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SLE march 2010(prometric)

1 . Female pt 8 wks postpartum,not smoker diagnosed to hae asthma,her


asthma was not controlled she attended E! " times last month,on #2 agonist
and oral steroid,she came c$o whee%ing and s.o.& mildl' c'anosed using her
intercostal muscles,whee%' chest,#()1*0$100 ()120 (+2),2 (EF)"*,there is
oedema in her -oot up to the knee,the most likel' diagnosis )
1 . .+(/
2 . pulmonar' em&olism
" . 0cute asthma attack
1 . 0ngioedema
2 . Female pt deeloped sudden loss o- ision(&oth e'es) while she was walking
down the street,also c$o num&ness and tingling 2n her -eet ,there is
discrepanc' &$w the complaint and the -inding ,
+$E re-le3es and ankle 2erks presered,there is decrease in the sensation and
weakness in the lower muscles not going with the anatom',what is 'our action )
1 . .all ophthalmologist
2 . .all neurologist
" . call ps'chiatrist
1 . reassure her and ask her a&out the stressors
" . same scenario in 4.2 what is the diagnosis )
1 . .onersion disorder
2 . Somato-orm disorder
1 . male pt deeloped corneal ulcer in his !t e'e a-ter trauma what is the 53 )
1 . topical 0& 6 analgesia
2 . topical steroid
7 . -emale pt with !t e'e pain and redness with water' discharge,no h.o
trauma,itching,+$E there is di--use congestion in the con2unctia and water'
discharge what 'ou8ll do )
1 . gie 0&
2 . gie antihistamine
" . topical steroid
1 . re-er her to the ophthalmologist
* . Epidemic disease in poor sanitation areas a--ecting children and 'oung
adults )
1 . hep 0
2 . #
" . .
1 . /
, . * mths &a&' with cr'ing episodes9current 2ell' stool,looks slightl'
pale,signs o- o&struction wht is 'our 53 )
1 . &arium enema
2 . immediate surger'
" . :. -luid 6 wait -or resolution
8 . 1, '.o adolescent, athletic ,with h$o !t -oot pain planter sur-ace,diagnosis is )
1 . planter -asciaitis
2 . alu3 ;;
" . alu3 ..;
< . pregnant lad' 1* wks presented with aginal &leeding ,enlarged
a&domen,omiting ,her uterus is smaller than e3pected -or the gestational
age,#h.= 80,>$S snowstorm appearance,diagnosis )
1 . complete h'dati-orm mole
2 . partial h'dati-orm mole
10 . 12 '.o &o' c$o a&dominal pain a-ter plauing -oot&all,he denied an' h$o
trauma ,the pain is in the Lt paraum&ilical region what in3 'ou want to do )
1 . .?!
2 . ultrasound kidne'
11 . 7 '.o child with h.o -eer and swelling o- the -ace ant to the &oth ears
(parotid gland enlargement) what is the most common complication )
1 . La&r'nthitis
2 . meningitis
" . encephalitis
1 . orchitis
12 . what is the meaning o- di--icult' &reathing )
1 . d'spnia
2 . tach'cardia
1" . -emale pt complaining that she alwa's isuali%e that snakes crowling to her
&a&' cri&,and this is a--ecting her marriage,diagnosis is )
1 . @allucination
11 . -emale pt c$o seer migraine that a--ecting her work,she mentioned that she
was improed in her last pregnanc',to preent that )
1 . &io-eed&ack
2 . propranolol
17 . 0&out /5 in AS0 )
1 . a&out B 10 C
2 . 5ost o- the pt o- insulin dependant t'pe
" . -emale more a--ected with t'pe 2 /5
1 . most o- D://5 are o&ese
1* . Flu accine not gien to the &a&' who is allergic to )
1 . egg
1, . (t with as'mptomatic Erichomniasis )
1 . treat her an'wa' regardless
2 . treat her i- she is s'mptomatic onl'
18 . 1, '.o,she missed her second dose o- arecila accine,the -irst one a&out 1
' ago what 'ou8ll do )
1 . gie her dou&le dose accine
2 . gie her the second dose onl'
" . see i- she has anti&od' and act accordingl'
1< . pt with gonorrhea in-ection what else 'ou want to check -or
1 . .lam'dia trachomatis
20 . -emale pt with 0ortic stenosis,she deeloped s'ncope while she was in the
class and she recoered immediatel',what is the cause o- s'ncope )
1 . alular rupture
2 . s'stemic h'potension
21 . dia&etic pt well controlled,she came with h.o di%%iness and sweating a-ter
taking a medication #S)*0 what drug that ca'se her pro& )
22 . male pt with acute urine retention what is 'our action )
1 . insert -oll'8s cath and ask him to come &ack to the clinic .
2" . :n &attered women which is true )
1 . mostl' the' come -rom poor socioeconomic area
2 . usuall' the' marr' a second iolent man
" . mostl' the' come to the E$! c$o ..;;;
1 . mostl' the' think that the hus&and respond like this &ecause the' still hae
strong -eeling -or them
21 . smoking withdrawal s'mptoms peak at )
1 . 1F2 da's
2 . 2F1 da's
" . 7., da's
1 . 10F11 da's
27 . 5other who is &reast -eeding and she want to take 55! accine what is
'our adice )
1 . can &e gien sa-el' during lactation
2 . contain lie &acteria that will &e transmitted to the &a&'
" . stop &reast -eeding -or ,2 hrs a-ter taking the accine
2* . male pt c$o pain in his !t el&ow,he said that he is using the hummer a lot in
his work diagnosis )
1 . lateral epichond'litis
2, . 70 '.o male with di--icult' swallowing -ood with wt loss )
1 . +esophageal cancer
28 . 'oung -emale with pain in her el&ow(lateral epichond'litis) &est treatment is
)
1 9.;;;; . DS0:/
2 . electric ..;;;;
2< . what drug that improe the surial in .@F
1 . digo3in
2 . @'drala%in
" . diuretic (can8t remem&er the name )
"0 . old man with &ilateral knee pain and tenderness that increase with walking
and relieed &' rest G
1 . !0
2 . +0
"1 . !egarding peritonitis )
1 . .omplicated appendectom' the cause is anero&e organism
2 . rigidit' and the cause is paral'tic ileus
" . can &e caused &' chemical erosions
1 ..;;;; .
7 .;;;;; .
"2 . regarding 5: all e3cept )
1 . unsta&le angina,longer duration o- pain and can occur een at rest .
2 . sta&le angina,shorter duration and occur with e3certion
" . there should &e H wae in 5:
1 . een i- there is er' pain-ul unsta&le angina the cardiac en%'mes will &e
normal
7 ;;;;;; .
"" . (t with scoliosis, 'ou need to re-er him to the ortho when the degree is )
1 . 7
2 . 10
" . 17
1 . 20
"1 . * mths &a&' with undescending testis which is true )
1 . till the mother that he need s'rger'
2 . in most o- the cases spontaneous descent a-ter 1 'ear
" . surger' indicated when he is 1 'ears
1 . unlikel' to &ecome malignant
"7.21 '.o (t with as'mptomatic congenital inguinal hernia )
1 . immediate surger'
2 . surger' indicated when he is I"7 '
" . electie surger' i- it is reduci&le
1 ..;;;; .
"* . the most e--ectie thing regarding counseling )
1 . -amil' rapport
2 . well ad2usted appointment &e-ore counseling
" .;;;;;; .
", . :n a certine stud' the' are selecting the 10th -amil' in each group,ahat is
the t'pe o- stud' )
1 . s'stemic stud'
2 . non randomi%ed stud'
" .;;;;;; .
"8 . /eep laceration in the ant aspect o- the wrist,causing in2ur' to the median
nere,the result is )
1 . claw hand
2 . drop hand
" . ina&ilit' to oppose the thum& to other -ingrs
"< . 70 '.o male with num&ness in the little -inger and he has degeneratie
cericitis with restriction in the neck moement,also there is num&ness in the
ring -inger and atroph' o- the thenar muscle9compression in the el&ow,what
'ou8ll do )
1 . surgical decompression
2 . .0E scan -or surical spine
" ;;; .
1 ;;;; .
10 . 'oung pt with lier cirrhosis and ascitis what diuretic to gie )
1 . spironolactone
2 ..;;;; .
" .;;;; .
11 . *0 '$o male with hematuria and &ladder calculi what organism mostl'
inoled )
1 . schistosoma hematopium
2 ..;;;;;
12 . (t with cough ,? ra'showed upper lo&e ;;;.9-i&rosis and he is working
in a crowded area(case o- E# : guess)
Jhat 'ou8ll gie the -amil' contact )
1 . #acilli ;;;;;
2 ..;;;; .
1" . &a&' with -ace cellulitis and er'thema what is the causatie organism )
1 . @ in-luen%a t'pe &
Staph I strept I @ in-luen%a ( in children)
strept I Staph ( in adult)
11 . the &est indicator -or progression o- la&our )
1 . descent o- the head
2 . uterine contractions
17 . &a&' with white papules in his -ace what is 'our action )
1 . reassure the mother and it will resole spontaneousl'
2 . gie her anti&iotic
" ;;;;; .
1* . old man with generali%ed a&dominal pain E)"8.2,a&scent &owel sound,3
ra')dilated small &owel and part o- the transerse colon,no no -luid leel )
1 . pancreatitis
2 . per-orated peptic ulcer
" . &acterial colitis
1 .;;; .
1, . pt with pepti ulcer using anti acid,presented with -orce-ul omiting that
contains -ood particle )
1 . gastric outlet o&struction
2 .;;;;;; .
18 . pregnant lad' with cardiac disease presented in la&our,'ou8ll do all e3cept )
1 . epidural anesthesia
2 . .$S
" . diuretic
1 . digitalis
7 . +2
1< . 0nti&iotic -or communit' acHuired pneumonia
1 . =entamicin90mo3icillin
2 . Er'throm'cin
" .;;;;; .
70 . &a&' presented with skin lesion in his shoulder since &irth )
1 . straw&err' ;;;;
2 ;;;;;; .
71 . pt with rheumatic -eer a-ter untreated strep in-ection a-ter man' 'ears
presented with 5itral regurge,the cause o- massie regurge is dilatation o- )
1 . !t atrium
2 . !t entricle
" . Lt atrium
1 . Lt entricle
72 . old -emale with pu&ic itching with &lood' discharge,then she deeloped
pea shaped swelling in her la&ia,most likel' )
1 . #artholin c'st
2 . #artholin gland carcinoma
" . #artholin a&scess
7" . male pt with @ED on medication,wel controlled,the pt is using garlic water
and he is conenced that it is the reason -or #( control,what 'ou8ll do as his
ph'sician )
1 . tell him to continue using it
2 . to stop the medication and continue using it
" . tell him that he is ignorant
1 . to stop using garlic water
71 . -orcing the child to go to the toilet &e-ore &edtime and in the morning,'ou8ll
contro the pro&lem o- G
1 . enuresis
2 ;;; .
77 . the wound will heal when )
1 . &ecome sterile
2 . -ormation o- epithelium
" ..;;; .
7* . which o- the -ollowing is a disease improing drug -or !0 )
1 . DS0:/
2 . @'dro3'chloroHuine
" ;;;;;
7, . adolescent -emale came to 'ou in the clinic 2ust -or -ollowup what 'ou8ll
gie her )
1 . .a9-olic acid
2 . .a9 %inc
" . -olic acid9%inc
1 ..;;; .
78 . 70 '.o male with rectal &leeding,+$E there is e3ternal hemorrhoid,'our
action )
1 . E3cision o- the hemorrhoid
2 . rigid sigmoidoscop' and e3cision o- the hemorrhoid
" 9..;;;;; . colonscop'
1 .;;;; .
7< . &a&' with tonic clonic conulsions,what drug 'ou8ll gie the mother to take
home i- ther is another sei%ure )
1 . /ia%epam
2 . phen'toin
" . pheno&ar&
*0 . -emale pt with /5 well controlled and she wants to get pregnant,and she
asked 'ou a&out the risk o- congenital a&normalit',to aoid this dia&etes
control should start in )
1 . &e-ore pregnanc'
2 . 1st trimester
" . 2nd trimester
1 . "rd trimester
*1 . pregnant lad', she wants to do a screening tests,she insist that she doesn8t
want an' inasie procedure,'ou8ll do )
1 . >$S
2 . amniosenteses
" ;;;;; .
*" . pt complaining that urine is coming out -rom her agina,the cause is )
1 . esico aginal -istula
2 . esico cutaneous -istula
" ;;;; .
*1 . a mother &rought her 10 '$o o&ese &o' to the -amil' practice clinic ,what is
'our adice )
1 . same dietr' ha&&its onl' e3ercise
2 . -at -ree diet
" . multi-actorial interentions
1 .;;;; .
*7 . male pt with a c'anotic heart disease;;;;;.(incomplete 4)
1 . 0S/
2 . KS/
" . (/0
1 . truncus arteriosus
** . pt c$o pain when moing the e'e,-undoscop')normal )
1 . optic neuritis
2 . papillodema
" .;;;;;;; .
1 ;;;;;; .
i remem&er one H
case o- sudden death in athlete ans is )
o&structie h'pertophic cardiom'opath'
SLE march 2010(prometric)
E.histol'tica c'st is destro'ed &' )
Free%ing
#oiling
:odine treatment
.hlorine
(atient a-ter accident , the le-t ri&cage moe inward during inspiration and
outward during e3piration )
Flial chest
=reatest risk o- stroke )
/5
Eleated &lood pressure
Famil' histor' o- stroke
@'perlipedemia
Smooking
.hild has pallor , eats little meat , &' inestigation )microc'tic h'pochromic
anemia . what will 'ou do )
Erial o- iron therar'
5ultiitamin with iron dail'
Ereatment o- mania that doesnot cause hepatoto3icit'
Lithium
S.0 patient , the macula is cherr' red , and a&sence o- a--erent papillar' light
re-le3
!etinal arter' o cclusion
:n-lammator' &owel disease is idiopathic &ut one o- -ollowing is possi&le
underl'ing cause
:mmunological
(atient present with high &lood pressure (s'stolic 200) , tach'cardia
5'driasis , sweating . what is the to3icit' )
0ntichlenergic
S'mpathomemitic
Eric'clic antidepressant
+rganophosphorous compounds
i think the answer is s'mpathomimetic
Ereatment o- .hlam'dia with pregnan' )
0%ithrom'cin
Er'throm'cin &ase
the ma3imum &od' lenght will &e reached a-ter menarch &'
* months
1 'ear
2 'ears
(atient deeloped sudden loss o- ision &ilaterall' while she was walking in
the street , -ollowed &' num&ness , the su&2ectie s'mptoms are di--erent -rom
o&2ectie , and does not match anatomical , what is 'our diagnosis )
.onersion s'ndrome(i think this is the answer
0-ter in-lammator' phase o- wound , there will &e wound healing &' )
:- the wound is clean
0ngiogenesis
Epithelial tissue
+ld male with tender knee , pain , crepitus . the diagnosis )
+steorhritis
0nk'losin spond'litis
!heumatoid
5other has &a&' with cle-t palate and asks 'ou what is the chance o- haing a
second &a&' with cle-t palate or cle-t lip ,
27C
70C
C1
1C
i think the answer is 27
1 liter -luid de-icit eHuals
1 kg
0-ter accident patient with tach'cardia , h'potension , what will &e 'our initial
step
!apid :KF cr'stalloid
.E
.;;
* ' child was &orn to @#S positie mother is @#S positie , he was onl'
accinated &' #.= a-ter &irth , what 'ou will gie him now )
@#K 9 oral polio 9 /E( 9 hi&
@#K 9 oral polio 9 dt 9 55! 9hi&
@#K 9 oral polio 9 /t 9 55!
Ereatment o- non in-lammator' acne
!etinoic acid
Treatment of comedones: Topical retinoids .
2 . Treatment of papules or pustules: Topical benzoyl
peroxide plus topical antibiotics, mainly clindamycin
or erythromycin .
3 . In severe cases, intralesional steroid injection or
oral antibiotics, such as tetracycline or erythromycin
may be added .
Jhich is not true :n emergenc' management o- stroke
=ie :KF to aoid /7 70C
=ie dia%epam in conulsions
0nticonulsants not needed in i- sei%ures
5ust correct electrol'tes
Ereat eleated &lood pressure
S.0 complications in adults
.ere&ral in-arction
.ere&ral hemorrhage
Ehe most common risk -or intracere&ral stroke
@'pertension
.;;;
;;;;
Ehe antidepressant used -or secondar' depression that cause se3ual
d's-unction
Sertatlie
0m'pramine
Leo-lu3ine
(reiousl' health' -emale patient presented to E! with d'snea , ane3iet' ,
tremor , and she &reath heail' , the s'mptoms &egan 20 minutes &e-ore she
came to E! , in the hospital she deeloped num&ness perior&ital and in her
-ingers , what 'ou will do
0sk her to &reath into a &ag
Eake &lood sample to look -or alcohol to3icit'
Jhat is the most important in councling
E3clude ph'sical illness
Esta&lishing ra&&ot
Famil'
Schedule appointement
:n &reaking &ad news
Find out how much the patient know
Find out how much the patient wants to know
(atient with chest pain that aggreated&' couphing, there is added sound on
le-t sternal &order .in ecg 'ou will -ind
St changes
(r prolongation
@'peroltage
Ehe most common site -or isceral hemangioma is
Lier
.hild with large perior&ital hemangioma , i- this hemangioma cause
o&struction to ision , when will &e permenant decrease in isual acuit'
0-ter o&struction &' one da'
#' 1 week
#' " months
#' * months
Ehe s'mptoms o- so-t tissue sarcoma
(rogressie enlarging mass
"7 'ear -emale with &ilateral &reat pain , that decrease a-ter menstruation , the
&reast is nodular with prominent " cm mass su&areolar , a3illar' l'mph nodes
are not enlarged , what 'ou will do
5ammograph' -ollowed &' us
See her ne3t c'cle
Fine needle &iops' -ollowed &' tissue studies
(regnant with &leeding -or 12 hours and tissue , the ceri3 is 1 cm
.omplete a&ortion
:ncomplete a&ortion
5olar pregnanc'
2 month in-ant with omiting a-ter each meal , he is in 70 centile ,
@e passed meconium earl' and stool , diagnosis is
5idgut olulus
5econium ileus
@ischsprung disease
(atient with d'sphagia to solid and liHuid , and regurg , &' &arium there is non
peristalsis dilatation o- osophagus and airF-luid leel and tapering end .
diagnosis is
+sophageal spasm
0chalasia
+sophageal ca
Ehe most common cause o- cough in adults is
0sthma
=erd
(ostnasal drip
=irl with amenorrhea -or man' months . &mi is 20 and is sta&le oer last 7
'ears . diagnosis
Eating disorder
(ituitar' adenoma
+ld -emale with itching o- ula , &' e3amination there is pale and thin agina ,
no discharge . what is management
Estrogen cream
.orticosteroid cream
Flucona%ole
(atient with d'suria , -reHuenc' , urgenc' , &ut no -lank pain , what is the
treatment
.ipro-lo3acin po od -or "F7 da's
Dor-ocin po od -or , L 11 da's
(atient with -lank pain , -eer , omiting , treatment is
@ospitali%ation and intraenous anti&iotics and -luid
(atient present with mid -ace pain , erethematous lesions and esicles on
perior&ital and -orehead , the pain ia at nose , nose is er'thematous . what is
diagnosis
!oseola
@s
@erpes %oster
5ale with itching in groin er'thematous lesions and some hae clear centers ,
what is diagnosis )
(soriasis
Einea curis
Er'thrasma
Kasoconstrictie nasal drops complication
!e&ound phenomenon
Ehe use-ul e3curcise -or osteoarthritis in old age to maintain muscle and &one
Low resistance and high repetion weight training
.onditioning and low repetion weight training
Jalking and weight e3ercise
..;;;;;;;;;;
>nilateral worsening headach , nausea , e3cacer&eted &' moement and
aggreated &' light in 1, old girl
5igraine
.luster
/iet supplement -or osteoarthritis
=inger
+ld male with a&dominal pain , nausea , w&c , . what is true a&out appendicitis
in elderl'
.t not use-ull -or diagnosis
J&c is o-ten normal
!upture is common
:- there is no -eer the diagnosis o- appendicitis is unlikel'
0nemia is common
+ld patient with &ilateral enlarged knee , no histor' o- trauma , no tenderness ,
normal esr and cFreactie proteins . the diagnosis is
+steoarthritis
=out
:n-ectous arthritis
(atient has decrease isual acuit' &ilateral , &ut more in rt side , isual -ield is
not a--ected , in -undus there is irregular pigmentations and earl' cataract
-ormation . what 'ou will do
!e-er to ophthalmologist -or laser therap'
!e-er to ophthalmologist -or cataract surger'
Jhat is the most common treatment -or 2uenile rheumatoid arthritis
:ntraarticular in2ection o- steroid
+ral steroid
(aracetamol
/Fpenicillamine
0sprin
which o- the -ollowing decrease mortalit' a-ter 5:
metoprolol
nitrogl'cerine
thia%ide
morphine
the cardiac arrest in children is uncommon &ut i- occur it will &e due to
primar'
respirator' arrest
h'poolemic shock
neurogenic shock
old -emale with recurrent -racture , it d insu-ecienc' and smoker . which
e3ogenous -actor has the gretest e3ogenous side e--ect on osteoporosis
old age
smoking
vit d insufeciency
continue smoking
recurrent -racture
patient presented with sudden chest pain and d'snea , tactile ocal -remitus
and chest moeme&t is decreased , &' 3Fra' there is decreased pulmonar'
marking in le-t side , diagnosis
atelectasis o- le-t lung
spontaneous pneumothora3
pulmonar' em&olism
&o' a-ter running -or hours , has pain in knee and mass on upper sur-ace o-
ti&ia
osgood scatter disease
ilioti&ial &and
Osood!"chlatter disease
Osood!"chlatter #say: $oz!ood shlot!ter$% disease is one of the most
common causes of &nee pain in youn athletes. It causes s'ellin, pain and
tenderness just belo' the &nee, over the shin bone #also called the tibia%.
Osood!"chlatter commonly affects boys 'ho are havin a ro'th spurt
durin their pre!teen or teenae years. One or both &nees may be affected .
pancreatitis
am'lase is slowl' rising &ut remain -or da's
am'lase is more speci-ic &ut less sensitie than lipase
ranson criteria has seerit' (predictie) in acute pancreatitis
pain is increased &' sitting and relieed &' l'ing down
contraceptie pills is associated
patient has -eer , night sweating , &lood' sputum , weight loss , ppd test was
positie . 3Fra' show in-iltrate in ape3 o- lung , ppd test is now reactionar' ,
diagnosis
actiation o- primar' t#
sarcoidosis
case control is
&ackward stud'