368- Schizophrenia patient who took neuroleptic medication for her psychosis.
Which of the following is side effect of her medication?

A. Sizure
B. Akathisia
C. Hyperthermia
D. Myocardial Infraction

369- 25 yo medically free 38 GA , SVD = CTG: fetus heart rate 180 + early deceleration , what may lead to CS?
1- fetal HR
2- early deceleration
3- patient age

370- female patient k/c Renal failure + DM+ HTN, complaining of chest pain and SOB
Lab: potassium 6 , what expected ECG changes ?
1- peaked T wave
2- peaked P wave
3- short PR interval
4- narrow QRS

371- long scénario with ABG : PH 7.55 , HCO3 43, PaCO2 22, PaO2 92..?
1- uncompensated metabolic alkalosis
2- both metabolic and respiratory alkalosis
3- respiratory alkalosis with compensated metabolic
4- metabolic alkalosis with compensated respiratory

372- 54 YO female medically free came to the clinic for routine checkup. Her cardiac examination revealed grade 4 pansystolic murmur heard best at the apex and radiate to the axilla. She is symptomatic and the rest of her examination is normal. What is the best next step to confirm the diagnosis?
A. Transthoracic Echo
B. Transesophageal Echo

Pics:
ECG
CTG
blood film
moro reflex

373- esophageal varices to prevent future recurrence/bleeding?
BB
H2
PPi
No need

374- MI ecg in lead v5-6
Anterior
Posterior
Lateral

375- Case of child use Rifampicin ask about side effect? Discoloration

376- 6 week old infant presented with forceful vomiting, baby is is born full term to a 23 YO primigravida uneventful pregnancy with normal vaginal delivery, on examination no congenital anomalies were noted what is the most likely diagnosis
A) duodenal atresia
B) necrotising Enterocolitis
C) Hirschsprung's
D) pyloric stenosis

377- 56 Y.O male patient known to have an allergy to penicillin and sulfa antibiotics presented with UTI. Which antibiotic is most appropriate?
A. Nitrofurantoin.
B. Trimethoprim/ sulfamethoxazole.
C. Ampicillin.
D. Cephalexin.

378- 27 Y.O with history of confusion for 2 days and seizure for 5 hours. He is not oriented to time, place and person. He has history of unprotected sex for 6 years. Serum cryptococcal antigen positive, what is the most appropriate next step?
A. HIV serology.
B. SF Toxoplasmosis testing.
C. CSF Syphilis serology.
D. Herpes simplex testing

379- 25-year-old female known case of epilepsy came with generalized tonic clonic seizure for 35 minutes and started on 20 mg IV lorazepam but did not respond, what are you going to give her next?
A- IV Phenytoin
B- IV Phenobarbital
C- IV Steroid
D- IV Fentanyl

380- Case for baby have before eczema and lesions described in Q ( Honeycrusted on mouth )
What the organism cause it ?
A- S.aures
B- Streptoo. Group A
C- Varicella
D- Coxsaki A virus

Osteoarthritis.

381- 70-year-old male K/C of HTN with progressive decline in cognitive state, MRI showed Periventricular white matter Hyperintensities, what is the diagnosis?
A- Vascular dementia
B- Alzheimer disease

نفس هذا بس مغيرين قايلين
Gradually decline in cognitive state

382- Case about child with UTI
What makes you suspect UTI?
A. fever.
B. leukocyte
C. nitrite

383- sjogren syndrome which type of RTA: + Labs: Shows low K Normal Na
A. RTA l
B. RTA II
C. RTA II
D. RTA IV

384- 43YO male known case of hepatitis B infection presented with fever and confusion, examination reveled disorientation, asteraxis and positive shifting dulness
Ascetic fluid analysis:
SAAG= 1.2
Neutrophils= 350 or 320
Culture bending
What is the most appropriate treatment?
A- IV diuretics and metronidazole
B- Lactulose enema and IV Ceftriaxone
C- High ascetic fluid aspiration and propranolol

385- male had type 1 DM and his family best time to start celiac screening. Which of the following is the best advice?
A. Screen at diagnosis then every 5 years.
B. Screen at diagnosis then every 2 years.
C. Screen annually. later o n every 3 tears.
D. No need for screening.