468- Patient presented with DVT what regimen to use:
A- Aspirin 61 mg
B- Enoxaparin 40 mg SC
C- Fondaparinux 20 mg
D- Hepatin 10,000 U IV ✅

469- Child came with painfull red swollen hemiscrotum. On examination, mass was palpated with -ve cough impulse. The mass was tender and extended to the inguinal area. Left testes cannot be palpable. Which of the following is the most likely diagnosis?
A- testicular torsion
B- Epidydomorchitis
C- Incarcerated inguinal hernia ✅
D- Testicular appendicular tortion

470- 63 years old male came with rectal bleeding with unintentional weight loss, he was pale, on PE empty rectum and no masses were identified but bleeding with fresh blood was noted. Which of the following is most appropriate next step?
A- proctoscopy
B- colonoscopy ✅
C- UGI Endoscopy
D- fecal occult blood

471- Male patient complains of episode of hematemesis. normal past medical history Labs show mild anemia ,All over labs are normal except elevated urea level in blood?
A-Mallory Weiss syndrome
B-erosive gastritis
C-PUD ✅

472- Female patient using warfarin. What contraception is most appropriate for her?
a) Pop
b) Depoprovira
c) IUCD ✅
d) OCP

473- child with pica, pale, low socioeconomic state , low haemoglobin, hand lead was 2 , iron profile was normal, x-ray report dense metaphyseal bands , what is the treatment?
A. vit-K
B. D-penicillamine ✅
C. Iron

474- Pt with symptoms of hypothyroidism
Lab shows high TSH then ask how to confirm dx of hypothyroidism?
A) repeat TSH after 4 wks
B) thyroxin level ✅
C) thyroid scan
D) FNA

475- Male k/c of acute pancreatitis came with abdominal pain in RUQ
In US : gallbladder stone and dilated CBD 1.4
What is most appropriate management
A- laparoscopic cholecystectomy
B- ERCP ✅
C- ABx
D- MRCP

476- Pt with renal colic what to do next :

A.MRI
B.abdominal Ct
C.Us
D.X ray KUB

477- History of multiple still birth, aptt prolonged. Dx
A. Antiphospholipid ✅
B. Protein C deficiency
C. Protein S deficiency

478- The baby heart auscultation on the mother umbilicus ,,which is the presentation?
A-shoulder ✅
B-face
C-breech

If the scenario came like this. Check out the other recalls.

479- Elderly patient DM and chronic smoker came to be evaluated for 2 days history of sudden left arm weakness, and there was no pain that resolved spontaneously. On examination, there wasn’t carotid bruit. All PE was normal apart from cardiac murmurs. Which of the following is the most appropriate initial imaging?
A ⁃ TEE
B ⁃ carotid duplex US
C ⁃ Carotid CTA
D ⁃ Brain MRI ✅

480- Case of A. Fib on warfarin the on follow up the INR was 6.5, she isn’t on high risk of bleeding nor undergoing surgery. Which of the following would be appropriate step after holding the warfarin?
A- vit K
B- FFP
C- Reassess after 2 day ✅
D- FFP and cryoprecipitate

481- Case of patients with right unilateral lower limb weakness and loss of sensation. Which artery is most likely affected?
A ⁃ Left MCA
B ⁃ Left ACA ✅
C ⁃ Basilar artery
D ⁃ Vertebral artery

482- Patient with history of vomiting for 24 hours due to food poisoning. He came today to emergency department complaining of hematemesis. Nasogastric tube was done and showed fresh blood.
What is the most likely diagnosis?

A. Gastritis
B. Dieulafoy lesion
C. Peptic ulcer
D. mallory weiss syndrome ✅

483- Malaria officer asked the municipality (amana) "something about eradication of mosquitoes".
Which of the following mosquitoes should be targeted:

A. Curlex
B. Anopheles ✅
C. Aedes aegypti
D. Aedes albopictus

484- A mother of a 3 month old baby Telling the doctor she’s going crazy She thinks that there’s a snake near her baby. She said that she didn’t see the snake and she knows it’s not true. She check on baby crib  50 times a day What’s the most likely diagnosis 
A. Delusional 
B. Hallucination 
C. Postpartum psychosis 
D. Obsession ✅

485- 30 years old pregnant women by in vitro fertilization (IVF) and diagnosed with ectopic pregnancy and scheduled of laproscopic removal of the prgnency. On US imaging: 4 cm tubal pregnancy on the right, and hydrosalpinx on the left. What is the management?
A. Salpingotomy on the right only
B. Salpingectomyontherightonly
C. Removal of both tubes(Bilateral tuboectomy) ✅
D. Hysterosalpingography with contrast