SMLE Ride ~ November Part 1 2024 Past Paper PDF

SMLE Ride ~ By The Elites November 2024 https://t.me/SMLERide :‫رابط القناة‬ We have ensured that all the questions were solved with their resources; however, if you have any doubts please double-check the answers.🙏🏻 ‫ال تنسونا من دعواتكم‬ SMLE Ride ~ By The Elites...

SMLE Ride ~ By The Elites November 2024 https://t.me/SMLERide :‫رابط القناة‬ We have ensured that all the questions were solved with their resources; however, if you have any doubts please double-check the answers.🙏🏻 ‫ال تنسونا من دعواتكم‬ SMLE Ride ~ By The Elites November Part 1 Q1) 61 years old man presents with history of constantly thinks about aliens landing in his backyard especially when away from home. Despite knowing that aliens do not exist , he feels overwhelmed with the idea that they have landed. He fears that he is going insane. Which of the following is the most diagnosis? A- Delusion B- Obsession C- Compulsion D- Hallucination Answer: B, Psych SMLE File. *Similar Question MedGard 2 Q179 Q2) 23 years old college student was brought to the psychiatric outpatient clinic with 3 months history of persecutory delusions hearing voices commenting on his actions and disorganized behavior without disturbance of mood then returning to normal with no medication. Which of the following is the most likely diagnosis? A- Schizophreniform disorder B- Brief psychotic disorder C- Delusional disorder D- Schizophrenia Answer: A, MedGard. *Similar Question MedGard 2 Q206 Q3) A 37 year old man with a history of chronic duodenal ulcer presented to the emergency department complaining of frequent postprandial vomiting since 2 weeks. On physical examination, he was dehydrated with positive succussion splash when shaking the abdomen. Which of the following is the most expected acid base abnormality? A- Metabolic acidosis B- Metabolic alkalosis C- Compensated metabolic acidosis D- Compensated metabolic alkalosis Answer: B, , Schwartz and Bailey & Love. *Similar question in MedGard2 Q287 https://t.me/SMLERide SMLE Ride ~ By The Elites Q4) A 38 year old man with history of recurrent acute pancreatitis over the last 10 years, presents with a 12 hour history of frequent episodes of vomiting fresh blood. Intravenous fluid resuscitation was initiated Upper gastrointestinal endoscopy: isolated bleeding fundal varices which has been controlled by sclerotherapy US : splenomegaly , normal portal vein and thrombosed splenic vein. Which of the following is the most appropriate management? A- Splenectomy B- Portacaval shunt C- Distal splenorenal shunt D- Sengstaken blakmore tube Answer: A, UpToDate *Similar question in MedGard2 Q307 Q5) A 68 year old man was admitted through the emergency department with a 24 hour history of sudden severe lower abdominal pain associated with progressive abdominal distention and constipation. On examination the abdomen was hugely distended, tympanic with tenderness over the left iliac fossa. Digital rectal examination confirmed an empty rectum Test results WBC 22 Abdomen plain x ray: Y shaped shadow surrounded by a hugely colon arising from pelvis Which of the following is the most appropriate intervention? A- fleet enema B- colonoscopy C- ct with double contrast D- sigmoid colectomy with end colostomy Answer: D, Explanation by TA “The best next step will be colonoscopy for decompression, while the best intervention will be sigmoidectomy. The most appropriate management is D, since after colonoscopy, the patient will be still at high risk of recurrence” *Similar question in MedGard2 Q313 Q6) 45 year old presented to the emergency department with 12 hour history of vomiting fresh blood. He has history of recurrent peptic ulcer. Physical examination was normal Upper GIT endoscopy: Esophagitis , multiple non bleeding gastroduodenal ulcers, the distal one is in the 4th part of duodenum. Which of the following has the most diagnostic value? A- calcium B- parathormone C-fasting serum gastrin D- vasoactive intestinal polypeptide https://t.me/SMLERide SMLE Ride ~ By The Elites Answer: C, UpToDate. *Similar question in MedGard2 Q361 *Note: Recurrent ulcer + Unusual location (Other than 1st or 2nd parts of the duodenum) should raise the suspicion of ZES. Q7) A 50 year old man underwent an open mesh repair of a left inguinal hernia. He presented 2 months later because he noticed that the left testes had become smaller in size. Which of the following is the most likely cause? A- Ligation of testicular artery B- Mesh migration to the scrotum C- Thrombosis of pampiniform plexus D- Tightening of external inguinal ring Answer: C, MedGard answer C (Hamza said both A + C). *Similar Q in MedGard2 Q399 Q8) A 20 year old man was hit by a car 2 hours ago. On examination his abdomen is distended, tense and tender. BP 100/70 HR 120 RR 30 T 35 Spo2 90%. Which type of shock is the most likely diagnosis? A- Septic B- Cardiogenic C- Hemorrhagic D- Anaphylactic Answer: C, UpToDate *Similar Q in MedGard2 Q460 Q9) A 25 year old man is undergoing appendectomy for acute appendicitis, upon entering the peritoneal cavity the surgeon could not find the appendix. Which of the following is the most effective way to localize the appendix? A- Following the terminal ileum B- Palpating the ileocaecal valve C- Looking at the confluence of the taenia coli D- Following the course of the right colic artery Answer: C, The Mont Reid, Surgery by Hamoud. *Similar Q in MedGard2 Q478 https://t.me/SMLERide SMLE Ride ~ By The Elites Q10) A 30-year-old woman presented with a history of recurrent urinary tract infections. She notices it happening after sexual intercourse. Which of the following is the most appropriate recommendation? A. Antibiotic if symptomatic B. Daily antibiotics for 6 months C. Antibiotic course for 2 weeks D. Postcoital single-dose antibiotic Answer: D, Confirmed. Q11) 50 years old known case of type 2 dm he came complining of burning sinsation since 2 month he was diagnosed with tb 3 month ago he is on INH and rifampicin ? A- Amitriptyline B- vit b12 C - pyridoxine D - vit b3 Answer: C, Um-Alqura file. *Similar Q in MedGard2 No.42 Q12) 5yr viral infection attacks he is on saba two times no improvement mx? A. ICS B. oral steroids C. leukotriene D. cough sedative Answer: A, Um-Alqura file. Q13) A 3-year-old boy develops fever, drooling of the mouth, difficulty in swallowing, noisy breathing, and neck pain. Examination is unremarkable. Of the following, the MOST appropriate diagnostic study is : A. lumbar puncture B. MRI of the brain C. MRI of the spinal cord D. CT scan of the neck E. lateral X-ray of the head and neck Answer: E, Mahdi file (Epiglottitis case). https://t.me/SMLERide SMLE Ride ~ By The Elites Q14) 76-year-old male presents with reducible inguinal hernia and moderate pain. what is the treatment? A- open mesh repair B- non surgical management C- open repair without mesh D- exploratory laparotomy with hernia repair Answer: C, Hamoud channel. Q15) 90-year-old Female patient with with long standing incisional hernia, came to ER with abdominal pain and fecalith discharge, her hernia is strangulated with ulcers and necrotic all vital are normal, what will u do? A. Dressing B. Laparoscopy C. MRI D. Laparotomy abdomen Answer: D, Hamoud file. Q16) 10-year-dd boy presents to the clinic complaining of abdominal pain, frequent diarrhea that ts sometimes bloody, and pain usually accompanying defecation. His mother noted that be has lost weight over the last three months since the onset of the problem. Ine boy also has aches and pains of his joints. On examination, he looked ill, pale, with a soft abdomen, no tenderness or organomegaly (see lab resumts). Blood pressure 110/70 mmHg Heart rate 100 /mm Respiratory rate 16 /min Temperature 38.6" C Test Result Normal Values Sodium 132 1 34-146 mmol/ 1 Potassium 3.2 3 5-5.1 mmol/L Creatinine so? omol. Blood urea nrtrogen 5 6.1 B to 6 4 mmol/L Hb 82 112-165 g/L C-reactive peptide 1.1 0-0 5 mg/di Albumin 32 36-52 g/L Which of the following treatments should be tried first? A. Metronidazole B. Corticosteroids C Gluten free diet D 5 aminosalicylates https://t.me/SMLERide SMLE Ride ~ By The Elites Answer: D, MedGard (5-ASA used in UC induction). Q17) Female patient presents to you with suprapubic pain and right iliac fossa pain. Abdominal ultrasound is insignificant. What will you do next? A- Transvaginal ultrasound B- Abdominal CT scan C- Diagnostic laparoscopy D- Open appendectomy Answer: B, Appendicitis approach. Q18) A 40 years old male with history of smoking 5 pack year came to ER with retrosternal chest pain radiated to neck (or shoulder), on exam his blood pressure is 156/92 On ECG has ST depression in inferior leads. Which of the following is the most CONSIDERABLE risk factor for his condition? A- age B- smoking C- male gender D- hypertension Answer: B, In Another recall Confirmed A but the age was 55, This Q came in my exam and i agree with B, because the recall change. Q19) Mva with stabilized neck and intubated with still GCS of 8 now management A- Dpl B- Laparotomy C- Vascular access Answer: C, ABCDE Approach. Q20) 55-year-old k/c of A fib, dilated cardiomyopathy, HTN complain of palpitation, HR : 170 bpm , BP 120/80, SPO2 92%. what of the following is most appropriated next step : A. Digoxin B. Propranolol C. Diltiazem Answer: A, Um-Alqura file. *Similar Q in MedGard1 No.440 https://t.me/SMLERide SMLE Ride ~ By The Elites Q21) RDS scenario: preterm born on 29th week. tachypnic, grunting, nasal flaring, Most appropriate mx: A- cpap with 100% oxygen B- Surfactant Answer: B, Nelson. Q22) A 32-year-old patient became pregnant through in-vitro fertilization. She is now 7 weeks pregnant and is scheduled for laparoscopic surgical excision of an ectopic pregnancy (see report). Ultrasound: Presence of a right-sided 4-cm ectopic pregnancy and a left tubal hydrosalpinx. Which of the following is the most appropriate procedure? A. Right-sided salpingotomy alone B. Right-sided salpingectomy alone C. Excision of both right and left tubes D. Intraoperative methotrexate injection Answer: C, Confirmed. Q23) A 5-year-old girl presents to the clinic with pallor and irritability. On examination, she has mild jaundice and her spleen was enlarged by 4 cm (see lab results). Test Result Normal Values RBC 4.4 4.6-4.8 x 1012/L Hb 82 112-165 g/L Reticulocyte 9 0.2-1.2 % MCH 39 28-33 pg/cell MCV 80 80-95 fl Peripheral blood smear Test Result Microspherocytes ++ Anisocytosis Mild Which of the following is the most likely diagnosis? A. Biliary obstruction B. Sickle cell anemia C. Hereditary spherocytosis D. Autoimmune haemolytic anemia Answer: C, AMBOSS. *Similar Q in MedGard2 No.1143 https://t.me/SMLERide SMLE Ride ~ By The Elites Q24) Pt presented with palpitations, diagnosed now with AFib ( given). Next most appropriate investigation? A. Carotid US B. Thyroid Function test C. Exercise tolerance test D. 24 ECG monitoring Answer: B, Um-Alqura file. Q25) A 58-year-old woman with acute onset shortness of breath and pleuritic chest pain. She is diagnosed with pulmonary embolism. Which of the following is an indication to do thrombophilia workup? A. Age above 55 years B. Being on oral contraceptive pills C. Has a history of connective tissue disease D. Has negative family history of thrombosis Answer: B (According to MedGard), and C (According to Dr. Elaf.). Q26) 41-year-old woman Para 4 presented to the Gynecology Clinic with post-coital bleeding for the past three months. Her cycle is irregular, and she is not taking any contraception. Examination revealed a soft abdomen with no palpable masses. Which of the following is the most appropriate next step in management? A. Pap smear B. Pelvic ultrasound C. Endometrial biopsy D. Dilatation and curettage Answer: A, Confirmed. Q27) 27 years old female complaining of green-yellow discharge that started after her mensuration, Upon examination: red lesions on cervix, What’s the diagnosis? A. atrophic vaginitis B. Bacterial vaginosis C. candidiasis D. trichomoniasis Answer: D, Wafa file. Q28) Patient was on amlodipine and losartan, and they want to add another anti hypertensive medication, i think cuz she was not responding, what you will add? https://t.me/SMLERide SMLE Ride ~ By The Elites A- Alpha blockers B- Beta blockers C- ACEI D- Diuretics (sure did not specify, thiazide or loop diuretics) Answer: D, NICE guidelines (Thiazide diuretics). Q29) A 28 year old female known to have an ovarian cyst, came to your clinic asking about contraception, which of the following methods is most appropriate for her? A- OCP B- Oral progestins only pills C- Vaginal ring D- Male condom Answer: A, Wafa file. Q30) 30s y woman asking for effective and reversible method of contraceptive, which if the following is the most effective: A. Vaginal ring containing hormones B. Female condom C. Male condom D. Spermicide Answer: A, Wafa file. Q31) 50 year old female, presented complaining of a sensation of pelvic pressure but no stress incontinence. Her work involves lifting heavy objects. On examination you find mucosa bulging through the vagina. What’s the most appropriate management? A. Kegel exercises B. Pessary C. Bladder neck fixation D. Colporrhaphy Answer: D, Confirmed. Q32) 11 month old child, brought by his parents they reported a 1 day history of fresh blood in stool associated with foul smell and dark brown stool on examination the child was pale (they didn’t mention pain or any abdominal examination), What’s the best diagnostic tool: A- barium enema B- barium meal https://t.me/SMLERide SMLE Ride ~ By The Elites C- radioisotope scan D- US abdomen Answer: C, Mahdi file. Q33) Pediatric pt with SOB and cough since 3 days. Mom traid SABA but no improvement. On exam: right lower lobe wheezing and absent breath sound. Next initial management? A. AP and lateral CXR B. Bronchoscopy C. Chest CT Answer: A, Suspicion for FB. *Note (According to UpTodate): - If high suspicion (Hx of choking, playing, eating nuts, etc…): Go with bronchoscopy. - If low-moderate suspicion: Do CXR first. Q34) US showing bilateral thyroid nodules. The right nodule being 3x4mm in size, and the left is 1x2mm. Next? A. FNA both B. FNA the larger one C. total thyroidectomy D. Follow up with US Answer: D, Hamoud file. Q35) 40 years old male with left neck mass, thyroid ultrasound done and showed 1.5*2 cm cold mass, FNA cytology revealed suspicious follicular neoplasm, which of the following the best initial management? A. Left hemithyroidectomy. B. Repeat FNA. C. Prescribe thyroxine. D. Radioactive ablation. Answer: A, Hamoud file. Q36) 68-year-old patient k/c of DM andHT, presented to the hospital with chest pain for 2 hours. The pain is retrosternal, associated with nausea and sweating. BP 112/77, HR 78. ECG showed ST segment elevation in lead II, lead IlI and aVF. What is the most appropriate next step in evaluating this patient? A. ECHO https://t.me/SMLERide SMLE Ride ~ By The Elites B. Order cardiac enzyme C. Chest X-ray D. Right-sided ECG Answer: D, Um-Alqura file. Q37) 32 years old male with neck mass and dysphagia, US done and showed mass 2*3 cm, FNA cytology reveled hypercellular of large poorly cohesive spindle-like shape cells, labs showed high calcitonin, Which of the following is the most likely diagnosis? A. Papillary B. Medullary C. Anaplastic D. Follicular Answer: B, Hamoud file. Q38) 4 weeks boy have tachypnea and tachycardia cyanosis and irritability wich s/s associated with this presentation? A-Jaundice B-Difficult feeding Answer: B, Safder file Q39) 11-month-old boy is not moving his right hand and when he presented to the hospital it appeared that he had right ulnar and radial fracture presented after 2 days history of fall on an outstretched hand when the doctor asked the parents why they didn’t bring him earlier they said that they didn’t see any bruises. child is dressed well, well-nourished and has had regular well baby visits. A) Treat the child and inform the authorities B) Believe the parents and treat the child C) Treat the child and order head CT D) Call the police Answer: B, SMLE brain ethics file. Q40) 10 days post PCI present with sharp chest pain worse with coughing improved with leaning forward. Auscultation scartch sound (something like that) with muffled heart sound Raised JVP, No vitals. What do u expect on ECG? A) sinus tachy B) diffuse ST elevation https://t.me/SMLERide SMLE Ride ~ By The Elites Answer: B, AMBOSS *Similar Q in MedGard2 No.29 Q41) 4 years old came with URTI, high fever, drooling of saliva and multiple enlarged lymph node. He did not receive any vaccine Which of following vaccine might prevent this condition A-Hemophilus B-Streptococcus C-Diphtheriae D-Polio Answer: A, Safder. Q42) 38 weeks in labor with Intrauterine fetal death with regular contraction and cervix 6cm, what is the management? A. C-section B. Augmentation of labor Answer: B, Confirmed. Q43) Cord prolapse what do you see in the CTG? A. Prolonged deceleration B. Acceleration C. Bradycardia Answer: C, Wafa file. Q44) Liver cirrhosis case, which food he must avoid A- Fat B- Protein C- Carbohydrates D- Minerals and vitamins Answer: A, no resource except telegram channel. Q45) A 22 year old woman presented to the clinic with 2 months history of polyarthralgia, skin rash, mucosal ulcers and fatigue. Her clinical examinations revealed malar rash over her face and active arthritis at several joints. Hb 100 (120-160 g/L female) Platelets count 100 (150-400) ×109/L https://t.me/SMLERide SMLE Ride ~ By The Elites WBC 3 (4.5-10.5 ×109/L) ESR 35 (2-10 mm/h female) Lupus anticoagulant positive Urea 5 (2.75-7.4 mmol/L) Creatinine 78 (44-115 umol/L) C-reactive peptide 5 (