SMLE with Muath.

نزلت درجات التحكيم النهائية ، الف مبروك للجميع وفالكم التخصصات اللي تتمنوها 🤍🤍.

الدرجات نزلت على ممارس بلس 👏🏻

صباح الخير جميعا
احد قدر يطلع درجته وكيف؟

4 y/o boy has chronic constipation despite eating high fiber diet and stool softeners, examination shows empty rectum but after DRI huge gush of stool, management?
A. Surgery ✅
B. Increase stool softener dose
C. Refer to oncology
D. Increase high fiber diet

Dx hirschsprung disease
Definitive management is surgery by pull-through procedure .

3- year-old patient came due to 10 cm, hard, immobile mass on the lateral neck area. Aspiration revealed lymphatic fluid. what is the next step on management?
A. Chemotherapy
B. Radiotherapy
C. Surgical intervention
D. Sclerotherapy✅

Dx is cystic hygroma

Management:
Depend on the size of the swelling
If less than 2cm >surgery
If 2cm and more> sclerotherapy

26 January
38 year old Female came for diabetes screening hba1c 5.5
Wheight 91 kg and height 160 what to give ?
A-insulin
B-metformin ✅
C-glyburide
D-Acarbose

Metformin can be prescribed to prevent DM in pre diabetic patients if BMI >35 or she have history of GDM or age less than 60.

Channel name was changed to «SMLE with Muath.»

17/1
1. Question about infertile couple seeking surrogacy, the physician knows that it is not allowed in the hospital but does not know if it is legal or not in Saudi Arabia,
What should the physician tell the couple?
A) Tell them it is not allowed in the hospital
B) Refer them to surrogacy clinics/agencies
C) Tell them it is not legal in Saudi Arabia
D) Tell them you cannot help them (not sure)

If there is no (give them an appointment and read about it )in the options go with A✅.

2. Newborn comes to follow up clinic, you notice that there is a single testis in the scrotum, and the other is in the inguinal canal but can be pushed down to the scrotum. What is the diagnosis?
A) undecended testis
B) Retractile testis✅
C & D were wrong choices

3. Child with suspected renal scarring, which imaging is the best modality to diagnose? (2 similar questions came in the same block)
A) renal US i think
B) I don’t remember
C) DMSA scan✅
D) MAG3 renogram scan

4. Picture of CTG given with no interpretation, and the mother was given both epidural and Magnesium sulfate. You have to read the CTG ( it showed reduced variability). What is the cause of the finding in the CTG?
A) Epidural
B) MgSO4✅
C&D were wrong choices

5. 2 year old child with poor growth and chronic diarrhea and buttock wasting?? What is the diagnosis
A) Crohns disease
B) cystic fibrosis
C) celiac disease✅
D i don’t remember

6. Mother planning to get pregnant, she needs which dose of folic acid?
A) 0.8✅
B) 1.2
C&D I don’t remember

1-35 yo female medically free presented to the er with a history of sob increase on exersion upon examminayion notice splenomegaly pale conjuntiva peripheral
smear spherocytosis : hb 9 retic increased all liver profile high what is your mx?
A. steroid
B. iron
C. blood transfusion



similar recall: Typical case of hemolytic anemia and blood film show spherocytosis,Hb:8, MCV MCHC normal range, WBC: 3, PLT: 500, LDH AST ALT high, low haptoglobin most appropriate treatment?

A-blood transfusion
B-steroids
C-hydroxyurea

This is a case of autoimmune hemolytic anemia and the answer is steroid for both ✅.

6 years old boy with pubic hair , bone age 6 years , testicular size 2 cm , Serum DEAS slightly high
Most likely cause ?
A-Brain tumor
B-Premature benign pubarche ✅
C-Congenital adrenal hyperplasia
D-Testicular tumor

الهيئة تأخرت علينا بدرجات يناير 🥲

Patiet with uretric stone measure 4mm in US . Stable
Management
1- double J stent
2- conservative ✅
3- ESWL

Picture and symptoms of liver cirrhosis
SAAG > 1.1
Heart failure
Nephrotic syndrome
Portal HTN ✅
TB

full term born came with respiratory distress and chest X ray showed fluid in the fissures. He is born by cesarean section. Most likely diagnosis A- Transient tachypnea of newborn
B- Sepsis C- Meconium aspiration D- Hyaline membrane disease


Baby born in 38 week ( not preterm ) via C/S and after that develop tachycardia and tachypnea and grunting A- Hyaline membrane disease B- pulmonary "something" C- Meconium Aspiration syndrome D- Transient Tachypnea of the New born


- A mechanic comes to you in the clinic complaining of shortness of breath during
exertion. However, he is able to continue his work as the symptoms go away when he rests.
What is his NYHA class?
A. NYHA class I
B. NYHA class I| ✅
C. NYHA class IlI

Pt has severe worst headache ever for several hours associated with neck pain, ct scan appears normal, what next to diagnose her?
A. mri brain
B. Lumbar puncture
C. MRA

515- 0.6*0,9 LEFT 2.2 * 2.6 No TSH giving (Multinodular Diffuse large goiter) (TSH not giving in exam)
A- Follow up
B- Thyroid scan
C- FNA large
D- FNA both
كانت جهه اقل من 1cm والثانيه اكبر من 1cm

26 yr pt came to Er after a first episode of generalize tonic conic seizure ,labs & examination are normal ,no neurological
deficit ,what to do next
A EEG
B ECG
C LP
D CT head

https://t.me/FM98SMLE/1250

Pt had HCC ask about the fallow up by what?
AFP
CT
Pro thrombin

1case of child 6 yr had pus from ear febril
Tm 38.7
Bp140/110
Tackycardiac
Rr20

Diagnosis??
Otitis media
Serious otitis media
Otitis externa