600- Came from india RUQ pain, intermittent fever, jaundice.
Imagaing: Single Hypo-echoic homogenous mass.
A- Amoebic abscess ✅

601- Patient after cholangitis intervention with the following WBCs 9, RR 18, HR 80 (exactly 80 not 90), normal BP, Temp: 38 exactly 38). What is the cause:
- sepsis
- SIRS
- bactermia ✅
- septic shock

602- Typical case on nephrotic syndrome, ask about highly diagnostic test ( no renal biopsy )
A. Serum albumin
B. US
C. Urine total protein ✅
D. Electrolytes

603- 23 y/o pregnant women came to antenatal clinic with hx of 2 preterm birth C/O vaginal spotting of blood , which of the following recommended tx ?
A. Progesterone ✅
B. Estrogen
C. Indomethacin
D. MgSo4

604- 62. Male pt complain of recurrent heartburn increase when lay down at night, he felt a bitter taste in his mouth when he was lifting weight at gym, diagnosis?
A. Esophagitis ✅
B- PUD
B. Gastritis
C. Boerhaave syndrome

605- Case of back pain and the diagnosis was written (Lumbar Spinal stenosis). What is the first step in management?
A. Lumbar laminectomy
B. Physiotherapy ✅
C. Epidural analgesia

606- Spherocytosis picture
Osmotic fragility ✅
( No EMA in choices ).

607- 418- Mom came to pediatrion with exclusef breast feeding and doctor advise iron advise next month. age of baby now?
A.1
B.2
C.3 ✅

608- 76 male reducible inguinal hernia with moderate pain. Mx?
A- Open with mesh ✅
B- simple repair
C- Non- surgical procedure

609- Malaria Tx:
Artemensisin combination ✅

610- Child fever knee pain Refuse to touch. Most important investigation:
A- Joint aspiration ✅

611- male hemangioma 4x4
A- Avoid excessive sport ✅

612- High velocity trauma, pt hypotensive despite giving IV fluids.
X-ray showed open book fracture.
What is the most appropriate next step?
A. Pelvic binder ✅

613- RTA. Shifted trachea. GCS 15/15 BP 90/70:
A- Needle decompression ✅

614- An elderly man with a case of HF came with dyspnea, palpitation. He is on captopril. He was started on furosemide and symptoms got better. What should be added next for this patient
A. Digoxin
B. Carvedilol ✅
C. Amlodipine
D. Cant remember

615-29 yo female presented with severe epigastric pain radiating to the back she’s had sleeve gastrectomy 3 months ago. Physical examination revealed epigastric tenderness. Lab, Amylase high. Stable vitals USG was negative for biliary stones but positive sludge and normal biliary ducts. Most appropriate next step?
A- Ultrasound endoscopy
B- Something and pyloromyotomy
C- Lap Cholecystectomy ✅
D- Percutaneous Cholecystostomy

616- Young man with palpitation only, comes Suddenly lasts for 5-10 mins
Everything was normal
ECG normal rhythm
What is the most appropriate? Initial invx?
Holter ✅
Echo
Excercize ecg

617- 32 y/o Obese woman complaining of irregular mensuration and chronic anovulation, endometrial sample showed: atypical complex hyperplasia .. what’s the most definitive treatment(complete scenario) ?
- tamoxifen
-Letrozole
-progesterone ✅
-spironolactone

618- patient female elderly with symptoms of Orthopnea SOB PND, JVP, Bilateral basal crackles. S3. what is the diagnosis
A- Pulmonary edema
B- MI
C- Mitral regurgitation ✅
D- Right sided heart failure

619- Severe asthma, patient can not complete 1 sentences, inspiratory and expiratory wheeze, High Co2 and low 02, how will you manage? or normal
A- Mugnesium sulphate
B - IV Theophillin
C- Intubation and mechanical ventilation ✅
D- High flow oxygen