Haad Exam Mcqs
Haad Exam Mcqs
Haad Exam Mcqs
DR.ABDELNASIR
ELSHEIKH
2015
(medicine)
1. Evidence based medicine:
as in text book.
(Pediatrics)
2. What is the best source of iron in a 3 month old infant?
breast milk.
yellow vegetables.
fruit.
infants absorb 100% of the iron in breast milk (less than 1 mg/L), but
cannot absorb all of the iron in infant formulas.
(OB/GYNE)
3. 16 wk GA with (++) glycosuria, FBS 4.4, 1 hr PB 8, 2 hr PB 7.2
renal glycosuria.
GDM.
K.M syndrome.???
GOOD LUCK
syndrome).
GOOD LUCK
For GDM Dx:
100 g Glucose Load, mg/dL Time
(mmol/L)
95 (5.3) Fasting
180 (10.0) 1-h
155 (8.6) 2-h
140 (7.8) 3-h
(Family medicine)
4. A disease lasts 2-3 wk with fatality rate of 30 %:
incidence = prevalence.
has no relation.
(ID med.)
5. What is the least effective AB of the following to staph. aureus:
clindamycin.
erythromycin.
amoxicillin.
Vancomycin.
(OB/GYNE)
6. 35 wk GA PG with pre-eclampsia BP is high with ankle edema, the
best to be done is:
diarutics.
labetolol.
immediate delivery.
GOOD LUCK
Aim for delivery when the pregnancy is at term.
GOOD LUCK
(Medicine)
7. 35Y/O presented with left iliac pain and dysuria, management
include all the following except:
blood C+S.
microscopy of urine.
IVP.
urine C+S.
norfloxacin.
(Pediatric surgery)
8. 10 Y/O boy woke up at night with lower abdominal pain, the most
important thing to be examined is:
testis.
kidney.
lumbosacral spine.
The age between 10-15 years, the sever lower abdominal pain, Hx of
the same event are all risk factors for testicular torsion.
(ID med.)
9. The most important way to prevent disease transmission b/w patients
and health workers is:
wear gloves for all patients.
wearing a mask.
needle container.
(Orthopedics)
10. Colle’s fracture:
distal end of the radius.
scaphoid fracture.
GOOD LUCK
GOOD LUCK
(Orthopedics)
11. A child fell on an out-stretched hand and flexed elbow, exam
showed swelling around the elbow with no radial pulse, best
management:
closed reduction.
open reduction.
(Medicine)
12. A patient having an IV line developed an infection, what is the most
important source?
infected IVF.
bactermia.
The most common site of infection following a line insertion is the entry
site.
(Medicine)
13. Most common association with acanthosis negricans (one):
hodgkin lyumphoma.
non-hodgkin lymphoma.
internal malignancy.
DM.
insulin resistance.
GOOD LUCK
GOOD LUCK
(Medicine)
14. Xanthoma:
on lateral aspect of the upper eyelid.
hard plaque.
around arterioles.
deposited in dermis.
They are usually soft plaques that are located in the dermis at the
inner aspect of the upper eyelid.
(Surgery)
15. Patient suspected of having brain abscess, the most important q. in
the history is:
frontal sinusitis.
ear discharge.
head injury.
bronchioctasis.
Hx. of vomiting.
(Medicine)
16. The following are true about H. Pylori except:
related to gastric outlet incontinence.
GOOD LUCK
GOOD LUCK
(OB/GYNE)
17. 60 Y/O lady on OCP 21 days a month having recurrent vaginal
bleeding (spotting) after the stop of estrogen, best Tx:
endometrial Bx.
add progestone.
stop estrogen.
(OB/GYNE)
18. A post transvaginal hysterectomy having vaginal urine dripping
during micturition Dx:
vesicovaginal fistula.
urethrovaginal fistula.
ureterovaginal fistula.
(OB/GYNE)
19. Most common site of gonococcus infection in females in:
cervix.
posterior fornix.
urethra.
The first place this bacterium infects is usually the columnar epithelium
of the urethra and endocervix. Non-genital sites in which it thrives are
in the rectum, oropharynx and the conjunctivae. The vulva and vagina
are usually spared because they are lined by stratified epithelial cells.
(OB/GYNE)
20. Post D&C the most common site of perforation is the:
the fundus.
cervix.
GOOD LUCK
(Medicine)
21. Regarding typhoid fever, all are true except:
fever and red spots appear on the same time.
Rash only occur in 1/3 of the patient and usually appear in the 2ed
week of infection.
(Medicine)
22. High output HF causes includes all except:
anemia.
MR.
AV fistula.
paget’s disease.
(OB/GYNE)
23. One of the following is a known cause of polyhydraminos:
maternal diabetes insipidus.
duodenal atresia.
renal agenesis.
(Medicine)
24. The differentiating feature of chron’s disease from ulcerative colitis
is:
it affects the ileum.
granuloma.
crypt abscess.
Hx of smoking.
GOOD LUCK
25. MI with premature ventricular contractions, the best Tx:
digoxin.
lidocaine.
quindine.
(Medicine)
26. A middle aged man having black spots on his thigh for years, it is
starting to become more black with bloody discharge, the best
management is to:
wide excision.
incisional Bx.
cryotherapy.
radiotherapy.
immunotherapy.
(OB/GYNE)
27. A 34wk GA lady presented with vaginal bleeding of an amount
more of that of her normal cycle.
O/E utrine contracts every 4 min, bulged membrane, the cervix is 3
cm dilated, fetus is in a high transverse lie and the placenta is on the
posterior fundus.
US showed translucency behind the placenta and the CTG showed
FHR of 170, the best line of management is:
C/S immediately.
give oxytocin.
aminocsthesis.
GOOD LUCK
GOOD LUCK
(OB/GYNE)
28. It is C/I to stop preterm delivery in the following condition:
aminochoronitis.
placental abruption.
preeclampsia.
a & b.
(OB/GYNE)
29. PPH happens more commonly with:
multiple pregnancies.
anaemia.
preterm delivery.
(OB/GYNE)
30. Before you start instrumental delivery it is important to check if there
is:
face presentation.
CPD.
breech presentation.
cord prolapse.
(OB/GYNE)
31. In occipitoposterior malpositioning of the fetal head, all of the
following are true except:
10% if all vertex deliveries.
presentation.
android pelvis is a predisposing factor.
GOOD LUCK
GOOD LUCK
(Family medicine)
32. Important tools for listening to a patient include:
using tools for asking.
imagination.
a sense of humor.
(Medicine)
33. The mechanism of action of ASA:
inhibition of the platlet cyclo-oxygenase.
(Medicine)
34. The mechanism of action of heparin:
activation of antithrombin III.
(Medicine)
35. One of the major factors causing physiological hypoxemia is:
ventilation-perfusion mismatch.
GOOD LUCK
GOOD LUCK
September 2003
(MHT – 2008)
(Ortho.)
1- 20 years old male presented with volar wrist injury with median nerve
involvement, what is the clinical picture:
a. Wrist drop.
b. Claw hand.
c. Sensory loss only.
d. Inability to oppose thumb towards fingers.
e. No metacarpophalangeal joint flexion.
Both ulnar and median nerves provide sensory and motor innervations to the
hand, with median narve supplying the medial part including the thenar muscles
to the 3rd digit, and the ulnar on the other two lateral. Injury at the wrist involving
radial nerve will cause wrist drop, if ulnar nerve is effected it results in the
characteristic claw hand.
(med.)
2- A 25 years old male with 3 days Hx of swelling and arthralgia of knees
joint. A day later,it involved the Rt wrist also, there is Hx of travel to India.
Physical examination reveled, Temperture 39, tender joints with swelling.
Aspiration was done for knee joint it gave 50 cc turbid fluid with gram –ve
cocci; what is the causative organism:
a. Brucella.
b. Staph. aureus.
c. Strept pyogen.
d. Strept pneumonia.
e. Niceria gonoria.
(ophth.)
3- Anterior uveitis is a character of the following except:
a. R.A.
b. Sarcoidosis.
c. Behcet disease.
d. Riter's syndrome.
e. Ankylosing spondolitis.
GOOD LUCK
uveitis): idiopathic, seronegative
syndrome, Ankylosing spondolitis), IBD,
disease(e.g. Sarcoidosis), infection(e.g.
- 15 -
GOOD LUCK
gonococal, syphilis, toxoplasmosis, brucellosis, T.B.), Behcet disease. Eye
involvement of R.A. episcleritis, scleritis, keratoconjunctivitis.
(ophth.)
4- A 30 years old male present to E.R. complaining of visual deterioration for
3 days of Rt. Eye followed by light preception, the least cause is:
a. Retinal detachment.
b. Central retinal arterial embolism.
c. Vitreous hemorrhage.
d. Retro-orbital neuritis.
e. Retinitis pigmentation.
(I don’t know)
(med.)
5- A 50 years old patient come with a Hx. Of wt. loss, palpitation, cold
preference and firm neck selling, the diagnosis is:
a. Simple goiter.
b. Graves.
c. Toxic nodular goiter.
d. Parathyroid adenoma.
e. Thyroiditis.
(gyne.)
6- A 25 years old female patient who is with 2ry amenorrhea, her prolactin
level is 400 ng/ml. the probability to have pituitary prolactin secrecting
adenoma is:
a. <25.
b. 25-49
c. 50-74
d. 75-85
e. >85
Prolactin levels in excess of 200 ng/mL are not observed except in the case of
prolactin-secreting pituitary adenoma (prolactinoma). In 50 % of those having high
prolactin levels there is radiological changes in the sella turcica
GOOD LUCK
GOOD LUCK
(med.)
7- 55 years old male patient presented with cough for 10 years which did not
bother him much, it is productive of mucoid and purulent sputum
alternatively, Hx of excessive smoking for 23 years. He is obese 123 kg. He
was wheezing during talking with you. On examination you find rhonchi
allover his chest, the most probable diagnosis is:
a. Chronic bronchitis.
b. Emphysema.
c. Pneumothorax.
d. Cystic fibrosis.
e. Bronchiactasis.
Cough productive of sputum on most days for at least 3 months of the year for
more than 1year is the symptomatic definition of Chronic bronchitis(COPD).
Smoking is it's dominant causal agent, frequent infective exacerbation occur giving
purulent sputum, there may be wheeze or quiet breath sounds on examination.
Cystic fibrosis is an Autosomal recessive condition where patient presents with
respiratory symptoms since early life. It is the most common cause of
bronchiactasis.
(med.)
8- A 28 years old female. Presented complaining of fleeting arthralgia for
days, has tender swelling of her Rt knee. WBC=9.8, ESR=80, Rh F= -ve,
VDRL= +ve and has 19 to 20 RBC in her urine sample. The next step will be:
a. ASO titer.
b. Blood culture.
c. U/S of the kidney.
d. Double strand DNA.
e. C-reactive protein.
(med.)
9- A 48 years old female with long standing infection present with
bradycardia, your management with be:
a. I.V. fluid
b. Atropine.
c. Dopamine
d. …….
GOOD LUCK
(I don’t know)
GOOD LUCK
(surg.)
10- Indication for valve replacement in infective endocarditis include all
exapt:
a. Viral endocarditis.
b. Resistant bacterial endocarditis.
c. Fungal endocarditis.
d. Aortic valve regurgitation.
e. C.H.F.
(surg.)*
11- 50 yr old female noticed firm neck swelling with hx of palpitations and weight
loss, your diagnosis is:-
a. Simple goiter
b. Toxic nodular goiter
c. Parathyroid adenoma
d. thyroditis
(med.)
12- A 33 year Saudi male complaining from lower back pain and
considerable morning stiffness. X-ray showed sclerosis joint. Other criterion
of this disease are all the following except:
e. Common in male.
f. –ve Rh F.
g. No subcutaneous nodules.
h. Aortic complications.
(I don’t know)
The features presented: young, male, lower back pain, morning stiffness, sclerosis
of sacroiliac joint, other association include;
Thoracic excursion decreased, chest pain, hip & knee involvement,
enthesitides of calcanea; tibial; ischial tuberosities or planter fascia, crohn's/UC,
psoriform rashes, amyloid, carditis, iritis, recurrent sterile urethritis, aortic valve
diseas.
GOOD LUCK
(pedia.)
13- The child can walk without support in:
a. 6 months
b. 9 months
c. 15 months
d. 18 month
12 months walk with one hand held, 15 months independently and takes a step up
at 18 months.
(Primary care)
14- In PHC which statement is correct:
a. Use less lab. techniques.
b. Examine each patient completely.
c. Write prescription as patient remained.
d. Reassurance of patient only at tertiary Hospital.
(ortho.)
15- Flexion, adduction, and internal rotation is:
a. Anterior hip dislocation.
b. posterior hip dislocation.
(ortho.)
16- 32 year old Egyptian male patient came with open tibial fracture what is
the appropriate medication:
a. Gentamycin.
b. Penicillin, Gentamycin and 3rd generation Cephlosporin.
c. Acetazo….
d. Acetazo…+ Gentamycin.
e. Ciprofloxacin + Gentamycin
Cefazolin for all grade I and II open fractures, Gentamycin is added for all grade III
as well as contaminated wound, penicillin required in farm injuries for clostridial
coverage.
(Physiology)
17- Forced vital capacity:
a. Volume of gas that can be expelled after inspiration in one minute.
b. Volume of gas that can be expelled in the 1st second.
c. Volume of gas that can be expelled after maximal inspiration.
d. Maximal air flow rate in FVC.
GOOD LUCK
e. Maximal air flow in 1 second.
GOOD LUCK
Volume of gas that can be expelled in the 1st second of forced vital capacity is
FEV1 forced expiratory volume in 1seconed.
Volume of gas that can be expelled after maximal inspiration is VC vital capacity.
FVC is the same as VC but more forceful and rapid.
(med.)
18- Within 6 hours after attending a dinner party, 10 participants developed
sever N/V, abdominal cramp and diarrhea. Most of them resolved
spontaneously. Few were admitted for correction of dehydration. The most
probable cause is:
a. Salmonella food poisoning.
b. Botulism.
c. Staphylococcal food poisoning.
d. Giardiasis.
e. Clostridium perfringes food poisoning.
(Med.)
19- 38 years old female, her thyroid F.N.A showed follicular neoplasm. What
of the following suggestion?
a. Increase T3 and T4.
b. Cold nodule on scan.
c. Lymphadenopathy.
d. Tonsillar radiation.
The diagnosis of follicular thyroid carcinoma usually occurs during the evaluation
of a cold thyroid nodule. Fine needle aspiration (FNA) is the diagnostic tool of
choice in evaluating thyroid nodules. These tumors are more typically uninodular
and spread to lymph nodes is uncommon. There may be hyperfunctioning
metastases. Radiation to the neck is a risk factor (but the term ,Tonsillar radiation, was
not quit clear in the question).
(med.)
20- In DKA, all the following are true except:
a. Increase of corticosteroid, glucagon and G.H.
b. Body water deficit is 4 to 6 L
(I don’t know)
GOOD LUCK
DKA is a complex disordered metabolic state characterized by hyperglycemia,
acidosis, and ketonuria. DKA usually occurs as a consequence of absolute or
relative insulin deficiency that is accompanied by an increase in counter-regulatory
hormones (ie, glucagon, cortisol, growth hormone, epinephrine). This type of
hormonal imbalance enhances hepatic gluconeogenesis, glycogenolysis, and
lipolysis Hyperglycemia usually exceeds the renal threshold of glucose absorption
and results in significant glycosuria. Consequently, water loss in the urine is
increased due to osmotic diuresis induced by glycosuria. This incidence of
increased water loss results in severe dehydration, thirst, tissue hypoperfusion,
and, possibly, lactic acidosis.Typical free water loss in DKA is approximately 6
liters or nearly 100 mL/kg of body weight. The initial half of this amount is derived
from intracellular fluid and precedes signs of dehydration, while the other half is
from extracellular fluid and is responsible for signs of dehydration.
(please read about DKA)
(med.)
21- Asthma after 40 years old. What is true?:
a. Could be psychological.
b. Eosinophiles are increased significantly.
c. Peak expiratory value change from night to day.
d. Oral steroid change the peak expiratory value significantly.
(med.)
22- Old age female presents with morning stiffness, on examination there is
distal interphalangeal joint enlargement. What is this swelling called:
a. Sigmoid.
b. Hebreden.
c. Bouchar.
d. Synovial swelling.
Heberden's nodes are deformity caused by marginal osteophytes which lie at the
base of the distal phalanx. Less commonly, the proximal may be involved and here
it is called Bouchar's nodes.
(med.)
23- The following are characteristics features of brucellosis except:
a. Lymphadenopathy
b. Hepatomeglly.
c. Splenomegally.
d. Diarrhea.
GOOD LUCK
e. Backache.
GOOD LUCK
Other symptoms and signs include:
Fever, sweating, weakness, headache, anorexia, pain in limbs and back, rigors,
joint pain, spinal tenderness.
(Psych.)
24- Good prognosis factors in schizophrenia are all the following, except:
a. Good premorbid adjustment.
b. Acute onset.
c. Male.
d. Family hx. Of mood disorder.
(Psych.)
25- Criteria of major depressive illness:
a. Late morning awaking.
b. Hallucination with flight of ideas.
c. High self-steam.
d. Over eating.
e. Decrease of eye contact in conversation.
GOOD LUCK
Children may fail to make expected weight (3) Significant weight loss
gain rather than losing weight. when not dieting, or weight
gain. or decrease or increase
in appetite nearly every day
GOOD LUCK
Similar to adults (4) Insomnia or hypersomnia
nearly every day
Concomitant with mood change, (5) Psychomotor agitation or
hyperactive behavior may be observed. retardation nearly every day
Disengagement from peer play, school (6) Fatigue or loss of energy
refusal, or frequent school absences may nearly every day
be symptoms of fatigue.
Child may present with self-depreciation (7) Feeling of worthlessness or
(e.g., "I'm stupid," "I'm a retard"). excessive or inappropriate
guilt
Problems with attention and concentration (8) Diminished ability to think
or concentrate, or
indecisiveness, nearly every
day
There may be additional nonverbal cues for (9) Recurrent thoughts of
potentially suicidal behavior. death, recurrent suicidal
ideation, or a suicide attempt
or committing suicide
Same as adults B. Symptoms do not meet the
criteria for mixed bipolar
disorder.
Clinically significant impairment of social or C. Symptoms cause clinically
school functioning is present. Adolescents significant distress or
also may have occupational dysfunction. impairment in social,
occupational, or other
important areas of
functioning.
Similar to adults D. Symptoms are not directly
caused by a substance or a
general medical condition
Psychotic symptoms in severe major E. Symptoms are not caused by
depression, if present, are more often bereavement, the symptoms
auditory hallucinations (usually criticizing persist for longer than two
the patient) than delusions. months or are characterized
by marked functional
impairment
GOOD LUCK
(Surg.)
GOOD LUCK
26- Gastric lavage is contraindicated:
a. Aspirin.
b. Cleaning solution.
c. Vitamin E.
d. ….bean.
(I don’t know)
(primary care)
a. Inform him directly after confirm the diagnosis regardless his wishes.
b. Only the patient family should be informed.
c. 50% survival rate should be calculated as recent study and discussed with the
patient.
d. This responsibility should be conducted by the social worker.
e. Informed the patient according to his morals, knowledge and psychiatric conditions.
Rules
• Time & place • Honesty • As much as much pt want
• Never give specific time period • Do not remove all hopes
• Confidentiality • Autonomy • Follow up
GOOD LUCK
(med.)
GOOD LUCK
29- A 36 years old man, obese. Recently, developed polyuria, polydepsia and
weight loss. Urine analysis showed glucosuria and ketone. FBS is 280 mg/dl.
The best initial therapy is:
a. Intermitted I.M. insulin injection till stabe.
b. NPH or Lenti insulin 30 units daily + diabetic diet.
c. Sulphonylurea + D.D.
d. Metformin
The most common indication for insulin therapy in type 2 diabetes is failure to
achieve glycemic control with diet, exercise, and oral medications.
Insulin replacement is also needed if the patient develops signs of glucose toxicity.
Occasionally the physician may order an IM insulin injection in order to
increase the absorption rate of the insulin
o REGULAR INSULIN is the ONLY insulin that shall be given IM
GOOD LUCK
GOOD LUCK
*-Fasting plasma glucose goal is 90 to 130 mg per dL (5 to 7.2 mmol per L), preprandial
goal is less than 140 mg per dL (7.8 mmol per L), and postprandial goal is less than 180
mg per dL to achieve an A1C of 7 percent. A1C goals should be individualized
GOOD LUCK
)
GOOD LUCK
(med.)
30- Pulmonary stenosis:
a. Commonest lesion in turner's syndrome.
b. P2 is loud indicates sever stenosis.
c. Ejection click means it is valvular.
d. All of the above.
(I don’t know)
In valvular PS, auscultation reveals a normal S1 and a widely split S2, with a soft
and delayed P2. Valvular PS typically causes a systolic crescendo-decrescendo
ejection murmur in the left upper sternal border that increases with inspiration and
radiates diffusely.
In patients with pliable valve leaflets, a systolic ejection click may precede the
murmur, distinguished from aortic ejection sounds by its increased intensity on
expiration and softening on inspiration
(pedia.)
31- cardiac congenital heart disease in child, all true except:
a. 4-5%
b. VSD is the commonest.
c. ASD patient should not play a competition.
d. …….
GOOD LUCK
Mucopolysaccharidoses
GOOD LUCK
VSDs are the most common congenital heart defects encountered after bicuspid
aortic valves.
Some children with ASDs have poor weight gain, they remain somewhat small,
and they may have exertional dyspnea or frequent upper respiratory tract
infections, but generally have no restrictions on their activity
(gyne.)
32- The most frequent complication of cesarian hysterectomy is:
a. Pelvic cellulites.
b. Pulmonary embolism.
c. Bladder injury.
d. Hemorrhage.
e. Ureteral injuries.
(gyen)
33- Secondary amenorrhea:
a. Part of Sheehan syndrome.
b. Commonly associated with turner syndrome.
c. Always pathological.
d. May be due to gonadal agenesis.
e. It is rare to be gonaal agenesis.
GOOD LUCK
X chromosome (45,X gonadal dysgenesis). Amenorrhea occurs because the
ovaries are replaced with fibrous tissue and do not produce much estrogen.
GOOD LUCK
Gonadal dysgenesis — In young women with primary amenorrhea, the single
most common cause is primary ovarian failure due to gonadal dysgenesis.
(med.)
34- A 14 years old boy with type 1 D.M. presented in coma. His blood
glucose level is 33 mmol/l. Na is 142 mmol/l, K is 5.5 mmol/l, bicarb is 10
mmol/l. the following are true except :
a. The initial Rx. Should be I.V. normal saline 3 l/hour for 1-2 hours
b. I.V. insulin loading dose 1 u/kg is necessary.
c. I.V. Na bicarbonate could be given if pH is 7 or less.
d. Hyprephosphatemia can occur during trement.
e. Hyperchloremia can occur during treatment
(I don’t know)
In DKA Serum potassium levels initially are high or within the reference range due
to the extracellular shift of potassium in exchange of hydrogen, which is
accumulated in acidosis, in spite of severely depleted total body potassium.
The serum sodium level usually is low.
The serum chloride levels and phosphorus levels always are low. Hypoglycemia
and/or hypokalemia may develop with correction of ketoacidosis
References:
1. Kumar.
2. Danish
3. Clinical examination, Talley.
4. Oxford hand book of clinical medicin.
5. Mont reid
6. Up to date
7. E-medicein
GOOD LUCK
GOOD LUCK
(Continue)
September 2003
(HAK, FHM – 2008)
Med.
35 - 82 y/o female presented to ER in confusion with hypotension.
BP was 70/20, P=160/min, rectal T 37.7ºC. The most likely of the
following would suggest sepsis as a cause of hypotension is:
a- Low systemic vascular resistance & high cardiac output.
b- High systemic vascular resistance & low cardiac output.
c- Pulmonary capillary wedge pressure less than 26.
d- PH is less than 7.2 .
e- Serum lactate dehydrogenase more than 22.
Pedia.
36 - Which of the following vaccines must not be given to a
household contact with immunodeficiency child :
a- MMR.
b- BCG.
c- Influenza B.
d- Oral polio .
e- Hepatitis.
GOOD LUCK
GOOD LUCK
Pedia.
37 - Term baby born to a mother who developed chickenpox 7
days before delivery . The baby is a symptomatic. Which is true :
Family med.
38 - Definition of TRUE NEGATIVE. (Review FAMCO)
- Def. of true negative: negative results that come back actually
representing the absence of the disease.
Surg.
39 - 55 y/o presented with bleeding. On ex. found to have external
hemorrhoids. One is true:
a- Advice for removal of these hemorrhoids.
b- Do rigid sigmoidoscopy.
c- Ask him to go home & visit after 6 months.
d- Do barium enema.
GOOD LUCK
GOOD LUCK
*Hemorrhoids : check Hb if bleeding is prolonged or heavy .
Examine abdomen to exclude other lesions. Digital rectal
examination.
Sigmoidoscopy to exclude other lesions. Proctoscopy to confirm
presence of piles.
Med.
40 - 42 y/o female presented with 5 months Hx of N, V & malaise.
Na is low, Cr is high, Glucose is 2.7 mmol/L & HCO3 is 10.
a- hypothyroidism.
b- Addison's disease .
c- hypervolemia because of the vomiting .
d- pheochromocytoma.
e- SIADH.
Med.
41 - 55 y/o female presented to ER because her family noticed
skin discoloration. Has Hx of 5 kg loss over 3 weeks. Her medical
Hx is –ve apart from vitiligo. Her examination is within normal
except for scleral icterus & skin jaundice. Her Ix : WBC 2500 ,Plt
70000, MCV 106, Hct 17, Retics count 15, T.bil 3, which of the
following test will be more associated with the syndrome she
has:
a- Chromosomal kariotype of bone marrow.
b- Antiparietal cells antibodies.
c- Extrahepatic biliary obstruction .
d- Decrease gastric fluid .
GOOD LUCK
be conducted are either:
GOOD LUCK
Smooth muscle antibody(SMA) , which is +ve in chronic active
hepatitis 40-90%,1ry biliary cirrhosis 30-70 %, idiopathic cirrhosis
25-30%.
Or mitochondrial autoantibodies (AMA) , which is +ve in 1ry
biliary cirrhosis 60-90 % , chronic active hepatitis 25-60% ,
idiopathic cirrhosis 25-30%.
*Gastric parietal cells antibody is usually associated with
pernicious anaemia & atrophic gastritis.
Surg.
42 - What is the most common site for indirect inguinal hernia :
a- Anterolateral.
b- Posterolateral.
c- Anteromedial.
d- Posteromedial.
e- Any where.
Ped.
43- Which one of the following component causes contact
dermatitis in children?
a- Citric acid
b- Cinnamon
c- … (name of very strange tree which is very unrecognizable)
d- … (name of very strange tree which is very unrecognizable)
GOOD LUCK
clothing materials (elastic or latex compounds).
GOOD LUCK
Hematology
44- Which drug can be givin to G6PD patient?
a- ASA
b- Sulphonamide.
c- Nitrofurantoin.
d- Chloroquine.
Med
45- Radiological features of Miliary TB?
a- Sparing lung apices.
b- …
c- Septal line.
d- No glandular enlargement
e- Small cavity.
Surg
46- Conscious with multiple trauma patient. Your priority is:
a-intubate the patient
b-peritoneal lavage then insert IV.
c-assess airway, breathing & BP.
d-insert IV line then send blood for matching.
GOOD LUCK
GOOD LUCK
Surg
47- 30 years old man with long history of Crohn’s disease.
Indication of surgery is:
a-internal fistula
b-external fístula
c-intestinal obsturction
d-megacolon syndrome.
Med.
48- Heparinization includes all except:
-increase PT
-increase PTT
-Anti inflammatory.
- open potential collateral vessels
Radiology
49- Filling defect in IVP & hypoechoic mass in US:
-Blood clots
-Tumer
-Uric acid stones.
-… Papilla!!
The Q is not clear!! Anyway another similar Q from Sep 2004.
GOOD LUCK
GOOD LUCK
IVP study done for a male & showed a filling defect in the renal
pelvis non-radio opaque. U/S shows echogenic structure &
hyperacustic shadow. The most likely diagnosis is:
a. Blood clot
b. Tumor
c. Uric acid stone
d. ???
Stones cause hyperacustic shadows.
All types of renal calculi are radiopaque except urate
stones (5% of all stones)
Med
51- Acute suppurative cholangitis. All except:
-Dangerous disease result from concurrent biliary infection &
obstruction.
-Jaundice.
-Increase Serum amylase.
-Increase SGOT & serum ALP
-Hypotension & mental confusion in severe cases.
GOOD LUCK
right upper quadrant pain, and jaundice — occurs in only 50 to
GOOD LUCK
75 percent of patients with acute cholangitis. Confusion and
hypotension can occur in patients with suppurative cholangitis,
producing Reynold's pentad, which is associated with significant
morbidity and mortality. Hypotension may be the only presenting
symptom in elderly patients or those on corticosteroids, while
septic shock in severe cases can lead to multiorgan failure.
Laboratory tests — Routine laboratory tests typically reveal an
elevated white blood cell count with neutrophil predominance,
and a cholestatic pattern of liver function test abnormalities with
elevations in the serum alkaline phosphatase, gammaglutamyl
transpeptidase (GGT), and bilirubin (predominantly conjugated)
concentration. Serum amylase can be increased to three to four
times normal, suggesting an associated pancreatitis.
However, a pattern of acute hepatocyte necrosis can be seen in
which the aminotransferases may be as high as 1000 IU/L. This
pattern reflects microabscess formation in the liver.
Treatment — The mainstays of therapy are antibiotics and
establishment of biliary drainage. Other general measures
include fluids to maintain urine output, correction of
coagulopathy, and frequent monitoring of vital signs for evidence
of sepsis. In cases of suspected sepsis, monitoring for
multiorgan failure from endotoxemia is essential.
Community
52- Definition of the following. (All with its right definition) except:
-prevalence is …
-infant mortality rate is ….
-incidence & prevalence are the same.
-Incidence is …
Psychiatry
53- Severe postpartum depression mostly associated with:
-Decrease socioeconomic class.
-Emotional separation between the patient & his mother.
-Past Hx of depression.
-1st birth delivery.
-Poor wt gain during pregnancy.
GOOD LUCK
Stressful life events in the previous 12 months/ Lack of perceived
GOOD LUCK
social support from family and friends for the pregnancy / Lack of
emotional and financial support from the partner / Living without
a partner/ Unplanned pregnancy / Having contemplated
terminating the current pregnancy / Previous miscarriage/
Family psychiatric history/ A poor relationship with one's own
mother/ Not breastfeeding/ Unemployment in the mother (no job
to return to) or in the head of household/ A lifetime history of
depression in the husband or partner/ Child-care related
stressors/ Sick leave during pregnancy related to hyperemesis,
uterine irritability, or psychiatric disorder/ High number of visits to
prenatal clinic/ A congenitally malformed infant/ Personality
factors (high neuroticism and high introversion)/ Personal history
of bipolar disorder.
Surg
55- 45 years old lady presents with bloody nipple discharge. Most
likely Dx:
-Breast ca.
-Fibroadenoma
-Ductal Papilloma.
-Ducat ectasia.
Surg
56- A 82 years old patient present with urinary retension. What is
the most proper treatment in ER?
-Insert Folly’s Cath then send to clinic.
-Insert Folly’s Cath then send to home.
-O.R. for prostatectomy.
-Admission, Investigation, then do cystoscope or TRUP.
GOOD LUCK
GOOD LUCK
Q is not complete.. as I remember it was in our exam (Oct 2007),
acute urinary retention. But unfortunately I don’t remember the
choices
Radiology
57- Air Bronchogram is characteristic feature of:
-Pulmonary edema.
-HMD= Hyaline membrane disease.
-Lobar Pneumonia.
-Lung Granuloma.
Psych*
58- Characteristic feature of major depressive illness is:
A. Late morning awakening.
B. Hallucination and flight of ideas.
C. High self-esteem.
D. Over-eating.
E. Decreased eye contact during conversation.
For me, I’ll choose decrease eye contact, coz although over eating is a
feature of major depressive disease, but it is not consistent
GOOD LUCK
Loss of interest can be in peer play or (2) Markedly diminished
school activities. interest or pleasure in
almost all activities most of
the day, nearly every day
GOOD LUCK
Children may fail to make expected (3) Significant weight loss
weight gain rather than losing weight. when not dieting, or weight
gain. or decrease or
increase in appetite nearly
every day
Similar to adults (4) Insomnia or hypersomnia
nearly every day
Concomitant with mood change, (5) Psychomotor agitation or
hyperactive behavior may be observed. retardation nearly every day
Disengagement from peer play, school (6) Fatigue or loss of energy
refusal, or frequent school absences nearly every day
may be symptoms of fatigue.
Child may present with self-depreciation (7) Feeling of worthlessness
(e.g., "I'm stupid," "I'm a retard"). or excessive or
inappropriate guilt
Problems with attention and (8) Diminished ability to think
concentration or concentrate, or
indecisiveness, nearly every
day
GOOD LUCK
Psychotic symptoms in severe major E. Symptoms are not caused
depression, if present, are more often by bereavement, the
auditory hallucinations (usually symptoms persist for longer
GOOD LUCK
criticizing the patient) than delusions. than two months or are
characterized by marked
functional impairment
Pedia *
59- A child has croup after waking up of sleep; the differential
diagnosis includes all EXCEPT:-
- Pneumonia
- Forien body aspiration
- Tonsilitis
- Cystic Fibrosis
-!
OB/GYN
60- Which of the following doesn’t cause IUGR?
-Toxoplasmosis
-CMV.
-Rubella.
-Syphilis.
-HSV2.
OB/GYN
61- Action of O.C.P:
-Inhibition of estrogen then ovulation.
-Inhibition of prolactin then ovulation
-Inhibition of protozoa by changing the cervical mucosa.
-Inhibition of mid cycle gonadotropin then ovulation
-Inhibition of implantation of the embryo.
GOOD LUCK
GOOD LUCK
Other estrogenic mechanisms of action include suppression of
ovarian steroid production, due to suppression of gonadotropin
secretion, and a possible decrease in responsiveness of the
pituitary to gonadotropin-releasing hormone.
Progestin-related mechanisms also may contribute to the
contraceptive effect. These include:
* Effects on the endometrium, rendering it less suitable for
implantation
* Alterations in cervical mucus, which becomes less permeable
to penetration by sperm
* Impairment of normal tubal motility and peristalsis
Med *
62- Which of the following is not associated with phenytoin
toxicity?
- hirsutism
- osteomalacia
- ataxia
- osteoprosis
Med
63- Thyroid cancer associated with:
-Hyperthyroidism
-Hypothyroidism
-Euothyroid.
-Toxic Nodules.
Q is not clear!!!
Surg.
64- All of the followings are complications of laparoscopic
cholycystectomy except:
-Incisional hernia above the umbilicus.
-Persistent pneumo peritonitis.
-Bile leakage.
-Ascitis.
GOOD LUCK
GOOD LUCK
Surg.
65- Post lap chole patient presented with progressive Jaundice.
The most appropriate investigation is:
-ERCP.
-IV cholangiogram.
-…
OB/GYN:
66- The most common cause of Post Partum Hemorrhage is:
-Uterine Atony
-Multiple Pregnancy.
-Pre Eclampsia.
-…
GOOD LUCK
GOOD LUCK
September 2004
(AH – 2008)
(Urology)
2. An 80 year old gentleman presented to ER with Hx of
decreased urine stream, hesitancy, urgency & frequency. What
is the cause?
a. Stricture
b. Benign prostate hypertrophy
c. Narrowing of the external meatus
d. Urethral stone
e. ???
BPH is common in ages above 40 yrs (24% from 40-
60yrs & 40% if >60yrs old). It's associated with
frequency, urgency & decreased urinary stream.
Stricture & narrowing of the external meatus doesn't
cause decreased urinary stream
Uretheral stones causes severe colicky pain &
haematuria
(Urology)
3. IVP study done for a male & showed a filling defect in the renal
pelvis non-radio opaque. U/S shows echogenic structure &
hyperacustic shadow. The most likely diagnosis is:
a. Blood clot
b. Tumor
c. Uric acid stone
d. ???
Stones cause hyperacustic shadows.
All types of renal calculi are radiopaque except urate
stones (5% of all stones)
GOOD LUCK
)
GOOD LUCK
(OB/GYN)
4. A 38year old lady with gonorrhea. Whereis the most likely site
for isolation of the organism?
a. Pharynx
b. Cervix
c. Urethra
d. Vagina
e. Posterior fornix
Gonorrhea causes vaginal discharge, dysurea &
intermenstrual bleeding
Diagnosis is by Gram stain & culture of a swab taken
from the urethra in males & the endocervix in females
showing the organism.
(Medicine)
5. Which of the following is the least likely to cause infective
endocarditis:
a. ASD
b. VSD
c. Tetrology of Fallot
d. PDA
50% of all endocarditis occurs on normal valves
Predisposing cardiac lesions:
i. Aortic/ mitral valve disease
ii. IV drug users in tricuspid valves
iii. Coarctation
iv. PDA
v. VSD (Fallot's Tetrad included)
vi. Prosthetic valves
(Medicine)
6. Which of the following is believed to reduce mortality in CHF?
a. Digitalis
b. Furosamide
c. Enalopril
d. Procaimide
e. Asprin
ACE Inhibitors, beta blockers & spironolactone
GOOD LUCK
decrease morbidity in CHF
)
GOOD LUCK
(Pediatrics)
7. A 15 year old boy came with Hx of yellowish discoloration of
sclera, vomiting & abdominal pain. Investigations: bilirubin 253
indirect bilirubin 93 albumin 38 (30-50) T.protein 78 (60-80) ALT
838 AST1005. What is the most likely diagnosis?
a. Infective hepatitis
b. Gilbert disease
c. Acute pancreatitis
d. Auto-immune hepatitis
e. Obstructive jaundice
Increased AST> ALT early in the course of the
disease with jaundice (increased bilirubin )
Gilbert's Disease is congenital hyperbilirubinemia with
normal liver enzymes & is not associated with vomiting
or abdominal pain
Acute pancreatitis causes a slight increase in liver
enzymes
Obstructive jaundice is most common in F>M who are
obese & old age
(Medicine)
8. Rheumatoid Arthritis:
a. Destruction in articular cartilage
b. M=F
c. No nodules
d. Any synovial joint
e. HLA DR4
A. is true plus destruction of bones
B. is false the M:F is 1:3
C. is false Nodules are present in elbows & lungs
D. is false because it doesn't affect the dorsal &
lumbar spines
E. is true but it also affects HLA DR1
(Medicine)
9. Pre-Renal Failure:
a. Casts
b. Urine Osm <400
c. Urine Na <20 mmol/L
d. Decreased water excretion
GOOD LUCK
e. Haematuria
GOOD LUCK
Casts are seen in interstitial nephritis &
glomerulonephritis which are intrinsic renal failure
Urine osm <400 in intrinsic renal failure but >500 in
pre-renal failure
Urine Na <200 mmol/L is in pre-renal failure if >200 it
is intrinsic renal failure
Decreased water excretion in all types of renal failure
Haematuria like a. in intrinsic & post renal failure
(Pediatrics)
10. Full term baby born with a birth weight of 3.8kg, developed
jaundice on 2nd day of life he is on brest feeding his Hb
180gm/L Direct Coomb's test –ve Indirect Coomb's test –ve
Total bilirubin 11gm/dl Indirect bilirubin 184mmol/L The
Diagnosis is:
a. Breast milk jaundice
b. Undiagnosed neonatal sepsis
c. Physiological jaundice
d. Due to minor antigen blood group incompatibility
e. ABO incompatibility
PSL Jaundice is the most common cause of jaundice
in FT Babies from 2-5 days while breast feeding
Breast milk jaundice & undiagnosed jaundice are
persistant jaundice beyond 14days
Minor Ag Blood group & ABO incompatability are
usually early onset jaundice (<24hrs) & have a +ve
coombs test
(Orthopedics)
11. A 32 year old female work as a file clerck she developed
sudden onset of low back pain moderate in severity for 3 days
duration when she was bending to pick up files. There is no
evidence of nerve root compression. What is the proper
action?
a. Bed rest for 7 days to 10 days
b. Traction
c. Narcotics analgesia
d. Early activity with return to work
e. CT scan for lumbosacaral vertebra
We treat the pain first because the patient has been
GOOD LUCK
suffering for the past 3days
GOOD LUCK
Bed rest not advisable. Returning to normal activities
as soon as possible is better than bed rest but can't be
done without proper analgesia
Traction is not indicated
In the question they said no evidence of nerve root
compression so CT is not nessesary
(Medicine - Surgery)
12. Patient with infective cyst incision & drainage was done,
dressing twice daily with gauze & saline. On the 3rd day post
I&D the patient developed nausea, confusion, hypotension &
exfoliate rash on hands & dark brown urine. The most
appropriate diagnosis is:
a. Necrotizing fasciatis
b. Drug reaction
c. Toxic shock syndrome
d. Clostridium difficile
TSS is caused by staph. Aureous wich is the most
common organism in infected wounds & skin
TSS causes shock, confusion, fever, rash with
desquamation, diarrhea, myalgia, increased CPK,
decreased platelets (associated with the use of
tampons)
Patient wasn't taking any drugs to have a drug
reaction
Necrotizing faciatis causes severe gangrene
(Medicine)
13. A 30 year old man with upper abdominal pain & dyspepsia.
Which of the following do not support Dx of PUD?
a. Hunger pain
b. Epigastric mass
c. Epigastric tenderness
d. Heart burn
e. Haematemesis
Signs & Symptoms of PUD are tender epigastric pain
related to hunger, eating specific foods, time of day,
dyspepsia, heart burn, retrosternal pain, losing weight,
anorexia, anemia, melena or haematemesis
GOOD LUCK
(Medicine)
14. A 80 year old lady with RA had swelling of the distal
interphlangeal joints. What is the name of this lesson?
a. Hebarden's nodules
They are swelling of DIP & indicates osteoarthritis
(OB/GYN)
15. The most frequent complication associated with caesarian
hysterectomy is:
a. Pelvic cellulites
b. Pulmonary embolism
c. Bladder injury
d. Haemorrhage
e. Uretheral injury
The most common complication is haemorrhage
especially bleeding from the infundibulo-pelvic or
utero-ovarian pedicle or the vaginal cuff
The most serious complication is injury to the ureters
(Emergency Medicine)
16. A 12 year old female brought by her mother to ER after
ingestion of unknown number of paracetamol tablets.
Clinically she is stable. Blood paracetamol level suggest
toxicity. The most appropriate treatment is:
a. N-acetylcestine
IV infusion: 150mg/kg in 200ml 5%dex over 15mins
then 50mg/kg in 500ml 5%dex over 4hrs then finally
2oomg/kg in 1L 5%dex over 16hrs
(Pediatrics)
17. A 5 year old boy brought to the ER by his mother complaining
of drooling saliva, inability to drink & eat. On examination there
was a congested larynx. The most appropriate diagnosis is:
a. Viral pneumonia
b. Croups
c. Acute epiglottitis
d. Bacterial pneumonia
e. Bronchiolithitis
GOOD LUCK
It occurs at any age, rapid onset, causes drooling of
saliva & inability to drink or eat, no cough & you could
see the congested larynx
Croup has a slow onset, occurs at ages <4yrs with a
barking cough & the ability to swallow fluids
(Surgery)
18. A 45 year old female came with nipple discharge containing
blood. The most likely cause is:
a. Duct papilloma
b. Duct ectasia
c. Breast abcess
d. Fibroadinoma
e. Fat necrosis of breast
Bloody discharge is more likely to be a sign of
intraductal papilloma or a neoplasm
Green/ yellow/ brown discharge favours duct ectasia
Milky/ watery discharge a hormonal imbalance
(OB/GYN)
19. ? year old woman her menstrual period has stopped since 7
weeks. She was complaining of light bleedidng & discomfort.
She had +ve pregnancy test at home. The best test for her now
is:
a. B-HCG
b. Human prolactin
c. Progesterone
d. Esteriol
e. Prolactine
Home testing is sensitive to values of 25iu/L of B-HCG
At the hospital we have to quantitate B-HCG to rule
out/ in ectopic pregnancy as in the question
(Medicine)
20. All are recognized symptoms of IBS except:
a. Sense of incomplete defication
b. Loss of weight
c. Sense of abdominal distension
d. Rectal bleeding
GOOD LUCK
e. Passage of mucus per rectum
Rectal bleeding occurs in IBD (UC & Chron's)
GOOD LUCK
(ENT)
21. The most prominent symptom of acute otitis media is:
a. Pain
b. Hearing loss
c. Tinnitus
d. Discharge
e. Vertigo
AOM presents with rapid onset of pain, fever &
sometimes irritability, anorexia, or vomiting
In AOM drum bulging causes pain then purulent
discharge if it perforates
(OB/GYN)
22. One of the following increases the amniotic fluid:
a. Patient of diabetes insipidus
b. Duodenal atresia
c. Renal agenesis
d. Old primigravida
I'm not sure!!!!
(OB/GYN)
23. Before doing instrumental delivery you have to exclude:
a. Cord prolapse
b. Cranio-pelvic disproportion
c. Breech
d. Abruption placentae
To do an instrumental delivery the head must be
engaged; the membranes ruptured; the position of
head is known & the presentation suitable; there must
not be cephalo-pelvid disproportion
(OB/GYN)
24. Management of pre-eclampsia includes all except:
a. Bed rest
b. Diuretics
c. Hospitalization
d. Non-stress test
e. NSAID
Diuretics deplete the already reduced plasma volume
GOOD LUCK
& are especially contraindicated
GOOD LUCK
(OB/GYN)
25. Regarding menopause, one of these is a major health problem:
a. Cardiovascular disease
b. Depression
c. Osteoperosis
d. Endometrial carcinoma
The menopause accelerates bone loss which
predisposes to fracture of femur neck, radius &
vertebrae in later life
(Medicine)*
26. In moderate to severe asthmatic patient you find all except:
a. Decrease Po2 <60
b. PCO2 >60
c. HCO3 decreased
d. IV hydrocortisone relief after few hours
e. Dehydration
I'm not sure!!!!!
(Medicine)
27. A 45 year old presented with polyurea, urine analysis showed
glucosurea & -ve ketone FBS 14mmol. What is the best
management of this patient?
a. Intermediate IM insulin till stable
b. NPH or Lent insulin 30mg then diet
c. Sulphonylurea
d. Diabetic diet only
e. Metformin
In older patients the first approach is by diet only,
especially that he is not clearly into glucose toxicity
Tablet treatment for DM II are used in association with
dietary treatment when diet alone fails starting with
Metformin if no contraindications
GOOD LUCK
(Clinical pharmacology)
28. All of the following are side effects of furasomide except:
a. Hyperkalemia
b. Hypoglycemia
c. Bronchospasm
d. Haemolytic anemia
e. Pre-renal azotemia
Side effects of furasomide are hypotension,
hypokalemia, hyperglycemia, haemolytic anemia
(Medicine)
29. The most specific investigation for pulmonary embolism is:
a. Perfusion scan
b. X-ray chest
c. Ventilation scan
d. Pulmonary angiography
The recommended 1st line imaging modality is CT
pulmonary angiography
(Medicine)
30. All may cause increased BP except:
a. Obesity
b. High alcohol intake
c. Smoking
d. Gout
e. NSAID use
I'm not sure!!!!
(Medicine)
31. Polycystic renal disease is:
a. AD
b. AS
c. Sex-linked dominant
d. Sex-linked recessive
e. Autosomal dominant combined with…
There are two types the most common one is the adult
type which is Autosomal Dominant
The child type is recessive
GOOD LUCK
(Medicine)
32. A 62 year old male known to have BA. Hx for 1 month on
bronchodilator + beclomethasone had given thiophilline. Side
effects of thiophilline is:
a. GI upset
b. Diarrhea
c. Facial flushing
d. Cardiac arrhythmia
The most common side effects are cardiac arrhythmia,
anxiety, tremors, tachycardia & seizures
Always monitor ECG
(Medicine)
33. Patient with Hx of severe hypertension, normal creatinine, 4g
protein 24 hrs. right kidney 16cm & left kidney 7cm with…
suggesting of left renal artery stenosis. Next investigation:
a. Bilateral … renal angiography
b. Right percutanious biopsy
c. Left precutanious biopsy
d. Right open surgical biopsy
e. Bilateral renal vein determination
Renal angiography is the gold standard but done after
CT/MRI as it is invasive
(Medicine)
34. A 60 year old male presented with Hx of 2hrs chest pain ECG
showed ST elevation on V1-V4 with multiple PVC & ventricular
tachycardia. The management is:
a. Digoxin
b. Lidocane
c. Plavix & morphine
d. Amidarone
Treatment of MI is "MONA"
M=morphine, O=oxygen, N=nitro, A=asprin/antiplatelet
GOOD LUCK
(Surgery)
GOOD LUCK
35. A 30 year old male presented with Hx of chest pain & left side
shortness of breath BP 80/50. On examination left sided chest
hypes-resonanse. The diagnosis is:
a. Pneumonia with plural effusion
b. MI
c. Spontaneous pneumothorax
Its an easy question….. ☺
(Surgery)
36. All are signs & symptoms suggestive of acute appendicitis
except:
a. Vomiting
b. Anorexia
c. Paraumbalical pain shifting to right lower quadrent
d. Temp 38.1C
e. Sitting & leaning forward
Another easy question….. ☺ ☺
(Orthopedics)
37. In lumbar disc prolapse at L4-L5 the patient will have:
a. Pain at groin & front of thigh
b. Hypoesthesia around the knee
c. Weakness of dorsiflextion of foot
d. Absent ankle reflex
e. Fasciculation at calf muscle
Signs & symptoms of L4-L5 disk prolapse are: pain
from butt to lateral leg & dorsum of foot; sensory loss
of dorsum of foot & anterolat of lower leg; none of the
reflexes are lost;& diminished strait leg raising
(OB/GYN)
38. A 35 year old lady G4, P3+1 presented with 1 year Hx of
irregular, heavy menstrual bleeding. Physical examination was
normal. The most likely diagnosis is:
a. Nervous uterus
b. Early menopause
c. Dysmenorrheal with heavy bleeding
d. DUB=dysfunctional uterine bleeding
e. Endometriosis
Yet another easy question….. ☺ ☺ ☺
GOOD LUCK
(OB/GYN)
GOOD LUCK
39. A 20 year old married lady presented with HX of severe left
lower abdominal pain amenorrhea for 6 weeks. The most
appropriate investigation to rule out serious DDx is:
a. CBC
b. ESR
c. Pelvic US
d. Abdominal x-ray
e. Vaginal swab for culture & sensitivity
To rule out ectopic pregnancy…. It is a must!!
(Medicine)
40. Gastro-Esophageal Reflux Disease best diagnosed by:
a. History
b. Physical examination & per-rectal examination
c. History & barium meal
d. History & upper GI endoscopy
Because we have to rule out other impordant DDx like
oesophagitis, infection, duodenal or gastric ulcers,
cancers
(Clinical pharmacology)
41. All of them are renal complications of NSAIDs except:
a. Acute renal failure
b. Tubular acidosis
c. Interstitial nephritis
d. Upper GI bleeding
I'm not sure!!!
(Medicine)
42. A 26 year old female complaining of headache more severe in
the early morning mainly bitemporal, her past medical Hx is
unremarkable. She gave Hx of OCP use for 1 year.
Ophthalmoscope examination showed pappilledema but there
is no other neurological findings. The most probable diagnosis
is:
a. Optic neuritis
b. Benign intracranial hypertention
c. Encephalitis
d. Meningitis
e. Intracranial abscess
GOOD LUCK
GOOD LUCK
BIH headaches are typically present on waking up or
may awaken the patient. It could be accompanied by
other signs of increased ICP like vomiting,
papilledema, epilepsy, or mental change
(Medicine)
43. All can cause secondary hyperlipidemia except:
a. Hypothyroidism
b. Alcoholism
c. Nephrotic syndrome
d. Estrogen therapy
e. Hypertension
It's not a cause of 2ndry hyperlipedemia
(Pediatrics)
44. A 6 year old girl developed day time wetting for 2 days. She is
fully toilet trained. She is afebrile & dry for 4 years. The most
appropriate diagnostic measure is:
a. Bladder US
b. Examination of vaginal vault
c. Urine analysis & culture
d. Urine specific gravity
e. Voiding cysto-urethrography
I don't know this!!!!!!!
GOOD LUCK
(continue)
September 2004
(GHT – 2008)
(OB/GYN)
44) a 40 year old female complaining of dysurea, febrile, married for 20
years no previous history of UTI ,no urgency, frequency or hematurea
the diagnosis will be:
a) acute pylonephritis
b) subacute pylonphritis
c) vaginitis
d) cystitis
e) urethritis (non-gonorrhea)
The female with dysurea no fever its not pylonephritis, vaginitis is possible
especially if associated with discharge in cystitis you expect more urinary
symptoms and its common in females and immediately after marriage
(honeymoon cystitis){this is my personal opinion}
(OB/GYN)
45) A 30 year old female with history of vaginal hysterectomy with
anterior and posterior repair, is complaining of urine coming from the
vagina during micturation the diagnosis is:
a) Uretro-vaginal fistula
b) Urethro-vaginal fistula
c) Recto-vaginal fistula
The lady with the drippling from the vagina during urination has a urethro-
vaginal fistula because the bladder stores the urine and during voiding only
the urine passes from the bladder to urethra to be expelled so if there a
fistula in the urethra the urine will pass to the vagina during voiding only
which is the only time the urethra will contain urine. If there was a fistula
communicating with the bladder or ureter the patient would be continuously
drippling because these sites contain urine all the time.
(Medicine)
46) history of recurrent pneumonia, foul smelling sputum with blood,
clubbing :
a) Bronchiactasis
Clinical features of bronchiactasis is recuurent pneumonia because of the
dilated bronchi so there’s a reduction in the ability of the clearance of
secretions and pathogens from the airways. The sputum is copious and
could be foul smelling and the patients would have clubbing. A lung abcess
also causes clubbing and foul smelling sputum but if properly treated why
would it recur. COPD has frequent infective exacerbations but doesn’t
cause clubbing. Pneumonia is an acute process and no clubbing occurs.
GOOD LUCK
GOOD LUCK
(OB/GYN)
47) Trichomanas vaginalis all true except:
a) Generally STD
b) Causes cytological cervical discharge
c) Common in DM
d) Caused by protozoa
Trichomoniasis is a sexually transmitted protozoal infection. Causes a
yellow-green, malodorous, diffuse discharge in addition to dysurea,
frequency, pitechiae on vagina and cervix, irritated and tender vulva. Saline
(wet mount) will show motile flagellated organisms, WBCs and inflammatory
cells. Treatment 2 gm metronidazole single dose P.O. (same for pregnancy)
treat partner. Alternative is same drug 500 mg, BID for 7 days.
Candidiasis minimum white cheesy discharge, intense pruritis, dysurea
and dyspareunia. Comes in immunosuppressed(DM. AIDS), recent
antibiotic, pregnancy. Saline KOH will show hyphea and spores.
Treatment miconazole, clotrimazole, butoconazole, terocanazole
suppositories and/or cream for 1,3 or 7 days, or single dose of
fluconazole 150 mg po in single dose (during pregnancy topical
treatment only).
Bacterial vaginosis caused by gardenella vaginalis, mycobacteria
hominis and anaerobes. Causes a grey, thin, diffuse discharge and fishy
odor. Saline wetmount >20% clue cells (squamous epithelium dotted with
coccobacilli), pucity of WBCs and lactobacilli and a positive whiff test
(fishy odor upon adding KOH). No treatment for non pregnant
asymptomatic unless undergoing pelvic surgery, treatment by
metronidazole for 7 days oral or topical or clindamycin local. Routine
treatment for partner is not recommended
(Ophthalmology)
48) a 45 year old male presented to the ER with sudden headache,
blurriong of vision, excruciating eye pain and frequent vomiting:
a) Acute glaucoma
b) Acute conjunctivitis
c) Acute iritis
d) Episcleritis
e) Corneal ulceration
These are typical features of closed angle glucoma which presents acutely
with red painful eye, nausea and vomiting, halos around light, hazy cornea,
mid dilated non-reactive pupil and extremely high intraocular pressure.
Closed angle glucoma represents 5% of glucoma. The rest is open angle
glucoma which presents insidiously with bilateral (the previous was
unilateral), progressive loss of peripheral visual field. Iritis= anterior uveitis
presents with photophobia and ciliary flush (redness around the iris see
Toronto notes). Corneal ulcer presents with photophobia, foreign body
sensation and decreased visual acuity (if central). Episceritis is
asymptomatic may present with mild pain and red eye. Causes a sectroal or
GOOD LUCK
diffuse injection of vessels which is radially directed. Conjunctivits presents
GOOD LUCK
with red itchy eye, foreign body sensation, discharge and crusting of
eyelashes in the morning.
(Pediatrics)
49) a 5 year old boy presented to the ER with tonic clonic convulsions,
his father gave gistory of frequent febrile convulsions the most
appropriate anticonvulsant treatment:
a) Phenytoin
b) Diazepam
c) Clonazepam
st
1 line of management of seizures is diazepam (for purpose of abortion of
the attack).
(Community Medicine)
50) Incidence is ….
(Community Medicine)
51) Standard deviation is….
(Medicine)
52) Irritable bowel syndrome all EXCEPT
a) Abdominal distention
b) Mucous PR
c) Feeling of incomplete defecation
d) PR bleeding
Features of IBS: rome II criteria for IBS: at least 3 mounths (consecutive) of
abdominal pain with 2 out of the following 3: relief with defecation, change in
form of stool or change in frequency of stool. Symptoms that support the
diagnosis abnormal stool frequency, abnormal form, abnormal passage
(straining, urgency, sense of incomplete defecation), passage of mucous
and bloating or feeling of distention. Absence of alarming features which are
weight loss, nocturnal defecation, blood or pus in stool, fever, anemia and
abnormal gross findings on flexible sigmoidoscopy.
(Surgery)
53) Most common cause of surgical intervention in infallamtory bowel
disease
a) Crohn’s disease
b) Bleeding
GOOD LUCK
c) Fistula
d) Intestinal obstruction
GOOD LUCK
Most common indication of surgery in crohn’s disease is intestinal
obstruction
(Psychiatry)
54) a 20 year old lady thinks that she’s fat although her height and
weight are ok:
a) Bulimia
b) Aneroxia nervosa
c) Depression
Psychiatry typical features of aneroxia nervosa where the patient senses
that he or she is fat despite being thin. Bulimia is people who vomit what
they eat.
(Medicine)
55) Rgearding H. Pylori eradication:
a) Clarithromycin for 1 week
b) Bismuth, rantidine amoxil for 2 weeks
c) PPI 2 weeks , amxil or 1 week clarithromycin
Recommended treatment of H.pylori : eradication upon documentation of
infection is controversial since most will not have peptic ulcer or cancer. 1st
line PPI+ clarithromicin + amoxicillin or metronidazole (3 drugs, twice daily
for one week).
(Medicine)
56) one type of food is protective against colon cancer:
a) Vit. D
b) Fibers
Colon cancer the presumed environmental influence is high fat
consumption and low fiber consumption.
(Medicine)
57) A 34 year old male presented with right knee pain, swelling,
redness and fever for 2 days with no history of trauma, sore throat,
not other joint involvement, the most appropriate diagnosis is:
a) R.A.
b) Rh fever
c) Septic arthritis
d) Gout
Septic arthritis any acutely inflamed (red, hot and tender) joint must role out
septic arthritis. RA is multiple joints, symmetrical painful swelling over long
periods and is more in females. Gout usually affects older age groups and
GOOD LUCK
starts in first metatarsopharyngeal joint and its also usually red hot and
tender. Abscnce of URTI, cardiac features, chorea, emotional liability
GOOD LUCK
makes R. fever less likely (in which joint affection is usually involving large
joints and is migratory). To rule out septic arthritis joint aspiration is
required. (look at the table of joint aspiration in Toronto notes)
(Medicine)
58) A patients ECG showed anterior wall MI with PVCs he’s on
digoxin, warfarrin lasix what treatment would you like to add:
Patients with acute MI and PVC no treatment at all is given.
GOOD LUCK
March 2006
(AAF & FSSh – 2008)
(primary care)
1- Evidence based medicine :
a. Practice medicine as in the book
b. Practice according to the department policy
c. Practice according to Available scientific evidence
d. Practice according to Facility
e. Practice according to Latest published data
EBM is the use of current best evidence in making decisions about the care of the
individual patient. It means integrating individual clinical expertise with the best
available external clinical evidence from systematic researches.
(dermatology)
2- 45 y.o man, sudden eruption all over the body with palm and foot
involvement. Most likely Dx is:
a. Syphilis
b. Erythema multiforme “most probably”
c. Erythema nodosum
d. Fixed drug eruption ??
e. Pityriasis rosea
GOOD LUCK
subcutaneous fat and is frequently associated with fever, malaise, and
GOOD LUCK
joint pain and inflammation. It presents as tender red nodules on the shins
that are smooth and shiny.
fixed drug eruption are more common on the limbs than the trunk; the
hands and feet “not necessarily palms and soles”. Lesions may occur
around the mouth or the eyes. The genitals or inside the mouth may be
involved in association with skin lesions or on their own.. can be caused
by: acetaminophen, sulfonamide antibiotics, tetracycline, Phenobarbital,
phenolphthalein. Pityriasis rosea most often affects teenagers or young
adults. In most cases there are no other symptoms, but in some cases the
rash follows a few days after a upper respiratory viral infection. Herpes
viruses 6 and 7 have sometimes been associated with pityriasis rosea. It
begins with one large (2-5cm),oval herald patch, smaller secondary
multiple lesions appear within 1-2 weeks.
(medicine)
3- Causes of Secondary hyperlipidemia are all exept:
a. HTN
b. Nephritic syndrome
c. Hypothyroidism
d. Obesity
(pharmacology)
4- NSAIDs cause all except :
a. Acute Renal failure
b. Tubular necrosis
c. Hypokalemia
d. Interstitial nephritis
(medicine)
5- Obese 60 yo lady (( 5th day post cholycystectomy )) , complaining of SOB ,
decreased BP : systolic = 60 …O/E : swelling of the Rt leg .The Dx is
a. Hypovolemic shock
b. Pumlonary Embolism
c. MI
d. Hmrgic shock
e. ……
Diagnosis: In 2006, Scarvelis and Wells overviewed a set of clinical criteria for
DVT, Wells score or criteria: (Possible score -2 to 9)
GOOD LUCK
Active cancer (treatment within last 6 months or palliative) -- 1 point
GOOD LUCK
Calf swelling >3cm compared to other calf (measured 10cm below tibial
tuberosity) -- 1 point
Collateral superficial veins (non-varicose) -- 1 point
Pitting edema (confined to symptomatic leg) -- 1 point
Swelling of entire leg - 1 point
Localized pain along distribution of deep venous system -- 1 point
Paralysis, paresis, or recent cast immobilization of lower extremities -- 1
point
Recently bedridden > 3 days, or major surgery requiring regional or general
anesthetic in past 12 weeks -- 1 point
Previously documented DVT -- 1 point
Alternative diagnosis at least as likely -- Subtract 2 points
Interpretation: Score of 2 or higher - deep vein thrombosis is likely. Consider
imaging the leg veins. Score of less than 2 - deep vein thrombosis is unlikely.
Consider blood test such as d-dimer test to further rule out deep vein thrombosis.
(medicine)
6- A 55 years old male with COPD , complaining of 1 wk fever and productive
cough on CXR showed Left upper pneumonia , sputum culture +ve for H.inf,
most drug effective is :
a. Pencillin
b. Doxycycline
c. Cefuroxime
d. Gentamycin
e. Carbinacillin
(pediatrics)
7- 8 years old boy , has 6 year old hight &bone scan of 5.5 years .Dx is :
a. Steroid
b. Genetic
c. Hypochondroplasia
GOOD LUCK
d. Hypothyroidism
GOOD LUCK
Constitutional if he is otherwise healthy or there is much delay of bone age &
growth age are close to each other.
(Emergency medicine)
8- The effectiveness of ventilation during CPPR is measured by :
a. Chest rise
b. Pulse oximeter
c. Pulse acceleration
(medicine)
9- All are signs of IBD except :
a. Bleeding per rectum
b. Feeling incomplete defacation
c. Mucuss with stool
d. Wt loss
e. Abdominal distention
GOOD LUCK
Abdominal distension is known presentation of IBS.
GOOD LUCK
(surgery)
10-All suggest acute appendicitis except:
a. Fever 38.1
b. Anorexia
c. Vomiting
d. Umbilical pain shifting to the Rt lower Quadrant
e. Pain improving with sitting and leaning forward
(medicine)
11- A 15 yo male with 3 day hx of yellow sclera , anorexia and abdominal pain.
LFT >>> Total bilirubin = 253 , indirect = 98 , ALT = 878 , AST = 1005.The
Dx is :
a. Gilbert’s disease
b. Infective hepatitis
c. Obstructive Jaundice
d. Acute pancereatitis
e. Autoimmine hepatitis
High ALT,AST causes from liver it self. ,high GGT,ALP causes from
obstructive bile
ALT > AST (both are increased but ALT more):-
This happens in acute causes:
1- Acute viral hepatitis.
2- Ischemia.
3- Drugs induced hepatitis.
4- Extra hepatic obstruction.
AST > ALT:-
This happens in chronic causes:
1- Chronic hepatitis.
2- Liver cirrhosis.
3- Alcoholic hepatitis.
4- Infiltration: fatty liver, cancer.
↑ AST only occur in :
1- Sever muscle exertion.
2- Hemolysis.
3- MI.
4- Nephritic syndrome.
5- ↓T3,T4.
6- Anti-TB drugs (isoniaside).
GOOD LUCK
GOOD LUCK
(gynecology)
12- A 35 y.o female G4 P2 + 1 , 1 yr hx of irregular heavy bleeding ,
Examination within normal .Most likely Dx?
a. Early menopause
b. Narvouse uterus
c. Dymsmennorreah
d. DUB
e. Endometriosis
This question is not clear, if G is mentioned that means the lady is pregnant ….How
ever we can just make small notes about bleeding during pregnancy and without
pregnancy…. During pregnancy :Heavy vaginal bleeding or bleeding that occurs
before 12 weeks may indicate a serious problem, including an ectopic pregnancy or
miscarriage.
bleeding that occurs after 12 weeks also may indicate a serious problem, such as
placenta previa. Without pregnancy: Ovulation can cause midcycle bleeding.
Medications, such as OCP, sometimes cause abnormal vaginal bleeding. Minor
bleeding between periods during the first few months may happen if recently started
using birth control pills. Also not taking the pills at a regular time each day. An
intrauterine device (IUD) also may increase chances of spotting or heavy
periods.Infection of the pelvic organs may cause vaginal bleeding, especially after
intercourse or douching. Sexually transmitted diseases (STDs) are often the cause of
infections. Other, less common causes of abnormal vaginal bleeding that may be
more serious include the following: Sexual abuse, An object in the vagina, Uterine
fibroids are a common cause of heavy periods., Structural problems, such as
urethral prolapse or polyps, Cancer of the cervix, uterus, ovaries, or vagina, Other
diseases, such as hyperthyroidism or diabetes , age 40 or older, abnormal vaginal
bleeding may mean perimenopause. In a woman who has not had a menstrual
period for 12 months, vaginal bleeding is always abnormal .
GOOD LUCK
GOOD LUCK
(medicine)
13-A 30 years old male with hx of pain and swelling of the Rt knee, synovial
fluid aspiration showed yellow color opaque appearance , variable viscosity.
WBC = 150,000 , 80% neutrophils, poor mucin clot,Dx is :
a. Goutism Arthritis
b. Meniscal tear
c. RA
d. SA ( septic arthritis )
e. Pseudogout arthritis
any acutely swollen joint with pain and redness is SA until proven otherwise !
Normal joint fluid is viscous and appears clear to light yellow. Cloudy joint
fluid is abnormal and suggestive of inflammation or an infection. Bloody
joint fluid is also abnormal and may be caused by trauma to the joint.
Normal joint fluid has none or few blood cells. Large numbers of red blood
cells indicate bleeding in the joint. Large numbers of white blood cells can
occur with infection, inflammatory arthritis, gout, or pseudogout
Crystals are an abnormal finding. Uric acid crystals indicate gout; CPPD
crystals occur with pseudogout. Bacteria is also abnormal. A culture can
identify the source of infection.
Chemical Analysis: Joint fluid can also be tested for glucose, protein, and
lactic dehydrogenase (LDH). Abnormal joint fluid results which may
indicate inflammation or infection are:
Glucose - less than 40 mg/dl
Protein - greater than or equal to 3 g/dl
LDH - great than 333 IU/L
Septic arthritis :Acute inflammation of one or more joints caused by infection.
Suppurative arthritis may follow certain bacterial infections; joints become swollen,
hot, sore, and filled with pus, which erodes their cartilage, causing permanent
damage if not promptly treated by giving antibiotics, draining the pus, and resting
the joint
(medicine)
14- A 30 years old teacher complaining of excessive water drinking and
frequency of urination, O/E = Normal. You suspect DM and request FBS =
6.8 .the Dx is :
a. DM
b. DI
c. Impaired fasting glucose
d. NL blood sugar
e. Impaired glucose tolerance
GOOD LUCK
GOOD LUCK
In patients who present with symptoms of uncontrolled diabetes (eg,
polyuria, polydipsia, nocturia, fatigue, weight loss) with a confirmatory
random plasma glucose level of >200 mg/dL (11.1 mmol/dl), diabetes
can be diagnosed. In asymptomatic patients whose random serum glucose
level suggests diabetes, a fasting plasma glucose (FPG) concentration
should be measured. The oral glucose tolerance test no longer is
recommended for the routine diagnosis of diabetes.
(medicine)
15- Hirsutism associated with which of the following?
a. Anorexia
b. Juvenile hypothyroidism
c. Digoxin Toxicity
d. C/o citrate??
Hirsutism can be caused by abnormally high androgen levels or by hair follicles that
are more sensitive than usual to normal androgen levels. The disorders may be
caused by abnormalities of the ovaries or adrenal glands. Serum levels of free
testosterone, the biologically active androgen that causes hair growth, are regulated
by sex hormone–binding globulin (SHBG). Lower levels of SHBG increase the
availability of free testosterone. SHBG levels decrease in response to the following:
Exogenous androgens
Certain disorders that affect androgen levels, such as PCOS
Congenital or delayed-onset adrenal hyperplasia
Cushing syndrome
Obesity
Hyperinsulinemia
Hyperprolactinemia
Excess growth hormone
Hypothyroidism
Conversely, SHBG levels increase with higher estrogen levels, such as the levels
that occur during oral contraceptive therapy. The resultant increased SHBG
levels lower the activity of circulating testosterone. The severity of hirsutism
does not correlate with the level of increased circulating androgens because of
GOOD LUCK
GOOD LUCK
individual differences in androgen sensitivity of the hair follicle. Hirsutism may
also be caused by:
Signs and Symptoms : Hair growth on the abdomen, breasts, and upper lip (male-
pattern hair growth in women) ,Irregular menstrual periods ,Acne , Abnormally
malodorous perspiration , Loss of feminine body shape, Signs of masculinity –
deepening voice, frontal balding, enlarged clitoris, enlarged shoulder muscles ,
Cushing's syndrome.
(gynecology)
16-The most accurate Dx of Ectopic Pregnancy is :
a. Culdocentesis
b. Pelvic U/S ?
c. Endometrial Biobsy
d. Serial B-HCG
e. Laproscopy
US probably is the most important tool in diagnosing an extrauterine pregnancy, but
does not aid in differentiating an early intrauterine pregnancy, a missed abortion,
and an ectopic pregnancy if not conclusive. That is why it is combined with serial
B-HCG levels to diagnoste an ectopic pregnancy. In short, serial serum bhCG levels
are necessary to differentiate between normal and abnormal pregnancies and to
monitor resolution of ectopic pregnancy once therapy has been initiated.
Laparoscopy - The need for laparoscopy in the diagnosis of ectopic pregnancy has
declined with the increasing use of ultrasound. It is still useful, however, in certain
situations when a definitive diagnosis is difficult. also used as definitive management in
early ectopic gestation.
(dermatology)
17-A 12 yr old female, non pruritic annular eruption in the rt foot for 8 months,
looks pale and not scaling. Had no response to 6 wks of miconazole.
a. Discoid lupus erythramatosis
b. Erythema nodosum
c. Tinea corporis
d. Granulomatous annulare
e. Choricum marginatum
GOOD LUCK
GOOD LUCK
Diagnosis clinical presentation treatment options
Topical, intralesional Annular or papulosquamous plaques, with Subacute
and systemic or without scale, on sun-exposed areas cutaneous lupus
corticosteroids; erythematosus
antimalarials
Topical and systemic Scaly, annular, erythematous plaques or Tinea corporis
antifungals papules on glabrous skin
Topical and Indurated, nonscaly, skin-colored annular Granuloma
intralesional plaques and papules, usually on the annulare
corticosteroids extremities
(medicine)
18-A 26 yr old female, hx of 6 month bilateral temporal headache increasing in
the morning with hx of OCP for the last 1 yr. O/E BP = 120/80 , fundoscopy
showed bilateral papilledema .Dx is :
a. Encephalitis
b. Meningitis
c. Optic neuritis
d. BIH = Benign intracranial Hypertention
e. Intracerebrall abscess
Pseudotumor cerebri literally means "false brain tumor." It’s due to high
pressure caused by the buildup or poor absorption of CSF . The disorder is
most common in women between the ages of 20 and 50. Symptoms of raised
intracranial pressure which include headache, nausea, vomiting, and
pulsating intracranial noises, double vision, loss of visual accuracy, and even
blindness, which closely mimic symptoms of brain tumors without
causative lesions seen on MRI or CT.
Treatment:Treatment of the primary and secondary forms of intracranial
hypertension is similar reduce intracranial hypertension. While there are no
randomised controlled trials to guide the choice of treatment most
practitioners recommend acetazolamide and weight loss to treat primary
idiopathic hypertension. In the secondary forms, correcting the underlying
mechanism, for example, treating the venous thrombosis, or stopping the
causative medication is indicated. Excess cerebrospinal fluid may be
removed by repeated spinal taps . Steroids may be prescribed to reduce
swelling of brain tissue If visual loss progresses despite optimal medical
therapy (usually acetazolamide, methazolamide, or furosemide (frusemide)
GOOD LUCK
in adequate doses), consideration of optic nerve sheath fenestration or lumbar
GOOD LUCK
(primary care)
19-2ndry prevention is least useful in which disease ?
a. Breast CA
b. DM
c. Leukemia
d. Malnutrition of children
e. Toxemia in pregnancy
(!!)
20-Garlic water Question ??
(psychiatry)
21-A male presented with headache , tinnitus and nausea thinking that he has a
brain tumor. He had just secured a job in a prestigious company and he thinks
that he might not meet it’s standards . CNS exam , CT all within normal .
What is the Diagnosis :
a. Generalized Anxiety disoreder
b. Hypochondriasis
c. Conversion reaction
d. Panic attack
The core feature of hypochondriasis is not preoccupation with
symptoms themselves, but rather the fear or idea of having a serious
disease. The fear or idea is based on the misinterpretation of bodily
signs and sensations as evidence of disease. The illness persists despite
appropriate medical evaluations and reassurance.
The diagnosis should be considered strongly if the patient has a history
of hypochondriasis (or other somatization disorder) or has had multiple
workups and if the patient's complaints are markedly inconsistent with
objective findings or the examination yields no abnormal findings.
Further psychiatric history should be obtained with regard to a history
of hypochondriasis (or corresponding behaviors) in family members or
a sudden, unexplained loss of function that spontaneously resolved.
Consideration for, and confidence in, a diagnosis of hypochondriasis is
also increased if the patient changes emphasis with regard to key
symptoms or describes new symptoms inconsistent with others.
Diagnostic criteria
The patient has for hypochondriasis
a preoccupying fear include thea following:
of having serious disease.
The preoccupation persists despite appropriate medical
evaluation and reassurance.
GOOD LUCK
The belief is not of delusional intensity (as in delusional
disorder, somatic type) and is not restricted to a concern about
appearance (as in persons with BDD).
The preoccupation causes clinically significant distress or
impairment.
The preoccupation lasts for at least 6 months.
The preoccupation is not explained better by another mood,
anxiety, or somatoform disorder.
(surgery)
22-Anal fissure , more than 10 days , which of the following is true :
a. Loose bowel motion
b. Conservative management
c. Site is at 12:00
d. ………
It is an incomplete question.
The patient reports severe pain during a bowel movement, with the pain lasting
several minutes to hours afterward. The pain recurs with every bowel movement,
and the patient commonly becomes afraid or unwilling to have a bowel movement,
leading to a cycle of worsening constipation, harder stools, and more anal pain.
Approximately 70% of patients note bright red blood on the toilet paper or stool.
Occasionally, a few drops may fall in the toilet bowl, but significant bleeding does
not usually occur with an anal fissure. If the fissure persists over time, it progresses
to a chronic fissure that can be distinguished by its classic features. The fibers of the
internal anal sphincter are visible in the base of the chronic fissure, and often, an
enlarged anal skin tag is present distal to the fissure and hypertrophied anal papillae
are present in the anal canal proximal to the fissure. Most anal fissures occur in the
posterior midline, with the remainder occurring in the anterior midline (99% of
men, 90% of women). Two percent of patients have both anterior and posterior
fissures. Fissures occurring off the midline should raise the possibility of other
etiologies (eg, Crohn disease), an infectious etiology (eg, sexually transmitted
disease, AIDS), or cancer. Treatment: First-line medical therapy consists of therapy
with stool-bulking agents, such as fiber supplementation and stool softeners.
Laxatives are used as needed to maintain regular bowel movements. Sitz baths after
bowel movements and as needed provide significant symptomatic relief because
they relieve some of the painful internal sphincter muscle spasm. Recurrence rates
range from 30-70% if the high-fiber diet is abandoned after the fissure is healed.
This rate can be reduced to 15-20% if patients remain on a high-fiber diet.
GOOD LUCK
NTG, often limiting its use. The main adverse effects are headache and dizziness;
GOOD LUCK
therefore, instruct patients to use NTG ointment for the first time in the presence of
others or directly before bedtime. Surgical therapy: Surgical therapy is usually
reserved for acute anal fissures that remain symptomatic after 3-4 weeks of medical
therapy and for chronic anal fissures. Contraindications: The main contraindication
to surgery for an anal fissure is impaired fecal continence because this could be
worsened with surgery. This contraindication mostly applies to patients with minor
incontinence (occasional seeping). however, those with irritable bowel syndrome
and incontinence to liquid stool can develop fissures if they become constipated.
These patients are at the most risk for surgical treatment of an anal fissure because
their typical bowel pattern is loose and more difficult to control.
(surgery)
23-A 56 yo male complaining of PR bleeding O/E , external hemorrhoid.Rx?
a. Excisional
b. Send home and follow up
c. Observation for 6 months
d. Rigid sigmoidoscopy of normal excise it
(pediatrics)
24-12 mnth old baby can do all except :
a. Walk with support of one hand
b. Pencil grip
c. Open a drawer
d. Respond to calling his name
e. Can play simple ball
(surgery)
25-fracture of a rib can cause all except :
a. Pneumothorax
b. Hemothorax
c. Eosophageal ingjury
d. Liver injury
Position of the fractured rib in the thorax helps identify potential injury to specific
underlying organs. Fracture of the lower ribs usually is associated with injury to
abdominal organs rather than to lung parenchyma. Fracture of the left lower ribs is
GOOD LUCK
associated with splenic injuries, and fracture of the right lower ribs is associated
GOOD LUCK
with liver injuries. Fracture of the floating ribs (ribs 11, 12) is often associated with
renal injuries
(medicine)
26-hyperprolactinemia associated with all of the following except :
a. Pregnancy
b. Acromegaly
c. OCP
d. Hypothyroidism
GOOD LUCK
evaluating physician must decide whether a radiographic study is indicated. In
GOOD LUCK
many cases, with the availability of MRI scanners, imaging is performed earlier
and at lower prolactin levels to rule out a non–prolactin-producing tumor.
o When the underlying cause (physiologic, medical, pharmacologic) cannot be
determined and an MRI does not identify an adenoma, idiopathic
hyperprolactinemia is diagnosed.
o Other differentials to be considered : Acromegaly Pituitary Macroadenomas
or Microadenomas, Prolactinoma
o Other Problems: Alcoholic cirrhosis ,Nipple stimulation ,Chest wall tumors
(pediatrics)
27-After delivery start breast feeding :
a. As soon as possible
b. 8 hrs
c. 24 hrs
d. 36 hrs
e. 48 hrs
(medicine)
28-A 27 years old male with tonic clonic seizures in the ER , 20 mg Diazepam
was given and the convulsion did not stop . what will be given ?
a. Diazepam till dose of 40 mg
b. Phenytoin
c. Phenobarbitone
GOOD LUCK
if more than 1 hr no improvement may need general anesthesia in ICU.
GOOD LUCK
Treat the underlying cause if identifiable ( hypoglycemia, infection, etc)
(pediatrics)
29-Child brought to ER with tonic clonic convulsions , Hx of recurrent febrile
seizures , what will you give him to take home to use in case of a new
convulsion ??
a. Phenytoin
b. Diazepam
c. Phenobarb
d. Clonazepam
(medicine)
30-60 years old male complaining of decreased lipido , decreased ejaculation ,
FBS = 6.5 mmol, increased prolactin , Normal FSH and LH , your opinion is
a. Measure Testosterone level
b. He has DM
c. Do CT of head
d. He has Normal Fasting Blood sugar
In hyperprolactenimea in males you have to exclude pituitary adenoma, so ct
is the most appropriate answer.
(medicine)
31-Osteoporosis with back pain
a. Vitamin D decreased
b. Rule out if the X-ray is normal
(medicine)
32-27 yo male has symmetric oligoarthritis , involving knee and elbow , painful
oral ulcer for 10 years , came with form of arthritis and abdominal pain.Dx
is:
a. Behjets disease
b. SLE
c. Reactive arthritis
d. UC
e. Wipple’s disease
The diagnosis of Behçet disease was clarified by an international study group (ISG)
.This group developed ISG criteria, which currently are used to define the illness.
At least 3 episodes of oral ulceration must occur in a 12-month period. They must
be observed by a physician or the patient and may be herpetiform or aphthous in
GOOD LUCK
nature. At least 2 of the following must occur: (1) recurrent, painful genital ulcers
GOOD LUCK
that heal with scarring; (2) ophthalmic lesions, including anterior or posterior
uveitis, hypopyon, or retinal vasculitis; (3) skin lesions, including erythema
nodosum, pseudofolliculitis, or papulopustular lesions (may also include atypical
acne); and (4) pathergy, which is defined as a sterile erythematous papule larger
than 2 mm in size appearing 48 hours after skin pricks with a sharp, sterile needle (a
dull needle may be used as a control).
(Pediatrics)
33-5 mnth old baby , in ER with sudden abd pain + V , the pain lasts 2-3 min wth
intervals of 10 -15 minutes in between each attack :
a. Intussesption
b. Infantile colic
c. Appendicitis
GOOD LUCK
GOOD LUCK
older children may involve polyps, mickle diverticulum , lymphoma, meconium
ileus( cystic fibrosis)& hemorrhagic foci (henoch-schonlein purpura), IBD.
Symptoms: intermittent colicky abdominal pain with legs drawn up initially
releaved by passage of stool (jelly stool).
Infantile colic : The most commonly accepted definition of colic, which originated
in 1954,4 describes using the "rule of three": crying for more than three hours per
day, for more than three days per week, and for more than three weeks in an infant
that is well-fed and otherwise healthy. The motor behaviors of infants with colic
also were first described in 1954.4 Colicky infants have attacks of screaming in the
evening with associated motor behaviors such as flushed face, furrowed brow, and
clenched fists. The legs are pulled up to the abdomen, and the infants emit a
piercing, high-pitched scream.5
(pediatrics)
34-12 mnth old baby with “Hg A 58%, Hg S 38% , HgA2 2% , Hg F 5%
Dx is :
a. Thalasemia minor
b. Thaslasemia Major
c. Sickle cell anemia
d. Sickle cell thalasemia
e. Sickle cell trait
GOOD LUCK
GOOD LUCK
(medicine)
35-43 yo female presented wth 6 mnth history of malaise , N,V . Lab results :
Na = 127, K= 4.9 , urea =15 , Ceriatinine = 135 , HCO3 = 13 , glucose =2.7.
Most likely Dx is :
a. Hypothyroidism
b. Pheochromocytoma
c. Hypovolemia due to vomiting
d. SIADH
e. Addison’s disease
GOOD LUCK
Urinary and sweat sodium also may be elevated.
GOOD LUCK
The most consistent finding is elevated blood urea nitrogen (BUN) and
creatinine due to the hypovolemia, a decreased GFR and a decreased renal
plasma flow.
Hypercalcemia, the cause of which is not well understood, may be present in
a small percentage of patients. However, hypocalcemia could occur in
patients with Addison disease accompanied by idiopathic
hypoparathyroidism.
Hypoglycemia may be present in fasted patients, or it may occur
spontaneously. It is caused by the increased peripheral utilization of glucose
and increased insulin sensitivity. It is more prominent in children and in
patients with secondary adrenocortical insufficiency.
Liver function tests may reveal a glucocorticoid-responsive liver
dysfunction.
Autoantibody testing: Thyroid autoantibodies, and/or adrenal autoantibodies
may be present.
Modest hyperprolactinemia has been reported in cases of Addison disease
and also in secondary adrenocortical insufficiency. It is responsive to
glucocorticoid replacement.
(medicine)
36-23 yo female presented wth the finding of hyperbilirubinemia , O/E : WNL ,
Lab : Total Bilirubin =3.1 , direct = 0.4, the most likely Dx is :
a. Gilbert’s disease
b. Crigler Najjar syndrome
c. Duben Johnson syndrome
d. Rotor’s disease
e. Sclerosing Cholangitis
GOOD LUCK
unmasked by an intercurrent illness or stress.
GOOD LUCK
History: At least 30% of patients are asymptomatic, although nonspecific
symptoms such as abdominal cramps, fatigue, and malaise are common.
Abdominal symptoms in these patients are a poorly defined entity and may
be secondary to underlying anxiety. No relationship exists between these
abdominal symptoms and plasma bilirubin levels.
Physical: Mild jaundice is present intermittently in some individuals, but no
other abnormal physical examination findings are evident. Infants
homozygous for Gilbert syndrome may have a greater increase in neonatal
jaundice when breastfed or when other disorders of heme metabolism are
coinherited.
a diagnosis of Gilbert syndrome can be made in the presence of (1)
unconjugated hyperbilirubinemia noted on several occasions; (2) normal
results from CBC count, reticulocyte count, and blood smear; (3) normal
liver function test results; and (4) an absence of other disease processes.
Liver function tests: With the exception of unconjugated hyperbilirubinemia,
standard liver function test results are normal.
(gynecology)
37-15 yo female , menarche at age of 13 , complaining of menstrual pain , not
sexually active O/E and pelvic US : Normal , Rx is :
a. Laprotomy
b. Danazol
c. Cervical dilatation
d. NSAIDs
(pediatrics)
38-3 years old boy on routine exam for surgical procedure , a low pitch murmur
continuous in the Rt 2nd intercostals space radiate to the Rt sterna border ,
increased by sitting and decreased by supination , What do u want to do after
that ?
a. Send him to cardiologist
b. Reasurrance & tell him this is an innocent murmur
c. Do ECG
GOOD LUCK
TYPES (5):
1. Stillʹs (Vibratory) Murmur
o mechanism: caused by vibration of the AV valves, ventricular wall
and/or the chordae tendinae (represents a LV outflow murmur); also
due to the friction of RBC's against cardiac muscle
o most common in 3-8 year olds
o most common innocent murmur
o quality: low-pitched musical or vibratory in nature
o maximal: over 2nd-4th L intercostal space lateral to the LLSB
midway between the sternal border and apex
o radiat.: to the apex, aortic, and pulmonary areas
o loudest: in supine position, with exercise and fever
2. Venous Hum
o mechanism: blood flows down from collapsed cervical veins to
dilated intrathoracic veins causing the venous walls to flutter thus
producing a low-pitched murmur
o most common in 3-8 year olds
o R-sided in 50%, L-sided in 30%, and bilateral in 20%
o quality: low-pitched
o maximal: supraclavicular fossa
o radiat.: to the aortic and pulmonary areas
o loudest: standing with chin tilted up (disappears in supine position
with the head flexed, by compressing the external jugular vein)
3. Pulmonary Ejection Murmur
o also called 'Pulmonary Flow Murmur', 'Basal Ejection Systolic
Murmur', or 'Physiologic Pulmonary Systolic Ejection Murmur'
o mechanism: at the beginning of systole, blood above the pulmonic
valve is stationary but is then sheared away from the artery walls
when blood is ejected from the right ventricle
o most common in 3-8 year olds
o quality: high-pitched blowing
o maximal: over pulmonic area (2nd L parasternal space)
o radiat.: to LLSB, L axillae, left side of neck and slightly to the aortic
area
4. Carotid Bruit
o also called 'Supraclavicular Arterial Bruit'
o mechanism: turbulance in the carotid arteries as the blood is
accelerated early in systole
o most common in 3-8 year olds
o bilateral in 62%, R-sided in 24%, and L-sided in 14%
o quality: high-pitched blowing with systoic thrill over the the carotid
vessels
o maximal: over the carotid vessels or supraclavicular fossa
o radiat.: below the clavicle to the aortic or pulmonary areas
GOOD LUCK
5. Peripheral Pulmonary (Artery) Stenosis
o mechanism: when the right and left pulmonary arteries veer off from
the main pulmonary artery at sharp angles, turbulance is produced
during systole
o most common during the 1st year of life then disappears
o quality: high-pitched blowing
o maximal: over pulmonic area (2nd L parasternal space)
o radiat.: along the pulmonary arterial tree so can be heard over both
axillae, the aortic area, and in the back.
(orthopedics)
39-17 yo male while playing foot ball , fell on his knee , (( turn over )) what do
u think the injury that happened is ?
a. Medial meniscus lig
b. Lateral meniscus lig
c. Medial collateral
d. Lateral collateral
e. Ant cruciate lig
1. The medial collateral ligament (MCL) is more easily injured than the lateral
collateral ligament (LCL). It is most often caused by a blow to the outer side
of the knee (such as occur in contact sports) that stretches and tears the
ligament on the inner side of the knee.
2. Cruciate ligaments :
o Injuries to the cruciate ligaments of the knee are typically
sprains.Cruciate ligament injuries don't always cause pain, but typically
cause a loud "pop."
Rupture of the ACL is among the most serious of the common knee injuries
and results from a variety of mechanisms. ACL tears are more common than
PCL tears
GOOD LUCK
patter displaces the tibia backward and pulls apart the PCL.
GOOD LUCK
Onset of edema and pain tends to occur within the first 3 hours after
injury.
PCL harm signifies a major injury and rarely occurs as an isolated injury.
3. niscus Inju
Mechanism ofries
injury
o Meniscus tears are sometimes related to trauma, but significant
trauma is not necessary. A sudden twist or repeated squatting can tear
the meniscus. The timing of the injury is important to note, although
patients often cannot describe a specific event.
o Meniscus tears typically occur as a result of twisting or change of
position of the weight-bearing knee in varying degrees of flexion or
extension (Rotational movements) . A partial or total tear of a
meniscus sometimes occurs if an athlete quickly twists or rotates the
upper leg while the foot is firmly planted, such as those that occur in
field sports such as soccer, and football.
o Given that the medial meniscus is more firmly fixated and attached to
the MCL capsule, it is more vulnerable to injury.
(pediatrics)
40-A full term boy , wheiging 3.8 , developed jaundice at 2nd day of life ,
Coomb’s test is –ve , HB = 18 , bilirubin = 18.9 & indirect = 18 .4. O/E :
baby is healthy and feeding well , the most likely Dx is :
a. Physiological jaundice
b. ABO compatibility
c. Breast milk jaundine
d. Undiscovered neonatal sepsis
Jaundice that manifests before the first 24 hours of life should always be considered
pathologic until proven otherwise. In this situation, a full diagnostic workup with
emphasis on infection and hemolysis should be undertaken. In infants with severe
jaundice or jaundice that continues beyond the first 1-2 weeks of life, the results of
the newborn metabolic screen should be checked for galactosemia and congenital
hypothyroidism, further family history should be explored, the infant's weight curve
should be evaluated, the mother's impressions as far as adequacy of breastfeeding
should be elicited, and the stool color should be assessed.
Physiological Jaundice :
Typically, presentation is on the 2nd or 3rd day of life.
Jaundice that is visible during the first 24 hours of life is likely to be
nonphysiologic; further evaluation is suggested.
caused by a combination of increased bilirubin production secondary to
accelerated destruction of erythrocytes, decreased excretory capacity secondary
to low levels of ligandin in hepatocytes, and low activity of the bilirubin-
conjugating enzyme UDPGT.
GOOD LUCK
GOOD LUCK
Breast Milk Jaundice :
BMJ is a diagnosis of exclusion. Detailed history and physical examination
showing that the infant is thriving and that lactation is well established are key
elements to diagnosis. Breastfed babies should have 3-4 transitional stools and
6-7 wet diapers and should have regained birth weight by the end of the second
week of life or demonstrate a weight gain of 1 oz/day.
True BMJ manifests after the first 4-7 days of life. A second peak in serum
bilirubin level is noted by the 14th day of life.
Decreased clearance of bilirubin may play a role in breast milk jaundice and in
several metabolic and endocrine disorders.
(psychiatry)
41-A 43 yo female , presented to ER with paralysis of both LL and parasthesia in
both UL for 2 hours ,She was lying on a stretcher unable to move her LL (
neurologis could not relate her clinical findings 2 any medical disease .Hx
showed she was beaten by her husband .The Dx is :
a. Complicated anxiety disorder
b. Somatization disorder
c. Conversion disorder
d. Psychogenic paralysis
e. Hypochondriasis
(psychiatry)
42-The best Rx for the previous case is :
a. Benzodiazipines
b. Phenothiazine
c. MAOI
d. SSRIs
e. Supportive psychotherapy
GOOD LUCK
GOOD LUCK
September 2006
(AAF – 2008)
OB/GYN
33% 21-24
28% 25-28
14% 29-32
9% 33-36
7% 37-40
GOOD LUCK
GOOD LUCK
In Labour
The optimal mode of delivery for preterm breech has not been fully
evaluated in clinical trials and the relative risks for the preterm infant and
mother remain unclear. Overall, decisions regarding mode of delivery will
need to be made on an individual basis however with the evidence available
to us at this time, Royal Women's Hospital recommended practice is to
perform emergency caesarean section for any woman presenting in preterm
labour with breech presentation except where; vaginal delivery is imminent.
The likelihood is high that the trend will continue toward 100% cesarean
delivery for term breeches and that vaginal breech deliveries will no longer
be performed.
OB/GYN
GOOD LUCK
GOOD LUCK
OB/GYN
3- 33 yo with multiple C sections , 6th day post op, clothes stained with
copious serosangious dishcahrge :
-Vesicocutaneous fistula
-Entercutaneos fistula
-Hematoma
-Stitch abscess
- Wound dehiscence.
Fascial dehiscence: An infrequent but emergent complication of a wound
breakdown in C- section is a fascial dehiscence. It occurs in approximately
5% of patients with a wound infection and is suggested when excessive
discharge from the wound is present. If a fascial dehiscence is observed, the
patient should be taken immediately to the operating room where the wound
can be opened, debrided, and reclosed in a sterile environment.
OB/GYN
OB/GYN
GOOD LUCK
Treatment of bacterial vaginosis with oral metronidazole during the second and
third trimester of pregnancy does not reduce the occurrence of preterm delivery.
GOOD LUCK
Ortho
Colles fracture is the most common extension fracture pattern. The term is
classically used to describe a fracture through the distal metaphysis approximately
4 cm proximal to the articular surface of the radius. However, now the term tends
to be used loosely to describe any fracture of the distal radius, with or without
involvement of the ulna, that has dorsal displacement of the fracture fragments.
Colles fractures occur in all age groups, although certain patterns follow an age
distribution. In elderly individuals, because of the relatively weaker cortex, the
fracture is more often extra-articular. Younger individuals tend to require a
relatively higher-energy force to cause ht e fracture and tend to have more
complex intra-articular fractures. In children withopen physes, an equivalent
fracture is the epiphyseal slip. This is a Salter I or II fracture with the deforming
forces directed through the weaker epiphyseal plate.
With scaphoid fractures, the point of maximal tenderness lies in the anatomic
snuffbox, which lies between the tendons of the extensor pollicis brevis and
abductor pollicis longus. Radial deviation of the wrist or axial loading of the first
metacarpal may increase pain.
Pedia
GOOD LUCK
GOOD LUCK
Pedia
GOOD LUCK
GOOD LUCK
Pedia
Pedia
10- 8 mnth old with dehydration , fever , depressed ant fontanelle, vomiting ,
crying but no neck stiffness . no similar symptoms in family . what important
investigation u want to do ?
a)Blood Culture
b)CBC & differential
c)CSF exam ( I think to rule out meningitis , but not sure )
d) Chest X ray
Derma
11- Female pt developed lesions on the cheek & nose and diagnosed as
Rosacea . Rx is:
a) Amoxacillin
b) Tetracycline
Rosacea is a common condition characterized by symptoms of facial flushing and
a spectrum of clinical signs, including erythema, telangiectasia, coarseness of skin,
and an inflammatory papulopustular eruption resembling acne.The diagnosis of
rosacea is a clinical diagnosis. Skin biopsy may be necessary to exclude other
disease eg: polycythemia vera, CTD (eg, lupus erythematous, dermatomyositis,),
photosensitivity. Rosacea is defined by persistent erythema of the central portion
of the face lasting for at least 3 months. Supporting criteria include flushing,
papules, pustules, and telangiectasias on the convex surfaces. Secondary
characteristics are burning and stinging, edema, plaques, a dry appearance, ocular
manifestations, and phymatous changes.
The etiology is unknown. Before the initiation of therapy, the triggering factors that
exacerbate the patient's rosacea should be identified and avoided if possible.
Common triggering factors include hot or cold temperatures, wind, hot drinks,
caffeine, exercise, spicy food, alcohol, emotions, topical products that irritate the
GOOD LUCK
skin and decrease the barrier, or medications that cause flushing.
GOOD LUCK
ANTIBIOTICS : Oral antibiotics, such as tetracycline, doxycycline (Vibramycin),
and metronidazole (Flagyl) effectively treat papulopustular rosacea. Topical
metronidazole (cream [MetroCream] or gel [MetroGel]) administered twice daily is
as effective as oral tetracycline22 and is considered the agent of choice for
pustular and papular rosacea [Evidence level A, randomized controlled trials];
however, some patients experience burning and stinging with the use of topical
metronidazole. Some studies23 suggest that topical metronidazole also reduces
erythema and telangiectasis in some patients. Topical clindamycin (Cleocin) is an
effective alternative in patients who are pregnant; the use of oral tetracycline or
metronidazole is undesirable during pregnancy24 [Evidence level A, randomized
controlled trial]. The antibiotic gel or cream should be applied across the entire
face, rather than "spot treating" the lesions.25
Med
OB/GYN
a) Low lying
b) Marginal placenta
c) Partial Placenta Previa
d) Lateral Placenta Previa
The 4 generally recognized subtypes are (1) complete or total, in which the
GOOD LUCK
placenta covers 360° of the internal cervical os; (2) incomplete or partial, in which
0°-360° of the internal cervical os is covered by placental tissue; (3) marginal, in
GOOD LUCK
which the placental tissue abuts but does not cover the internal cervical os; and (4)
low lying, in which the edge of the placenta lies abnormally close to but does not
abut the internal cervical os.
OB/GYN
14. Pregnant Teacher in her 20th week reported 2 of her student developed
meningitis. Prophylactic Treatment:
_ Chemoprophylaxis
GOOD LUCK
meningitis.
GOOD LUCK
o These contacts include household contacts, daycare center
members who eat and sleep in the same dwelling, close contacts in
military barracks or boarding schools, and medical personnel
performing mouth-to-mouth resuscitatio.nRifampin (600 mg PO
q12h) for 2 days has been shown to rapidly eradicate the carrier
stage, and the prophylaxis persists for as long as 10 weeks following
treatment.
o Alternative agents include ceftriaxone (250 mg IM) as a single dose
in adults. It also is the safest choice in pregnant patients. It has been
shown to eradicate the carrier state for 14 days. Ciprofloxacin (500-
750 mg) as a single dose also is efficacious.
Pedia
15- Mother brought her 18 month old infant to ER with Hx of URTI for the last
2 days with mild respiratory distress. This evening the infant start to have
hard barking cough with respiratory distress. O/E: RR 40/min, associated
with nasal flaring, suprasternal & intercostals recessions. What is the most
likely Dx?
a) Viral Pneumonia
b) bacterial Pneumonia.
c) Bronchiolitis
d) Acute epiglottitis
c) Trachiobronchiolitis.
OB/GYN
C
ervical incompetence is not generally treated except when it appears to
threaten a pregnancy. Cervical incompetence can be treated using cervical
circlage. The complications described in the literature have been rare:
hemorrhage from damage to the veins at the time of the procedure; and
GOOD LUCK
fetal death due to uterine vessels occlusion.
GOOD LUCK
T his is usually performed after the 12th week of pregnancy, the time after
which a woman is least likely to miscarry for other reasons - but it is not
done if there is rupture of the membranes or infection.
The cerclage is usually removed just before childbirth so that the patient
can give birth vaginally. In some cases, the cerclage may be left in place,
and the baby is then delivered by cesarean section.
Ophtha
17- a 45 y/o male came to the ER with sudden headache, blurred vision,
excruciating eye pain and frequent vomiting . The most likely Dx:
a) Acute conjunctivitis.
b) Acute iritis
c) Acute glaucoma
d) Episcleritis
e) Corneal ulceration
Acute angle guacoma
S ymp : Acute onset of severe pain; blurred vision; ,frontal headache; halos
around lights;; red eye/conjunctiva , severe eye pain, discomfort, nausea,
and vomiting
Signs : increased IOP greater than 30 mm Hg (normal range: 10 to 23 mm
Hg), a mid-dilated pupil (4 to 6 mm),sluggish reaction of the pupil to direct
illumination, a shallow anterior chamber, a hazy cornea, and hyperemic
conjunctiva
Risk factors for acute angle-closureglaucoma include anterior placement
of the lens, hyperopia, myopia, narrow angle, and shallow anterior
chamber. An attack of acute angle-closure glaucoma in predisposed
persons can occur as a result of dim lighting or use of certain medications
(e.g., dilating drops, anticholinergics, antidepressants). Medications such
as sulfa derivatives and topiramate (Topamax) can cause swelling of the
ciliary body and secondary angle closure.
Rx : Lowering IOP with acetazolamide 500 mg orally once; and one drop
each of 0.5% timolol maleate (Timoptic), 1% apraclonidine (Iopidine), and
2% pilocarpine (Isopto Carpine) one minute apart and repeated three
times at five-minute intervals . Immediate referral to an ophthalmologist!!If
acute angle-closure glaucoma is not treated immediately, damage to the
optic nerve and significant and permanent vision loss can occur within
hours. Therapy is initiated to lower the intraocular pressure, reduce pain,
and clear corneal edema in preparation for iridotomy. Definitive treatment
for primary acute angle-colsure glaucoma is laser iridotomy. Surgical
iridectomy can be performed if a laser iridotomy is not successfully
GOOD LUCK
performed.
GOOD LUCK
Med
18- Patient in ER : dyspnea, Rt sided chest pain , engourged neck viens and
weak heart sounds , absent air entry over Rt lung . Plan of Treatment for this
patient:
a) IVF, Pain killer, O2
b) Aspiration of Pericardium
c) Respiratory Stimulus
d) Intubation
e) Immediate needle aspiration , chest tube .
Symptoms and signs of tension pneumothorax may include the following:
Physical:
GOOD LUCK
Pedia
19- Which of the following physical findings in boys is the earliest indication
that the puberty has begun?
Pedia
20- A 48 hour old newborn infant in critical care unit with respiratory
distress & Jaundice. Hb 9g/dl, retic 4%. Maternal Hx of previous normal term
pregnancy without transfusion, Blood typing shows hetero specificity
between mother and child. Indirect Coomb’s test is +ve. The most probable
Dx is:
a) Thalassemia
b) Maternal-Fetal blood group incompatibility
c) Sickle cell anemia.
d) Septicemia.
e) Hereditary Red cell enzyme defect.
Community Med
GOOD LUCK
GOOD LUCK
Pedia
22- An 18 months old baby brought by his mother. She complains that her
child says only mama & baba. Otherwise the baby is completely normal.
First step to evaluate this patient is:
a) Physical Examiniation.
b) Chromosomal Analysis
c) Hearing Evaluation.
d) Developmental testing.
e) CT scan of the head.
Pedia
23- A full term infant brought by his mother weighing 3800gm developed
jaundice on the 2nd day of life. The infant appears healthy & breast- fed well.
Hb 18 g/dl. Direct & indirect coomb’s tests are negative. T.Bili 189umol/dl.
Indirect bili 184 umol/dl. The most likely Dx is:
GOOD LUCK
GOOD LUCK
(continue)
September 2006
(RAB – 2008)
Pediatrics
24. A 5 day old baby vomited dark red blood twice over the past 4 hours. He is
active & feeding well by breast. The MOST likely cause is :
A) Esophagitis
B) Esophageal Varices
C) Gastritis
D) Duodenal Ulcer
E) Cracked Maternal Nipples
Pediatrics
25.A 5 year old patient was seen in the ER with history of fever & a sore throat.
Which of the following suggest a viral etiology for his complaint?
A) Presence of a thin membrane over his tonsils
B) A palpable tender cervical lymph node
C) Petechial rash at the hard & soft palate
D) Absence of cough
E) Rhinorrhea of clear colorless secretions
Answer: E , the answers A,B,C all go with a bacterial etiology and a viral etiology
would CAUSE cough as a symptom hence the answer is E (viruses cause runny
nose) reference :
http://www.clevelandclinic.org/health/health-nfo/docs/3500/3500.asp?index=11751
Medicine
26.An 80 year old lady presented to your office with a 6 month history of stiffness
in her hand,bilaterally. This stiffness gets worse in the morning and quickly
subsides as the patient begins ge daily activities. She has no other significant
medical problems. On examination the patient has bilateral bony swellings at the
margins of the distal interphalangeal joints on the (2nd-5th) digits. No other
abnormalities were found on the physical examination. These swellings represent :
A) Heberden’s nodes
B) Bouchar’s nodes
C) Synovial thickenings
D) Subcutaneous nodules
GOOD LUCK
E) Sesamoids
GOOD LUCK
Answer: A , the history suggests osteoarthritis which has both heberden’s nodes and
bouchard’s ,depending on the location the names of the nodes differ heberden’s
nodes are at the DIPJ while bouchard’s nodes are at the PIPJ. Reference:
Saunders’pocket essentials of Clinical medicine (parveen KUMAR)
Medicine
27.Which of the following radiological features is a characteristic of miliary
tuberculosis:
A) Sparing of the lung apices
B) Pleural effusion
C) Septal lines
D) Absence of glandular enlargement
E) Presence of a small cavity
Medicine
28.A 70 year old woman presented with a 3 day history of perforated duodenal
ulcer, she was febrile ,semi comatose and dehydrated on admission. The BEST
treatment is :
A) Transfuse with blood, rehydrate the patient , perform vagotomy and drainage
urgently
B) Insert a NGT (nasogastric tube) & connect to suction, hydrate the patient, give
systemic antibiotics and observe.
C) Insert a NGT & connect to suction, hydrate the patient ,give systemic antibiotics
and perform placation of the perforation.
D) Hydrate the patient ,give blood ,give systemic antibiotics and perform
hemigastrectomy
E) Non of the above
Surgery
29.The following are complications of laproscopic cholecystectomy EXCEPT:
A) Bile leak
B) Persistent pneumoperitoneum
C) Shoulder tip pain
D) Ascites
GOOD LUCK
E) Supraumbilical incisional hernia
GOOD LUCK
Answer: B (not persistent)
http://www.surgery.usc.edu/divisions/tumor/pancreasdiseases/web%20pages/BILIA
RY%20SYSTEM/laparoscopic%20chole.html
Surgery
30.Fissure-in-ano MOST commonly occurs:
A) Posteriorly
B) Anteriorly
C) Laterally
D) In men
E) In cases of diarrhea
Surgery
31.A 20 year old man involved in a RTA brought to ER by friends.On examination
he was found to be conscious but drowsy .Vitals: HR 120 beats/min , BP 80/40 the
MOST urgent initial management measure is :
A) CT scan of brain
B) X-RAY of cervical spine
C) Rapid infusion of crystalloid
D) ECG to exclude heamopericardium
E) U.S abdomen
Medicine
32.A 30 year old man presents with shortness of breath after a blunt injury to his
chest,RR 30 breaths/min,CXR showed complete collapse of the left lung with
pneumothorax, mediastinum was shifted to the right. The treatment of choice is:
A) Chest tube insertion
B) Chest aspiration
C) Thorocotomy and pleurectomy
D) IV fluids & O2 by mask
E) Intubation
Answer: A reference blueprints in medicine 2nd edition part one CVS 1.chest pain
GOOD LUCK
GOOD LUCK
Surgery
33.A cervical lymph node is found to be replaced with a well differentiated thyroid
tissue. At the operation there are no palpable lesions in the thyroid gland. The
operation of choice is:
a) total thyroidectomy & modified dissection
b) total thyroidectomy and radical neck dissection
c) total thyroidectomy
d) thyroid lobectomy and removal of all local lymph nodes
e) thyroid lobectomy and isthmusthectomy and removal of all local enlarged lymph
nodes.
Answer: A reference:
http://coloradosurgicalservice.com/articles/Thyroid_Cancer.html
Pharamology
34.One of the following combination of drugs should be avoided:
a)cephaloridine and paracetamol
b)penicillin and probenecid
c)digoxin and levadopa
d)sulphamethoxazole and trimethoprim
e)tetracycline and aluminium hydroxide
http://www.forces.gc.ca/health/hs_staff_sites/MCSP/ppt/engraph/Adverse_Drug
_Interactions_in_Elderly.ppt#1
Medicine
35.a 40 year old man presented to the ER with 6 hour history of severe epigastric
pain radiating to the back like a band associated with nausea.NO vomiting or
diarrhea.No fever. On examination the patient was in severe pain with epigastric
tenderness.ECG was normal,serum amylase was 900u/l,AST and ALT are elevated
to double normal.which of the following is the LEAST likely precipitating factor to
this patients condition
a)hypercalcemia
b)chronic active hepatitis
c)chronis alcohol ingestion
d)hyperlipedemia
e)cholethiasis
GOOD LUCK
GOOD LUCK
Pediatrics
36.Cellulitis occurring about the face in young children (6-24 months) and
associated with fever and purple skin discoloration is MOST often caused by:
a)group A beta haemolytic streptococci
b)heamophilis influenza type B
c)streptococcus pneumoniae
d)streptococcus aureus
e)pseudomonas
Community Medicine
37.Which one of the following diseases is NOT transmitted by mosquitoes?
a)rift valley fever
b)yellow fever
c)relapsing fever
d)filariasis
e)dengue fever
Surgery
38.a non opaque renal pelvis filling defect is seen on IVP.Ultrasound reveals dense
echoes and acoustic shadowing.The MOST likely diagnosis is:
a)blood clot
b)tumor
c)sloughed renal papilla
d)uric acid stone
e)crossing vessel
Surgery
39.in a conscious multiple trauma patient your priorities are:
a)to stop bleeding,then IV fluids
b)to secure air entry,breathing then BP
c)to start an iv fluid and send blood for cross matching
GOOD LUCK
d)to intubate the patient
e)to do peritoneal lavage then IV fluids
GOOD LUCK
Answer:B reference:
(basic life support)
Psychiatry
40.Delusion
a)perception of sensation in absence of an external stimulus
b)misinterpretation of stimulus
c)false belief not in accordance of a persons culture
d)manifestation of…
e)unconscious inhibition of..
answer:C reference:
http://www.medterms.com/script/main/art.asp?articlekey=26290
Surgery
41.a 20 year old patient had deep laceration in his right wrist.which of the following
is the result from this injury
a)wrist drop
b)claw hand
c)sensory loss only
d)inability of thumb opponins to other fingers
e)inability of flexion of the interphalangeal joint
Answer: B reference:
http://www.hs.columbia.edu/dept/ps/2006/academics/year1/anat/anat_exam3_bplesi
ons.pdf
OB/GYNE
42.Before any instrumental delivery we should rule out:
a)cord prolapse
b)cephalopelvic disproportion
c)face presentation ??
d)placental abruption
Trained operator
Legitimate indication
Cervix fully dilated (rare exception = in multip before 10cm dilation if
GOOD LUCK
fetal distress)
GOOD LUCK
No cephalo-pelvic disproportion (CPD)
Head engaged (rare exception to this rule = if difficulty in delivering
2nd twin in fetal distress)
Presentation known (not breech - but can use forceps to deliver after-
coming head; not occipitolateral as forceps can crush face)
Contractions present
Membranes ruptured
Bladder empty
Face presentations
<36wks gestation
Bleeding from fetal blood sampling (FBS) site (ventouse delivery only)
Maternal infection
Haemorrhagic fetal conditions
Surgery
43.a 75 year olf man came to the ER complaining of acute urine retention what will
be ur initial management:
a)send patient immediately to OR for prostatectomy
b)empty urinary bladder by folley’s catheter and tell him to come back to the clinic
c)give him antibiotics because retention could be from sort of intection
d)insert folly’s catheter and tell him to come back to the clinic (b & d are repeated)
e)admission,investigation which include cystoscopy then…
Pediatrics
44.Coarctation of the aorta in commonly associated with which of the following
syndromes?
a)down
b)turner
c)patau
d)edward
e)holt orain
GOOD LUCK
Answer: B (2nd edition illustrated textbook of paediatrics)
GOOD LUCK
Pediatrics
45.a …year old child with tonsillitis & follicle & membrane over the tonsils with
fever. The fever reduced after 2 days of penicillin. For how many days are you
going to keep the patient on penicillin?
a)3 days
b)5 days
c)7 days
d)10 days
e)14 days
Medicine
46.a patient came to you & you found his BP to be 160/100,he isn’t on any
medication yet. Lab investigations showed:
Creatinine (normal)
Na 145 (135-145)
K 3.2 (3.5-5.1)
HCO3 30(22-30)
What is the diagnosis?
a)essential hypertension
b)pheochromocytoma
c)addisons disease
d)primary hyperaldosteronism
OB/GYNE
47.in a vesicular mole:
a)B-hCG is lower than normal
b)fundal height in lower than normal
c)fetal heart can be detected
d)ovarian cyst is a common association
e)hypothyroid symptoms may occur
Answer: D
Reference: http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x12416.html
GOOD LUCK
GOOD LUCK
Surgery
48.which of following mostly occur in a patient with intracranial abscess
a)cough
b)vomiting
c)ear discharge
d)frontal sinusitis
Community medicine
49.what is the best method for preventing infection from one patient to another & to
health care workers?
a)wearing gloves when examining every patient
b)hand washing before & after each patient
c)wearing a mask & gown before examining an infected person
d)recapping needles & put them in a sharp container
e)isolation of all infected persons
Community medicine
50.your asked to manage an HIV patient who was involved in a car accident.You
know that this patient is a drug addict & has extramarital relations. What are you
going to do?
a)complete isolation of the patient when he is in the hospital
b)you have the right to look after the patient to protect yourself
c)you will manage this emergency case with taken all the recommended precautions
d)you will report him to legal authorities….after recovery
e)tell his family that he is HIV positive
Answer: C
Microbiology
51.A family went to a dinner party after 6 hours they all had symptoms of
abdominal pain,nausea, vomiting and dehydration. Some of them recovered while
others needed hospitilzation. What’s the most likely organism?
a)giardia
b)staph aureus
c)salmonella
d)c.perfiringis
e)c.boyulism
GOOD LUCK
Answer:B
GOOD LUCK
Reference:medical diagnosis and management (Danish)
http://www.nmenv.state.nm.us/fod/Food_Program/documents/safety/foodborne_i
llness_ref.pdf
Community medicine
52.when a person id predicted NOT to have a disease he is called (negative).then
what is true negative?
a)when a person is predicted to have a disease,has it
b) when a person is predicted to have a disease,doesn’t have it
c)when a person is predicted to not to have a disease,doesn’t have it
d) when a person is predicted to not to have a disease,has it
e)when risk cannot be assessed
Answer: C
Microbiology
53.a 25 year old male who recently came from India presented with a 3 days history
of left knee pain + swelling, 1 day history of right wrist swelling.on examination it
was swollen, tender,red with limitation of movement.50 cc of fluid was aspirated
from the knee.Gram stained showed gram positibe diplococci.Whats the most likely
organism?
a)brucella
b)nisseria meningitides
c)strep. Pneumonia ??
d)staph aureus
e)strept. pyogens
Answer: ----- (if all else fails go with C ) but strep pneumonia can cause
opteomylitis and it is diplocci
http://aapredbook.aappublications.org/cgi/content/extract/2003/1/3.98
Psychiatry
54.A…year old lady presented to you and told you that she knows she has cancer in
her stomach.She visited 6 doctors before you & had an ultrasound done…times &
barium meal….times.No one believes what she said & told you that you’re the last
doctor she’s going to see before seeiking herbal medicine.whats the diagnosis?
a)generalized anxiety
b)panis attack
c)conversion reaction
d)hypochondriasis
e)anxiety
Answer: D
Reference:http://www.medterms.com/script/main/art.asp?articlekey=18717
GOOD LUCK
Ophthalmology
)
GOOD LUCK
55.A patient came to you complaining of gradual loss of vision & now he can only
identify light.which of the following is the LEAST cause of his problem?
a)retinal detachment
b)central retinal artery embolism
c)vitreous hemorrhage
d)retinitis pigmentosa
e)retrobulbar neuritis
Surgery
56.which of the following is the most likely cause of infection after IV fluid through
a canula?
a)infection of the fluid in the factory
b)infection of the fluid during passing in the canula
c)infection at the site of needle insertion
d)disseminated infection due to transient bacteremia
Answer: C
Surgery
57.Which of the following indicates that a breast lump is safe to leave after
aspiration?
a)a cyst that doesn’t refill
b)solid rather that cust
c)cytology showed fibrocystic disease
e)minimum blood in aspiration fluid
Answer:C
Reference: http://www.mayoclinic.com/health/breast-lumps/BR00013
Surgery
58.IV fluid in burn patients in given:
a) ½ of total fluid is given in the first 8 hours post burn
b) ¼ of total fluid is given in the first 8 hours post burn
c) the whole total fluid is given in the first 8 hours
d) ½ of total fluid is given in the first 6 hours post burn
e) ¼ of total fluid is given in the first 6 hours post burn
Answer: A
Reference: Churchill textbook
GOOD LUCK
Medicine
GOOD LUCK
59.a 15 year old boy came to your clinic for a check up.Hes asymptomatic.His CBC
showed: Hb 118 g/L,WBC 6.8 , RBC 6.3 (high) , MCV 69 (low) ,MCH (low),
Retics 1.2 %(1-3)
Whats the most likely diagnosis?
a)iron deficiency anemia
b)anemia due to chronis illness
c)B-thalasemia
d)sickle cell disease
e)folic acid deficiency
Answer:A
http://www.drkaslow.com/html/blood_cell_counts.html
http://www.mcg.edu/pediatrics/CCNotebook/chapter2/anemia.htm
CPR
60.whats the ratio of ventilation to chest compression in a one person CPR?
a) 2 ventilation & 15 compression at rate of 80-100/min
b)1 ventilation & 15 compression at rate of 80-100/min
c)2 ventilation & 7 compression at rate of 80-100/min
d)1 ventilation & 7 compression at rate of 80-100/min
e)3 ventilation & 15 compression at rate of 80-100/min
Answer: A
Reference: http://www.fotosearch.com/LIF131/cprcycle/
Medicine
61.a 28 year old lady presented with history of increased bowel motion in the last 8
months.About 3-4 motions/day .Examination was normal.Stool analysis showed:
Cyst,yeast:nil
Mucus ++
Culture:no growth
Whats the most likely diagnosis?
a)inflammatory bowel disease
b)irritable bowel disease
c)diverticulitis
Answer: A
GOOD LUCK
GOOD LUCK
(continue)
September 2006
(IYF – 2008)
(ENT)
62- Facial nerve when it exits the tempromandibular joint and enter parotid
gland it passes:
a) Deep to retromandibular vein
b) Deep to internal carotid artery
c) Superficial to retromandibular vein and ext. carotid artery (It is the
most lateral structure within parotid gland)
d) Deep to ext. carotid artery
e) Between ext. carotid artery and retromandibular vessels
(ENT)
63-a patient presented to you complaining of left submandibular pain and
swelling when eating. O/E, there is enlarged submandibular gland, firm. What
is the most likely Dx?
a) Mumps
b) Sjogren’s syndrome
c) Hodgkin’s lymphoma
d) Salivary gland calculi ( this is the clinical presentation, see Kumar 5th
edition p.261)
(ENT)
64- Ferq. Use of nasal vasoconstrictors can cause:
a) Rhinitis sicca (sicca means dry)
b) Allergic rhinitis
c) Septal perforation
GOOD LUCK
e) It is deaths per 10,000 live birth
GOOD LUCK
(OB/GYN)
66- About antepartum hemorrhage:
a) Need immediate assessment by vaginal exam
b) Mother risk is more than fetal risk (bcz its one of the leading cause of
maternal death)
(OB/GYN)
67- Which of the following tests is mandatory for all pregnant woman?
a) HIV
b) Hepatitis B surface antigen
c) VDRL (veneral disease research laboratory)
all of them are mandatory
(Medicine)
68- When lactic acid accumulates, body will respond by:
a) Decrease production of bicarbonate
b) Excrete CO2 from the lungs ( if lactic acid accumulate → metabolic
acidosis, the body compensate to some extant by hyperventilation, via
medullary chemoreceptor, leading to ↑ removal of CO2 in the lung and partial
compensation of the acidosis)
c) Excrete Chloride from the kidneys
d) Metabolize lactic acid in the liver
(Medicine)
69- What is the initial management of acute hypercalcemia?
a) Correction of exter-cellular fluid (by adequate rehydration)
(OB/GYN)
70- Which of the following suggests enormous ovarian cyst more than
ascites?
a) Fluid wave
b) Decrease bowel motion
c) Shifting dullness
d) Tympanic central, dullness lateral
e) Dullness central, tympanic lateral
GOOD LUCK
GOOD LUCK
(Medicine)
71- A 25 years old student presented to you with sever headache over the last
few days. O/E he was agitated and restless. What Dx must be considered this
case?
a) Acute sever migraine
(OB/GYN)
72- A pregnant lady 34 weeks came to you in labor. O/E, the baby is back
down, transverse lie, cervix is 3 cm dilated and bulging membrane. Her
contractions are 1/ 4 minutes. U/S showed posterior fundal placenta. What is
the management?
a) C. section (the leady is in labor, cervix is dilated and she is contracting →
C.S bcz fetus is transverse)
b) Amniotomy
c) Oxytocin
d) Amniocentesis to assess fetal lung maturity
(Ortho)
73- Sciatica:
a) Never associated with sensory loss
b) Maybe associated with calf muscle weakness (if herniation disk occur @
S1 pt. cannot do planter flexion of the foot)
c) Do not cause pain with leg elevation
d) Causes increased lumber lordosis
(OB/GYN) *
74- U/S of pregnant lady showed posterior wall placenta. It dose not reach
examining finger by vaginal exam. Which of the following is true?
a) Complete placenta previa
b) Normal site placenta
c) Low lying placenta (bcz it’s in the posterior wall and dose not reach
examining finger)
d) Placenta previa marginalis
e) Incomplete centralis
GOOD LUCK
GOOD LUCK
(OB/GYN)
75- All of the following is true about IUGR except:
a) Asymmetric IUGR is usually due to congenital anomalies (In most
cases of IUGR, especially those due to primary placental insufficiency, the
fetal abdomen is small, but the head and extremities are normal or near
normal. This finding is known as the head-sparing effect. In cases of severe,
early-onset IUGR, those due to chromosomal anomalies, the fetus tends to be
more symmetrically small)
b) IUGR babies are more prone to meconium aspiration and asphyxia
c) Inaccurate dating can cause misdiagnosed IUGR
(Radiology)
76- What is the simplest method to diagnose fractured rib:
a) Posteronterior x ray (sensitivity is low 50%) ?
b) Lateral x ray
c) Tomography of chest (more sensitive than plian radiographs, can give the
number of fractured ribs)
But if simple means the least complicated method (easy to do, easy to
read). Answer will be A even though it is less sensitive
(OB/GYN)
77- A healthy 28 years old lady P1+0 presented to you with 6 months
amenorrhea. What is the most likely cause for her amenorrhea?
a) Pregnancy (the most common cause of 2nd amenorrhea is pregnancy)
b) Turner syndrome (cannot be, bcz they have ovarian dysgenesis →
infertility)
(Medicine)
78- Definition of status epilepticus:
a) Generalized tonic clonic seizure more than 15 minutes
b) Seizure more than 30 minutes without regains consciousness in
between (see Kumar 5th edition p.1177)
c) Absence seizure for more than 15 minutes
GOOD LUCK
GOOD LUCK
(OB/GYN)
79- Action of contraceptive pills:
a) Inhibition of estrogen and then ovulation
b) Inhibition of prolactin then ovulation
c) Inhibition of protozoa by change in cervical mucosa
d) Inhibition of midcycle gonadotropins then ovulation (OCP contain
estrogen and progesterone or progesterone only, they place the body in a
“pseudopregnancy” state by interfering with pulsatile release of FSH and LH
from the ant. Pituitary this lead to suppresses ovulation
e) Inhibition of implantation of the embryo
(Medicine)
80- Rubella infection:
a) Incubation period 3-5 days
b) Arthritis (its one of the complications of Rubella but its rare, see Kumar
5th p.54 and Illustrated Textbook of Pediatrics 2nd p.190)
c) Oral ulcers
d) Start with high fever
e) Don’t cause cardiac complications or deafness
GOOD LUCK
GOOD LUCK
(continue)
September 2006
(AHM – 2008)
OB/GYN
Q81) Best detector of progress of labor is:
a- dilatation.
b- descent.
c- dilatation & descent.
d- degree of pain.
e- fetal heart rate.
OB/GYN
Q82) A35 years old primi 16 weeks gestation coming for her first
check up. She is excited about he pregnancy. No history of any
previous disease. Her blood pressure after a rest was 160/100. after
one week her BP was 154/96. what is the most likely diagnosis?
a- pre-eclampsia.
b- chronic HTN.
c- lable HTN.
d- chronic HTN with superimposed pre-eclampsia.
GOOD LUCK
e- transient HTN.
GOOD LUCK
http://www.aafp.org/afp/20041215/2317.pdf 2nd page
labile: Some people’s blood pressure changes often and
repeatedly due to various factors. These people can have
high blood pressure due to emotional stress. Symptoms may
include headaches and ringing in the ears. Treatment using
blood pressure medication isn’t always effective. Doctors
sometime prescribe anti-anxietymedications instead. People
going through stressful situations should monitor their blood
pressure in case stress-induced high blood pressure
develops.
Confirmed by a consultant
OB/GYN
Q83) A 55 years old man known case of COPD. Now complaining
of 1 week fever, productive cough. CXR showed left upper lobe
pneumonia. Sputum culture positive H.influenza. what are you
going to give him?
a- penicillin.
b- doxycyclin.
c- cefuroxime.
d- gentamycin.
e- carbincillin.
Confirmed by a consultant
http://www.emedicine.com/EMERG/topic385.htm
GOOD LUCK
History
The typical presentation is a previously healthy infant boy aged 6-12
months with sudden onset of colicky abdominal pain with vomiting.
Paroxysms of pain occur 10-20 minutes apart.
Initially, loose or watery stools are present concurrent with vomiting
and, within 12-24 hours, blood or mucous is passed rectally.
Early in the course, the patient appears completely well between the
episodes of abdominal pain.
Lethargy may dominate the initial presentation. However, lethargy
usually occurs later in the process.
The classic triad of colicky abdominal pain, vomiting, and red currant
jelly stools occurs in only 21% of cases.
OB/GYN
Q85) A 15 years old girl her menarche was at age of 13 years. She
is complaining of menstrual pain. She is not sexually active. Her
examination & pelvic US were normal. How are you going to
manage her?
a- laprotomy.
b- danazol.
c- cervical dilatation.
d- NSAID.
Confirmed from a consultant
Primary care
Q86) A 32 y.o. lady work in a file clerk developed sudden onset of
low back pain when she was bending on files, moderately sever for
3 days duration. There is no evidence of nerve root compression.
What is the proper action?
a- bed rest for 7 to 10 days.
b- traction.
c- narcotic analgesia.
d- early activity with return to work.
e- CT scan for lumbosacral vertebrae.
GOOD LUCK
I don’t know
GOOD LUCK
Surgery
Q87) A 45 y.o. lady presented with nipple discharge that contains
blood. What is the most likely diagnosis?
a- duct papilloma.
b- duct ectasia.
c- breast abscesss.
d- fibroadenoma.
e- fat necrosis of breast.
Breast disorders:-
Breast infection
Breast abscess (pus discharge)
Breast cyst according to the type of Cyst
Breast duct papilloma - typically a bloody nipple discharge;
sometimes yellow nipple discharge.
Mastitis
Breast cancer
Ductal ectasia - may cause a green or brown nipple discharge
Breast duct cancer (see Breast cancer)
Breast papilloma (see Breast lump)
Paget's disease of nipple - cancause a bloody nipple discharge
http://www.wrongdiagnosis.com/sym/nipple_discharge.htm
Medicine
Q88) In moderate to sever asthmatic patient, you will find all the
following EXCEPT:
a- PO2 < 60
b- PCO2 > 60
c- low HCO3
d- IV hydrocortisone will relieve the symptoms after few hours.
e- dehydration.
GOOD LUCK
GOOD LUCK
Medicine
Q89) A 30 y.o. man presented with history of left sided chest pain
& shortness of breath. BP 80/50. On examination, hyper-resonant
chest on the left side. The most likely diagnosis:
a- pneumonia with pleural effusion.
b- MI.
c- spontaneous pneumothorax.
OB/GYN – surgery
Q90) A 20 y.o. married lady presented with history of left lower
abdominal pain & amenorrhea for 6 weeks. The most appropriate
investigation to role out serious diagnosis is:
a- CBC.
b- ESR.
c- pelvic US.
d- abdominal XR
e- vaginal swab for culture & sensitivity.
GOOD LUCK
GOOD LUCK
so if you suspect there's a problem, don't wait for a positive
pregnancy test to contact your caregiver.
Pain that gets worse when you're active or while moving your
bowels or coughing
http://www.babycenter.com/0_ectopic-
pregnancy_229.bc?articleId=229&showAll=true
Medicine
Q91) Greatest risk for stroke:
a- DM.
b- family history of stroke.
c- high blood pressure.
d- hyperlipidemia.
e- cigarette smoking.
Medicine
Q92) this Q was about forced vital capacity (FVC).
For more information: http://www.spirxpert.com/indices5.htm
Pharmacology
Q93) Vertigo, inability to perceive termination of movement &
difficulty in sitting or standing without visual due to some toxic
reacts that likely to occur in 75% of patient with long term use of:
a- penicilline.
b- tetracycline.
c- amphotricin B.
d- streptomycin.
e- INH.
GOOD LUCK
GOOD LUCK
Pharmacology
Q94) patient had anterior wall MI and will he was transferred to
ICU the nurse notice that he has PVC …. 20 per minute. He is on
digoxin, diuretic. What do you want to add?
a- propanolol.
b- amidarone.
c- moxillin.
d- nothing.
Medicine
Q95) patient was diagnosed to have D U and was given ranidetin for
2 weeks and now he is diagnosed to have H.pylori. what is your
choice of management?
a- Omeprazol+ clarithromcin+ amoxacylin.
b- bismuth+ tetracycline+ metronidazol.
c- metronidazol+ amoxicillin.
d- omeprazol+ tetracycline.
GOOD LUCK
GOOD LUCK
Bismuth subsalicylate 525 mg PO qid, plus
metronidazole 500 mg PO tid and tetracycline
500 mg PO qid and a PPI (eg, lansoprazole 30 mg
PO [optimal dose] or omeprazole 20 mg PO
[optimal dose]) for 14 days
Bismuth subsalicylate 525 mg PO qid, plus
metronidazole 250 mg PO qid and tetracycline
500 mg PO qid and any H2RA for 14 days
http://www.emedicine.com/med/topic591.htm
Medicine
Q96) Patient had abdominal pain for 3 months, what will support
that pain due to duodenal ulcer?
a- pain after meal 30-90 min.
b- pain after meal immediately.
c- pain after nausea & vomiting.
d- pain after fatty meal.
e- pain radiating to the back.
GOOD LUCK
stimulation of gastric acid secretion is the highest.
GOOD LUCK
o About 50-80% of patients with duodenal ulcer
experience nightly pain, as opposed to only 30-40% of
patients with gastric ulcer and 20-40% of patients with
nonulcer dyspepsia (NUD).
o Pain is often relieved by food, a finding often cited as
being specific for duodenal ulcer. However, this
symptom is present in only 20-60% of patients and
probably not specific for duodenal ulcer.
http://www.emedicine.com/med/topic591.htm
Ophthalmology
Q97) 30 y.o. patient complaining of 1 day history of ptosis & he
noticed his eye coming outward?????,,,, on examination his pupil
reflex was normal……. ???
a- carotid aneurysm.
b- 3rd N palsy.
c- 4th N palsy.
d- 6th N palsy.
e- strabismus.
Community Medicine
Q98) Using the following classification:
Total Non-case Case Risk factor
A+B B A Present
C+D D C Absent
B+D A+C Total
Relative risk of those with the risk factor to those without risk
factor is:
a- A/A+B b- A/A+B c- C/C+D d- AD/BC e-A/B
C/C+D C/D
GOOD LUCK
GOOD LUCK
March 2007
(FHM – 2008)
Pediatrics/ Hematology
1) An 8-year-old girl presented with fever, numerous bruises over
the entire body, and pain in both legs. Physical examination
reveals pallor and ecchymoses and petechiae on the face, trunk
and extremities. Findings on complete blood count includes a
hemoglobin of 6.3 g/dl, white cell count of 2800/mm3 and platelet
count of 29,000/mm3. Which of the following would be the MOST
appropriate diagnostic test?
A. Hb electrophoresis.
B. Bone marrow aspiration.
C. Sedimentation rate. (ESR)
D. Skeletal survey.
E. Liver and spleen scan.
Pediatrics /Ortho
2) A 2-year-old baby was brought to the clinic because of inability
to walk straight. On examination, there was asymmetry of skin
creases in the groin. The Trendelenburg’s sign was positive on
the left side. Your diagnosis is:
A. Fracture pelvis.
B. Congenital hip dislocation.
C. Fracture femur on the left side.
D. Poliomyelitis.
E. Rickets.
Pediatrics
3) An 18-month-old child is found to have dental decay in the
upper central and lateral incisors. This is MOST suggestive of:
A. Excessive fluoride ingestion.
B. Milk-bottle caries.
C. Tetracycline exposure.
D. Insufficient fluoride intake.
GOOD LUCK
E. Failure to brush the child’s teeth properly.
)
GOOD LUCK
Infants & children who are put to bed with bottle containing
fermentable liquids (milk or sucrose containing fruit juices) are of
particular risk of developing severe dental caries.
Characteristically fluid collects around the upper anterior &
posterior teeth.
Illustrated textbook of pediatrics.
Pediatric Surgery
4) A mother brought her 16-month-old baby boy to the emergency
room. She said the baby was crying on and off for about 24
hours, now he is passing currently jelly stool. The MOST likely
diagnosis is:
A. Necrotizing enterocolitis.
B. Duplication of the Gut.
C. Intussusception.
D. Bowel obstruction secondary to internal hernia.
E. Meckel’s diverticulum.
GOOD LUCK
GOOD LUCK
Pediatrics/ Cardiology
5) A 7-moth-old boy presented with history of interrupted feeds
associated with difficulty in breathing and sweating for the last 4
months. Physical examination revealed normal peripheral pulses,
hyperactive precordium, normal S1, loud S2 and Pansystolic
murmur grade 3/6 with maximum intensity at the 3rd left
intercostal space parasternally. The MOST likely diagnosis is:
A. Small PDA (Patent ductus arteriosus).
B. Large ASD (Atrial septal defect).
C. Aortic regurgitation.
D. Mitral regurgitation.
E. Large VSD (Ventricular septal defect).
GOOD LUCK
GOOD LUCK
Pediatrics
6) Which of the following vaccines must NOT be given to a
household contact of an immunodeficient child?
A. Mumps, measles and rubella.
B. BCG.
C. Influenza vaccine.
D. Oral polio vaccine.
E. Hepatitis B vaccine.
Pediatrics
7) A 6-year-old girl presented with low grade fever and arthralgia
for 5 days. She had difficulty in swallowing associated with fever
3 weeks prior to presentation. Physical examination revealed a
heart rate of 150/min and pansystolic murmur at the apex. There
was no gallop
and liver was 1 cm below costal margin. The MOST likely
diagnosis is:
A. Bacterial endocarditis.
B. Viral myocarditis.
C. Acute rheumatic fever.
D. Pericarditis.
E. Congenital heart failure.
Pediatrics
8) A 10-year-old girl presented with a 2-day history of fever and a
4 cm, warm, tender and fluctuant left anterior cervical lymph
node. The MOST likely diagnosis is:
A. Hodgkin’s disease.
B. Acute lymphoblastic leukemia (ALL).
C. Histiocytosis X.
D. Acute bacterial lymphadenitis.
E. Metastatic neuroblastoma.
GOOD LUCK
GOOD LUCK
Pediatrics/ ENT
9) Fetid (i.e: offensive odor) unilateral nasal discharge in
childhood is commonly caused by:
A. Atrophic rhinitis.
B. Adenoids.
C. Foreign body (neglected).
D. Choanal atresia.
E. Deviated nasal septum.
Pediatrics
10) A 3-year-old child wakes from sleep with croup, the
differential diagnosis should include all EXCEPT:
A. Pneumonia.
B. Post nasal drip.
C. Tonsillitis.
D. Cystic fibrosis.
E. Inhaled foreign body.
ID/Pharmacology
11) Which of the following antibiotics has the least activity
against S. aureus?
A. Erythromycin.
B. Clindamycin.
C. Vancomycin.
D. Dicloxicillin.
E. First generation cephalosporins.
GOOD LUCK
GOOD LUCK
Medicine
12) A 61-year-old man with known ischemic heart disease and
peripheral vascular disease is started on an ACE inhibitor by his
GP for hypertension. Three weeks later he is admitted with
increasing confusion and vomiting. Investigations reveal:-
CBC: Hb 14.9 g/dl, MCV 88 fl, WBC 13.6 x 109/L;
U & Es: Na+ 131 mmol/L, K+ 7.3 mol/L, urea 37.8 mmol/L, Cr 858
umol/L.
The patient is suffering from:
A. Diabetic nephropathy.
B. Phaeochromocytoma.
C. Polycystic kidney disease.
D. Raised intracranial pressure.
E. Renal artery stenosis.
Psychiatry
13) A 65-year-old male with hypertension, congestive heart
failure, and peptic ulcer disease came to your office for his
regular blood pressure check. Although his blood pressure is
now under control, he complains of an inability to maintain an
erection. He currently is taking propranolol, verapamil,
hydrochlorothiazide, and ranitidine. On examination his blood
pressure is 125/76 mmHg. His pulse is 56 and regular. The rest of
the cardiovascular examination and the rest of the physical
examination are normal. Which of the following generally
considered to be the MOST common cause of sexual
dysfunction?
A. Pharmacological agents.
B. Panic disorder.
C. Generalized anxiety disorder (GAD).
D. Major depressive disorder (MDD).
E. Dysthymic disorder.
GOOD LUCK
GOOD LUCK
Family and Community Medicine
14) You have received the computed tomography (CT) scan
report on a 34-year-old mother of three who had a malignant
melanoma removed 3 years ago. Originally, it was a Clerk’s level I
and the prognosis was excellent. The patient came to your office
1 week ago complaining of chest pain and abdominal pain. A CT
scan of the chest and abdomen revealed metastatic lesions
throughout the lungs and the abdomen. She is in your office, and
you have to deliver the bad news of the significant spread of the
cancer. The FIRST step in breaking news is to:
A. Deliver the news all in one blow and get it over with as quickly
as is humanly possible.
B. Fire a “warning shot” that some bad news is coming.
C. Find out how must the patient knows.
D. Find out how much the patient wants to know it.
E. Tell the patient not to worry.
GOOD LUCK
people who have failed with other techniques
GOOD LUCK
Medicine
16) A 46-year-old man, a known case of diabetes for the last 5
months. He is maintained on Metformin 850 mg Po TID, diet
control and used to walk daily for 30 minutes.
On examination: unremarkable.
Some investigations show the following:
FBS 7.4 mmol/L
2 hr PP 8.6 mmol/L
HbA1c 6.6%
Total Cholesterol 5.98 mmol/L
HDLC 0.92 mmol/L
LDLC 3.88 mmol/L
Triglycerides 2.84 mmol/L (0.34-2.27)
Based on evidence, the following concerning his management is
TRUE:
A. The goal of management is to lower the triglycerides first.
B. The goal of management is to reduce the HbA1c.
C. The drug of choice to reach the goal is Fibrates.
D. The goal of management is LDLC ≤ 2.6 mmol/L.
E. The goal of management is total cholesterol ≤ 5.2 mmol/L.
Medicine
17) Regarding the criteria of the diagnosis of diabetes mellitus,
the following are true EXCEPT:
A. Symptomatic patient plus casual plasma glucose ≥ 7.6
mmol/L is diagnostic of diabetes mellitus.
B. FPG ≥ 7.0 mmol/L plus 2 h-post 75 gm glucose≥ 11.1 mmol/L
is diagnostic of diabetes mellitus.
C. FPG ≤ 5.5 mmol/L = normal fasting glucose.
D. FPG ≥ 7.0 mmol/L = provisional diagnosis of diabetes mellitus
and must be confirmed in another setting in asymptomatic
patient.
E. 2-h post 75 gm glucose ≥ 7.6 mmol/L and < 11.1 mmol/L =
impaired glucose tolerance.
GOOD LUCK
GOOD LUCK
Medicine
18) A 24-year-old woman develops wheezing and shortness of
breath when she is exposed to cold
air or when she is exercising. These symptoms are becoming
worse.Which of the following is
the prophylactic agent of choice for the treatment of asthma in
these circumstances?
A. Inhaled β2 agonists.
B. Oral aminophylline.
C. Inhaled anticholinergics.
D. Oral antihistamines.
E. Oral corticosteroids.
Pediatrics
19) Which of the following medications has been shown to be
safe and effective for migraine
prophylaxis in children?
A. Propranolol.
B. Fluoxetine.
C. Lithium.
D. Naproxyn.
E. Timed-released dihydroegrotamine mesylate (DHE-45).
Medicine
20) Which one of the following regimens is the recommended
initial treatment for most adults with active tuberculosis?
A. A two-drug regimen consisting of isoniazid (INH) and rifampin
(Rifadin).
B. A three-drug regimen consisting of isoniazid, rifampin, and
ethumbutol (Myambutol).
C. A four-drug regimen consisting of isoniazid, refimpin,
pyarazinamide and ethumbutol.
D. No treatment for most patients until infection is confirmed by
culture.
E. A five-drug regimen consisting of Isoniazid, rifampin,
pyrazinamide, ethumbutol and ciprofloxacin
GOOD LUCK
GOOD LUCK
Psychiatry
21) Characteristic feature of major depressive illness is:
A. Late morning awakening.
B. Hallucination and flight of ideas.
C. High self-esteem.
D. Over-eating.
E. Decreased eye contact during conversation.
Psychiatry
22) A 26-year-old patient came to your office with recurrent
episodes of binge eating (approximately four times a week) after
which she vomits to prevent weight gain. She says that “she has
no control” over these episodes and becomes depressed
because of her inability to control herself. These episodes have
been occurring for the past 2 years. She also admits using self-
induced vomiting, laxatives, and diuretics to lose weight. On
examination, the patient’s blood pressure is 110/70 mmHg and
her pulse is 72 and regular. She is not in apparent distress. Her
physical examination is entirely normal.
What is the MOST likely diagnosis in this patient?
A. Borderline personality disorder.
B. Anorexia nervosa.
C. Bulimia nervosa.
D. Masked depression.
E. Generalized anxiety disorder.
Psychiatry *
23) Good prognostic features in schizophrenia include all but
ONE of the following:
A. Good premorbid adjustment.
B. Acute onset.
C. Male gender.
D. Family history of mood disorder.
GOOD LUCK
Basic Psychiatry. Dr. Al-Sughier.
Good prognostic factors: late onset, acute onset, obvious
precipitating factor, good premorbid personality, presence of mood
symptoms, presence of positive symptoms, good support (married,
stable family)
Bad prognostic factors: young age at onset, insidious onset,
no precipitating factors, poor premorbid personality, low IQ, many
relapses, poor compliance, negative symptoms, poor support system,
FHx of schizophrenia
Note that FHx of schizophrenia is considered a bad prognostic
factor, unlike FHx of other mood disorders, which is considered
a good prognostic factor in some references
Psychiatry
24) A 23-year-old female came to your office with a chief
complaint of having “a peculiarly jaw”. She tells you that she has
seen a number of plastic surgeons about this problem, but “every
one has refused to do anything”. On examination, there is no
protrusion that you can see, and it appears to you that she has a
completely normal jaw and face. Although the physical
examination is completely normal, she appears depressed.
What is the MOST likely diagnosis in this patient?
A. Dysthymia.
B. Major depressive disorder (MDD) with somatic concerns.
C. Somatization disorder.
D. Body dysmorphic disorder.
E. Hypochondriasis.
GOOD LUCK
GOOD LUCK
Psychiatry
25) A 29-year-old waiter consulted you regarding what he
describes as “an intense fear” before he begins his nightly
performance. He tells you that it is only a matter of time before he
“makes a real major mistake”. What is the MOST likely diagnosis
in this patient?
A. A specific phobia.
B. A social phobia.
C. A mixed phobia.
D. Panic disorder without agoraphobia.
E. Panic disorder with agoraphobia.
Psychiatry
26) Known risk factors for suicide include all the following
EXCEPT:
A. Repeated attempts at self injury.
B. Male sex.
C. Symptoms of depression with guilt.
D. Drug and alcohol dependence.
E. If the doctor asked the patient about suicide.
GOOD LUCK
GOOD LUCK
Its written clearly in Basic Psychiatry, Dr.Al-Sughier, Asking
about suicidal intention is very important, it will not make suicide
more likely.
Epidemiology
27) Incidence is calculated by the number of:
A. Old cases during the study period.
B. New cases during the study period.
C. New cases at a point in time.
D. Old cases at a point in time.
E. Existing cases at a study period.
OB/GYN
28) The site MOST likely to yield gonococci in women is:
A. The cervix.
B. The urethra.
C. The rectum.
D. The pharynx.
E. Posterior vaginal fornix.
Surgery
29) A 25-year-old female has had a sore left great toe for the past
4 weeks. On examination, the lateral aspect of the left toe is
erythematous and puffy, with pus oozing from the corner
between the nail and the skin tissue surrounding the nail. This is
the first occurrence of this condition in this patient. At this time,
what should you do?
A. Nothing and reassurance.
B. Have the patient soak her toe in saline three times daily.
C. Have the patient apply a local antibiotic cream, and prescribe
systemic antibiotics to be taken for 7-10 days.
D. Under local anesthesia, remove the whole toenail.
E. Debride the wound.
GOOD LUCK
GOOD LUCK
Treatment of Infected IGTN: with mild infection it may possible
to adopt the above regimen in addition to administration of
antistaphelococcal antibiotics. If this fails, carry out the following:
*Simple nail avulsion with curettage of infected granulation tissue
under local anesthetics. Antistaph antibiotics should be
administrated.
*Wedge excision. Lateral & medial nail & nail bed are removed
together with granulation tissue & germinal matrix. Liquefied
phenol may be applied to the germinal matrix to ensure complete
removal.
*Zadik’s procedure: this is reserved for recurrent IGTN. The nail
is avulsed & the germinal matrix completely excised after raising
a skin flap to expose it. To ensure complete removal of the
germinal matrix liquefied phenol is applied after protecting the
skin. The nail should not regrow after this procedure.
Surgery
30) A 28-yaer-old male comes to your office with rectal bleeding
and local burning and searing pain in the rectal area. The patient
describes a small amount of bright red blood on the toilet paper.
The pain is maximal at defecation and following defecation. The
burning and searing pain that occurs at defecation is replaced by
a spasmodic pain after defecation that lasts approximately 30
minutes. What is the MOST likely diagnosis in this patient?
A. Adenocarcinoma of the rectum.
B. Squamous cell carcinoma of the rectum.
C. Internal hemorrhoids.
D. Anal fissure.
E. An external thrombosed hemorrhoid.
Surgery
31) A 23-year-old female consulted her physician because of
breast mass; the mass is mobile, firm, and approximately 1 cm in
diameter. It is located in the upper outer quadrant of the right
breast. No axillary lymph nodes are present. What is the
treatment of choice for this condition?
A. Modified radical mastectomy.
B. Lumpectomy.
C. Biopsy.
D. Radical mastectomy.
GOOD LUCK
E. Watchful waiting.
GOOD LUCK
Surgery
32) A 25-year-old man has a right inguinal herniorrhaphy and on
the second post-operative day develops excruciating pain over
the wound and a thin, brown, foul-smelling discharge. His
temperature is 39oC and his pulse rate is 130/min. A gram stain of
the exudate shows numerous gram positive rods with terminal
spores. The MOST important step in the management of this
patient is:
A. Massive intravenous doses of penicillin G.
B. Administration of Clostridia antitoxin.
C. Wide surgical debridement.
D. Massive doses of chloramphenicol.
E. Wide surgical debridement and massive doses of penicillin G.
Surgery
33) A 55-year-old man presented to emergency room with central
abdominal pain radiating to his back. Examination showed
localized central abdominal tenderness. Chest X-ray and back
Xray were normal. Your MOST likely diagnosis is:
A. Perforated duodenal ulcer.
B. Acute cholecystitis.
C. Acute appendicitis.
D. Acute pancreatitis.
E. Diverticulitis.
Surgery
34) On the 6th post-operative day closure of colostomy, a 52-year
old man had a swinging fever and complained of diarrhea. The
MOST likely diagnosis is:
A. Gastroenteritis.
B. Colitis.
C. Irritable bowel syndrome.
D. Pelvic abscess.
E. Cholecystitis.
GOOD LUCK
GOOD LUCK
Postoperative fever
Days 0 to 2
o Mild fever (T<38 C) (Common)
o Tissue damage and necrosis at operation site
o Haematoma
o Persistent fever (T> 38 C)
o Atelectasis: the collapsed lung may become secondarily infected.
o Specific infections related to the surgery: e.g. biliary infection post
biliary surgery, UTI post urological surgery
o Blood transfusion or drug reaction
Days 3-5
o Bronchopneumonia
o Sepsis
o Wound infection
o Drip site infection/ phlebitis
o Abscess formation, e.g. subphrenic or pelvic, depending on the
surgery involved
Symptoms of Pelvic abscess are:-
Pelvic pain
Pelvic tenderness
Fever
Increased urination frequency
Diarrhea
After 5 days
o DVT
o Specific complications related to surgery, e.g. bowel
anastomosis breakdown, fistula formation
o After the first week
o Wound infection
o Distant sites of infection, e.g. UTI
o DVT, pulmonary embolus
Reference :-
http://www.patient.co.uk/showdoc/40000174
http://www.ssat.com/cgi-bin/abstracts/06ddw/SSAT_DDW06_239.cgi
GOOD LUCK
GOOD LUCK
Surgery
35) A 40-year-old female presented to the clinic with central neck
swelling which is moving with swallowing. The mass is hard and
the patient gave history of dysphagia. You should:
A. Request thyroid function tests and follow-up in 2 months.
B. Refer the patient to Gastroenterology for the diagnosis of
dysphagia.
C. Admit the patient as a possible cancer thyroid and manage
accordingly.
D. Give the patient thyroxin and send her home.
E. If the patient is euthyroid, ask her to come in 6 months.
Surgery
36) A 30-year-old male patient with long history of Crohn’s
disease. Surgery is indicated if he has:
A. Internal fistula.
B. External fistula.
C. Intestinal obstruction.
D. Abdominal mass.
E. Stagnant bowel syndrome.
Most common cause of surgical intervention in Crohn’s disease
is intestinal obstruction. Other indications of surgery are: failure
of medical treatment, steroid dependant cases, fistula, short
bowel syndrome, abscess formation, ca, growth retardation,
Hemorrhage.
Anesthesia
37) All of the following signs or symptoms are characteristics of
an extracellular fluid volume deficit EXCEPT:
A. Dry, sticky oral mucous membranes.
B. Decreased body temperature.
C. Decreased skin turgor.
D. Apathy.
E. Tachycardia.
GOOD LUCK
GOOD LUCK
Surgery
38) A 30-year-old female presented with painless breast lump.
Ultrasound showed a cystic lesion. Aspiration of the whole lump
content was done and was a clear fluid. Your NEXT step is:
A. Do nothing and no follow-up.
B. Send the aspirated content for cytology and if abnormal do
mastectomy.
C. Reassure the patient that this lump is a cyst and reassess her
in 4 weeks.
D. Book the patient for mastectomy as this cyst may change to
cancer.
E. Put the patient on contraceptive pills and send her home.
Emergency medicine
39) A 70-year-old male was brought to the emergency with
sudden onset of pain in his left lower limb. The pain was severe
with numbness. He had an acute myocardial infarction 2 weeks
previously and was discharged 24 hours prior to his presentation.
The left leg was cold and pale, right leg was normal. The MOST
likely diagnosis is:
A. Acute arterial thrombosis.
B. Acute arterial embolus.
C. Deep vein thrombosis.
D. Ruptured disc at L4-5 with radiating pain
E. Dissecting thoraco-abdominal aneurysm.
Clinical Pharmacology *
40) Complications of long term phenytoin therapy include the
following EXCEPT:
A. Hisutism.
B. Osteoporosis.
C. Osteomalacia.
D. Macrocytosis.
E. Ataxia.
GOOD LUCK
GOOD LUCK
Surgery
41) A 20-year-old man sustained a deep laceration on the anterior
surface of the wrist. Median nerve injury would result in:
A. A claw hand defect.
B. A wrist drop.
C. A sensory deficit only.
D. An inability to oppose the thumb to other fingers.
E. The inability to flex the metacarpophalangeal joints.
Surgery
42) A 70-year-old patient presented with a skin lesion in the left
thigh for many years. This lesion is black, size 1x1 cm. It started
to be more pigmented with bleeding. You will advice:
A. Cryotherapy.
B. Incisional biopsy.
C. Wide excision.
D. Immunotherapy.
E. Radiotherapy.
Dermatology
43) Which of the following is MOST commonly seen in patients
with acanthosis nigricans?
A. An underlying internal cancer.
B. An underlying non-Hodgkin’s lymphoma.
C. An insulin resistant state.
D. Diabetes mellitus.
E. An underlying Hodgkin’s lymphoma.
Medicine
44) The FIRST step in the management of acute hypercalcemia
should be:
A. Correction of deficit of Extra Cellular Fluid volume.
B. Hemodialysis.
C. Administration of furosemide.
D. Administration of mithramycin.
GOOD LUCK
E. Parathyroidectomy.
GOOD LUCK
(continue)
March 2007
(GHT – 2008)
(Medicine)
45) A 43-year-old man is brought to the emergency department
after a motor vehicle accident involving a head-on collision. He
mentioned that he is having headache and dizziness. During
his overnight admission for observation, he developed
polyuria and his serum sodium level rises to 151 meq/L. All of
the following tests are indicated EXCEPT:
A. Overnight dehydration test.
B. Measurement of response to desmopressin (dOAVP).
C. MRI scan of the head.
D. Measurement of morning cortisol level.
E. Measurement of plasma and urine osmolality.
GOOD LUCK
GOOD LUCK
(Pediatrics)
46) A 7-month-old child is brought to your office by his mother.
He has an upper respiratory tract infection (URTI) for the past
3 days. On examination, there is erythema of the left tympanic
membrane with opacification. There are no other signs or
symptoms. What is the MOST likely diagnosis in this patient?
A. Acute otitis media.
B. Otitis media without effusion.
C. Chronic otitis media.
D. Otitis media with effusion.
E. Chronic suppurative otitis media.
(Pediatrics)
47) A 6-year-old girl is brought to the family health center by her
mother. The child today had sudden onset of a painful sore
throat, difficulty swallowing, headache, and abdominal pain.
The child has had no recent cough or coryza and was exposed
to someone at school that recently was diagnosed with a
“strep throat”. On examination the child has a temperature of
40oC. She has tender anterior cervical nodes and exudative
tonsils. The lungs, heart, and abdominal examination are
benign. What treatment would you offer for this child?
A. Zithromax.
B. Penicillin V.
C. Ciprofloxacin.
D. No antibiotics, rest, fluid, acetaminophen, and saline gargles.
E. Trimothoprim.
GOOD LUCK
(Medicine)
48) A 28-year-old woman came to your clinic with 2-moth history
of flitting arthralgia. Past medical history (PMH):
Unremarkable. On examination: she is afebrile. Right knee
joint: mild swelling with some tenderness, otherwise no other
physical findings.
CBC: HB 124 g/L = 12.4 g\dl) WBC: 9.2 x 109/L ESR: 80 mm/h
Rheumatoid factor: Negative VDRL: Positive
Urine: RBC 15-20/h PF Protein 2+
The MOST appropriate investigation at this time is:
A. Blood culture.
B. A.S.O titer.
C. C-reactive protein.
D. Double stranded DNA.
E. Ultrasound kidney.
(Medicine)
49) The single feature which BEST distinguishes Crohn’s disease
from ulcerative colitis is:
A. Presence of ileal disease.
B. Cigarette smoking history.
C. Presence of disease in the rectum.
D. Non-caseating granulomas.
E. Crypt abscesses.
GOOD LUCK
(Community Medicine)
50)The MOST effective method of health education is:
A. Mass media.
B. Group discussion.
C. Internal talks.
D. Individual approach.
E. None of the above.
(Surgery)
51) A 30-year-old man had pelvic fracture due to blunt trauma.
Retrograde urethrography demonstrated disruption of the
membranous urethra. The BEST initial treatment is:
A. Passage of transurethral catheter.
B. Suprapubic catheter.
C. Perineal repair.
D. Retropubic repair.
E. Transabdominal repair.
(Medicine)
52)45-year-old man presented with anorexia, fatigue and upper
abdominal pain for one week. On examination he had tinge of
jaundice and mildly enlarged tender liver. Management
includes all EXCEPT:
A. Liver ultrasound
B. ERCP
C. Hepatitis markers
D. Serum alanine transferase
E. Observation and follow up
The case looks like acute hepatitis with the acute history, the
GOOD LUCK
fatigue, mild jaundice and mild hepatomegaly. Investigations
GOOD LUCK
include LFT, hepatitis markers and US liver. Treatment is
observation and follow up. ERSP is not needed (not obstructive).
(Medicine)
53) 30-year-old man presented with upper abdominal pain and
dyspepsia. Which of the following doesn’t support the
diagnosis of peptic ulcer:
A. Hunger pain
B. Heart burn
C. Epigastric mass
D. Epigastric tenderness
E. History of hematemesis
(Medicine)
54) 26-year-old man presented with headache and fatigue.
Investigations revealed:
Hb 8 g/dl MCV 85 fL retics 10%
All the following investigations are useful EXCEPT:
A. Coomb’s test
B. Sickling test
C. Serum bilirubin
D. Serum iron
E. Hb electrophoresis
GOOD LUCK
GOOD LUCK
folic acid because with the high turn over in the bone marrow it
gets consumed.
(Surgery)
55) 80-year-old man presented with dull aching pain in the loins.
Investigations showed high urea and creatinine. Ultrasound of
the abdomen showed bilateral hydronephrosis. Most common
cause is:
A. Stricture of urethral meatus
B. Neoplasm of the bladder
C. Prostatic enlargement
D. Pelvic CA
E. Retroperitoneal fibrosis
(Medicine)
56) 35-year-old woman presented with exertional dyspnea.
Precordial examination revealed loud S1 and rumbling mid
diastolic murmer at apex. Possible complications of this
condition can be all the following EXCEPT:
A. Atrial fibrillation
B. Systemic embolization
C. Left ventricular failure
D. Pulmonary edema
E. Pulmonary hypertension
GOOD LUCK
pulmonary arteries, so more constriction is more resistance and
GOOD LUCK
therefore pulmonary hypertension results. The left option is left
ventricular failure which doesn’t occur, on the contrary the LV is
very relaxed since less blood is passing through the stenosed
valve to the ventricle so the requirements on the LV is less and
the stress is less and ejection fraction is normal.
(Community Medicine)
57) Standard precautions are recommended to be practiced by all
healthcare workers (HCW) to prevent spread of infections
among patient and HCW. Most important measure:
A. Wearing gloves when examining any patient
B. Hand washing before and after examining any patient
C. Wearing masks and gowns before examining infected patients
D. Recapping contaminated needles and disposing it in sharp
container
E. Isolating all infected patient in single rooms
(Medicine)
58) 32-year-old Saudi man from Eastern province came to you for
routine pre-employment physical exam. He has always been
healthy and his examination is normal.
Lab:-
HCT: 35% MCV: 63fL WBC: 6800/ul retics:
4000/ul (0.7%) Platelet: 27000/ul
his stool: -ve for occult blood
The most direct way to confirm suspected diagnosis:
A. Peripheral smear
B. Measure Hb A2 level
C. G6PD screening
D. Measure iron, TIBC and ferritin level
E. Bone marrow stain for iron
GOOD LUCK
iron.
GOOD LUCK
(Medicine)
59) 15-year-old Saudi boy presented to ER with fever, skin rash
and shock. He was resuscitated and admitted to isolation ward
with strong suspicion of meningococcal meningitis. LP
confirmed the diagnosis. One of the following statements is
TRUE:
A. Patient should be isolated in –ve pressure room
B. Prophylaxis treatment should be given to all staff and patient
were in ER when the patient was there
C. Ciprofloxacin 500 mg once is an acceptable chemotherapy
D. Meiningococci are transmitted by contact only
E. Meningococci are resistant to penicillin
(Medicine)
60) Most common source of bacterial infection in I.V canula is:
A. Contamination of fluids during manufacturing
B. Contamination of fluids during insertion of the canula
C. Contamination at site of entry through skin
D. Contamination during injection of medication
E. Seeding from remote site due to intermittent bacteremia
GOOD LUCK
GOOD LUCK
(Ethics)
61)Mr. A is 68-year-old businessman diagnosed to have
hepatocellular carcinoma. One is true regarding disclosure
(informing patient) :
A. Patient should be told immediately after confirming the diagnosis
regardless of his whishes
B. Only patient’s family should be informed
C. 50% survival rate should be calculated according to literature and
discuss with the patient
D. Social worker should be responsible to tell the patient
E. Patient morale and understanding should be studied before telling
him
(Surgery)
62)70-year-old woman has had MI. 2 days after admission she
developed abdominal pain and diarrhea with passage of blood.
Abdomen x-ray showed distended intestine with no fluid level.
Serum amylase level slightly elevated with mild fever. The
diagnosis is:
A. Ulcerative colitis
B. Acute pancereatitis
C. Ischemic colitis
D. Diverticulitis
E. Phenindione-induced colitis (*phenindione is an anticoagulant)
GOOD LUCK
GOOD LUCK
(Medicine)
63) Patient presented to ER with dyspnea, right-sided chest pain,
engorged neck veins and weak heart sounds. Auscultation: no
air entry over the right lung. The treatment is:
A. I.V fluids, pain killer and oxygen
B. Aspiration of pericardium
C. Respiratory stimulant
D. Intubation
E. Immediate needle aspiration and chest tube
(Medicine)
64) 55-year-old male presented to you office for assessment of
chronic cough. He stated that he has been coughing for the
last 10 years but the cough is becoming more bothersome
lately. Cough productive of mucoid sputum, occasionally
becomes purulent. Past history: 35 years history smoking 2
packs per day.
On examination: 124 kg, wheezes while talking. Auscultation:
wheezes allover the lungs. The most likely diagnosis is:
A. Smoker’s cough
B. Bronchiectasis
C. Emphysema
D. Chronic bronchitis
E. Fibrosing alveolitis
GOOD LUCK
GOOD LUCK
(Clinical pharmacology)
65) Anticoagulant effect of heparin based on:
A. Alteration of thrombin levels
B. Potentiation of antithrombin III
C. Activation of plasmin into plasminogen
D. Inactivation of ionized calcium
E. Reduction of available factor VII
(Medicine)
66) 25-year-old man had fixation of fractured right femur. two
days later he became dyspnic, chest pain and hemoptysis.
ABG:-
pH: 7.5 pO2: 65 pCO2: 25
initial treatment is:
A. Furosemide
B. Hydrocortisone
C. Bronchoscopy
D. Heparin
E. Warfarin
(Medicine)
67) 25-year-old student presented to your office complaining of
sudden and severe headache for 4 hours. History revealed
mild headache attacks during the last 5 hours. On
examination: agitated and restless. The diagnosis is:
A. Severe migraine attack
B. Cluster headache
C. Subarachnoid hemorrhage
D. Hypertensive encephalopathy
E. encephalitis
GOOD LUCK
GOOD LUCK
There must be more to the question, however, cluster headache
is more in a males. It causes pain in retro-orbital and on the
nose. Associated with flushing, lacrimation and rhinorrhea. It
occurs in bouts (for example daily for 2 weeks and then a few
months with no symptoms and then a daily for another few
weeks and so on). Migraine is well know to be more in females,
with aura which is most commonly visual and GI, throbbing in
nature (it was also found to be more common in smart
people…..that’s why its more common in ladies :-).
Subarachnoid hemorrhage is classically described as the worse
headache in you life!!!! Very severe, associated with seizures,
loss of consciousness, meningeal signs. Even in a patient with a
chronic headache such as migraine if they come with a
headache more than they usually experience they should have a
brain CT to role it out (it only takes a few seconds to do the CT
and it rules out a devastating disease). Sometimes SAH is
proceeded by several warning headaches’ the most common
cause is trauma and the most common cause of spontaneous
SAH is aneurism. Dr.Noor says its migraine since migraine is by
far more common than cluster headache in addition to the
restlessness and the4 hour duration and again more feature
have to be mentioned.
GOOD LUCK
GOOD LUCK
2009(HMM – 2008)
(Surgery)
1. in abdominal trauma, all true except:
a) spleen is the common damaged organ
b) badly injured spleen need splenectomy
c) abdominal lavage (DPL) often exclude abdominal hemorrhage
d) abdominal examination often accurate to localize the site of
trauma
e) !!
N.B. Following insertion of the catheter into the peritoneum,
attempt to aspirate free intraperitoneal blood. DPL can't diagnose
retroperitoneal hemorrhage. Abdominal examination might help to
know the site of injury. Choice C may be the answer
(Surgery)
2. anorectal abscess, all true except:
a) first line of Rx is ABC
b) physical sign can be hidden if it is in supra levator space
c) usually originates from intra- sphinctric space
d) usually originates from anal gland infection
e) !!
N.B. 1st line of tx is incision and drainage
(Surgery)
3. intestinal obstruction, all true except:
a) increase temp and pulse with localize rigidity and tenderness
indicate strangulation
b) serum amylase could be elevated
c) always require surgery
d) if high obstruction the distension will be absent
e) !!
N.B. Rx includes also non-surgical method
(Surgery)
4. acute appendicitis in children: question is not much clear
a) leukocytosis is diagnostic
b) rarely perforated if it is not well treated
c) can cause intestinal obstruction
d) need ABC before surgery for every child
e) !!
GOOD LUCK
GOOD LUCK
N.B. If appendicitis goes untreated, the inflamed appendix can burst
24 to 72 hours after the symptoms begin. So, perforation is
common. Complications include mass, abscess and perforation.
Choice C may be the answer
(Surgery)
5. in breast CA, all true except:
a) 2 cm mass with free axilla is stage I
b) Chemotherapy is must for pre-menopausal with +ve axilla
c) Radical mastectomy is the choice of surgery
d) Yearly mammogram for contra-lateral breast
e) !!
N.B. BCS is the treatment of choice(lumpectomy with wide local
excision + radiotherapy)
(Surgery)
6. inhalation injury in burns, all true except:
a) CO is major cause of death in early stage
b) Pt should be admitted to ICU for observation even without skin
burn
c) Singed vibrissae is respiratory sign
d) Bronchioles and alveoli could burn from hot smoke
e) !!
N.B. injury to upper airway.
(Surgery)
7. ischemic leg:
a) golden periods 4-16 hrs
b) nerves are first structure to be damage
c) angiogram is done in all pt
d) parasthesia pts are more critical than those with pain
e) !!
N.B. and symptom is numbness- light touch is 1st sensation to lose
(Surgery)
8. acute cholangitis, all true except:
a) E-coli is most common organism
b) Septic shock is most likely complication
c) Jaundice is uncommon
d) ERCP and papillotomy is best Rx
GOOD LUCK
GOOD LUCK
(Surgery)
9. RT colon CA, all true except:
a) profound anemia
b) occult blood
c) dyspeptic symptoms
d) melena
e) RLQ mass
N.B. Lt colon Ca symptoms include (obstruction and PR bleeding)
(Surgery)
10.recent heamothorax:
a) thoracotomy and decortication
b) aspiration of chest
c) insertion of chest tube
d) volume replacement only
(Surgery)
11.thyroid CA associated with:
a) hyperthyroidism
b) hypothyroidism
c) euthyroid
d) only metastatic tissue produce hormone
e) toxic nodule
N.B hyperthyroidism with Grave's, toxic multinodular goiter and
toxic nodule
(Orthopedics)
12.fractured humorous commonly associated with:
a) radial N injury
b) ulnar N injury
c) medial N injury
d) axillary N injury
e) musculocutaneous N injury
N.B. also associated with profunda brachi artery injury
(Orthopedics)
13.fractured pelvis commonly associated with:
a) bladder injury
b) penile urethra injury
c) bulbomembraneus urethra injury
d) ureter injury
GOOD LUCK
e) !!
N.B. I tried to find the answer but I can't. The choice may be C.
GOOD LUCK
(Surgery)
14.best treatment for tension pneumothorax & pt in distress:
a) IVF
b) O2
c) Respiratory stimulator
d) Aspiration of air by needle
e) Intubation
(ENT)
15.ranula:
a) Forked uvula
b) Thyroglossal cyst
c) Swelling at the floor of mouth
d) !!
(Medicine)
16.critical count of platelets which lead to spontaneous bleeding is:
a) 1000
b) 50.000
c) 75.000
d) 100.000
e) 200.000
N.B. less than 20.000
(Surgery)
17.which one will give bilateral breast CA:
a) lobular breast ca (ILC)
b) intraductal breast ca (IDC)
c) mucinous breast ca
d) paget disease
e) medullary breast ca
f) tubular breast ca
N.B. ILC (bilateral)- IDC (common)
(Surgery)
18.the best method for temporary control of bleeding is:
a) arterial tourniquet
b) venous tourniquet
c) direct finger pressure
d) adrenaline
e) !!
GOOD LUCK
N.B. well known method in the story of ABCDE
GOOD LUCK
(Psychiatry)
19.anorexia nervosa, all true except:
a) lethargy
b) langue hair
c) amenorrhea
d) young female
e) !!
N.B. I think e will be the wrong choice
(Psychiatry)
20.hypochondriasis, all true except:
a) more common in medical students
b) less common in male
c) more common in lower social class
d) defined as morbid preoccupation of one's body or health
(ENT)
21.all are speech disorders except:
(I am not sure whether b and d is a real choices or not)
a) Stuttering
b) Mumping
c) Cluttering
d) Palilia
e) !!
Cluttering
Stuttering
Apraxia
Lisp
Rhotacism
Spasmodic dysphonia
Aphasia
Dysarthria
Huntington's disease
Laryngeal cancer
Selective mutism
Specific Language Impairment
Speech sound disorder
Voice disorders
GOOD LUCK
GOOD LUCK
(Psychiatry)
22.family behavior toward schizophrenic pt affect prognosis adversely:
a) double binding
b) over emotion behavior
c) schismatic parents
d) projective identification
e) !!
N.B. I didn't understand the question.
(Urology)
23.premature-ejaculation, all true except:
a) most common sexual disorder in males
b) uncommon in young men
c) Benefits from sexual therapy involving both partners
d) it benefit from anxiety Rx
e) !!
N.B. Premature ejaculation (PE) is the most common sexual
dysfunction in men younger than 40 years.
(ENT)
24.the most prominent symptoms of acute otitis media is:
a) Pain
b) Hearing loss
c) Discharge
d) Tinnitus
e) Non of the above
N.B. triad (pain-deafness and tinnitus)
(Anesthesia)
25.length of trachea in adult is:
a) 11-12 cm
b) 24cm
c) 20cm
d) 4cm
e) Non of the above
N.B. it is a fact that mentioned in applied anatomy book
GOOD LUCK
-
GOOD LUCK
(Surgery)
26.indication of trachostomy, all true except:
a) foreign body in larynx
b) LT recurrent nerve cut
c) CA larynx
d) In some procedure which involve in radiation exposure
e) Non of the above
N.B. bilateral recurrent N injury is an indication
(ENT)
27.fetal unilateral nasal discharge is feature of:
a) Adenoid
b) Choanal atresia
c) Foreign body
d) RT atrophy !!
e) !!
N.B. forget everything about ENT except this question. It is quite
common
(ENT)
28.best first aid to control epistaxis is:
a) Adrenaline
b) Cold application on forehead
c) Good pinching or compression lower end of nose for 5-8 min
d) Non of the above
e) !!
N.B. whenever you see bleeding, pressing is the usual intervention
(Psychiatry)
29.known risk factor of suicide include all of the following except:
a) depression
b) previous self attempt
c) females less than males
d) drug and alcohol dependence
e) if doctor ask the pt any suicidal attempt
N.B. it is well demonstrated in psychiatry book (dr.alsagir)
GOOD LUCK
)
GOOD LUCK
(Surgery)
30.gastric lavage:
a) ineffective after 12 hrs Paracemamol intake
b) indicated with paraffin oil
c) used more in semiconscious pt than induced vomiting
d) pt should be in RT side
e) !!
N.B. actually ineffective after 1 hr.
(Surgery)
31.A 50 yr old man presented with central abdominal pain radiated to
back. Abdominal and back x ray is normal. Dx is:
a) cholecystitis
b) appendicitis
c) pancreatitis
d) diverticulitis
(Medicine)
32.acute GN, all is acceptable Ix except:
a) complement
b) urinanalysis
c) ANA
d) Blood culture
e) Cystoscopy
(Medicine)
33.all of the following precipitate seizure except:
a) hypourecemia
b) hypokalemia
c) hypophosphatemia
d) hypocalcemia
e) hypoglycemia
(Medicine)
34. A 25 yr old pt presented with headache , avoidance of light & resist
flexion of neck, next step is:
a) EEG
b) C-spine X-ray
c) Phonation
d) Non of the above
e) !!
GOOD LUCK
N.B. I suspect meningitis, the Rx is Abx + LP
)
GOOD LUCK
(Medicine)
35.A 20 yr old female present with fever, loin pain & dysuria,
management include all of the following except:
a) urinanalysis and urine culture
b) blood culture
c) IVU (IVP)
d) Cotrimexazole
e) !!
N.B. I suspect PN. So, Rx includes admission, Abx & re-hydration.
(Surgery)
36.surgery- the most effective monitoring method in pt with acute
bleeding is:
a) HB
b) HCT
c) Vital sign
d) Amount of blood loss
e) !!
N.B. Blood loss could be internal one
GOOD LUCK
GOOD LUCK
(continue)
1 (NAA – 2009)
37- (ENT)
The most common cause of epistaxis in children is:
a) polyps
b) trauma
c) dry air
d) thrombocytopenia
e) !!
38- (pedia)
The amount of Na+ in ORS “oral rehydration solution” in (WHO) is:
a) 150 meq
b) 120
c)90
d)60
e) 30
GOOD LUCK
GOOD LUCK
Composition of standard and reduced osmolarity ORS solutions
75 60-70 50 90 Sodium
65 60-70 40 80 Chloride
20 20 20 20 Potassium
10 10 30 10 Citrate
39- (pedia)
Child with epiglotitis will present with all of the following EXCEPT:
a) fever
b) dysphagia
c) like to lie in supine position
d) stridor
e) !!
Epiglottitis usually presents abruptly and rapidly with fever, sore throat,
dysphagia, respiratory distress, drooling, and anxiety.
Physical: Patients tend to appear seriously ill and apprehensive.
Characteristically, patients have a "hot potato" muffled voice and may
have stridor. Usually children will assume the "sniffing position" with
their nose pointed superiorly to maintain an adequate airway.
GOOD LUCK
d) 75 %
e) 100 %
GOOD LUCK
involves a lack of the clotting facyor IX . (sex linked, X linked recssive)
Men and women each have 23 pairs of chromosomes. Women have two X
chromosomes; men have one X and one Y chromosome. Hemophilia is an X-
linked genetic disorder, which means that it's passed from mother to son on
the X chromosome. If the mother carries the gene for hemophilia on one of
her X chromosomes, each of her sons will have a 50% chance of having
hemophilia.
41- (pedia)
All of the following are true about pyloric stenosis, EXCEPT:
a) incidence male more than female
b) onset is generally late in the first month of life
c) vomitus is bile stained
d) appetite is good
e) jaundice occur in association
42- (pedia)
Risk factor of sudden death syndrome include all of the following, EXCEPT:
a) cigarette smoking during pregnancy
b) old primigravida
c) crowded living room
d) prematurity
e) small gestational age
GOOD LUCK
GOOD LUCK
43- (pedia vs. surgery)
A 2yr boy has rectal pain, bleeding with perinatal itching and constipation for
3 days, physical examination revealed a perianal erythematous rash which
extend 2 cm around the anal ring, most likely Dx:
a) anal fissure
b) rectal polyp
c) ulcerative colitis
d) streptococcal infection
e) malacoplakia
brucella abourtus is less likely to cause more severe disease in cattles &
human than b. melitansis. Rarely transmitted by breast feeding & intercourse
(human to human). Human can be infected through eating, drinking,
inhalation, skin wound. It is a gram –ve rod.
45- (pedia)
Children are expected to walk without support at age of:
a) 6 months
b) 9 monthes
c) 15 monthes
d) 18 monthes
e) 20 monthes
GOOD LUCK
46- (pedia)
Which of the following vaccines NOT given to a household contact with
immunodeficient child:
a) hepatitis
b) DPT
c) oral polio
d) BCG
Who should not get the oral polio vaccine? OPV should not be given when
there is a higher risk of bad effects caused by the vaccine, including the
following:
Being moderately or severely (badly) ill with or without fever.
Having someone in the house with a weak immune system.
History of a severe allergic reaction to a dose of OPV.
Long-term treatment with steroid medicine.
Weak immune system. The immune system is the part of the body that
normally fights off sickness and disease. A weak immune system may
be caused by cancer, HIV or AIDS, inborn immune deficiency, or
taking medicines, such as chemotherapy.
47- (pedia)
Symptoms of cystic fibrosis in neonate:
a) meconium ileus
b) pneumothorax
c) steatorrhea
d) rectal prolapse
e) !!
48- (pedia)
DKA in children, all of the following are true EXCEPT:
a) don’t give K+ till lab results come
b) ECG monitoring is essential
c) if pH < 7.0 give HCO3-
d)NGT for semiconscious pt
e) furosemide for pt with oligouria
GOOD LUCK
)
GOOD LUCK
49- (med, onco)
Common symptoms of Hodgkin lymphoma not seen in non Hodgkin
lymphoma:
a) night sweat
b) superior vena cava syndrome
c) CNS involvement
d) intussusception
e) bone pain
I don’t know
50- (pedia)
To prevent tetanus in neonate:
a) give anti-tetanus serum to neonate
b)give immunoglobulin to mother
c) give tetanus toxoid
d) give antibiotics to mother
e) give penicillin to child to kill tetanus bacilli
51- (pedia)
MMR given at age of:
a) 3 months
b) 8 months
c) 12 months
d) 24 months
e) !!!
52- (pedia)
Hypothyroid in young baby usually due to:
a) endocrine irresponse
b) enzyme def.
c) drug by mother
d) agenesis
c) !!!
maldescent of the thyroid and athyrosis are the commonest cause of sporadic
congenital hypothyroidism … (abo warda)… but not realy sure
GOOD LUCK
)
GOOD LUCK
53- (med)
Blood pressure, all of the following are true EXCEPT:
a) if 2/3 of cuff false high BP
b) internal cuff must cover 80% of arm
c) follow circadian vary late night high BP
d) high BP 3 standard deviation away from normal
e) you have to have more than one reading to Dx high BP
54- (med)
All of the following drugs advised to be given to elderly pt, EXCEPT:
a) cimitidine
b) thyroxin
c) digoxin
d) chloropromide
e) !!
is a sulphonylurea, best avoided in elderly ppl and in those with renal failure.
55- (surgery)
Percentage (%) of reinfarction for pt undergoing non-cardiac surgery:
a) 5%, 3 months after the infarct
b) 15% , 3 months after the infarct
c) 35%, 3 months after the infarct
d) 5%, 3-6 months after the infarct
e) 35%, 3-6 months after the infarct
56- (med)
Furosemide increase excretion of :
a) Na+
b) K+
c) phosph.
d) non of the above
GOOD LUCK
e) !!
GOOD LUCK
furosemide causes high blood Na+, urea, glucose, cholesterol. And low blood
K+, Ca+.
57- (med)
Heparin anticoagulant action depend on :
a) potentiation of antithrombin three
b) change plasmin to plasminogen
c) affect prothrombin
d) affect ionized Ca++
e) !!!
heparin
potentiates antithrombotic affect in antithrombin three
warfrin
inhibits vitamin K-dependent gamma carboxylation of factors 2, 7,
9, 10.
GOOD LUCK
GOOD LUCK
59- (community med)
Communicable diseases controlled by:
a) control the source of infection
b) block the causal of transmition
c) protect the susciptable pt
d) all of the above
e) non of the above
60- (OB/Gyn)
Anti D ig not given to a pregnant if :
a) 25- 28 wk
b) anti D Ab titer of 1:8
c) after amniocentesis
d) after antepartum hemorrhage
e) after chorion villi biopsy
61- (med)
Blood pH :
a) high after diarrhea
b) low after vomiting
c) more in Rt atrium than Lt atrium
d) lower in Rt atrium than Lt ventricle
e) lower in renal vein than renal artery
a. after diarrhea (which is alkali) the blood will be acidic (low pH)
b. after vomiting (which is acidic ”Hcl”) the blood pH will be alkali (high
pH)
c. O2 low H+ and high pH… so, the pH in Rt atrium “ low O2” will be
lower than the Lt atrium “high O2”
d. Lt ventricle has more oxygenated blood than Rt atrium
e. blood in arteries is more oxygenated than that in veins
GOOD LUCK
GOOD LUCK
62- (OB/Gyne)
Premenstrual tension :
a) more in the first half of menses
b) 60% associated with edema
c) associated with eating salty food
d) menorrhagia
e) !!
GOOD LUCK
GOOD LUCK
63- (OB/Gyne)
Blockage of first stage labor pain by :
a) block of the lumbosacral plexus afferent
b) block of the lumbosacral plexus efferent
c) block of the pudendal nerve
d) block of sacral plexus
e) !!
I don’t know
64- (OB/Gyne)
If a pregnant eating well balanced diet, one of the following should be
supplied :
a) Ca++
b) phosph.
c) vit. C
d) none of the above
e) !!
I don’t know
65- (OB/Gyne)
Most important cause of immediate post partum hemorrhage :
a) laceration of cervix
b) laceration of vagin
c) uterine atony
d) placental fragment trtention
all of these choices are true but the commenest cause of PPH is uterine atony.
66- (OB/Gyne)
Dysparunea caused by all of the following EXCEPT :
a) cervicitis
b) endometriosis
c) lack of lubricant
d) vaginitis
e) uterine prolapse
GOOD LUCK
GOOD LUCK
67- (OB/Gyne)
All of the following are normal flora and should not treated, EXCEPT:
a) trichomonus
b) candida
c) E.coli
d) fragmented bacteria
e) !!
68- (OB/Gyne)
Rx of bacterial vaginitis
a) ampicillin
b) tetracycline
c) metronidazol
d) erythromycin
e) !!
69- (ER)
management of anaphylactic shock all of the following, EXCEPT :
a) I.V.F
b) 100% O2
c) corticosteroid
d) !!
e) !!!
70- (surgery)
All of the following are signs of allergy to local anesthesia, EXCEPT :
a) laryngeal spasm
b) urticaria
c) low BP
d) bronchospasm
I don’t know
GOOD LUCK
)
GOOD LUCK
71- (Surgery)
gastric aspiration :
a) cuffed NGT may prevent aspiration
b) !!
c) !!!
72- (Surgery)
Below the inguinal ligament, where is the femoral artery :
a) medial
b) lateral
c) anterior
d) posterior
e) !!
GOOD LUCK
GOOD LUCK
2010
(Medicine)
73- Hepatitis most commonly transferred by blood is:
a) HBV.
b) HAV.
c) HCV (previously known as non a non b).
d) None of the above.
(Medicine)
74- Primary TB:
a) Usually involves upper lobe of lung.
b) Normal X-ray.
c) +ve PPD test.
d) None of the above.
e) All of the above.
(Medicine)
75- Increased bleeding time is seen in all of the following except:
a) Hemophilia.
b) Scurvy.
c) VwD (Von-Willebrand disease).
Answer: a.
GOOD LUCK
(Medicine)
76- Serum ferritin reflects:
a) Total iron stores.
b) Serum iron.
c) Bone marrow iron.
d) None of the above.
(Medicine)
77- Which one shifts oxyheamoglobin dissociation curve to the LEFT:
a) Hypoxia.
b) Acidosis.
c) High altitude.
d) None of the above.
(Community Medicine)
78- Treatment of contacts is applied in all of the following except:
a) Bilharisiasis.
b) Malaria.
c) Hook worm.
d) Filariasis.
(Community Medicine)
79- The best way for health education:
a) Mass media.
b) Interview.
c) ??
GOOD LUCK
Answer: I don’t know
GOOD LUCK
(Clinical Pharmacology)
80- Which one of these drugs is administered orally:
a) Amikacin.
b) Neomycin.
c) Gentamycin.
d) Streptomycin.
e) Tobramycin.
Answer: b. All aminoglycosides have very poor oral uptake. Neomycin is too
toxic for enteral use. So it is given orally (also Kanamycin) mainly to act on
bowel flora in preparation for bowel surgery.
(Clinical Pharmacology)
81- Chronic use of steroids will give:
a) Osteomalacia.
b) Myopathies of pelvic girdle.
c) Increased risk of breast Ca.
d) Hypoglycemia.
(ENT)
82- Swallowed foreign body will be found in all of the following except:
a) Stomach.
b) Tonsil.
c) Pharyngeal pouch.
d) Piriform fossa
Answer: b.
(Medicine)
83- All of the following are true about pulmonary embolism, except:
a) Normal ABG.
b) Sinus tachycardia is the most common ECG finding.
c) Low plasma D-dimer is highly predictive for excluding PE.
d) Spiral CT is the investigation of choice for diagnosis.
e) Heparin should be given to all pts with high clinical suspicion of PE.
GOOD LUCK
Answer: a. In PE, ABG will show decreased PaO2 and PaCO2.
GOOD LUCK
(Clinical Pharmacology)
84- All of the following cause gastric irritation, except:
a) Erythromycin.
b) NSAIDS.
c) Sucralfate.
d) Diclofenac.
e) Penicillins.
GOOD LUCK
Answer: a.
GOOD LUCK
(Medicine)
88- In DKA, use:
a) Short and intermediate acting insulin.
b) Long acting insulin.
(Urology)
89- In Testicular torsion, all of the following are true, except:
a) Very tender and progressive swelling.
b) More common in young males.
c) There is hematuria.
d) Treatment is surgical.
e) Has to be restored within 12 hours or the testis will infarct.
Answer: c.
(Ophthalmology)
90- Question about congenital squint
(Medicine)
91- All of the following causes secondary HTN, except:
a) Pheochrmocytoma.
b) Addison’s disease.
c) Hyperaldosteronism (conn’s disease)
d) Renal disease.
e) Pregnancy.
f) Primary hypothyroidism.
GOOD LUCK
GOOD LUCK
(Clinical Pharmacology)
92- All of the following are true about paracetamol poisoning, except:
a) Metabolic acidosis.
b) Hypoglycemia.
c) Bronchospasm.
d) Liver Failure.
e) Acute renal tubular necrosis.
Answer: c.
(ENT)
93- Adenoids:
a) Can be a chronic source of infection.
b) Causes snoring.
c) Located at the back of the nasopharynx 1 inch above the uvula.
d) Involved in the immune system reaction.
e) All of the above.
Answer: e.
(Pediatrics)
94- Cellulitis in children (6 – 24 months) is most commonly caused by:
a) H. influanzae.
b) Group A Streptococcus.
c) Staphylococcus.
GOOD LUCK
GOOD LUCK
2011
(OB/Gyne)
01 All the following drugs should be avoided in pregnancy EXCEPT:
a) Na+ Valproate.
b) Glibenclamide.
c) Keflex.
d) Septrin.
e) Warfarin.
Answer = b) Glibenclamide.
(Community Medicine)
02 Secondary prevention is best effective in:
a) DM.
b) Leukemia.
c) Pre-eclampsia.
d) Malabsorption.
Answer = d) Malabsorption.
(Surgery)
03 Complications of colostomy are all the following EXCEPT:
a) Malabsorption of water.
b) Prolapse.
c) Retraction.
d) Obstruction.
e) Excoriation of skin.
Answer = e) Excoriation of skin.
- 186 -
GOOD LUCK
(
GOOD LUCK
(Medicine)
04 Regarding rubella infection, one is TRUE:
a) Incubation period is 3-5 days.
b) Causes oral ulcers.
c) Causes arthritis.
d) Does not cause any heart problem to the fetus.
Answer = c) Causes arthritis.
(Orthopedics)
05 Avascular necrosis of the head of femur is usually detected clinically
by:
a) 3 months.
b) 6 months.
c) 11 months.
d) 15 months.
Answer = a) 3 months. X-rays are diagnostic in the first few weeks. No
source I reviewed talked about when it can be 'clinically' detected.
(Ophthalmology)
06 All the following may cause sudden unilateral blindness EXCEPT:
a) Retinitis pigmentosa.
b) Retrobulbar neuritis.
c) Retinal detachment.
d) Vitreous hemorrhage.
e) Central retinal artery embolism.
Answer = a) Retinitis pigmentosa. It causes gradual night blindness.
(Medicine)
07 Fecal leukocytes come with all EXCEPT:
a) Shigellosis.
b) Clindamycin induced colitis.
c) Idiopathic ulcerative colitis.
GOOD LUCK
Answer = b) Clindamycin induced colitis.
GOOD LUCK
(Medicine)
08 In a child with TB, all is found EXCEPT:
a) A history of exposure to a TB patient.
b) Chest x-rays findings.
c) Splenomegaly.
d) A (+ve) culture from gastric lavage.
Answer = All is correct!
(Medicine)
09 In brucellosis, all is true EXCEPT:
a) Back pain.
b) Hepatomegaly.
c) Splenomegaly.
d) Lymphadenopathy.
e) Gastroenteritis.
Answer = e) Gastroenteritis.
(Medicine)
10 All can be used for the treatment of acute gout EXCEPT:
a) Allopurinol.
b) Penicillamine.
c) Gold salt.
d) Paracetamol.
e) Indomethacin.
Answer = b) Penicillamine.
(Pediatrics)
11 In a 6 months old patient with sepsis, the most likely organism will be:
a) Listeria.
b) ﺁ-Hemolytic Streptococci.
c) H. Influenza type B.
d) Staph. Epidermis.
Answer = c) H. Influenza type B.
GOOD LUCK
(Medicine)
12 In mycoplasma pneumonia, there will be:
a) A (+ve) cold agglutinin titer.
b) Lobar consolidation.
Answer = Both are correct!.. A positive cold agglutinin titer occurs in
50-70% of patients, and lobar consolidation may also be present but rare.
(Medicine)
13 The treatment of community acquired pneumonia is:
a) First generation cephalosporin.
b) Penicillin G + second generation cephalosporin.
c) Erythromycin.
d) Erythromycin + Gentamycin.
Answer = c) Erythromycin.
(Pediatrics)
14 All are vaccines given in Saudi Arabia to normal children EXCEPT:
a) TB.
b) Pertussis.
c) H. Influenza type B (HiB).
d) Mumps.
e) Diphtheria.
Answer = All are given nowadays, HiB was the correct
answer a few years ago but not anymore.
(Pediatrics)
15 UTI in children is:
a) Diagnosed by isolation of 105 of the same organism by a clean
catch.
Answer = No other choice!
GOOD LUCK
GOOD LUCK
(Medicine)
16 Hypokalemia occurs with all EXCEPT:
a) Metabolic alkalosis.
b) Acute tubular acidosis.
c) Chronic diarrhea.
d) Hyperaldosteronism.
e) Furosemide.
Answer = b) Acute tubular acidosis.
(Medicine)
17 Urine analysis will show all EXCEPT:
a) Handling phosphate.
b) Specific gravity.
c) Concentrating capacity.
d) Protein in urine.
Answer = a) Handling phosphate.
(Medicine)
18 In acute renal failure, all is true EXCEPT:
a) Phosphatemia.
b) Uremia.
c) Acid phosphate increases.
d) K+ increases.
(Surgery)
19 In a patient with anaphylactic shock, all are correct treatments
EXCEPT:
a) Epinephrine.
b) Hydralazine.
c) Adrenaline.
d) Aminophillin.
Answer = b) Hydralazine. It causes anaphylactic reactions.
GOOD LUCK
GOOD LUCK
(Surgery)
20 A partial thickness burn:
a) Is sensitive.
b) Is insensitive.
c) Will change to slough within 2-3 weeks.
d) Needs a split graft.
e) Needs a free flap.
Answer = Could be sensitive if superficial, insensitive if deep,
will start to heal within 2-3 weeks, and may need a split graft
if deep. So, all is true EXCEPT (e).
(Urology)
21 In an 82 years old patient with acute urinary retention, the management
is:
a) To empty the bladder by Foley's catheter and follow up in the
clinic.
b) To insert a Foley's catheter then send the patient home to come
back in the clinic.
c) To admit and investigate by TURP.
d) Immediate prostatectomy.
Answer = b) To insert a Foley's catheter then send the
patient home to come back in the clinic.
(Medicine)
22 A 6 years old female from Jizan with haematuria, all the following
investigations are needed EXCEPT:
a) Hb S.
b) Cystoscopy.
c) Hb electrophoresis.
d) Urine analysis.
e) U/S of the abdomen to see any changes in the glomeruli.
Answer = c) Hb electrophoresis.
GOOD LUCK
GOOD LUCK
(Medicine)
23 In a patient with Hb = 8, MCV = 82, retic = 10%, all is needed
EXCEPT:
a) Hb electrophoresis.
b) Coombs test.
c) Serum iron level.
d) Serum bilirubin level.
Answer = c) Serum iron level.
(Medicine)
24 A boy with a cola urine colour, 3 weeks back a throat swab showed
group A â-hemolytic streptococci, all is in favor of diagnosing post
streptococcal glomerulonephritis EXCEPT:
a) Red cell casts in urinalysis.
b) Increased creatinine.
c) Streptozyme test.
d) Decreased complements.
e) Shrunken kidney by U/S.
Answer = e) Shrunken kidney by U/S. Its either normal or slightly
enlarged.
(Medicine)
25 In a patient with weight loss, all can be a cause EXCEPT:
a) Thyrotoxicosis.
b) Nephrotic syndrome.
c) TB.
d) AIDS.
Answer = b) Nephrotic syndrome will cause edema = more weight
GOOD LUCK
GOOD LUCK
(Medicine)
26 A 36 years old female with FBS = 14 mmol & glucosuria, without
ketones in urine, the treatment is:
a) Intermittent I.M. insulin NPH.
b) Salphonylurea + diabetic diet.
c) Diabetic diet only.
d) Metformin.
Answer = c) Diabetic diet only.
(Surgery)
27 50 years old female with rectal bleeding, on examination an external
hemorrhoid was found, the treatment:
a) Advice excision of hemorrhoid.
b) Do nothing and follow up in 6 months.
c) Send home on iron tablets.
d) Bowel enema + colonoscopy.
e) Rigid sigmoidoscopy.
Answer = d) Bowel enema + colonoscopy.
(Surgery)
28 In peritonitis:
a) The patient rolls over with agony (pain).
b) The patient lies still.
c) Pulse rate is decreased.
Answer = a) The patient rolls over with agony (pain).
(OB/Gyne)
29 A cord prolapse occurs in all EXCEPT:
a) Premature rupture of membranes.
b) Preterm delivery with rupture of membranes.
c) Oligohydramnios.
d) Head high in pelvis.
Answer = c) Oligohydramnios.
GOOD LUCK
GOOD LUCK
(OB/Gyne)
30 In diabetes in pregnancy:
a) Oligohydramnios occurs.
b) Hypoglycemia occurs in the baby after delivery.
c) Hypercalcemia occurs in the baby.
Answer = b) Hypoglycemia occurs in the baby after delivery.
(Surgery)
31 Stress ulcers can be found in all EXCEPT:
a) Burns.
b) Aspirin.
c) CNS lesions.
d) Penicillin.
Answer = d) Penicillin.
(Medicine)
32 Peripheral neuropathy can occur in all EXCEPT:
a) Lead poisoning.
b) DM.
c) Gentamycin.
d) INH (anti-TB).
Answer = All can cause peripheral neuropathy!
(Medicine)
33 In a patient with upper abdominal pain, all is in favor of peptic ulcer
EXCEPT:
a) Hunger pain.
b) Heart burn.
c) Epigastric mass.
d) Epigastric tenderness.
e) Hematemesis.
Answer = c) Epigastric mass.
GOOD LUCK
GOOD LUCK
(Medicine)
34 Premalignant lesions have:
a) Pedunculated polyps.
b) Villous papilloma (adenoma).
c) Polypoid polyp.
d) Juvenile polyp.
Answer = b) Villous papilloma.
(Surgery)
35 Multiple ulcers on the medial aspect of the leg with redness and
tenderness around it are most likely:
a) Venous ulcers.
b) Ischemic ulcers.
c) Carcinoma.
Answer = a) Venous ulcer.
(Surgery)
36 A 35 years old female with bloody discharge from the nipple, on
examination there is cystic swelling near areola, the most likely diagnosis is:
a) Duct ectasia.
b) Intra-ductal papilloma.
c) Fibroadenoma.
Answer = b) Intra-ductal papilloma.
GOOD LUCK
GOOD LUCK
2011
(Surgery)
37- Appendicitis most diagnostic:
a) fever
b) diarrhea
c) urinary symptoms
d) leukocytosis
e) tender Rt lower quadrant with rebound
(Surgery)
38- Pt known to have gall stones presented with central abd. Pain and
bruising in the flanks, Dx
a) acute cholecystitis
b) acute pancreatitis
c) !!
d) !!
e) !!
(Orthopedics)
39- congenital hip dislocation (CDH)
(Orthopedics)
40- Supra-condylar fracture pt presented with swelling and cyanosis of
finger after plaster. Management:
GOOD LUCK
(Orthopedics)
41- Adduction hip & internal rotation in fixed position will be :
(Pediatrics)
42- Neonatal just delivered , term pregnancy. Developed resp.distress
CXR showed multicystic lesion in Lt side shifted mediastinum to the Rt ,
decreased bilatral breath sound & flat abdomen:
a) Diaphragmatic hernia
b) RDS
c) Emphysema
d) !!
e) !!!
(Pediatrics)
43- A 2 month – boy with projectile vomiting. On examination olive mass
in Rt upper quaderant of abdomen. 1st step of investigation is:
a) x-ray abd.
b) U&E
c) Barium study
d) !!
e) !!!
(Surgery)
44- 2 day-old neonate presented with peri-rectal bleeding, Dx
a) Mickles diverticulum
b) Intussception
c) Fissure –in-ano
d) !!
e) !!!
GOOD LUCK
intussception : blood PR (jam like)
GOOD LUCK
(Surgery)
45- Child with imperforated anus the most useful diagnostic procedure
is:
(Pediatrics)
46- 18 month-old pt ,the mother complain that pt is saying only mama
baba , no other words .pt otherwise completely normal. 1st step to
evaluate :
a) Physical examination
b) Hearing test
c) Developmental test
d) Test speech
e) !!
(Pediatrics)
47- perinatal asphyxia could cause by all EXCEPT :
a) Abruptio placenta
b) Hyper emisis gravidium
c) Pre-eclampsia
d) !!
e) !!!
(OB/Gyne)
48- Sign and symptoms of normal pregnancy,EXCEPT:
a) Hyperemesis
b) Hegar sign
c) Chadwick's sign
d) Amenorrhea
GOOD LUCK
Chadwick's sign : bluish discoloration to the cervix and vaginal walls
GOOD LUCK
(OB/Gyne)
49- In twins all true, EXCEPT :
(OB/Gyne)
50- Ectopic pregnancy, EXCEPT :
(OB/Gyne)
51- Breech presentation all true , EXCEPT:
(OB/Gyne)
52- In lactation all true, EXCEPT:
GOOD LUCK
)
GOOD LUCK
(OB/Gyne)
53- secondary amenorrhea
a) always pathalogical
b) is part of sheehan syndrome
c) turner syndrome
d) !!
e) !!!
(OB/Gyne)
54- Pt with post partum hemorhage & infertility, all can be found
EXCEPT:
no idea
(OB/Gyne)
55- Placenta previa, all true EXCEPT:
(OB/Gyne)
56- PID(pelvic inflammatory dis), all true EXCEPT:
a) Infertility
b) Endometriosis
d) Dysparunia
c) Can be treated surgically
e ) !!!
GOOD LUCK
GOOD LUCK
(Surgery)
57- Laprascopy could be used in all, EXCEPT:
a) Infertility
b) Intestinal obstruction
c) 1ry amenorrhea
d) !!
e) !!!
(OB/Gyne)
58- Recurrent abortion:
a) Genetic abnormality
b) Uterine abnormality
c) Thyroid dysfunction
d) DM
e) Increased prolactin
(OB/Gyne)
59- DIC occur in all ,EXCEPT:
a) Abruptio placenta
b) Fetal death
c) DM
d) Pre-eclampsia
e) !!
(OB/Gyne)
60- Pregnancy induced HTN, all true EXCEPT:
a) Ankle edema
b) Polyuria
c) Exaggerated reflex
d) RUQ pain
e) !!
GOOD LUCK
GOOD LUCK
(OB/Gyne)
61- Pyelonephritis in pregnancy , all true EXCEPT:
(Medicine)
62- All indicate severity of bronchial asthma ,EXCEPT:
(ENT)
63- All are normal in association with teething EXCEPT:
a) Rhinorrhea
b) Diarrhea
c) Fever > 39 C
d) Irritability
E) !!
(Medicine)
64- Pt come within 3 hrs H/O Lt side weakness , examination revealed Lt
side hemiparesis, pulse 120/min irregular with diastolic murmer at mitral
area. 1st step of nanagement :
a) heparin
b) digoxim
c) EEG
d) carotid angiography
GOOD LUCK
e) echo
GOOD LUCK
(Medicine)
65- pt with fever , pallor petechei, echemosis, CBC as WBC 2,800 /mm3
,Hb 6 &
plt 2900 . next step of investigation :
(Medicine)
66- pt on chemotherapy presented with fever , all should be done ,
EXCEPT:
a) blood culture
b) urine culture
c) aspirine is effective
d) broad spectrum antibiotics
e) !!
(Surgery)
67- crohn's disease indication of surgery is:
a) internal fistula
b) external fistula
c) intestinal obstruction
d) abd.mass ????
e) !!
(Surgery)
68- in affected index finger, all can be used , EXCEPT:
a) rubber tourniguet
b) xylocaine
c) adrenalin
d) ring block
e) !!
GOOD LUCK
no idea
GOOD LUCK
(Medicine)
69- pt with low grade fever and arthalgia for 5 days, presented with
pansystolic murmer at the apex.H/O difficulty in swallowing with fever 3
wks back. Most likely diagnosis:
a)bacterial endocarditis
b) viral myocarditis
c) acute rheumatic fever
d) pericarditis
e) !!
major criteria(polyarthritis,pericarditis,chorea,eryth.margenatum
&subcutaneous nodule)
(Medicine)
70- sign of congestive heart failure in children all .EXCEPT:
a)gallop rhythm
b) periorbital edema
c) basal crept.
d) hepatomegaly
e) bounding pulse
(Medicine)
71- 7 month-old infant with 4 months H/O interruption of feeding,
normal S1 loud S2 pansystolic murmer grade III/IV at 3rd Lt intercostal
parasternally,
with hyperactive pericardium. Dx:
a) large VSD
b) large ASD
c) PDA
e) AR
e) MR
GOOD LUCK
GOOD LUCK
(Medicine)
72- Pt presents with fever swelling is felt,Ant.lymph node swelling warm,
tender &fluctuant Dx:
a) viral infection
b) bacterial lymphadenitis
c) Hodgkin L.
d) ALL
e) !!
GOOD LUCK
GOOD LUCK
2012
(SURGERY)
73- A 50 years old female patient with H/O weight loss, preference
of cold weather, palpitation, there is H/O firm swelling in the
anterior neck for 5 years Dx:
a) Simple goiter
b) Diffuse toxic goiter (gravis disease)
c) Toxic nodular goiter
d) Carotid body tumor
e) Parathyroid edema
(SURGERY)
74- Patient presented with fluctuant redness of finger bulb.
Treatment:
a) Incision
b) Penicillin
c) !!
d) !!
e) !!
(OB/GYN)
75- Infertility, all true, EXCEPT:
a) Male factor present 24%
b) Normal semen analysis is >20,000,000
c) Idiopathic infertility is 27%
d) High prolactin could be a cause
e) !!
GOOD LUCK
(MEDICINE)
76- Patient with H/O fever, peripheral blood film +ve for malaria:
a) Banana shaped erythrocyte is seen in P. vivax
b) Mostly duo to P. falciparium
c) Treated immediately by primaquin 10mg for 3 days
d) Response to Rx will take 72 hr to appear
e) !!
(GYN/OBST)
77- Primary amenorrhea duo to:
a) Failure of canalization of mullarian duct
b) Kallmann syndrome
c) Agenesis
d) All of the above
e) Non of the above
Primary amenorrhea:
-No menses by age of 14 and absence of 2ry sexual CCx.
-No menses by age of 16 with presence of 2ry sexual CCx
Causes: Gonadal dysgenesis 30%, Hypothalamic-pituitary failure e.g
Kallmann syndrome( defecient GnRH), congenital absence of uterus
(20%) “agenesis of Mullerian system”, Androgen insensitivity (10%),
(SURGERY)
78- Patient oliguria one contraindicated: "??"
a) I.V. ringer lactate
b) I.V.P
c) !!
d) !!
e) !!
GOOD LUCK
Q is not clear for me :s
GOOD LUCK
(SURGERY)
79- Patient with multiple trauma, conscious.Rx:
a) ABC
b) I.V.F
c) Cross match
d) !!
(SURGERY)
80- Among the causes of Prtal HTN, which of these will cause the
lease hepatocellular damage
a) Schistosomiasis
b) Alcoholic cirrhosis
c) Post necrotic scaring
d) Cirrhosis duo to chronic active hepatitis
e) !!
(GYN/OBST)
81- Obstructed labor: "??"
a) Primigravida
b) Easy to be Dx early before starting labor
c) !!
d) !!
e) !!
Q is not clear for me :s
(SURGERY)
82- RTA with urethral bleeding. Step of management:
a) Insert foley's cath
b) Stabilize the pelvis
c) Insert suprapubic cath
d) !!
e) !!
The life is too short but… you can do something going on & everyone
can remember you in good things that you did
GOOD LUCK
2012
(Medicine)
1.complications of systemic hypertension are all EXPECT:
a) Intracerebellar haemorrhage
b)Renal artery stenosis.(this causes HTN)
c)!!
d)!!!
(Medicine)
2.S3 occur in all of the following EXCEPT:
a)Tricuspid regurgitations.
b)young athelete.
c)LV failure.
d)mitral stenosis.
Physiological 3rd heart sound, is a filling sound that results from rapid
diastolic filling as occurs in Healthy young adults, children, Athelets,
pregnancy and fever.
Pathological 3rd heart sound is a mid diastolic sound that results from
reduced ventricular compliance and if it's associated with tachycardia ,it is
called gallop rhythm.
LT ventricular S3
It's louder at apex and expiration.
IT is a Sign of LV failure and may occur in AR, MR,VSD and PDA.
RT ventricular S3
It's louder at left sternal edge and with inspiration.
Occurs with RT ventricular failure or constrictive pericarditis.
(Danish).
GOOD LUCK
(Medicine)
3.Treatment of chronic atrial fibrillation all, EXCEPT:
a)cardioversion
b)digoxin
c)warfarin
d)!!
When AF is due to an acute precipitating event such as alcohol toxicity,
chest infection, hyperthyroidism, the provoking cause should be treated.
Strategies for acute management of AF are ventricular rate control or
cardioversion (+/- anticagulation).
Ventricular control rate is achieved by drugs which block the AV node,
while cardioversion is achieved electrically with DC shock., or medically
with anti-arrythmic.
In general, each patient deserves at least one cardioversin trial.
If patient is unstable and presents in shock , severs hypotension, pulmonary
edema, or ongoing myocardial ischemia, DC cardioversion is a must.
In less unstable patients or those at high risk for emboli due to cardioversion
as in mitral stenosis, rate control is adopted ( digoxin, b-blocker or
verapamil to reduce the ventricular rate.
If it's unsuccessful then cardiovert the patient after anticoagluanting him for
4 wks.
In chronic atrial fibrillation, cardioversion is contra-indicated due to risk of
thrombus dislodge
(kumar &clark,Danish)
(Medicine)
4.Treatment of unstable angina include all EXCEPT:
a)heparin
b)nitroglycerin
c)b-blocker
d)aspirin
e)!!!
Hospitalization
Strict bed rest, supplemental oxygen.
Sedation with benzodiazepine if there is anxiety.
Systolic blood pressure is maintained at 100-120 mmHg and pulse should be
lowered to 60/min.
Heparin, antiplatelet, nitrates and b-blocker.
(Danish)
GOOD LUCK
GOOD LUCK
(Medicine)
5.Patient with RT femur fracture developed chest pain,
hemoptysis, ABG Po2 below 65 pCO2 increased, first line of
management:
a)Heparin.
b)aminophyllin.
c)!!!
d)!!
(Medicine-Rheumatology)
6.patient with pain in sacroiliac joint, with morning stiffness. X-
ray of sacroiliac joint… all will be found EXCEPT:
a) RF –ve
b)subcutaneous nodules.
c)male> female
d)!!
(ENT)
7.Glue ear, one is true:
a)can be treated by grummet tube insertion.
b)!!
c)!
GOOD LUCK
GOOD LUCK
serous otitis media= secretory otitis media= mucoid otitis media= glue ear.
This is an insidious condition characterized by accumulation of non-
purulent, sterile effusion in the middle ear cleft.
Causes include, malfunctioning of Eustachian tube such as in adenoid
hyperplasia, chronic rhinitis & sinusitis, tonsillitis
Viral infection &Allergy that leads to increase secretory activity
Unresolved otitis media occur in inadequate antibiotic therapy in acute
suppurative otitis media may inactivate infection and acts as a stimulus to
for mucosa to secrete more fluid.
Treatment is with decongestant, antiallergic, antibiotics &middle ear
aeration by valsalva maneuver.
But if fluid is thick it should be removed surgically by myringotomy &
aspiration of fluid
Or grommet insertion.
(Medicine)
8.The first symptom of left heart failure is:
a)orthopnea
b)edema
c)dyspnea on exertion
d)!!
(ENT)
9.Tinnitus, one is true:
a) Not expert by children.
b)!!
c)!!!
tinnitus is a ringing sound with it's origin within the patient's ear, particularly
at night.
Types are (a) subjective, which can be heard by the patient in anemia,
arteriosclerosis, HTN & certain drugs that act through the inner ear or
central auditory pathway
(b)objective, heared by stethoscope such as in glomus tumor & carotid
artery aneurysm.
This type is less frequent.
GOOD LUCK
GOOD LUCK
Tinnitus synchronus with respiration can be due to abnormal patent
Eustacian tube, palatal myoclonus due to clonic contraction of (stapedius
and tensor tympani).
Treatment: as long as it's a symptom, the underlying cause should be
treated in addition to sedations and masking of tinnitus
(disease of ear nose & throat, Pl dhingra)
(Pediatrics)
10.Treatmentof tetrology of fallot ,all true EXCEPT:
a)Thoracotomy
b)use of systemic antibiotics.
c)chest tube insertion.
d)!!
(OB/Gyne)
11.The following are risk factors of puerperal infection EXCEPT:
a) endometriosis
b)cervical laceration
c)haemorrhage
d)anemia
e)retained placenta
GOOD LUCK
(hacker and moore).
GOOD LUCK
(Urology)
12.Epididymitis, one is true:
a)The peak age between 12 &18.
b)u/s is diagnostic.
c)The scrotal contents are within normal size.
d) typical iliac fossa pain.
e) non of the above.
(Medicine)
13.The following are features of rheumatic fever, Except:
a)restless, involuntary abnormal movements.
b)subcutaneous nodules.
c)rashes over trunk and extremities.
d)short PR interval on ECG.
e)migratory arthritis
Clinical features:
Sudden onset of fever ,joint pain, malaise and loss of appetite.
Diagnosis also relies on the presence of
Two or more major criteria or one major plus two or more minor criteria
Revised Ducket jones criteria
Major criteria are carditis, polyarthritis, chorea, erythema marginatum and
subcutaneous nodules.
Minor criteria are fever, arthralgia, previous rheumatic fever, raised ESR/c-
reactive protein.
Leukocytosis and prolonged PR interval on ECG.
GOOD LUCK
GOOD LUCK
(Pediatrics)
14.All are differential diagnosis of croup except:
a)pneumonia
b)foreign body inhalation.
c)cystic fibrosis.(NOT SURE)
d)tonsillitis.
e)!!
croup is an acute viral infection of the upper and lower respiratory tract
that occurs primarily in the in infants and young children 3 months to 3yrs
old after an upper respiratory tract infection.
It is characterized by hoarsness, fever, a distinctive harsh ,brassy cough,
Persistent stridor during inspiration, and varying degrees of respiratory
distress syndrome.
Causes are:
Viral laryngotracheitis, spasmodic croup, bacterial trachieitis
Less common causes are epiglottis, inhalation of smokes trauma to throat,
retropharyngeal abcess, laryngeal foreign body, angioedema, infectious
mononucleosis, measles and diphtheria.
(Pediatrics)
15.!! child presented with HX of restless sleep during night,
somnolence "sleepiness" during day time, headache….etc
the most likely diagnosis is
a)sinopulmonary syndrome
b) sleep apnea
c)laryngeomalacia
d)adenoidectomy.
GOOD LUCK
GOOD LUCK
(Surgery)
16.All are complications of laporoscopic cholecystectomy
except:
a)incisional hernia above umbilicus
b)persistent pneumoperitonitis
c)bile leakage.
d)ascites
e)!!
(Surgery)
17. patient presented after post-laporoscopic cholystectomy
with progressive jaundice, the most appropriate investigation is:
a)ERCP
b)i.v.cholangiogram
c)!!
d)!!!
(Medicine)
18.All of the following organisms causes diarrhea with invasion
except:
a)shigilla
b)yersenia
c)salmonella
d)cholera
e)campylopacter
GOOD LUCK
invasive pathogens penetrates into the intestinal mucosa.
GOOD LUCK
They destroy the epithelial cells and produce the symptoms of dysentery :(
low volume bloody diarrhea ,with abdominal pain)
Those organisms are shigella, salmonella, campylobacter , enteroinvasive,
enterohaemorrhagic E.coli, Enterotoxigenic E.coli, yersenia enterocolitica,
vibrio parahaemolyticus, clostridium difficile.)
IN vibrio cholera , achlorohydra, or hypochlorydia facilitaes passage of the
cholera bacilli into small intestine, where they proliferate and elaborate an
exotoxin which produces massive secretion of isotonic fluid into the
intestinal lumen.
(clinical medicine, kumar)
(Ophthalmology)
19.All are true about congenital squint except:
a)there is no difference of the angle of deviation of squint eye between far
& near vision.
b)!!
c)!!!
d)!!!!
squint(strabismus) is a condition one eye deviates away from the fixation
point .under normal condition both the eyes are in proper alignment.
The presence of epicanthus and high errors of refraction stimulate squint
and this is called apparent squint but in fact there is no squint.
In a non paralytic squint the movement of both eyes are full but only one
eye is directed towards the fixated target, the angle of deviation is
constant and unrelated to direction of gaze .
Paralytic squint there is underaction of one or more of the eye muscles due
to a nerve palsy, extraocular muscles that tether of the globe.
(lecture notes on ophthalmology).
(Psychiatry)
20.good prognostic factor for patient with schizophrenia is
a) +ve family history
b)no obvious cause
c)gradual onset
d)prominent affective symptoms.
e)flat mood
GOOD LUCK
GOOD LUCK
(Pediatrics)
21.a child attended the clinic 3 times with history of cough for 5
days, he didn't respond to symptomatic treatment, one is true in
management:
a)CXR is mandatory
b)trial of bronchodilator
c)trial of antibiotics
(Medicine)
22.benign prostatic hyperplasia , all are true EXCEPT:
a)prostitis
b)nocturia
c)diminished size and strength of stream
d)haematuria
e)urine retention
this condition mostly affect men above 60 yrs ,the aetiology is unknown.
Microscopically, hyperplasia affects the glandular elements of prostate
and causes enlargement of the gland that distorts the urethra, obstructing
the bladder outflow.
Symptoms initially starts with nocturia, difficulty or delay in initiating urination
,decrease forcefulness of urinary stream, post void dribbling, suprapubic
pain occurs if bladder bacteruria is present, bladder stones develop from
stagnation of urine, flank pain from dilatation of ureters.
Occasionally, severe haematuria due to rupture of prostatic veins ,
bacteruria or stone disease.
(clinical medicine, kumar)
(Orthopedics)
23.which of the following is not true regarding osteomylitis:
a)puomyositis
b)epiphyseal plate destruction
c)septic arthritis( it can develop due to septic arthritis)
GOOD LUCK
d)septicemia
e) after bone growth
GOOD LUCK
osteomylitis is a serious bone infection, causative organisms are :
staphylococcus 9o%
streptococci, H.influenza and (salmonella in sickle cell disease with episode
of bone crisis).
It spreads either haematogenously , local infection or by skin breakdown in
the setting of vascular insufficiency.
In acute form onset is sudden with fever and severe pain at site of bone
infection.
On X-ray it may be falsely –ve in early phase, soft tissue swelling,
periarticular demineralizarion and erosion of bone.
Treatment is with debridment of necrotic bone.
Prolonged administration of a combination of (ciprofloxacine + rifampicin)
(Danish)
(Surgery)
24.Varicose veins will affect all the following EXCEPT:
a)short saphenous vein.
b)long saphenous veins.
c)popliteal vein
d)perforaters.
Varicose veins are a disorder of the superficial ( long and short saphenous
veins) and communicating veins which are the saphenofemoral,
perforating.
(Text book of surgery)
(Ophthalmology)
25.retinal detachment, all true except:
a)more common in hypermtropic patient than myopic
b)!!
this is a condition in which there is separation of the two retinal layers, the
retina proper and the pigmentary epithelium by the subretinal fluid.
Causes are:
Vitreous haemorrhage, toxemia of pregnancy that results in accumulation
of exudates in the subretinal space, weakness of the retina such as lattice
degeneration that increases the probability of a tear forming, highly
myopic people, those who had undergone cataract surgery, detached
retina in the fellow eye and recent severe eye trauma.
(lecture notes on ophthalmology).
GOOD LUCK
GOOD LUCK
(Orthopedics)
26.All of the following muscles are rotator cuff except:
a) supra-spinatous
b)teres minor
c)infraspinatous
d)deltoid
GOOD LUCK
2012
(OB/Gyne)
1) The most common cause of post partum hemorrhage is:
a) Uterine atony
b) Multiple pregnancy
c) Pre-eclampsia
Answer is A
PPH:
Loss of more than 500 cc after vaginal delivery or more than 1 L
after CS.
It could be Early: within 24 hours PP. or
Late: after 24 hours, but within 6/52.
Causes:
Uterine atony: most common due to:
a)labour: -prolonged or induced.
b)uterus: -infection or over distention.
c)placenta: -previa or abruption.
2) Tissue : retained placenta , retained blood ,GTN.
3) Trauma.
4) Thrombin.
(OB/Gyne)
2) The following drug can be used safely during pregnancy:
a) Septrin
b) Cephalexin
c) Tetracycline
d) Aminoglycoside
e) Cotrimoxazol
Answer is D
GOOD LUCK
GOOD LUCK
Drugs & pregnancy:
Septrin = cotrimoxazole: can be used.
Cephalexin = 1st gen. cephalsporins: can be used.
Tetracycline: safe, but causes dental staining.
Aminoglycosides: as gentamycin: causes congenital defness
(OB/Gyne)
3) A16 year old pregnant,which of the following is the least likely to be
a complication of her pregnancy:
a) Anemia
b) Pelvic complication
c) Toxemia
d) Low birth wt infant
e) Infant mortality
ﻦﻴﻳرﺎﺸﺘﺳﻻا ﻦﻣ ﺮﻴﺘآ ﺎﻨﻟﺎﺳ ﺮﻴﺤﻣ لاﺆﺳ ﻲﺒﻏ لاﺆﺳ اﺰه ﺔﺑﺎﺟﻻا ﺖﻧﺎﻜﻓ
(Psychiatry) *
4) In schizophrenia, the following is good prognosis:
a) Family Hx of schizophrenia
b) Gradual onset symptoms
c) Predominant o f affective symptoms
d) Absence of precipitating factors
Answer is C
Good prognosis of schizophrenia:
Acute onset
Precipitating factors
Good cognitive functioning
Good premorbid functioning
No family history
Presence of affective symptoms
Absence of structural brain abnormalities
Good response to drugs
Good support system
GOOD LUCK
GOOD LUCK
(Community Medicine) *
5) Secondary prevention is least likely of benefit in :
a) Breast cancer
b) Leukemia
c) DM
d) Toxemia of pregnancy
Answer is B
(Community Medicine)
6) An example of secondary prevention is:
a) Detection of asymptomatic diabetic pt
b) Coronary bypass graft
c) Measles vacc
d) Rubella vacc
Answer is B
primary prevention:
Action to protect against disease as immunization.
Action to promote health as healthy lifestyle.
Secondary prevention:
Identifying & detecting a disease in the earliest stage before
symptoms appears, when it is most likely to be treated successfully
(screening).
Tertiary prevention:
Improves the quality of life of people with various diseases by
limiting the complications.
(Community Medicine)
7) Control of infection disease
a) Control source of infection
b) Block channel of transmissioin
c) Protect the receiver of infection
d) All of the above
Answer is D
GOOD LUCK
)
GOOD LUCK
(OB/Gyne)
8) Primary mechanism of contraceptive pills:
a) Cause changes in cervical mucosa
b) Cause changes in endometrium preventing implantatioin
c) Inhibit relase of estrogen from follicle
d) Inhibit gonadtropin surge (no ovulation)
Answer is D
(OB/Gyne)
9) Indication of hepatitis during pregnancy is high level of :
a) WBC
b) Alk phospht
c) SGOT
d) BUN
Answer is B
(Ophthalmology)
10) Cause sudden loss of vision all of the following,EXCEPT:
a) Retinal detachment
b) Central retinal artery embolism
c) Vitreous hemorrhage
d) Retinitis pigmentosa
e) Retrobullbar neuritis
GOOD LUCK
Answer is D
GOOD LUCK
Sudden vision loss:
Central retinal artery embolism: sudden painless loss of vision.
Vitreous hemorrhage: sudden loss of vision
Causes: Proliferative diabetic retinopathy.
Retinal detachment.
Retinal vein occlusion.
Retinitis pigmentosa: inherited disease causes gradual loss of vision.
Retrobullbar neuritis: optic neuritis without swelling of the optic disc:
causes loss of vision.
(Ophthalmology) *
11) All can predispose to retinal detachment, EXCEPT:
a) Cataract surgery
b) More in hypermetropic eye than myopic eye
c) ?????????
d) ????????????
Answer is B
Retinal detachment:
Causes:
- Trauma.
- DM.
- Inflammation.
- Aging.
Risk factors:
- Past Hx.
- FHx.
- Myopia.
- Surgry: cataract removal.
Symptoms:
-Sudden onset of blurred vision, flash of lights.
GOOD LUCK
GOOD LUCK
(Community Medicine)
12) In ischemic heart disease
a) Prevalence is the number of case discovered yearly
b) Incidence is new cases yearly
c) There is association between HTN & ischemic heart
disease
d) Smoking is an absolute cause if IHD
Answer is B
Incidence is a measure of the risk of developing some new condition within a
specified period of time.
the prevalence of a disease is defined as the total number of cases of the disease
in the population at a given time, or the total number of cases in the population,
divided by the number of individuals in the population.
(ENT) *
13) Glue ear
a) Invariably caused by adenoid enlargement
b) Can be treated by inserting grommet-tube
c) Can lead to sensory neural deafness
Answer is B
Otitis media:
GOOD LUCK
Perforation in the ear drums with active bacterial infection.
Otorrhae is +ve.
GOOD LUCK
(Medicine)
14) Rubella
a) Incubation period 3-5 days
b) Start with high fever
c) Cause arthritis
Answer is C
Rubella:
(Pediatrics) *
15) If the child has croup after waking up of sleep, what are DDx
a) Pneumonia
b) Foreign body aspiration
c) Tonsillitis
d) Cystic fibrosis
No idea
GOOD LUCK
GOOD LUCK
2013
(Medicine)
16- A pt had abd pain and found to have gastric ulcer all are
predisposing factor, except:
a) Tricyclic antidepressant
b) NSAIDs
c) Delayed gastric empyting
d) Pyloric sphinter incompetence
e) Sucralfate
Answer is E
Aggressive factors for peptic ulcer:
(Pediatrics)
17-a 2 weeks old infant with jaundice,cirrhosis and ascites,the cause
is:
a) Gillberts disease
b) Criggler-najjar syndrome
c) Congenital biliary atresia
d) Dubin jhonson syndrome
Answer is C
GOOD LUCK
Gilbert's disease is common, affecting up to 10% of some
Caucasian populations. The most significant symptom of this
condition is jaundice. Affected individuals ordinarily have no
jaundice. However, jaundice appears under conditions of exertion,
stress, fasting, and infections
Dubin-Johnson syndrome :Mild jaundice, which may not appear until
puberty or adulthood, is the only symptom of Dubin-Johnson
syndrome.
Physical findings do not identify all cases of biliary atresia. No findings are
pathognomonic for the disorder.
Infants with biliary atresia are typically full term and may manifest
normal growth and weight gain during the first few weeks of life.
Hepatomegaly may be present early, and the liver is often firm or
hard to palpation. Splenomegaly is common, and an enlarging
spleen suggests progressive cirrhosis with portal hypertension.
Direct hyperbilirubinemia is always an abnormal finding and may
be present from birth in the fetal/embryonic form. Consider biliary
atresia in all neonates with direct hyperbilirubinemia.
In the more common postnatal form, physiologic jaundice
frequently merges into conjugated hyperbilirubinemia. The
clinician must be aware that physiologic unconjugated
hyperbilirubinemia rarely persists beyond 2 weeks. Infants with
prolonged physiologic jaundice must be evaluated for other
causes.
In patients with the fetal/neonatal form (polysplenia/asplenia
syndrome), a midline liver may be palpated in the hypogastrium.
The presence of cardiac murmurs suggests the presence of
associated cardiac anomalies.
A high index of suspicion is key to making a diagnosis because
surgical treatment by age 2 months has clearly been shown to
improve the likelihood of establishing bile flow and to prevent the
development of irreversible biliary cirrhosis.
GOOD LUCK
GOOD LUCK
Criggler-najjar syndrome
A family history of Crigler-Najjar syndrome
Yellow skin (jaundice) and yellow color of the whites of the eyes
(icterus), which begin on the 2nd or 3rd day of life and progressively
worsens
Jaundice that persists beyond 2 weeks without an obvious cause
Confusion and changes in thinking (resulting from brain toxicity of
bilirubin)
(OB/Gyne)
18-post pill amenorrhea, all true except:
GOOD LUCK
failure, polycystic ovary syndrome, weight loss, and
GOOD LUCK
hyperprolactinemia before arriving at a diagnosis of idiopathic postpill
amenorrhea. Prior to 6 months, detailed laboratory evaluation is not
indicated, but after 6 months of amenorrhea, the history and physical
status should again be carefully evaluated. Any history of weight
change, galactorrhea, hirsutism, headaches, or "hot flashes" should be
noted. On examination, evidence of hirsutism, virilization, expressible
galactorrhea, or ovarian enlargement should be sought. The presence
of any of these findings warrants laboratory testing. Pregnancy should
always be excluded before further testing. If the patient shows no
clinical evidence of premature ovarian failure, polycystic ovaries,
anorexia nervosa, or hyperprolactinemia, or if laboratory evaluation
fails to confirm clinical suspicions, it is appropriate to wait another 6
months before further evaluation. These disorders may be
differentiated from idiopathic postpill amenorrhea by measuring serum
levels of gonadotropins, estradiol, testosterone, and prolactin and by
sella polytomography. It is important to define whether the treatment
objective is resumption of a normal menstrual pattern or restoration of
fertility, or both, for therapy will differ depending upon the objective.
Ovulation can be induced with clomiphene or bromocriptine in 50-75%
of women. Rarely, human menopausal gonadotropin and human
chorionic gonadotropin may be needed. If fertility is not an issue, cyclic
estrogen and progesterone may be useful to maintain adequate
estrogen effects but will obviously continue to suppress the
hypothalamic-pituitary-ovarian axis.
- Some women may encounter post-pill amenorrhea or
oligomenorrhea, especially when such a condition was pre-existent.
(OB/Gyne)
19-indication of progress of labor:
a) Dilation
b) Descent
c) Dilation and descent
Answer is C
GOOD LUCK
)
GOOD LUCK
The progress of labor may be measured in terms of cervical
effacement, cervical dilatation ,and descent of the fetal head
(Surgery)
20-pt sustained abdominal truma,and was suspect intra-peritoneal
bleeding,the most important diagnostic test is:
a) CT scan
“if vitally stable”
b) Direct peritoneal lavage DPL
Answer is A
(Surgery)
21-Peritonitis
GOOD LUCK
GOOD LUCK
(Surgery - Pediatric)
22-child has tracheoesophageal fistula, all can be used in
management, except
Initial treatment:
3-prophylactic antibiotics
GOOD LUCK
)
GOOD LUCK
(Surgery)
23-old pt with jaundice,gall bladder is palpable,the most likely cause:
a) Ca of head pancreas
COURVOISIERS LAW :
(Surgery)
24-old lady ,with 3 days Hx of perforated peptic ulcer, presented
semicomatosed, dehydrated, febrile. The appropriate management:
2- IVF,foley catheter
3- Antibiotics
4- Surgery
GOOD LUCK
incorporating ulcer
,Graham patch and
highly selective
2
3
4
GOOD LUCK
(Orthopedics)
25-Congenital dislocation of hip; all are true EXCEPT:
a) More in girls
b) Best examined after 12-36 hours from birth
c) There will be limitation in abduction of thigh
d) Barlow test will give click indicating CDH
e) Can be treated by splint
answer is D
CDH
more in female
first born child
breech
10% bilaterally
Barlows maneuver: detects unstable hip patient is placed in supine
position and attempt is made to push femurs posteriorly with knees at
90 hip flexed and hip will dislocate
Ortolanis sign: the clunk produced by relocation of a dislocated
femoral head when the examiner abducts the flexed hip and lifts the
greater trochanter anteriorly.
RX: by pavlike harness---- maintains hip reduction with hip flexed at
100 to 110 degree
(Medicine)
26-the most important factor predisposing to stroke is:
a) DM
b) HTN
C) Hyperlipidemia
d) Cholesterol
e) ???????
answer is C
GOOD LUCK
GOOD LUCK
Risk factors for strok:
(Unspecific)
27-All are true; EXCEPT:
a) Iron supplement is not essential in all breast fed infant
b) Normal pregnancy are not always end in normal deliveries
c) All TB regimes should have INH
d) One or more essential amino acids are deficient in most
vegetables
e) Protein of low biological value present in cereals and legumes
answer is A
(Orthopedics)
28-acute gait disturbance in children; all are true EXCEPT:
a) Commonly self limited
b) The usual presenting symptom is limping
c) Radiological investigation can be reveal the DX
d) Most often no cause can be found
e) ???????
Answer: unknown
An acute limp implies an underlying pathology that causes disruption
of the standard gait pattern; the challenge for the physician is to
identify this pathology. The cause of a limp can range from something
as serious as a life-threatening bone tumor to something as minor as a
pebble in a shoe. The clinician must consider the spine, pelvis and
lower extremities for a possible etiology. A useful approach is to
consider the causes of limping from head to foot to avoid overlooking
common underlying conditions such as diskitis, psoas abscess or
septic hip, which are less obvious than conditions involving the lower
GOOD LUCK
extremities
GOOD LUCK
(Surgery)
29-Varicose vein can be in all veins, EXCEPT:
a) Long saphenous vein
b) Short saphenous vein
c) Poploteal vein
d) Perforators
e) ??????
answer is D
(Surgery)
30- All can complicate excision of abdominal aortic aneurysm,
EXCEPT:
a) Paraplegia
b) Renal failure
c) Hepatic failure
d) Leg ischemia
answer is C
Abdominal aortic aneurysm (AAA):
GOOD LUCK
Risk factor to rupture:
GOOD LUCK
1-increase aneurysm diameter 2-COBD 3-HTN 4-recent rapid
expansion 5-symptomatic
Signs of rupture: triad of 1-abdominal pain 2- pulsatile abdominal mass
3-Hypotensin
Differential diagnosis :
1-acute pancreatitis 2-aortic dissection 3-MI 4-perforated ulcer 5-
renal colic
Diagnostic test: use U/S to follow AAA clinically , other test involve
contrast CT and A-gram
Indication for surgical repair more than 5 cm
Possible operation complication : MI, atheroembolism, delcamping,
hypotension, acute renal failure , urethral injury, hemorrhage.
(OB/Gyne) *
31-All of following can increase risk of puerperal infection, EXCEPT:
a) Hemorrhage
b) RPOC ?? (maybe EPOC evac. Product of concepts)
c) Endometriosis
d) Anemia
e) ??????
Answer: unknown
GOOD LUCK
GOOD LUCK
(Medicine)
32-The following drugs can be used in prophylaxis of malaria in
chlorquine-resistant area, EXCEPT:
a) Mefloquin
b) Doxycyclin
c) Proguanil
d) Chlorquine+dapsone+pyrimethamin
e) ??????
answer is D
Limited chloroquine resistance: chloroquine plus proguanil, alternative
doxycyline or mefloquine
(Clinical Pharmacology)
33-Which of the following side effect is not associated with phenytoin:
a) Hirsutism
b) Macrocytic anemia
c) Asteomalasia
d) Ataxia
e) Osteoporosis
answer is E
Side effects of phenytoin:
1-CNS: cerebral edema ; dysarthria; extrapyramidal syndrome
2-EENT: diplopia ; nystagmus; tinnitus.
3-CVS: hypotension
4-GI: gingival hyperplasia ; altered taste
5-GU: pink or red urine.
6- DERMA: hypertrichosis; exfoliative dermatitis
7- Hypocalcaemia
8- Agranulocytosis; aplastic anemia, macrocytic anemia
9-Asteomalasia.
GOOD LUCK
GOOD LUCK
2013
(OB/Gyne)
34. Which of the following does not cause IUGR:
a) Toxoplasmosis.
b) CMV.
c) Rubella.
d) Syphilis. ??
e) HSV II. ??
The answer: controversial (d) or( e)
BRS (Sakala):
- All of these can cause IUGR. 1ry HSV can cause IUGR but 2ry herpes
infection does not increase obstetric hazards including IUGR.
Essentials of Ob/Gyn (Hacker & Moore):
- IUGR causes are TORCH: Toxoplasmosis, others, Rubella, CMV & HSV.
- In the obstetric infections, syphilis impact on pregnancy didn't include
IUGR.
(Pediatrics)
35. One of the following is NOT a feature of Henoch-Schoenlein purpura
(HSP):
a) arthritis.
b) rash over the face.
c) abdominal pain.
d) normal platelet count.
e) !!
The answer: (b)
Emed:
- HSP skin rash distribution: lower extremities( dorsal surface of the legs),
buttocks, ulnar side of arms & elbows.
- workup: CBC: can show leukocytosis with eosinophilia & a left shift,
GOOD LUCK
thrombocytosis in 67% of cases. Decreased platelets suggests
thrombocytopenic purpura rather than HSP.
GOOD LUCK
(OB/Gyne)
36. One drug of the following CAN NOT cross the placenta:
a) Heparin.
b) Warfarin.
c) Aspirin.
d) !!
e) !!
The answer: (a).
Dr.Drug:
Heparin: doesn't cross the placenta & doesn't enter the breast milk.
Warfarin: crosses the placenta but doesn't the enter the breast milk.
Aspirin: all salysilates cross the placenta and enter he breast milk.
(Pediatrics)
37. All can cause short stature, EXCEPT:
a) Hypothyroidism.
b) Turner syndrome.
c) Down syndrome.
d) Klinefilelter syndrome.
e) !!
The answer: (d)
Emed:
-Klinefelter (47,xxy) -in male only- is the most common chromosomal
disorder associated with male hypogonadism and infertility. Infants and
children affected by this syndrome have normal height, weight and HC.
Height velocity is increased by the age of 5 years. Adult height is taller than
average with disproportionally long arms and legs.
(Pediatrics)
38. In neonates, the following need Rx:
a) Erupted teeth. ??
b) Hydrocephalus.
c) Absent femoral pulse.
d) !!
GOOD LUCK
The answer: I don't know ( may be (a))
GOOD LUCK
WUS ped:
Erupted teeth are supposed to be removed to avoid aspiration.
Emed:
As a general rule, shunting is avoided, if possible, in children younger than 6
months b/c they have high risk of infection.
(OB/Gyne)
39. Vaginal trichomoniasis, all are true, EXCEPT:
a) More in diabetic.
b) Protozoal infection.
c) Dx by microscopic examination of diluted vaginal smear.
d) Rx by Metronidazole.
e) !!
The answer: (a).
BRS ( Sakala ):
. T. vaginalitis: - Humans are the only host. – STD. – Protozoal parasite. –
Resides asymptomatically in male semen.
-Most common cause of vaginitis worldwide.
. Dx: 1) clinical: vulvular erythema & edema. – A profuse, malodorous,
frothy, yellow-green discharge. – T. cervicitis with red, punctuate lesions (
strawberry patches). – Vaginal pH more than 4.5.
2) Wet-mount salinepreparation. (low cost office procedure).
3) Culture: most sensitive.
. Rx: Metronidazole either; 500 mg PO BID/7D or single 200 mg dose. – the
partner should be treated.
(Pediatrics)
40. APGAR score:
a) of 12 points.
b) color is not important.
c) Heart rate is important.
d) !!
e) !!
GOOD LUCK
The answer: (c).
GOOD LUCK
WUS ped:
. APGAR score is a tool that can be used to define the state of an infant at
given times , usually at 1 and 5 min. of life.
2 1 0
>100 <100 absent HR
Good/ strong cry Slow/weak cry Absent Respiratory Effort
(irregular)
Active motion Some flexion Limp Muscle tone
Cough or sneezing grimace No response Reflex (irritability)nasal
suction
Completely pink Acrocyanosis Blue, pale color
(peripheral)
(Surgery)
41. Appendicitis in elderly:
a) less risk of perforation.
b) more rigidity.
c) can mimic intestinal obstruction.
d) !!
e) !!
The answer: (c).
(Medicine)
42. Nitroglycerine cause all of the following, EXCEPT:
a) increase coronary blood flow.
b) Methemoglobinemia.
c) Venous pooling of blood.
d) Efficient for 5 min. if taken sublingual.
e) Lowers arterial blood pressure.
GOOD LUCK
The answer: most likely (c).
GOOD LUCK
Dr.Drug: Nitroglycerine;
. -t1/2: 1-4 min. –Dose: 0.3-0.6 mg SL may be repeated Q5min for 15 min for
acute attack.
. Action: - ^^coronary blood flow. – produce vasodilation.- decrease LVED
vol. (preload).- decrease myocardial O2 consumption
. Therapeutic effect: - relief or prevention of angina attack. - ^^C.O. –
decrease BP.
A-Z drugs: one of the S/E of Nitroglycerine is: Methemoglobinemia.
(Pediatrics)
43. Meningitis in childhood, all are true, EXCEPT:
a) Group B streptococci and E.coli are the most common cause in neonates.
b) H.influenza meningitis can be treated by ampicillin or chloramphenicol. ?
c) Present with specific signs in neonates.
d) If pneumococcal meningitis, Rifampicin is given to contact. ?
e) !!
The answer: may be(b) or (d)
(Surgery)
44. The following are true regarding laparoscopic cholecystectomy, EXCEPT:
a) Commonest complication is wound infection.
b) Pt readmission is frequent.
c) Pt can be discharged after 1-2 days.
d) !!
The answer: (b).
GOOD LUCK
GOOD LUCK
Mont Reid: Laparoscopic cholecystectomy:
Advantages: -decreases postop. Complications. –smaller incision. –improved
cosmesis. – quicker return to work. – quicker return of bowel fx. –shorter
hospital stay.
Complications: a. pneumoperitonium. b. trocar insertion (bleeding, injury to
bowel). c. cholecystectomy (bile duct injury, wound infection).
(Medicine)
45. In atrial fibrillation and stroke, all are true , EXCEPT:
a) Aspirin can be given in AF for prevention of stroke.
b) Warfarin can be given in AF for prevention of stroke.
c) Non valvular AF can cause stroke.
d) !!
e) !!
The answer: I'm not sure (a).
GOOD LUCK
GOOD LUCK
(Surgery) *
46. Pt underwent laparoscopic cholecystectomy, and now came with jaundice,
the most important Inx is:
a) ERCP.
b) !!
c) !!
d) !!
The answer: (a).
Mont Reid:
One of the complications of laparoscopic cholecystectomy is bile duct injury
(leak or stricture).
My comment: The stricture will present with obstructive jaundice -the Inx
of choice is ERCP (Dx & Rx).
(Surgery) *
47. All can be complication of laparoscopic cholecystectomy, EXCEPT:
a) Bile Leak.
b) Ascites.
c) Supra-umbilical hernia. [site of trocar insertion]
d) Persistent pneumoperitonium.
e) Shoulder pain. [irritation of diaphragm]
The answer: (b)
(OB/Gyne)
48. Regarding HSV II, all are true, EXCEPT:
a) Use of fetal scalp electrode increase the risk of infection.
b) !!
c) !!
The answer: is NOT (a).
BRS (Sakala):
GOOD LUCK
)
GOOD LUCK
Risks of internal direct fetal heart rate (FHR) monitoring, using fetal scalp
electrode include:
. fetal scalp abscess
. inoculation of maternal genital tract infections (e.g. herpes, HIV).
(OB/Gyne)
49. Neonate with APGAR score 3 after 1 min, the most important action is:
a) Chest expansion.
b) Warm.
c) Ventilation.
d) Bicarb. Inj..
e) !!
The answer: (c).
(Medicine)
50. Allopurinol, one is true:
a) !!
b) Effective in acute attack of gout.
c) decreases the chance of uric acid stone formation in kidneys
d) Salisylates antagonize its action.
e) !!
The answer: (c).
Dr.Drug: Indication of Allopurinol:
. Prevention of attacks of gouty arthritis uric acid nephropathy. [but not in
acute attack]
. Rx of 2ry hyperuricemia, which may occur during Rx of tumors or leukemia.
. Salisylates may decrease the beneficial effects of uricosuric medication
(Sulfinpyrazone & Probenecide)but no interaction with Allopurinol. [Dr.Drug
& A-Z Drugs].
GOOD LUCK
GOOD LUCK
(Medicine)
51. Premature ventricular contraction (PVC),all are true EXCEPT:
a) If anti-arrhythmic given after MI for protection of PVC --> decrease
chance of sudden death.
b) Use of anti-arrhythmic type I increase mortality.
c) PVC in normal population doesn't increase risk of sudden death.
d) !!
e) !!
The answer:(c) from the available.
Emed:
. Synonyms: premature ventricular contractions (PVCs) or complexes or beat
or depolarization, ventricular premature complexes (VPCs), ventricular
extrasystole, ventricular ectopic beats OR benign ventricular arrhythmia.
. VPCs are ectopic impulses originating from an area distal to the His-Purkinji
system.
. VPCs are the most common ventricular arrhythmia.
. Assesment and Rx of VPCs is challenging and complex.
. The significance of VPCs is interpretted in the context of the underlying
cardiac condition.
. Ventricular ectopy leading to VT, which, in turn, can degenerate into V.Fib.
is one of the common mechanisms for sudden cardiac death.
. Isolated PVC are reasonably common.They occur in as many as 40% of
patients with apparently normal hearts.
. The Rx paradigm in the 1970s & 1980s was to eliminate VPCs post MI.
Recent arrhythmia-suppression studies have demonstrated that eliminating
VPCs with available anti-arrhythmic drugs INCREASE the risk of death to
pts without providing any measurable benefit.
. Drugs of choice in pts with VPCs post MI: Class III are safe but they DO
NOT DECREASE the risk of death.
. Clinical trials have suggested that type I anti-arrhythmic agents and racemic
Sotalol INCREASE mortality in pts post MI.
. Risk in asymptomatic pts: it depends on the frequency (> or= 2 consecutive
VPCs or >10% of all ventricular depolarization on any of the ECG
recordings). If recorded during exercise associated with 205 folds increase
risk of cardiovascular death. Less frequent VPCs didn't increase the risk.
GOOD LUCK
GOOD LUCK
(Pediatrics)
52. Development in children, all are true EXCEPT:
a) At 1 yr, can feed himself by spoon.
b) !!
c) !!
The answer: no available other answers to judge wether (a) is the correct
choice or not.
I advice you to review your preferable pediatric textbook to have a look on
the developmental milestones before the exam.
According to CDI ( Child Development Institute) spoon feed mean age is
15/12 (12-18 monthes)
but according to AAP ( American Academy of Pediatrics) : by the end of
12/12 the child is capable of finger feed.
AAP- by the end of the 1st yaer:
i) Social & emotional:
. anxious with strangers.
. cries when parent leaves.
. enjoys imitating people in his play.
. finger-feed himself.
. extend arm or leg to help when being dressed.
ii) Movement:
. reaches sitting position without assisstance.
. assume hand-and-knee position.
. pulls self up to stand.
. crawls forward on belly.
. creeps on hands and knees.
. walks holding into furniture.
. stands momentarily without support.
. may walk 2 or 3 steps without support.
iii) Language:
. responds to simple verbal requests.
. responds to ''no''.
. uses simple gestures e.g. shaking hand for ''no''.
. says ''dada'' & ''mama''.
. tries to imitate words.
GOOD LUCK
GOOD LUCK
iv) Cognitive:
. begins to use objects correctly ( drinking from a cup, brushing hair)
. looks at the correct picture when the image is named.
(Pediatrics)
53. Whooping cough in children, all are true EXCEPT:
a) Absolute lymphocytosis.
b) Can cause bronchiectasis.
c) Pt is infective for 5 weeks after onset of symptoms.
d) !!
e) !!
The answer: most likely (c) [ the other choices are not available b/c they
usually ask about the MOST correct answer].
(OB/Gyne)
54. Toxemia in pregnancy, all are true EXCEPT:
a) More in primigravida than multigravida.
b) More in multiple pregnancy.
c) can progress rapidly to toxemia.
d) !!
e) !!
The answer: I don't know but it is not (a) or (b). The choice (c) is not clear.
BRS (Sakala): . Age extremes (<20y, >34y).
Risk factors of Pre-eclampsia:
. Nulliprity (8X).
Group 22 - KSU, Riyadh (March -
GOOD LUCK
2008 / Safar - 1429)
. D.M.
. Non-immune fetal hydrops.
- 250 -
GOOD LUCK
. Multiple gestations. . chronic HTN.
. Hydatidiform mole. . Pre-existing ranal disease.
. small vessel disease ( e.g. SLE, long standing type I D.M.).
(Dermatology)
55. All are true in black hairy tongue, EXCEPT:
a) Hydrocortisone can be used.
b) Advice pt not brush his tongue.
c) !!
d) !!
e) !!
The answer: (b)
Emed: Black hairy tongue:
. Defective desquamation of the filiform papillae that results from a variety of
precipitating factors (poor oral hygiene, use of medications e.g. broad-
spectrum Abx & therapeutic radiation of the head & neck). All cases are
characterized by hypertrophy and elongation of filiform papillae with a lack
of desquamation.
. Seen more in those: tobacoo use, heavy coffee or tea drinkers, HIV +ve.
. Rarely symptomatic.
. Rx: . In many cases, simply BRUSHING THE TONGUE with a toothbrush
or tongue scraper is sufficient.
. Medication: if due to candidiasis: Antifungal (Nystatin), Keratolytic agents (
but irritant).
(Pediatrics)
56. About Kernicterus, all are true EXCEPT:
a) Can occur even if neonate is 10 days old.
b) It causes neurologicl abnormalities, it can be reversed.
c) Can cause deafness.
d) All types of jaundice cause it.
e) !!
The answer: mostly (b)
I'm in doubt about (d) b/c Jaundice is a clinical entity not a disease. And it is
wrong If they mean All types of bilirubin cause Kernicterus b/c conjugated
GOOD LUCK
bilirubin is water-soluble and can't penetrate BBB)
GOOD LUCK
UptoDate: Kernicterus:
. Severe hyperbilirubinemia TSB>25-30 mg/dl (428-513 micromol/l) is
associated with increased risk of Bilirubin-Induced Neurological Dysfunction
( BIND) which occurs when bilirubin crosses BBB & bind to brain tissue.
. The term acute bilirubin encephalopathy (ABE) is used to describe acute
manifestation of BIND.
. The term '' KERNICTERUS'' is used to describe the chronic & permanent
sequelea of BIND.
So, rgarding the choice (b) is not a rule b/c early detection can prevent
permanent neurological deficit & reverse the acute (ABE) but the
''KERNICTERUS'' is a term used to describe the chronic sequelea.
Emed: Kernicterus:
. Age: Acute bilirubin toxicity appears to occur in the 1st few days of life of
the term infant. Preterm infants may be at risk of toxicity for slightly longer
than a few days. If injury has occured, the 1st phase of acute bilirubin
enchephalopathy appears within the 1st week of life.
. Complications of kernicterus: Extrapyramidal system abnormalities,
auditory dysfunction, gaze dysfunction, dental dysplasia.
(OB/Gyne)
57. Amenorrhea is a feature of all, EXCEPT:
a) Hypothyroidism.
b) Stein-Leventhal syndrome. (= PCOS= Poly Cystic Ovarian Syndrme)
c) !!
d) !!
e) !!
The answer: not (a) or (b).
BRS( Sakala):
. Causes of amenorrhea (classified by anatomic site):
Hypothalamus: tumors, anorexia nervosa, severe weight loss, stress,
exercise.
Pituitary: panhypopituitarism, Sheehan's syndrome.
Ovarian follicle: gonadal dysgenesis, ovarian failure, vanishing testes,
steroidogenic enzyme defect.
GOOD LUCK
GOOD LUCK
Corpus leutium: PCOS, hyperprlactinemia [ tumors, drugs, chest wall
stimulation, hypothyroidism.
Uterus (endometrium): PREGNANCY, androgen insensitivity,
Mullrian agenesis, Asherman syndrome.
Outflow tract: Imperforate hymen, vaginal agenesis, cervical stenosis.
(Pediatrics)
58. Regarding child with moderately severe asthma, all are true EXCEPT:
a) PO2<60
b) PO2>60
c) low Bicarb. Level.
d) I.V. cortisone can help.
e) !!
The answer: (a).
My comment:
. In very severe, life threatening attack:
Normal or increased PCO2 ----------- Low pH (resp. acidosis) --
High
Bicarb, level.
. In moderately severe attack:
Hyperventilation low PCO2 -High pH (resp. alkalosis) --Low
GOOD LUCK
Bicarb. Level.
GOOD LUCK
(Surgery)
59. Indirect inguinal hernia, all are true EXCEPT:
a) You can get above it.
b) !!
c) !!
d) !!
e) !!
The answer: (a) if the stem of the question is about scrotal swelling.
Mont Reid: Indirect inguinal hernia:
. Sac lies anteriomedial to cord, exiting through the internal ring; lateral to the
inferior epigastric artery.
. Caused by a congenital patency of the processus vaginalis, indirect inguinal
hernia refers to herniation through internal ring facilitated by a weak inguinal
floor.
(Medicine)
60. The first symptom in pt with Lt heart failure:
a) orthopnea.
b) PND.
c) Pedal edema.
d) Exertional dyspnea. ??
e) !!
The answer: I'm not sure, but it may be (d).
GOOD LUCK
GOOD LUCK
(OB/Gyne)
61. The safest Rx of Chlamydia trachomonalis ( I think it is trachomatis)
during pregnancy is:
a) Nitrofurantoin.
b) Azithromycin.
c) Erythromycin base. ??
d) Tetracycline.
e) Erythromycin sulfate. ??
The answer: I am not sure ( b/c the site of infection is not specified
but it could be urethritis). However, it could be (c) or (e).
Emed:
. Tetracycline is C/I in pregnancy.
. DOC: erythromycin or azithromycin
. Pregnancy category:
* nitrofurantoin: B
* azithromycin: B
* erythromycin base: B
* Tetracyclin: C
* Erythromycin sulfate: B
(Urology)
62. Benign prostatic hypertrophy can present with all, EXCEPT:
a) Nocturia.
b) Hematuria.
c) urinary retention.
d) poor stream.
e) prostatitis.
The answer: (e).
SurgRecall:
. Obstructive urinary Sx (LUTS) include: hesitancy, intermittency,
nocturia, weak stream, UTI (hematuria) and urinary retention.
GOOD LUCK
GOOD LUCK
(Ophthalmology)
63. Acute glaucoma, all are true EXCEPT:
a) refer to ophthalmologist.
b) give miotic before referral.
c) can present with headache.
d) can present with abdominal pain.
e) pupil size in acute glaucoma is larger than normal.
The answer: (b)
(Ophthalmology)
64. Congenital squint, all are true EXCEPT:
a) if you cover the non-squint eye, the squint eye will move to the
opposite side.
b) angle of deviation is fixed for near & far vision.
c) !!
d) !!
The answer: I think (b)
GOOD LUCK
GOOD LUCK
(Surgery) *
65. All of the following muscles are part of rotator cuff, EXCEPT:
a) supra-spinatus.
b) Infra-spinatus.
c) Deltoid.
d) Subscapularis.
e) Teres minor.
The answer: (c)
(Community Medicine)
GOOD LUCK
- 1429)
GOOD LUCK
2014
(Medicine)
1- Most important complication of systemic hypertension:
Pontine infarction
Renal artery stenosis
Subdural hemorrhage
Intracerebral hemorrhage
Complication of HTN : CVA , MI , cardiomyopathy , nephropathy,
retinopathy
Renal artery stenosis is a cause of secondary HTN not complication.
(Medicine)
2- S3 can be auscultated in all, except :
Mitral stenosis
Mitral regurgitation
Lt sided heart failure
Thyrotoxicosis
Pathological S3 occurs due to decrease ventricular compliance causes:lt
ventricule -LVF & dilatation
AS, MR ,VSD , PDA, pregnancy, thyrotoxicosis
Rt ventricle :RVF, constrictive pericarditis
(Medicine)
3- A 30 y male came to ER with polyuria but –ve keton. Random blood suger
280 mg/dl . management:
Nothing done only observe
Insulin 30 U NPH+ diet control
Diet and exercise
Oral hypoglycemic
GOOD LUCK
GOOD LUCK
Pt is symptomatic & RBS ≥11.1 DX is DM type 2. RX initially with diet
and exercise and decrease Wt for 6-8 wks if further add metformin
(Medicine)
4- Pt with chromic atrial fibrillation more than 6 months , all can be given
except :
Cardioversion
Heparin
Digoxin
Cardioversion has no role in the treatment of chronic AF.
AF treatment: rate, rhythm control and anticoagulation
(Medicine)
5- All symptoms and signs of brucellosis , except :
Backache
Lymphadenopathy
Splenomegaly
Hepatomegaly
Gastroenteritis
(Medicine) *
6- All cause recent loss of weight , except:
AIDS
Cancer
Nephritic syndrome
Kwashiorkor
Nephritic syndrome cause increase in weight due to fluid retention.
GOOD LUCK
GOOD LUCK
(Surgery)
7- Most important cause of hand infection
Trauma
Immune deficiency
Hematogenous route
Most common and most important cause of hand infection is hand trauma
(Surgery)
8- Pt conscious with multiple trauma, first step in management :
Assess airway
Iv line
Endotracheal intubation
Blood transfusion
First step in trauma patient is assessing and securing the airway.
(Medicine)
9- A blood transfusion given to child who then developed a bleed, what is the
cause:
↓prothrombin
↑fibrinolytic activity
↓ca++
↓fibrinogen
↓platelets
Bleeding due to depletion of platelets and clotting factors in stored blood
Fibrinogen deplete faster than platelets →answer is ↓fibrinogen
Treatment first is FFP if not corrected then platelet transfusion
GOOD LUCK
GOOD LUCK
(Pediatrics)
10- A child came to ER due to hematouria after history post strept GN, so the
diagnosis test:
Low C3
Increase BUN creatinine
Streptozyme
(OB/Gyne)
11- Infertility due to endometriosis ,Rx:
Progesterone
Danazle
Radiotherapy
No medical treatment ↑fertility and rates with endometriosis. laparoscopy
is perfect “surgical Rx”
(OB/Gyne)
12- Cord prollapse caused by all of the following except :
Premature labor
Malpresentation
PROM
Twin pregnancy
Oligohydramnious
Oligohydramnious is associated with cord compression not prolapsed
except if the cause of oligohydramnious is PROM
GOOD LUCK
GOOD LUCK
(OB/Gyne)
13- α fetoprotein increase in all except:
Myelomeningocele
Spina bifida
Encephalitis
Breach presentation
↑in: preg Dating error-multiple fetuses – placental bleeding – open neural
tube defect- ventral wall defect (omphalocele - gastrosdisis) – renal
anomalies (polycystic or absent kidneys –congenital nephrosis)- fetal
demise – sacrococcygeal ……..
(OB/Gyne)
14- The most dangerous symptom during pregnancy is:
PV bleedin
Ankle swelling
Hyperemesis
Cramps
Ante Partum Haemorrhage is an obstetric Emergency
GOOD LUCK
GOOD LUCK
2014
(pedia)
01 childnood asthma, all of the following EXCEPT:
a) brochospasms are induced by exercise
b) Inhalation of beclomethasone is used safely
c) Inhalation via aerochamber in younger children
d) Hypercapnia is the first physiological changes
e) Cough is the only symptom (abu wardra p 223)
(ob/gyn)
02 pregnant pt with hepatitis, Dx. By:
a) GOPT
b) BUN "body urea nitrogen"
c) WBC
d) !!
e) !!
HUCKER P 238: screen: hep surface antigene. After screening do liver function
tests and hapatitic panel(to be honest i couldnt know what is GOPT, although in the
paper its chosen as the correct answer)`
(ob/gyn)
03 most common cause of postpartum hemorrhage:
a) Uterin atony
b) Retained placental fragment
c) Cervical laceration
d) Non of the above
Hucker p 151: 80% of postpartum hemorrhage is (a)
(pharma_ob/gyn)
04 action of oral contraceptive pills:
a) Inhibition of estrogen then ovulation
b) Inhibition of prolactin then ovulation
c) Inhibition of protozoa by changing the cervical mucosa
d) Inhibition of midcycle gonadotrophins then ovulation
e) Inhibition of implantation of the embryo
GOOD LUCK
(surgery)
05 most important complication and cause of death in organ transplant in
recipients is:
a) Rejection
b) Immunosupression
c) Steroid overdose
d) Infection
e) !!
(these are all complications of transplant(steroid side effects as immunosuppression)
but i recall that infection is the most dangrous of them)
(medicine)
06 rubella infection:
a) Incutubation (or they ment incubation?) period 3-5 days (correct:14-21 days)
b) Arthritis (davidson p 35: immune-mediated artheritis/artheralgia affects 30%
of women)
c) Oral uncers (not mentioned)
d) Start with high fever
e) Don't cause cardia complications or deafness (not right)
(anatomy)
07 rotator cuff muscles, all of the following EXCEPT:
a) Supra-spinatus
b) Teres minor
c) Deltoid
d) Infra-spinatus
e) Subscapularis
(The mnemonic "SITS" is often used to remember the four muscles of the rotator
cuff.)
(mixed)
08 all of the follwoint are true, EXCEPT:
a) Iron is not essential for all breast fed children(mothers' milk is poor of iron)
b) Every anti TB regimen contains INH
c) One or more essential mino acids are found in vegetables
d) !!
e) !!
(Although it is not required in any breastfed infant, iron is required in anemic
exclusively breastfed infants. Every anti TB regimen contains isoniazid (INH) and
all essential amino acids may be obtained from plant sources, and even strict
vegetarian diets can provide all dietary requirements.)
GOOD LUCK
GOOD LUCK
(pedia)
09 management of trachea-esophageal fistula all of the following EXCEPT:
a) Chest tube
b) Gastrrostomy
c) Pulmonary toilet
d) !!
e) I.V antibiotics
(eMedicine: tracheoesophageal fistula, treatment: In healthy infants without
pulmonary complications, primary repair is performed within the first few days of
life. Repair is delayed in patients with low birth weight, pneumonia, or other major
anomalies. Initially, treat patients conservatively with parenteral nutrition,
gastrostomy, and upper pouch suction until they are considered to be low
risk....broad spectrem antibiotics if develop lower respiratory tract inferction)
Its obvious that a chest tube wouldn¢t be needed in the management of this case.
(E.R_ surgey)
10 most commonly affected organ in abdominal blunt trauma:
a) Liver
b) Spleen (emergency medicine recall p 419)
c) Kidney
d) Intestine
e) !!
(pedia)
11ristk factor for HSV II accusation in infants all of the following EXCEPT:
a) Cervical transmission is commoner than labial
b) Maternal first episonde is of greater risk than recurrence
c) Maternal antibodies against HSV I protect from HSV II
d) Head electrodes increase risk of infection
e) !!
(ob/gyn)
12 best detector for progress of labor is:
a) Dilatation
b) Descent (hucker p 115)
c) Dilatation and descesnt (but from what i recall from ob/gyn course this is the
answer, plus a net source indicated dilatation as the the detector)
d) Degree of pain
e) Fetal heart rate
GOOD LUCK
GOOD LUCK
(ob/gyn)
13 PET: (Pre-eclampsia)
a) Commoner in mutipara than primigravida
b) Mostly in diabetic
c) Hedache and blurred vision (ob/gyn secrets p 212
d) Progress very fast to eclampsia
e) !!
(secrets p 213: risk factors include nulliparity and diabetes)
(ob/gyn)
14 a 25 year old pregnant presented with fever and sore throat (in flue season)
then she developed non productive cough and dyspnea, she was extremely
hypoxic, the most likely Dx:
a) Staph. Pneumonia
b) Strep. Pharyngitis
c) Pneumococcal pneumonia
d) Viral pneumonia(The initial symptoms of viral pneumonia are the same as
influenza symptoms: fever, a dry cough, headache, muscle pain, and weakness.
Within 12 to 36 hours, there is increasing breathlessness; the cough becomes worse
and produces a small amount of mucus. There is a high fever and there may be
blueness of the lips.)
e) pseudomonas pneumonia
(pedia)
15 henoch-schonelein ppurpura, all of the following are true EXCEPT:
a) Arthritis (true: abu warda book p 360 table 24.18)
b) Rash on the face (wasn¢t included in the rash described in the book p 264-6)
c) Platelets normal
d) Abdominal pain (colicky..may present with melena and hematemesis due to
GI petechiae)
e) focal glomerulonephritit)
(pharma_ ob/gyn)
16 post pill amenorrhea, all of the following are true EXCEPT:
a) more in pt with history of menstrual irregularity (true: katzug p 695)
b) the more usage the higher the risk
c) more the (or than?) 6 months need investigations (if it goes more than 3
months, but it happened that some wemen had amenorea for as long as 4 month
then resume normal periods..according to Dr.Gerard M. DiLeo, Obstetrics and
gynecology)
d) non of the above(this answer was selected as correct)
GOOD LUCK
GOOD LUCK
(pedia)
17 breath holding attacks:
a) mostly in children between 5-10 years
b) usually prevented by diazepam
c) may presdipose to generalized convulsion (abu warda p327: wich is called
reflex anoxic seizure, described in fig 25.8)
d) increase the risl of epilepsy (the child might be prone to fainting later in
childhood)
e) characteristically come with no prededing emotional upset (the blue type
does)
(community)
18 prospective and retrospective studies, all are true EXCEPT:
a) retrospective are typically more biased than prospective
b) retrospective are typically more quickly than prospective
c) prospective allocation of person into group is based on presence or absence of
disease
d) prospective in more in cost than retrospective
e) effect is more identifiable in prospective (also retrospective studies have less
ethical issues )
(pedia)
19 a 3 year old child awaken from sleep with croup, DDx:
a) pneumonia
b) tonsillitis
c) post nasal drip
d) cystic fibrosis
e) foreign body inhalation (from abu warda p 218 fig 14.4, croup is an acute
upper airway obstruction situation, and hence F.B inhalation would mostly be the
answer because it's the acute situation amongst given choices).
(ophtha)
20 retinal detachment all of the following are true EXCEPT:
a) can lead to sudden loss of vision
b) more in far sighted than near sighted (more in nearsighted peaple, source:
about.com, article by Troy Bedinghaus, O.D)
c) follow cataract surgery
d) if you suspect it sent for ophthalmologist
e) !!
GOOD LUCK
GOOD LUCK
(ophtha)
21 glaugoma, all of the following are true EXCEPT:
a) Commonly present with headache(true)
b) Associated with abdominal pain (i found vague hints on the net, as in
eMedicine, that it might present with abdominal pain, but its true that it might
present with nausea and vomiting)
c) Preceded by hallow and light flashes (it presents with hallos specially round
lights,from www.merck.com:angle -closure glaucoma) but i dont know if its
preceded by )
d) Miotic (from same source as above, headache due to glausoma decrease wth
sleep. wich imght be due to sleep induced miosis. so this might be the answer.....in
the paper no anwer was selected)
e) !!
(pedia)
22 child with APGAR score 3 in 1 min, the most important step is:
a) Ventilation: an APGAR score below 7 in min 1 is low
There are 4 main steps in the basic resuscitation of a newborn infant. ABCD:
A: OPEN THE AIRWAY by placing the infant¢s head in the neutral position with
the neck slight extended. Do not flex or over extend the neck. GENTLY CLEAR
THE THROAT.
B: ventilate.
b) Chest expansion
c) Volume expansion
d) Drying
e) Warming (drying and warming witha warm towel must be done to all infants
after birth)
[Postgraduate Training Course in Reproductive Health/Chronic Disease
2004,Neonatal resuscitation,Dave Woods,Neonatal Medicine,School of Child
and,Adolescent Health,University of Cape Town,www.gfmer.ch]
(surgery)
23 all are complication of laparoscopic cholecystectomy EXCEPT:
a) Wound infectin is the common complication
b) Restlessness rate increases (what do they mean by that?!?!?)
c) Admission duration usually less than 2 days
d) Early mobilization
e) Post-op pain
..........this is a very vague question, as C and D are not complications!! and B is not
clear (its was chosen as the answer in papers)
GOOD LUCK
)
GOOD LUCK
(med.)
24 gastric ulcer, pathogenic factors, EXCEPT:
a) Tricyclic antidepressant (in katzung peptic/gastric ulcer not mentioned in side
effects of tricyclics. in toxicity it causes bowel and bladder paralysis..p 509)
b) Pyloric sphincter incompetence (wich would decrease contact time between
gastric contents and acids with gastric mucosa)
c) Sepsis (true. source:cleveland clinic:Sepsis by Steven P.LaRosa, MD)
d) Salicylate ingestion
e) Delayed gastric emptying (would increase contact time between gastric
contects with gastric mucosa. so it's a risk factor..although it was chosen in the
papers as the answer)
(surgery)
25 breast cancer in female under 35 yr. all of the following are true EXCEPT:
a) Diagnosis and treatment are delayer due to the enlarged number of benign
disease
b) The sensitivity of the mammogram alone is not enough for Dx
c) Family history of benign or malignant disease is predictive of Dx(fewer than
3% of breast ca are caused by "breast ca gene":lawrance general surgery p 377)
d) All discrete breast lumps need fine needle aspiration
e) !!
(senstivity in younge wemen is 90-95%. but in p.375 lawrance:" often FNA is
performed to establish a presumptive cytologic Dx" but if <3 cm.....not
needed................so i would choose D as the answer
(med)
26 intestitial lung disease all of the following are true EXCEPT:
a) Insidious onset exertional dyspnea
b) Bibasilar inspiratory crepitation in physical examination
c) Hemoptysis is an early symptom (no included in the symptoms and dyspnea
might be the only early symptom)
d) Total lung capacity volume is reduces
e) !!
(ob/gyn.)
27 gonococcal infection:
a) Less common in females with IUCD
b) Causes permanent tubal blocking (what i recall, and i also role out C )
c) No need for laparoscopy for further diagnostic evaluation
d) !!
e) !!
GOOD LUCK
GOOD LUCK
(ENT)
28 tinnitus all of the following are true EXCEPT:
a) Symptom not experienced by children
b) Present in anemia (net source: anemia may present with tennitus: vascular
tennitus)
c) As salicylate copmlication that improves with drug withdrawal
d) If associated with deafness, it improves as hearing loss improves
e) !!
(pedia)
29 a 2 months old baby found to be jaundiced + enlared and cirrhotic liver, Dx
is:
a) Crigler-nijjar syndrome(juandice at 24hr-2weeks)
b) Dubin-johnson syndrome(causes a dark liver:eMedicine)
c) Sickle cell disease (i dont think it would cause liver cirrhosis, because:"Ten of
the evaluable patients (19%) died of a chronic terminal visceral involvement related
to sickle cell disease which was mainly liver cirrhosis." and they are talking about
adults. from:Patterns of mortality in sickle cell disease in adults in France and
England. Hematol J. 2002;3(1):56-60.)
d) Congenital biliary obstruction(liver biopsy show extrahepatic fibrosis,
prolifration of biliary duct. abu warda p 279)
e) Gilbert's syndrome
(the answer chosen in papers is D)
(pharma_ob/gyn)
30 which drug does not cross the placenta:
a) Heparin
b) Aspirin
c) Warfarin
d) Tetracycline
e) Diazepam
GOOD LUCK
GOOD LUCK
(pedia)
32 an 18 months old baby can typically:
a) Feed himself by a spoon (abu warda p 26)
b) Say a vocabulary of approximately 10 words
c) Build tower of 10 bricks
d) Drinks by a cup (by 12 months)
e) !!
(micro_medicine)
33 all are entero-invasive microorganisms, EXCEPT:
a) Shegella sonnei
b) Salmonella typhi
c) Yersinea enteritis
d) Vibrio cholera (the organism is non-invasive, lippincott's micro. p 185)
e) Campylobacter intritis
(ortho)
34 "AVN" avascular necrosis of femoral head becomes evident clinically in:
a) 3 months
b) 6 months
c) 9 months
d) 12 months
e) 17 months
(ob/gyn)
35 IUGR occurs with all of the following, ESCEPT:
a) Rubella
b) CMV
c) HSV II (transmission is during delivery)
d) Toxoplasmosis
e) Syphilis
(pharma_ob/gyn)
36 drug avoided in pregnancy, EXCEPT:
a) Cotrimox
b) Cephalexin(FDA pregnancy category B. This medication is not expected to be
harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become
pregnant during treatment. Cephalexin can pass into breast milk and may harm a
nursing baby. Do not use this medication without telling your doctor if you are
breast-feeding a baby. ).
c) Glibenclamide
d) Na+ valporate
GOOD LUCK
e) Doxicyclin
GOOD LUCK
(surgery)
37 the following is true in suspected acute appendicitis in a 70 yr old person:
a) Perforation is less likely than usual (perforation is more common in elderly)
b) Rigidity is more marked than usual
c) Abdominal X-ray is not usrful
d) Out look is relatively good (the prognosis is very bad in elderly)
e) Intestinal obstructin may be mimicked
(lawrance)
(ophtha)
38 recognized fearure of congenital squint include all the following EXCEPT:
a) Asymmetry of corneal light reflex
b) Covering non squinting eye causes movement of affected eye oopposite to
squint
c) Manifestation of latent during fatigue
d) Non variation in the angle of deviation of squinting eye with near or distant
fixation
e) !!
(med)
39 regarding atrial fibrillation "AF", all of the following are true, EXCEPT:
a) Non valvular AF will lead to stroke. (the only given answer and was marked
as, the right answer)
b) Through (e) are !!!!
(med)
40 a 70 yr old male, suddenly felt down & he is diabetic, it could
a) May be the ptnn is hypertensive and he developed sudden rising BP
b) He might forgot his oral hypoglycemic agent dose
c) Sudden ICH which rise his ICP
d) !!
e) !!
Vague question and answers!!!
(med)
41 most of the causes of infection:
a) Anemia which is most probably the cause during pregnancy
b) Retained placenta
c) Hemorrhage during pregnancy
d) Endometriosis
e) !!
GOOD LUCK
Vague question and answers!!!
GOOD LUCK
(psych)
42 pt with schizophrenia, the best prognostic sign is:
a) Gradual onset
b) Family history of schizophrenia
c) Age of the patient
d) Coincidence of other psychological problems (as i recall )
e) !!
GOOD LUCK
GOOD LUCK
2014
(Pediatrics)
1- Acute gait disturbance in children, all of the following are true EXCEPT:-
a- Commonly self limiting
b- Usually the presenting complaint is limping
c- Radiological investigation can reveal the Dx
d- most often there is no cause can be found
e- !!
(Medicine)
2- the following can be used in prophylaxis in malaria in chlorquine resistant
area Except:
a-mefloquine
b-doxycycline
c-chlorquine with proguani
e-dapsone
dapson is antileprosy agent, also there is new drug called malorone can be
used in prophylaxis
(Ophthalmology)
3- anterior uvetitis occur in all of the following except:
a-RH reheumatid arthritis
b-sarcoidosis
c-ankylosing spondylatis
d-Reiter"s syndrome
e-Behcet' disease
causes include JRA ,IBS,Herpes ,lupus, lyme disease
(Ophthalmology)
4- Which the of the following is true is true regarding red eye:
a-more redness occure in corioscleral "suggest iritis"
b-if associated with fixed mid –fixed dilated pupil suggest anterior uvitis
c-in case of glaucoma treatment is mydratics
GOOD LUCK
(Immunology)
5- all of the following are true about measles vaccine except:
a-1 out of 10 develop measles as result of vaccine
b-it is not effective if given within 48hrs of expose to measles
c-40 year old man usually gives positive immunity to measle
d-presence of IgM antibodies incicate recent infection
(Clinical Pharmacology)
6-which of the following combination is safe:
a-alcohol and metronidazol
b-digxin and amidrone
c-warafrin and propanolol
d-furosemide and gentamycin
(??Medicine)
7-regarding aphthous ulceration in the mounth all are true except:
a-there is no treatment for acut ulcer
b-tetracyclin suspension helps in healing
c-there is immunological role in its role in its development
d-mostly idiopathic in orgin
(Clinical Pharmacology)
8-which of the following is NOT associated with phentoin toxicity:
a-hirustism
b-osteomalcia
c-ataxia
d-osteoprosis
(OB/Gyne)
9-which of the following is not cause oF IUGR:
A-toxoplasmosis
B-RUBELLA
C-CMV
D-SYPHILIS
E-HSV
GOOD LUCK
GOOD LUCK
(Pediatrics)
10-One of the following is not a feature of Henoch-Schonlein Purpera:-
A-arthitis
b-rash on the face
c-normal platelet count
d-abdominal pain
e-hematuria
(Dermatology)
11-the following drugs can be used for acne treatment except:
a-ethinyl estradiol
b-retin A
c-vit A
d-erythromycin ointment
e-azelenic acid
(Medicine)
12-the following murmer can be accentuated by postioning of the patient:
a-aortic regurgitation by sitting
b- venous hum by lying down
c-pericardial rub by sitting
d-outflow innocent murmer by sitting
(OB/Gyne)
13- One of the following drugs is safe in pregnancy
a- Metronidazole is unsafe in first trimester
b- Chloramphenicol in last trimester
c- Erythromycin estolate is safe in all trimesters
d- Nitrofurantoin
e- !!
(Clinical Pharmacology)
14- One of the following drugs can NOT cross the placenta:
a- Heparin
b- Warfarin
c- !!
GOOD LUCK
(Medicine)
15-one of the following is the single most important cause of stroke:
a-D.M.
b-HTN
c-family history
d-hyperlidemia
e-hypercholesteremia
(Psychiatry)
16- Regarding antidepressant side effects, all of the following are true
EXCEPT:
a- Anticholinergic side effect tend to improve with time
b- Sedation can be tolerated by prolonged use
c- Small doses should be started in elderly
d- Fluxetine is safe drug to use in elderly
(Psychiatry)
17- One of the following is secondary presenting complaint in patient with
panic attack disorder:
a- Dizziness
b- Epigastric pain
c- Tachycardia
d- Chest pain
e- Phobia
(Medicine)
18- All the following are differentials of acute abdomen except:
a-pleurisy
b-MI
c-herpes zoster
d-polyarteritis nodsa
e-pancreatitis
(Medicine)
19- All the following can cause small stature in children except:
a-hyopthyrodism
b-tunner syndrome
c-klinefenter syndrome
GOOD LUCK
d-down syndrome
GOOD LUCK
(Pediatrics)
20- in new born ,the following needs immediate treatment:
a-asymptomatic hydrocele
b-erupted tooth
c-absent femoral pulse
(OB/Gyne)
21- about vaginal trichomonosis all the following are true except;
a-common in diabetics
b-is protozoal infection
c-diagnosed by wet smear
d-treated by metronadazol
(Pediatrics)
22- A 6 weeks old infant presented with yellowish eye discharge and
persistant tearing of one eye since birth, all of the following are true Except:
a- Rx include sulphacetamide ointment daily
b- Advice the mother to do warm massage
c- Can be Rx by systemic antibiotics
d- Do probing to bypass the obstruction
e- !!
(OB/Gyne)
23- APGAR score
a- out of 12 points
b- color is not important
c-heart rate is important
(Surgery)
24 -about appendicitis in elderly:
a-perforation is not common
b-gives more rigitiy than usual
c-can mimic obstruction
GOOD LUCK
)
GOOD LUCK
(Medicine)
25- HSV type 1 infection of the oral cavity, all true EXCEPT:
a- Is the commonest viral infection in the oral cavity
b- Can give gingivostomatitis
c- In primary infection, there is systemic involvement
d- May present with tonsillitis without oral lesion
e- !!
(Clinical Pharmacology)
26- all the following are side effect of thiazide diuretics except:
a-has diabetogenic effect
b-cause hypocalemia
c-cause hypomagnesimia
d-flat curve response
e-cause hypokalemia
(Clinical Pharmacology)
27- Nitroglycerine cause all the following EXCEPT:
a- Lowers arterial blood pressure
b- Increase coronary blood flow
c- Effect for 5 min if taken sublingually
d- Causes venous pooling of blood
e- Can produce meth-hemoglobinemia
(Medicine)
28- Meningitis in children, all of the following are true EXCEPT:-
a- Commonest is streptococcal and E.Coli in neonates
b- H.influenzae meningitis Rx is ampicillin or chloramphinicol
c- Produce non-specific sign in neonates
d- If due to pneumococcal, Refampicin is given as prophylaxis
e- !!
(Surgery)
29- all the following are true except regarding laproscopic cholycytectomy:
a-comonest complication is wound infection
b-patient readmission is frequent
c-it reduce hospital stay
d-patient can be discharged after 1-2 days
GOOD LUCK
GOOD LUCK
(Medicine)
30- One of the following is NOT useful in patient with atrial fibrillation “AF”
and Stroke:
a- Aspirin and AF
b- Warfarin and AF
c- Valvular heart disease can lead to CVA in young patient
d- AF in elderly is predisposing factor
e- !!
(Orthopedics)
31- Concerning green stick fracture in children, all are true EXCEPT:
a- Exremely painful
b- Most commonly involve the forearm
c- Function of the limb is preserved
d- Is incomplete fracture
(Medicine)
32-all the following regarding NSAID ALL TRUE EXCEPT:
A-acute renal failure
b-acute tubular necrosis
c-interstisial nephritis
d- hyperkalemia
(Clinical Pharmacology)
33- regarding H2 blocker all are true except :
a-morning dose effective more than evening dose.
b-long term maintance therapy should be avoided
GOOD LUCK
GOOD LUCK
2014
(Medicine)
Q37. Regarding Allopurinol:-
- is a uricouric agent
- decrease the development of uric acid stones
- useful in acute attack of gout
(Medicine)
Q39. ECG stress test is indicated in the following except:-
GOOD LUCK
Indications of stress test are:-
Diagnosis of CAD in patients with chest pain that is atypical for
myocardial ischemia.
Assessment of functional capacity and prognosis of patients with
known CAD.
Assessment of prognosis and functional capacity of patients with
CAD soon after an uncomplicated myocardial infarction (before
hospital discharge or early after discharge.(
Evaluation of patients with symptoms consistent with recurrent,
exercise-induced cardiac arrhythmia.
Assessment of functional capacity of selected patients with
congenital or valvular heart disease.
Evaluation of patients with rate-responsive pacemakers.
Evaluation of asymptomatic men > 40 years with special occupations
(airline pilots, bus drivers, etc
Evaluation of asymptomatic individuals > 40 years with two or more
risk factors for CAD.
Evaluation of sedentary individuals (men 45 years and women 55
years) with two or more risk factors who plan to enter a vigorous
exercise program.
Assessment of functional capacity and response to therapy in
patients with ischemic heart disease or heart failure.
Monitoring progress and safety in conjunction with rehabilitation
after a cardiac event or surgical procedure.
(Surgery)
Q40. Screening program for prostatic Ca, the following is true:-
GOOD LUCK
disease).
GOOD LUCK
(Medicine)
Q41. Premature ventricular contracture (PVC), all are true except:-
(Pediatrics)
Q42. About the development of the child, all true except:-
a child can feed himself by a spoon starting from the age of 18
months
(Pediatrics)
Q43. Whooping cough in children, all true except:-
GOOD LUCK
GOOD LUCK
(ENT)
Q44. Commonest cause of otorrhea:-
- Otitis externa
- CSF otorrhea
- Liquefied eczema
- Eustachian tube dysfunction
Acute otorrhea is recognized by being of duration of <3 weeks,
whereas chronic otorrhea is marked by lasting >6 weeks. Those that
fall between these parameters are called sub-acute
The most common cause of otorrhea is prolonged and untreated ear
infection caused by over exposure and submersion in water
(swimmer’s ear) or from a forien body entering the ear canal.
Other potential causes are CSF leak, mastoiditis, cholesteatoma or
tumors of the surrounding areas.
(ENT)
Q45. Commonest cause of deafness in children:-
- Barotraumas
- Measles
- Meningitis
- Chronic serous otitis media
(ENT)
Q46. A lady with epistaxis after quttary of the nose, all true except:-
GOOD LUCK
nostril with gauze or cotton that has been soaked in a topical
GOOD LUCK
decongestant. Direct pressure should be applied continuously for at
least five minutes, and for up to 20 minutes. Tilting the head forward
prevents blood from pooling in the posterior pharynx
(Medicine)
Q47. Indication for CT brain for dementia, all true except:-
- Younger than 60 years old
- After head trauma
- Progressive dementia over 3 years
(OB/GYN)
Q48. Pregnancy induced hypertension, all true except:-
- Use of birth control pills increases the risk
- Common in primigravida
- Changing the partner increases the risk
(OB/GYN)
Q49. Vomiting in pregnancy, all true except:-
- Hospital admission causes it
- More in molar pregnancy
- More in pregnancy induced hypertension
GOOD LUCK
GOOD LUCK
(Surgery)
Q50. regarding infection in the finger bulb, all true except:-
(Derma)
Q51. Scabies infestation, all true except:-
GOOD LUCK
GOOD LUCK
exposure to an infested animal. The immediate itching protective
mechanism can prevent the mite from burrowing.
SCABICIDES – treatment options include either topical o total
medications. Topical options include permetherin cream, lindane,
benzyl benzoate, crotamiton lotion and cream, sulfur, Tea tree oil.
Oral options include ivermectin.
(Medicine – Derma)
Q52. All of the following cause photosensitivity except:-
- Lithium ???
- Propranolol
- Tetracycline
- Chloropromazine
- Chloropropamide
GOOD LUCK
GOOD LUCK
Antidepressants Cancer
clomipramine (Anafranil) Chemotherapy
isocarboxazid (Marplan) *dacarbazine (DTIC)
maprotiline (Ludiomil) fluorouracil (5-FU) G
sertraline (Zoloft) methotrexate (Mexate) r
venlafaxine (Effexor) o
procarbazine (Matulane, u
TRICYCLIC AGENTS, e.g. Elavil, Natulan) p
Asendin, Norpramin, Sinequan, vinblastine (Velban,
Tofranil, Aventyl, Vivactil, Velbe) 2
Surmontil 2
Cardiovasculars (see -
Antihistamines also Diuretics)
astemizole (Hismanal) ACE INHIBITORS, e.g. K
cyprohepatadine (Periactin) S
Capoten, Vasotec, U
diphenhydramine (Benadryl) Monopril, Accupril, ,
loratadine (Claritin) Altace
terfenadine (Seldene) *amiodarone (Cordarone) R
diltiazem (Cardizem) i
Antimicrobials disopyramide (Norpace) y
a
azithromycin (Zithromax) lovastatin (Mevacor) d
griseofulvin (Fulvicin, Grisactin) nifedipine (Procardia) h
QUINOLONES, e.g. Cipro, pravastain (Pravachol)
Penetrex, *Maxaquin, Noroxin, quinidine (Quinaglute, (
Floxin etc.) M
sulfasalazine (Azulfidine) simvastatin (Pzocor) a
r
*SULFONAMIDES, e.g. Gantrisin, sotalol (Betapace) c
Bactrim, Septra, etc. h
TETRACYCLINES, e.g. Diuretics
*Declomycin, Vibramycin, Minocin, acetazolamide (Diamox) -
Terramycin amiloride (Midamor)
2
furosemide (Lasix) 0
Antiparasitics metolazone (Diulo, 0
*bithionol (Bitin) Zaroxolyn) 8
chloroquine (Aralen) *THIAZIDES, e.g.
/
mefloquine (Lariam) HydroDiuril, Naturetin,
pyrvinium pamoate (Povan, etc. S
Vanquin) a
quinine *Hypoglycemic f
a
Sulfonylureas r
Antipsychotics acetohexamide (Dymelor)
chlorprothixene (Taractan, Tarasan) chlorpropamide -
haloperidol (Haldol) (Diabinese)
*PHENOTHIAZINES, e.g. glipizide (Glucotrol) 1
Compazine, Mellaril, Stelazine, 4
glyburide (Diabeta, 2
Phenergan, Thorazine, Micronase) 9
chlorpromazine etc. tolazamide (Tolinase) )
risperidone (Risperdal) tolbutamide (Orinase)
thiothixene (Navane)
GOOD LUCK
Nonsteriodal Anti-inflammatory Drugs
(NSAIDs)
All nonsteroidal anti-inflammatory drugs e.g. ibuprofen
(Motrin), naproxen (Anaprox, Naprosyn), Orudis, Feldene,
Voltaren, etc.
The new agents include: etodolac (Lodine), nabumetone
(Ralafen), oxaprozine (Daypro)
GOOD LUCK
(ENT)
Q53. All true about black hairy tongue, except:-
(Medicine)
Q54. Blistering skin rash is a feature of the following dermatoses except:-
- Erythema herpiticum
- Erythema multiforme
- Sulphonamide allergy
- Erythema nodosum
GOOD LUCK
Eczema herpiticum:- A febrile condition caused by cutaneous
dissemination of herpesvirus type 1, occurring most commonly in
GOOD LUCK
children, consisting of a widespread eruption of vesicles rapidly
becoming umbilicated pustules
Skin reactions are the most common adverse reactions to sulfa
medications, ranging from various benign rashes to life-
threatening Stevens-Johnson syndrome and toxic epidermal
necrolysis.
Erythema nodosum:- the formation of tender, red nodules on the
front of the legs
(Pediatrics)
Q55. About kernicterus all are true, EXCEPT:-
(Pediatrics)
Q56. Diarrhea can occur in all the following, EXCEPT:-
- Hypothyroidism
- Hyperthyroidism
GOOD LUCK
Rapid heartbeat
Fatigue
GOOD LUCK
Weight loss
Diarrhea or frequent bowel movements
Irritability and anxiety
Vision problems (irritated eyes or difficulty seeing)
Menstrual irregularities
Intolerance to heat and increased sweating
Infertility
(Clinical pharmacology)
Q57. All true about cephalosporin use, except:-
(Medicine)
Q58. All of the following drugs contraindicated in G6PD deficiency,
except:-
- Aspirin
- Nitrofurantoin
- Chlorquine
- Sulphonamide
- Gentamycin
GOOD LUCK
- Pyrimethamine
- Quinine
GOOD LUCK
- Chloroquinine
- Pamaquine
Antibacterials:-
- Most sulpphonamides
- Dapsone
- Nitrofurantoin
- Nitrofurazone
- Furazolidone
- Chloramphenicol
- Ciprofloxacin
Miscellaneous:--
Vitamin K
- Probenecid
- Nalidixic acid
- Quinidine
- Dimercaprol
- Phenylhydrazine
(Dermatology - Plastic)
Q59.Dysplastic nevus syndrome all of the following are true except:-
- Autosomal dominant
- Without family history of melanoma, risk of malignant transformation
in 0.6% as whole life risk
GOOD LUCK
- The criteria for FAMM syndrome are as follows:
The
occurrence of malignant melanoma in 1 or more first- or
second-degree relatives
The presence of numerous (often >50) melanocytic nevi, some of
which are clinically atypical
Many of the associated nevi showing certain histologic features
(Ophthalmology)
Q60.Regarding Stye infection of the lower eyelid, all true except:-
P.S:- though sometimes referral is needed, but it is never the first option
GOOD LUCK
GOOD LUCK
(Dermatology)
Q61. Psoralin ultraviolet ray A (PUVA) all of the following are true
except:-
- useful in vitiligo
- contraindicated in SLE
- Used to treat some childhood intractable dermatosis
Intractable = unstoppable
Dermatosis = any skin disease not characterized by
inflammation
- Increase the risk of basal and squamous cell cancer
Psoralens and ultraviolet A light (PUVA) is medically necessary for
the following conditions after conventional therapies have failed:
o Severely disabling psoriasis (i.e., psoriasis involving 30% or
more of the body);
o Cutaneous T-cell lymphoma (mycosis fungoides);
o Severe refractory atopic dermatitis/eczema;
o Severe urticaria pigmentosa (cutaneous mastocytosis);
o Severe lichen planus;
o Severe parapsoriasis;
o Pityriasis lichenoides;
o Granuloma annulare;
o Alopecia areata;
o Photodermatoses;
o Eosinophilic folliculitis and other pruritic eruptions of HIV
infection;
o Vitiligo;
o Severe refractory pruritis of polycythemia vera;
o Morphea and localized skin lesions associated with
scleroderma
PUVA (phototherapy) should be used in the lowest doses possible as
higher doses and more exposure increase the risk of skin cancer
- Psoralens should not be used by:
o Children under age 12, because the UV light therapy may
cause cataracts
o People who have diseases that make their skin more sensitive
to sunlight (such as lupus)
o Fertile men and women who do not use birth control. There is
a small risk of birth defects.
o Pregnant women, because of possible effects on developing
fetuses
Side effects (short-term)
o Skin redness, headache, nausea, itching.
o Burns.
o The spread of psoriasis to skin that was not affected before
(Koebner's response).
GOOD LUCK
o Nausea from the medication.
GOOD LUCK
Side effects (long-term)
o Squamous cell carcinoma,
o Melanoma
o To lesser extent – not dose dependent - for basal cell
carcinoma
o Premature skin damage associated with sun exposure.
o Discolored spots on the skin.
o Overgrowth of the scaly layer of skin caused by exposure to
sunlight (actinic keratosis).
(Medicine)
Q62. Regarding moderately severe asthma, all true except:-
- PO2 < 60 mm Hg
- PCO2 > 60 mm Hg ,early in the attack
- Pulsus Paradoixcus
- I.V cortisone help in few hours
A typical arterial gas during an acute uncomplicated asthma attack
reveals normal PaO2, low PaCO2 and respiratory alkalosis. Hypoxemis in
a PaO2 range of 60 to 80 mm Hg frequently is found even in moderately
severe asthma.24 However, a PaO2 < 60 mm Hg may indicate severe
disease.
So the answer (PCO2 > 60 mm Hg “early attack”) is clearly WRONG as this may
happen late in the attack of asthma
The answer (PO2 < 60 mm Hg) CAN BE CONSIDERED WRONG. As usually
the PO2 goes below 60 in SEVERE ASTHMA rather than a MODERATLY-
SEVERE ASTHMA
(Surgery)
Q63. In indirect inguinal hernia all of the following are true, EXCEPT:--
You can get above the swelling (if descends to scrotum)
- Swelling descends to the scrotum
GOOD LUCK
GOOD LUCK
2014
(pediatrics)
Q-1: Childhood asthma…..all are true except:
Answer:E
Explanation: Regarding A: Upper respiratory tract infection is the most
common cause of asthma exacerbations!!! not broncohospasm only
which is not a complicated problem!
-so A, B, C and D are correct
(Ob/Gyne)
Q-2: Pregnant patient with hepatitis:
A-SGPT; ALT
B-SGOT; AST
C-BUN
D-WBC
Answer: A
Explanation: ALT is the correct answer as it is the more specific
enzyme to liver injury, plus AST normally rises in pregnancy!
GOOD LUCK
(Ob/Gyne)
Q-3: Most common cause of post-partum bleeding:
A-Uterine atony
B-Laceration
C-Retained placental tissue
D-Uterine inversion
Answer:A
Explanation: All the above are causes of post-partum bleeding but
uterine atony caused by over distention of the uterus due to risk
factors (multiple gestation, polyhydramnios, multiple gestations) is
responsible for around 80% of cases.
(Ob/Gyne)
Q-4: Actions of oral contraceptive pills:
Answer:D
Explanation: The correct answer is D as this is method of action!
(Surgery)
Q-5: Most common cause of death in organ transplant recipients is:
A-Rejection
B-Infection
C-Steroid overdose
D-Immunosupression
GOOD LUCK
GOOD LUCK
(pediatrics)
Q-6: Rubella infection:
Answer: D
Explanation: Rubella's incubation period is 14-21 days, Rubella does
not cause oral ulcers but it causes only low-grade fever and
arthritis.Arthrits is a very common manifestation of the infection in
adults.
(Orthopaedics)
Q-7: Rotator cuff muscles are all of the following except:
A-Supraspinatus
B-Infraspinatus
C-Teres minor
D-Subscapularis
E-Deltoid
Answer: E
Explanation: The above mentioned muscles are the rotator cuff
muscles which is an anatomical term given to the group of muscles
and their tendons that act to stabilize the shoulder. Along with the
teres major and the deltoid the four muscles of the rotator cuff make
up the six scapulohumeral (those that connect to the humerus and
scapula) muscles of the human body.
(Medicine)
Q-8: Which of the following is false?
GOOD LUCK
Answer:A
GOOD LUCK
Explanation: Although it is not required in any breastfed infant, iron is
required in anemic exclusively breastfed infants. Every anti TB
regimen contains isoniazid (INH) and all essential amino acids may be
obtained from plant sources, and even strict vegetarian diets can
provide all dietary requirements.
(Pediatric surgery)
Q-9: Management of Tracheoesophageal fistula:
A-Chest tube
B-Gastrostomy
C-IV antibiotics
D-Pulmonary toilet
E-IVG sump catheter
(Surgery)
Q-10: Most commonly affected organ in blunt abdominal trauma is:
A-Liver
B-Spleen
C-Kidney
D-Intestine
Answer: A
Explanation: 1-Liver 2- Spleen 3-Greater omentum
GOOD LUCK
GOOD LUCK
(Ob/Gyne)
Q-11: Risk factors for HSV2 in infants include all the following except:
Answer: C
(Ob/Gyne)
Q-12: Best detector for progress of labor is:
A-Dilatation
B-Descent
C-Dilatation and descent
D-Degree of pain
E-Fetal heart rate
Answer: C
(Ob/Gyne)
Q-13: Preeclampsia, PET:
A-Commoner in multipara
B-More in diabetics
C-Headache and blurred vision
D-Rapidly progresses to eclampsia
GOOD LUCK
women with a multiple gestation (twins, triplets, and more). The single
GOOD LUCK
most significant risk for developing pre-eclampsia is having had pre-
eclampsia in a previous pregnancy.
(Ob/Gyne)
Q-14: A 25 year old pregnant lady presented during the flu season with
fever and sore throat after that she developed non-productive cough
and dyspnea, she was extremely hypoxic. The most probable
diagnosis is:
A-Staphylococcus pneumonia
B-Streptococcal pharyngitis
C-Pneomococcal pneumonia
D-Viral pneumonia
E-Psuedomonas pneumonia
Answer: D
Explanation: The initial symptoms of viral pneumonia are the same as
influenza symptoms: fever, a dry cough, headache, muscle pain, and
weakness. Within 12 to 36 hours, there is increasing breathlessness;
the cough becomes worse and produces a small amount of mucus.
There is a high fever and there may be blueness of the lips.
(Pediatrics)
Q-15: Henoch Schonlein purpura (HSP)…..all the following except:
A-Arthritis
B-Rash in the face
C-Normal platelets
D-Focal glomerlunephritis
E-Abdominal pain
Answer: B or C.
Explanation: Arthritis, focal glomerlunephritis, and abdominal
pain all occur.
Rash typically occurs in the thighs and buttocks but does occur
in the face, the platelets CAN be raised (which helps in differentiating
the disease from ITP and TTP).Personally I will choose B.
GOOD LUCK
GOOD LUCK
(Ob/Gyne)
Q-16: Post-pill amenorrhea….all except:
Answer: B
(Pediatrics)
Q-17: Breath holds attacks:
Answer: C
Explanation: Description: the child is often having a tantrum or
crying and after giving a long cry, which empties their lungs they fail to
breathe in again. Over the next 15 seconds or so the child goes blue in
the face, passes out and may even have a brief seizure or fit.
(Community medicine)
Q-18: Comparing the prospective and retrospective studies, all are
true except:
GOOD LUCK
GOOD LUCK
(Pediatrics)
Q-19: A 3 year old child woke up from sleep with croup…..diagnosis:
A-Tonsillitis
B-Pneumonia
C-Post nasal drip
D-Cystic fibrosis
E-Foreign body inhalation
Answer: E
(Medicine)
Q-20: Gastric ulcer ….pathogenic factors:
A-Salicylate ingestion
B-Sepsis
C-Pyloric sphincter incompetence
D-Delayed gastric emptying
E-Tricyclic antidepressants
Answer: A
Very important note: the question in the paper was:
Which of the following does not cause gastric ulcer, but I
have found this as the only reason to cause gastric ulcer.
(Surgery)
Q-21: Breast cancer in a female that is less than 35 year of age…all
true except:
Answer: D
GOOD LUCK
GOOD LUCK
(Medicine)
Q-22: Interstitial lung disease …..All true except:
Answer:C
(Ob/Gyne)
Q-23: Gonoccocal infection…..which is true:
Answer:B
(ENT)
Q-24: Regarding tinnitus……all true except:
Answer: A
Explanation: Tinnitus can present in children, and it is a symptom of
iron deficiency anemia.
GOOD LUCK
GOOD LUCK
(Pediatrics)
Q-25: A 2 month old baby found to have jaundice with an enlarged
cirrhotic liver…Dx:
A-Crigler-Najjar syndrome
B-Dubin-Johnson syndrome
C-Sickle cell anemia
D-Congenital biliary obstruction
E-Gilberts syndrome
(Ob/Gyne)
Q-26: Which of the following drugs does not cross the placenta?
A-Heparin
B-Chloramphenicol
C-Tetracycline
D-Warfarin
E-Diazepam
F-Aspirin
Answer:A
Explanation: Chloramphenicol causes Gray baby syndrome while
tetracycline causes teeth defects in the child, warfarin causes birth
defects, and diazepam causes exaggerated reflexes in the newborn.
Aspirin causes intracranial bleeding.
(Pediatrics)
Q-27: Epidydimitis:
GOOD LUCK
GOOD LUCK
Explnation:The diagnosis is made physical exam and tests like
ultrasound can differentiate this case from diseases like: testicular
cancer, enlarged scrotal veins (varicocele) and a cyst within the
epididymis.
(Pediatrics)
Q-28: 18 months baby can typicallydo the following except:
(Medicine)
Q-29: All of the following are entero-invasive microorganisms except:
A-Shigella
B-Salmonella
C-Vibrio cholera
D-Yetrnia enteritis
E-Campylobacter enteritis
Answer: C
Explanation: The principal pathogens in this group are Salmonella,
Shigella, Campylobacter, invasive E coli, and Yersinia
(Orthopaedics)
Q30- Avascular necrosis of the head of the femur becomes clinically
evident after:
A-3 months
B-6 months
C-9 months
D-12 months
Answer:C
GOOD LUCK
GOOD LUCK
(Ob/Gyne)
Q-31: IUGR can be caused by all of the following except:
A-Syphilis
B-CMV
C-Toxoplasmosis
D-Herpes simplex II
E-Rubella
Answer:D
Explanation: HSV II is usually contracted during normal delivery.
(Ob/Gyne)
Q-32: Drugs that should be avoided during pregnancy include all of the
following except:
A-Cotrimox
B-Cephaeline
C-Na valproate
D-Doxicyclin
E-Glibenclamide
Answer:B
Cephaeline is the major component of Ipecac, a potent emetic.
(Suregery)
Q-33: The following is true about suspected acute appendicitis in a 70
year old man:
Answer:E
Explanation: Elderly patients have the highest mortality rates. The
usual signs and symptoms of appendicitis may be diminished, atypical
GOOD LUCK
or absent in the elderly, which leads to a higher rate of perforation.
GOOD LUCK
(Ophthalmology)
Q-34: Regarding congenital squint…..all of the following are true
except:
Answer: B.
(Medicine)
Q-35: Regarding atrial fibrillation…:
Answer is A
(Medicine)
Q-36: A 70 year Saudi diabetic male suddenly fell down, this could be:
Answer:B
GOOD LUCK
GOOD LUCK
2014
Obs&Gyn
37- All of the following drugs should be avoided during pregnancy except :
1. Na valproiate.
2. Warfarin
3. Glibinclamide
4. Septrin
5. Ceflex
These drugs should be avoided
Community medicine *
I don’t know
GOOD LUCK
Surgery
1. Malabsorption of water
2. Excoriation of skin
3. Retraction
4. Obstruction
Complications of colostomy:
Colostomy necrosis, irritation to the skin, retraction, obstruction, parastomal
hernia and prolapse
Pediatrics
Rubella:
Spread person to person,virus may be shed beginning 7 days before rash to
14 day after, The incubation period varies from 12 to 23 days (average, 14
days).
Signs and symptoms: fever,Rash, adenopathy , arthritis and arthralgia
Orthopedics
41- Avascular necrosis of head of femur usually detected clinically by the age
of:
1. 3 months
2. 6 months
3. 11 months
4. 15 months
I don’t know
GOOD LUCK
GOOD LUCK
Ophthalmology
42- All the following may cause sudden uni-lateral blindness, except:
1. Retinitis pigmentosa
2. Retinal detachment
3. Retrobulbar neuritis
4. Vetrous hemorrhage
ENT
Surgery
GOOD LUCK
GOOD LUCK
Surgery
1) ERCP ??
2) IV cholangiogram
Medicine
46- All of the following organisms cause diarrhea with invasion except:
1) Shiglla
2) Yersenia
3) Cholera
4) Compylopactor
Cholera cause clinical disease by producing an enterotoxin that promotes
the secretion of fluid and electrolytes into the lumen of the small intestine.
Ophthalmology
1) There is difference of the angle of deviation of squint eye between far and
near sightness
I don’t know
Psychiatry
GOOD LUCK
5) Flat mood
GOOD LUCK
Good prognosis
_ acute onset
_ early treatment
_ good response to treatment
_ female sex
_ good occupational and social adjustment previously
Poor prognosis
_ early age at onset
_ insidious onset
_ poor previous adjustment
_ negative symptoms
_ street drug use
Pediatrics
49- Child attend the clinic 3times with H/O cough for 5 days not responding
to symptomatic Rx one is true in manigment:
Urology
1) Prostits
2) Noctouria
3) Haematouria
4) Urine retention
5) Diminished size &strength of stream
BPH Symptoms
GOOD LUCK
A weak stream
GOOD LUCK
Dribbling after finishing
Feeling the bladder has not completely emptied after finishing
Pain or burning while urinating
Orthopedics
1) Pyomyositus
2) Epiphyseal plate destruction
3) Septicemia
4) Septic arthritis
I don’t know
Medicine
1) Orthopnea
2) Dyspnea on exertion
3) Oedema
ENT
GOOD LUCK
GOOD LUCK
Surgery
1) Thoracotomy
2) Use of systemic antibiotics
3) Chest tube insertion ??
Infants may require surgery to improve blood flow to the
lungs and decrease cyanosis. Once the child is past infancy,
corrective open heart surgery is performed
Chest tube maybe used as a drainage tube to keep the chest free of
blood post operatively, but is not use as a way to manage
Tracheoesohegeal fistula (TOF)
Obs&gyn
55- The following are risk factor for puerperal infection , except:
1) Endometriosis
2) Cervical laceration
3) Anemia
4) Retained placenta
5) Hemorrhage
predisposing factors, such as prolonged and premature rupture of the
membranes, prolonged (more than 24 hours) or traumatic labor, cesarean
section, frequent or unsanitary vaginal examinations or unsanitary delivery,
retained products of conception, hemorrhage, and maternal couditions, such
as anemia or dehilitation from malnutrition.
GOOD LUCK
GOOD LUCK
Urology
Medicine
GOOD LUCK
History of previous rheumatic fever or rheumatic heart disease
GOOD LUCK
Pediatrics
1) Pneumonia
2) Forien body inhalation
3) Tonsillitis
4) Cystic fibrosis???
DDX:
Airway Foreign Body
Bacterial Tracheitis
Diphtheria
Epiglottitis
Inhalation Injury
Laryngomalacia
Neoplasm (compressing trachea)
Peritonsillar Abscess
Retropharyngeal Abscess
Subglottic Stenosis
Vascular Ring, Right Aortic Arch
Pediatrics
59- Child present with Hx of resless sleep during night ,somnolence during
day time , headch …….. the most likely diagnosis :
1) Sinopulmonary syndrome
2) Sleep apnea
3) Adenoidectomy
4) Laryngomalacia
GOOD LUCK
GOOD LUCK
2014
(Surgery)
1. The incidence of surgical infection is reduced with:
Trauma, advanced age and the use of braided sutures increase the
incidence of surgical infection. Postoperative antibiotics are not proven
to decrease the incidence of surgical infection.
_____________________________________________________
(Surgery)
2. A 70 kg male with a 40% total body surface area burn and
inhalation injury presents to your service. The fluid resuscitation
that should be initiated is:
GOOD LUCK
(Surgery)
3. Which of the following is true concerning inhalation injury:
(Surgery)
4. Which of the following concerning the epidemiology of burn injury
is true:
Sorry, I could not find the answer to this question. The original answer
was D.
_____________________________________________________
GOOD LUCK
GOOD LUCK
(Surgery)
5. A 21 year old is involved in a head-on collision as the driver of a
motor vehicle. He is noted to be severely tachypneic and
hypotensive. His trachea is deviated to the left, with palpable
subcutaneous emphysema and poor air entry in the right
hemithorax. The most appropriate first treatment procedure
should be:
(Surgery)
6. Postoperative adhesions are the most common cause of small
bowel obstruction. Choose the true statement about
postoperative adhesions:
GOOD LUCK
_____________________________________________________
GOOD LUCK
(Surgery)
7. The most sensitive test for defining the presence of an
inflammatory focus in appendicitis is:
(Surgery)
8. Carcinoma of the colon is:
Left sided colon cancer, including the rectum, account for more than
78% of all cases of colon cancer. The frequency of colon cancer is
essentially the same among men and women. Only 15% of cases
present as obstruction because colon cancer only causes obstruction
at a very late stage. It is associated with a second carcinoma in only
3% of patients. The 5-year survival rate for colon cancer depends on
the stage of the disease and can not be determined by nodal
involvement alone (Duke's C and Duke's D both have nodal
involvement, but the 5YSR for Duke's C is 30%, whereas the 5YSR for
Duke's D is less than 10%).
_____________________________________________________
GOOD LUCK
GOOD LUCK
(Surgery)
9. Which of the following diseases is NOT frequently associated
with pyogenic liver abcesses:
(Surgery)
10. The greatest risk of developing chronic hepatitis and
cirrhosis occurs after:
a. Hepatitis A infection.
b. Hepatitis B infection.
c. Hepatitis C infection.
d. Hepatitis D infection.
e. Hepatitis E infection.
GOOD LUCK
GOOD LUCK
(Surgery)
11. Which of the following liver tumors is often associated with
oral contraceptive agents:
a. Hepatocellular carcinomas.
b. Liver cell adenomas.
c. Focal nodular hyperplasia.
d. Angiosarcoms.
e. Klatskin's tumor.
(Surgery)
12. A 48 year old male patient is admitted to the hospital with
acute pancreatitis. Serum amylase concentration is 5400 IU/L.
He is complaining of severe generalized abdominal pain and
shortness of breath. He is haemodynamically stable after
appropriate intravenous fluid infusions over the first 6 hours.
Which one of the following is the least significant indicator of
disease severity in acute pancreatitis during the first 48 hours:
GOOD LUCK
GOOD LUCK
(Surgery)
13. In the inguinal region, the integrity of the abdominal wall
requires which of the following structures to be intact:
a. Transversalis fascia.
b. Lacunar ligament.
c. Inguinal ligament.
d. Iliopectineal ligament.
e. Femoral sheath.
(Surgery)
14. A patient with gross hematuria after blunt abdominal
trauma has a normal-appearing cystogram after the intravesical
instillation of 400 ml of contrast. You should next order:
a. A retrograde urethrogram.
b. An intravenous pyelogram.
c. A cystogram obtained after filling, until a detrusor response
occurs.
d. A voiding cystourethrogram.
e. A plain film of the abdomen after the bladder is drained.
GOOD LUCK
GOOD LUCK
(Surgery)
15. Varicose veins:
Varicose veins are not merely a cosmetic problem because they can
cause discomfort, pain and ulceration. Although Duplex
ultrasonography is the standard imaging modality used for the
diagnosis of varicose insufficiency syndromes, varicose veins can be
diagnosed without the use of ultrasonography, using MRI or
venogram. Elastic stockings do not treat the condition; they only
relieve the symptoms until a definitive treatment is done. Varicose
veins may recur after surgical excision by accessory veins, collateral
veins, and tributary veins that can dilate rapidly under the influence of
high pressure and can appear in the same distribution as the vein that
has been removed.
_____________________________________________________
(Surgery)
16. The key pathology in the pathophysiology of venous
ulceration is:
The changes that occur in the skin and subcutaneous tissues that lead
to venous ulceration are the consequence of venous hypertension,
which causes interstitial edema and hypoxia to the skin cells, which
makes the skin liable to break down from minor trauma. Transudation
of proteins, hemosiderin deposition and fibrosis are all due to the high
venous pressure, so high venous pressure is the key pathology.
_____________________________________________________
GOOD LUCK
GOOD LUCK
(Surgery)
17. Lymphedema is diagnosed most effectively by:
(Surgery)
18. Splenectomy does NOT have a role in the management of
patients with hemolytic anaemia due to:
a. Spherocytosis.
b. Elliptocytosis.
c. Pyruvate kinase deficiency.
d. Glucose-6-phosphate dehydrogenase deficiency.
e. Sickle cell anaemia.
_____________________________________________________
(Surgery)
19. A 23 year old white female is diagnosed as having chronic
ITP. Which of the following will best predict a favorable remission
after splenectomy:
Sorry, I could not find the answer. The original answer was D.
_____________________________________________________
GOOD LUCK
GOOD LUCK
(Surgery)
20. A 40 year old white male is transferred to your institution in
septic shock less than 24 hours after onset of symptoms of a
non-specific illness. He underwent a splenectomy for trauma 5
years ago. Antibiotic coverage must be directed against:
a. Streptococcus, group A.
b. Klebsiella pneumoniae.
c. Staphylococcus aureus.
d. Escherichia coli.
e. Streptococcus pneumoniae.
(Surgery)
21. The following are appropriate methods for the treatment of
inflammatory processes in the breast EXCEPT:
GOOD LUCK
GOOD LUCK
(Surgery)
22. Factors associated with an increased relative risk of breast
cancer include all of the following EXCEPT:
a. Nulliparity.
b. Menopause before age 40.
c. A biopsy showing fibrocystic disease with a proliferative
epithelial component.
d. First term pregnancy after age 35.
e. Early menarche.
(Surgery)
23. The following statements about adjuvant multi-agent
cytotoxic chemotherapy for invasive breast cancer are correct
EXCEPT:
GOOD LUCK
GOOD LUCK
(Surgery)
24. The single blood test performed by a good laboratory that
would be expected to be the most sensitive for determining
whether the patient is euthyroid, hypothyroid or hyperthyroid is:
a. T3 uptake.
b. Total T3.
c. Total 4.
d. TSH (thyroid stimulating hormone).
e. Free T4.
_____________________________________________________
(Surgery)
25. Treatment of a patient with the clinical picture of thyroid
storm should include all of the following EXCEPT:
a. Propranolol.
b. Propylthiouracil.
c. Salicylates.
d. Sodium iodide.
e. Acetaminophen.
(Surgery)
26. Papillary carcinoma of the thyroid is characterized by all of
the following EXCEPT:
GOOD LUCK
(Surgery)
27. Relative to the complications that may be associated with
thyroidectomy, which of the following statements is correct:
Sorry, I could not find the answer. The original answer was E.
_____________________________________________________
(Surgery)
28. In a patient with elevated serum level of calcium without
hypocalciuria, which of the following tests is almost always
diagnostic of primary hyperparathyroidism:
(Surgery)
29. The most common cause of hypercalcaemia in a
hospitalized patient is:
GOOD LUCK
GOOD LUCK
(Surgery)
30. Some patients develop hypoparathyroidism after thyroid or
parathyroid operations. What is the treatment for
hypoparathyroidism:
(Surgery)
31. The most common cause of dysphagia in adults is:
a. Achalasia.
b. Paraesophageal hernia.
c. Sliding hiatus hernia.
d. Carcinoma.
e. Esophageal diverticulum.
_____________________________________________________
(Surgery)
32. The most common cause of esophageal perforation is:
a. Penetrating trauma.
b. Postemetic rupture.
c. Carcinoma of the esophagus.
d. Caustic ingestion.
e. Instrumentation.
GOOD LUCK
GOOD LUCK
(Surgery)
33. Which of the following is the most potent known stimulator
of gastric acid secretion:
a. Pepsinogen.
b. Gastrin.
c. Acetylcholine B.
d. Enterogastrone.
e. Cholecystokinin.
_____________________________________________________
(Surgery)
34. A 64 year old man has had intermittent abdominal pain
caused by a duodenal ulcer (confirmed on GI series) during the
past six years. Symptoms recurred six weeks prior to admission.
If perforation occurs, treatment is:
(Surgery)
35. The peak incidence of acute appendicitis is between:
(Surgery)
36. Acute appendicitis:
GOOD LUCK
e. Presents with vomiting in 25% of cases.
GOOD LUCK
Appendicitis occurs more in males than females with a ratio of (1.4:1).
Vomiting is present in more than 50% of cases. Fecoliths are present
in up to 25% of cases without perforation and even more in cases with
perforation.
_____________________________________________________
(Surgery)
37. The mortality rate from acute appendicitis in the general
population is:
a. 4 per 100.
b. 4 per 1000.
c. 4 per 10000.
d. 4 per 100000.
e. 4 per 1000000.
_____________________________________________________
(Surgery)
38. The most common complication of Meckel's diverticulum
among adults is:
a. Bleeding.
b. Perforation.
c. Intestinal obstruction.
d. Ulceration.
e. Carcinoma.
(Surgery)
39. Which of the following is true concerning hemorrhoids?
They are:
GOOD LUCK
cause, although family history, pregnancy and chronic constipation
GOOD LUCK
may play a role. Hemorrhoids are dilatations of the inferior or superior
rectal VEINS, not arteries. A high bulk diet is used as prophylaxis for
hemorrhoids. Anemia is very rare with hemorrhoids, because if they
bleed, the bleeding is minimal and will not cause anemia.
_____________________________________________________
(Surgery)
40. A 17 year old boy presents with pain over the umbilicus 10
hours prior to admission. During transport to the hospital the pain
was mainly in the hypogastrium and right iliac fossa. He has
tenderness on deep palpation in the right iliac fossa. The most
likely diagnosis is:
a. Mesenteric adenitis.
b. Acute appendicitis.
c. Torsion of the testis.
d. Cystitis.
e. Ureteric colic.
_____________________________________________________
(Surgery)
41. In acute pancreatitis the chief adverse factor is:
(Surgery)
42. Complications following pancreatitis may include all of the
following EXCEPT:
a. Pulmonary atelectasis.
b. Altered mental status.
c. Shock.
d. Afferent loop syndrome.
e. Sepsis.
GOOD LUCK
GOOD LUCK
2014
(GS)
43. Patients presenting with acute cholecystitis are best treated by
cholecystectomy at which time interval after admission ?
a) 4 hours
b) 48 hours
c) 8 days
d) 10 days
e) 14 days
(GS)
44. Which one of the following is true of acalculous cholecystitis ?
GOOD LUCK
(GS)
45. A 40-year-old male drug addict and alcoholic of 25 years duration
is admitted with a 12-Ib weight loss and upper abdominal pain of three
weeks duration. Examination reveals a mass in the epigastrium.
His temperature is 99F and his white cell count is 14,000.
The most likely diagnostis is :
a) Pancreatic pseudocyst
b) Subhepatic abscess
c) Biliary pancreatitis
d) Hepatic abscess
e) Splenic vein thrombosis
(UROLOGY)
46. The most likely cause of gross hematuria in a 35-year-old man is :
a) cystitis
b) ureteral calculi
c) renal carcinoma
d) prostatic carcinoma
e) bladder carcinoma
(GS)
47. A no.20 French catheter is :
a) 20cm long
b) 20 mm in circumference
c) 20 dolquais ( French measurement ) in diameter
d) 20 mm in diameter
GOOD LUCK
e) 20 mm in radius
GOOD LUCK
The french catheter scale is commonly used to measure the outer (not
the inner) diameter of cylindrical medical instruments including
catheters.
(UROLOGY)
48. Concerning urinary calculi, which one of the follwing is true ?
Answer from churchil page 382 : urinary calculi are often idiopathic,
90% are radiopaque, 75% are calcium oxalate stones.
(MEDICINE)
49. In a gram-negative bacterial septicemia :
(MEDICINE)
50. In septic shock:
GOOD LUCK
e) Two or more organisms are responsible in the majority of cases.
GOOD LUCK
The mortality rate in septic shock may reach up to 50%, though gram
negative bacteria are the most common pathogens , other gram
positive and some fungi may cause it . its usually common in older
people and immunodefecincy states .
(MEDICINE)
51. Hyperkalemia is characterized by all of the following except:
(MEDICINE)
52. Normal daily caloric intake is :
a) 0.3 kcal/kg
b) 1.3kcal/kg
c) 2.0kcal/kg
d) 3.5kcal/kg
e) 35kcal/kg
(ANESTHESIA)
53. Which of the following would most likely indicate a hemolytic
transfusion reaction in an anesthetized patent?
GOOD LUCK
e) bleeding and hypotention
GOOD LUCK
acute hemolytic transfusion reaction (AHTR) is generally due to ABO
incompatibility and most common cause is incorrect patient
identification, it commonly presents with fever and chills but patients
under general anesthesia present with bleeding and hypotention.
(ANATOMY)
54. Which of the following organs is likely to receive a proportionately
greater increase in blood flow ?
a) kidneys
b) liver
c) heart
d) skin
e) none of the above
am sorry l couldn’t find the answer . but the original answer was : c
(GS)
55. A 48-year-old man with pyloric stenosis with severe vomiting
comes into the hospital, there is marked dehydration, and the urine
output 20 ml/hour. HCT 48, BUN 64mg, HCO3 – 33mEq/l, Cl 70
mEq/l, and K 2.5 mEq/l.
The predominant abnormality is :
a) aspiration pneumonia
b) hypochloremic alkalosis
c) salt-losing enteropathy
d) intrinsic renal disease
e) metabolic acidosis
Clear history of severe vomiting with losing of the acid into the
vomitus, and hypochloremia , hypokalemia and alkalosis.
GOOD LUCK
GOOD LUCK
(GS)
56. Concerning the treatment of breast cancer, which of the following
statement is false?
(GS)
57. What is the most important predisposing factor to the development
of an acute breast infection?
a) trauma
b) breast feeding
c) pregnancy
d) poor hygiene
e) diabetes mellitus
(GS)
58. A 46-year-old female wrestler !! ☺presents with a painful
mass 1×2 cm in the upper outer quadrant of the left breast. There are
areas of ecchymosis laterally on both breasts. There is skin
retraction overlying the left breast mass. What is the most likely
diagnosis?
a) fat necrosis
b) thrombophlebitis
c) hematoma
d) intraductal carcinoma
GOOD LUCK
e) sclerosing adenosis
GOOD LUCK
(ANESTHESIA)
59. The most important factor in the development of spinal headaches
after spinal anesthesia is :
when epidural anesthetics are placed with a larger needle than that
used for spinal anesthetics, the likelihood of headache is higher .
(MEDICINE)
60. The respiratory distress syndrome after injury is due to :
a) pneumothorax
b) aspiration
c) pulmonary edema
d) pulmonary embolus
e) none of the above
(GS)
61. Clear aspirated fluid from breast cyst will be :
a) sent to cytology
b) thrown away
c) sent to biochemical analysis
d) combined with biopsy
GOOD LUCK
GOOD LUCK
(GS)
62. A lady presented with perforated peptic ulcer and INR = 5 needs
preoperatively:
a) protamine sulphate
b) frozen blood
c) fresh frozen plasma
d) fresh frozen blood
(GS)
63. An old man undergoing brain surgery and on asprin. He needs
prior to surgery:
a) vitamin K parenterally
b) vitamin K orally
c) delay surgery for 2 days
d) delay surgery for 2 weeks
e) none of the above
(GS)
64. All of these diseases are predisposings to cancer stomach except:
a) pernicious anaemia
b) H. pylori
c) Linitis plastica
d) Peptic ulcer
e) All of the above
GOOD LUCK
GOOD LUCK
(GS)
65. All statements are correct for papillary thyroid carcinoma except:
(GS)
66. Right sided cancer colon may present with one of these signs
except:
a) anemia
b) mass
c) pain
d) obstruction
e) bleeding
(GS)
67. The inguinal canal is :
GOOD LUCK
GOOD LUCK
the inguinal canal lies parallel to and immediately above the inguinal
ligament. In the new born child , the deep ring lies almost directly
posterior to the superficial ring so that the canal is considerably shorter
at this age. Its roof is consists of the lowest fibers of the internal
oblique and transverses abdominis muscle the floor is formed by the
inguinal ligament . posterior wall is formed by facia transversalis . and
its anterior wall is formed by the external oblique aponeurosis.
(GS)
68. Regarding strangulated inguinal hernia these statements are
correct exept:
(GS)
69. Femoral hernia is usually :
femoral hernia is more common in female but its not the most
common, the most common hernia remains inguinal hernia. Femoral
hernia presents below and lateral to pubic tubercle.
GOOD LUCK
GOOD LUCK
(MEDICINE)
70. Oral anticoagulants :
warfarin should not be given in pregnant lady specially during the 1st
and 3rd trimesters, it crosses placenta as well as blood brain barrier, it
is usually difficult to reverse warfarin within short time because it has
long half life and it works on vit-K factors which takes time to reverse ,
barbiturates decrease the anticoagulant effect of warfarin
(MEDICINE)
71. Risk of DVT can be decreased by these measures except:
(GS)
72. Cause of giant breast includes these statements except:
a) diffuse hypertrophy
b) cystosarcoma phylloids
c) giant fibroadenoma
d) all of the above
e) none of the above
GOOD LUCK
GOOD LUCK
2014
(OB/GYN)
1) Vulvovaginal candidiasi
Vulvovaginal Candidiasis
(OB/GYN)
2) Bacterial vaginosis
GOOD LUCK
Bacterial vaginosis
R x by * metronidazole
* Clindamycin
(OB/GYN)
3) Trichomoniasis
Trichomoniasis
Infection by trichomonas vaginalis
Parasite infection at Reproductive, renal and urology systems.
Affect male and female.
It is sexual transmitted disease
40% are asymptomatic in female.
80% are asymptomatic in male.
Vulvolar irritation, vaginal discharge,(copious, frothy, water
dysuria)
Dx by * culture * wet prep *Pap smear * Direct antibody
Alurescent test.
GOOD LUCK
R+ by – mitronidazole for both partner
GOOD LUCK
(OB/GYN)
4) Chlamydia trachomatis infections:
Chlamydia.
Infection by chlmydia trachomatis.
It is STDs (the commonest)
A symptomatic (70%).
Symptoms: * mucopurlet vaginal discharge.
* urthral symptoms
dysuria
* Pelvic pain pyuria
Frequency
* Posticoital bleeding
* Conjunctivitis in infant
Dx by * culture
* (PCR)
* Direct immature antibody test.
Rx by doxycyclin / tetracycline / azothromycin.
STDs:- (1) chlymedia (2) gonorrhea (3) gental warts (4) syphilis
(5) Herpes simplix of vulva (condylomata accunomata)
(OB/GYN)
5) The most important mechanism of action of combined oral
contraceptive is:
a. Inhibition of implantation
b. Inhibition of fertilization
c. Alteration of tubal motility
d. Alxteration of cervical mucous
e. Ovulation suppression
GOOD LUCK
Combined OCP.
Law dosage of estrogen + progstron.
Mechanism of action:-
(1) – ovuatory suppression ↓ FSH
↓ LH
(2) – Cervical thicking ↓ sperm penetration
(OB/GYN)
6) Possible mechanisms of action of intrauterine contraceptive
devices:
a. Inhibition of implantation
b. Alteration of endometrium
c. Suppression of ovulation
d. (2) and (b)
e. (2) and (c)
GOOD LUCK
GOOD LUCK
IUD
Coper Progestron
Side effect: (1) intermenstral bleeding (2) utrian perforation (3) PID
in 1st days (4) ↑ ectopic pregnancy (5) Expulsion (6) dysmenorrhea
and menorrhea for copper one.
(OB/GYN)
7) Non-contraceptive use of combined oral contraception include
a. Menvorrhagia
b. Primary dysmenorrheal
c. Functional small ovarian cyst
d. All of the above
e. None of the above
GOOD LUCK
(OB/GYN)
8) Intrauterine contraceptive devices are associated with
a. Decreases menstrual loss
b. Septic abortion
c. Cervical dyplasia
d. Decrease risk of pelvic infection
e. Unchanged rate of ectopic pregnancy
Look at Question 5
(OB/GYN)
9) Absolute contraindication to the insertion IUCD is
a. History of genital herpes
b. History of molar pregnancy
c. Positive pregnancy test
d. History of ectopic pregnancy
e. None of the above
Look at Question 5
(OB/GYN)
10) Progestin only contraceptive pills:
a. Suppress ovulation
b. Increase cervical mucous
c. Associated with increased incidence of breakthrough bleeding
d. May cause Menorhagia
The question may be wrong if it is except answer will be (d)
progestron OCP use in (higher failure rate than combined)
1- Post partum (Brest feeding)
2- Women with myocardial disease Combined is
3- Women with thremboembolic disease Contraindicated
GOOD LUCK
GOOD LUCK
(OB/GYN)
Isoimmunization
- Sensitization rants
incompatible blood transfusion
fetal placental hemorrhage (ectopic pregnancy)
any type of abortion
Labor and delivery.
(OB/GYN)
12) The class of antibody responsible for hemolytic disease of the
newborn is:
a. IgA
b. IgG
c. IgM
d. IgE
e. IgD
GOOD LUCK
GOOD LUCK
(OB/GYN)
13) All of the following are seen in utero with alloimmune hypdors
EXCEPT:
a. Anemia
b. Hyperbilirubinemia
c. Kemicterus
d. Extramedullary hematopoiesis
e. Hypoxia
(OB/GYN)
14) An Rh - woman married to an Rh+ man should receive Rh immune
globulin under which of the following conditions?
a. Ectopic pregnancy
b. External cephalic version
c. Both
d. Neither
Look at Question 11
(OB/GYN)
15) The most common cause of polyhydramnios is
a. Immune hydrops
b. Nonimmune hydrops
c. Diabetes
d. Factors which o=impair fetal swallowing
e. Idiopathic
Polyhydramnios
- amniotic volume >2000cc at any stage
* Causes
1- Idiopathic (most common.)
2- Type 1 DM
3- Multiple gestation – fetal hydrops.
4- Fetal
Chromosomal anomaly – malformed lung – duodenal atresia
* Complication.
1- Cord prolapse (2) Placental abruption (3) Malpresention
4- Preterm labor 5- Post partum hemorrhage.
GOOD LUCK
* Dx by aminocentasis if it sever / mild to moderate →no treatment
GOOD LUCK
(OB/GYN)
16) Generally accepted cutoff values for plasma glucose on the 1000
gm, 3- hour glucose tolerance test in pregnancy (according to the
National Diabetes Group) include all of the following EXCEPT:
a. fasting glucose > 90 mg/dl
b. fasting glucose ≥105 mg/dl
c. 1 hour value ≥190 mg/dl
d. 2 hour value ≥165 mg/dl
e. 3 hour value ≥145 mg/dl
PG 7.8 PG ≥10.3
No GDM GDM
7.8 ≤ PG 10.3
GDM GDM
a. 2%
b. 4%
c. 8%
d. 15%
e. 20%
Some studies mention 2%
Prevalence between 2 – 4 but more common is 4%
GOOD LUCK
GOOD LUCK
(OB/GYN)
18) Normal pregnancy in the 2nd trimester is characterized by all of
the following EXCEXPT:
a. Elevated fasting plasma glucose
b. Decreased fasting plasma glucose
c. Elevated postprandial plasma insulin
d. Elevated postprandial plasma glucose
e. Elevated plasma triglycerides
(OB/GYN)
19) Gestational diabetes is associated with
a. Increased risk of spontaneous abortion
b. Increased risk of fetal cardiac malformation
c. Increased risk of fetal CHS malformation
d. Intrauterine growth restriction
e. Decreased head circumference abdominal circumference ratio
Look at the table
They usually ask about gestational DM compilations
These table contain DM type 1, type 11, and gestational DM
Complication
(OB/GYN)
20) Infants of mothers with gestational diabetes have an increased risk
of all of the following EXCEPT:
a. Hypoglycemia
b. Hyperglycemia
c. Hypocalcemia
d. Hyperbilirubinemia
e. Polyeythemia
Look at the table
GOOD LUCK
GOOD LUCK
(OB/GYN)
21) Gestational diabetes is associated with an increased risk of all
of the following EXCECPT:
a. Cesarean section
b. Shoulder dystocia
c. Fetal macrosomia
d. Intrauterine fetal death
e. Intrauterine growth restriction
Look at the table
(OB/GYN)
22) Infants of mothers with gestational diabetes are at increased risk of
be coming
a. Obese adults
b. Type II diabetics
c. Neither
d. Both
Look at the table
(OB/GYN)
23) Control of gestational diabetes is accomplished with all of the
following EXCEPT:
a. Insulin
b. Diet
c. Oral hypoglycemic agents
d. Exercise
Oral hypoglycemic agents are contraindication in pregnancy
GOOD LUCK
GOOD LUCK
(OB/GYN)
24) Compare with Type II diabetes, Type I diabetes is associated with
all of the following EXCEPT:
a. Greater incidence of preeclampsia
b. Greater incidence of preterm delivery
c. Greater risk of maternal hypoglycemia
d. Greater risk of maternal diabetic ketoacidosis
e. Reduced risk of intrauterine growth restriction
Look the table
(OB/GYN)
25) Gestational diabetes substantially increases the mother's risk for
the ultimate development of
a. Type I diabetes
b. Type II diabetes
c. Neither
d. Both
Look at the table
GOOD LUCK
GOOD LUCK
Tables 6. Complications of DM in pregnancy
Maternal Fetal
GOOD LUCK
Macrosomia: maternal hyperglycemia Hypertension/pre-eclampsia
leads to fetal hyperinsulinism resulting especially if pre-existing
in accelerated anabolism Intrauterine nephropathy/proteinuria)
growth retardation (UGR) (DM type 1 polyhydramnios
only)
Diabetic Emergencies
Delayed Organ Maturiy Hypoglycemia
Fetal lung immaturity: hyperglycemia Ketoacidosis
interferes with surfactants synthesis Diabetic coma
(respiratory distress syndrome)
End-organ involvement or
Congenital Anomalies (not GDM) deterioration (not GDM)
2-7x increased risk of cardiac (VSD), Retinopathy
NTD, GU (cystic kidneys) Naphropathy
GI (anal atresia), MSK (sacral
agenesis) Other
Pyelonephritis/UTI
Labour and Delivery Increased incidence of spontaneous
Preterm labour/prematurity abortion (not GDM)
Increased incidence of stillbirth
Birth trauma
Neonatal
Hypoglycemia, hyperbilirubinemia and
jaundice, hypocalcemia, polycythemia
GOOD LUCK
Note: Pregnancies complicated by GDM do not manifest an increased
risk of congenital anomalies because GDM develops after the critical
period of organogenesis (in T1).
GOOD LUCK
GOOD LUCK
2014
(OB/Gyne)
The patient appears her stated age. Axillary and pubic hair are
scant . Breasts are tanner stage IV . External genitalia are normal
female . A mass is palpable within the inguinal canal.
Pelvic exam reveals an absent cervix with the vagina ending in
a blind pouch. the uterus and overaies are difficult to delineate.
GOOD LUCK
28.Karyotype is performed on the patient's peripheral blood
lymphocytes .The karyotype is most likely
a)46 xx
b) 45 x
c)46 xy
d)46 xx, 45 x
e)47 xxy
29. the hormone profile in this patient would include all of the
following EXCEPT:
a)elevated LH
b)elevated estradiol for a male
c)normal to elevated FSH
d)normal to slightly elevated testosterone for a male.
e)normal testosterone for a female.
GOOD LUCK
(obstetric & gynecology recall)
GOOD LUCK
33.All of the following are true about this patient except:
a)H-Y antigen is present
b) these patients are always sterile
c)antimullerian hormone is present
d)normal levels of dihydrotestosterone
e) clitromegaly may develop later in life.
GOOD LUCK
2014
(OB/GYN)
34) atrophic vaginitis is best treated with:
a- Oral metronidazole.
b- Topical miconazole.
c- Prolonged application of topical estrogen.
d- Oral estrogen & progestin therapy.
e- Topical sulfa cream.
(OB/GYN)
35) hormone replacement therapy is contraindicated in which of the
following conditions:
a- Chronic hypertension.
b- Type 1 DM.
c- Previous MI.
d- Hypercholesterolemia.
e- Recurrent deep vein thrombophlebitis.
Absolute contraindications:
GOOD LUCK
Venous thrombosis
Well-differentiated and early endometrial cancer (once treatment
for the malignancy is complete, is no longer an absolute
contraindication.) Progestins alone may relieve symptoms if the
patient is unable to tolerate estrogens.
Relative contraindications:
Migraine headaches
Personal history of breast cancer
History of fibroids
Atypical ductal hyperplasia of the breast
Active gall bladder disease (Cholangitis, Cholecystitis)
(OB/GYN)
36) Surveillance of pt on hormone replacement therapy includes all
of the following except:
a- Blood pressure.
b- Breast examination.
c- Glucose tolerance test.
d- Pelvic examination.
e- Endometrial sampling in the presence of abnormal bleeding.
(OB/GYN)
37) Age of menopause is predominantly determined by:
a- Age of menarche.
b- Number of ovulation.
c- Body mass index.
d- Socioeconomic status.
e- Genetics.
GOOD LUCK
GOOD LUCK
(OB/GYN)
38) All of the following result from combined estrogen-progestin
replacement therapy except:
(OB/GYN)
39) All of the following r known to increase the risk of osteoporosis in
the postmenopausal women except:
a- Early menopause.
b- Cigarette smoking.
c- Low calcium intake.
d- Sedentary life style.
e- Black race.
GOOD LUCK
Women with a slender build experience more bone loss than
other women.
)
GOOD LUCK
A history of eating disorders increases the risk of osteoporosis.
Women whose family history includes osteoporosis have a
higher risk of developing this condition.
Some medications such as diuretics, steroids, and
anticonvulsants increase the risk.
Women who smoke or drink alcohol experience a higher
incidence of osteoporosis
(OB/GYN)
40) all of the following are characteristic changes seen in
menopause except:
GOOD LUCK
GOOD LUCK
(OB/GYN)
41) diagnosis of hydatidiform mole can be made accurately on the
basis of:
a- Elevated B-hCG.
b- Pelvic U/S.
c- Pelvic exam.
d- Chest radiograph.
e- Absence of fetal heart tones in a 16 weeks size uterus.
Diagnosis is based on a typical sonographic “snowstorm” pattern. The
following findings also support a diagnosis of hydatidiform mole:
Absence of a gestational sac, by ultrasound assessment, or
absence of fetal heart tones, by Doppler, after 12 weeks.
Pregnancy test showing elevated human chorionic gonadotropin
(hCG) serum levels greater than 100,000 IU.
Development of preeclampsia prior to 20 weeks.
Uterine size greater than estimated gestational size.
Vaginal bleeding.
(OB/GYN)
42) definitive therapy for hydatidiform mole is most commonly:
a- Evacuation.
b- Abdominal hysterectomy.
c- Evacuation followed by methotrexate therapy.
d- Evacuation followed by hysterectomy.
e- Radiation.
Hydatidiform mole necessitates uterine evacuation via suction
curettage. Oxytocin I.V. may be used to promote uterine contractions.
Postoperative treatment varies, depending on the amount of blood lost
and complications. If no complications develop, hospitalization is
usually brief, and normal activities can be resumed quickly, as
tolerated.
GOOD LUCK
(OB/GYN)
43) evacuation of hydatidiform mole may be complicated by:
In the treatment after evacuation & curettage of the uterus, I.V oxytocin
is given simultaneously to help stimulate uterine contractions & reduce
blood loss which will decrease the incidence of uterine perforation &
trophoblastic embolization (this can lead to acute respiratory distress).
(OB/GYN)
44) Following evacuation of a molar pregnancy, B-hCG titers will fall
to undetectable levels in about 90% of pt within:
a- 2 wk.
b- 4 wk.
c- 8 wk.
d- 10 wk.
e- 12-16 wk.
(OB/GYN)
45) After the B-hCG titer become undetectable, the pt treated for
hydatidiform mole should be followed with monthly titers for a
period of:
a- 3 months.
b- 6 months.
c- 1 yr.
d- 2 yr.
e- 5 yr.
GOOD LUCK
initially are checked on a weekly basis, until they’re repeatedly
GOOD LUCK
negative; then on a monthly basis for one year. A baseline chest X-
ray is used to rule out pulmonary involvement, and a head computed
tomography scan may be performed to rule out cranial metastases.
Another pregnancy should be postponed until at least 1 year after hCG
levels return to normal.
(OB/GYN)
46) A 25 year old G3P1 present to the emergency room complaining
of lower abdominal crampy pain 6 wk from her last normal period
.She has had significant vaginal bleeding but no passage of tissue.
a- Incomplete abortion.
b- Complete abortion.
c- Missed abortion.
d- Threatened abortion.
e- Ectopic pregnancy.
Abdominal pain
Amenorrhea
GOOD LUCK
Vaginal bleeding
GOOD LUCK
Ectopic pregnancy should be suspected in any women of reproductive
age with these symptoms, however, these symptoms are not
diagnostic of ectopic pregnancy; they are the same as those
associated with threatened abortion, which is far more common but
without abdominal pain or just mild dull pain not lead to that
emergency. Transvaginal ultrasound examination (TVS) is the most
useful test for determining the location of a pregnancy. If the imaging
study is non diagnostic, then one or more serum human chorionic
gonadotropin (hCG) concentrations are needed to make this
assessment. Transvaginal ultrasound — Ultrasound is used to
detect the presence (or absence) of a gestational sac within or outside
of the uterus and thereby establish a diagnosis. Sonographic
measurement of endometrial thickness has also been studied as a
diagnostic test for ectopic pregnancy, but most investigators have not
found it to be clinically useful.
(OB/GYN)
47) Ectopic pregnancy can be ruled out with a high degree of
certainty if:
GOOD LUCK
GOOD LUCK
(OB/GYN)
48) Physical exam reveals the uterus to be about 6 wk size. Vaginal
bleeding is scant with no discernible tissue in the cervical os. There
are no palpable adnexal masses. The uterus is mildly tender.
Ultrasonographic exam does not reveal a gestational sac.
Which of the following should be recommended?
I don't know.
(OB/GYN)
49) If the above pt presented at 8 wk gestation & pelvic exam
revealed unilateral adnexal tenderness w/o discernible mass,
consideration should be given:
a- Observation.
b- Culdocentesis.
c- Laparoscopy.
d- Dilatation & curettage.
e- Laparotomy.
I don't know.
(OB/GYN)
50) the most common antecedent cause of ectopic pregnancy is:
a- Salpingitis.
b- Congenitally anomalous tube.
c- Endometriosis.
d- Tubal surgery.
e- Previous sterilization.
GOOD LUCK
anomalies, or tumors. Pelvic infection (e.g., nonspecific
GOOD LUCK
salpingitis, chlamydia, gonorrhea), especially recurrent infection,
is a major cause of tubal pathology and, therefore, the increasing
incidence of ectopic pregnancy Tubal pathology, particularly chronic
salpingitis, is observed in up to 90 percent of ectopic pregnancies.
Chronic salpingitis is six times more common in tubes containing an
ectopic pregnancy than in normal tubes.
(OB/GYN)
51) The majority of ectopic pregnancies occur in the:
a- Ampullary tube.
b- Ovary.
c- Isthmic tube.
d- Cervix.
e- Fimbriated (distal) tube.
(OB/GYN)
52) The most common presenting symptom of ectopic pregnancy is:
Abdominal pain
Amenorrhea
Vaginal bleeding
GOOD LUCK
GOOD LUCK
99 percent, amenorrhea in 74 percent, and vaginal bleeding in 56
percent
(OB/GYN)
53) Acceptable management of possible ruptured ectopic pregnancy
would include all of the following except:
a- Exploratory laparotomy.
b- Diagnostic laparoscopy followed by observation.
c- Partial salpingectomy.
d- Total salpingectomy.
e- Observation followed by methotrexate.
(OB/GYN)
54) If the above described pt has had a previous term pregnancy
prior to her current ectopic pregnancy, her chances of subsequent
intrauterine pregnancy would be about:
a- 80%.
b- 60%.
c- 40%.
d- 20%.
e- <10%.
Those with previous normal pregnancy have about 80% after their
ectopic pregnancy to achieve intrauterine pregnancy. a study of
surgical and medical therapy of ectopic pregnancy reported the rates
of recurrent ectopic pregnancy after single dose methotrexate,
salpingectomy, and linear salpingostomy were 8, 9.8, and 15.4
percent, respectively Women who have had conservative treatment for
ectopic pregnancy are at high risk (15 percent overall) for recurrence.
GOOD LUCK
(OB/GYN)
55) A serum progesterone value <5 ng/ml can exclude the diagnosis
of a viable pregnancy with a certainty of:
a- 20%.
b- 40%.
c- 60%.
d- 80%.
e- 100%.
(OB/GYN)
56) In normal pregnancy, the value of B-hCG doubles every
a- 2 days.
b- 4 days.
c- 8 days.
d- 10 days.
e- 14 days.
The mean doubling time for the hormone ranges from 1.4 to
2.1 days in early pregnancy.
GOOD LUCK
GOOD LUCK
(OB/GYN)
57) A syndrome seen in preeclamptic women called HELLP
syndrome is characterized by all of the following except:
(OB/GYN)
58) The most common presenting prodromal sign or symptom in pt
with eclampsia is:
(OB/GYN)
59) The most consistent finding in pt with eclampsia is:
a- Hyper reflexia.
b- 4+ proteinuria.
c- Generalized edema.
d- DBP >110mmHg.
e- Convulsions.
GOOD LUCK
Amnesia & other mental status changes.
GOOD LUCK
(OB/GYN)
60) Appropriate responses to an initial eclamptic seizure include all
of the following except:
(OB/GYN)
61) Eclampsia occurring prior to 20 wk gestation is most commonly
seen in women with:
a- Hx of chronic hypertension.
b- Multiple gestation.
c- Gestational trophoblastic disease (molar pregnancy).
d- Hx of seizure disorder.
e- Hx of chronic renal disease.
GOOD LUCK
GOOD LUCK
(OB/GYN)
62) Of the following, the most common complication of eclampsia is:
a- Magnesium intoxication.
b- Recurrent seizures following administration of magnesium
sulfate??.
c- Intracranial hemorrhage.
d- Maternal death.
e- Pulmonary edema.
(OB/GYN)
63) If a woman with preeclampsia is not treated prophylactically to
prevent eclampsia; her risk of seizure is approximately:
a- 1/10
b- 1/25
c- 1/75
d- 1/200
e- 1/500
(OB/GYN)
64) Likely contributory mechanisms of the anticonvulsant action of
MgSO4 include all of the following except:
GOOD LUCK
GOOD LUCK
(OB/GYN)
65) All of the following antihypertensive medications are considered
safe for short term use in pregnancy except:
a- Captopril.
b- Methyldopa.
c- Hydralazine.
d- Nifedipine.
e- Labetalol.
(OB/GYN)
66) The reason to treat severe chronic hypertension in pregnancy is
to decrease the:
a- Incidence of IUGR.
b- Incidence of placental abruption.
c- Incidence of preeclampsia.
d- Risk of maternal complication such as stroke.
GOOD LUCK
blood clotting disorder
GOOD LUCK
Risks to the fetus and newborn depend on the severity of the disease
and may include, but are not limited to, the following:
stillbirth
October 2007
1- middle aged male s involved in RTA , his RR is 30/min , heart sounds is muffeled & the JVP
is elevated , BP/ 80/40 & a bruise over the sternum. Dx
a- pericardiac Tamponade
b- pneumothorax
c- pulmonary contusion
d- hemothorax
2- obese 54 year lady " cholecystectomy " 5th day post-op she complain of SOB &
decreased BP 60 systolic ,, on exam unilateral swelling of Rt. Leg the Dx is:-
a- hypovolomic shock
b- septic shock
c- pulmonary embolism
d- MI
e- Hg. Shock
GOOD LUCK
friends. On examination, found to be conscious but drowsy. HR 120/min, BP 80/40.
The MOST urgent initial management measure is:
a- CT brain
b- X-ray cervical spine
c- Rapid infusion of crystalloids
d- ECG to exclude hemopericardium
e- U/S abdomen
5- Patient fall on outstretched hand. On examination, both radial & ulnar pulses
intact. Wrist had dinner fork deformity. Tender radial head. Dx:
a- Colle’s Fracture
b- Fracture of distal ulna & displacement of radial head
c- Fracture of shaft radius with displacement head of ulna
GOOD LUCK
is: a- internal fixation with plate
b- Internal fixation with intramedullary locked
nail c- External fixation with intramedullary
locked nail d- traction & balance
e- cast around hip
)
11- 10 yr old boy woke up at night with lower abdominal pain, important area to check:
a- kidney
b- lumbar
c- rectum
d- testis
12- 40 yr old male with 4 days history of sudden eruption over the entire body
GOOD LUCK
including palms & feet :
a- erythema nodosum
b- erythema multiforme
c- pit. rosea
15- 8 years old boy for evaluation of short stature. His height is of 6 year old & bone
scan of 5.5 years ,, Dx is:
a- steroid therapy
b- genetic
c- constitutional
d- hypochondroplasia
e- hypothyroidism
16- 80 yr old female who was put in nursing home 3 months back is complaining of 3.6
Kg weight loss in the last month , excessive crying , when her situation is worse she
sometimes forgets (has poor short memory). Her husband died 2 yrs ago. Dx
a- Depression
b- Alzheimer’s
GOOD LUCK
d- Long arm of chromosome 8
e- Short arm of chromosome 17
20- 12 yr old girl with malaise, fatigue, sore throat & fever. On examination: petechial
rash on palate, large tonsils with follicles, cervical lymphadenopathy &
hepatosplenomegaly. All are complications EXCEPT:
a- Aplastic anemia
b- Encephalitis
c- Transverse myelitis
d- Splenic rupture
e- Chronic active hepatitis
22- 1 month old with massive hepatosplenomegaly, bluish skin nodules, & lateral
GOOD LUCK
neck swelling, the next step is:
a- CBC
b- lumber
puncture c- Do
EBV serology d-
BM scan
e- Liver biopsy
23- 8 month old baby came with dehydration, fever 40 C, poor feeding & convulsions.
depressed ant. Fontanelle, vomiting, & crying with red ears. No neck stiffness. Her
3 yr old brother is asymptomatic. What is the most important investigation to do:
a- Blood culture
b- CBC &
differential c- CSF
examination d-
Chest xray
e- Urine analysis
24- 25 yr old male patient had he give a Hx of Lt knee swelling & pain 5 days back ,
two days back he had Rt wrist swelling & redness. He had recently traveled to
India. On examination there was tenderness & limitation of movement. 50 cc of
fluid was aspirated from the knee. Gram stain showed gram negative diplococci.
What is the most likely organism?
a- Brucella
Militans b- N.
gonorrhea
c- Staph aureus
d- Strep
pneumonia e-
Strep pyogenes
25- 17 year old boy presented to the ER complaining of sudden onset of abdominal
pain & leg cramps, he had history of vomiting 2 days ago, he was dehydrated .
Na = 150 , K = 5.4 ,, glucose =
GOOD LUCK
23mmol The best initial
investigation is
a- CBC
b- Blood
culture c- ABG
d- Urinanalysis
(dipstick) e- U/S
26- young age male presented after RTA with injured membranous urethra , best
initial ttt is :
a- Passage of transurethral
catheter b- Suprapubic catheter
c- Perineal repair
d- Retropubic repair
e- Transabdominal repair
GOOD LUCK
meds b- Aspirin 325
c- aspirin
81 d-
warfarin
e- dipyrmidol
)
31- After infarction , the patient become disinhibeted , angree & restless . The
area responsible which is affected:
a- premotor
area b-
temporal area
c- pre- frontal area
32- middle age acyanotic male with CXR showing increase lung marking &
enlarged pulmonary artery shadow, most likely Dx:
a- VSD
b- Aorta
coarctation c-
Pulmonary stenosis
d- ASD
e- Truncus arteriosus
GOOD LUCK
Edward
d- Patau
e- Holt-Oram
34- 5 day old infant not feeding, lethargy, has burned sugar smell urine.
Dx: a- Maple urine synd
b-
phenylketonurea
c- Gaucher’s
35- All are true about the best position in hearing the murmurs,
EXCEPT: a- supine : venous hum
b- sitting : AR
c- sitting : pericardial rub
d- supine : innocent outflow
obstruction e- Lt lateral in : MS
36- 3 year old child needs oral surgery & comes to your clinic for checkup. On
examination 2/6 continuous murmur , in upper Rt sternal borders that disappear
with sitting , next step:
a- Give AB prophylaxis
b- Ask cardiology
consult c- Clear for
surgery
d- Do ECG
)
37- A daycare center supervisor pregnant in her 20 wk. she recently discovered that
2 of her students developed meningitis. Prophylactic treatment:
a- Observe for development of
meningitis b- Meningitis polysaccharide
vaccine
c- Rifampicin 600 po bid for 2
days d- Ciprofloxacin 500 po once
e- Ceftraixone 250 IM or Iv once
GOOD LUCK
38- 10 yr old child has +ve TB test , mantoux test was –ve in the last week , ttt
: a- INH
b- INH+ rifampicin
c-
INH+rifampicin+stereptomycin
d- No need for treatment
e- None of the above
39- 16 year old male presented with 5 days pain behind the Lt ear , 3 wks ago patient
had previous otitis media ttt with amoxicillin for 1 week but he was incompliant. Ex
: tenderness over the mastoid with slight swelling , ear : loss of cone of light with
slight congestion. Dx:
a- acute otitis media
b- serous otitis
media c- chronic
mastoiditis d- acute
mastoiditis e-
parotiditis
GOOD LUCK
b-
Tracheobronchiolitis
c- Spasmodic croup
d- Acute
epiglotitis e-
Angioedema
45- 27 years old male with tonic colonic in ER for 35 min, 20 mg diazepam was given
& convulsion did not stop, You will give:
a- Diazepam till total dose of 40
mg b- Phenytoin
c- Phenobarbitone
GOOD LUCK
3200
49-
Total Non-Case Case Risk Factor
A+B B A Present
C+D D C Absent
B+D A+C Total
Relative risk of those with the risk factor to those without the risk
factor: a- A/A+B
C/C+
D b-
A/A+B
c-
C/C+D
d-
AD/BC
e- A/B
GOOD LUCK
C/D
50- 6 month old baby presented to the clinic with 2-day history of gastroenteritis.
On examination: decreased skin turgor,depressed anterior fontanelle & sunken
eyes. The Best estimate of degree of dehydration:
a- 3%
b- 5%
c-
10%
d-
15%
e-
25%
51- elderly male , who had anterior wall MI, while transfer from the CCU nurse
noticed he is having now recurrent attacks of PVC, ECG showed more than 20
ventricular PVC. He has pulmonary edema, BP? , he is in digoxine & furosamide.
What do you want to add to his medication
a- amidrone
b- propnalol
c- flecanide
d-
Mexiletine
e- Do
nothing
52- a 29 year old teacher has recurrent attacks of intense fear before the
beginning of her classes in the 2ry school , She said : Its only a matter of time
before I do mistakes , Dx :
a- specific
phobia b- social
phobia
c- mixed phobia
GOOD LUCK
d- panic attacks with
agoraphobia e- panic without
agoraphobia
55- drug adduct swallow 2 open safety pins , X-ray show the present of them in
the small intestine , What is the ur plan :
a- admit and do OR immediately
b- admit & do serial x-ray of the abdomen observe for passage of
pins c- send patient home
GOOD LUCK
c- urethrovaginal fistula
d- cystitis
58- 45 yr old lady presents with nipple discharge that contains blood. What is the
MOST likely Dx:
a- ductal papilloma
b- ducta ectasia
c- fibroadenoma
d- duct CA
59- after aspiration of cystic mass in the breast the result was clear fluid, next step
a- Send the aspirated content for cytology and if abnormal do mastectomy
b- Reassure the patient that this lump is a cyst and reassess her in 4 weeks
c- Book the patient for mastectomy as this cyst may change to cancer.
d- Put the patient on contraceptive pills and send her home
60- after 2 wks ant. wall MI , old age female developed sudden leg pain , it is pale &
pulsless. Dx :
a- acute arterial thrombus
b- acute arterial embolus
c- DVT
d- Ruptured disc at L4-5 with radiating pain
e- Dissecting thoraco-abdominal aneurysm
61- a 34 yr old divorced lady complains of 15 months amnorrhea , FSH very high , Dx :
a- Pregnancy
b- ovulation
c- Premature ovarian failure
d- Hypothalamic lesion
e- Pituatary microadenoma
GOOD LUCK
62- a 25 year old male had Rt inguinal hernioraphy , on the 2nd day after the
operation , he developed severe pain over the wound site , with foul smelling
discharge , his temp is 39 & HR is 130/min . Gram stain showed G+ve rodes with
terminal spores , ttt
a- Massive IV pencillin
V b- clostridium
antitoxin
c- wide surgical
debridement d-
chlormphinicol
e- wide surgical debridment & Massive pencillin V
63- causes of
Polyhydraminos: a-
Renal agenesis
b- Duodenla atresia
c- Mother with diabetes
insipidus d- Post mortem
pregnancy
66- a 28 yr lady with 7 week history of amnorrhea has lower abdominal pain ,
GOOD LUCK
home pregnancy test was +ve , comes with light bleeding, next step:
a- Check
progesterone b-
HCG
c- Placenta
lactogen d-
Estrogen
e- Prolactin
67- All causes hyperprolactenemia, EXCEPT: a- pregnancy
b-
acromegaly
c-
methyldopa
d- allopurinol
e- Hypothyroidism
GOOD LUCK
diffusion c- perfusion
problem
d- elevated 2.3 DPG
72- A 15 yr old boy came to your clinic for check up. He is asymptomatic. His CBC
showed: Hb 118 g/l WBC 6.8 RBC 6.3 (high) MCV 69 (low) MCH (low) Retic 1.2 (1-
3)% what is the most likely diagnosis?
a- Iron deficiency anemia
b- Anemia due to chronic
illness c- β-thalssemia trait
d- Sickle cell disease
e- Folic acid deficiency
73- Hb electrophersis done for a patient shows HbA1=58% , HbS = 35% , HbA2 = 2%
, HbF = 5 % , Dx :
a- Thalasemia minor
b- Thalasemia major
c- Sickle cell trait
d- Sickle cell anemia
e- Sickle cell thal.
74- 80 yr old male came to the ER complaining of acute urine retention. What is
the INITIAL management:
a- Send patient immediately to OR for prostatectomy
b- Empty urinary bladder by foley’s catheter & tell him to come back to clinic
c- Give him antibiotics because retention could be from some sort of
infection d- Admission, investigation which include cystoscopy & then maybe
TURP
e- Insert foley catheter & tell him to come back later to clinic
GOOD LUCK
75- first sign of
LSHF a-
orthopnea
b- dyspnea on
exertion c- pedal
edema
d- PND
e- chest pain
78- CCB drugs like verapmil , dilitazem, nifedipine are effective EXCEPT:
a- Prinzmetal angina
b- Hypertension
c- Atrial tachycardia
d- Ventricular tachycardia
e- Effort angina
79- a 5 day old child vomited blood twice over the last 4 hr , he is healthy , active &
GOOD LUCK
feeding well by breast , Dx :
a- esophigitis
b- esophageal varices
c- gastritis
d- duodenal ulcer
e- cracked maternal nipple
80- 5 yr old seen in ER presented with fever & sore throat , which of the fallowing
suggest viral etiology :
a- Presence of thin membrane over the tonsils
b- Palpable tender cervical LN
c- Petechial rash over hard or soft palate
d- absence of cough
e- Rhinorrhea of colourless secretion
81- 80 yr old female presented with hx of 6 months bilateral hand stiffness that’s
worse in the morning but subsides as she begins her daily activities. PMH:
unremarkable. on Ex : she has bony swelling at the margin of distal interphalengeal
joint of 2nd to 5th digits. These swellings represent:
a- Heberdens nodules
b- Bouchards nodules
c- Sesamoid
d- subcutenous nodule
e- synovial thickening
GOOD LUCK
& levadopa
d- sulphamethaxazole &
trimethoprim e- tetracycline &
aluminum hydroxide
86- A on-opaque renal pelvis filling defect seen with IVP , US revels dense echoes
& acoustic shadowing , The MOST likely Dx:
a- blood
clot b-
tumor
c- sloughed renal
papilla d- uric acid
stone
e- crossing vessels
87- 46 yr old female presented for the third BP reading, high blood pressure
160/100 . she is not on any medication. Lab investigation showed
GOOD LUCK
Urea: normal
Creatinine:
normal Na=145
(135-145) K= 3.2
(3.5 – 5.1)
HCO3= 30 (22-
28)
What is the Dx?
a- Essential
hypertension b-
Pheochromocytoma
c- Addison’s Disease
d- Primary Hyperaldosteronism
88- 32 yr old lady works as a file clerk developed sudden onset of lower back pain
when she was bending to pick up files, moderately severe for 3 days duration.
There is no evidence of nerve root compression. What is the proper acrion:
a- Bed rest 7-10
days b- Narcotic
analgesia
c- Early activity with return to work
immediately d- CT for lumbosacral vertebra
90- 10 months old child presented with mild dehydration after he has frequent
vomiting & diarrhoea , ttt :
a- ORS
b- ORS+
GOOD LUCK
antimeitc c-
ORS+AB
d-
ORS+AB+antiemetic
e- IVF?
GOOD LUCK
36 hrs
e- 48
hrs
97- All are true for the prescripsion of antidepresents ttt for patient with
depression & somatisation disorders, EXCEPT:
a- Smaller doses may needed in elderly
b- potential side effect should not explain 2 the patient , b/c he will develop
it c- fluoxetine safe for elderly
98- the most specific investigation to detect pulmonary embolism is : a-
perfusion scan
b- pul angiogram
c- ventilation scan
d- CXR
100- 45 year old female come to the ER complaining of Rt hypochondrial pain which
increases with respiration , on Ex there is tenderness over the Rt hypochondrium,
Next investigation is
a- X-ray
b- US of upper abdomen
c- CT
GOOD LUCK