272- Patient had a fracture and is being treated, he developed severe pain and swelling, what which of the following signs, indicates the earliest damage?
A- Decrease pulse
B- Parasthesia
C- Discoloration
D- Foot drop

Rectal prolapse Pic.

273- 64 year-old boy, diagnosed with TB. On rifampin. What is the side effect?
A- discoloration in body fluid
B- changing behavior
C- decrease immunity
D-Renal low plt and hg

274- female with small femoral hernia, most appropriate Mx:

A. laproscopic repair
B. simple open remai
C. mesh open repair
D. observation

275- After ERCP for management of obstructive jaundice patient develop abdominal pain and examination reveals distended abdomen with nick, chest, and abdominal emphysema, which one most likely injured during this procedure:
A- esophagus
B- trachea
C- duodenum
D- stomach

276- Elderly hx of DM and HTN , c/o calf pain when he walk 200 meter , which is relieved by rest. What to advice him?
A. aerobic exercise
B. resistance exercise
C. supervised exercise program
D. non supervised exercise program

277- What is the most common site of aspiration of foreign body:
-Trachea
-left main bronchus
-right main bronchus

278- A male patient with Ulcerative colitis had several episodes of diarrhea for 7 days. Not associated with vomiting.
Which of the following is the best fluid to give him ?
A- Half Normal saline
B- Ringers lactate
C- Colloid

279- Full term delivered healthy baby
Which vaccine should be given before discharge :

A- HBV & BCG
B- HBV& DTAP
C- MMR & BCG
D-DTAP & BCG

280- The most common risk factor in prostate cancer:
A- Age

281- Female 27 Years old with abdominal pain, constipation and vomiting fir 4 days, the doctor decided to do Abdominal CT, which of the following test is indicated?
A) CBC
B) Pregnancy test
C) RFT
D) LFT

282- 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

283- Child have dry non purulent conjunctivitis, cracked red lips, erythema (I think trunk, sole, hand) what's the diagnosis?
A- Kawasaki disease
B- Rubella
C- Measles

284- Child with widening of the joints, and delayed walking with numbers exactly like this: Ca 2.2, Phosphate 2.1, ALP 1030, It was exactly like this, no PTH given. What is the most likely diagnosis?
A- Hypophosphatasia
B- Renal osteodystrophy
C- Vit D deficiency rickets
D- Familial hypophosphatemic rickets

285- 25 year old presented to ER after open wound to scalp 6 hour ago.
Which of the following is for his wound management?

A. Secondary suture
B. Leave it to heal by granulation
C. Debridement primary suture
D. Debridement and Leave it to heal by granulation

286- 24y/o male presented after
chemotherapy for the treatment of colorectal cancer what electrolytes
abnormality would you suspect?
A- hypokalemia
B- hypocalcemia
C- hyponatremia
D- hypomagnesemia

Pics:
HSP
CTG early deceleration
Lobar pneumonia

287- Patient was planned to do appendectomy and in the OR the appendix was not inflamed but the surgeon remove it as a common procedure and he didn’t recall if he told the patient or not:
A- ask another surgon to tell the patient
B- tell the patient it as a protocol
C- consult health committee
‎D- don’t tell the patient

288- Patient presented with Greenish -brown colored ring in the Corneoscleral junction. Complain of dysarthria, dyskinesia what is your diagnosis?
A- Hemochromatosis
B- Wilson’s disease
C- hamartoma
D- Autoimmune hepatitis

289- child with pica, pale, low socioeconomic state , low haemoglobin, hand lead was 2 , iron profile was normal, x-ray report dense metaphyseal bands , what is the treatment?
A. vit-K
B. D-penicillamine
C. Iron