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Ninja SMLE Recall: منشور #36142 — TG.ME

Ninja SMLE Recall@ninjasmle · 14.1K subscribers Open in TelegramOpen

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t.me/ninjasmle/36142

September 9, 2026 180 5

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A 27 year old male known case of ALL admitted for chemotherapy; after 19 days he complains of crampy RLQ pain for the past 2 hours with diarrhea. He had blood with the last bowel motion. Physical exam revealed grade 1 oral mucositis and RLQ tenderness with rebound. Labs: vitally stable, pancytopenia (WBC 0.9). What is the most appropriate investigation? A. Upper GI endoscopy B. Lower GI endoscopy C. CT abdomen D. US abdomen Answer: C 48·Sep 15 A 27 year old male k/c ALL admitted for chemotherapy; after 19 days he complains of crampy RLQ pain for the past 2 hours with diarrhea. He had blood with the last bowel motion. Physical exam revealed grade 1 oral mucositis and RLQ tenderness with rebound. Labs: vitally stable, pancytopenia (wbc 0.9). What is the most appropriate investigation? A. Upper GI endoscopy B. Lower GI endoscopy C. CT abdomen D. US abdomen Answer: C Neutropenic enterocolitis (typhlitis) is the inflammation and necrosis of the cecum and surrounding tissues that may complicate the treatment of acute leukemia. It may involve any segment of the gastrointestinal tract including small intestine, appendix, and colon. The patient develops right lower quadrant abdominal pain, often with rebound tenderness and a tense, distended abdomen, in a setting of fever and neutropenia. CT scan may show marked bowel wall thickening, particularly in the cecum, with bowel wall edema, mesenteric stranding, and ascites, and may help to differentiate neutropenic colitis from other abdominal disorders such as appendicitis, diverticulitis, and Clostridium difficile–associated colitis. 44·Sep 15 Neutropenic enterocolitis (typhlitis) DIAGNOSIS Neutropenic enterocolitis is usually diagnosed by detection of the characteristic CT findings in neutropenic patients presenting with fever and abdominal pain and tenderness. All patients suspected of having neutropenic colitis should undergo abdominal CT scanning. Both oral and intravenous (IV) contrast should be given, when feasible. However, oral contrast is sometimes not tolerated in patients with severe gastrointestinal tract symptoms, and IV contrast is typically avoided in patients with kidney function impairment. In addition to CT scanning, blood and stool cultures and Clostridioides difficile toxin assays should be performed. Barium enema is hazardous in the presence of potentially necrotic bowel since it can cause perforation. Similarly, colonoscopy is relatively contraindicated in the presence of neutropenia and thrombocytopenia, and air insufflation may precipitate cecal perforation. In those very few patients who underwent colonoscopic examination, mucosal irregularity with nodularity, ulcerations, and hemorrhagic friability, as well as a mass-like lesion mimicking carcinoma, have been described. 46·Sep 15 اختباري كان ١٥ سبتمبر الاختبار مكرر بالنسبة لي كل القسمين التكرار جدا كبيير! ذاكرت تجميعات سايلنت والحمراني الله يجزاكم خير شوي فبراير شوي مايو شوي جون جولاي كامل اوقست كامل وبعض سبتمبر قيم بوي ملف الصور حق الدكتور مكرمي الله يجزاه خير جاء منه 6 صور الحمدلله المراجعة المراجعة المراجعة كنت احط الاسئلة الصعبه علي في ملف وراجعتهم كامل مع الشرح قبل الاختبار وربي الاختبار ابسط واوضح من التجميعات وحتى لو انك منت عارف السؤال الخيارات توضح وين الاجابه الصح اهم شيء توكلوا على الله ولاتتوترون ابدا وحاولوا تتذكرون الاسئلة الجديدة وتنقلونها لانفسكم 115·Sep 15 A 53-day-old boy is referred to the Paediatric Clinic for investigation of anaemia. He was born full term and he is a known case of G6PD deficiency. On examination, both height and weight are in the 10th percentile, the rest of the examination is normal (see lab results). Test Result Normal Values Hb g/L Platelet count x 109/L Total bilirubin 25.1 <20.5 mol/L Urinalysis Result Normal Values Color Clear Clear or light yellow Leukocytes 0 0-3 per high power field Erythrocytes 0 0-2 per high power field Which of the following is the best management? A. Blood transfusion B. Iron supplement C. Reassurance D. Folic acid Answer: C 127·Sep 15

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