Mva with splenic tear Done splenectomy What is goona decrease in his blood after surger ?
A.Insulin
B.Glucagon
C.Tg
D.Glucose

Abdulrahman: The answer is insulin because it is an anabolic hormone. The hormonal response of physiologic stress includes elevation in the serum levels of glucagon, glucocorticoids, and catecholamines and reduction in insulin.

Husband has gonorrhea, his wife presented with UTI symptoms how to confirm diagnosis?
A-Ano genital swap
B- endo cervix swap
C- superior vaginal swap
D- urine culture

Another recall: Woman her husband has gonorrhea what’s the most diagnostic for her?
A. Anogenital swap
B. High vaginal swap
C. Endocervical swap
D. Urine culture

Abdulrahman: The answer is endocervical swab. A low vaginal swab would be correct (not upper/high) UTD:
- Men: Nucleic acid amplification tests (NAAT) of the first-catch urine is the diagnostic test of choice. A urethral swab is also an acceptable specimen for NAAT.
- Women: NAAT of a self- or clinician-collected vaginal swab is the preferred diagnostic test. An endocervical swab is an equally appropriate alternative specimen for NAAT if a speculum exam is already being performed.

17 years old male presented with severe asthma exacerbation on albuterol and long acting glucocorticoid, hx of admission 2 yrs ago on the exam: respiratory distress and diffuse expiratory wheezing, he Received systemic glucocorticoid and beta-agonist inhaler but no improvement, CXR: hyperinflation, Ph 7.3, What do next?
A- admission to ICU
B- discharge and reassurance
C- discharge and follow up next day
D- Admit to the medical ward

Abdulrahman: The answer is A. The patient is in exacerbation (excludes B and C) and Intubation should not be done in the medical ward.

السلام عليكم ورحمة الله وبركاته جميعاً،
بس تنبيه الله يسعدكم والله حبيت أذكركم فيه 🤍

الخطأ وارد ووجهات النظر قد تكون مختلفة.
أنا منب معصوم عن الخطأ وإجاباتي مب ١٠٠٪؜ صحيحة (إلا الأسئلة اللي جتني بالجراحة بإختباري اللي جبت فيه ١٠٠٪؜ بالقسم وبقول لكم إذا جاني سؤال منهم وتذكرت إنه جاني).

محد راح يعطيكم الإجابة الصحيحة ١٠٠٪؜ إلا اللي كتب السؤال بالهيئة. المصادر والآراء تختلف بالإجابة، وهذا اللي يخلي الناس يجيبون درجات مختلفة حتى ولو هم صححوا من مصادر موثوقة. أنا اللي علي إني أقرّب لكم الإجابة بقدر الإمكان وأعطيكم وجهة نظري من بحثي بالمصادر المعتمدة، لأني جالس أجاوب على أصعب الأسئلة اللي وصلتني منكم بالفورم.

بعض الكورسات اللي تكون بمبلغ مادي يتجنبون الإجابة على أغلب الأسئلة اللي ذكرتها، لأنهم يعرفون إن الآراء تختلف وماودهم يظهرون بشكل سيء يؤثر عليهم.

يمديني أجاوب على أسهل الأسئلة وأطلع بصورة أفضل بكثير، ولكن الشيء هذا والله تطوع مني ومن زملائي عشان فائدتكم وما نبغى منكم إلا إنكم تستفيدون والله وتبشروننا بأعلى الدرجات الممكنة وتدعون لنا إذا استفدتم.

نحتاج مساعدتكم والله لو وجدتم خطأ بتصحيحنا، واللي يتواصل معي بالخاص يعرف إني ما أزعل لو أحد جاني وصحح لي شيء. مايحتاج السب والشتم والدخول في النية على شيء مايسوى. أتذكر د. وفاء أول مافتحت قناتها كانت مضاربات مع الناس اللي يدخلون عليها بكل مكان ويغلطونها، والحين هي صارت مصدر للرزدنتس بالقايني ماشاءلله وهي لسا R1


إذا كان عندكم نقاش أو خلاف على سؤال، تأكدوا إنكم قرأتم السؤال صح مع الخيارات وبعدها تواصلوا معي بالخاص أو أرسلوه بالقوقل فورم وبنقدر نتناقش فيها، بس ودي يكون معاكم مصدر معتمد وموثوق عشان يستفيدون اللي يشوفون الأسئلة وأنا أستفيد مع إني دخلت أوفثا وبعت القضية 😂

تم تعديل إجابة السؤال هذا لD

A 30 year old woman had a gradual decrease of visual acuity since the last 3 years. Now she has a disability due to very low vision. What is the diagnosis?
A) glaucoma
B) cataract
C) macular degeneration
D) retinitis pigmentosa
E) keratitis

The answer is most likely D.
- Glaucoma affects the field of vision (not visual acuity).

- She is young, so we can exclude macular degeneration and cataract unless she was exposed to a risk factor. Also cataract most likely occurs in one eye.

- Retinitis pigmentosa is likely the answer, since it is a genetic disorder and most likely present with this presentation of only bilateral decreased vision for a couple of years. It can also present with trouble in night vision and visual field defects. It is not uncommon in Saudi Arabia and will present with a similar scenario like this.

- Keratitis is less likely because it is caused mostly by an infection and she will have symptoms.

هذه قناة وصلتني فيها حلول شهور أسئلة الـSMLE النموذجية، الحلول كلها مكتوبة مع المصادر، ومراجعة أكثر من مرة
العمل لوجه الله هذا رابط القناة:
https://t.me/SMLEGOLDEN

Pt6 hrs post femoral artery repair, pt developed swelling and neurological signs. What to do next
A- Cta
B- Ct
C- Duplex ultrasound
D- Compartment pressure release

This is another recall of the same scenario but with different choices. The answer here is D.

ماشاءلله الملف راح يوصل ل100 صفحة من أسئلتكم 😂
وصل مجموع الأسئلة 263 سؤال.

راح أوقف رابط الأسئلة مؤقتاً, لأن الأسئلة زادت الصدق وبدأ بعضها يتكرر.
راح أعطيكم خبر إذا رجعت فتحته ❤️

تم تعديل إجابة السؤالين الأولى هنا:
The answer is "Are keeping up with your freinds?" since he rarely uses inhalers and is asymptomatic. You want to see how it affects his daily life.

Child thin diet mainly milk and low in meat with labs of microcytic hypochromic anemia what to give ?
A. Iron supplement
B. Multivitamins with iron

Another recall: Child eating a lot of milk but he does not eat meat, MCV hypochromic microcytic anemia , how will you manage this child ?
A. Oral vitamins + iron
B. Trial of iron then then observe
C. Folic acid
D. Iron

Abdulrahman: The answer is Trial of iron then then observe. This patient drinks a lot of milk and little meat, which made him present with iron deficiency anemia. In summary, treatment of iron deficiency anemia in children is with dietary advice and oral iron therapy for several months

- Illustrated: iron is required for normal brain development and there is evidence that iron deficiency anemia is associated with behavioral and intellectual deficiencies, which may be reversible with iron therapy. A simple strategy is to provide dietary advice to increase oral iron and its absorption in all children with subclinical deficiency and to offer parents the option of additional treatment with oral iron supplements.
- Nelson: In an otherwise healthy child, a therapeutic trial of iron is the best diagnostic study for iron de"ciency as long as the child is re-examined and a response is documented.

Healthy with Routine check up ,Gall bladder polyp 0.6 cm , what's next:
A. ERCP
B. Surgical consultant
C. Liver function
D. Urgent cholecystectomy

Similar question: A lady came to family clinic to chick up they saw polyp in side the gallbladder in the US the polyp is 4mm in size, What will you do :
A. referral to surgery
B. follow up every 6 M

Abdulrahman: The answer should be observation/follow up (B in the second question). Surgery is indicated only if symptomatic or >1cm polyp. In the case of patients with primary sclerosing cholangitis (PSC) with cirrhosis, cholecystectomy is indicated for gallbladder polyps that are >8 mm. In patients who are unable or unwilling to undergo surgery and for patients with a gallbladder polyp ≤8 mm, we continue surveillance with an ultrasound evaluation every three to six months. In the absence of concurrent cirrhosis, we suggest cholecystectomy regardless of gallbladder polyp size.

Hashimoto thiroiditis associated with any type of thyroid cancer:
A- Medullary
B- Follicular
C- Lymphoma
D- Papillary

Abdulrahman: The answer is C. Preexisting chronic autoimmune ( Hashimoto’s thyroiditis) is the only known risk factor for primary thyroid lymphoma and is present in approximately one half of patients.

Patient diabetic admitted to hospital on Metformin , which is best during hospitalisation :
A. Metformin
B. Sliding scale insulin
C. Pre and post prandial insulin
Abdulrahman: The answer is B if he is a diabetic patient and admitted for another reason not related to his diabetes. If the patient is undergoing long hospitalization (>2 days), the best would be pre and post-prandial insulin and basal insulin.

Another recall: adult pt, hypertensive, heart failure, diabetic on diet, exercise and metformin came with symptoms of whatever I think heart failure and he was hospitalized how to manage his diabetes in the hospital?
A- metformin
B- glizide
C- sliding insulin
D- Basal and prandial insulin

Abdulrahman: Since the patient here is most likely going to stay in the hospital for a while, the best is to start pre and post-prandial insulin and basal insulin.

P.t known case of DM1 came to ER ( with typical DKA ) and then they mentioned Diagnosed as DKA and IV fluid start what next to give :
1- IV insulin
2- Iv insulin as well as long acting insulin
3- SC insulin
4- sliding scale insulin
Since this is a case of DKA, the answer is fixed dose IV insulin first. Here is another scenario from Om-Alqura: