Family med DHA/april/2023

1-ventral wall Lenia mesh use >

2-case of heria With skin changes is incarceration / strangulation
3-Turner what else to examine ? TSH hypothyroidism
4-splenic laceration in a 9 y/o boy 2cm after accident what to do?
5-precautions in TB /meningitis
6-HTN in an old patient lifestyle mod
7-I most proper way to induce labor in 41 gestation-> rupture of membranes
8-Zone 3 penetrating neck injury
what type of repair?endovascular/open
9-Kawasaki def ft > IvIg 10-bil conj inj
11-A- fib patient Female, HTN , now Back to sinus rythem, what to do with warfarin ?
12- 20 y/o male FAP > colonoscope/genetic testing
13-population screening…Colorectal cancer
14-diabetic female perianal pain, fever , ^wBC, abcEess
15-SLE patient , signs of liver cirrhosis , low albumin
16- tt in Hipylori not responsive to 10 days antibiotics…repeat for 14 days /change the tt
17-GBS meningitis newborn..empiric Ampecillin
18-Contraindicated In preg..nitrofurantoin/cipro
19-SLE + seizures , which tt? Steroids+phyntoin /cyclophosphamide
20-pap smear dove every> 3yrs .
21-type of DPP4 inhibitor that doesn’t need dose mod in renal disease—linagliptin
22-1 y/o male microcytic anemia, frontal bossing dec adult hb ..B thalassemia
23-immunedef ..hypogamma globulenemia?
24-TOF
25-RUQ pain, fever,jaundice..ascending cholangitis
26-male after accident, dec BP, JVD,
absent breath sounds, tracheal deviation
Rt side tension pneumothorax
27-rt side hemothorax, what to do > Rt lateral decubitus 
28-Is sepsis physiologic response ? Cellular anaerobic resp
29-bad prognosis in pancreatitis..high lipase/amylase 
30-most dignostic test in asthma case spirometry
31-UTI in pediatric Amoxicillin aral .
32-hep А vaccination in apt who recieved blood 3 wks ago ? give the vaccine /after 6
months
33-TLS.->hypocalcemia
34-immuno compromised ped , , avoid voicella vac
35-case of crohns> Fecal calprotectin
36-Kartegner synd , infertility male  
37-Croup case mx > steroid , inhaled epi
38- vascular lesion on face ped..hemargioma
39-hew to reduce dermatitis > non soap cleansers.
40-dec wt,apetite jaundice » pancreatic ca 41-parkinson case
42-Dec cognition in elderly >hearing test
43-Case of ebola wants to get out ..call security
44-how to dec post partum Hem > active management of 3rd Stage labor 
45-mother smoking..SIDS
46-Most common risk factor for placental abruption? HTN
47-most reliable indication of outcome in diabetic mother? glucose tolerance/HBAlC
48-Trichomonas »metronidadale
49-cervical incompetence
50-Eu thyroid sicK syndreme labs ..dec T3, T4 , inc ReveseT3
51-group 3 pulmorary HTN ..lung disease
52-GI stromal tumor..wide local excision
53-cephalohematoma/caput
54-Cardiac tamporade after accident
55-placental abruption manage..rapid response team
56-recurrent laryngeal nerve injury after thyroid surgery
57-polyhydamnious+pain +vag bleeding after membane rupture+fetal brady
Placental abruption / placenta previa
58-pregnant + suspicious cervical lesion..pap smear/colposcopy
59-ECG..inf wall MI
60- post op patient has STEMI, what to do? Give thrombolytics/ angioplasty
61-recurrent vomiting for days > alkaline urine
62-MRSA..give vancomycin
63-BPH..alpha blockers
64-pheochromocytoma..alpha blockers
65-egg allergy..don’t give inf vaccine
66-HTN not responsive to tt..renal artery stenosis
67- HTN with persistent high blood pressure readings, what is the cause..use of
antacids/pseudoephedrine
68-iron toxicity, 95 level of iron, presenting after several hours..IV deferoxamine
69-blood film malaria type ..Plasmodium Falciparum
70-vaginal bulge+urinary freq..cystocele
71-woman has anxiety about dealing with her coworkers, counseling..show empathy
72-urge incontinence case
73-aortic stenosis+pul edema..this diseases has worse prognosis when presenting with
heart failure sx
74-elevated AST ALT 900..
hepA Ig M
75-primary dysmenorrhea..NSAIDs.
76-uterine fudus cancer lymph nodes..paraaortic
77-pt with fam hx of DM, fasting and HBA1C impaired,what to do ,.OGTT/follow up 
78-ques about vaccine education,,tell the parents the importance of vaccinations and
correct any misinformation
79-ventral henria repair, mesh placement underlay-onlay-inlay
80-developmental milestones
1) Social smile,head lag mild
elevate his head..2months
2)rides tricycle..3 yrs 
3)hops on one foot, recognizes colors..4yrs

81-vascular surgery
most common Cause of death during
hospital stay in a patient who underwent vascular surgery
MI /stroke/ PE 
82-most cammen cause of death in a patient who need
renal dialysis ? CVD
83-pediatric patient URTI
SX + membranous exudates on tonsils
,causitive agent? influenza / RSV/EBV
84-Herpetic gingivostomatilis..HSV
85-primary amenorrhea
in 18 y/o,gymnast + delayd puberty, now tanner 5..Hypogonadotropic hypogonadism
86-turner synd with delayed puberty..what test most useful to order..FSH-LH/TSH
87-13 yo female,Short stature+ primary amenorrhea+ absent 2ndry sexual characterestics,
cause ? chsomosomal / hormonal
88-Sexual harassment at the work place, most likely person to be involved? Supervisor /
coworker/ client
-89-wrist drop + unable to extend fingers ? mid shaft humerus fracture
90-spiral goove fracture in humens ? wrist drop.
91- left lower limb swelling for
3 morths, non pitting edema +darkening of skin + no hx of prev DVT,what’s the best test
to diagnose?
Lymphacentegraphy/ conventional venogram/ duplex/MR venogram
*the ques was repeated 2 times 
92-diabetic pt+ diplopia + ptosis of rt eye , pupils equal reactive to light?
/ PCA aneyrysm/daibetic 3rd nerve injury
93-DPP4- inhibitors what desn’t need dose modification in renal discase ? linagliphin /
sita / saxa
94-infertile couple ask about surrogate preg in saudi arabia, you're not surr if it’s legal,
what do you tell them?  take time to review the subject and get back to them after 2
weeks
95-pre op ped pt doesn’t speak arabic what to do?
Listen  with stethoscope then let the child listen to his heartbeat
96-physiologic reflux in ped after milkfeeding+ normal growth parameters? Reassurance
97-thrombocytopenia+hemolytic anemia+normal coagulation study? TTP
98-HSP pediatric patient picture
99-post strep GN in pediatric, what to ask about? Hx of skin infection 

100-
attending doctor wants ta give pip-tazo to a patient who is allergic to penecillin, what do
you do? Gently refuse 
101-complication during tonsillectomy bleeding that prolonged the procedure time, the
patient asks what happened?
explain and reassure
102-old man given anti TB meds then had liver injury and went ICU,
his son warts to complain ? inform
him that the doctors made the right choice
103-boggy uterus+ Obese + terderness ?adenomyosis
104-incidentally Found fibroid + no sx ? follew up yearly
105-child bearing age female + married? Do beta hcg
106-adnexal fullness+ BHCG 2500 + empty uterus? pelvic U/S
107-Benign Feature of ovarian tumor on ultrasound? bilaterlal
108-35 yo female, her sister has avarin ca , her mother Breast cA ,The patient has no sx
or breast mass, what's best screening for her? BRCA / mammogram
109-lactating female febrile, breast tenderness + area of redness? Give atibiotics/ incesion
and drainage.
110-male,20 yo,hasFAp what to do? Gene testing/ colonoscopy
111-Mallory weis tears in stable male,normal labs ?
abservation/ endoscopy
112-endometriosis dx ? Labrascopy / Us/ hysterosalpingogram
113- pediatric hypoglycemia? 2.5 ml/kg
in 10% dextrose

114-pediatric had severe diarrhera

and dehydration was given fluids then went into coma, why? Rapid correction lead to
cerebral edema

115-opioid overdeoe + resp dep -> Ventilation

116-new born with metabolic+Resp acidosis, what’s proven to increase survival?
Resp support
117-post op old man+ decreased urine output? 500 NS challenge,
118-old man had MI 6 weeks ago, when can he do elective cholecystectomy?now
after 6 manths /open
119-what to rule out before sport participation ? H0CM
120-persistent breech presentation? C/S
121-Asthma pt didn-t improve an inhalers what to do?observe the pt using his inhalers
122-Asthma ped moderate/ mild persistent? add ICs
123- middle age female has anemia, dark stools ?Fecel occult blood
124-  most commen sx of retroperitoneal sarcoma ? compression / bleeding
125-Least effective session period for aerobic exercise? 15 min/ 20min