SLE March 2009

1-mother come to ypu complaining of that her child not use his right arm
to take things from her and he keeps his arm in pronation position and
fisted , Ho you ill sol!e this orthopedic proplem "
1# orthopedic referral for possi$le surgical correction
2# rapid supponation of forarm


2-child ith positi!e goer sign hich is most diagnostic test " muscle
$iopsy
pregnant , ith history of %&' ( years $ack ) hat ill you gi!e her "
1# aspirin
2# clopidogril
*# LM+ heparin
female pt come ith generali,ed a$dominal pain $y e-amination you
faound suprapupic tenderness , $y .& e-amination there is 'enderness
in mo!ing cer!i- and tender adne-ia diagnosis is " pel!ic inflamatory
disease
*- pt female (* years old , as healthy $efore , in the pre!ious * month
there is spotting of $lood that last for 2 days and stop hat you ill do
for her
1. endometrial $iopsy
2. 'SH le!el
3. prolactin le!el
4. urine pregnancy test

(-young man come ith headach he is discri$ing that this
headach isthe orst headach in his life hat of the folloing ill
$e less helpful "
1# /sking more details a$out headach
2# do M01 or 2' scan
*# skull - ray
(# L.
3-lady come to you complaining that she enter the hom of her grand
father4old man 5 and she found that the things are not in its place and
there is decrease of his memory $ut his personality intact 2' $rain and
all immaging are normal hat you ill suspect "
1# /l,ehimer disease
2. multi infarct dementia
6-7 pt younge female has osteoporosis gi!inng history of dietary ha$it
lo in calcium and !it % Ho you ill manage her " gi!e her !it % and ca
supplement
8-7 'reatment of pt ith yelloish !aginal discharge and itchy $y sa$
and cultur it is 'richomonas !aginalishich of the folloing is correct "
1# start treatment ith metronida,ol
2# start treatment ith clindamycin
*# no need to treat hus$and
4. !aginal sa$ culture after 2 eeks
9-pt come complaining of ptosis diplopia dysphagia hat in!estigation
you ill do for him " anti$odies to acetyl cholin receptors
9-pt gi!e history of malaise fatige and gi!e history of decrease meat in
her diet ,h$ as 9 and hypochromic microcytic anaemia hatyou ill
gi!e her "
1# 'rail of iron therapy
2. iron and multi!itamin
10-7 pt come to you ith pain in posterior of neck and accipital area , no
affection of !esion , $y cer!ical - ray there ere decrease of :oint
space " hat is your diagnosis " cr!ical spondylosis
11-child $rought $y mother due to $leeding per nose , $y e-amination
you found many $ruises in his $ody ,o!er his $ack ,a$domen and thigh ,
hat is your diagnosis " a$use
12-pt come to you for check up he has %M his $lood sugar is ell
controled ,$ut his ;. is 1*9<96 ,all other physical e-amination sho no
a$normality including neurological e-amination ,he is folloing
regularly in ophthalmology clinic , +hat youill put in your plan to
manage this pt " =i!ing /2E inhi$itor
1*-7pt ith hyperkalemia hat a$normality you ill see in E2= " peaked
' a!e
1(-man change his :o$ , he must in ne :o$ to talk in front of 30 persons
, he feels that he can not do this and he send his frind to do that in stead
of him ho can you help him
1# prpranolol
2. ;iofeed$ack
13-;oy12 years old come to you complaining of that he orries a$out
himself $ecause he see that his frinds has a-illary hair andhe is not like
them , a$out se-ual maturity of $oys hat is first feature "
1# testicular enlargement
2# penile elongation
*# hair in a-illa
(# hair in the pupic area
16-come ith precordeal pain E2= S' segment ele!ation pt gi!en
aspirin and nitrate , $ut no relei!e of pain hat ne-t step you ill do "
gi!e morphin 1&
18-7 pt female gi!ing historry of menorrhagia since last * month ,her H;
> 9 ,+hat is the first action to do "
1# endometrial $iopsy
2. hospitali,ation for $lood transfusion
19-old lady 4305 gi!ing history of 4postmenopausal symptoms5 , hot
flushes$est drug to reduce these symptom is "
1# estrogen only
2# progestron only
*# com$ined pills 4estrogen and progesteron 5

19-.0E=?/?' L/%@ =1&1?= H1S'A0@ AB 1?20E/SE% ;A%@ +E1=H'
/;AC' * D= B0AM 'HE L/S' &1S1' /?% LA+E0 L1M; E%EM/ 'A
2A?BE0M 'H/' SHE H/% .0EE2L/M.S1/ " ME/SC01?= ;.
20-pregnant lady 4g1p0541* eek5 she looks ane-ious ,$ut she is happy
a$out her pregnancy her $lood pressur is 1(2<96 she do e-ercise (-3
times < eek she denies that she has any pre!ious medical pro$lem "
hat is diagnosis"
1# pre echlampsia
2# pregnancy induced hypertension
3. chronic hypertension
21-.t has car accident hich of the folloing trauma you ill hapen to
him "
1# tamponade of the heart
2# flial chest
*# pneumothora-
(# all of the a$o!e

22-pt come ith trauma of the chest, on inspection you found one
segment ithdron inside in inspiration and go out side during
e-piration " hat you suspect " Blial chest
2*-Lactating mother has mastitis in outer upper segment in left $reast,
hat is $est mangement "
1# stop $reast feading from that side and e!acuate milk $y sucktion
pump
2. continue $reast feeding from that side ith anti$iotics and local
heat application
2(-7 $est treatment of acut cystitis "
1#ciproflo-acin
2# norflo-acin
*# Erythromycin
23-'he in!estigation of high sensiti!ity and specificity of urolithiasis "
1# 1&.
2# E 0/@ a$domen
*# CS
(# M01
3# nuclear scanF<LEB'
26-7 pt come to E0 ith eak rapid puls , hat to do "
1# gi!e him 2 $reath
2# do 2.0 42$reath < *0 compression5#
*#ait until team of resuscitation come

28-7 ptith acute a$domen you ill find "
1# rapid shallo $reath
2# rapid prolomged $reath

29-most common side effect of atropine "
1# $rady cardia
2# dryness of mouth

29-pt come ith meta$olic acidosis ,she take drug o!erdose of hich of
the folloing " salicylate




*0-a$out hepatitis $ !accination scheduling for adult
*1-a$out " female patint came ith se!er !aginal $leedind
hat is the approptiate initial managementGG

HIJK LMN $lood transfusion
*2-child present 4picture of duschene muscular dystrophy

HIJK LMN muscle $iopsy
**-drug that cause meta$olic acidosis 4anion ga$ >19
aspirin
*(-the Ouestion as hich of the folloing does not co-relate ith the
finding of hyperkalemia
and the options ere
1-.eaked ' a!e
2-$road 70S comple-
*-increased .-0 inter!al
(-Sign a!e pattern
3-a$sent . a!e
*3-another Ouestion pt ith hypertension $y fundoscopy there is
cupping of optic disc , hat ill you suspect "
1# hypertensi!e retinopathy
2# open angle glaucoma
3. angle clousure glucoma
*6-+hat of the folloing ill not help you in diagnosis of multiple
sclerosis
1# !isual e!oked potential
2# 2' scan
*# L.
4. M01
*8-Most common cause of chronic hypertension "
1# %M
2# Hypertension
3. interstitial renal disease
*9-.t 19 months old $oy , ith history of current :elly stool diagnosis "
intussusseption


*9-another Ouestion " female 1* years old , come complaining of mass in
her left $reast in loer outer Ouadrant , it is soft tender a$out 2cm in
si,e , pt denies its aggre!ation and relea!ing $y special condition her
menarch is as age of 12 , hat is diagnosis " 1-Bi$roadenoma
2- Bi$rocystic disease
another Ouestion " pt has serious disease ho ypu ill conduct this $ad
nes for him "
1# gi!e him clues that he has serious disease
2# 'o ask him ho much he kno a$out disease
*# till him immediatly that and go aay t
4. ?ot to till him

(0-/nother Ouestion , .t ith dis phagia ,ptosis ,diplopia hat
in!estigation you ill ask " anticholeinesterase anti$odies

(1-pt 62 years old female complaining of pruritis of pupic area , ith
$loody discharge she use many treatment $ut no impro!ement , then
she de!elope pea shape mass in her la$ia , she ent to you to sho you
this mass hat ill come to your mind as diagnosis " 1# ;artholin cyst
2# ;artholin gland carcinoma
*# ;artholin gland a$cess

(2-years old male come to you complaining of discomfort in anal area ,
constrictino of anal sphinctor , spots of fresh $right red $lood after
defication , $lood staining on toilet paper after using it you ill suspect "
hemorrhoids
(*-i thnk also a$out anal fissure $ut in 7 no pain and also in the choices
no anal fissure also the spots of fresh $lood come at end of defication
hich is more ith hemmorrhoids $ut in anal fissure $lood ill apear as
streak on the stool
((-pregnant 429 eek 5 she sit ith child , this child de!elop
chickenpo- , she come to you asking for ad!ice , you found that she is
seronegati!e for 4!aricella5 anti$ody , hat ill $e your management "
gi!e her4&P1=5 !aricella ,oster immunoglo$ulin
gi!e her acyclo!ir
gi!e her !aricella !accin
ait until symptom apear in her
(3-pt *2 years old come to you orries a$out one of his moles , gi!ing
history that his father had moles , e-cisional $iopsy done to him $ut
no he has metastasis in lungs , $ones and li!er , hat ill come to
your mind a$out malignant change of mole "
irregular $order
presence of thim in the thigh
omogenous colour
(6-- female pt diagnosed as polymialgia rheumatica , hat you ill find
in clinical picture to support this diagnosis "
osteophyte in :oint radiograph
tenderness of pro-imal muscle
eakness of pro-imal muscle

(8- (0 years old male come to you complaining of sudden :oint selling ,
no history of trauma , no history of chronic diseas hat is the
in!estigation you ill ask "
2;2
ES0
M01 of knee :oint
rheumatoid factor
(9-pregnant ith hyperthyroidism hat you ill gi!e her "
propylthiuouracil
0adioacti!e iodine