Postmenopausal, mammo 2 years back normal. Now mammography reveals a B and micro calcifications, next step?
A- Core biopsy
B- Ultrasound
C- Excision
D- Chemoradiation

Better recall: Postmenopausal, mammo 2 years back normal. Now mammography reveals a speculated mass with irregular margins and micro calcifications, next step?
A- Core biopsy
B- Ultrasound
C- Excision
D- Chemoradiation

Abdulrahman: The answer is A. The patient’s findings are definitely worrisome (speculated mass with irregular margins on top of microcalcifications). We have to go for a core biopsy.

32 w pregnant, Premature rupture of membranes 4 ws ago , came today with pain and bleeding spots, next :
A- Tocolytic
B- Steroid
C- Surfactant
D- Antibiotics

Abdulrahman: She is 32 weeks and there is premature rupture of membrane 4 weeks? That is very significant and should not happen. Unfortunately, since she is <34 weeks pregnant, the risk of fetal demise is high due to lung hypoplasia and skeletal deformity. Both B and D are correct. Since she is presenting only now with pain and spots of bleeding, I would prioritize the antibiotics. In full question though, make sure of what the choices are exactly. Is the steroid actually betamethasone and is it the right antibiotic regimen (ampicillin and erythromycin)?

48 Y/O very obese lady,BMI 41 had plevic organ prolapse many time and then had surgery, what do you expect she’s having now :
A- Entrocele
B- Rectcele
C- Uterine prolapse
D-Cytocele
E-Vesicocele

Abdulrahman: The answer is A (due to hx of POP surgery).

58 yo female presented with pelvic organ prolapse and Her BMI is 38. She has a family history of surgical repair of POPs. What will you most commonly find ?
A- Cystocele
B- Rectocele
C- Enterocoele
D- Uterine prolapse

Another recall: 48 y.o very obese lady, BMI 41 had hx of pelvic organ prolapse had no surgery, but she had + family history of prolapse repair what do you except she’s having now:
A- Enterocele
B- Rectocele
C- Uterine prolapse
D- Cystocele

Abdulrahman: The answer here is cystocele (no hx of surgery and is the most common type of POP). If the patient is complaining of constipation, think of rectocele.

male with lower back pain ,erythmatous and B/L knee joint Labs were of insignificant values ,how to dx?
A- HLB27
B- MRI SPINE
C- CT SPINE
D- JOINT Aspiration

Better recall:A 45-year-old male patient complaining of back pain worsen in the night, not improved by rest, and improved with exercise and in the morning, and the most likely diagnosis is Ankylosing spondylitis, which of the following is the most appropriate test in this case?
A- HLA b27
B- MRI sacroiliac
C- CT sacroiliac
D- Anti CCP

Abdulrahman: The answer is B (MRI of the sacroiliac joint) as it is a case of ankylosing spondylitis. A positive test for HLA-B27 alone is not diagnostic for axSpA, and a negative test for HLA-B27 does not exclude the diagnosis of axSpA. HLA-B27 can be useful to increase the confidence of a diagnosis of axSpA in patients in whom plain radiographs or magnetic resonance imaging (MRI) also exhibit abnormalities consistent with axSpA. Not a lot of patients in Saudi Arabia turn out to be HLA-B27 positive, this is why we usually go for MRI.

male patient present in the ER after RTA with tibial fracture and he was stable, what is our priority in regard to his management
A- control the pain
B- Control bleeding
C- Limit soft tissue injury

Another recall: A case of a pt with femur fracture after an accident, vitally stable, there is an obvious deformity. What is the most important management:
A- analgesia for pain
B- decrease bleeding
C- decrease soft tissue injury
D- maintaining normal joint function

Abdulrahman: The answer is B. Even if the patient is hemodynamically stable, you have to follow the ABCs in cases of trauma, and controlling the bleeding is a a part of it (C) especially in cases of femur fractures, where there is a high risk of major blood loss.

هذا السؤال غالباً تابع لأسئلة الTrauma بالجراحة وجاني بإختباري اللي جبت فيه 100 بالجراحة الحمدلله

تلبيةً لطلب العديد من متابعي فريق Review Team
نُعلن عن إعادة رفع الفيديوهات المسجلة لدورة اختبار SMLE للعام الماضي 2021

*SMLE course 2021*

والتي سيتم إتاحة مشاهدتها على قناة اليوتيوب الخاصة بالفريق من خلال روابط خاصة سوف ترسل على قناة التليجرام، سيتم فتح كل رابط لمدة ٤٨ ساعه ثم إعادة إغلاقه


🔴خلال شهر August 1-16


أما بالنسبة للكورس الجديد لهذا العام سيُعلن عنه في سبتمبر 2022 بإذن الله

مع تمنياتنا لكم بالتوفيق والنجاح ✨

هذا كورس أم القرى الله يجزاهم ألف خير ❤️

A male patient who is a known alcoholic for many years presents with abdominal pain, vomiting and hematemesis. He was recently managed as a case of perforated peptic ulcer. On exam, there is epigastric? tenderness. Liver enzymes are normal. Diagnosis is
A- Acute pancreatitis
B- Chronic pancreatitis
C- Varices
D- Mallory-weiss

Abdulrahman: The answer is D, due to his history of alcohol use, abdominal pain, and repeated vomiting which lead to the hematemesis. If the answer was varices, he would at least have some signs and symptoms of liver failure or will present first with hematemesis.

indications for oxygen home therapy COPD-32
A- 6.3
B- 7.9
C- 7.3
D- 8.3

Better recall: Which of these is an indication for home oxygen therapy in COPD?
A- 1 reading of Po2 <7.8pka
B- 2 readings of Po2 <7.3
C- 1 reading of Po2 <8
D- 2 readings of Po2<6.3

Abdulrahman: The answer is two readings Po2 <7.3. Here are the other indications for long term home oxygen therapy in COPD patient:
1- PaO2 in ABG (out of time of acute attack) less than 55
2- PaO2 55-59 + one of the following: dependent edema (Cor pulmonale), polycythemia (Hct > 56%), pulmonary hypertension, Nocturnal hypoxemia

had prosthetic valve disease since 10 days. Underwent dental procedure and developed infective endocarditis. What's the organism caused infective endocarditis?
A- Staph aureus
B- Staph epidermis
C- Strept viridians

Abdulrahman: The answer is C. Answers vary between references as to what are the organisms that cause infective endocarditis. I’ve decided on what is found Davidson’s and Harrison’s books (approved references by SCFHCS):

Child has inflammation in hemiscrotum upon exploration there was viable testes but inflammation in epididymis and cord and swelling what the dx:
A- epididymitis
B- incarcerated inguinal hernia
C- testicular torsion
D- not remembered

Another recall: unilateral testicular painful swelling since 1 day, on exploration red scrotum viable but cord edematous:
A- Torsion
B- Incarcerated inguinal hernia
C- Testicular appendages torsion
D- epididymitis

Abdulrahman: The answer is epididymoorchitis/epididymitis.
- Epididymitis: Inflamed scrotum and edema
- Appendiceal testis torsion: Vertical testicle and blue dot sign
- Testicular torsion: Horizontal testicle
- Incarcerated inguinal hernia: Inflamed and red inguinal area with a visible mass extending to the scrotum

22 month infant with LEFT inflamed red hemi scrotum, on examination there was red firm irreducible painful scrotal swelling which is extended to to left inguinal region. LEFT testis couldn't be palpated. What is the diagnosis?
A. Torsion appendix testis.
B. testicular torsion
C. epididymo orchitis.
D. incarcerated inguinal hernia

Abdulrahman: The answer is D.

8 years old Female pt brought by her mother to the emergency department with nausea and vomiting after ingestion of 2 packages of paracetamol, each package contains 20 tables, this is happened before 24 hours after fight with her mother. On examination pt looks jaundiced has right hypochondrial tenderness, Bp=90/60mmhg HR=86, no labs provided. What is the stage of paracetamol toxicity?
A-1
B-2
C-3
D-4

Abdulrahman: The answer is B. The patient ingested a toxic amount of paracetamol before 24 hours, has RUQ pain, and early signs of abnormal LFT (jaundiced). Stage 3 will present with much more severe symptoms (encephalopathy, renal failure, acidosis, coagulopathy).