456- 55 y.o Patient k/c smoker only. Presents with signs and symptoms of MI. ECG shows lead II,III,AVF
depression. Hist vitals are: BP: 150/92 Pulse: 99 Which of the following is the most considerable risk factor
for MI in this case?
A. HTN
B. Smoking ✅
C. Age

457- A pregnant woman GA 30 weeks with preterm labour was given a Tocolytic. What is the rationale behind giving tocolytics ?
A- To Delay the delivery until 37 weeks
B- To maximize the effect of steroids
C. To prevent PROM
D.

Answer is: To prolong labor in order to give steroid.

458- Advantages of mediolateral episiotomy over midline episiotomy:
A. Less rectal tear ✅

459- Female found that she have UTI, the patient has penicillin resistance what drug is contraindicated for this patient?

A. Pipracillin tazopactam ✅
B. Cipro
C. Ceftriaxon

460- 45-year-old women medically free with no personal or family history of cancer. Asking about when to to start colon cancer screening?
A- no need for screening for her case
B- Start now and every 5 years
C- Start at 50 years with annual colonoscopy
D- Strat at 50 with annual Fecal occult blood ✅

461- Case of Depressed patient and the doctor will prescribe a drug for her. asking which reuptake inhibitors should be prescribed?
A- DOPA
B- GABA
C- serotonin ✅
D- Acetylcholine

462- Case of saddle PE Sudden SOB and the patient was unstable, BP: 90/50, HR: 120, O2 saturation: 89%. CTA showed massive saddle pulmonary embolism. Which of the following is the most appropriate management?
A- LMWH
B- Aspirin
C- thrombolytic ✅
D- warfarin

463- 4 months year old boy sore throat decreased oral intake can’t swallow solid food has enlarged lymph node. vaccinated up to date. What is the most likely organism ?
A- Hib
B- streptococcus pyrogens ✅
C- Staphylococcus arues
D- pneumococcus

464- case of hyperthyroidism and palpation. What will you do for her as initial management?
A. PTU
B. Methimazole
C. Propranolol ✅

465- Patent with behavioral change and become aggressive and violent?
A. low serotonin ✅
B. high serotonin
C. low endorphin
D. high endorphin

466- Pregnant complain of recurrent stillbirth and positive pregnancy test which vaccine can give her!
A- Rubella
B- Influenza ✅
C- Measles
D- Varicella

467- Old age pt with cardiomegaly. he's asymptomatic
Echo showed: EF 40%
what is the best Mx
A. Lisinopril ✅

468- Patient presented with DVT what regimen to use:
A- Aspirin 61 mg
B- Enoxaparin 40 mg SC
C- Fondaparinux 20 mg
D- Hepatin 10,000 U IV ✅

469- Child came with painfull red swollen hemiscrotum. On examination, mass was palpated with -ve cough impulse. The mass was tender and extended to the inguinal area. Left testes cannot be palpable. Which of the following is the most likely diagnosis?
A- testicular torsion
B- Epidydomorchitis
C- Incarcerated inguinal hernia ✅
D- Testicular appendicular tortion

470- 63 years old male came with rectal bleeding with unintentional weight loss, he was pale, on PE empty rectum and no masses were identified but bleeding with fresh blood was noted. Which of the following is most appropriate next step?
A- proctoscopy
B- colonoscopy ✅
C- UGI Endoscopy
D- fecal occult blood

471- Male patient complains of episode of hematemesis. normal past medical history Labs show mild anemia ,All over labs are normal except elevated urea level in blood?
A-Mallory Weiss syndrome
B-erosive gastritis
C-PUD ✅

472- Female patient using warfarin. What contraception is most appropriate for her?
a) Pop
b) Depoprovira
c) IUCD ✅
d) OCP

473- 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

474- Pt with symptoms of hypothyroidism
Lab shows high TSH then ask how to confirm dx of hypothyroidism?
A) repeat TSH after 4 wks
B) thyroxin level ✅
C) thyroid scan
D) FNA

475- Male k/c of acute pancreatitis came with abdominal pain in RUQ
In US : gallbladder stone and dilated CBD 1.4
What is most appropriate management
A- laparoscopic cholecystectomy
B- ERCP ✅
C- ABx
D- MRCP