597- Rectocele pic with case: lady complains of pain and leakage of mucus, what’s the dx?
A- rectocele ✅
B- hemorrhoids

598- Ctg pic with case: Pregnant lady,41 GA in labor on epidural analgesia, mg sulfate for pre-eclampsia and oxytocin, CTG showed prolonged deceleration and the mother was hypotensive, most likely cause of the CTG finding:
A. Mg sulfate
B. Oxytocin
C. Epidural analgesia ✅

-Chancroid pic
- p. Falciparum pic
-Open fracture
-Fibroids
-Bacterial vaginosis
-Svt
-Down syndrome
-Malaria
-mulloscum contagiousm
- failure to thrive
- IDA

599- Female 20 years recently develop mass 2x2 cm that is oval in shape and smooth wall. what is your Dx?
A - breast cyst
B- fibroadenoma ✅
C - fibrocystic cancer
D - intraductal carcinoma

600- Came from india RUQ pain, intermittent fever, jaundice.
Imagaing: Single Hypo-echoic homogenous mass.
A- Amoebic abscess ✅

601- Patient after cholangitis intervention with the following WBCs 9, RR 18, HR 80 (exactly 80 not 90), normal BP, Temp: 38 exactly 38). What is the cause:
- sepsis
- SIRS
- bactermia ✅
- septic shock

602- Typical case on nephrotic syndrome, ask about highly diagnostic test ( no renal biopsy )
A. Serum albumin
B. US
C. Urine total protein ✅
D. Electrolytes

603- 23 y/o pregnant women came to antenatal clinic with hx of 2 preterm birth C/O vaginal spotting of blood , which of the following recommended tx ?
A. Progesterone ✅
B. Estrogen
C. Indomethacin
D. MgSo4

604- 62. Male pt complain of recurrent heartburn increase when lay down at night, he felt a bitter taste in his mouth when he was lifting weight at gym, diagnosis?
A. Esophagitis ✅
B- PUD
B. Gastritis
C. Boerhaave syndrome

605- Case of back pain and the diagnosis was written (Lumbar Spinal stenosis). What is the first step in management?
A. Lumbar laminectomy
B. Physiotherapy ✅
C. Epidural analgesia

606- Spherocytosis picture
Osmotic fragility ✅
( No EMA in choices ).

607- 418- Mom came to pediatrion with exclusef breast feeding and doctor advise iron advise next month. age of baby now?
A.1
B.2
C.3 ✅

608- 76 male reducible inguinal hernia with moderate pain. Mx?
A- Open with mesh ✅
B- simple repair
C- Non- surgical procedure

609- Malaria Tx:
Artemensisin combination ✅

610- Child fever knee pain Refuse to touch. Most important investigation:
A- Joint aspiration ✅

611- male hemangioma 4x4
A- Avoid excessive sport ✅

612- High velocity trauma, pt hypotensive despite giving IV fluids.
X-ray showed open book fracture.
What is the most appropriate next step?
A. Pelvic binder ✅

613- RTA. Shifted trachea. GCS 15/15 BP 90/70:
A- Needle decompression ✅

614- An elderly man with a case of HF came with dyspnea, palpitation. He is on captopril. He was started on furosemide and symptoms got better. What should be added next for this patient
A. Digoxin
B. Carvedilol ✅
C. Amlodipine
D. Cant remember

615-29 yo female presented with severe epigastric pain radiating to the back she’s had sleeve gastrectomy 3 months ago. Physical examination revealed epigastric tenderness. Lab, Amylase high. Stable vitals USG was negative for biliary stones but positive sludge and normal biliary ducts. Most appropriate next step?
A- Ultrasound endoscopy
B- Something and pyloromyotomy
C- Lap Cholecystectomy ✅
D- Percutaneous Cholecystostomy