232- asymptomatic elderly presented for abdominal pain evaluation no fever no wight loss no night sweating chest x-ray showed 1cm lesion biopcy showed
noncaseaiting granuloma
what is that appropriate management?

A. observation
B. follow up after or every 6 month by CT chest
C. start anti TB
D. surgical excision

233- Neurogenic shock case Best initial treatment:
- iv fluids
- O- blood
- steroid

234- 50 y/o female present with uterine spotting, no history of wt loss, most probable cause:
Endometrial Hyperplasia
Endometrial hypoplesia
Uterine cancer

235- 45 y\o female medically free present with flank pain, fever what is the treatment:
Ciprofloxacin
Ceftriaxone

236- Middle aged female patient with history of myomectomy. in operation note: they enter uterine cavity during surgery. What is the most likely developed in future pregnancy?
A. Placenta previa
B. Placenta acreta
C. Placenta Increta
D. Placenta percreta

237- 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

238- What of the following decreases the risk of preeclampsia?
A. Antibiotic
B. Aspirin
C. MgS04

239- What of the following decreases the risk of eclampsia?
A- Antibiotic
B- Aspirin
C- MgS04

240- Patient coming from an endemic area for malaria. Later on, he was admitted to the hospital with Heart failure. Doctor did not ask the patient about travel or medication history. Thus, he ordered the nurse to give digoxin. Who is at fault?
A) Computerized drug prescription system
B) Nurse failed to write drug formularies
C) Pharmacist who failed to check prescription
D) Patient who did not bring his medicine pack/ report his medicines

240- A doctor used the Foceps, place it in wrong position and injured the stylomastoid bone, what is the result?
A.Baby cannot close his left eyes
B.Loss of taste in anterior ⅔

241- Female with vaginal discharge Grey, fishy odor , smear : show clue cells, Treatment?
A. Metronidazole
B.Topical clotrimazole

242- Pt old his regular doctor transfured to another hospital he’s upset and wants medical record and referral to his regular doctor ?
A- Convince him that there’s equally compitant doctors
B- Give report and refer him
C- Refuse
D- Calm him down and tell him to come tomorrow to decide

243- Male dr wants to examine a female patient and he asked the nurse to come with him what did the doctor practice ?
A- privacy
B- justice
C- Nonmaleficence

244- Patient came with vaginal discharge she have done CS with episiotomy 10 days ago , the obstetrician diagnosed her with UTI and described Abx , but she did not improve then she went to another obstetrician and he found infected vaginal swab , What is the medical error done by the first obstetrician?
A. let the midwife assist him and depend on her
B. doctor failed to follow the surgical safety protocol in the OR
C. No communication between the 1st and 2nd obstetrician
D. Genuine different assessment or diagnosis of patient case

245- 2.5 y/o boy keeps yelling NO (and some other like this) what will you advise the parents?
A) Ignorance
B) Counselling
C) Positive reinforcement
D) Punish the child

246- PRESCHOOL CHID WILL WENT TO SPLENOECTOMY, WICH VACCINE SHOULD HE TAKE ?
A) RUBELLA
B) VARICELLA
C) H. INFLUNZA
D) MEALESES

247- 43 YO male known case of hepatitis B infection presented with fever and confusion, examination reveled disorientation, asteraxis and positive shifting dulness

Ascetic fluid analysis:
SAAG= 1.2
Neutrophils= 350 or 320
Culture bending

What is the most appropriate treatment?

A- IV diuretics and metronidazole
B- Lactulose enema and IV Ceftriaxone
C- High ascetic fluid aspiration and propranolol
D- ?

248- 32 YO G3P0020 admitted as a case of incomplete abortion for D&C, during D&C, there was profuse bleeding which required vigorous curettage. After D&C she cam to the clinic after 6 months complaining of no menstruation despite positive pre-menstrual symptoms

What is the area affected from endometrium based on history:
A- sponge
B- Functional
C- Basilar
D- Compact

249- 3 YO female presented with vesicular rash in the gums, tongue, buccal mucosa and hard palate. Upon examination the patient looked dehydrated with dry mucosal surfaces. The lesions were painful and some of them bleeds. The mother stated her daughter cannot eat because of pain

What is the most likely organism?
A- herpes simplex virus
B- Herpes zoster virus
C- Staphylococcus aureus
D- Streptococcus pneumonia

250- What is the AB that use in ICU patient have pneumonia:
A. Vancomycin
B. Azithromycin
C. Ceftoxime
D. Amoxicillin