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1 - use for treatment of pseudomembranous colitis :

Metronidazole
It is inexpensive, effective treatment for pseudomembranous colitis. It is
the preferred first line of treatment, with a response rate of 86-!" when
used orall# in adult men. It is e$ual to vancom#cin in relapse rate with
hi%her side effect profile. &n oral dose of !'( m% $id for )-1( da#s is
recommended. It is not recommended for children or for women durin%
pre%nanc# .
! . female with histor# of *t h#pochondrial pain fever an sli%ht +aundice
dx :
acute cholec#stitis
, . -eep +aundice with palpable %allbladder :
ca of head of pancreas
. . /t after perforated %allbladder under%o chol#c#stectom# return with
fever and elevation of *t loop of diaphra%m dx :
subphrenic abscess
' . pt with acute perianal pain since ! da#s with blac0 mass !1, pain
increase with defecation *x :
evacuation under local anesthesia
6 . rhumatoid arthritis distal interphalen%ial nodules
hebriden nodules
) . pt old male with *23 fullness with 4t loss not constant bowel habit
anemic pale Ix :
colonoscop#
8 . iron deficienc# anemia Ix :
- serum iron
- ferritin 55
- 6I78
. there 3 about patient with diabetes and h#per tension... which one of
anti h#pertensive madication #ou wanna add first
1 . &89
! . b-bloc0er
, . ca-channel bloc0er
. . alpha-blo0er
1
1( - /atient present with retinal arter# occlusion, which is wron% :
&- /ainful loss of vision .
7-- /ainless loss of vision .
11 - /atient present with acute precarditis , In 98: we see :
- ;-6 se%ment elevation .
- $ waves
- prolon%ed /* interval
1! -
epidemiolo%ical stud# want to see the affect of smo0in% in the
broncho%enic carcinoma , the# saw that is (" of smo0er has
broncho%enic carcinoma .
,(" of non <smo0er has the disease , the specificit# of the disease as a
ris0 factor is :
- )("
- ,("
- ("
===>?@A BCD EFGHI )( JKLI M?BN OPKQ =JLRST
1, - bab# present with pain in the ear ,b# examination there is piece of a
%lass deep in his ear canal , the mother mention a histor# of a bro0en
%lass in the 0itchen but she clean that completel# .... 4e treat that b# :
&- 7# appl#in% a stream of solution to s#rin%in% the ear .
7- *emove it b# forceps .
c-refer her to otolar#n%olo%# 55
1. - *U of open tibial fracture :
aVcephazolin
bVcephazolinW%entam#cin
cV%entamicin
dVcephazolinW%entamicinWmetronidazole
---------------
1' - which of the followin% found to reduce the ris0 of postherpetic
neural%ia :
aVcorticosteroids onl#
bVcorticosteroidsWvalac#clovir
cVvalac#clovir onl#
2
------------------------
16-8mo. old infant with on Xoff recurrent cr#in% episodes X hx of current
+ell# stools :
aVintussception
bVintestinal obstruction
cVmic0elYs diverticulitis
dVstran%ulated hernia
------------------------
1) - a man with oblon% swellin% on top of scrotum increase in size with
valsalva maneuver most li0el# -x :
aVdirect in%uinal hernia
bVindirect in%uinal hernia
cVvaricocele
dVfemoral hernia
-----------------------
18-,wee0s old male newborn with swellin% of scrotum transparent to
li%ht X irreducible :
aVepid#demitis
bVh#drocele
-----------------
1 - a #oun% %irl experienced cramp# abdominal pain X proximal
muscular wea0ness but normal reflexes after receivin% septra
Ztrimethoprim sulfamethoxazole : Z
aVfunctional m#ositis
bVpol#m#ositis
cV%uillian barre s#ndrome
dVneuritis
-----------------------
!( - which dru% causes ;29 li0e sundrome :
aVh#dralazine
bVpropranolol
cVamox#cillin
--------------------------
!1 - when u %ive aspirinWclopide%rol :
aVpt with a hx of previous MI
bV&cute MI
cVhx of previous ischemic stro0e
dVhx of peripheral arter# disease
eVafter cardiac capt
----------------------------------
3
!!-1) # with [x of *t iliac fossa pain rebound tenderness Wve %ardin%
what is the Ix that u will do 5
1 . 2&/*&;8\/] 55
! . us
, - 8.6 ;8&^ 55
---------------------------------------
!, . child with [x of _*6I before , 4s now have both 0nee tender red
inflamed dx
rheumatoid arthritis
---------------------------
!. . old female came complain from pan in her +oint increase with wal0in%
-x
osteoarthritis
!' .- pt came with [x of nec0 discomfort palpitation cold sweet 6;[ low
6. hi%h tender nec0 -x: thetrization
subacute th#roiditis
!6 . pt with ulcerative colitis #ou will start ttt with :
8\*6I8\;69*\I-;
!) . pt with prostatitis ttt :
ciprofloxacin
!8 . in iv canula and fluid :
site of enter# of canulla is a common site of infection
! . pt with nec0 ri%idit# re%or fever petichial rash over extremeties the
causative m`o is
menin%ococcal menin%itis
,( . pt female wor0 in office came with vulva itchin% #ellow va%inal
dischar%e
6richomoniasis
,1 . inferior wall MI
leads !.,.&ab
,! - commonest cause of chronic renal failure :
aV[6^
bV-M
-----------------------
4
,, - commonest cause of !r# [6^ :
aVpheochromoc#toma
bVcushin%Ys disease
cVrenal arter# stenosis
dVrenal parench#mal disease
------------------------
,. - pt with pres#ncope X tach#cardia X [x of old MI , on examination
cannon a waves in ca/, X 98: showed wide 3*; complexes..most
li0el# -U :
aVpreexistin% &a bloc0
bVantero%rade &a bloc0
cVreentrant &a nodal tach#cardia
dVbundle bransh bloc0
IYm not sure about the answers
,' - a football pla#er presented with 0nee pain after a hit on the lateral side of
his 0nee
on exam.dincreased laxit# on val%us stress
ne%ative lachman X mcmurr#Ys test...most li0el# -x :
aVlateral meniscus tear
bVmedial meniscus tear
cV&82 tear
dV/82
-------------------
,6 - primi%ravida with [x of smo0in%, presented with /a bleedin%, she
develpoed painless labor X delivered, she was told that there was no
abnormalit# with her or her fetus...whatYs the most li0el# cause of her
abortion :
aVcervical incompetence
bVfetal chromosomal abnormalities
----------------------
,) - pre%nant Z1w0s :&V presented with /a bleedin% X passin% some
tissues, on exam. cervical os was opened Z1cmV whatYs the -x :
aVcomplete abortion
bVthreatened abortion
cVincomplete abortion
dVmissed abortion
------------------------------
,8 - a woman with c#clical Zonl# with mensesV bilateral breast masses which
5
are tender X about 1x! cm , no palpable axillar# l#mph nodes wer found
initial *x :
aV\8/
bVdanazol
cVsur%ical removal
----------------------
, - primi%ravida Z,'w0s :&V presented to the antenatal care with lower limb
edema X 7/ 1'(e5 whatYs #our mana%ement :
aVduiretics
bVimmediate 8;
cVdecrease salt inta0e
dVadmission with meternal X fetal monitorin%
--------------------
.( - commonest si%nes#mptom of placental abruption :
aV/a bleedin%
bVuterine contractions
.1 - woman with wee0s [x of elevated er#thematous wheals overall her
bod# , she also has lip swellin% no [x of recent travel or food aller%# or
dru% in%estion, -x :
aVchronic an%ioedema X urticaria
bVcontact dermatitis
cVsolar dermatitis
dVcholiner%ic dermatitis
-------------------------
.! - a cuople Zthe#Yre !'#rs oldV came to #our office after 6months of
unprotected intercouse X the# wanted to be assesed for possible causes of
infertilit#...what is #our mana%ement :
aVsemen anal#sis
bVlaparoscop#
cVwait X see
dVbod# temperatue chart
-------------------------
., - a man sits alone in a room ,loo0s as he is listenin%, then he start to nod
X mutter X tal0s
whatYs the -x :
aVhallucination
bVdelusions
.. - &ll causes of h#ponatremia except ::
6
-iabetis insipidus Z-I Z
.' - -ru% of choice for otitis media :
&moxacillin
most common chromosomal abnormalit# is::.6 -
-own s#n. Z6risom# !1 Z
.) - /t complain from diplopia nausea vomitin% bac0 pain :
;omatization disorder
.8 - 8hild with pain in one testis elevated on examination b# doppler there is
decrease blood suppl# -x :
6esticular tortion
. - Infant 6 m a%e with wheezin% and respirator# distress ttt :
7ronchodilator
'( - /t with astma came with difficult# in tal0in% and silent chest ttt :
Iv aminofellin Z ifm not sure Z
'1 - pt said that aliens tal0 to him otherwise he is not complainin% of
an#thin%...whatYs the *x :
aVantidepressants
bVantips#chotic
cVbehavioral therap#
dVchloropromazide
-------------------------
'1 - elderl# pt developed disor%anized behavior, decreased attention, X
impaired memeor# 1! hrs post sur%er# Zaortic femoral popliteal b#passV
whatYs the most li0el# -x 5
aVdelerium
bValzeheimerYs dementia
cVmulti infarct dementia
---------------------------
'! - old lad# came to #our office with her dau%hter who said that her mother
has behavioral chan%es Za%itation X a%%ressionV X poor self care
u canYt do approprite ph#sical X neurolo%ical examination
whatYs #our next step 5
aVantidepressant
bVimmediate referral to a %eriatric ph#sician
--------------------------
7
',-6(#rs old lad# on estro%en, she developed va%inal bleedin% whatYs the
most important action 5
aVstop the estro%en
bVta0e endometrial sample
cVadd pro%esterone
--------------------------
'. - ph#sician careless about his dut# considered as :
aVmalpractice
bVcriminal practice
cVmalfeasance
dVnonfeasance
---------------------
'' - nulli%ravida came with '#rs [x of oli%omenorrhea ,on examination
inflammator# acne X hisutism ..what disease comes to #our mind 5
aVadrenal tumor
bVh#perprolactinemia
cV/8\-
dVh#poth#roidism
-----------------------
'6 - #ou were with a consultant when he wrote &89I for a pt who have
documented aller%# to them, u suppose that he 0nows better , what
commitment u had violated :
aVhonest# to pt
bVprofessional competence
cVappropriate pt relationship
dV$ualit# of care
eVmaintain% trust
& pre%nant lad# presented with sudden ri%ht le% swellin%') -
X painZli0e -a6 pictureV, what investi%ation u would do
. bed rest Ximpedance pleth#smo%raph#g a-heparin
. bed rest , impedance pleth#smo%raph#g b-warfarin
c- veno%raph#, bed rest X heparin
. bed rest, impedance pleth#smo%raph#g d-inferior vena cava filterpresence
'8 - of anti-[7s indicates :
8
aVcarrier state
bVinfectivit#
cVprevious infection or vaccination
dVacute infection
-------------------------
' - old pt with hx of treated lun% 8& ZiYm not sure about the $uestion but I
thin0 he was debilitated for some reasonV presents with fever productive
cou%h ,sputum showed :-ve or%anism X the buffered charcoal #east a%ar
showed the or%anism..whatYs the or%anism :
aV0lebsiella pneumonia
bVm#coplasma pneumonia
cVureaplasma
dVle%ionella
--------------------------
6( - old lad# presents with sensorineural hearin% loss in *6 ear associated
with dizziness, loss of corneal reflex,facial numbness X tinnitus, M*I
showed dilated internal auditor# canal ..most li0el# -x :
aVacoustic neuroma
bVcholesteatoma
------------------------------
61 - whatYs true about uterova%inal prolapse :
aVcommon cause of infertilit#
bVheaviness on erect position
---------------------------
6! - old man presents with flan0 pain, X interrupted voidin% , renal _;
showed bilateral h#dronephrosis ,whatYs the most li0el# -x :
aVbladder tumor
bVprostatic h#perplasia
cVrenal stones
6, - uncomplicated lar% pnumothorax 5
aVshifted tracha
bVs#nchornized clic0
9
6. - & 1.# female, with 6 month [x of lower mid abdominal pain , the pain is
colic0# radiate to the bac0 and upper thi%s, be%in with onset of mense, and
last for !-. d, she missed several da#s of school durin% the last ! months,
b# /x abd and pelvis normal, normal !r# sex development ..
most li0el# -x :
- primar# d#smenorrhea .
- secondar# d#smenorrhea .
-#smenorrhea Zor d#smenorrhoeaV is a medical condition characterized b#
severe uterine pain durin% menstruation. 4hile man# individuals
experience minor pain durin% menstruation, d#smenorrhea is dia%nosed
when the pain is so severe as to limit normal activities, or re$uire
medication .
-#smenorrhea can feature different 0inds of pain, includin% sharp,
throbbin%, dull, nauseatin%, burnin%, or shootin% pain. -#smenorrhea ma#
precede menstruation b# several da#s or ma# accompan# it, and it usuall#
subsides as menstruation tapers off. -#smenorrhea ma# coexist with
excessivel# heav# blood loss, 0nown as menorrha%ia .
;econdar# d#smenorrhea is dia%nosed when s#mptoms are attributable to
an underl#in% disease, disorder, or structural abnormalit# either within or
outside the uterus. /rimar# d#smenorrhea is dia%nosed when none of these
are detected .
6he main s#mptom of d#smenorrhea is pain concentrated in the lower
abdomen, in the umbilical re%ion or the suprapubic re%ion of the abdomen.
It is also commonl# felt in the ri%ht or left abdomen. It ma# radiate to the
thi%hs and lower bac0. \ther s#mptoms ma# include nausea and vomitin%,
diarrhea, headache, faintin%, and fati%ue. ;#mptoms of d#smenorrhea
usuall# be%in a few hours before the start of menstruation, and ma#
continue for a few da#s .
6' - old man lifts wei%ht complain of sever headache 7/1'(e'
he answers $uestion and then become drows#
dia%nosis
aVsubaracnoid hemorrha%e
bVmi%rine
cVtension headache
66 - pt loss taste in ant !e, of ton%ue and deviation of mouth which nerve
affected
aVfacial
bVtri%eminal
6) - eldrl# women present with diarrhea, hi%h fever X chills,d#suria other
ph#sical examination is normal includin% no bac0 pain ,
-ia%nosis :
10
&- bacterial c#stitis .
7- 7acterial %astroenteritis .
8- airal %astroenteritis .
d-p#lonephritis
68 - pt ceo menorrha%ia with examination retroverted uterus with uterosacral
li%ament tenderness
dia%nosis :
aVendometriosis
bVadenom#osis
cVfibroid
6 - 31echild pt presented ! u complainin% of hon# crust , #ellow blusters
: ..hh
aVImpeti%o
)( Z old pt with h#poth#rodism on th#roxin , Zman# s#mptoms V , labs all
normal Z 6;[ , 6, , 6. Vexcept low 8& , hi%h phosphate , -x :
&. /rimar# h#perparath#rodism .
7. ;econdar# h#perparath#rodism .
8. _ncontrolled h#poth#rodism
6he !ndar# /6[ is elevated due to decreased levels of calcium or 1,!'-
dih#drox#-vitamin -,. It is usuall# seen in cases of chronic renal disease or
defective calcium receptors on the surface of parath#roid %lands .
)1 - 3e. brou%ht to #ou the pulse less , low blood pressure , 98: showed &b ,
man%ment :
aV8/* .
bV8ardioversion .
)! - 3e pt with pres#ncope X tach#cardia X [x of old MI , on examination
cannon a waves in ca/, X 98: showed wide 3*; complexes..most li0el#
-U :
aV aentricular tach#cardia .
), - 3 e bab# present with pain in the ear ,b# examination there is piece of a
%lass deep in his ear canal , the mother mention a histor# of a bro0en %lass
in the 0itchen but she clean that completel# .... 4e treat that b# :
&. &ttempt irri%ation removal .55
7. &ttempt forceps removal 55.
11
8. &ttempt removal with a suction catheter .
-. &rran%e prompt otolar#n%olo%# evaluation .
9. Instill acetone into the external auditor# canal .
). - 3e lon% home \! therap# for pt with 8\/- :
when /o! ' < 88
when po! less than 88 .
nocturnal onl# .
i dont 0now the answer
)' - 3e ,6-s#ncope of pt is
warin% s#mptoms .
)6 - scenario . /t with metatarsal fracture , U- ra# not show exact fracture ,
next investi%ation :
&-_; .
7-86 .
8-M*I .
M*I is useful in the assessment of metatarsal fractures and dislocations,
soft tissue, the plantar plate, structures of the capsule, the extent of marrow
h#peremia, the exact number of bones involved, and small chip fractures .
86 scannin% is not essential for dia%nosin% metatarsal fractures. If 86 is
planned, it should be performed in at least ! planes: the coronal plane
Zperpendicular to the sole of footV and the axial plane Zparallel to the soleV.
4ith the modern multisection scanners, ima%es can be ac$uired in 1 plane
and reconstructed in other planes with fairl# hi%h de%ree of resolution .
)) - 3 e pre%nant lad# came to antenatal clinic for routine chec0up , her
:lucose tolerance test was hi%h %lucose , dia%nosed as %estational -M ,
man%ment :
insulin .
a-^utritional advice .
b-\ral h#po%l#cemic a%ent .
c-*epeat :66 .
d-[% &1c
)8 - bab# havin% [Ia of a mother havin% [Ia also , most not receive vaccine :
\ral /olio vaccine .
12
) - bab# brou%ht to #ou after he in%ested dru% tablets from there relatives
house , mane%ment Z no time in the 3 :Z
:astric lava%e .
8( - 3 e a #oun% %irl experienced cramp# abdominal pain X proximal
muscular wea0ness but normal reflexes after receivin% septra Ztrimethoprim
sulfamethoxazole : Z
aVfunctional m#ositis
bVpol#m#ositis
cV%uillian barre s#ndrome
dVneuritis
;I-9 9bb986;
6he most common adverse effects are %astrointestinal disturbances
Znausea, vomitin%, anorexiaV and aller%ic s0in reactions Zsuch as rash and
urticariaV. b&6&2I6I9; &;;\8I&69- 4I6[ 6[9 &-MI^I;6*&6I\^ \b
;_2b\^&MI-9;, &26[\_:[ *&*9, [&a9 \88_**9- -_9 6\ ;9a9*9
*9&86I\^;, I^82_-I^: ;69a9^;-c\[^;\^ ;]^-*\M9, 6\UI8
9/I-9*M&2 ^98*\2];I;, b_2MI^&^6 [9/&6I8 ^98*\;I;,
&:*&^_2\8]6\;I;, &/2&;6I8 &^9MI&, \6[9* 72\\- -];8*&;I&;,
&^- []/9*;9^;I6IaI6] \b 6[9 *9;/I*&6\*] 6*&86 Z;99 4&*^I^:; .Z
[ematolo%ic
&%ranuloc#tosis, aplastic anemia, thromboc#topenia, leu0openia,
neutropenia, hemol#tic anemia, me%aloblastic anemia,
h#poprothrombinemia, methemo%lobinemia, eosinophilia .
&ller%ic
;tevens-cohnson s#ndrome, toxic epidermal necrol#sis, anaph#laxis,
aller%ic m#ocarditis, er#thema multiforme, exfoliative dermatitis,
an%ioedema, dru% fever, chills, [enoch- ;chonlein purpura, serum
sic0ness-li0e s#ndrome, %eneralized aller%ic reactions, %eneralized s0in
eruptions, photosensitivit#, con+unctival and scleral in+ection, pruritus,
urticaria, and rash. In addition, periarteritis nodosa and s#stemic lupus
er#thematosus have been reported .
:astrointestinal
[epatitis, includin% cholestatic +aundice and hepatic necrosis, elevation of
serum transaminase and bilirubin, pseudo-membranous enterocolitis,
pancreatitis, stomatitis, %lossitis, nausea, emesis, abdominal pain, diarrhea,
anorexia .
:enitourinar#
*enal failure, interstitial nephritis, 7_^ and serum creatinine elevation,
toxic nephrosis with oli%uria and anuria, and cr#stalluria .
Metabolic
[#per0alemia, h#ponatremia .
^eurolo%ic
&septic menin%itis, convulsions, peripheral neuritis, ataxia, verti%o,
tinnitus, headache .
/s#chiatric
13
[allucinations, depression, apath#, nervousness .
9ndocrine
6he sulfonamides bear certain chemical similarities to some %oitro%ens,
diuretics Zacetazolamide and the thiazidesV, and oral h#po%l#cemic a%ents.
8ross-sensitivit# ma# exist with these a%ents. -iuresis and h#po%l#cemia
have occurred rarel# in patients receivin% sulfonamides .
Musculos0eletal
&rthral%ia and m#al%ia .
*espirator# ;#stem
8ou%h, shortness of breath, and pulmonar# infiltrates
Miscellaneous
4ea0ness, fati%ue, insomnia .
81 - female brou%ht to #ou after she in%ested hi%h dose of paracetamol
tablets 8 hours bac0 , mane%ment Z no time in the 3 : Z
^-ac#t#lc#stine
8! - heo pt presented with pre%Wle% swellin%
1 - pleth#smo%raph#,bed rest,heparin
! - veno%ram,bed rest,heparin .
8, - most imp factor in smo0in% ttt
desire of pt to stop smo0in% 55
iFjBkRA JlBQ EI?BPmLI
M >n oKpqrI oPstLI >?@A uTI BvwI?BPH RAx i@jBGA yA BvGz{
8. - heo pt presented with d#surea,no flan0 pain
c#stitis
8' - most ris0 factor for acute coronar# s#nd
decrease [-2 level
86 - heo pt presented with wheezin%,6 months old bab#
bronchodilator
8) - heo pt presented with silent chest and asthma
aminoph#lline
88 - heo pt presented with ;8& ,;9a9* /&I^,4[&6 I; 6[9 M&^&:M9^6
14
1 - pain0eller,iv fluid,observation 55
! - blood transfusion .
, - admission the pt 55
--------------------------------------------------------------
8 - the bactrial toxin use as ttt
botulism
( - contraindicated vaccine w [Ia pt
polio
1 - intelectual abilit# of child mesure b#
8^; examination
,-1st line for ttt ;29 with low side effect
1 - ^;&I-
! - methotrexat
. - peptic ulcer common with
pain chan%e with eatin%
' - all indication for endoscop# except
normal male more than .' #rs old
6 - acute otitis media creteria
- not should be w effusion
- rapid si%n and s#mptom
) - heo pt presented with moderate asthma
salmetrol
8 - \! suppla#
supportive ttt
- heo pt presented with c#anosis,;\7,chest clear
15
humulec0e maneuver
1(( - most cause of _*6I
*;a
I|} JKLI E?@l o~I JCx?|NIx II M H
GK BQ JCRwr yA LB{ BNn JL PkRGLBQ BLIx o{BH M ?BsGHrI >BLI

:ood luc0
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