SMLE - B

اختباري كان اليوم في مركز سلطنة عمان كل مااتذكر سؤال بكتب 1-70 years old woman ,sexually active,hysterectomy done before,and she complains of prolapse and enlarged vaginal openini what is the appropriate procedure? A-vaginal pessary B-sacrospinous fixation 2-

A 39-year-old G6 P5005 Is seen in the Antenatal Clinic for routine check-up at 22 weeks of gestation. Her blood pressure found to be 140/90 mmH and no proteinuria. Which of the following is the most appropriate treatment? A. Methyldopa B. Verapamil C. Nifedipine D. Hydralazine

A 10-year-old boy presents to the clinic complaining of abdominal pain, frequent diarrhoea that is some7mes bloody, and pain usually accompanying defeca7on. His mother observed that he has lost weight over the last 3 months since the onset of the problem. The boy also has aches and pains of his joints. On examina7on, he looks ill, pale, with a so\ abdomen, no tenderness or organomegaly (see lab resuits). Blood pressure 110/70 mm Heart rate 100 /min Respiratory rate 16 /min Temperature 38.6° C Test Result Normal Values Sodium 132 134-146 mmol/L Potassium 3.2 3.5-5.1 mmol/L Crea7nine 31 27-62 mol/L Blood urea nitrogen 5.6 1.8 to 6.4 mmol/L Н6 82 112-165 g/L C-reactive pep7de 1.1 0-0.5 mg/di Albumin 32 36-52 g/L Which of the following is the most likely diagnosis? A. Celiac disease B. Crohn's disease C. Ulcerative coli7s D. Chronic dysentery

An 18-year-old man presented to the Emergency Room with bleeding from a deep 10 cm anterior laceration of his right thigh. Which of the following is the most appropriate next step? A. Apply tourniquet B. Call a vascular surgeon C. Put direct pressure on the wound D. Put pressure on the femoral artery above the wound

A 23-year-old woman with systemic lupus erythematosus (SLE) presented to the clinic with a 3- month history of lower-extremity swelling and shortness of breath. She has not had chest pain, palpitations, or fevers. On physical examination, she has jugular venous distention and engorgement with inspiration. Heart sounds are distant; a prominent early diastolic sound without gallops or murmurs is heard. Breath sounds are normal. Abdominal examination reveals shifting dullness. Pitting edema to the level of the knees is noted (see lab results). Blood pressure 110/70 mmHg Heart rate 95 /min Respiratory rate 25 /min Temperature 36.6 °C Oxygen saturation 90 % Test Result Normal Values Hb 90 130-170 g/L (Male) 120-160 g/L (Female) Platelets count 450 150-400 x 109/L WBC 3 4.5-10.5 x 109/L Creatinine 150 44-115 mol/L Albumin 28 34-56 g/L Complement C3 0.5 0.7-1.5 g/. Complement C4 0.1 0.15-0,45 g/L. Aspartate aminotransferase 100 12-40 IU/L Alanine aminotransferase 94 5-40 IU/L Which of the following SLE association most likely explains the current condition? A. Constrictive pericarditis B. Myocardial infarction C. Liver failure D. Renal failure

A 65-year--Old man known to have COPD presented to the Emergency Department with increasing dyspnea. cough, expectoration, and fever. Initial assessment revealed fully conscious patient with mild distress, central cyanosis and bilateral wheezing on chest auscultation. The patient was started on high flow oxygen and salbutamol nebulizer bull 1 hour later, his level of consciousness Is reduced (see lab results) Test Result Normal Values ABG HC03- 36 22-28 mmol/L ABG PCO2 9 4.7-6.0 kPa pH 7.18 7.36,7.45 ABG PO2 15 10.6-14.2 kPa Which of the following is the best initial step in management? a. Start mechanical ventilation b. Reduce oxygen flow c. Order brain CT scan d. Give naloxone

Young male previously healthy presented with pneumonia with x ray showing lower lobe infiltration, vitally stable and culture is pending, which antibiotic do you want to start him? A- Moxifloxacin 400 mg IV once B- Cefatzdime 1 Gm IV every 8 hrs C- Meropenem 1 Gm IV every 8 hrs D- Pipracillin-Tazobactam 40mg oral

A 12 or 10 year old boy came for routine checkup and says he is taller than his classmates and has hyperextensibility of joints. Height was mentioned I think 1.78m. Systemic exam is normal What is likely diagnosis? Marfan syndrome Ehlers Danlos Sydnrome Klinefelter Syndrome

A 57 yo female diagnosed with PE, Which of the following will be an indication for thrombophilia testing? A-Age >55 B-On OCP C-Hx of connective tissue disease D-Negative family hx of coagulopathy

A male worked in military training, and he had hard training. He presents with oliguria and is diagnosed with renal failure. “What indicates acute kidney injury by hypovolemia? A. Fractional excretion of sodium > 2% B. Bun/Cr >20% C-Urine osmolarity <350 D. Presence of red fragmented cell in urine

A patient post thyroidectomy was unable to maintain a high-pitched voice. Which of the following is the injured nerve? A. Superior laryngeal B. Inferior laryngeal C. Recurrent laryngeal D. External laryngeal.

Primagravida about 9 weeks pregnant (not sure but early pregnancy) positive home pregnancy test, came with complaints of scanty blood and contractions. US showed intrauterine sac with normal fetal heart beat Next action? A- pelvic exam B- US to check placental placement C- bed rest

Pt with pharyngitis for 2 days, what is the possible complication and on examination their exudates, which of the following is a likely complication? A. Scarlet fever B. Glomerulonephritis C. Rhuematic fever D. Meningitis

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

Case of trauma with pelvic/lower abdominal pain, patient is stable, no sign of obvious external bleeding. What is the appropriate initial investigation? ⁃ pelvic x ray ⁃ Pelvic MRI without contrast ⁃ Pelvic CT without contrast ⁃ Retrograde urethrogram (no mention of blood in meatus in the scenario)

A 56-year-old nulliparous and menopaused for 4 years, presented to the clinic with intermitent vaginal bleeding for the last 4 weeks. The bleeding was scanty and bright in color. Pelvic examinaton shows healthy vagina and cervix with a small amount of blood in the cervical os. Which of the following is the next step in management? A. No treatment necessary B. Dilaton and curetage C. Endometrial biopsy D. Pelvic ultrasound

Case about Patient with RUQ pain …..etc , improved after 3 days of admission , US shows multiple gall bladder stones and mild dilation of extrahepatic duct , mx ? A- cholecystectomy before discharge B- ERCP

Pt did a right inguinal repair 2 months ago, now presenting with shrunkun right testicle, what is cause? - testicular artery ligation - thrombosis of pampinoform plexus - tight ex ring of inguinal canal

12-year-old boy presents to the Emergency Department after a fall that led to a supra-condylar fracture. Presently his distal pulses are not palpable. Blood pressure 110/70 mmHg Heart rate 120 /min Which of the following is the most appropriate management? A. Early K-wire B- expolartion

Case of patient with pneumonia admitted to ICU, what is the best empiric ABx Vancomycin Ceftrixone Azithromycin

Patient with mutiple blood pressure reading 155/88, with hyperlipidemia controlled on statin, BMI 31. Now BP is 148/86 what you will do? A. Give antihypertensive B. Life style modification and weight loss

asthmatic woman .... What indicate severe asthma in this patient: A. Peak flow rate 200 liter/minutes B. Respiratory rate > 20 C. O sat <90% D. Cannot complete one sentence in one breath

female patient in an emergency and the doctor is busy or at a different place. What is the most appropriate order can doctor make over the phone? 1. Pethidine 2. Paracetamol 3. Total parental nutrition

Pregnant in first trimester, physiological changes during first trimester? A- increased 20-25% blood volume B- increased 40-45% blood volume C- increased 60% blood volume

A 57-year-old man presents with 2 days of abdominal pain, nausea, and vomiting Examination revealed a distended, tympanic and mildly tender abdomen without rebound or guarding Hb: 15 WBC: 12 X-ray: Multiple air-fluid leveis. CT scan: Multiple dilated loops of small bowel with a transition point in the distal small bowel, with some adjacent mesenteric fat stranding Which of the following Is the most appropriate next step in management? A. Observation B. Colonoscopy C. Diagnostic laparoscopy D. Exploratory laparotomy

اللي اختبروا اليوم او يتذكر صيغ افضل او اسئلة جديدة يرسل وبالتوفيق للجميع April question: اللي اختبروا ارسلوا الاسئلة في اختباركم او وصلتكم خاص @smle_b - Send the Qs that u remembered private @@smle_b

6wks newborn full term Known case of G6PD presenting for follow up no complains Hgb low - Billirubin normal THIS IS THE ONLY LAB PROVIDED >NO MCV < What type of anemia? A- Hemolytic anemia B- physiological anemia C- iron deficiency anemia D-Anemia of chronic disease

Heart failure and atrial fibrillation what is he best rate control medication Digoxin Bisiprolol Amlodipine Lidocaine

6 months old baby known case of G6PD came to hospital, on examination there is pallor conjunctive No mention of jaundice In labs HGb was only low There was no mention of reticulocyte No mention of iron profile Others labs was normal Diagnosis: A- physiological anemia of newborn B- thalasemia trait C- G6PD hemolysis

Elderly pt, Dm, HTn, IHD, present with leg pain and absent doralis Pedis pulse, ankle brachial index 0.3 CTA show 3cm popliteal artery oclusion, appropriate mange? - amputation -thromboemboliectomy -heparin

Young female with oval shaped mass, slowly increase in size over year, painless, freely mobile, not related to cycle dx? A-fibroadenoma, B-Phylloid

9 month Baby come with abdominal distension and ribbon of stool. He passed meconium at the second day of life Best tett : • a. X-ray • b. biopsy • c. rectal manometer D-Endoscopy

Or Man who experienced a road traffic accident (RTA), had a lucid interval, and then lost consciousness, with a convex lesion found on CT scan, what is the most appropriate management? A- Shunt B- Craniotomy C- Mannitol D- Intubation

اللي اختبروا اليوم او يتذكر صيغ افضل او اسئلة جديدة يرسل وبالتوفيق للجميع April question: اللي اختبروا ارسلوا الاسئلة في اختباركم او وصلتكم خاص @smle_b - Send the Qs that u remembered private @@smle_b

السلام عليكم ورحمه الله وبركاته أنا امتحنت يوم 4/4 جاني السؤال هذا واحسبه جديد Patient with symptoms and signs of COPD.The patient is already on Inhaled Ventolin and Ipratopium,not improved CT:diffuse lung emphysematous change,what is the next most appropriate treatment: A.Ihaled corticosteroid B.Inhaled long acting beta agonist C.lung reduction therapy D.long term oxygen therapy

Management of -ve cocobaciili (age not mentioned) a-Cipro b-Azithro c-Cefuroxime d-Dexamethasone

Eldery female came with AUB, asking for contraception ? A-Mirena iud B-Combined OCP C-Progestin only

A 33-year-old women presents with history of right upper quadrant pain and yellow sclera. Examination reveals unwell patent with abdominal tenderness but no guarding (see lab results and report). Test Result Normal Values Total bilirubin 30 3.5-16.5 mol/L WBC 15 4.5-10.5 x 109/L Alkaline phosphatase 280 39-117 IU/L Ultrasound of Abdomen: Multiple gallstone, no pericholecystic fluid, common bile duct is dilated and measures 1 cm. Which is the following is most likely diagnosis? A. Acute pancreatts B. Acute chioecystts C. Choledocholithiasis D. Ascending cholangits

Y.O. male patient post prosthetic aortic valve replacement 7 days ago presented with history of fever for 3 days. He was diagnosed with infective endocarditis. What is the most likely causative organism? A. Staph epidermis B. Strep viridians C. Staph aureus

35yo Female with RT bloody/or green nipple discharge mamo negative, us shows bilateral duct dilation and something on Rt breast ddx(IDP,duct ectasia etc..) next? A-duct excision B-core needle biopsy C-galactography D-mastectomy