251- case of interstitial pneumonitis most commonly associated with?
A-Viral pneumonia
B- Lobar pneumonia
C- Bronchopneumonia
D-Secondary tuberculosis

252- infant or child!! with pneumonia and atelectasis, what is best Investigation:
a) fluoroscopy
b) rigid bronchoscopy
c) flexible bronchoscopy
d) x-ray

253- Lady with fibroadenoma (given) underwent excision Histopathology result: fibroadenoma + invasive ductal carcinoma What is the management?
A- Radiotherapy
B- Chemotherapy
C-Mastectomy
D- High risk screening protocol

254- Patient with CKD stage 2 with fatigue and pallor investigations
show anemia and low MCV and slight increased something MCH
maybe. Next step:
A- (Serum) Iron study
B- Reticulocyte count
C- Serum Transferritin
D- Serum erythropoietin

255- What is the age in month of child talk 6-10 words, know 2 body parts, immature pencil grasp?
A-17
B-19
C-12
D-24

256- 64 year old man has been waking up in the middle of the night to go to the bathroom he also had difficulty initiating micturition and complains of dribbling a diagnosis of BPH was made after a transrectal ultrasound guided biopsy and the patient was prepared for TURP what electrolyte abnormality is highly likely due to this surgery?

A) hypokalemia
B) hypocalcemia
C) hyperkalemia
D) hyponatremia
E) hypernatremia

257- Pregnant in active labor (I think) She has history of recurrent vaginal HSV infections, next step?

A. Instrumental delivery
B. Speculum exam or vaginal exam
C. CS
D. Acyclovir

258- A mother after ROM came to the emergency department. She has history of herpes infection 2 years back OE doctor sees an inactive H.simplex lesion. What is the next step?
A. Sterile speculum examination
B. CS
C. Instrumental delivery
D. Give acyclovir

259- Patient known case of peptic ulcer disease in medications but failed to respond, upper endoscopy done and revealed multiple
ulcers in antrum. What is the best treatment?
A. Pyloroplasty and vagotomy
B. Total gastrectomy
C. partial distal gastrectomy (anterectomy)

260- 18 years male came with stap wound injury next to umblicus with small opening clean and bleeding stopped Vitally stable with normal lab results Ct : smal splenic laciration with minemum fluid surrounding it . What is the best definite management
A) wound closure
B) AB
C) splenictomy
D) exploratory labromyomy

261- 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

262- 53 years old male patient heavy smoker presented with SOB,cyanosis and distended JVP. The patient is heavy smoker for many years and wants to quit now. What is the *best* way to help him quit?


A. Varenicline
. B. Nicotine replacement therapy
C. Bupropion
D. Behavioral therapy.

264- patient had in Coronary care unite with Myocardial
infarction and associated with cardiac arrhythmia , patient now
had numbness and paresthesia on right leg femoral pulse intact
but below that was either diminished or absent, left leg normal
pulse. what to do next?

265- 50 year old sustained blunt trauma to the chest with persistent pneumothorax and significant air leak through double intercostal tubes ( ICT ) . Which of the following is the most appropriate next procedure ?
A.Reposition of ICT
B.Prompt thoracotomy to treat
C.Endotracheal intubation
D.Fiber - optic bronchoscopy to diagnose

266- Unvacinated child came with lymph node swelling and fever, when they tried to take culture there was bleeding from the throat, what is the most likely diagnosis ?
-Diphtheria
-H.Influenza
-Streptococcus pneumo

267- patient with chronic constipation, she mentioned that she needs to push the vagina backwards to relieve the constipation, what is the best management ?
- Removal of the enterocele
- Anterior Colporrhaphy
- posterior Colporrhaphy
- I don't remember the 4th option

268- Patient has grandiose delusions and hallucinations, what does he have ?
Neurosis
Psychosis

269- patient diagnosed with schizophrenia and started treatment , what is true about his prognosis ?
5% have remission
Most will have remission?
70% will have good quality of life
33% will
ماني فاكر ايش كان آخر خيار

270- 3 month Preterm baby has a chronic lung disease, both parents are smokers, he was sleeping in with his parents in there bed, parents brought him dead to the ER, what is the most likely cause?

A- Sudden lung distress syndrome
B- Sudden infant death syndrome

271- pregnant patient at 37 weeks gestation, known case of RH immunization, fetus found to have anemia, what is the management?
Delivery of the baby
Give blood to the fetus ( not written like this)