● Middle age male presented to ER with retrosternal chest...

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SMLE 2019 18 TH OF NOVEMBER Glory team Please don't hesitate to contact us if you have any correction, comments or suggestions. [email protected] Medicine: 2-17 Surgery: 18-26 OB/GYN: 26-31 Pediatric: 32-41
Glory Group, 18th of November 1 MEDICINE: Typical case of UC, investigations : A- TFT B- CT abdomen C- Celiac disease D- Forget it but definitely wrong Answer is B N.B: For diagnostic purposes should be ANCA X-ray and CT for acute exacerbation to rule out toxic megacolon and Endoscopy (e.g., colonoscopy) with histological examination is considered the best test to definitively diagnose UC. Patient k/c diabetes and smokers with claudication for 100m when he goes to the mosque, his femoral pulse is intact but distal pulse is diminished, what is most appropriate : A- medical risk stratification B- surgical bypass of stenosis C- endovascular repair of stenosis D- Smoking cessation with aggressive blood sugar control Answer is D N.B: Chronic limb ischemia:- Control risk factors Aspirin Statin extraintestinal symptom of crohn Disease : A- Erythema nodosum B- Erythema gangrenosum C- Erythema marginatum Answer is A
Glory Group, 18th of November 2 patient take ACEI, CCBs, thiazide , develop LL edma mainly , other Normal but in investigation all RFT test deteriorated , what you will do A- Stop ACEI B- Change thazide to frismide C- No change Answer is A N.B: ACEI not contraindicated in CKD But suddenly elevated BUN and Creatinine > stop ACEI Because we don’t know about the cause could be bilateral renal artery stenosis > 50 years male take antihypertensive : ARBs, CCBs , RFTs Normal Which drug could be taken in this case without C/I : A- ACEI B- Atenolol Answer is : N.B: BB not contraindicated But nor recommended to combined with CCB I think the answer is C or D ( in other recall there was thiazide in the choices) if was there it is correct two qs about prevention of re infarction : A- Anti platelet B- Surgery Answer is A Female in her fifties develops MI and she was asking about the best way to prevent a reinfarction: A-Use of aspirin for short duration B-Use of Calcium channel blocker indefinitely C-Use of ACEI if she develops heart failure to prevent cardiac changes Answer is A N.B: Aspirin prevent platelets aggregation therefore its risk of reinfarction
Glory Group, 18th of November 3 Middle age male presented to ER with retrosternal chest pain. ECG shows inferior wall MI . He was put on morphine and sublingual glycerin infusion until finish prep. To move him to cath lab. However pt became worse and deteriorated. What is the cause of pt deterioration?

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