(1)

1. Case of organophosphate poisoning symptoms of miosis,

diarrhea, twitching. Treatment?
=oxygen
=recently ingested gastric lavage+ charcoal
=Atropine & parlidoxin
2. Carbon monoxide Poisoning.
Dia: = ABG (serum carboxyhemoglobin level)
(Normal < 5 & smoker <10)
=ECG (old & cardiac patient)
Treat: =100% oxygen (till asymptomatic or carboxy: normal)
= Hyperbaric O2 (pregnant, cardiac ischemia & CNS
Sign)
3)
ANTIDOTES
=Acetaminophen => N-acetylcystine.
=Benzodiazepam => Flumazenil
=Barbiturates => urine alkalization, dialysis, active charcoal
=Iron => deferxamine
=Opioids => naloxone
=B-blocker => Glucagon
=copper,lead,arsenic,gold => penicillamine
4) Treatment of panic disorder?
Benzodiazepine (immediate relief). SSRI

(2)

5.Obsessive compulsive disorder treatment?

.
(Fluoxetine (SSIRs) sertraline.)
6. a patient with repeated HIV VE test still insisting no I am
suffering from HIV.
(Hypochondriasis)
7. A woman encountered with RTA tow month back in which
many casualties occurred. When she recall she start to weep.
(Post-traumatic stress disorder)
8. A man admitted for elective surgery in a hospital. Next day
found drowsy, sweating, blood sugar normal, no h\o alcoholism
and no major illness.
(Hospital phobia)
9. Young boy with involved in fighting, robbery,stealing,lying,
.
(Conduct disorder)
10. Imagine physical defect or abnormality that leads to
multiples surgery\skin problems and still not satisfy
Body dysmorpic disorder
11. A pt : intentionally cause symptoms for gain financial benefit
, or avoiding to present in court or high authority.
( Malingering )

(3)

12. Mostly female complains different organs at times like

multiples sites pain, also neurological,GI,sexual problems
.Frequent clinics contacts.
13. Anorexia nervosa. What is a required feature?
(Fear of weight gain)
14. ECG of MI + history of recent intracranial bleeding, next.
(Urgent PTCA\PCI)
( less than 90 minutes Thrombolysis if no any .
contraindication and non-availability of Angioplasty

15 ,ECG of ventricular tachycardia in an IHD patient due to MI.

(4)

16. ECG of AF with low BP and unstable.

(Send emergency department)

17. RTA patient come with increase JVP, muffled sound and with
good air entry on both lungs. Investigation?
(ECHO)
18. Patient with abd: aortic aneurysm.
=1f size is less than 5.5

(observation with u\s)

=More than 5.5 or with thrombosis

=Rupture AA unstable
If stable

(surgery)

(urgent surgery)
(Do CT scan first)
(5)

19: 60 years old man with dizziness, tachycardia, old h\o of AF and
25 % carotid stenosis. What is next step?
(Echo)
20. A pt: with HTN come with heart failure. S3 sound .what kind
of cardiomyopathy with HTN.
(Hypertrophic \Dilated cardiomyopathy)
21. Patient is taking ACE inhibitor what you will watch.
(Renal function)
22. A patient comes with severe chest pain in ER with normal
ECG. Next investigation.
(Troponin I\T)
23. A child with wide and fixed and splitting S2 murmur.
(ASD)
24. Patient with hypovolemic and low BPgiven I/v fluids.
How to monitor adequacy of fluids given?
(See CVP) By measuring urine output
25.pt: with COPD, HTN, ch: AF, on antnihypertention drugs.
(

Which drug you will add for cardiac death prevention.

(WARFARIN)
26.A pt: with ST elevation MI already taking ACE inhibitor
Aspirin. What you add.
(6)

(B-Blocker)

27. A child with systolic murmur 2\6 on upper sternum when lying
down disappear .
(Innocent murmur)
28. Failure to thrive + pan systolic murmur in 4 month old child
diagnosis?
.
(VSD)
(Murmur disappear due to pulmonary hypertension)
29. Old lady with hip # underwent hip fixation surgery after 24
hours she went into pulmonary embolism and died .what is the
cause of death?
(Cardiopulmonary arrest)
30. Stab wound with bilateral equal air entry, distended neck veins,
hypotension.diagnosis?
.
.
(Tamponade)
31. Scenario in which patient has systolic murmur, chest pain,
dizziness and dyspneadiagnosis?
(Aortic stenosis)
32. Scenarios Pulmonary Embolism
Chest pain, dyspnea, chest basal crepts
=Post-operative patients (Mojo surgery)
=After long flight traveling
=H\O DVT, OCP
(7)

33. A young man presented with sudden onset of pale, cold, lower
limb with absent pulses. Cause?
(Arterial embolism)
34. A middle age man with knee pain, difficulty in walking. Right
calf swelling +pain and also size is bigger than left. Investigation
(Doppler ultrasound)
35. An old man come with left eye pain, feeling curtain like
shadow, pervious history of HTN,DM and left carotid stenosis.
(Amarurosis fungax)
36. Carotid stenosis more than 60%.
(Carotidendartrectomy y Surgery)
37. Male with motor vehicle accident (bumper crush injury on
right lower leg). Right foot appears cold than left. Cause.
(Arterial occlusion)
38. Case scenario description of painful breast swelling that
come and goes with menses answer:
(Fibrocystic disease)=>Excisional biopsy
# A case of hydatid cyst evacuation done 15 day ago now come
with little bleeding ultrasound clear .Os is closed. Next?
( D&N
(8)

39. 7 years old girl with pubic hair and breast buds
diagnosis? .
(Central precocious puberty)
40. 58yrs old female G8P8 with stress incontinence & vaginal
prolapse treatment?
.
.
(Vaginal hysterectomy with anterior colporrhaphy)
41. Pregnant patient with 9cm dilated cervix and in severe pain,
now requests for treatment of pain.?
.
(Epidural)
42. Patient with complaints of fever, adnexal tenderness &
mucopurulent dischargediagnosis?
.
(PID)
43. CIN II & IIItreatment?? (High grade dysplasia)
(Leep &C0ld-Knife Conization .If recurrent hysterectomy
(Colposcopy with cone biopsy)
44. Weeks pregnant as per LMP on antenatal care her fundus
height is 28 weeks .what will you
do.
.
(Recheck
for date)
45. A middle age woman lump in breast, suspected Ca breast
.having Ca-colon family history .what is the risk factor.
(Early Menarche late menopause)
46. A 52 years old menopause DM, with normal Pap smear 1 year
back .No active complain .next investigation.
(Mammography)

(9)
47: Middle age woman with lump 2.5 cm non tender ,firm on
upper quadrant, no discharge, no skin change, no axillary lymph
node enlargement.
(Fibroadinoma)
48: A full term in labor room with good progress cervix 4 cm
dilatation + +2 stations. She progress to 9 cm and + 4 station.
Suddenly fetal heart beat drop from 140 to 40 beats with variable
deceleration. What will you do?
(C-Section)
49: A middle age woman come with severe dysplasia pap smear
result .what next?
(Colposcopy Cone biopsy)
50. A young lady with menses irregularities from 23 to 35 days
with normal menstrual loss. What you advise her?
(OCP)
51: A female present with multiple pain full ulcers on labia,
cervix red purulent discharge, + lymphadenopathy.
(Herpes simplex virus) if active (C-section in pregnancy)

52: A case of amenorrhea, milky nipple discharge. Infertility,

bitempral hemianopia.
(High LH\ FSH) (Bromocriptine or cabergoline)

(10)
53: G3P2 previous 2 normal vaginal deliveries with breech
presentation at 38 weeks. She was presented on clinic before 34 &
36 weeks but no action taken. What next?
(External cephalic version)
54. 16 years old girl with h\o amenorrhea, no breast and no pubic
hairs. High FSH. Low estrogen diagnosis?
(Gonadal digenesis) Turner syndrome
55: fetal compaction due to smoking.
(IUGR)
56. CMV complication in fetus.
(Anencephaly)
57. Meningococcal prophylaxis in contacts?
( Rifampicin 600mg 2 doses. And 10 mg per kg for kids.
58. Child with high grade fever, cough, and dyspnea diagnosed
pneumococcal pneumonia mother is concerned about other kids at
home and school. ? .
.
(No treatment)
59. Infant on cows milk with pallor only. Labs: low Hb, low RBC,
normal platelets, normal WBC.diagnosis?
.
(Iron deficiency anemia)
60. Child with unilateral hemarthrosis of knee. Labs: TT normal,
PT normal, APTT increased..diagnosis.
..(
(Hemophilia)

(11)
62. Painless testicular mass or acute severe pain?
(Emergency surgery)
63: A young girl with mumps involving overiescomplication.
(NSAID)
64; 10 years boy parotid swelling with intermittent testicular pain.
What do next?
(NSAID)
65: 10 years boy with Von Willibrand disease developed perfused
epistaxis.what would you give?
(DDVAP)
66: A child with pain in hand and leg and hepatosplenomegaly:
( Heamoglobn S)
67: A young man come with multiple bruises all over body after
taking Tab:Septran .
(G6PD)
68.A child living in farm house history of abdominal pain, no
diarrhea. UTI . What investigation.
( Stool for Ova and cyst)
70. A 4years old child with burn lower limb and perineal region.
What will go first?
Water (other option,K,Na,urea)

(12)
71:A CHLID with 38 fever , active, hydrated and playful. What
will you do?
(Observation)
72: A 13 years obese boy with knee pain since 8 month. No history
of trauma, weakness and numbness but Rt: leg is shorter than left
leg .
( Slipped capital femoral) Rx; surgery with pinning
73:child swallow 50fils coin on x-ray coin in stomach .and no
active complain.
(observation stool)
74: A child with common Coryza.
( Parvovirus)
75: Most common Diarrhea induced virus in child.
(Rota virus)
76: A child with clay color stool .increase direct bilirubin &
alkaline phosphate .dark urine. Investigation? (Bil-atresia)
HIDA

(U\S abd)

78: A child with high grade fever, sore throat ,lymphadenopathy,

hepatosplenomegaly with rash .
(Atypical lymphocytosis)

( 13)
79:A child with displaced supracondylar #humerus .
(open reduction+ internal fixation)
80: A baby with jaundice, bilious vomiting and on X- ray double
bubble shadow.
(Duodenal Atresia)(First of life)
81: A child with projectile vomiting and small mass in epigastrium.
Investigation?
(U\S ) pyloric stenosis (2nd or 3rd of life)
82: picture of Hand (Kawasaki) child with pain in hand , fatigue.
Asking about investigation.
( Echo b\c of coronary artery aneurysm )

( 14)
83: picture of x- ray ( Rickets) Lab: finding.

( High Alkaline phosphate and low or normal Ca & phosphate)

84: A child with watery diarrhea few time a day,but baby is active
and gaining wt;
(Toddlers diarrhea)

(14)
86: A child with mild dehydration.
(oral 2% glucose +75 mmol Nacl
87-B: Severe dehydration in male child.
(100 ml \kg)

88:A child URTI treated with Amoxicillin and he developed face

puffiness and lower legs edema. Finding in lab?
(RBC cast) Nephritis
89: A 7 years old child with non-bloody diarrhea and knee pain.one
of taller twin.
(crohns disease)
90: A child having jaundice after 3 days.,
(Physiological)
91: Case after 15 days still bilirubin 35 mg and indirect 7 mg +
CNS symptoms.
(Plasma exchange)
92: DM mother delivered baby and his sugar is 40 mg. what is next
management.
(20%I\V glucose)
93: Side effect of forceps delivery.
(Facial Palsy)

(15)
94. Side effect of vacuum delivery.
(cephlhaematoma) corneal abrasion
95: A child who is good at home but at school not co-operative,
does not talk to any body.
(selective mutism)
96: A 15 days old boy looking pale, mother has AB-ve,temp.35c.
least common cause.
(G6PD)
97: Neonatal jaundice ,temp: 35c ,constipation and not feeling well
direct billi: high .and indirect slightly high
(sepsis)
98. Term neonate with fluid in interlobar fissuresdiagnosis?
.
(Transient tachypnea of newborn)
99. Child with round worm manifestationtreatment?
.
(Ibendazole.)
100.. Child with digital clubbing, failure to thrive,
diarrhea.diagnosis??
.
( Cystic fibrosis)

101. Child with acute lymphocytic leukemia scheduled for some

surgery, but parents dont want to proceed with surgery and want to
leave the hospital with child. What would u do?
(Age concerned)

( 16)
102 Patient with acute asthma, on treatment with ipratropium +
salbutamol+ oral steroids. On DC what would u
give? . . . . . . . . .
(flucotisone)
103. Case scenario with CSF findings of low glucose, PMNs
with fever &
meningismus.diagnosis?
.
( Bacterial meningitis)
104. Patient with croup with barking cough, treatment?
.
(Racemic epinephrine)
105. Acute otitis media red, bulging tympanic membrane,
fever. Treatment?
.
(Amoxicillin)
106. Otitis externa in child.
(Tropical antibiotics and steroids drops)
107: Picture of Molluscum contagiosum.

( 17)
108, Hiistory of dysphagia to solids, now with liquidsnext
what would u do?
= UGI endoscopy if you suspect mechanical obstruction or
=otherwise barium swallow.
= In achalasia than manometry

109,.omplaint of bloody diarrheano travelling history, no

vomitingoptions : Most common campylobacter,
110.12. Case of raised PSA level 8.8 with obstructive urinary
symptomsnext step?
.
(TURP)
= if BPH=>hard,PSA more than 10 =>transractal biopsy
=if BPH=>enlarge+ PSA 1 to 5 => Finasteride
=if PBH=> enlarge+HTN & PSA 5 to 9+> Alpha-blocker

110. Case of fever with chills, ringed structure in blood cells.

Diagnosis,(thick and thin slide)
(Malaria)
111. Case of ptosis, miosis, warm face.diagnosis.
(Horners syndrome)

(18)
112.. Case of diabetic patient with complaints of blurred vision,
haloes (rings) around lights at night time. Diagnosis.
.
.
(cataract)
113. Patient with complaints of headache with photophobia, neck
stiffness, ptosis,no fever..diagnosis? if severe occipital
.
(Subarachnoid hemorrhage,)
114. Female with proximal muscle weakness (difficulty combing
hair) CK levels are increased, no problems in eye..
Diagnosis? Inflammatory myopathy. (polymyositis)
115. Male patient, lifted heavy object with complaints of low back
pain. Ankle reflex is present, no neurologic deficittreatment?
.
(Rest & NASID)
# If incontinence with back pain & radiating (immediate
intervention.
116. Patient with hypertension with recurrent gouty attacks on
allopurinol 150 mg for 6months. Now has come for follow up.
Next what to do?
(Increase allopurinol dose to 300 mg.)

117. Pt. with SLE and lupus nephritis is on cyclophosphamide

now in remission. How to monitor that disease is in remission?
.
( low Complement level)

(19)

118. Elderly patient with fever, left lower quadrant pain, peritoneal
signs plus history of constipation.diagnosis.
(
..
(Perforated diverticuli
119. Single blind study means? (Patient does not know)
120. Selection bias (deliberately select good patient for good
result)
121. patient does some pipe workdiagnosis?
(Asbestosis)
122.. 1st post-op day chest x-ray shows patchy infiltrates
(atelectasis). What should have been done before intubation? . .
.
(Clear secretions)
123. Case of post-menopausal bleeding if more than 1 year do
endometrial biopsy
124. Man talks in sleep, gets out of bed, in bed side saying
yallah, comes to doc with wife saying that he was talking in sleep
(saw horse race in dream) diagnosis?
(Nightmares)
125. Interpret the study.cross- sectional, cohort, case-control,
ecology??
126. Which test should be applied for the above mentioned
study? T test? Paired t test? Chi square?
127. Bacterial meningitis. Already on treatment with
ceftriaxone & vancomycin, awaiting microbiology resultsnext
step.
(20)

=>if .no gram VE

stop vancomycine

=>if old age +listeria or HIV Add Ampicillin

128. UTI in young female,treatment???

=>Uncomplicated (cystitis) TMP-SMX(setran) 3days
( Quinolone)
=>Comlicated

=> Pregnancy

Same above for 7-14 days

Nitrourantoin

129. Case of amenorrhea & galactorrheathe medicine which

increases prolactin??
......
.
( Finothyzine)
130. Health care worker with PPD of 16next step?
.
(CXR)
131. Long term Naproxen given for osteoporosisside effect?
.
( Fluid retention => CCF=> Renal failure)
132. Middle age male with nephrotic syndrome, no RBC casts
no hypertension, no hematuria.diagnosis??
( membranous nephropathy)
133.A young man with HTN, joint pain taking thyzoid
diuretic+ NSAID come with hematuria, proteinuria, RBC in urine,
creatinine and urea 30,hypoalbuminea.
(21)

(Membranous G.N.) Adult

Minimal change G.N > in children
Interstitial G.N >Drug induced (hematuria, rash, eosinophilia)
IgA nephropathy >with RIT infection
Focal segmental G.N > I\V drugs abuser

134. TSH normal, multinodular thyroid, one large lobe & others
are small & diffuse. What would u do?
(FNA)if TSH low=>Thyroid scintigraphy
135.Pt;withweakness,abd.pain,arthralgia,myalgia,wt.loss,hyperpig
mentation of skin increase potassium low sodium ,low glucose .
(Addisons Disease)
136.43 years old man complaints of epigestric pain, increase an
amylase.diagnosis?
( acute pancreatitis)
137. Patient found unconscious, deeply jaundiced, AST +, ALT+
GGT+ , Bilirubin increased.diagnosis?
( alcoholic hepatitis)
138. Female with 1.0 x 1.2 cm stone in ureter. What next? (.
(Extracorporeal shock wave lithotripsy)
(22)

140. Patient with low respiratory rate 8/min.what would u

do?? .
(Endotracheal intubation)
141. Female with maculopapular rash under the breast, burning n
pruritic.treatment?
(ketoconazole)
142. Male patient came from Bangladesh trip, now has cord like
erythematous swelling on medial aspect of lower limb above knee.
what would u do?
(Aspirin + warm compression)
143, Ulcers on hands & mouthexposure with sheep/
goat..diagnosis?
Francisella tularemia?
144. Elderly male was fine until yesterday. Then became
aggressive with his grandson, irritable with memory loss
diagnosis??
( UTI)
145.Case of multiple abortion in first and second trimester (
( First=>Septum uterus )( 2nd => cervical incompt)
146. Gastric tumor involved both ovaries.
.
( Krukenberg)
147.25 years old woman with menorrhagia, pupuric rash,gingival
bleeding since last month.Hb:12.5 mg,WBC 6600/platelets 7300/m
(ITP)

(23).

148 .Picture of SLE with butterfly rash on face.

.
(Increase protein and decrease albumin)

149: A 50 years old woman with bleeding PR, lower abd. Pain,
Hemorrhoid (none bleeding) wt. loss. She is refusing PR.
(Colonoscpoy.)
150: Child with single febrile fit .what will you tell mother
.
(Nothing will happen)
151. Juvenile arthritis
.
(Iridocyctitis)
152. Ankylosing Spondylitis
(Anterior Uveitis)
153. Rheumatoid Artheritis
(kertoconjuntivitis Sicca)
154.A child 14 month with irritability, excessive crying after
wake up after few minutes pain free than again crying and pulling
legs towards abdomen .stool mix with blood.
.
( Intussuscption)(Barium(Air) enema )

(24)

155:A 32 years woman with constant neck pain associated

fatigue ,malaise, myalgia, loose stool, felling cold and diffuse
enlarge thyroid ,tender to touch. TSH 1.0 u/ml T3 300 and T4 20.
(RTI)
(Sub acute Granulomaous thyroiditis)
156:A44 years old woman with .9 cm palpable mass non tender in
midline of neck which rise with swallowing .what will do for
diagnosis.
( FNA )
157:A nurse come with palpitation, wt.loss ,heat intolerance,
diffuse enlargement of thyroid .Diffuse Iodine uptake.
( Graves disease)
158:65 years old man history of fatigue, wt:loss past 6 month,
Hepatosplenomegaly ,lymphadenopathy, Hb:8.9,WBC
250000.Perepheral film show ?(CLL)
(lymphocytosis)
159: A 4 years old boy with high grade fever ,cough , nasal
discharge, fatigue, Hepatosplenomegaley and lymphadenopathy
with scattered patechiae peripheral . film show (ALL)
(Lymphoblast more than 25%) bone marrow biopsy
160: 32 years old pregnant lady history of SOB upon climbing up
stairs .Hb 10.5 ,2/6 systolic murmur .
(Normal pregnancy Anemia)

( 25)
161: A vegetarian complaining of weakness ,lethargic, palpitation,
mild dyspnea, pale looking, Hb:8.2microcytic RBC on
film.Diagnosis?
(Serum ferritin level)
162: DM- 1 with pain, swelling, tenderness of right thigh
.Treatment?
(Wound debridement) I&D
163:52 years old man with severe abd: pain vomiting, wt.; loos,
jaundice, pain reliving with forward bending.
(Palpable mass on right hypocodrium with respiration)
( Ca- head pancreas )
164: Post-operative patient is shifted to ward and after 12 hours his
BP 80/55 mm Hg pulse 140beat/min. what is the cause?
(Haemmarrage)
165: 23 years old man with hematemesis, systemic examination
low BP, Tachycardia otherwise stable. management?
(I\V saline push)
166: A patient comes with diarrhea after 7 days course of
Amoxicillin. (Clostridium Deficili) . Management?
(Oral Metronidazole\ oral vancomycin)
167: A case of condyloma acuminata.
( Human papilloma virus)

(26)
168.Differentiate Adrenal gland 0r pituitary origin (Cushing
disease )
(High dexamethasone test)
169: A 24 years old woman come with right lower ab: pain.On abx-rays showing ,Two teeth,
( Teratoma)
170. A patient sifted from OT to ICU after second day, fever,
difficulty in breathing + basal crepts. X- Rays show haziness.
(Physiotherapy and spirometer)
1-2 day >Atelectasis
3- 5 day> UTI,I\V and catheter line
4- 6 >DVT pulmonary embolism
5-7 >Wound infection
(Treatment of post-operative >Early ambulation
172. Pt.; came in ER after fall from camel with loss of
consciousness now he is conscious .After 15 mint again
unconscious. Next (epidural hematoma)
(CT scan)
173. 35 years old lady come with vertigo when lying on left side
and but relived immediately with positional change. Diagosis?
(Benign positional vertigo)>Dix-hallpike maneuvers.

(27)
#Menieres disease >recurrent sever vertigo, hearing loss, ear
fullness and tinnitus lasting in hours & day
(Low Na + diuretics)
#Vestibular or labyrinthitis (acute peripheral vestribulopathy)

(benign positional vertigo)>Dix-hallpike maneuver.

#Menieres disease >recurrent sever vertigo, hearing loss, ear
fullness and tinnitus lasting in hours & day
(Low Na + diuretics)
#Vestibular or labyrinthitis (acute peripheral vestribulopathy)
Acute onset of svere vertigo, head motion intolerance and Gait
unsteadiness+ vomiting & nausea& nystamus or unilateral tinnitus.
( corticosteroids)
174: Young lady throbbing headache>2hours and less than 24
hours. Nausea, photophobia noise sensitivity, relieved with sleep
and darkness. (Migraine)
(NSAID)
( Acute >Triptans)
175: Young male severe pain. Unilateral per orbital headache last
in 30 min and ipsilateral lacrimation& nasal stiffness. Has
repeated attacks.

(28)
( Cluster Headache)
176: Mostly 30 years old lady complaining of tight band like pain
on frontal. Occipital, neck pain, nausea, vomiting or aura .worsen
with stress & improved with relaxation or massage
(Tension Headache)( highO2)
177: 35 years old woman come with sudden onset pain
,weakness of arm ,leg and dizziness + blurring of eyes .(some time
loss of eye site)After some time recover completely. Diagosis?
(Multiple sclerosis)> MRI
178: A child staring into space briefly for 5 to 10 second,
eye,fluttering & lip smacking,(EEG>3H z)
(Absence (petit Mall) seizures) >Eithosuximide

179.

SEIZURES

(1)Partial seizures ;progressive jerking without loss of

consciousness.
(2) Complex seizure >lip smacking with impaired level of
consciousness and followed by confusion.
(3) Tonic-clonic (grand mal) Simple complex +tongue bite+ urine
incontinence (10 Hz)
(4) Status epilepticus> seizure more than 10 min and repeated
without gaining consciousness.
(Start ABC)

(29)
180: An elderly patient with his son, he said that my father is
forgetting everything since last few months, language deficits,
depressed and agitated.
(Alzheimers disease) MRI or CT
(Donepezil, rivastigmine)
181: An old man with resting tremor, rigidity, bradykinesia,
shuffling gate .moon like face. What is Diagnosis?
(Extrapyramidal) (Parkinsons disease)Levodopa & carbidopa
182: An old man with dementia, walking like feet glued to floor
and complains of urine inconstancy.
(Normal Hydrocephalus)
183: A middle age man come with severe right eye pain, blurring
in eye, nausea, vomiting. Pupil is dilated, hard, red eye.
(Closed-Angle Glaucoma) timolol, pilocarpine
184; Loss of sensation on face .which nerve?
(Trigeminal nerve (V)
185: A patient comes with deviation of eye up wards. Which
nerve?
(Trochlear (4Th) nerve)
186: A pt.: come with wrist drop and loss of sensation of dorsal
surface of hand, index and thumb. Nerve
(Radial nerve)

(30)
187: Loss of sensation in little finger .
( Ulner nerve)
188: picture of X- Ray (Hip # of femur of head) 70 years old lady
complain of pain, and cannot walk.
(Hemiarthroplasty)
189: carpal tunnel syndrome (NC study)
190: A young newly married woman with recurrent UTI+
discharge and itching on genital region.
(Levofloxin+metronidazole)
190: A young man with generalized lymphadenopathy, high grade
fever , hepatomegaly .what is next,
(viral load for HIV)
191: pt: with high grade fever +head ach. clinical and
lab:diagnosis is meningitis .what next?
(admission + I\V antibiotics)
192 pt: with high grade fever, cough, tachycardia; X-Rays shows
lower lobe infiltration BP-90\60mmHg.what next?
(admission I\V antibiotics)
193: A 25 years young man with one single supraclavicular lymph
node, red mild tender H\o 10 days back URT infection and was
treated. What is next?
(Follow-up in 2 weeks)

(31)
194: A known case of COPD, DM comes with fever, SOB. Next
(Antibiotics+steroids+B-inhalar)
195: 22 years army soldier smoker for routine examination found
a single -supraclavicular lymph node no active complains .cause
( GI ca)
196: G3P2 previous 2 normal vaginal deliveries with breech
presentation at 38 weeks. She was presented on clinic before 34 &
36 weeks but no action taken. What next?
(External cephalic version)
197: A pt : with Fever ,pain in RUQ, jaundiced and deranged
LFT .Next?
(Ultrasound)
198: a young man with 4 days h\o constipation and bleeding PR,
and hesitating to pass stool. What next? (Fissure in ano)
(Stool softener diet)

199: young pt. present in ER with severe pain in testis and pain
relieved with lifting scortum.
(Epididymo orchitus)
200: A man with RTA an iron rod hurt in his anus to abdomen.
(Emergency laparotomy)

(32)
201; A middle age man come with lower abdominal pain,
constipation, bleeding PR, fever old h\o diverticulosis .what is
diagnosis?
(Diverticulitis)
202: A pt: come with swelling in knee joint there is effusion and
asking for investigation.
(Arthroscopy)
203: A elderly man IHD, HTN, DM, have severe epigestric pain
after a meal; what is diagnosis?
(Mesenteric Ischemia)
204; An old man with severe abd: pain sudden frank bleeding PR.
What is the diagnosis?
(Ruptured diverticula)
205: A male known case of DM, come with diarrhea, postural
dizziness. What is this?
(diabetes complication)
206: Plural fluid analysis: protein>1.8gm,PH> 7.43.diagnosis?
( Hepatic Hydrothorax)
207: A young man with jaundice, and abnormal movements
(CNS).what will your lab finding.
(low ceruloplasmin)

(33)
208: A burn pt: with chest and abdomen ,60 kg wt; fluid in 24
hurs.
(4.3 liter)
209: A young man with h\o RTA ,now bleeding from multiple
sites ,prolong PT,APTT,low platelets. What would you transfuse?
( FFP)
210. A young man RTA with severe head injury .non responsive
,eye opining with maximum stimuli and extensor hand response
(GCS score 5 )
211: A long standing Cushing syndrome pt: .On steroids
replacement since 20 years .Asymptomatic come to with Z-Score
2.2. what is next?
(alendronate ( Bisphosphonate)
212: 8 years boy come with URT infection. labs: HB;5.0 mg, Wbc
5000, platelets 20000. What is diagnosis?
(Aplastic Anemia)
213. A young African , looking pale, lethargic. Lab: HB;9.0,WBc:
9000 otherwise normal. RDW:13 .Diagnosis.
(B- Thalassemia)
214:50 years old man h\o eruption along thoracic dermatomes
.prsent with eye itching and burring; (HPZ )
(flourcin Dye )

(34
215: A young man with polyuria, polydipsia, urine sp:gravity 1.001
with history of RTA. What investigation for diagnosis?
(Water deprivation test for DI)
216. Case of pan hypopituitarism. Which hormone to replace
first?
(cortisol)
217;Case of Cushings syndrome .investigation?
( 24 hours free urine cortisol )
(or evening salivary cortisol)
( overnight low dose dexamethasone )
( after noon ACTH level high )
218: distinguish B\W central DI & Nephrogenic DI.
(DDAVP challenge)
219: case of Acromegaly (insulin like growth factor IGF-1)
(Confirmatory test oral glucose suppression test)
220: SIADH
euvolumic

low Na and high urine osmolality with

(restrict water) demeclocyclin and tolvaptan.

221: radiology picture of skull. PIGETs disease.

(high serum alkaline phosphate with normal Ca &
Phosphate)

(35)

222: Lab report diagnosis for Renal tubular acidosis (RTA)

Urea 16
( High in RTA 4) K 5.5 (or Low in RTA 1 &2)
Cl 115
Hco3 21 ( or low)in RTA 2
(treatment RTA 1 & 2 with Potassium citrate)
PERICARDITIS

LEUKOCORIA

Na 14310: A young man with HTN, joint pain taking thyzoid

diuretic+ NSAID come with hematuria, proteinuria, RBC in urine,
creatinine and urea 30,hypoalbuminea.
(Membranous G.N.) Adult
Minimal change G.N > in children
Interstitial G.N >Drug induced (hematuria, rash, eosinophilia)
IgA nephropathy >with RIT infection
Focal segmental G.N > I\V drugs abuser

( High in RTA 4) K 5.5 (or Low in RTA 1 &2)

Cl 115
Hco3 21 ( or low)in RTA 2
(treatment RTA 1 & 2 with Potassium citrate)