493- Patient came for routine f/u and did CT scan,accidentally found 1 cm lung nodule , he’s smoker. The mass was 1cm with sharp borders. No symptoms

A-Biopsy ✅
B-Surgery
C-No follow up
D-Follow up ct 3 to 6 mo

494- Pregnant 28 weeks came with bilateral breast mass it was movable and the size was3x4 cm, most appropriate next step?

A- reassurance and follow up after delivery
B-bilateral breast ultrasound ✅
C-Bilateral breast mammogram
D-MRI

Answer depends on the age of the patient
40 or more —> Mammogram ( C )
Less than 40 —> US ( B )
If No age sepcified —> B. Because it’s clinically benign.

495- 78 YO post-op contaminated surgery. Admitted to ICU and given 6 L of crystalloid IVF and 1 PRBC in the last 12 h. Broad spectrum antibiotics were given. , CVP is 40”over fluid treatet = no hypoVoluimia” 8-12
Vitals:
BP 70/45
HR: 125
T: 38.6
O2: 93%
Labs: WBC 8 Most appropriate IV intervention:

A-albumin
B-2 L crystalloid fluid
C-norepinephrine ✅
C-frusemide

496- Typical case of hemolytic anemia and blood film show spherocytosis,Hb:8, MCV MCHC normal range, WBC: 3, PLT: 500, LDH AST ALT high, low haptoglobin most appropriate treatment?

A-blood transfusion
B-steroids
C-hydroxyurea

497- 31w pregnant lady complains of small and slow vaginal bleeding, shes a confirmed case of low lying placenta,

A-expectant management
B- Biophysical profile
C- CTG
D- Emergency delivery
100% sure about the choices

498- Diagnosis

499- delivered bab At 35 weak and the physican ask to put pationt vaccination schedule
WHEN we arrenge it?
A. As soon as discharge
B. after 2 weak of Current date of delivery
C. After 2 weak of expected date of delivery

Answer is: As scheduled according to chronological age except HBV given at discharge or 1 month after birthday.

500- Case of patients with upper and lower limb weakness and inapropriatw talk. Which artery is most likely affected?
A ⁃ MCA ✅
B ⁃ ACA
C ⁃ Basilar artery
D ⁃ Vertebral artery

501- diabetic patient with gout. Which of the following drugs aggravates his arthritis?
A: Lasix ✅
B: Plavix
C: Aspirin
D: Metformin

502- 3 years old asthmatic child, mother is concerned as they are not leaving the house much as they must use the nebulizer and it needs power source, what to advice?
A. The mother is right
B. Find a portable nebulizer
C. Educate about inhaler use and stop nebulizer ✅

503- Child angry say no yelling hitting his mother
a.Temper tantrom ✅
b.Deporesion
c.Major anxity disorder
d.Anxity with depression

504- A 56-year-old woman was exposed to chemical burns to her
trunk. on arrival to the Emergency Department, she was
conscious and alert. Examination showed 5 cm x 11 cm wound at her back with burned clothes and powder of chemicals on her clothes and skin
Which of the following is most appropriate next step after removing her clothes?
A. Antibiotic.
B. Powder sweeping ✅
C. Surgical debridment.
D. Water irrigation for 30 minutes.

505- Case of neonate ader ventouse there bulging in head under periosteum within line of head sutures?
A. Cephalohematoma ✅
B- caput hematoma

506- Pt after intubation ( ithink ) develop witish plaque ask about managment
A-Nyastin ✅
B-Metronidazole
C-Flucanazole

507- Child full term in first vist ask about which one need immediate treatment :
A- spina befida
B- absent femoral pulse ✅

If by B they mean CoA.

508- Septic arthritis case and asking about the appropriate test:
A-joint aspiration✅

509- Asthma pt not controlled, but in in clinic improved after use of inhaler what to do next?
• A- Observe inhaler use ✅
• B- Add another medication

510- Patient with severe Depression. With polyuria in polydipsia and drinking so much water. Urine diluted. What is the diagnosis ?
A-psychogenic polydipsia ✅
B-diabetes insipidus

511- Pt known know case of diabetes Mellites came with abnormal liver function test LFTS were all high:
A- hemochromatosis
B- viral hepatitis
C- autoimmune liver disease
D- non -alcoholic fatty liver disease ✅

512- Pt was admitted as diagnosis of MI. 10 days later he develop retrosternal chest pain radiate to the neck What should we see in the ECG ?
A. Diffuse ST elevation✅
B. Afib
C. None