(SLE march 2010(prometric

Female pt 8 wks postpartum,not smoker diagnosed to have asthma,her .1 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 pulmonar& em%olism .2 /cute asthma attack .! /ngioedema .0 Female pt developed sudden loss o, vision(%oth e&es1 while she was walking .2 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 preserved,there is decrease in the sensation and weakness in the lower muscles not going with the anatom&,what is &our (action -all ophthalmologist .1 -all neurologist .2 call ps&chiatrist .! reassure her and ask her a%out the stressors .0 (same scenario in 4.2 what is the diagnosis .! -onversion disorder .1 Somato,orm disorder .2 (male pt developed corneal ulcer in his t e&e a,ter trauma what is the 53 .0 topical /% 6 analgesia .1 topical steroid .2 Drugs that are usually contraindicated in corneal ulcer are topical corticosteroids and anesthetics ,emale pt with t e&e pain and redness with water& discharge,no h.o .7 trauma,itching,*#E there is di,,use congestion in the con2unctiva and water& (discharge what &ou8ll do give /% .1 give antihistamine .2 topical steroid .! re,er her to the ophthalmologist .0 Epidemic disease in poor sanitation areas a,,ecting children and &oung .) (adults hep / .1 " .2

- .! . mostly associated with intravenous drug use .0 mths %a%& with cr&ing episodes9current 2ell& stool,looks slightl& ) .+ ( pale,signs o, o%struction wht is &our 53( (Dance's sign %arium enema ,irst i, not surger& .1 immediate surger& .2 :.v ,luid 6 wait ,or resolution .! Contrast enema is diagnostic in approximately 95% of intussusception cases. It is ..therapeutic and curative in most cases with less than 2 !hour duration (&.o adolescent, athletic ,with h#o t ,oot pain planter sur,ace,diagnosis is 1+ .8 planter ,asciaitis .1 ;;valu3 .2 ..;valu3 .! "reatment options for plantar fasciitis include rest# massage therapy# stretching# night splints# motion control running shoes# physical therapy# Cold therapy# orthotics# anti! .inflammatory medications# in$ection of corticosteroids and surgery in refractory cases pregnant lad& 1) wks presented with vaginal %leeding ,enlarged .< a%domen,vomiting ,her uterus is smaller than e3pected ,or the gestational (age,"h-= 80,>#S snowstorm appearance,diagnosis complete h&dati,orm mole diploid %xx %xy no fetus tissue evelop into .1 choriocarcinoma partial h&dati,orm mole haploid %9#&&' or 92#&&&' .2 &.o %o& c#o a%dominal pain a,ter plauing ,oot%all,he denied an& h#o 12 .10 (trauma ,the pain is in the Lt paraum%ilical region what in3 &ou want to do @@@ -? .1 ultrasound kidne& .2 &.o child with h.o ,ever and swelling o, the ,ace ant to the %oth ears 7 .11 ((parotid gland enlargement1 what is the most common complication La%r&nthitis .1 meningitis .2 encephalitis .! orchitis .0 (what is the meaning o, di,,icult& %reathing .12 d&spnia .1 tach&cardia .2

,emale pt complaining that she alwa&s visuali$e that snakes crowling to her .1! (%a%& cri%,and this is a,,ecting her marriage,diagnosis is

Aallucination .1

,emale pt c#o sever migraine that a,,ecting her work,she mentioned that she .10 (was improved in her last pregnanc&,to prevent that %io,eed%ack .1 propranolol .2 migraine increase in pregnanc& (/%out .5 in BS/ .17 a%out C 10 D %ut 2!.+D .1 5ost o, the pt o, insulin dependant t&pe .2 ,emale more a,,ected with t&pe 2 .5 .! most o, E:..5 are o%ese .0

(Flu vaccine 6 F 55 egg .1

not given to the %a%& who is allergic to .1)

('t with as&mptomatic Grichomniasis .1+ treat her an&wa& regardless .1 treat her i, she is s&mptomatic onl& .2 &.o,she missed her second dose o, varecila vaccine,the ,irst one a%out 1 1+ .18 (& ago what &ou8ll do give her dou%le dose vaccine .1 give her the second dose onl& .2 see i, she has anti%od& and act accordingl& .!
live attenuated vaccine /ll children &ounger than age 1! &ears (one dose at 12I17 months and a second dose at age 0I) &ears H (Ever&one age 1! &ears and older who has never had chickenpo3 (two doses, given 0I8 weeks apart H /n&one missing a dose at the recommended times should get the shot at their ne3t visit

pt with gonorrhea in,ection what else &ou want to check ,or .1< -lam&dia trachomatis .1
N. gonorrhoeae, Chlamydia infection is a common cause of nongonococcal urethritis in men

,emale pt with /ortic stenosis,she developed s&ncope while she was in the .20 (class and she recovered immediatel&,what is the cause o, s&ncope valvular rupture .1 s&stemic h&potension .2

or %rain h&poper,usion dia%etic pt well controlled,she came with h.o di$$iness and sweating a,ter .21 (taking a medication "S()0 what drug that ca&se her pro% (male pt with acute urine retention what is &our action .22 .insert ,oll&8s cath and ask him to come %ack to the clinic .1 (:n %attered women which is true.2! mostl& the& come ,rom poor socioeconomic area .1 usuall& the& marr& a second violent man .2 ..;;;mostl& the& come to the E# c#o .! mostl& the& think that the hus%and respond like this %ecause the& still have .0 strong ,eeling ,or them (smoking withdrawal s&mptoms peak at .20 da&s 1F2 .1 da&s 2F0 .2 da&s 7.+ .! da&s 10F10 .0 5other who is %reast ,eeding and she want to take 55 vaccine what is .27 (&our advice can %e given sa,el& during lactation .1 contain live %acteria that will %e transmitted to the %a%& .2 stop %reast ,eeding ,or +2 hrs a,ter taking the vaccine .! male pt c#o pain in his t el%ow,he said that he is using the hummer a lot in .2) his work diagnosis(F GEEE:>S F hammer J lateral epichond&litis ( E?GEES:*E 5>S-LE .1 medial epichond&ltitis ( ,le3ore 1 F gol, F2 (&.o male with di,,icult& swallowing ,ood with wt loss 70 .2+ *esophageal cancer .1 &oung ,emale with pain in her el%ow(lateral epichond&litis1 %est treatment is .28 ( ES/:. i, not release o, tendone9.;;;; .1 ..;;;; electric .2 what drug that improve the survival in -AF .2< digo3in .1 A&drala$in .2

( diuretic (can8t remem%er the name .! %.%locker 6 --" 6 /-E: old man with %ilateral knee pain and tenderness that increase with walking .!0 Kand relieved %& rest / .1 */ .2 . egarding peritonitis( GGG (-ipro,lo3acin .!1 -omplicated appendectom& the cause is anero%e organism.1 rigidit& and the cause is paral&tic ileus .2 can %e caused %& chemical erosions .! ..;;;; .0 .;;;;; .7 (regarding 5: all e3cept .!2 .unsta%le angina,longer duration o, pain and can occur even at rest .1 sta%le angina,shorter duration and occur with e3certion .2 there should %e L wave in 5: in M2 .! even i, there is ver& pain,ul unsta%le angina the cardiac en$&mes will %e .0 normal ;;;;;; .7 ('t with scoliosis, &ou need to re,er him to the ortho when the degree is .!! 7 .1 10 .2 17 .! 20 .0 (mths %a%& with undescending testis which is true ) .!0 till the mother that he need s&rger& .1 in most o, the cases spontaneous descent a,ter 1 &ear .2 surger& indicated when he is 0 &ears .! unlikel& to %ecome malignant .0 (&.o 't with as&mptomatic congenital inguinal hernia !7.20 immediate surger& .1 surger& indicated when he is N!7 & .2 elective surgery if it is reducible if more than 5 years .3 ..;;;; .0 (the most e,,ective thing regarding counseling .!) ,amil& rapport .1 well ad2usted appointment %e,ore counseling .2 .;;;;;; .! :n a certine stud& the& are selecting the 10th ,amil& in each group,ahat is .!+

(the t&pe o, stud& s&stemic stud&.1 non randomi$ed stud& .2 .;;;;;; .! .eep laceration in the ant aspect o, the wrist,causing in2ur& to the median .!8 (nerve,the result is claw hand .1 drop hand .2 ina%ilit& to oppose the thum% to other ,ingrs .! ulnar nerve I dislocation o, el%ow F claw hand 5edian I FF . ina%ilit& to oppose the thum% to other ,ingrs adial nerve I wrist drop

Foot drop FFFFF peroneal nerve -lu% ,oot ( congential

&.o male with num%ness in the little ,inger and he has degenerative 70 .!< cervicitis with restriction in the neck movement,also there is num%ness in the ring ,inger and atroph& o, the thenar muscle9compression in the el%ow,what (&ou8ll do surgical decompression .1 -/G scan ,or survical spine .2 ;;; .! ;;;; .0 (&oung pt with liver cirrhosis and ascitis what diuretic to give .00 spironolactone .1 ..;;;; .2 .;;;; .! &#o male with hematuria and %ladder calculi what organism mostl& )0 .01 (involved schistosoma hematopium .1 ..;;;;;2 't with cough ,? ra&showed upper lo%e ;;;.9,i%rosis and he is working .02 (in a crowded area(case o, G" : guess (Ohat &ou8ll give the ,amil& contact ;;;;;"acilli .1 ..;;;; .2 (%a%& with ,ace cellulitis and er&thema what is the causative organism .0! A in,luen$a t&pe % .1

(the %est indicator ,or progression o, la%our .00 descent o, the head .1 uterine contractions .2 (%a%& with white papules in his ,ace what is &our action .07 reassure the mother and it will resolve spontaneousl& .1 give her anti%iotic .2 ;;;;; .! old man with generali$ed a%dominal pain G(!8.2,a%scent %owel sound,3 .0) (ra&(dilated small %owel and part o, the transverse colon,no no ,luid level pancreatitis .1 per,orated peptic ulcer .2 %acterial colitis .! .;;; .0 pt with pepti ulcer using anti acid,presented with ,orce,ul vomiting that .0+ (contains ,ood particle gastric outlet o%struction .1 .;;;;;; .2 (pregnant lad& with cardiac disease presented in la%our,&ou8ll do all e3cept .08 epidural anesthesia .1 -#S .2 diuretic .! digitalis .0 *2 .7 /nti%iotic ,or communit& acLuired pneumonia .0< =entamicin9/mo3icillin .1 Er&throm&cin .2 .;;;;; .! (%a%& presented with skin lesion in his shoulder since %irth .70 ;;;; straw%err& .1 ;;;;;; .2 pt with rheumatic ,ever a,ter untreated strep in,ection a,ter man& &ears .71 (presented with 5itral regurge,the cause o, massive regurge is dilatation o, t atrium .1 t ventricle .2 Lt atrium .! Lt ventricle .0 old ,emale with pu%ic itching with %lood& discharge,then she developed .72 (pea shaped swelling in her la%ia,most likel& "artholin c&st.1

"artholin gland carcinoma .2 "artholin a%scess .! male pt with AGE on medication,wel controlled,the pt is using garlic water .7! and he is convenced that it is the reason ,or "' control,what &ou8ll do as his (ph&sician tell him to continue using it .1 to stop the medication and continue using it.2 tell him that he is ignorant .! to stop using garlic water .0 ,orcing the child to go to the toilet %e,ore %edtime and in the morning,&ou8ll .70 Kcontro the pro%lem o, enuresis .1 ;;; .2 (the wound will heal when .77 %ecome sterile .1 ,ormation o, epithelium .2 ..;;; .! (which o, the ,ollowing is a disease improving drug ,or ES/:. .1 A&dro3&chloroLuine .2 ;;;;;! / .7)

adolescent ,emale came to &ou in the clinic 2ust ,or ,ollowup what &ou8ll .7+ (give her -a9,olic acid .1 -a9 $inc .2 ,olic acid9$inc .! ..;;; .0 &.o male with rectal %leeding,*#E there is e3ternal hemorrhoid,&our 70 .78 (action E3cision o, the hemorrhoid .1 rigid sigmoidoscop& and e3cision o, the hemorrhoid .2 colonscop&9..;;;;; .! .;;;; .0 %a%& with tonic clonic convulsions,what drug &ou8ll give the mother to take .7< (home i, ther is another sei$ure .ia$epam .1 phen&toin .2 pheno%ar% .! ,emale pt with .5 well controlled and she wants to get pregnant,and she .)0

asked &ou a%out the risk o, congenital a%normalit&,to avoid this dia%etes (contro should start in %e,ore pregnanc& .1 1st trimester .2 2nd trimester .! !rd trimester .0 pregnant lad&, she wants to do a screening tests,she insist that she doesn8t .)1 (want an& invasive procedure,&ou8ll do >#S .1 amniosenteses .2 ;;;;; .! (pt complaining that urine is coming out ,rom her vagina,the cause is .)! vesico vaginal ,istula .1 vesico cutaneous ,istula .2 ;;;; .! a mother %rought her 10 &#o o%ese %o& to the ,amil& practice clinic ,what is .)0 (&our advice same dietr& ha%%its onl& e3ercise .1 ,at ,ree diet .2 multi,actorial interventions .! .;;;; .0 (male pt with a c&anotic heart disease;;;;;.(incomplete 4 .)7 /S. .1 MS. .2 './ .! truncus arteriosus .0 (pt c#o pain when moving the e&e,,undoscop&(normal .)) optic neuritis .1 papillodema .2 .;;;;;;; .! ;;;;;; .0

i remem%er one L

(case o, sudden death in athlete ans is

o%structive h&pertophic cardiom&opath&

(SLE march 2010(prometric

(E.histol&tica c&st is destro&ed %& Free$ing "oiling :odine treatment -hlorine "he most common presentation of ame(ic colitis is gradual onset of (loody diarrhea# .a(dominal pain# and tenderness spanning several wee)s* duration "he most typical presentation of ame(ic liver a(scess is fever# right upper +uadrant .pain# and tenderness of less than ,- days* duration

'atient a,ter accident , the le,t ri%cage move inward during inspiration and (outward during e3piration Flial chest

(=reatest risk o, stroke .5 Elevated %lood pressure Famil& histor& o, stroke A&perlipedemia Smooking

hypertension is the single greatest ris) factor for stro)e. .ypoglycemia is the most common electrolyte a(normality that produces stro)eli)e symptoms. -hild has pallor , eats little meat , %& investigation (microc&tic h&pochromic anemia . what will &ou do( Grial o, iron therar& 5ultivitamin with iron dail& Greatment o, mania that doesnot cause hepatoto3icit& Lithium E* L:ME F>E-G:*E GESG 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 2001 , tach&cardia 5&driasis , sweating . what is the to3icit&( /ntichlenergic S&mpathomemitic Gric&clic antidepressant *rganophosphorous compounds

Greatment o, -hlam&dia with pregnan&( /$ithrom&cin Er&throm&cin %ase

the ma3imum %od& length will %e reached a,ter(%e,ore1 menarche %& ) months 1 &ear 2 &ears 'atient developed sudden loss o, vision %ilaterall& while she was walking in the street , ,ollowed %& num%ness , the su%2ective s&mptoms are di,,erent ,rom o%2ective , and does not match anatomical , what is &our diagnosis( -onversion 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
'hases o, healing( FGhe in,lammator& phase( 'latelets are the ,irst cells that aggregate to the wound, degranulation (platelet reaction1, the& release several c&tokines. ('.=F, :=FF1, E=F,F=F1 F Ghe proli,erative phase( Fi%ro%lasts, epithelial cells, and vascular endothelial cells, start to proli,erate and the cellularit& o, the wound increases. F 5aturation phase( Oound contraction occurs to some degree in primar& closed wounds %ut is a pronounced ,eature in wounds le,t to close %& secondar& intention. Ghe wound has +0F80D o, its original tensile strength at !F0 months postoperative.

(*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, having a , second %a%& with cle,t palate or cle,t lip 27D 70D

D1 0D i think the answer is 27 liter ,luid de,icit eLuals 1 kg 1 /,ter accident patient with tach&cardia , h&potension , what will %e &our initial step apid :MF cr&stalloid -G .;; & child was %orn to A"S positive mother is A"S positive , he was onl& ) ( vaccinated %& "-= a,ter %irth , what &ou will give him now A"M 9 oral polio 9 .G' 9 hi% A"M 9 oral polio 9 .G 9 55 9Ai% A"M 9 oral polio 9 .G 9 55 Greatment o, non in,lammator& acne topical etinoic acid .Treatment of comedones: Topical retinoids Treatment of papules or pustules: Topical benzoyl .2 peroxide plus topical antibiotics, mainly clindamycin .or erythromycin In severe cases, intralesional steroid injection or .3 oral antibiotics, such as tetracycline or erythromycin .may be added Ohich is not true :n emergenc& management o, stroke =ive :MF to avoid .7 70D =ive dia$epam in convulsions /nticonvulsants not needed in i, sei$ures 5ust correct electrol&tes Great elevated %lood pressure S-/ complications in adults -ere%ral in,arction -ere%ral hemorrhage Ghe most common risk ,or intracere%ral stroke A&pertension .;;; ;;;; Ghe antidepressant used ,or secondar& depression that cause se3ual d&s,unction

Sertatlie /m&pramine Levo,lu3ine 'reviousl& health& ,emale patient presented to E with d&snea , ane3iet& , tremor , and she %reath heavil& , the s&mptoms %egan 20 minutes %e,ore she came to E , in the hospital she developed num%ness perior%ital and in her ,ingers , what &ou will do /sk her to %reath into a %ag Gake %lood sample to look ,or alcohol to3icit& Ohat 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 aggrevated %& coughing , there is added sound on le,t sternal %order .in ecg &ou will ,ind St changes 'r prolongation A&pervoltage Ghe most common site ,or visceral hemangioma is Liver -hild with large perior%ital hemangioma , i, this hemangioma cause o%struction to vision , when will %e permenant decrease in visual acuit& /,ter o%struction %& one da& "& 1 week "& ! months "& ) months Ghe s&mptoms o, so,t tissue sarcoma 'rogressive enlarging mass tumors can grow rather large, pushing aside normal tissue, %e,ore the& are ,elt or cause an& pro%lems. Ghe ,irst noticea%le s&mptom is usuall& a painless lump or swelling

&ear ,emale with %ilateral %reat pain , that decrease a,ter menstruation , the !7 %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 cervi3 is 1 cm -omplete a%ortion :ncomplete a%ortion 5olar pregnanc& , month in,ant with vomiting a,ter each meal , he is in 70 centile 2 Ae passed meconium earl& and stool , diagnosis is 5idgut volvulus 5econium ileus Aischsprung disease
new%orn period with %ilious emesis, cramp& a%dominal pain, distention, and the passage o, %lood or mucus in stool. 'ostsurgical adhesions. .3 ( /? an ma& reveal the a%sence o, intestinal gas 6 upper =: is the stud& o, choice and shows

a%normal location o, the ligament o, Greit$

ttt ( E= tu%e , :M ,l uid , Surgical repair

AirschsprungPs .isease ( Eeonates present with ,ailure to pass meconium within 08 hours o, %irth, accompanied %& %ilious vomiting and FGGK children with less severe lesions ma& present later in li,e with chronic constipation. .3 ( FullFthickness rectal %iops& ttt ( surgical repair

'atient with d&sphagia to solid and liLuid , and regurg , %& %arium there is non peristalsis dilatation o, osophagus and airF,luid level and tapering end . diagnosis is *sophageal spasm QQ non peristalsis /chalasia ( peristalsis *sophageal ca
5otilit& disorders (achalasia, scleroderma, esophageal spasm1 present with %oth liLuid .and solid d&sphagia

Ghe most common cause o, cough in adults is /sthma =erd

'ostnasal drip

=irl with amenorrhea ,or man& months "5: is 20 and is sta%le over last 7 &ears . diagnosis Eating disorder 'ituitar& adenoma *ld ,emale with itching o, vulva , %& e3amination there is pale and thin vagina , no discharge . what is management Estrogen cream -orticosteroid cream Flucona$ole 'atient with d&suria , ,reLuenc& , urgenc& , %ut no ,lank pain , what is the treatment -ipro,lo3acin po od ,or !F7 da&s Eor,ocin po od ,or + I 10 da&s

'atient with ,lank pain , ,ever , vomiting , treatment is Aospitali$ation and intravenous anti%iotics and ,luid 'atient present with mid ,ace pain , erethematous lesions and vesicles on perior%ital and ,orehead , the pain ia at nose , nose is er&thematous . what is diagnosis oseola Asv Aerpes $oster 5ale with itching in groin er&thematous lesions and some have clear centers , ( what is diagnosis 'soriasis Ginea curis Er&thrasma

Masoconstrictive nasal drops complication e%ound phenomenon

Ghe 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 Oalking and weight e3ercise ..;;;;;;;;;;

>nilateral worsening headach , nausea , e3cacer%eted %& movement and aggrevated %& 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 O%c is o,ten normal upture is common :, there is no ,ever the diagnosis o, appendicitis is unlikel& /nemia is common

*ld patient with %ilateral enlarged knee , no histor& o, trauma , no tenderness , normal esr and cFreactive proteins . the diagnosis is *steoarthritis =out :n,ectous arthritis 'atient has decrease visual acuit& %ilateral , %ut more in rt side , visual ,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& Ohat is the most common treatment ,or 2uvenile rheumatoid arthritis F :ntraarticular in2ection o, steroid *ral steroid 'aracetamol .Fpenicillamine /sprin

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 in child

h&povolemic shock neurogenic shock -ardiac adult old ,emale with recurrent ,racture , vit d insu,ecienc& and smoker . which e3ogenous ,actor has the gretest e3ogenous side e,,ect on osteoporosis old age smoking vit d insu,ecienc& continue smoking recurrent ,racture patient presented with sudden chest pain and d&snea , tactile vocal ,remitus and chest moveme%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 Os ood!"chlatter disease Os ood!"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%. Os ood!"chlatter commonly affects boys 'ho are havin a ro'th spurt .durin their pre!teen or teena e 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 sensitive than lipase ranson criteria has severit& (predictive1 in acute pancreatitis pain is increased %& sitting and relieved %& l&ing down contraceptive pills is associated

patient has ,ever , night sweating , %lood& sputum , weight loss , ppd test was positive . 3Fra& show in,iltrate in ape3 o, lung , ppd test is now reactionar& , diagnosis activation o, primar& t" sarcoidosis case control is %ackward stud&