IMLE 10/2019

Which of the following is not treatment option for Placenta accreta ?

B-linch

Correct Incorrect Correct answer

Insertion of ballons

Correct Incorrect Correct answer

Hysteroctomy

Correct Incorrect Correct answer

Packed cell

Correct Incorrect Correct answer

Embolization

Correct Incorrect Correct answer

What is not a risk factor of intrauterine infection?

Obesity

Correct Incorrect Correct answer

Eclampsia

Correct Incorrect Correct answer

Caesarean

Correct Incorrect Correct answer

Instrumental

Correct Incorrect Correct answer

Prolonged

Correct Incorrect Correct answer

A 25-year-old, 1-day post-partum, complains of fever, chills, and lower abdominal pain. On examination her temperature is 39.3 C. Which of the following is the first therapeutic step?

Intravenous vancomycin

Correct Incorrect Correct answer

Wait for an additional temperature measurement of above 38, in a 2-hour interval

Correct Incorrect Correct answer

Investigate for source of fever and obtain cultures

Correct Incorrect Correct answer

Broad spectrum IV antibiotic treatment including 3 antimicrobial agents

Correct Incorrect Correct answer

Broad spectrum oral antibiotic treatment including 2 antimicrobial agents

Correct Incorrect Correct answer

A 30-year-old woman, married plus 2 children, presents to the emergency room on the 28 th week of her 3 rd pregnancy with abdominal pain, nausea, and vomiting.
Which of the following supports the diagnosis of acute appendicitis?

MRI demonstrating an elongated structure, at least 5 mm thick, in the right abdomen

Correct Incorrect Correct answer

Right pelvic tenderness on rectal or vaginal examination

Correct Incorrect Correct answer

Oral temperature of 39.2 C

Correct Incorrect Correct answer

Uterine tenderness

Correct Incorrect Correct answer

A left shift on complete blood count

Correct Incorrect Correct answer

Which of the following is true regarding hypothyroidism during pregnancy:

Hypothyroidism during pregnancy should be ruled out by repeating TSH testing every 6 weeks

Correct Incorrect Correct answer

Hashimoto thyroiditis is the most common cause of hypothyroidism during pregnancy✓

Correct Incorrect Correct answer

Uncontrolled hypothyroidism increases the risk of gestational diabetes

Correct Incorrect Correct answer

Subclinical hypothyroidism is found in 5% of pregnant women

Correct Incorrect Correct answer

Screening for hypothyroidism (FT4) should be obtained in all pregnant women

Correct Incorrect Correct answer

Pre-pregnancy diabetes increases the risk for all the following except:

Tracheoesophageal fistula

Correct Incorrect Correct answer

Coarctation of the aorta

Correct Incorrect Correct answer

Renal agenesis

Correct Incorrect Correct answer

Sacral agenesis

Correct Incorrect Correct answer

Anencephaly

Correct Incorrect Correct answer

Which of the following is defined as superimposed preeclampsia?

A 28 years old woman, married plus 1 child, on her 2 nd pregnancy, mild hypertension was noted since her 18 th week of pregnancy. Now on her 28 th week, urine protein is 250 mg over 24 hours.

Correct Incorrect Correct answer

A 20 y.o woman, 24 week pregnant, presents with feet edema and blood pressure of 145/88, and 140/92 after 30 minutes. this is the first episode in her pregnancy.

Correct Incorrect Correct answer

A 40 y.o woman, 36 th week pregnancy, presents with severe headaches. Mild hypertension is known since her 32 nd week, and blood pressure at the emergencey room is measured 168/98 and 170/91 an hour apart. Spot urinary protein +2.

Correct Incorrect Correct answer

A 39 y.o woman, married with 3 children, on her 10 th week of her 4 th pregnancy. Blood pressure at the clinic was 145/88 and 138/98 an hour apart. Urinary spot protein +3.

Correct Incorrect Correct answer

A 38 y.o woman, married plus 1 child on her 18 th week of her 2 nd pregnancy. Blood pressure at the clinic was 138/100 one week ago, and 24 hour urinary protein 380 mg. blood pressure now 143/82.

Correct Incorrect Correct answer

Which of the following women has a Bishop score above 7?

Soft, posterior cervix, 2 cm dilated, 50% effaced, head at spina -2

Correct Incorrect Correct answer

Soft, medial cervix, 3 cm dilated, 70% effaced, head at spina -2

Correct Incorrect Correct answer

Hard, medial cervix, 2 cm dilated, 80% effaced, head at spina -2

Correct Incorrect Correct answer

Soft, posterior cervix, 2 cm dilated, 50% effaced, head at spina -1

Correct Incorrect Correct answer

Hard, posterior cervix, 3 cm dilated, 50% effaced, head at spina -1

Correct Incorrect Correct answer

Most appropriate magnesium infusion of neuroprotection

long dose 4 gr. During 20-30 min, 1 gr per 1 hour

Correct Incorrect Correct answer

6 gr over 20-30 min 2gr. Per 12 hour

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4 gr over 20-30min 2 gr per 24 hour

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6gr over 20-30 min 1 gr per 18 hour

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2gr over 20-30min 1 gr /h. over 24hour

Correct Incorrect Correct answer

All of the following are risk factors for preterm rupture of membranes ( PROM ) except:

Intrauterine infection

Correct Incorrect Correct answer

Polyhydramnion

Correct Incorrect Correct answer

Urinary tract infection

Correct Incorrect Correct answer

Cervical incompetence

Correct Incorrect Correct answer

Eclampsia

Correct Incorrect Correct answer

A 23 – year – old primipara woman on her 13th week of pregnancy , presents to the clinic with a temperature of 37 . 5 – 30°C over the last 3 days , malaise , and leg pain. You suspect a primary CMV infection . All of the following are possible complications of primary CMV infection except:

Echogenic bowel

Correct Incorrect Correct answer

Intra uterine growth restriction

Correct Incorrect Correct answer

Preterm labor

Correct Incorrect Correct answer

Brain ventricular dilatation

Correct Incorrect Correct answer

Oligohydramnion

Correct Incorrect Correct answer

Which of the following is the meaning of the term Fecundity?

Achievement of a live birth in a cycle of unprotected

Correct Incorrect Correct answer

Intercourse Mechanical infertility due to cervical stenosis

Correct Incorrect Correct answer

Achievement of a conception in a cycle of unprotected intercourse

Correct Incorrect Correct answer

Achievement of a conception in a year of unprotected intercourse

Correct Incorrect Correct answer

Which of the following has the most significant incluence on a couple’s fertility?

Ethnicity

Correct Incorrect Correct answer

Geographical location

Correct Incorrect Correct answer

The man’s age

Correct Incorrect Correct answer

Line of employment

Correct Incorrect Correct answer

The woman’s age

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True regarding sperm test:

Abnormal sperm test repeat in one week

Correct Incorrect Correct answer

No need for repeat normal test

Correct Incorrect Correct answer

Infertility work up should include at least 2 sperm test even if initial test normal incorrect

Correct Incorrect Correct answer

Annual sperm test

Correct Incorrect Correct answer

What instructions should be given to a patient referred to a sperm test?

The patient should avoid intercourse for 2 – 5 days , and ejaculate in the laboratory only

Correct Incorrect Correct answer

The patient should avoid intercourse for 2 – 5 days , and bring the sperm to the laboratory within 1 hour from ejaculation

Correct Incorrect Correct answer

A sperm test can be performed at any time without any special instructions

Correct Incorrect Correct answer

The patient should avoid intercourse for 7 days , and bring the sperm to the laboratory within 6 hours from ejaculation

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The patient should have normal intercourse with a condom , and bring the sperm in the condom within 1 hour from ejaculation

Correct Incorrect Correct answer

Cervical Infertility was diagnosed in a couple following diagnostic work up that ruled out other explanations for their infertility Which of the following is the first treatment of cervical infertility?

Antibiotic treatment and intra uterine Insemination

Correct Incorrect Correct answer

Surgical repair of the cervix by recurrent dilatations

Correct Incorrect Correct answer

Cervical infertility is self – resolving and does not require treatment

Correct Incorrect Correct answer

Cervical conization

Correct Incorrect Correct answer

In vitro fertilization

Correct Incorrect Correct answer

Which of the following findings on physical examination is the most specific for endometriosis?

Tenderness in the anterior vaginal fornix

Correct Incorrect Correct answer

Tender nodules in the posterior vaginal fornix , and pain when moving the uterus

Correct Incorrect Correct answer

A mobile ovarian mass , with a 5 cm diameter

Correct Incorrect Correct answer

Granulation of the cervical external os

Correct Incorrect Correct answer

An enlarged and tender uterus

Correct Incorrect Correct answer

A 26 – year – old woman has been diagnosed with endometriosis and is not interested in conceiving at this point . She has begun danazol treatment . Which of the following describes the mechanism of action of this drug?

Direct anti androgen effect on the endometrial tissue

Correct Incorrect Correct answer

Direct binding to pituitary estrogen receptors and creating a hypo estrogenic environment

Correct Incorrect Correct answer

Inhibition of enzymes involved in steroidogenesis , therefore increasing serum estrogen levels

Correct Incorrect Correct answer

Inhibition of LH and FSH from the hypophysis through a hypothalamic effect

Correct Incorrect Correct answer

A couple comes for infertility consultation following a year and a half of unsuccessful trials to conceive . The woman is 23 – years – old , was laparoscopically diagnosed as having endometriosis , including endometriomas of 7cm on her right ovary, and 5 cm on the left ovary . In addition , she has a distal Obstruction of the left fallopian tube . The man is 25 – years – old , with severe oligoterato – zoospermia – 3 million sperm cells , with 10k motility , and 1 % normal morphology . Which of the following is true regarding their chances of a successful in – vitro fertilization ?

Endometriosis significantly reduces the rates of conception with in – vitro fertilization, regardless of the male factor

Correct Incorrect Correct answer

There rates of in – vitro fertilization are mostly influenced by the woman's age and the sperm characteristics , and not by the endometriosis

Correct Incorrect Correct answer

Endometriosis influences the number of aspirated oocytes , and does not reduce the rate of successful implantation and conception

Correct Incorrect Correct answer

There is an absolute indication to remove the endometriomas before initiating fertility treatments

Correct Incorrect Correct answer

Which of the following defines the difference between gamete intra fallopian transfer ( GIFT ) , and zygote intra fallopian transfer ( ZIFT ) ?

In ZIFT , sperm and oocytes are mixed in a catheter and returned to the fallopian tube

Correct Incorrect Correct answer

In GIFT , oocyte fertilization is performed in vitro

Correct Incorrect Correct answer

In ZIFT , a fertilized oocyte is returned to the fallopian tube

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GIFT requires laparoscopy , while ZIFT may be performed through the cervix without sedation

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GIFT is performed when there is a mechanical problem , and ZIFT Is performed when the fallopian tubes are normal

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Which of the following regarding the outcome of the use of combined oral contraceptives and systemic and malignant diseases is true?

When used over 3 years , combined oral contraceptives reduce the risk of hepatic carcinoma

Correct Incorrect Correct answer

Combined oral contraceptives decrease the risk of breast cancer , but increase the risk for benign breast fibrocystic diseases

Correct Incorrect Correct answer

Combined oral contraceptives reduce the risk of breast and endometrial cancer . This effect begins with the beginning of treatment , and stops when the drug is ceased

Correct Incorrect Correct answer

Combined oral contraceptives reduce the risk of breast and endometrial cancer within a year of treatment , and the effect continues even after the drug is ceased

Correct Incorrect Correct answer

Combined oral contraceptives protect bone density deterioration , decrease rheumatoid arthritis progression , and increase the risk of colorectal cancer

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A and/or D

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B and/or C

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A 70 – year – old woman presents with vaginal itching and pain during intercourse. Examination reveals vaginal atrophy, with no unusual discharge. The labia minora are fused in the clitoral area , and a whitish wrinkled surface is found on the perineal skin . Which of the following is the recommended work up and treatment ?

Biopsy and local treatment with testosterone

Correct Incorrect Correct answer

Biopsy and clobetasole cream

Correct Incorrect Correct answer

Surgical excision of the lesion

Correct Incorrect Correct answer

Biopsy and local alcohol injection

Correct Incorrect Correct answer

Biopsy and local tacrolimus injection

Correct Incorrect Correct answer

A 32 – year – old woman presents with vaginal pain. Examination reveals tender, Irregular ulcers in the vagina , and similar ulcers in the oral cavity. Which of the following is the appropriate work up for this patient ?

EBV serology

Correct Incorrect Correct answer

Ulcer biopsy

Correct Incorrect Correct answer

Vaginal smear

Correct Incorrect Correct answer

Examination by an ophthalmologist

Correct Incorrect Correct answer

Diagnostic therapeutic trial with cyclophosphamide

Correct Incorrect Correct answer

A 27 – year – old woman presents with severe pain during intercourse , mainly at the beginning of the penetration . Examination with a swab produces pain upon contact with the posterior forchette . Which of the following is the recommended initial treatment ?

Gabapentin 100mg X 3 / d for 3 months

Correct Incorrect Correct answer

Vestibulectomy

Correct Incorrect Correct answer

CO2 laser vaporation

Correct Incorrect Correct answer

Low dose tricyclic antidepressants

Correct Incorrect Correct answer

Local lignocaine and pelvic floor physiotherapy

Correct Incorrect Correct answer

A 55 – year – old woman , a generally healthy mother of 3 , has a PAP smear result of high grade squamous intraepithelial lesion ( high grade SIL ) , and referred to a colposcopy. Coniozation biopsy reveals intraepithelial cervical neoplasia, CIN3 , that does not involve the cone margins . Which of the following is the recommended treatment in this patient ?

Radical hysterectomy

Correct Incorrect Correct answer

Cervical laser ablation

Correct Incorrect Correct answer

Cryoablation of the lesion with liquid nitrogen

Correct Incorrect Correct answer

Simple hysterectomy

Correct Incorrect Correct answer

Repeat colposcopy in 6 months

Correct Incorrect Correct answer

A-32-year-old woman, who diagnosed with HIV on the previous month, he come in for a gynecological examination. She has a normal PAP smear 2 year ago. Which of the following tests should be performed in her condion?

Endocervical curettage

Correct Incorrect Correct answer

CT PET

Correct Incorrect Correct answer

Colposcopy

Correct Incorrect Correct answer

Serum HPV antibodies

Correct Incorrect Correct answer

Repeat PAP smear

Correct Incorrect Correct answer

An overweight single with no children, 31-year-old woman has an endometrial biopsy due to excessive bleeding, biopsy result is atypical endometrial hyperplasia. Which of the following is the recommended treatment for this patient?

Metformin treatment and repeat the biopsy 6 months

Correct Incorrect Correct answer

Follow up and repeat biopsy after the next menstrution

Correct Incorrect Correct answer

Hysterectomy and salpingo-oopherectomy

Correct Incorrect Correct answer

Hysterectomy and endometrial excision

Correct Incorrect Correct answer

High dose pregesterone and endometrial biopsy follow up

Correct Incorrect Correct answer

73 year old female, a week after a hysterectomy due to vaginal dome prolapse, complains of gluteal pain that worsens when she shits, which of the following procedures did this woman most probably have ?

Uterosacral ligament suspension

Correct Incorrect Correct answer

Vaginal mesh colpopexy

Correct Incorrect Correct answer

Abdominal Sacrocolpopexy

Correct Incorrect Correct answer

Iliococcygeal vaginal suspension

Correct Incorrect Correct answer

Sacrospinous ligament fixatioin

Correct Incorrect Correct answer

Which of the following histological finding is typical for granulose cell tumor?

Back to back endometrial appearance

Correct Incorrect Correct answer

Endometrial serous papillary epithelium

Correct Incorrect Correct answer

Transitional epithelium within the tumor

Correct Incorrect Correct answer

Signet cell epithelium in a normal ovary

Correct Incorrect Correct answer

Call exner bodies within the tumor

Correct Incorrect Correct answer

Which of the following findings in tissue from uterine cavity curettage point to partial hydatidiform mole?

Diffuse hydropic changes in the chorionic villi

Correct Incorrect Correct answer

Maternal RBC's only

Correct Incorrect Correct answer

Trophoblast diffuse atypia

Correct Incorrect Correct answer

Triploid karyotype

Correct Incorrect Correct answer

Negative p57 stain

Correct Incorrect Correct answer

A 75 – year – old female with atrial fibrillation is treated with coumadin. She is a candidate for lumpectomy and sentinel lymph node biopsy due to right breast malignancy. Which of the following is the recommended preoperative anti-thrombotic therapy ?

Stop coumadin 5 days prior to surgery , cover with clexane (LMWH)

Correct Incorrect Correct answer

Stop coumadin 5 days prior to surgery , no further treatment needed

Correct Incorrect Correct answer

Stop coumadin 5 days prior to surgery , cover with aspirin

Correct Incorrect Correct answer

Stop coumadin 5 days prior to surgery , cover with aspirin

Correct Incorrect Correct answer

A woman on her 39th week of gestation presents to the emergency room with prolapse of cord. Which of the following statements is most accurate regarding the common situation in which this would occur, and the most appropriate management?

Cord prolapse is more common in term babies, and it requires artificial rupture of membranes and instrumental delivery

Correct Incorrect Correct answer

Cord prolapse is more common in vertex presentation vs. transverse or footling breech, and it requires an emergency cesarean section

Correct Incorrect Correct answer

Cord prolapse is more common in term vs. preterm babies, and it requires an emergency cesarean section

Correct Incorrect Correct answer

Cord prolapse is more common in non vertex presentations, and it requires delivering the baby as soon as possible

Correct Incorrect Correct answer

A 72 year old male, with ischemic heart disease and a history of anterior wall MI ten years ago, complains of recent worsening dyspnea. He is on metroprolol and aspirin. On examination – heart rate 70/min sinus, blood pressure 140/80, and expiratory rales over the lung bases. Echocardiography –anterior wall akinesia, left ventricular ejection fraction (LVEF) of 38%. What is the most appropriate management at this time?

Add digoxin

Correct Incorrect Correct answer

There is a clear indication for automatic implantable cardiac defibrillator (AICD) implantation

Correct Incorrect Correct answer

There is a clear indication for cardiac re-synchronization treatment (CRT) pacemaker implantation

Correct Incorrect Correct answer

Angiotensin converting enzyme inhibitor (ACEI) and furosemide should be added

Correct Incorrect Correct answer

Add spironolactone

Correct Incorrect Correct answer

A 68 year old female with hypertension that is medically treated, diabetes, mitral stenosis due to reheumatic disease, and CVA 3 years ago. She is admitted due to first onset of atrial fibrillation that returned spontaneously to sinus rhythm. Treatment plan includes beta blockers only. On the day before discharge an echocardiography is performed and demonstrates normal cardiac function, moderate left atrium enlargement, and sever mitral stenosis. Which of the following thearpies is recommended in this patient?

Aspirin

Correct Incorrect Correct answer

Rivaroxaban

Correct Incorrect Correct answer

Apixaban

Correct Incorrect Correct answer

Dabigatran

Correct Incorrect Correct answer

Warfarin

Correct Incorrect Correct answer

All of the following improve survival with reduced ejection fraction (<35%), except:

Carvedilol

Correct Incorrect Correct answer

Digoxin

Correct Incorrect Correct answer

Enalapril

Correct Incorrect Correct answer

Sacubitril-valsartan (entresto)

Correct Incorrect Correct answer

Spironolactone

Correct Incorrect Correct answer

A 56 -year-old female is evaluated at the ER for compressing chest pain and increasing dyspnea that started 3 hours prior to her admission. Past medical history is positive for hypertension treated with ACE inhibitors. On examination – disoriented, temperature 36.6 C°, blood pressure 85/50, heart rate 118/minute, respiratory rate 24/min, room air saturation 90%, Sᴣ gallop on auscultation, inspiratory rales over the lung, limbs feel cold. ECG is below. Chest X-ray – pulmonary edema. She is given aspirin at the ER. Which of the following is the most appropriate management of this patient?

IV metoprolol

Correct Incorrect Correct answer

Percutaneous Coronary Intervention

Correct Incorrect Correct answer

Fibrinolytic treatment

Correct Incorrect Correct answer

Admit to ICU for stabilization

Correct Incorrect Correct answer

Which of the following is the most correct statement with regards to severe aortic regurgitation?

Coarse systolic murmur over the aorta radiating to the neck

Correct Incorrect Correct answer

Enhanced s2 over the aorta due to aortic component (A2)

Correct Incorrect Correct answer

Peripheral pulse is called pulsus parvus et tardus

Correct Incorrect Correct answer

Wide pulse pressure

Correct Incorrect Correct answer

ST depression and T wave inversion in leads v1-v2, aVF , and III on ECG are common findings in patients with AR

Correct Incorrect Correct answer

A 48 year old male with no known heart disease complains of compressing pain at the front chest. On examination- hemodynamically stable, room air saturation is normal, with no other abnormal findings. On ECG –ST segment elevation of 3mm in leads II, III and aVF. He is treated with aspirin, clopidogrel, and heparin. Which of the following is the most appropriate management?

Differential diagnosis includes pulmonary embolism as well

Correct Incorrect Correct answer

Await troponin levels before decision on primary percutaneous coronary intervention (PCI)

Correct Incorrect Correct answer

If the patient has known active peptic ulcer disease then fibrinolytic treatment with tissue plasminogen activator (tPA) is the treatment of choice

Correct Incorrect Correct answer

Primary PCI is the treatment of choice if available at the hospital

Correct Incorrect Correct answer

Primary PCI is limited to patients who failed therapy with fibrionolytic therapy (tPA)

Correct Incorrect Correct answer

Acute iv treatment with beta blockers can benefits with st elevation (stemi)which of the following is the most correct statement regarding this treatment ?

Decreas pain and decrease risk of fatal arthymias

Correct Incorrect Correct answer

Dose not affect infraction size

Correct Incorrect Correct answer

Decreas the risk of atrial origin fatal arthmyas

Correct Incorrect Correct answer

Decreas the risk of further blood clots formation in the coranry arteries

Correct Incorrect Correct answer

Improve the cerebral blood flow

Correct Incorrect Correct answer

A 20 year old male is diagnosed with meningococcal meningitis, which of the following is correct?

Neisseria meningitidis is the most common etiology of community acquired bacterial meningitis

Correct Incorrect Correct answer

Meningococcemia may be accompanied by petechial rash

Correct Incorrect Correct answer

Photophobia is rare sign in bacterial meningitis

Correct Incorrect Correct answer

Most of the patients with meningococcal do not need adjuvant dexamethasone therapy

Correct Incorrect Correct answer

Antibiotics treatment is recommended only after bacterial identification and sensitivity analysis

Correct Incorrect Correct answer

A and/or B

Correct Incorrect Correct answer

C and/or D

Correct Incorrect Correct answer

Which of the following is correct regarding c.difficile ?

Stool culture is the best choice for diagnosis

Correct Incorrect Correct answer

Antibiotic treatment for a pneumonia is a risk factor for the disease

Correct Incorrect Correct answer

Daptomycin is the treatment of choice

Correct Incorrect Correct answer

Younger patient are at high risk for disease

Correct Incorrect Correct answer

Length of treatment is 5 days only

Correct Incorrect Correct answer

A 20 year old female complains of pain during urination, right flank pain and fever up to 39c. Which of the following is correct?

E.coli is the cause of about 30% of acute uncomplicated UTI

Correct Incorrect Correct answer

E.coli is the cause of about 30% of acute uncomplicated UTI

Correct Incorrect Correct answer

In the majority of the cases E.coli is sensitive to common antibiotics treatment and resistance to antibiotics is mostly not a problem in these bacteria

Correct Incorrect Correct answer

Incidence of UTI is equal among young men and women (ages 18-30)

Correct Incorrect Correct answer

Beta-lactams antibiotics are the first line treatment for uncomplicated UTI

Correct Incorrect Correct answer

Which of the following is correct regards to Brucellosis?

Osteomyelitis is more common at the cervical spine than at lumbar spine

Correct Incorrect Correct answer

Vancomycin is the preferred treatment

Correct Incorrect Correct answer

About half of the patients have musculoskeletal signs along with fever

Correct Incorrect Correct answer

More than half the patents develop hepatosplenomegaly

Correct Incorrect Correct answer

Nervous system involvement is rare

Correct Incorrect Correct answer

Which of the following is the most common bacteria in spine osteomyelitis?

Streptococcus pneumonia

Correct Incorrect Correct answer

S.aureus

Correct Incorrect Correct answer

Q fever

Correct Incorrect Correct answer

Pseudomonas

Correct Incorrect Correct answer

Pertussis

Correct Incorrect Correct answer

Patient with chronic renal failure stage IV-V also have normocytic normochromic anemia. What is the primary cause for anemia in these patients?

Erythropoitin deficiency

Correct Incorrect Correct answer

Vitamin B12 or folic acid deficiency

Correct Incorrect Correct answer

Short half life of RBCs

Correct Incorrect Correct answer

Iron deficiency due to chronic GI bleeding

Correct Incorrect Correct answer

A 20 years old HIV patient is found in a confused state with a fever of up to 38.4c . lab-hemoglobin 8.2gr\dl ; platelets 16000\ml ; urea 60mg\dl ; creatinine 2.5mg\dl ; total bilirubin 5.5mg\dl ; direct bilirubin 0.5mg\dl ; indirect bilirubin 5.0mg\dl; LDH 1150 u\I ; Pt 13 sec ; INR 1.08 ; PTT 30 sec ; control PTT 30 sec ; fibrinogen 300mg\dl . schistocytes are seen on peripheral blood smear . Which of the following is the most likely diagnosis ?

Hemolytic- uremic synfrome (HUS)

Correct Incorrect Correct answer

Von-willebrand disease (VWD)

Correct Incorrect Correct answer

Immune thrombocytopenic purpura

Correct Incorrect Correct answer

Disseminated intravascular coagulation

Correct Incorrect Correct answer

Thrombotic thrombocytopenic purpura

Correct Incorrect Correct answer

Which of the following is correct wih regards to acute promyelocutic leukemia (ALP)?

Combination of anthracyclin with cyctatarabine is the treatment of choice.

Correct Incorrect Correct answer

Allogenic hematopoietic stem cell transplant is the treatment of choice.

Correct Incorrect Correct answer

Cure rates in this leukemia do not exceed 15%.

Correct Incorrect Correct answer

Retonoic acid-tretinoin (ATRA) is the treatment of choice.

Correct Incorrect Correct answer

APL patients are prone to systemic thrombotic events due to DIC.

Correct Incorrect Correct answer

A 62 year old male who is treated with spironolactone and digoxin is admitted with a potassium level of 6.5 , on Ecg spiked – t waves. Which of the following is the most appropriate management?

A calcium gluconate in drip for 20-30 minutes

Correct Incorrect Correct answer

Dialysis is indicated

Correct Incorrect Correct answer

Calcium gluconate in push for 2-3 minutes

Correct Incorrect Correct answer

Immediate kayexalate

Correct Incorrect Correct answer

Fluid infusion with 0.9% normal saline

Correct Incorrect Correct answer

Which of the following is the main cause of mortality in patients with chronic kidney disease stage 3-4 ?

Uremia

Correct Incorrect Correct answer

Cardiovascular disease

Correct Incorrect Correct answer

Infection

Correct Incorrect Correct answer

Osteoporotic fractures

Correct Incorrect Correct answer

Malignancy

Correct Incorrect Correct answer

In which of the following hemodialysis accesses there is increase rate of infections?

Av fistula

Correct Incorrect Correct answer

Internal jugular vein

Correct Incorrect Correct answer

Femoral vein

Correct Incorrect Correct answer

External jugular vein

Correct Incorrect Correct answer

Subclavian vein

Correct Incorrect Correct answer

Urinary tract infection

Renal vein thrombosis

Correct Incorrect Correct answer

Bilateral renal artery emboli

Correct Incorrect Correct answer

Niphrolithiasis

Correct Incorrect Correct answer

Acute renal papillary necrosis

Correct Incorrect Correct answer

Which of the following is characteristic of IgA neuropathy in adult?

Rapidly deteriorating renal failure

Correct Incorrect Correct answer

Increased blood pressure

Correct Incorrect Correct answer

Recurrent episodes of macrohematuria

Correct Incorrect Correct answer

Nephrotic syndrome

Correct Incorrect Correct answer

Recurrent urinary tract infection

Correct Incorrect Correct answer

68 years old female is referred to the ER due to diarrhea and vomiting of 4 days. On admission general deterioration , Blood Pressure 80/40 , heart rate 120/minute, no fever. Labs : creatinine 4mg/dl BUN 90mg/dl . Fluid infusion is started and patient improve as well as blood pressure , on 3rd day of her admission she looks we stable , normal CBC, creatinine 4mg/dl. Which of the following is correct with regards to etiology of her renal damage ?

Interstitial nephritis is the most probable cause of lack improvement in creatinine level

Correct Incorrect Correct answer

Patient most probably had undiagnosed chronic renal failure

Correct Incorrect Correct answer

Irreversible damage is most probable one and should prepare for dialysis treatment

Correct Incorrect Correct answer

Ischemia associated acute kidney injury ( AKI ) is most probably etiology

Correct Incorrect Correct answer

Kidney biopsy should be performed to diagnose the cause of renal failure

Correct Incorrect Correct answer

What is the most common cause of chronic renal failure western world?

Glomerular disease

Correct Incorrect Correct answer

Tubulointerstitial disease

Correct Incorrect Correct answer

Minimal change disease

Correct Incorrect Correct answer

Diabetic nephropathy

Correct Incorrect Correct answer

Nephrolethiasis

Correct Incorrect Correct answer

66 year old male in brought to ER due to high fever , cough and confusion . In last 3 days the patient complains of abdominal pain and diarrhea for 2 days . On exam fever 39 blood pressure 135/80 heart rate 110/minute breath 22/min . Lung ascultation coarse rales and decrease air sound over the base of the right lung , chest x-ray demonstrate right lower lobe pneumonia . Labs 18.000 WBC with 80% neutrophil . Sputum neutrophils without bacteria , no blood in stool what is the most appropriate treatment ?

Ceftriaxone

Correct Incorrect Correct answer

Ampicillin

Correct Incorrect Correct answer

Amoxicillin clavulanic acid

Correct Incorrect Correct answer

Levofloxacin

Correct Incorrect Correct answer

Oxacillin

Correct Incorrect Correct answer

55 year old male diagnosed with COPD and severe obstruction with air trapping according to recent pulmonary function test , he is treated with bronchodilators he is now reffered to ER due to dyspnea , productive cough with yellowish sputum , fever and myalagia . On examination tachypnea 18/min temprature 38.2 room air saturation 90% expiratory wheezing over lung , no jugular vien distention chest x-ray no infiltrate or congestion. Which of the following test will have the most significant contribution to the diagnosis ?

Arterial blood gases

Correct Incorrect Correct answer

B-type natriunetric peptide

Correct Incorrect Correct answer

Troponin

Correct Incorrect Correct answer

Echocardiography

Correct Incorrect Correct answer

Angio ct of the pulmonary arteries

Correct Incorrect Correct answer

Which of the following is the most common pathogenesis of lower respiratory tract bacterial infection ?

Aspiration from the oropharynx

Correct Incorrect Correct answer

Airbrone infection

Correct Incorrect Correct answer

Hematogenous spread

Correct Incorrect Correct answer

Gastric content aspiration

Correct Incorrect Correct answer

Sspread from pleura to the lung tissue

Correct Incorrect Correct answer

A 60 years old female is admitted with community acquired pneumonia. She undergoes a chest CT that demonstrates large left pleural effusion. Which of the following is the most urgent indication for Thoracostomy tube insertion?

Loculated effusion

Correct Incorrect Correct answer

Fluid glucose less than 60mg/dl

Correct Incorrect Correct answer

Fluid pH less than 7.2

Correct Incorrect Correct answer

Fluid positive for bacteria Gram stain

Correct Incorrect Correct answer

Presence of pus on diagnostic pleural tap

Correct Incorrect Correct answer

Which of the following is correct with regards to arterial blood gases during asthma attack?

Oxygen saturation is usually about 90%

Correct Incorrect Correct answer

Normal paco2 is indicative of severe disease

Correct Incorrect Correct answer

Increase in paco2 during the beginning of the attack

Correct Incorrect Correct answer

Blood gases should be obtained during every asthma attack

Correct Incorrect Correct answer

Pulsus paradoxus resolves during severe attack

Correct Incorrect Correct answer

A 60-year-old female has acute rheumatoid arthritis. Which of the following is the most expected finding in this patient’s blood tests?

Autoimmune hemolytic anemia

Correct Incorrect Correct answer

Normochromic normocytic anemia

Correct Incorrect Correct answer

Leukopenia

Correct Incorrect Correct answer

Thrombocytopenia

Correct Incorrect Correct answer

Elevated creatinine levels

Correct Incorrect Correct answer

A 54 years old female is evaluated for fever malaise decreased appetite headaches and shoulder pain for about 2 months on examination – temprature 38.2 c blood pressure 130/85 heart rate 100/minute tenderness on palpation and decrease pulse at right temporal artery . labs – hemoglobin 10g/dl (normal range 12-16), normal liver function tests and ESR 60mm/h . what is the most likely diagnosis?

Takayasu arteritis

Correct Incorrect Correct answer

Occiptral neuralgia

Correct Incorrect Correct answer

Giant cell arteritis

Correct Incorrect Correct answer

Polymyoalgia rheumatica

Correct Incorrect Correct answer

Tension headache

Correct Incorrect Correct answer

A 28 years old female complains of chronic fatigue . high titer of anti dsDNA and antinuclear antibodies are found on blood tests . which of the following will contribute to the diagnosis of systemic lupus erythematosus (SLE) according to the SLICC criteria ?

Butterfly rash of the face and hemolytic anemia

Correct Incorrect Correct answer

High complement levels and leukopenia

Correct Incorrect Correct answer

Antiphopholipids antibodies and low complement levels

Correct Incorrect Correct answer

Anemia(hemoglobin less than 10g/dl)

Correct Incorrect Correct answer

Uveitis and pericarditis

Correct Incorrect Correct answer

A 19 years old male is admitted due to blood pressure of 190/120 headaches muscle pain joint pain and abdominal pain . he also has livedo reticularis , left testicle pain and swelling , weight loss of 6kg in the last 6 months . labs – WBCs 15000 , hemglobin 10g/dl ESR 100/h . urinalysis – protein RBCs WBCs all negative . what is the most likely etiology?

Lupus glomerulonephritis

Correct Incorrect Correct answer

Rheumatoid arthritis

Correct Incorrect Correct answer

Antiphospholipids syndrome

Correct Incorrect Correct answer

Polyarthritis nodosa

Correct Incorrect Correct answer

Sjorgen syndrome

Correct Incorrect Correct answer

Which of the following most typically characterizes the pain in ankylosing spondylitis?

Usual onset after age 40

Correct Incorrect Correct answer

Morning stiffness

Correct Incorrect Correct answer

Noctornal pain

Correct Incorrect Correct answer

Pain increase with rest

Correct Incorrect Correct answer

Rapid onset of pain

Correct Incorrect Correct answer

A 40 years old female is admitted due to scleral jaundice and generalized pruritus. On admission she is hemodynamically stable with no fever. on examination – skin and scleral jaundice , signs of scratching , no other abnormal findings . labs – AST 60 IU/L (normal 30-150) ALT 70 IU/L (normal 14-63) ALP 300 IU/L (30-150) GGT 350 (normal 5-60) bilirubin 5mg/dl (normal up to 1) and direct bilirubin 3.5 . liver ultrasound is normal with no bile duct dilation . antimitochondrial antibodies (AMA) is positive, what is the most likely diagnosis?

Primary biliary cirrhosis

Correct Incorrect Correct answer

Primary sclerosing cholangitis

Correct Incorrect Correct answer

Acute alcoholic hepatitis

Correct Incorrect Correct answer

Cirrhosis secondary to HBV infection

Correct Incorrect Correct answer

Acute cholangitis

Correct Incorrect Correct answer

40 year old man with liver cirrhosis secendry to HBV hepatitis is treat with fusid and aldactone du to ascitis, he is brought to ER duto bloody vomiting that started on the morning. On addmission BP 90/50 , tachycardia 120 . No fever, fresh blood is drained by nasogastric tube, after initial treatment with Intravenous fluid and units blood the patient now stable with BP 120/80 and heart rate 80 what next step in managment?

Start B-blocker

Correct Incorrect Correct answer

Ascite tup

Correct Incorrect Correct answer

Start refaximin

Correct Incorrect Correct answer

IV fluid

Correct Incorrect Correct answer

Gastroscopy and variceall ligation

Correct Incorrect Correct answer

Which of the following is used as maintenance therapy in inflammatory bowel disease ?

Oral glucocorticoid

Correct Incorrect Correct answer

Acathioprine

Correct Incorrect Correct answer

5 Asa (sulfasalazine)

Correct Incorrect Correct answer

Anti TNF -a (infliximab)

Correct Incorrect Correct answer

6mercap topurine (6-mp)

Correct Incorrect Correct answer

What is recommended screening for 35 year old healthy man with brother who was diagnosis with colon cancer at age 50 year?

Colonoscopy at age 40

Correct Incorrect Correct answer

Colonoscopy now

Correct Incorrect Correct answer

Colonoscopy at age 50

Correct Incorrect Correct answer

No need colonoscopy

Correct Incorrect Correct answer

Colonoscopy at age 60

Correct Incorrect Correct answer

Which of the following is common eitology of acute pancreatitis ?

Abdomonial trauma

Correct Incorrect Correct answer

Medication

Correct Incorrect Correct answer

ERCP

Correct Incorrect Correct answer

Cholethiasis

Correct Incorrect Correct answer

Alcohol consumption

Correct Incorrect Correct answer

27 old woman brought ER with blurred consciousness after sucidal attempted by taking medication that she found at her diabetic grandmother house, capillary glocose check confirm hyperglycemia which of the following test with assist in differentiating between insulin intoxication or sulfanylurea intoxication?

Peripheral blood insulin

Correct Incorrect Correct answer

C peptide

Correct Incorrect Correct answer

IGF-I

Correct Incorrect Correct answer

Cortisol

Correct Incorrect Correct answer

IGF-11/ IGF-I ration

Correct Incorrect Correct answer

33 year old healthy man found to have ca 12 ( normal up to 10.5 ), on routine blood test. He feels well and asymptomatic, what is most likely diagnosis?

Sarcoidosis

Correct Incorrect Correct answer

Lung malignancy

Correct Incorrect Correct answer

Multiple endocrine neoplasia type 1

Correct Incorrect Correct answer

Multiple myeloma

Correct Incorrect Correct answer

Primary hyperparathyroidism

Correct Incorrect Correct answer

66 year old man bank clerk BMI 31 . Blood test -fasting glocose 138 . LDL 131 , HBA1C 6.7% , triglyceride 210 mg/dl ( normal up to 150) . Fasting glocose was 127 one month ago. What is the most appopriate managment?

New onset diabetes , start therapy with metformin and basal insulin until optimal control HBA1C level low than 5,7%

Correct Incorrect Correct answer

Borderline require low carbohydrate diet and physical activity regemin no need for medication therapy.

Correct Incorrect Correct answer

Immediate test for antiglutamic acid decarboxylase (GAD) is needed to distinguish between type 1 and type 2 diabetes

Correct Incorrect Correct answer

New onset diabetes , start therapy with metformin and instruct patient on healthy life style.

Correct Incorrect Correct answer

Equivocal diagnosis repeat test in month and decide on therapatic plan.

Correct Incorrect Correct answer

80 year old man who is clear minded and functional under goes evaluation for depression , past medical history is positive for ischemic heart disease with PTCA and stent insertion to right coronary artery last year. Endocardiography demonstrate moderate decrease in left ventricle function.

Lab : T3 1.1 ( 3,1 – 6,8) T4 0.6 ( 12-22) TSH 54 ( 0.27 – 4.2)
What is the most appopriate managment ?

Low dose T4+ T3 regemin

Correct Incorrect Correct answer

T3 alone regimen

Correct Incorrect Correct answer

Low dose T4 regimen at 12,5 – 25

Correct Incorrect Correct answer

Hight dose T4 regimen at 150-200

Correct Incorrect Correct answer

Standard dose T4 regimen 75-100

Correct Incorrect Correct answer

A 5 years old boy present with sleepness rapid appearance of skin lesion seen the attached photography, on examination at the emergency room he was sleep but reacted to a light stimulation , pale,tempreture of 38.5 ,respiratory rate was 40 per min ,blood pressure70/40mmhg,o2 saturation was 95% in room air ,and his heart rate was 70/ min ,treatment with supplemental oxygen was initiated ,a peripheral IV line was inserted and initial lab and blood culture were obtained .which of the following is the most appropriated next step?

Intravenous dopamine dripat at 10mg/min and hydrocortison.

Correct Incorrect Correct answer

Intravenous dopamine dripat at 10mg/min and hydrocortison.

Correct Incorrect Correct answer

Repetitive dose of intravenous saline 20ml/kg and systemic antimicrobial treatment

Correct Incorrect Correct answer

Repetitive dose of intravenous saline 20ml/kg and systemic antimicrobial treatment

Correct Incorrect Correct answer

20ml/kg intravenous saline and urinary toxic screen.

Correct Incorrect Correct answer

A 8 year old boy with milk allergy and asthma is examined at the ER due to rhinorrhea, shortness of breath, and itching around the mouth, minutes after eating a cheese containing cake, his examination revealed shortness of breath, cyanosis, prolonged expirium and wheezing over both lungs, the face and pharynx are not swollen, which of the following is the most appropriate immediate treatment?

Corticosteroids

Correct Incorrect Correct answer

IM Adrenaline

Correct Incorrect Correct answer

Supplemental oxygen and follow up

Correct Incorrect Correct answer

Antihistamines

Correct Incorrect Correct answer

Salbutamol

Correct Incorrect Correct answer

A 3 month old infant present to the ER with restlessness over the last few day. Examination reveals the conscious and alert ,pale ,normal prefusion ,his pulse is 240/min, blood pressure 80/60 ,normotensive fontanella ,and normal heart rate and lung auscultation ,his ECG is below .which of the following is the most appropriate immediate treatment?

Digoxin(digitalis) loading dose

Correct Incorrect Correct answer

Rapid Nacl 0.9% infusion

Correct Incorrect Correct answer

Synchronized cardioversion

Correct Incorrect Correct answer

Amiodarone loading dose

Correct Incorrect Correct answer

Vagal maneuver

Correct Incorrect Correct answer

A 5 year old girl’s examination reveals a 2/6 mid-high sternal border heart murmur, and wide fixed s2 split ,which of the following is the most probable diagnosis?

Atrial septal defect

Correct Incorrect Correct answer

Aortic stenosis

Correct Incorrect Correct answer

Ventricular septal defect

Correct Incorrect Correct answer

Pulmonic stenosis

Correct Incorrect Correct answer

Tricuspid regurgitation

Correct Incorrect Correct answer

A 10 years old, generally well boy presents with fever and rhinorrhea for 3 days, on the 4th day shortness of breath and malaise were noticed, examination reveals a sick looking boy, blood pressure of 80/40 mmHg, room air O2 saturation of 96% heart rate of 160/min temprature of 37.1, respiratory rate 30/min, crepitations on both lungs, and an apical 2/6 heart murmur, which of the following is the most appropriate immediate treatment ?

Dopamine

Correct Incorrect Correct answer

Ceftriaxone (rocephine)

Correct Incorrect Correct answer

Captopril (capoten)

Correct Incorrect Correct answer

Oxygen and nebulized beta agonists

Correct Incorrect Correct answer

IV immunoglobolins

Correct Incorrect Correct answer

A diagnostic cardiac catherization reveals the following:

Which of the following is the most probable diagnosis?

Patent foramen ovale

Correct Incorrect Correct answer

Aortic insufficiency

Correct Incorrect Correct answer

Tetralogy of fallot

Correct Incorrect Correct answer

Patent ductus arteriosus

Correct Incorrect Correct answer

Ventrical septal defect

Correct Incorrect Correct answer

A preterm baby, 30 weeks of gestation was ventilated for 2 days, at 14 days enteral feeding was begun, and at 16 days he developes green colored vomiting, abdominal distention, several events of apnea, hypoglycemia, and metabolic acidosis his abdominal x-ray is attached. which of the following is the most likely diagnosis?

Pyloric stenosis

Correct Incorrect Correct answer

Intussusception

Correct Incorrect Correct answer

Duodenal atresia

Correct Incorrect Correct answer

Biliary atresia

Correct Incorrect Correct answer

Necrotizing enterocolitis

Correct Incorrect Correct answer

A neonatal examination revealed the finding shown in the attached picture, what leading mechanism?

Intrauterine infection

Correct Incorrect Correct answer

Cerebral palsy

Correct Incorrect Correct answer

Clavicular fracture

Correct Incorrect Correct answer

Brachial plexus injury

Correct Incorrect Correct answer

Congenital absence of elbow

Correct Incorrect Correct answer

Baby was born at home and did not receive standard hospital neonatal care, he was circumscribed on day 8 of life, 1day later he develooed bleeding at the site of circumcision, lab finding showed prolonged pt , possible cause?

Intrauterine infection

Correct Incorrect Correct answer

Preputitum penis

Correct Incorrect Correct answer

Neglect performance of circumcision

Correct Incorrect Correct answer

Congenital disease

Correct Incorrect Correct answer

Decrease in Vitamin K

Correct Incorrect Correct answer

Which of the following is the first sign of property in boys?

Testicular growth

Correct Incorrect Correct answer

Elongation of the penis

Correct Incorrect Correct answer

High growth spurt

Correct Incorrect Correct answer

Axillary hair

Correct Incorrect Correct answer

Hair growth at the penile base

Correct Incorrect Correct answer

16 y/o boy have severe developmental delay and autisim. Exam reveals his testes large of his age , he has hyperlaxity in his fingers , fascial demorphisim, which of the following is possible diagnosis?

Galactosemia

Correct Incorrect Correct answer

Klienffilter

Correct Incorrect Correct answer

Ataxia talangectasia

Correct Incorrect Correct answer

Fragile x

Correct Incorrect Correct answer

Prada willi syndrome

Correct Incorrect Correct answer

4 y/o presents with 2 days history of temperature up to 39, pharyngeal pain, exam reveals strawberry tongue, pallor around mouth, and rash. Tx??

IV vancomycin untill he is better

Correct Incorrect Correct answer

Trimethoprim _ sulfamethaxole for 1 week

Correct Incorrect Correct answer

Amoxicillin for 10 days

Correct Incorrect Correct answer

Doxycycline for 1 week

Correct Incorrect Correct answer

Pipracillin _ tazobactum for 1 week

Correct Incorrect Correct answer

3 year old generally healthy boy present to ER with fever and vomiting for a day, his examination is significant for brudzinski and kernings signs ,lab finding revealed turbid c.s.f of gram positive cocci in pairs on gram stain which of the following c.s..f finding are most accurate ?

glucose 50 mg,100 wbc mm, 50% lymphocyte

Correct Incorrect Correct answer

glucose 200mg, 1500 wbc, 50%lymphocyte

Correct Incorrect Correct answer

glu 45 mg, 500 wbc,decrease proteins , increase cl-

Correct Incorrect Correct answer

glu 100mg, 2300 wbc, normal protein and chloride

Correct Incorrect Correct answer

glucose 2 mg 4500 wbc , protine increase

Correct Incorrect Correct answer

A 5 year old generally well boy, presents with an infected wound on his right palm. A picture of the finding on examination is attached. Which of the following is the recommended treatment for this patient:

Moxypen(amoxicillin)

Correct Incorrect Correct answer

Zinnat(cefuroxime)

Correct Incorrect Correct answer

Respirim(trimethoprim/sulfa)

Correct Incorrect Correct answer

Ceforal(cephlexin)

Correct Incorrect Correct answer

Doxilin(doxycycline)

Correct Incorrect Correct answer

An 8 years old girl is admitted and treated for rheumatic fever, without cardiac involvement. Which of the following will you recommend on discharge?

Immediate diagnosis and treatment of every of streptococcal tonsillitis

Correct Incorrect Correct answer

Prophylactic treatment with oral penicillin V until the age of 21 years?

Correct Incorrect Correct answer

Prophylactic treatment with oral penicillin V for the next 5 years

Correct Incorrect Correct answer

Prophylactic treatment with oral amoxicillin until the age of 40

Correct Incorrect Correct answer

IM benzanthine penicillin once monthly, until the age of 18?

Correct Incorrect Correct answer

A 10 years old girl presents with up to 38.3 , cough during the day, headache and purulent nasal discharge over the last 8 days. Examination is significant for tenderness above the maxillary sinuses and post nasal drip . Which of the following is the recommended treatment?

Amoxicillin- clavulanate ( augmentin)?

Correct Incorrect Correct answer

Amoxicillin ( mexypen)?

Correct Incorrect Correct answer

Ciprofloxacin (ciproxin)

Correct Incorrect Correct answer

Cephalexin (ceforal)

Correct Incorrect Correct answer

Clindamycin ( dalacinc)

Correct Incorrect Correct answer

A and/or B

Correct Incorrect Correct answer

C and/orD

Correct Incorrect Correct answer

Which of the following is considered normal in the development of a 3 and a half month old infant?

Withdrawal to the word "no"

Correct Incorrect Correct answer

Transferring an object between hands

Correct Incorrect Correct answer

Holding an object between a finger and a thumb

Correct Incorrect Correct answer

Babbling

Correct Incorrect Correct answer

Smiling in reaction to a voice and seeing a face

Correct Incorrect Correct answer

A 2 year old rans and climbs stases , builds a tower from 7 blocks, eats from a spoon, and compress a sentence from 2-3 words. Which of the following is true regarding his developmental stage?

Delay in fine motor skills

Correct Incorrect Correct answer

Delay in language skills

Correct Incorrect Correct answer

Delay in gross motor skills

Correct Incorrect Correct answer

Normal for his age

Correct Incorrect Correct answer

Delay in motor and language skills

Correct Incorrect Correct answer

Which of the following language skills developmental pattern is normal?

Being able to compose 4 word sentence at 2 years of age

Correct Incorrect Correct answer

Syllables at 1 year of age, and 2-5 words at 2 years of age

Correct Incorrect Correct answer

Being able to say 1-2 words at 1 year of age

Correct Incorrect Correct answer

As long as a child is able to say 30 words at the age of 3 years, language developmental pace is not significant

Correct Incorrect Correct answer

Being able to say at least 5 separate words at 1 year of age.

Correct Incorrect Correct answer

1 year old is examined due to the following findings in picture, after having bathed in water that was too hot, according to his mother. Which of the following may be found in a higher incidence in this child?

Cranial fractures

Correct Incorrect Correct answer

Scapular fractures

Correct Incorrect Correct answer

Sternal fractures

Correct Incorrect Correct answer

Jow fractures

Correct Incorrect Correct answer

Pelvic fractures

Correct Incorrect Correct answer

A 13 year old boy presents with bloody diarrhea over the last 2 months, intermittent fever, and weight loss. Laboratory is significant for anemia, and elevated inflammatory markers. Intestinal biopsy reveals granulomas in the small bowel wall . Which of the following phenomena is common in the most likely diseases?

Toxic megacolon

Correct Incorrect Correct answer

Pyoderma gangrenisumc

Correct Incorrect Correct answer

Oral aphthos

Correct Incorrect Correct answer

Positive celiac serology

Correct Incorrect Correct answer

Positive mantuox test

Correct Incorrect Correct answer

A 1 year old girl was born at 30 week of gestation ,and her NICU stay had surgical excision of the terminal ileum including the cecum and the ascending and transverse colon. She is fed with formula based on cow milk protein, which of the following deficiencies may the girl develop:

Triglycerides

Correct Incorrect Correct answer

Essential amino acids

Correct Incorrect Correct answer

phosphor

Correct Incorrect Correct answer

magnesium

Correct Incorrect Correct answer

vitamin b 12

Correct Incorrect Correct answer

a 3 years old boy has been having recurrent events of rectal prolapse since birth, over the last year , since he began attending kindergarten , he had recurrent episodes of shortness of breath, diarrhea and weight loss, attributed to recurrent viral diseases. Which of the following test may aid in diagnosis the cause of the rectal prolapse?

Complete blood count

Correct Incorrect Correct answer

Stool culture

Correct Incorrect Correct answer

Alpha antitrypsin level in the stool

Correct Incorrect Correct answer

Abdominal ultrasound

Correct Incorrect Correct answer

A 10 years old boy has been experiencing right upper quadrand pain over the last year. Physical examination is significant for jaundice. Laboratory results reveal elevated serum lipase and the attached sonogram. Which of the following is the most likely cause of his disease?

Crohn‘s disease

Correct Incorrect Correct answer

Peptic ulcer

Correct Incorrect Correct answer

Autoimmune jaundice

Correct Incorrect Correct answer

Chronic hemolysis

Correct Incorrect Correct answer

Cystic fibrosis

Correct Incorrect Correct answer

A 5 month old infant has been diagnosed as having beta-thalassemia major which of the following is curative treatment for this disease?

Bone marrow transplantion

Correct Incorrect Correct answer

Iron chelation

Correct Incorrect Correct answer

Recurrent blood transfusions

Correct Incorrect Correct answer

Hydroxurea

Correct Incorrect Correct answer

Splenectomy

Correct Incorrect Correct answer

A 5yr old boy has recurrent episode of 8-10 grade pain. A blood smear is attached. Which of the following complications are expected in this disease?

Lymphoma

Correct Incorrect Correct answer

Leaukemia

Correct Incorrect Correct answer

Pneumococcal infection

Correct Incorrect Correct answer

Autoimmune disease

Correct Incorrect Correct answer

Permanent rash

Correct Incorrect Correct answer

3 years old girl , less active lately ,eating sand , peeling paint off the wall, she has pallor, soft abdomen, non palpable spleen, LABS: HB :7.2. Mcv : 60. RDW:17% RBC:3.2*10/dL Ferritin : 2mg . What is the treatment ?

Vitamin B12

Correct Incorrect Correct answer

Iron supplement (correct)

Correct Incorrect Correct answer

Eltroxin

Correct Incorrect Correct answer

Gluten free diet

Correct Incorrect Correct answer

Recurrent blood transfusions

Correct Incorrect Correct answer

10 year old girl present with a slowdown in her growth rate and malaise, laboratory results are attached which of the following will contribute to the confirmation of the common etiology?

Chest and neck MRI looking for a “vanishing gland”

Correct Incorrect Correct answer

Thyroid sonogram

Correct Incorrect Correct answer

Technetium scan

Correct Incorrect Correct answer

Serum antibodies for thyroglobulin and thyroid peroxidase

Correct Incorrect Correct answer

Serum thyroglubulin

Correct Incorrect Correct answer

12 year old boy has been diagnosed with type 1 diabetes 9 months ago and has been treated well. Which of the following is true regarding the sport activity of this boy?

Heavy weight gain lifting should be avoided due to a risk of elevated intraocular pressure during valsalva

Correct Incorrect Correct answer

There is no need to avoid sport, including competitive sports

Correct Incorrect Correct answer

Sports should be decreased during the first year due to a risk of hypoglycemia

Correct Incorrect Correct answer

Long run should be avoided due to a risk of arrhythmia

Correct Incorrect Correct answer

Sport should be avoided during the first year due to tendency of unsatisfactory diabetics control

Correct Incorrect Correct answer

2 year old has been brought to the ER due to diarrhea and fever over the last day, the parents say he is drinking well. Examination is significant for impaired consciousness, pallor, and malaise. His BP 60/40 and HR 160. Lab results: glucose 40 mg/dl, sodium 125 meq/l, potassium 7meq/l.
Which of the following is the most likely cause?

Obstructive uropathy

Correct Incorrect Correct answer

Acute adrenal insuficiency

Correct Incorrect Correct answer

Sulfonyurea ingestion

Correct Incorrect Correct answer

Water intoxication

Correct Incorrect Correct answer

Hyponatremic dehydration

Correct Incorrect Correct answer

A 7 years old boy is hospitalized due to reccurent liver abscess caused by s.aureus. he also has reccurent skin infections with the same causative agent. Which of the following tests will diagnose his mos likely disease?

Killing capacity of natural killer cells

Correct Incorrect Correct answer

Skin testing of delayed type hypersensitivity?

Correct Incorrect Correct answer

50% hemolytic complement activity

Correct Incorrect Correct answer

Neutrophil elastase levels

Correct Incorrect Correct answer

Neutrophil superoxid (O2) production?

Correct Incorrect Correct answer

A and/or C

Correct Incorrect Correct answer

B or/and E

Correct Incorrect Correct answer

A 17 years old boy has developed urticaria, shortness of breath and impaired consciousness 30 minutes after being stung by a bee. After receiving the standard treatment, the boy had a full recovery. Skin testing was positive for a bee venom. Which of the following is the approach in this case?

Immediate systemic steroid treatment with future bee stings

Correct Incorrect Correct answer

Immediate anti histamines treatment with future bee stings

Correct Incorrect Correct answer

Monoonal antibody treatment with future bee stings

Correct Incorrect Correct answer

Inhaledd beta agonists treatment with future bee stings

Correct Incorrect Correct answer

Venom immunotherapy for bee venom as soon as possible

Correct Incorrect Correct answer

A 4-year-old boy has presents with high fever over the last 7 days. His examination is significant for a fine skin rash, right cervical lymphadenitis, non-purulent conjunctivitis, and the finding in the attached photograph.
Which of the following is the recommended treatment?

Intravenous penicillin

Correct Incorrect Correct answer

Oral steroids

Correct Incorrect Correct answer

Aspirin + IVIG

Correct Incorrect Correct answer

Intravenous ceftriaxone

Correct Incorrect Correct answer

High dose intravenous steroids

Correct Incorrect Correct answer

A 7 year old boy present with 3 days of abdominal pain, ankle pain, and the rash demostrated in the picture (rash made of dots on buttocks and legs). These lesions are elevated and do not dissapear with pressure, blood count is normal. Whats is the recommended treatment?

IVIG

Correct Incorrect Correct answer

NSAIDs

Correct Incorrect Correct answer

oral prednisone

Correct Incorrect Correct answer

oral ppi

Correct Incorrect Correct answer

IV hydration and analgesia

Correct Incorrect Correct answer

A finding in the physical examination of a month and a half old female infant is demonstrated in the attached picture, which of the following is a risk factor for her condition?

Large for gestational age birth weight

Correct Incorrect Correct answer

Polyhydramnios

Correct Incorrect Correct answer

Second or third delivery

Correct Incorrect Correct answer

Delivery…

Correct Incorrect Correct answer

Southeast asian decent

Correct Incorrect Correct answer

A 2 years old is examined due to refusal to walk over the last week. When forced to stand up he is restless and prefer to lie down on the side, examination reveals a generally well toddler, which walks with a limp, normal reflexes, and no tenderness over the spine or any other skeletal abnormal finding. Laboratory results include a normal blood count and elevated CRP. Which of the following tests will contribute the most to his diagnosis?

Spinal X-ray

Correct Incorrect Correct answer

Vertebral biopsy

Correct Incorrect Correct answer

Hip sonogram

Correct Incorrect Correct answer

Lumbar puncture

Correct Incorrect Correct answer

Spinal MRI

Correct Incorrect Correct answer

A 3 years old girl came home from kindergarten refusing to step on her left leg. Her examination is normal except her inability to bear weight on her left leg. Her x-ray is attached
Which of the following is the most likely the diagnosis?

Ankle sprain

Correct Incorrect Correct answer

Toddler fracture

Correct Incorrect Correct answer

Tibial osteomyelitis

Correct Incorrect Correct answer

Fibular fracture

Correct Incorrect Correct answer

Ewing sarcoma

Correct Incorrect Correct answer

Physical examination of the ear of 2 years old child with fever is shown in the attached picture. Which of the following defines this finding?

Otitis with effusion

Correct Incorrect Correct answer

Otitis with a bulging ear drum

Correct Incorrect Correct answer

Normal ear drum

Correct Incorrect Correct answer

Hemotympanum

Correct Incorrect Correct answer

Cholesteatoma

Correct Incorrect Correct answer

The attached picture demonstrates findings during routine physical Check-up of a 1 year old infant. Which of the following tests is mandatory in this situation.(picture)

Biopsy from the lesion

Correct Incorrect Correct answer

Fundoscopy

Correct Incorrect Correct answer

Fungal culture

Correct Incorrect Correct answer

Hair fragility testing

Correct Incorrect Correct answer

Neural conductance testing

Correct Incorrect Correct answer

An 8 years old boy is examined following a two-minute tonic-clonic generalized seizure from which he was recovered completely. He has normal development and there is no history of head trauma or a family history of convulsive disorder. In examination his temperature is 36.4C blood pressure is 102/65 his pulse is 80 bpm, and he has normal neurologic exam. EEG an MRI are normal. which of the following approaches is recommended?

Valproic acid (Depalept) treatment for 2 years

Correct Incorrect Correct answer

Carbamazepine (tegratol) treatment for at least one year

Correct Incorrect Correct answer

Close clinical and developmental follow up

Correct Incorrect Correct answer

Repeat sleep and awake eeg within a month

Correct Incorrect Correct answer

Levetiracetam (Keppra) treatment for 6 months

Correct Incorrect Correct answer

An 8 month old infant has recurrent events of apnea and cyanosis that appear after crying and resolves spontaneously within 30 seconds with full recovery.
Physical neurological and developmental exams are normal. Which of the following is the appropriate approach to this condition?

Video EEG

Correct Incorrect Correct answer

Electroencephalogram (EEG)

Correct Incorrect Correct answer

Tilt test to create vagal effect

Correct Incorrect Correct answer

Clinical follow up and parental reassurance

Correct Incorrect Correct answer

Electrocardiogram (ECG)

Correct Incorrect Correct answer

A 3 year old boy that started walking at the age of one year has developed pelvic weakness and lordosis beginning at the age of one and half year and has now severe difficulty in changing from lying down to standing position .A maternal uncle (the mother’s brother ) had this disease and died at young age. Which of the following is expected in this boy blood work?

Significantly increased creatine phosphokinase (CPK)

Correct Incorrect Correct answer

Metabolic acidosis

Correct Incorrect Correct answer

Significantly increased ammonia

Correct Incorrect Correct answer

Significantly increased alpha fetoprotein

Correct Incorrect Correct answer

Persistent hyperkalemia

Correct Incorrect Correct answer

A 6 year old boy is examined due to difficulty in concentrating and in school his history including pregnancy, delivery and development is normal, as is his physical and neurological examination.
Which of the following is recommended as first step?

Eye sight examination

Correct Incorrect Correct answer

EEG

Correct Incorrect Correct answer

ECG

Correct Incorrect Correct answer

Thyroid function tests

Correct Incorrect Correct answer

Computerized attention test

Correct Incorrect Correct answer

A 1 –day – old baby has prenatal screening significant for bilateral hydronephrosis and oligohydramnios .on examination the baby urinates in a fragmented pattern , urinary stream is low , and there is a palpable mass in his lower abdomen , laboratory results: potassium 6.5, sodium-135 creatinine 1. which of the following is the most likely diagnosis?

Hydro calycosis

Correct Incorrect Correct answer

Hypospadias

Correct Incorrect Correct answer

Posterior ureteral value

Correct Incorrect Correct answer

Vesico- ureteral refllux

Correct Incorrect Correct answer

Ureteropelvic junction obstruction

Correct Incorrect Correct answer

A 3-year-old girl diagnosed with weight gain, feet edema. BP – normal. Albumin 1.9 (low), cholesterol 320 mg/dl, renal function – normal, urinay protein-creatinine ratio is above 10. What is most likely diagnosis:

Minimal change disease

Correct Incorrect Correct answer

Rapidy progressive glomerulonephritis

Correct Incorrect Correct answer

Membranous nephropathy

Correct Incorrect Correct answer

Focal segmental glomerulosclerosis

Correct Incorrect Correct answer

Post infectious

Correct Incorrect Correct answer

1-year-old child is brought to emergency department due to diarrhea and vomiting over the last 2 days. On examination – impaired consciousness, reaction to pain only, normal turgor, but dry mucosa. Lab results before administration of IV fluids: serum sodium-168. What is most appropriate IV solution:

Albumin 20%

Correct Incorrect Correct answer

NaCI 0.9%

Correct Incorrect Correct answer

NaCl 0.33%

Correct Incorrect Correct answer

NaCl 0.45%

Correct Incorrect Correct answer

2 months old infant has inspiratory and expiratory stridor for the last week, no fever or any additional complains. On physical examination – 2 hemangiomas 1-2 cm large on lower lip and chin. What is most appropriate treatment:

Propranolol

Correct Incorrect Correct answer

Prostaglandin E1

Correct Incorrect Correct answer

Nebulized

Correct Incorrect Correct answer

Aerosolized

Correct Incorrect Correct answer

Satulol

Correct Incorrect Correct answer

5-year-old boy had tonsillectomy and adenoidectomy 3 weeks ago, after surgery vomited few times. Presents with fever, purulent cough, right chest pain, shortness of breath. On examination – seems sick, temp 39, respiratory rate-45 with retractions, reduced breath sounds. Chest x-ray is attached *(opacity on right lobe). What should be performed at this point:

Urgent lung ct

Correct Incorrect Correct answer

Sputum culture by bronchoalveolar lavage

Correct Incorrect Correct answer

Direct lung puncture biopsy of the finding

Correct Incorrect Correct answer

Intravenous treatment with ticarcillin/clavulanute

Correct Incorrect Correct answer

Intravenous treatment with ticarcillin/clavulanute

Correct Incorrect Correct answer

A 5-years-old present with stridor, cough and a high fever for a day. Examination reveals a sick boy, with a productive cough and a large amount of purulent sputum. He is not drooling. Which of the following is the most common causative agent of the boy’s condition?

Adenovirus

Correct Incorrect Correct answer

Parainfluenza virus

Correct Incorrect Correct answer

Herophilus influenza

Correct Incorrect Correct answer

Staphylococcus aureus

Correct Incorrect Correct answer

Moraxella catarrhalis

Correct Incorrect Correct answer

A 35 – year – old male was treated with a psychiatric drug and developed a life – threatening rash . Which of the following drugs did he most likely receive?

Diazepam

Correct Incorrect Correct answer

Fluoxetine

Correct Incorrect Correct answer

Lamotrigine

Correct Incorrect Correct answer

Clonazepam

Correct Incorrect Correct answer

Fluvoxamine

Correct Incorrect Correct answer

A patient has been recently diagnosed with schizoprenia. which of the following predicts bad prognosis?

A limited support system

Correct Incorrect Correct answer

late onset (older age)

Correct Incorrect Correct answer

negative symptoms

Correct Incorrect Correct answer

being single

Correct Incorrect Correct answer

family history of psychotic disorder

Correct Incorrect Correct answer

A patient in the psychiatric ward stands for hours in a still, Uncomfortable posture. He is mute, negativism, and smiles to himself without an external stimulus. Which of the following is the best treatment?

Lamotrigine

Correct Incorrect Correct answer

Electo-compulsive therapy (ECT)

Correct Incorrect Correct answer

Carbamazepine

Correct Incorrect Correct answer

Fluvoxamine

Correct Incorrect Correct answer

A57 years old man in the midst of a divorce crisis report difficulty fallings sleep,feelingangry,depressed&distressed over the last week,he denies feeling despair,gailt,worthlesses or hopeless,he functions partially at work and at home. Whis is the most likely disorder?

Post traumatic stress disorder

Correct Incorrect Correct answer

Stress disorder

Correct Incorrect Correct answer

Acute stress disorder

Correct Incorrect Correct answer

Adaptive disorder

Correct Incorrect Correct answer

Major depressed

Correct Incorrect Correct answer

A woman age 60 wishes to discontinue treatment with benzodiazepines . Which of the following drugs carries a higher risk of withdrawl syndrome?

Clonazepam

Correct Incorrect Correct answer

Zolpidem

Correct Incorrect Correct answer

Diazepam

Correct Incorrect Correct answer

Lorazepam

Correct Incorrect Correct answer

A75-year-old woman was hospitalized in an internal medicine ward due to pneumonia. Three days later she deteriorated, reports nausea, difficulty concentrating, drowsiness and depersonalization. Physical examination reveals tremor and myoclonus. Her son reports that upon admission she had failed to tell the staff she has been taking three tablets of 2mg clonazepam per day for the last year, hence, has not been receiving it for the last 3 days. Which of the following is not a part of benzodiazepine withdrawal syndrome?

Difficulty concentrating

Correct Incorrect Correct answer

Nausea

Correct Incorrect Correct answer

Myoclonus

Correct Incorrect Correct answer

Drowsiness

Correct Incorrect Correct answer

Depersonalization

Correct Incorrect Correct answer

A 40 year old homeless woman arrives in an ambulance to the emergency room after she was found without conciousness on the street. Physical examenation reveals an unconscios woman with respiratory depression,narrow pupils, and needle marks on her arms. Which of the following is the best treatment for her current condition?

Fluvoxamine

Correct Incorrect Correct answer

Diazepam

Correct Incorrect Correct answer

Naloxone

Correct Incorrect Correct answer

Carbamezapine

Correct Incorrect Correct answer

Risperidone

Correct Incorrect Correct answer

29 years old male was referred after having recurrent plastic surgery, on the same organ which were defined by the doctors as unnecessary. Which organ is the most likely to be the focus of this disorder?

Hips

Correct Incorrect Correct answer

Arms

Correct Incorrect Correct answer

Neck

Correct Incorrect Correct answer

Penis

Correct Incorrect Correct answer

Eyes

Correct Incorrect Correct answer

A 32 – year – old schizophrenic female has begun risperidone treatment . Which of the following adverse eflects is typical of risperidone use?

Increased prolactin

Correct Incorrect Correct answer

Hyperthyroidism

Correct Incorrect Correct answer

Increased vitamin B12

Correct Incorrect Correct answer

Increased rate of psoriasis

Correct Incorrect Correct answer

Weight loss

Correct Incorrect Correct answer

Which of the following is not included in the advantages of long acting (versus short acting) benzodiazepines?

Plasma levels are more stable

Correct Incorrect Correct answer

Reducing the frequency of taking the drug during the day

Correct Incorrect Correct answer

Fewer withdrawal symptoms

Correct Incorrect Correct answer

A reduced sedative effect

Correct Incorrect Correct answer

Which of the following is not an indication for topiramate?

Bulimia nervosa

Correct Incorrect Correct answer

Drug withdrawal

Correct Incorrect Correct answer

Alcohol withdrawal

Correct Incorrect Correct answer

Migraine prophylaxis

Correct Incorrect Correct answer

Seizures

Correct Incorrect Correct answer

Which of the following is not included in mini mental testing (MMSE), with regards to to cognitive functions?

Short term memory

Correct Incorrect Correct answer

Orientation

Correct Incorrect Correct answer

Insight

Correct Incorrect Correct answer

Long term memory

Correct Incorrect Correct answer

Naming

Correct Incorrect Correct answer

A 50 – year – old male is married and father of 2, depressed and is unemployed for 3 months. Which of the following is not a risk factor for complete suicide?

His gender

Correct Incorrect Correct answer

His age

Correct Incorrect Correct answer

His employment status

Correct Incorrect Correct answer

His mental status

Correct Incorrect Correct answer

His support system

Correct Incorrect Correct answer

A 23 – year – old female presents with many superficial cuts on her forearms. Which of the following is typical for this behavior?

No intention of dying

Correct Incorrect Correct answer

Associated with avoidant personality disorder

Correct Incorrect Correct answer

Incidence is equal across genders

Correct Incorrect Correct answer

Resolves within a few weeks

Correct Incorrect Correct answer

Associated with schizoid personality disorder

Correct Incorrect Correct answer

A 35 – year – old male was treated with perphenazine due to a psychotic state, and developed extrapyramidal adverse effects . Which of the following treatments is not appropriate for this condition?

Watchful waiting

Correct Incorrect Correct answer

Reduce the dose of the dopamine blocking drug and adding an anticholinergic drug

Correct Incorrect Correct answer

Reduce the dose of the dopamine blocking drug

Correct Incorrect Correct answer

Replacing the drug with a dopamine and serotonin blocker

Correct Incorrect Correct answer

Adding an anticholinergic drug

Correct Incorrect Correct answer

A 28 – year – old woman was brought to the emergency room after ingesting 90 valium pills. Which of the following is the treatment of choice in this patient?

Flumazenil

Correct Incorrect Correct answer

Adderall

Correct Incorrect Correct answer

Modafinil

Correct Incorrect Correct answer

Nardil

Correct Incorrect Correct answer

Azenil

Correct Incorrect Correct answer

In a patient – therapist appointment of a patient with an anxiety disorder, the patient was asked to write a weekly Journal, describing the dates and times in which he had panic attacks , and the thoughts that followed each episode. Which of the following treatment methods is used in this line of interventional treatment ?

Psychodrama

Correct Incorrect Correct answer

Cognitive behavioral psychotherapy

Correct Incorrect Correct answer

Dynamic psychanalytic psychotherapy

Correct Incorrect Correct answer

Hypnosis Movement therapy

Correct Incorrect Correct answer

A patient confesses to her therapist that she is in love with him . She wishes to cease therapy so they can be a romantic relationship Which of the following describes this episode?

Containing

Correct Incorrect Correct answer

Therapeutic alliance

Correct Incorrect Correct answer

Interpretation

Correct Incorrect Correct answer

Holding

Correct Incorrect Correct answer

Transference

Correct Incorrect Correct answer

During a psychiatric evaluation the patient complements the psychiatrist looks, asks her if she is married, and asks her out on a date for that evening. Which of the following describes this behavior?

Impaired social judgment

Correct Incorrect Correct answer

Impaired reality testing

Correct Incorrect Correct answer

Impaired orientation to place

Correct Incorrect Correct answer

Impaired thought process

Correct Incorrect Correct answer

Impaired time orientation

Correct Incorrect Correct answer

A 34 – year – old schizophrenic patient begins haloperidol treatment without any other medications . He presents to the emergency room a month later with muscle rigidity, fever of 38 . 9°C , and severe confusion Laboratory examination reveals leukocytosis, elevated liver function test , and elevated creatinine kinase level ( CK ) 786 . Which of the following is the most likely diagnosis?

Hyperprolactinemia

Correct Incorrect Correct answer

Secondary parkinsonism

Correct Incorrect Correct answer

Serotonin syndrome

Correct Incorrect Correct answer

Neuroleptic malignant syndrome

Correct Incorrect Correct answer

Akathisia

Correct Incorrect Correct answer

A77 year – old woman has been found wondering around her neighborhood confused and disoriented. During her emergency room examination , she is confused, agitated, and disoriented in time and place . Her husband reports that up until recently she was in good health , except for hypothyroidism treated with eltroxin Over the last few months she has been complaining of dizziness , and 3 weeks ago he found her in the morning laying on the floor beneath the bed , slightly confused and with a sign of blunt trauma on her forehead . He reported that they haven ‘ t thought it important, and therefore did not seek medical attention Which of the following is the most likely diagnosis?

Normal behavior for her age

Correct Incorrect Correct answer

Huntington' s dementia

Correct Incorrect Correct answer

Alzheimer' s dementia

Correct Incorrect Correct answer

Head trauma related dementia

Correct Incorrect Correct answer

Frontotemporal dementia

Correct Incorrect Correct answer

A 27 – year – old math teacher male complains of a prolonged depressed mood, for the last 10 years . He reports that life always seemed too hard for him , he has not found pleasure , and mostly felt like a fallure , lacking a direction , passion , or ambition . He felt unattractive and has not sustained a prolonged romantic relationship Lately he has thought of ending his pointless existence , but has not tried to hurt himself because he thought it would hurt his students . Which of the following is the most likely diagnosis?

Borderline personality disorder

Correct Incorrect Correct answer

Obsessive compulsive disorder

Correct Incorrect Correct answer

Cyclothymia

Correct Incorrect Correct answer

Obsessive compulsive personality disorder

Correct Incorrect Correct answer

Dysthymia

Correct Incorrect Correct answer

A 55 – year – old generally healthy male , senior engineer in a big software company, with no regular medical treatment , complains of difficulties concentrating , memory loss, and a feeling of slow and non – creative thinking especially in the mornings , over the last few weeks . During his examination he reports significant sadness , difficulty falling asleep, decreased appetite , anhedonia , and thoughts that his life is pointless over the last 2 months . Which of the following is the most likely explanation for his cognitive difficulties?

Pseudodementia

Correct Incorrect Correct answer

Alzheimer' s dementia

Correct Incorrect Correct answer

Multiple sclerosis

Correct Incorrect Correct answer

Vascular dementia

Correct Incorrect Correct answer

Chronic psychotic disorder

Correct Incorrect Correct answer

During a psychiatric evaluation of a 35 – year – old male he is asked if he thinks that people are talking about him behind his back In response he answers that the examiner knows the answer to this question as the examiner can anyway read his thoughts. Which is true regarding this evaluation?

Impaired insight

Correct Incorrect Correct answer

Impaired social judgment

Correct Incorrect Correct answer

Impaired reality testing

Correct Incorrect Correct answer

Normal mental status

Correct Incorrect Correct answer

Impaired orientation

Correct Incorrect Correct answer

Which of the following is an accepted indication for electroconvulsive therapy (ECT)?

Conversion disorder

Correct Incorrect Correct answer

Post traumatic disorder

Correct Incorrect Correct answer

Psychotic depression

Correct Incorrect Correct answer

Deterioration in attention deficit hyperactive disorder

Correct Incorrect Correct answer

Anorexia nervosa

Correct Incorrect Correct answer

A 25 – year – old female who is an English literature student , arrives to the ER after being stopped for driving too fast On examination she reports not sleeping more than 2 hours a night in the past week and that she took a bank loan of 150,000 NIS so she can open her own clothes import business . She is in a very good mood, speaks very fast, laughs a lot , and at times it is hard to follow her thoughts as she rapidly changes subjects. She claims that her thought is fast and strong and that she is more concentrated than she has ever been . She also claims that she has unique abilities to run the business and that she only found out about it this week . Which of the following is the most appropriate treatment?

Fluoxetine

Correct Incorrect Correct answer

Clarithromycin

Correct Incorrect Correct answer

Methylphenidate

Correct Incorrect Correct answer

Amphetamine

Correct Incorrect Correct answer

Olanzapine

Correct Incorrect Correct answer

Which of the following is most characteristic of patients with obsessive – compulsive disorder?

Tend to invest time and energy in interpersonal relationships even on account of work and career

Correct Incorrect Correct answer

Tend to ‘cut the corners’ at work and therefore usually complete assignments on time

Correct Incorrect Correct answer

Tend to create unstable interpersonal connections and do not maintain stable relationships

Correct Incorrect Correct answer

Tend to easily distinguish between important and non – important and therefore get rid of invaluable things

Correct Incorrect Correct answer

Tend to create high self – standards and expectations and tend to criticize themselves

Correct Incorrect Correct answer

A 32 – year – old male who is a qualified accountant cannot find a job for the past 6 months . He reports that during his studies and Interviews he is nervous , afraid to talk, very nervous in group situations since he is afraid that he will sound nervous and will blush and get confused , and therefore he does not talk . As a result , he does not go out much on new dates and is reluctant to look for a job . Which of the following is the most likely diagnosis?

Panic disorder

Correct Incorrect Correct answer

General anxiety disorder

Correct Incorrect Correct answer

Agoraphobia disorder

Correct Incorrect Correct answer

Social anxiety disorder

Correct Incorrect Correct answer

Specific phobia

Correct Incorrect Correct answer

A 26 – year – old frightened female complains of repeat episodes of physical phenomena ” that are accompanied be a strong fear of death during such episode and also fear between the episodes and fear of future episodes . Which of the following is not common in the described diagnosis?

Choking sensation

Correct Incorrect Correct answer

Dizziness

Correct Incorrect Correct answer

Nausea

Correct Incorrect Correct answer

False thoughts

Correct Incorrect Correct answer

Tremor

Correct Incorrect Correct answer

A 52 – year – old female who is married with three children is employed as an electrical engineer. She was diagnosed with breast cancer last year and is treated with chemotherapy and radiation . Which of the following is she most likely to develop?

Adjustment disorder

Correct Incorrect Correct answer

Delirium

Correct Incorrect Correct answer

Post – traumatic stress disorder

Correct Incorrect Correct answer

Major depression

Correct Incorrect Correct answer

Delusional disorder

Correct Incorrect Correct answer

76 years old male with a past history of prostatectomy, past medical history is positive for hypertension, hyperlipidemia, diabetes mellitus admitted due to abdominal pain and melena. Now after 2 weeks of admission at the surgery department he screams and mumbles in the last 3 nights claiming that demons haunt him and try to kill him. He is in extreme restlessness. During the morning he talks excellent and does not remember what happened at night.
What is the recommended treatment?

Strap to bed during the night

Correct Incorrect Correct answer

Haloperidol

Correct Incorrect Correct answer

Paroxetine

Correct Incorrect Correct answer

Oxazepam

Correct Incorrect Correct answer

Iloperidone

Correct Incorrect Correct answer

A 41 years old reports constantly looking over his shoulder since he is concerned that he dropped a coin or accidentally stepped on a bug and killed it. he avoids touching objects, after touching one he needs to convince himself he didn’t break it. Diagnosis?

OCD

Correct Incorrect Correct answer

Paranoid personality disorder

Correct Incorrect Correct answer

Hypochondriasis

Correct Incorrect Correct answer

Acute and transient paranoid psychosis

Correct Incorrect Correct answer

Schizophrenia

Correct Incorrect Correct answer

Which of the following best predicts aggression in mentally ill patients?

Previous episodes of aggression

Correct Incorrect Correct answer

Drug abuse

Correct Incorrect Correct answer

Exposure to unexpected stress stimuli

Correct Incorrect Correct answer

The time and course of mental illness

Correct Incorrect Correct answer

Full compliance with treatment recommendation

Correct Incorrect Correct answer

A 70 – year – old male is examined at the ER due to groln pain for 6 hours. On examination – a 6 cm tender Inguinal mass . What is the most appropriate next step?

An attempt to reduce the mass

Correct Incorrect Correct answer

Abdominal CT

Correct Incorrect Correct answer

Mass aspiration to rule out an abscess

Correct Incorrect Correct answer

Urgent surgery

Correct Incorrect Correct answer

Groin ultrasound

Correct Incorrect Correct answer

An 81 – year – old male is admitted due to multiple vomiting over the last week. What is the most common metabolic abnormality in patients with multiple vomiting due to gastric outlet obstruction?

Hyperkalemia, hyperchloremia , metabolic acidosis

Correct Incorrect Correct answer

Hyperkalemia , hyperchloremia , metabolic acidosis

Correct Incorrect Correct answer

Hyponatremia , hypokalemia , metabolic alkalosis

Correct Incorrect Correct answer

Hyponatremia , hypochloremia , metabolic acidosis

Correct Incorrect Correct answer

Hypokalemia , hypochloremia , metabolic alkalosis

Correct Incorrect Correct answer

A 3 – year – old girl is brought to the ER with a mass at the umbilicus that followed an episode of crying and wild behavior . Which of the following is correct regarding umbilical hernia in children?

Very common in children and should resolve until the age of 5 years

Correct Incorrect Correct answer

Should be operated early due to risk of bowel incarceration

Correct Incorrect Correct answer

Should be operated after the age of 1 year in order to allow for normal development

Correct Incorrect Correct answer

Uncommon in children and never resolves spontaneously

Correct Incorrect Correct answer

A 56 y.o male patient is admitted due to abdominal pain for a month. One of the surgeons suggest to continue the evaluation with diagnostic laparscopy. Which of the following is correct?

This approach is accompanied with many complications

Correct Incorrect Correct answer

This approach is highly diagnostic

Correct Incorrect Correct answer

This approach is less common nowdays

Correct Incorrect Correct answer

4. This approach’s main advantages is to identify retroperitoneal pathology

Correct Incorrect Correct answer

An elderly patient is brought to the ER with severe abdominal pain and bloody diarrhea for the first time in his life . He also has heart failure . On examination – left upper quadrant tenderness . Labs – lactic acidosis . What is the next step in management?

Abdominal CT

Correct Incorrect Correct answer

Abdominal ultrasound

Correct Incorrect Correct answer

Abdominal angiography

Correct Incorrect Correct answer

Abdominal X – ray supine and upright or left lateral decubitus

Correct Incorrect Correct answer

50 y.o male, presents to the ER wih acute upper GI hemorrhage. the most common etiology?

Gasto/duadenal ulcer

Correct Incorrect Correct answer

Mallory weis

Correct Incorrect Correct answer

Esophageal varices

Correct Incorrect Correct answer

Gastritis / duadenitis

Correct Incorrect Correct answer

Which of the following bariatric procedures is considered restrictive only?

LABG

Correct Incorrect Correct answer

Roux-en y

Correct Incorrect Correct answer

Duodenal switch

Correct Incorrect Correct answer

BPD

Correct Incorrect Correct answer

70 years old male arrives to the ER with fever,chills,RUQ pain,scleral jaundice, abdominal Ultrasaund:bilateral duct dilatation&cholilithiasis what’s the next step?

HIDA scan

Correct Incorrect Correct answer

Percutaneous cholecystomy

Correct Incorrect Correct answer

Triphasis abdominal CT

Correct Incorrect Correct answer

ERCP

Correct Incorrect Correct answer

A woman age 65 undergoes a virtual colonoscopy that demonstrates cholelithiasis. She denies any other history of abdominal pain or pancreatitis . Does not mention she has reflux associated with certain foods and that responds well to anti/acid medication. Which of the following is the recommended treatment ?

Cholecystectomy

Correct Incorrect Correct answer

Oral medcation that dissolves the stones

Correct Incorrect Correct answer

Injection of a substance that dissolves the stone in the gall bladder

Correct Incorrect Correct answer

Follow up only

Correct Incorrect Correct answer

During a laparoscopic appendectomy due to a perforated appendicitis a culture is taken from the free fluid in the right lower quadrant. Which of the following bacterias is the most likely to grow?

Group D streptococcus

Correct Incorrect Correct answer

Streptococcus viridians

Correct Incorrect Correct answer

Bacteriodes Fragilis

Correct Incorrect Correct answer

Pseudomona aeuroginosa

Correct Incorrect Correct answer

Which of the following is the most common etiology for hemobilia?

A tumor at the papilla of vater

Correct Incorrect Correct answer

Caumadin intake

Correct Incorrect Correct answer

Iatrogenic injury

Correct Incorrect Correct answer

Liver penetrating trauma

Correct Incorrect Correct answer

45 years old pedestrian female involved in motor accident is brought to the ER, on admission blood pressure 130/80, heart rate 100/min on FAST no free abdominal fluid, pelvic x ray- multiple fractures is open book configuration. All of the following will help stable except:

Angioembolization

Correct Incorrect Correct answer

Pelvic binding with bed sheet

Correct Incorrect Correct answer

Extraperitoneal packing

Correct Incorrect Correct answer

Laparotomy

Correct Incorrect Correct answer

40 y.o. male present to ER with abdomenal stab knife. on admittion fully alert and hemodymamically stable. on examenation 5cm stab wound right and below the umbilicus with protruding omentum outside the skin without perotinitis. most apropiate next step?

Abdomenal CT

Correct Incorrect Correct answer

Laparotomy

Correct Incorrect Correct answer

Diagnostic perotineal lavage

Correct Incorrect Correct answer

FAST

Correct Incorrect Correct answer

Local wound exploration

Correct Incorrect Correct answer

Which of the folowing is condidered a negative prognostic factor in patient with thyroid carcinoma?

Well differentiated carcinoma in histology

Correct Incorrect Correct answer

size 1.5 cm

Correct Incorrect Correct answer

male gender

Correct Incorrect Correct answer

age below 40

Correct Incorrect Correct answer

Which of the following is typical in primary hyperparathyroidism?

Oliguria

Correct Incorrect Correct answer

Kidney stones

Correct Incorrect Correct answer

Diarrhea

Correct Incorrect Correct answer

Increased appetite

Correct Incorrect Correct answer

Which of the following is the most common etiology of primary hyperaldosteronism?

Bilateral adrenal hyperplasia

Correct Incorrect Correct answer

Aldosterone producing adenoma

Correct Incorrect Correct answer

Famillal hyperaldosteronism

Correct Incorrect Correct answer

Aldosterone producing adenocarcinoma

Correct Incorrect Correct answer

Which of the following CT findings is a positive prognostic factor for adrenal incidentaloma?

ill – defined margins

Correct Incorrect Correct answer

High vascularity

Correct Incorrect Correct answer

Slow contrast washout

Correct Incorrect Correct answer

High lipid content

Correct Incorrect Correct answer

A 45 – year – old healthy female is at the ER due to right upper quadrant pain that started the night before . Pain was accompanied by some nausea but no vomiting or fever. The ER doctor reports that Murphy sign was positive . What is the most likely diagnosis?

Acute appendicitis

Correct Incorrect Correct answer

Cholecystitis

Correct Incorrect Correct answer

Diverticulitis

Correct Incorrect Correct answer

Pancreatitis

Correct Incorrect Correct answer

Which of the following increases the risk for postoperative surgical site infection?

BMI 22

Correct Incorrect Correct answer

Hypothermia

Correct Incorrect Correct answer

Increased oxygen delivery

Correct Incorrect Correct answer

Septal scrub the night before surgery

Correct Incorrect Correct answer

A 33 – year – old male arrives at the ER with abdominal pain. On abdominal CT a retroperitoneal mass suspicious of sarcoma is identified Sarcoma may arise from all of the following cell, except:

Epithelial cells

Correct Incorrect Correct answer

Muscle cells

Correct Incorrect Correct answer

Lipid cells

Correct Incorrect Correct answer

Bone cells

Correct Incorrect Correct answer

A 32 – year – old male is evaluated for an abdominal mass . On biopsy – desmoid tumor. Which of the following has a high incidence of desmoid tumor?

Familial adenomatous polyposis

Correct Incorrect Correct answer

Ehlers – Danlos syndrome

Correct Incorrect Correct answer

Neurofibromatosis

Correct Incorrect Correct answer

Crohn’s disease

Correct Incorrect Correct answer

Zollinger – Ellison syndrome

Correct Incorrect Correct answer

When is the correct timing of preoperative prophylactic antibiotic treatment?

When is the correct timing of preoperative prophylactic antibiotic treatment ?

Correct Incorrect Correct answer

The evening before surgery

Correct Incorrect Correct answer

3 hours before surgery

Correct Incorrect Correct answer

Within an hour before surgery

Correct Incorrect Correct answer

Which of the following metabolic changes are common after gastrectomy?

Low albumin

Correct Incorrect Correct answer

Elevated triglycerides

Correct Incorrect Correct answer

Hyperglycemia

Correct Incorrect Correct answer

Vitamin B12 deficiency anemia

Correct Incorrect Correct answer

Childhood radiation exposure is the most important risk for which of the following?

Medullary thyroid carcinoma

Correct Incorrect Correct answer

Thyroid lymphoma

Correct Incorrect Correct answer

Follicular thyroid carcinoma

Correct Incorrect Correct answer

Papillary thyroid carcinoma

Correct Incorrect Correct answer

Which of the following is a risk factor for wound dehiscence?

Prolonged steroid use

Correct Incorrect Correct answer

Use of metal skin staples

Correct Incorrect Correct answer

Use of synthetic sutures

Correct Incorrect Correct answer

Use of prophylactic antibiotics

Correct Incorrect Correct answer

Which of the following correctly characterizes an amebic abscess in comparison to pyogenic (bacterial) abscess?

Amebic abscess is usually without jaundice while jaundice is common in pyogenic abscess

Correct Incorrect Correct answer

Amebic abscess is usually at age over so while pyogenic abscess is mostly between ages 20 to 40

Correct Incorrect Correct answer

Amebic abscess is usually presents with several lesions while pyogenic abscess is mostly solitary

Correct Incorrect Correct answer

Amebic abscess is more common in diabetic patients while pyogenic abscess is less common in diabetic patients

Correct Incorrect Correct answer

Which of the following delays wound healing?

Infection

Correct Incorrect Correct answer

Hypocalcemia

Correct Incorrect Correct answer

Vitamin B6 deficiency

Correct Incorrect Correct answer

Aspirin

Correct Incorrect Correct answer

What is the most common etiology of small bowel obstruction in industrialized countries?

Small bowl tumors

Correct Incorrect Correct answer

Incarcerated inguinal hernia

Correct Incorrect Correct answer

Post open surgery adhesions

Correct Incorrect Correct answer

Intestinal malrotation

Correct Incorrect Correct answer

A 71 – year – old female is at the ER due to epigastric pain. After a history and physical examination – what blood tests would you ask for?

Lactate only

Correct Incorrect Correct answer

CBC , short chemistry , liver and pancreatic function tests

Correct Incorrect Correct answer

CBC and short chemistry

Correct Incorrect Correct answer

CBC only

Correct Incorrect Correct answer

A 28 – year – old male is at the ER due to upper abdominal pain without signs of peritonitis . Which of the following imaging studies would you ask for?

No signs of peritonitis , no need for imaging studies at this time , observation only

Correct Incorrect Correct answer

Plain abdominal X – ray

Correct Incorrect Correct answer

Abdominal CT

Correct Incorrect Correct answer

Abdominal ultrasound

Correct Incorrect Correct answer

A and/or D

Correct Incorrect Correct answer

B and/or C

Correct Incorrect Correct answer

A 24 – year – old male is at the ER due to bloody vomiting . On gastroscopy – duodenal ulcer . Which of the following is the most common cause of duodenal ulcer?

NSAIDS

Correct Incorrect Correct answer

Smoking

Correct Incorrect Correct answer

Alcohol

Correct Incorrect Correct answer

Helicobacter pylori

Correct Incorrect Correct answer

A patient undergoes colonoscopy with an incomplete resection of a polyp. Which of the following pathology results will be an indication for oncological surgical resection ?

Intra – mucosal carcinoma

Correct Incorrect Correct answer

Hamartoma

Correct Incorrect Correct answer

Hyperplastic polyp

Correct Incorrect Correct answer

Tubulo – villous adenoma with high – grade dysplasia

Correct Incorrect Correct answer

A 60 yo female undergoes routine mammography that demonstrates cultures of suspicious calcification in three different areas of her right breast. Biopsy from two of those areas, 5cm apart diagnosed Ductal carcinoma in situ (DCIS). What is the most appropriate management?

Mastectomy with or without immediate breast reconstruction.

Correct Incorrect Correct answer

Mastectomy with or without immediate breast reconstruction, but also wide axillary lymph node dissection.

Correct Incorrect Correct answer

Neoajuvant therapy with antihormonal medication.

Correct Incorrect Correct answer

Breast conserving surgery with excision of one of the calcification groups diagnosed with DCIS.

Correct Incorrect Correct answer

A 73 yo male is brought to the ER due to acute lower GI bleeding. Which of the following is the most common etiology?

Hemorrhoids

Correct Incorrect Correct answer

inflammatory bowel disease

Correct Incorrect Correct answer

Diverticulosis

Correct Incorrect Correct answer

Arteriovenous malformation (AVM)

Correct Incorrect Correct answer

Neoplasia

Correct Incorrect Correct answer

A 20 – year – old male complains of one week of severe anal pain that increases substantially during defecation as cutting knives sensation with fresh blood . It all started following constipation . The patient refuses rectal examination due to pain with every touch but no mass is seen outside the anus . What is the recommended treatment on top stool softeners and analgesics ?

Calcium channel blockers ointment

Correct Incorrect Correct answer

Incision over the hemorrhoid and blood clot removal

Correct Incorrect Correct answer

Surgical excision of the internal hemorrhoids

Correct Incorrect Correct answer

Anal dilatation

Correct Incorrect Correct answer

Laxatives and polyethylene glycol solution

Correct Incorrect Correct answer

A 57 – year – old psychiatric patient is admitted due to abdominal distention and lack of bowel movements. On examination – blood pressure 130/85 , heart rate 92/minute, temperature 37.6°C. The abdomen is very distended , without significant tenderness. Ampule is empty on rectal examination. Abdominal X – ray is below. What is the most appropriate next step ?

Diagnostic laparoscopy

Correct Incorrect Correct answer

Laxatives and enemas

Correct Incorrect Correct answer

Laparotomy with involved bowel resection

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Endoscopic decompression

Correct Incorrect Correct answer

Laxatives and polyethylene glycol solution

Correct Incorrect Correct answer

A 50 – year – old male , status post kidney transplant . At some point following the transplantation a rejection occurred . Which of the following rejections may completely resolve with appropriate treatment?

Acute rejection

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Chronic rejection

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Hyper acute rejection

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B lymphocytes rejection

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A 76 – year – old male who is usually healthy without medications , can climb two floors with no difficulty . He is a candidate for elective right inguinal hernia repair. Which cardiac evaluation is required prior to surgery ?

Echocardiography

Correct Incorrect Correct answer

ECG

Correct Incorrect Correct answer

Stress test

Correct Incorrect Correct answer

Holter

Correct Incorrect Correct answer

A 35 – year – old male with Crohn ‘ s disease is currently on remission and without any treatment . During the Last year he was treated with 5 mg prednisone and antibiotics for one week due to an episode of exacerbation . He is now a candidate for finger nail removal under local anesthesia . Which of the following is recommended to avoid adrenal insufficiency?

No need for any treatment prior to surgery

Correct Incorrect Correct answer

50 mg hydrocortisone prior to surgery

Correct Incorrect Correct answer

100 mg hydrocortisone prior to surgery

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150 mg hydrocortisone prior to surgery

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A 65 – year – old female is admitted due to fever, chills, and jaundice. Ultrasound demonstrates cholelithiasis with bile duct dilatation . Which of the following is the most probable bacteria that led to these symptoms?

Staphylococcus aureus

Correct Incorrect Correct answer

Streptococcus pyogenes

Correct Incorrect Correct answer

E . Coli

Correct Incorrect Correct answer

Bacteroides

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In whom of the following . venous thromboembolism prophylactic therapy is indicated?

A 20 – year – old male , usually healthy , candidate for umbilical hernia repair

Correct Incorrect Correct answer

A 35 – year – old male , usually healthy , candidate for hemorrhoidectomy

Correct Incorrect Correct answer

A 35 – year – old male , candidate for rectal Surgery due to malignancy

Correct Incorrect Correct answer

A 30 – year – old female , candidate for planned caesarean section

Correct Incorrect Correct answer

A cirthotic patient is referred to an inguinal hernia repair. Which scoring system is used to assess the risk and mortality?

Glasgow score system

Correct Incorrect Correct answer

Child – Pugh score

Correct Incorrect Correct answer

APACHE score

Correct Incorrect Correct answer

Ranson ' s criteria score

Correct Incorrect Correct answer

Staging of hemorrhagic shock is according to the percent blood loss. What is the percent blood loss in stage 3?

5 – 15%

Correct Incorrect Correct answer

35 – 50%

Correct Incorrect Correct answer

30 – 40%

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20 – 30%

Correct Incorrect Correct answer

45 – 60%

Correct Incorrect Correct answer

A 30 – year – old male is brought to the trauma unit due to chest trauma . Blood pressure is low and heart rate of 122 / minute Chest X – ray – wide mediastinum. What is the most likely diagnosis ?

Cardiac tamponade

Correct Incorrect Correct answer

Tension pneumothorax

Correct Incorrect Correct answer

Sepsis

Correct Incorrect Correct answer

Head trauma

Correct Incorrect Correct answer

A 22 – year – old male is brought to the trauma unit following a gun – shot wound to the pelvis . He rapidly deteriorates and one of your colleagues is concerned that the patient may suffer from the lethal triad . What is the lethal triad?

Acidosis , hyperthermia , coagulopathy

Correct Incorrect Correct answer

Acidosis , hypothermia , coagulopathy

Correct Incorrect Correct answer

Alkalosis , hypothermia , coagulopathy

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Alkalosis , hyperthermia , coagulopathy

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Which of the following is not included in Ringer Lactate solution?

Calcium

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Sodium

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Magnesium

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Potassium

Correct Incorrect Correct answer

A mother of a 16 – year – old male with hand injury is interested about wound healing and is told that wound healing has several stages . Which of the following blood cells is the most dominant during the first two days of the inflammation phase?

Fibroblasts

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Neutrophils

Correct Incorrect Correct answer

Macrophages

Correct Incorrect Correct answer

Lymphocytes

Correct Incorrect Correct answer

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