43- X ray Picture:
Elderly with abdominal pain, and vomiting. On abdominal x ray you see a cofffee been shape in the intestines with part of the large colon twisting to the upper right hypochondirum what’s the diagnosis?

- Sigmoid volvulus✅

44- Female patient came to ER complaining of RUQ pain from 8h, the patient has jaundice with fever of 37.9
Elevated WBC.
A. pancreatitis
B. cholangitis ✅
C. Cholecystitis

45- Standard therapy for PPH due to uterine atony?
A-oxytocin
B-ergot

46- 37 year old female pt g8 p7 at 36 weeks of gestation had previous recurrent postpartum that required blood transfusion.
She is medically free
What is the most appropriate preventable measure in delivery?

A- deliver the patient in Operation Room
B- elective cs in 38 week of gestation
C- start active management in 3rd stage of labor
D- give preload crystalloid fluid in labor to over come postpartum hypovolemia

47- Management of PROM in active herpes simplex virus
A CS
B IV acyclovir

48- Case of PROM at 37 weeks when to give antibiotics?
A- prior to delivery
B- Postpartum

49- Pregnant in 34 week of GA came with labor pain admitted, she had PROM 4 weeks ago , O/E cervix is 3 cm, there is clear liquor, Ask about next step?
A- Emergency CS
B- call Anastasia and deliver pt
C- Wait until 37 weeks
D- give her corticosteroids

50- PROM How to confirm its amniotic fluid?
A. Sterile speculum examination
B. Abx
C. chemical testing
D. Fetal hormones

51- RTA one lung dull to percussion
A- tension pneumothorax
B- massive hemothorax
C- pulmonary contusion

52- uti screening in pregnancy:
A. 12
B. 20
C. 26
D. 30

53- husband has 2 siblings with scd the wife not mentioned , what is the likelihood of affecting his children to be diagnosed with scd?
A. Very high
B. Not at risk
C. Low risk if mother negative
D. Advice not to have children

54- child croup what mc organism ?
A. Parainfluenza

55- milestone 6 months?
A. Palmr
B. Planter
C. Rolling

56- Female had infertility for 6 years, complains of severe dysmenorrhea

A-Leiomyoma
B-Endometriosis
C-Adenomyosis

57- Nullipaurs with menorrhagra and occasional dysmenorrhea want contraception what to give
A- ocp
B-Depo injection
C- vaginal ring
D- progesterone only pills

58- 44 female c/o dysmenorrhea + menorrhage Pelvic exam revealed uterus symmetric enlarge and tender endometrial biopsy normal
A- adenomosis
B- endometriosis
C- sarcoma
D- liomyoma

59- A trauma case. The trachea was shifted to the right side. There was expanded lungs and mediastinum. The patient was hypotensive.
What is the most likely dx?
A. Thoracic aortic injury. ✅
B. Tension pneumothorax.
C. Cardiac tamponade.


Another recall
trauma with hypotension , x-ray : trachea shifted to the right , expanded lungs and widened
mediastinum. What is the dx ?
A- Massive haemothorax
B- Pneumothorax
C- Thoracic aorta rupture ✅
D- Spontaneous pneumothorax

60- 7yrs old with rash on her cheeks and joints pain and anima what the most specific test regarding her disease activity
A- anti ccp
B- bnp
C- ANA
D- Anti dna ds

61- Fungal infection in pregnant lady how to treat?
A. Oral antifungal
B. Topical antifungal

62- A patient came to ER (long scenario) he has weakness and Paresthesia in left leg with power of 2/5. Other limbs normal. What is the cause?

A- Migraine
B- Right MCA
C- Right ACA
D- Basilar