Ifom ( material + recalls all year)

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1-Picture of pancreas asking about next test to do? -Pet -intravenous cholangiography -liver and spleen imaging 2- Jaundiced patient with pain become confused and picture showing choledocholithiasis what is the next step? Ercp , open surgery 3-Patient came with burning sensation and food going back with pharyneal erythema ddx? -GERD -achalasia •Surgery and trauma and others 1-Pt who had a blunt eye injury, eye movments in all directions is normal, normal cranial nerves examination, normal visual acuity, what to do next? - Head xray - Nothing - recommend him blowing his nose with his mouth closed 2-Pnumothorax 3-pt after rta has widening mediastinum on x-ray what part is more likely to be injured? Thoracic aorta 4-Mother has osteoperosis and daughter is asking how to decrease risk ? Reduce wt Take vit d and ca 5-Old Male pt with coronary heart disease PSA level is 4.1 (normal is 4) and on exam there is a nodule on prostate what is the next step? - biopsy - re-evaluate after 6 months - re-evaluate after 3 weeks 6-Pt has bp of 136/90 and does not have hypertension, how to protect her kidneys? -Control her bp -Control her blood sugar 7-Patient came with confusion found on the street on exam he had opthalmopathy and ataxia ? Alchol withdrawal wernicke syndrome 8-Cancer pt on oxycodone came with lower back pain radiating to lower limbs with tingling and numbness, what to do next? -Increase the dose -add codiene with acetomephine - gabapentin 9-Paget disease of the bone ( bone deformity + high alp ) 10-Patient came with bee sting developed urticaria low blood pressure and difficulty breathing, next step? - remove the sting immediately - im epinephrine 11-Old patient came with blood in the urine and hypercalemia? - glomerulonephritis - renal cell carcinoma

Cardio - 1-Pt with chest pain and infeior mi asking about which artery 2- after a surgery a pt has sob and chest pain and other symptoms his ecg shows S1Q3T3 pattern, the question was asking for a diagnosis. -Pulmonary embolism 3-pt presented with chest pain and ecg showed st segment elevation in all leads ( pericarditis) what drug to give? -naproxen 4- cariogenic shock / obstructive shock 5-septic shock 6-Pt wants to stop smoking which drug to give ? Bupropion •Infectious - 1-pt travelling and is asking about how to protect from hep d ? Give hep b vaccine - 2-Pt only having oral sex, he is at risk of developing? - Hiv -hsv -chlamydia 3-Pt 14 year old brought by her mother, in the case it was also mentioned that she miss school regularly with greenish vaginal discharge and the cultured organism has flagellas what to look for next? -Gonnorhea and chlymedia -Hiv -urinalysis 4-Dengue fever case ( positive tourniquet test) 5-Case either typhoid or yellow fever🙄 6- HIV Pt with watery diarrhea what is the organism cd4 count is 20 -cryptosporidium? 7-pt who had ppd test 15cm but negative xray what to do next? -isoniazid for 9 months 8-pt with pain at fore head it runs along the nose with lesions what is the causative organism? -HSV -HZV 9-Pt with meningitis symptoms and has rash what is the organisim? -bacterial -viral 10-Pt with ALL and in isolation due to staph aureus infection how could we decrease his risk of infection? -Washing hands frequently -Air entery in the room in one direction -Gown -Face mask 11- homosexual came with painful urination and bloody stool , causative organism? - chalamydia? •Respiratory 1-pt with uncontrolled asthma, she is on saba. What to give next? -Inhaled steroids 2-patient received blood transfusion next day he had shortness of breath on exam and xray he had bilateral lower lobes opacity ? -ARDS -pulmonary edema 3- acute bronchitis 4-Smoker patient with peripheral lung nodule next step? - Ct - bronchoscopy 5-patient came with shortness of breath decreased fev1 and increase fev1/fvc ratio what is the mechanism? - destruction of alveoli - interstitial fibrosis - bronchial inflammation •Endocrine - 1-Pt with dka what to give with fliuds? -Insulin 2-pt after falling down from 5 m on her head develops hyponatermia and she had basal skull fracture what is the cause? -SIADH 3-pt with elevated t4 and the thyroid is nodular on exam ? -Graves -Multinodular goitre -Hashimoto 4- obese patient proximal myopathy and striae ? -Cushing 5- patient with giant cell arteritis taking many drugs one of them is steroid stopped his drug for a week because he couldn't go and get new ones after that he developed proximal muscle weakness what is the cause ? - stopping predinsone - Stoping metoprolol •Psychiatry (the choices were actual drug names) 1-Child with halucination and abnormal behaviors what is drug of choice? 2-GAD case 3-Depression case, what medication to give medication 4-Medication for GAD 5-Bipolar case 6-Adhd case (pt is talkative , plays with everthing arround him, interrupts the teacher, avoids eye contact.) •Derma 1-melanoma pic ttt , wide excision 2- pt who works in the sun has a lesion on his face that has been growing rapidly - Bcc -scc -amelanotic melanoma 3-pytriasis rosea vs teania versicolour what to give as treatment 4-pt with itching arround his umbilicus (had a picture looked as eczema) -topical steroids -systemic steroids •Rheumatology 1-SLE case 2-pt with wrist pain and metacarpel pain, her RF was positive. What is the diagnosis? -RA -mixed connective tissue disease 3- Ankylosing spondylitis 4- pt has gout and takes NSAIDS but this time the pain is not relived, what to give? -Cholchicine -acetaminophen -Steroids -Allopurinol •Neuro: 1- optic neuritis present who got better after taking steroid what next test to do? -mRI 2- patient after eating outside developed paralysis in upper body part and face mainly , where part is affected? -Neuromuscular junction 3-Alzheimer disease GI

09/05/2022 recalls : Causes of hyperacute T wave Transient synovitis Uterine anony Women&husband delivered baby preterm at 26 , wish to conceive again but are afraid to have similar condition? What advice would you give to them ? - preterm labor can be readily identified and manged - preterm labor increases the risk of having preterm against ( my answer ) - many questions about alzehimer and dementia - many Infectious ds - gardnella vaginalis Parkinson Tx - schizophrenia - general anxiety syndrome - ADHD - vulavar itching in postmenopausal women, Sx of vaginal dryness .. what to give to relief dyspareunia ? ( my answer corticosteroids) - hyperpigmented legion on labia major ( I answered Bx ) - watery diarrhea affected teacher and children at the same time - angina cases ( stress echo ) - Scabies Case - A man is traveling for volunteering in an African country , what preventing measure to prevent malaria ( I answered physical barrier like net ) Another question asked also about malaria, how to reduce the causes ( I answered control of vector ) Cor pulmonale Nipple discharge, erythema, fixed mass, lyph node involvement ( I answered inflammatory carcinoma of breat ) Endometriosis Pt present with dysphagia to solid but not liquid food .. what to do next ( I answered esophageal manometry ) - Many questions about major anxiety syndrome Many questions about major anxiety syndrome A question of a women who started a new job but, can't focus or finish projects , often awakes at night 2 am and couldn't sleep again Lacunar infraction case, what is the offending factor Appendicitis case Ectopic pregnancy case ( explatory laparscopy ) Painful vaginal bleeding after a motor accident I think so ... placental abruption Purulent urethral discharge , no organism on culture but wbc or pus are present ... I answered chlamidya Polymyalgia rheumatic ( proximal muscle weakness, can't get up from Chair , ESR high A pt with history of gout but didn't start any medicine, came with Sx again What to give ( answered steroids ) Pt came with pain in MCP , PIP and knee ... spares DIP ( rheumatoid arthritis) Pt undergoes ERCP , what is the complication ( I answered pancreatitis) Pt pot-op had epidural anasthesia presented with urinary retention.. A catheter trial failed follow by a small catheter insertion after several trials ... days later a catheter was removed and clots of blood were observed ... the patient has urgency now but unable to void .. which of the following best diagnosis ? - urethral trauma - hypotonic bladder - clots in the urinary bladder My answer ( urethral trauma )

12/05/2022 Cardio PE dx Inf MI TOF IEC Prophylaxis Cardiac tamponade Pulmo Aspiration PN COPD tt ASTHMA tt Cor pulmonal Hematology IDA SICKLE ANEMIA H spherocytosis dx Hodgkin lymphoma dx B12 def HUS tt Renal UTI Endocrine Hyperparathyriodism tt Hypothyroid dx Pheocromocytoma DKA Rheumatalogy OA dx Ms Back pain tt SLE dx Avascular necrosis head of femur RA dx Gout dx Giant cell artheritis Osteomylitis tt Anky spondy Neuro Subdural hematoma dx Dementia dx Delirium dx Alzhemier Dx GIT Barret oseph invst Crohn D Diverticulitis tt Appendicities dx PBS invstg Derma Scabies dx Atopic demratitis dx Pityros rosea dx Squamos canc dx Melanoma dx Psychiatry MDD dx ADHD dx GAD dx tt Schizoph tt Bipolar tt Biostat Prevelance RR Cohort study 5 opthalmology questions I dont remmber them Watery diarrhea for teacher and all students organism? Dengu fever Kwashiorkor D lack of protein in child

IFOM CSE recalls 2022: 27/04/2022 ⁃ HB serology of a mother who just gave birth (+ve infection) , what to give to the baby ? ⁃ 2 Q legg calve perthes (limping boy, limited internal rotation and abduction of the hip, x-ray is shown) ⁃ Alcoholic with macrocytic anemia , what to give? (They also gave B12 and folic acid levels, it was folic acid deficiency) ⁃ 3-4 about cancer screening..basically cases of patients come for routine exam , FHx is given, PMHx, last Pap results etc ..what do you do next ? ⁃ Ms flare tx ⁃ Typical appendicitis case ⁃ Sicke cell pain crisis, susceptible infection? (What organism) ⁃ Std chlamydia ⁃ A man with purulent urethral discharge gram stain shown gr negative cocci , what to give besides doxacycline ? ⁃ HIV pt with ppd test 5mm and no abnormality detected on xray .. what to do ? ⁃ Otitis media tx ⁃ Sinusitis tx ⁃ Know the treatment and organisms for all infections really well ⁃ Parkinson dx ⁃ Alzehimer’s disease Dx ⁃ Q asking about normal aging vs dementia ..(there is a table about it in the notes try to have a look 🤓) ⁃ Pericarditis Dx with ECG ⁃ Gout tx ⁃ Melanoma dx (with pic) ⁃. Atopic dermatitis pic ⁃ Parapneumonic effusion ⁃ 2-3 Q Amenorrhea ⁃ Abnormal uterine bleeding in a women in her 50’s , what to do next ? ⁃ Case of PPH ..what’s the cause (uterine atony) ⁃ Pre-eclampsia Dx ⁃ Stress inc casue ⁃ Overflow inc dx ⁃ One more Q about inc I can’t remember exactly but it was sth about BPH and overflow inc ..what pharmacological treatment? (Not sure tho 😅) ⁃ Hypothyroidism Case ⁃ Hyperthyroidism case..the patient’s symptoms were kinda’ severe .. what treatment to give ? ( they gave all the treatment options of hyperthyroidism.. so know how to pick what 🥸) ⁃ 2Q Anaphylaxis ( 1 is treatment and the other is Dx ) ⁃ HIV patient with p.jirovecii ,,what is the cause? ( low CD4-T count) ⁃ Hyperosmolar hyperglycemic state case , fluid was given , what else should u give ? ⁃ Opioid toxicity ⁃ Biostat (2 calculation questions) ⁃ Biostat ( a new drug was tested in trials on patients who have the disease and have no history of Gi bleeding, after that it was released to the market, ~10 died due to hepatotoxicity.) why didn’t they know about this side effect of the drug while testing it ? The question seems stupid 😂 but the choices were logical to decide 👍🏻 ⁃ 2-3 ethics questions ⁃ Typical ALS case .. asking about drug (Riluzole) ⁃ Acute pancreatitis case, (amylase elevated, epigastric pain?) what to do next ? ⁃ 2 syncope questions , asking about the possible cause ⁃ Kid with febrile seizure..what to do next ? ⁃ ECG of arrythmia , unstable patient, what to do ? ⁃ Drug that prevent mortality in MI patient. ⁃ Patient with cardiac murmur that increases with squatting etc Dx (AS,MS,HCM, MR,AR) ⁃ Fat embolism case Dx ⁃ Patient with progressive kyphosis PFT parameters ⁃ Patient with symptoms of ILD what to do next ? (Spirometry) ⁃ Testicular ca case dx ⁃Epidydymitis ⁃ Immune deficiency asking what antibody is decreased ⁃ Hypercalcemia ..what to give ? ⁃ Patient wants to quit smoking ..what can u give? (Nicotine patch ?) ⁃ Idiopathic juvenile arthritis ⁃ Malaria Case + blood smear.. Dx ⁃ Lupus case ⁃ Few complicated neuro cases 08/05/2022 Do NMBE as you can .. There are my questions which I remember : Down syndrome Klinefilter syndrome Contraception Many qs about thyroid Increase of PTH related to lung cancer CAH Breast enlargement in male Primary amenorrhea Cushing Hypothyroidism After thyroidectomy —> what you should follow ( about parathyroid) Malaria Picture about Herpes simplex or syphilis ( not sure ) Picture for actinic keratosis Case for immunosuppresstion in recurrent pneumonia,, how to diagnose ? Treatment of BACTERIAL VAGINOSIS Meningitis Coxsacki virus Travelers diarrhoea Hepatitis A Vaccines in child 11 years old Many many qs cardiology Many qs about side effects for drugs 09/05/2022

23/5/22 Derma : - scabies - Melanoma - Diaper rash Statistics: - prevalence - Sensitivity Eithics: - preterm question - Pt with drug trail Psycho: - GAD - MDD - ADHD - Schizophrenia - Mania - Alcohol withdrawal Cardio - MS , MR - TOF - DVT - CHF - Shock parameters - Statin Rx Pulmonary: - asthma - COPD - PE - bronchiectasis - Pneumothorax - Pleural effusion - Lung cancer Endocrine: - hyperparathyroid - Hypothyroid - CAH - DM , DKA - Hypothyroidism in newborn Rheumatology: - ACL - Transient synovitis - A vascular necrosis - OA - SLE indue nephritis - TNF drug screening Inefction: - UTI - HIV diarrhea - Malaria - Hepatitis vaccine CNS : - MS - Parkinson - Alzahimar - Epidural hematoma - Delirium Renal: - HUS - GN - Hyper K - Urine retention - Stones Dx Hematology - SCD - Hemophilia - IDA 3 Q - Folic deficiency - TTP - hereditary spherocytosis OB/GYn: - preeclampsia - Vaginal discharge ( gray ) - OCP - Brest mass

Sunday 25/4/2021 #Biostat Cohort / Relative risk Positive predictive value #Renal Pyelonephritis UTI Allograft rejection presenting after 8 weeks Of transplant. #Hema Megaloblastic anemia alcoholic girl. deficiency in vit b12 cobalmin.No folate in choices. # Immune Vaccines after splenectomy. Pneumococcal Anaphylaxis ( IM epinephrine) SLE #Pulmonary COPD and its exacerbation Asthma TT know full management Pneumonia PE Allergic rhinitis Sinusitis TT #Endocrine Hypothyroidism Solitary firm nodules mgt PCOS/ amenorrhea cases Addison Cushing ruddy rounded face Congenital adrenal hyperplasia DM. Oral metrormin Diabetes insipidus Primary Polydipsia #Rheumatology Gout calcium pyrophosphate dihydrate (CPPD) Transient synovitis Osteosarcoma Paget MM Ankylosing spondylitis Polymyagia rhumatica CLL/ CML/ AML cases # Musculoskeletal Achillis tendonitis Plantar fasciitis Tendinits #CNS Multiple sclerosis Stoke Parkinson case Levy dementia and its site ( temporal or parietal ) Meningitis 3 cases mgt Low back pain Disk in pt known Ankylosing spondylitis. MGT Low back pain mets in elderly Elderly fall from ladder. He was confused after reaching hosp, 30min he lost con. Intercerbal hemorrhage Epidural(my answer) subarachnoid hemorrhage? #derma Melanoma Psoriasis mechanism of action. Scabies Actinic keratosis #Infectious History of Chlamydia Bacterial vaginosis tt Candida 3 cases STD postive urine sperm? The cause -orchitis ( my answer ) -epididymitis Denuge fever Purtusis harsh cough Malaria chemoprophlaxis Malaria prevention for couple who are travelling TB HIV screening Girada history of travel #Cardio Infective endocarditis in iv drug user causing ( Diastolic murmur ) -mitral regurgitation -mitral stenosis -tricuspid regurgitation -tricuspid stenosis ( my answer ) Pericarditis TT Nsaids Pericarditis ECG Pleural effusion transudate, whats mgt? Fat embolism Questions about cardiac drugs, diltazem beta blockers etc #Psychiatry Major depression GAD Antidepressants antipsychotics drugs mechanism of action( receptors ) noradrenaline Bipolar disorder Mania Cycolthyma *Many cases of motor vehicle collision asking for management. #OBS ⁃ Pregnant presented after car accident painful bleeding ( abruptio placentae ) ⁃ Placenta previa painless bleeding ⁃ Prematurity ⁃ Magnesium sulfate SE on infant ⁃ Cervical and endometrial cancer ⁃ Meconium aspiration ⁃ Pap smear screening questions and the appropriate interventions #Peds ⁃ Best weight measure for obese children BMI ( my answer) ⁃ Trisomy one case ⁃ One development milestone question #surgery Colorectal cancer. Elderly bleeding. Do colonoscopy Anal fissure bleeding case Haemorroids Appendicitis Incontenince elderly 90yrs cause, i think poor pelvic floor anatomy Bilary colic

⚫️4/11/2020⚫️ -pic of external ear swelling not erythematous , scenario: 14 yo girl after piercing, not febrile. Whats the causative organism? -Electrolyte disturbance in Tumor lysis syndrome -Osteolmylitis of hip “on xray” -Plantar fasietis •Pic of Erythematous rash over trunk and digits in a 6 yo boy.Dx? -Ankylosing spondylitis ass valvle disease: AR -Mcc of deudenal ulcer -Opiod toxicity -Alcoholic hallucinations tx -Stimulants toxicity -Pt with smoking stain on fingers . What to do ? Assess will to change , start tx, nicotine patch -Elderly Pt with lung cancer , refuses to start tx. What to do ? Refer to ethics department, Pallative, convince. -Pt with suicidal attempt, discussed to start therapy with sister What to say? Therapy will reduce future risk -Pic of knee xray, after 1 year of surgery. How to manage the complication? Female with Uti causative organism? Female with postcoital bleeding.. mucopus cervix. Whats the organism? Boy came for routine assessment in dormitory. Hx of splenectomy and had peumococcal polysaccaride vacc. Next step? Ppt, HAV vacc, varecella vacc, pnuomococcal conjugate vacc Female with itchy vulva + watery discharde , 3 sexual partners . Next step? HIT. What to give the pt? PE case 2ndry to DVT. Next step? Xray, CTPA Pt with numbness in the outer lateral side of the thigh. What nerve? Cutaneous Lateral femoral. Pt with varicocele, whats the pathology ? Impotent veins. Pregnant with hx of malaria travelling to Ghana, recommendation other than mosquito net and rebellents? Give mefloquine single dose, untill return back , dont give. Pr from Panama w fever night sweats and thromocytopenia. Dx? Dengue, Malaria 20 yrs old female with 2 rt. Breat masses (2 cm) soft, not painful, no nipple and skin changes. Dx? Fibroadenam -50 yrs old female with upper lateral mass , on mammogrham dense breast tissue. Confirm dx? FNA -Pregnant on 37 wks with Preecclamsia taking methyldopa. Whats next? Give diuretic , induction of labor. -pph whats the cause? uterine atony. -52 with irregular cycles previously heavy menses. What to give? Cocs, iud -30 yrs female with painful labial cystic mass. Dx? Syphllis, bartholin -elderly pt with feeding tube and recurrent aspiration pneumonia .how to prevent? -Alcoholic pt. brought by his wife complaining of visual hallucinations. InitialMx? Halopredol. Hospitalize -pt with strangulated hernia after heavy wt lefting. Next step? Exploratory surgery, abd US. -pancreatitis Dx -appendicular mass Dx -polymyositis Dx -RA what Ab to look for ? -2 cases about cervical conditions asking about next step in dx.

20 May .... Aktenic keratosis Scabies Malaria PID Utrine atony Inf MI which artery Hemiballismus locate the lesion PD SSRI SE ARDS post op Lobar hemothorax Pneumonia HZV Measles BCC Fat embolism Depression Hypoglycemia DKA with ABG study what to expect on electrolytes HHS Thyroid Q (post thyroidectomy and old lady with hypothyroid feature) Rupture aorta after MVA how will pt die Cardiogenic shock RR and fatality rate and type of study(case control or cohart) Osteogenesis imperfecta in which the defect happen CF transmission ratio HTN emergency tx Intial assessment of renal in newly dx DM A Fib type of anticoagulant Appendicitis antibiotics Turner syndrome Pulled elbow OA Gout Anti phospholipid syndrome HPV vaccine Giardiasis Acne tx Urethral injury with betterfly hematoma in the perineum after MVA what to do intially Nerve root compression Acute rhinitis Lithium toxicity tx Asherman syndrome CAH in teen age with pubertal delay Pt wabt to quit smoking what to do Infant with HBV +ve mother what to give beside vaccine Recurrent pneumonia im the same place of the lung; what to advice pt( quit alcohol cuslz its aspiration type) Cluster headache Contraception in hypertensive pt PCOS UTI in young male pt what is the organism Complement deficiency in child Liver cirrhosis

6.Inguinal hernia (small bulge increase with strain and disappear with lying down) cause- patent processes vaginalis Psychiatry: OCD Surgery: 1. Patient had burns what is the first step to do ? Intubation 2. Patient had splenectomy received before pnemuccocal polysachride - now he should recieve pneumococcal conjugate 3. Incarcerated inguinal hernia - emergency surgery Respiratory 1. Bronchitis- FEV1 decreased and the ratio also decreased? 2. Asthmatic patient on SABA only she had increased in symptoms severity- check the step up treatment for asthma 3. Pneumonia CAP MCC - strep pneumonia 4. Patient had arthroplasty someting related to femur surgery before and now presented with rash( over the thorax and typical symptoms of embolism- FAT EMBOLISM 5. Another question symptoms of DVT and PE - CT angio Endocrine 1. Typical symptoms of cushing 2. Pleural effusion it showed an exudate most probably - empyema/parapnemonic effussion - whats the next step 3. DKA 4. Patient had normal TSH on US , 1.5 cm no history of anything that causes high-risk ... - RAIU or FNA ? 5. Patient with hyperthyroidism typical symptoms- TSH will be low and RAIU will be high ?

IFOM CSE recalls 2021: Ifom recall 26/4/2021 Rheumatology 1. Acute gout attack treatment- NSAIDs 2. High ALP and an xray picture- paget disease 3. Rheumatoid arthritis typical scenario; know how the mechanism of it 4. Ankylosing spondylitis cvs complication- i dont know 5. High ESR and CK levels with shoulder pain - polymyalgia rehumtica Cardiology: 1. At the hospital showed ECG showed ST elevation, patient was playing then lost his conciousness - Ventricular tachyarrythmia 2. Orthostatic hypotension is due to- peripheral alpha blockade 3. IV drug user had a mid-diastolic mumur - tricuspid stenosis my answer Peds 1. Neonate was born with plethoric facies - what to check for ? Glucose levels/electrolytes/ echo/ xray 2. 18 months milestones- know whats its normal or abnormal 3. Meconium aspiration, what to do? I don’t remember the options 4. Pregnant lady that drink alot of alcohol- alcohol fetal syndrome know its mechanism 5. Typical kawshiorkor symptoms (edema, protubernt belly) - caused by inadequate amount of proteins Neurology 1. Alzheimer disease: amyloid plaques 2. Typical Parkinson’s symptoms 3. Patient loss the sensation on the outside part of the thigh- Lateral femoral cutaneous nerve 4. Patient had a hit on his head and then lost his consciousness- i think epidural hematoma 5. Back pain cases 6. Stroke cases Dermatology Pictures: ⁃ Typical scabies pictures ⁃ Melanoma ⁃ Actinic keratosis Psoriasis mechanism of action Infectious 1. Patient had piercing presented with a bump what is the cause- pseudomonas arginosa 2. Harsh cough, inspiratory stridor in child what is the organism - 3. Dengue fever typical symptoms 4. 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 5. Study STDs and GYNE discharges- Gyne: 1. PPH cause - uterine atony 2. Preeclampsia patient typical symptoms at 37 weeks what to do- induce labor 3. breast mass, appear dense on mammogram, firm, mobile, 2 cm - whats is the next step? I think core needle biopsy ? 4. 2 breast masses doesn’t change with mensuration, non tender, mobile mass- fibroadenoma 5. Patient had high grade squamous intraepithelial lesion on pap smear- HPV positive? Colonoscopy? 6. Athletes, BMI 19 cause of amenorrhea- decreased FSH and LH 7. 12 years old, no breast no menstruation yet the mother is worried what to do next ? 8. Barothioln cyst that is symptomatic- Incison and drainage 9. Ectopic pregnancy BHCG was 2,500- repeat after 48 hours/ Transvaginal US ? GI: 1. GERD symptoms went endoscopy (showed thickness, erythema) what drug to give? Pantorazole / ranitidine 2. Right lower quadrant pain started at the navel (which is the umbilicus, then changed to RLQ - appendicitis 3. Pain radiates to the back, better with leaning forward- pancreatitis 4. Red spots on tissue paper and pain with defecation, - Anal fissure 5. Typical biliary colic symptoms, no murphy sign and no jaundice Hematology 1. Lymphadenopathy and hepatosplenomegaly + severe lymphocytosis - CLL 2. IgG ... - multiple myeloma Emergency: Shock questions 1. Patient fall from a place: CI was low, PCWP was high and he was hypotensive, whats is the type of shock ? 2. Patient had an MI, i think cardiogenic shock ? You should know what is CI,PCWP and SVR 3. Child was outside then had urticaria other anphaylactic symptoms what to give- IM epinephrine 4. Typical acute limb ischemia symptoms- angiography Immuno Immunologic transfusion reactions (study the causes of each) Urology: 1. Patient had PSA elevated, next step ? TRUS biopsy 2. Erectile dysfunction: testesrone 300 ng/dL- next step ? 3. 12 years old erythema and tenderness and absent reflex - testicular torsion 4. Kidney stone (uric acid) treatment- 5. Patient had BPH and urinary incontince what is the cause

Recalls 22th May 2021 Cardio: ○ Elderly e symptoms of congestive heart failure, there is typical diastolic murmer, Q is what is the cause? Mitral stenosis ○ Shock parameters : systemic vasc resistance, cardiac output..etc in a pt e cardiogenic shock ○ MI 2 cases ○ pt with Vague history and cardic symptoms but there is hyperacute T wave .. hyperkalemia Rhematology: ○ osteoarthritis biggest risk factor : Age? Acohol? Pt is elderly and heavy alcohol .. u must concentrate on how many drinks per day.. ○ Gout 1st initial step : aspiration? ○ Ankylosing spondylitis typical presentation ○ Rh arthritis confirm diagnosis ( Ana , anti.ro , anti ccp Git : ○ Crohns disease . Physician want to add a drug for him its a TNF.. what baseline investigation to do before starting the drug : echo, liver enzymes, lung function test ○ GE A teacher in a day care had diarrhea and then her students had it . Whats the organism ? Gardia , e coli , salmonella etc ○ Elderly bloody diarrhea .. i think ulcerative colitis ○ A female e vague abd pain .. suspcted abd malignancy what to do next? ○ A case of obstructive jaundice. A female e itching and jaundice : q about the pathophysiology: intrahepatic duct obstruction, hepatocytes abnormality.. etc ○ Pt underwent ERCP has severe RUQ pain radiating to the back postoperatively. Why? Missed stone, GB empyema, cholangitis, pancreatitis.. etc ○ Dysphagia. Chronic progressive what to do 1st for diagnosis. Manometry, x.ray, endoscopy, esoph ph ○ Alcoholic pt e hematamesis.. he was resuscitated and bleeding stopped what to do next? Endescopy i answered.. ○ Alcohol recieved glucose then developed encephalopathy.. ( Wernicke ) what would prevent this? Thiamine ○ Pt underwent cholecystectomy then developed seizures he was admitted for 4 days .. options: alcohol withdrawal, delerium, encephalopathy, tetanus ○ Diabetic female Anal pain and fever, fluctuant mass.. abscess ? Q is what to do next.. excision and drainage. ○ Pt is planned for endescopy .. has a mitral vavle prolapse, What to give for prophylaxis for infecive endocarditis? Options amoxicillin a day before , cephalosporin an hour before the procedure , 6 hours prior, or no need?? ○ Car accident little girl .. RUQ tenderness + hemodyn instability : internal hge ○ Congenital heart disease TOF ○ STI : 2 cases .. asking about the organisms.. a case with negative gram stain And another case e positive gram stain Nephro ○ Male e severe pain radiating to the groin. Nephrolithisis ○ Post strep GN ○ Elderly e family history of ca prostate and high psa .. what to do next? Observation? Repeat psa? Biopsy? Neuro: ○ Ring enhanced cerebral lesion + lung upper lobe lesion? TB, Aspergillosis, Mets.. etc ○ CT scan: hydrocephalus elderly pt ○ Giant cell arteritis typical presentation. How to confirm? Artery Biopsy? ○ Migraine typical presentation . Drug of choice? Triptan ○ 2 optic disc images .. description of vision loss peripheral hemianopia ( revise vision loss "peripheral, central etc ) ○ Multible sclerosis diagnosis ○ Parkinson disease treatment ○ Head trauma e loss of consciousness what diagnosis . Subdural, epidural, SAH, concussion ? ○ Hypothyroidism causing AF. Mngment ○ Female e Tremor, diarrhea and features of thyrotoxicosis. What to do next? TSH ○ pt e thyroid nodule, family history of thyroid cancer, what gene responsible? RET ○ Hyperaldosteronism ○ PCOs typical presentation ○ Major depressive disorder ○ Schizophrenia ○ female e insomnia, worrying and stressed..anxiety or OCD not sure ○ Emergency contraceptive .. after 5 days from intercourse . Which method ? Iu device ? ○ Postpartum urine retention ○ dysmenorrhea and irregular cycle. There is An image of uterus hysterescopy . diagnosis? Endometriosis, Ca , fibroid ? ○ Sinusitis clinical features . How to confirm diagnosis ? CT, mri, sinus dischrge culture, nasal endoscopy? ○ Herpes zoster typical presentation initial step.. acyclovir

Exam 26/9/2021🌸 -*Preoperative prophylaxis in pt has MVP -*HOCM *Cardic tamponade *mitral stenosis *Multifocal atrial tachycardia *Septic shock parameters *Cardiogenic shock parmeters *SLE *Ankylosing complication *Sojren syndrom * Ashma *COPD *Lung carcenoma *Asbstonses *A typical pnemonia *GERD *ttt of menengitis in elderly pt *Amylotrophic lateral sclerosis *Infertility dx *Prostate mass firm how to dx? *Muddlary carcinoma asking about calcitonin. *Phyochromocytom tt *Chlamidia infection ttt *Penil ulcer dx picture *Herps zoster picture *15y female ,tuner stge 4,not get menarch ,sexualy active.investigation? Us,fsh ,pregnancy test..( no observation in the choices) *Cyclocymia *GAD *Presentation of depressin but no full criteria and i chose by exclusion adjustement disorder. *Acute tubuler necrosis *Immunity : child with recurrent nesseria menengititis complement deficency *Pt under went desensitization for penicillin,and in 3rd dose she develop urtecaria dx *Congenital adrenal hyperplasia *Gynecomastia. *Hemochromatosis Biostatistic P value Sensitivity Other 2 qs Derma: Psorasis Melanoma Actinic keratosis *Vaccination

🎯 Meningitis + brainstem involvement + Immunocompromised patient Dx. Listeria meningitis 🎯 Ataxia + seizures + headache + menigism + pneumonia + diarrhoea + not responding to cephalosporin + trumblibg motility Dx. Listeria Monocytogenes Rx. IV amoxicillin/ampicillin and gentamicin (cephalosporin usually inadequate)

recalls 8/10/2020 : 33- Diabetic age > 45 and high cholestrol give ? statin , also see other indication of statins 34- pt from Brazil came with hypopigmented macule and parathesia with nerve thickining ? Leprosy 35- pergnanat at 22 wk gestarion and painless bleeding with friable mass at cervix IO closed but EO opened next step ? CS , nonstress test , 36- child with vision prob ( optic glioma) and hyperpigmented macule ? NF1 37- child with bilous vomiting and US show ceacum at the left ? malrotation , CF , intassussiption 38- neonate with vomiting and he didn't pass meconium his sibling has CF and xray showing dilated loop of bowel and dilated colon ? i think it is hurchsbrung ( failure of migration of neural cell ) but there is CF also 39- pt with post streptococcus GN what to do to prevent progression of renal disease ? AB , antihypertensive, no intervention 40- pt with septic shock and heart failure with basal crackles but no edema what to give ? NS , epinephrine , hydrocotison 41- old pt with polyurea , polydepsia and wt loss what will be abnormal ? s.glucose , s.ketones , u. ketones

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recalls 8/10/2020 👍 1- the most effective emergency contraceptive method? copper IUD 2- cardiogenic shock parameter 3- STEMI in V1-V3 artery ? LAD 4- cloudy discharge from nipple and all examination was normal ? reexamine in 6 weeks , measure prolacine , US 5- smooker with irregular lung mass came with seizures and inhancing brain mass in CT ? primary bronchial Ca , TB , spregillosis, sarcoid 6- Want to vaccinate 92% of Children with MMR and achieve 97% immunity what type of method ? herd imm , passive imm , active imm 7- endometriosis laproscopy pic 8- petryasis rosia pic 9- nurse with small itchy vesicles and scaling in bilateral hands ? hydrophilic eczema , HSV, 10- scabes pathogenesis : hypersesitivity 11- osgood shclater Mx beside NSAID ? exercise as tolerated , surgery , traction 12- transient synovitis : reassurance 13- child with tonsilitis then tender hot edematous joint and fever ? septic artharitis , 14- roghby player had trauma durring the game came with pain above knee exagerated with extention Dx ? quadriceps rupture , ACL , 15- child has otitis media temp 39.5 came with seizures no other abnormality ? febrile seizures , meningitis , encephalitis 16-Iron deficiency anema pic of spoon nail 17-elderly vegetarian with high MCV : B12 deficiency 18-elderly with vitB12 zinc and other nutrients defviciency what is the cause? increase vitB12 utilization , increase immunity and nutrient need , .... 19-hereditory spherocytosis cause of anemia ? RBC destruction 20-How to reduce sickle mortality ? ampicillin 21-TTP Mx : plasmapharesis 22-Multiple sclerosis Dx 23- Mitral stenosis 24- TOF Dx 25- pt with dellusion and long dirty nails ? dellusional disorder , schizophrenia , schizoeffective 26-MDD what is next ? check suicidality 27- couple with preterm labour came for councilling and they were tearful what is your response ? preterm labour become predictable by advance means , the risk of preterm labour now inrcrease and you should have more antenatal visit , the risk of preterm labour low 28-pt with high BP fail to control with lifestyle modification next ? thiazide diuretics 29- pt with BP 140/90 adviced to do regular exercise and decrease wt what is next ? observe , antihypertensive , investigate 30- child with High Na, low K and high renin what is next to confirm Dx ? renal biopsy , check urine metanephrines , 31- postmenupose have dry and atrophied vagina but no more hot flashes experience at this time what to do for dyspiurnia ? vaginal lubricant , oral hormone replacement , vaginal steroid 32- calculate prevalence from diagram