SMLE - B

Q : S&S of appendicitis with x-ray imag asking about next step ?? Appendectomy CT abdomin .. ..

Clue cell, clear case about Bacterial Vaginosis

40 years healthy woman with sudden onset right lower limb pain. Her examination reveals intact femoral pulse but absent distal pulses, diminished sensory exam with an altered motor exam. Vital signs normal ECG : atrial fibrillation What is the most appropriate management ? A. Femoral embolectomy B. Above knee amputation C. Catheter-directed thrombolysis D. Heparin and observe

Child can skip draw rectangle and count from 1-10 and recognize the opposite ? A-4 B-5 C 3 D 2

Type of sport recommended for premenstrual syndrome 1. Aerobic ✅ 2. Flexibility and mobility 3. Stability and balance 4. Coordination and agility

75 y.o TIA (fully resolved weakness ) , pt had AFib What to give -no need for Anticoagulation -Warfarin target INR 2-3 ✅ -Warfarin target INR 3-4 -aspirin

75-year-old type 2 diabetic undergoes a bowel resection for colon cancer. He is well priar to the operation with well-controlled diabetes and no other underlying condition. The operation is successful and the patient is given postoperative insulin and IV dextrose. 2 days after the operation he becomes very agitated Na = low K = low Cr = low Serum osm : low Urine osm : normal Which of the following is the most likely cause? A.Water overload ✅ B. Addison's disease C. Diabetic nephropathy D. SIADH

A 40-vear-oid Healthy Primigravida with a history previous deep venous thrombosis Which of the following is the most appropriate management? A. Aspirin B. Heparin C. Enoxaparin D. No anticoagulation

Pregnant pt not high risk dosage of folic acid 1 5 10 15

2- Old male patient with painless hematuria (no mention of right flank pain) no dysuria or history of renal stones Urine analysis only shows RBC Cultures negative ⁃ cystoscopy✅

-A child is admitted to the PICU with a subdural hematoma. The father reports the child fell from his bed. On physical examination, the child has ecchymosis on the buttocks and back and bilateral femoral fractures*?. What's the most likely diagnosis? A. Hematoma B. Pathological fracture C. Battered child syndrome D. Accidental injury

13 months old pt. His mother noticed that he stopped smiling, low activity, fatigue. While examining the pt. he had multiple movements of neck flexion followed by extension of body & limbs lasting for 1-2 seconds in a repetitive pattern. EEG showed slow wave & multifocal spikes (not sure, but it wasn’t hypsarrythmia or chaotic pattern) What’s the diagnosis ? A- Juvenile myoclonic epilepsy B- Infantile spasms (West syndrome) C- Lennox-Gastaut syndrome

A 75-year-old man presents to the Outpa7ent Department, complaining of back pain and increasing difficulty with passing urine (see lab results). PSA WAS HIGH A. Prostatitis B. Prostatic cancer✅ C. Urinary bladder cancer D. Benign prostate hyperplasia

A 22-year-old man presents with altered sensorium for the last 2 days and headaches for 5 days, with a history of fever for the preceding month. On examination, there is nuchal rigidity (see lab results). Test Result Normal Values Hb 100 130-170 g/L WBC 11 4.5-10.5 x 109/L Glucose, fasting 7.22 3.5-6.5 mmol/L Cerebrospinal Fluid: Appearance turbid clear Cells 240 0-3 /uL Total protein 3.6 0.22-0.33 g/L Glucose 2.7 2.50-3.89 mmol/L Neutrophils 23 0-1% Lympocytes 73 0-1% Which of the following is the most likely diagnosis? A. Septicemia B. Tubercular meningitis C. Phylogenic meningitis D. Viral meningoencephalitis

A 33-year-old man presented to the Emergency Department with a 24-hour history of epigastric pain. Physical examination confirmed tenderness in the epigastric area with normal bowel sounds (see lab results and report) Blood pressure 100/60 mmHg Heart rate 110 /min Temperature 37.7 °C Test Result Normal Values WEBC 14 4.5-10.5x 109/L Amylase 223 24-151 IU/L Erect chest x-ray: Free air under diaphragm. Which of the following is the most appropriate next step in management? A. Gastrografin swallow B. Gastroduodenoscopy C. Exploratory laparotomy D. Conservative treatment

♦️hypertensive patient was prescribed Hydralazine 25mg by his physician. Instead he took Hydroxyzine 25mg. Which of the following is the likely type of error? A) Look-a-alike error B) Sound-a-alike error C) Illegal prescription D) Handwriting error

🔆patient give him lipid medication Then he start to have facial edema, flushing and other symptoms then you prescribe aspirin for 3 day and symptoms subside and diabetic on metformin, High cholesterol, high LDL 4.9. And other labs was given What is the medication he took for dyslipidemia cussed this side effect ? A. Rosuvastatin B. Niacin C. Ezetimibe D. Cholestyramin Vaginal discharge with odor and clue cell Pregnant lady, presents to ED with 6 hours complain of clear fluid release for 6 hours pelvic examinaLon shows pooling at the posterior fornix A. ruptured membrane B. Normal vaginal discharge C. Bacterial vagin

Female with crying spells,she feels low and tried, before her menstrual cycle, it also affecting her job, they Advised her to do exercises, which exercise u advise her to do ? A. aerobics B. flexibility and mobility C. Coordination and agility

18y/o female brought by her parents for evaluation of fine hand tremor, O/E there is jaundice and spleen is just palpable below costal margin, Investigations: Serum copper: low Transaminases are high Ceruloplasmin is low Bilirubin is 38 Direct bilirubin is 22 24 hr urine copper is high What is your treatment? A- ursodeoxycholic acid B- Deferoxamine C- D-penicillamine D- Prednisone

Pediatric patient presented with pneumonia he has dermatitis and recurrent infections and small size platelets no mention of bleeding what is the diagnosis  Atopic dermatitis  Wiskot aldrich syndrome✅

14 Apr pt with non insulin dependent DM Come with upper back swelling lesion + multiple opening discharge What is the diagnosis? A.Abcess B.Carbuncle C.Fruncle

2-calculate the i.v fluid for pediatric weight 12kg in all day A-1100 B-1200 C-2000