Patient came to er in shock Peripheral pressure was 15 And mean aerial pressure is 15/16 Vascular resistance was 2000 Cardiac out put was 2.4 l What type of shock
A- cardiogenic shock
B- septic shock
C- hypovolimoc shock

Abdulrahman: The answer is missing the CVP or PCWP. Let’s break it down:
- Mean arterial pressure: Low (70 and 100 mm Hg)
- Systemic vascular resistance: High (excludes septic, anaphylactic, and neurogenic shock)
- Cardiac output: Low (4-8 is normal)
- CVP/CWP (missing): If low, then it’s hypovolemic. If it’s high, the answer is cardiogenic.
They will give you the normal values in the exam, so don’t worry.

Pt with hx of IHD with no fever , low CO , low wedge pressure and normal RT ventricular pressure . What's the type of shock ?
A- Septic
B- Cardiogenic
C- Anaphylactic
D- Hypovolemic

Abdulrahman: The answer is D because of the low wedge pressure (important to differentiate between cardiogenic and hypovolemic). Check the table and algorithm more to easily differentiate between the types of shock.

Which of the following drugs increase the survival in a patient with heart failure :
A- Beta blocker.
B- ACE inhibitors
C- Digoxin
D- Nitrites.

Abdulrahman: Both A and B are correct choices. I would go with ACE-I because they are mainly the first drugs to be used in patients with heart failure, so they have the priority.

Pt RTA with multiple facial laceration O2 sat 80%, best airway
A- Orotracheal tube
B- Nasotracheal tube
C- Surgical tracheostomy
D- Cricothyrotomy

Abdulrahman: The answer is D. The best way to support the airway is always Orotracheal. After that, cricothyrotomy. Nasotracheal is not ideal in an emergency setting. In our case, there is facial or C-spine injury, so don’t do orotracheal, go for cricothyrotomy.

32 years old female with right cervical lump. Upon examination she has enlarged cervical lymph node with normal thyroid gland. Percutaneous biopsy taken from the lump. Histopathology report: follicular thyroid cells, which of the following is the most likely diagnosis?
A- Ectopic thyroid
B- Follicular thyroid carcinoma
C- Papillary thyroid carcinoma
D- Cyst

Abdulrahman: The answer is C.

للتذكير, ترا الأسئلة كلها مكتوبة بملف جاهز وراح أرسله لكم بإذن الله بعد ما أجاوب على كل الأسئلة وتنتهي فترة تصحيحنا (15-20 أوقست) 💙

Female with bloating and GI symptoms. Started gluten free diet by herself and now she is better and visiting the GP. What to do?
A- Dietician referral
B- GI referral
C- No need to continue on gluten free diet
D- Stop gluten free diet and then do celiac serology

Better recall: Female convinced she is allergic to gluten she said (wheat) and did gluten free diet by her own and there was relief of symptoms:
A- Refer to gastroenterologist
B- Introduce gluten and then investigate for celiac
C- then no need to eat gluten if feel good

Abdulrahman: The answer is to continue the gluten diet and investigate celiac disease. Celiac is a lifelong disease, it should be diagnosed properly. No need to refer to a gastroenterologist to do the tests (Anti-tissue transglutaminase (tTG) and/or Anti-endomysium (EMA)) and interpret them.

4 years old came with his mother she complains he is irritable easily and picky in his food. He drinks 3 glass of *raw* cow milk daily and heats red meat. His mother says that his brother has the same issue. What is the dx
A- iron def
B- thalassemia a trait

Abdulrahman: No labs are shown at all to make a proper diagnosis. I would go with A most likely since ingesting a large amount of cow milk can cause IDA.

Old patient came for elective cholecystectomy you find out he was admitted 2 weeks ago in icu for management of MI, what will you do?
A- do it in this admission
B- delay it 6 weeks
C- delay it 6 months
D - no need to do it anymore

Another similar question (or different recall?): 55 year old diabetic female patient has to do elective cholecystectomy but she had an episode of myocardial infarction 6 weeks ago. What is the most proper course of action in this case?
A- Open Cholecystectomy In Same Admission
B- Laparoscopic Cholecystectomy
C- Laparoscopic Cholecystectomy In 6 Months
D- Observation

Abdulrahman: The correct answer is to do laparoscopic cholecystectomy after 6 weeks. I think choice B is the same as in the first question (6 weeks) which is correct.

السؤال هذا ترا جاني في إختبار الهيئة بالملّي وجاوبت عليه FAST والحمدالله هذه درجتي بالسيرجري بعد الإختبار:

تم تعديل إجابة السؤال هذا لC وعدلت الشرح 👍🏼

A female patient presented complaining of a sudden urge to void, frequent voidings during the day and getting up to void more than once per night. She diagnosed as urge urinary incontinence. Which of the following considers the most appropriate management?
A- Kegel exercises
B- Vaginalcones
C- Oxybutynin
D- Oxybutynin and Kegel exercises

Abdulrahman: The answer is A. UTD: Behavioral therapies (e.g., bladder training, bladder-control strategies, pelvic floor muscle training, fluid management) should be offered as first-line therapy to all patients with overactive bladder.

2 yr boy, diarrhoea , some times with blood , refuse to eat meat at all , has two elder sisters with same pattern. What's next :
A- chromosomal essay
B- Anti immunoglobulin ( written exactly like this)
C- Antidiarrheal

Abdulrahman: This is a very bad recall. Please send me a better one if you find it. Anyway, You can’t start ant-immunoglobulins right away and you can’t give antidiarrheal in this case because the bleeding is worrisome.