問題一覧
1
Jane is a 37-year-old woman who has presented to your clinic for the first time. She has a facial rash shown in the following photograph. According to her, the rash is more prominent when she is exposed to sunlight. She also complains of 4-kg weight loss in the past 3 months, occasional low-grade fever, and fatigue. She has had intermittent painful and mildly swollen wrists and knees to which recent finger pain has been added. On examination, oral ulcers that she has never noticed before are found. You order laboratory tests, which are remarkable for mild normocytic, normochromic anemia; mild thrombocytopenia; an elevated ESR of 110; positive ANA, and positive ds-DNA antibody. Which one of the following is the most appropriate long-term treatment option for her?
HYDROXYCHLORQUINE
2
Parents of a 4-year-old girl has brough her to the Emergency Department after she started feeling short of breath and dizzy half an hour ago at home. Parents deny any other previous similar episodes or any significant recent or past medical conditions. On examination, a very rapid thready and hardly perceptible pulse is felt. She has a blood pressure of 98/65 mmHg and respiratory rate of 35 breaths per minute. He is afebrile and has normal peripheral perfusion. You start oxygen via non-rebreathable face mask, put him on cardiac monitoring, and stablish an intravenous line. Cardiac monitoring shows the following rhythm. Which one of the following is the most appropriate next step in management?
Put an icepack on his face.
3
A 10-day-old boy is brought to the emergency department due topersistent bilious vomiting for the past 10 hours. He is irritable,refuses to feed, and had his last bowel movement 24 hours ago.On examination, his abdomen is firm and distended with hypoactive bowel sounds and tenderness to palpation. There is a small amount of stool in the rectal vault, and occult blood is present in is the stool.What is the next step in management?
Exploratory laparotomy
4
A 2-day-old boy, born at 39 weeks to a 17-year-old primigravida with no prenatal care, had an uncomplicated delivery with Agar scores of 9 at both 1 and 5 minutes. He is formula-feeding well and has stooled twice but has had only a single wet diaper in the past 48 hours. He weighs 2.89 kg, which is a 3% decrease from birth weight. His physical examination is unremarkable.What is the next step in management?
Increase fluid intake
5
A young woman complain of 1 week of fatigue , change in color and dark brown urine . She has RUQ tenderness and ALT 1055u/l ?
Acute Viral Hepatitis
6
Read the question
infantile spasm
7
Read the question?
Lumbar puncture
8
What is the answer?
Breath holding spell
9
What is the answer?
viral gastroenteritis
10
What is the answer?
C1 esterase inhibitor
11
What is the answer?
Admission to hospital
12
What is the answer?
Ultrasonography of the neck
13
What is the answer?
this is the right age for her to give human papilloma virus vaccine
14
What is the answer?
A full course of vaccination should be started now
15
WHAT IS THE ANSWER?
Intravenous ceftriaxone and flucloxacillin
16
What is the answer?
cows milk protein intolerance
17
The lesion is benign but should be excised as it can become infected
18
BCC
19
Perform at biopsy of skin lesion
20
The patient’s physician should consider anal cytological screening with a Pap test
21
D
22
refer
23
Progress is evaluated with serial radio logical examination