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

100- Pt after fell down from hight present with open fracture and dirty , what the most appropriate next step in the management ?
A- oral antibiotic
B- open fixation
C- surgical debridement
D- external fixation

101- Pt known case of dm , discharged after inguinal hernia repair, what it is your advise to him ?
A) Abdominal plinder
B ) avoid lifting heavy objects for 6 months
C) laxitive or frusimode i cant remember

102- Which one of the following indicates Rheumatoid arthritis in pleural effusions?
A- ph >7.6
B- Glucose <1mmol
C- Transudative

103- which of the following is more specific for SLE
A.Anti-dsDNA
B.Anti-Smith
C. AntiCCP

104- An 81 year old male presenting with memory loss and difficulty remembering grandsons name, medically free apart from occasional alcohol intake. What is the likely diagnosis of his presentation?
A) MultiInfract Dementia
B) Alzahimers Disease
C) Alcohol Induced encephalopathy
D) Parkinsonism with Dementia

105- Patient present with “ring in his eyes” what is most likely diagnosis
A. Wilson's Disease
B. Hemochromatosis

106- Child with Supracondylar fracture, he has absent pulse, Next step?
A, K-wire Fixation
B, Explore

107- Child sits in tripod position, reaches out to things, flips from prone to supine and vice versa, cannot hold cereal properly between two fingers how old is he?
A- 3 months
B- 6 months
C- 9 months

108- Ectopic pregnancy case initial BhCG 2900, given methotrexate, one week later BhCG 6000 what to do:
A- repeat methotrexate
B- Diagnostic laparoscopy

109- Long case with Kayser–Fleischer ring and low Ceruloplasmin how to treat?
A- Penicilliamine
B- EDTA

110- Child was in a farm then presented with signs organophosphate poisoning (didn’t mention dx) how to treat?
A- atropine

111- Man come to the ER for poly Truman and he was intubated after resuscitation admitted to the ICU what is the best approach to exclude cervical spine injury and remove neck collar?
A. MRI neck
B.Ap and lateral x-ray neck
C. Clinical judgment
D. Ct neck

112- Old patient with altered lvl of consiousness fell from the stairs, was brought to ER, done CT for him showing epidural hematoma. Asking about most likely affected artery:
A. Pontine
B. Basilar
C. Anterior cerebral artery
D. Middle meningeal artery

113- 36 Year old male patient diagnosed with WPW and he is on BB but still uncontrolled. What to do?
A- Add CCB
B- Increase the dose.
C- Give amiodarone.
D- Radiofrequency ablation

114- pediatric with seizure and other signs, labs showed metabolic acidosis, urine analysis: aminoaciduria and glycosuria, and cataract what’s the diagnosis?
A. Galactosemia
B. Homocystinuria
C. Methylmalonic Academia
D. Maple syrup urine syndrome

115- G3p0, A2 now at 5 weeks presented with spotting on examination open os and no active bleed. History showed 2 abortions at 2nd trimester, last one with D&C diagnosed as incompetent cervix. Your diagnosis now for the third pregnancy of this patient?
A- Asherman syndrome
B- Incompetent cervix
C- Chromosomal anomaly

116- Patient with thyroid mass measuring 2*3 on one lobe, patient is asymptomatic, TSH and T4 are normal, Bethesda 4, what’s next step in management?
A. Hemithyroidectomy
B. Nodule excision
C. Total thyroidectomy

117- A patient has had an oil dissolvant injected by a mistake in his fingers what is the appropriate management?
1. Surgical removal of the dissolvent
2. Put ice and left it
3. Antibiotic
4. Steroids

118- Stepping reflex when disappear
1- 2 months
2- 4 months
3- 6 months
4- 8 months