2. 25 y old patient presented with history of heart burn & regurgitation ( especially on bending ) >2 times/week for the last 6 months.
Examination was unremarkable

3. What is the most probable diagnosis?
What are the investigations you have to do for this patient to reach to the diagnosis?
How you will treat this patient?

5. 50 year old male patient presented with history of dysphagia for solid relieved by drinking fluid & walking or changing position after meal for the last 10 years .
Patient also had nocturnal cough & some times chest pain .
He is neither smoker nor alcohol drinker.

6. What is your provisional diagnosis?
How you investigate this patient?
What is the treatment?

8. 50 year old male patient presented with history of dysphagia for solid increasing in severity to be even to liquid for the last 3 months associated with history of loss of about 15 kg of his weight.
The patient is chronic heavy smoker & also alcohol drinker.
Q1-What is your Provisional diagnosis:
Q2-How you investigate this patient?

10. 25 year old patient presented with history of dyspepsia for the last month.
Examination was normal .
Q1: How you will investigate this patient to diagnose H-Pylori ?
Q2:What are the diseases caused by H-Pylori?
Q3:What is the regimen for H-Pylori eradication?

13. 60 year old patient presented with history of dyspepsia for the last 3 months associated with loss of about 15 Kg of patient weight.
O/E: Patient was pale ,emaciated with palpable left supraclavicular lymph nodes.
Abdominal examination: Palpable mass in the epigastric area.
Q1: What is the provisional diagnosis?
Q2: What are the risk factors for this condition?
Q3:What is the management?

15. 35 year old patient presented with history of sudden severe abdominal pain of few hours duration.
His plain abdominal X-ray is shown below.
Q1-What is the diagnosis?
Q2-What are the causes?

17. 17 year old female brought by her mother because of short stature & delayed puberty with past history of diarrhea.
Examination: revealed anemia with angular stomatitis & absence of secondary sexual characters.
Q1: What is the diagnosis?
Q2:How you investigate this patient?

21. 30 year old male patient presented with H/O frequent attacks of bloody diarrhea for the last 2 years.
O/E: Patient looked anemic ,emaciated with tender abdomen.
Q1-What is the most probable diagnosis:
Q2-How you assess the severity of his condition?
Q3-What are the lines of management for this patient?

24. 65 year old patient admitted to the casaulity because of history of haematamesis & malena of one day duration.

25. A-How clinical examination may help you to know the cause of patients GI bleeding?
B-list the risks of death in this patient?
C-what are the lines of management?

26. 60 year old male patient presented with history of altered bowel habit , abdominal discomfort with bleeding per rectum & weight loss of few months duration.
O/E: Patient is pale & emaciated with palpable abdominal mass .
Q1- What is the most probable diagnosis?
Q2-What are the risk factors?
Q3-How you investigate this patient?

28. 70 year old male patient presented with history of abdominal pain , fever & bloody diarrhea of few days duration he gives history of urinary tract infection 6 weeks ago for which he received antibiotics.
On examination: Patient is toxic feverish & dehydrated
Abdominal examination revealed tenderness of left abdomen
Q1-What is differential diagnosis .
Q2-What is the management?

30. 60 year old patient presented with history of anaroxia ,abdominal discomfort & weight loss for the last 6 months.
On examination: Patient looks pale ,emaciated
Abdominal examination revealed hepatomegaly ( liver span of 18cm) the liver is hard in consistency with irregular surface.
Q1- What is the most probable diagnosis?
Q2- How you investigate this patient?

32. What are the causes of the following deformity?

34. 55 year old male patient presented with history of jaundice of few months duration , recently he is discovered to have diabetes mellitus. also he complains of shortness of breath & joint pain with darkening of his skin.
On examination: He is jaundiced ,His JVP was 6 cm above the sternal angle with spider telengectasia & bilateral leg oedema.
Abdominal examination revealed : hepatosplenomegaly & positive shifting dullness .
Q1-What is the most probable diagnosis?
Q2-How you investigate this patient?
Q3- What is the treatment?

38. 55 year old female patient presented with history of generalized fatigue with progressive itching of 5 years duration recently patient developed jaundice, with bone pain & diarrhea .
On examination: The patient is jaundiced with periorbital xanthoma.
Abdominal examination revealed hepatosplenomegaly .
Q1-what is the most probable diagnosis?
Q2-How you investigate this patient?
Q3-What is the treatment?

46. 17 year old patient presented with history of recurrent jaundice with abnormal involuntary movement of 2 years duration.
On examination: He was jaundiced with brownish pigmented ring at the periphery his iris , with choreoathetotic movement .
Examination of his abdomen revealed hepatosplenomegaly.
A-What is the most probable diagnosis?
B-what are the investigations you have to do for this patient?
C-What is the treatment?

49. 55 year old male patient known case of ulcerative colitis presented with history of recurrent right upper abdominal pain ,fever & jaundice for the last 3 years.
On examination : The patient was jaundiced , his temp. was 39C , abdominal examination revealed liver span of about 11cm with palpable spleen & shifting dullness was +ve.
A-What is the most probable diagnosis?
B How you investigate this patient?
C- What is the treatment?

53. 25 year old female patient presented with history of jaundice , generalized fatigue , joint pain , abdominal distention & bilateral leg oedema she gives history of amenorrhea too.
On examination: She was jaundiced , pale with spider telengectasia & bilateral leg oedema.
Abdominal examination: revealed hepatosplenomegaly , shifting dullness was +ve.
A- What is the most probable cause of her chronic liver disease?
B-How you investigate this patient?
C- What is the treatment?

55. 30 year old patient presented with history of jaundice & upper abdominal discomfort & anaroxia for the last 3 months.
He is not alcohol drinker & has no history of jaundice before.
On examination : He was jaundiced & abdominal examination revealed tender hepatomegaly.
Investigations: AST:400U/L(normal up to 40 ),ALT 500U/L ( normal up to 40 ),TSB :54umol (normal up to17) 35 umol direct & 19 umol indirect, Alkaline phosphetase 180U/L.
A-What is your investigations to know the cause of his condition?

56. 50 year old male patient known case of alcoholic liver cirrhosis admitted to hospital for treatment of increasing ascites.
On examination :The patient was conscious , oriented , he was jaundiced with many spider telengectasia on his trank.
Abdomen was distended , transmitted thrill was +ve.
Two days after admission patient becomes agitated with altered level of consciousness .
Reexamination revealed confused patient with flapping tremor.
A-What is this complication?
B-What is the management?

57. 55 year old male patient known case of liver cirrhosis due to chronic hepatitis B viral infection for the last 10 years , he was Ok on conservative treatment .Last few months patient developed increasing ascites , anaroxia & weight loss.
On examination: He was emaciated , pale & jaundiced .
Abdominal examination revealed distended abdomen with palpable mass felt at right upper abdomen with positive transmitted thrill.
A- What is the most probable diagnosis.
B- what are the investigations that you have to do for this patient?

58. 50 year old male patient who is a known case of primary Polycythemia presented with history of right upper abdominal pain & abdominal swelling of few days duration.
On examination: there was tender hepatomegaly & shifting dullness was positive

59. A- What is the diagnosis?
B-how will you investigate this patient?
C-What is the treatment?

60. 25 year old patient presented with H/O fever ,rigor & right hypochondrial pain of 3 weeks duration , he had had H/O of appendecectomy 2 months ago.
O/E: There was pallor , temperature 39 c with tender right hypochondrium.

61. A-What is the most probable diagnosis?
B-List 3 important investigations?
C-what is the treatment?