5.dr hishsham

7/23/2019 5.Dr Hishsham

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(1)

1. Case of organophosphate poisoning symptoms of miosis,

diarrhea, twitching. Treatment?

=oxygen

=recently ingested gastric lavage+ charcoal

=Atropine parlidoxin

!. Car"on monoxide #oisoning.

$ia% = A&' (ser)m car"oxyhemoglo"in level*

(ormal - smoer 1/*

=0C' (old cardiac patient*

Treat% =1// oxygen (till asymptomatic or car"oxy% normal*

= 2yper"aric 3! (pregnant, cardiac ischemia C4 .

4ign*

5* AT6$3T04=Acetaminophen =7 8acetylcystine.

=&en9odia9epam =7 :l)ma9enil

=&ar"it)rates =7 )rine alali9ation, dialysis, active charcoal

=6ron =7 deferxamine

=3pioids =7 naloxone

=&8"locer =7 'l)cagon

=copper,lead,arsenic,gold =7 penicillamine

;* Treatment of panic disorder?

&en9odia9epine (immediate relief*. 44


2/39

-.3"sessive comp)lsive disorder treatment?

. (:l)oxetine (446 >0 test still insisting no 6 am

s)ffering from 26>.

(2ypochondriasis*

. A woman enco)ntered with


3/39

1!. Fostly female complains different organs at times lie

m)ltiples sites pain, also ne)rological,'6,sex)al pro"lems

.:reG)ent clinics contacts.

15. Anorexia nervosa. @hat is a reG)ired feat)re?

(:ear of weight gain*

1;. 0C' of F6 + history of recent intracranial "leeding, next.

(Hrgent #TCAB#C6*

( less than D/ min)tes Throm"olysis if no any .

contraindication and non8availa"ility of Angioplasty

1- ,0C' of ventric)lar tachycardia in an 62$ patient d)e to F6.

(;*


4/39

1. 0C' of A: with low and )nsta"le.

(4end emergency department*

1. #, m)ffled so)nd and withgood air entry on "oth l)ngs. 6nvestigation?

(0C23*

1. #atient with a"d% aortic ane)rysm.

=1f si9e is less than -.- (o"servation with )Bs*

=Fore than -.- or with throm"osis (s)rgery*

=


5/39

1D% / years old man with di99iness, tachycardia, old hBo of A: and

!- carotid stenosis. @hat is next step?

(0cho*

!/. A pt% with 2T come with heart fail)re. 45 so)nd .what ind

of cardiomyopathy with 2T.

(2ypertrophic B$ilated cardiomyopathy*

!1. #atient is taing AC0 inhi"itor what yo) will watch.

(


6/39

!. A child with systolic m)rm)r !B on )pper stern)m when lying

down disappear .

(6nnocent m)rm)r*

!. :ail)re to thrive + pan systolic m)rm)r in ; month old childJ

diagnosis? .

(>4$*

(F)rm)r disappear d)e to p)lmonary hypertension*

!D. 3ld lady with hip L )nderwent hip fixation s)rgery after !;

ho)rs she went into p)lmonary em"olism and died .what is the

ca)se of death?

(Cardiop)lmonary arrest*

5/. 4ta" wo)nd with "ilateral eG)al air entry, distended nec veins,

hypotensionJ.diagnosis? . .

(Tamponade*

51. 4cenario in which patient has systolic m)rm)r, chest pain,di99iness and dyspneaJdiagnosis?

(Aortic stenosis*

5!. 4cenarios #)lmonary 0m"olism

Chest pain, dyspnea, chest "asal crepts

=#ost8operative patients (Foo s)rgery*

=After long flight traveling

=2B3 $>T, 3C#

(*


7/39

55. A yo)ng man presented with s)dden onset of pale, cold, lower

lim" with a"sent p)lses. Ca)se?

(Arterial em"olism*

5;. A middle age man with nee pain, diffic)lty in waling.


8/39

5D. years old girl with p)"ic hair and "reast ")ds

diagnosis? . (Central precocio)s p)"erty*

;/. -yrs old female '# with stress incontinence vaginal

prolapse treatment? .. (>aginal hysterectomy with anterior colporrhaphy*

;1. #regnant patient with Dcm dilated cervix and in severe pain,

now reG)ests for treatment of painJ.? .

(0pid)ral*

;!. #atient with complaints of fever, adnexal tenderness

m)cop)r)lent dischargeJdiagnosis?

. (#6$*

;5. C6 66 666Jtreatment?? (2igh grade dysplasia*

(Meep C/ld8Nnife Coni9ation .6f rec)rrent hysterectomy

(Colposcopy with cone "iopsy*

;;. @ees pregnant as per MF# on antenatal care her f)nd)sheight is ! wees .what will yo)

do. . (


9/39

(D*

;% Fiddle age woman with l)mp !.- cm non tender ,firm on

)pper G)adrant, no discharge, no sin change, no axillary lymph

node enlargement.

(:i"roadinoma*

;% A f)ll term in la"or room with good progress cervix ; cm

dilatation + +! stations. 4he progress to D cm and + ; station.

4)ddenly fetal heart "eat drop from 1;/ to ;/ "eats with varia"le

deceleration. @hat will yo) do?

(C84ection*

;D% A middle age woman come with severe dysplasia pap smear

res)lt .what next?

(Colposcopy Cone "iopsy*

-/. A yo)ng lady with menses irreg)larities from !5 to 5- days

with normal menstr)al loss. @hat yo) advise her?

(3C#*

-1% A female present with m)ltiple pain f)ll )lcers on la"ia,

cervix red p)r)lent discharge, + lymphadenopathy.

(2erpes simplex vir)s* if active (C8section in pregnancy*

-!% A case of amenorrhea, mily nipple discharge. 6nfertility,

"itempral hemianopia.

(2igh M2B :42* (&romocriptine or ca"ergoline*


10/39

(1/*

-5% '5#! previo)s ! normal vaginal deliveries with "reech

presentation at 5 wees. 4he was presented on clinic "efore 5;

5 wees ")t no action taen. @hat next?

(0xternal cephalic version*

-;. 1 years old girl with hBo amenorrhea, no "reast and no p)"ic

hairs. 2igh :42. Mow estrogen diagnosis?

('onadal digenesis* T)rner syndrome

--% fetal compaction d)e to smoing.

(6H' complication in fet)s.

(Anencephaly*

-. Feningococcal prophylaxis in contacts?

(


11/39

(11*

!. #ainless testic)lar mass or ac)te severe pain?

(0mergency s)rgery*5% A yo)ng girl with m)mps involving overiescomplication.

(4A6$*

;P 1/ yearOs "oy parotid swelling with intermittent testic)lar pain.

@hat do next?

(4A6$*

-% 1/ years "oy with >on @illi"rand disease developed perf)sed

epistaxis.what wo)ld yo) give?

($$>A#*

% A child with pain in hand and leg and hepatosplenomegaly%

( 2eamoglo"n 4*

% A yo)ng man come with m)ltiple "r)ises all over "ody after

taing Ta"%4eptran .

('#$*

.A child living in farm ho)se history of a"dominal pain, no

diarrhea. HT6 . @hat investigation.

( 4tool for 3va and cyst*

/. A ;years old child with ")rn lower lim" and perineal region.

@hat will go first?

@ater (other option,N,a,)rea*


12/39

(1!*

1%A C2M6$ with 5 fever , active, hydrated and playf)l. @hatwill yo) do?

(3"servation*

!% A 15 years o"ese "oy with nee pain since month. o history

of tra)ma, weaness and n)m"ness ")t


13/39

( 15*

D%A child with displaced s)pracondylar Lh)mer)s .

(open red)ction+ internal fixation*/% A "a"y with a)ndice, "ilio)s vomiting and on Q8 ray do)"le

")""le shadow.

($)odenal Atresia*(:irst of life*

1% A child with proectile vomiting and small mass in epigastri)m.

6nvestigation?

(HB4 * pyloric stenosis (!ndor 5rdof life*

!% pict)re of 2and (Nawasai* child with pain in hand , fatig)e.

Asing a"o)t investigation.

( 0cho "Bc of coronary artery ane)rysm *


14/39

( 1;*

5% pict)re of x8 ray (


15/39

(1;*

% A child with mild dehydration.

(oral ! gl)cose +- mmol acl8&% 4evere dehydration in male child.

(1// ml Bg*

%A child H gl)cose*

D5% 4ide effect of forceps delivery.

(:acial #alsy*


16/39

(1-*

D;. 4ide effect of vac))m delivery.

(cephlhaematoma* corneal a"rasionD-% A child who is good at home ")t at school not co8operative,

does not tal to any "ody.

(selective m)tism*

D% A 1- days old "oy looing pale, mother has A&8ve,temp.5-c.

least common ca)se.

('#$*

D% eonatal a)ndice ,temp% 5-c ,constipation and not feeling well

direct "illi% high .and indirect slightly high

(sepsis*

D. Term neonate with fl)id in interlo"ar fiss)resJdiagnosis?

. (Transient tachypnea of new"orn*

DD. Child with ro)nd worm manifestationJtreatment?

. (6"enda9ole.*

1//.. Child with digital cl)""ing, fail)re to thrive,

diarrheaJ.diagnosis?? .

. ( Cystic fi"rosis*

1/1. Child with ac)te lymphocytic le)emia sched)led for somes)rgery, ")t parents donOt want to proceed with s)rgery and want to

leave the hospital with child. @hat wo)ld ) do?

(Age concerned*


17/39

( 1*

1/! #atient with ac)te asthma, on treatment with ipratropi)m +

sal")tamol+ oral steroids. 3n $C what wo)ld )

give? . . . . . . . . . (fl)cotisone*

1/5. Case scenario with C4: findings of low gl)cose, #FOs

with fever

meningism)sJ.diagnosis? .

( &acterial meningitis*

1/;. #atient with cro)p with "aring co)gh, treatment?

. (


18/39

( 1*

1/, 2iistory of dysphagia to solids, now with liG)idsJnext

what wo)ld ) do?

= H'6 endoscopy if yo) s)spect mechanical o"str)ction or

=otherwise "ari)m swallow.

= 6n achalasia than manometry

1/D,.omplaint of "loody diarrheaJno travelling history, no

vomitingJoptions % Fost common campylo"acter,

11/.1!. Case of raised #4A level . with o"str)ctive )rinary

symptomsJnext step?

. (TH


19/39

(1*

11!.. Case of dia"etic patient with complaints of "l)rred vision,

haloes (rings* aro)nd lights at night timeJ. $iagnosis. .

. (cataract*

115. #atient with complaints of headache with photopho"ia, nec

stiffness, ptosis,no feverJ..diagnosis? if severe occipital

. (4)"arachnoid hemorrhage,*

11;. :emale with proximal m)scle weaness (diffic)lty com"ing

hair* CN levels are increased, no pro"lems in eyeJ..

$iagnosis? 6nflammatory myopathy. (polymyositis*

11-. Fale patient, lifted heavy o"ect with complaints of low "ac

pain. Anle reflex is present, no ne)rologic deficitJtreatment?

. (


20/39

11. 0lderly patient with fever, left lower G)adrant pain, peritoneal

signs pl)s history of constipation.diagnosis. (

.. (#erforated divertic)li

11D. 4ingle "lind st)dy means? (#atient does not now*

1!/. 4election "ias (deli"erately select good patient for good

res)lt*

1!1. patient does some pipe worJdiagnosis?

(As"estosis*

1!!.. 1st

post8op day chest x8ray shows patchy infiltrates(atelectasis*. @hat sho)ld have "een done "efore int)"ation? . .

. (Clear secretions*

1!5. Case of post8menopa)sal "leeding if more than 1 year do

endometrial "iopsy

1!;. Fan tals in sleep, gets o)t of "ed, in "ed side saying

RyallahO, comes to doc with wife saying that he was taling in sleep

(saw horse race in dream* diagnosis?

(ightmares*

1!-. 6nterpret the st)dyJ.cross8 sectional, cohort, case8control,

ecology??

1!. @hich test sho)ld "e applied for the a"ove mentioned

st)dy? T test? #aired t test? Chi sG)are?

1!. &acterial meningitis. Already on treatment with

ceftriaxone vancomycin, awaiting micro"iology res)ltsJnext

step.

(!/*


21/39

=7if .no gram >0 stop vancomycine

=7if old age +listeria or 26> Add Ampicillin

1!. HT6 in yo)ng female,treatment???

=7Hncomplicated (cystitis* TF#84FQ(setran* 5days

( S)inolone*

=7Comlicated 4ame a"ove for 81; days

=7 #regnancy

itro)rantoin

1!D. Case of amenorrhea galactorrheaJthe medicine which

increases prolactin?? . . . . . .

. ( :inothy9ine*

15/. 2ealth care worer with ##$ of 1Jnext step?

. (CQ


22/39

(Fem"rano)s '..* Ad)lt

Finimal change '. 7 in children

6nterstitial '. 7$r)g ind)ced (hemat)ria, rash, eosinophilia*

6gA nephropathy 7with


23/39

1;/. #atient with low respiratory rate KminJ.what wo)ld )

do?? . (0ndotracheal int)"ation*

1;1. :emale with mac)lopap)lar rash )nder the "reast, ")rning n

pr)riticJ.treatment?

(etocona9ole*

1;!. Fale patient came from &angladesh trip, now has cord lie

erythemato)s swelling on medial aspect of lower lim" a"ove nee.

what wo)ld ) do?

(Aspirin + warm compression*

1;5, Hlcers on hands mo)thJexpos)re with sheepK

goatJ..diagnosis?

:rancisella t)laremia?

1;;. 0lderly male was fine )ntil yesterday. Then "ecame

aggressive with his grandson, irrita"le with memory lossJ

diagnosis??

( HT6*

1;-.Case of m)ltiple a"ortion in first and second trimester (

( :irst=74ept)m )ter)s *( !nd=7 cervical incompt*

1;. 'astric t)mor involved "oth ovaries.

. ( Nr)en"erg*

1;.!- years old woman with menorrhagia, p)p)ric rash,gingival

"leeding since last month.2"%1!.- mg,@&C //Kplatelets 5//Km

(6T#*


24/39

(!5*. .

1; .#ict)re of 4M0 with ")tterfly rash on face. .

. (6ncrease protein and decrease al")min*

1;D% A -/ years old woman with "leeding #


25/39

1--%A 5! years woman with constant nec pain associated

fatig)e ,malaise, myalgia, loose stool, felling cold and diff)se

enlarge thyroid ,tender to to)ch. T42 1./ )Kml T5 5// and T; !/.

(


26/39

( !-*

11% A vegetarian complaining of weaness ,lethargic, palpitation,

mild dyspnea, pale looing, 2"%.!microcytic saline p)sh*

1% A patient comes with diarrhea after days co)rse of

Amoxicillin. (Clostridi)m $eficili* . Fanagement?

(3ral Fetronida9oleB oral vancomycin*

1% A case of condyloma ac)minata.

( 2)man papilloma vir)s*


27/39

(!*

1.$ifferentiate Adrenal gland /r pit)itary origin (C)shing

disease *

(2igh dexamethasone test*

1D% A !; years old woman come with right lower a"% pain.3n a"8

x8rays showing ,Two teeth,

( Teratoma*

1/. A patient sifted from 3T to 6CH after second day, fever,

diffic)lty in "reathing + "asal crepts. Q8 and catheter line

;8 7$>T p)lmonary em"olism

-8 7@o)nd infection

(Treatment of post8operative 70arly am")lation

1!. #t.P came in 0< after fall from camel with loss of

conscio)sness now he is conscio)s .After 1- mint again

)nconscio)s. ext (epid)ral hematoma*

(CT scan*

15. 5- years old lady come with vertigo when lying on left side

and ")t relived immediately with positional change. $iagosis?

(&enign positional vertigo*7$ix8hallpie mane)vers.


28/39

(!*

LFeniereOs disease 7rec)rrent sever vertigo, hearing loss, ear

f)llness and tinnit)s lasting in ho)rs day

(Mow a + di)retics*

L>esti")lar or la"yrinthitis (ac)te peripheral vestri")lopathy*

("enign positional vertigo*7$ix8hallpie mane)ver.

LFeniereOs disease 7rec)rrent sever vertigo, hearing loss, ear

f)llness and tinnit)s lasting in ho)rs day

(Mow a + di)retics*

L>esti")lar or la"yrinthitis (ac)te peripheral vestri")lopathy*

Ac)te onset of svere vertigo, head motion intolerance and 'ait

)nsteadiness+ vomiting na)sea nystam)s or )nilateral tinnit)s.

( corticosteroids*

1;% Eo)ng lady thro""ing headache7!ho)rs and less than !;

ho)rs. a)sea, photopho"ia noise sensitivity, relieved with sleep

and darness. (Figraine*

(4A6$*

( Ac)te 7Triptans*

1-% Eo)ng male severe pain. Hnilateral per or"ital headache last

in 5/ min and ipsilateral lacrimation nasal stiffness. 2as

repeated attacs.


29/39

(!*

( Cl)ster 2eadache*

1% Fostly 5/ years old lady complaining of tight "and lie painon frontal. 3ccipital, nec pain, na)sea, vomiting or a)ra .worsen

with stress improved with relaxation or massage

(Tension 2eadache*( high3!*

1% 5- years old woman come with s)dden onset pain

,weaness of arm ,leg and di99iness + "l)rring of eyes .(some time

loss of eye site*After some time recover completely. $iagosis?

(F)ltiple sclerosis*7 F


30/39

(!D*

1/% An elderly patient with his son, he said that my father is

forgetting everything since last few months, lang)age deficits,

depressed and agitated.

(Al9heimerOs disease* F


31/39

(5/*

1% Moss of sensation in little finger .

( Hlner nerve*1% pict)re of Q8 *

1D1% pt% with high grade fever +head ach. clinical andla"%diagnosis is meningitis .what next?

(admission + 6B> anti"iotics*

1D! pt% with high grade fever, co)gh, tachycardiaP Q8


32/39

(51*

1D;% A nown case of C3#$, $F comes with fever, 43&. ext

(Anti"iotics+steroids+&8inhalar*1D-% !! years army soldier smoer for ro)tine examination fo)nd

a single 8s)praclavic)lar lymph node no active complains .ca)se

( '6 ca*

1D% '5#! previo)s ! normal vaginal deliveries with "reech

presentation at 5 wees. 4he was presented on clinic "efore 5;

5 wees ")t no action taen. @hat next?

(0xternal cephalic version*

1D% A pt % with :ever ,pain in


33/39

(5!*

!/1P A middle age man come with lower a"dominal pain,

constipation, "leeding #


34/39

(55*

!/% A ")rn pt% with chest and a"domen ,/ g wtP fl)id in !;

h)rs.

(;.5 liter*

!/D% A yo)ng man with hBo


35/39

(5;

!1-% A yo)ng man with poly)ria, polydipsia, )rine sp%gravity 1.//1

with history of # challenge*

!1D% case of Acromegaly (ins)lin lie growth factor 6':81*

(Confirmatory test oral gl)cose s)ppression test*

!!/% 46A$2 low a and high )rine osmolality with

e)vol)mic

(restrict water* demeclocyclin and tolvaptan.

!!1% radiology pict)re of s)ll. #6'0Ts disease.

(high ser)m alaline phosphate with normal Ca

#hosphate*


36/39

(5-*

!!!% Ma" report diagnosis for


37/39

M0HN3C3 dr)gs a")ser

( 2igh in


38/39

Cl 11-

2co5 !1 ( or low*in


39/39

5.dr hishsham

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