SMLE team

ظهرت نتايج اكتوبر ٢٠٢٥ برقم الأحقية تقدر تشوف الدرجة لمعرفة الدرجات ( النتيجة + الاداء ) : - https://scfhs.org.sa/ar/ExaminationResult لمعرفة الدرجة بالنسبة المئوية % : - https://scfhs.org.sa/ar/E-Services/weighted_score ربما تتأخر عند البعض وراح تنزل لك خلال الساعات الجايه لاتقلق. و تقدر تفتح ممارس+ ممكن تنزل فيه قبل الرابط.

مساكم الله بالخير كيف امسيتو؟ ابقو على الفايل ده عشره الحمدلله انا امتحنت امس وجاني كثير منه الامتحان عموماً فيه تكرار بالذات في الأوبس والبدياتريك الشويه فيه اسئله جديده او طريقتها مختلفه كان المديسين والسيرجري ماكان كثير بس عموماً الامتحان متوسط ماصعب وماساهل عايز زول مركز وفاهم مش حافظ بس وبالتوفيق ليكم جميعاً ودعواتكم لي بالنجاح 🌹✨

الحمد لله خلصت أول سكشن ميدسن وسيرجري الأمور كانت زي الفل ولله الحمد، الأسئلة مكررة ومعروفة، بس فيه سؤالين جديدين بأراجعهم وأكتبهم أول ما أوصل البيت إن شاء الله. ارتاحوا واطمئنو ❤

A study of colon cancer in a population of 100,000. New cases: 300, Existing cases: 75. What is the cumulative prevalence? A. 0.375% B. 0.45% C. 0.375 per 1000 D. 0.45 per 1000 ⸻ 31 A child presents with febrile seizure. The mother is worried about recurrence and already gives antipyretics. What is the best advice? A. Reassure B. Perform EEG C. Start antipyretics when fever is present D. Educate the family about how to deal with future seizures ⸻ 32 A 7-year-old child presents with upper abdominal pain that wakes him from sleep and subsides when eating. His mother mentions that he has a history of peptic ulcer previously. What is the most diagnostic for the suspected diagnosis? A. EGD with biopsy B. Over-the-counter antacids C. Give PPI D. H. pylori antibiotic prophylaxis ⸻ 33 A 35-week pregnant woman presents with vaginal bleeding. Ultrasound shows placenta previa covering the os completely. She was stabilized, and the bleeding stopped. What is the most appropriate management? A. Induce labor B. Do cesarean section immediately C. Wait until 37 weeks, then do cesarean section D. Wait until 37 weeks for labor ⸻ 34 A female patient is brought by her husband 1 week after delivery with mood swing, tearfulness, irritability, anxiety, and fatigue. She is diagnosed with postpartum blues. What is the treatment? A. Start SSRI B. Family support ⸻ 35 A 5–10-year-old child with stage 4 chronic kidney disease presents with bone pain and elevated parathyroid hormone. What is the expected finding? A. Hypercalcemia B. Hyperphosphatemia C. High vitamin D ⸻ 36 A pediatric patient presents with jaundice and dark urine after a daycare outbreak. What is the most appropriate management? A. Reassurance B. Hydration C. Acyclovir D. Ribavirin

Upper endoscopy reveals a perforated duodenal ulcer, which was surgically repaired and appropriately treated. Which of the following is the most important preventive measure? A. Stop NSAIDs B. Diet with high fiber C. Regular follow-up for gastric health ⸻ 13 A neonate presents with prolonged bleeding after venipuncture and hepatosplenomegaly. The mother has a history of systemic lupus erythematosus (SLE). Labs show thrombocytopenia with normal PT and PTT. What is the next step in management? A. Fresh frozen plasma (FFP) and corticosteroids B. Platelet transfusion and intravenous immunoglobulin (IVIG) ⸻ 14 A patient with meningitis has cerebrospinal fluid findings of slightly low glucose and high lymphocytes. What is the most appropriate treatment? A. Acyclovir B. Steroid C. Meropenem D. Ceftriaxone and vancomycin ⸻ 15 Patient from India presents with symptoms of meningitis. CSF shows low glucose, high protein, and lymphocytic predominance. What is the most likely cause? A. Bacterial meningitis B. Tuberculous meningitis C. Viral meningitis ⸻ 16 A 4-year-old with constipation who is being toilet trained. The mother asks how to prevent it. A. Use more laxatives B. High fiber diet with bran supplements C. Spend more time on the toilet after each meal and maintain adequate fluids ⸻ 17 A 2-month-old boy’s mother noticed his right eye goes inward while feeding. She is concerned. What is the most initial management? A. CT B. Urgent referral to ophthalmology C. Reassure ⸻ 18 A middle-aged man came with a metallic object lodged in his eye. What to do next? A. Referral to ophthalmology B. Removal of object and irrigation C. Outpatient follow-up ⸻ 19 A 55-year-old man with chronic hepatitis C presents with a palpable right upper quadrant mass. CT scan shows a 6×6 cm mass in the right lobe of the liver. Biopsy confirms hepatocellular carcinoma. What is the most appropriate management step? A. Start chemotherapy B. Start radiotherapy C. Referral for palliative medicine D. Referral for surgical resection ⸻ 20 A neonate with meconium aspiration and severe respiratory distress. What to do? A. Masked oxygen B. Intubation ⸻ 21 A child collapses while playing and is brought to the ER. ECG shows SVT. He is unstable. What should be done? A. Adenosine B. Amiodarone C. Cardioversion ⸻ 22 A 9-year-old girl presents with pain between her legs after falling from a bicycle. On exam, a hematoma is noted in the left labia. What is the most appropriate management? A. Ice bag placement B. Prophylactic antibiotics C. Examination under anesthesia D. Surgical evacuation of hematoma ⸻ 23 A 62-year-old woman with atrial fibrillation on warfarin develops a subdural hematoma after a fall. INR = 3.9. She has already received vitamin K. What is the most appropriate next step in management? A. Restart warfarin B. Fresh frozen plasma (FFP) C. Activated factor VII (rFVIIa) D. 4-factor PCC ⸻ 24 A pediatric girl presents with a urinary tract infection (UTI). The mother asks how to prevent recurrence. What is the most important advice? ⸻ 25 A pediatric patient comes with watery diarrhea for 2 days, occurring 6 times/day. Child is vaccinated against rotavirus. What is the causative organism? A. Rotavirus B. Giardiasis C. Shigella D. Norovirus ⸻ 26 A patient with atrial fibrillation presents with sudden severe abdominal pain out of proportion to exam findings. What is the most appropriate investigation? ⸻ 27 Lab findings in Rickets: • PTH: High • Vitamin D: Low • Phosphate: Low • Calcium: Low or low-normal • ALP: High • GGT: Normal ⸻ 28 A 24-hour-old neonate presents with ambiguous genitalia. Labs show: Na low, K high, HCO₃ low, Glucose low, 17-hydroxyprogesterone high. What is the most likely diagnosis? A. 21-hydroxylase deficiency B. 17-hydroxylase deficiency C. 11β-hydroxylase deficiency D. 3β-hydroxysteroid dehydrogenase deficiency ⸻ 29 A 4-year-old presents with acute diarrhea containing blood and mucus. What is the most likely causative agent? A. Rotavirus B. Norovirus C. Campylobacter jejuni ⸻ 30

20 October exam الاختبار اغلبه تجميعات اكتوبر ، الله يوفقنا جميع، كتبت اللي اتذكره عدلوا لي لو احد عنده ريكول افضل 1 A young woman in the childbearing age presents with chronic pelvic pain and heavy menstrual bleeding. {There was a picture of a sagittal view CT scan showed a gray, well-defined circle in the uterus } What is the best next step in management? A. Myomectomy B. Uterine artery ablation C. Oral contraceptive pills (OCP) D. — 2 A 6-year-old child had anuresis during the day and night and chronic constipation. On examination, you found a sacral dimple. What will be the most appropriate next step in management? A. Treat chronic constipation B. Lumbar spine MRI C. Spinal ultrasound D. Urodynamic studies ⸻ 3 A patient after total thyroidectomy presents with numbness around the mouth and peripheral limbs. What is the cause? A. Hypoparathyroidism B. Injury to recurrent laryngeal nerve ⸻ 4 A pregnant woman with a history of five previous C-sections is now pregnant again. She also has diabetes and hypertension for the past 10 years. During this pregnancy, the doctor advised her to undergo tubal ligation (“banding the tube”). What is the most appropriate action? A. Take consent from her alone B. Take consent from both her and the father C. Take consent from her and tell her to inform her husband D. Perform it without consent ⸻ 5 A 6-month-old infant presents with pneumonia, chronic diarrhea, and otitis. Labs show normal T cells but undetectable IgG, IgM, and IgA. What is the most likely diagnosis? A. Severe Combined Immunodeficiency (SCID) B. X-linked (Bruton) Agammaglobulinemia ⸻ 6 A 63-year-old woman presented with exertional dyspnea for 8 months. She was diagnosed with COPD 3 years ago and has had 4 exacerbations in the last year. She completed pulmonary rehabilitation and quit smoking 2 years ago. Medications include long-acting β2 agonist, inhaled glucocorticoid, roflumilast, and albuterol as needed. Examination revealed no jugular venous distention; decreased breath sounds, a loud pulmonary component of S1. • Chest radiograph: Normal • Echocardiogram: EF 60%, no valvular/wall motion abnormalities, mean pulmonary artery pressure 55 mmHg Which of the following is the most appropriate treatment? A. Daily prednisone B. Long-term oxygen therapy C. Overnight pulse oximetry D. Repeat pulmonary rehabilitation ⸻ 7 A 22-year-old woman with a history of multiple sexually transmitted diseases presented at the 37th gestational week for her first antenatal visit. The obstetrician is concerned about this maternal infection which may cause conjunctivitis and blindness in the newborn. Which of the following is the most suitable for health promotion and illness prevention? A. Reassurance B. Azithromycin administration C. Newborn screening after delivery D. Referral to infectious disease clinic ⸻ 8 A pregnant woman is admitted for labor. After continuous pushing, she is now exhausted. The baby is engaged at +2 station and shows minimal variability with late decelerations. What is the most appropriate management? A. Cesarean section B. Operative vaginal delivery C. Reassessing after 1 hour D. Oxytocin ⸻ 9 A patient presented 5 days after an operation with foul-smelling greenish discharge from the surgical wound. What is the most likely responsible organism? A. Staphylococcus aureus B. Streptococcus pyogenes C. Clostridium perfringens D. Pseudomonas aeruginosa ⸻ 10 A woman is currently under follow-up for a molar pregnancy. She wants contraception. Which of the following is the most appropriate option? A. Vaginal ring B. Intrauterine device (IUD) C. Oral contraceptive pills (OCP) ⸻ 11 A child presents with symptoms of celiac disease and has positive anti-tTG IgA and positive anti-endomysial antibody (EMA). Which of the following is considered the definitive diagnostic test? A. No further testing needed B. Duodenal biopsy C. HLA typing D. Repeat serology in 6 months ⸻ 12 An elderly patient presents with epigastric pain.

السلام عليكم اليوم اختبرت ٢٠ اكتوبر جاني سؤال : Iron dose for pregnant women A-1000 B-2000 C-3000 D-4000 جاني كذا بالضبط بدون وحدات

Child have 4 day history of dark urine and jaundice preceded by diarrhea some children in the school have the same thing Her lab has elevated liver enzyme in hundreds Asking about management 1. Rehydration and rest 2. ⁠acyclovir 3. ⁠entecavir Question about patient with bloody nipple discharge 1. Fat necrosis 2. Intraductal papiloma

2 questions about infantile colic One of them the option does not make sense at all except “Simethicone” so i choose it The other one has the “Simethicone” and “reassure” as well so I was not sure which one they want But if i am not mistaken both of them were asking about “initial management” Patient 2 years had watery diarrhea and vomiting fully vaccinated they specify that he also had his rota vaccine and asking about what is the most likely cause 1. Rota 2. ⁠Noro Question about breif jerky movement of one limb it same as the one in the October files but the question not asking about the type of the seizure which is myoclonic they were asking about the management and they listed anti seizures medications in the choices 1. valproic acid 2. phenobarbital 3. ⁠lamotrigine 4. ⁠and something starts with E I forgot There is question saying child diagnosed with “HSP” exactly just saying the abbreviation like this and he have new onset abdominal pain swelling around the ankles (i think bilaterally) and hematourea and protein in urine asking about what is the cause for his presentation 1. Early nephritis due to sle 2. ⁠JIA 3. ⁠it is expected with HSP and it is due systemic vasculitis 4. ⁠something else i cannot recall I am not if this the question or not but i think it is there was a family history of sle Question about Reed-Sternberg cells it was very short scenario and this is the key word in the question 1. AML 2. ⁠Hodgkin lymphoma

The question about febrile seizure consultation choices were 1. There is 2% chance to develop epilepsy 2. ⁠anti epileptic medication daily will reduce the risk 3. ⁠anti pyretic during fever will reduce the risk of future epilepsy 4. ⁠the child will have intellectual disability

Baby in weeks (i think 6) have persistent jaundice, triangular face and butterfly vertebrae what is the diagnosis? The options is so random the only one has “syndrome” in it was “Alagille syndrome” and it is the correct answer

For the 11 years old boy with HTN ge actually was referred from the school because of this issue he also has acanthosis nigricans with family history of both DM and HTN The question asking what is the most appropriate thing to do as part of the initial investigation? choices 1. Renal ultrasound 2. ⁠ambulatory blood pressure monitor 3. ⁠plama renin level 4. ⁠and something i forgot but i think metanephrine level

Pt present 5 day after op with foul smelling greenish discharge from surgical wound What's the responsible organism?? A. staphylococcus aureus B. Streptococcus pyrogenes C. Clostridium perferinges D. Pseudomonas aeruginosa Female pt with SLE was prescriped prednisolone 60 mg for 6 weeks but she continued for extra 6 weeks without taper, Found dead in bathtub What is the Cause? A. Perforated dudenal ulcer B. Hypertensive cerebral hemorrhage C. Acute Cerebral vasculitis D. intestinal ischemia with perforation Pt came with symptoms of ( EOM weakness, vertical nystagmus, reactive meiosis , dysarthria, ataxia) Where is the lesion? A. Basilar B. Anterior cerebral C. Middle cerebral D. Posterior cerebral A couple came to the clinic due to peimary infertility, IVF went successfully but there was excess amount of cryopreserved sperm what to do about it?(not exact citation but same concept) A-keep it for use for indefinite time B-its prohibited ethically and religiosly C-keep it for a specific time frame then ethically discard it D-keep it in a governmental authorized fertility center Preterm neonate ( i think 28 weeks) with respiratory distress, he was on CPAP 6cm for 2 months, when we try to put him on nasal cannula (off of CPAP) the neonate developed monophasic wheeze What the cause?? A- subglottic stenosis B- tracheomalacia secondary to intubation C-Bronchopulomnary dysplasia Hypertensive dyslpidimic Pt with present with 4h resolved slurred speech without other symptoms what is the target of LDL ??? A. Less the 2 B. Less than 2.2 C. Less than 2.5 D. Less than 3 Child with 4 recurrent adenotonsillitis within one academic year, his parents worried bc it affects his school attendance What to do?? A. Immediate tonsillectomy B.prophylactic antibiotics in cold C. Proper washing & respiratory etiquette D. Avoid outdoor activities during cold season Epilepstic mother on lamotrigine , she didn't have a seizure attack since 6 months, didn't have baby with NTD , but her cousin had baby with spina bifida A. 5mg folic acid during pregnancy B. 5 mg folic 3-6 months before pregnancy C. Give aspirin D. Folic acid of 400 micrograms with multivitamins

17-year-old male C/O of anorexia, nausea, and abdominal pain (RLQ). febrile 38.4 rebound tenderness. During open appendectomy. Appendix and cecum normal, terminal ileum edematous and inflamed. Which of the following is the most appropriate next step? Close then colonoscopy Close and Antibiotics Perform appendectomy lleocecal resection

اختبرت اليوم 15/10 ناسيه عمره boy underwent adrenalectomy for a cortisol-secreting adenoma causing Cushing’s syndrome. Which of the following postoperative management plans is most appropriate for this patient? A- IV hydrocortisone and taper gradually B- immediately stop corticosteroid ما اذكر باقي الخيارات

هذي الاسئله اللي جاتني نسخ ولصق من مايو Pediatric patient presented with generalized seizure, hypoglycemia, ketones ?in the urine with characteristic odor. What is the dx .A. Galactosemia .B. Phenylketonuria .C. Maple syrup urine disease D-Fatty acid oxidation defect Mother brought his 9 month child to well baby clinic ,he didn't receive any previous vaccine, his mother believes fact that the vaccine will harm his child, after she read and educated about the benefits of the vaccination then convinced, she told to the physician just give my child the necessary vaccination. Which of the following are the necessary vaccinations to his age 9th month: A) DTaP,BCag B) DTaP, BCG, IPV , OPV C)DTaP, measles, BCG, Hep B, OPV D) DTaP, measles, MCV 4, OPV Mother brought his 9 month child to well baby clinic ,he didn't receive any previous vaccine, his mother believes fact that the vaccine will harm his child, after she read and educated about the benefits of the vaccination then convinced, she told to the physician just give my child the necessary vaccination. Which of the following are the necessary vaccinations to his age 9th month: A) DTaP,BCag B) DTaP, BCG, IPV , OPV C)DTaP, measles, BCG, Hep B, OPV D) DTaP, measles, MCV 4, OPV 10- 5 years old girl came with black circles below both eyes, complains of chronic rhinorrhea and nasal itching darkening under the eyes pale mucosa. What is the most likely diagnosis? A. Allergic rhinitis B. Foreign body C. Ciliary dyskinesia D. rhinitis medicamentosa 16- 67 years old male complaining of painless hematuria , whx is the diagnostic test? A- Cystoscopy B- CT abdomen C- Iv pyelogram D- Us 19- which area in Saudi arabia requires prophylaxis for Dengue fever? A/North B/East C/South D/West Scd patients present with swelling and pain in hand A.cellulite B.dactylitis 30- A man fell from the roof of a 2 story building. He was confused, eyes opening to sound, localizes pain. What is the severity of his brain injury? A-mild B-moderate C-severe D-minimal pregnant with epilepsy controlled by phenytoin delivered 5 days neonate has blood streak in skin and bleeding from umbilicus what is the cause ? A- Vit K B- Sepsis Patient on Day 3 chemotherapy suddenly found arrested code blue done and shifted to the icu what is cause of this sudden event ? A- sepsis B- Arrhythmia C- Pulmonary embolism Case of stoke RT side hemipegia and power 0/5 Left side facial palsy aphasia and he is dominant RT handed and face Anathesia ? A-Rt side MCA B-Left MCA C- Lateral medullary syndrome Diabetic patient came complaining of nausea and vomitting, as well as feeling of epigastric fullness. There was a delay in gastric emptying (glucose levels had a lag from what the projected levels would be after taking his insulin). Best way to Diagnose? A-Endoscopy B-Nuclear scan C-Urea’s breathe test D-Colonoscopy Patient with Thyroglossal cyst diagnosis not mentioned central swelling moves with tongue protrusion what is the treatment? A-Surgical B-Aspiration 63- 36 male presented with hypertension (high blood pressure reading given) he have a family history of hypertension and both his sisters have hypertension He have high creatinine and protein in urine How will you manage? A-ACEI B-alpha blocker C-beta blockerb