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Medical Exam Review – Comprehensive Solved Questions (2024) – Clinical Scenarios, Diagnostics & Management Summary

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This document contains a complete collection of solved multiple-choice clinical questions from a medical exam dated 12 January 2024. It covers a wide spectrum of disciplines including pediatrics, obstetrics and gynecology, internal medicine, surgery, emergency medicine, ethics, and pharmacology. Each item presents a clinical scenario followed by the correct answer, providing a full high-yield review suitable for exam preparation. The content is comprehensive and reflects typical exam-style case presentations and management steps.

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Clinical Scenarios, Diagnostics & Management
Course
Clinical Scenarios, Diagnostics & Management

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1/7 yo girl healthy engaged with her age very well, developed hair on mons and labia majora, no
breast enlargement, no musculature, normal size clitoris, growth normal
A- Adrenal hyperplasia
B- Premature adrenarche
C- normal development

2/child with flu- like symptoms fever and cough on physical exam show Crackles and bronchial
breath sounds . On CXR diffuse infiltration more dens consolidation in middle lobe . (Pic CXR
given)
Heart rate , respiratory rate blood pressure, O2
All within acceptable range

Most appropriate Mx?

A- Inhaled steroid with SABA
B- Admission and IV ABX
C-Discharge on Amoxicillin for 7 days
3/ pt with disc , effect calf muscle and latral side of legs ?
L3-L4
L4-L5
L5-S1
S1-S2

4/ 17 years pt febrile , abdominal pain , rebound tenderness at mcburney's point , wbc high , x
ray
show right fossa ?
A- appendectomy
B- gall bladder US
C- urology consultation

:. Alverado score > high was 7 No need image

5/Breast cancer screening in 45 y old female ? after 1 year

6/Alcoholic, right hypochondriac pain and i think weight loss ,alpha fetoprotein is high No other
labs ,Image: CT showed multiple lesion in liver and cirrhosis A-Hepatocellular carcinoma B-
pancreatic cancer
7/Complete ttt of HCV next (US follow up every 6 months)
8/Elevated fasting and hba1c next ? OGTT
9/Privacy invaded in e-research
10/Consent from her and ask her to tell her husband
11/Pregnant lady, presents to ED with 6 hours complain of clear fluid release for 6 hours pelvic
examination shows pooling at the posterior fornix A. ruptured membrane B. Normal vaginal
discharge C. Bacterial vaginosis
12/Worst headache ever? SAH
13/19 months milestones
14/TTN
15/RDS

,16? Diabetic mother In 12week og gestation high Hga1c which increase dramatically ? Congenital
malformation
17/ A child with typical celiac disease symptoms (weight loss, abdominal bloating, flattening of
buttocks) , what is the most appropriate step? A- anti endomysial antibody B- duedenal biopsy C-
other irrelevant (No anti Tga antibody)
18/Foreign body aspiration
19/PPH following forceps delivery ? Genital tract lacrimation
20/Most common cause of PPH ? Atony
21/Child and his brother have flu most likely organism ? RSV
22/Child with iron deficiency anemia (MCV 68 RBC : 4.6)? Oral iron
23/Known case of chronic hypertension , on 22weeks of gestation what to give ? Nifedipine
24/Case of gallstone ileus ? ex laparotomy
25/Pyloric stenosis typical
26/Finding in TLS ? hypK hypoCa
27/Child with HPS next step is ? correction of fluid and electrolyte
28/Sigmoid volvulus case typical
29/Case of ecg not clear but the case going with Pulmonary embolism , elderly with DM
presented with SOB and chest pain ,

Choices were , Drug induced , PE ,Cardiogenic shock
30/Vaccine limited to ? pregnant women
31/Severe bitten by her husband?
32/Lucid interval and convex hematoma on CT , next step ? mannitol -craniotomy -shunt
32/Case of meningitis with neck rigidity and skin rash and other feature, how to diagnose ? LP
33/Tantrum
34/Left portal HTN
35/Aortic regurgitation feature , early diastolic increase when leading forward
36/Case of tension PTX folloing trauma resent with dceasr air entery and hyperresonancs right
side ?
37/Case of hemothorax following trauma present with dullness ?
38/Case of pneumonia and dullness over the right chest , what findings on Xray ? effusion
39/Case of acute epiglottitis typical feature with droling and setting in tripid and high fever
40/Low CO,PCWP? Hypovolemic
41/Tender tense abdomen after RTA? Hemorrhagic
41/Cellulitis case orbital
42/DVT in pancreatitis
43/Gastroscopy in case of wight loss old age
44/ Q with pseudomonas and recurrent infection ask about Dx ? Cystic fibrosis,,
45/8 y with family hx of eczema , in this age group what is the common site :
- flexors
- scalp
- dorum of foot
- back
46/Infant Mortality Rate has decreased to 4.8 in 2020 in Saudi Arabia.
Which of the following figures involved in This:
A) Number of women in childbirths age
B) Number of deaths in saudi arabia in 2020

, C) children who died in 2020 and not
completed their first year
47/Old female with history of epilepsy had seizure and fell down the stairs, presented with back
pain with urine and fecal incontinence and inner thigh pain, next appropriate management?
A-EEG
B - MRI Lumbar
C -Reassure as post-ictal state
48/6 months old baby came for vaccination
Before you give it , his mother inform you last vaccine he develop skin reaction /sob and
managed in emergency

Cancel vaccine
Delay vaccine
Check previous vaccine
Give some
49/Old male present with lower Gi bleeding and is continous bleeding now after NGT and giving
fluids blood
What to do
Colonoscopy
Angiography
50/A 60 years old man smoker with sudden onset of chest pain radiates to back and left radial
and femoral absent. What is the best diagnosis?

Echo
ECG
Aortic CT angio
51/What risk increase with valproic acid ? Neural tube defect
52/Patient pregnant and was on plaquinil (hydroxychloroquine) what to do?
Refer to rheumatology to stop
Stop medication
Switch to other med
Continue
53/Child presented with sandpaper like rash , he had URTI a week ago.
What's the causative organism?
A. Parvovirus B19
B. Streptococcus pyogenes
C. Streptococcus pneumonia

54/Infant with grunting coryza fever expiratory wheezing rib retraction
Air trapped

Which one is the most appropriate IMMEDIATE intervention?

A - Erythromycin
B- Pencilin
C-Steroid
D-Oxygen
55/6 months old boy his mother noticed that he doesn’t feed well, complaining from vomiting
and recurrent chest infections and dystonic nec , what has the highest risk factor to develop this
case
A. Obese baby
B. Preterm infant
C. Post rubella infection

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