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5/21/2018 Sle Mar2010
1/16
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$100 120 +22 EF"*,there is
oedema in her -oot up to the knee,the most likel' diagnosis
1.+/
2.pulmonar' em&olism
".cute asthma attack
.ngioedema
2.Female pt deeloped sudden loss o- ision(&oth e'es) while she was walking
down the street,also c$o num&ness and tingling n her -eet ,there is
discrepanc' &$w the complaint and the -inding,+$E re-le3es and ankle erks 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
.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
.male pt deeloped corneal ulcer in his !t e'e a-ter trauma what is the 53
1.topical & 6 analgesia
2.topical steroid
7.-emale pt with !t e'e pain and redness with water' discharge,no h.o
trauma,itching,+$E there is di--use congestion in the conunctia and water'
discharge what 'oull do
1.gie &2.gie antihistamine
".topical steroid
.re-er her to the ophthalmologist
*.Epidemic disease in poor sanitation areas a--ecting children and 'oung
adults
1.hep
2.#
".
./
.*mths &a&' with cr'ing episodes9current ell' stool,looks slightl'
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pale,signs o- o&struction wht is 'our 53
1.&arium enema
2.immediate surger'
".:. -luid 6 wait -or resolution
8.1'.o adolescent, athletic ,with h$o !t -oot pain planter sur-ace,diagnosis is
1.planter -asciaitis
2.alu3;;
".alu3..;
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1.egg
1.t with as'mptomatic richomniasis
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 'oull 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
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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
19.;;;; .DS:/
2.electric..;;;;
2
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".electie surger' i- it is reduci&le
..;;;; .
"*.the most e--ectie thing regarding counseling
1.-amil' rapport
2.well adusted 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 inur' to the median
nere,the result is1.claw hand
2.drop hand
".ina&ilit' to oppose the thum& to other -ingrs
"
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Staph I strept I @ in-luen%a ( in children)
strept I Staph ( in adult)
.the &est indicator -or progression o- la&our 1.descent o- the head
2.uterine contractions
7.&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
";;;;; .
*.old man with generali%ed a&dominal pain "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
.;;; .
.pt with pepti ulcer using anti acid,presented with -orce-ul omiting that
contains -ood particle
1.gastric outlet o&struction
2.;;;;;; .
8.pregnant lad' with cardiac disease presented in la&our,'oull do all e3cept1.epidural anesthesia
2.$S
".diuretic
.digitalis
7.+2
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72.old -emale with pu&ic itching with &lood' discharge,then she deeloped
pea shaped swelling in her la&ia,most likel'
1.#artholin c'st
2.#artholin gland carcinoma
".#artholin a&scess
7".male pt with @D on medication,wel controlled,the pt is using garlic water
and he is conenced that it is the reason -or # control,what 'oull do as his
ph'sician
1.tell him to continue using it
2.to stop the medication and continue using it
".tell him that he is ignorant
.to stop using garlic water
7.-orcing the child to go to the toilet &e-ore &edtime and in the morning,'oull
contro the pro&lem o-G1.enuresis
2;;; .
77.the wound will heal when
1.&ecome sterile
2.-ormation o- epithelium
"..;;; .
7*.which o- the -ollowing is a disease improing drug -or !
1.DS:/2.@'dro3'chloroHuine
";;;;;
7.adolescent -emale came to 'ou in the clinic ust -or -ollowup what 'oull
gie her
1.a9-olic acid
2.a9 %inc
".-olic acid9%inc
..;;; .
78.70'.o male with rectal &leeding,+$E there is e3ternal hemorrhoid,'our
action
1.E3cision o- the hemorrhoid
2.rigid sigmoidoscop' and e3cision o- the hemorrhoid
"9..;;;;; .colonscop'
.;;;; .
7
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*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
."rd trimester
*1.pregnant lad', she wants to do a screening tests,she insist that she doesnt
want an' inasie procedure,'oull do
1.>$S
2.amniosenteses
";;;;; .
*".pt complaining that urine is coming out -rom her agina,the cause is1.esico aginal -istula
2.esico cutaneous -istula
";;;; .
*.a mother &rought her 10 '$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
.;;;; .
*7.male pt with a c'anotic heart disease;;;;;.(incomplete 4)
1.S/
2.KS/
"./
.truncus arteriosus
**.pt c$o pain when moing the e'e,-undoscop'normal
1.optic neuritis
2.papillodema
".;;;;;;; .
;;;;;; .
i remem&er one H
case o- sudden death in athlete ans is
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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'pochromicanemia . what will 'ou do
rial o- iron therar'
5ultiitamin with iron dail'
reatment o- mania that doesnot cause hepatoto3icit'
Lithium
S 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'
ntichlenergic
S'mpathomemitic
ric'clic antidepressant
+rganophosphorous compounds
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i think the answer is s'mpathomimetic
reatment o- hlam'dia with pregnan'
%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&ectie s'mptoms are di--erent -rom
o&ectie , and does not match anatomical , what is 'our diagnosis
onersion s'ndrome(i think this is the answer
-ter in-lammator' phase o- wound , there will &e wound healing &'
:- the wound is clean
ngiogenesis
Epithelial tissue
+ld male with tender knee , pain , crepitus . the diagnosis
+steorhritis
nk'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
C
i think the answer is 27
1liter -luid de-icit eHuals
1kg
-ter accident patient with tach'cardia , h'potension , what will &e 'our initial
step
!apid :KF cr'stalloid
.;;
*' 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 / 9 hi&
@#K 9 oral polio 9 dt 9 55! 9hi&
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@#K 9 oral polio 9 /t 9 55!
reatment 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 conulsionsnticonulsants not needed in i- sei%ures
5ust correct electrol'tes
reat eleated &lood pressure
S complications in adults
ere&ral in-arction
ere&ral hemorrhage
he most common risk -or intracere&ral stroke
@'pertension.;;;
;;;;
he antidepressant used -or secondar' depression that cause se3ual
d's-unction
Sertatlie
m'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
sk her to &reath into a &ag
ake &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
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12/16
: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
he 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'-ter o&struction &' one da'
#' 1 week
#' " months
#' * months
he 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'
2month 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 air-luid leel and tapering end .
diagnosis is
+sophageal spasm
chalasia
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+sophageal ca
he most common cause o- cough in adults is
sthma
=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 creamorticosteroid cream
Flucona%ole
atient with d'suria , -reHuenc' , urgenc' , &ut no -lank pain , what is the
treatment
ipro-lo3acin po od -or "7 da's
Dor-ocin po od -or 1 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
inea curis
Er'thrasma
Kasoconstrictie nasal drops complication
!e&ound phenomenon
he use-ul e3curcise -or osteoarthritis in old age to maintain muscle and &one
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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'
nemia is common
+ld patient with &ilateral enlarged knee , no histor' o- trauma , no tenderness ,
normal esr and creactie 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 uenile rheumatoid arthritis
:ntraarticular inection o- steroid
+ral steroid
aracetamol
/penicillamine
sprin
which o- the -ollowing decrease mortalit' a-ter 5:
metoprolol
nitrogl'cerine
thia%ide
morphine
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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 -remitusand chest moeme&t is decreased , &' 3ra' 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 &andOsood!"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 . 3ra' show in-iltrate in ape3 o- lung , ppd test is now reactionar' ,
diagnosis
actiation o- primar' t#
sarcoidosis
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case control is
&ackward stud'