Internal Medicine
Internal Medicine
Internal Medicine
Cardiology OXF.
I. Common Cardiac Presentations.
1. Chest Pain.
***) Young medical student complains of chest pain, palpitation, dyspnea, and feeling of
impending death. The symptoms occur every time when he is studying. The most likely
diagnosis is: Q2012
A. Conversion disorder
B. Panic attack
C. Somatoform disorder
D. Hypochondriasis
E. Syncope
2. Syncope.
***) Which of the following is classical feature of cardiac syncope:
A. Gradual onset
B. Warning symptoms
C. Rapid recovery
D. Residual neurological deficit
E. Precipitated by sudden turning of the head
3. Postural Hypotension.
***) All of the following are causes of postural hypotension, except:
A. Diabetes
B. Hypovolemia
C. Prolonged bed rest
D. Addison's disease
E. Hyperthyroidism
Answer: E* Hyperthyroidism
4. Pulses.
***) Collapsing pulse is found in all of the following, except:
A. Aortic regurgitation
B. Patent ductus arteriosus
C. Mitral stenosis
D. Pregnancy
E. Anemia
5. Heart Murmurs.
***) One of the following can cause pansystolic murmur: Q2012
A. Coarctation of the aorta
B. Aortic regurgitation
C. Mitral regurgitation
D. Atrial septal defect
E. Aortic stenosis
6. Cardiac Arrest.
***) In cardiac arrest all of the following drugs may be used, except:
A. Adrenaline
B. Neostigmine
C. Calcium chloride
D. Isoprenaline
E. Lignocaine
Answer: B* Neostigmine
Answer: B* Hypothyroidism
Answer: E* Salbutamol
4. Cardiac Anatomy.
***) The heart chamber that is situated most posterior is the:
A. Right atrium
B. Right ventricle
C. Left atrium
D. Left ventricle
E. A+D
Answer: A* Hypothyroidism
***) Indications for the use of Beta-blockers include all of the following, except:
A. Hypertension
B. Ischemic heart disease
C. Migraine
D. Bronchial asthma
E. Anxiety
Answer: E* Tremors
2. Digoxin.
***) The treatment of digitalis-induced arrhythmia may include all of the following, except:
A. Withdrawal of digitalis
B. Phenytoin administration
C. Calcium gluconate administration
D. Potassium supplements
E. Xylocaine administration
***) All of the following are side effects of digoxin therapy, except:
A. Nausea and vomiting
B. Yellow vision
C. AV block
D. Ventricular extrasystole
E. Insomnia
Answer: E* Insomnia
3. ACE inhibitors.
***) All of the following are side effects of ACE-inhibitors, except: Q2012
A. Hypokalemia
B. Angioneurotic edema
C. Hyperkalemia
D. Dry cough
E. Hypotension
Answer: A* Hypokalemia
IV. Cardiac Diseases and Conditions.
1. Angina Pectoris.
***) A 65 year old male, presented complaining of retrosternal chest pain of 4 months duration,
the pain precipitated with walking uphill, last 5 minutes, relieved with rest. Clinical examination
was normal, and electrocardiogram was normal sinus rhythm. The most likely diagnosis is:
A. Stable angina pectoris
B. Unstable angina
C. Chronic pericarditis
D. Musculoskeletal
E. Reflux esophagitis
***) Which of the following drug is useful in the treatment of angina pectoris:
A. Salbutamol
B. Propranolol
C. Digoxin
D. Quinidine
E. Phenytoin
Answer: B* Propranolol
***) All the following can cause false positive troponin except: Q2012
A. Septic shock
B. Pulmonary embolism
C. Pulmonary edema
D. Uncontrolled HTN
E. Renal failure
***) All the following can cause increased in troponin except: Q2012
A. Pulmonary edema
B. MI
C. Pneumonia
D. Congestive heart failure
E. Myocarditis
Answer: C* Pneumonia
***) All the following are features of metabolic syndrome except: Q2012
A. BP over than 135/85
B. LDL over than 160
C. FBS over than 110
D. HDL less than 50 in females
E. Waist circumference over than 40 inches in males
***) Risk factors for ischemic heart disease include all the following, except:
A. Hypertension
B. Smoking
C. Obesity
D. High cholesterol level
E. High level of high density lipoproteins (HDL)
***) Risk factors for ischemic heart disease include all the following, except:
A. Excessive exercise
B. Positive family history
C. Cigarette smoking
D. Hypertension
E. Hyperlipidemia
***) Major risk factors for coronary artery disease include all the following except:
A. Hypertension
B. Smoking
C. Male sex
D. Elevated low density lipoprotein level (LDL)
E. Elevated high density lipoprotein level (HDL)
***) All of the following are risk factors for coronary artery disease, except:
A. Hyperlipoproteinemia
B. Diabetes mellitus
C. Hypertension
D. Obesity
E. Diet rich in polyunsaturated fats
***) The prognosis of myocardial infarction is adversely affected by all of the following, except:
A. Diabetes mellitus
B. Left ventricular failure
C. Syncope
D. Advancing age
E. Nausea and vomiting
***) All of the followings are true regarding chest pain of myocardial infarction, except:
A. Duration more than 30 minutes
B. Associated with nausea
C. Relieved with sublingual nitrate
D. Not related to breathing
E. Left shoulder radiation
***) In myocardial infarction the following serum enzyme rises latest and remains elevated for
the longest period:
A. SGOT
B. LDH
C. Alkaline phosphatase
D. CPK
E. Acid phosphatase
Answer: B* LDH
***) All of the following about myocardial infarction are true, except:
A. May present with pulmonary edema
B. Streptokinase is used in management
C. Morphine is helpful
D. Captopril is contraindicated
E. Arrhythmias are the commonest cause of death in the first hour
***) The management of unstable angina includes all of the following, except:
A. Aspirin
B. Anticoagulants
C. Digoxin
D. Nitrates
E. Beta blockers
Answer: C* Digoxin
***) All of the following are used in the treatment of acute myocardial infarction, except:
A. Morphine
B. Streptokinase
C. Nitroglycerin
D. Aspirin
E. Salbutamol
Answer: E* Salbutamol
Answer: D* Endocarditis
5. Arrhythmias.
***) Patient known to have Wolff-Parkinson-White (WPW) syndrome presented with atrial
fibrillation, stable vitals. The best management is: Q2012
A. Verapamil IV
B. Digoxin IV
C. DC shock
D. Amiodarone IV
E. Diltiazem IV
Answer: D* Amiodarone IV
***) 50 years old male asthmatic presented with palpitations, BP 130/85, ECG showed narrow
QRS complex, regular, absent P wave. The best management is: Q2012
A. Propranolol IV
B. Diltiazem IV
C. Adenosine IV
D. DC shock
E. Amiodarone IV
Answer: B* Diltiazem IV
Answer: B* Terbutaline
***) Electrical cardioversion is a useful mode of therapy in each of the following, except:
A. Ventricular tachycardia
B. Ventricular fibrillation
C. Bradycardia due to hypothyroidism
D. Atrial fibrillation
E. Atrial flutter
Answer: A* Atropine
Answer: A* Digoxin
***) All of the following drugs may be used to treat ventricular tachycardia, except:
A. Lignocaine
B. Amiodarone
C. Verapamil
D. Phenytoin
E. Procainamide
Answer: C* Verapamil
***) Recognized causes of ventricular extrasystoles include all of the following, except:
A. Hypokalemia
B. Beta blockers drugs
C. Digitalis
D. Quinidine
E. Tricyclic antidepressants
Answer: D* Quinidine
8. Atrial Fibrillation.
***) All of the following are causes of atrial fibrillation, except:
A. Ischemic heart disease
B. Rheumatic heart disease
C. Digitalis
D. Thyrotoxicosis
E. Pneumonia
Answer: C* Digitalis
9. Heart Failure.
***) All of the following are features of left ventricular failure, except:
A. Orthopnea
B. Peripheral edema
C. Pulsus alternans
D. Bilateral basal crepitations
E. Kerley B lines on chest X-ray
***) Signs of left ventricular failure include all of the following, except:
A. Third heart sound
B. Triple rhythm
C. Pulsus alternans
D. Bilateral basal crepitation
E. Gross liver enlargement
***) Signs of left heart failure include all of the following, except:
A. Gallop rhythm
B. Basal crepitation
C. Pulsus alternans
D. Hepatomegaly
E. Displaced and sustained apical impulse
Answer: D* Hepatomegaly
***) A 50 years old male who was seen in the casualty complained of sudden onset severe left
anterior chest pain radiating to the left arm. It was not relieved by sublingual nitrates. He was
short of breath; frothy blood was coming out of his mouth. He was hypotensive, cold, cyanotic
and profusely sweating. There were diffuse bilateral wheezes and basal crepitations on chest
examination. The heart sounds were soft and there was third heart sound, but there were no
murmurs. Patient suffering from:
A. Acute bronchial asthma
B. Angina pectoris with acute bronchial asthma
C. Acute pulmonary edema secondary to myocardial infarction
D. Acute viral pneumonia with pleuritic chest pain
E. Dissecting aneurysm
***) Crepitations which are late inspiratory and unchanged with cough are typical of: Q2012
A. Pneumonia
B. Lung fibrosis
C. Pleural effusion
D. Pulmonary edema
E. Subcutaneous emphysema
Answer: E* Hypervolemia
Answer: B* Morphine
11. Hypertension.
***) Causes of secondary hypertension include all of the following, except: Q2012
A. Renal artery stenosis
B. Crohn's disease
C. Cushing's syndrome
D. Polycystic kidney disease
E. Primary hyperaldosteronism
Answer: C* Simvastatin
Answer: C* Hypoparathyroidism
Answer: C* Dopamine
***) All of the following drugs are used in the management of hypertensive crises, except:
A. Nitroprusside
B. Hydralazine
C. Nifedipine
D. Salbutamol
E. Diazoxide
Answer: D* Salbutamol
***) The following drugs could be given safely as a treatment of hypertension to a patient with
peripheral vascular disease, except:
A. Alpha-methyldopa
B. Nifedipine
C. Captopril
D. Propranolol
E. Hydrochlorothiazide
Answer: D* Propranolol
***) All of the following are major criteria for the diagnosis of rheumatic fever, except:
A. Carditis
B. Polyarthritis
C. Chorea
D. Arthralgia
E. Erythema marginatum
Answer: D* Arthralgia
***) All of the following are major criteria of rheumatic fever, except:
A. Fever
B. Carditis
C. Polyarthritis
D. Chorea
E. Subcutaneous nodules
Answer: A* Fever
***) All of the following are major criteria for the diagnosis of rheumatic fever, except:
A. Arthritis
B. Prolongation of PR interval on ECG
C. Chorea
D. Erythema marginatum
E. Subcutaneous nodules
***) All of the following are major criteria for the diagnosis of rheumatic fever, except:
A. Carditis
B. Polyarthritis
C. Chorea
D. Arthralgia
E. Erythema marginatum
Answer: D* Arthralgia
***) Major manifestations of rheumatic fever include all the following except:
A. Polyarthritis
B. Carditis
C. Chorea
D. Erythema nodosum
E. Subcutaneous nodules
***) John's major criteria in rheumatic fever include all of the following, except:
A. Carditis
B. Chorea
C. Arthritis
D. Rheumatic nodules
E. Erythema multiforme
***) All of the following drugs are used on the treatment of rheumatoid fever, except:
A. Penicillin
B. Erythromycin
C. Aspirin
D. Prednisone
E. Copper
Answer: E* Copper
Answer: B* Hepatomegaly
***) All of the following are recognized finding in infective endocarditis, except:
A. Hematuria
B. Changing murmur
C. Koilonychia
D. Osler's node
E. Splenomegaly
Answer: C* Koilonychia
***) Clinical features of subacute bacterial endocarditis (SBE) may include all of the following,
except:
A. Anemia
B. Splenomegaly
C. Low grade fever
D. General weakness
E. Anorexia
***) The following physical signs can be found on examination of the hands of a patient with
infective endocarditis, except:
A. Erythema marginatum
B. Osler's nodules
C. Splinter hemorrhage
D. Clubbing of the fingers
E. Janeway lesion
Answer: E* Hyperthyroidism
***) In acute cardiac tamponade all of the following are true, except:
A. It may occur after injuries or cardiac surgery
B. It produces a shock-like state
C. The cardiac dullness is enlarged
D. Jugular venous pressure is lowered with collapse of neck veins
E. Immediate relief by aspiration or exploration must be done
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Respirology OXF.
I. Common Respiratory Presentations.
1. Clubbing.
***) All of the following are the causes of clubbing of fingers, except:
A. Subacute bacterial endocarditis
B. Pulmonary abscess
C. Emphysema
D. Hepatic cirrhosis
E. Ulcerative colitis
Answer: C* Emphysema
***) All of the following are the causes of clubbing of fingers, except:
A. Bronchiectasis
B. Crohn's disease
C. Pulmonary embolism
D. Infective endocarditis
E. Fibrosing alveolitis
***) All of the following are the causes of clubbing of fingers, except:
A. Bronchogenic carcinoma
B. Rheumatoid arthritis
C. Tetralogy of Fallot
D. Lung fibrosis
E. Mesothelioma
Answer: C* COPD
2. Hemoptysis.
***) Hemoptysis is commonly associated with all of the following, except:
A. Bronchiectasis
B. Bronchial carcinoma
C. Uncomplicated bronchial asthma
D. Mitral stenosis
E. Pulmonary infarction
***) All of the following diseases are well known causes of massive hemoptysis, except:
A. Tuberculosis
B. Bronchiectasis
C. Idiopathic pulmonary fibrosis
D. Acute pneumonia
E. Mitral stenosis
2. Chest X-Rays.
***) Regarding chest X-Ray all are true except:
A. Routine CXR is done in A-p view with full inspiration
B. Right done of diaphragm is seen at the level of 6th anterior rib
C. Visceral pleura cover the lung
D. Right hilum is usually lower than the left
E. Pneumothorax appears radiolucent
Answer: A* Routine CXR is done in A-p view with full inspiration
Answer: C* 75 – 97 %
***) All of the following conditions may cause aspiration pneumonia, except:
A. Gastroesophageal reflux
B. Achalasia
C. Phrenic nerve palsy
D. Werdnig-Hoffman disease
E. Tracheo-esophageal fistula
***) Clinical signs consistent with lobar pneumonia include all the following, except:
A. Reduced chest movement
B. Whispering pectoriloquy
C. Pleural rub
D. Deviation of the trachea
E. Bronchial breathing
Answer: B* Empyema
Answer: E* Primary
3. Bronchiectasis.
***) Any of the following may be commonly found in patients with bronchiectasis, except:
A. Clubbing of fingers
B. Lung crepitations
C. Absence of sputum
D. Hemoptysis
E. Pulmonary hypertension
5. Lung Tumors.
***) The commonest symptom of bronchial carcinoma is:
A. Cough
B. Chest pain
C. Cough and pain
D. Coughing blood
E. Weight loss
Answer: A* Cough
6. Asthma.
***) One of the following differentiates the asthma from COPD: Q2012
A. Hyperreactive airways
B. Variability
C. Wheezes
D. Hyperinflation
E. Cough
Answer: B* Variability
***) All of the following are signs of severe asthma, except: Q2012
A. Silent chest
B. Low PO2
C. Loud wheezy chest
D. Pulsus paradoxus
E. Cyanosis
***) All of the following are found in patient with bronchial asthma, except: Q2012
A. Hyperinflated chest
B. Wheezing
C. Dyspnea
D. Clubbing
E. Cough
Answer: D* Clubbing
***) All of the following are components of airway obstruction in asthma, except:
A. Mucous plugging
B. Laryngospasm
C. Inflammation of airways
D. Bronchospasm
E. Edema of airways
Answer: B* Laryngospasm
***) All the following are typical components of bronchial asthma, except:
A. Bronchospasm
B. Stridor
C. Edema of airways
D. Mucus production
E. Feeling of suffocation
Answer: B* Stridor
***) Acute asthmatic attack may be precipitated by all of the following, except:
A. Exercise
B. Sudden change of air temperature
C. Infection
D. Paracetamol injection
E. Crying
Answer: E* Crying
Answer: A* Cough
***) Typical attack of bronchial asthma consists of each of the following, except:
A. Marked dyspnea
B. Attacks of cough
C. Expiratory wheezes
D. Bradycardia
E. Restlessness
Answer: D* Bradycardia
7. Management of Asthma.
***) The following are useful in the treatment of a severe asthmatic attack, except:
A. IV Aminophyllin
B. Intravenous hydrocortisone
C. Sodium cromoglycate
D. Oxygen
E. Inhaled Salbutamol
***) All of the following medications can be used in first step in the management of bronchial
asthma as a reliever therapy, except:
A. Salbutamol
B. Salmeterol
C. Beclomethasone
D. Fluticasone
E. Leukotriene antagonist
***) All of the following drugs could be used in controlling acute attacks of bronchial asthma,
except:
A. Aminophyllin
B. Ketotifen (Zaditen)
C. Adrenaline
D. Salbutamol
E. Corticosteroids
***) Substances thought to normally mediate the bronchospasm in asthma include all of the
following, except:
A. Prostaglandines
B. Histamine
C. Slow reacting substance of anaphylaxis
D. Sodium cromoglycate
E. Eosinophilic chemotactic factor of anaphylaxis
Answer: B* Emphysema
***) All of the following complications of chronic obstructive pulmonary disease, except:
A. Cor pulmonale
B. Polycythemia
C. Respiratory failure
D. Left ventricle failure
E. Bronchogenic carcinoma
9. Respiratory Failure.
***) Blood gas analysis in type 1 respiratory failure shows: Q2012
A. High PCO2 and normal PO2
B. Low PCO2 and normal PO2
C. Normal PCO2 and high PO2
D. High PCO2 and low PO2
E. Normal PCO2 and low PO2
***) The usual causes of low arterial oxygen tension (PaO2) include all of the following, except:
A. Right to left shunt
B. Ventilation perfusion mismatch
C. Impaired diffusion capacity
D. Hyperventilation
E. Hypoventilation
Answer: D* Hyperventilation
Answer: C* Dyspnea
***) All of the following clinical findings are seen in patients with pulmonary embolism, except:
A. Hypoxia
B. Right heart failure
C. Cyanosis
D. Deep vein thrombosis
E. Bradycardia
Answer: E* Bradycardia
***) All of the following are clinical evidence of pulmonary embolism, except:
A. Hypoxia
B. Pleural friction rub
C. Hypercapnia
D. Right ventricular failure
E. Deep venous thrombosis
Answer: C* Hypercapnia
11. Pneumothorax.
***) A 3 years old boy with staphylococcal pneumonia suddenly develops increasing respiratory
distress. The possible diagnosis requiring urgent action is:
A. Pneumatocele formation
B. Pleural effusion
C. Tension pneumothorax
D. Progression of pneumonia
E. Lung abscess formation
***) In patient who is receiving assisted ventilation with positive end expiratory pressure
(PEEP). The sudden occurrence of hypotension most likely caused by:
A. Hypovolemia
B. Acute congestive cardiac failure
C. Haemothorax
D. Massive atelectasis
E. Tension pneumothorax
Answer: E* Empyema
***) An exudative pleural effusion may be due to all of the following, except:
A. Pulmonary tuberculosis
B. Congestive cardiac failure
C. Bronchogenic carcinoma
D. Acute pancreatitis
E. Mesothelioma
***) One of the following is aspirated from the pleural cavity in chylothorax:
A. Fresh blood
B. Lymph
C. Serous fluid
D. Saliva
E. Bile
Answer: B* Lymph
13. Sarcoidosis.
***) 40 years old woman presented with 2 months history of dry cough, nasal blockage, low
grade fever, the CXR showed enlarged both right and left hilum. All of the following are in favor
of the sarcoidosis diagnosis, except: Q2012
A. Presence of right paratracheal lymphadenopathy
B. Increased lymphocytes by bronchoscopic bronchioalveolar lavage
C. Disappearance of the radiological findings after 3 months without treatment
D. Presence of deforming arthritis
E. Negative PPD test
Answer: A* Hypocalcemia
Answer: E* Acute silicosis is usually fatal within a year of the first appearance of symptoms
***) Features of the Pickwickian syndrome may include all of the following, except:
A. Obesity
B. Somnolence
C. Hypocapnia
D. Polycythemia
E. Hypoxia
Answer: C* Hypocapnia
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Endocrinology OXF.
I. Common Endocrine Presentations.
1. Obesity.
***) All of the following disorders occur with greater frequency in obese people, except:
A. Degenerative joint disease
B. Hypertension
C. Psychosocial disability
D. Anemia
E. Thromboembolic disorder
Answer: D* Anemia
***) Obese persons are at increased risk for all of the following, except:
A. Cholelithiasis
B. Diabetes mellitus
C. Hypothyroidism
D. Hypertension
E. Hypertriglyceridemia
Answer: C* Hypothyroidism
Answer: A* Below 7%
***) The following are true in diabetes mellitus type 1, except: Q2012
A. It starts usually below 30 years old age
B. Absolute insulin deficiency
C. Sulfonyl Urca drugs are contraindicated
D. Anti-GAD antibodies are usually positive
E. Develops hyperosmolar hyperglycemic coma without insulin
***) The following are more in favor of type I diabetes mellitus than type II, except:
A. Association with ketoacidosis
B. Association with HLA-DR3 or HLA-DR4
C. Strong family history of diabetes
D. Present of islet cell antibodies
E. Abrupt onset of signs and symptoms
Answer: E* Insulinoma
Answer: D* Insulinoma
Answer: D* Chlorpromazine
***) There is an association between the use of biguanide oral hypoglycemia agent metformin
(Glucophage) and the development of:
A. Lactic acidosis
B. Respiratory acidosis
C. Metabolic acidosis with normal anion gap
D. Metabolic alkalosis
E. Marked respiratory alkalosis
Answer: E* Regular
***) 63 years old woman with DM type 2, which is small controlled. Her physical examination
is positive for peripheral neuropathy in the feet and non proliferative retinopathy. Urinalysis is
positive for proteinuria. One of the following treatments is positive for attenuate the course of
renal disease: Q2012
A. Beta blockers
B. ACE inhibitors
C. HMG-CoA
D. Dietary carbohydrate restriction
E. Weight reduction
Answer: A* Macroglossia
Answer: C* Alopecia
***) The following gastrointestinal manifestations can be related to diabetes mellitus, except:
A. Constipation
B. Diarrhea
C. Fecal incontinence
D. Duodenal ulcer
E. Gastric atonia
***) Neuropathic (Charcot) joints may be seen in all of the following, except:
A. Diabetes mellitus
B. Syringomyelia
C. Leprosy
D. Tabes dorsalis
E. Huntington chorea
***) 55 years old male presented with DKA (diabetes type 2), ABGs showed pH 7.05, HCO3 12,
K 3.1. The best treatment is: Q2012
A. Fluids, insulin, K, HCO3
B. Fluids, insulin, K
C. Fluids, insulin, HCO3
D. Insulin only
E. Fluids, K, HCO3
Answer: C* Sweating
5. Hypoglycemia.
***) Causes of hypoglycemia include all of the following, except:
A. Insulinoma
B. Hypoadrenalism
C. Paracetamol overdose
D. Alcohol
E. Thiazide diuretics
6. Insulinoma.
***) 30 years old female nurse presented with decreased level of consciousness, labs showed
increased insulin, glucose 30, increased C peptide and negative sulphonylurea. The most likely
cause is: Q2012
A. Exogenous insulin
B. Insulinoma
C. MEN 1
D. MEN 2
E. Hypoglycemia
Answer: B* Insulinoma
Answer: B* Iodine
***) Which of the following laboratory tests is the most sensitive indicator of primary
hypothyroidism:
A. T4
B. T3 resin uptake
C. T3 by RIA (radioimmunoassay)
D. TSH (thyroid-stimulating hormone)
E. Radioiodine uptake
3. Thyrotoxicosis.
***) All of the following are manifestations of hyperthyroidism, except: Q2012
A. Loss appetite
B. Preference for cold
C. Excessive warm sweating
D. Palpitation
E. Nervousness
***) A 28 years old obese auxiliary nurse admitted with chest tightness and palpitation, her pulse
was 105 regular, T3 and T4 levels were normal and TSH was 0.03 (normal range 0.4-4.1 mlU/l),
and the thyroglobulin level was suppressed as well as thyroid uptake. The most likely diagnosis
is:
A. Graves’s disease
B. Toxic multinodular goiter
C. DeQuervin thyroiditis
D. Factitious thyrotoxicosis
E. Plummer disease
***) All of the following about Grave's disease (thyrotoxicosis) are true, except:
A. Cause lid lag
B. TSH is high
C. Pretibial myxedema is a feature
D. Causes exophthalmus
E. Myopathy may occur
***) All of the following about Grave's disease (thyrotoxicosis) are true, except:
A. Pretibial myxedema
B. Myopathy
C. Atrial fibrillation
D. Oligomenorrhea
E. Aortic incompetence
***) All of the following about Grave's disease (thyrotoxicosis) are true, except:
A. Tremor of both hands
B. Carpopedal spasm
C. Pretibial myxedema
D. Tachycardia
E. Lid retraction
***) All of the following may be used in the treatment of thyrotoxicosis, except:
A. Neomercazole
B. Radio-active iodine
C. Surgery
D. Propranolol inderal
E. Cyclophosphamide
Answer: E* Cyclophosphamide
***) All of the following may be used in the treatment of thyrotoxicosis, except:
A. Radioactive iodine
B. Carbimazole
C. Potassium perchlorate
D. Cyclophosphamide
E. Propranolol
Answer: D* Cyclophosphamide
4. Thyroid Storm.
***) Thyroid storm can present with all the following except: Q2012
A. Fever
B. Coma
C. Heart failure
D. High T3, T4
E. Bradycardia
Answer: E* Bradycardia
5. Hypothyroidism.
***) All of the following are features of myxedema, except:
A. Hoarseness of voice
B. Pretibial myxedema
C. Pleural effusion
D. Menorrhagia
E. Deafness
Answer: C* Clonus
Answer: E* Polycythemia
***) All of the following are clinical features of hypothyroiditis, except:
A. Deafness
B. Loss of weight
C. Dry skin
D. Slow-relaxing reflexes
E. Carpal tunnel syndrome
Answer: C* Hypocalcemia
2. Hypoparathyroidism.
***) 35 years old female presented with bone pain and generalized weakness. Labs show
decreased PTH, decreased Ca, and normal Vitamin D. The most likely diagnosis is: Q2012
A. 1-alpha-hydroxylase deficiency
B. Hypoparathyroidism
C. Vitamin D deficiency
D. Vitamin C deficiency
E. Vitamin B12 deficiency
Answer: B* Hypoparathyroidism
V. Adrenal Gland.
1. Adrenal Cortex & Cushing's syndrome.
***) Cushing's syndrome is a recognized cause of all of the following, except:
A. Hypertension
B. Hirsutism
C. Osteomalacia
D. Obesity
E. Hyperglycemia
Answer: C* Osteomalacia
***) Features of Cushing's syndrome include all of the following, except:
A. Hypertension
B. Psychiatric symptoms
C. Diabetes mellitus
D. Tall stature in children
E. Hypokalemia
Answer: E* Hyperkalemia
Answer: D* Hyperkalemia
Answer: B* Hypokalemia
***) The following about chronic adrenocortical insufficiency (Addison's disease) are true,
except:
A. Causes increased skin pigmentation
B. Plasma ACTH is low
C. Causes small heart
D. May be secondary to tuberculosis
E. Vitiligo is recognized association
Answer: D* Hypertension
3. Hyperaldosteronism.
***) A patient with an aldosterone-secreting tumor is likely exhibiting all of the following signs
and symptoms, except:
A. Hypertension
B. Alkalosis
C. Edema
D. Hypokalemia
E. Low plasma renin activity
Answer: C* Edema
4. Pheochromocytoma.
***) One of the following would be unexpected finding in a patient with pheochromocytoma:
A. Paroxysmal hypertension
B. Persistent hypertension
C. Excessive sweating
D. Bilateral tumor in 50% of cases
E. Palpitation
***) Which one of the following tumors is associated with paroxysmal hypertension:
A. Pheochromocytoma
B. Carcinoid tumor
C. Gastrinoma
D. Hepatoma
E. Seminoma
Answer: A* Pheochromocytoma
5. Gynecomastia.
***) Which of the following is the most common cause of gynecomastia:
A. Liver failure
B. Physiologic
C. Hyperparathyroidism
D. Tumors
E. Idiopathic
Answer: B* Physiologic
Answer: E* Hyperparathyroidism
Answer: E* Glibenclamide
Answer: D* Hydrochlorothiazide
Answer: B* Furosemide
***) Which one of the following hormones does the anterior pituitary secrete:
A. Vasopressin
B. Oxytocin
C. Growth hormone
D. Insulin
E. Calcitonin
***) The anterior pituitary produces all of the following hormones, except:
A. ADH (Antidiuretic Hormone)
B. LH (Luteinizing Hormone)
C. Prolactin
D. TSH (Thyroid Stimulating Hormone)
E. FSH (Follicular Stimulating Hormone)
***) All the following hormones are increased with stress except:
A. ACTH
B. GH
C. TSH
D. Insulin
E. Glucagon
Answer: B* GH
2. Hypopituitarism.
***) All of the following are clinical features of panhypopituitarism, except: Q2012
A. Hyperpigmentation
B. Hypotension
C. Cold intolerance
D. Loss of secondary sexual characteristics
E. Infertility
Answer: A* Hyperpigmentation
***) In Sheehan's syndrome the patient may present with all of the following, except:
A. Hypoglycemia
B. Hyperpigmentation
C. Infertility
D. Hypotension
E. Hair loss
Answer: B* Hyperpigmentation
***) A 25 years old woman suffers a severe intra-partum haemorrhage. One of the following
symptoms is evidence of pituitary infarction:
A. Infrequent urination
B. Diarrhea
C. Easy bruising
D. Lactation failure
E. Constipation
3. Hyperprolactinemia.
***) Elevated prolactin levels are expected in all the following, except:
A. Pregnancy
B. Hypothyroidism
C. Pituitary adenoma
D. Phenothiazine use
E. Ectopic pregnancy
4. Acromegaly.
***) All of the following are clinical features of acromegaly, except:
A. Headache
B. Excessive sweating
C. Muscular weakness
D. Large tongue
E. Loss of hair
5. Diabetes Insipidus.
***) Patients with diabetes insipidus do not usually exhibit:
A. Polydipsia
B. Polyuria
C. Urine specific gravity of less than 1.008
D. Papilledema, optic atrophy and nystagmus
E. Hypernatremia
Gastroenterology OXF.
I. Common GI Presentations.
1. The Mouth.
***) Leukoplakia refers to:
A. A microscopic lesion
B. Atrophy
C. A cancer
D. A white patch
E. An ulcer
Answer: A* Sarcoidosis
Answer: B* Hepatosplenomegaly
2. Dysphagia.
***) Dysphagia may occur in all of the following, except:
A. Carcinoma of esophagus
B. Systemic sclerosis
C. Achalasia
D. Candida esophagitis
E. Ulcerative colitis
3. Esophageal Scleroderma.
***) The manometric studies in scleroderma patient with esophageal involvement shows: Q2012
A. Absence peristalsis, decreased LES tone
B. Absence peristalsis, increased LES tone
C. Positive peristalsis, decreased LES tone
D. Positive peristalsis, increased LES tone
E. None of above
4. Achalasia.
***) Concerning achalasia of the esophagus all of the following are true, except:
A. It occurs more in women about forty years of age
B. There is progressive dysphagia but with periods of remissions and relapses
C. Regurgitation and aspiration pneumonia are common
D. Barium swallow shows dilatation of the esophagus above a smoothie narrowed lower end
E. Treatment of choice is by giving antispasmodics and antibiotics
6. Vomiting.
***) All of the following are causes of vomiting, except:
A. Raised intracranial pressure
B. Uncomplicated duodenal ulcer
C. Diabetic ketoacidosis
D. Hypercalcemia
E. Digitalis intoxication
8. Diarrhea.
***) Diarrhea may occur with all of the following, except:
A. Crohn's disease
B. Diabetes mellitus
C. Sarcoidosis
D. Thyrotoxicosis
E. Lincomycin intake
Answer: C* Sarcoidosis
Answer: E* Hypothyroidism
Answer: B* Hyperparathyroidism
Answer: B* Cholera
***) A 25 years old man who just arrived from a trip overseas, complains of bloody diarrhea for
few days. The least likely cause is:
A. Giardiasis
B. Shigella enteritis
C. Amoebic dysentery
D. Campylobacter infection
E. Ulcerative colitis
Answer: A* Giardiasis
***) The most appropriate intervention to prevent dehydration in patients with watery diarrhea
is:
A. Limit oral intake
B. Intravenous saline
C. Oral rehydration salt (ORS) solution
D. Antimotility agents
E. Antibacterial agents
9. GI Bleeding.
***) 50 years old male presented with massive hematemesis and found to have splenomegaly,
clubbing and palmar erythema. You must think of bleeding from: Q2012
A. Mallory-Weiss tear
B. Esophageal varices
C. Duodenal ulcer
D. Gastric ulcer
E. Erosive gastritis
***) Hematemesis and melena may be caused by all of the following, except:
A. Gastric carcinoma
B. Gastric ulcer
C. Mallory-Weiss syndrome
D. Duodenal ulcer
E. Hypothyroidism
Answer: E* Hypothyroidism
***) Hematemesis and melena in a patient with liver cirrhosis is likely to be due to all of the
following, except:
A. Gastric ulcer
B. Hepatoma
C. Bleeding esophagus varices
D. Duodenal ulcer
E. Abnormal clotting mechanism
Answer: B* Hepatoma
***) Which of the following is considered as a poor prognostic indicator in upper gastrointestinal
bleeding:
A. A presentation of melena rather than hematemesis
B. Young age
C. Chronic rather than acute ulcer
D. Duodenal rather than gastric ulcer
E. Female sex
Answer: D* Duodenal rather than gastric ulcer
Answer: B* Mg trisilicate
Answer: E* Hemorrhoids
***) In acute bleeding from esophageal varices after resuscitation, the treatment of choice is:
A. Intra-arterial vasopressin
B. Balloon tamponade
C. Endoscopic sclerotherapy
D. Portocaval shunt
E. Gastroesophageal devascularization
Answer: C* Clubbing
2. Barrett's Esophagus.
***) With regard to Barrett's syndrome esophagus, all are true except:
A. Occurs when columnar metaplasia epithelium replaced the normal squamous epithelium
B. Associated with increased risk of developing esophageal SCC
C. Esophagectomy is warranted if high grade dysplasia is found
D. Operative therapy prevents further progression of the disease
E. It is found in around 10% of patients with long standing GERD
3. Gastritis.
***) Acute erosive gastritis is best diagnosed by:
A. History
B. Gastric analysis
C. Endoscopy
D. Double-contrast upper GI
E. Capsule biopsy
Answer: C* Endoscopy
Answer: C* Pylorus
4. Zollinger-Ellison Syndrome.
***) The most common site of origin of the tumor associated with the Zollinger-Ellison
syndrome is:
A. Stomach
B. Duodenum
C. Lymph node
D. Spleen
E. Pancreas
Answer: E* Pancreas
5. Peptic Ulcer Disease PUD.
***) Helicobacter pylori can lead to all the following except: Q2012
A. MALT lymphoma
B. Gastric ulcers
C. Duodenal ulcers
D. Gastric cancer
E. GERD
Answer: E* GERD
***) All of the following about peptic ulcer diseases are true, except:
A. Helicobacter pylori is important factor
B. Duodenal ulcer may become malignant
C. Omeprazole is helpful in treatment
D. Zollinger-Ellison is a recognized cause
E. Relapse may occur
***) All of the following have been associated with chronic duodenal ulcer, except:
A. Hyperparathyroidism
B. Zollinger-Ellison syndrome
C. Chronic pulmonary insufficiency
D. Smoking
E. Pernicious anemia
***) All of the following drugs are used in the treatment of duodenal ulcer, except:
A. Sucralfate
B. Calcium antagonists
C. Bismuth
D. Pirazepine
E. H2-receptors antagonists
***) The following drugs are used in the management of peptic ulcer disease, except:
A. Famotidine
B. Sucralfate
C. Omeprazole
D. Anticholinergic drugs
E. Salazopyrin
Answer: E* Salazopyrin
***) The following drugs are used in the management of peptic ulcer disease, except:
A. Ranitidine
B. Cimetidine
C. Famotidine
D. Omeprazole
E. Mebendazole
Answer: E* Mebendazole
***) All the following drugs are used for H. pylori eradication, except: Q2012
A. Tetracycline
B. Metronidazole
C. Clarithromycin
D. Amoxicillin
E. Ciprofloxacin
Answer: E* Ciprofloxacin
***) All the following are risk factors to develop gastric ulcer except:
A. Increased fiber in diet
B. NSAIDs
C. Stress
D. Smoking
E. Alcohol
***) The most common pathophysiologic mechanism of duodenal ulcer is primarily related to:
A. Gastric acid hypersecretion
B. Hypergastrinemia
C. Deficient duodenal buffers
D. Rapid gastric emptying
E. Hyperpepsinogen secretion
***) Concerning Crohn's disease, all the following are true, except:
A. It is a chronic transmural granulomatous inflammation
B. It involves the terminal ileum only
C. It commonly presents an abdominal mass, bloody diarrhea and anemia
D. Internal fistula is common
E. Commonly associated with perianal suppuration
***) Systemic complications of ulcerative colitis include all of the following, except:
A. Ankylosing spondylitis
B. Sclerosing cholangitis
C. Keratoderma blenorrhagica
D. Episcleritis
E. Pericarditis
***) Recognized complications of ulcerative colitis include all of the following, except:
A. Cholangitis
B. Arthropathy
C. Toxic megacolon
D. Increased incidence of carcinoma of colon
E. Erythema marginatum
***) All of the following symptoms are associated with ulcerative colitis, except:
A. Heartburn
B. Bloody diarrhea
C. Abdominal pain
D. Fatigue
E. Weight loss and anemia
Answer: A* Heartburn
***) All of the following investigations are beneficial in the diagnosis of ulcerative colitis,
except:
A. Stool studies
B. Upper endoscopy
C. Colonoscopy
D. Abdominal X-Ray
E. Serologic studies (ANCA)
***) All of the following complications are associated with ulcerative colitis, except:
A. Pyoderma gangrenosum
B. Uveitis
C. Primary sclerosing cholangitis
D. Vitamin B12 deficiency
E. Renal stones
***) Cigarette smoking is a risk factor for all of the following, except:
A. Emphysema
B. Peripheral vascular disease
C. Ischemic heart disease
D. Ulcerative colitis
E. Cancer of bladder
***) 70 years old male presented abdominal pain; on examination he has irregularly irregular
pulse and bloody diarrhea. He gives history of CVA, peripheral vascular disease and MI. You
must think of: Q2012
A. Ulcerative colitis
B. Pancreatitis
C. Inferior MI
D. Acute mesenteric ischemia
E. Diverticulitis
Answer: D* Lactulose
***) The following can precipitate hepatic encephalopathy in a patient with liver cirrhosis,
except:
A. Infection
B. High carbohydrate diet
C. Gastrointestinal bleeding
D. Hypokalemia
E. Sedation
***) Hepatic encephalopathy in a cirrhotic patient may be precipitated by all of the following,
except:
A. Use of diuretics
B. Constipation
C. Narcotics
D. Neomycin
E. Paracentesis
Answer: D* Neomycin
***) All of the following are factors precipitating portosystemic encephalopathy, except:
A. Diarrhea
B. Infection
C. Diuretic therapy
D. Narcosis
E. Shunt operations
Answer: A* Diarrhea
***) Hepatic encephalopathy in cirrhosis is typically precipitated by all the following, except:
A. Infection
B. Hypokalemia
C. Gastrointestinal bleeding
D. Lactulose therapy
E. Abdominal surgery
2. Cirrhosis.
***) All of the following can cause liver cirrhosis, except:
A. Hemochromatosis
B. Hepatitis B, C
C. Budd-Chiary syndrome
D. Hepatitis A
E. Biliary cirrhosis
Answer: D* Hepatitis A
***) All of the following are signs of chronic liver disease, except:
A. Parotid gland enlargement
B. Increase of body hair
C. Spider Naeyia
D. Gynecomastia
E. Palmar erythema
3. Hemochromatosis.
***) A 35 years old male comes for evaluation of abdominal discomfort, tiredness and arthralgia.
The examination reveals slate-grey skin pigmentation, hepatomegaly and hypogonadism.
Random blood sugar is 250mg/dl. The most likely diagnosis is:
A. Cirrhosis
B. Wilson disease
C. Hemochromatosis
D. SLE
E. Chronic pancreatitis
Answer: C* Hemochromatosis
4. Autoimmune Hepatitis.
***) 30 years old female (DM type 1) presented with jaundice, labs show increased in ALT,
AST, positive ANA, ASMA, negative antimitochondrial antibodies and normal alkaline
phosphatase. The most likely diagnosis is: Q2012
A. Primary biliary cirrhosis
B. Primary sclerosing cholangitis
C. Viral hepatitis
D. Autoimmune hepatitis
E. Hepatocellular carcinoma
5. Wilson's disease.
***) Wilson disease is a disorder of plasma protein of one of the following elements:
A. Iron
B. Cobalt
C. Zinc
D. Copper
E. Magnesium
Answer: D* Copper
6. Jaundice.
***) Causes of conjugated hyperbilirubinemia include: Q2012
A. Crigler Najar syndrome type 1
B. Gilbert's syndrome
C. Hemolysis
D. Dubin-Johnson syndrome
E. Carotenemia
Answer: B* Albumin
***) All of the following are manifestations with indirect hyperbilirubinemia, except:
A. Gilbert's syndrome
B. Dubin Johnson syndrome
C. Crigler Najar syndrome
D. ABO incompatibility
E. Physiologic neonatal jaundice
***) Direct hyperbilirubinemia may be associated with all the following except:
A. Hemolysis
B. Periampullary neoplasm
C. Common bile duct stricture
D. CA head of pancreas
E. Stone in common bile duct
Answer: A* Hemolysis
Answer: C* Fever
***) The disease characterized by the three symptoms: diarrhea, dementia, and dermatitis are
caused by:
A. Ariboflavinosis
B. Beriberi
C. Scurvy
D. Pellagra
E. Kwashiorkor
Answer: D* Pellagra
2. GI Malabsorption.
***) One of the following is not dependent on bile salts for its absorption: Q2012
A. Vitamins A
B. Vitamin B
C. Vitamin K
D. Vitamin D
E. Vitamin E
Answer: B* Vitamin B
***) Young female presented with leg pain, gum bleeding and Ecchymosis. The most
appropriate vitamin deficiency is: Q2012
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin D
E. Vitamin E
Answer: C* Vitamin C
***) Iron is absorbed at: Q2012
A. Stomach
B. Duodenum & Jejunum
C. Ileum
D. Colon
E. Descending colon
Answer: E* Cholecyctitis
Answer: C* Ileum
Answer: A* Jejunum
***) Concerning hypovitaminosis all of the following statements are correct, except:
A. Vitamin A deficiency leads to xerophthalmia
B. Vitamin Bl (thiamine) deficiency leads to beriberi
C. Vitamin C deficiency leads to scurvy
D. Vitamin K deficiency leads to bleeding
E. Vitamin B12 deficiency leads to microcytic anemia
***) All of the following statements concerning bile acid are true, except:
A. It is degradation product of old RBC
B. It is essential for digestion and absorption of fat and fat soluble-vitamins
C. It stimulates peristaltic movements
D. It has antiseptic action
E. It is absorbed mostly in the terminal ileum
***) The terminal ileum is the absorptive site for which of the following:
A. Glucose
B. Folic acid
C. Bile salts
D. Xylose
E. Iron
***) Diseased or surgically resected terminal ileum will significantly reduce the absorption of
one of the following:
A. Iron
B. Bile salts
C. Folic acid
D. Vitamin
E. Calcium
***) Which of the following has the greatest effect on enhancing calcium absorption from the
gastrointestinal tract:
A. 25-hydroxycholecalciferol
B. 24,25-dihydrocholecalciferol
C. 1.25-dihydrocholecalciferol
D. Parathyroid hormone
E. Calcitonin
Answer: C*1.25-dihydrocholecalciferol
V. Toxicology.
1. Acute Poisoning.
***) Induction of vomiting is contraindication in patients poisoned with:
A. Kerosene
B. Paint
C. Wax
D. Floor polish
E. All of above
***) Glue sniffers are liable to show the following clinical features, except:
A. Euphoria
B. Dizziness
C. Headache
D. Ataxia
E. Major epileptic fits
***) All of the following are well recognized complications of heroin addiction, except:
A. Viral hepatitis
B. Bacterial endocarditis
C. Tetanus
D. Acute sinusitis
E. Thrombophlebitis
Answer: B* Mercury
2. Organophosphate Poisoning.
***) Organophosphate poisoning can manifest by all of the following, except:
A. Pulmonary edema
B. Constipation
C. Bradycardia
D. Convulsions
E. Muscular weakness
Answer: B* Constipation
Answer: A* Tachycardia
***) The dose of atropine that should be given in case of organophosphorus compounds
poisoning is:
A. Atropine 1 mg
B. Atropine 2-4 mg
C. Atropine 1 ampoule
D. Atropine should be administered until full atropinization occur
E. Atropine should be administered until cyanosis disappear
Answer: C* Atropine should be administered until tachycardia, flushing and dry mouth occur
***) A 20 years old farmer was found in a semi comatose state with constricted pupils and frothy
sputum. One of the following should be considered as first line of treatment:
A. Verapamil
B. Diazepam
C. Atropine
D. Morphine
E. Dexamethasone
Answer: D* Atropine
Answer: E* Hypothermia
***) Ingestion of plants which contain atropine alkaloids (like Datura) can produce all of the
following symptoms, except:
A. Hallucinations
B. Flushing of the skin
C. Tachycardia
D. Pin point pupils
E. Dry mouth
3. Salicylate Poisoning.
***) In salicylates poisoning all are true, except:
A. Hyperpnoea is the most frequent sign
B. A ferric chloride test on urine is positive
C. Plasma salicylate concentration is not value in assessing of the poisoning severity
D. Sodium bicarbonate IV can clearly increase the urinary excretion of salicylates
E. In an alert patient vomiting should be increased to prevent continued salicylate absorption
Answer: C* Plasma salicylate concentration is not value in assessing of the poisoning severity
4. Paracetamol Poisoning.
***) All the following about paracetamol poisoning are true, except: Q2012
A. Metabolic acidosis
B. Hypoglycemia
C. Bronchospasm
D. Hepatic failure
E. Acute renal tubular necrosis
Answer: C* Bronchospasm
Answer: D* Acetylcysteine
***) All the following about paracetamol poisoning are true, except:
A. The clinical features in the first 3-4 hrs are nausea and vomiting
B. Acute liver failure occurs after 3-4 days
C. Death may occur after ingestion of 25 grams of paracetamol
D. Naloxone is the treatment of choice
E. Prothrombin time is the best guide to the severity of liver damage
5. Lead Poisoning.
***) Toxicity of lead:
A. Mainly in children
B. An occupational hazard in liquid batteries manufacturers
C. Affect the inelegancy
D. Can cause anemia
E. All of the above
***) All of the following are clinical features of lead poisoning, except:
A. Anorexia and vomiting
B. Anemia
C. Diarrhea
D. Wrist and foot drop
E. Encephalopathy
Answer: C* Diarrhea
***) All of the following are the features of chronic lead poisoning, except:
A. Anemia
B. Attacks of abdominal colic
C. Emphysema
D. Constipation
E. Arthralgia
Answer: C* Emphysema
***) Chronic lead poisoning in children may cause all the following, except:
A. Mental retardation
B. Seizure disorders
C. Aggressive behavior disorders
D. Diarrhea
E. Chronic abdominal pain
Answer: D* Diarrhea
******************************************************************************
Nephrology OXF.
I. Common Renal Presentations.
1. Polyuria.
***) All of the following can cause polyuria, except: Q2012
A. Hyperglycemia
B. Diabetes insipidus
C. Hypothyroidism
D. Psychogenic
E. Hypercalcemia
Answer: C* Hypothyroidism
***) Polyuria and polydipsia can be due to all of the following, except:
A. Deficiency of arginine and vasopressin
B. Deficiency of insulin
C. Hypercalcemia
D. Hyperkalemia
E. Psychogenic causes
Answer: D* Hyperkalemia
Answer: E* Hyperkalemia
***) Thirst and polyuria may be caused by all of the following, except:
A. Hypercalcemia
B. Diabetes mellitus
C. Hypothyroidism
D. Diabetes insipidus
E. Hypokalemia
Answer: C* Hypothyroidism
Answer: D* Pregnancy
***) Hematuria either macroscopic or microscopic is found in all of the following, except:
A. Infective endocarditis
B. Papillary necrosis
C. Use of anticoagulants
D. Amyloidosis
E. Schistosoma haematobium infection
Answer: D* Amyloidosis
***) Recognized causes of macroscopic hematuria include all of the following, except:
A. Glomerulonephritis
B. Urinary tract infection
C. Accelerated hypertension
D. Exposure to cold
E. Renal cysts
***) Recognized causes of macroscopic hematuria include all of the following, except:
A. Glomerulonephritis
B. Renal cyst
C. Urinary tract infection
D. Renal calculus
E. Proximal tubular acidosis
***) All of the following can cause proteinuria in excess of 3 grams per 24 hours, except:
A. Membranous glomerulonephritis
B. Malignant hypertension
C. Diabetic nephropathy
D. Obstructive uropathy
E. Renal amyloidosis
***) The protein present in the greatest quantity in the urine of normal people is:
A. Albumin
B. Tamm-Horsfall protein
C. Gamma globulin
D. Amylase
E. Bence-Jones protein
Answer: A* Albumin
***) All of the following statements are correct about routine urine examination, except:
A. Specific gravity of 1015 is normal
B. Red blood cell cast is normal finding
C. One red blood cell is normal finding
D. One white blood cell is normal finding
E. Negative sugar is normal finding
***) The most definitive diagnosis for urinary tract infection is:
A. Presence of 10 000 bacteria per ml in urine culture
B. Presence of WBC in the urine
C. Presence of WBC and protein in the urine
D. Presence of 100 000 bacteria per ml in a properly collected urine by culture
E. Presence of pain in the right loin
Answer: D* Presence of 100 000 bacteria per ml in a properly collected urine by culture
***) Regarding urinary tract infection all of the following are true, except:
A. Frequency and foul smelling urine are presenting complaints
B. First morning specimen voided is not suitable for colony count
C. Fever
D. Abdominal pain
E. Nearly always causes pyuria
Answer: B* First morning specimen voided is not suitable for colony count
3. Glomerulonephritis.
***) Which of the following urinary findings is most characteristic of glomerulonephritis: Q2012
A. Hyaline cast
B. Granular cast
C. RBCs cast
D. WBCs cast
E. Epithelial cast
***) Which of the following urinary findings is most characteristic of acute glomerulonephritis:
A. Proteinuria
B. Microhematuria
C. Granular casts
D. Erythrocyte casts
E. Hyaline casts
Answer: A* Hypercholesterolemia
***) Acute glomerulonephritis may be associated with which one of the following:
A. Glycosuria
B. Elevated serum cholesterol
C. Elevated serum complement
D. Encephalopathy
E. Hypercalcemia
***) Complications of post streptococcal acute glomerulonephritis may include all of the
following, except:
A. Hyperkalemia
B. Hypernatremia
C. Encephalopathy
D. Pulmonary edema
E. Anuria
Answer: B* Hypernatremia
***) Which of the following is not associated with post streptococcal glomerulonephritis:
A. Hematuria
B. Fatty casts
C. Red blood cell casts
D. Edema
E. Oliguria
***) Manifestations of the nephritic syndrome include all of the following, except:
A. Oliguria
B. Hypertension
C. Pulmonary edema
D. Hematuria
E. Peripheral neuropathy
***) In which of the following diseases would you expect to find the nephritic syndrome:
A. Pyelonephritis
B. Acute glomerulonephritis
C. Urinary tract infection
D. Mild hypertension
E. Amyloidosis
4. Nephrotic Syndrome.
***) The nephrotic syndrome is characterized by all the following, except:
A. Edema
B. Proteinuria
C. Hypoalbuminemia
D. Hyperlipidemia
E. Hypertension
Answer: E* Hypertension
Answer: A* Hypocholesterolemia
***) All of the following can cause calcification in the renal tract, except:
A. Shistosomiasis
B. Hyperparathyroidism
C. Tuberculosis
D. Nephrotic syndrome
E. Hydatid cyst
***) The following are recognized causes of acute renal failure, except:
A. Goodpasture’s syndrome
B. Hemolytic uremic syndrome
C. Minimal change disease
D. Scleroderma crisis
E. Post infectious glomerulonephritis
***) Causes of acute renal failure include all the following except:
A. Severe dehydration
B. Severe burn
C. Uncomplicated urinary tract infection UTI
D. Severe hemorrhage
E. Hemolytic uremic syndrome
***) Complications of acute renal failure include each of the following, except:
A. Pulmonary edema
B. Hyperkalemia
C. Hypernatremia
D. Encephalopathy
E. Acidosis
Answer: C* Hypernatremia
***) A patient with acute renal insufficiency is likely to develop any of the following
disturbances, except:
A. Hypoalbuminemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
E. Hyperphosphatemia
Answer: D* Hypernatremia
Answer: D* Hypernatremia
***) One of the following is not an absolute indication for dialysis in chronic renal failure
patients: Q2012
A. Hyperkalemia
B. Hypercalcemia
C. Pulmonary edema
D. Metabolic acidosis
E. Pericarditis
Answer: B* Hypercalcemia
Answer: C* Diabetes
***) All of the following are complications of chronic renal failure, except:
A. Hyperkalemia
B. Alkalosis
C. Anemia
D. Hypertension
E. Renal osteodystrophy
Answer: B* Alkalosis
***) Complications of chronic renal failure include all of the following, except:
A. Peripheral neuropathy
B. Pericardial involvement
C. Hypercalcemia
D. Anemia
E. Proximal myopathy
Answer: D* Hypercalcemia
***) In chronic renal failure the serum concentration of the following substances is increased,
except:
A. Uric acid
B. Calcium
C. Urea
D. Creatinine
E. Phosphorus
Answer: B* Calcium
***) All of the following drugs are contraindicated in chronic renal failure, except:
A. Tetracycline
B. Nalidixic acid
C. Nitrofurantoin
D. Aspirin
E. Methyldopa
Answer: E* Methyldopa
Answer: D* Digoxin
***) In the polycystic disease of the kidney presenting in adulthood all of the following are true,
except:
A. It is inherited as an x-linked
B. It can cause hypertensive heart disease
C. It is associated with cysts of the liver and pancreas
D. It is associated with aneurysm of the circle of Wills
E. It commonly cause microscopic hematuria
******************************************************************************
***) ABGs showed pH 7.2, PCO2 23, HCO3 16, PO2 85. The acid base imbalance is: Q2012
A. Metabolic alkalosis and respiratory acidosis
B. Metabolic acidosis and respiratory alkalosis
C. Metabolic alkalosis and respiratory alkalosis
D. Normal ABG
E. Metabolic acidosis and respiratory acidosis
***) In a patient with metabolic acidosis, Serum bicarbonate 10, Sodium 130, Calcium 110,
Blood glucose 79, Urea 20, the anion gap in this patient is:
A. 5
B. 10
C. 15
D. 20
E. 25
Answer: B* 10
***) All of the following can cause metabolic acidosis with anion gap, except: Q2012
A. Renal failure
B. Diabetic ketoacidosis
C. Lactic acidosis
D. Aspirin overdose
E. Renal tubular acidosis
Answer: D* Vomiting
Answer: A* Acidosis
***) A 45 years old patient with severe nephritic syndrome is admitted with nausea, fever and
vomiting. BP is 90/50 mmHg, HR 110/m, RR 20/m, pH 7.05, PaCO2 32mmHg, Na 132mmol/L,
K 4.0mmol/L, Cl 103mmol/L, HCO3 17mmol/L, albumin 1.5g/dl, BUN 20mg/dl, Creatinine
1.4mg/dl. One of the following acid base disorders is present:
A. Anion gap metabolic acidosis
B. Non anion gap metabolic acidosis
C. Non anion gap metabolic acidosis and respiratory alkalosis
D. Anion and non anion gap metabolic acidosis
E. None of the above
3. Hypernatremia.
***) Hypernatremia is known to occur in which of the following: Q2012
A. Syndrome of Inappropriate ADH Secretion (SIADH)
B. Diabetes insipidus
C. Renal failure
D. Hypothyroidism
E. Addison's disease
Answer: A* Na – Sodium
***) All of the following are common clinical features in cases of severe hyperntremia, except:
A. Dry mucous membranes
B. Hypothermia
C. Delirium
D. Tachycardia
E. Hypotension
Answer: B* Hypothermia
4. Hyponatremia.
***) Hyponatremia can present with all the following except: Q2012
A. Restlessness
B. Headache
C. Increased appetite
D. Seizures
E. Weakness
***) All of the following statements are correct about hyponatremia, except:
A. Sodium serum level of 132mEq/L is considered hyponatremia
B. It can be a manifestation of adrenogenital syndrome
C. When correcting hyponatremia, body weight is important in calculating the deficit
D. Hyponatremia does not cause convulsions
E. It may associate with inappropriate antidiuretic hormone syndrome
***) Concerning hyponatremic dehydration all of the following are true, except:
A. Serum sodium is over 150mmol/L
B. Leads to intracellular dehydration
C. Neurological manifestations may be present
D. The skin is doughy
E. Best management is by rapid rehydration
Answer: D* SIADH
***) SIADH can present with all the following except: Q2012
A. Decreased serum osmolality
B. Decreased serum sodium
C. Increased urine sodium
D. Hyperkalemia
E. Increased urine osmolality
Answer: D* Hyperkalemia
***) Which of the following statements concerning clinical and laboratory findings in patients
with inappropriate secretion of antidiuretic hormone is correct:
A. High serum sodium
B. Low urine sodium
C. Low blood pressure
D. May lead to seizures
E. Evidence of dehydration
6. Hyperkalemia.
***) 50 years old male patient of DM, HTN, IHD, on the following medications, Statin, insulin,
beta blocker, and ACE inhibitors started recently. After 2 weeks he presented with weakness,
and the labs showed K 7.1, FBS 300, and CPK 300. The most likely cause of hyperkalemia is:
Q2012
A. Hyperglycemia
B. Rhabdomyolysis due to statins
C. ACE inhibitors
D. HTN
E. IHD
***) All of the following are used in the treatment of hyperkalemia, except: Q2012
A. Calcium resonium
B. Sodium bicarbonate
C. Amiloride
D. Salbutamol
E. Calcium gluconate IV
Answer: C* Amiloride
Answer: E* Hyperkalemia
***) All of the following are ECG manifestations of hyperkalemia, except: Q2012
A. Peak T wave
B. Wide QRS
C. Prolonged PR
D. Absent T wave
E. Ventricular Fibrillation
Answer: C* Captopril
***) All of the following are used in the treatment of hyperkalemia, except:
A. I.V glucose plus soluble insulin
B. I.V 10% calcium gluconate
C. I.V sodium bicarbonate
D. Dialysis
E. Amiloride
Answer: E* Amiloride
7. Hypokalemia.
***) 55 years old male presented with generalized muscle weakness, he recently started Lasix.
The most likely electrolyte disturbance is: Q2012
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hyponatremia
E. Hypocalcemia
Answer: B* Hypokalemia
Answer: C* Spironolactone
8. Hypercalcemia.
***) All of the following are causes of hypercalcemia, except: Q2012
A. Acute pancreatitis
B. Sarcoidosis
C. Multiple myeloma
D. Cancer of lungs
E. Hyperparathyroidism
Answer: E* Hyperkalemia
Answer: E* Osteomalacia
Answer: E* Hypogonadism
***) All of the following are useful in the acute treatment of hypercalcemia, except:
A. Hydration using intravenous saline solution
B. Furosemide
C. Hydrochlorothiazide
D. Mithramycine
E. Calcitonin
Answer: C* Hydrochlorothiazide
9. Hypocalcemia.
***) All of the following are side effects of furosemide, except: Q2012
A. Hypokalemia
B. Hyperuricemia
C. Hyperglycemia
D. Ototoxicity
E. Hypercalcemia
Answer: E* Hypercalcemia
Answer: D* Pseudopseudo-hypoparathyroidism
10. Pophosphate.
***) The serum alkaline phosphatase level is characteristically normal in:
A. Hemolytic jaundice
B. Osteomalacia
C. Osteitis deformans
D. Hypophosphatasia
E. Primary hyperparathyroidism
Answer: C* Hypothyroidism
Answer: B* Amyloidosis
***) Recommended treatment for osteoporosis includes all the following except:
A. Estrogen
B. Potassium
C. Exercise
D. Calcium
E. Vit D
Answer: B* Potassium
******************************************************************************
Hematology OXF.
I. Basics of Hematology.
1. Hematology.
***) The majority of hemoglobin in erythrocytes from the normal adults is termed:
A. Hemoglobin F
B. Hemoglobin A
C. Hemoglobin A2
D. Hemoglobin C
E. Hemoglobin Bart's
Answer: B* Hemoglobin A
Answer: C* 7 days
***) In human being, normal red blood cell survival time is approximately:
A. One month
B. 80 Days
C. Three months
D. 120 days
E. Five months
Answer: A* Neutrophils
Answer: A* Hypopituitarism
***) Generalized increased pigmentation may be seen in all of the following, except:
A. Nelson's syndrome
B. Hemochromatosis
C. Chronic renal failure
D. Panhypopituitarism
E. Primary biliary cirrhosis
Answer: D* Panhypopituitarism
2. Palmar Erythema.
***) All of the following can cause palmar erythema, except:
A. Epilepsy
B. Alcoholism
C. Rheumatoid arthritis
D. Pregnancy
E. Polycythemia
Answer: A* Epilepsy
3. Splenomegaly.
***) Splenomegaly is expected to be present in all of the following, except:
A. Glucose-6-phosphate dehydrogenase deficiency
B. Congenital spherocytosis
C. Hemoglobin H disease
D. Pyruvate kinase deficiency
E. Chronic immune hemolytic anemia
4. Lymphadenopathy.
***) Generalized lymphadenopathy is seen in all of the following, except:
A. Sarcoidosis
B. Hepatic cirrhosis
C. Lymphoma
D. HIV infection
E. Infectious mononucleosis
***) All of the following are causes of cervical lymph node enlargement, except:
A. Infectious mononucleosis
B. Toxoplasmosis
C. Anemia
D. Tuberculosis
E. Rheumatic fever
Answer: C* Anemia
***) All of the following are causes of cervical lymph node enlargement, except:
A. Multiple myeloma
B. Sarcoidosis
C. Tuberculosis
D. Chronic lymphoid leukemia
E. Phenytoin
5. Polycythemia.
***) All of the following may produce polycythemia, except:
A. Cushing’s syndrome
B. Primary hepatoma
C. Heavy smoking
D. Gastric carcinoma
E. High altitudes
Answer: C* Lymphoma
6. Thrombocytopenia.
***) Thrombocytopenia caused by increased platelet destruction is most closely associated with
which of the following:
A. Aplastic anemia
B. Acute leukemia
C. Combination chemotherapy
D. Systemic lupus erythematosus SLE
E. Excessive ethanol uptake
8. Neutrophilia.
***) All of the following are causes of neutrophil leucocytosis, except:
A. Bacterial infection
B. Myocardial infarction
C. Viral infection
D. Leukemia
E. Leukemoid reaction
Answer: E* Infancy
9. Neutropenia.
***) All of the following are causes of neutropenia, except:
A. Viral infections
B. Felty's syndrome
C. Typhoid fever
D. Myocardial infarction
E. Congenital
Answer: B* Corticosteroids
10. Eosinophilia.
***) Which of the following would be least likely to be associated with eosinophilia: Q2012
A. Asthma
B. Contact dermatitis
C. Parasitic infection
D. Mycobacterial infection
E. Prednisone administration
***) Which of the following would be least likely to be associated with eosinophilia:
A. Toxoplasmosis
B. Hypoadrenocorticism
C. Loeffler's endocarditis
D. Allergic vasculitis
E. Myxedema
Answer: E* Myxedema
Answer: C* Beta-thalassemia
***) Which of the following would be most likely to be a cause of hypochromic microcytic
anemia:
A. Thalassemia
B. Immune hemolytic anemia
C. Methotrexate therapy
D. Obstructive jaundice
E. Phenytoin therapy
Answer: A* Thalassemia
***) Microcytic hypochromic blood picture is seen in all of the following, except:
A. Iron deficiency anemia
B. Lead poisoning
C. Thalassemia
D. Sideroblastic anemia
E. Sickle cell anemia
2. Iron Metabolism.
***) All of the following increase iron absorption in the small intestine, except:
A. Increased acidity
B. When iron is complemented with lactose
C. Ascorbic acid
D. Tea drinking
E. Iron of animal source
***) In a patient with anemia all of the following might suggest the presence of iron deficiency
anemia, except:
A. Microcytosis
B. Koilonychia
C. Peripheral neuropathy
D. High iron binding capacity
E. Low serum ferritin
Answer: E* Meningitis
***) Aplastic anemia may occur following the administration of which of the following:
A. Penicillin
B. Prednisolone
C. Tetracycline
D. Chloramphenicol
E. Erythromycin
Answer: D* Chloramphenicol
V. Hemolytic Anemia.
1. Hemolytic Anemia.
***) Hemolysis may occur in all of the following, except:
A. Hereditary spherocytosis
B. Aplastic anemia
C. Thalassemia
D. Sickle cell anemia
E. Glucose-6-phosphate deficiency
***) The presence of hemolysis is indicated by all of the following clinical manifestations,
except:
A. Present or reduced serum haptoglobin
B. Increased number of reticulocytes
C. Elevated serum lactate dehydrogenase
D. Microcytic red blood cell indices
E. Shortened red blood cell survival
2. Thalassemia.
***) All of the following are features of thalassemia, except: Q2012
A. Bone marrow hyperplasia
B. Hair on end appearance
C. Hypochromic microcytic RBCs
D. Increased osmotic fragility
E. Splenomegaly
Answer: D* Thalassemia
Answer: C* 8 months
***) Concerning Thalassemia major, all the following are true, except:
A. Hemolytic anemia resulting from imbalance of alpha and beta globin chains
B. Patient becomes symptomatic in the second 6 months
C. Facial deformities are present from expansion of the bone marrow
D. Splenomegaly is present after 2 years from presentation
E. Hypochromic microcytic anemia
***) The following features may be found in an adult with sickle cell anemia, except:
A. Aseptic necrosis of bone
B. Massive splenomegaly
C. Chronic leg ulcers
D. Hematuria
E. Impaired ability to concentrate urine
4. G6PD Deficiency.
***) All the following are oxidant stress which can cause hemolysis in patient with Glucose-6-
phosphate dehydrogenase (G6PD) deficiency, except:
A. Infection
B. Sulfa drugs
C. Vit E
D. Fava beans
E. Nitrofurantoin
Answer: C* Vit E
***) All of the following about pernicious anemia are true, except:
A. Is a disease of elderly
B. Weight loss is a common feature
C. Subacute combined degeneration can occur
D. Gastric atrophy with achlorhydria
E. Treatment should be continued for two years
***) All of the following are causes of macrocytic anemia, except: Q2012
A. Vit B12 deficiency
B. Folate deficiency
C. Hypothyroidism
D. Hyperthyroidism
E. Chronic liver disease
Answer: D* Hyperthyroidism
***) A macrocytic peripheral blood smear may be seen in any of the following, except:
A. Alcoholism
B. Hypothyroidism
C. Celiac disease
D. Folate deficiency
E. Iron deficiency
***) All of the following are causes of macrocytosis (large red cells), except:
A. Alcoholism
B. Hypothyroidism
C. Chronic renal failure
D. Sideroblastic anemia
E. Hemolysis
2. Folate Deficiency.
***) Megaloblastic anemia secondary to folate deficiency is best corrected by administering
folate:
A. Intravenously 10 mg daily
B. Intramuscularly 1 gm daily
C. Orally 5 mg daily
D. Subcutaneously 100 mg monthly
E. In combination with ascorbic acid
Answer: C* Orally 5 mg daily
***) Which of the following statements about megaloblastic anemia is not true:
A. Serum folic acid and vitamin B12 may be normal
B. Manifestation may appear in the first year of life
C. White blood cells and platelets are normal
D. Occasionally treatment is required for life
E. In Jordan goat's milk may be a factor in its etiology
VII. Hemostasis.
1. Hemostasis.
***) A boy bleeding a lot after circumcision may have any of the following, except:
A. Factor XIII deficiency
B. Factor XII deficiency
C. Factor XI deficiency
D. Factor X deficiency
E. Factor IX deficiency
***) In vascular injury the immediate response that produce hemostasis is:
A. Platelet adherence at the injury site
B. Vasoconstriction
C. Liberation of serotonin
D. Thrombus formation
E. Platelet plug formation
Answer: B* Vasoconstriction
2. Heparin-Induced Thrombocytopenia.
***) Anticoagulant effect of heparin is based on: Q2012
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
***) With anti-coagulant (heparin) therapy the antidote treatment of choice is: Q2012
A. Calcium gluconate
B. Protamine sulfate
C. Potassium chloride
D. Vitamin K
E. Cetrovorum factor
***) Important uses of acetylsalicylic acid include all of the following, except:
A. Acute rheumatic fever
B. Antipyretic
C. Thrombocytopenia
D. Transient ischemic attacks
E. Mild migraine headache
Answer: C* Thrombocytopenia
***) Contraindications to the use of streptokinase therapy include all of the following, except:
A. Bleeding peptic ulcer
B. Infective endocarditis
C. Surgery to eye
D. Cor pulmonale
E. Severe hepatic insufficiency
3. Vitamin K Deficiency.
***) The most frequent and clinically important vitamin deficiency developing in patients with
cholestatic liver disease is which of the following:
A. Vitamin D
B. Vitamin A
C. Vitamin B12
D. Vitamin Bl
E. Vitamin K
Answer: E* Vitamin K
***) Vitamin K dependent coagulation factors may include all the following, except:
A. Factor 2
B. Factor 7
C. Factor 9
D. Factor 11
E. Factor 10
Answer: D* Factor 11
VIII. Neoplasms.
1. Polycythemia Rubra Vera.
***) Polycythemia Rubra Vera is associated with all of the following, except:
A. Raised ESR
B. Pruritus
C. Hemorrhage
D. Hyperuricemia
E. Thrombosis
3. Lymphoma.
***) Which of the following tumors has a strong association with a viral infection:
A. Acute lymphoblastic leukemia
B. Acute myelogenous leukemia
C. Histiocytosis
D. Burkitt's lymphoma
E. Hodgkin's disease
4. Hodgkin Lymphoma.
***) Concerning Hodgkin's lymphoma all of the following are correct, except:
A. It occurs in both males and females but more in males
B. It occurs in children and old ages
C. Histologically it is multi-cellular infiltration with a characteristic giant cells
D. It starts usually in extra-nodal tissues
E. Radiotherapy forms the main line of treatment in early stages
***) All the following are histological subtype of Hodgkin's lymphoma except:
A. Lymphocyte predominant
B. Lymphocyte depleted
C. Mixed cellularity
D. Nodular sclerosis
E. Leukemic lymphocytic predominant
5. Multiple Myeloma.
***) The following are features of multiple myeloma, except: Q2012
A. Renal failure
B. Hypocalcemia
C. Lytic bone lesions
D. Anemia
E. M-band on protein electrophoresis
Answer: B* Hypocalcemia
***) All of the following about multiple myeloma are true, except:
A. Backache
B. Recurrent infections
C. May cause hypercalcemia
D. Presence of Bence-Jones protein in urine
E. High alkaline phosphatase
Answer: E* Polycythemia
2. Platelets.
***) The most helpful and reliable bedside platelet function is:
A. Platelet adhesiveness
B. Bleeding time
C. Clot retraction
D. Platelet size
E. Clotting time
Answer: B* Bleeding time
3. Coagulation Factors.
***) To stop bleeding in hemophilic baby you have to give:
A. Fibrinogen
B. Albumin
C. Fresh frozen plasma
D. Cryoprecipitate
E. Platelet rich plasma
Answer: D* Cryoprecipitate
***) The liver is the sole site of synthesis of all of the following coagulation factors, except:
A. Factor II
B. Factor V
C. Factor VII
D. Factor IX
E. Factor IV
Answer: E* Factor IV
Answer: C* Factor 8
4. Blood Transfusion.
***) All of the following are complications of blood transfusion, except: Q2012
A. Hypothermia
B. Hypocalcemia
C. Hyperkalemia
D. Thrombocytopenia
E. Thromboembolism
Answer: E* Thromboembolism
***) In massive blood transfusion, all the following are complication except:
A. Acute congestive heart failure
B. Transmission of infection
C. Transfusion reaction
D. Hypercalcemia
E. Hyperkalemia
Answer: D* Hypercalcemia
***) All of the following are potential risks of massive blood transfusion, except:
A. Acidosis
B. Impaired hemostasis
C. Hypokalemia
D. Citrate toxicity
E. Impaired oxygen delivery
Answer: C* Hypokalemia
***) All the following are possible complications of blood transfusion except:
A. Hypercalcemia
B. Congestive cardiac failure
C. Hyperkalemia
D. Incompatibility
E. Non-cardiogenic pulmonary edema
Answer: A* Hypercalcemia
***) All the following diseases are transmitted through blood transfusion except:
A. Syphilis
B. Helicobacter Pylori
C. Malaria
D. Hepatitis B and C
E. Epstein-Bar virus
Answer: B* Helicobacter Pylori
X. Immunosuppressive Drugs.
1. Steroids.
***) Prolonged use of corticosteroids may cause the following, except: Q2012
A. Proximal myopathy
B. Metabolic alkalosis
C. Avascular necrosis of the head femur
D. Thrombocytopenia
E. Leukocytosis
Answer: D* Thrombocytopenia
Answer: C* Hyperkalemia
Answer: C* Hyperkalemia
***) All of the following are side effects of long term steroid therapy, except:
A. Osteoporosis
B. Hypertension
C. Hematuria
D. Diabetes mellitus
E. Delayed healing of wounds
Answer: C* Hematuria
***) Corticosteroids could be used in the treatment of all the following, except:
A. Acute leukemia
B. Nephrotic syndrome
C. Sydenham's chorea
D. Rheumatoid iridocyclitis
E. Addison's disease
******************************************************************************
Answer: B* Pheochromocytoma
2. Rigors.
***) Rigors are typical features of all of the following, except:
A. Brucellosis
B. Primary pulmonary tuberculosis
C. Malaria
D. Acute pyelonephritis
E. Acute cholangitis
Answer: E* Rubella
II. DRUGS.
1. Common Drugs.
***) One of the following is bacteriostatic antibiotic: Q2012
A. Penicillin
B. Aminoglycosides
C. Erythromycin
D. Imipenem
E. Aztreonam
Answer: C* Erythromycin
***) Which of the following antibiotics is the best treatment for pseudomembranous colitis:
A. Ampicillin
B. Flucloxacillin
C. Gentamycin
D. Vancomycin
E. Cefuroxime
Answer: D* Vancomycin
Answer: D* Cefepime
Answer: E* Metronidazole
***) The drug of choice for a child with pneumococcal pneumonia is:
A. Penicillin
B. Streptomycin
C. Chloramphenicol
D. Sulfa drugs
E. Erythromycin
Answer: A* Penicillin
Answer: A* Ampicillin
***) The following antimicrobial drugs are effective against staphylococci, except:
A. Teicoplanin
B. Metronidazole
C. Imipenem
D. Cephalexin
E. Cloxacillin
Answer: B* Metronidazole
Answer: C* Amphotericin B
Answer: E* Griseofulvin
Answer: A* Bacterial
Answer: B* Streptococcus
Answer: B* Giardia
***) All of the following can cause food poisoning by producing toxin, except:
A. Staphylococcus
B. Clostridium perfringens
C. Clostridium botulinum
D. Salmonella
E. Bacillus cereus
Answer: D* Salmonella
***) Which one of the following is usually not a feature of staphylococcal food poisoning:
A. Abdominal cramps
B. Fever
C. Hypotension
D. Vomiting
E. Diarrhea
Answer: B* Fever
***) The characteristic incubation period for staphylococcus aureus food poisoning is:
A. 1 to 6 hrs
B. 8 to 24 hrs
C. 1 to 4 days
D. 6 to 15 days
E. 15 to 21 days
Answer: A* 1 to 6 hrs
***) Regarding staphylococcal food poisoning all of the following statements are true, except:
A. Contaminated meats and confectionery constitute the most outbreak
B. Vomiting and severe abdominal cramps are prominent symptoms
C. The acute symptoms usually subside within 12 hours
D. Central nervous system manifestations are usually present
E. Majority of patients require no specific treatment
***) Salmonella can reach the food from one of the following:
A. Animal excreta at time of slaughter
B. From human excreta
C. Raw to cooked food by hand, surfaces and utensils in kitchen
D. Water polluted by sewage
E. All of above
Answer: C* 1 day
***) A child complaining of bloody diarrhea, vomiting and abdominal pain 20 hours after eating
a chicken mostly likely has:
A. Staphylococcal food poisoning
B. Botulism
C. Appendicitis
D. Salmonella food poisoning
E. Meckel's diverticulitis
***) Which of the following organisms are used for routine testing of water:
A. Typhoid
B. Salmonella
C. Coliform
D. Streptococci
E. Staphylococci
Answer: C* Coliform
2. Malaria.
***) Which of the following drugs is useful for Plasmodium falciparum malaria
chemoprophylaxis:
A. Emetine hydrochloride
B. Trimetoprim
C. Chloroquine
D. Metronidazole
E. Rifampicin
Answer: C* Chloroquine
3. Tuberculosis (TB).
***) All of the following statements regarding tuberculosis are true, except:
A. The risk of developing TB disease is greatest within the first year following infection
B. Most cases of tuberculosis occur as a result of primary infection
C. Isoniazid chemoprophylaxis may be given to selected high risk patients over 35 years of age
D. Incidence of the disease among elderly is higher than that of middle aged
E. Most cases of tuberculosis can be successfully treated with antituberculous drugs
Answer: B* Airborne
Answer: D* Tonsil
***) A positive tuberculin test (PPD) is considered when the induration diameter is:
A. 3millimeter
B. 5millimeter
C. 7millimeter
D. 9millimeter
E. 10millimeter and more
***) The least amount of reaction which would be considered a definite positive reaction to PPD
in children is:
A. Any reaction
B. Over 5mm erythema
C. Over 5mm induration
D. Over 10mm erythema
E. Over 10mm induration
Answer: C* Methimazole
Answer: C* Kanamycin
***) Contacts with a patient having TB who recently changed from negative to positive for PPD
test should receive:
A. INH
B. Rifampicin
C. INH + Rifampicin
D. Streptomycin
E. INH + Rifampicin + Ethambutol
Answer: A* INH
Answer: E* Ethambutol
Answer: B* Chickenpox
5. Infectious Mononucleosis.
***) All of the following are true about infectious mononucleosis, except:
A. Caused by Epstein-Barr herpes virus
B. Myocarditis may occur
C. Splenic rupture is a recognized complication
D. Liver function tests are usually normal
E. Blood smear shows atypical large lymphocytes and lymphocytosis
***) All of the following about infectious mononucleosis (glandular fever) is correct, except:
A. Sore throat
B. Cervical lymphadenopathy
C. Ampicillin is a drug of choice
D. Splenomegaly
E. Mild hepatitis is common
6. Toxoplasma.
***) Acquisition (transmission) of Toxoplasma occurs in all of the following situations, except:
A. Contact with an acutely infected adult
B. Contact with cat feces of an infected cat
C. Ingestion of inadequately cooked meat of an infected cow
D. Blood transfusion from an acutely infected person
E. Transplacentally to the fetus from an acutely infected mother
Answer: E* Toxoplasmosis
7. Viral Hepatitis.
***) All of the following about hepatitis infection are false, except: Q2012
A. Hepatitis B is transmitted by feco-oral route
B. Vaccination is available for hepatitis C
C. Incubation period for hepatitis A is 14-21 days
D. Hepatitis D is a DNA virus
E. Interferon treatment is required for hepatitis E
***) In hepatocellular carcinoma, all the following are true except: Q2012
A. It can be caused by hepatitis A
B. It may lead to cirrhosis
C. It leads to increased alfa feto protein
D. It may cause fever
E. It can be associated with polycythemia
Answer: C* Hepatitis B
***) All of the following about hepatitis B vaccination are false, except: Q2012
A. Hepatitis B vaccine is given in 2 doses
B. Vaccine is protective for maximum 10 years after administration
C. Vaccine is safe in immune-compromised persons
D. Vaccine offers also partial protection against hepatitis C infection
E. Vaccine should not be used in children younger than 10 years of age
***) Chronic carrier is an important source of spread of all of the following, except:
A. Amoebic dysentery
B. Typhoid
C. Bacillary dysentery
D. Cholera
E. Infectious hepatitis (hepatitis A)
***) All of the following about hepatitis B infection are true, except:
A. May be transmitted sexually
B. Can cause chronic active hepatitis
C. Hepatoma is recognized complication
D. Vaccination is available
E. Caused by RNA virus
***) All of the following about hepatitis B infection are true, except:
A. May be transmitted sexually
B. Can cause chronic active hepatitis
C. Hepatoma is recognized complication
D. Vaccination is available
E. Recovery is invariable
***) The greatest risk for infection transmitted by blood transfusion is present in one of the
following:
A. Syphilis
B. Hepatitis B
C. Hepatitis C
D. Human immunodeficiency virus (HIV)
E. Urinary tract infection
Answer: C* Hepatitis C
***) All of the following are the causes of chronic hepatitis, except:
A. Hepatitis B
B. Hepatitis C
C. Methyldopa
D. Alpha-1-antitrypsin deficiency
E. Ulcerative colitis
8. AIDS.
***) All of the following about acute HIV infection are true, except: Q2012
A. It is associated with a very high viral load
B. It occurs in at least 70% of HIV infection
C. Patients have low infectiousness in this stage
D. Maculopapular rash can occur in the upper trunk
E. It is diagnosed by viral PCR
***) All of the following about acquired immunodeficiency syndrome (AIDS) are true, except:
A. It is transmitted by sexual contact
B. It can be transmitted by blood transfusion
C. The incubation period varying from one year to ten years
D. Kaposi's sarcoma can occur
E. Vaccine is available
9. Candida albicans.
***) All of the following about candidiasis are true, except:
A. It is more common in diabetes
B. It may complicate treatment with antibiotics
C. It may cause vaginitis
D. It is usually accompanied by systemic upset
E. It may be seen in immune compromised patients
Answer: E* Thyrotoxicosis
Answer: D* Anhidrosis
Answer: A* Streptococcus
***) All of the following about diphtheria toxin are true, except:
A. It is an exotoxin
B. It blocks protein synthesis
C. It leads to neuritis
D. It leads to carditis
E. It is neutralized by antitoxin even after penetration into the cells
Answer: C* Listeria
12. Brucellosis.
***) Regarding brucellosis, one of the following is true: Q2012
A. It is caused by gram positive bacilli
B. The most virulent form is brucella abortus
C. Treatment can be achieved by doxycycline and rifampin for 6 weeks
D. Meningitis is the commonest cause of death
E. Diagnosis is obtained by blood cultures in chronic cases
***) 20 years old male presented with fever, arthritis, increase in ESR and brucella titer, the best
management is: Q2012
A. Repeat titer in 3 months
B. 6 weeks of doxycycline and rifampin
C. 6 weeks of doxycycline
D. 6 weeks of rifampin
E. 2 weeks of doxycycline and rifampin
Answer: A* Leucocytosis
***) Penicillin could be a drug of choice for treatment of the following, except:
A. Scarlet fever
B. Brucellosis
C. Pneumococcal meningitis
D. Streptococcal skin infection
E. Tonsillitis
Answer: B* Brucellosis
13. Tetanus.
***) All of the following are true about tetanus, except:
A. Trismus is characteristic
B. The longer incubation period is better in the prognosis
C. CSF is usually normal
D. Temperature is usually very high
E. If the patient survives, recovery is complete
Answer: A* It's the result of wound infection by gram negative anaerobic rod of clostridia group
***) All of the following statements of anti tetanus immunization are true, except:
A. To prevent tetanus neonatorum women should be actively immunized by puberty
B. Immunization during pregnancy is avoided because of its harmful effect on the fetus
C. Recommended for universal use regardless of age
D. Important for workers in contact with soil, sewage or domestic animals
E. For severe wounds, give a booster if more than 5 years have elapsed since the last dose
Answer: B* Immunization during pregnancy is avoided because of its harmful effect on the fetus
Answer: B* Tetanus
***) All of the following about typhoid fever are true, except:
A. Humans are only reservoirs
B. Headache is a prominent symptom
C. Rose spots occur during the second week
D. Splenomegaly can occur
E. Leucocytosis is usually present
***) During the first week of typhoid fever, all of the following may be found, except:
A. Headache
B. Constipation
C. A palpable spleen
D. Sore throat
E. Positive blood culture
***) The followings are features of the first week of typhoid fever, except:
A. Constipation
B. Leucocytosis
C. Dry cough
D. Positive blood culture
E. Headache
Answer: B* Leucocytosis
Answer: B* Dysphagia
***) A 20 years old patient presented with 5 days history of gradually increasing fever, headache
and constipation. Provisional diagnosis of typhoid fever was suggested. Diagnosis can be best
confirmed at this stage by which of the following:
A. Widal test
B. Blood cultured
C. Urine culture
D. Stool culture
E. Clinical examination
***) All of the following drugs may be used in the treatment of typhoid fever, except:
A. Chloramphenicol
B. Ampicillin
C. Cotrimoxazole
D. Ceftriaxone
E. Tetracycline
Answer: E* Tetracycline
Answer: E* Men
16. Cholera.
***) The following about cholera are true, except:
A. Individuals with achlorhydria are more susceptible to infection
B. Disease is mediated by exotoxin
C. Causes metabolic acidosis
D. Usually involves huge bowels
E. Tetracycline is used on then treatment
Answer: A* Carriers exceed those with symptoms and carrier state can persist for a few months
***) All of the following factors shorten the viability period of Vibrio cholera, except:
A. Dryness
B. Chemotherapeutics
C. Coldness
D. High temperatures
E. Disinfectants
Answer: C* Coldness
17. Spirochetes.
***) All of the following are viral disease, except:
A. Warts
B. AIDS
C. Herpes zoster
D. Lyme disease
E. Varicella
18. Rabies.
***) The incubation period for rabies is:
A. 24 hours
B. 2 to 3 days
C. 2 to 3 weeks
D. 1 to 2 months
E. 6 to 12 months
Answer: D* 1 to 2 months
***) Immunization against rabies (post-exposure) is given in 6 doses as follows:
A. At 0, 5, 9, 14, 60, 90
B. At 0, 5, 14, 21, 30, 120
C. At 0, 3, 7, 14, 30, 90
D. At 0, 3, 10, 21, 60,120
E. At 0, 3, 30, 60, 90,120
Answer: C* Cecum
Answer: D* Metronidazole
20. Leishmaniasis.
***) Cutaneous leishmaniasis can be transmitted through the:
A. Bite of an infective female anopheles mosquito
B. Bite of infective female sandflies
C. Bite of infective glossina (tsetse) fly
D. Bite of infective aedes mosquitoes
E. Bite of infective male sandflies
***) All of the following are signs and symptoms characterizing ascariasis, except:
A. Urticaria
B. Cough and hemoptysis
C. Eosinophiles
D. Splenomegaly
E. Vague abdominal pain
Answer: D* Splenomegaly
23. Schistosomiasis.
***) Bilharziasis is transmitted through
A. Culex mosquito
B. Anopheles mosquito
C. Cercaria in polluted water
D. Direct contact with patients
E. Contaminated food
Answer: E* Schistosomiasis
24. Zoonosis.
***) Which of the following is not a zoonosis:
A. Salmonellosis
B. Cholera
C. Brucellosis
D. Anthrax
E. Rabies
Answer: B* Cholera
Answer: D* Diphtheria
25. Meningitis.
***) One of the following is the most common cause of meningitis: Q2012
F. Bacterial
G. Fungal
H. Viral
I. Parasitic
J. None of above
Answer: C* Viral
***) 35 years old male presented with headache, fever and positive meningeal signs, the next
step in management is: Q2012
A. Give ceftriaxone and vancomycin
B. Do CT scan
C. Do LP
D. Do CXR
E. Do blood culture
Answer: E* Gram positive cocci are the most common organisms to cause infection
Answer: C* Pneumococcus
***) A gram stain report from cerebrospinal fluid CSF showed gram positive diplococci, the
organism is:
A. Neisseria meningitidis
B. B hemolytic streptococci group B
C. Streptococcus pneumonia
D. Haemophilus influenzae
E. Escherichia coli
***) Meningitis caused by haemophilus influenzae type B is most common in children of age:
A. Under 2 months
B. 3 months - 4 years
C. 5 years - 8 years
D. 8 years - 10 years
E. Over 11 years of age
***) A 15 months old child developed hydrocephalus following meningitis. The most likely
causative organism is:
A. E.Coli
B. Salmonella
C. Meningococci
D. H.influenza
E. Listeria monocytogenes
Answer: D* H.influenza
***) The most common organism causing meningitis in toddlers (6 months - 3 years) is:
A. Diplococcus pneumonia
B. Group C Neisseria meningitides
C. Group A hemolytic streptococcus
D. Haemophilus influenzae type B
E. E.Coli
***) At what age meningitis cannot be excluded with confidence in children presenting with
febrile convulsions:
A. Five years
B. Four years
C. Three years
D. Nine months
E. All ages
***) In bacterial meningitis affecting a 15 years old boy which of the following organisms is
most often implicated:
A. Streptococcus
B. Staphylococcus
C. Meningococcus
D. Haemophilus influenza
E. Pneumococcus
Answer: E* Pneumococcus
***) Which one of the following is the earliest sign in a newborn with sepsis and meningitis:
A. Refusal of feeding
B. Hyperirritability
C. Respiratory distress
D. Stiff neck
E. Jaundice
***) The following are typical changes in CSF in pyogenic meningitis, except:
A. High protein
B. High glucose
C. High polymorph cells
D. High CSF pressure
E. Turbid CSF
***) The best treatment of bacterial meningitis in 12 months old patient is:
A. Ampicillin
B. Amikacin and ampicillin
C. Rifampicin
D. Chloramphenicol and ampicillin
E. Cefalotin and gentamycin
***) The most common route of infection of most types of meningitis is the:
A. Blood stream
B. Direct extension from the middle ear
C. Extension from a skull fracture
D. Extension from the cribriform plate
E. Wounds
***) All of the following are indications for lumbar puncture, except:
A. Diagnosis of meningitis
B. Diagnosis of multiple sclerosis
C. Suspicion of a mass lesion in the brain
D. Benign intracranial hypertension
E. Intrathecal injection of drugs
26. Encephalitis.
***) Each of the following statements is true about encephalitis, except:
A. CSF sugar is either normal or little raised
B. In most cases the etiology is viral agents
C. Prognosis is generally good
D. CSF cells are mainly segmented neutrophils
E. Some meningeal signs may present
27. Osteomyelitis.
***) The usual causative microorganism of the hematogenous acute osteomyelitis is:
A. Beta-hemolytic streptococcus
B. E.coli
C. Staphylococcus aureus
D. Mycobacterium TB
E. Clostridium
Answer: E* Staphylococcus
Answer: B* 2 weeks
***) A school boy who presents with a three days illness caused by acute osteomyelitis is likely
to have all of the following, except:
A. Severe localized pain
B. Fever
C. Neutrophil leucocytosis
D. Abnormal limb X-ray
E. A blood culture growth of staphylococci
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Neurology OXF.
I. CNS Anatomy.
1. Anatomy.
***) One of the following is the twelfth cranial nerve: Q2012
A. Accessory nerve
B. Trigeminal nerve
C. Glossopharyngeal nerve
D. Hypoglossal nerve
E. Vagus nerve
***) All the following muscles are supplied by the trigeminal nerve except:
A. Tensor veli palatini
B. Tensor tympani
C. Masseter
D. Posterior belly of digastric
E. Mylohyoid
2. Marfan syndrome.
***) 22 years old male has feature of arm span greater than height, subluxed lenses, flattened
corneas, and dilation of the aortic ring. The most likely diagnosis is: Q2012
A. Ehlers-Danlos syndrome
B. Marfan syndrome
C. Werner's syndrome
D. Laurence-Moon-Biedl syndrome
E. Hunter's syndrome
3. Aphasia.
***) 65 years old male with DM and HTN, develops acute right sided hemiplegia, on
examination he has intact comprehension, can obey commands but unable to speak or repeat
phrases. His language disturbance represents one of the following: Q2012
A. Receptive aphasia
B. Expressive aphasia
C. Global aphasia
D. Anomic aphasia
E. Cerebellar aphasia
4. Tremor.
***) All of the following are causes of tremor, except:
A. Parkinsonism
B. Familial
C. Hypoglycemia
D. Anxiety
E. Hyperparathyroidism
Answer: E* Hyperparathyroidism
5. Chorea.
***) All of the following are causes of chorea, except:
A. Rheumatic fever
B. Huntington's disease
C. Carbamazepine
D. Polycythemia rubra vera
E. Pregnancy
6. Pupillary Abnormalities.
***) Pinpoint pupils are seen in all the following, except: Q2012
A. Organophosphorus poisoning
B. Opiates overdose
C. Pontine hemorrhage
D. Subarachnoid hemorrhage
E. Insecticide intoxication
Answer: B* Fasciculation
***) Upper motor neuron lesion can produce all the following except:
A. Increased deep tendon reflexes
B. Extensor plantar response
C. Muscle weakness
D. Fasciculation
E. Spasticity
Answer: D* Fasciculation
***) All of the following are signs of upper motor neuron lesion, except:
A. Increase in tone
B. Hyperreflexia
C. Fasciculation
D. An extensor plantar reflex
E. Pyramidal weakness
Answer: C* Fasciculation
***) Signs of upper motor neuron lesion include all of the following, except:
A. Hypertonia
B. Clonus
C. Pyramidal weakness
D. Hyperreflexia
E. Marked fasciculation
Answer: D* Clonus
***) The following are signs of lower motor neuron lesion, except:
A. Weakness
B. Wasting
C. Fasciculation
D. Hypertonia
E. Decreased reflexes
Answer: D* Hypertonia
***) All of the following are signs of a lower motor neuron lesion, except:
A. Hypotonia
B. Reflex loss
C. Muscle wasting
D. Extensor plantar reflex
E. Fibrillation
Answer: C* Spasticity
10. Headaches.
***) All the followings regarding headache is true, except:
A. It may be caused by temporal arteritis
B. It may be secondary to benign intracranial hypertension
C. Tension headache is common
D. It occurs usually in the evening when it is due to brain tumor
E. It may be secondary to hypertension
***) The following statements regarding cluster headache are true, except:
A. Affects approximately 0.1% of the population
B. More common in females
C. Similar to migraine, may have a familial predisposition
D. The attack is often associated with autonomic features
E. It has two forms, episodic and chronic
***) High steppage gait can be seen in all of the following, except:
A. Guillain-Barre syndrome
B. Hereditary motor sensory neuropathy
C. Lead poisoning
D. Vitamin B12 deficiency
E. Folic acid deficiency
Answer: E* Folic acid deficiency
Answer: D* Anemia
2. Epilepsy.
***) Causes of epileptic fits include all of the following, except:
A. Head injury
B. Brain tumor
C. Hypoglycemia
D. Hypercalcemia
E. Systemic lupus erythematosus
Answer: D* Hypercalcemia
***) Causes of epilepsy include all of the following, except:
A. Cerebrovascular accident
B. Encephalitis
C. Head injury
D. Acute bronchopneumonia
E. Brain abscess
Answer: E* Dipyridamole
Answer: B* Diazepam
***) Side effects of phenytoin (Epanutin) include all of the following, except:
A. Hypertrophy of the gums
B. Anemia
C. Ataxia
D. Pseudolymphoma
E. Benign intracranial hypertension
3. Parkinson's disease.
***) All of the following are clinical features of Parkinson's disease, except:
A. Causes tremor
B. Hypokinesis
C. Mask face
D. Respond to bromocriptine
E. Bilateral extensor plantar reflex
***) All of the following are clinical features of Parkinson's disease, except:
A. Pill-rolling tremor
B. Lead-pipe rigidity
C. Aphasia
D. Bradykinesia
E. Shuffling gait
Answer: C* Aphasia
***) All of the following are clinical features of Parkinson's disease, except:
A. Rigidity
B. Tremor
C. Hypokinesis
D. Extensive sensory loss
E. Expressionless face
4. Multiple Sclerosis.
***) The following about multiple sclerosis are true, except:
A. Causes paresthesia
B. Diplopia is a feature
C. Is a remitting and relapsing disease
D. Causes urinary symptoms
E. More common in elderly
5. Peripheral Neuropathies.
***) All of the following can cause peripheral neuropathy, except:
A. Lead poisoning
B. Diphtheria
C. Guillain-Barr syndrome
D. Vitamin B12 deficiency
E. Vitamin C deficiency
Answer: C* Median
***) In carpal tunnel syndrome the nerve compressed is the:
A. Ulnar
B. Radial
C. Median
D. Musculocutaneous
E. Posterior interosseous
Answer: C* Median
***) Causes of carpal tunnel syndrome occur in all of the following, except:
A. Primary amyloidosis
B. Myxedema
C. Rheumatoid arthritis
D. May be idiopathic
E. Ankylosing spondylitis
***) Causes of carpal tunnel syndrome include all of the following, except:
A. Pregnancy
B. Myxedema
C. Multiple sclerosis
D. Acromegaly
E. Rheumatoid arthritis
***) The skin overlying the hypothenar muscle of the palm is supplied by the:
A. Radial nerve
B. Median nerve
C. Ulnar nerve
D. Anterior interosseous nerve
E. Superficial radial nerve
***) A patient presents with wasting of small muscles of hand with thenar sprain. What is the
most probable nerve could be affected:
A. Ulnar nerve
B. Median nerve
C. Axillary nerve
D. Musculocutaneous nerve
E. Thenar nerve
6. Myasthenia Gravis.
***) The lesion of myasthenia gravis is in the:
A. Anterior horn cell
B. Neuromuscular junction
C. Sensory ganglia
D. Parasympathetic ganglia
E. Sympathetic chain
***) All of the following about myasthenia gravis are true, except:
A. Causes ptosis
B. Weakness is usually proximal
C. Recognized cause of respiratory failure
D. Anticholinesterase therapy is harmful
E. Can cause bulbar muscle weakness
Answer: C* Thymectomy
7. Horner's Syndrome.
***) Findings in Horner's syndrome include:
A. Miosis
B. Anhidrosis of half of face
C. Enophthalmos
D. Ptosis
E. All of the above
***) Which one of the following tumors may be associated with Horner's syndrome:
A. Pancoast tumor
B. Main bronchus carcinoma
C. Carcinoma of the lower third of the esophagus
D. Carcinoid tumor
E. Hepatoma
Rheumatology OXF.
I. Immunology & Investigations.
1. Immunology.
***) One of the following is true regarding 40 years old man with history of shortness of breath
after exposure to penicillin 15 years ago: Q2012
A. Amoxicillin can be given safely to this patient since it has been more 10 years after reaction
B. It is contraindicated to give this patient further dose of penicillin
C. You can give penicillin safely if combined with NSAIDs
D. Small doses of penicillin should be safe
E. Cephalosporin antibiotics are safe in this patient
***) In a patient with anaphylactic shock, all are correct treatments, except: Q2012
A. Epinephrine
B. Hydralazine
C. Adrenaline
D. IV fluids
E. Steroids
Answer: B* Hydralazine
***) IgE mediated hypersensitivity reaction like bronchial asthma is: Q2012
A. Type I hypersensitivity reaction
B. Type II hypersensitivity reaction
C. Type III hypersensitivity reaction
D. Type IV hypersensitivity reaction
E. Type V hypersensitivity reaction
Answer: D* Pulmonary TB
II. Rheumatological Diseases and Conditions.
1. Osteoarthritis (OA).
***) Osteoarthritis:
A. Is commoner in males than females
B. Usually secondary to overweight only
C. Usually treated by arthroplasty
D. Chondrocytes imbalance is the main pathology
E. Physical therapy is not useful in moderate cases
***) A 50 years old woman complains of redness, swelling and stiffness of the distal
interphalangeal joints of the hands without other joint complaints, the most likely diagnosis is:
A. Rheumatoid arthritis
B. Erosive osteoarthritis
C. Systemic lupus erythematosus
D. Ankylosing spondylitis
E. Systemic sclerosis
2. Septic Arthritis.
***) The most common cause of acute pyogenic arthritis in adults is:
A. Streptococcal infection
B. Haemophilus influenza
C. Escherichia coli
D. Neisseria gonorrhea
E. Proteus mirabilis
Answer: A* Staphylococcus
***) The most frequent etiological agent in septic arthritis in children 2 months to 4 years of age
is:
A. Pneumococci
B. Streptococci
C. Candida albicans
D. Staphylococcus epidermidis
E. Staphylococcus aureus
Answer: B* Hepatitis A
3. Rheumatoid Arthritis.
***) All of the following about rheumatoid arthritis are true, except:
A. More common in females
B. Splenomegaly is a feature
C. Colchicine is used in the treatment
D. Pericardial effusion may occur
E. Amyloidosis is a recognized complication
***) All of the following are true about rheumatoid arthritis, except:
A. Episcleritis may occur
B. Amyloidosis is a recognized complication
C. Causes carpal tunnel syndrome
D. Pericarditis may occur
E. Retinitis pigmentosa is a feature
***) All of the following joints may be involved in rheumatoid arthritis, except:
A. Proximal interphalangeal joints
B. Knee joints
C. Distal interphalangeal joints
D. Wrist joints
E. Ankle joints
***) All of the following are extra-articular manifestations of rheumatoid arthritis, except:
A. Pericarditis
B. Mononeuritis multiplex
C. Fibrosing alveolitis
D. Pneumoconiosis
E. Scleritis
Answer: D* Pneumoconiosis
***) All of the following are extra-articular manifestations of rheumatoid arthritis, except:
A. Pleural effusion
B. Episcleritis
C. Keratoderma blenorrhagica
D. Anemia
E. Keratoconjunctivitis sicca
***) Rheumatoid arthritis may cause all of the following in the hand, except:
A. Joint ankylosis
B. Rupture of extensor tendons
C. Intrinsic contractures
D. Rupture of flexor tendons
E. Heberden's nodes
Answer: C* Polycythemia
Answer: B* Shoulder
***) A 50 years old male awoke in the midnight with severe pain in his left big toe. He was
taking some diuretics for hypertension. His toe was swollen, hot and severely tender, and patient
was unable to stand on it. The most probable diagnosis is:
A. Reiter's syndrome
B. Acute pyogenic arthritis
C. Rheumatoid arthritis
D. Osteoarthritis
E. Acute gouty arthritis
***) Acute gouty arthritis can be precipitated by all of the following, except:
A. Initiation of all purina therapy
B. Alcohol
C. Severe dieting
D. Steroid therapy
E. Surgery
***) In gouty arthritis which of the following is the most specific diagnostic finding:
A. Family history of gout
B. Presence of sodium urate crystals in synovial fluid
C. Prompt response to colchicine therapy
D. Presence of hyperuricemia
E. Involvement of the big toe
Answer: D* Allopurinol
***) Which drug inhibits uric acid synthesis by inhibiting xanthine oxidase:
A. Probenecid
B. Phenylbutazone
C. Colchicine
D. Allopurinol
E. Indomethacin
Answer: D* Allopurinol
2. Pseudogout.
***) In crystal synovitis all are true except:
A. Pseudo gout is caused by Na urate
B. Pseudo gout is caused by Ca urate
C. Arthroscopy is useful
D. Septic arthritis is a differential diagnosis
E. First metatarsophalangeal joint is the commonest site
IV. Spondyloarthropathies.
1. Ankylosing Spondylitis.
***) Ankylosing spondylitis is associated with: Q2012
A. HLA B27
B. HLA B8
C. HLA DR4
D. HLA A3
E. HLA A56
***) The radiological findings of obliteration of the sacroiliac joints with ossification in the
spinal ligaments (bamboo spine) are characteristics of:
A. TB arthritis
B. Gouty arthritis
C. Rheumatoid arthritis
D. Ankylosing spondylitis
E. Osteoarthritis
Answer: C* Gouty
3. Plasma Autoantibodies.
***) Positive tests for rheumatoid factor commonly occur in which the following:
A. Ankylosing spondylitis
B. Reiter's syndrome
C. Down's syndrome
D. Sjogren's syndrome
E. Chronic gout
***) In systemic lupus erythematosus (SLE) all of the following are true, except:
A. Involve the proximal interphalangeal joints
B. Pneumonitis may occur
C. Raised anti DNA support the diagnosis
D. Chloroquine is used in management
E. Elevated complement indicates activity
***) All of the following are features of systemic lupus erythematosus, except:
A. Alopecia
B. Pleurisy
C. Depression
D. Raised level of C reactive protein
E. Neutropenia
***) All of the following are features of systemic lupus erythematosus, except:
A. Fever
B. Abdominal pain
C. Myopathy
D. Glomerulonephritis
E. Keratoderma blenorrhagica
Answer: B* Hyperthyroidism
***) Raynaud’s phenomenon may be associated with all of the following, except:
A. Cervical rib
B. Obesity
C. Scleroderma
D. Systemic lupus erythematosus
E. Rheumatoid arthritis
Answer: B* Obesity
VI. Vasculitides.
1. Polyarteritis Nodosa.
***) All of the following are features of polyarteritis nodosa, except:
A. Commoner in males
B. Hypertension may occur
C. Mononeuritis multiplex
D. Death usually from anemia
E. Myocardial infarction can occur
2. Behçet's Disease.
***) All of the following about Behchet's disease are true, except:
A. It causes orogenital ulceration
B. It spares the CNS
C. Arthritis is a feature
D. Colchicine is used in the management
E. Superior vena cava obstruction may occur
***) All of the following about Behchet's disease are true, except:
A. Iritis may occur
B. Thrombophlebitis may occur
C. It is a viral infection
D. Steroids can be used in the treatment
E. Neurological complications may occur
Answer: E* Osteomyelitis
Answer: E* Amyloidosis
***) Erythema nodosum may be associated with all of the following, except:
A. Sarcoidosis
B. Tuberculosis
C. Streptococcal pharyngitis
D. Crohn's disease
E. Rheumatoid arthritis
Answer: D* Indomethacin
Answer: B* Dermatomyositis
***) Iris skin lesion is a major diagnostic feature of one of the following skin disorders:
A. Atopic dermatitis
B. Scarlet fever
C. Measles
D. Erythema multiform
E. Erythema marginatum
******************************************************************************
Epidemiology OXF.
I. Public Health.
1. Epidemiology.
***) The most single best measure to control antibiotic resistance in hospitals is: Q2012
A. Vaccination
B. Hand hygiene
C. Isolation
D. Antibiotic restriction policy
E. Resistance surveillance systems
Answer: C* Isolation
***) The relationship between doctors and doctor’s non flu patients is: Q2012
A. Rate
B. Ratio
C. Incidence
D. Prevalence
E. Epidemiology
Answer: B* Ratio
***) Preventing the onset of the disease by acting on either the causative agent or the host is
called:
A. Tertian prevention
B. Primary prevention
C. Screening
D. Secondary prevention
E. Rehabilitation
***) Prevention medicine encompasses all of the following levels of prevention, except:
A. Health promotion
B. Disability limitation
C. Specific protection
D. Early diagnosis and prompt treatment
E. Trauma-emergency care
***) All of the following services are provided by primary health care, except:
A. Anti-smoking education
B. Sanitary inspection
C. School health
D. Genetic testing
E. Blood hemoglobin testing
***) Primary health care services include all of the following, except:
A. Health education
B. Sanitary inspection
C. Mental health
D. Genetic testing
E. Blood hemoglobin testing
***) All of the following are criteria for screening of a disease, except:
A. The natural history of the disease should be understood
B. The disease must represent an important health problem
C. Suitable screening tests for the disease must exist
D. Screening should be available to and used by the entire population
E. Accepted treatment for the disease must be available
***) Screening of children has been proven cost effective for all of the following, except:
A. Tuberculosis
B. Iron deficiency anemia
C. Hypertension
D. Vision impairment
E. Phenylketonuria
Answer: C* Hypertension
***) Which of the following is accomplished by introducing into the body a specific immune
substance that acts directly against exposure to the infectious etiologic agent:
A. Passive immunization
B. Active immunization
C. Susceptibility
D. Indirect transmission
E. Natural immunity
***) In perhaps no public health program is nutrition more important than in:
A. Maternal and child health
B. Adult health
C. Occupational health
D. Communicable disease
E. School health
***) The most efficient method for the prevention and control of human immunodeficiency virus
(HIV) infection:
A. Vaccination
B. Treat AIDS patients
C. Education of the public
D. Screening of the public for HIV infection
E. Screening of donating serum
***) In epidemiological studies collection of information about the disease under study is
obtained by all of the following means, except:
A. Mass health examination
B. Specialized clinics
C. Private physicians
D. National census
E. Health care centers
***) Of the five major sources of air pollution, the leading source is:
A. Refuse disposal
B. Industry
C. Power plants
D. Transportation
E. Space heating
Answer: D* Transportation
***) In Jordan the most efficient reproach for the control of Brucellosis is:
A. Treatment of patients with the disease
B. Identification and treatment of infected animals
C. Public education
D. Eradication of infected animals
E. Vaccination of the public against the disease
***) The most common cause of perinatal morbidity and mortality in Jordan:
A. Obstetrical trauma
B. Septicemia
C. Hemorrhages
D. Toxemia
E. Prematurity and its complications
Answer: C* Age
Answer: E* Prevalence
***) 200 persons were invited to a dinner. 10 persons of those who ate fish developed food
poisoning. Given that 100 persons ate fish in that dinner. The attack rate among those who ate
fish:
A. 5%
B. 10%
C. 20%
D. 30%
E. 35%
Answer: B* 10%
Answer: E* Virulence
***) The manner in which an infectious disease behaves in a community may be determined by
all of the following, except:
A. Size of the reservoir of infection
B. Virulence of the infective agent
C. Number of hospital beds
D. Portal of entry of the infective agent
E. The standard of hygiene
***) All of the following disease should be reported to health authorities according to
regulations, except:
A. Tuberculosis
B. Cholera
C. Rabies
D. Diabetes mellitus
E. Malaria
***) Which of the following list of pollutants is found in greatest concentration in the urban
atmosphere:
A. Nitrogen oxides
B. Sulfur oxides
C. Carbon monoxide
D. Hydrocarbons
E. Fluorides
***) All of the following could be regarded as occupation related disease, except:
A. Varicose veins
B. Cartilage tears
C. Infective hepatitis
D. Gastric ulcer
E. Sickle cell anemia
Answer: A* Time elapsing between the exposure to the agent and the appearance of symptoms
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