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 ❤️
وصل مجموع الأسئلة 263 سؤال.
راح أوقف رابط الأسئلة مؤقتاً, لأن الأسئلة زادت الصدق وبدأ بعضها يتكرر.
راح أعطيكم خبر إذا رجعت فتحته ❤️
Quick Recall
pediatric pat k/c of Asthma since age 2 years he is now asymptomatic with rare uses of albuterol inhalers, he came for counseling, he had contact sport participation, what is best question to ask to know his response: A- "Are keeping up with your freinds?"…
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.
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.
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.
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.
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.
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:
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).
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.
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.
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.
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.
Typical of Osteoarthritis improve on ibuprofen and paracetamol, what’s the next?
A- Do standing x ray
B- MRI
Abdulrahman: The question is short and has to have more info. I will choose A based on the presumption that the patient has not been diagnosed with osteoarthritis yet. Osteoarthritis (OA) is essentially a clinical diagnosis. Radiography may be considered if the diagnosis is unclear or an alternative diagnosis suggested subsequent to initial investigations. Conventional radiographic diagnosis of OA includes narrowing of the joint space, osteophytes, subchondral cysts, and subarticular sclerosis.
A- Do standing x ray
B- MRI
Abdulrahman: The question is short and has to have more info. I will choose A based on the presumption that the patient has not been diagnosed with osteoarthritis yet. Osteoarthritis (OA) is essentially a clinical diagnosis. Radiography may be considered if the diagnosis is unclear or an alternative diagnosis suggested subsequent to initial investigations. Conventional radiographic diagnosis of OA includes narrowing of the joint space, osteophytes, subchondral cysts, and subarticular sclerosis.
child with perforated dum and discharge come out what is the diagnosis
A- acute OM
B- otitis externa
C- Chronic OM
Better recall: Pediatric patient presents with ruptured tympanic membrane confirmed on otoscopy. There is no ear pain but constant purulent discharge in the middle ear. Diagnosis?
A. Acute otitis media
B. Otitis media with effusion
C. Otitis externa
Abdulrahman: The answer is chronic suppurative otitis media based on this given info. UTD: Chronic suppurative otitis media (CSOM), or chronic otomastoiditis, is a perforation of the eardrum with chronic drainage from the middle ear cleft. T It should not be confused with longstanding otitis media with effusion (OME, or "serous" otitis media), or persistent AOM, both of which involve an intact tympanic membrane and no drainage.
As for acute otitis media, occasionally, it requires middle ear effusion (MEE) and acute signs of middle ear inflammation. The tympanic membrane will rupture in the course of AOM. This is usually associated with ear pain and fever of relatively short duration, followed by pain relief associated with the onset of otorrhea. The drainage often has a clear or white appearance. By the time the patient is seen, the perforation may have healed, but the drainage may continue for some time, especially if otitis externa has developed.
A clinical diagnosis of AOM can be made in children with either:-
- Bulging of the tympanic membrane; distinct fullness or bulging of the tympanic membrane is the most specific and reproducible sign of acute inflammation. Pneumatic otoscopy is not necessary in children with bulging of the tympanic membrane.
- Perforation of the tympanic membrane with acute purulent otorrhea if acute otitis externa has been excluded.
A- acute OM
B- otitis externa
C- Chronic OM
Better recall: Pediatric patient presents with ruptured tympanic membrane confirmed on otoscopy. There is no ear pain but constant purulent discharge in the middle ear. Diagnosis?
A. Acute otitis media
B. Otitis media with effusion
C. Otitis externa
Abdulrahman: The answer is chronic suppurative otitis media based on this given info. UTD: Chronic suppurative otitis media (CSOM), or chronic otomastoiditis, is a perforation of the eardrum with chronic drainage from the middle ear cleft. T It should not be confused with longstanding otitis media with effusion (OME, or "serous" otitis media), or persistent AOM, both of which involve an intact tympanic membrane and no drainage.
As for acute otitis media, occasionally, it requires middle ear effusion (MEE) and acute signs of middle ear inflammation. The tympanic membrane will rupture in the course of AOM. This is usually associated with ear pain and fever of relatively short duration, followed by pain relief associated with the onset of otorrhea. The drainage often has a clear or white appearance. By the time the patient is seen, the perforation may have healed, but the drainage may continue for some time, especially if otitis externa has developed.
A clinical diagnosis of AOM can be made in children with either:-
- Bulging of the tympanic membrane; distinct fullness or bulging of the tympanic membrane is the most specific and reproducible sign of acute inflammation. Pneumatic otoscopy is not necessary in children with bulging of the tympanic membrane.
- Perforation of the tympanic membrane with acute purulent otorrhea if acute otitis externa has been excluded.
Middle aged Females patient has myalgia, joints pain, irritability which are resolved after ingestion of cold milk what's the possible diagnosis
A- 1ry hyperparathyroidism
B- 2ry hyperparathyroidism
C- 3ry hyperparathyroidism
D- Milk alkali syndrome
Abdulrahman: Here is the full question with the answer from Om-Alqura:
A- 1ry hyperparathyroidism
B- 2ry hyperparathyroidism
C- 3ry hyperparathyroidism
D- Milk alkali syndrome
Abdulrahman: Here is the full question with the answer from Om-Alqura:
Best to prevent asthma exacerbation ?
A- pefr tech
B- spacer device skills
C- change environment
Another recall: Asthmatic child with exacerbation but you should do advice
A. Educate about using if spacer (or inhaler)
B. Educate about using FEV(or omorbidit)
C. Environmental measurement
Another recall: 6 yo child k/c of bronchial asthma He is known player in a school team. Presented with acute exacerbation. Which of the following helps in decreasing recurrence of the exacerbation? (Something like that)
A. Asking how do you use your spacer devices
B. Asking ho to use the spirometry at home ?
C. Environmental measures c.....
Abdulrahman: The answer is to ask the child how he is using his spacer device, since it is the most important thing to do first. Some children will put the spacer away from the mouth and breath in, as opposed to securing the mouth on the spacer itself. This is a common mistake in both adults and children.
A- pefr tech
B- spacer device skills
C- change environment
Another recall: Asthmatic child with exacerbation but you should do advice
A. Educate about using if spacer (or inhaler)
B. Educate about using FEV(or omorbidit)
C. Environmental measurement
Another recall: 6 yo child k/c of bronchial asthma He is known player in a school team. Presented with acute exacerbation. Which of the following helps in decreasing recurrence of the exacerbation? (Something like that)
A. Asking how do you use your spacer devices
B. Asking ho to use the spirometry at home ?
C. Environmental measures c.....
Abdulrahman: The answer is to ask the child how he is using his spacer device, since it is the most important thing to do first. Some children will put the spacer away from the mouth and breath in, as opposed to securing the mouth on the spacer itself. This is a common mistake in both adults and children.
A 63 years old male, not to have hypertension and is a smoker. Presented with retrosternal chest pain, localized and non radiating.
ECG Showing ST Depression in Lead II, III and aVF.
Blood Pressure: 156/93
Which of the following risk factors is strongly associated with his presentation?
A- Smoking
B- Hypertension
C- Age
D- Male Gender
Another recall that I wrote after my exam: 55 y.o Patient k/c smoker only. Presents with signs and symptoms of MI. ECG shows lead II,III,AVF depression. Hist vitals are:
BP: 150/92
Pulse: 99
Which of the following is the most considerable risk factor for MI in this case?
A. HTN
B. Smoking
C. Age
Abdulrahman: The answer is smoking. The patient isn’t a k/c HTN, his vitals only show hypertension.
ECG Showing ST Depression in Lead II, III and aVF.
Blood Pressure: 156/93
Which of the following risk factors is strongly associated with his presentation?
A- Smoking
B- Hypertension
C- Age
D- Male Gender
Another recall that I wrote after my exam: 55 y.o Patient k/c smoker only. Presents with signs and symptoms of MI. ECG shows lead II,III,AVF depression. Hist vitals are:
BP: 150/92
Pulse: 99
Which of the following is the most considerable risk factor for MI in this case?
A. HTN
B. Smoking
C. Age
Abdulrahman: The answer is smoking. The patient isn’t a k/c HTN, his vitals only show hypertension.
Old pt bedridden wz basal ganglia dis, swallow proplem, best to initial feed
A- GASTRSTOMY
B- JUNSTOMY
C- NGT
Another recall: A case of basal ganglia stroke, with difficulty in swallowing and absent gag reflex. History of losing weight. How to provide nutrition?
A. Gastrostomy
B. Jejunostomy
C. NGT
Abdulrahman: The answer is gastrostomy. Dr. Thawaba and Dr. J agree with this answer.
A- GASTRSTOMY
B- JUNSTOMY
C- NGT
Another recall: A case of basal ganglia stroke, with difficulty in swallowing and absent gag reflex. History of losing weight. How to provide nutrition?
A. Gastrostomy
B. Jejunostomy
C. NGT
Abdulrahman: The answer is gastrostomy. Dr. Thawaba and Dr. J agree with this answer.