Mr. X is a 52 years old egyptian male who lived in the states for 20 years where he worked in a fast food restraunt. he is back home 6 month ago. he statred to complian of constipation 3 month ago...he tried many things from high fiber diet, laxatives and even enemas, and all had temporary effect. he came to my office asking for help..abdominal palpation was free. hyperaudible bowel sounds were remarkable. no history of pain during defecation..ferquency of  defecation is once every 3 to 4 days..

QUIZ questions: What is the most important single examination i didn't mention..and what is its contrainducation?

29 yo female presents with sever right-sided abdominal pain and vomiting. Pain came on last night and has steadily worsened. Emesis began in morning. ABD exam displays guarding. Rebounding and positive rovsing's signs. WBC 12000, HCT 41, PLT 366000. Surgery is scheduled and her appendix is removed the same day. Pathology finding shown here, reveal likely cause of her illness.

CAST YOUR VOTE.

1. Endometriosis

2. Deciduosis

3. Fecal material

4. Strongyloidiasis

5. Schistosomiaisis

6. Actinomycosis

7. Yersinia

8. Enterobiasis

Case: A person with age of 53years admited to the hosptial with the severe abdominal pain. The doctor diagnose that the gallblader is fibroused and is removed soon after perfoming ultra sound. When the operation is done the patient is complaining that his sensation on the right side from umblicus upto end of the abdomen is lost.

QUIZ questions: What should be the proper reason for that complain? What should you diagnosed?

26 yo male arrived via an ambulance from his work (building site worker) with typical acute abdomen symptoms. Fast diagnostic and diagnosis: perforated gastric ulcer. Patient underwent an operation and was transported to a ward. No complications.

On third day he started exhibited strange behaviour.
He is waking up in the middle of the night. No logical contact. He is very excited and his arms tremble. He behaves offensively towards the doctors and sometimes falls down on the floor with trembles all over the body.
Pressure 150/95, HR 120/min

Quiz questions:
1. What's the most probable diagnosis?
2. What are the procedures and treatment? Be careful - one bad move could be tragic.