409- Child present with short stature, obese with pink streation which of the following the next step ?
A- MRI brain
B- MRI adrenal
C- morning and night free cortisol

410- 10 YO female patient complaining of chronic rinorrhea , cough , conjunctivitis by PE there was red discoloration around eyes and there puggy pale nasal mucosa what's Ddx?
1.allergic rhinitis
2.ciliary dyskanesia

411- Female patient hx of depression ( symptoms ) complaining of constipation which drug cause this side affect?
1.TCA
2.MAO
3.SSRI

412- A 25 year old female primigravidae just delivered and her blood group is O negative
and her baby blood group is O positive. What is the next appropriate management?
A) No Need for Anti-D
B) Give Anti-D for the mother
C) Inform the parent about the findings/result
D) Give Anti-D to both the mother and the baby

413- Pregnant female presented to the clinic with giant vulvar wart, how would you treat it?

A. Cryotherapy
B. Electrocautery
C. Observation

414- Question about lung nodule size 8mm there was growing of nodule from previous CT scan your management?
1.referal to thoracic surgery
2.neddle aspiration
3.follow up 3-6 m
4. Chest x.ray

Pics:

1-Scenario with a picture asking what is this:
Skin tag

2-CTG picture showing late deceleration, asks about the cause: uteroplacental insufficiency

3-ECG hyperkalemia with a scenario:
Ca Gluconate

4-Spherocytosis pic and a scenario forgot what is the Q

5-Cholasma

6- HSP

415- 47 year obese lady with HTN at your clinic what preventive measures to do?
1. Fasting glucose
2. Pap smear
3. Occult blood
( no mammogram in choices )

416- Female patient had Pressure and heaviness pain , cycle severe menorrhagia what is the most likely the location of the fibroid?
A. Submucosal
B. Intramural

417- 4-year-old boy came with midshaft femoral fracture. With 30 degree angulation. Which of the following is the most appropriate management?
A- pavlik harness
B- Closed reduction with hip spica
C- Open reduction with IMN
D- Open reduction with fixed plate

418- Mom came to pediatrion with exclusef breast feeding and doctor advise iron advise next month. age of baby now?
A.1
B.2
C.3

419- Preterm when to start vaccination?
A-At discharge
B- when the baby weight 1.5 kg

Better recall:
4 months baby born preterm 33 weeks due to emergency cescrian section regarding his vaccines what is the most appropriate protocol to follow?
A. Decrease the dose of vaccines and give it as scheduled
B. Give vaccines according to corrected age
C. Schedule vaccination according to chronological age
D. Create th schedule according to calculated weight

420- Which of the following is the best contaception in pt w a history of PE?
A- IUD
B- permenat steriilization
C- levonorgestrel
D- condom

421- 1 year complain of massive hepatosplenomegly , brusies skin , swelling in latral aspect of neck what the most appropriate investigation?
A- Bone marrow aspiration
B- lumber punc
C- EBV serology
D- Mri thorax

422- Female c/o urine leakage with cough, sneezing, exercise and with urgency.
What type of incontinence does she have?
A. Urge incontinence
B. Stress incontinence
C. Mixed incontinence
D. Overflow incontinence

423- 80 yr old male c/o inability to urinate with Abd. Pain and severe need of urination
What to do?
A. Cystoscopy
B. Emergency TURP
C. Foley cath + culture

424- Screening for bacteriuria in pregnancy ?
A. 12 weeks
B. 25 weeks
C. 30 weeks

425- A female came to ER with signs and symptoms of appendicitis, appendectomy was done, intra-operatively the surgeon discovered the appendix was normal, but it is the standard of care to remove the appendix even if it is normal, what should the surgeon do?

A. Tell the patient what happened and that it is the standard of care
B. Do not tell the patient
C. Write a report about what happened and give it to the hospital committee

426- Pediatric case h/F sore throat & fever then 3 days he develops body rash on the thighs and buttocks.Lab finding suggest renal insult with anemia and normal Plat count) plus ll edema +black tea urine.
A- post streptococcal GN
B- HUS
C- HSP (Henoch-Schonlein Purpura)

427- Typical symptoms of Croup, how to manage?
Answer: Dexa and epinephrine

427-