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:

75-year-old female presented with left abdominal pain, by US there is multiloculates, hard left adrenal mass. CA125 within normal. What's the most appropriate management:
A-Cystectomy.
B-Oophorectomy.
C-Hysterectomy with bilateral oophorectomy.
D-Referer to gynecology oncology centre.

Abdulrahman: I am sure that this is an adnexal mass (not adrenal mass). Her age is definitely worrisome. The patient has O-Rads classification 5 (multilocular cysts with solid components). She should be referred to a gynecologic oncologist to decide what type of surgery to do (oophorectomy or other types of procedures).

Another similar question: Ovarian cyst 6 cm with high ca125 high u/s showed multi Loculated, cystic something . Which of the following is the most appropriate management?
A. cystectomy
B. oopherctomy
C. aspiration
D. observe

Abdulrahman: The answer is B, since the CA125 is high. Between these choices, we have to do an oophorectomy.

Female pt complaining of amenorrhea for 4-months T4 low Prolactin 200 What the dx
A- primary hypothyroidism
B- hyperprolactinemia

Abdulrahman: The question is missing a lot of info and I am sure it will be much more clear in the exam. Judging from the given info, the answer should be a prolactinoma , since it can cause her symptoms of menopause and low t4 (due to secondary hypothyroidsim) and high prolactin (PRL)

- The usual normal range for serum prolactin premenopausal women is up to 30 mcg/L. A serum PRL of >200 micrograms/L is highly suggestive of a PRL-secreting pituitary adenoma (prolactinoma).

-Hypothyroidism predisposes to hyperprolactinemia. However, basal serum prolactin concentrations are normal in most hypothyroid patients,Hypothyroidism and drug-induced hyperprolactinemia (with the exception of risperidone) usually result in mild elevations of prolactin (< 100 ng/mL). Untreated primary hypothyroidism may itself be associated with modest hyperprolactinemia.

24y/o male presented with *diarrhea and fatigue* ader chemotherapy for the treatment of colorectal cancer what electrolytes abnormality would you suspect?
A- hypokalemia
B- hypocalcemia
C- hyponatremia
D- hypomagnesemia

Better recall: pt with colorectal cancer presents with abdominal pain and diarrhea for days now experiencing generalized muscle weakness. ECG shows flattering of T wave. What are possible electrolyte imbalance ?
1/ hypomaganesium
2/ hyponatremia
3/Hypokalemia
4/Hypocalcemia

Abdulrahman: Both hyponatremia and hypokalemia can present with diarrhea. The answer is hypokalemia due to the ECG findings.

- Diarrhea after chemotherapy leads to hypokalemia.
- Hypomagnesemia will be manifested by fatigue and muscle pain.
- Hyponatremia will cause neurological symptoms.