Typical signs and symptoms of PCOS. High BMI
In addition to weight reduction what is the initial step?
A- Danazol and metformin
B- Metformin and clomiphenate ✅
C- IVF and salicylic acid
D- Laparoscopic ovarian wedge resection and something else

برضو هذا السؤال من الاسئلة اللي جاتني فالاوبي بس في Section 3.

Sit without support, Crawl, hold things between thumb and index finger, walks around furniture, pulls up to be standing, say dada:
A- 8
B- 10 ✅
C- 12
D- 14

تو كتبته من المايلستونز اللي جاتني

39 year old female complaints of heartburn and regurgitations for 6 months burning is
primary after eating and occasionally has chest pain, not associated with weight loss or lifestyle
changes. the patient mentioned that she eats dinner 2 hours before going to bed and complains
of heartburn primarily at night.. She's taking omeprazole 20 mg per day did endoscopy . She
had distal esophagitis. her BMI is 28
What is the appropriate next step?
A. add antacids twice per day
B. ranitidine before bed
C. advice weight loss ✅
D. refer for nissen fundoplicati

المريض بيسوي عملية استئصال لعنق المعده وقررو يخلون البيشنت على
Total parenteral nutrition (TPN)
Patient on TPN, what’s a common metablic abnormality?
كان السؤال وش المتوقع بيحصل عنده من خلل في الالكترولايت
الاختيارات جاتني كذا متأكد لان هالسؤال ذاكرته وصححته هنا بالقروب
A- Hypokalemia ✅
B- hyprcalcemia
C- hyponatremia
D-Hyperphosphatemia


Answer is A.
Patients on TPN are vulnerable to develop Refeeding syndrome.
Refeeding syndrome is Characterized by several electrolyte abnormalities as:
- High Glucose, and Chloride.
- Low K, PO4, Mg.

Ref: Thawabah course.

Here’s a similar Q from thawabah files:

Pt after fell down from hight present with open fracture and dirty , what the most appropriate next step in the management ?
A- oral antibiotic
B- open fixation
C- surgical debridement ✅
D- external fixation

Answer is C.
Remember the Management of Open fracture very well and also in sequence:

1- ATLS protocol and control the bleeding.
2- IV Antibiotics and Tetanus Toxoid.
3- Closed reduction and immobilization by a cast or splint.
4- ER Irrigation, Debridement and external fixation.

Once the infection controlled and patient stabilized you can now go for OR to do:
5- Definitive Management by Open Reduction and Internal Fixation ( ORIF ) by IM nail or screws.

This sequence is Very important. Whichever comes in the choices first choose it.

Oral Antibiotics is not recommended it should be given Peripherally by IV line.

28 years old female tried to get pregnant for many years, did IVF 2 times, now she’s pregnant in i forgot which week but was 2nd trimester and US showed multiple fibroids, how to treat her without harming her pregnancy?
A- myomectomy
B- GnRH injections

Another recall:
Female with history infertility and previous abortion and try IVF two time with failure , she is having multiple uterine fibroid. Which of the following will help her the most to get pregnant
A- Myomectomy
B- Uterine artery embolization
C- Medical therapy ✅
D- GNRH to decrease the size of fibroid


Answer is Medical therapy.
( she’s Now pregnant )
UTD: Operations on the uterus is best to be avoided in the pregnancy due to risk of bleeding, Uterine rupture and pregnancy loss.

Note: if she’s not pregnant and wishes to preserve fertility answer is Myomectomy.

37 year old female primigravida at 34 GA, know to have multiple fibroids, presented now with abdominal pain and fever on examination: cervix is closed and no evidence of contractions.
What is the most appropriate management?
A- Observation ✅
B- Myomectomy
C- CS
D- Induction of labor

Answer is Observation.
Best answer would be Pain management.
Red degeneration of fibroid is a common complication in pregnancy causing abdominal pain and fever and it’s usually managed Conservatively by Pain reduction.

Man diagnosed with appendicitis due to rigidity and abdominal tenderness
During the surgery the appendix was fine, what to do now?
A- Remove the appendix and close
B- Look for meckles diverticulum ✅
C- Do open surgery and explore
D- Close without doing anything

Note: If you schedule for appendectomy and during the procedure you found normal appendix:

1- look for other DD as:
Meckel’s diverticulum, PID…
2- If open —> do Appendectomy
If lap —> NO Appendectomy.
3- if you found inflammation in terminal ilium —> refer the patient to Gastroenterology for IBD evaluation.

boy circumcised mother said urine smell foul fever 39 for 1d what indicated uti in this pt
A.Fever duration
B.Being a male
C.Fever 39✅
D.Age

2 year old baby boy uncircumcised came with fever, rigor and has emesis once, start at morning
Fever : 39.1
What will indicate upper urinary tract infection more ?
A) being male
B) duration of fever
C) temperature 39.1✅
D) vomiting

Another similar question: Baby uncircumcised have fever, Q: what is the indicator that increases the probability of the baby having UTI?
A- Duration of fever
B- uncircumcised✅
C- Fever of 38.1
D- Being a male

هذا السؤال سهل ينلعب فيه بالخيارات.
UTD: Probability of UTI increase when:
-Age is less than 12 months
-Fever of 39 or more
-Uncircumcised
-Being a female.
-Duration of 48h or more.

يسعد مسائكم ياحبايب
والله اني متفهم للوضع وراكم اختبار وتحتاجون احد يرد عليكم بسرعه لكن والله ماقدر الحق بين الشغل وبين الرسائل وبين التجهيز للتقديمات
وانتم عاد تعرفون روتيشن الجي اس كيف ثقيل..

مارح اخليكم ان شاء الله برد عليكم واحد واحد بس حبيت اعطيكم خبر عشان ما احد يعتب ويشيل بخاطره.

الله يسعدكم ويسر اموركم يارب والمعذره عاللي تاخرت عليهم فالرد.

A six year old girl presenting to the pediatric emergency department with unstable gait and progressive difficulty climbing the stairs over the last 10 days the parents reported that the child has been “choking on her own saliva” the symptoms began was prickly sensation in the fingers and toes that developed to ascending and symmetrical there is a history of viral gastroenteritis three weeks before

physical examination confirms the absence of the knee-jerk reflex CSF analysis of weighted protein concentration with normal cell count
nerve conduction test reduced velocity which off the following is most appropriate treatment:
1-plasma exchange
2-IVIG ✅
3-MTX
4-steroids

جاني مرتين بالاختبار.

Child with 3 degree burn and 1% of genitalia surface affected:
A- Refer to burn unit ✅
B- sterile wound ointment
C- antibiotic ointment
D- dressing and discharge


Answer is A
Burns involving the face, hands, feet, genitalia, perineum, or major joints are an indication of referral to burn unit.
Ref: Schwartz.

Patient is suspected to have posriasis in the valva , highest diagnostic tool?
A-Biopsy ✅
B-scrach with hydroxyde
C-something iodine
D- Clinical diagnosis


Paoriasis is a Clinical diagnosis but when vulvar lesions are present biopsy becomes the diagnostic tool in this situation.
Ref: UTD.
جاني فالاختبار.

Pt with vesicles and maculopapular rash in the right chest, how to diagnose?
A- Blood culture
B- Skin biopsy
C- Skin swab for culture
D- No further tests required ✅

جاني في نوڤمبر
الكيس كانت واضحة انها shingles

No further tests required unless there’s a neurological symptoms in which we use PCR to diagnose it.

ماكان فيه Neurological Symptoms.
الاجابة D.