1. for Health Education Programs to Be Successful All Are
Content
1. For health education programs to be successful all are true except : abcdehuman behavior must be well understood Information should be from cultural background Doctors are only the health educators Methods include pictures and videos (mass media) Involve society members at early stage
1. A 29 Y.O female has a breast lump in the upper outer quadrant of the left breast, firm, 2 cm. in size but no L.N involvement … what is the most likely diagnosis? a- fibroadenoma 2. What is the management for the above patient? abcdemammogram (true if patient > 35 years) excisional biopsy FNA breast US follow up in 6 months
1. A 27 yrs. old female C/O abdominal pain initially periumbilical then moved to Rt. Lower quadrant … she was C/O anorexia,nausea and vomiting as well. O/E: temp.38c, cough, tenderness in RT lower quadrant but no rebound tenderness. Investigations: slight elevation of WBC's otherwise insignificant... The best way of management is: abcdego to home and come after 24 hours admission and observation further lab investigations start wide spectrum antibiotic paracetamol
1. What is the most likely diagnosis for the above patient? a- mesenteric lymph adenitits b- acute appendicitis c- peptic ulcer 1. A 24 yrs old pt. came for check up after a promiscuous relation 1 month ago... he was clinically unremarkable, VDRL : 1/128 … he was allergic 2 penicillin other line of management is : abcdampicillin amoxicillin trimethoprim doxycyclin
1. 7- A 24 years old female pt. C/O: gray – greenish discharge, itching... Microscopic examination of discharge showed: flagellated organism … most likely diagnosis is: a- trichomoniasis (trichomonas vaganalis) 2. A 43 yrs. old female pt. presented to ER with H/O: paralysis of both lower limbs and paraesthesia in both upper limbs since 2 hours ago... she was seen lying on stretcher & unable to move her lower limbs (neurologist was called but he couldn't relate her clinical findings 2 any medical disease!!!) when history was taken, she was beaten by her husband … the most likely diagnosis is: abcdeabcdecomplicated anxiety disorder somatization disorder conversion disorder psychogenic paralysis hypochondriasis benzodiazepines phenothiazine monoamine oxidase inhibitor selective serotonin reuptake inhibitor supportive psychotherapy
1. The best treatment for the previous case is:
1. A 58 yr.old male pt. came with HX of fever, cough with purulent foul smelling sputum and CXR showed: fluid filled cavity … the most likely diagnosis is: a- Abscess b- TB c- Bronchiectasis 1. A 28 yrs. old lady, C/O chest pain, breathlessness and feeling that she'll die soon. O/E: just slight tachycardia... otherwise unremarkable... the most likely diagnosis is: a- panic disorder 1. A patient (known case of DM) presented to u with diabetic foot (infection) the antibiotic combination is: a- ciprofloxacin & metronedazole
1. A young pregnant lady (Primigravida), 32 weeks of gestation came to you C/O: lower limbs swelling for two weeks duration... she went to another hospital and she was prescribed ( thiazide & loop diuretic ) .. O/E: BP: 120/70, mild edema, urine dipstick: -ve and otherwise normal…. The best action is: abcdecontinue thiazide & stop loop diuretic cont. loop diuretic & stop thiazide stop both continue both and add potassium sparing diuretic cont. both & add potassium supplement
1. A 17 yrs. old football player gave HX of Lt. knee giving off .. the most likely diagnosis is : abcdeLat. Menisceal injury medial menisceal injury lateral collateral ligament medial collateral ligament Ant. Cruciate ligament
1. 15- A 10 yrs. old boy presented to clinic with 3 weeks HX of limping that worsen in the morning... This suggests which of the following: a- septic arthritis b- leg calve parthes disease c- RA d- a tumor e- slipped capital femoral epiphysis 1. A full term baby boy brought by his mother weighing 3.8 kg. Developed jaundice at 2nd day of life... Coomb’s test –ve, Hb: 18, billrubin: 18.9 & indirect: 18.4 O/E: baby was healthy and feeding well... the most likely diagnosis is: abcdphysiological jaundice ABO incompatibility breast milk jaundice undiscovered neonatal sepsis
1. A 62 yrs. old female pt. a known case of osteoporosis & on 1 alpha + Ca supplement... her lab works shows normal level of PO4, Ca & ALP … her Xray shows osteopenia with SD = -3.5 …. The best action is to: abcdcontinue on same medications start estrogen start estrogen & progesterone add alevdonate ( bisthmus phosphate)
1. A 38 yrs old female … came to you at your office and her pap smear report was unsatisfactory for evaluation... the best action is : a- Consider it normal & D/C the pt. b- Repeat it immediately c- Repeat it as soon as possible d- Repeat it after 6 months if considered low risk e- Repeat it after 1 year if no risk 1. A 17 yrs. old school boy was playing foot ball and he was kicked in his Rt. eye... few hours later he started to complain of: double vision & echymoses around the eye... The most likely Diagnose is: abcdcellulites orbital bone fracture global eye ball rupture subconguctival hemorrhage
1. A 35 yrs old female pt. C/O: acute inflammation and pain in her Lt. eye since 2 days... she gave Hx of visual blurring and use of contact lens as well … O/E : fluorescence stain shows dentritic ulcer at the center of the cornea .. The most likely diagnosis is: a- corneal abrasion b- herpetic central ulcer c- central lens stress ulcer d- acute episcleritis e- acute angle closure glaucoma 1. A 65 yrs old lady came to your clinic with Hx of 5 days insomnia and crying ( since her husband died ) the best Tx. For her is : abcdlorazipam floxitein chlorpromazine haloperidol
1. A 25 yrs old Saudi man presented with Hx of mild icterus, otherwise ok... Hepatitis screen : HBsAg +ve , HBeAg +ve , anti HBc Ag +ve (this should be core anti body, because core antigen doesn’t leave hepatocyte to the blood "prof. Yasawi" ) , the diagnosis : abcdeacute hepatitis B Convalescent stage of hep. B Recovery with seroconversion Hep. B Hep B carrier Chronic active Hep. B
1. 25 yrs. old man presented to ur clinic with one month HX of aching pain in the elbow, radiates down to the lateral forearm..the pt. frequently plays squash … O/E: Pain increases with dorsiflexion of the wrist performed under resistance specially with elbow extended … the most likely diagnosis : abcdeolecranon stress fracture olecranon bursitis lateral tennis elbow radial tunnel syndrome ligament sprain
1. 8 wk Primigravida came to you with nausea & vomiting choose the statement that guide you to hyperemmesis gravidarm : abcdeketonia ECG evidence of hypokalemia Metabolic acidosis Elevated liver enzyme Jaundice
1. Injury of the hand leads to median nerve injury: a- claw hand b- wrist drop c- sensory defect only 1. 60 year old male was refer to you after stabilization investigation show Hgb 8.5 g/L, hect: 64%, RBC 7.8 , WBC 15.3 & Plt. 570 Diagnosis : aabcdiron def. Anemia Hgb pathy CLL 2ry polycythemia Polycythemia rubra Vera
1. Pregnant women G4P3+1 on GA 10 wk came to you with IUCD inserted & the string is out from O.S what is the most important measure : abcdeleave the IUCD & give A.B leave the IUCD & send to Ob/ Gynaecologist to remove leave the IUCD Do laparoscopy to see if there is ectopic preg. Reassurance the pt
1. 17 year old male while play football felt on his knee “tern over “ what do think the injury happened abcdeabcdMedial meniscus lig. Lateral meniscus lig. Medial collateral lig. Lat. collateral lig. Antr. Crussate lig. Pain less vaginal bleeding. Tone increased of uterus. Lower segmental abnormality. Early 3rd trimester.
1. Placenta previa excludes :
1. Pregnancy test +ve after : a- one day post coital b- 10 day after loss menstrual cycle?? c- One wk after loss menstrual cycle
1. 45 year old female complaining of itching in genitalia for certain period, a febrile, -ve PMH, living happily with here husband since 20 year ago on examination no abdominal tenderness , erythema on lower vagina , mild Gray discharge no hx of UTI. Pyleonephritis most probable diagnosis: abcdVaginitis Cystitis CA of vagina Urithritis ( non gonococal )
1. 20 year lady come to ER with Hx of Rt sever lower abdominal pain with Hx of amenorrhea for about 6 wk the most serious diagnosis of your deff. Diagnosis could reach by: abcdeCBC ESR U/S of the pelvis Plain X-ray Vaginal swab for C/S
1. Pt had arthritis in tow large joint & pansystolic murmur ( carditis ) Hx of URTI the most important next step: a- ESR b- ASO titre c- Blood culture 1. 35 years prime 16 wk gestation PMH coming for her 1st cheek up she is excited about her pregnancy no hx of any previous disease. Her B/P after since rest 160/100 after one wk her B/P is 154/96 Most likely diagnosis: abcdePre eclempsia Chronic HTN Lable HTN Chronic HPT with superimposed pre eclampsia Transit HPT??
1. Women complain of non fluctuated tender cyst for the vulva. Came pain in coitus & walking, diagnosed Bartholin cyst. What is the ttt: a- incision & drainage b- refer to the surgery to excision (after you reassure her) c- reassurance the pt d- Give AB 1. 42 yr old male presented with history of sudden appearance of rash maculopapular rash – including the sole& the palm, the most likely diagnosis is: abcdesyphilis Erethyma nodosum Erythema marginatum Pitryasis rocae Drug induced
1. A mother calls you about her 8 years old son; known case of DM-1 fell comatose. She is not sure if he took the night 7 morning dose of insulin. You will advice her to: abcdebring the child immediately to the ER Call an ambulance Give him IV glucagons Give him IV insulin Give him drink contains sugar
1. year old lady on …….., feels dizzy on standing, resolves after 10-15 minutes on sitting, decrease on standing, most likely she is having : a- orthostatic hypotension 1. What is the most appropriate treatment for the above patient : abcdeantiemetic antihistamine change the antidepressant to SSRI thiazide diuretics audiometry
1. 23 years old lady with one month history of nasal discharge & nasal obstruction, she complained of pain on the face, throbbing in nature , referred to the supraorbital area, worsen by head movement, walking,& stopping. On - ---------- examination, tender antrum with failure of transillumination ( not clear ), the most likely the diagnosis is: abcdefrontal sinusitis (we can NOT trannsiiluminate it) maxillary sinusitis dental abscess chronic atrophic rhinitis chronic sinusitis
1. A 29 Y.O female has a breast lump in the upper outer quadrant of the left breast, firm, 2 cm. in size but no L.N involvement … what is the most likely diagnosis? a- fibroadenoma 2. What is the management for the above patient? abcdemammogram (true if patient > 35 years) excisional biopsy FNA breast US follow up in 6 months
1. A 27 yrs. old female C/O abdominal pain initially periumbilical then moved to Rt. Lower quadrant … she was C/O anorexia,nausea and vomiting as well. O/E: temp.38c, cough, tenderness in RT lower quadrant but no rebound tenderness. Investigations: slight elevation of WBC's otherwise insignificant... The best way of management is: abcdego to home and come after 24 hours admission and observation further lab investigations start wide spectrum antibiotic paracetamol
1. What is the most likely diagnosis for the above patient? a- mesenteric lymph adenitits b- acute appendicitis c- peptic ulcer 1. A 24 yrs old pt. came for check up after a promiscuous relation 1 month ago... he was clinically unremarkable, VDRL : 1/128 … he was allergic 2 penicillin other line of management is : abcdampicillin amoxicillin trimethoprim doxycyclin
1. 7- A 24 years old female pt. C/O: gray – greenish discharge, itching... Microscopic examination of discharge showed: flagellated organism … most likely diagnosis is: a- trichomoniasis (trichomonas vaganalis) 2. A 43 yrs. old female pt. presented to ER with H/O: paralysis of both lower limbs and paraesthesia in both upper limbs since 2 hours ago... she was seen lying on stretcher & unable to move her lower limbs (neurologist was called but he couldn't relate her clinical findings 2 any medical disease!!!) when history was taken, she was beaten by her husband … the most likely diagnosis is: abcdeabcdecomplicated anxiety disorder somatization disorder conversion disorder psychogenic paralysis hypochondriasis benzodiazepines phenothiazine monoamine oxidase inhibitor selective serotonin reuptake inhibitor supportive psychotherapy
1. The best treatment for the previous case is:
1. A 58 yr.old male pt. came with HX of fever, cough with purulent foul smelling sputum and CXR showed: fluid filled cavity … the most likely diagnosis is: a- Abscess b- TB c- Bronchiectasis 1. A 28 yrs. old lady, C/O chest pain, breathlessness and feeling that she'll die soon. O/E: just slight tachycardia... otherwise unremarkable... the most likely diagnosis is: a- panic disorder 1. A patient (known case of DM) presented to u with diabetic foot (infection) the antibiotic combination is: a- ciprofloxacin & metronedazole
1. A young pregnant lady (Primigravida), 32 weeks of gestation came to you C/O: lower limbs swelling for two weeks duration... she went to another hospital and she was prescribed ( thiazide & loop diuretic ) .. O/E: BP: 120/70, mild edema, urine dipstick: -ve and otherwise normal…. The best action is: abcdecontinue thiazide & stop loop diuretic cont. loop diuretic & stop thiazide stop both continue both and add potassium sparing diuretic cont. both & add potassium supplement
1. A 17 yrs. old football player gave HX of Lt. knee giving off .. the most likely diagnosis is : abcdeLat. Menisceal injury medial menisceal injury lateral collateral ligament medial collateral ligament Ant. Cruciate ligament
1. 15- A 10 yrs. old boy presented to clinic with 3 weeks HX of limping that worsen in the morning... This suggests which of the following: a- septic arthritis b- leg calve parthes disease c- RA d- a tumor e- slipped capital femoral epiphysis 1. A full term baby boy brought by his mother weighing 3.8 kg. Developed jaundice at 2nd day of life... Coomb’s test –ve, Hb: 18, billrubin: 18.9 & indirect: 18.4 O/E: baby was healthy and feeding well... the most likely diagnosis is: abcdphysiological jaundice ABO incompatibility breast milk jaundice undiscovered neonatal sepsis
1. A 62 yrs. old female pt. a known case of osteoporosis & on 1 alpha + Ca supplement... her lab works shows normal level of PO4, Ca & ALP … her Xray shows osteopenia with SD = -3.5 …. The best action is to: abcdcontinue on same medications start estrogen start estrogen & progesterone add alevdonate ( bisthmus phosphate)
1. A 38 yrs old female … came to you at your office and her pap smear report was unsatisfactory for evaluation... the best action is : a- Consider it normal & D/C the pt. b- Repeat it immediately c- Repeat it as soon as possible d- Repeat it after 6 months if considered low risk e- Repeat it after 1 year if no risk 1. A 17 yrs. old school boy was playing foot ball and he was kicked in his Rt. eye... few hours later he started to complain of: double vision & echymoses around the eye... The most likely Diagnose is: abcdcellulites orbital bone fracture global eye ball rupture subconguctival hemorrhage
1. A 35 yrs old female pt. C/O: acute inflammation and pain in her Lt. eye since 2 days... she gave Hx of visual blurring and use of contact lens as well … O/E : fluorescence stain shows dentritic ulcer at the center of the cornea .. The most likely diagnosis is: a- corneal abrasion b- herpetic central ulcer c- central lens stress ulcer d- acute episcleritis e- acute angle closure glaucoma 1. A 65 yrs old lady came to your clinic with Hx of 5 days insomnia and crying ( since her husband died ) the best Tx. For her is : abcdlorazipam floxitein chlorpromazine haloperidol
1. A 25 yrs old Saudi man presented with Hx of mild icterus, otherwise ok... Hepatitis screen : HBsAg +ve , HBeAg +ve , anti HBc Ag +ve (this should be core anti body, because core antigen doesn’t leave hepatocyte to the blood "prof. Yasawi" ) , the diagnosis : abcdeacute hepatitis B Convalescent stage of hep. B Recovery with seroconversion Hep. B Hep B carrier Chronic active Hep. B
1. 25 yrs. old man presented to ur clinic with one month HX of aching pain in the elbow, radiates down to the lateral forearm..the pt. frequently plays squash … O/E: Pain increases with dorsiflexion of the wrist performed under resistance specially with elbow extended … the most likely diagnosis : abcdeolecranon stress fracture olecranon bursitis lateral tennis elbow radial tunnel syndrome ligament sprain
1. 8 wk Primigravida came to you with nausea & vomiting choose the statement that guide you to hyperemmesis gravidarm : abcdeketonia ECG evidence of hypokalemia Metabolic acidosis Elevated liver enzyme Jaundice
1. Injury of the hand leads to median nerve injury: a- claw hand b- wrist drop c- sensory defect only 1. 60 year old male was refer to you after stabilization investigation show Hgb 8.5 g/L, hect: 64%, RBC 7.8 , WBC 15.3 & Plt. 570 Diagnosis : aabcdiron def. Anemia Hgb pathy CLL 2ry polycythemia Polycythemia rubra Vera
1. Pregnant women G4P3+1 on GA 10 wk came to you with IUCD inserted & the string is out from O.S what is the most important measure : abcdeleave the IUCD & give A.B leave the IUCD & send to Ob/ Gynaecologist to remove leave the IUCD Do laparoscopy to see if there is ectopic preg. Reassurance the pt
1. 17 year old male while play football felt on his knee “tern over “ what do think the injury happened abcdeabcdMedial meniscus lig. Lateral meniscus lig. Medial collateral lig. Lat. collateral lig. Antr. Crussate lig. Pain less vaginal bleeding. Tone increased of uterus. Lower segmental abnormality. Early 3rd trimester.
1. Placenta previa excludes :
1. Pregnancy test +ve after : a- one day post coital b- 10 day after loss menstrual cycle?? c- One wk after loss menstrual cycle
1. 45 year old female complaining of itching in genitalia for certain period, a febrile, -ve PMH, living happily with here husband since 20 year ago on examination no abdominal tenderness , erythema on lower vagina , mild Gray discharge no hx of UTI. Pyleonephritis most probable diagnosis: abcdVaginitis Cystitis CA of vagina Urithritis ( non gonococal )
1. 20 year lady come to ER with Hx of Rt sever lower abdominal pain with Hx of amenorrhea for about 6 wk the most serious diagnosis of your deff. Diagnosis could reach by: abcdeCBC ESR U/S of the pelvis Plain X-ray Vaginal swab for C/S
1. Pt had arthritis in tow large joint & pansystolic murmur ( carditis ) Hx of URTI the most important next step: a- ESR b- ASO titre c- Blood culture 1. 35 years prime 16 wk gestation PMH coming for her 1st cheek up she is excited about her pregnancy no hx of any previous disease. Her B/P after since rest 160/100 after one wk her B/P is 154/96 Most likely diagnosis: abcdePre eclempsia Chronic HTN Lable HTN Chronic HPT with superimposed pre eclampsia Transit HPT??
1. Women complain of non fluctuated tender cyst for the vulva. Came pain in coitus & walking, diagnosed Bartholin cyst. What is the ttt: a- incision & drainage b- refer to the surgery to excision (after you reassure her) c- reassurance the pt d- Give AB 1. 42 yr old male presented with history of sudden appearance of rash maculopapular rash – including the sole& the palm, the most likely diagnosis is: abcdesyphilis Erethyma nodosum Erythema marginatum Pitryasis rocae Drug induced
1. A mother calls you about her 8 years old son; known case of DM-1 fell comatose. She is not sure if he took the night 7 morning dose of insulin. You will advice her to: abcdebring the child immediately to the ER Call an ambulance Give him IV glucagons Give him IV insulin Give him drink contains sugar
1. year old lady on …….., feels dizzy on standing, resolves after 10-15 minutes on sitting, decrease on standing, most likely she is having : a- orthostatic hypotension 1. What is the most appropriate treatment for the above patient : abcdeantiemetic antihistamine change the antidepressant to SSRI thiazide diuretics audiometry
1. 23 years old lady with one month history of nasal discharge & nasal obstruction, she complained of pain on the face, throbbing in nature , referred to the supraorbital area, worsen by head movement, walking,& stopping. On - ---------- examination, tender antrum with failure of transillumination ( not clear ), the most likely the diagnosis is: abcdefrontal sinusitis (we can NOT trannsiiluminate it) maxillary sinusitis dental abscess chronic atrophic rhinitis chronic sinusitis
