DHA Flashcards
(240 cards)
1
Q
What is the metabolic effect in a patient with necrotizing pancreatitis who has improved after a drain?
A
Hypoglycaemia
2
Q
What is the most appropriate treatment regimen for a 17-year-old football player with macular hyperpigmentation on the trunk and arms that lightens with sun exposure?
A
Topical steroid cream
3
Q
What does the ECG show in pericarditis?
A
Diffuse ST segment elevation
4
Q
What is the next management step for a patient with black stool and bright fresh rectal bleeding after upper and lower endoscopy revealed no diagnosis?
A
Abdomen CT
5
Q
What is the best treatment for ADHD in children less than 6 years old?
A
Behavioral therapy
6
Q
What is the best treatment for ADHD in children over 6 years old?
A
CNS stimulants, specifically methylphenidate
7
Q
What should be done for a patient with persistent neck pain, diaphoresis, normal troponin, and unremarkable ECG?
A
Repeat troponin after 6 hours
8
Q
What increases prognosis in COPD?
A
Allopurinol
9
Q
What are the symptoms of depression according to SIG E CAPS?
A
Sleep (hypersomnia or insomnia), Interest (loss of interest or pleasure), Guilt (feelings of worthlessness), Energy (fatigue), Concentration (↓), Appetite (↑ or ↓), Psychomotor agitation or retardation, Suicidal ideation
10
Q
Which medication should be given to a patient with generalized anxiety disorder?
A
Escitalopram
11
Q
What are the CXR findings in neonatal lung diseases for RDS?
A
Ground glass appearance and air bronchogram
12
Q
What is the diagnosis for a clinical scenario of painless genital ulcer and skin rash?
A
Secondary syphilis
13
Q
What is the treatment for a positive H. pylori test?
A
Metronidazole + PPI + clarithromycin
14
Q
What should be done for a patient with dyspepsia not responding to H2 blockers?
A
PPIs
15
Q
What important question should be asked for a young lady with suspected DVT and amenorrhea?
A
History of OCP use
16
Q
How to manage parasitic liver lesions?
A
Deroofing, aspiration, and antibiotics
17
Q
What metabolic changes can be expected after diarrhea?
A
Metabolic acidosis
18
Q
What is the addiction effect of nicotine in cigarettes?
A
Addiction effect
19
Q
Which antibiotic for TB can exacerbate gout?
A
Pyrazinamide
20
Q
What is the recommended treatment for traveler’s bloody diarrhea caused by Campylobacter?
A
Ciprofloxacin or Azithromycin
21
Q
What is a common health concern in poor areas?
A
Hepatitis A
22
Q
What is the bilirubin level in hemolytic jaundice?
A
Increased indirect bilirubin
23
Q
What medication should be given to a 55-year-old male with atrial fibrillation to prevent complications?
A
Warfarin
24
Q
What advice should be given to travelers regarding fruit?
A
Peel fruit
25
What is the diagnosis for a patient with chronic disease presenting with microcytic hypochromic anemia and normal ferritin?
Anemia of chronic disease
26
What possible complication can arise from pharyngitis with cervical lymphadenopathy and swollen tonsils?
Scarlet fever
27
What are the microscopic findings in minimal change disease?
Effacement of podocyte foot processes and loss of normal charge barrier
28
What is the prophylactic treatment for cluster headaches?
Verapamil and lithium
29
What are the symptoms and signs for diagnosing a migraine?
Headache, nausea, photophobia, and phonophobia
30
What is the diagnosis and treatment for tension headaches?
Diagnosis is tension headache; treatment is analgesics
31
What are the complications of polymyalgia rheumatica?
Giant cell arteritis, blindness, and stiffness
32
What is the next step for frontal sinusitis not responding to analgesics?
Antibiotics, specifically amoxicillin
33
What is the first step in management for a patient with low O2 levels?
Administer O2
34
What should be done if a patient experiences red man syndrome after vancomycin?
Stop and label the medication
35
What is the LDL level goal in a normal diabetic patient?
<70 mg/dl
36
What medication is likely responsible for a low potassium level in an elderly man with asthma and heart failure?
Salbutamol
37
What is the next step for a patient with pleuritic chest pain and a pleuritic friction rub?
CT Thorax
38
What is the cause of lung cancer in a 40-year-old male with no smoking history?
Asbestos exposure
39
What is the diagnosis of DVT?
US duplex
40
What is the diagnosis for a patient with distal and proximal hand joint swelling and morning stiffness with negative RF?
Reactive arthritis
41
What is released during neurohormonal stress?
Corticotropin
42
What is the diagnosis for a patient with bilateral leg pain and loss of hair who smokes and has DM and HTN?
Chronic limb ischemia
43
What medication should be added for an elderly patient with CHD on lisinopril and furosemide?
Bisoprolol
44
What medication should be added for a patient with RA on prednisone and methotrexate who still has symptoms?
Infliximab
45
What are the lab findings in sick euthyroid syndrome?
High T3, T4, and low reverse T3
46
What are the lab findings in a patient with meningitis showing high protein and low glucose?
Bacterial meningitis
47
What is the likely cause of increased INR in a patient recently started on clarithromycin?
Clarithromycin
48
What treatment should be avoided in a patient with ventricular tachycardia?
Verapamil
49
What is the most appropriate treatment for a young man with hypertrophic cardiomyopathy who had a cardiac arrest?
Implantable Defibrillator
50
What is the differential diagnosis for a 30-year-old female with painless jaundice and normal liver enzymes?
Gilbert syndrome
51
What is the differential diagnosis for a child with clumsy gait and resistance to neck flexion?
Guillain-Barré Syndrome
52
What should be done for an elderly patient with pneumonia who becomes restless and agitated?
Call the doctor to give lorazepam
53
What electrolyte abnormality is likely in a patient diagnosed with ALL and presenting with high potassium?
Hyperkalemia
54
What would you expect to see on an X-ray for a 30-year-old female with sudden onset shortness of breath after giving birth?
Cardiomegaly
55
What is the most likely diagnosis for a patient with hemoptysis and nephropathy showing anti-GBM antibodies?
Rheumatoid arthritis
56
What organism is indicated by a positive urea breath test for H. Pylori in a child?
Helicobacter pylori
57
What is the diagnosis for a patient with lower limb spasticity and upper limb spasticity?
Diplegia
58
What is the next step for a 71-year-old patient with urine retention and severe pain with urination?
Foley catheter and culture
59
What investigation should be done for cortisol at 8 am normal level after dexamethasone administration?
Brain MRI or CT for adrenal gland
60
What is the investigation of choice for a patient diagnosed with acromegaly on octreotide?
CT abdomen
61
What is the high diagnostic value test for a patient with cough and shortness of breath after exercise?
Methacholine test
62
What is the next step for an asthmatic patient taking SABA and inhaled steroids with no response?
Systemic steroid
63
What is the diagnosis for a patient with left parasternal heave and early diastolic murmur?
Aortic regurgitation
64
What is the diagnosis for a patient with HBV serology showing HBsAg negative, AntiHBs positive, and HBcAg positive?
Previous infection of HBV
65
What is the diagnosis for a patient with meningitis showing protein increase and glucose decrease?
Bacterial meningitis
66
What is the diagnosis for a patient with right upper quadrant pain and high direct bilirubin?
Cholangitis
67
What is the diagnosis for a patient with anal pain and bleeding with a boggy appearance at the anus?
Hemorrhoids
68
What type of cancer is associated with population screening?
Oral cancer
69
What was the patient's serum cholesterol level?
The doctor stated it was one of the best values he had ever seen for a man his size and age.
70
What symptoms did the patient admit to experiencing?
A dull, aching, viselike pain around his chest, with radiation to the left shoulder.
71
What did the patient experience when the pain was at its worst?
Nausea and vomiting.
72
What did the patient's wife say about his condition?
She has never seen him in so much pain, but he is a 'stubborn old goat.'
73
What were the physical examination findings?
The patient was sweating and diaphoretic, had vomited twice, blood pressure was 160/100 mm Hg, and pulse was 120 and irregular.
74
What did the ECG reveal?
Significant Q waves in V1 to V4, with significant ST-segment elevation in the same leads and reciprocal ST changes in the inferior leads (II, III, and aVF).
75
What is the most likely diagnosis for this patient?
Acute inferior wall myocardial infarction (MI).
76
What should be the first priority for this patient?
Administer streptokinase or tissue plasminogen activator (t-PA) intravenously (IV).
77
What is the diagnosis for a smoker with a cough and white sputum, with efv less than 70%?
COPD.
78
What should a female with DM1 do to help with numbness and burning sensation in her feet?
Engage in aerobic exercise.
79
What food should a patient with hypercholesterolemia avoid?
Brown meat.
80
What is the likely diagnosis for a patient with face swelling when sleeping who is a smoker?
Bronchial carcinoma.
81
What is likely to be positive in a patient with Raynaud's phenomenon and other symptoms?
Anti-Scl-70 (anti-topoisomerase I antibody).
82
What behavior change stage is a patient trying to quit smoking but unable to?
Contemplation.
83
What is the minimum volume of blood needed to do a culture?
10 mL.
84
Which vitamin is known to reduce cancer risk?
Vitamin D.
85
What is the most common infection in Saudi Arabia that disables patients from work?
Hepatitis B infection.
86
How can one prevent waterborne diseases from Entamoeba?
Drink boiled water.
87
What additional measurements should be taken to assess obesity in children besides BMI?
Girth measurement.
88
How can plague be prevented?
By killing rodents.
89
What group of people was prevented from performing Hajj & Umrah in 2015 due to MERSA-Co?
Elderly with DM.
90
What is the most common associated risk factor for heart disease in an inactive, overweight smoker?
Obesity.
91
What is the best way to prevent MERSA?
By hand washing.
92
What is important for a patient to quit smoking?
Patient desire.
93
What lipid level has more risk for CAD?
LDL.
94
What is the best way to prevent stroke?
Control hypertension.
95
What is the commonest virus causing rejection of expatriates or laborers from working in Saudi?
HBV.
96
What is the best initial management for a patient with cretinism?
Iodine supplementation.
97
What is the diagnosis for a 48-year-old man with episodic productive cough and digital clubbing?
Bronchiectasis.
98
What is a contraindication to thrombolysis?
The presence of atrial fibrillation.
99
What is a common genetic factor influencing bronchial asthma?
Leukotriene concentrations are influenced by genetic factors.
100
What is the minimum wheal required for a positive tuberculosis screening test?
10 mm.
101
What is the diagnosis for a patient with clear symptoms of Cushing syndrome and low ACTH?
Adrenal adenoma.
102
What is the management for a patient with dementia and abnormal behaviors?
Refer to a geriatric clinic.
103
What is the best treatment for a patient with recurrent chest infections and low platelets?
Wiskott-Aldrich syndrome.
104
What is the treatment for a child with kwashiorkor?
Nutritional supplementation.
105
What is the diagnosis for a child with status epilepticus?
Severe seizure activity.
106
What is the management for a child with a UTI?
Antibiotics.
107
What is the diagnosis for a child with hematuria after skin lesions?
HSP.
108
What is the management for a child with bruises in the labia majora?
Consider abuse.
109
What is the diagnosis for a child with absent red eye reflex?
Retinoblastoma.
110
What is the age recommended for pap smear screening for married women?
20-24 years.
111
How often should pap smear screening be done?
Every 3 years.
112
What is the management for a patient with a 5 cm serous fibroid?
Myomectomy.
113
What is the treatment for a pregnant woman who wants to quit smoking?
Cognitive Behavioral Therapy (CBT).
114
What is the diagnosis for a pregnant woman with vaginal bleeding and uterine tenderness?
Abruptio placenta.
115
What is your advice for a patient with a 3-year history of normal symptoms?
Reassurance
116
What is the treatment for a patient asymptomatic with a 5 cm serous fibroid?
Myomectomy
117
What is the treatment for a female patient with a fibroid who wants to keep her fertility?
Laparoscopic hysterectomy
118
What is the best way to help a pregnant woman who wants to quit smoking?
CBT
119
What is the diagnosis for a 36-week pregnant woman with a history of smoking who complains of vaginal bleeding and uterine tenderness?
Abruptio placenta
120
What is the diagnosis for a pregnant woman in her 37th week who fainted and complains of severe abdominal pain without bleeding?
Pulmonary embolism
121
What does painful vaginal bleeding in a pregnant woman indicate?
Placenta abruptio
122
What is the diagnosis for a patient with a previous C-section now pregnant at 36 weeks with abdominal pain, hypotension, and tachycardia?
Uterine rupture
123
What should be done for a 36-week pregnant lady with features of abruptio placenta, severe bleeding, hypotension, tachycardia, and anemia?
ICU admission and multiteam work
124
What will you do for a patient with placental abruption and BP 80/40?
Ultrasound
125
What is the acid-base balance of a fetus with asphyxia due to abruptio placenta?
Respiratory acidosis
126
What does a CTG with variable deceleration indicate?
Cord compression
127
What is the diagnosis for a CTG showing three contractions without deceleration?
Head compression
128
What does a CTG showing late deceleration indicate?
Head compression
129
What will you do for a pregnant lady in labor with active contractions every 3 minutes and cervix dilated to 5 cm after 4 hours with grade 1 heart activity on CTG?
Oxytocin
130
What is causing the deceleration in a pregnant woman during labor who was given analgesia and oxytocin?
Oxytocin
131
What is the cause of no change in heart rate of the fetus during contractions in a patient receiving oxytocin?
Oxytocin
132
What is the cause of CTG showing multiple repeated contractions and sluggish fetal heart rate response in a mother given epidural analgesia and oxytocin?
Oxytocin
133
What is the management for a 34-week pregnant woman who does not feel her baby move but has a reactive CTG?
Urgent cesarean section
134
What is the absolute contraindication for external cephalic version in a 34+2 week pregnant woman with a history of cesarean section?
Previous cesarean section
135
What is the absolute contraindication for external cephalic version in a 43-year-old woman with a history of C-section and now pregnant at 36 weeks?
Previous cesarean section
136
What is the management for a 31-year-old pregnant woman at 37 weeks with ROM in labor and breech presentation?
Cesarean section
137
What is the fetal presentation for a pregnant woman with a hard lump at the epigastrium and fetal heart sounds heard at the umbilicus?
Face
138
What type of twins are dizygotic?
Monochorionic monoamniotic
139
What is the best presentation for normal vaginal delivery in case of twins?
Breech cephalic
140
What is the risk of smoking to a pregnant woman?
Low birth weight for the fetus (IUGR)
141
What question will you ask a pregnant lady, G4P3, 35 years old, 34 GA, who complains of bleeding 2 hours ago?
Intercourse
142
What is a possible cause for a 34-year-old G4P3 woman at 32 weeks who has never come to an ANC visit?
Visit is expensive
143
What type of prevention is used when treating a pregnant woman with hepatitis?
Primary
144
What should a woman whose husband started HBV treatment and is negative be advised regarding sexual relations?
Tell her to use a condom
145
What is the treatment for a 40-year-old female primigravida with a history of DVT?
Heparin
146
What investigation should be done for a female of productive age with symptoms of DVT?
Venous duplex
147
If a pregnant 32-year-old paraplegic woman develops a DVT after a cesarean section, which organ would first receive a detached thrombus?
Left kidney
148
What is the diagnosis for a patient at 22 weeks with abdominal pain, decreased fetal movement, and shortness of breath?
Amniotic fluid embolism
149
What does a 40-week gestation primigravida with hypoxia, drowsiness, and agitation for 6 hours have?
Amniotic fluid embolism
150
What is the diagnosis for a postpartum patient with DVT who started on enoxaparin and then developed PE?
Same
151
What is the cause of symptoms in a 10-week pregnant woman with weight loss, fatigue, decreased appetite, and vomiting after each meal?
H. Pylori
152
When should a 12-week pregnant woman with gallbladder stones have a cholecystectomy?
Now
153
What will you do for a pregnant lady with recurrent pain known to have gallstones?
Open surgery in the second trimester
154
What does a pregnant woman with a mild systolic ejection murmur along the left lower sternal border radiating to the carotid have?
Physiological of pregnancy (no radiation)
155
What does high BhCG in the second trimester indicate?
Normal pregnancy
156
In what week of gestation do alveoli form?
12 weeks
157
What is suspected in a patient in the third trimester with high blood glucose despite close observation?
Neonate hyperglycemia
158
What is gestational diabetes?
Normal pregnancy associated with a diabetogenic condition due to progesterone
159
What is safe in pregnancy with diabetes?
Metformin
160
What drug is contraindicated for a woman with controlled diabetes who develops dysuria and frequency with high creatinine?
Amoxicillin
161
What is the diagnosis for a 36-week pregnant woman with hypertension and high plasma protein?
Preeclampsia
162
What is the diagnosis for a pregnant woman at 15 weeks with nausea and headache and a BP of 168/100?
Preeclampsia
163
What is the diagnosis for a pregnant woman at 22 weeks with nausea, headache, and a BP of 168/100 without protein in urine?
Preeclampsia
164
What is the diagnosis for a 39-week pregnant woman with a BP of 150/90, normal urine analysis, and no headache or vision changes?
Eclampsia
165
What may complicate a hypertensive lady controlled in pregnancy?
Abnormal fetal presentation
166
What is the treatment for a 24-week pregnant woman at 22 weeks with nausea and headache and a BP of 168/100?
Hydralazine
167
What should be given to a female with severe preeclampsia?
Methyldopa
168
What is the drug of choice for eclamptic seizures?
Phenytoin
169
What indicates severe preeclampsia in a pregnant woman with a BP of 140/90 and platelets of 90?
BP
170
How to diagnose recovery from preeclampsia?
BP
171
When should education about breastfeeding start?
2nd trimester
172
What is contraindicated for breastfeeding in a pregnant woman with HCV and cracked nipples?
HCV
173
What should be done for a pregnant lady exposed to rubella 3 days ago?
Nothing
174
What vaccine should be given preconception?
Rubella
175
What vaccine is contraindicated in pregnancy?
HPV
176
What is the best way to protect a pregnant lady with no past history of chickenpox from the disease?
Avoid contact with patients
177
What is the most appropriate diagnosis for a 15-year-old female not menstruating, short stature, and short neck?
Turner syndrome
178
What is the first sign of puberty in females?
Adrenarche
179
What is the diagnosis for a 42-year-old woman with secondary dysmenorrhea and heavy menses with symmetrical uterine enlargement?
Endometritis
180
What is the diagnosis for a patient with sudden acute pain and a mass in the ovary?
Ruptured ovarian cyst
181
What is the diagnosis for a patient with irregular menses, acne, and facial hair with a weight of 60 kg?
PCOS
182
What is the treatment for a woman with PCOS who is not planning to get pregnant soon?
Metformin
183
What investigation should be done next for a case of PCOS with normal FSH, high LH, and high testosterone?
Glucose and lipid
184
What is the diagnosis for a 30-year-old woman with a painless vaginal mass under the urethral orifice that bleeds when touched?
Bartholin abscess
185
What is the causative agent for a female patient with a wart in the vagina after repeated unprotected intercourse?
Herpes simplex
186
What is the diagnosis for a female patient with a small papule on the genital area with central pitting after unprotected sexual intercourse?
Herpes simplex
187
What is the primary action of oral contraceptives?
Decrease estrogen to prevent ovulation
188
What is the type of estrogen that is abundant in humans?
Estradiol
189
What is the diagnosis for multiple questions of a female with right lower quadrant pain, some with positive pregnancy tests and some with negative?
Acute appendicitis
190
What is the treatment for ectopic pregnancy at 6 weeks?
Methotrexate
191
What is the management for an ectopic pregnancy at 6 weeks, less than 3.5 cm, stable with mild pain?
Serial BHCG
192
What is the management for a 24-year-old primigravida with irregular menses, lower abdominal pain, scanty vaginal bleeding, and an empty uterus on ultrasound?
Surgical
193
What is the next step for a pregnant woman with a history of multiple abortions who is now 11 weeks pregnant?
Confirm pregnancy by BHCG
194
What is the best predictor of complications in pregnancy for a woman with a history of multiple abortions now 11 weeks pregnant?
Abdominal pain
195
What is the type of abortion for a pregnant woman at 13 weeks with vaginal bleeding and a closed internal os?
Unembryonic sac
196
What is the diagnosis for a patient at 8 weeks gestational age with closed os and brownish color during PV?
Threatened abortion
197
What is the management for a pregnant woman who came to the ER at 18 weeks with bleeding and an open cervix?
IV fluid and D&C
198
What type of PPH is associated with retained placenta and bleeding?
Primary
199
What is the classification for SVD with 800 ml blood loss visible to the eye?
Primary PPH
200
What should be given for PPH?
Oxytocin (first drug to be given)
201
What should be done for a pregnant woman discovered to be Rh-negative at 16 weeks?
Ultrasound
202
What is the best next action for a 32-week gestation woman with lower abdominal and back pain, confirmed fetal heart positive?
Inform neonatologist, give corticosteroids and strict bed rest
203
What is the most important thing to check before instrumental delivery?
Breach
204
What is the management for a 42 weeks + 3 days pregnant woman with a bishop score of 8 and reactive CTG?
Cesarean section
205
What is the management for a pregnant woman at 37 weeks + 8 days with protein +2, ketonuria, and high glucose?
Induction of labor
206
What was the source of bleeding noted during a C-section for a pregnant woman at 38 weeks?
Liver hemangioma
207
What can cause a 4th degree perineal tear during vaginal delivery?
Unrestrained legs and squatting position
208
What is the diagnosis for a preterm baby delivered with difficult breathing?
Meconium aspiration
209
What should be done for a mother counseling about colicky pain in her infant?
Reassure the mother; 80% of infants have the same complaint
210
What is the best drug for a pregnant woman with UTI when culture shows E. coli sensitive to TMP/SMX, ciprofloxacin, and nitrofurantoin?
Ciprofloxacin
211
What is the treatment for a female at 38 weeks with UTI?
Nitrofurantoin
212
What is the diagnosis for a patient with vaginal itching and a bad smell with flatellaprazite on microscopic examination?
Trichomoniasis
213
What is the diagnosis for yellowish-green vaginal discharge that increases with intercourse?
Trichomonas vaginitis
214
What should be given to a pregnant lady complaining of foul-smelling vaginal discharge?
Amoxicillin
215
What is the diagnosis for a female with fever and suprapubic pain with vaginal discharge?
Acute cervicitis
216
What should be done for a couple with bilateral fallopian tube obstruction seeking infertility treatment?
Tell the wife
217
What should be done for a pregnant woman complaining of severe abdominal pain and uterine contractions after being given 6 mg of Mg sulfate?
Decrease the dose
218
What is the diagnosis for increased vaginal discharge with intercourse?
Trichomonas vaginitis
219
What would you give a pregnant lady complaining of foul-smelling vaginal discharge?
Amoxicillin
220
What is the diagnosis for a female with fever, suprapubic pain, and vaginal discharge?
Acute cervicitis
221
What should you tell a wife when a couple comes in for infertility and investigations show bilateral fallopian tube obstruction?
Tell wife
222
What to do for a pregnant woman with severe abdominal pain and uterine contractions after being given 6mg Mg sulfate?
Give her Ca gluconate
223
What type of infection is a pregnant woman more liable to if a 50gm glucose test shows high glucose levels?
Candida
224
What to do for a pregnant woman complaining of genital warts?
Cryotherapy
225
What to do for a pregnant woman in early 2nd trimester with painful cervical bleeding?
Pap smear
226
What is the next step for ectopic pregnancy with peritonitis?
Laparotomy
227
What indicates a poorer outcome in a patient with severe pre-eclampsia with proteinuria, low platelets, abdominal pain, and high uric acid?
High proteins
228
When should a 55-year-old with normal mammography repeat the test?
1 year
229
What to do for a 28-year-old female with a normal pap smear 3 years ago?
Nothing
230
When does ovulation happen?
Peak of LH
231
What is the prominent estrogen during pregnancy?
Estradiol
232
What to give a patient with nervousness, irritability, and severe premenstrual symptoms?
Intradermal progestogen patch
233
What is the best predictor of glycemic control for pregnant women?
OGTT
234
What test should be done for a pregnant lady in week 13 GA with bleeding and suspected infection?
Pap smear
235
What is contraindicated in liver transplant?
Acute hepatitis B, chronic C, liver cirrhosis, end-stage liver disease
236
What is the management for a patient admitted after surgery who developed inferior MI?
Thrombolytic is contraindicated post-surgery
237
What ligament is affected in trauma to the knee with severe pain and swelling?
ACL
238
What is the management for a patient with fever and upper right pain with positive echinococcus?
Albendazole
239
What is the management for a man in the ER with pain in the right lower quadrant, nausea, and vomiting with U/S showing thick-walled gallbladder?
Lap appendectomy after 12 weeks
240
What is the diagnosis for an alcoholic patient with severe epigastric pain radiating to the back, nausea, vomiting, and elevated lipase and amylase?
FNA
