119- Patient suspected to have asthma , which of the following is the most definitive way to diagnose asthma ?
A- History , Examination, response to bronchodilators
B- Spirometry and PFT

120- Soldier going to southern region of Saudi Arabia. What is the best malaria prophylaxis?
A. Malarone
B. Atovaquone-proguanil
C. Mefloquine
D. Chloroquine

121- Case of molar pregnancy (very high Bhcg...), what is the highest diagnostic test??
A. US
B. Direct biopsy

122- A 73 year old woman is brought to ER after a fall at home. She is diagnosed with left hip fracture (see lab results) Weight 82 kg Sodium 136 (normal) Potassium 4.2 (normal) Creatinine 68 (normal) What is the best order by the admitting orthopedic surgeon to prevent deep vein thrombosis?
A. Aspirin 81 mg PO daily
B. Enoxaparin 40 mg SC daily
C. Fondaparinux 10 mg SC daily
D. Heparin sulfate 10,000 units IV BID

123- Term Female came for labour , her prenatal history was urine culture (not vaginal swab for culture) positive 100000 GBS and asthma wich is managed by SABA , now what to give during labor and delivery?
-Ampicillin
-betamethasone

124- Pelvic Fracture with injury to membranous part of urethra. Blood seen in external meatus. What is the most appropriate action?
A. Cystoscopy
B. Folly’s Catheter
C. Suprapubic catheter
D. CT pelvis

125- Case for sudden pain in the left leg associated with reduce sensation and color change?
A- US
B- Ct angio
C- conventional radio

126- Pt complain of profuse discharge and tender vaginal fornix
A. Acute salpingitis
B. Acute cervicitis
C. Appendicitis

127- Case of pancreatic cyst for 5 Ws with collection was 18 cm x 24 cm how to manage?
A- Percutaneous drainage
B- Endoscopic drainage
C- Surgical drainage

128- Patient diagnosed with Ulcerative Colitis 6 years ago. when to be screened for colon cancer?
A. Annually till age of 50
B. If there is mild inflammation
C. At time of diagnosis
D. 8-10 years after diagnosis

129- Female, G1P0, missed her period for 3 months, has irregular period, doesn’t know gestational age. On Ultrasound, 11 weeks was calculated. What is the most likely mthod of dating gestational age here?
A-crown-rump length
B-femur length
C-estrogen or progesterone Lvl
D-abdominal circumference

130- 2 month old baby at the clinic what to do?
A. BMI
B. Head circumference

131- Newborn/infant with stridor worse when prone improves when supine, mother is concerned, what to do?
A Start laser treatment
B Tell her it will resolve on its own by first birthday
C Tell her it will get worse
D-Do Laryngoscope

132- 14 y female complain of vaginal bleeding in interval of 3 weeks to 2 months, she has normal development and normal secondary features, every thing normal What to do?
A- Reassure
B- OCP
C- Order FSH and prolactin

133- Pt who is allergic to penicillin which of the following is contraindicated
A-Ceftriaxone
B-Tazocin

134- Patient presented to the ER with diarrhea, nausea, vomiting, salivation, lacrimation and abdominal cramps. What do you suspect?
A) Organophosphate poisoning
B)Paracetamol poisoning
C) Aspirin
D)Penicillin

135- Known SCA and received blood transfusion 3 weeks ago Now he came for his hepatitis A vaccine You should :
A-Give the vaccine
B-ask him to come after 3 months
C-Ask him to come after 6 months
D-Ask him to come after 9 months

136- Patient smokes 20 cigarettes and vital signs show BP 140/92 Which of the following is the most considerable risk factor for MI ?
A) Hypertension
B) Smoking
C) Age

137- A boy with ambiguous genitalia, diagnosed with 17β-Hydroxysteroid dehydrogenase. What type of trait in this disease?
A) Multifactorial
B) X-linked dominant
C) Autosomal recessive
D) Autosomal dominant

138- Pediatric patient presented with generalized seizure, hypoglycemia, ketones in the urine with characteristic odor. What is the dx?
A. Galactosemia.
B. Phenylketonuria.
C. Maple syrup urine disease.
D-Fatty acid oxidation defect