399- A 15 month or 18 month child brought to you, he was last reviewed with the primary care
physician and received vaccination when he was 2 months old. Havent received any vaccination
after that. He has had multiple times, upper resptract infection. Now he has come with cough
fever, runny nose, again Uooer respiratory tract infection. Now nbs?
1. Give antibiotics, wait for 10 days and then again start vaccination acording to age.
2. Start vaccination now according to current age.
3. Give the missed vaccination plus start vaccination according to age.

400- A 45-year-old smoker came to the clinic for his diabetes follow-up. During discussion, he acknowledged that smoking is not good for his health. He plans to quit this year. According to the Stages of Change Model, at what stage of change is this patient?
A. Precontemplation
B. Contemplation
C. Preparation
D. Maintenance

401- Pt with UTI (fever,flank pain ) what is absolutes contraindication?
Tazocin
Nitro
Cipro

402- -Child with Down Syndrome and Complaining of Chronic Constipation with decreased inactivity. What Screening Test to Send for the Patient?
A. hypothyroidism (or TFT i forgot)
B. Anti-Tissue Transglutaminase.
C. Stool analysis.

403- preterm labour 27 what is most important mx:
A- Atosiban
B- Abx
C- Steroid
D- Magnesium sulfate

404- Case of 3 years old he has breathing hold, no inspiratory stridor and monophasic wheeze and barking cough ?
A- bronchiolitis
B- Tracheomalacia
C- Laryngomalacia
D- Bronchial asthma

405- Case elderly came with difficulty urinating and history of back pain his psa and alk are high what is the diagnosis?
A- Prostatic cancer
B- BPH

406- Pregnant delivered her baby at home, the baby has onle bruses , what is the dx?
Invst show : normal plte and high pt and ptt
A-Thrombophilia
B-Itp
C-Factor X def
D-Hemorrhagic disease of the newborn

407- Trichomoniasis scenario how to treat the husband?
A- Metronidazole
B- No need

408- Female came with white breast discharge and high prolactin, what radiology you will do?
A- Pelvic MRI
B- Chest MRI
C- Sella turcica MRI

409- Child present with short stature, obese with pink streation which of the following the next step ?
A- MRI brain
B- MRI adrenal
C- morning and night free cortisol

410- 10 YO female patient complaining of chronic rinorrhea , cough , conjunctivitis by PE there was red discoloration around eyes and there puggy pale nasal mucosa what's Ddx?
1.allergic rhinitis
2.ciliary dyskanesia

411- Female patient hx of depression ( symptoms ) complaining of constipation which drug cause this side affect?
1.TCA
2.MAO
3.SSRI

412- A 25 year old female primigravidae just delivered and her blood group is O negative
and her baby blood group is O positive. What is the next appropriate management?
A) No Need for Anti-D
B) Give Anti-D for the mother
C) Inform the parent about the findings/result
D) Give Anti-D to both the mother and the baby

413- Pregnant female presented to the clinic with giant vulvar wart, how would you treat it?

A. Cryotherapy
B. Electrocautery
C. Observation

414- Question about lung nodule size 8mm there was growing of nodule from previous CT scan your management?
1.referal to thoracic surgery
2.neddle aspiration
3.follow up 3-6 m
4. Chest x.ray

Pics:

1-Scenario with a picture asking what is this:
Skin tag

2-CTG picture showing late deceleration, asks about the cause: uteroplacental insufficiency

3-ECG hyperkalemia with a scenario:
Ca Gluconate

4-Spherocytosis pic and a scenario forgot what is the Q

5-Cholasma

6- HSP

415- 47 year obese lady with HTN at your clinic what preventive measures to do?
1. Fasting glucose
2. Pap smear
3. Occult blood
( no mammogram in choices )

416- Female patient had Pressure and heaviness pain , cycle severe menorrhagia what is the most likely the location of the fibroid?
A. Submucosal
B. Intramural

417- 4-year-old boy came with midshaft femoral fracture. With 30 degree angulation. Which of the following is the most appropriate management?
A- pavlik harness
B- Closed reduction with hip spica
C- Open reduction with IMN
D- Open reduction with fixed plate