A 37-year-old man with type 1 diabetes mellitus presents to the ofce with history of prolonged hypoglycemia during intense exercise, despite eatng a meal prior to the actvity. He is using insulin glargine and insulin aspart with meals (see lab result). Test Result Normal Value Н6А1C 7.0 4.7-5.6 % Which of the following is the most appropriate management of this patent's hypoglycemia on the days that he exercises?
**A. Decrease meal-tme insulin aspart dose prior to exercise, contnue insulin glargine dose
B. Increase meal-tme protein prior to exercise, contnue current insulin doses
C. Switch insulin aspart to a sliding-scale regimen, contnue insulin glargine dose
D. Discontnue insulin glargine, contnue insulin aspart dose

A 60-year-old man complaining of right knee pain for several years that has increased
over the last few months. He also has noticed frequent knee clicks. A diagnosis of osteoarthritis
is suspected.
Which of the following is the most appropriate to confirm the diagnosis?
A. Bilateral knee X-rays.
B. MRI of the right knee.
C. No further investigation.✅
D. Arthroscopy for the right knee.

A case of shoulder dislocation:
Clinical presentation: Arm flixed, held in adduction and internal rotation, with loss of contour

A- sub-coracoid posterior shoulder dislocation
B- sub-glenoid posterior shoulder dislocation
C - inferior shoulder dislocation
D- anterior shoulder dislocation

23 Nov

5- Case of elderly having abdominal pain with dilated small and large bowel, persistent hypokalaemia regardless iv potassium
What to do next?
A - ca glocunate
B - Check for associated hypomagnesemia☘️

🍪 4) A 27-year-old primigravida presented at 36-weeks of gestation with headache, blurred vision
(see lab result).
Blood pressure 160/110 mmHg
Heart rate 76 /min
Respiratory rate 18 /min
Temperature 36.8 °C
Test Result Normal Values
Protein +++ absent
Which of the following is the most appropriate medication for acute treatment of hypertension? (In my exam it didn’t say “acute treatment”, just most appropriate)
A. Clonidine
B. Methyldopa
C. Labetalol
D. Sodium nitroprusside

Case of ACTIVE neuropsychiatric lupus with MRI findings of active lesions
What is the managment?
-Cyclophosphamide + corticosteroids
-Cyclophosphamide only
-Corticosteroids only
-Rituximab + Steroids

43-year-old never married woman is complaining of abnormal uterine bleeding for the last 3
months. She was placed on progestin tablets to control her bleeding by a family physician prior
to referral. One of the sisters had a diagnosis of thyroid cancer 2 years ago.
Blood pressure 110/70 mmHg
Heart rate 76 /min
Respiratory rate 16/min
BMI 17 kg/m2
Which of the following would make the highest risk of endometrial cancer?
**A. Nulliparity
B. Underweight
C. Progesterone therapy
D. Family history of thyroid canc

65 years old female with a recent difficulty to describe the things, she cannot describe the items probably (she called an dogs as cat), with no hx of behivoral changes or memory loss or head trauma. neurologist ordered an MRI what do expect in MRI findings?

A. Hippocampcal atrophy
B. Temporal atrophy
C. Cudate atrophy

3 years old boy with barky cough, cyanotics, holding spill, no inspiratory stridor, positive monophasic wheeze in auscultation, dx:
A Bronchitis or bronchiolitis
B Tracheomalacia
C Laryngomalacia
D Bronchial asthma
امس اختباري جا هذا

A mother brought her 2-week-old infant and considered mul6ple collec6ons on his skin. 3
collec6ons 2 of them were superficial red flat spots on the lower limp and the third was in the right of the eyelid, which of the following is the appropriate step in management?
A. refer to ophthalmologist
B. refer to a pediatric surgeon for excision
C. reassure the mother that it will disappear in 5 years
D. an/bio/c for 1 week

2 weeks neonate brought by his mother concerned about three skin lesions two of them are in his thigh, which were flat and red. The third one was in his eyelid, which was bigger than red. What is your management?
A- refer to ophthalmologist
B- referred to pediatric surgeon
C- reassure that it will disappear at the age of 5

A 30-year-old man is found to have cardiomegaly on chest X-ray during pre-
employment check- up. He Denies chest pain, dyspnea, orthopnea or PND. Physical
examination unremarkable (see reports).
Blood pressure 120/80 mg Heart rate 76 / min Respiratory rate 18 /min .
Electrocardiogram: Normal.
Echocardiogram: Dilated left Ventricle with ejection fraction of 40%.
Which of the following is the best management?
A. Digoxin
B. Lisinopril
C. Furosemide
D. Echocardiogram in 6 months

A female patient in her 30s, has menorrhage for 2 months.
Diagnosed of sub serosal fibroid 2*3 cm.
I think her complain is infinitely.

A) observe
B) NSAIDs
C) embolization or ligation
D) myoectomy

19-month-old boy presented to the clinic with right lower eyelid swelling, erythema, and tenderness for 1 day. He has fever reaching up to 38.5° C with decreased appetite and activity. He was given diphenhydramine without any improvement of the eyelid swelling. His parent denied any visual disturbances, diplopia or any other swelling. Which of the following is the most likely diagnosis?
A. Cellulitis ✍🏻
B. Hypoproteinemia
C. Allergic reactions
D. Subperiosteal hematomas