2. Waleed Azayzeh
Laith Al- Najada
Islam Al-Tarawneh
Family medicine archive G1 A+B
13 Questions
30 min
352023
3. Q1 DM
Patient +40 high BMI and family history of type 2 DM comes to
screen for DM
When should you screen him ?
o Right away
What are the cut off values of diagnosis
o HBA1C: >=6.5
o Fasting Blood Glucose: >=126
o OGTT : >=200
4. Q2 Abdominal pain
The name of this sign?
o Cullen’s sign
What are the peritoneal signs?
o Percussion tenderness
o Abdominal tenderness on palpation
o Rigidity
o Diminished or absent bowel sounds
5. Q3 Dizziness
Patient present with severe persistent vertigo for 2 days associated
with severe nausea and vomiting. HINTS test showed abnormal head
impulse
Diagnosis
o Vestibular neuritis
Management
bed rest and anti-emetic for 3 days
Treat the symtopms
6. Q4 Hypertension
45 years old doctor come to your clinic his blood pressure was
130/85?, normal blood sugar level ,his ascvd is 5% what is your initial
management ?
Life style modification only Like exercise , avoid smoking and alcohol
..etc
7. Q5 Chest pain
Diagnosis according to ECG ?
o Inferior STEMI
Management ?
o Heparin / aspirin / morphine (only
with severe pain) /oxygen(SatO2
<90)
o (Beta Blockers and sublingual
triglyceride contraindicated in
inferior MI)
8. Q6 Fatigue
Typical case of chronic fatigue syndrome
Diagnosis
o chronic fatigue syndrome
What is your management ?
o Supportive
o Addressing the underlying medical condition
9. Q7 Dyslipidemia
76 years old patient with history of heart attack his LDH level is
more than 185 what is your management ?
Life style modification + moderate intensity statin
10. Q8 Headache
Case of typical cluster headache case
Diagnosis?
Aggravating factors for this condition:
o Smoking and alcohol
o Stress
o Perfume – paints
o Nitroglycerin
o Could be genetic
First line management -- high flow oxygen and parental Triptan
11. Q9 Adult health maintenance
51 years old male military man
What are the recommended vaccines ?
o Tdap , influenza , covid-19 , meningococcal
What are the recommended cancers to be screened ?
o Colon only
12. Q10 Geriatric health maintenance
The name of the test ?
o Time-Up and go test
What is it used for ?
o Assessment of the risk of falling in geriatric age group
13. Q11 Geriatric health maintenance
What is the name of the scoring
system ?
o Katz index
Explain the scoring system?
a. A score of 6 full functiom
b. 5 good function
c. 3-4 moderate impatment
d. 2 or less sever functional
impairment
14. Q12 Osteoporosis
Risk of osteoporosis-related fractures
o advanced aging, previous fracture after age of 50, small trauma fracture, on
glucocorticoid, falls, family history of hip fracture and current smoking, BMD
<-3
Prevention
15. Q13 URTI
What is the abnormal finding in this S-ray?
o Thumbprint Sign
Your diagnosis?
o Epiglottitis
16. Group 1 C+D
Family medicine archive
13 Questions / 1 Question for every lecture
17. Q1 DM
Patient +40 high BMI and family history of type 2 DM comes to
screen for DM
When should you screen him ?
o Right away
What are the cut off values of diagnosis
o HBA1C: >6.5
o Fasting Blood Glucose: >126
o OGTT 75g: >200 after 2 hours
18. Q2 Abdominal pain
The name of this sign?
o Cullen’s sign
What are the peritoneal signs?
o Percussion tenderness
o Abdominal tenderness on palpation
o Guarding
o Diminished or absent bowel sounds
19. Q3 Dizziness
Patient present with severe persistent vertigo for 2 days associated
with severe nausea and vomiting. HINTS test showed abnormal head
impulse
Diagnosis
o Vestibular neuritis
Management
20. Q4 Hypertension
45 years old doctor come to your clinic his blood pressure was
130/85?, normal blood sugar level ,his ascvd is 5% what is your initial
management ?
o Start treatment by non-pharmacological therapy (like weight reduction, salt
restriction, physical activity…etc) and reassess in 3-6 months.
21. Q5 Chest pain
Diagnosis according to ECG ?
o Inferior STEMI
Management ?
o Heparin / aspirin / morphine (only
with severe pain) /oxygen(SatO2
<90)
o (Beta Blockers and sublingual
triglyceride contraindicated in
inferior MI)
22. Q6 Fatigue
Typical case of chronic fatigue syndrome
Diagnosis
o chronic fatigue syndrome
What is your management ?
23. Q7 Dyslipidemia
73 years old patient with history of heart attack his LDH level is more
than 185 what is your management ?
Life style modification + high intensity statin and ezetimibe.
24. Q8 Headache
Case of typical cluster headache case
Diagnosis
Aggravating factors for this condition
First line management
25. Q9 Adult health maintenance
51 years old male military man
What are the recommended vaccines ?
o Tdap , influenza , covid-19 , meningococcal
What are the recommended cancers to be screened ?
o Colon only
26. Q10 Geriatric health maintenance
The name of the test ?
o Time-Up and go test
What is it used for ?
o Assessment of the risk of falling in geriatric age group
27. Q11 Geriatric health maintenance
What is the name of the scoring
system ?
Katz index
Explain the scoring system?
a. A score of 6 full functiom
b. 5 good function
c. 3-4 moderate impatment
d. 2 or less sever functional
impairment
28. Q12 Osteoporosis
Risk of osteoporosis-related fractures
o advanced aging, previous fracture after age of 50, small trauma fracture, on
glucocorticoid, falls, family history of hip fracture and current smoking, BMD
<-3
Prevention
29. Q13 URTI
What is the abnormal finding in this S-ray?
o Thumbprint Sign
Your diagnosis?
o Epiglottitis
31. • Q1 : pregnant lady presented with syncope
,SOB & chest pain .
1. Diagnosis?
pulmonary embolism
2. What is the name of this clinical sign?
Hamptons Hump
32. • Q2:Geriatric maintenance case:
1.Recommended vaccines?
single zoster dose , meningococcal, tdap , covid ,
influenza
2.Name of the test that assess the risk of falls?
time up and go test
33. • Q3:known Diabitic male patient , came with
bp: 155/90 case
• 1.initial treatment
• 2.what advice you give him
34. • Q4: Typical case of epiglottitis
Name of the child’s position?
Tripod posture
36. • Q6:meniere’s disease case
• 1.diagnosis
• 2.treatment
• Q7: tension headache case
1.diagnosis
2.agravating factors for this condition
37. • Q8: typical case of chronic fatigue syndrome
• 1.diagnosis
• 2.lab investigations you will order
• Q9: case about drug induced dyspepsia
• Q10:*inferior STEMI case , BP :80/50
1.diagnosis
2.initial management
38. • Q11: hyperlipidaemia case non diabetic ,
LDL:165
1.initial treatment
• Q12: explain the one step strategy in the
diagnosis of GDM
40. Q1:
• A 55 years old male comes to the hospital for
his regular health maintenance, he stopped
smoking 12 years ago, he used to smoke 20
cigarettes per day for 12 years.
1- mention cancer screening tests to do?
Lung cancer, Colon cancer
2- Mention 5 other screening tests to do?
Dyslipidemia, DM, obesity, hypertension,
promote smoking cessation, depression,…
41. Q2
• A 60 years old female suffering from
spontaneous , episodic feeling of rotations
that is associated with tinnitus and vomiting.
• What is your diagnosis? Meniere’s Disease
• What is the management especially in the
early stages?
Lifestyle modification ( salt & caffeine
restriction, …)
42. Q3
• A case of osteoporosis:
• What are the guidelines for screening of
osteoporosis?
• Mention the risk factors for osteoporosis?
43. • The name of the test?
Time-Up and go test
• What is it used for?
Assessment of the risk of falling in
geriatric age group
Q4
44. • Diagnosis according to ecg?
Acute Anteroseptal Myocardial Infarction
• Management?
Q5
45. Q6
• A 30 years old patient complaining of
recurrent attacks of rotational movement,
they usually occur when he stands up from
sitting.
• Mention 2 diagnoses to differentiate?
1- Benign Paroxysmal Positional Vertigo
2- Orthostatic Hypotension
• How can you prove the diagnosis?
By doing Dix-Hullpike maneuver (positive= BPPV),
Measure blood pressure for orthostatic hypotension
46. Q7
• A male patient came for periodic health
maintenance, his blood pressure was 135/85,
he was non smoker, with negative family
history of hypertension
• How do you deal with this case?
1- Do other CVD screening tests (DM,
dyslipidemia, obesity …)
2- if diagnosed with Hypertension, we can
do lifestyle modification(salt restriction,
diet, exercise, …)
47. • A patient with recurrent attacks of unilateral headache, each
attack lasts from hours to days, the attacks are preceded by a
feeling of weakness, visual abnormalities & confusion.
• Diagnosis?
Migraine with Aura
• Mention 2 abortive drugs?
NSAIDs, Acetaminophen, Ergotamine
• Mention 2 prophylactic drugs?
Anti-Epileptics (Valproic Acid)
Anti-Hypertensive drugs (Beta blockers)
Anti-Depressants
Q8
48. • A patient with very severe headache that is
located in his left eye, associated with
lacrimation, sweating
• Diagnosis?
Cluster headache
• Drugs of choice?
High pressure Oxygen, Triptan
Q9
49. • What is the abnormal
finding in this S-ray?
Thumbprint Sign
• Your diagnosis?
Epiglottitis
Q10
50. Q11
• What is the name of this sign?
Xanthelasma
• What does it indicate?
Hypercholesterolemia
51. • A 30 years old patient with fever, he has no cough, the
examination showed tonsillar exudate with swelling in the
anterior cervical lymph nodes.
1- Diagnosis?
Acute bacterial pharyngitis
2- What is the most common organism for it?
Group A beta hemolytic streptococci
3- Your management?
1- Antibiotics for 10 days
2- soothing measures( warm beverages, gargling with salt
and water, hard lozenges,..)
3- Symptomatic pain & fever relief(NSAIDs)
Q12
52. Q13
• A 40 years old male patient with dyspepsia
and abdominal pain that is related to food,
there were no alarming signs.
1- What is your initial management?
do H.pylori test
2- If all the tests were negative, what is the drug
to be used?
PPI for 4 to 8 weeks
53. Q14
• The name of this sign?
Grey Turner sign
• What is the cause of this sign?
pancreatitis
What are the peritoneal signs?
1- percussion tenderness
2- abdominal tenderness on palpation
3- guarding
4- Diminished or absent bowel sounds
54. Q15
• A 30 years old female patient with lower
abdominal pain which is more in the right iliac
region
• Give 4 differentials
1- Acute appendicitis, pregnancy,
pancreatitis, crohns disease, ….
56. 50 years old femall What’s the screening test ?
54 years old male previous smokers before 12
years , 20 cigarettes per day for 12 years What is
the cancer Screening tests ?
What is the role for screening for osteoporosis ?
Bppv diagnostic test and treatable manoeuvre ?
65. Not the same picture and not
related mainly to the question
Male patient 38 years old , normal TSH ,
normal blood sugar , k+ 2.6 (mmol/L)
What is your interpretion for this patient:
Secondary hypertension stage 2/
hypokalemia
causes for this condition:
primary hyperaldosteronism
Renal artery stenosis
Cushing syndrome
66. كان بالزبط الصورة نفس مو
بالصورة مبين
Mediastinal
distension
Interpretation for this chest x-
ray ,What is your diagnosis:
Right middle lobe
consolidation
diagnosis : lobar pneumonia
67. • Patient with DM with no comorbidities list 3
treatment goals: according to a1c FBG 2HPP
A1C <7.0%,
Preprandial capillary plasma glucose 80–130
mg/dL
Peak postprandial capillary plasma glucose
less than 180mg/dl
68. • ECG with ST elevation in lead v1 V2 v3
v4,diagnosis? Acute Anteroseptal STEMI
Initial management:
69. • Patient with burning epigastric pain and
indigestion that is worse while lying down.
• Diagnosis: GERD
• List 3 other organic causes of dyspepsia:
1.Peptic ulcer
•2. Gastric or esophageal cancer.
•3. Pancreatic or biliary disorders.
70. What's this test and for
what ?
Dix hillpike , BPPV
what's the maneuver used
in the management of this
condition ?
Epley's maneuver
71. Q6) A case of continuous vertigo (description shows it
is peripheral) What test should be done to confirm it
as such ?
A: HINTS exam
Abnormal head impulse
Unidirectional nystagmus
No vertical skew
72. •
Q7) A patient with signs and symptoms of acute
appendicitis. Give diagnosis and 4 differentials
74. •
Q9) A 50y old patient with dyspepsia and has been
given PPIs with no imorovement..(detailed Hx: no
alarming signs; pt is allergic to penicillin)
(a
What is the next investigation that needs to be
done?
Test for H. pylori
b) Treatment?
Either *triple therapy with no penicillin/its derivatives
Or quadruple therapy
75. Cancer screening for 52 year old woman , non
smoker , and recommended vaccines
• Screening for colon cancer and breast cancer
• Vaccines: Tdap , influenza , covid-19
76. A case of migraine with aura
• Mention 2 abortive treatments: samutriptan ,
ergometrine
• Mention 2 indications for prophylaxis:
77. strep throat with management
• Most common bacterial pathogen: group a
beta hemolytic streptococci
• Management : Treat for 10 days with oral
penicillin (PCN) or amoxicillin. Treat PCN-
allergic patients with clindamycin for 10 days
or azithromycin for 5 days.
78. Osteoporosis case
• Screening guideline: dexa scan for 65 and
older or younger with osteoporosis related
fracture risk
• Mention 4 advices to prevent it : no alcohol,
no smoking, vitD, calcium physical activity
79. A case with dyslipidemia ( labs pic)
• What is your interpretation: low HDL high LDL
• LDL=192
• Management :life style modification + High
intensity statin
81. Station 1
What’s the dx ?
inferior stemi
*What is your management?
Heparin / aspirin / morphine (only with
severe pain) /oxygen(SatO2 <90)
(Beta Blockers and sublingual triglyceride
contraindicated in inferior MI)
82. Station 2
What’s your INTREPRITATION
axis was normal
rate was 78
rhythm was irregularly irregular
p wave was absent
What’s your dx
atrial fibrillation
83. 49 years old , was diagnosed with
hyper tension 3 months ago , and
came back with this appearance
What is this sign called ?
Angioedema of the lips
What's the cause of this condition ?
Side effect of ACE inhibitor
85. Osteoporosis risk factors ?
risk of osteoporosis-related fractures*. ?
advanced aging, previous fracture
after age of 50, small trauma fracture,
on glucocorticoid, falls, family history
of hip fracture and current smoking,
BMD <-3
86. What this is test called ?
DEXA scan
when to perform screening for
osteoporosis ?
Any women more than 65 years old
Or any women aged more than 55
with osteoporosis-related fractures*.
88. A case of fatigue
Whats the cause of this fatigue
hypothyroidism mostly Hashimoto
Whats the management
levothyroxine
•
فحص صورة كانت
thyroid function test
elevated tsh
elevated TPO more than
200
90. 60 years old female suffering from
spontaneous , episodic vertigo that’s
associated with tinnitus and vomiting
Whats your dx
Meniere’s disease
Whats the management
lifestyle modification like salt and
caffeine restriction , and diuresis
91. What's this test and for what is used ?
Dix hillpike , BPPV
what's the maneuver used in the
management of this condition ?
Epley's maneuver
92. A case history showing epigastric pain
relieved with food
what's the dx ?
duodenal peptic ulcer
What are the ddx ?
Pancreatitis , cholecystitis , GERD …
93. A case history of abdominal pain in the
RIF shifted to the umbilicus
DX? APPENDICITIS
DDX FOR APPENDICITIS ??
95. What is your interpretation of this ECG,what is your
diagnosis ?? Sinus Bradycardia
Station 1
96. What is your interpretation of this ECG,what is your
diagnosis ??
You should describe it well !!
normal Sinus rhythm
Station 2
انها المهم بس الصورة نفس مو
normal
97. Your Dx ??
Cushing syndrome
Write 2 signs ?
1) Abdominal striae .
2) Moon face .
3) Buffalo hump .
Causes ?
High cortisol
Station 3
99. Station 5
Female 65 years old, do
dexa scan for screening
osteoporosis
T-score : -0.8
What's your diagnosis ??
Its Normal
100. Station 6
Pregnant women in her second trimester with history
of one month fatigue
High TSH (Normal Rang (0.4-4)
Normal T3,4
What is your diagnosis??
Subclinical hypothyroidism
What is your management??
Levothyroxine (because pregnancy is indication for
treatment of subclinical hypothyroidism)
102. According to FDA , mention 2 drugs used in smoking
cessation ??
1) Nicotine replacement therapy
2) Virnicline
Mention one disease is caused by smoking ??
COPD , Lung cancer …
Station 8
103. Patient with HTN and DM on Atenolol and -BRIDE his PB
140/90 (when he sit) and 110/80 (when he stand)
1 ) What is the type of his complain?
2 ) Two causes of his complain?
1-Orthostatic hypotension
2-Antihypertensive medication (atenolol) +
DM (autonomic nervous system dysfunction)
Station 9
106. Station 12
Mention all the screening tests which can be done for a 50
years old woman w/o any risk facor ??
HPV , Cervical CA , dyslipidemia , BP , colorectal CA ,
107. Station 13
Female Pt. with hx of fatigue 3 months ago and high
RDW, hb: 10
Case of anemia
whats your Dx and RX??
Iron deficiency anemia
Ferrous sulfate
108. Station 14 (bonus )
Young child
Not obvious changes in CBC
and pt and ptt and ALT 1000
AST 1200 ?
Your DX ?
Hepatitis A
Rx:
supportive care only (iv fluids
,rest …)
109. Station 15
Case scenario about stock and
gloves sign
*Mention 2 drugs in management
of it ?
Pregabalin – larika
Duloxetine ,Gabapentin
111. *What this maneuver called :
Dix-Hallpike maneuver
*Used for the diagnosis of?
Benign paroxysmal positional vertigo
112. Old female come with epigastric pain to ER
*What is your interpretation of this ECG ,what is your diagnosis:
Chronic Inferior STEMI
*What is your management?
Heparin / aspirin / morphine (only with severe pain) /oxygen(SatO2 <90)
(Beta Blockers and sublingual triglyceride contraindicated in inferior MI)
113. Patient denise chest pain
*What is your interpretation of this ECG,what is your diagnosis:
Left ventricular Hypertrophy
114. كان بالزبط الصورة نفس مو
بالصورة مبين
Mediastinal
distension
Interpretation for this chest x-
ray ,What is your diagnosis:
Right middle lobe pneumonia
Most common cause :
Bacterial infection
116. What is this sign?
Xanthelasma
What the cause of this sign?
Hyperlipidemia/hypercholesterole
mia
(
الدكتور من معتمدة اجابة اي بنعرف ما
)
117. What is this sign?
Acanthosis nigrigans
Indication (cause) for?
Insulin resistance
118. Not the same picture and not
related mainly to the question
Male patient 38 years old , normal TSH ,
normal blood sugar , k+ 2.1 (mmol/L)
What is your interpretion for this patient:
Secondary hypertension stage 2/
hypokalemia
What causes for this condition:
primary hyperaldosteronism
Renal disease
Cushing syndrome
119. Pregnant women in her second
trimester with history of one
month fatigue
TSH=7 Normal Rang (0.4-4)
Normal T3/T4
Hb=11
What is your diagnosis:
Subclinical hypothyroidism
What is your management:
Levothyroxine (because
pregnancy is indication for
treatment of subclinical
hypothyroidism)
120. According to FDA ,
mention 2 drugs used in
smoking cessation:
Nicotine replacement
therapy
Nicotine agonist ; virnicline
121. Female 71 years old, do dexa
scan for screening
osteoporosis
T-score : -1.9
What is your diagnosis:
Osteopenia
What is your management:
vit d, ca, lifestyle
modification
(not calcitonin or
bisphosphnate)
122. What this calculator called?
Frax score
When it consider positive?
When hip fracture is greater
than 5%
When major fracture greater
than 20%
123. Uncontrolled DM patient come to your clinic and you order urinalysis
The result of test shows excessive albumin : 126
** What is your diagnosis: nephropathy due to microalbuminuria
** What is your management : ACE inhibitors
124. What is your spot diagnosis:
Graves disease (not exophthalmos)
125. Patient 45 years old,came to your
clinic with numbness and burning
sensation
**what’s the name f this sign?
Stock and gloves
**what’s your first line
management?
Preglitinb - larika
130. Q3
• Picture of reticular tonsillitis (pharyngitis)
• Treatment if you find out that the patient is
allergic to penicillin? cefixime
131. Q4
• Mention two drugs used to treat smoking
addiction:
• Mention two diseases are related to smoking
• Bupropion
• Nicotine replacement therapy
132. Q5
• A known case of DM came for a regular check-
up, his albumin in urine was 130
• What is the diagnosis ?
• Ttx?
• Microalbuminuria
• ACEIs or ARBs
133. Q6
• Picture of dexa scan, bone density is -3.5
• Dx? Osteoporosis ^-^
• Mention two treatments that reduce the risk
of vertebral and non-vertebral fracture
Bisphosphonate
Denosumab
Teriparatide
135. Q8
• An asymptomatic patients coming for a check-
up, turns out he has an elevated tsh yet
normal t3,t4
• What is the diagnosis ?
• When do we treat it with levothyroxine
136. • Subclinical hypothyroidism
• When the TSH level is greated than 10
• TSH level 5-10 with goiter or positive anti TPO
antibodies
• متاكد موpatients at risk of coronary artery
disease
138. Q1:
A. Write down two findings
B. What is your Dx
A. Right side hyperlucency + tracheal shifting
B. Tension pneumothorax
139. Q2:
A. What is the Dx?
B. Two causes of this
condition
A. Intestinal obstruction
B. Tumor (cancer) + vulvolus
Different picture
140. Q3:
A. Right down two findings in this ECG ?
B. What is you management?
141. A. ST-elevation in inferior leads (II, aVF) +
bradycardia + reciprocal changes (T-
inversion, ST-depression)
B. Aspirin + O2 + Morphine
NOTE:
Beta-blockers and nitroglycerine are contraindicated in right
coronary A occlusion (right ventricle / inferior MI)
Beta blocker causes severe bradycardia (SA is affected)
Nitroglycerine right ventricular infarction leads to decrease of the preload for
the left ventricle. So nitroglycerine may cause severe hypotension
142. Q4:
65 y with previous hip fracture
All labs were normal (including Ca++)
A. What is the Dx?
B. Two drugs for treatment of this condition:
A. Osteoporosis
B. Bisphosphonate + Denosumab +
Teriparatide
143. Q5:
A. What is the Dx?
B. Two labs to confirm
your diagnosis:
A. Graves disase
B. TSI (Thyroid stimulating immunoglobulin) + free T4/T3
144. Q6:
Hx of Asymptomatic patient with TSH 6.2
mlU/L
A. What is the Dx?
B. What is your management?
A. Subclinical hypothyroidism
B. Conservative (just follow up)
145. Q7:
A. What is this condition?
B. What is the cause?
A. Xanthelasma
B. Hyperlipidemia
146. Q8:
Write down two drugs for smoking
cessation:
1. Bupropion
2. Varenicline
3. Nicotine replacement therapy
147. Q9:
Patient with HTN and DM on Atenolol and other drugs
his PB 140/90 (when he sit) and 110/80 (when he
stand) he is complaining from dizziness (longer Hx)
A. What is the type of his complain?
B. Two causes of his complain?
A. Positional dizziness (orthostatic hypotension)
B. Antihypertensive medication (atenolol) + DM
(autonomic nervous system dysfunction)
148. Q10:
13 years old male come with 2 days
Hx of fever (38.2) and anterior
cervical LN tenderness
A. What is the Dx?
B. What is the treatment?
A. Tonsillitis (strepthroat / bacterial pharyngitis)
B. Penicillin 10 days
149. Q11:
Write down three red flags for headache
1. Papilledema (visual disturbances)
2. Focal neurological deficit
3. Age above 50
4. neck stiffness
5. Sudden onset worst headache in the patient life
165. Mention steps for breaking bad news ?
SPIKES
1. Setting
2. Perception
3. Invetation
4. Knowledge
5. Emotin and empathy
6. Strategy and summary
166. 1.what this test is called?
Dix-Hallpike maneuver
2.Used for the diagnosis
of?
Benign paroxysmal
positional vertigo
3.What is the name of
treatment procedure?
Epley maneuver
167. 1.What this test is called?
Monofilament test
2.Used to test for what ?
For touch sensation
168. 1.Diagnosis ?
A.Viral pharyngitis
B.Streptococcal pharyngitis
2.Mention centor criteria
I. Age <15 (+1)
II.Absence of cough (+1)
III.Fever (+1)
IV.Tender anterior cervical LNs
(+1)
V.Presence of transudate(+1)
VI.Age >45 (-1)
169. 1.What this test is called?
DEXA- scan
2.Used for diagnosis of ?
osteoporosis
3.What are T-score value?
170. 66 Years old male , smoking 40 Pack / year , Medically
free , Medications free , with random glucose 160 ,
HR:70 , BMI : 26 .
1- 3 Recommended vaccines for his age ?
2- 4 Screening tests for his age ?
3- according to JNC8 recommendations , what do you
want to do to this pt?
171. 1- 1.Pneumococcal vaccine
2. Tetanus vaccine
3. Influenza vaccine
2- 1.Colon cancer
2. Abdominal Aortic Aneurysm
3. Lung Cancer
4. Hypertension
3- Screening tests for prediabetes and type 2 diabetes
include measurement of fasting plasma glucose or
HbA1c level or an oral glucose tolerance test but we
recommend to decrease weight ( DASH diet ) , stop smoking
, restrict salt and cohol intake , and increase his physical
activity .
174. A B
•
Q2:
•
PICTURE A?
•
Subcutaneous nodules
•
PICTURE B?
•
Erythena marginatum
•
What is the most common
complication comes with
these?
•
rheumatic heart disease
175. A B
•
Q3: what is
the name
of each
sign?
•
A
•
Cullen’s
sign
176. Q4:
A and B represent ?
A : Kernig sign
B : Brudzinki sign
A B
177. •
Q5:
.1
What this test is called?
–
DEXA- scan
.2
Used for diagnosis of ?
–
osteoporosis
.3
What is the cut-off point for
diagnosis?
–
-2.5
178. Q6: 66 Years old male , smoking 40 Pack / year , Medically free , Medications free ,
with BP 140/80 , HR:70 , BMI : 24 .
1- 3 Recommended vaccines for his age ?
1.Pneumococcal vaccine
2. Tetanus vaccine
3. Influenza vaccine
2- 4 Screening tests for his age ?
1.Colon cancer
2. Abdominal Aortic Aneurysm
3. Lung Cancer
4. Hypertension
3- according to JNC8 recommendations , what do you think about his BP ?
Stage 1 HTN , no need for medication , but we recommend to decrease weight (
DASH diet ) , stop smoking , restrict salt and cohol intake , and increase his
physical activity
179. •
Q7:
Present with chest pain and shortness of
breath :
1- From history , mention 4 risk factors for PE
? 1- History of DVT , PE
2- Malignancy
3- Immobilization for long time or major
surgery
4- Smoking , Obesity
2- Write down the Beck’s triad of cardiac
tamponade
1- Hypotension
2- Muffled heart sounds
3- increased JVP
180. •
Q8: write the tips in the stage 6 of breaking
bad news (Have a clear Strategy and
Summarize)
•
1-Agree on a plan about next step.
•
2- Don’t rush the patient to make decisions if
possible.
•
3-Summarize and check patients
understanding.
•
4-Offer assistance to call a family member to
fetch him.
182. Station 1 6Marks
35 Years old male , He has just quit smoking :
1-Which type of smoking cessation medication
he used ?
2- Write down 5As modality of patient approach
3- This patient is at which stage of behavioral
change?
184. Station 2 3Marks
48 Years female patient , come with cough , fever
and fatigue .
By physical examination , her temperature was 38 ,
Cervical lymph nodes tenderness and cough , and
her throat as you can see :
1- Centor Score ?
2-Your next step ?
3-Most common causative organism ?
185. Answers
1- 2
2- Rapid antigen detection test or throat culture
If +VE : treat with antibiotic ( penicillin )
If –VE : No Antibiotics
3- Group A Beta hemolytic streptococcus
bacteria
186. Station 3 8MArks
1- A , B ?
2- 3 Differential diagnosis of
peripheral vertigo ?
3- 3 Differential diagnosis of
Central causes of vertigo ?
190. Station 5 9Marks
66 Years old male , smoking 40 Pack / year ,
Medically free , Medications free , with BP
140/80 , HR:70 , BMI : 24 .
1- 3 Recommended vaccines for his age ?
2- 4 Screening tests for his age ?
3- according to JNC8 recommendations , what
do you think about his BP ?
191. Answers
1- 1.Pneumococcal vaccine
2. Tetanus vaccine
3. Influenza vaccine
2- 1.Colon cancer
2. Abdominal Aortic Aneurysm
3. Lung Cancer
4. Hypertension
3- Stage 1 HTN , in the general population aged ≥60 years,
initiate pharmacologic treatment at ≥150 / 90 , So in this
patient no need for medication , but we recommend to
decrease weight ( DASH diet ) , stop smoking , restrict salt and
cohol intake , and increase his physical activity .
192. Station 6 5Marks
With patient of Breast Cancer , During the
Breaking bad news session , at step 4 ( Give
knowledge and information ) , mention the
tips
193. Answers
1-Give a warning shot to get the patient ready “As you know we
did... (investigation) and unfortunately the results were not as we
hoped!.
2-Allow a large pause if needed to let patient digest that shot.
(silence here is the best to allow patient to express feelings)
3-Then (in a respectful gentle tone) provide the diagnosis In simple
clear words "I’m sorry to tell you this, but your investigations show
you have ..." .
4-Give facts in small doses with pausing in between.
5-Give time for patient’s emotional reaction, wait for him to re-
initiate the conversation, or seem to be ready to talk.
194. Station 7 7
Marks
Present with chest pain and
shortness of breath :
1- From history , mention 4 risk
factors for PE ?
( I know there is no history
but generally from picture may
be ? )
2- Write down the Beck’s triad
of cardiac tamponade
195. Answers
1 1- History of DVT , PE
2- Malignancy
3- Immobilization for long time or major surgery
4- Smoking , Obesity
5- Inherited blood disease
2 1- Hypotension
2- Muffled heart sounds
3- increased JVP
197. Q1:
1. What class of
antihypertensives this drug
belongs to ?
ACEI
2. What is the most common
side effect of this drug ?
Dry cough
1. What is the
mechanism of action
of this drug ?
Insulin sensitizing
agent
2. Common side effect
?
GI upset
198. Q2:
1. What is this called ?
Goiter
2. Mention DX
Hashimoto thyroiditis
199. Q3:
1. Mention the stages
of behavior
changes in smoking
cessation
Precontemplation
Contemplation
Preparation
Action
Maintenance
200. Q4:
1. What this test is called?
DEXA- scan
2. Used for diagnosis of ?
osteoporosis
3. What is the cut-off point
for diagnosis?
-2.5
201. Q5:
1. Mention the name of
this lesions
A.Subcutaneous
nodules
B.Erythema
marginatum
2. This major criteria used
to diagnose?
Rheumatic fever
A B
202. Q6:
1.What is this ?
Acanthosis negricans
2. Test to do ?
Fasting plasma glucose
3. Mention another dermal
change
Necrobiosis lipoidica
203. Q7:
Mention steps for breaking bad
news
1.Setting
2.Perception
3.Invitation
4.Knowledge
5.Emotion and empathy
6.Summery and strategy
204. Q8:
1. Diagnosis ?
A. Viral pharyngitis
B. Streptococcal
pharyngitis
2. Mention centor criteria
I. Age <15 (+1)
II. Absence of cough (+1)
III.Fever (+1)
IV.Tender anterior
cervical LNs (+1)
V. Presence of
transudate(+1)
VI.Age >45 (-1)
A
B
205. Q9:
1. What this test is called?
Monofilament test
2. Used to test for what ?
For touch sensation
206. Q10:
1. what this test is called?
Dix-Hallpike maneuver
2. Used for the diagnosis of?
Benign paroxysmal
positional vertigo
3. What is the name of
treatment procedure?
Epley maneuver
238. Q5:
An otherwise healthy 12-year-old male is brought to the ED with a chief
complaint of chest pain. The patient has been complaining of the pain over the
past week. Which of the following is true?
A. The friction rub of pericarditis is best heard when patients are lying supine.
B. Cardiac causes of chest pain more commonly occur in the setting of exertion.
C. In pediatric patients, myocardial infarction is most common in females.
D. On physical examination, only diastolic murmurs are cause for concern of an
underlying cardiac problem.
E. Valve disorders are the most common cardiac causes of pediatric chest pain.
Answer B
239. Q6:
• . A 45-year-old obese woman presents with right upper
quadrant abdominal pain for several weeks. Her pain is
worse after she eats. Which of the following clinical
features supports the diagnosis of biliary colic?
• A. Worsened pain on eating protein
• B. Colicky spasms of abdominal pain lasting 15 minutes
• C. Radiation of pain to right shoulder
• D. Fever >101.5°F E. Antecedent use of nonsteroidal
anti-inflammatory drugs (NSAIDs)
• Answer C
254. Family medicine Mini – OSCE
Group A1/2
Done by : Rahaf Al Hosban and Jenine Nueirat
255. Q1: Smoker male patient , complain from dry cough , SOB
and fever of 38
What’s your diagnosis?
COVID-19
Describe the imaging findings that can be seen in this patient
bilateral diffuse(more in the peripheral) infiltrates with lower lobe
predominance, ground glass opacities or consolidation .
256. Q2: 50 years patient complain from sever headache
which associated with visual disturbance
What’s your diagnosis
Temporal arteritis
Next step
Biopsy ?
257. Q3:
What is this test ?
Head impulse
What is the most likely diagnosis?
Vestibular neuritis
258. Q4:
What is the name of this sign ?
Stooped posture
What investigation you want to do ?
Dexa scan
259. Q5: young adult came to your clinic and tells you that he
wants to quit smoking ( he’s a moderate smoker)
Write down 4 behavioural tips that can help your patient
.1
Eat fruits and vegetables
.2
Give yourself a break
.3
Lean in your loved ones
.4
Avoid alcohol and other triggers
Write NRT with their doses
260. Q6:
What’s the name of this test ?
Blood occult stool test
Used for the screening of ? Colon cancer
When done ? 50 years
Name vaccines given at this age RZV
261. Q7 :Diabetic , COPD , obese patient complain from
chronic fatigue
Mention 4 causes of fatigue
.1
DM
.2
Depression
.3
COPD
.4
Idiopathic chronic fatigue
4 sleep hygiene measures
.1
maintaining a regular morning rising time
.2
Increasing activity level in the afternoon
.3
Avoid exercise in the evening or before bedtime
.4
Increase daytime exposure to bright light
262. Q8 : lab results for patient showing high LDL + he’s
suffering from multiple comorbidities
What’s your management
Statins
The patient came after few months and (
new lab results showing normal LDL but
decreased HDL and high triglycerides) ,
what’s your management
Fibrates
263. Q9 : Elderly in his 70’s with history of falling down, he’s
taking more than 5 drugs ( the doctor mentioned them )
What’s the most common cause in this case ?
Polypharmacy
What’s your management
Discharge unnecessary medications
Tools to Help Decrease Polypharmacy :
.1
Beers Criteria
.2
STOPP Criteria
.3
START Criteria
264. Q10: Acute chest pain radiate to
the neck , and increased with
exercise and movement
What’s your diagnosis?
Pericarditis
266. Q1:25ys male pt complain of chronic chough
1.what the diagnosis ?
Post nasal drip
(upper respiratory cough syndrome)
2. mention 2 clinical signs?
Swelling turbinates
direct visualization of postnasal drainage
cobblestoning of the posterior pharynx.
269. 1.what is the test name?
Time up and go test
2.Normal value?
≤ 10 second
3. What the test used for?
Assesment for falls in geriatric
270. 1.what is the clinical signs?
A.erythema marginatum
B. subcutaneous nodule
2.what is the organism?
(GAS)group A streptococcus
B A
Q3
271. Q4:
1.Name of the test?
Dix-hallpike test
2.When consider the test positive?
If positive, patient will experience vertigo and
you will observe nystagmus
3.Test used for diagnosing of?
benign paroxysmal positional vertigo
272. Q5 :
55ys male pt, Complain of thunderclap headache ,
worsing with cough , LP done ,results of CSF (pic)
1.Finding in CSF?
xanthocromia
2.Diagnosis?
subarachnoid hemorrhage
274. 1.What is the diagnosis?
Osteoporosis
2.What Advices give to her when she take 1st line treatment?
( Bisphosphonate)
with 8 oz of water upon awakening,
remain upright,
avoid food for 30min afterward
3.Write 2 side effects?
hypocalcaemia ,
nausea
eosophagitis
photosensitivity
osteonecrosis of the jaw
279. Q10
1. 4 life threatening causes of chest pain?
acute coronary syndrome
PE
Aortic dissection
Pericarditis
2.Long case scenario(sharp chest pain ,worsen with
movement &respiration , temp 38,5)
a. Dx ? Pericarditis
b. clinical sign? Pericardial friction rub
280. Q11
27ys old female pt newly married complain from RIF pain
and tenderness ,her LMP from 10 days ?
1. 4 DDx ?
• Appendicitis
• Pelvic pain
• Constipation
• Inguinal hernia
2. 6 point of Alvarado score ?
282. Q1
•
This Patient with secondary hypertension
•
What is the diagnosis ? Obstructive sleep
apnea
•
Three symptoms of this condition ?
Snoring , somnolence , fatigue
284. •
What the name o this sign ? Acanthosis
nigricans
•
If the RBS was 300 what is your next step ?
Life style modification and metformin
•
What you would advise him about life style ?
Weight loss , exercise , smoking cessation ,
stop alcohol
285. Q3
•
Name of this ? Epley maneuver
•
Used for treatment of ? episodic triggered (
MCQ )
286. Q4
66 year old man come to screen
1- What type of prevention ? Secondary prevention
2- Write 4 conditions to be screened with the tool
that use ?
Colon Ca – colonscopy
Lung Ca – LDCT
AAA – abdominal US
Hypertension – blood pressure measurment
287. •
3- Vaccine give to him ?
•
Pneumococcal , zoster , influenza , Tdap
288. Q5
•
When we use this ? In osteopenia to decide
giving bisphosphonates or not according to 10
years fracture risk
•
Other three component used in this ?
Current smooking
RA
Glucocorticoide
289. Q6
•
Question about 35 year old patient with
postprandial fullness , there was no red flag
•
What is your next step ? Do H.pylori test
•
If was negative ? -Trial of prokinetics, motility
agents; metoclopramide, domperidone
•
When you refer to endoscopy ? – Unintended
weight loss – Progressive dysphagia –
Odynophagia – Persistent vomiting
290. Q7
•
4 most common endocrine cause of fatigue ?
•
Hypothyroidism , DM , apatheic
hyperthyroidism , pituitary insuffecancy
•
4 symptoms of chronic fatigue syndrome ?
post-exertional malaise, sleep problems,
cognitive impairment, and orthostatic-related
symptoms
291. Q8
•
Patient on statin therapy
•
2 test you do before statin ?
•
KFT , LFT
Management If develop mild to moderet muscle
symptoms ? A- Discontinue the statin until the
symptoms can be evaluated.
B- Evaluate the patient for other conditions that
might increase the risk for muscle symptoms
(e.g., hypothyroidism, reduced renal or hepatic
function, rheumatologic disorders such as
polymyalgia rheumatica, steroid myopathy,
vitamin D deficiency, or primary muscle diseases).
292. C- If muscle symptoms resolve, and if no contraindication exists, give the
patient the original or a lower dose of the same statin to establish a causal
relationship between the muscle symptoms and statin therapy.
D- Once a low dose of a statin is tolerated, gradually increase the dose as
tolerated.
E- If, after 2 months without statin treatment, muscle symptoms or
elevated CK levels do not resolve completely, consider other causes of
muscle symptoms listed above.
F- If persistent muscle symptoms are determined to arise from a condition
unrelated to statin therapy, or if the predisposing condition has been
treated, resume statin therapy at the original dose.
293. Q9
A. Write the diagnosis ? Cluster headache
B. Treated by ? 100% O2 nebulizer
294. Q10
•
Dm type 1 patinet work in Covid19 lab ,
present with fever , SOB , chest x ray was
done
295. •
Describe the x ray ? Opacity on both side …..?
•
Investigations you order ? PCR , may need
O2sat , ABG
•
Medication you prescribe ? ( 4 point )
paracetamol or other analgesia, antipyritic ,
Vitamen c , antibiotic , may need o2 , ….?
298. •
Give 2 signs seen in the picture:
a.corneal arcus , xanthelasma
•
What is the next step?
Lipid profile
•
Give 3 other conditions to do the test:
diabetes, hypertension, clinical atherosclerosis
symptoms, erectile dysfunction, inflammatory
diseases; RA, SLE....
299.
300. •
What is this test?
Head impulse
•
What is the most likely diagnosis?
peripheral cause ; vestibular neuritis
301.
302. •
What is this sign ?
.Levine sign
•
What is your management?
call for help, oxygen, morphine, sublingual
nitrate , aspirin 325 mg , heparin , plan for
cath....
303.
304. •
What is this sign?
Air under diaphram
•
what is your diagnosis?
perforated viscus. peptic ulcer
305. Pt 40 year old came to you complaining
of sever depression & he take this drug
306. •
What is this drug used for ?
Smoking cessation
•
Do you advise him to take this drug?
no , varenicline increases risk of suicide; the
patient has severe depression
307.
308. •
What is the diagnosis?
Osteopenia
•
What is the managment?
frax score to decide giving bisphosphonates or
not , non pharmacological treatment; smoking
and alcohol cessation, vit d and ca
supplements , weight bearing exercise,.....
•
When he should repeat test again?
in 2 years
309.
Pt came to you complaining of chronic fatigue ….
•
Mention the most common causes of psychatric
fatigue: (4points)
depression , anxiety disorders, somatization
disorder, drug withdrawal
•
What are the initial tests done foe chronic
fatigue pt ?
.CBC, TSH , ESR, FBS, HBA1C , KFT, LFT, CK...
310.
50 years old male came to emergency BP 166/110
high creatinine glucose urea (+3) microalbumine
urea
•
According to the pt what determine that it’s
secondary HTN?
his age ( extreme age above 50 ), high presenting
blood pressure above 160/100 , presenting with end
organ damage ( kidney )
•
What is the goal of HTN needed?
140/90 because he has CKD ( not 150 / 90 according
to his age)
•
What is persistent HTN?
above target bp despite being on 3 anthypertensives
in maximum dose one of them is diuretic
311.
52 years old female postmenauopausal she did
mammogram 6m ago had HTN
•
What screening test she need?
A) Cervical ca
b) ovarian ca
c) osteoporosis
d)breast ca
•
What you well give her vaccines?
flu vaccine (influenza) , zoster vaccine , dtap
booster
312.
Diabetic pt came for regular testing
creatinine 0.6/ FBS 120
•
What drug seems she take ?
SGLT2 inhibitor
•
What other tests you will order next visit?
fundoscopy , microalbuminuria , lipid profile , LFT
313.
Pt complaining of dyspepsia associated with food
•
What is red flags you will look for?
bleeding(melena , ...) , unintended wt loss , family
hx of gi malignancies , dysphagia ( in history not
physical or labs !)
•
What is your management?
life style modification and prokinetic like
metoclopramide or domperidone
315. Q1 : Answer the questions about these
images of patient visit the clinic ..
316. A- What is your next step ?
Lipid profile
B- Mention the indications To giving statin?
indications to start stating primary or secondary
prevention……
317. Q2: patient coming to clinic complaining
of vertigo ..
Result : No
movement
318. A- what is the name of this test ?
HINTS exam
B- this test used for (MCQ) :
continuous spontaneous
C-What is the diagnosis ?
central cause such as stroke ( mostly
cerebellar)
320. A- what is the name of the test ?
PHQ2 (patient health questionnaire
B- For what reason we use it ?
screening for depression
C- If positive , what is your next step ?
PHQ9 and further psychological evaluation
321. Q4: patient 45y , came to emergency room complaining of chest
pain , after doing the examination & investigation its B.p was 90/70 ,
high jugular venous pressure , No heart sound heard by stetho-scope,
and his chest x-ray as the below ..
322. A- What is the diagnosis ?
cardiac tamponade
B- what is the name of these symptoms ?
Beck triad
323. Q5: 20y old came to clinic complaining of
cough of 10 week duration , No fever , medically
free , …
324. A- What is the diagnosis ?
Postnasal drip or upper airway cough
syndrome
B- What is the management ?
managed by nasal steroids ,
antihistamine and nasal decongestants
326. A- mention three indications to use it ?
osteoporosis , osteopenia with frax score of 20%
for major fractures or 3% hip fracture , fragility
fracture
B- Mention two side effects to this medication ?
gastroesophageal reflux, esophagitis,
hypocalcemia, jaw necrosis….
327. Q7: 35 y old male , complaining of Dyspepsia , he is
chronic smoker .. And don’t want to quit smoking , ..
A- write five investigation to exclude the causes of the
complain ?
h.pylori urea breath test, stool ag,,,, LFT,,,,,RUQ
ultrasound,,,,,,,lipase,amylase,,,,,, CBC
B- when to refer the patient to Endoscopy ?
same red flags
C- according to his smoking status .. What the stage of
change he is ?
precontemplation
328. Q8: The mother came to clinic with her two children of age
6m & 4y old , the Childs complaining of red throat , runny nose ,
no fever , no LN enlargement …
A- what is the preferred antibiotic to give in this case ?!
no need for antibiotics mostly viral.
B- what is the drug management for the complain ?
Antipyretics ,, nasal normal saline,,,,nasal decongestant
C- if the mother asking about giving her Childs (Flu vaccine),
what do you recommend her ?
flu vaccine should be given to the 3 year-old child but not for
those under 6 month-old
329. Q9: 35 y old female , came to clinic of 3 week Headache
, scalp tenderness , systemic joint pain , unilateral vision
loss , ..
A- What is the investigation of choice for this case ?
ESR,
B- What is the most likely diagnosis ?
temporal arteritis
330. Q10: diabetic 45 y old male patient taking
Glucophage & Amaryl , …
A- five Investigations And Tests to do ?
Microalbuminuria , urea and creatinine , LFT, HbA1C , FBS ,
electrolytes , lipid profile , vitamin b12 , fundoscopy….
B- If he had proteinuria and creatinine of 2.5 , What is the next
step ?
stop metformin and follow up KFT and FBS if high start
insulin or other oral hypoglycemic that can be given to a
patient of CKD
C- if his B.p 150/80, What is the most proper Antihypertensive ,,
And what do you order ( 2 point ) to monitor this drug after being
used ?
ACE- I or ARB , monitor Urea , Creatinine and K+ ( potassium )
331. Q11: 35 y old male complaining of Epigastria Pain ..
A- Five Differential diagnosis ?
acute coronary syndrome MI ,Perforated viscus
,Pancreatitis ,Epigastric hernia ,Stomach ulcer
B- Five Investigations to exclude cause of pain ?
ECG,TT and cpk,CBC and chemistry ,Amylase ,Cxr
,2DECHO ,US
C- A patient with inferior lead STEMI .. Headache ,
B.p is 90/50 , What drug to be avoided (MCQ) ??
Nitroglycerin
332. Q12: patient with SOB & chest pain ,
diagnosed as PE .. Mention the Risk factors for
such case ( 5 points) ?!
• previous DVT or PE2-recent surgery 3-
prolonged bed rest 4- pregnancy 5-
malignancy 6-hemoptysis 7 tachycardia
335. Q1
child present with stridor and dysphagia and high grade fever...
what is the name of the sign ??
Thumb sign
what is the most common cause of this
disease?
HIB, haemophilus influenzae type b
causing epiglottitis
The patient is cyanosed and decrease o2
saturation , what is the next step ?
intubate and admit ti ICU or secure airway
336. Q2
What is the name of the sign ?
Cullen’s sign
What does it indicate ?
pancreatitis, pancreatic necrosis, retroperitoneal
hemorrhage due to trauma or pancreatitis, ectopic
pregnancy
337. Q3
what is the name of this
thing ?
Frax tool
What is the diagnosis ?
Osteopenia
Management ?
1.life style
(diet,exercise,
sunexposure) and
ca and vit d supp
2.bisphophonates
338. Q4
A 44-year-old woman presented to the clinic to
establish care , She had a history of hyperlipidemia,
type 2 diabetes, Physical examination revealed
obesity and acanthosis nigricans
What is your diagnosis (based on photo)?
Hypertriglyceridemia.
What medication would you like to add beside statin
and insulin ?
fibrates
Other than cvs disease risk , what is the biggest risk
in this case ?
pancreatitis
https://www.aafp.org/afp/2009/0415/p699.html
339. Q5
What is the name of this questionnaire ?
PHQ 2 ,patient health questionnaire or depression screening tool
If secondary causes were ruled out ,, what other questions do you
ask to confirm the diagnosis ?
340. Q6
Name of this manuever ?
dix hallpike
If the result was negative , what is
your next step ?
assess for orthostatic hypotension
341. Q7
A 55 year old man came to your clinic for screening tests
If you knew that He took tdap before 5 years , what tests
you will do ?
BP measurement ( htn)
Low dose ct ( lung cancer )
Prostate specific antigen ( prostate cancer )
Colonoscopy ( colorectal cancer )
chest CT, lipid profile , FBS or HbA1C, BP measurement,
colonoscopy ( I ACCEPT PSA and DRE although it is not
recommended anymore)
الدكتورة إجابة
342. Q8
Patient with bilateral headache , Mild to moderate in intensity , History of breast
cancer
What is the diagnosis and what is the treatment ?
Tension-Type Headache
Tx : NSAID , analgesia , paracetamol
If the patient came back after several months with more severe headache and
aura , and neurological symptoms
What is the diagnosis and what will you order ?
brain metastasis ,
neuroimaging ( MRI , CT )
343. Q9
Fasting blood sugar 250
BP 120/80
Creatinine = 1.6
*What is the next step ?
Repeat FBS for conformation
* what is your management?
1. life style modification(.....)
2. give sulfonylureas or insulin because his creatinine is 1.6 so
metformin is Contraindicated
* 2 side effects of the drug you chosen?
Hypoglycemia
Weight gain
If the patient developed HTN Which drug we use??
ACE inhibitor or ARBs
مهم
344. Q10
A 60 year old man who had past Percutaneous coronary intervention and
has a stent ,, came to your clinic saying that he wants to quit smoking after 3
months .
Which behavioral stage is he in ?
Contemplation
he says that he is willing to use Varenicline (Chantix), what is your medical
opinion ?
I would prefer the usage of bupropion , bupropion is recommended for
smoking cessation in patients with cardiovascular disease
no, it is not a good option for you because of its bad effects on heart; it
can increase the risk of MI and you have had PCI!
الدكتورة إجابة
Mention the 5 “r”s
Relevance
Risk
Rewards
Roadblocks
345. Q11
65 y old age complaining of dyspepsia , he has
dysphagia no vomiting ,, h pylori test was positive
What’s the next step?
refer for endoscopy, the patient has 2 red flags
( the age and dysphagia )
347. 1- Describe what you see in each picture
SC nodules B-->erythema marginatum
2- What’s your diagnosis ?
dx--> acute rhaumatic fever
3 Mangement >> antibiotic penicillin
348.
349. Female controlled htn blood pressure 130 / 90 no history of cvd
take enalopril From picture ASCVS risk was 5 (not this picture
but similar one )
-Did she need aspirin ? No
-Did she need statin ? No
-other 2 things when put in Ascvd score ? Diabetes and smoking
-2 side effect of her anti hypertensive
medication ?
Cough and angioedema
350. patient With continuous spontaneous vertigo
What is your target physical examination ?
Head impulse , nystgmus
• 2- if + what diagnosis ? Central ( stroke )
351. -What is your spot diagnose ?
)Mark on red area ) Osteoprosis
- first line mangement ?
Bisphsphonate
-Electrolyte disterbance
should be aware in treatment ?
Hypocalcemia
352. -when we do this
screening test ?
(Low dose lung ct
)
in adults aged 5 5
to 80 years who
have a 3 0 pack-
year smoking
history and
currently smoke or
have quit within
the past 15 years.
353. • Vaccination for pregnant
1. Influanza vaccine >> in october
2. Tinnitus vaccine >> third trimester ( 27 – 36
weeks of gestation )
354. 1-mention basic investigation in fatigue :
CBC/LFT/KFT/TFT/CK/ESR
2- 4 indication for abdominal x ray ?
1- choylithiasis
2- nephrolithiasis
3- appendicolith
4- pancreatic calsification
355. - Differential for right iliac fossa pain ?
• Appendicites
• Pelvic pain
• Constapation
• Inguinal hernia
- Investigation of abdomial pain ?
• cbc
• Electrolyte
• Urinanalysis
• Amylase and libase
- Treatment ?
Establish IV accesses and hydrate patient >> npo
Treat symptom >> analgesic , antiemetic , antiacid
357. Patient with chest pain radiate to left arm
relived within 15 min start after exertion
• Diagnose ? Stable angina
• Investigation ? Ecg , cardiac enzyme , cbc
• Treatment ? Aspirin ,oxygen , nitroglyceren ,
heparin
358. - New onset of worst headache in patient
life ?
Differential ? Cranial infection , inter cerebral
hemorrhage
Investigation ? Ct without contrast ,MRI without
contrast
360. A-what is the finding? Corneal arcus
B-what is the next step ? Lipid profile
361. •
A- what it’s the antihypertensive drug
Contraindication in this case ? ACEI
B- mention other two contraindications for
This drug ?
1-Pregnancy or breastfeeding
2- Previous angioedema
3- pt. with hyperkalemia
C- mention 3 uses for this drug ?
• Acute myocardial infarction (heart attack)
• Heart failure (left ventricular systolic dysfunction)
• diabetes mellitus
• Stroke
362. If age patient 65 year , name 3 vaccination you
should give :
Influenza
pneumococcal
zooster
365. male pt aged 50 years in clinic dr ordered for HbA1C /lipid
profile the result was normal
A-write 4 screening test ?
•
Abdominal Ultrasonography
•
BP measurement
•
Colonoscopy
•
Low dose CT scan
•
prostate specific antigen (PSA)
366. •
What it’s the diagnosis ?
Compression fracture
•
T score for this case ?
•
T= < or = -2.5
367. 12 yrs old child with fever 38.6 with cervical
LN swelling , absence cough
1-what is his centor score
2-what is the treatment
Answers
1- 5
2- antibiotics
368. • What it’s the D.X ?
• Diabetic dermopathy
• Mention other two skin lesions can occur in
this pt . ?
• Necrobiosis lipoidica
• Acanthosis nigricans
369. عندو واحد سؤال في كان
dyspepsia
ال كل حاطه وكانت
red flags
من اكثر عمرو كان بس موجوده مش انها
50
فهاي
red flag
• What it’s the next step ?
• Upper endoscopy
370. عشان خطط يعمل بلش واحد انو سؤال في كان
دخان يترك
• Name this stage ?
• Preparation
• ** example for :
• Relevance >>>> pregnancy
• Roadblocks >>>> wt gain
371. • Name of these test
- Head impulse
- nystagmus
• Diagnosis >> central
cause
373. • Centor score = 2
• Manegment >>> rapid antigen test >>> if +ve
give anti biotic
If –ve order for culture …. >>> if +ve give anti
biotic
If –ve supportive
386. Q1
• MCQ
• Patient came to family clinic like this picture
what your management :
1. not your responsibility
2. Do ECG if normal المريض روح
3. Do ECG if normal repeated every hour and do
cardiac enzyme
387. Q2
A. Write the diagnosis ? Cluster headache
B. Treated by ? 100% O2 nebulizer for 15 m
ريكورد
388. q3
• Patient 44 y old came with fever ,absente of
cough ,(tonsilar exudate according to picture )
A. Centor score =3
B. Approach : do throat culture and rapid
antigen test if negative conservatve if
positive treat with antibiotic
C. Two bacteria causes URTI :gA streptoccocs
+…
389. Q4
A. What the picture show ? Frax score
B. if the results was 20% and 9% what your
management ? Bisphosphanate and life style
modification اكيد ومش
390. q5
A. ؟ اكثر ليستفيد للمريض بتضيف شو
B. Mention the 5 As
391. Q6
A. Test with high HbA1c and FPG and
cholesterol +LDL What the diagnosis ?DM
+dyslipidemia
B. Management : metformin +statin +life style
modification
392. Q7
A. What is this picture ? dix-hallpike test
B. For what ? Diagnosis for BPPV
C. What is this picture ?epley maneuver
D. For what ?treatment for BPPV
393. Q8
A. Picture for what ?diabetic foot ulcer
B. Tow medication for numbness ? Pregapalien
+duloxetine
C. If diagnosed with HTN mention one
medication and the common side effect for it
?ACE inhibitors
chronic cough
397. Q12
A. FEMALE pt. with dysurea ,frequency ,no
fever or vaginal discharge =empirical
treatment
B. Two month later her husband came with
dysurea =culture and urine analysis
سؤالMCQ
402. *3 year old children ,come to clinic with 38.3
fever but with cough /no tender LN
1-calculat centor scor : 2
2-management :
Culture /RADT test
3-mention two Ddx :
Infectious mononucleosis/
group A streptococcus
403. FRAX score : T score = -2.3
major osteoporotic = 30
hip fracture = 4.7
1-Dx : osteopenia
2- mention 4 lines for management :
Bisphosphonate /raloxifene /denosumab /
calcitonin / Vit D / Ca supplemet/ ……..
404. **Patient come to your clinic with dizziness
1-Intial evaluation :
BP measurement
2- Three causes for
His dizziness :
Give 3 causes for orthostatic hypotension
405. PFT : FEV1/FVC = 70 %
PRE-BRONCHIDILATOR FEV1 = 40 %
POST-BRONCHIDILATOR FEV1 = 50 %
1- Dx : COPD
2- If age patient 65 year , name 3 vaccination
you should give :
Influenza / pneumococcal / zooster
407. *35 year man ,obese and smoke , come to your
clinic . His father was diabetic and diagnose
with colon CA at 55 .
**Three screening test in this visit .
FBS,Hba1c / blood pr / lipid profile
408. Patient suffer from dyspepsia,
pain is related to food
1-intial step in your management :
Exclude red flag symptoms
2-If all investigation is normal , mention first
choice drug and duration :
PPI for 3 month
409. 1-mention basic investigation in fatigue :
CBC/LFT/KFT/TFT/CK/ESR
2-MENTION 4 sleep hygiene ;
Avoid caffeine / increase activity in afternoon /
increase exposure to sunlight /
use bed only for sleep
410. *Patient with asthma , recurrent 3 times/W at
nighttime :
1- what the severity of asthma :
Moderate or severe persistent asthma ( both
accepted )
2- how to control this condition :
high dose inhaled corticosteroid
412. Q1:
A-write name of this test? test of skew
B-if result of this test is vertical gaze what is the diagnosis ?
Central vertigo(stroke)
C-write two other test with their result according to your
diagnosis ?
1-test of nyastigmus…..vertical
2-head impulse……no saccade (negative)
413. Q2:
A-what is the finding? Corneal arcus
B-what is the diagnosis (or what do you look for in
screening ) ? dyslipidemia
C-write two indication of statin therapy ?
1-LDL>=190
2-diabetic pt aged 40-75yr with LDL(70-189)
414. Q3:
A-what is the name of this finding ? Necrobiosis lipoidica
B-write two side effects of sulphonylurea ?
1-hypoglycemia 2-weight gain
250
كأنو
C-if the patient HbA1C=8 and RBG=
And the pt. is smoker ,take number of drugs like metformin
and has multiple neuropathy give 3 lines of management ?
1-lifestyle modification(stop smoking/ improve diet)
2-pregabalin/gabapentin….
3-b12 supplemment
417. Q6- what is this test , and its used for screening
of what ?
PHQ 9…….for depression
418. Q7- female patient 42 years old came to clinic
complained from dry cough , there is fever 38
and tender lymph node
A-centor score ? 3
B-management ? Order for culture or rapid
antigen test if + give antibiotic/ if – supportive
419. Q8-female pt aged 56 years with chronic kidney
disease ,in clinic dr ordered for HbA1C /lipid profile
and measured bpr the result was normal
A-write 3 screening test ?
1-mamogram
2-colonoscopy
3-dexa scan
B-write 3 vaccines for this pt ?
1-influenza vaccine
2-pneumococcal vaccine
3-zoster vaccine
420. Q9-HTN pt. with stroke and gout
A- what is the prefered medication for this pt ?
ACEI
B-write 5 basic investigations for htn pt ?
1-cbc/Hct/Hb
2-HbA1c/FBG/RBG
3-ecg
4-lipid profile
5-complete urinanalysis
421. Q10-female pt 27 years presented with chronic
dyspepsia and feel it as epigastric pain
A-if the red flag excluded what is the next step ?
Looking for h.pylori(urea breath test/stool
antigen test)
B-if anti acid is failed what is the next line of
management ?
TCA
422. Q11-write 4 indications to pt with headache to
do neuroimaging ?
1-neurological deficit
2- neck stiffness
3- sever headache after trauma
4-papilledema
424. • Test of skew was positive + picture of two
results for head impulse test
• what is the result of the test in picture?
Normal
• what other tests you should do ? Test of
nystagmus
425. • 56 years old male he was screened for htn
blood glucose and lipid profile
• What other screening tests you should do ?
Colon ca , lung ca , prostate
• What vaccination you should give him ?
Influenza , pneumococcal and zoster
426. • 49 years old female with dry cough temp 37.5
no exudates and lymph node swelling
• Centore score ? -1+0+0+0+1 = zero
• Management ? Conservative
427. • Red flags for headache ?
Worst hedache ever , focal neurological signs
and papilloedema
428. What is the name of the lesion ? Acanthosis
nigricans
Mention 3 causes ? Dm , pcos , steroids .....
430. • Tsh low with normal t3 and t4
• What is the diagnosis ?
Subclinical hyperthyroidisim
431. • What is it called ? Fraxscore
• What does it mean or indicate ? For the risk
of fractures in the nesxt 10 years
• When to use it ? Osteoporosis *
432. • Mention lab tests for htn patient ? Cbc , hb,
urinalysis, lipid profile .....
• Mention clinical sign for sec causes of htn ?
Diaphoresis and tachycardia for
pheochromocytoma , renal bruits for
renovascular disease , obstructive sleep apnea
.......
433. • Pic for colles fracture ?
• What is the name of fracture ?
• Describe it ? Linear fx of distal radius with
displacement of ulna ...
434. • Male came to the clinic hba1c 6.2 fbg 120
ldl 200
• What is the diagnosis ? Prediabetic
• What is the management ? Life style
modifications weight diet exercize ,
metformine , statine
• When to repeat tests ? After 1 year
437. • Regarding Chronic fatigue syndrome :
• 1- mention 4 symptoms (criteria)
• -unrefreshing sleep –post exertional malaise -a substantial reduction
or impairment in the ability to engage in pre-illness levels of various
life activities -cognitive impairment -orthostatic intolerance
2- mention 3 lines of management
• -CBT -GET -anti-depressants?
438. 8 years old boy comes to the clinic with his mother with a history of mild
trauma on his heel, he has tenderness in his ankle with no erythema or
swelling, and can bear weight, what’s your diagnosis ?
diagnosis: normal X-ray tx: reassurance
439. 1- Describe what you see in each picture
SC nodules B-->erythema marginatum
2- What’s your diagnosis ?
dx--> acute rhaumatic fever
440. An 18 years old male patient comes to the clinic with dry cough, his body
temperature is 38.5, he has tonsillar exudates and tender anterior cervical
lymphadenopathy.
1- calculate his centor score? 3
2- what’s your management
order throat culture or fast antigen detection test and wait for results
441. • Regarding Metformin :
• 1- mention 3 benefits
• low side effects like hypoglycemia -cheap drug -reduces the risk of
cardiovascular events -prevents from the development of DM type 2
• 2- if this patient is set to do a surgery, when should he stop using metformin
before surgery, and why ?
• stop the drug before 48 hours to prevent lactic acidosis
442. • A 56 years old male patient comes to your clinic suffering from
COPD :
• 1- Mention 3 screenings you would do for him
• -blood pressure--> hypertension -colonoscopy--> colorectal cancer -
random blood glucose--> DMM
• 2- mention 3 vaccines that you would give him
• -varicella -pneumococcal vaccine-infleunza vaccine
443. 1- What’s the name of this test ?
test of skew
2- if this test result was abnormal, then what would be the result
of the head impulse test and nystagmus test ?
2)head impulse-->normal, no saccade -nystagmus-->vertical
nystagmus
444. • A picture of lab results where the TSH and T4 are both below the
normal level
• What’s your diagnosis ? 2ndry hypothyroidism
445. • A picture of DEXA scan results where T-score is -4
• 1- what’s your diagnosis?
• osteoporosis
• 2- mention 3 lines of management
• weight bearing exercises bisphosphonates calcium
and vit D supplements
447. Q1:
TSH T3 T4
Low Low Low
What’s your diagnosis:
Secondary hypothyroidism
448. Q2:
1) What’s your diagnosis:
Dyslipidemia
2) What is the next step :
Lipid profile
3) What is the indication of statin in
primary prevention :
1- LDL-C >=190 mg/dl
2- Diabetes and aged 40-75 years with
LDL-C between 70-189 mg/dl
3- No diabetes and estimated 10 year
ASCVD risk of >= 7.5 % who are
between 40 to 75 years of age with
LDL-C between 70-189 mg/dl
449. Q3:
1) What is diagnosis :
Varicella Zoster
infection
2) How we can
prevent it :
Varicella vaccination
452. Q6:
• Age 50
• Fever 38.5 With cough No lymph node
enlargement
• On pic > no exudate erythema
1) what is his centor
score?
zero
2) what is the treatment?
conservative
No AB
453. Q7:
1) What’s the pattern of disease:
Obstructive
2) What is your Dx?
asthma
3) What is your management :
Stop smoking
Avoid triggers
Pharmacological:
SABA….
454. Q8:
female / 60 year
1) What’s your diagnosis:
IDA
2) What is the possible causes in this
case :
* malabsorption > celiac dis
* blood loss > AUB
* increased requirement like cancer
MCV Hb RDW
70 10 High
455. Q9:
Pt with vertical nystagmus ..
نتيجة تتوقع شو test of skew + head
impulse?
• skew : Abnormal
• head impulse : Negative
456. Q10:
• HBa1c : 8.5
• Fasting : 150
• Random : 200
1) Diagnosis:
DM
2) First line of ttt :
3) If there is loss of sensation after 6 months:
* metformin side effect ( B12 deficiency )
* neuropathy as complication
4) Screening for nephropathy and when ?
Microalbuminuria : Every one year
KFT every 6 month
457. Q11: A
Patient smoker / age 19 / ER with BP 170/110
1) Diagnosis:
secondary HTN
2) انه عرفت كيف secondary :
Age less than 20
First reading of BP is high
458. Q11: B
Drug of choice
Recurrent stroke ACE
Migraine B2 blocker
Post MI b2 blocker or ACE
?????
Pregnancy methyldopa
459. Q12:
Patient came to clinic / 38 y / his dad >
توفى
colorectal cancer at 55 year :
1) At which age do colorectal cancer screening :
40
2) What’s other screening teat do at this visit :
Lipid profile
BP measurement
461. األول السؤال
1-what is the test name
2-if +ve what is the diagnosis
Answers
1-Dix Hillpike maneuver
2-BPPV
462. 12 yrs old child with dry cough fever38.6
with cervical LN swelling
1-what is his centor score
2-what is the treatment
Answers
1- 4
2- antibiotics
463. A 66yrs old female medically came to
your primary care
:
facility
A-Mention 4 screening test you would
do for her
B-mention 3 vaccines you would give
to her
A-Mammogram
BP
Blood glucose
Dexa scan
B-Vaccines:
Pneumococcal
Influenza
464. Patient age 18 clime mountain and suddenly
faint ….the BP160/100
4 Basic investigations for Hypertensive
pt:....
What is the cause of low potassium mention 3 :
Diuretics /hyperaldosteronism (cons disease)
Cushing disease
465. Patient age 45 and uric acid analysis is
measured :6.5 , write down 3 indication of
treatment :
1. One ore more attack
2. Leukemia
3.And more than 10 score in its criteria
466. A female patient age 45 :
قيم في جدول في كان
t score
ال و
z score
What is the diagnosis : osteoporosis
Write down three non pharmacological
treatment to this patient :
1.Exposure to the light
2.Diet rich with vitamin d
3.Calcium rich diet
4.Weight loss but not less than 20 bmi
5. Walking and exersice
467. 45 year old female .. A1C : 6.7 , Fasting 129
- Diagnosis? Diabetic patient
- mention 3 line of Treatment ?
Metformin/diet and weight loss/ sulphanylurea
(amarel)/ insulin
468. ال قيم فيها صورة
TSH ,T4, T3
ال حاطه كانت و
normal
values
TSH high, T4,T3 normal
1- diagnosis : subclinical hypothyroidism
2- when do you treat it: pregnancy, infertility,
when patient becomes symptomatic, goiter,
dyslipidemia, refractory iron def. Anemia
بدها كان
بس
3
470. What is the abnormality : st elevation in lead
2,3,avf
What is the diagnosis: inferior mi
471. ال قيم فيه جدول
rbc/hct/rdw/iron /ferritin :
What is your diagnosis : iron deficiency anemia
Write three cause you want to investigate for :
-malabsorption
-blood loss
-low diet intake
473. Q1 Case :
Table with value of ( T3 / T4 / TSH )
فيه كان
T3 AND T4 normal
TSH decrease
What diagnosis ? subclinical hyperthyroidism
474. •
Q2 :
•
1- what the name of
these picture ?
•
asthma action plan
•
Q2 :
•
if the PT come with
no improvement of
symptoms Write 4
causes :
•
)
تقريبا هيك زي
)
475. •
Q2:
•
Pt with value
•
HbA1C : 5.3
•
FPG :95
•
1- What your diagnosis :
•
Normal pt
•
2-
•
ك فحص يسوي بده اذا
screening
•
بعد كانه ؟؟ يعمله الزم متى
3
او
4
سنوات
476. •
Q4: pt with
history of HTN:
•
1- what the name
of this sign ?
•
buffalo hump
•
2- what your
diagnosis ?
•
Cushing
syndrome
477. •
Q5:
•
patients come with fatigue
•
1-write 3 investigation?
•
CBC/ KFT / KFT / TSH /ESR
•
•
2- Write 4 Good Sleep Hygiene measures?
•
- maintaining a regular morning rising time
- increasing activity level in the afternoon
- avoiding exercise in the evening or before bedtime
- increasing daytime exposure to bright light
- taking a hot bath within the two hours before
bedtime
478. •
Q6 :
•
1- What diagnosis ? PVC
•
2- what treatment ? reassurance
479. •
Q7 :
•
1- What the name of
virus?
•
varicella-zoster
•
2-
•
أي تكتب لو بنعطيه عمر الي
ال عمر فوق شخص
50
صح
480. •
Q8 :
Male pt 66 years old , smoker
Write 4 screening ?
Q9 : CBC decrease MCV /MCHC/ MCH
INCREASE RDW ?
1- what diagnosis ? IDA
2- Write 4 possible causes ?
3- 3 sign appear in pt ?
angular stomatitis , koilonychia, pallor
481. •
Q10:
•
1- what the name of this test ? test of skew
•
2- if + what diagnosis ? Central ( stroke )
482. •
Q11
•
55 years old pt presented with fever 38.9
•
With no cough ……….
•
1- 1-what is his centor score ?
+1
2-what is the treatment?
Conservative
483. Q12:
A 44 yrs old male with multiple cardiovascular risks
and a history of ischemic heart disease LDL 200
g/LTG 150 g/L
What is your management??
Start statin therapy
Modify risk factors
Weight reduction
Smoking cessation
486. Question 2
1-What is the diagnosis
2-Mention 3 eye changes in this disease
Answers
1-Hyperthyroidism
2- Exophlamus
Lid lag
Lid retraction
487. Question 3
ECG picture with ST segment elevation in leads
2,3 avf
1-Findings in the ECG
2-Diagnosis
3- 4 lines of treatment
488. Question 4
PFT
1-type of the disease (obstructive or
restrictive)
2- diagnosis
كان الثاني السؤال جواب
Asthma
ال النه
percentage
change after bronchodilator
كان
>
12
%
489. Question 5
Picture of koilonychia
1-name of the finding in the picture
2-what is the most probable diagnosis
490. Question 6
12 yrs old child with dry cough fever38.6
1-what is his centor score
2-what is the treatment
Answers
1- 4
2- antibiotics
491. Question 8
What is the findings in the picture
Mention 4 causes
findings
Angioedema
Causes
ACE inhibitors
Bee stings
492. Question 9
A 66yrs old female medically came to your
primary care facility
A-Mention 4 screening test you would do for
her
B-mention 3 vaccines you would give to her
A-Mammogram
BP
Blood glucose
Dexa scan
B-Vaccines:
Pneumococcal
Influenza
Zoster
493. Question 10
A 44 yrs old male with multiple
cardiovascular risks and a history of
ischemic heart disease LDL 200 g/LTG 150
g/L
What is your management??
Start statin therapy
Modify risk factors
Weight reduction
Smoking cessation
494. Question 11
Male patient screened for DM
HbA1c 6.3
Fasting blood sugar 120
1-what is the diagnosis
2-what are the lines of treatment
1-prediabetic
2- metformin
Weight reduction
Smoking cessation
495. Question 12
Patient BP is 150/90
1-mention 4 signs you would exam for
secondary HTN
2-mention 4 test you would do for him
497. 1-
- Hints Test Picture, ans. Head impulse
- if +ve what's the diagnosis? Ans: Peripheral
disease.
2- Exophthalmos Pic
- What's the diagnosis? Ans: hyperthyroidism
- mention 3 what causes this disease? Ans:
Graves, Thyroid Adenoma , Toxic Thyroiditis
etc
3- X-ray pic of air under diaphragm, diagnosis?
PUD
498. 4- ECG with ST elevation in lead v1 V2 v3
v4 and lead 3 , diagnosis? Acute Anterior
STEMI , management? Ans: Mona B.
5- Pic of angular stomatitis , diagnosis? Iron
deficiency anemia
6- Tounge of Viral infection ?
12 year old, no fever, no exudates , no
lymph node tinderness ,
- centorscore ? 1
- management? Conservative
499. 7- PFT pic
- Pattern of disease? Obstructive
- diagnosis? COPD
8- 66 year old , -2.6 T score
Diagnosis? Osteoporosis
What's first line treatment? Bisphosphonats
Mention 3 screening test? Blood glucose level,
colorectal cancer, lung cancer, Blood Pressure
etc.
9- 45 year old female .. A1C : 6.7 , Fasting 129
- Diagnosis? Diabetic patient
- Treatment ? Metformin
- SE of that treatment? B12 Def., Lactic
acidosis , GI Upset
500. 10- 20 year old female, BP. 170/100
- Causes of 2ndry Hypertension ? Cushing,
Hyperthyroidism, Sleep Apnea
- Lab tests ? CBC, Lipid profile, Urine
analysis , ECG
11- 30 year old , pregnant in 8th week it's
July now, What's the vaccine? And when to
give ?
1- Tdap , 27th - 36 th week
2- recombinant influenza , anytime ( Usually
in October )
504. Q3. CBC picture, diagnosis : Iron deficiency anemia,
Management plan: diet, oral ferrous sulphate, iv..
if no improvement what are the possible causes:.
505. Q4. Xanthalasma on both eyelids,
what you do next : order lipid profile.
506. Q5. Image of sore throat and erythema, temp.
38.6, dry cough for 3 days, age 40, no
Lymphadenopathy. Centor criteria: 1,
management : conservative (self limited)
507. Q6. Image of air fluid level, small
bowel obstruction.
Hypertensive DM patient on atenolol ..... Dizziness 140/80 when he sit 110/90 stand what is the type of dizziness? Causes of this type Orthostatic hypotension Atenolol + DM
Focal neurologic signs
Papilledema
Neck stiffness
Immunocompromised state
Sudden onset of the worst headache in the patient's life
Personality changes
Headache after trauma
Headache that is worse with exercise
>50 years old
