tx ? - Sudden onset chest pain and SOB in pt underwent surgery dx? Pe - PE in a pt who had hemorrhagic stroke 3 months ago asking for contra to give thrombolysis ? - Pneumonia causing septic shock asking for parameters ? - Urge incont mechanism? Detruser hyperactivity - Dysphagia ,acid regurgitation, feeling of food stuck at chest? Achalasia - Obese ,irregular menses, constipation , somnolent dx? Hypothyroidism - Otitis media - Pt bed ridden with hx of stroke fed with tube , onset of low bp tachycardia hyperventilating temp 38 dx?  aspiration pneumonia / Re infarction - Anaphylaxis 3 q ( mechanism / management/ dx) - Another anaphylactic reaction to blood transfusion asking for the cause ? Iga deficiency - 4 yo systolic murmur at the lt sternal border other wise healthy ? ( all congenital ht disease were listed ) - Giant cell arteries pt taking prednisone, metformin, developed proximal myopathy cause? Medication discontinuation , myositis - Young pt with back pain and +ve leg raise test dx.? - Refugee with >15 induration ppd otherwise healthy what to do next ? INH 9 month/ rifampin and inh 6 month/ no treatment - Child hx of travel jaundice ,fever , nausea and vomiting? Yellow fever / malaria/ typhoid - Traveler diarrhea cause? Ecoli - Nausea and vomiting after eating at a restaurant then started having weakness dx? - Dengue fever +ve tourniquet - HIV with diarrhea? Cryptosporidium - Malarias prophylaxis ( just check if the Mx is teratogenic cuz one of the answers was contraception ) - Gonococcal arthritis - Septic arthritis - Pregnant bp 180/110 and high cr and LFT but 24 urine 1. 6 g dx? Preeclampsia/ other options unlikely - PCOs Mx. ? - Picture of nipple ulcer with no mass  mammogram with no calcification or fhx of breast ca what next? Biopsy / fna/ reassure/ re examin after 1 month -  Picture of Peri umbilical rash raised rough and black tx? Topical steroid/ oral steroid/ topical anti fungal / biopsy - Contraception for a lady with hx of migraine - 4 month infertility pt has hx of 9 week miscarriage treated with vacuum next step? Reassuring/ seminal study/ clmophine/ endometrial biopsy - All - Peripheral smear pic with CML - Oral sex risk of infection with? HIV/ hsv/ syphilis - HPV - Pt with constipation and posterior bulging of vagina dx? Rectocele - Stable Pt with a fib echo was done what next ? TSH level - Obese lady what to decrease her risk of developing osteoporosis? Wt reduce - ADHD dx - GAD dx - 17 yo with hallucinations? ( haloperidol was not an option) try go through typical and atypical medications by name  - Dark color urine with clots elevated cr and BUN in pt taking thiazides? Acute tubular necrosis - MM Pt with burning pain radiating to butt tx ? Oxycodone / gababentine - Ct scan large pancreas in a smoker with nausea and vomiting what next ? Laparotomy/ us / pecutanus trans hepatic cholngiography - Pt with family hx of breast ca - ve Pap smear 2 years ago now have painless rot adenexal mass what next ? Pap smear / laparotomy - Dyspareunia and  spotting dx? Endometriosis -  77 yo Palpable mass between symphysis pupis and umbilicus what next ? US - Chrons dx - Picture of squamous cell ca in forehead - Back pain and tenderness what next ? MRI spine - Vaginal itch and white discharge ( they described the hyphe but didn’t mention it ) vaginal ph 4  asking about the cause she has it ? I think this is candidiasis so I chose diabetes - COPD. 3q - Bipolar dx - Stung by bee 10 min ago  and had angioedema Mx ? - Osteoarthritis X-ray picture for dx - Bloody nipple discharge - Macular degeneration dx - Blunt eye trauma - Orthostatic hypotension Pt taking thiazides - Conns dx - Toxic multi-nodular goiter dx - Renal artery stenosis resistant htn - Melanoma pic next step ?

66 observation in couple due to infertility ( 4 months duration) 67 oral Antibiotics 68 radial nerve injury 69 NNT 70 ARR 71 biostat ( rsv vaccine) what concern you about the result? 72 biostat ( mi and troponin) 73 case fatality 74 HIV infection 75 tb not to treat... The questipn aboud ppd result 76 yellow or typhoid fever 77 hypercalciuria 78 decrease protein intake 79 purine catabolism 80 alcohol withdrawal 81 MMR 82 Rt heart failure 83 cryptospordium parvum 84 E.coli travellar diarrhea 85 E coli UTI 86 chalmydia urethritis 87 exotropia 88 contraindication to thrombolytic therapy is hemorrhogic stroke 3 months ago 89 contraception levongestrel IUCD 90 ocp 91 contraception with malaria prophyiaxis 91 pre eclampsia 92 pelvic us for abnormal pap 93 pelvic us for tender abdominal mass 94 bartholian cyst.. İncision drainage 95 Incision and drainage * 96 buspirone? * 97 TVUS 98 BİOPSY prostate nodule 99 melanoma biopsy 100  meckel scan? 101 DVT 102 appendicitis 103 alcohol abuse 104 search literature... Medical student want to learn about specific case 105 consent from the mother 106 bupropion 107 control blood pressure ( GN) 108 serum glucose ( screeining) 109 adequate calcium and vit d to prevent 110 maternal mortality 111 coartation of aorta 112 prostaglandin 113 mast cell... Mechanism of Anaphylaxis 114 Iga defeciency... Anaphylaxis 115 remove the sting immediatly 116 osteomyletis 117 mri spine 118 hep b vaccine to prevent hepatitis d 119 hemophilius influenza type b vaccine to prevent epiglottitis 120 von will brand disease 121 Iv normal saline to resusitate 122 insulin in dka after normL saline 123 withdrawal of prednison  causes weakness 124 observation after blunt eye trauma 125 choroid neovascularization.. As a cause of wet macular degeneration 126 papilloma... Causing breast bloody discharge 127 statin tx 128 biopsy for breast lesion 129 colchicine for gout 130 tension pneumothorax on physical exam? Dullness on the left, trachea deviated to right

IFOM CSE recalls 2022: 17/10 1/women present  with erythema   and swelling  in the valvua and she can't  site..there was picture What is treatment? 2) obse women with bmi 34 and have recurrent  candidal  infections..she have iud for contraception..last menstrual  cycle is 2 months  ago? What is the cause of her recurrent  infections? Dm Pregnancy Iud And the other options  not relevant 3) epitglotitis  typical presentation  what is the causative organism? 4)copd picture  x Ray shows increase AP diameter 5) bullous emphysema  rupture with pnemotharax  what  you will find in  examination ? 6) VWD 7)pic of melanoma  in the  upper back how to ttt? Wide range exscional biobsy Electrical dissection  and cruttage 8) squmaus cell cancer pic 9)number need to treat 10)pos partum  hemorrhage  11) neonate his mother  concerning  about <2 cm pink color mass in his head? What is diagnosis?  12)typical presentation  of Ms how to dx? 13)GAD 14)MDd 15)ADHD 16)ALL 17)CML WHAT IS PATHOGENSIS? 18) post cholecystectomy  pain and the was pic shows dilated cbd with stone in it? Next step in management 19)viral precarditis 20)atrial  fibrillation  asking about next invs next to echo? 21) inferior  wall mi artey involve.? 22)St elevation  in anterior  lead asking about digonsis? 23) occult blood positive and low hb  next  step in managing? 24)  8 months  child with  consistent vomiting  since birth?  Low k..low cl what is dignosis ? GERD PYLORIC STENOSIS 25) PT WITH asthma  not responding  to saba what next step in managing him? 26) cardiogenic  shock after mi 27)septic shock prameter 28)urge incontrnanse mechanism? 17/10 1 S1Q3T3 ecg.... PE 2 ARDS 3 pneumonia treatment in healthy patient...Doxycyclin 5 Copd diagnosis 6 Bronhitis diagnosis 7 Asthma... Add fluticasone 8 Nodule in the upper lung.... Best next step... Chest ct .... 9 Cardiogenic shock parameters 10 Artery occluded in ınferior mi... RCA 11 Prophylaxis in infective endocarditis... Amoxicillin 12 Pericarditis... Naproxin ... 13 GAD 14 ADHD 15 Bibolar 16 alzehimer 17 Patient has declined cognitive function... Due to Diphenylamine 18 Treatment of MDD... Citaopram 19 Parkinson.. Micrographia 20 Multiple sclerosis... Do brain MRI 21 Patient with acute spinal cord compression. Do spinal decompressive surgery ... 22 Alcoholic hepatitis 23 Palpable mass in the abdomin next step... Pelvic us 24 Necrotizing fascitis case... Do surgical depridement 25 Long term reflux with new onset dysphagia... Do endoscopy ..... 26 Lupus 27 Mixed connective tissue disease .... 28 Renal cell carcinoma... 29 renal tubular acidosis in infant 30 SIADH after trauma 31 essential hyperyension .... 32 Phenoxbenzamine for pheocromocytoma 33 MNG 34 cushing 35 TSH for patient with a fib .... 36 BCC 37 Psoriasis 38 Case of tinia corporis... Topical anti fungal 39VZV.. Cause for face lesion extending from forehead to nose .... 40Neuropathic pain... Pergabalin 41ITP... prednisone 42CML... 43 Paget disease of bone 44Check ESR in GCA 45Meningitis.... Nisseria because he has maculopapular rash 46Bone marrow transplant for SCID 47Chronic allograft rejection 48Dengue dx 49Urge incontinence mechanism.. Hyperactive bladder 50Osteoarthritis dx 51Transient synovitis.. Ibuprofen 52TOF... Rt ventricle outflow obstruction 52Ascending cholongitis... Endoscopic sphincterotomy 53OSA case 54Renal failure after ACEI.. renal artery stenosis ... 55Nephrotic syndrome... High protein in the urine 56Protein deficiency in malnutrition 57Wernic encephalopathy 58VitB12 deficiency 59Laryngeal cancer 60 Butolinum... Neuromuscular junction Continue 17/10 61 oral sex increase risk of what? 62 trichomonas infection 63 hyperkalemia due to ACE mechanism 64 Discontinue thiaxide in orthostatic hypotension 65 acetylcystine in acetaminophen toxicity

Cont.. 66.Febrile Seizure mx 67.Pt with para spinal tenderness. Next step? 68.Absolute risk reduction 69.SLE 70.Family tells you not to tell the diagnosis to the pt (terminal illness) because it will affect him. What to do? Options were ask another colleague to tell the diagnosis / ask the pt how much he wants to know /  tell patient the diagnosis / listen to the family and not tell the Pt. 71.Pic of melanoma. Dx 72. Cause /pathogenesis of vegetation. Options were platelet fibrin / macrophage activation 73. Pt with air under the diaphragm. Next step? 74. Pt is 49,never had colon cancer screening and his father was diagnosed with colon cancer at 52. Next step? 75. Pt with sob on exertion and quit smoking less than 15 yrs ago. Next step. 76. Know the screening ages and criteria for cervical  cancer, breast cancer, colon, AAA. There was a case that involved all three and asking what to do for the pt at this visit based on her hx. 77. Patient with constipation, irregular period, fatigue. Next step ? 78. Pt started to have irregular period after using contraceptive. Why? 79.pt with the Pco. At risk of developing which cancer. 80. Pt stopped contraceptive but still period is irregular and there's slight hirsutism. Period before the contraceptive was regular. Cause? . (Lab values were given) 81. Pt with hypercalcemia. What to give. 82. Pt with PE and stable. Next step? 83. Pt the pneumonia and his 3 brothers died due to pneumonia. All Ig were low, low platelet, cd4 was low. Dx? Bone marrow suppression /  combined T and B cell suppression. 84. Pt came from residential home with influenza and other residents are not vaccinated. How to prevent infection for other residents.? 85.Alzheimer dx 86. Baby of hbv positive mother. What to give? 87. Tx of acne (open comedones) 88. Pt came with watery diarrhea after travelling? Management. 89. Pt with HUS and renal involvement . How to confirm the dx. 90.pt with heavy menses and gingival bleeding. Has hx of Coagulation problem in family. Appt high. Other lab values were normal. Dx? 91. Ecg of Pericarditis 92. Ecg of Afib and unstable Pt. Next step? 93. Acoustic neuroma 94. Pt on heparin and now has low platelet. Next step? 95. Mx of dengue fever 96. Bloody nipple discharge and mammogram normal. Dx?

62. Elderly Pt with bilateral hip  pain and x ray showed degeneration and  slight sublaxation. Dx? 63. Fat embolism. 64. Neuroeoplietic malignant syndrome 65. Pt with ng tube and central venous catheter is required. How to ensure pt safety. Remove ng tube first / wear mask / use normal saline on pt skin before insertion? This is all i remember for now. Good luck 😇

Leen: 13.10.2022 1.Female pt who is a smoker came with hoarseness of voice. Laryngscopy pic was given and showed a lesion. Asking about next step? Biopsy /reassurance/ quit smoking? 2. Pt has mennigococcal Menigitis asking about precautions. Contact /airborne /droplet?. Antibiotic prophylaxis wasn't an option 3. Pyloric stenosis and asking about k, cl and ph 4. Pt  with kyphosis asking about lung parameters (residual volume, total lung capacity, response to bronchodilator and fev/fvc ratio) 5. 18 yr old with Painless firm testicular mass asking for  Dx 6. Sudden Onset testicular pain and no hx of trauma and testes is elevated. Dx? 7. Pt traveled came with fever. Pic showing ring stage of malaria 8. Pt with positive antimitochondrial antibody. Next step? Measure fasting lipid 9.  X ray of Slipped capital epiphyses 10 x ray of leg calve perthes disease 11. Pregnant pt with BP above 140 and low plt. Dx pre eclampsia with severe features 12. ALS tx 13. MS came with flare. What to give? 14. Pt came with headache with jaw opening. Next step.? Check ESR 15. Double blinded study helps to decrease what? 16. 13 yr old boy with 3 months of abdominal pain and diarrhea. Diarrhea is also present at night. high ESR. UC was an option. 17. Dka 20. HHS given fluid what else to give? Iv insulin / sc insulin? 21. Anaphylaxis came with rash. What to give. 22. Pt after RTA with chest pain and  Creatinine kinase and MCK was high. MI/myocardial contusion? 23. Murmur that increase with valsava. 24. Sob due to pDa. What to give? 25. Male with proximal Myopathy and high ESR. Next step. 26. Otitis media tx 27. Know organism for bacterial rhinosinisitis 28. Sca came with painful crisis. He's at risk of developing what infection(organism) ? 29. Pt with high bp and diffuse retroprotineal LAD. What's the cause? 30. CLL 31. Pt came with back pain and she underwent Mastectomy last year and received chemo and radiation. What lab is expected to be high? Ca/mg/ vit D.? 32. pathogenesis of CF 33. baby born in rural area. Stiff on examination. Know the pathogenesis of tetanus 34. Know the pathogenesis of bronchectasis 35. Baby with ecezma. Not sure 36. Pt taking allopurinol for 2 weeks. Came with skin manifestions. Toxic epidermal necrolysis/ scalded skin syndrome /  both Phemigous were given as option. 37. Pt with jaundice and wt loss with palpable mass in RUQ and a picture was given. 38. Acute pancreatitis. Next step in dx? 39. Acute appendicitis dx 38. Pt with rectal bleeding and colonoscopy showed colon  full of blood but no specific  bleeding site is seen. Next step. Ct /laproscopy ? 39. Uti. Tx 40. Sensitivity. 41. Urine retention after taking Amtritypline. Mechanism? 42. Mechanism of stress incontitence 43. Contraception to decrease heavy menses 44. Pt first prenatal visit. She is Rh negative and husband is positive. Next step? 45. Hiv pt with 5mm ppd and cxr negative. What to do? 46. GAD. Management 47. Migratory thrombophlebitis. Suggestive of ? Malignancy 48. Pt  2 days post MI came sob and crackles. Dx 49. Pt most MI and about to be discharged. What drug to give decreases recurrence /Complication? 50. Pt brought to the ED with LOC. No other hx is known. When wake up he says he didn't have breakfast. Dx? 51. Female with mucoprulent discharge and cervix is friable. Organism ? 52. Elderly female with vaginal itching disrupting sleep. Pic was given and examination was limited due pain and vaginal agglutination. Tx? 53. Rash between fingers worse at night. Scabies tx? 54. MM at risk of what infection? 55. Pt with BPH and takes alpha blocker. Fell down last night when getting out bed. Cause? Orthostatic hypotension. 56. Alcohol withdrawal 57. Pt with Respiratory depression and pupil 2mm. What to give? 59. Vit c deficiency 60. Anorexia nervosa. Pt with light hair on the back. Don't remember the rest of the question but BMI was low. 61. Asking  about cause of increase ICP in pt with subdural hge.

Wait for culture 31. Klainfelter syn. (Marafanoid hapitus) with intellectual disability & puberty delay , n.step? Genetic testing 32. Chronic lymphocytic leukemia (typical presentation) 33. Lung cancer with high calcium, in which mechanism? PTHrp 34. Patient using cyclophosphamide, hemorrhagic cystitis 35. Viral sinusitis , what's the cause? Rhinovirus 36. Meconium aspiration in newborn ,good saturation , n.step? Bag & mask ventilation Endotracheal intubation 37. ITP, low platelet with bleeding, managment 38. Melanoma on the palm of the hand , what's the most prognostic factor? 39. Elderly patient her diagnosis is cancer , when she came to the clinic with her daughter & son they're asking not to reveal the dx for her and to tell them first before she knows, what you'll do? Ask the patient if she want's to know her dx first Tell them the dignosis without telling the patient, other options 40. Post traumatic stress disorder in a combat. Tx 41. Fibroid ( leiomyoma) in a 47ys old female ,her uterus is 20 week-size and causing her anemia & pelvic pressure , what's managment? Hysterectomy Ocp Others 42. Best contraceptive method in a postpartum female, she wants a relible method. 43. MS acute flare with MRI (white, periventricular lesions), tx? Iv Gluccocorticoids 44. Osteoarthritis best first step in managment? 45. Physical activity with weight loss 46.Risk factors of breast cancer, case of a woman now is diagnosed with breast cancer and they described when she started menarch and how many children she has , alcoholic , so now the risk factors very well you can distinguish the answer. 47.Case of parkinson but they said on CT scan we see cortical infarctions, (I think just distraction cause they described typical parkinson physical examination finding) What's the tx? Carvidopa/levodopa 48. Hemophilia tx 49.Preeclampsia ( HTN with headache ) 50. Aortic dissection, sudden chest pain radiating to the back , difference in BP between two hands, what's managment? give anticoagulants , antihypertensive , others 51. Otitis externa , microorganism , pseudomonas 52. Acute Pancreatitis , hypertriglycerid 3000 amylase lipase high(thousands) , n.step? Give octerotide, prednisone , meropenim, anticoagulant

J-Y👩‍⚕️: Recalls 10/10/2022 1.Child type 1 DM , age 10 , clear presentation , high glucose & Dka , what's mechanism of ketoacidosis (not for dm1) ? Insulin resistance Decrease pyruvate to liver Increase acetate & hydroxypyrate maybe (can't remember them accurately) Increase glecneogensis 2.Child picture , intellectual dis. , late development milestones , short nail or fingers like this( hypoplstic of distal phalanges) 3.Photo of psoriasis on knees asking pathophesiology and answer epidermal hyperplasia 4.Cardiogenoc shock after acute CHF & MI (told ECG st elevation) and MR features(murmer& biabasilar crackels) , cold clammy extremmities High pcwp, low co , high svr 5.Another shock parameters in septic shock( pyelonephritis in elderly) 6.Patient HTN with 4 cm adrenal mass, n step? Adrenalectomy! Not the mass Radiation Diuretics Adrenal empolization 7.Patient remote(8years)  hx of nonhodgkin lymphoma, now presenting with acute LBP High ESR, all neurological exam normal, no fever, normal CXR Epidural abscess Vertebral osteomyelitis Metastates Spinal stenosis Spinal cord compression 8.Old pt signs hypothyroidism High Tsh like 17, normal Ft4, T3 Cause? Primary Hypothyroidism, secondary hypothyroid, grave, 9.CAP what's the microorganism (strept pneumonie) 10.Ct of abdomen picture, I think pancreatic adenocarcinoma because of the scenario upper abdominal pain with hx of smoking . Sjogern in a female, which antibody? ro- ssa CAH ..Ambiguous gentalia picture with sever hypotension, asking about parameteres( na k cl Hco3) 11.Mdd but they focused about husband decease from 2 ys to distract. But typical case all critera symptoms. 12.Penile lesion picture in MSM , recurrent painful that prevent the patient from sex , asking the cause? Hiv or varecilla or chlamydia or neisseria gonorrhoeae (but no urethritis), I think the main cause or status of the patient it would be HIV but they were asking about the cause of these lesions There was no HSV in options 13.Vaccinations in 11 mounths old baby who didn't recieve any of them before Hbv , mmr, varecilla, inactivated polio Hbv, Hemophaelus influenza b, inactivated polio Other options include HAV. 14.Breast cyst in 45 ys old after complete resolve what to do Reexamine in 3 mounths Ultrasound in 3 mounths Mammography 3 mounths 15.GAD man 56 years old , CBT only no SSRi 16.Continue Lithium in pregnancy as mood stabilizer 17.Partial Seizure in a patient he has lack of awareness of this specif movement which happens for 2 minutes, his friends tell him that he does this movement and he says that he is unaware of this ! Complex partial seizure or simple partial , other options 18. Ards after hospitalization but weird cxr 19. Ecg ,dx  AF 20.Anticoagulant in valvular disease 21. Motile organism in vaginosis , trichomonatis , metronidazole 22. Intersteial lung dusease from an extrathoracic cause kyphosis 23. Asbestosis patient smoker and worked his whole life in shipyard occupation 24.Chronic copd (bronchitis) in a heavy smoker asking paramters of pft Low fvc low fev1/fvc ratio 25. MM typical case with high cr & bun Asking what's the cause if kidney injury, Light cell casts 26. Anterior cruciate ligament , positive drawer test 27. Medial meniscus tear I think , he described the test of Thessly is positive, 28. Bladder ruptuer after accident, high riding prostate with blood in urethral meatus. 29. Pregnant with GERD , and obese , she already takes calcium component drug and small frequent meals but not feeling well , what to do , add ranitidine , refer to surgery like this/other options 30. The famous question always repeated about ferile neutropenia, isn't responsive to antibiotics for 7 days, they did new cultures, what to do next? Continue antibiotics and Add acyclovir Continue antibiotics and Add antifungal

8 / September 2021 Immune mechanism in psoriasis disease Melanoma>> most prognostic factor Otitis externa in child >> causative organism Basilar skull fracture AlS MS acute flare ttt HUS>>, causative organism AML CLL PFT in pt with bronchiti Pyloric stenosis Colon cancer Esophageal cancer >> Pancreatic carcinoma PET RF of breast cancer Breast cancer metz Breast cyst in 40 aged woman MM Epigastric carcinoma ACL tear Legg calv perhaps disease SCFE Meniscus tear Incidences Counfound Bias Sensitivity Mood stabilizer that use in pregnancy GE Parameter of GE AF Parameter of shock 2q Narcolepsy MDD OSA Amenorrhea 2 q Infertility 3 q Hypothyroidism 2 q MNG AUB 2 Q Restrictive lung disease in kyphosis ( decrease chest compliance ) Pneumonia Opoid toxicity Next step for Meconium aspiration in vigorous cyanotic baby HHS >> lab invx : s.osmolarity Boy with hyperlipidemia and FHx of MI in young age >> next step statin or follow up in one year Lead poisoning & sidroblastic anemia Vit c deficiency Diabetic neuropathy Cause of Renal Failure in MM Vertebral fracture Trichomoniasis ttt Ueithritis in male >> ttt Strangulated hernia IIH Unilat tender Breast mass in girl patient >> next step .. reassurance Hemophilia Urinary retention &BPH SCI >> level of lesion GCA RAS Pheocromocytoma ttt ARDS MI complicated by Cardiogenic shock Mycoplasma pneumonia Rhinovirus Vaccines Vaccines in 11 mth child Anticoagulant in valvular AF Prophylaxis FOR IE ITP in childe with skin rash .. next step Pericarditis &pericardial effusion Parkinson ttt in elderl Painful ejaculation ttt Ankylosing spondylitis extra articular manifestaions >>AI Bicuspid Aortic valve (stenosis) in young pt CVID Down syndrome >>type of inherited disease >>chromosomal Baby with digital hypoplasia >> phenytoin exposure