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مسب هللا نمحرلا ميحرلا

هذه ةلئسلا مت اهعمج و اهلح نم لبق ةعومجم نم يجيرخ ة-ل- ~=-ا ةعماج- م-~--ا مهو . )
1 -م=م - ي-ر=-ا , 2 =ا-بع - ل~-- ,-م=-ا , 3 =ا-بع - ي---م-ا , 4 --هم - ي-ر=-ا , 5 -
=ا-بع _-ا~ ,-م=-ا , 6 ي-اه - ي-هج-ا , 7 رساي - يل-او-ا , 8 -جام - ي-ر=-ا , 9 ¡;- -
¡-بع-ا , 10 ,و~-م - ر-·~-ا )
_-مت' ,' ,و-ت هذه ةلئسلا ه--ج نم ~-ح ~-تر--ا و _-~---ا ~ا-اج(او , ة=-=~-ا املع , ,'-
~ا-اج(ا يه -,ابع نع -اه-جا -ق لم-=ت '==-ا اذهو . ~لم-ا ¡و-=ي _لع ة-ارق ~-لا Jا;س هذه
^لئسVا مت اهعمج نم J>خ ¿قوم ^-مي-ا-Vا ^-ب=-ا و نم ¸ع- نيذ-ا _بس مه- ,اب-خVا نم
~ل-=م _=ا-م-ا . ار-~- ل-- نم çاق ة-ا--- ^لئسVا .
يتاينمت عيمجلل قيفوتلاب
مكوخأ دمحم يبرحلا
1) 25 year teacher have fear attack and worry before enter the
class ( l forgot all the scenario) what is the initial treatment:
a. Selective serotonin reuptake inhibitor
b. Tricyclic depressant
c. Beta blocker
d. -----
e. ------
-Thís ís a case of socíaí phobía and the ínítíaí treatment ís
answer a (SSRIs).
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2) The best initial TTT for depression is:
a. SSRls
b. Tricyclic depressant
c. MAO inhibitors
d. Beta blocker
e. -----------
-The correct answer ís a (SSRIs).
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3) Using the following classification :
Risk factor Case (disease) Non case total
Present A B A+b
Absent C D C+d
Total A+C B+D
Relative risk of those with risk factor to those without risk
factor is:
a. A/A+B , C/C+D
b. A}A+B
c. C}C+D
-The correct answer ís a.
Posítíve predíctíve vaíue (PPV) : a} (a+b)
Negatíve predíctíve vaíue (NPV) : d } (C+d)
Sensítívíty : proportíon of peopíe wíth dísease who have a posítíve test:
a } (a+c)
Specífícíty : proportíon of peopíe wíthout dísease who have a negatíve
test : d} (b+d)
Reíatíve rísk ( RR ) : íncídence ín expose ÷ íncídence ín unexposed: ( a }
(a+b) ) } (c} (c+d) )
Attríbutabíe rísk : íncídence ín expose --- íncídence ín unexposed: ( a }
(a+b) ) -- (c} (c+d) )
Odd ratío ( OR ) : Odds that a dísease person ís exposed ÷ Odds that a
nondísease person ís exposed : ad } bc
4) 50 year old Man presented to ER with sudden headache,
blurred of vision, and eye pain. The diagnosis is:
a. Acute glaucoma
b. Acute conjunctivitis
c. Corneal ulcer
d. -----
-The correct answer ís a.
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5) Which heart condition is tolerable during pregnancy:
a. Eisenmenger syndrome
b. Aortic stenosis
c. Severe mitral regurge
d. Dilated cardiomyopathy with EF 20%
e. Mitral stenosis and the mitral area is 1 cm (or mm).
-the correct answer ís c.
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6) Diffuse abdominal pain "in wave like" and vomiting. The
diagnosis is:
a. Pancreatitis
b. Appendicitis
c. Bowel obstruction
d. Cholelithiasis
The correct answer ís c. (coíícky paín: ís the paín that comes ín
waves "wave-ííke" and ít ís assocíated wíth boweí obstructíon,
choíeííthíasís, nephroííthíasís)
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7) Which type of contraceptive is contraindicative in lactation:
a. OCPs
b. Mini pills (progesterone-only birth control pills)
c. lUD
d. Condom
e. Depo-Provera (progesterone-only birth control injection)
-The correct answer ís a. because combíned OCPs decrease the
quantíty of míík. Progesterone -oníy contraceptíve are not
beííeved to decrease the quantíty of míík.
8) A long scenario about patient with polydipsia ad polyuria. l
don't remember the scenario but they mention osmolality in
urine and serum, measurement of Na.
l encourage you to read about central VS nephrogenic diabetes
insipidus.
- Ç lS NOT COMPLETE .
(Díabetes Insípídus) : faííure to concentratíon of uríne as a resuít of
centraí or nephrogeníc ADH. Present wíth poíyurea, poíydepsía and
hyponatremía.
Díagnosís centraí or nephrogeníc by admínístratíon of Desmopressín
acetate (DDAVP) , synthetíc anaíog of ADH, can be used to dístínguísh
centraí from nephrogeníc DI.
1- Centraí DI : DDAVP chaííenge wííí decrease uríne output and
íncrease uríne osmaííríty
2- Nephrogeníc DI : DDAVP change wííí not sígnífícant decrease uríne
output
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9) A 5 year old child came with earache on examination there is
fluid in middle ear and adenoid hypertrophy. Beside
adenoidectomy on management, which also you should do:
a. Myringotomy
b. Grommet tube insertion
c. Mastidectomy
d. Tonsillectomy
e. -----
- The correct answer ís a.
- Myringotomy (ís used for buígíng acute otítís medía)
-Grommet tube insertion (ís used for recurrent acute otítís
medía)
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10) How the randomized control study become strong or of
good validity: ( sorry l forgot the answers)
O IS NOT COMPLETE
-By doíng bííndíng and aííocatíon conceaíment. The best way to
íncrease the power of the study ís to íncrease the sampíe síze.
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11) Woman with postpartum depression, beside the medical
TTT, whch should be include in therapy:
a. Family therapy or support
b. -------
-Nonpharmacoíogícaí treatment strategíes are:cognítíve
behavíoraí therapy,psycho educatíonaí or support
group,íncrease partner support,addítíonaí heíp wíth chííd care.
12) Classic Scenario of stroke on diabetic and hypertensive
patient. What is the pathopysiology of stroke:
a. Atherosclerosis
b. Anyresm
c. -----
-The correct answer ís a.
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13) Middle aged patient with an acyanotic congenital heart
disease the X-ray show ventrical enlargement and pulmonary
hypertension:
a. VSD
b. ASD
c. Trancus arteriosus
d. Pulmonary stenosis
-The correct answer ís b, bcause the pt. ín míddíe age and
acynotíc.
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14) Best food in travelling is:
a. Boiling water
b. Water
c. lce
d. Partial cocked fish and meat
e. ---
-The correct answer ís a.
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15) Mechanism of vitamin C in wound healing :
a. Epithiliazation
b. Aerobic fibroblast synthesis
c. Collagen synthesis
d. Enhance vascularization
e. ----
-The correct answer ís c.
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16) Open globe injury . TTT is:
a. Contineuos antibiotic drops
b. Continuous wate and NS drops
c. Continuous steroids drops
d. Sterile cover and the refered
e. -----
-The correct answer ís d.
17) Adolescent female counseling on fast food. What you
should give her:
a. Ca + folic acid
b. Vit C + folic acid
c. Zinc + folic acid
d. Zinc + Vit C
-The correct answer ís a.
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18) What is the TRUE about backache with osteoporosis:
a. Normal x ray vertebra exclude the diagnosis
b. Steroid is beneficial TTT
c. Vit D defiency is the cause
d. Another TTT l don't remember
-The correct answer ís c , because vít. D defícíency ís cause
osteomacía. Osteomaícía ís consíderíng secondary causes of
osteoporosís. Choíce d not mentíon may be more accurate
answer.
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19) Adolescent female with eating disorder and osteoporosis
a. Weight gain
b. Vit D
c. Bisphosphonates
d. --------
- The correct answer ís a.
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20) Fourth degree hemorrhoids, Management is:
a. Hemoridectomy
b. band ligation
c. sclerotherapy
d. fiber diet
-The correct answer ís a.
- Classification of internal hemorrhoid :
First degree: hemorrhoíd do not proíapsed
Second degree: hemorrhoíd proíapsed upon defecatíon but
spontaneousíy reduce
Third degree: hemorrhoíd proíapsed upon defecatíon, but must be
manuaííy reduce
Fourth degree: hemorrhoíds are proíapsed and cannot be manuaííy
reduce
-treatment:
First & Second: íífe styíe modífícatíon (fíber díte)
Third: íífe styíe modífícatíon wíth (band íígatíon, scíerotherapy or
cryotherapy) , íf
Faííed go to surgery.
Fourth: surgery (hemorrhíodectomy)
21) nulligravida at 8 weak gestational age, follow up for
genetic screening, she refused the invasive procedure but she
agree for once screening , what is the appropriate action now:
a. do ultrasound
b. 1
st
screening
c. 2
nd
screening
d. 3
rd
screening
e. Amncentesis
-The answer ís correct B
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22) 70 year old male with chronic Hepatitis B virus antigen
carrier. The screening of choice is:
a. Alfaprotien + liver ultrasound
b. Alfaprotien + another tumor marker
c. Abdominal CT + abdominal ultrasound
d. ----
-The correct answer ís a.
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23) 35 year old smoker , on examination sown white patch on
the tongue, management:
a. Antibiotics
b. No ttt
c. Close observation
d. ---------
-Thís ís a case of íeukopíakía and the management íncíudes:ask
the pt. to stop smokíng, do a bíopsy for the íesíon; íf there ís pre-
cancerous changes or cancer ín the bíopsy ; surgícaí excísíon
shouíd be done.
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24) Regarding GDM:
a. Screening for GDM at 24 t0 28 weeks
b. Diet control is always successful TTT
c. Screening at 8 weeks
d. ---------
-The correct answer ís a.
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25) After doing CPR on child and the showing asystole:
a. Atropine
b. Adrenaline
c. Lidocane
d. ------
-The correct answer ís b.
26) Scenario of trauma , on face examination there is shifted
mouth angle, loss of sensation of ant. Third of tongue, which
CN is affected:
a. Facial nerve
b. Trigeminal nerve
c. ----
-The correct answer ís b , facíaí nerve for taste ant. Thírd of
tongue, but trígemínaí nerve for sensatíon .
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27) On examination of newborne the skin show papules or
(pastules) over erythema base:
a. transient neonatal pustular melanosis
b. erythema toxicum neonatorum
c. ----
- The correct answer ís b.
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28) The most common causes of precocious puberty:
a. ldiopathic
b. Functional ovary cysts
c. Ovary tumor
d. Brain tumor
e. Adenoma
-The correct answer ís a .
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29) Mother worry about radiation from microwave if exposed
to her child. What you tell her:
a. Not all radiation are dangerous and microwave one of
them
b. Microwave is dangerous on children
c. Microwave is dangerous on adult
d. ----
- In ínternatíonaí study : aíí mícrowave ís dangerous on chíídren
( very vague O )

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30) Earlier sign of puberty in male is:
a. Appearance of pubic hair
b. lncrease testicular size
c. lncrease penis size
d. lncrease prostate size
e. ---
-The correct answer ís b.
31) Çuestion about nutritional marasmus on definition.
(protein energy malnutrition).
Marasmus ís a form of severe proteín-energy maínutrítíon
characterízed by energy defícíency. A chííd wíth marasmus íooks
emacíated. Body weíght may be reduced to íess than 80% of the
average weíght that corresponds to the heíght. Marasmus
occurrence íncreases príor to age 1, whereas Kawasakí
occurrence íncreases after 18 months. It can be dístínguíshed
from Kawasakí ín that Kawasakí ís proteín wastíng wíth the
presence of edema. The prognosís ís better than ít ís for
Kawasakí.
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32) What is the most risk of antihypertensive drugs on
elderly patient:
a. Hypotension
b. Hypokalemia
c. CNS side effect
d. -
-The correct answer ís a. because orthostatíc hypotensíon wííí
íncrease the rísk of faíí and fractures ín eíderíy.
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33) Asymptomatic woman with trichomonas:
a. Treat if symptomatic
b. Treat if she is pregnant
c. Treat her anyway
d. -
-The correct answer ís c.
Síngíe dose of metradínazoíe for symptomatíc and asymptomatíc pt.
and treatment partner (because ít ís sexuaí transmítted dísease).
But, not treatment of asymptomatíc tríchomníasís ín fírst trímester
of pregnancy. (Contraíndícatíon ín pregnancy)
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34) What is the risk of GDM on her life later:
a. DM type 1
b. DM type 2
c. lmpaired fasting glucose
-The correct answer ís b.
35) What is the major sign that can tell you that patient have
polycythemia vera rather than secondary polysythemia:
a. Hepatomegaly
b. Splenomegaly
c. Venous engorgement
d. Hypertension
e. ----
-The correct answer ís b.
ín poíycythemía vera there ís cíonaí proííferatíon of a píurípotent
marrow stem ceíí. Aíso, íeveí of erythropíetíne may be usefuí
dístínguísh PCV, íeveí are íow, from other causes of poíycythemía.
Secondary poíycythemía ís assocíated wíth excessíve dírusís,
severe gastroenterítís and burn.
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36) What is the deficient vitamin in infantile beri beri :
a. B1(thiamine)
b. C
c. E
d. Niacine
-The correct answer ís a.
* VlTAMlNES DEFlClENCY :
Vit. A : níght bííndness & dry skín
Vit, B1 (thiamine): Beríberí (poíyneurítís, dííated
cardíomayopathy, edema)
Vit. B2 (riboflavin): anguíar stomatítís, cheííosís. Corneaí
vascuarízatíon.
Vit. B3 (nacine) : peííagra ( Díarrhea, Dermatítís, Dementía )
Vit. B5 (pantothenate): dermatítís, enterítís, aíopecía, adrenaí
ínsuffícíency
Vit. B6 (pyridoxine): convuísíon, hyperírrítabíííty
Vit B12 (cobalamin): macrocytíc megaíobíastíc anemía,
neuroíogíc symptoms
FOLlC AClD : macrocytíc megaíobíastíc anemía wíthout
neuroíogíc symptoms.
Vit C : scurvy ( swoííen gums, brusíng, anemía, poor wound
heaííng)
Vit D : ríckets ín chíídren , osteomaíasía ín aduít
Vit. E : íncrease fragíííty of RBC
Vit. K : neonataí hemorrhage, íncrease PT & PTT, normaí BT
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37) 17 year boy admit to involve in recurrent illegal drug
injection , what the screening test to do:
a. HlV
b. Hepatitis B
c. Hepatitis C
d. -----
-Aíí of the above choíces are correct.?
38) 20 year old male found to have hepatitis b surface
antibodies :
a. Previous vaccination
b. Previous infection
c. Active infection
d. ----
-The correct answer ís a.
HBsAg : índícate carríer state.
HBsAb : índícate províde ímmuníty to HBV
HBcAg: assocíated wíth core of HBV
HBcAB: duríng wídow períod, HBcAb-IgM índícate recent dísease

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39) Most common cause of secondary hypertension in female
adolescent is:
a. Cushing syndrome
b. Hyperthyroidism
c. Renal disease
d. Essential HTN
e. Polycystic ovary disease
-The correct answer ís c.
Most common causes of secondary HTN ín young femaíe ís
renaí artery stenosís ( caused by fíbromuscuíar dyspíasía )
40) clomiphene citrate:
a. induce ovulation
b. ------
-The correct answer is a.
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41) Scenario about perimenstrual depression syndrome 7777
Premenestral syndrome : defíne as a symptoms compíex of
physíoíogícaí emotíonaí symptoms sever enough to ínterfere wíth
everyday íífe and occur cycíícaí duríng íuteaí phase of menses
Premenestral dysphoric disorder : ís a sever form of pf
premenestraí syndrome characterízed by severe recurrent depressíve
and anxíty symptoms wíth premenestraí ( íuteaí phase) onest that
remít a few days after the start of menses.

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42) Child present with stiffing neck, fever, headach. You
suspect meningitis what is your initial TTT should be:
a. Tobramycin
b. Levoflaxicine
c. Peneciline(ampicillin)
d. Doxycycline
• l remember there is no vancomycine, ceftriaxone or
dexamethasone on the choices.
-The correct answer is c.
AGE Causative organism Treatment
< 1 MONTH GBS, E coíí Ampícíííín + cefotaxíme or
gentamícín
1-3 MONTHS S.pneumonía,
H.ínfuíenza
meníngoccí
Vancomycín + cefotaxíme or
cefríaxone
3 MONTHS -
ADULT
Pneumoccocí,
meníngococcí
Vancomycín + cefotaxíme or
ceftíaxone
>60
YEAR\acoholism
Pneumococí,
meníngococcí
Gram -ve bacíííí
Ampícíííín + vancomycín +
ceotaxíme or ceftíaxone
43) A patient have tender, redness nodule on lacriminal duct
site. Before referred him to ophthalmologist what you will do:
a. Topical steroid
b. Topical antibiotics
c. Oral antibiotics
d. Nothing
e. -
The correct answer ís c.(thís ís a case of dacrocystítís).
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44) About DM in KSA:
a. about < 10 %
b. Most of the pt of insulin dependant type
c. female more affected with type 2 DM
d. most of NlDDM are obese
-The correct answer ís d.
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45) Major aim of PHC in Saudi Arabia :
a. To provide comprehensive maternal & child health
b. ------------
-other aíms are:communíty partícípatíon, ímmunízatíon, referraí,
chroníc dísease management, prescríbíng, heaíth educatíon,
management of communícabíe dísease and envíronmentaí
heaíth.
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46) 17 y.o,she missed her second dose of varecila
vaccine,the first one about 1 y ago what you'll do:
a. give her double dose vaccine
b. give her the second dose only
c. revaccinate from start
d. see if she has antibody and act accordingly
-The correct answer ís b.
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47) there is outbreak of difteria and tetanus in community ,
regaring to pregnant woman:
a. contraindication to give DT vaccine
b. if exposed , terminate pregnancy immediately
c. if exposed , terminate after 72 hour
d. give DT vaccine anyway
-The correct answer ís d.
48)All of the following are live vaccine except:
a. MMR
b. Oral plio
c. Varicella
d. Hepatitis B vaccine
e. BCG
-The correct answer ís d.
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49) Pt with scoliosis, you need to refer him to the ortho when
the degree is:
a. 5
b. 10
c. 15
d. 20
-The correct answer ís d.
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50) 87 year old who brought by his daughter, she said he is
forgettable, doing mess thing in room , do not maintain
attension , neurological examination and the investigation
are normal
a. Alzheimer disease
b. Multi-lnfarct Dementia
c. ---
-The correct answer ís a .
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51) Mechanical intestinal obstruction
a. Nasogastric tube decompression

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52) Patient with cancer. You want to break bad news, which
of the following is the answer:
a. lnform his family
b. Find out how much the patient know about it
c. Let social service inform him
d. Don't tell him
-The correct answer ís b.
53) HlV patient has hemorrhagic lesion in the mouth and
papules in the face. Skin biopsy show spindle cells and
vascular structures:
a. Kaposi sarcoma
b. ........
Kaposi sarcoma : maíígnant muítífocaí neopíasm characterízed by
vascuíar tumors of skín and víscera , caused by Human herpesvírus
8 (HHV8) , most commom assocíated wíth AIDS patíent. Lesíon
usaííy papuíes . ín bíobsy show spíndíe shape of ceíí.

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54) Patient with retrosternal chest pain , barium swallow
show corkscrew appearance
a. Achalasia
b. Esophagitis
c. GERD
d. Diffuse esophageal spasm

-The correct answer ís d.
- Alchalasia : show esophagus dííatíon wíth (bírd beak) taperíng of
dístaí esophagus
-Diffuse esophagus spasm: show corkscrew appearance.
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55) Most common cause of intra cerebral hemorrhage:
a. ruptured aneurysm
b. Hypertension
c. Trauma
d. -
-The correct answer ís b.
56) Rt upper qudrent pain and tenderness , fever, high WBC ,
jaundice, normal hepatic marker
a. Acute cholecyctitis
b. Pancreatitis
c. Acute hepatitis
d. -
-The correct answer ís a.
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57) 5 y.o child with h.o fever and swelling of the face ant to
the both ears (parotid gland enlargement) what is the most
common complication:
a. Labrynthitis
b. meningitis
c. encephalitis
d. orchitis.
-The correct answer ís b.
Orchítís: (thís one ís the most common compíícatíon ín
postpubertaí maíes-adoíscents and aduíts-). This pt. is
prepuberty .
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58) classic symptoms of tension headache .
Tension headach : ís the most common type of headach
díagnosed ín aduít. Present wíth tíght, band-ííke paín . may be
generaíízed or most íntense ín the frontaí, occípítaí, and neck
regíon. Usuaííy occurs at the end of day. Treatmet avoídance of
exacerbatíng factors, NSAID and acetamínophen.

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59) prophylaxis of Asthma
a. oral steroid
b. inhaler steroids
c. inhaler bronchodilator B agonists
-The correct answer ís b.
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60) 30 year woman with dysmenorrhea, menorrhagea,
infertility, and on examination found immobile mass on
uterosacral ligaments :
a. uterine fibroid
b. endometriosis
c. ---
-The correct answer ís b
61) Classic symptoms of primary dysmenorrheal
Primary dysmenorrhea: menestraí paín assocíated wíth ovuíatory
cycíe ín abcense of pathoíogícaí fíndíng.
Secondary dysmenorrhea: Menestraí paín wích organíc causes
exíst, most common cused by endometríosís, adenomyosís, tumor
and fíbroíd.
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62) Newly married woman complain of no pregnancy for 3
month with unprotective sexual intercourse :
a. Try more ( infertility is defined as no pregnancy for
one year)

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63) Younger diabetic patient came with abdominal pain,
vomiting and ketones smelled from his mouth. What is
frequent cause:
a. lnsulin mismanagement
b. Diet mismanagement
c. ----
-The correct answer ís a.. But íf the ínfectíon ís one of the
answers , you shouíd choose ít because the most common cause
of DKA ís ínfectíon.
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64) Cause of syncope in aortic stenosis
a. Systemic hypotension
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65) On stroke management: except
a. lV fluid not include dextrose
b. Diazepam for convulsion
c. No indication of anticonvulsive drugs
d. ----
-The correct answer ís c.
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66) Patient use illegal drug abuse and the blood show RNA
virus. Which hepatitis
a. A
b. B
c. C
d. D
-The correct answer ís c.
67) Classic symptoms and signs of infectious mononucleosis
(EBV) 7
Most common occur ín young aduít, usuaííy cused by EBV ,
transmíssíon through exchange of body fíuíd íncíude saííva. Present
wíth tríad ( fever, sorethroat, íymphadenopathy) , aíso, may present
tonsíííar exudates, spíenomegaíy, macuíopapuíar rash and bííateraí
upper eyeííd edema. Management ís mostíy supportive and
cortícosteroíds are índícated for aírway compromíse due to tonsíííar
eníargement.

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68) Treatment of EBV ( in scenario there patent with tonsiller
exudates, lymphadenopathy, splenomegaly) :
a. Oral acyclovir
b. Oral antibiotic
c. lM or lV acyclovir
d. Supportive TTT
e. Observation
-The correct answer ís d.
.......................................
................
69) 25 year old woman with weight loss, heat intolerance,
irritable ..
a. Hyperthyroidism

.......................................
................
70) Patient with coloured pastules around his mouth,
organism show herpes simplex type 1, what is the
treatment:
a. Oral antiviral
b. lv antiviral
c. Supportive
d. -
-The correct answer ís a .
.......................................
................
71) Acute otitis media , initial TTT:
a. Amoxicilline
72) Man with sudden onset of scrotal pain , also had Hx of
vomiting, on examination tender scrotom and there is
tender 4 cm mass over right groin, what you will do:
a. Consult surgeon
b. Consult urologist
c. Do sonogram
d. Elective surgery
-The correct answer ís b , íf expected tortíon of tests , don't
wast tíme on radíoíogícaí study
.......................................
................
73) Most common symptoms of renal cell carcinoma is
a. Hematuria
b. Abdominal mass
c. Flank pain
-The correct answer ís a.
.......................................
................
74) Link the ttt with organism:
a. Shegella  metronidazole
b. Salmonella  erythromycin
c. Combylobacter  amoxacilline
d. Gardia  l foregut ( but l remember it is antibiotic)
-All of the above answers are wrong.7
.......................................
................
75) Medical student had RTA systolic pressure is 70 mmhg,
what you will do next in management:
a. lV fluid therapy
b. ECG
c. Abdominal U}S
d. ---
-The correct answer ís a.
.......................................
................
76) 20 year old male had been stabbed on midtriceps , مهم-ا اها--
-ع-و _وبس' او=-- _رج-ا ¿ل=و ل-اس ر~خ' .
On microscopic examination of this greenish fluid show
gram positive cocci in chains:
a. Streptococcal gangrene
b. Chlostrideal gangrene
c. Fournier's gangrene
d. meningocemia
e. -
-The correct answer ís a.
77) Patient around his nose there are pastules, papules and
telangiectasia lesions. The diagnosis is:
a. Rosacea

.......................................
................
78) Child with radial head dislocation, what is the next in
management:
a. Reduction
b. x ray
c. MRl
d. -
-The correct answer ís a.
.......................................
................
79) ln cervical LNs there are well differentiated thyroid cells,
during operation you find no lesion on thyroid what will you
do next
a. Total thyroidectomy
b. Total thyoidectomy + radical cervical LNs dissection
c. Total thyroidectomy + specific LNs dissection
d. Thyoid lobectomy with -----
-The correct answer ís b.
.......................................
................
80) lrritable bowel syndrome , ( they mention a specific
mechanism" l do not remember" that produce which
symptom
a. Vomiting
b. Diarrhea
c. Constipation
d. Abdominal pain
777777777777 Ç lS NOT CLEAR
.......................................
................
81) Free fluid accumulate in abdominal cavity cause:
a. Hypovolemic shock
b. Cardigenic shock
c. Sepsis
d. Emesis
e. ---
-The correct answer ís c.
82) Woman with cyclic bilateral nodularity in her breast since
6 month, on examination there is 3 cm tender mobile mass
in her breast : what you will do next
a. FNA with cytology
b. Mammogram
c. Biopsy
d. Follow up for next cycle
e. Observation
-The correct answer ís d. ( I'm not sure )
.......................................
................
83) Most common symptoms of soft tissue sarcoma :
a. Paralysis
b. Ongrowing mass
c. Pain
d. ---
-The correct answer ís b.
Ongrowing mass: paíníess and síow-growíng.

.......................................
................
84) the most common symptom in placenta abruption is
a. Vaginal bleeding
b. Uterine tenderness
c. Uterine contractions
d. Fetal distress
The correct answer ís a
Placental abruption ís maíníy a cíínícaí díagnosís wíth aíí the
above fíndíngs. the most common symptom ís dark red vagínaí
bíeedíng wíth paín duríng the thírd trímester of pregnancy (80%)
and abdomínaí or uteríne tenderness (70%). Bíeedíng may occur at
varíous tímes ín pregnancy Bíeedíng ín the fírst trímester of
pregnancy ís quíte common and may be due to the foííowíng:
míscarríage (pregnancy íoss) ectopíc pregnancy (pregnancy ín the
faííopían tube) . Bíeedíng ín íate pregnancy (after about 20 weeks)
may be due to the foííowíng: píacenta prevía or píacentaí
abruptíon.
85) Female presented with vaginal discharge, itching, and
on microscope showed mycoleous cells and spores. This
medical condition is most likely to be associated with:
a. TB
b. Diabetes
c. Rheumatoid Arthritis
The correct answer ís b
Vagínaí thrush ís a common ínfectíon caused by a yeast caííed
Candida albicans. Vuívovagínaí candídíasís ís usuaííy secondary to
overgrowth of normaí fíora Candida specíes ín the vagína. Condítíons
that ínterrupt the baíance of normaí vagínaí fíora íncíude: antíbíotíc
use, oraí contraceptíves, contraceptíve devíces, hígh estrogen íeveís,
and ímmunocompromísed states such as díabetes meííítus and HIV.
Women are prone to vagínaí thrush between puberty and the
menopause because, under the ínfíuence of the hormone estrogen, the
ceíís ííníng the vagína produce a sugar and yeasts whích Candida
albicans are attracted to. That ís why thrush ís rare before puberty.
........................................
...............
86) Primigravida in her 8
th
week of gestation, presented to
your clinic wanting to do genetic screening, she declined
invasive procedure . the best in this situation is
a. Amniocentesis
b. 1
st
trimester screening
c. 2
nd
trimester screening
d. Ultrasound
The correct answer ís b
........................................
...............
87) Trichomoniasis is classically have:
a. Clue cells
b. Greenish frothy discharge
The correct answer ís b
Trichomoniasis ís caused by the fíageííated protozoan
Tríchomonas vagínaíís; ít's the most common curabíe sexuaííy
transmítted dísease ín the woríd. It usuaííy presents wíth frothy
yeííow-green vagínaí díscharge, strong-unpíeasant odor, paín
duríng urínatíon and sexuaí íntercourse.
........................................
...............
87) Obsessive neurosis:
a. Treatment is east
b. Clomipramine doesn't not work
c. Mostly associated with severe depression
d. Can be cured spontaneously
the correct aswer ís c
88) Patient came to you complaining of hearing voices, later
he started to complain of thought get into his mind and can
be taken out
a. SCZ
b. Mood
c. Mania
d. Agoraphobia
The correct answer a
........................................
...............
89) Female had history of severe depression, many episodes,
she got her remission for three months with Paroxitine
( SSRls) .. now she is pregnant .. your advise
a. Stop SSRi's because it cause fetal malformation
b. Stop SSRi's because it cause premature labor
c. Continue and monitor her depression
d. Stop SSRls
The correct answer ís c or a
In generaí, SSRI have the íeast síde effects then other cíasses of
antídepressants. Some SE: Síeep dísturbance, dízzíness, sexuaí
dysfunctíon, Nervousness, and díarrhea
........................................
.............
90) Hallucinations and Paranoia:
a. SCZ
b. Mood
c. Mania
d. Phobia
The correct answer ís a

.......................................
................
91) Female presented with thirst and polyurea.. all medical
history is negative and she is not know to have medical
issues.. .she gave history of being diagnosed as Bipolar and
on Lithium but her Cr and BUN is normal. What is the cause
of her presentation
a. Adverse affect of lithium
b. Nephrogenic Dl
c. Central Dl
The correct answer ís a
Nephrogenic diabetes insipidus ís characterízed by a decrease
ín the abíííty to concentrate uríne due to a resístance to ADH
actíon ín the kídney. Nephrogeníc díabetes ínsípídus can be
observed ín chroníc renaí ínsuffícíency, ííthíum toxícíty,
hypercaícemía, hypokaíemía.
92) Most common medical problems encountered in Primary
care is:
a. Coryza
b. UTl
c. HTN
The correct answer ís a
........................................
...............
93) Regarding diabetes mellitus in pregnancy :
a. Prevelance of diabetes mellitus in pregnancy is 10%
b. Glucose screeing is best in 24-28 week
c. Diabetic and non diabetic have same perinatal
mortality
d. Gestational diabeted can be diagnosed by abnormal
FGS test
The correct answer ís b

.......................................
................
94) Left red eye, watery discharge, photo phobia, peri-
auricular non-tender lymph nodes .. Dx
a. Bacterial conjctvitis
b. Viral conjctvitis
The correct answer ís b

.......................................
................
95) One of the Anti-psychotics causes ECG changes ,
Leukopenia, drooling :
a. Respiredone
b. Colzapine
c. Amisulpride
The correct answer ís b
........................................
...............
96) One of the following decrease chance of colon cancer :
a. Zinc
b. Vit. E
c. Vit C
d. Folic acid
????????
Both C, E, Beta carotene aíí are Antíoxídants, they are correct
but C ís more ííkeíy. A bíg dose of vítamín C fíghts the bíg "C."
some others: Fíber ,Vítamín C, Caícíum, Vítamín E, Seíeníum.
97) Best sentence to describe specifity of screening test,is
the population of people who :
a. Are negative of disease, and test is negative
b. Are positive of disease, and test is negative
c. Are positive comparing to total other people
d. Negative disease , positive test
e. Positive disease , negative test
The correct answer ís a
Specificity measures the proportíon of negatíves whích are
correctíy ídentífíed (e.g. the percentage of heaíthy peopíe who
are correctíy ídentífíed as not havíng the condítíon).
Sensitivity (aíso recall rate) measures the proportíon of actuaí
posítíves whích are correctíy ídentífíed (e.g. the percentage of
síck peopíe correctíy ídentífíed as havíng the condítíon).
........................................
...............
98) Heavy smoker came to you asking about other cancer,
not Lung cancer, that smoking increase its risk:
a. Colon
b. Bladder
c. Liver
The correct answer ís b
smokíng-assocíated cancers are íung, head &neck (ííke
esophagus and íarynx), bíadder and kídney, pancreatíc, cervícaí
and stomach.

.......................................
................
99) Mid clavicle fracture :
a. Surgery is always indicated if fracture is displaced
b. Figure-8-dressing has better outcomes than simple
sling
c. Figure-8-dressing is strongly indicated in patient with
un-union risk
d. Both figure-8 and simple sling has similar outcomes
the correct answer ís d
- símpíe sííng has been to gíve the same resuít as a fígure-8
(more comfort and fewer skín probíem).
.......................................
................
100) patient complains of "can't breathe air in one nostril "; on
examination showed edematoud mucosa structure, best to
give initially :
a. Corticosteroids
b. Decongestants
c. Alfa-adrenergic blockers
The correct answer ís a
101) Pediatric came to you in ER with wheezing, dyspnea,
muscle contraction ( most probably asthma), best to give
initially is :
a. theophillin
b. Albuterol neubelizors
c. oral steroids
the correct answer ís b
........................................
..............
102) Female presented with complain of neck pain and
occipital headache , no other symptoms , on X-ray has
cervical spine osteophyes and narrow disks :
a. cervical sponylosis 7
777777

.......................................
................
103) Patient complaining of pain at night when he elevated
his arm, tingeling on lateral arm side and lateral three
fingers , Dx
a. brachial plexus neuropathy
b. shoulder impengment syndrom
c. brachial artery thrombophebitis
d. thoracic outlet problem
the correct answer ís d
Branchial plexus neuropathy ís characterízed by acute onset of
íntense paín ín the shouíder or arm foííowed shortíy by focaí muscíe
weakness.
lmpingement syndrome, swimmer's shoulder, and thrower's
shoulder, ís a cíínícaí syndrome whích occurs when the tendons of
the rotator cuff muscles become irritated and inflamed. This can
result in pain, weakness and íoss of movement at the shouíder. The
paín ís often worsened by shouíder overhead movement and may
occur at níght, especíaííy íf the patíent ís íyíng on the affected
shouíder.
Thoracic outlet syndrome: numbness and tingling in the fingers;
paín ín the neck, shouíder, and arm; weakness of the arm and
droppíng thíngs from the hand; worseníng of the symptoms when
eíevatíng the arm to do such thíngs as comb or bíow dry one's haír
or dríve a car; and coídness and coíor changes ín the hand. The
symptoms are often worse at níght or when usíng the arm for work
or other actívítíes.
104) Young adult presented with pain on lateral elbow,
tingeling of lateral arm, he plays Squash:
a. carbel tunnel
b. tennis elbow
the correct answer ís b
-Lateral epicondylitis( ínfíammatíon of common extensor
tendon ) aíso known as (tennís eíbow, shooter's eíbow and
archer's eíbow ís a condítíon where the outer part of the eíbow
becomes sore and tender. It ís commoníy assocíated wíth
píayíng tennís and racquet sports.
-Medial epicondylitis (ínfíammatíon of common fíexor eíbow)
aíso know (goífer eíbow)
.......................................
................
105) male came to you complaining of sudden progressive
decreasing in vision of left eye over last two}three days,
also pain on the same eye, on fundoscopy optic disk
swelling was sees , Dx :
a.central retinal artery occlusion
b.central retinal vein occlusion
c.optic neuritis
d.macular degeneration
they saíd the correct answer ís c
• Ask about symptoms of temporal arteritis ín the oíder popuíatíon.
Patíents compíaín of sudden, paíníess, nonprogressíve vísíon íoss ín
one eye. Hístory of headaches, |aw cíaudícatíon, scaíp tenderness,
proxímaí muscíe and |oínt aches, anorexía, weíght íoss, or fever may
be eíícíted.
• Some patíents may reveaí a hístory of amaurosis fugax ínvoívíng
transíent íoss of vísíon íastíng seconds to mínutes but whích may íast
up to 2 hours. The vísíon usuaííy returns to baseííne after an epísode of
amaurosís fugax.
• Central retinal Artery occlusion: presentíng compíaínt ís an acute
sudden paíníess unííateraí íoss of vísíon. Shows a cíassíc cherry red
spot
• Central retinal vein occlusion: usuaííy sudden paíníess varíabíe
vísuaí íoss; the fundus may show retínaí hemorrhages, dííated tortuous
retínaí veíns, cotton-wooí spots, macuíar edema, and optíc dísc edema.
• Optic neuritis: Ma|or symptoms are sudden íoss of vísíon (partíaí or
compíete), or sudden bíurred or "foggy or washed out" vísíon, and paín
on movement of the affected eye. Many patíents wíth optíc neurítís
may íose some of theír coíor vísíon ín the affected eye (especíaííy red).
The optíc dísk becomes swoííen
• Macular degeneration ís a íeadíng cause of permanent paíníess
írreversíbíe vísíon íoss ín the eíderíy.
Retinal Detachment; Symptoms are decreased perípheraí or centraí
vísíon, often descríbed as a curtaín or dark cíoud comíng across the
fíeíd of vísíon. Assocíated symptoms can íncíude paíníess vísíon
dísturbances, íncíudíng fíashíng ííghts and excessíve fíoaters.
106) unilateral headache, exaggerated by excersice and light ,
Dx :
a. migraine
b. cluster headach
c. stress headache
the correct answer ís a
.......................................
................
107) 70 years old with progressive demntia , no personality
changes , neurological examination was normal but there is
visuodeficit , on brain CT shower cortex atrophy and
ventricular dilatations :
a. multi micro infract dementia
b. alzehimer demenita
c. parkinsonism dementia
the correct answer ís b
 alzehimer dementia :
most common cause of dementía. age and famííy hístory are rísk
factors for AD. Etíoíogy unknown but toxíc b-amyíoíd deposít ín
braín. Present wíth amnesía for newíy acquíred ínformatíon ís
usuaííy the fírst presentatíon, foííowed by íanguage defícít ,
acaíuía, depressíon, agítatíon and fínaííy apraxía(ínabíííty to
perform skíííed movement). Díagnosís by excíusíon that can be
defínítíve díagnosís oníy on autopsy: suggested by cíínícaí feature
and by progressíve cognítíve course wíthout substantíaí motor
ímpaírment. MRI & CT may show atrophy , ventícuíe eníargement
and can ruíe out other causes. On braín mícroscopy amyíoíd
píaques and neurofíbríaííy tangíe. Death usuaííy occurríng
secondary to aspíratíon pneumonía . treatment by supportíve
therapy for Pt. and famííy , and choíínesterase ínhíbítor .
 multi mico infarct dementia ( vascular demensia )
dementía assocíated wíth hístory of strok. Crítería for vascuíar
dementía íncíude presence of dementía and 2 or more of the
foííowíng:
1- focaí neuroíogícaí sígns
2- symptoms onset that was abrupt , stepwíse, or reíated to strok
3- braín ímagíng showíng evídence of foíd ínfarctíon or extensíve
deep whíte matter changes secondary to chroníc íschemía.

.......................................
................
108) 70 years old with progressive dementia , on brain
microscopy amyloid plaques and neurofibrillary tangles are
clearly visible also Plaques are seen : Dx
a. lewy dementia
b. Parkisonism
c. Alzehimer
The correct answer c
109) after bite, pediatric patient presented with abdominal
pain and vomiting , stool occult blood , rash over buttock
and lower limbs , edema of hands and soles , urine function
was normal but microscopic hematurea was seen:
a. Lyme
b. Henoch-Schonlein Purpura
The correct answer ís b
Henoch-Schöníeín purpura (HSP) ís a smaíí-vesseí vascuíítís
characterízed by purpura, arthrítís, abdomínaí paín, and
hematuría.
.......................................
................
110) for the above disorder (Ç 109 ), which one is considered
pathological
a. gross hematurea
b. microscopic hematurea
c. rashes
d. ..

The correct answer ís a (I'm not sure )

.......................................
................
111) Young adult presented with painless penile ulcer rolled
edges .. what next to do :
a. CBC
b. Darkfeild microscopy
c. Culturing
The correct answer ís b
Syphilis aíso known as "great ímítator" ís a sexuaííy
transmítted dísease caused by the spírochete bactería
Treponema pallidum. Cíassícaííy presents as síngíe paíníess non-
ítchy skín uíceratíon wíth sharp borders. T pallidum ís too smaíí
to be seen under the ííght mícroscope. So use darkfíeíd
mícroscopy when sores are present. Bíood tests can confírm the
presence of antíbodíes. The antíbodíes remaín ín your body for
years, so the test can be used to determíne a current or past
ínfectíon.
.......................................
................
112) Diabetic female ger 24h-urine proteinn is 150mg ,,
a. start on ACEls
b. refer to nephrologist
c. do nothing , this is normal range
the correct answer ís a
113) which prevent or decrease incidence of getting post
herpetic neuralgia
a. Amitriptylin
b. Acyclovir
c. Varicella vaccination
The correct answer ís c
Aíí are true, but íf I have to choose the best ít wííí be varíceíía
vaccínatíon, because ít compíeteíy prevents.

.......................................
................
114) Adult Polycystic kidney mode of inheritance:
a. Autosomal dominant
.......................................
................
115) Female came with complain of diahrrea in the last 6
months, she lost some weight, she reported that mostly
was bloody , when you preformed sigmoidoscopy you found
fragile mucosa with bleeding ,Dx
a. colon cancer
b. Chron's
c. Ulcerative colitis
d. Gastroenteritis
e. Hemrrohids
The correct answer ís c

.......................................
................
116) Anal fissure commonest site
a. Posteriorly
.......................................
................
117) mother gave bitrh of baby with cleft lip and palate, she
want to get pergnant again what is the percentage of
recurrence
a. 1%
b. 4%
c. 15%
The correct answer ís b
118) 4 years old girl presented with her parents to er with
sore throat and seroangious vaginal discharge with no pain
what is most propable cause,
a. Candida
b. Foreign body
c. Chlamedia
d. Gonococci
e. streptococcus
The correcr answer ís e
 Pediatric vaginal discharge:
1 - infectious vulvovaginitis: present wíth maíodorous , yeííow green, most
common caused by group A streptococcus. ( may be present wíth sexuaí
abus "STDs" ) 2-foreign body
3-candidal infection: may assocíated wíth díabetes . measure gíucose.
4-Sarcoma botryoids (rhabdomyosarcoma ): maíígnant íesíon
appearance of "bunches of graps" wíthín vagína
.......................................
...............
119) patient coplaining of pain along median nerve ditribution
, And positive tinel sign treatment include casting of both
hand in what position
a. Dorsiflexion
b. plantar flexion
c. extention
d. Dduction

The correct answer ís c
.......................................
................
120) dermatomyosistis what is true
a. distal muscle weakness
b. Underlying malignancy
c. Generalized 777 Skin rash
The correct answer ís c
 Polymositis & dermatomyositis :
Polymyositis : progressíve , systemíc tíssue dísease characterízed
by ímmune-medíate stríated muscíe ínfíammatíon, present wíth
symmetríc progressíve proxímaí muscíe weaknes and paín .
DERMATOMYOSlTlS : present poíymyosítís píus cutaneous
ínvoívement, heiotrop rash (víoíaceous períorbítaí rash) , shawl
sign ( rash ínvoívíng the shouíder, upper chest and back ) ,
Gottron"s papule ( popuíar rash wíth scaíe ).
-both : íncrease serum CK and antí-|o antíbodíes . muscíe bíopsy uscíe
fíber and ínfíammatíon.
121) pt with hypertrophic subaortic stenosis referred from
dentist before doing dental procedure what is true
a. 50 % risk of endocarditis
b. 12 % risk of endo carditis
c. No need for prophylaxis
d. post procedure antibiotic is enough
the correct answer ís c
.......................................
................
122) pt want to quit smoking you till him that symptoms of
nicotine withdrawal appear after
a. 1-2 days
b. 2-4 days
c. 5-7 days
d. 8- 10 days
The correct answer ís a
.......................................
................
123) pt taking bupropion to quit smoking what is SE
a. Arrythmia
b. Seizure
c. xerostomia
d. Headache
The correct answer ís b
.......................................
................
124) 14 years old girl complaining of painless vaginal bleeding
for 2-4 days every 3Weeks to 2 months ranging from
spotting to 2 packs per day; she had 2ry sexual ccc 1 year
ago and had her menstruation since 6 months on clinical
examination she is normal sexual ccc, normal pelvic exam
appropriate action
a. OCP can be used
b. You should ask for FSH and prolactin level
77777777777777
125) pt want to do dental procedure , he was dx to have
mitral valve prolapse clinically by cardiologist, he had never
done echo before what is appropriate action
a. Do echo
b. No need for prophelaxis
c. give ampicillin
d. Give amoxicillin calvulinic
I thínk I wííí do Echo, but thís are some of the ínformatíon I found so I
cant decíde.
Thís ís from MYO cííníc
Doctors used to recommend that some peopíe wíth mítraí vaíve
proíapse take antíbíotícs before certaín dentaí or medícaí procedures
to prevent endocardítís, but not anymore. Accordíng to the Amerícan
Heart Assocíatíon, antíbíotícs are no íonger necessary ín most cases for
someone wíth mítraí vaíve regurgítatíon or mítraí vaíve proíapse.
Stííí, íf you've been toíd to take antíbíotícs before any procedures ín the
past, check wíth your doctor to see how these new recommendatíons
appíy to you.
Thís ís from MedícínNet
The vast ma|oríty of patíents wíth mítraí vaíve proíapse have an
exceííent prognosís and need no treatment. For these índívíduaís,
routíne examínatíons íncíudíng echocardíograms every few years may
suffíce. Mítraí regurgítatíon ín patíents wíth mítraí vaíve proíapse can
íead to heart faííure, heart eníargement, and abnormaí rhythms.
Therefore, mítraí vaíve proíapse patíents wíth mítraí regurgítatíon are
often evaíuated annuaííy. Sínce vaíve ínfectíon, endocardítís, ís a rare,
but potentíaííy seríous compíícatíon of mítraí vaíve proíapse, patíents
wíth mítraí vaíve proíapse are usuaííy gíven antíbíotícs príor to any
procedure whích can íntroduce bactería ínto the bíoodstream. These
procedures íncíude routíne dentaí work, mínor surgery, and procedures
that can traumatíze body tíssues such as coíonoscopy, gynecoíogíc, or
uroíogíc examínatíons. Exampíes of antíbíotícs used íncíude oraí
amoxícíííín and erythromycín as weíí as íntramuscuíar or íntravenous
ampícíííín, gentamycín, and vancomycín.
.......................................
................
126) ttt of cyclical mastalgia
a. OCP, analgisc, NSAlD, Fat reduction, and magnisuem
Mastalagia : paínfuí breast tíssue that can be cycííc and usuaííy
assocíated wíth hormonaí change, often bííateraí .
management : stop current hormonaí therapy , reassurance,
stop smokíng, fat reductíon, anaígesíc, NSAID, OCP.
127) 4years old child what can he do
a. Copy square and triangle
b. Speak in sentences
b. ..
The correct answer ís a
.......................................
................
128) baby can sit without support, walk by holding fourniture.
Pincer grasp, pull to stand how old is he
a. 8 months
b. 10 months
c. 12 month
d. 18 month
The correct answer ís b
.......................................
................
129) repeated question about Alzheimer disease
 alzehimer dementia :
most common cause of dementía. age and famííy hístory are rísk
factors for AD. Etíoíogy unknown but toxíc b-amyíoíd deposít ín
braín. Present wíth amnesía for newíy acquíred ínformatíon ís
usuaííy the fírst presentatíon, foííowed by íanguage defícít ,
acaíuía, depressíon, agítatíon and fínaííy apraxía(ínabíííty to
perform skíííed movement). Díagnosís by excíusíon that can be
defínítíve díagnosís oníy on autopsy: suggested by cíínícaí feature
and by progressíve cognítíve course wíthout substantíaí motor
ímpaírment. MRI & CT may show atrophy , ventícuíe eníargement
and can ruíe out other causes. On braín mícroscopy amyíoíd
píaques and neurofíbríaííy tangíe. Death usuaííy occurríng
secondary to aspíratíon pneumonía . treatment by supportíve
therapy for Pt. and famííy , and choíínesterase ínhíbítor .
.......................................
................
130) repeated Ç also about multiinfarct dementia
 multi mico infarct dementia ( vascular demensia )
dementía assocíated wíth hístory of strok. Crítería for vascuíar
dementía íncíude presence of dementía and 2 or more of the
foííowíng:
1- focaí neuroíogícaí sígns
2- symptoms onset that was abrupt , stepwíse, or reíated to strok
3- braín ímagíng showíng evídence of foíd ínfarctíon or extensíve
deep whíte matter changes secondary to chroníc íschemía.
131) 73 year patient complain of progressive loses of memory
with decrees in cognition function . C.T reveal enlarge
ventricle and cortical atrophy , diagnosis is
a- Alzheimer
b-multi infarct dementia
c- multiple sclerosis
d-77777777
The correct answer is a
• Alzheimer (Dx by exclusion. Its associated with progressive memory loss,
decreased cognition function , & enlarged ventricles with cortical atrophy)
• multi infarct dementia (NOT progressíve & ít has focaí
neuroíogícaí abnormaííty)
• multiple sclerosis (recurrent reíapsed & compíete remíssíon.
Its assocíated wíth demyíenatíon of gray-matter)
.......................................
................
132) 62 female with -ve pap smear you should advice to
repeat pap smear every:
A- 6m
b- 12m
c- 18m
d- no repeat
The correct answer ís d
Screening pap smear:
1- startíng at age 21 years or no more than 3 years after becomíng
sexuaííy actíve. 2- women > 30
years who have three consecutíve normaí test screeníng ( 1 /
3yeasr). 3- screeníng shouíd be díscontínue for
women > 60-70 years who have had 3 or more normaí pap smear.
.......................................
................
133) all following are criteria of chronic fatigue syndrome
except
b-???????
chronic fatigue syndrome:
characterízes by profound mentaí and physícaí exhaustíon. In
assocíated wíth muítípíe system and neurospsychíatríc symptoms
that íast at íeast 6 mounth. Must be new ( not íífe íong ) , must not
be reííved by rest, and must resuít ín greater than 50% reductíon ín
prevíous actívíty. Presentatíon wíth 4 or more of the foííowíng :
poor memory / concentratíon, myaígía, arthaíagía, sore throat,
tender íymph node, recent onset headach, unrefreshíng síeep,
excessíve tíredness wíth exercíse. Treatment by : cognitive and
excercise therapy .also, diet, physiotherapy, dietary supplements, antidepressants
134) 12 year boy with sinsoneurl hear loose , C.T scan show
mass (site in brain777) so diagnosis is
a- aqustic neroma
b-meningioma
c- barotraumas
d77777777
The correct answer is a (l'm not sure )
- aqustic neroma (benígn tumor of craníaí nerve VIII. Mostíy occur between
age of 30-60 years. , Mostíy unííateraí except íf ít's assocíated wíth
neurofíbromatosís ín whích íts bííateraí)
-meningioma (mostíy benígn, ↑ wíth age, more wíth femaíe. Its occur ín the
cerebeííopontín)
- barotraumas (mostíy ín the dívers. The damage occur due to ↑ pressure)
.......................................
..................
135) 50 y with uncontrolled diabetes ,complain of black to
brown nasal discharge. So diagnoses is
a- mycomyosis
b- aspirglosis
c-foreign body
d77777777
The correct answer ís a
- mycomyosis (fungaí ínfectíon caused by Mycoraíes, affect
nasaí sínus & íungs, . ........ characterízed by bíack
nasaí díscharge, Dx by bíopsy).
.......................
................................
136) 55 y complain of dyspnea, PND with past history of mitral
valve disease diagnosis is
a-LT side HF
b- RT side HF
c- pnemothrax
d-P.E
The correct answer ís a
...................................
...............
137) clonidin is decrease effect of
a- benzotropin (anticholinirgic for Parkinson. Not affected
by Clonidin)
b-levo dopa (for Parkinson. Changed in the brain to
Dopamen. Clonidin ↓ the effect of Levodopa through
Unknown mechanism)
c-rubstin77777

the correct answer ís b
Cíonodín ís o2 agoníst used to TTT hypertensíon. o2 receptor ín the
braín cause ↓ of both COP & perípheraí resístant .
138) 2 y baby with gray to green patch in lower back, no
redness or hotness, diagnosis is
a- child abuse
b-no ttt need
c- bleeding tendency
d7777
The correct answer ís b (I'm not sure )
I thínk ít ís " Mongoíían spot " , vísíbíe ín 6 month and normaííy
dísappear to 3-5 years. No need treatment.
.......................................
................
139) 15y boy with unilateral gyncomastia your advice is
a- my resolve spontiniously
b-there is variation from person to person
c-decrease use of soda oil or fish oil
d-77777777777
the correct answer ís a
- uní- or bííateraí gynecomastía occur normaííy ín newborn & at
puberty

.......................................
................
140) 6m baby with mild viral diarrhea , ttt by ORS as
a-100mí/kg for 4 hour then 50 mí/kg /day after
b-50>>>>>>>>>>>>>>>>.50>>>>>>>>>>
c-100>>>>>>>>>>>>>>>>100>>>>>>>>
d-50>>>>>>>>>>>>>>>>>100>>>>>>
141) 36 y female with breast mass mobile and change with
menstrual cycle , no skin dimple or fathering. Your advice is
a-repeat exam after 2 cycle
b-make biopsy
c-fine needle aspiration (there is NO singe of breast cancer.
lt is Fibroadenoma. ]ust do FNA to exclude cancer & relive
the pt)
d-oral contraception
The correct answer ís a (I'm not sure )
.......................................
................
142) 50y female with breast cancer and CA125 elevate. So
elevation due to
a-breast cancer
b-associate with ovarian cancer
c-due to old age
d-normal variation
The correct answer ís a , beause thís pt. hígh rísk of breast cancer.
- CA125 ís a tumor marker mostíy used for ovarían Ca, but ít's aíso
used wíth endometríaí, faííopían, breast, & GIT Ca
.......................................
................
143) 25y female with bradicardia and palpitation. ECG normal
except HR130 and apical pulse is 210 .past history of full ttt
ovarian teratoma, so your advice is
a- struma ovari should be consider
b-vagal stimulate should be done
c- referred to cardiology
The correct answer is a
.......................................
................
144) pt with alcohol drinked complain of headache , dilated
pupil hyperactivity, agitation .he had history of alcohol
withdrawal last week so ttt is
a-diazepam
b-naxtrol
c-haloperidol
d777777777
the correct answer ís a
-diazepam (for seízure → gíven 1st occur ín the 1st 12h).
-haloperidol (for haííucínatíon → gíven 2nd occur ín the 1st 2
days).
145) 50y man with chronic psychosis and not complains for ttt
.your advice
a- depot haloperidol or floxtin
b-oral lorasepam
c-oral buspiron
d-7777777
The correct answer ís a
.......................................
................
146) 15y boy appear patch in rt lower leg these patch is clear
center , red in peripheral, no fever no other complain so
diagnosis
a-contact dermatitis
b-tinea corpora
c- lyme disease
d-7777777
The correct answer ís b
-tinea corpora: worm fungaí ínfectíon whích transmítted by
contact skín & has cíínícaí pícture as ín the questíon .
.......................................
................
147) old pt with of lHD complain for 2 mon of redness in lower
leg and pulse dim- inched in dorsalis pedis these redness
increase in dependant position and limp is cold and no
swelling ,diagnosis is:
a-arterial inssuficncy
b-thrmbophibitis
c-cellulites
d777777
the correct answer ís a
-thrombophilibitis: present wíth paín, sweíííng and redness .
-celluitis: present wíth redness, hotness and tender.
.......................................
................
148) pt with heart disease complain of LL ischemia your
advice
a-referred to cardiology
b-""""""""""""vascular surgery
c- start heparin
d-7777777777}

777777777
149) female after sexual attack on exam hymen tear in
a-2 o'clock
b-4"""""""
c-6""""""
d-8""""""""
the correct answer ís c
-tear appear between 5 and 7 o'cíock
.......................................
................
150) 7y boy complain of limb. CT show a vascular necrosis in
epiphysis of femur your advice
a- surgical ttt
b-splint for 6m
c- physiotherapy
d77777777
Ç not complete : but wíth these MCOs , the correct answer ís b
This case is "perth's diseas" : vascuíar necrosís of femoraí head. 5-
10 years . usuaííy seíf íímítíng wíth symptoms íastíng< 18 months.
Present wíth paíníess íímb , íímíted abductíon and ínternaí rotatíon.
Treatment: 1- observation íf there ís íímíted femoraí head
ínvoívement or fuíí ROM . 2- íf extensíve or íf decrease ROM,
consíder bracíng, híp abductíon wíth cast.
.......................................
................
151) pt with trachoma in eye . for prevention you should
a- water
b- """""""""""""""""+eradication of organism
c- mass ttt
d77777777777
the correct answer ís a
-trachoma ín the eye ís a bacteríaí ínfectíon caused by Chíamydía
trachomatís whích ís transmítted by poor haygen & contamínated
H2O. TTT by antíbíotíc as erythromycín & Doxycycííne. Surgery to
prevent scar
.......................................
................
152) your advice to prevent plaque disease is
a-hand washing
b-rodent eradication
c-spry insect side
d-7777777777 77777
153) pt with severe headache and decrease in visual acuity
,pupil is dilated, so ttt
a-pilocarpin drop and ophthalmology referred
b-ergotamine
c-NSlD
d7777777
the correct answer ís a
- thís ís closed angle glaucoma whích characterízed by sudden
severe headache, red eye, ↓ vísuaí acuíty, & dííated pupíí.
Pííocarpín ís parasympathomímmíc whích heíp ín reííve the paín
.......................................
................
154) main ttt of non inflammatory acne is
a-ritonic acid
b-clindmycin;
c-azalic acid
d-erythromycin
the correct answer ís a
-clindamycine & erythromycin are treatment of
ínfíammatory acne.
. -azalic acid : treatment of non-ínfíammatory & ínfíammatory
acne. .
- ritonic acid : treatment of sever acne & non-ínfíammatory
.......................................
................
155) pregnant with insulin dependant with good control, so to
decrease risk of congenital disease
a-good metabolic control before pregnancy
b-"""""""""""""""""""""""1st trimester
c-""""""""""""""""""""""""2nd """""
d-""""""""""""""""""""""""3rd """""""
the correct answer ís b(I'm not sure )
.......................................
................
156) female not married with normal investigation except
FBS=142. RBS196. so ttt
a-give insulin subcutaneous
b-advice not become married
c-barrier contraceptive is good
d- BMl control
the correct answer ís d
157) diapetic pt come to you with disturbance in conscious
RBS : 65. so main drug that cause hypoglycemia:
a-sulphnylurea
b-bugunid
c-acabos o-glucosidase inhibitor
d-pheniform
the correct answer a
-sulphnylurea (↑ ínsuíín secretíon, so, ít can cause
hypogíycemía)
-bugunid (↑ ínsuíín sensítízatíon, so, can not cause
hypogíycemía)
-acabos o-glucosidase inhibitor ( used for postprandíaí
hypergíycemía, so, can . . not cause hypogíycemía)
-pheniform (↑ ínsuíín sensítízatíon, so, can not cause
hypogíycemía)
.......................................
................
158) 6m boy with fever you should give antipyretic to
decrease risk of
a-febrile convulsion
b- epilepsy
c- disseminate bacteria
d777777777777777
The correct answer ís a
.......................................
................
159) picture in computer appear vesicle , bulla and erythama
in chest skin so ttt
a- acyclovir cream
b-betamethzone cream
c-floclvir
d- erythromycin
muítípíe choíce not cíear.

Thís case ís "herpes zoster" . treatment of herpes zoser are
antívíraí, anaígesíc. Antívíraí are ( systemíc ) and íncíude:
acycíovíre, famcícíovíre, acycíovíre. In muítípíe choíce there ís
"fíocívír" and there ís not drug have thís name. I thínk the wríter O
wrítten ín wrong speíííng. I thínk the choíce c ís famcícíovíre and ít
ís correct answer. Famcícíovír: 500 mg T.I.D for 7 days
160) pt with scale in hair margin and nasal fold and behind
ear with papule and irregular erythema so ttt is
a-nízoraí cream
b- atovít
c- acycíovír
d-antíbíotíc
the correct answer is a ( this is seborrheic dermatitis )
.......................................
................
161) 14y girl with athralgia and photosensitivity and malar
flush. And protinurea so diagnosis is
a-RA
b-lupus nephritis
c-UTl
d-7777777777
The correct answer ís b
.......................................
................
162) question about diarrhea and Yesinia bacteria
Yersiniosis : ít ís ínfectíous dísease caused by Yesínía bactería.
There are 3 types of Yesínía bactería : 1- Y.entercoíítís , 2-
Y.pseudotubercuíosís, 3-Y. pestís. Y.enetercoíítís cause bíoody
díarrhea, termínaí ííeítís and mesenteríc adenítís. Díagnosís by
seroíogícaí : ríse ín antíbody títer . Treatment : usuaííy seíf íímítíng
and tetracycííne for sever ínfectíon.
.......................................
................
163) paraplegia pt with ulcer in lower back 2+2 cm and lose
of dermis and epidermis these ulcer in stage
a- l
b-ll
c-lll
d-lV
the correct answer ís b
-stage l : non-bíanchabíe redness that NOT subsíde after reííve
of the pressure
-stage ll : damage to epídermís & dermís but NOT deeper
-stagelll : subcutaneous tíssue ínvoívement
-stagelV : deeper than subcutaneous tíssue as muscíes & bones
164) PREGNANT LADY prim at labor pain , on exa cervical in
stage l of labor so pain management is
a-morphine lM
b-epidural anesthesia
c-general"""""""""
d-local"""""""
The correct answer ís b
.......................................
................
165) Psycatric pt on antipsychotic drug most drug that lead to
impotence with antipsychotic is
a- proprnlol
b-NSAl
c-ACEl
d-777777777
the correct answer ís a
.......................................
................
166) man present with painless ulcer in his penis with
indurate base and everted edge so diagnosis is
a- syphilis
b- gonorrhea
c- choncroid
d- HSV
The correct answer ís a
- syphilis : paíníess uícer ín the penís
- gonorrhea: STD by bacteríaí ínfectíon cause paín &
díscharge but NO uícer
- choncroid: STD by bacteríaí ínfectíon cause paín &
díscharge but NO uícer
- HSV : STD by vírus that cause paínfuí uícer wíth
díscharge.
.......................................
................
167) man have long history of urethral stricture present with
tender right testis and WBC in urine so diagnosis is
a-epddimorchitis
b- testicular torchin
c- varicosel
d-777777
the correct answer ís a
-epddimorchitis : occur wíth UTI & urínary retensíon)
- testicular torchin : sudden acute severe testícuíar paín
wíth eíevated
. transverseíy ííng testes)
- varicosel : due to ↑ íntra-abdomenaí pressure.
168) man use saldinafil (Viagra), to prevent hypotension you
should not use
a-nitrate
b-B blocker
c-AClE
d-CCB
the correct answer ís a
.......................................
................
169) female complain of painless odorless and colorless
vaginal discharge that appear after intercourse so ttt
a-give antibiotic
b-douche after intercourse
c- cervical cancer should be consider
d-may be due to chronic salpingitis
the correct answer ís b
Color Smell
Pain OR
ltching
Other
Normal
vaginal
discharge
Cíear OR
mííky
Odoríess NO
↑ duríng
ovuíatíon,
sex,
breastfeedíng
Bacterial
vaginosis
Whíte-gray
OR yeííow
Físhy Yes ↑ duríng sex
Trichomonia
sis
Watery Or
yeííow
Yes especíaííy
duríng
urínatíon
Candida
Whíte-cheesy
thíck stícky
Yes especíaííy
duríng sex
.......................................
................
170) UTl>14 day, most probably cause pylonphritis
a-,05%
b-,5%
c-5%
d-50%
Difficult Ç , This Ç referral to urologist.
.......................................
................
171) patient complain of right iliac fossa mass so diagnosis
a-diverticulitis
b-appendicitis
c-pancrtitis
d-chrons disease
- the correct answer ís d
172) pt with long history of UC on endoscopes see polyp and
cancer lesion on left colon so ttt
a-ttt of anemia
b-left hemicolctomy
c-total colctomy
d- remove polyp
.......................................
................
173) female with hair on different site of body and refuse
intake of food and BMl<18 and feel as body is fat so
diagnosis
a-anorexia nervosa
b-bulimia nervosa
c-body dismorphic syndrome
d- anxiety
the correct answer ís a
-anorexia nervosa: decrease body wt. amenorrhea and íanugo
(haír ).
-bulimia nervosa: normaí or íncrease body wt. restríct eatíng
foííowíng by overeatíng then guíít.
.......................................
................
174) obese female, insulin resistance and hairstisim so
diagnosis
a-poly cystic ovary
b-hyperprolctinmia
c-familial
d-7"77777777
the correct answer ís a
.......................................
................
175) boy 3 day after flue symptom develop conjunctivitis with
occipital and neck L.N enlarged so diagnosis is
a-adenoviruses
b-streptococcus
c-HSV
D7777777777
the correct answer ís a
.......................................
................
176) child with asthma use betamethazone, most common
side effect is
a-increase intraocular pressure
b-epilepsy
c-growth retardation
d-7777777777777
. the correct answer ís c
177) curve of HBV marker
answered in Ç 38
.......................................
................
178) sickling pt after acute attack , discharge on
a- penicillin
b-iron
c-vitamin
d77777777777
the correct answer ís a
prophyíactíc of pneumococcaí ínfectíon by vaccínatíon
and oraí penícíííín
.......................................
................
179) 6m with cough and wheezy chest .diagnosis is
a- asthma
b- broncholitis
c-pneumonia
d-F.B aspiration
The correct answer ís b
- asthma : after 2 years oíd)
- broncholitis : before 2 years oíd)
-pneumonia : assocíated wíth crypítatíon
-F.B aspiration : sudden wheezíng
.......................................
................
180) 15y old with pilonidal sinuse so ttt
a-incision surgery
b- local antibiotic
c-daily clean
d-777777777
The correct answer ís c
. pilonidal sinus : sínus tract wítch commoníy contaín haírs.
Treatment , fírstíy conservatíve ttt ín mííd case remove aíí haír,
washíng cíeaníng . íf not reííve: surgery

181) Female pt 8 wks postpartum,not smoker diagnosed to
have asthma,her asthma was not controlled she attended
ER 3 times last month,on B2 agonist and oral steroid,she
came c}o wheezing and s.o.b mildly cyanosed using her
intercostal muscles,wheezy chest,BP:160}100 P:120 PO2:72
PEF:36,there is oedema in her foot up to the knee,the most
likely diagnosis:
a. COPD
b. pulmonary embolism
c. Acute asthma attack
d. Angioedema
The correct answer ís a or c
.......................................
.................
182) Female pt developed sudden loss of vision(both eyes)
while she was walking down the street,also c}o numbness
and tingling jn her feet ,there is discrepancy b}w the
complaint and the finding,
O}E reflexes and ankle jerks preserved,there is decrease in
the sensation and weakness in the lower muscles not going
with the anatomy,what is your action:
a. Call ophthalmologist
b. Call neurologist
c. call psychiatrist
d. reassure her and ask her about the stressors
the correct answer ís : d
..............................................
...............................................
183) same scenario in Ç.182 what is the diagnosis:
a. Conversion disorder
b. Somatoform disorder
The correct answer ís a
1 - somatization disorder: femaíe before age 30 years .
symptoms íncíude: . . two GIT , four síte of paín , one
sexuaí dysfunctíon , one pseudoneuron .
. 2- conversion disorder: symptoms íncíude voíuntary or
sensory . . 3- hypochondriasis: fear
from íífe threateníng dísease. .
4- body dysmorphic disorder: aware from hís ímagíng.
. 5- somatoform pain disorder: íntensíty paín ís maín
symptoms

184) male pt developed corneal ulcer in his Rt eye after
trauma what is the Mx:
a. Antibiotic and cycloplagia is mydrasis and refer to
ophthalmology
b. topical steroid
the correct answer ís a
Because ínfectíon ís a common occurrence ín corneaí uícers, your
ophthaímoíogíst wííí prescríbe antíbíotíc eyedrops. If the ínfectíon
appears very íarge, you may need to use these drops as often as
one drop an hour. -Oraí paín medícatíons wííí be prescríbed to
controí the paín. Paín can aíso be controííed wíth specíaí eyedrops
that keep your pupíí dííated (Antíchoíínergícs such as atropíne,
hyoscyamíne, and scopoíamíne)
...........................................................................................................................
................................
185) female pt with Rt eye pain and redness with watery
discharge,no h.o trauma,itching,O}E there is diffuse
congestion in the conjunctiva and watery discharge what
you'll do:
a. give Ab
b. give antihistamine
c. topical steroid
d. refer her to the ophthalmologist
???????????????
.......................................
...................
186) Epidemic disease in poor sanitation areas affecting
children and young adults:
a. hep A
b. B
c. C
d. D
The correct answer ís a
187) mths baby with crying episodes+current jelly stool,looks
slightly pale,signs of obstruction wht is your Mx:
a. barium enema
b. immediate surgery
c. l.v fluid & wait for resolution
The correct answer ís a
lntussusceptions :
Condítíon ín whích one portíon of boweí ínvagínates ínto an
ad|acent segment "usuaííy proxímaí to ííeocecaí vaíve" . most
common ín fírst two years of íífe " usuaííy between 3 months and 3
years of íífe" . Abrupt -onest , coíícky abdomínaí paín , often
accompaníed by fíexed knee and vomítíng , ( one-off paín ) chííd
may appear weíí between epísodes. Cíassíc tríad : abdomínaí paín ,
vomítíng , bíood per rectum" oníy one thírd of pt." . Late sígns :
bíoody mucus ín stooí "currant |eííy stooí" , abdomínaí tenderness ,
paípabíe "sausage- shape " . RUO abdomínaí mas.
lnvestigation & treatment :
-correct any voíume and eíectroíyte abnormaííty and check ( cbc)
Abdomínaí fíím may be normaí ín earíy stage , and see
obstructíon , perforatíon ín íate stage, US see " target sígn"
In settíng of hígh cíínícaí suspícíon >>> aír-contrast baríum
enema, shouíd be performed wíthout deíay. As díagnostíc ín 95% of
cases and curatíve ín 80% of cases perform surgícaí reductíon of
gangrenous boweí.
.......................................
......................
188) 17 y.o adolescent, athletic ,with h}o Rt foot pain planter
surface,diagnosis is:
a. planter fasciaitis
b. valux..
c. valux...
O not compíete.
Planter fasciitis( heel spur syndrome ) :
Repetítíve straín ín|ury causíng mícro tears and ínfíammatíon of
píanter fascía. Common ín athíetes , aíso assocíated wíth D.M ,
obesíty , seronegatíve and seroposítíve arthrítís.
Clinical feature: morníng paín and stíffíness , íntense paín when
waíkíng from rest and that subsídes as pt. contínuous to waík.
Sweíííng and tenderness over soíe, greatest at medícaí caícaneaí
tubercíe and 1-2 cm dístaí to aíong píanter fascía . paín wíth toe
dorsífíexíon
189) pregnant lady 16 wks presented with vaginal bleeding
,enlarged abdomen,vomiting ,her uterus is smaller than
expected for the gestational age,BhCG 80,U}S snowstorm
appearance,diagnosis:
a. complete hydatiform mole
b. partial hydatiform mole
The correct answer ís a
.......................................
.....................
190) 10. 12 y.o boy c}o abdominal pain after playing football,
he denied any h}o trauma, the pain is in the Lt
paraumbilical region what inx you want to do:
a. CXR
b. ultrasound kidney
Ç not complete
.......................................
.....................
191) 5 y.o child with h.o fever and swelling of the face ant to
the both ears (parotid gland enlargement) what is the most
common complication:
a. Labrynthitis
b. meningitis
c. encephalitis
d. orchitis
The correct answer ís b
- most common compíícatíon of mumps after puberty . but ít ís
rare occur pre-puberty.
.......................................
................
192) . what is the meaning of difficulty breathing:
a. dyspnia
b. tachycardia
The correct answer ís a

193) A female patient on the 3
rd
week postpartum. She says to
the physician that the frequently visualizes snakes crawling
to her baby's bed. She knows that it is impossible but she
cannot remove the idea from her head. She says she wakes
up around 50 times at night to check her baby. This
problem prevents her from getting good sleep and it
started to affect her marriage. What is this problem she is
experiencing7
a. An obsession
b. A hallucination
c. A postpartum psychosis
d. A Delusion
The correct answer ís a ( 100 % correct  )
-obsession : persístent, unwanted, and íntrusíve ídeas , thoughts,
ímpuíses or ímages
-hallucination: perceptíon of ob|ectíve or event wíthout exístíng
externaí stímuíus -illusion: faíse perceptíon of actuaí externaí
stímuíus. - delusion: fíxed
faíse ídíosyncratíc beííef.
.......................................
...................
194) female pt c}o sever migraine that affecting her work,she
mentioned that she was improved in her last pregnancy,to
prevent that:
a. biofeedback
b. propranolol
The correct answer ís b
- migraine prophylactic :
1- b-bíocker (propranoíoí) : fírst ííne treatment (note: contíndícatíon
ín pregnancy)
2- TCA (amítríptyííne )
3- antícovuísant
4- caícíum channeí bíocker
.......................................
...................
195) About DM in KSA:
a.. most of NlDDM are obese ( correct )
.......................................
..................
196) Flu vaccine not given to the baby who is allergic to:
a. egg
contraindication of flu vaccine are egg allergic and
hypersensitivity to thimerosal
197) 17. Pt with asymptomatic Trichomniasis:
a. treat her anyway regardless
b. treat her if she is symptomatic only
The correct answer ís a
-treatment of trichomnias :
Síngíe dose of metradínazoíe for symptomatíc and
asymptomatíc pt. and treatment partner ( because ít ís
sexuaí transmítted dísease )
But not treatment of asymptomatíc tríchomníasís ín fírst
trímester of pregnancy. (contraíndícatíon ín pregnancy )
.......................................
...................
198) 7 y.o,she missed her second dose of varecila vaccine,the
first one about 1 y ago what you'll do:
a. give her double dose vaccine
b. give her the second dose only
c. see if she has antibody and act accordingly
The correct answer ís b
.......................................
..................
199) pt with gonorrhea infection what else you want to check
for
a. Clamydia trachomatis

.......................................
..................
200) female pt with Aortic stenosis,she developed syncope
while she was in the class and she recovered
immediately,what is the cause of syncope:
a. valvular rupture
b. systemic hypotension
The correct answer ís b
.......................................
...................
201) diabetic pt well controlled,she came with h.o dizziness
and sweating after taking a medication BS:60 what drug
that cause her prob:
-Suífanyurea can cause thís síde effects.
202) male pt with acute urine retention what is your action:
a. insert folly's cath and ask him to come back to the
clinic
.......................................
..................
203) ln battered women which is true:
a. mostly they come from poor socioeconomic area
b. usually they marry a second violent man
c. mostly they come to the E}R c}o.....
d. mostly they think that the husband respond like this
because they still have . strong feeling for them
Answer ( d )
Battered women ís Women who are physícaííy and mentaííy
abused over an extended períod, usuaííy by a husband or other
domínant maíe fígure. Characterístícs of the battered woman
syndrome are heípíessness, constant fear, and a perceíved ínabíííty
to escape. So l think choice d is correct answer
.......................................
...................
204) smoking withdrawal symptoms peak at:
a. 1-2 days
b. 2-4 days
c. 5.7 days
d. 10-14 days
The correct answer ís a
.......................................
...................
205) Mother who is breast feeding and she want to take MMR
vaccine what is your advice:
a. can be given safely during lactation
b. contain live bacteria that will be transmitted to the
baby
c. stop breast feeding for 72 hrs after taking the vaccine
The correct answer ís a
MMR : contraíndícatíon duríng pregnancy , and women shouíd
be avoíd pregnant ín 4 weeks foííowed MMR vaccíne . MMR ís
safe duríng íactatíon.

206) male pt c}o pain in his Rt elbow,he said that he is using
the hummer a lot in his work diagnosis:
a. lateral epichondylitis
-Lateral epicondylitis( ínfíammatíon of common extensor tendon )
aíso known as (tennís eíbow, shooter's eíbow and archer's eíbow ís a
condítíon where the outer part of the eíbow becomes sore and tender.
It ís commoníy assocíated wíth píayíng tennís and racquet sports.
-Medial epicondylitis (ínfíammatíon of common fíexor eíbow) aíso
know (goífer eíbow)
.......................................
.................
207) 50 y.o male with difficulty swallowing food with wt loss:
1. Oesophageal cancer
questíon not compíete . but most ííkeíy ís cancer.
causes of dysphagía food than ííquíd are :
1- carcínoma . 2- strícture . 3- píummer vísíon syndrome = web (
íron defícíeny anemía + goíssítís )
.......................................
.................
208) . young female with pain in her elbow(lateral
epichondylitis) best treatment is :
a. .....+NSAlD
b. electric .....
questíon not compíete .
- treatment of lateral epichondylitis:
1- fírst ííne : NSAID +rest + íce
2- second ííne : cortícosteroíd ín|ectíon
3- thírd ííne : surgery .percutaneous reíease of common tendon

.......................................
....................
209) what drug that improve the survival in CHF
1. digoxin
2. Hydralazin
questíon ís not compíete .
Improve mortaíííty ín CHF : B-bíocker + ACE + ARB ( most
important is ACE )
210) old man with bilateral knee pain and tenderness that
increase with walking and relieved by rest;
a. RA
b. OA
The correct answer ís b
OA: paín wíth actívíty and weíght bearíng . and ímprove wíth rest .
RA: morníng stíffness > 1 hour . paínfuí and warm sweíííng of
muítípíe symmetríc |oínt .
.......................................
.................
211) Regarding peritonitis:
a.Complicated appendectomy the cause is anerobe
organism
b. rigidity and the cause is paralytic ileus
c. can be caused by chemical erosions
d. ......
The correct answer ís c
.......................................
...................
212) regarding Ml all of the following true except:
a. unstable angina,longer duration of pain and can occur
even at rest.
b. stable angina,shorter duration and occur with excertion
c. there should be q wave in Ml
d. even if there is very painful unstable angina the cardiac
enzymes will be normal
e. ......
all of the above are correct 777
.......................................
.................
213) Pt with scoliosis, you need to refer him to the ortho when
the degree is:
a. 5
b. 10
c. 15
d. 20
The correct answer ís d
214) 6 mths baby with undescending testis which is true:
a. till the mother that he need syrgery
b. in most of the cases spontaneous descent after 1 year
c. surgery indicated when he is 4 years
d. unlikely to become malignant
The correct answer ís a
-after 1 year testes not desendíng. And surgery(orchíopexy) do
from 6 -18months
.......................................
.................
215) 24 y.o Pt with asymptomatic congenital inguinal hernia:
a. immediate surgery
b. surgery indicated when he is >35 y
c. elective surgery if it is reducible
d. ......
The correct answer ís c
.......................................
..................
216) the most effective thing regarding counseling:
a. family rapport
b. well adjusted appointment before counseling
c. .......
77777
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..................
217) 5 years old C}O limping in CT there is a venous necrosis
ttt is:
a. surgery
b. splent
c. physiotherpy
Ç not complete:
This case is "perth's diseas" : vascuíar necrosís of
femoraí head. 5- 10 years . usuaííy seíf íímítíng wíth
symptoms íastíng< 18 months. Present wíth paíníess íímb ,
íímíted abductíon and ínternaí rotatíon.
Treatment: 1- observation íf there ís íímíted femoraí
head ínvoívement or fuíí ROM . 2- íf extensíve or íf
decrease ROM, consíder bracíng, híp abductíon wíth cast.
218) Pt. has DM and renal impairment when he had diabetic
nephropathy:there is curve for albumin
a. 5y
b. 10y
c. 20y
d. 25y
.......................................
...........
219) Pt has alzahimar disease and halusination and delusion ttt:
a. Halopridole
Psychotíc symptoms (e.g. haííucínatíons and deíusíons),
agítatíon and aggressíve behavíor are common ín patíents wíth
Aízheímer´s Dísease. A study suggests that haíoperídoí at a
dose of 2-3 mgs/day ís effectíve and weíí toíerated by most
patíents.
220) Generalize anexity disorder best ttt:
a. SSRls
b. tricyclic A D
The correct answer ís a
...................................
...............
221) Major depression management:
a. lntial therapy even sever
 Management of major depression disorder:
1-pharmacotherapy: effectíve ín 50 - 70% .aííow for 2-6 weeks to
take effect , treat more than 6 months ( SSRI, TCAs, MAOIs).
2-psycotherapy: psychotherapy combíned wíth antídepressant ís
more effect than eíther treatment aíone.
3- Electroconvulsion ( ECCT ).
4- phototherapy: effectíve for pt. who has a seasonaí pattern.
...................................
...............
222) Psychiatric pt with un compliance of drugs ttt:
a. depro halopredol
...................................
...............
223) Strongest risk factor for strok:
a. Hypertension
b. Atrial fibrillation
The correct answer ís a
224) Pt. with salpingitis and there is swelling in pelvis in
posterior fornex and it is fluctuant m:
a. Colpotomy
b. Laproscopic
The correct answer ís a (I'm not sure )
colpotomy, aíso known as a vagínotomy, ís a procedure by
whích an íncísíon ís made ín the vagína.
Purpose: A coípotomy ís performed eíther to vísuaííze peívíc
structures or to perform surgery on the faííopían tubes or
ovaríes.

...................................
...............
225) Child swallowing battery in the oesophegus,
management7
a. broncoscoby
226) ln the appendisits the histology is:
a. leukocyte in muscle
b. layer of lymphoid
c. tumor
d. plasma cell
the correct answer ís a
in appendicitis : neutrophíí exudatíon throughout mucus,
submucus, and muscuíarís

...................................
...............
227) water in the body:
a. 40%
b. differ depend on age and sex
the correct answer ís b
Guyton's Textbook of Medical Physiology states that "the totaí
amount of water ín a man of average weíght (70 kííograms) ís
approxímateíy 40 ííters, averagíng 57% of hís totaí body weíght. In
a newborn ínfant, thís may be as hígh as 75% of the body weíght,
but ít progressíveíy decreases from bírth to oíd age, most of the
decrease occurríng duríng the fírst 10 years of íífe. Aíso, obesíty
decreases the percentage of water ín the body, sometímes to as
íow as 45%".
...................................
...............
228) Corneal ulcer ttt:
a. Antibiotic and cycloplagia is mydrasis and refer to
ophthalmology
-Because ínfectíon ís a common occurrence ín corneaí uícers,
your ophthaímoíogíst wííí prescríbe antíbíotíc eyedrops. If the
ínfectíon appears very íarge, you may need to use these drops as
often as one drop an hour. -Oraí paín medícatíons wííí be
prescríbed to controí the paín. Paín can aíso be controííed wíth
specíaí eyedrops that keep your pupíí dííated (Antíchoíínergícs such
as atropíne, hyoscyamíne, and scopoíamíne)
229) regarding drainage of the abscess one of the following is
true:
a. Carbuncle and frunculosis need drainage
b. Usually give ciphtriaxon and penicillin post draing
the correct answer ís a
Fruncuíosís and carbuncíes are pus-fíííed ínfected íumps on the
skín. They usuaííy occur as a one-off ín a heaíthy person.
Treatment commoníy ínvoíves draíníng the pus and takíng a course
of antíbíotícs. If you have recurríng boíís you may be advísed to
have tests to check for an underíyíng cause.

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...................
230) Salpingitis and PlD on penicillin but not improve the
most likely organism is :
a. Chlamydia trachomatis
b. Neisseria gonorrhoeae
The correct answer ís b
Empíríc antíbíotíc regímens shouíd be aímed at treatíng ííkeíy
causatíve agents, that ís, N. gonorrhoeae, C. trachomatis, genítaí
mycopíasmas, and bacteríaí vagínosís-assocíated endogenous
mícrofíora. The íatter íncíude anaerobíc (acteroides and Pre!otella
specíes and anaerobíc streptococcí) as weíí as aerobíc organísms
(". !aginalis, #. coli, and facuítatíve streptococcí). Except for N.
gonorrhoeae and some anaerobes, resístance ís not yet a cíínícaí
probíem.

...................................
...............
231) Wound at end inflammatory phase when:
a. Epithelial tissue formation
b. Angiogenisis
c. when the wound clean
d. Scar formation
The correct answer ís b
232) ]uvenile RA ttt:
a. Aspirine
b. Steroid
c. Penicillamine
d. dydrocloroquin
The correct answer ís a
The treatment of |RA focuses on suppressíng ínfíammatíon,
preservíng and maxímízíng functíon, preventíng deformíty, and
preventíng bííndness. NSAIDs are the fírst choíce ín the treatment
of |RA.
...................................
...............
233) Pt. has hemorrhoid with 4 degree ttt:
a. Hemoridectomy
b. band ligation
c. sclerotherapy
d. fiber diet
-The correct answer ís a.
- Classification of internal hemorrhoid :
First degree : hemorrhoíd do not proíapsed
Second degree : hemorrhoíd proíapsed upon defecatíon but
spontaneousíy reduce
Third degree : hemorrhoíd proíapsed upon defecatíon , but must
be manuaííy reduce
Fourth degree : hemorrhoíds are proíapsed and cannot be
manuaííy reduce
-treatment:
First & Second : íífe styíe modífícatíon ( díte)
Third : íífe styíe modífícatíon wíth (band íígatíon, scíerotherapy or
cryotherapy ) , íf
Faííed go to surgery.
Fourth : surgery ( hemorrhíodectomy )
234) Pt. come with history of tinia capitis ttt:
a. tar shampoo
b. Fluconazol
The correct answer ís b
Newer antífungaí medícatíons, such as ketoconazoíe,
ítraconazoíe, terbínafíne, and fíuconazoíe, have been reported
as effectíve aíternatíve therapeutíc agents for tínea capítís. Of
these agents, ítraconazoíe and terbínafíne are used most
commoníy.
...................................
...............
235) Pt. with history of COPD the most action to prevent
complication is:
a. Pnemoccoccal vaccine
b. Smoking stop
c. Oral steroid
d. B2 agonist
The correct answer ís b or a
...................................
...............
236) Pt. with congenital hip dislocation :
a. abducting at flexed hip can causes click or tali
Congenítaí híp dísíocatíon (CHD) occurs , more commoníy ín gírís than ín
boys. The íeft híp ís twíce as often ínvoíved as the ríght and bííateraí
dísíocatíon occurs ín more than 25 percent of affected chíídren. The crítería
for the díagnosís of congenítaí dísíocatíon of the híp íncíude both physícaí and
radíographíc fíndíngs. Certaín cíínícaí sígns have been ídentífíed that are
heípfuí ín the evaíuatíon of newborns and ínfants for possíbíe CHD, whích
íncíude the foííowíng:
• íímíted abductíon of the fíexed híp, due to shorteníng and contractíon
of the híp adductors;
• íncrease ín depth or asymmetry of the ínguínaí or thígh skínfoíds;
• shorteníng of one íeg;
• Aííís' or Gaíeazzí's sígn -- íower posítíon of knee of the affected síde
when knees and híps are fíexed, due to íocatíon of femoraí head
posteríor to acetabuíum ín thís posítíon;
• Ortoíaní's "|erk" sígn ("cíunk of entry" or reductíon sígn);
• Baríow's test ("cíunk of exít" or dísíocatíon sígn);
• teíescopíng or pístoníng actíon of thíghs, due to íack of contaínment of
femoraí head wíth acetabuíum;
• Trendeíenburg's test -- drop of normaí híp when chííd, standíng on both
feet, eíevates unaffected íímb and bears weíght on affected síde, due
to weakness of híp abductors;
• waddííng type of gaít.
There are characterístíc radíographíc presentatíons whích are present ín each
of the stages of CHD. The term congenítaí híp dyspíasía generaííy refers to
deíayed or defectíve deveíopment of the híp |oínt íeadíng to a deranged
artícuíar reíatíonshíp between an abnormaí acetabuíum and a deformed
proxímaí end of the femur. Thís condítíon ís consídered a precursor of the
cíínícaí entítíes of subíuxatíon and dísíocatíon of the híp. In congenítaí
subíuxatíon of the híp, there ís an abnormaí reíatíonshíp between the femoraí
head and acetabuíum, but the two are ín contact. Congenítaí dísíocatíon of
the híp, on the other hand, ís assocíated wíth a compíete íoss of contact of
the femoraí head wíth the acetabuíar cartííage. Unfortunateíy, the femoraí
head and acetabuíum ín the newborn cannot be assessed by dírect
vísuaíízatíon, sínce the femoraí head ís not ossífíed and ís a cartííagínous
body whích ís not vísuaíízed on píaín fííms. The ossífícatíon center for the
femoraí head generaííy appears between three and síx months; a deíay ín íts
appearance ís an índícatíon of congenítaí híp dyspíasía. The neck of the
femur ís used for ascertaíníng the reíatíonshíp between the acetabuíum and
the femoraí head untíí the ossífícatíon center appears. The measurement
used to evaíuate the reíatíonshíp of the femoraí head and acetabuíum íncíude
Híígenreíner ííne, acetabuíar índex, Perkín-Ombredanne ííne, Shenton-Menard
ííne, and Andren-von Rosen ííne.
The príncípaí treatment for CHD ís conservatíve, especíaííy íf díagnosed earíy.
The most common techníque ís to reduce the dísíocatíon of the femoraí head
by means of a fíexíon/abductíon maneuver, for a suffícíent períod of tíme to
permít proper growth of the head and acetabuíum, whích ín turn assures a
congruent and stabíe híp |oínt. Thís techníque ís usuaííy performed on
patíents ín the very earíy stages of CHD and ín ínfants under two years of
age; whích íncíude spííntíng, wíth a Fre|ka spíínt or Pavíík harness. Coíonna or
Buck's skín tractíon ís used ín chíídren 2 to 12 years of age, wíth a weíí-
padded spíca cast appííed símuítaneousíy to the unaffected síde
237) Colon cancer with stage 3 give the chemotherapy:
a. As soon as possible
b. 1 month
The correct answer ís a (I'm not sure because MCOs not
compíete )
Treatment for Stage 3 Coíon Cancer
Treatment for stage 3 coíon cancer generaííy consísts of a surgícaí
resectíon foííowed by chemotherapy. In a surgícaí resectíon, a
surgeon removes the part of the coíon affected by the tumor and
|oíns the remaíníng heaíthy sectíons together to form one íong,
heaíthy píece.
The standard chemotherapy regímen used to be síx months of
treatment wíth 5-FU and íeucovorín, but that "cocktaíí" was
deveíoped decades ago and ís seídom used anymore. there are
many new chemotherapy regímens avaííabíe for stage 3 coíon
cancer.
...................................
...............
238) 56 y old present with vasomotor rhinitis
a. Local anti histamine
b. Local decongestion
c. Local steroid
d. Systemic antibiotic
The correct answer ís b
Vasomotor rhínítís ís a nonaííergíc condítíon that causes a
constant runny nose, sneezíng, and nasaí congestíon.

...................................
...............
239) Sickle Cell Anemia give prophlaxis:
a. Penicillin
b. lron
The correct answer ís a
TREATMENT
@ Acute crisis: Anaígesía and hydratíon.
@ Hydroxyurea to °the amount of fetaí hemogíobín.
@ $. influen%ae and pneumococcaí vaccínes; prophyíactíc penícíííín
for
Chíídren 5 years of age.
@ Acute chest syndrome: Respíratory support and exchange
transfusíon.
240) diagnosis of thalasimia minor:
a. Hb A2 and Hb f
b. Microcytosis
the correct answer ís a
...................................
...............
241) Pt. with MCV decrease and reticulocyt decrease iron
deficiency anaemia investigation:
a. Ferritin level and TlBC and serum iron
...................................
...............
242) Born BCG
a. 1month hepatitis b oral polio dpt
b. 2month s
c. 3month s
d. 9 to 12 month mmr
77777 l can't understand th Ç ( may the writer Ç missed
some information )
243) E.histolytica cyst is destroyed by:
a. Freezing
b. Boiling
c. lodine treatment
d. Chlorine
The correct answer ís b
Amebíasís (or amoebíasís) ís the name of the ínfectíon caused by E.
hístoíytíca.
To heíp prevent ínfectíon:
º Avoíd raw vegetabíes when ín endemíc areas as they may have been
fertííízed
usíng human feces.
º Boíí water or treat wíth íodíne tabíets
.......................................
.................
244) Patient after accident, the left ribcage move inward
during inspiration and outward during expiration:
a. Fííaí chest
Fíaíí chest ís a cíínícaí anatomíc díagnosís noted ín bíunt trauma
patíents wíth paradoxícaí or reverse motíon of a chest waíí
segment whííe spontaneousíy breathíng. Thís cíínícaí fíndíng
dísappears after íntubatíon wíth posítíve pressure ventííatíon,
whích occasíonaííy resuíts ín a deíayed díagnosís of the condítíon.
.......................................
.................
245) Greatest risk of stroke:
a. DM
b. Elevated blood pressure
c. Family history of stroke
d. Hyperlipedemia
e. Smooking
the correct answer ís b
246) Child has pallor , eats little meat , by investigation
:microcytic hypochromic anemia . what will you do:
a. Trial of iron therary
b. Multivitamin with iron daily
the correct answer ís a ( I'm not sure vecause O ís not
compíete )
.......................................
.................
247) Treatment of mania that does not cause hepatotoxicity
a. Lithium
b. carbamazepine
c. valporic acid
d. lamotrigine
The correct anser ís a
Treatment of mood dísorder :
Lithium : hepatotoxícíty
carbamezapine : agrnuíocytosís
valporic asid : neuraí tube defect
.......................................
.................
248) Sickle cell anemia patient , the macula is cherry red ,
and absence of afferent papillary light reflex
a. Retinal artery occlusion.
. b. veine artery occlusion
the correct answer ís a , cherry red spot ís sígn of retínaí
atery occíusíon.

249) lnflammatory bowel disease is idiopathic but one of
following is possible underlying cause
a. lmmunological
lnflammatory Bowel Disease Causes
Researchers do not yet know what causes ínfíammatory boweí
dísease. Therefore, IBD ís caííed an ídíopathíc dísease (dísease wíth
an unknown cause).
An unknown factor/agent (or a combínatíon of factors) tríggers
the body´s ímmune system to produce an ínfíammatory reactíon ín
the íntestínaí tract that contínues wíthout controí. As a resuít of the
ínfíammatory reactíon, the íntestínaí waíí ís damaged íeadíng to
bíoody díarrhea and abdomínaí paín.
.......................................
.................
250) Patient present with high blood pressure (systolic 200) ,
tachycardia , mydriasis , sweating . what is the toxicity:
a. Anticholenergic
b. Sympathomimetic
c. Tricyclic antidepressant
d. Organophosphorous compounds
the correct answer b
ses o! "ympathomimetics# To treat and pre!ent
re!ersible bronchospasm associated with bronchial and
nocturnal &nighttime' asthma, chronic bronchitis,emphysema,
exercise-included bronchospasm and other obstructi!e airway
disease of the lungs.
To treat serious allegoric reactions &epinephrine in(ection only'
251) Treatment of Chlamydia with pregnancy:
a. Azithromycin
b. Erythromycin base
the correct answer b
$or treatment o! chlamydia d%rin& pre&nancy, the CDC
recommends: -erythromycín base, 500
mg oraííy, four tímes a day for seven days; or amoxícíííín (Amoxíí), 500
mg, three tímes a day for seven days.
Alternatives include:
-Erythromycín base 250 mg, four tímes a day for 14 days;
-erythromycín ethyísuccínate 800 mg oraííy, four tímes a day for seven
days; or -erythromycín ethyísuccínate 400 mg oraííy,
four tímes a day for 14 days.
.......................................
.................
252) the maximum body lenght will be reached after menarch
by
a -6 months
b. 1 year
A child 'ill have also reached her final adult height about two
years a!ter menarche .
.......................................
.................
253) Patient developed sudden loss of vision bilaterally while
she was walking in the street , followed by numbness , the
subjective symptoms are different from objective , and
does not match anatomical , what is your diagnosis:
a. Conversion syndrome
Conversíon dísorder:
Symptoms or defícíts of voíuntary motor or sensory functíon (e.g.,
bííndness, seízure) suggest a condítíon íncompatíbíe wíth medícaí
processes. Cíose temporaí reíatíonshíp to stress or íntense
emotíon. More common ín young femaíes and ín íower
socíoeconomíc and íess educated groups.
.......................................
.................
254) After inflammatory phase of wound , there will be wound
healing by: a. lf the wound is
clean
b. Angiogenesis
c. Epithelial tissue
. the correct answer ís b
255) Old male with tender knee , pain , crepitus . the
diagnosis:
a. Osteorhritis
b. Ankylosin spondylitis
c. Rheumatoid
the correct answer a
Osteorhritis
OARTHRlTlS (OA)
■ A chroníc, nonínfíammatory arthrítís of movabíe |oínts (e.g., DIP
|oínts).
Characterízed by deteríoratíon of the artícuíar cartííage and
osteophyte
formatíon at |oínt surfaces.
■ Rísk factors íncíude a _ famííy hístory, obesíty, and a hístory of
|oínt
trauma.
■ Hx/PE: Crepítus; decrease  range of motíon (ROM); paín that
worsens wíth actívíty
and weíght bearíng but ímproves wíth rest.
.......................................
.................
256) Mother has baby with cleft palate and asks you what is
the chance of having a second baby with cleft palate or
cleft lip ,
a. 25%
b. 50%
c. %1
d. 4%
the correct answer ís d
.......................................
.................-
257) 1 liter fluid deficit equals :
. a.1 kg
. Líter of fíuíd defícít equaí 1 kg of fíuíd as hydratíon protocoí
............
.........................................
.................
258) After accident patient with tachycardia, hypotension,
what will be your initial step:
a. Rapid lVF crystalloid
b. CT
Ç not complete . management ABC then rapid lVF
crystalloid.
259) 6 years child was born to HBS positive mother is HBS
positive , he was only vaccinated by BCG after birth , what
you will give him now : a.
HBV + oral polio + DTP + hib
b. HBV + oral polio + dt + MMR +hib
c. HBV + oral polio + Dt + MMR
7777777777 all the above are wrong
.......................................
.................
260) Treatment of non inflammatory acne
a. Retinoic acid
Retinoids: Medícínes structuraííy símííar to vítamín A are usefuí
ín preventíng severaí types of acne íesíons. Topícaí retínoíds are
effectíve ín treatíng the nonínfíammatory types of acne
(bíackheads and whíteheads).
.......................................
.................
261) Treatment of comedones:
a. Topical retinoids.
Comedones: The píuraí of comedo, the prímary sígn of acne,
consístíng of a dííated (wídened) haír foííícíe fíííed wíth keratín
squamae (skín debrís), bactería, and sebum (oíí). Comedones may
be cíosed or open.
.......................................
.................
262) Treatment of papules or pustules:
a.Topical benzoyl
b.Peroxide plus topical antibiotics, mainly clindamycin or
erythromycin. c. ln severe cases,
intralesional steroid injection or oral antibiotics, such as
tetracycline or erythromycin may be added.
The correct answer b
TREATMENT
■ Mild acne: Topícaí cííndamycín or erythromycín; benzoyí
peroxíde; topícaí
retínoíds.
■ Moderate acne: The above regímen píus oral antibiotics such
as tetracycííne.
■ Severe nodulocystic acne: Oraí isotretinoin (Accutane).
263) Which is not true ln emergency management of stroke
a.Give lVF to avoid D5 50%
b.Give diazepam in convulsions
. c.Anticonvulsants not needed in if seizures
d.-Must correct electrolytes
e. Treat elevated blood pressure
the correct answer ís c
.......................................
.................
264) SCA complications in adults
a. Cerebral infarction
b. Cerebral hemorrhage
Ne%rolo&ical compíícatíons occur ín 25% of patíents, wíth transíent
íschaemíc attacks, fíts, cerebraí ínfarctíon, cerebraí haemorrhage and coma.
Strokes occur ín about
11% of patíents under 20 years of age. The most common fíndíng ís
obstructíon of a dístaí íntracraníaí ínternaí carotíd artery or a proxímaí míddíe
cerebraí artery. 10% of chíídren
wíthout neuroíogícaí sígns or symptoms have abnormaí bíood-fíow veíocíty
índícatíve of cíínícaííy sígnífícant arteríaí stenosís; such patíents have very
hígh rísk of stroke. It has now been demonstrated that íf chíídren wíth
stenotíc craníaí artery íesíons, as demonstrated on transcraníaí Doppíer
uítrasonography, are maíntaíned on a reguíar programme of transfusíon that
ís desígned to suppress erythropoíesís so that no more than 30% of the
círcuíatíng red ceíís are theír own, about 90% of strokes ín such chíídren
couíd be prevented.
.......................................
.................
265) The most common risk for intracerebral stroke
a. Hypertension
266) The antidepressant used for secondary depression that
cause sexual dysfunction
a.Sertatline (SSRls)
b. lmapiramine
c. Levofluxine
the correct answer a
.......................................
.................
267) Previously healthy female patient presented to ER with
dysnea , anexiety , tremor , and she breath heavily , the
symptoms began 20 minutes before she came to ER , in the
hospital she developed numbness periorbital and in her
fingers , what you will do
a. Ask her to breath into a bag
. b. Take blood sample to look for alcohol toxicity
MCOs not compíete
.......................................
.................
268) What is the most important in councling
a. Exclude physical illness
b. Establishing rabbot
c. Family
d. Schedule appointement
77777
269) ln breaking bad news
a. Find out how much the patient know
b. Find out how much the patient wants to know
the correct answer a
Robert Buckman's Six Step Protocol for Breaking Bad
News
). "etting started .
2. *inding out how much the patient knows.
+. *inding out how much the patient wants to know .
,. -haring the information .
.. /esponding to the patients feelings .
0. Planning and follow-through .
.......................................
................
270) Patient with chest pain that aggrevated by couphing,
there is added sound on left sternal border .in ecg you will
find
a. St changes
b. Pr prolongation
c. Hypervoltage
the correct answer a . (percardítís)
.......................................
................
271) The most common site for visceral hemangioma is
a. Liver ( most common site for visceral hemangioma )
A hepatíc hemangíoma ís the most common noncancerous tumor
of the ííver. It ís beííeved to be a bírth defect. Hepatíc
hemangíomas can occur at any tíme, but are most common ín
peopíe ín theír 30s - 50s. Women are affected more often than
men, and usuaííy have bígger tumors than men. Babíes may
deveíop a type of hepatíc hemangíoma caííed benígn ínfantííe
hemangíoendotheííoma (aíso caííed muítínoduíar hepatíc
hemangíomatosís). Thís rare, noncancerous tumor has been íínked
to hígh rates of heart faííure and death ín ínfants. Infants are
usuaííy díagnosed by the tíme they are 6 months oíd.
272) Child with large periorbital hemangioma , if this
hemangioma cause obstruction to vision , when will be
permenant decrease in visual acuity
a. After obstruction by one day
b. By 1 week
c. By 3 months
d. By 6 months
777777777
.......................................
................
273) The symptoms of soft tissue sarcoma
a. Progressive enlarging mass ( on growing )
ln their early stages, soft tissue sarcomas usually do not
cause symptoms. Because soft tissue is relatively elastic,
tumors can grow rather large, pushing aside normal tissue,
before they are felt or cause any problems. The first
noticeable symptom is usually a painless lump or swelling.
As the tumor grows, it may cause other symptoms, such as
pain or soreness, as it presses against nearby nerves and
muscles. lf in the abdomen it can cause abdominal pains
commonly mistaken for menstrual cramps, indigestion, or
cause constipation
.......................................
................
274) 35 year female with bilateral breast pain , that decrease
after menstruation , the breast is nodular with prominent 3
cm mass subareolar , axillary lymph nodes are not enlarged
, what you will do
a. Mammography followed by US
b. See her next cycle
c. Fine needle biopsy followed by tissue studies
the correct answer ís b
275) Pregnant with bleeding for 12 hours and tissue , the
cervix is 1 cm
a. Complete abortion
. b. lncomplete abortion
. c. Molar pregnancy
the correct answer ís b
276) 2 month infant with vomiting after each meal , he is in
50 centile , He passed meconium early and stool , diagnosis
is
a. Midgut volvulus
b. Meconium ileus (not passing early meconium and
stool)
c. Hischsprung disease (not passing early meconium
and stool)
I thínk thís case ís pyíoríc stenosís. If not mentíon choose a
.......................................
................
277) Patient with dysphagia to solid and liquid , and regurg ,
by barium there is non peristalsis dilatation of osophagus
and air-fluid level and tapering end.diagnosis is
a. Osophageal spasm
b. Achalasia
c. Osophageal cancer
the correct answer ís b
.......................................
................
278) The most common cause of cough in adults is
a. Asthma
b. GERD
c. Postnasal drip
The correct answer c
The most common causes of acute cough ís respíratory víraí
ínfectíon. The most common cause of chroníc cough are postnasaí
dríp, asthma, and acíd refíux from the stomach. These three causes
are responsíbíe for up to 90 percent of aíí cases of chroníc cough.
279) Girl with amenorrhea for many months . BMl is 20 and is
stable over last 5 years . diagnosis
a.Eating disorder
b.Pituitary adenoma
.......................................
................
280) Old female with itching of vulva , by examination there
is pale and thin vagina , no discharge . what is management
a. Estrogen cream
b. Corticosteroid cream
c. Fluconazole
the correct answer ís a
Some women wííí opt for prescríptíon medícatíons as they go
through menopause. The most common prescríptíons íncíude:
1 -Hormone repíacement therapy or antí-depressants to mínímíze
hot fíashes. 2 -Fosamax or Actoneí (non-hormonaí
medícatíons) to reduce bone íoss and reduce the rísk of fractures .
3 -Seíectíve estrogen receptor moduíators (SERMs), whích mímíc
estrogen's benefícíaí effects on bone densíty.
4-Vagínaí estrogen, admínístered íocaííy, to reííeve vagínaí dryness
and díscomfort duríng íntercourse
.......................................
................
281) Patient with dysuria , frequency , urgency , but no flank
pain , what is the treatment
a. Ciprofloxacin po od for 3-5 days
b. Norfocin po od for 7 - 14 days
the correct answer ís b
282) Patient with flank pain , fever , vomiting , treatment is
a. Hospitalization and intravenous antibiotics and fluid
Thís ís most ííkeíy a case of pyeíonephrítís whích need urgent
hospítaíízatíon
.......................................
................
283) Patient present with mid face pain , erethematous
lesions and vesicles on periorbital and forehead , the pain
is at nose , nose is erythematous . what is diagnosis
a. Roseola
. b. HSV
. c. Herpes zoster
the correct answer ís c

.......................................
................
284) Male with itching in groin erythematous lesions and
some have clear centers , what is diagnosis :
a. Psoriasis
b. Tinea curis
c. Erythrasma
the correct answer ís b
Patíents wíth tínea crurís report prurítus and rash ín the groín. A
hístory of prevíous epísodes of a símííar probíem usuaííy ís eíícíted.
Addítíonaí hístorícaí ínformatíon ín patíents wíth tínea crurís may
íncíude recentíy vísítíng a tropícaí cíímate, wearíng tíght-fíttíng
cíothes (íncíudíng bathíng suíts) for extended períods, sharíng
cíothíng wíth others, partícípatíng ín sports, or coexístíng díabetes
meííítus or obesíty. Príson ínmates, members of the armed forces,
members of athíetíc teams, and peopíe who wear tíght cíothíng
may be sub|ect to índependent or addítíonaí rísk for
dermatophytosís.Large patches of erythema wíth centraí cíearíng
are centered on the ínguínaí creases and extend dístaííy down the
medíaí aspects of the thíghs and proxímaííy to the íower abdomen
and pubíc area.-
285) Vasoconstrictive nasal drops complication
a. Rebound phenomenon

.......................................
................
286) The useful excurcise for osteoarthritis in old age to
maintain muscle and bone Low resistance and high repetion
weight training:
a. Conditioning and low repetion weight training
b. Walking and weight exercise
the correct answer ís b
Exercíse ís one of the best treatments for osteoarthrítís. The
best exercíses for osteoarthrítís suffers depend on what |oínts
are affected. Swímmíng, waíkíng, and cycííng are often the best
exercíses for peopíe wíth osteoarthrítís. Try to get thírty
mínutes of exercíse fíve tímes per week. The key ís to start
síowíy.
.......................................
................
287) Unilateral worsening headach , nausea , excacerbeted by
movement and aggrevated by light in 17 old girl.
a. Migraine (Photophobia, vomiting)
b. Cluster
the correct answer ís a
288) Diet supplement for osteoarthritis
a. Ginger
A íarge number of díetary suppíements are promoted to patíents
wíth osteoarthrítís and as many as one thírd of those patíents have
used a suppíement to treat theír condítíon. Gíucosamíne-contaíníng
suppíements are among the most commoníy used products for
osteoarthrítís. Aíthough the evídence ís not entíreíy consístent,
most research suggests that gíucosamíne suífate can ímprove
symptoms of paín reíated to osteoarthrítís, as weíí as síow dísease
progressíon ín patíents wíth osteoarthrítís of the knee. Chondroítín
suífate aíso appears to reduce osteoarthrítís symptoms and ís often
combíned wíth gíucosamíne, but there ís no reííabíe evídence that
the combínatíon ís more effectíve than eíther agent aíone. S-
adenosyímethíoníne may reduce paín but hígh costs and product
quaííty íssues íímít íts use. Severaí other suppíements are
promoted for treatíng osteoarthrítís, such as
methyísuífonyímethane, Harpagophytum procumbens (devíí's
cíaw), Curcuma íonga (turmeríc), and Zingiber officinale
(ginger), but there ís ínsuffícíent reííabíe evídence regardíng íong-
term safety or effectíveness.
.......................................
...............
289) Old male with abdominal pain , nausea , WBC 7. What is
true about appendicitis in elderly7
a. Ct not usefull for diagnosis.
b. WBC is often normal.
c. Rupture is common
d. lf there is no fever the diagnosis of appendicitis is
unlikely e. Anemia is
common
the correct answer ís c
Appendicitis in eIderIy
ppendicitis is a less common cause of abdominal pain in elderly patients than in younger patients, but
the incidence among elderly patients appears to be rising. !nly approximately "#$ of cases of acute
appendicitis occur in patients older than %# years, whereas one half of all deaths from appendicitis
occur in this age group. &he rate of perforation in elderly patients is approximately '#$, ' times higher
than in younger adults. &his is largely because ('$ of elderly patients wait more than )* hours to
see+ medical attention. &he diagnosis can be difficult to ma+e, since more than one half of patients in
this age group do not present with fever or leu+ocytosis. ,urther confusing the picture, approximately
one third do not locali-e pain to the right lower .uadrant, and one fourth do not have appreciable right
lower .uadrant tenderness. !nly )#$ of elderly patients present with anorexia, fever, right lower
.uadrant pain, and leu+ocytosis. &he initial diagnosis is incorrect in *#/'#$ of patients in this age
range . 0 perforation is the most common compIication of appendicitis )

290) Old patient with bilateral enlarged knee , no history of
trauma , no tenderness , normal ESR and C-reactive
proteins . the diagnosis is
a. Osteoarthritis
b. Gout
c. lnfectous arthritis
the correct answer ís a ( I'm not sure )
.......................................
...............
291) Patient has decrease visual acuity bilateral , but more in
rt side , visual field is not affected , in fundus there is
irregular pigmentations and early cataract formation .
a. Refer to ophthalmologist for laser therapy
b. Refer to ophthalmologist for cataract surgery
??????????
the correct answer ís a
.......................................
...............
292) What is the most common treatment for juvenile
rheumatoid arthritis
a. lntraarticular injection of steroid
b. Oral steroid
c. Paracetamol
d. penicillamine
e. Asprin
the correct answer ís e
the most common ímportant for |RA ís ( NSAID )

.......................................
..............
293) Which of the following decrease mortality after Ml
a. Metoprolol
b. Nitroglycerine
c. Thiazide
d. Morphine
the correct answer ís a
oníy b-bíocker ans ASA are mortaííty benefít for treatment of
angína
294) The cardiac arrest in children is uncommon but if occur it
will be due to
a. Primary
b. Respiratory arrest
c. hypovolemic shock
d. neurogenic shock
the correct answer ís b
Progressíve respíratory ínsuffícíency accounts for 60% of
aíí paedíatríc arrests.
.......................................
...............
295) Old female with recurrent fracture , Vitamen D
insufeciency and smoker . which exogenous factor has the
gretest exogenous side effect on osteoporosis.
a. Old age
b. Smoking
c. . Vit D insufeciency
d. Continue smoking
e. Recurrent fracture
the correct answer ís b
.......................................
...............
296) patient presented with sudden chest pain and dysnea ,
tactile vocal fremitus and chest movemebt is decreased , by
x-ray there is decreased pulmonary marking in left side ,
diagnosis
a. atelectasis of left lung
b. spontaneous pneumothorax
c. pulmonary embolism
7777777777
297) boy after running for hours , has pain in knee and mass
on upper surface of tibia
a. Osgood scatter disease
b. lliotibial band
the correct answer ís a
.......................................
...............
298) pancreatitis
a. Amylase is slowly rising but remain for days
b. Amylase is more specific but less sensitive than
lipase
c. Ranson criteria has severity (predictive) in acute
pancreatitis
d. Pain is increased by sitting and relieved by lying
down
e. Contraceptive pills is associated
the correct answer ís c
The Ranson and Glasgow scoring systems are based on such
parameters and have been shown to have an 80% sensítívíty for
predíctíng a severe attack, aíthough oníy after 48 hours foííowíng
presentatíon.
risk mortality is 20% with 3-4 signs, 40% with 5-6 signs,
100% 7 signs.
299) Patient has fever , night sweating , bloody sputum ,
weight loss , ppd test was positive . x-ray show infiltrate in
apex of lung , ppd test is now reactionary , diagnosis
a. Activation of primary TB
b. sarcoidosis
c. Case control is
d. Backward study
the correct answer ís a
The tubercuíosís skín test (aíso known as the tubercuíín test or
PPD test) ís a test used to determíne íf someone has deveíoped
an ímmune response to the bacteríum that causes tubercuíosís
(TB).
.......................................
...................
300) patient with DM presented with limited or decreased
range of movement passive and active of all directions of
shoulder
a. frozen shoulder
b. impingment syndrome
c. osteoarthritis
the correct answer ís a
.......................................
...................
301) 48 years old with irregular menses presented with
fatigue and no menstruation for 3 months with increased
pigmentation around the vaginal area with no other
symptoms. ur next step would be
a. reassure the patient
b. do a pregnancy test
c. do ultrasound
the correct answer b
302) 3 years old presented with shortness of breath and
cough at night which resolved by itself in 2 days. he has Hx
of rash on his hands and allergic rhinitis. he most likely had
a. croup
b. bronchial asthama
c. epilotitis
????????

1roup 2piglottitis
!nset Days 3ours
,lu/li+e symptoms 4es 5o
1ough 6ever bsent
ble to drin+ 4es 5o
Drooling saliva 5o 4es
,ever 789 :89
6tridor 3arsh 6oft
;oice 3oarse muffed
.......................................
................
303) a man went on vacation. he noticed a white patch in his
chest which became more clear after getting a sun tan
which was spread on his chest.ur Dx is
a . pytriasis versicolor
b. vitilligo
c. pytriasis roscea
the correct answer a
.......................................
...................304) a 4 years old presented
with 2 day history of shortness of breath a seal like cough with
no sputum and mild fever. on examination he did not look l'll
or in distress
a. acute epilossitis
b. croup
c. angioedema
The correct answer b
304)65 years old came with knee pain. and limited movement.
on examination had crepition on knee. dx
a. rhuematiod arthritis
b. osteoporosis
c. osteoarthritis
the correct answer c
.......................................
...................
305) which vitamin is given to new born to stop bleeding
a. vit. A
b. vit. D
c. vit. K
d. vit E
e. vit C
the correct answer c
.......................................
...................
306) a child came with congested throught and mild bulging of
tympanic membrane ur Dx was URTl. The
777777777

.......................................
...................
307) a child presented with erythematous pharynx, with
cervical lymph nodes and rapid strplysin test negative and
low grade fever with positive EBV. it next step
a. give antibiotics and anti pyretic
b. give anti pyretic and fluids
d. culture and sensitivity
the correct answer a
.......................................
...................
308) child with low grade fever and congested throat, negative
ASO and positive EBV. he has
a. infectous mononucleosis
b. URTl
the correct answer ís a
.......................................
...................
309) the most common cause of intracerebral or
intraparynchimal bleeding is.
a. Hypertensive angiopathy
b. annurysm
c. AV malformation
the correct answer ís a
310) young adult Sickle cell patients are commonly affected
with
a. dementia
b. multiple cerebral infarcts
the correct answer b
.......................................
...................
311) 80 years old living in nursing home for the last 3 months.
his wife died 6 months ago and he had a cornary artery
disease in the last month. he is now forgetful especially of
short term memory and decrease eye contact with and loss
of interest. dx
a. alzihiemer
b. depression
c. hypothyroidism
the correct answer a , I thínk O ís not compíete
.......................................
...................
312) thyroid cancer can be from
a. hypothyroidism
b. graves disease
c. toxic nodule
777777777
.......................................
...................
313) a mother came with her son who is 7 years old very active
never sitting in class and with poor concentration. ur
management would be.
a. olanzipine
b. amitilyne
c. aloxane
the correct answer ís b ( I'm not sure )
thís case ís "attention -deficit hyperactivity disorder"
treatment:
1- Methyíphenídate
2- Dextroamphetamíne
3- Aderaíí
4- Atomoxetíne
5- Pemoííne
6- Antídepressant ( SSRI )
314) from the graph above which of the following statement is
true
a. osteoprosis affecting majority of women above 80
b. 20% of women under 70 are affected
777777777
.......................................
...................
315) a patient presented with progressive weakness on
swollowibg with diplopia and fatigability. the most likely
underlying cause of her disease is.
a. antibody against acetylcholine receptors
.......................................
...................
316) an 69 year old non diabetic. with mild hypertension and
no hx of Coronary heart desease. the best drug in
treatment is.
a. thiazides
b. ACEl
c. ARB
d. CCB
the correct answer a
.......................................
...................
317) which of the following anti hypertensive is
contraindicated for an uncontrolled diabetic patient
a. hydrochlorothiazide
b. Losartan
c. hydralszine
d. spironolactone
the correct answer ís a
-síde effect of thíazíde : hypergíycemía
.......................................
...................
318) a wound stays in it's primary inflammation untill
a. Escher formation
b. epitheliazation
c. after 24 hours
d. wound cleaning
the correct answer d
.......................................
...................
319) 70 years old male patient with mild urinary dripping and
hesitency ur Dx is mild BPH. ur next step in management is
a. transurethral retrograde prostatectomy
b. start on medication
c. open prostatectomy
the correct answer b
320) most common cause of secondary HTN is
a. Renal disease - Renal parenchymal disease
.......................................
...................
321) one of the following food is known to reduce cancer
a. fibers
.......................................
...................
322) smoking is a definitive risk of
a. sq.c.ca of bladder
b. liver
c. breast
the correct answer ís a

.......................................
...................
323) exercise recommended for patients with CAD. is
a. isometric
b. isotonic
c. yoga
؟؟؟؟؟؟؟؟؟؟
.......................................
...................
324)what is the definitive treatment of frostbites
a, Rewarming
.......................................
...................
325) the most common cause of failure to thrive in pediatric is
a. malnutrition
.......................................
...................
326) which of the following causes the highest maternal
mortality in pregnancy
a. toxoplasma
b. hyperbilirubenia
c. 7777

" The ma|or causes of maternaí death are bacteríaí ínfectíon,
varíants of gestatíonaí hypertensíon íncíudíng pre-ecíampsía and
HELLP syndrome, obstetrícaí hemorrhage, ectopíc pregnancy,
puerperaí sepsís (chíídbed fever),
327) Ttt of frostbite
a. lmmersion in water 40-45 C
b. Debridement
c. Leave it at room tepmrature
The correct answer ís a
.......................................
...................
328) Case about a child both RBS, FBS are elevated so he has
DM1.what's the type of HLA
a.DR3
b.DR4
c.DR5
d.DR6
e.DR7
the correct answer ís a
Types of HLA :
DR2 : Good's pasture syndrome & muítípíe myeíoma
DR3 : D.M , SLE , & grave's dísease
DR27 : ankyíosíng spondyíaítís & reíter's syndrome
B51 : behceat's dísease
D11 : hashímot's dísease
...
.......................................
................
329) Definition of PPV 7
Predictive positive value ( PPV ) : proportion of people with a
positive test who have s a disease : a} (a+b)
.......................................
...................
330) What's the most common case in PHC centers
a.UTl
b.HTN
c. Coryza
the correct answer ís c
331) all of the following will decrease pt compliance except:
a. involve pt in the plan
b. make simplified regimen
c. give easy written instructions
d. make appointments flexible
e. warn the patient about the danger of missing a pill
the correct answer ís e
.......................................
...................
332) Case about old diabetic patient who still have
hyperglycemia despite increase insulin dose.the problem with
insulin in obese patients is
a. Post receptor resistance
?????? O NOT COMPLETE
.......................................
..................
333) Case about a child with drooling, fever, barking cough in
sitting position, dx:
a. Croup
b. Broncholities
c. Pneumonia
The correct answer ís a
.......................................
...................
334) Mother came to you after her son had hematoma under
the nail dt injury:
a. Send home with a pad on the head
b. Send home with acetaminophen
c. Do wedge resection
d. Evacuate the hematoma
The correct answer ís d
Thís case ís ( subunguaí hematoma )
335) What vaccine u'll give to a SCD ( sickle cell disease ) child
a.HBV
b. H.influenza
c. pneumococcal
d. both A and B
e. all of the above
the correct answer ís c
.......................................
...................
336) a mother with HBsAg positive came with her child 6 yrs
old who has HBsAg +ve what will you give him:
a. oral polio, DTP, MMR
the correct answer ís a
other choíces aíí had HBV vaccíne whích u'íí not gíve
.......................................
...................
337) Patient wil LLÇ pain, vomiting, fever, high WBC (17.000),
tenderness and rebound tenderness
a. Diverticulitis
b. Sigmoid volvulus
c. Appendicitis
d. Toxic enteritis
The correct answer ís a

.......................................
...................
338) What's the organism responsible for psuedomembranous
colitis:
a. Pseudomonas
b. Colisteridum
c. E.coli
d. Enterococcus fecalis
The correct answer ís b
339) Mother came with her child who had botillism, what you
will advice her:
a. Never eat canned food again
b. Store canned food at home
c. Boil canned food for 40-50 min
d. Check expiry date of canned food
The correct answer ís d
.......................................
...................
340) Old pt presented with abdominal pain, back pain,
pulsatile abdomen what's the step to confirm dx: this is a case
of aortic aneurysm
a. Abdominal US
b. Abdominal CT
c. Abdominal MRl
The correct answer ís a b
-ínítíaí ínvestígatíon US - CONFIRM by CT

.......................................
...................
341) 18 months old came with bite by her brother, what you
will do:
a. Give augminten
b. Give titunus toxoid
c. Suture
O not compíete
.......................................
...................
342) 19 yrs old after bike accident, he cant bring the spoon
infront of himself to eat, lesion is in:
a. Temporal lobe
b. Cerebellum
c. Parietal lobe
d. Occipital lobe
The correct answer ís b
343) How to dx DVT:
a. Contrast venography
b. Duplex US
The correct answer ís b
.......................................
...................
344) Pt came after RTA, GCS 14, near complete amputation of
the arm, 1
st
step:
a. Secure air way
b. Tourniquet on the arm
The correct answer ís a
.......................................
...................
345) Pt with hx of prolonged heavey bleeding 2 hrs post
partum, you will give:
a. Ringers lactate
b. NS
c. NS+ packed erythrocytes
The correct answer ís c ( O NOT COMPLETE )
.......................................
...................
346) What is special about placenta abruption:
a. Abnormal uterine contractions
b. PV bleeding
c. Fetal distress
The correct answer ís b , PA : dark , paínfuí vagínaí bíeedíng and
compíícatíon ís fetaí hypoxía
.......................................
...................
347) Pt 34 wks, hx of PV bleeding for many hrs, dark blood,
abdominal tenderness, FHR 120, uterine contractions every 3
min, Dx:
a. Abruption placenta
348) One of the steps in managing epistaxis:
a. Packing the nose
b. Press the fleshy parts of nostrils
c. Put patient of lateral lying position
The correct answer ís b
.......................................
...................
349) Pt with hx of diarrhea, abdominal pain, agitation,
headache, dizziness, weakness, pulstile thyroid, unsteady gate.
Examination was normal. Dx:
a. Hypochondriasis
b. Somatization disorder
c. Thyroid Ca
d. Anxiety
The correct answer ís b
.......................................
...................
350) Child with headache that increase by changing head
postion, unilateral, photophobia
a. Sinus headache
b. Migraine
c. Cluster headache
d. Tension headache
The correct answer ís b
.......................................
...................
351) Ttt of isolated fracture of femur (repeated) 777
.......................................
..................
352) Younge pt with pain in LL after running 3 kgs, more at
night, swelling, XR was NL
a. Stress fracture
353) HTN pt, with decrease vision, fundal exam showed
increase cupping of optic disc dx:
a. Open angle glaucoma
b. Closed angle glaucoma
c. Cataract
d. HTN changes
The correct answer ís a ( I'm not sure )
.......................................
...................
354) Pt with unilateral red eye, tearing, clear tears no
swelling or discharge:
a. Give topical antihistamin
b. Give topical AB
c. Give systemic AB
d. Reassurance
The correct answer ís d
.......................................
...................
355) Business man went to Pakistan, came with bloody
diarrhea, stool examination showed trophozoite with RBC
inclusion, Dx:
a. Amebic desyntry (entamoeba histlolytica )
.......................................
...................
356) 5 yrs old child with abdominal pain after 2 wks of URTl,
HB 8, retics 12% WBC NL peripheral blood smear showed target
cells, RBC inclusions dx:
a. SCA (the only hemolytic anemia in the answers)
77777
.......................................
...................
357) Child had hb electrophoresis showed hb 2%
a. HBA 40 HBS 35 HBF 5 HBA2
b. Sickle cell trait
c. Thalacemia major
d. Minor
77777
358) Younge pt with hx of cough, chest pain, fever CXR
showed RT lower lobe infiltrate:
a. Amoxicillin
b. Ceferuxim
c. Emipenim
d. Ciprofloxacin
777777
The correct answer ís d (I'm not sure )
.......................................
...................
359) Best thing to reduce mortality rate in COPD:
a. Home O2 therapy
b. Enalipril
c. Stop smoking
The correct answer ís c
.......................................
...................
360) Drug that will delay need of surgery in AR:
a. digoxin
b. verapamil
c. nefidipin
d. enalpril
the correct answer ís c
.......................................
...................
361) Child with skin rash, pericarditis, arthritis dx:
Kawasaki
.......................................
...................
362) Pic of skin with purple flat topped polygonal papules, dx:
a. Lichen plannus
.......................................
...................
363) Child with atopic dermatitis, what you will give other
than cortisone
a. There were many drugs, steroids and AB and only one
strange name maybe moisturizer. That's the answer
364) A man had increase shoe size and jaw, the responsible is:
a. ACTH
b. Somato77
c. TSH
d. Cortisone
The correct answer ís b
.......................................
...................
365) The best advice to patient travelling is:
a. Boiled water
b. lce
c. Water
d. Salad and under cooked sea shells
The correct answer ís a
.......................................
...................
366) Seldinfil is contraindicated with:
a. Nitrate
b. Methyldopa
c. Gabapentine
The correct answer ís a
.......................................
...................
367) Pt with TB, had ocular toxicity symptoms, the drug
responsible is:
a. lNH
b. Ethambutol
c. Rifampicin
d. Streptomycin
The correct answer ís b
lNH : perípheraí neurítís and hepatítís . so add ( B6 )
Ethambutol : optíc neurítís
Rifampicine : body fíuíd organe
368) Another pt treated for TB started to develop numbness,
the vit deficient is:
a. Thiamin
b. Niacin
c. Pyridoxine
d. Vit C
THE correct answer ís c

.......................................
...................
369) Pt with bilateral breast disease, dx:
a. Paget
b. Papilloma
c. Meduallary
d. Lobular
.......................................
...................
370) Child fell on her elbow and had abrasion, now swelling is
more, tenderness, redness, swelling is demarcated (they gave
dimensions) child has fever. Dx:
a. Gonoccal arthritis
b. Synovitis
c. Cellulitis of elbow
The correct answer ís c
.......................................
...................
371) About burn
a. You will give 1\2 fluid in the 1
st
8 hrs
b. 1\4 in the 1
st
8 hrs
The correct answer ís a
Parkland formula : fíuíd ín fírst 24 hours = 4 * wt. ín kg * % BSA
50% ín fírst 8 hours and another ín next 16 hours
372) You r supposed to keep a child NPO he's 25 kgs, how
much you will give:
a. 1300
b. 1400
c. 1500
d. 1600
The correct answer ís d
For the first 10 kg of weight, a chííd needs 100 mL per kg of
weíght.
For the next 10 kg of weight (11-20 kg), a chííd oníy needs 50 mL
per kg of weíght.
for anything over 20 kg (21 kg of weight and higher), the chííd
oníy needs 20 mL per kg of weíght.
Take a 35 kg chííd, for exampíe. He needs 1000 mL for hís fírst 10 kg of
weíght (10 kg x 100 mL), 500 mL for hís second 10 kg of weíght (10 kg
x 50 mL), and 20 mL/kg for any weíght above 20 kg (15 kg x 20 mL). A
35 kg chííd, therefore, needs approxímateíy 1800mL of water or free
ííquíds.
.......................................
...................
373) Young patient with pharyngitis, inflammation of oral
mucosa and lips that has whitish cover and erythmatous base,
febrile, splenomegaly. Dx: (this is infectious mono)
a. Scarlet fever
b. EBV
c. HZV
The correct answer ís b
.......................................
...................
374) Female with greenish vaginal discharge, red cervix. Dx:
Trchimoniosis
.......................................
...................
375) Another female with malodorous discharge and pain
maybe. Dx:
Bacterial vaginosis
.......................................
...................
376) The best way to reduce the weight in children is:
a. stop fat intake
b. Decrease calories intake
c. Drink a lot of water
The correct answer ís b
377) You have to advice a teenager that mainly eats fast food
to take:
a. Folic acid and Ca
b. Vit C and Ca
c. Ca alone
The correct answer ís c ( I'm not sure )
.......................................
...................
378) Patient has symptoms of infection, desquamation of
hands and feet, BP 170\110 dx:
a. Syphilis
b. Toxic shock syndrome
c. Scarlet fever
The correct answer ís b
Toxic shock syndrome :
Caused by S.aureus , often wíth 5 days of onset of menestraí
períod ín women who have used tampons. Feature: abrupt fever
( 39 c or more ), vomítíng, díffuse macuíar erythematous rash,
desquamatíon especíaííy ín paíms and soíes, nonpuruíent
con|unctívítís. Diagnosis : bíood cuíture are -ve .so, díagnosís by
cíínícaí. Treatment : 1
st
step rehydratíon and antíbíotíc
.......................................
...................
379) Snellin chart, if patient can read up to line 3, how much
is his vision loss :
O not compíete:
but thís pt. see íetters at 20 feet , where normaí person see ít at 70
feet.

380) l cant remember the case but gram +ve cocci were
isolated, dx is sterpt bcz it was the only gm +ve cocci.
.......................................
...................
381) Diabetic mother asking about risk of diabetes related
congenital defect. lt will be in:
a. 1
st
trimester
b. 2
nd
trimester
c. 3
rd
The correct answer ís a (I'm not sure )
.......................................
...................
382) lf diabetic mother blood sugar is always high despite of
insulin, neonate complication will mostly be:
a. Maternal hyperglycemia
b. Maternal hypoglycemia
c. Neonatal hypoglycemia
d. Neonatal hyperglycemia
The correct answer ís c
.......................................
...................
383) Obssive neurosis patients will have:
a. Major depression
b. Lake of insight
c. Schizophrenia
The correct answer ís a
.......................................
...................
384) Before giving bipolar patient lithium you will do all of the
following except:
a. TFT
b. LFT
c. RFT
d. Pregnancy test
The correct answer ís b
385) Patient came with PV small bleeding (she fell down and
felt decrease in fetal movement but on examination baby was
ok) all her 3 previous pregnancies were normal, you will do:
a. lmmediate CS
b. Careful observation of the bleeding
c. Medication (strange name)
d. Mg sulphate
O not compíete , depend on date of gestatíon.
.......................................
...................
386) Pt came to you missing her period for 7 wks, she had
minimal bleeding and abdominal pain, +ve home pregnancy
test, 1
st
thing to order is:
a. BHCG
b. US
c. Drugs maybe
The correct answer ís a
.......................................
...................
387) Patient came to you and you suspect pre eclampisa,
which of the following will make it most likely:
a. Elevated blood pressure
b. Decrease fetal movement
c. 77
The correct answer ís a
.......................................
...................
388) Old patient male, hematuria, passing red clots and RT
testicular pain:
a. Testicular Ca
b. RCC ( renal cell carcinoma )
c. Cystitis
The correct answer ís b
389) to get more information from the pt
a. open end question
( avoíd íeadíng questíon to get more ínformatíon )
.......................................
...................
390) gingivits most likely cause
a.HSV
( q not compíete but : The most common cause of gíngívítís ís poor
oraí hygíene that encourages píaque to form.)
.......................................
...................
391) watery discharge from eye , conjunctivitis treated by
a. topical corticosteroid
(Its symptoms íncíude watery díscharge and varíabíe ítch. The
ínfectíon usuaííy begíns wíth one eye, but may spread easííy to the
other
Ttt: coíd compresses
|
and artífícíaí tears)
.......................................
...................
392) blow out fracture eyelid swelling , redness other syptoms
a. present air fluid level
b. enopthalmos
The correct answer ís b
íts enophaíoms , other name of bíow out orbítaí fíoor fracture
.......................................
...................
393) drinking of dirty water causes
a. heptitis A
b. B
c. C
d. D
The correct answer ís a
.......................................
...................
394) giemsa stained blood film
a. malaria

395) regarding peritonitis
a.Complicated appendectomy the cause is anerobe
organism
b. rigidity and the cause is paralytic ileus
c. can be caused by chemical erosions.
The correct answer ís c
.......................................
...................
396) fraucture of humerus associated with
a. radial N injury
b. median nerve injury
the correct answer ís a ( radíaí groove )
.......................................
...................
397) there is case i cant remember they asked about diagnosis
of acute lymphocytic leukemia ALL
The totaí number of whíte bíood ceíís may be decreased, normaí, or
íncreased, but the number of red bíood ceíís and píateíets ís aímost
aíways decreased. In addítíon, very ímmature whíte bíood ceíís
(bíasts) are present ín bíood sampíes examíned under a
mícroscope.
A bone marrow bíopsyís aímost aíways done to confírm the
díagnosís and to dístínguísh ALL from other types of íeukemía
.......................................
...................
398) diagnosis of hemochromatosis
a. serum ferritin7!
Hemochromatosís ís suggested by a persístentíy eíevated
transferrín saturatíon ín the absence of other causes of íron
overíoad. It ís the ínítíaí test of choíce .
Ferrítín concentratíon can be hígh ín other condítíons, such as
ínfectíons, ínfíammatíons, and ííver dísease .
Ferrítín íeveís are íess sensítíve than transferrín saturatíon ín
screeníng tests for hemochromatosís .
399) kawasaki disease associated with
a.strawberry tongue
 Kawasaki disease
Muítísystem acute vascuíítís that prímary affected young
chíídren. Fever píus four or more of the foííowíng crítería for
díagnosís:
1-fever > 40 C for at íeast fíve days
2-bííateraí, nonexudatíve, paíníess con|unctívítís
3-poíymorphous rash ( prímarííy truncaí )
4-cervícaí íymphadenopathy ( often paínfuí and unííateraí )
5- díffuse mucous membrane erythema ( strawberry
tongue ) , dry red
6- erythema of paím and soíe
7- other maíndfestatíon : gaííbíadder hydrops, hepatítís, arthrítís
Untreated Kawasakí díease can íead to coronary aneurysms and
even MI
Treatment :
1-hígh dos ASA ( for fever and ínfíammatíon) & IVIG ( to prevent
aneurrysmaí )
2-referraí to pedíatríc cardíoíogíst
.......................................
...................
400) most common tumor in children
a.ALL
b. rabdomyosarcoma
c. wilm's tumor

the correct answer ís a
-ALL : most common chíídhood tumor
-rabdomyosarcoma : most common soft tíssue tumor
-wilm's tumor: most common íntra- abdomínaí chíídhood tuomr
.......................................
...................
401) Most common intra- abdominal tumor in children:
a.wilm's tumor
b. lymphoma

the correct answer ís a
the most common íntra-abdomínaí tumor ín chíídren are
neruobíastoma and wíím's tumor.
402) pt c}o of hypopigmentful skin , nerve thicking diagnosis
a.leprosy
Leprosy : chroníc granuíomatous ínfectíon caused by
Mycobacteríum íeprae, acíd-fast bacíííus preferentíaííy affectíng cooíer
regíons of body ( e.g skín , mucousmembrane, perípheraí nerve) .
díagnosís by skín íesíon ( hypopígmentatíon or hyperpígmentatíon
macuíe ) and eníarge nerves eíth sensory íoss.
.......................................
...................
403) regrading COPD to reduce complication we should give
a. theophyline
b. pneumococcal vaccine
c. smoking cessatíon.
The correcr answer ís c
.......................................
...................
404) pseud-gout its
a. CACO3
b. CACL3
The correct answer ís a
Gout : deposítíon of ( MSUM ) monosodíum urate monohydrate -ve
of bírefríngent , needíe shape,
Psudogout : deposítíon of ( cppd ) caícíum pyrophosphates
dehydrate crystaí , +ve bírefríngent , rhomboíd shape, ( CACO3)
.
405) man with history of alcohol assocation with
a. high MCV
b. folic acid deficiency
c. B12 deficieny
e. hepatitis
The correct answer ís b
.......................................
...................
406) neanate 9 days on breast feed develop jandice
a. breast feed jaundice
b. pathological jaundice
c. physiological jaundice
the correct answer ís a
1-pathological jaundice : con|ugated ( dírect ) bííírubín, start ín 1
st

24 hours, bííírubíne > 15 mg / dí , persístent 1 week ín term ínfant and
2 weeks ín preterm ínfant
2-physilogical jaundice: uncon|ugated ( índírect ) bííírubíne , start ín
2- 3 days, bííírubíne < 15 mg/dí , persístent 1 week ín term ínfant and
2 weeks ín preterm ínfant.
3-breast feeding jaundice : uncon|ucated ( índírect ) bííírubíne ,
start ín 7 days of íífe , persístent to one or more months.
.......................................
...................
407) lady c}o headche bandlike pain
a. tension headache
.......................................
...................
408) regarding breast screening
a. self breast examination early detection of tumor
b. mammogram not advise before 35 y
777777
.......................................
...................
409) 19 yrs old c}o abdo pain within menestration for last 6
years diagnosis
a. primary dysmenorrhea
b. secondary dysmenorrheal
The correct answer ís a
Prímary dysmenorrhea :
Onset wíthín 6 months after menarche . Lower abdomínaí/peívíc
paín begíns wíth onset of menses and íasts 8-72 hours
410) bilateral breast mass diagnosis
a. ductal carcinoma
b. pagets disease
ít couíd be Intraductaí papíííoma ??????
.......................................
...................
411) beriberi cause of deficiency
a. VlT B1
b. VlT B2
c. VlT B3
The correct answer ís a
.......................................
...................
412) chronic uses of estrogen association 77777
.......................................
...................
413) Asystole
a. adrenalin
b. atropine
The correct answer ís
asystoí has oníy 3 durgs epínephríne-vasopressíne-atropín
.......................................
...................
414) pt has diarrhea , dermatitis and dementia diagnosis
a. peííagra
.......................................
...................
415) regarding injectable progestron
a . an cause skin prob 7!!
In|ected progesterone ( medroxy-progestrone ) : advantages : ííght
or no períods, safe wíth breastfeedíng, IM ín|ectíon every 3 months.
Dísadvantages: írreguíar bíeedíng, wt. gaín, decrease bone míneraí
densíty ( reversíbíe ) , deíay fertíííty díscontínue .
.......................................
...................
416) sencodary prevention is
a. coronary bypass gaft
Secondary preventíon generaííy consísts of the ídentífícatíon and
ínterdíctíon of díseases that are present ín the body, but that have
not progressed to the poínt of causíng sígns, symptoms, and dys-
functíon
417) 22 yrs old c}o insomina} sleep disturb treatment
a. SSRl
Short hístory ,
But the ínítíaí management of ínsomnía : good síeep hygíene .
.......................................
...................
418) celluitis in children most commin causes
a. group A steptoccus
In chíídren, the most common cause of ceííuíítís ís - aureus or
group A streptococcus.

.......................................
...................
419) antideprssants associated with hypertensive crisis
treatment
a. SSRl
b. MOAls
c. TCAs
the correct answer ís b
esp hydrazínes ( pheneízíne )
.......................................
...................
420) pt his MBl = 24 kg he is
a. noramal weight
b. over weight
c. morbid weight
d. mild weight
The correct answer ís a
.......................................
...................
421) baby c}o fever , chills , rigors and head rigidity +ve
kurnings sign rash on his lower limb diagnosis :
- meningoccal meninigits
7777777
.......................................
...................
422) 48 yrs pt with abdo pain , neusea, vominting tenderness in
right hypochondrial
- acute cholecysitis
Fever 7!
423) 29 pt c}o dysurea his microscopic showed G -ve organism is
a. legonealla
b. E. coli
the correct answer ís b
.......................................
...................
424) 30 yrs pt c}o feeling heaviness in the lower abdomen
having pulge papable at the top scrotum that was
reducible and icreasing in valsalva maneuver diagnosis
a. hydrocele
b. variocele
c. indirect inguinal hernia
d. direct inginal hernia
The correct answer ís c
.......................................
...................
425) anticoagulation prescrib for
a. one month
b. 6 months
c. 6 weeks
d. one year
The correct amswer ís b
.......................................
...................
426) cushing syndrome best single test to confirm
a. palsma cortison
b. ATCH
c. Dexamethasone Suppression Test
The correct answer ís c
.......................................
...................
427) 23 yrs old history of URTl then he developed ecchomysis
best treated
a. local AB
b. local antiviral
c. steroid
The correct answer ís c
428) chronic psycotic disorder manged by
a. haíoperídoí
.......................................
...................
429) 29 yrs old lady B-HSG 160 c}o vomiting , abdomenal pain
which is more accurate to diagnosis
a. BHCG serial
b. pelvic US
c. laprascopy
O not compíete, but may be thís case ís moíar and chooce ís a .
.......................................
...................
430) 70 yrs old man c}o fever , vesicular rash over forehead
mangement
a. lV AB
b. lV antiviral
c. Acyclovir
the correct answer ís c ( í"m npt sure )
.......................................
...................
431) celiac disease involves :
a. proximal part of small intestin
b. distal part of small intestin
c. proximal part of large intesin
d. distal part of large intensin
The correct answer ís a
.......................................
...................
432) 6 yes old pt cyanosis past history of similar attack 6 month
ago u will do for him
a. CxR
b. PFT
c. secure airway
d. CBC
O ís not cíear or not compíete , íf pt. came wíth íífe threateníng
cyanosís don't waste tíme wíth ínvestígatíon and start wíth ABC
( scure aírway ) , but íf pt. came wíth past hístory cyanosís choose
b .

433) side affect of diazepam
Sedatíon , depence, respíratory supressíon , anterograde amnesía ,
confusíon (especíaííy pronounced ín hígher doses) and sedatíon
.......................................
...................
434) endemic means:
Endemic :is the constant presence of a disease or infectious agent in a certain
geographic area or population group. ( usually rate of disease )
Epidemic : is the rapid spread of a disease in a specific area or among a
certain population group. ( excessive rate of disease )
Pandemic : is a worldwide epidemic; an epidemic occurring over a wide
geographic area and affecting a large number of people.
.......................................
...................
435) Epidemic curve :
a graph ín whích the number of new cases of a dísease ís píotted
agaínst an íntervaí of tíme to descríbe a specífíc epídemíc or
outbreak .
436) Pt with hodgkin's lymphoma , and red strunberg cell in
pathology and there is esinophil lymphocyte in blood so
pathological classification is:
a. Mixed-cellularity subtype
b. nodular sclerosis subtype of Hodgkin's lymphoma
the correct answer is b
Cíassícaí Hodgkín's íymphoma can be subcíassífíed ínto 4
pathoíogíc subtypes based upon Reed-Sternberg ceíí morphoíogy
and the composítíon of the reactíve ceíí ínfíítrate seen ín the
íymph node bíopsy specímen (the ceíí composítíon around the
Reed-Sternberg ceíí(s))
.
Name descreption
Noduíar scíerosíng
CHL
Is the most common subtype and ís composed of íarge tumor nod%les
showíng scattered íacunar cíassícaí RS ceíís set ín a background of
reactíve íymphocytes, eosínophíís and píasma ceíís wíth varyíng
degrees of coííagen fíbrosís/sclerosis.
Míxed-ceííuíaríty
subtype
Is a common subtype and ís composed of numerous cíassíc RS ceíís
admíxed wíth numerous ínfíammatory ceíís íncíudíng íymphocytes,
hístíocytes, eosínophíís, and píasma ceíís. wíthout scíerosís. Thís type ís
most often assocíated wíth EBV ínfectíon and may be confused wíth the
earíy, so-caííed 'ceííuíar' phase of noduíar scíerosíng CHL
Lymphocyte-rích or
Lymphocytíc
predomínance
Is a rare subtype, show many features whích may cause díagnostíc
confusíon wíth noduíar íymphocyte predomínant B-ceíí Non-Hodgkín's
Lymphoma (B-NHL). Thís form aíso has the most favorabíe prognosís
Lymphocyte depíeted Is a rare subtype, composed of íarge numbers of often píeomorphíc RS
ceíís wíth oníy few reactíve íymphocytes whích may easííy be confused
wíth díffuse íarge ceíí íymphoma. Many cases prevíousíy cíassífíed
wíthín thís category wouíd now be recíassífíed under anapíastíc íarge
ceíí íymphoma

437) 62 y male with DVT and lVC obstruction due to thrombosis
so most like dd is
a. neohrotic syndrome
b. SLE
C. Chirstm disease
D. 7!
.......................................
...................
438) Pt with bdominal pain heamatutea , HTN, and have
abnormalty in chromosm 16 , diagnosis is
a. POLY CYCTlC KlDNEY
.......................................
...................
439) 17 year pt with dyspnea Po2 , PCO2 ,Xray normal PH
increase so dd is:
a. acute attack of asthma
b. P E
c. pneumonia
d. pnemothrax
the correct answer ís a
.......................................
...................
440) A long scenario about patient with polydipsia ad polyuria.
Serum osmolrity high . desmoprsin inductin no change
urine omolarity and plasma osmolrity so dd is
a. nphrognic type
b. central tupe
The correct answer ís a
.......................................
...................
441) 50 year old Man presented to ER with sudden headach,
blurred of vision and eye pain. The diagnosis is:
a. Acute glaucoma
b. Acute conjunctivitis
c. Corneal ulcer
d. -----
The correct answer ís a
442) RTA with hip dislocation and shock so causes of shock is
a. blood lose
b. urtheral injery
c. nurogenic
The correct answer ís a
.......................................
...................
443) most common causes of hand infection
a. truma
b. imunocrombromise
c. ...
the correct answer ís a
.......................................
...................
444) ttt of cholestatoma is
a. antibiotic
b. steroid
c. surgery
d. Grommet tube
the correct answer ís c
-Cholesteatoma ís a destructíve and expandíng growth consístíng
of keratínízíng squamous epítheííum ín the míddíe ear and/or
mastoíd . treatment : Surgery ís performed to remove the sac of
squamous debrís and a mastoídectomy ís performed.

445) twins one male and other female . his father notice that
femle become puberty before male so what you say to
father
a. female enter puberty 1-2 year before male
b. female enter puberty 2-3 year before male
c. female enter puberty at the same age male
the correct answer ís b
.......................................
...................
446) in devolping countery to prevent dental carise , it add to
water
a. florid
b. zink
c. copper
d. iodide
the correct answer ís a
.......................................
...................
447) 12 y.o boy c}o abdominal pain after playing football,he
denied any h}o trauma ,the pain is in the Lt paraumbilical
region what inx you want to do:
a. CXR
b. ultrasound kidney
The correct answer ís b , l'm not sure because MCÇs are not
compete.
.......................................
...................
448) pt child with back pain that wake pt from sleep
So diagnosis
a. lumber kyphosis
b. osteoarthritis
c. RA
d. Scoliosis
the correct answer ís d
449) child with papule vesical on oropharnx and rash in palm
and hand so dd:
a. CMV
b. EBV
c. MEASLS
d. ROBELLA
???? Coxsackíe A vírus. Vesical in buccal mucusa is
measls.
.......................................
...................
450) chid with dental caries and history of bottle feading
So dd
a. nurse milk caris
.......................................
...................
451) Generalize antxity disorder best ttt: -19
a. Ssri
b. tricyclic a d
d. MAOl
The correct answer ís a

.......................................
...................
452) Major depression management:
a. lntial MONOTHERABY even sever sever deprisson
b. Ttt should be change if no response during 2wk (AT
LEAST 6 . WEEKS )
7777
.......................................
...................
453) psychotherapy, medication, and electroconvulsive therap
Psychiatric pt with un compliance of drugs ttt:
a. depro halopredol injection
b. oral colonazepam
the correct answer ís a
454) mild diarrhea mangement :
a. oral antibiotis
b. lVF
c. ORS
the correct answer ís c
.......................................
...................
455) salpingitis and pid on penicillin but not improve the most
likely organism is :
a. chlamydia
b. nessiria
c. SYPHLlS
d. HSV
the correct answer b
.......................................
...................
456) Used for treatment of pseudomembranous colitis:
PO metronídazoíe ís the empíríc treatment of choíce (500 mg TID
for 10-14 days). For severe ínfectíons, oraí Vancomycín ís the
treatment of choíce (125 mg OID 10-14 days).
.......................................
...................
457) Lady with of right hypochondrial pain, fever and slight
jaundice. What is your diagnosis7
a. Acute cholecystitis.
O not compíete.
Most common presentíng symptom of acute choíecystítís ís
upper abdomínaí paín often radíatíng to ríght scapuía.
Nausea and vomítíng generaííy present. Patíents may report
fever.
458) Deep jaundice wit palpable gallbladder 7
i . a. Cancer head of pancreas .
Ç not complete
Pancreatíc cancer presents wíth abdomínaí paín radíatíng toward
the back, as weíí as wíth
|aundíce, íoss of appetíte, nausea, vomítíng, weíght íoss,
weakness, fatígue, and índígestíon.
Examínatíon: may reveaí a paípabíe, nontender gaííbíadder
(Courvoisier's sign) or mígratory thrombophíebítís
(Trousseau's sign). Díagnose by CT. treatment usuaííy
paíííatíve (due to metastasís at Dx).
.......................................
...................
459) Patient with perforated gallbladder underwent
cholecystectomy. Return to you with fever. On abdominal
X-ray, there is elevation of right hemidaiaphragm. What is
the possible diagnosis7
a. Subphrenic abcess
......................................
....................
460 ( 460 ( Patient with acute perianal pain since 2 days
with black mass 2*3 pain 4increase with defecation
Rx :
a. Evacuation under local anesthesia
Ç not complete
.......................................
...................
461) Rhumatoid arthritis distal interphalengial nodules
a. Hebrerden's nodes
Heberden's nodes are at the DIP whííe Bouchard's
nodes are at PIP.

462) Elderly patient with RLÇ fullness, weight loss, changed
bowel habit, anemic and pale. What is the investigation of
choice7
a. Colonoscopy.
Thís ís now the ínvestígatíon of choíce íf coíorectaí cancer ís
suspected províded the patíent ís fít enough to undergo the boweí
preparatíon. It has the advantage of not oníy píckíng up a prímary
cancer but aíso havíng the abíííty to detect synchronous poíyps or
even muítípíe carcínomas, whích occur ín 5% of cases.
......................................
....................
463) lnvestigation of choice in lron deficiency anemia7
a. serum iron
b. ferritin
c. TlBC
the correct answer ís b
Serum ferrítín ís the most sensítíve íab test for íron defícíency
anemía.
......................................
....................
464) ln patients with hypertension and diabetes, which
antihypertensive agent you want to add first7
a. þ-blockers
b. ACE inhibitor
c. o-blocker
d. Calcium channel blocker
the correct answer ís b
Díuretícs (ínexpensíve and partícuíaríy effectíve ín Afrícan-
Amerícans) and µ-bíockers (benefícíaí for patíents wíth CAD) have
been shown to reduce mortaííty ín uncompíícated hypertensíon.
They are fírst-ííne agents uníess a comorbíd condítíon requíres
another medícatíon. (see tabíe)
Popuíatíon Treatment
Diabetes with
proteinuria
ACEIs.
CHF µ-bíockers, ACEIs, díuretícs (íncíudíng
spíronoíactone).
lsolated systolic
hypertension
Díuretícs preferred; íong-actíng
díhydropyrídíne caícíum channeí
bíockers.
Ml µ-bíockers wíthout íntrínsíc
sympathomímetíc actívíty, ACEIs.
Osteoporosis Thíazíde díuretícs.
BPH o-antagonísts.
465) Patient presented with retinal artery occlusion, which of
the following is wrong:
a. painful loss of vision
b. painless loss of vision
the correct answer ís a
The most common presentíng compíaínt of retínaí artery
occíusíon ís an acute persístent paíníess íoss of vísíon.
......................................
....................
466) ECG finding of acute pericarditis7
a. ST segment elevation in all leads
Cíassíc ECG fíndíngs ín perícardítís: Low-voítage, díffuse ST-
segment eíevatíon.
......................................
....................
467) Epidemiological study want to see the effect of smoking in
the bronchogenic carcinoma, they saw that is 90% of
smokers has bronchogenic carcinoma.
30% of non-smokers has the disease, the specificity of the
disease as a risk factor is:
a. 70 %
b. 30 %
c. 90 %
MCÇs not complete
Sensitivity: The probabíííty that a díseased patíent wííí have a
posítíve test resuít.
Specificity: The probabíííty that a nondíseased person wííí have a
negatíve test resuít.
Disease
Presen
t
No
Disea
se
Positive
test
a b
Negative
test
c d
Sensitivity = a } (a + c) Specificity = d } (b + d)
Note:
- A sensítíve test ís good for ruííng out a dísease.
- Hígh sensítívíty = good screeníng test (↓ faíse negatíves).
- Hígh specífícíty = good for ruííng ín a dísease (good confírmatory
test).
468) Baby present with pain in the ear, by examination there is
piece of a glass deep in his ear canal, the mother mention
a history of a broken glass in the kitchen but she clean
that completely. We treat that by:
a. By applying a stream of solution to syringing the ear.
b. Remove it by forceps.
c. Refer her to otolaryngology
* Foreign bodies in the ear canal:
Techníques appropríate for the removaí of ear foreígn bodíes íncíude
mechanícaí extractíon, írrígatíon, and suctíon. Irrígatíon ís
contraíndícated for organíc matter that may sweíí and eníarge
wíthín the audítory canaí (e.g seeds). Insects, organíc matter, and
ob|ects wíth the potentíaí to become fríabíe and break ínto smaííer
evasíve píeces are often better extracted wíth suctíon than wíth
forceps. Líve ínsects ín the ear canaí shouíd be ímmobííízed before
removaí ís attempted.

Consultations: Consuít an ENT specíaííst íf the ob|ect cannot be
removed or íf tympaníc membrane perforatíon ís suspected.
......................................
....................
469) Treatment of open tibial fracture:
a. cephazolin
b. cephazolin+gentamycin
c. gentamicin
d. cephazolin+gentamicin+metronidazole
treatment of open fracture
1- Fírst-generatíon cephaíosporíns (Gram-posítíve coverage) such
as cephaíexín (1-2 g q6-8h) suffíce for Gustíío type I open fractures.
2- An amínogíycosíde (Gram-negatíve coverage) such as
gentamycín (120 mg q12h; 240 mg/d) ís added for types II and III
ín|uríes.
3- Addítíonaííy, metronídazoíe (500 mg q12h) or penícíííín (1.2 g
q6h) can be added for coverage agaínst anaerobes.
4- Tetanus prophyíaxís shouíd be ínstítuted.
5- Antíbíotícs generaííy are contínued for 72 hours foííowíng wound
cíosure.

Open fracture classification
Gustíío cíassífícatíon
I Low energy, wound íess than 1 cm
II Wound greater than 1 cm wíth moderate soft tíssue damage
III
Hígh energy wound greater than 1 cm wíth extensíve soft
tíssue damage
IIIa Adequate soft tíssue cover
IIIb Inadequate soft tíssue cover
IIIc Assocíated wíth arteríaí ín|ury
470) Which of the following found to reduce the risk of
postherpetic neuralgia:
a) corticosteroids only
b) corticosteroids + valacyclovir
c) valacyclovir only
The correct answer ís c
Patíents wíth herpes zoster shouíd receíve treatment to controí
acute symptoms and prevent compíícatíons. Patíents over the age
of 50, írrespectíve of other rísk factors, are at much greater rísk of
deveíopíng postherpetíc neuraígía and shouíd be offered
treatment. By ínhíbítíng repíícatíon of varíceíía zoster vírus, the
antívíraí agents acycíovír, famcícíovír, and vaíacícíovír attenuate
the severíty of zoster-specífícaííy, the duratíon of víraí sheddíng ís
decreased, rash heaííng ís hastened, and the severíty and duratíon
of acute paín are reduced. Attenuatíon of the severíty of the acute
ínfectíon and the neuraí damage ít causes shouíd reduce the
ííkeííhood of postherpetíc neuraígía.
......................................
....................
471) 8 months old infant with on & off recurrent crying
episodes & hx of current jelly stools:
a) intussception
b) intestinal obstruction
c) mickel's diverticulitis
d) strangulated hernia
The correct answer ís a
472) a man with oblong swelling on top of scrotum increase in
size with valsalva maneuver most likely Dx:
a) direct inguinal hernia
b) indirect inguinal hernia
c) varicocele
d) femoral hernia
the correct answer ís b
* lndirect hernia: Herníatíon of abdomínaí contents through the
ínternaí and then externaí ínguínaí ríngs and eventuaííy ínto the
scrotum (ín maíes).
- The most common hernía ín both genders.
- Due to a congenítaí patent processus vagínaíís.
- Indírect ínguínaí hernía íncreases ín síze ít becomes apparent
when the patíent coughs, and persísts untíí reduced.
* Direct hernia: Herníatíon of abdomínaí contents through the
fíoor of Hesseíbach´s
Tríangíe. (Hesseíbach´s tríangíe ís an area bounded by the ínguínaí
íígament, ínferíor epígastrícartery, and rectus abdomínís)
- Herníaí sac contents do not traverse the ínternaí ínguínaí ríng;
they herníate dírectíy through the abdomínaí waíí and are
contaíned wíthín the aponeurosís of the externaí obííque muscíe.
- Most often due to an acquíred defect ín the transversaíís fascía
from mechanícaí breakdown that ° wíth age.
......................................
....................
473) 3 weeks old male newborn with swelling of scrotum
transparent to light & irreducible:
a) epidydemitis
b) hydrocele
The correct answer ís b
.......................................
...................
474) a young girl experienced crampy abdominal pain &
proximal muscular weakness but normal reflexes after
receiving septra (trimethoprim sulfamethoxazole) :
a) functional myositis
b) polymyositis
c) guillian barre syndrome
d) neuritis
the correct answer is d
475) Which drug causes SLE like syndrome:
a) hydralazine
b) propranolol
c) amoxicillin
The correct answer ís a
- Drug-índuced SLE causes: Chíorpromazíne, Hydraíazíne,
Isoníazíd, Methyídopa, Penícíííamíne, Procaínamíde, Ouínídíne,
Suífasaíazíne.
......................................
....................
476) When to give aspirin and clopidogrel7
a) pt with a hx of previous Ml
b) Acute Ml
c) hx of previous ischemic stroke
d) hx of peripheral artery disease
e) after cardiac capt
The correct answer ís b

......................................
....................
477) 17 years with history of right iliac fossa pain rebound
tenderness +ve guarding what is the investigation that
you will do7
a. Laparoscopy
b. US
c. CT scan
the correct answer ís c
In appendícítís, CT scan wíth contrast has 95-98% sensítívíty whích
shows períappendíceaí streakíng.
478) Child with history of URTl before 3 weeks now has both
knees tender, red and inflamed. What is your diagnosis7
a. Rheumatoid arthritis
Ç is not complete
The díagnosís of |RA ís estabííshed by the presence of arthrítís,
the duratíon of the dísease for at íeast 6 weeks, and the excíusíon
of other possíbíe díagnoses. Aíthough a presumptíve díagnosís of
systemíc-onset |RA can be estabííshed for a chííd duríng the
systemíc phase, a defínítíve díagnosís ís not possíbíe untíí arthrítís
deveíops. Chíídren must be younger than 16 years oíd at tíme of
onset of dísease; the díagnosís of |RA does not change when the
chííd becomes an aduít. Because there are so many other causes of
arthrítís, these dísorders need to be excíuded before provídíng a
defínítíve díagnosís of |RA (Tabíe 89-2). The acute arthrítídes can
affect the same |oínts as |RA, but have a shorter tíme course. In
partícuíar, |RA can be confused wíth the spondyíoarthropathíes,
whích are assocíated wíth spínaí ínvoívement, and enthesítís, whích
ís ínfíammatíon of tendínous ínsertíons. Aíí of the pedíatríc
spondyíoarthropathíes can present wíth perípheraí arthrítís before
other manífestatíons and ínítíaííy may be díagnosed as |RA (Tabíe
89-3).
* |uvenííe rheumatoíd arthrítís: mono- and poíyarthropathy wíth
bony destructíon that occurs ín patíents ± 16 years of age and
íasts > 6 weeks. Approxímateíy 95% of cases resoíve by puberty.
Subtypes: Pauciarticular: ± 5 joints involved, assocíated wíth
an ↑rísk of iridocyclitis that íead to bííndness íf íeft untreated.
Polyarticular: >5 smaíí |oínts. Systemíc features are íess
promínent; carríes a ↓rísk
of írídocycíítís. Acute febrile: The íeast common subtype;
manífests as arthrítís wíthdaily high, spiking fevers and an
evanescent, salmon-colored rash. Hepatospíenomegaíy and
serosítís may aíso be seen. No írídocycíítís ís present; remíssíon
occurs wíthín one year.
......................................
....................
479) Old female came complain from pan in her joint increase
with walking, what is your diagnosis7
a. Osteoarthritis
Physícaí sígns of OA: Crepítus, ↓ range of motíon, paín that
worsens wíth actívíty
and weíght bearíng but ímproves wíth rest.

480) Patient came with history of neck discomfort, palpitation,
cold sweat, TSH low, T4 high, tender neck. What is your
diagnosis7
a. Subacute thyroiditis .
- Thyroiditis: Infíammatíon of the thyroíd gíand. Common types
are subacute granuíomatous, radíatíon, íymphocytíc, postpartum,
and drug-índuced (e.g., amíodarone) thyroídítís.
- Hx}PE: In subacute and radíatíon, presents wíth tender thyroíd,
maíaíse, and URI symptoms.
- Dx: Thyroíd dysfunctíon (typícaííy hyperthyroídísm foííowed by
hypothyroídísm),
aíí wíth J uptake on RAIU.
- Rx:
- µ-bíockers for hyperthyroídísm; íevothyroxíne for hypothyroídísm.
- Subacute thyroídítís: Antí-ínfíammatory medícatíon.
......................................
....................
481) ln ulcerative colitis, what you will start treatment with7
a. Cortícosteroíds ??
- Suífasaíazíne or 5-ASA (mesaíamíne).
- Crtícosteroíds and ímmunosuppressants índícated íf no refractory
dísease.
......................................
....................
482) Treatment of prostatitis7
a. Ciprofloxacin
treatment ís for 4-6 weeks wíth drugs that penetrate ínto the prostate,
such as trímethoprím or cíprofíoxacín.

.......................................
...................
483) ln lV canula and fluid:
a.Site of entry of cannula is a common site of infection.
......................................
....................
484) Patient with neck rigidity, rigor, fever, petechial rash over
extremities. The causative m\o is:
a. Meningococcal meningitis
Díscuss meníngítís !
......................................
....................
485) Female patient works in office came with vulva itching,
yellow vaginal discharge:
a. Trichomoniasis
486) another one old c}o bilateral knee pain with mild joint
enlargement
ESR and CRP normal dx:
a. Osteoarthritis
b. Rheumatoid arthritis
c. Gout7
The correct answer ís a
.......................................
...................
487) .Scitica increased incidence of :
a. Lumbar lordosis
b. Parasthesis

O not compíete but wíth these MCOs , correct answer ís b
.......................................
...................
488) old male c}o knee pain on walking with crepitus xray show
narrow joint space and subchondoral sclerosis:
a. Rheumatoid arthritis
b. Osteoarthritis
c. Gout
The correct answer ís b
.......................................
...................
489) 14y f with BMl 32.6 (associated big chart):
a. Overweight
b. Obese
c. Normal weight
The correct answer ís b
BMI < 16 : severe under WT.
BMI 16 - 20 : under wt.
BMI 20 - 25 : normaí
BMI 25 - 30 : over wt.
BMI 30 - 35 : obese cíassíc 1
BMI 35 - 40 : obese cíassíc 2
BMI > 40 : obese cíassíc 3
490) vaginal discharge odorless watry microscopy show clue
cells :
a. Bacterial vaginosis
b. Candidiasis
The correct answer ís a
.......................................
...................
491) Pregnant women on 3
rd
trímester ínfected wíth measeís can I gíve
her MMR?????
.......................................
...................
492) lactating women infected with rupella ....management is
:
a. MMR
b. Stop lactation
The correct answer ís a
MMR ís safe duríng íactatíng
.......................................
...................
493 ) which of following not live vaccine:
a. BCG
b. Hepatitis B
c. Oral polio
d. MMR
The correct answer ís b
.......................................
...................
493) the most commone cause of community acquired
pneumonia:
a. Hemophilus influenza
b. Strept.pneumonia
c. Mycoplasma
d. Kliebsella
The correct answer ís b
494) female after vaginal hesterectomy she complain of urin
come from vagina...dx:
a. Vesicovaginal fistula
b. Urethrovaginal fistula
c. Ureterovaginal fistula
The correct answer ís a
.......................................
...................
495) child rt ear pain and tenderness on pulling ear , no fever ,
O}E inflamed odemateous rt ear canal with yellow
discharge >>>>>>>>>>dx:
a. Otitis media
b. Otitis externa
c. Cholesteatoma
The correct answer ís b
......................................
....................
496) male with perianal pain ,tenderness ,fluctuant (perianal
abscess)
a. lncision and drainage
b. Warm bath
The correct answer ís a
......................................
....................
497) . pregnant 34w with vaginal bleeding.... what would
you ask about :
a. Cigarette smoking
b. Recent sexual intercourse
O not compíete , but wíth theses MCOs may be correct
answer ís a
......................................
....................
498) ln duodenal obstruction of neoborn what is the sign that
apper in xray:
a. Double bubble
499) the following more commone with type2 DM than type1
DM:
a. Weight loss
b. Gradual onset
c. Hereditary factors
d. HLA DR3+-DR4
The correct answer ís c
.......................................
...................
500) pt with open angle glaucoma and k}c of COPD and DM ttt:
a. Timelol
b. betaxolol
c. Acetazolamide
The correct answer ís c
.......................................
...................
501) pt child with back pain that wake pt from sleep So
diagnosis
a. lumber kyphosis
b. osteoarthritis
c. RA
d. Scoliosis
The correct answer ís a or d
.......................................
.............
502) 59 y}o presented with new onset supraventicular
tachycardia with palpitation,no Hx of SO Or chest pain
,chest examination normal , oxygen sat in room air = 98%
no peripheral edemaOthers normal, the best initial
investigation:
a. ECG stress test
b. Pulmonary arteriography
c. CT scan
d. Thyroid stimulating hormone
the correct answer ís d
503) Lactating women presented with breast engorgment and
tendress Your managements:
a. Warm compressor and continoue breast feeding
b. Dicloxacillin and continoue breast feeding
c. Dicloxacillin and milk expression
d. Discontinoue breast feeding and cold compressor
the correct answer ís a . tís case ís ( engorgement of breast ) . but
íf there are redness , sweíííng , fever thís case ís ( mastítís ) and
choose b
504) The Fastest route of antipsychotic is:
a. lM
b. lV
c. Oral
d. Sublingual
the correct answer ís b
505) While you are in the clinic you find that many patients
presents with red follicular conjactivitis (Chlamydia ) your
management is:
a. lmprove water supply and sanitation
b. lmprove sanitation and destroying of the vector
c. Eradication of the reservoir and destroying the vector
d. Destroy the vector and improve the sanitation

the correct answer ís a
506) The most important exogenous risk factor for
osteoporosis is:
a. Alcohol intake
b. Age
c. Smoking
d. Lack of exercise
the correct answer ís c
507) Patient with family history of coronary artery disease his
BMl= 28 came to you asking for the advice:
a. Start 800 calorie intake daily
b. Decrease carbohydrate daytime
c. lncrease fat and decrease protein
d. Start with decrease ... K calorie per kg per week
the correct answer ís d
508) Lactating mother newly diagnosed with epilepsy , taking
for it phenobarbital you advice is:
a. Discontinue breastfeeding immediately
b. Breastfeed baby after 8 hours of the medication
c . Continoue breastfeeding as tolerated
the correct answer ís c
-very vague questíon , some books avoíd Phenobarbítaí duríng
breast feedíng íf possíbíe. And ín Amerícan academy of pedíatríc
cíassífíed Phenobarbítaí as adrug that cause ma|or advers effect
ín some nursíng ínfant, and shouíd be gíven to nursíng women
wíth catíon .
509) Pregnant women has fibroid with of the following is True:
a. Presented with severe anemia
b. Likely to regress after Pregnancy
c. Surgery immediately
d. Presented with Antepartum He
the correct answer ís b
Fíbroíds may aíso be the resuít of hormones. Reproductíve
hormones ííke estrogen and progesterone can stímuíate ceíí
growth, causíng fíbroíds to form. Duríng pregnancy, your ínfíux
of hormones may cause your fíbroíds to grow ín síze. After
pregnancy and duríng menopause most fíbroíds begín to shrínk,
due to a íack of hormones.
510) A known case of chronic atrial fibrillation on the warfarin
5 mg came for follow up you find lNR 7 but no signs of
bleeding you advice is:
a. Decrease dose to 2.5 mg
b. Stop the dose and repeat lNR next day
c. Stop warfarin
d. Continoue same and repeat lNR
the correct answer ís b
lNR ACTlON
>10 Stop warfarín. Contact patíent for examínatíon. MONITOR INR
7-10 Stop warfarín for 2 days; decrease weekíy dosage by 25% or by 1 mg/d
for next week (7 mg totaí); monítor INR
4.5-
7
Decrease weekíy dosage by 15% or by 1 mg/d for 5 days of next week (5
mg totaí); repeat monítor INR
3-
4.5
Decrease weekíy dosage by 10% or by 1 mg/d for 3 days of next week (3
mg totaí); repeat monítor INR.
2-3 No change.
1.5-
2
Increase weekíy dosage by 10% or by 1 mg/d for 3 days of next week (3
mg totaí);
<1.5 Increase weekíy dose by 15% or by 1 mg/d for 5 days of next week (5 mg
totaí);
511) Patient is a known case of CAD the best exercise:
a. lsotonic exercise
b. lsometric exercise
c. Anerobic exe
d. Yogha
the correct answer ís c
1-anerobíc exercíse ( endurance ) : for ímprove cardíac functíon
2- weíght bearíng excercíse ( ísometríc ) : for buííd muscíe strength
, bone densíty
3- stretchíng excercíse : for prevent cramp , stíffness and back paín
512) The mechanism of action of Aspirin:
a. lnhibit cycloxgenase
b. lnhibit phospholipase A2
c. lnhibit phospholipid D
the correct answer ís a
513) The absolute contraindication of breastfeeding is :
a. Asymptomatic HlV patient
b. Active hepatitis C
c. Pulmonary TB on treatment 3 months
The correct answer ís a
Absolute contraindication of breastfeeding :
1-Infants with galactosemia.
-!others who use illegal drugs.
"-!others infected with #I$% human &-cell lymphotropic virus type I
or type II% or who have an active herpes lesion on the breast.
'-!others ta(ing any of the following medications: radioactive
isotopes% cancer chemotherapy agents% such as antimetabolites
.
514) A boy felt down on his elbow , the lateral x-ray shows:
a. Anterior Pad sign
b. Posterior pad sign
c. Anterior line of humerous intersecting the cubilium
d. Radial line forming 90 degree with cubilium

the correct answer ís b
515) A known case of treated hodgkin lymphoma(mediastinal
mass) with radiotherapy Not on regular follow up presented
with gradual painless difficulty in swallowing and SOB ,
There is facial swelling and redness : DX
a. SVC obstruction
b. lVC obstruction
c. Thoracic aortic aneurysm
d. Abdominal aortic aneursm
The correct answer ís a
________________________________________________________________________
516) Patient is presented with hand cellulitis and red streaks
in the hand and tender axillary lymphadenopathy. This
condition is more likely to be associated with:
a. Malignancy
b. Pyoderma
c. Neuropathy
d. Lymphangitis
the correct answer ís b (l'm not sure )

516) Young aged male presented to ER after blunt trauma to
Abdomen, CT scan shows intramural hematoma: your
management is
a. Lapratomy with evacuation of the hematoma
b. Dissection of duodenum
c. Observation
the correct answer ís c
517) Patient presented with sore throat, anorexia, loss of
appetite , on throat exam showed enlarged tonsils with
petechi on palate and uvula , mild tenderness of spleen and
liver :DX
a. Group A strep
. b. EBV
The correct answer ís b
518) Patient with GERD has barret esophagus , this metaplasia
increase risk of :
a. Adenocarcinoma
b. Squmaou cell carcinoma
the correct answer ís a
519) Complication of Sleep apnea is :
a.CHF
b. ..
the correct answer ís a
sleep apnea : Hypoxic pulmonary vasoconstriction  PAH 
Cor Pulmonale  CHF
complication of sleep apnea : sleep apnea increases health risks such as
cardiovascular disease, high blood pressure, stroke, diabetes, clinical depression, weight
gain and obesity. The most serious consequence of untreated obstructive sleep apnea is to
the heart. In severe and prolonged cases, there are increases in pulmonary pressures that
are transmitted to the right side of the heart. This can result in a severe form of congestive
heart failure (cor pulmonale.
520) Which of the following medication can be used as
prophylaxis in appendectomy:
a. Cephalexin
b. Ceftriaxone
c. Metronidazole
d. Vancomycin
e. Ampicillin
The correct answer ís b
1
st
ííne of antíbíotíc : 1- cefoxítín 2- cefotetan
2
nd
ííne of treatment : 1- metradínazoíe 2- ampícíkkín-suíbactam
521) Which of the following prognostic factor for SLE:
a. ANA levels
b. Sex
c. Age
d. Renal involvement
The correct answer ís d
522) The most common site for osteomyelitis is:
a. Epiphysis
b. Diaphysis
c. Metaphysis
d. Blood flow
The correct answer ís c
523) ln "holding breath holding" which of the following True:
a. Mostly occurs between age of 5 and 10
b. lncrease Risk of epilepsy
c. A known precipitant cause of generalized convulsion
d. Diazepam may decrease the attack
Breath holding spells are the occurrence of epísodíc apnea ín chíídren,
possíbíy assocíated wíth íoss of conscíousness, and changes ín posturaí tone.
They are most common ín chíídren between 6 and 18 months and usuaííy not
present after 5 years of age. They are unusuaí before 6 months of age. A
posítíve famííy hístory can be eíícíted ín 25% of cases. It may be confused
wíth a seízure dísorder.
There are four types of breath holding spells.
1-The most common ís termed simple (reath holdin& spell, ín whích the
manífestatíon ís the hoídíng of breath ín end expíratíon. There ís no ma|or
aíteratíon of círcuíatíon or oxygenatíon and the recovery ís spontaneous.
2-The second type are the Cyanotic (reath)holdin& spells. They are
usuaííy precípítated by anger or frustratíon aíthough they may occur after a
paínfuí experíence. The chííd críes and has forced expíratíon sometímes
íeadíng to cyanosís (bíue ín coíor) , íoss of muscíe tone, and íoss of
conscíousness. The ma|oríty of chíídren wííí regaín conscíousness. The chííd
usuaííy recovers wíthín a mínute or two, but some faíí asíeep for an hour or
so. Physíoíogícaííy, there ís often hypocapnea (íow íeveís of carbon díoxíde)
and usuaííy hypoxía (íow íeveís of oxygen. There ís no "post íctaí" phase (as ís
seen wíth seízures), no íncontínence, and the chííd ís fíne ín between speíís.
EEGs are normaí ín these chíídren. There ís no reíatíonshíp to the subsequent
deveíopment of seízures or cerebraí ín|ury as a consequence of breath
hoídíng speíís.
3-In the thírd type, known as *allid (reath)holdin& spells, the most
common stímuíus ís a paínfuí event. The chííd turns paíe (as opposed to bíue)
and íoses conscíousness wíth ííttíe íf any cryíng. The EEG ís aíso normaí, and
agaín there ís no post íctaí phase, nor íncontínence. The chííd ís usuaííy aíert
wíthín a mínute or so. There may be some reíatíonshíp wíth aduíthood
syncope ín chíídren wíth thís type of speíí.
4- A fourth type, known as Complicated (reath)holdin& spells, may
símpíy be a more severe form of the two most common types. Thís type
generaííy begíns as eíther a cyanotíc or paíííd speíí that then ís assocíated
wíth seízure ííke actívíty. An EEG taken whííe the chííd ís not havíng a speíí ís
stííí generaííy normaí.
DX: cíínícaí , good hístory íncíude sequence of event , íack of íncontínence
and no post íctaí phase. Treatment : reassurance and íron.
524) lnfant brought by the mother that noticed that the baby
has decreasing feeding , activity and lethargic On
examination febrile(39), tachycardic ,his bp 75}30, with
skin rash . DX:
a.Septic shock
Ç not complete
525) Old patient newly diagnosed with hyperthyroidism
presented with (hyperthrodism symptoms) The best initial
symptomatic treatment is:
a. BB ( beta-blocker )
b. PTU
The correct answer ís a
_______________________________________________________________________
526) lnfant presented with hemangioma on the back . your
management is:
a. lntralesional injection of corticosteroids
b. Topical corticosteroids
c. Excise of the lesion
527) Pregnant lady , 34 wk GA , presented with vaginal
bleeding more than her menstruation. On examination ,
cervix is dilated 3 cm with bulging of the membrane, fetal
heart rate = 170 bpm . The fetus lies transverse with back
facing down . us done and shows that placenta is attached
to posterior fundus and sonotranulence behind placenta.
Your management is :
a. C}S
b. Oxytocin
c.Tocolytics
d.Amniotomy
the correct answer ís a
528) lnfant with congenital hip dislocation:
a. +ve click in flexion ,abduction
b. The only treatment is surgery
c. Not reduced with flexion and abduction of the hip
the correct answer ís a . thís ís ortoíaní test

529) ln irritable bowel S. the following mechanism 7
contraction and slow wave myoelectricity seen in:
a.Constipation
b. Diarrhea
the correct answer ís a
529) Which is not found in coarctation of the aorta:
a. Upper limb hypertension
b. Diastolyic murmur heard all over precordium
c. Skeletal deformity on chest x-ray
the correct answer is a (l'm not sure )
530) Female patient presented with tender red swelling in the
axilla with history of repeated black head and large pore
skin in same area: ttt is
a. lmmidate surgery
b. Topical antibiotic
c. Cold compressor
d. Oral antibiotic
531) ln indirect hernia the relation of the sac to the cord
structure is:
a. Anteromedial
b. Anterolateral
c. Posteromedial
d.Postrolateral
the correct answer ís b
532) The most common cause of croup is:
a. Parainfluenza
b. lnfluenza
the correct answer ís a
533) kwashikor disease usually associated with :
a. decrease protein intake, decrease carbohydrate
b. increase protein , increase carbo
c. decrease protein , increase carbo
the correct answer is c. in the book, written there is
decrease protein and adequate amount of carbohydrate,
but with this only MCÇs the answer is c
534) in cachectic patient, the body utilize the proteins of the
muscles :
a. to provide Amino acid and protein synthesis
b. to maintain bloodflow to vital organ
c. to increase body fat
the correct anwser ís a ( I'm not sure )
535) patient is complaining of memory loss. Alzehimer disease
is diagnosed what is the cause of this:
a. brain death cell
Ç not complete
536) Parents brought their baby to you who is on bottle
feeding. On exam whitish lesion on either side of teeth
seen with blackish lesion on maxillary incisors and second
molar teeth. There is history of leaving the baby with bottle
in his mouth during sleeping. The Dx:
a. Nursery dental caries
b.Gingvostomatis
the correct answer ís a
537) Which of the following medication if taken need to take
the patient immidiatly to the hospital:
a. Penicillin
b. diphenhydramine
c. OCPs
d. Çuinine or Çuinidine
the correct answer ís d (I'm not sure ) , quínídíne ís
antíarrhythmía .
538) 43 y}o female presented with severe DUB other
examination normal . your management is
a. D &C
b. Ocps
c. Hysterectomy
d. Blood transfusion
the correct answer is a
539) Baby with vesicles on the face and honey comb crust
which of the following organism cause it: Staph aureus
540) Female patient presented with migraine headache which
is pulsatile, unilateral , increase with activity . Dosn't want
to take medication. Which of the following is appropriate:
a. Bio feedback
b. TCA
c. BB
the correct answer ís a
Bíofeedback has been shown to heíp some peopíe wíth
mígraínes. Bíofeedback ís a techníque that can gíve peopíe better
controí over body functíon índícators such as bíood pressure, heart
rate, temperature, muscíe tensíon, and braín waves. The two most
common types of bíofeedback for mígraínes are thermaí
bíofeedback and eíectromyographíc bíofeedback.
541) lnfant born with hemangioma on the rt eyelid what is
appropriate time to operate to prevent amylopia:
a. 1 day
b. 1 week
c. 3 months
d. 9 months
díffícuít O. but may be the correct answer ís b or c
542 ) Young patient on anti TB medication presented with
vertigo which of the following drug cause this:
a. Streptomycin
b. Ethambutol
c. Rifampcin
the correct answer ís a , streptomycín cause 8
th
nerve damage.

543) The CPR for child is
a. 30 chest compression 2 ventilation . (Lone rescuer)
b. 15 chest c 2 ventilation . (2 or more rescures)
c. m15 chest compression 1 ventilation
the correct answer ís a
544) Picture show large ulcer over medial side of the leg . what
is your management
a. Shave biobsy
b. Elevate the legs and stocking
c. Topical steroids
the correct answer ís b
.......................................
...................
545) 2months infant with white plaque on tongue and
greasy ,past h}o clamydia conjunctivitis after birth treated
by clinamycin what is ttt:
a. Oral nystatin
b. Topical steroids
c. Topical acyclovair
d. Oral tetracycline
the correct answer ís a. oraí nystatín : antífungaí
.......................................
...................
546) child rt ear pain and tenderness on pulling ear , no
fever , O}E inflamed odemateous rt ear canal with yellow
discharge >>>>>>>>>>dx:
a. Otitis media
b. Otitis externa
c. Cholesteatoma
the correct answer ís a
.......................................
...................
547) 34y female with HlV pap smear negative, about cervical
cancer screening :
a. After 3m if negative repeat after 6m
b. After 6m ........... annually
c. After 1y..............annually
The correct answer ís b ( I'm not sure , confuse wíth choíce c )
548) female about 30y with breast cancer (given cbc -chem.
And reavel low hb and hematocrite..) what is the next step
in mangment:
a. Staging
b. Lumpectomy
c. Mastectomy
d. chemotherapy

the correct answer ís a
.......................................
...................
549) child with moderate persistant BA On bronch.dilat
inhaler. Presented with acute exacerbation what will you
add in ttt:
a. Corticosteroid inhaler
b. lpratropum bromide inhaler
the correct answer ís b
.......................................
...................
550) about head and neck injury :
a. Hoarsness of voice and stridor can occure with mid
facial injury
b. Tracheostomies contraindicated
c. Facial injury may cause upper air way injures
.......................................
...................
551) lactating women 10 days after delivary developed
fever ,malaise, chills tender Lt breast with hotness and
small nodule in upper outer quadrant with axillary LN
.Leucocytic count was 14 *10}L dx:
a. lnflammatory breast cancer
b. Breast abscess
c. Fibrocystic disease
the correct answer ís b

552) 70y male with osteoporosis the T score of bone
densometry would be :
a. -3.5
b. -2.5
c. 1
d. 2
e. 3.5

the correct answer ís b
.......................................
...................
553) child with epistaxis.... management:
a. Compression on nose and leaning forward
b. ....................backward
the correct answer is a
.......................................
...................
554) scenario about female underwent abdominal operation
she went to physician
For check..... U}S reveal metal thing inside abdomen (a.e
missed during operation)
What will you do :
a. Call the surgeon and ask him what to do
b. Call attorney and ask about legal action
c. Tell her what you found
d. Tell her that is one of possible complications of
operation
e. Don't tell her what you found
The correct answer ís c
.......................................
...................
555) male ptn with scaly fine papular rash on fornt of
scalp,nose and retroauricular....(i think tinea capitis) ttt
is:
a. Ketoconazole cream.
b. Oral augmentin
c. ... cream
the correct answer ís a
556) All can cause gastric ulcer except:
a- Tricyclic antidepressant.
b- Delay gastric emptying.
c- Sepsis.
d- Salicylates.
e- Gastric outlet incompetent.

The correct answer ís a
Trícycííc antídepressant use ín treatment of peptíc uícer.
.......................................
...................
557) 48year old female lost her menstruation for 2 cycles, the
method of contraception is condom, examination was
normal except for dusky discoloration of the cervix. What u
will do next:
a.Progesterone challenge.
b.Beta HCG.
c.Pelvic u}s
The correct answer ís b
.......................................
...................
558) ttt of yeast vaginitis: Clotrimazole , Fluconazole ,
Ketokonazole
Treatment of yeast vaginitis ( candida albicans ) : topical
azole or PO fluconazole , oral azole should be avoided in
pregnant.

.......................................
...................
559) 15 y}o female complaining of pain during menstruation,
not sexually active, medical hx unremarkable, physical
examination normal, how to treat:
a- NSAlD.
b- Danazole.
c-
The correct answer ís a
.......................................
...................
560) What is true about alpha blocker:
a. Causes hypertension.
b. Worsen benign prostatic hyperplasia.
c. Cause tachycardia.
d-
the correct answer ís c
aípha bíocker :cause orthostatíc hypotensíon and tachycardía.
561) cyclic menstruation that increase in frequency:
a. Polymenorrhea.
b. Hypermenorrhea.
c. Menorrhagia.
d. Dysmenorrhea.
e.

The correct answer ís a
Polymenorrhea : frequent menestratíon ( < 21 day cycíe )
Hypermenorrhea or menorrhagia : abnormaííy heavy and
proíonged menstruaí períod at reguíar íntervaís . more than 80 mí
of bíood íoss per cycíe or proíonged bíeedíng , more than 8 days.
Oligomenorrhea : íncrease íength of tíme between menses ( 35-
90 days b\w cycíe)
Metrorrhagia : bíeedíng bwteen períod.
Menometrorrhagia : exessíve and írregíar bíeedíng.

.......................................
...................
562) A pregnant lady came to you to screen her fetus for down
syndrome, what is the best method:
a. Amniocentesis. + Karyotyping
b. Choriocentesis.
c.
the correct answer ís a

.......................................
...................
563) What is the most common chromosomal abnormality7
a. Trisomy 13
b. Trisomy 21
the correct answer ís b
-down syndrome ( trísomy 21 ) ís the most common
chromosomaí abnormaííty.
.......................................
...................
564) Best 2 test to screen for hepatocellular carcinoma:
a. Liver biopsy and alpha-fetoprotein.
b. Liver ultrasound and alpha-fetoprotein.
c. Abdomen CT and
d.
The correct answer ís b
565) A child came to ER with fever, stridor, . , x-ray showed
swollen epiglottis, in addition to oxygen, what u will do7
a. Throat examination.
b. An emergency tracheostomy.
c. Endotracheal intubation.
d. Nasopharyngeal intubation.
The correct answer ís c
.......................................
...................
566) 24 y}o female newly diagnosed type 2 DM, she is wearing
glasses for 10 years, how frequent she should follow with
ophthalmologist:
a. Every 5 years.
b. Annually
The correct answer ís b
-for type 1 diabetic : retína screeníng annuaííy begínníng 5
years after onset of díabetes, generaí not before onset of puberty.
- for type 2 diabetic : screeníng at the tíme of díagnosís then
annuaí
.......................................
...................
567) What is the initial management for a patient newly
diagnosed knee osteoarthritis.
a. lntra-articular corticosteroid.
b. Reduce weight.
c. Exercise.
d. Strengthening of quadriceps muscle.
The correct answer ís b
.......................................
...................
568) A lady came to your clinic said that she doesn't want to
do mammogram and preferred to do breast self-
examination, what is your response7
a- Mammogram will detect deep tumor.
b- Self-examination and mammogram are complementary.
c- Self-examination is best to detect early tumor

answer ís b ( I'm not sure because MCOs not compíete and depend
on age of pt.
.......................................
...................
569) What is the best frequency for breast self-examination7
a. Daily.
b. Weakly.
c. Monthly.
d. Annually.

The correct answer ís c
570) Patient with left bundle branch block will go for dental
procedure , regarding endocarditis prophylaxis:
a. No need
b. Before procedure.
c. After the procedure.
d.
The correct answer ís a
.......................................
...................
571) classical characteristic for genital herpes.
Painful ulcers & vesicles
.......................................
...................
572) most common vaginal bleeding :
a. cervical polyps
b. menstruation
c. 7777
oníy wíth these MCOs , the correct answer ís b
.......................................
...................
573) best stimulant for breast milk secretion:
a. breast feeding
b. oxytocin
c. 777
the correct answer ís a
.......................................
...................
574) child with aspirin intake overdose ...what kind of acid
base balance:
a. metabolic alkalosis wt respiratory
b. metabolic acidosis wt respiratory alkalosis
c. respiratory alkalosis with metabolic acidosid
d. respiratory acidosis with metabolic alkalosis
The correct answer ís c
Aspirin toxicity < in early stages, salicylate will stimulate respiratory center →
↑== → respiratory al+alosis that will be compensated by metabolic acidosis. In
late stage, it will interfere with 1!3, fat, & protein metabolism as well as
!xidation phosphorylation lead to ↑ lactate, pyrovate, & +eton bodies. ll will lead
to ↓p3. 6igne & symptoms includes< nausea, vomiting, ↑==, ↑temp, ↑3=,
sweating, cerebral or pulmonary edema, & coma. >ve anion gap. &&&< hydration,
correct ?>, gastric lavage or activated charcoal, urine al+ali-ation, hemodialysis)
575) therapeutic range of lNR :
a. 2.5-3.5
b. 2.0-3.0
c. 777
The correct answer ís b
.......................................
...................
576) q about antidepressant:
a. start single type even patient have sever depression
b. start any one of them they all have the same efficacy
c. stop the medication after 2 weeks if no improvement
The correct answer ís a
.......................................
...................
577) patient with depression started on amitryptaline , he had
headache or dizzness , vomitting77 im not sure what
exactly was the symptoms
a. change to SSRl
b. 77
Ç not complete , but amitriptyline is TCA .
.......................................
...................
578) patient had horsenss of voice for 3 weeks... next to do:
a. throat swab
b. laryngoscopy
c. 777
The correct answer is b , l'm not sure because MCÇs
are not complete.
.......................................
...................
579) single diagnostic for stroke:
a. high cholesterol
b. high systolic blood pressur
the correct answer ís b , I'm not sure , but wíth these mcqs , b ís
correct.
580) unfaivrable prognosis for schezophrenia:
a. family Hx
b. failed marrige
c. adolscen age77 not sure
d. presence of psychosis
the correct answer ís a
.......................................
...................
581) Rt lung :
a. have 1 fissure
b. contain 7 segment
c. 777 read about lung anatomy segment names!!
Rt íung has 3 íobes & 10 segments (medíaí basaí segment oníy ín ínf.
Lobe of Rt íung)
Lft íung has 2 íobes & 9 segments (Línguíar segments ín íft íung)
.......................................
...................
582) q about specifity:
a. test is +ve in disese population
b. test is +ve in healthy poplation
c. test is -ve in diseased population
d. test is -ve in healthy population
The correct answer ís d
.......................................
...................
583) stage 3 colon ca  Give Chemo ASAP
.......................................
...................
584) patient with upper abdominal pain, nausea vomitting,with
back pain, he is smoker for long time daily, fecal fat was
+ve
a. acute pancreatitis
b. chronic pancreatitis
c. pancreatic CA

The correct answer ís b
585) in school, 10 of patient had the dis of the first week ,
then 30 pt. had the dieses the next week , the percentage
infection of this school is:
a. 10%
b. 20%
c. 30%
d. 40%
Ç is not clear or not complete, but l think the correct
answer is b.
.......................................
...................
586) patient had headche describe it as aband around his
head, increase with stress and , i dont remeber the ques
DX is:
a. tension headache
b. migraine
c. cluster headache
The correct answer ís b
.......................................
...................
+,-. *atient 'as presented (y (oll%s in his !oot , (iopsy
sho'ed s%( dermal lysis , !l%orescent stain sho'ed /&0 ,
'hat is the most li1ely dia&nosis #
A. Bolus epidermolysis .
B. Pemphigoid vulgaris .
C. Herpetic multiform .
D. Bullous pemphigoid .
The correct answer ís d
.......................................
...................

588) Patient was presented by difficulties of breathing from
one side of his nose , on examination there was
erythramatus swelling , what is the best initial treatment :
A. Decongestant .
B. Steroid .
C. Sympathomimetics . 77
The correct answer is c ( l'm not sure )
Explain: thís sweíííng míght be nasopharyngeaí angíofíbroma whích ís
híghíy vascuíar sweíííng & prone to epístaxís, so to decrease the
síze we míght use íocaí or systemíc decongestants whích are
sympathomímetícs, so answer ís not cíear.
589) Patient with cystic nodule (acne) and scars , what is the
best treatment :
A. Retinoin .
B. Erythromycin .
C. Doxycyclin .
The correct answer ís a ( I'm not sure )
thís seems to be an advanced ínfíammatory stage of acne sínce
there r scars so íf the retínoíD meant here ís systemíc (ísotretínín)
so ít wííí be the choíce. If topícaí ít wííí not be effectíve as ít ís
effectíve oníy ín the non-ínfíammatory stage (comedones). Both
erythromycín (íocaí) & doxycycíín (systemíc) can be used but ín
advanced stage systemíc ís better.
.......................................
...................
590) Patient was presented by constipation, vomiting ,
abdominal distension , with old scar in the lower abdomen ,
x ray showed dilated loops with air in the rectum , what is
the best initial management :
A. NGT decompression , and lV line .
B. Rectal decompression and antibiotics .
C. Suppositories .
The correct answer ís a
thís ís a case of íntestínaí obstructíon due to adhesíons from
prevíous abdomínaí surgery (commonest cause) so the ínítíaí
treatment wouíd be decompressíon of the íntestíne & repíace íost
fíuíds
.......................................
...................
591) Which of the following is not living vaccine :
A. Hepatitis B .
B. MMR .
C. Oral polio
D. BCG
The correct answer ís a
Hepatítís B ís the oníy vaccíne prepared by genetíc engíneeríng so íts
not íívíng vaccíne.
592) Six years old child was born to a mother with hepatitis
B , he does not received any vaccines before , what you will
give now :
A. DTP , MMR , Hib
B. DTP , MMR .
C. DT , MMR , Hib
D. DT, MMR .
The correct answer ís d
both Pertussís & H.ínfíuenza vaccíne are not needed after 1 year
of age.
.......................................
...................
593) Which of the following describes the end of the early
inflammatory phase .
A. Formation of eschar .
B. Formation of ground base of collagen .
C. The end of angiogenesis .
The correct answer ís c
.......................................
...................
594) Female patient , known case of VitD deficiency ,
smoking , and recurrent fall, which of the following is the
greatest exogenous risk for osteoporosis :
A. Advanced age .
B. Recurrent fall .
C. Vit D .
D. Smoking .
The correct answer ís d
Advanced age & femaíe gender are the most ímportant factors
for osteoporosís but they are endogenous. Smokíng ís an
índependent exogenous rísk factor for osteoporosís
595) Blood sugar in DM type 1 is best controlled by :
A. Short acting insulin .
B. Long acting .
C. lntermediate .
D. Hypoglycemic agents .
E. Basal and bolus insulin .
The correct answer ís e
Very vague questíon. We can excíude hypogíycemíc agents.
Short acting insulin ís best ín emergencíes ííke DKA as ít can be
gíven IV. We can use eíther íong actíng aíone daííy or a míxture of
short & íntermedíate actíng ínsuíín daííy. Basal & bolus , ( short
acting + intermediate or long ), boíus´ of short-actíng or very-
short-actíng ínsuíín before meaís to deaí wíth the assocíated ríse ín
bíood-sugar íeveís at these tímes. In addítíon, they take an eveníng
ín|ectíon of íong- or íntermedíate-actíng ínsuíín that heíps
normaííse theír basaí (fastíng) gíucose íeveís. Thís offers greater
fíexíbíííty and ís the most commoníy adopted method when
íntensífíed ínsuíín therapy ís used to províde optímaí gíycaemíc
controí.
.......................................
...................
596) Which of the following is true regarding perths disease :
A. Commonly seen between 11-16 years of age .
B. Always unilateral .
C. May present by painless limp .
D. Characteristically affect the external rotation of hip .
E. More in female .
The correct answer ís c
Perthes dísease (Leg-Caíve perthes dísease) ís a condítíon
affectíng the híp |oínt where there ís degeneratíve avascuíar
necrosís of the femoraí head. It affects chíídren aged 3-12 years &
ís more common ín maíes. It ís most commoníy but not aíways
unííateraí ( 85% ís unííateraí ). It presents maíníy by severe híp
paín & íímpíng that íncreases by movement but ít can present by
paíníess íímp. It characterístícaííy affects the ínternaí rotatíon &
abductíon of the híp & íímíts these movements.
597) Which of the following is true regarding gastric lavage :
A. Patient should be in the right lateral position .
B. lt is not effective after 8 hours of aspirin ingestion .
The correct answer ís b
íavage ís effectíve oníy 1 hour after íngestíon of any poíson. After
that íts íneffectíve
.......................................
...................
598) SSRl was prescribed to a patient with depression , the
effect is suspected to be within :
A. One day .
B. Two weeks .
C. Three to four weeks .
The correct answer ís c
Aííow 2 - 6 weeks to take effect , and treat for > 6 months
.......................................
...................
+22. Randomi3ed controlled st%dy 'ill (e stron&er (y #
A. Systemic >>>>
B. Following at least 50 % of the participant .
7777777
.......................................
...................
600) Partner lost his wife by AMl 6 months ago , presented by
loss of appetite , low mood , sense of guilt , what is the
diagnosis :
A. Beverament .
B. Major depression episode .
The correct answer ís a
- Ma|or depressíon ís a psychíatríc condítíon that occurs regardíess
of events that happen ín íífe, whííe normaííy most peopíe wouíd
have beverament after death of a cíose person.
601) An adult was presented by sore throat , congestion ,
fatigue , petechia in soft palate , tender spleen , and liver ,
what is the most likely diagnosis :
A. EBV .
Only 1 choice7
This could be Rubella infection as petechia in soft palate
(Forschheimer spots) occur in rubella also. But liver &
spleen affection are more common in EBV. Also since it is
an adult then we might suspect leukemia as the cause.
.......................................
...................
602) Patient was presented by blepharitis , acne roseca , but
no keratitis , what is the best treatment :
A. Topical chlorophenicol .
B. Topical gentamicin .
C. Oral doxycyclin .
The correct answer ís c
.......................................
...................
603) Diabetic patient was presented by spastic tongue ,
dysarthria , spontenous crying what is the most likely
diagnosis :
A. Parkinson .
B. Bulbar palsy .
C. Pseudobulbar .
D. Myasthenia gravis .
The correct answer ís c
Thís ís a bít trícky. Buíbar paísy ís the LMNL of the íast 4 CN, whííe
pseudobuíbar paísy ís the UMNL of the íast 4 CN. So spastícíty of
tongue ís UMNL. But Díabetes causes LMNL of craníaí nerves due to
perípheraí neuropathy. So maybe the cuase here ís CNS affectíon
due to atheroscíerosís from macroangíopathy of díabetes.
604) Which of the following is describe the normal
developmental stage for 6 months old child :
A. Sits without support .
B. Rolls front to back . (7-8 months)
C. No head lag . (3 months)
D. Stand alone . (1 year)
The correct answer ís a
.......................................
...................
605) Which of the following personality is characterized by
inflexibility , perfectionism 7
A. OCD .
B. Not otherwise specified .
C. Narcissistic .
The correct answer ís b
Obsessíve compuísíve personaííty dísorder ís dífferent from
obsessíve compuísíve dísorder and ís characterízed maíníy by
perfectíonísm whííe OCD ís characterízed by repetítíve actíons due
to compuísíon. if OCPD is present in the choices it would be
the answer.
.......................................
...................
606) What is the commonest cause of otorrhea :
A. Acute otitis media .
B. Basal skull fracture .
C. External otitis .
The correct answer ís a
.......................................
...................
607) Patient was presented by ear pain , red tympanic
membrane , apparent vessels , with limited mobility of the
tympanic membrane , what the most likely diagnosis :
A. Acute otitis media .
B. Tympanic cellulitis .
C. Mastoditis .
The correct answer ís a
608) What is the management of acute congestive glaucoma :
A. lV acetazolamide and topical pilocarpine . (true)
.......................................
...................
609) Eight years old child with late systolic murmur best
heard over the sterna border , high pitch , crescendo ,
decrescendo ,>> diagnosis is :
A. Physiological murmur .
B. lnnocent murmur .
C. Ejection systolic murmur .
D. Systolic regurgitation murmur .
The correct answer ís c ( I'm not sure )
.......................................
...................
610) Child was presented by coryza , skin rash ,
conjunctivitis , and multiple spots in the mouth :
A. Measles .
B. Rubella .
The correct answer ís a.
Measíes : due to con|unctívítís whích ís not present ín rubeíía
.......................................
...................
611) Which of the following could be seen in patient with
bulimia :
A. Hypokalmeia .
B. Metabolic acidosis .
The correct answer ís a
buíímía ís aka bíng eatíng whích means the patíent eats a íot
then does forced vomítíng so there ís íoss of acíds & eíectroíytes
whích íeads to hypokaíemía & metaboííc aíkaíosís.

612) Maximum spinal height is reached after menarche by
how many years 7
A. Months .
B. Two years .
C. Three years .
The correct answer ís c
menarche ís at 12-14 years and maxímum heíght ís about 17 years
.......................................
...................
613) Pregnant lady 34 weeks of gestation presented by
vaginal bleeding , which of the following is relevant to ask
about :
A. Smoking .
B. Desire of future pregnancy .
C. The result of last pap smear .
D. Hx of vaginal irritation .
The correct answer ís a , because smokíng ís an ímportant rísk
factor for antepartum he
.......................................
...................
614) Female patient with marginal placenta previa , with 6 cm
dilated cervix , what is your management :
A. Fetal monitoring .
B. Delivery if fully dilated .
C. Tocolytics >
The correct answer ís a ( I'm not sure )
I couídn´t fínd the answer correctíy so based upon the gíven
data, fetaí monítoríng ís a must ín any case of hígh rísk pregnancy.
Aíso as the PP ís margínaí, there ís possíbíííty of deíívery wíthout
severe PPH and the cervíx ís aíready dííated.
615) Which of the following drugs increase the survival in a
patient with heart failure :
A. Beta blocker .
B. ACE inhibitors .
C. Digoxin .
D. Nitrites .
The correct answer ís b
New updated ínformatíon. As ACE ínhíbítors ínhíbít aídosterone
whích íf present ín hígh concentratíons causes modífícatíon of the
cardíac myocytes ín the íong term.
.......................................
...................
616) Elderly patient presented by SOB , rales in auscultation ,
high ]VP , +2 lower limb edema , what is the main
pathophysiology :
A. Left ventricular dilatation .
B. Right ventricular dilatation .
C. Aortic regurgitation.
D. Tricuscpid regurgitation .
The correct answer ís a ( cofuuuuuuuse )
Difficult question. Here we have both symptoms of Lft
ventrícuíar faííure (SOB, Raíes) & Rt ventrícuíar faííure (Hígh |VP &
LL edema). So, more commoníy íft ventrícuíar faííure íeads to rt
ventrícuíar faííure due to overíoad and not více versa . so the most
correct ís Lft ventrícuíar dííatatíon.
.......................................
...................
617) Patient with high output fistula , for which TPN was
ordered , after 2 hours of the central venous
catheterization , the patient become comatose and
unresponsive , what is the most likely cause :
A. Septic shock .
B. Electrolytes imbalance .
C. Delayed response of blood mismatch .
D. Hypoglycemia .
E. Hypernatremia .
The correct answer ís a
618) Female patient presented by tender mass below the
axilla , with previous history of pores and black heads in
that's area <<< what is your management :
A. Go to surgery immediately .
B. Oral antibiotics .
C. Topical antibiotics .
D. Steroid .
The correct answer ís a , Thís ís mostíy an ínfected abscess.
.......................................
...................
619) Child was presented by erythema , and swelling in his
hand after 18 hours of bee sting , what is your management
in this case :
A. Epinephrine .
B. Antihistaminic drugs .
C. Hospitalization .
The correct answer ís b
18 hours ís a íong duratíon so íts unííkeíy to be anaphyíactíc shock
& more ííkeíy a reguíar reactíon to bee stíngs so antíhístamínícs ís
the best soíutíon
.......................................
...................
620) Which of the following is true regarding metformin :
A. Main complication is hypoglycemia .
B. Can lead to weight gain .
C. lt suppress the hepatic glauconeogenesis .
The correct answer ís c
.......................................
...................
621) Child was presented by congested throat , coryza , high
grade fever , which of the following is true regarding this
condition :
A. Viral > bacterial .
B. Bacterial > viral .
C. Antibiotics should be given any way .
D. lt is most likely due to EBV .
The correct answer ís b ??????
622) Benign tumors of stomach represent almost :
A. 7 %
B. 21 %
C. 50 %
D. 90 %
The correct answer ís a
.......................................
...................
623) 60 years old patient presented by recurrent venous
thrombosis including superior venous thrombosis , this
patient most likely has :
A. SLE .
B. Nephrotic syndrome .
C. Blood group O .
D. Antiphospholipid syndrome .
The correct answer ís d
.......................................
...................
624) Elderly male patient was presented by left lower
abdomen tenderness , fever , elevated WBC count , what is
the most likely diagnosis :
A. lnflammatory bowel .
B. Diverticulitis .
The correct answer ís b
.......................................
...................
625) 22 years old male patient was presented by recurrent
attacks of diarrhea , constipation , and abdominal pain
relieved after defecation , but no blood in the stool , no
weight loss : what is the diagnosis :
A. lrritable bowel Syndrome
626) Patient was presented by back pain relieved by
ambulation , what is the best initial treatment :
A. Steroid injection in the back .
B. Back bracing .
C. Physical therapy .
The correct answer ís c
.......................................
...................
627) Patient with long history of constipation presented by
painful defecation , followed by bleeding , pain persist for
hours after defecation what is the diagnosis :
A. Anal fissure .
B. Thrombosed external piles .
C. lnternal hemorrhoid .
The correct answer ís a
.......................................
...................
628) Elderly male patient underwent colectomy for colon
cancer in which micrometastais was detected in the lymph
nodes , what is the best explaniation :
A. Good prognosis .
B. Liver metastasis .
C. lt is sensitive to chemotherapy . (Dukes class C cancer best
for chemotherapy)
D. lt is locally advanced .
The correct answer ís c
.......................................
...................
629) lV drug abuser was presented by fever , arthralgia ,
conjunctival hemorrhage , what is the diagnosis :
A. Bacterial endocarditis .
.......................................
...................
630) Female patient was presented by dysurea , epithelial
cells were seen urine analysis , what is the explanation in
this case :
A. Contamination .
B. lnfection .
The correct answer ís b
631) Patient was presented by tremor , fever , palpitation ,
diagnosed as case of hyperthyroidism , what is your initial
treatment :
A. Surgery .
B. Radio iodine .
C. Beta blockers . Propylthioracil .
The correct answer ís c , fírstíy B-bíocker then Prophyíthíouracíí
because we are afraíd of arrhythmías
.......................................
...................
632) Young female patient presented by pain during the first
2 days of menses , menarche was 2 years back , what is
your initial treatment :
A. OCP .
B. NSAlD .
The correct answer ís b , NSAID ít ís the best ínítíaí treatment for
dysmenorrheaí
.......................................
...................
633) Female is planning to get pregnant , she want to get
MMR vaccine also , what is your action :
A. Delay the pregnancy 2-3 months after vaccination .
B. lt is safe during pregnancy .
The correct answer ís a
.......................................
...................
634) Which of the following is true regarding varicella vaccine
during breast feeding :
A. lt is safe .
B. No breast feeding except after 3 days of the immunization .
Couldn't find the answer
.......................................
...................
635) Patient underwent abdominal surgery due to intestinal
perforation many years back , presented by abdominal pain
, distension , constipation , what is the best investigation in
this case :
A. Barium enema .
B. Ultrasound .
C. Small bowel barium study .
The correct answer ís c
636) True negative test is best described as following :
A. Not suspected to have the disease who actually do not have
.
.......................................
...................
45-. *atient 'ith AM/ and m%ltiple *6C , is yo%r treatment !or
this arrhythmia #
A. Amiadrone .
B. No treatment .
.......................................
...................
638) Adenosine dose should be reduced in which of the
following cases :
A. Chronic renal failure .
B. Patients on thiophyline .
The correct answer ís a
.......................................
...................
639) Which the following is the commonest complication of
patient with chronic atrial fibrillation :
A. Sudden death .
B. Cerebra vascular accidents .
The correct answer ís b , due to muítípíe atríaí thrombí
.......................................
...................
640) Which of the following is most likely seen in case of
active glomerlonephritis :
A. RBC casts .
.......................................
...................
641) Target HbA1c is less than :
A. 6.5
B. 8
C. 9
The correct answer ís a
642) Female patient with candida most likely has :
A. DM .
B. SLE .
The correct answer ís a
.......................................
...................
643) Which of the following indicates good prognosis in
schizophrenia :
A. Family history of schizophrenia .
B. Gradual onset .
C. Flat mood .
D. Prominent affective symptoms .
E. No precipitating factors .
The correct answer ís d
.......................................
...................
644) Pregnant woman with suspected DVT , what is the best
initial investigations :
A. Duplex US .
B. D dimer .
C. Platysomgraphy .
D. Venogram .
The correct answer ís a
.......................................
...................
645) Which of the following is true regarding crohns disease :
A. Partial thickness involvement .
B. Fistula formation .
C. Continuous area of inflammation .
D. Mainly involve the recto sigmoid area .
The correct answer ís b
646) Patient serology showed antibodies to the surface
antigen for hepatitis B , what is your diagnosis :
A. Previous infection or immunization .
B. Chronic carrier .
C. Highly infective .
The correcr answer ís a
.......................................
...................
647) Young male patient presented by acute scrotal pain , US
showed reduced blood flow , what is the diagnosis :
A. Testicular torsion .
B. Trauma .
C. lnfection .
D. Hernia .
The correct answer ís a
.......................................
...................
648) Female patient is sure that she is pregnant for 2
months , on examination , the uterus is larger than
suspected , B-hcg is very high , the doctor diagnosed her as
having tumor which is chemo sensitive , what is the
diagnosis :
A. Ovarian cancer
B. Endometrial cancer .
C. Gestational trophoblastic .
The correct answer ís c
.......................................
...................
649) Which of the following is true regarding infertility :
A. lt is Failure to conceive withing 6 months . (1 year)
B. Male factor > female factors . (the reverse)
C. lt could be due to high prolactin levels .
D. Rare to be due anovulotion . (common)
E. Only diagnosed by HSG . (need full lab & imaging
investigations)
The correct answer ís c
650) 32 years old female patient presented by irregular
menses , menses occurs every two months , on examination
every thing is normal , which of the following is the LEAST
important test to ask about first :
A. CBC .
B. Pelvic US .
C. Coagulation profile .
D. DHES .
The correct answer ís c
.......................................
...................
651) Patient with early rheumatoid arthritis , what is your
management to decrease the limitation of movement :
- Do not use analgesics or steroids, use DMARDs like
methotrexate or antiTNF, hydroxychloroquine
.......................................
...................
652) Patient with truncal obesity , easy bruising ,
hypertension , buffalo hump , what is the diagnosis :
A. Cushing .
.......................................
...................
653) Patient is known case of cervical spondylolysis ,
presented by parasthesis of the little finger , with atrophy
of the hypothenar muscles , EMG showed cubital tunnel
compression of the ulnar nerve , what is your action now :
A. Ulnar nerve decompression .
B. Steroid injection .
C. CT scan of the spine .
The correct answer ís a
654) Well known case of SCD presented by plueritic chest pain
, fever , tachypnea , respiratory rate was 30 , oxygen
saturation is 90 % what is the diagnosis :
A. Acute chest syndrome .
B. Pericarditis :
C. VOC .
The correct answer ís a , or pneumonía wouíd be more correct íf ít
was the answer
.......................................
...................
655) Child with hemangioma around the eye , operation
should be done within ... :
A. 1 Week
B. 3 months .
C. 6 months .
The correct answer ís a ( I'm not sure )
We oníy fear of reductíon ín the functíon of the eye due to
hemangíoma so ít shouíd be removed.
.......................................
...................
656) Which of the following is the recommended diet to
prevent lHD :
A. Decrease the intake of meat and dairy .
B. Decrease the meat and bread .
C. lncrease the intake of fruit and vegetables .
7777
The correct answer ís c
.......................................
...................
657) Which of the following can lead to polyhydrmnios :
A. Duodenal atresia .
B. Renal agenesis .  Oligohydramnios
C. Post term pregnancy . Oligohydramnios
D. Diabetes inspidious .

The correct answer ís a
658) Adult polycystic kidney disease is inherited as:
A. Autosomal dominant .
B. Autosomal recessive .
C. X linked .
The correct answer ís a
.......................................
...................
659) The best treatment for bacteroid :
A. Clindamycin .
.......................................
...................
660) You have an appointment with your patient at 10 am who
is newly diagnosed DM , you came late at 11 am because
you have another complicated patient , what are you going
to say to control his anger :
A. Do not say any thing .
B. Told him that there is another patient who really need your
help .
O not compíete, but may be The correct answer ís b
.......................................
...................
661) Well known case of DM was presented to the ER with
drowsiness , in the investigations : Blood sugar = 400
mg}dl , pH = 7.05 , what is your management 7
A. 10 units insulin + 400 cc of dextrose .
B. 0.1 unit}kg of insulin , subcutaneous .
C. NaHCO .
D. One liter of normal saline .
The correct answer ís d
.......................................
...................
662) What is the best method for history taking :
A. Yes or no questions .
B. Open ended .
C. Silent listening .
The correct answer ís b
663) What you will give to prevent hemorrhagic disease of
newborns :
A. Vitamin K .
.......................................
...................
664) Arterial injury is characterized by :
A. Dark in color and steady .
B. Dark in color and spurting .
C. Bright red and steady .
D. Bright red and spurting .
The correct answer ís d
.......................................
...................
665) 14 years old girl complaining of painless vaginal bleeding
for 2-4 days every 3Weeks to 2 months ranging from
spotting to 2 packs per day; she had 2ry sexual ccc 1 year
ago and had her menstruation since 6 months on clinical
examination she is normal sexual ccc, normal pelvic exam
appropriate action
a. OCP can be used
b. You should ask for FSH and prolactin level
c. Don't do anything & explain this is normal
the correct answer ís c
.......................................
...................
666) 4 years old child what can he do
a. Copy square and triangle
b. Speak in sentences
the correct answer ís a , íf copy square 4 years , but íf copu círcíe 3
years
.......................................
...................
667) baby can sit without support, walk by holding fourniture,
Pincer grasp, pull to stand how old is he
a. 8 months
b. 10 months
c. . 12 month
d. 18 month
The correct answer ís b
668) Patient came after deep laceration at the anterior part
of the wrist:
a. Wrist drop
b. Sensory loss only
c. Claw hand
d. Unable to do thumb opposition
The correct answer ís d
2- Radial nerve injury : wríst drop , common wíth humers ín|ury
(humers groove)
3- Unlar nerve injury : cíaw hand , common wíth eíbow ín|ury
4- Median nerve inury :unabíe to do thumb opposítíon , common
wíth wríst ín|ury
.......................................
...................
669) Best way to diagnose post streptococcus
glomerulonephritis (spot diagnosis):
a) Low C3
b) 7or RBC casts
c) 7
The correct answer ís a ( I'm not sure )
Wíth these MCOs , I thínk the correct answer ís a , but most
sensítíve ín díagnosís of post streptococcus gíomeruíonephrítís ís
increase ASO titer : íumpy-bumby ímmunofíuorescence. or
(streptozyme test, which tests antibodies to ASO) ( íf ASO
títer wrítten wíth MCOs , ít ís correct answer .
......................................
....................
670) COPD patient with emphysema has low oxygen prolonged
chronic high CO2, the respiratory drive is maintained in this
patient by:
a. Hypoxemia
b. Hypercapnemia
c. Patient effort voluntary
d. 7
The correct answer ís a ( I'm not sure )
.......................................
...................
671) Child with ear pain with positive pump test for tympanic
membrane, treatment is:
a. Maryngiotomy
b. Amoxicillin}Potassium ...
7
The correct answer ís a
672) Patient has fatigue while walking last night. He is on
atrovastatin for 8 months, Ciprofluxacin, Dialtizem and
alphaco... the cause of this fatigue is:
a. Dialtizem and Atrovastatin
b. Atrovastatin and Ciprovluxacin
c. Atrovastatin and Alphaco
d. 7
the correct answer ís b ( I'm not sure )
.......................................
...................
673) Patient with ischemic stroke present after 6 hours, the
best treatment is:
a) ASA
b)TPA
c) Clopidogril
d)lV heparin
e) Other anticoagulant
The correct answer ís a
1- TPA : admínístered wíthín 3h of symptoms onset ( íf no
contraíndícatíon)
2- ASA: use wíth 48h of íschemíc stroke to reduce rísk of
death.
3- Calopidogril : can be use ín acute íschemíc
4- Heparin & other anticoagulant : ín patíent has hígh rísk of
DVT or AF

.......................................
...................
674) Patient with lateral and vertical diplobia, he can't abduct
both eyes, the affected nerve is:
a) ll
b)lll
c) Vl
d)V
I thínk thís ís dípíopa because nerve 4 , but wíth thís O I choose
c

675) lnfant with heamangioma on forehead obscuring the
vision, best thing to do is to remove the lesion to avoid
amblyobia, after:
a) One day
b)One week
c) One month
d)6 months
e) One year
The correct answer ís b ( I'm not sure )
.......................................
...................
676) Photophobia, blurred vision, keratic 77 behind cornea
and cells in anterior chamber, the best treatment is :
a) Topical antifungal
b)Topical Acyclovir
c) Antibiotic
d)7
The correct answer ís b
.......................................
...................
677) Most common medical problems faced in primary health
care is:
a) Coryza
b)UTl
c) Hypertension
d)Diabetes
The correct answer ís a
.......................................
...................
678) Old lady afraid of Osteoprosis, to avoid the risk, you
should advise her to do:
a) Weight bearing exercise
b)7
c) 7
d)7
O ís not compíete.
679) Obese lady with essential hypertension, lab work
showed: high Na, High K, The reason for Hypertension is:
a) Obesity
b)High Na intake
c) High K intake
d)7
The correct answer ís a , more than 85% of essentíaí
hypertensíon wíth BMI > 25 .
......................................
....................
680) Patient with eruptive purpuric rash,
hepatosplenomegaly, ....
a) 7
b) 7
c) 7
d) 7
.......................................
...................
681) Single thyroid nodule showed high iodine uptake, best
treatment is:
a) Radio lodine 131
b)Send home
c) Antithyriod medication
d)Excision if present
The correct answer ís c
.......................................
...................
682) Athletic with tina pedis best treatment is:
a) Topical antifungal
b)Systemic antifungal
c) Drug starts with trebenafine
d)7
The correct answer ís a
683) Young patient with congested nose, sinus pressure,
tenderness and green nasal discharge, has been treated
three times with broad spectrum antibiotics previously,
what is your action7
a) Give antibiotic
b)Nasal corticosteroid
c) Give anti histamine
d)Decongestant
The correct answer ís b
.......................................
...................
684) Thyrotoxicosis include all of the following, Except:
a) Neuropathy
b)Hyperglycemia
c) Peripheral Proximal myopathy
d)
O ís not compíete , aíí MCOs are wrong , may be choíce d ís
correct íf mentíon .
.......................................
...................
685) Male patient has hair loss started as fronto-temporal and
moving toward the vertex (top of the head) the diagnosis
is:
a) Androgenic alopecia
b)Tinea Captus
c) 7
d)7
The correct answer ís a
.......................................
...................
686) Young healthy male has abdominal pain after basketball.
Examination fine except for Left paraumbilical tenderness,
what to do:
a) Abdominal US
b)Flat plate graph
c) Send home & reassess within 48 hours
d)7
The correct answer ís c ( I'm not sure ) , confuse wíth choíce a
687) 10 year-old boy with ..to tell that spinal cord length will
stop after:
a) 7
b) 7
Length stop at L1 \ L2
.......................................
...................
688) Child with atopic dermatitis at night has stridor plus
barking cough on and off from time to time, diagnosis is:
a) BA
b)Croup
c) Spasmadic Croup
d)7
The correct answer ís c
Spasmadic croup : recurrent sudden upper aírway
obstructíon whích present as srídor and cough . approxímateíy
50% of chíídren have atopíc dísease.
.......................................
...................
689) Sickle cell anemia patient presented with asymptomatic
unilateral hip pain, most likely diagnosis is:
a) Septic arthritis
b)Avascular Necrosis
c) 7
The correct answer ís b
.......................................
...................
690) Best drug to treat depression in children and adolescent
is:
a) Fluxetine (Prozac)
b)7
.......................................
...................
691) Old male with neck stiffness, numbness and parasthesia
in the little finger and ring finger and positive raised hand
test, diagnosis is:
a) Thoracic outlet syndrome
b)lmpingement syndrome
c) Ulnar artery thrombosis
d)Do CT scan for Cervical spine
The correct answer ís a
692) Patient diagnosed with obstructive jaundice best to
diagnose common bile duct obstruction:
a) ERCP
b)US
c) 7
The correct answer ís a
.......................................
...................
693) Endometriosis best diagnosed by
a) US
b)Laproscopy
c) Lapratomy
d)7
The correct answer ís b
.......................................
...................
694) Child was sick 5 days ago culture taken showed positive
for meningococcal. Patient now at home and asymptomatic
your action will be:
a) Rifampicin
b)lM Ceftrixone
c) 7
d)7
O not compíete ( í.m ceftríaxon síngíe dose or oraí rífampícín
2-5 days )
.......................................
...................
695) lnfant with bright blood, black stool and foul smelling
stool. Best way to know the diagnosis:
a) US
b)Radio lsotop scan
c) Angiogram
d)7
Aíí MCOs are wrong , íf stooí anaíysís ís present , ít ís correct.
696) Primary hyperaldosteronism associated with:
a) Hypernatremia
b)Hypomagnesemia
c) Hypokalemia
d)Hyperkalemia
The correcr answer ís c
.......................................
...................
697) A vaccination for pregnant lad with DT
a) Give vaccine and delivery within 24 hrs
b)Contraindicated in pregnancy
c) Not contraindicated in pregnancy
d)7
The correct answer ís c
.......................................
...................
698) A study done to assess the risk of long taking Ca in two
groups the diseased group with long Ca plus control
according to geographical location, site, and population. lt
adds (77) this type of study:
a) Cohort
b)Case Control (retrospective)
c) Correlation study
d)7
The correct answer ís a
Cross-Sectional Study:
status of índívíduaí wíth respect to presence and absence of
both exposure and dísease assessed at one poínt ín tíme
case control study ( retrospective ) :
sampíes a group of peopíe who aíready have a partícuíar
outcome (cases) and
compares them to a símííar sampíe group wíthout that outcome
(controís)
cohort study : ( prospective, incidence , longitudinal )
sub|ects are sampíed and as a group are cíassífíed on the basís
of presence or
absence of exposure to a partícuíar rísk factor
.......................................
...................
699) Define Epidemiology
a) 7 "The study of the distribution and determinants of
disease prevalence in man"
700) Case Control description
a) Start with the outcome the FU risk factors
b) 7
......................................
....................
701) Using gastric lavage :
a) Useless after 8 hours of ASA ingestion
b)No benefit after 6 hours of TCA ingestion
c) 7
The correct answer ís a
.......................................
...................
702) 10 years old child with rheumatic fever treated early, no
cardiac complication. Best to advice the family to continue
prophylaxis for:
a) 1 month
b)3 ys
c) 4 ys
d)15 ys
The correct answer ís d ( I'm not sure , íf there ís 11 years
choose ít )
Amerícan heart assocíated has recommended aíí patíent wíth
hístory rheumatíc fever be píaced on íonge term penícíííín
prophyíaxíc. Duratíon of prophyíaxís depends on presence or
absent of cardítís, but for chíídren wíthout cardítís , duratíon
mínímum 5 years or at age 21, whíchever ís íonger.
703) Picture of large neck mass only no other manifestations
or organomegaly or lymphadenopathy, diagnosis is:
a) Mononucleosis
b)l would say Goiter
c) 7
d)Lymphoma
The correct answer ís b
.......................................
...................
704) Patient with nausea, vomiting, and diarrhea developed
postural hypotension. Fluid deficit is:
a) lntracellular
b)Extracellular
c) lnterstitial
The correct answer ís b
.......................................
...................
705) Cardiac syncope:
a) Gradual onset
b)Fast recovery
c) Neurological sequence after
d)7
The correct answer ís b
.......................................
...................
706) Best way to decrease pain in elderly with bilateral knee
pain and crepitation is:
a) NSAlD
b)Decrease weight
c) Exercise
d)7
The correct answer ís b , (I'm not sure )
707) Young female with whitish grey vaginal discharge KOH
test 77 smell fish like diagnosis is:
a) Gonorrhea
b)Bacterial Vaginosis
c) Trachomanous Vaginalis
d)7
The correct answer ís b
.......................................
...................
708) Old lady with osteoporosis asked for treatment for
prevention:
a) VlT. D
b)VlT. E
c) Retonic Acid
d)7
The correct answer ís a
.......................................
...................
709) Young male with morning stiffness at back relieved with
activity and uveitis:
a) Ankylosing Spondylitis
b)7
.......................................
...................
710) Best way to prevent infection in medical practice in
pediatric
a) Wear gloves
b)Wash hand
c) Wear mask
d)Wear gown
The correct answer ís b
.......................................
...................
711) High risk for developing colon cancer in young male is:
a) Smoking, high alcohol intake, low fat diet
b) Smoking, low alcohol intake, high fat diet
c) Red meat diet, garden's disease (Gardner syndrome)
d) lnactivity, smoking
The correct answer ís c
712) Alternative therapy for severe depression and resistance
to anti-depressant medications are:
a) SSRl
b)TCA
c) ECT
The correct answer ís c
.......................................
...................
713) Patient had history of pancreatic cancer on
chemotherapy then improved completely, came to doctor
concerning about recurrence of cancer and a history of
many hospital visits. This patient has:
a) Malingering
b)Hypochondriasis
c) Factitious
d)Conversion
The correct answer ís b
.......................................
...................
714) Patient came with neck swelling, ,moves when patient
protrude his tongue. Diagnosis is:
a) Goiter
b)Tyroglossus Cyst
c) Cystic Hygroma
d)7
The correct answer ís b
.......................................
...................
715) Pregnant patient came with neck swelling and multiple
nodular non-tender goiter the next evaluation is:
a) Thyroid biopsy
b)Give anti-thyroid medication
c) Radiation lodine
d)TSH & Free T4, or just follow up
The correct answer ís d
716) Young patient with HTN came complaining of high blood
pressure and red, tender, swollen big left toe, tender
swollen foot and tender whole left leg. Diagnosis is:
a) Cellulitis
b)Vasculitis
c) Gout Arthritis
d)77
The correct answer ís a , because tender and swoííen whoíe íeft
íeg.
.......................................
...................
717) What is the injection that is routinely given to newborn
to inhibit hemorrhage:
a) Vit. K
b)Vit. C
c) Vit. D
d)Vit. E
The correct answer ís a
.......................................
...................
718) Patient with strong genetic factor for colon cancer, what
is the medication that could decrease the risk of colon
cancer:
a) Folic Acid.
b)Vit. C
c) Vit. K or A
d)Vit. E
The correct answer ís a ( foíaíc acíd and vít. C both are prevent
coíon cancer , but foíat reduce rísk ín peopíe who geníc
predísposíng )
.......................................
...................
719) Patient with asthma, well controlled by albutarol, came
complaining of asthma symptoms not respond to albutarol,
what medication could be added:
a) Corticosteroid inhaler
b) Long acting B-agonist
c) Oral corticosteroid
d) Theophyline
The correct answer is a
720) Henosch-Scholen purpura affect:
a) Capillary
b)Capillary and venule
c) Arteriole, capillary and venule
d)Artery to vein
The correct answer ís c
.......................................
...................
721) Contraceptive pill that contain estrogen increase risk of:
a) Breast Ca
b)Ovary Ca
c) Cervical Ca
d)7
The correct answer ís a
.......................................
...................
722) Patient came with upper respiratory tract infection with
red conjunctiva, the cause is:
a) Viral infection
b)Bacterial infection
c) Fungal infection
d)7
The correct answer ís a
.......................................
...................
723) Healthy patient with family history of DM type 2, the
most factor that increase chance of DM are:
a) HTN and Obesity
b)Smoking and Obesity
c) Pregnancy and HTN
d)Pregnancy and Smoking
The correct answer ís a
724) Patient complaining of back pain and hypersensitive skin
of the back, on examination, patient had rashes in the
back, tender, red base distributed as blunt shape on the
back, diagnosis is:
a) Herpes Zoster
b)CMV
c) 7
d)7
The correct answer ís a ( q not compíete )
.......................................
...................
725) Old patient complaining of hematuria, on investigation,
patient has bladder calculi, most common causative
organism is:
a) Schistosoma
b)CMV
c) 7 virus
d)7 virus
The correct answer ís a
.......................................
...................
726) Blood culture show gram negative rod shape that grow
only on charcoal free fungal organism is:
a) Staph. Aureus
b) Chlamydia
c) Klebsiella
d) Mycoplasma
Aíí above are wrong , le&ionella : grame negatíve rod growth on
charcoaí agar
.......................................
...................
727) Klebesilla feacalis cause the following disease:
a) Pneumonia
b) 7
c) 7
d) 7
Enterococcus faecalis  Cause Gastroenteritis
.......................................
...................
728) Dermatomyositis came with the following symptoms:
a) Proximal muscle weakness
b)Proximal muscle tenderness
c) 7
d)7
The correct answer ís a
.......................................
...................
729) Bursitis of the elbow joint caused by:
a) Elbow trauma
b)Autoimmune disease
c) Staph. Aureus
d)7 rupture of bursa
The correct answer ís a
.......................................
...................
730) Patient came with symptoms of anxiety including
palpitation, agitation, and worry. The first best line for
treatment is:
a) SSRl
b)TCA
c) B-blocker
d)MAOl
The correct answer ís a , I'm not sure
May be the correct answer ís b because there ís agítatíon ( aíso,
síde effect of SSRI)
.......................................
...................
731) Pregnant diagnosed with UTl. The safest antibiotic is:
a) Ciprofloxacin
b)Ampiciln
c) Tetracycline
d)7
Wíth these MCOs , the correct answer ís b , but íf present
nitrofurantion ís more accurate answer . UTI ín pregnancy
treated by : nitrofurantion or cephalosporine ( 3- 7 days ) ín
symptomatíc or asymptomatíc UTI . avoíd fíuroroquínoíone
( whích íncíude : cíprofíoxacín, gatífíoxacíne, íevofíoxacín,
norfíoxacín ).
732) Patient is complaining of right side pharynx tenderness
on examination patient had inflamed right tonsil and
redness around tonsil with normal left tonsil. The diagnosis
is:
a) Parenchymal tonsillitis
b)Çuinse parapharyngeal abscess
c) 7
d)7
The correct answer ís b
.......................................
...................
733) Patient came complaining of fever, night sweating, and
hemoptysis with positive PPD test. Examination was
normal, CXR shows infiltrate of left apical lung but in lateral
X-ray showed nothing the repeated PPD test showed
normal result diagnosis is:
a) Sarcoidosis
b)Reactivated TB
c) Mycoplasma infection
d)Viral infection
The correct answer ís b
......................................
....................
734) Femal patient came with lower abdominal pain, fever on
exam patient has lower abdominal tenderness and tender
cervical fornix, the most appropriate way to diagnose the
problem is:
a) Laproscopy
b)Heterosalpingography
c) Abdominal CT
d)Radionuclar Study
The correct answer ís a
.......................................
...................
735) The best non-medical therapy is proven to be of benefit
for osteoarthritis is:
a) Muscle strength exercise
b) Give NSAlD
c) Back slap
d)7
The correct answer ís a
736) Hematological disease occurs in children, treated with
heparin and fresh frozen plasma what is the disease:
a) Hemophilia A
b)Hemophilia B
c) Von-wille brand disease
d)DlC thrombosis
The correct answer ís d
.......................................
...................
737) Child with URTl is complaining of bleeding from nose,
gum and bruising the diagnosis is:
a) Hemophilia A
b)lTT
c) 7
d)7
The correct answer ís b
.......................................
...................
738) Patient came complaining of vague abdominal pain for 6
hours then shifted to right lower quadrant diagnosis is :
a) Acute appendicitis
b)Diverticulitis
c) 7
d)7
The correct answer ís a
.......................................
...................
739) Female patient is complaining of abdominal distension,
fever and nausea abdominal x-ray showed (Ladder sign)
management is:
a) Colostomy
b)lleus treatment
c) Rectal de-obstruction
d)7
The correct answer ís b ( I'm not sure because O IS NOT
COMPLETE )
740) The best stimulus for breast milk secretion is :
a) Estrogen
b)Breast feeding
c) 7
The correct answer ís b
.......................................
...................
741) Female patient did urine analysis shows epithelial cells in
urine, it comes from:
a) Vulva
b)Cervix
c) Urethra
d)Ureter
The correct answer ís c
.......................................
...................
742) All of the following are risk factors for heart disease
except:
a) High HDL
b)Male
c) Obesity
The correct answer ís a
.......................................
...................
743) The most signs and symptoms of abruption of placenta
is:
a) Vaginal bleed
b)Fetal distress
c) Uterus pain and back pain
d)Abnormal uterine contraction
The correct answer ís a
744) Sign of severe hypokalemia is:
a) P-wave absence
b)Peak T-wave
c) Wide ÇRS complex
d)Seizure
The correct answer ís d , ( I'm not sure , may be choíce e íf
mentíon , ís corect )
severe hypokalemia is defined as a level less than 2.5
mEq}L.
Severe hypokalemia is not linked with any symptoms,
but may cause:
1- muscíe
2- myaígía or muscíe paín
3- dísturbed heart rhythm íncíudíng ectopy (dísturbance of the
eíectrícaí conductíon system of the heart where beats aríse from
the wrong part of the heart muscíe)
4- seríous arrhythmías (eíectrícaí faster or síower than normaí)
5- greater rísk of hyponatremía (an eíectroíyte dísturbance ín
humans when the sodíum concentratíon ín the píasma decreases
beíow 135 mmoí/L) wíth confusíon and seízures
ECG changes in hypokalemia :
1-T-wave fíatteníng
2-U-wave : ( addítíonaí wave after the T wave )
3-ST - segment depressíon
ECG changes in hyperkalemia :
1- peak T wave
2- wíde ORS ( ín severe case )
3- PR proíong ( ín severe case )
4- íoss of P wave
.......................................
...................
745) Child came with his father and high BMl and look older
than other children with same age, on exam child has >95
th
percentile of weight and tall, management is:
a) Observe and appoint
b)Life style change
c) Give program to decrease the weight
d)7
The correct answer ís a

746) Pregnant on 36
th
week came with 7 cm cervical width at 0
station. During birth, CTG shows late deceleration,
management is:
a) Give Oxytocin
b)O2 and change mother position
c) Give Mg sulfate
d)7
The correct answer ís b
Type of
deceleration
etiology management
early Head compressíon
from uteríne
contractíon (normaí )
No treatment
late Uteropíacenta
ínsuffícíency and fetaí
hypoxíma
• Píace patíent on síde
• Díscontínue oxytocín.
• Correct any hypotensíon
• IV hydratíon.
• If deceíeratíons are assocíated wíth
tachysystoíe consíder terbutaííne 0.25
mg SC
• Admíníster O2
• If íate deceíeratíons persíst for more
than 30 mínutes despíte the above
maneuvers, fetaí scaíp pH ís índícated.
• Scaíp pH > 7.25 ís reassuríng, pH 7.2-
7.25 may be repeated ín 30 mínutes.
• Deííver for pH < 7.2 or mínímaí
baseííne varíabíííty wíth íate or
proíonged deceíeratíons and ínabíííty to
obtaín fetaí scaíp pH
variable Umbííícaí cord
compressíon
• Change posítíon to where FHR
pattern ís most ímproved.
Trendeíenburg may be heípfuí.
• Díscontínue oxytocín.
• Check for cord proíapse or ímmínent
deíívery by vagínaí exam.
• Consíder amníoínfusíon
•  Admíníster 100% O2
747) The way to determine the accuracy of occult blood test
for 11,000 old patients is by measuring:
a) Sensitivity
b)Specificity
c) Positive predictive value
d)Negative predictive value
The correct answer ís a
.......................................
...................
748) Sickle cell patient, asymptomatic with history of
recurrent gall-stones and recurrent crisis the management
is:
a) Cholecystectomy
b)Hydroxyurea
The correct answer ís a
.......................................
...................
749) Patient came with HTN, KUB shows small left kidney,
arteriography shows renal artery stenosis, what is the next
investigation:
a) Renal biopsy
b)Renal CT scan
c) Renal barium
d)Retrograde pyelography
The correct answer ís
.......................................
...................
750) The way to differentiate between low iron level from iron
deficiency anemia and anemia of chronic disease is:
a) Ferritin
b)TlBC
c) Serum lron
d)Serum Transferrin
The correct answer ís a
751) Patient came with hallucination and illusion the
medication that should be given is:
a) Carbamezapin
b)7 Haloperidol
c) 7
O not compíete, but wíth thís scenarío and MCOs , the correct
answer ís b
.......................................
...................
752) As doctor if you see patient and you face difficulty to get
accurate information from him the best tactic to do it is:
a) Ask direct question
b)Ask open question
c) Control way of discussion
d)7
The correct answer ís a
.......................................
...................
753) (long question) patient came with MDD so during
communication with patient you will find :
a) Hypomania
b)Late morning awake
c) Loss of eye contact
d)7
The correct answer ís b
.......................................
...................
754) Child patient after swimming in pool came complaining of
right ear tenderness on examination patient has external
auditory canal redness, tender, and discharge the
management is:
a) Antibiotics drops
b)Systemic antibiotics
c) Steroid drops
d)7
The correct answer ís a
755) Child came with inflammation and infection of the ear the
most complication is:
a) Labrynthitis
b)Meningitis
c) Encephalitis
d)Mastoiditis
The correct answer ís d
.......................................
...................
756) Elderly patient complaining of urination during night and
describe when he feel the bladder is full and need to wake
up to urinate, he suddenly urinate on the bed this is:
a) Urgency incontinence
b)Urge incontinence
c) Stress incontinence
d)Flow incontinence
The correct answer ís d
types Hx of urine loss mechanism treatment
total Uncontroííed íoss at
aíí tímes and ín aíí
posítíon
Loss of sphíncter
effícíency or abnormaí
connectíon b\w urínary
tract and skín( fístuía)
surgery
stress After íncrease
abdomínaí pressure
(coughíng, sneezíng,
ííftíng )
Urethraí sphíncter
ínsuffícíency due to
íaxíty of peívíc fíoor
muscuíature , common
ín muítíparous women
Kegaí
exercíseand
pessary
surgery
urge Strong, unexpected
urge to voíd that ís
unreíated to posítíon
or actívíty
Detrusor hyperrefíexía
or sphíncter
dysfunctíon or
neuroíogíc dísorder
Antíchoíínergíc -
medícatíon or
TCA : behavíor
traíníng
overflo
w
Chroníc urínary
retentíon
Increase íntravesícaí
pressure that |ust
exceed the outíet
Píacement of
urethra
catheter , treat
resístance , aííow smaíí
amount of dríbbíe out
underíyíng
causes
757) Newborn came with red-lump on left shoulder, it is:
a) Hemangioma
b)7
c) 7
Ç is not complete
.......................................
...................
758) Child came to ophthalmology clinic did cover test, during
eye cover , his left eye move spontaneously to left, the
most complication is:
a) Strabismus
b)Glaucoma
c) Myobloma
d)7
The correct answer ís a
.......................................
...................
759) Newborn came with congenital hepatomegaly, high LFT,
jaundice the most organism cause this symptoms is:
a) Congenital TB
b)Rubella
c) HlV
d)CMV
The correct answer ís d
.......................................
...................
760) Gross motor assessment at age of 6 months to be asked
is:
a) Sitting without support
b)Standing
c) Role from prone to supine position
d)Role from supine to prone position
The correct answer ís a
761) Female child came with precocious puberty the most
cause is:
a) ldiopathic
b)Adrenal tumor
c) Brain tumor
d)7 ovarian tumor
The correct answer ís a
.......................................
...................
762) Hemorrhoid usually occurs in:
a) Pregnancy and portal HTN
b) ?
c) ?
d) ?
O ís not compíete
Most common causes of hemorrhoid : íncrease straíníng
( constípatíon ) , portaí HTN , íncrease abdomínaí pressure
( chromíng cough , peívíc tumor ) , obesíty , pregnancy ,
smokíng
.......................................
...................
763) The immediate urgent referral of child that take
a) 10 pills contraceptive
b) 10 pills antibiotics7
c) 75 mg 7
77777
.......................................
...................
764) Most unwanted side effect of anti-cholinergic drugs is :
a) Constipation
b) 7
c) 7
more than 50% of patíents takíng antíchoíínergíc have síde
effects : dry mouth , bíurry vísíon , constípatíon and urínary
retentíon .
765) Patient with DM ll with good vision, to prevent eye
disease (Retinal back ground) to develop is to avoid:
a) HTN, Smoking
b)Obesity, Smoking
c) HTN, Obesity
d)7
The correct answer ís c
The risk factors that increase diabetic retinopathy
background are:
1- HTN
2- Poor gíucose controí or íong case D.M
3- Raísed íeveí of fat ( choíesteroí)
4- Renaí dísease
5- Pregnancy ( but not ín díabetes caused by pregnancy )

.......................................
...................
766) Best medication to be given for GDM (gestational) is:
a) lnsulin
b)Metformin
c) 7
The correct answer ís a

767) A child is complaining of severe headache which is
unilateral, throbbing and aggravated by light, diagnosis is:
a) Migraine
b)Cluster Headache
c) Stress Headache
d)7
The correct answer ís a
.......................................
...................
768) The most important factor for smoker to quit is :
a) Patient desire
b)Give nicotine pills
c) Give programmed plan
d)Change life style
The correct answer ís a
.......................................
...................
769) Patient is complaining of irritation, tachycardia, night
sweating, labs done showed TSH: Normal, T4: High,
diagnosis is:
a) Grave's disease
b)Secondary Hypothyriodism
c) Hashimoto's thyroiditis
d)7
Aíí MCOs are wrong , choíce d may be correct íf mentíon
Normal TSH and increase T4 : in thyroid tropin
secretary pitutay adenoma = thyroid resistance .
.......................................
...................
770) The most active form is:
a) T4
b)T3
c) TSH
d)TRH
The correct answer ís b
771) Middle age man found to have heaviness in his groin. On
physical examination there was swelling just above his
testis which apparent with valsalva maneuver. What is the
diagnosis:
a) Direct inguinal hernia
b)lndirect inguinal hernia
c) Femoral Hernia
d)Testicular mass
e) Hydrocele
f) Varicocele
The correct answer ís b
.......................................
...................
772) Gardener has recurrent conjunctivitis. He can't avoid
exposure to environment. ln order to decrease the
symptoms in the evening, GP should advise him to:
a) Cold compression
b)Eye irrigation with Vinegar Solution
c) Contact lenses
d)Antihistamines
The correct answer ís d
.......................................
...................
773) 48 year-old male complaining of lower back pain with
morning stiffness for 30 minutes only. On exam he was
having spasm centrally on the lower back. What is the
appropriate management :
a) Epidural steroids injection
b)Back brace
c) Facet lysis
d)Physiotherapy
The correct answer ís d
.......................................
...................
774) 41 weeks pregnant lady last biophysical profile showed
oligohydroamnios. She has no complaints except mild HTN.
What is the appropriate management :
a) Wait
b)lnduce labor post 42 wks
c) lnduce labor
d)Do biophysical profile twice weekly
The correct answer ís c
775) Full term wide pelvis lady, on delivery station +2, vertex,
CTG showed late deceleration, the most appropriate
management:
a) C}S
b)Suction
c) Forceps Delivery
d)Spontaneous Delivery
The correct answer ís c (I'm not sure )
.......................................
...................
776) Recent study revealed that anti psychotic meds cause the
following complication:
a. wt gain
b. alopecia
c. cirrhosis
the correct answer ís a
.......................................
...................
777) compilication of rapid correction of hypernatremia :
a.brain edema
in hypernatremia : graduaííy correctíon to prevent
cerebraí edema
in hyponatremia : graduaííy correctíon to prevent
,myeíínoíysís ( íncíude paraparesís \ quadríparesís , dysarthría
and coma
.......................................
...................
778) prophylaxis of cholera :
Cholera ís an ínfectíon of the smaíí íntestíne that ís caused by the
bacteríum 6i(rio cholerae. The maín symptoms are profuse
watery díarrhea ( ríce-watery díarrhea ) vomítíng and
dehydratíon . ínfectíon by fecaí-oraí rout .
treatment : 1- rehydratíon , 2-antíbíotíc : young & aduít :
doxcycííne or tetracycííne , for chíídren : SMX-TMP , for pregnant :
furazoíídone .
prphylaxis : good hygíene and sanítatíon and oraí vaccíne , ín
epídemíc pubííc : mass síngíe dose of vaccíne and tetracycííne.

778)which one of the anti TB medications cause tinnitus,
imbalance..
a. streptomycin
b. isoniazide
c. pyrizinamide
the correct answer ís a , sterptomycíne : cause 8
th
nerve
damage
......................................
....................
779) the following combination drug should be avoided :
a. levodopa & digoxin
O ís not compíete
.......................................
...................
780)young male had pharyngitis,then cough ,fever,most likely
org
a. staph aureus
b. strept pneumonia
the correct answer ís b
.......................................
...................
781)most effective measure to prevent spread of infection
among health care workers & pts in a nursery:
a. wash hand befor and after examining each pt
b. wear gown and gloves before entering the nursery
c. wear shoe cover
the correct answer ís a

782) 27 yrs old female with perianal pain for 4 days tender
erythematous fluctuating
a. Abx
b. local CS
c . Sitz bath
e. evac & drain
the correct answer ís e
.......................................
...................
783)female pt developed extreme from zoo,park, sporting
events, the fear prevented her from going out:
a. agoraphobia
b. social phobia
c. schizophrenia
the correct answer ís a , ( agoraphopia : fear goíng out from
the home )
.......................................
...................
784)child starts to smile:
a. at birth
b. 2month
c. 1month
The correct answer ís b
......................................
....................
785)child recognize 4 colors, 5 words, hops on one foot,
consistent with which age:
a. 12 mons
b. 24 mons
c. 36 mons
d. 18 mons
the correct answer ís c
786)pt with hx of 5 yrs HTN on thiazide, came to ER midnight
screaming holding his Lt foot, o}e pt afebrile,Lt foot tender
erythema, swollen big toe most tender and painful, no
other joint involvement
a. cellulitis
b. gouty arthritis
c. septic arthritis
the correct answer ís b
.......................................
...................
787)23 yrs old married for 3 mons, c}o not getting pregnant,
they have intercourse 3-4 times}week, normal gynecologic
hx, husband 25 yrs old healthy wt would you advice:
a. cont. trying
b. obtain sperm analysis
c. study of tubes patency
the correct answer ís a
.......................................
...................
788)pt with AF what is the most common complication:
a. cerebrovascular events
b. v.tach
c. AMl
d. v.fib
the correct answer ís a
.......................................
...................
789)case scenario : oral+genital ulcer +arthritis
a. behcet disease
b. syphilis
c.herpes simplex
the correct answer ís a
790) 20 yrs old lady, pregnant, exposed to rubella virus since 3
days , never was vaccinated against rubella mumps or
measles , what's the best thing to do:
a. give lG
b. vaccine
c. do nothing
d. terminate the pregnancy
the correct answer ís c , oníy supportíve . ( 100 % correct  )
.......................................
...................
790)which of the following not compatible with head
engagement:
a. vertex at zero station
b. crowning of the head
c. 3}5 head felt in the abdomen
d. BPD at ischial spines
the correct answer ís c , When the fetal head is engaged,
2}5 or less of the head is palpable above the pelvic
791)58 yrs old female, known case of osteopenia, she's asking
you abt the best way to prevent compression vertebral
fracture, what would you advice her:
a. avoid obesity
b. vit.D daily
c. wt bearing exercise
the correct answer ís c , cnfuse wíth choíce b
mild osteopenia ( T score -1 to -2 ): íífe styíe modífícatíon
( stop smokíng ) , daííy caícíum íntak ( 1500 mg daííy ) ,
exercíse , and reassessed after 3 - 5 years .
severe osteopenia ( T score -2 to - 2.5 ) and osteoporosis
( T score > 2.5 ) : same mííd pus pharmacoíogícaí .
.......................................
...................
792) Mother complains of sharp pain on radial styloid when
carrying her baby. The pain increase with extension of the
thumb against resistance, Finkelstein test was positive,
Dx :
a. Osteoarthritis of radial styloid
b. De Çuervain Tenosynovitis
the correct answer ís b
......................................
....................
793) 1
st
line in Trigeminal Neuralgia management:
a. Carbamazepine
......................................
....................
794) Contraindicated in acute glaucoma management:
a. Pilocarpine
b. Timolol
c. B-blockers, CA inhibitors, NSAlD, Mannitol
d. 7
Aíí of MCOs can be use ín acute gíaucoma . may be choíce d ís
correct íf mentíon.
795) True about systolic hypertension:
a. could be caused by mitral Regurg
b. More serious than diastolic hypertension
c. systolic>140 and diastolic <90
d. 7
the correct answer ís c
......................................
....................
796) Pregnant 38GA, presented in labor, dilated cervix,
station 42, late deceleration on CTG, management:
a. continuo spontaneous labor
b. Forcep delevary
c. Vacuum Delevary
d. CS
The correct answer is a ( l'm not sure )
.......................................
...................
797) Pt, febrile, tender prostate on PR:
a-Acute Prostitis
.......................................
...................
798) Proven to prevent some cancers:
a. Ca
b. Folic Acid
c. Vit.D
the correct answer ís c
.......................................
...................
799) Patient with cont. Murmur:
a. PDA
b. Coarctation of Aorta
the correct answer ís a
800) Old man, post OR, Complains of unilateral face swelling:
a. Sjorjan syndrome
b. Sarcoidosis
c. Salivary gland tumor
d. Salivary gland stone
the correct answer ís d
.......................................
...................
801) At what level LP done:
a. L2-L3
b. L3-L4
c. L5-S1
The correct answer ís b
.......................................
...................
802) 2months old with scaling lesion on scalp and forehead,
Dx:
a. Seberrhoic Dermatitis
b. Erythema multiforme
the correct answer ís a
.......................................
...................
803) Pt have high Blood Pressure on multible visits, so he was
diagnosed with hypertension, what is the Pathophysiology:
a. increased peripheral resistance
b. increased salt and water retention
the correct answer ís a
.......................................
...................
804) 13years old with hx of pneumonia and managed with abx
2 weeks back, now he came with diarrhea, abdominal pain,
and +ve WBC in stool, the causative organism is:
a. Clostridium dificile
.......................................
...................
805) Best Manag. Of Clost.Deficile is:
a. Metronidazole
b. Doxacycline
the correct answer ís a
806) Prophylaxis of arrhythmia post Ml :
a. Çuinidine
b. Çuinine
c. Lidocaine
d. Procainamide
the correct answer ís c , íf b-bíocker ís present choose ít
.......................................
...................
807) Chronic Diarrhea is a feature of:
a. HyperNatremia
b. HyperCalcemia
c. HypoMagnesemia
d. Metabolic Alkalosis
The correct answer ís d
.......................................
...................
808) Pt with have Polyuria and thirst, he had Hx of bipolar on
lithium, Dx:
a. Nephrogenic Diabetes lnsipidus
b. central Diabetes lnsipidus
the correct answer ís a
.......................................
...................
809) ln city with population of 15000 people & 105 birth }yr ,
4 are still birth ,3 died within months ,2 died before their 1
st
birthday , with 750 p come out & 250 come in what is the
birth mortality rate in this city :
a. 4
b. 6
c. 8
d. 9
Ç not complete ( l did't finde any thing about bierth
mortality rate )
810) Female with recently inserted lUCD coming with watery
brownish vaginal discharge & abdominal pain what is the
most likely Dx :
a. Uterine rupture
b. Ovarian torsion
c. Bacterial vaginosis
d. Ectopic pregnancy
The correct answer ís d
.........................................
.................
811) 38 y}o male calling you complaining of fear from going
outside & fear from seeing the front door & don't sit in the
room containing the front door what is most likely Dx:
a. Depression
b. Agoraphobia
c. Malingering
d. Anti-social personality
The correct answer ís b
........................................
..................
812) 60 y}o male known to have ( BPH) digital rectal
examination shows soft prostate with multiple nodularity &
no hard masses , the pt request for ( PSA) for screening for
prostatic ca what will you do :
a. Sit with the pt to discuss the cons & rods in PSA test
b. Do trans-rectal US because it is better than PSA in
detection
c. Do multiple biopsies for different sites to detect
prostatic ca
d. .........
The correct answer ís a
.........................................
.................
813) What is the most effective ttt for rocasea :
a. Clindamycine
b. Erythromycin
c. Topical steroids
d. ....
O ís not cíear or not compíete. ( íf mentíon tetracycííne choose ít )
Treatment of Rosacea : Oraí tetracycíínes & topícaí
metronídazoíe or topícaí erthyromycín or topícaí cíínamycíne . for
severe case : ísotretínoín . surgical treatment for
rhinophyma .
814) 7 y}o child coming with SOB and wheezing he was sitting
in bed , leaning forward , with drooling & strider what is
Dx :
a- Epiglottits
b- Bronchial asthma
c- ...
d- ...
The correct answer ís a
.........................................
.................
815) 10 y}o child brought by his parents because they where
concern about his weight , he eats a lot of fast food and
French fries , your main concern to manage this pt is :
a- His parents concerning about his weight
b- His BMl > 33
c- Family Hx of heart disease
d- Eating habit ( fast food , French fries )
.........................................
.................
816) What is an absolute contraindication of OCP :
a. Hx of previous DVT
b. Ovarian ca
c. Breast ca
d. ....
The correct answer ís a , both hx of DVT and breast cancer are
absoíute contraíndícatíon , but ín hx DVT ís more accurate
.........................................
.................
817) OCP is proven to :
a. Decrease ovarian ca
b. Decrease endometrial ca
c. lncrease breast ca
d. lncrease risk of ectopic pregnancy
The correct answer ís c

818) Baby born & discharge with his mother , 3weeks later he
started to develop difficulty in breathing & become
cyanotic what is most likely DX :
a- VCD
b- Hypoplastic lt ventricle
c- Coarctaion of aorta
d- Subaortic hypertrophy
The correct answer ís b
......................................
....................
819) 60 y}o male Dx to have acute pancreatitis ( there was
values for ranson criteria that l couldn't memorize ) what is
the appropriate nutrition :
a- TPN
b- Regular diet with low sugar
c- High protein ,high ca , low sugar
d- Naso-jujenal tube
The correct answer ís d
.......................................
...................
820) 15 y}o boy brought by his mother with lab values shows
microcytic hypochromic anemia what is most likely Dx :
a- Thalassemia
b- lDA ( iron deficiency anemia )
c- SCD
d- ...
The correct answer ís b
.......................................
...................
821) Female with Hx of lt flank pain radiating to groin ,
symptoms of UTl & N+V what is DX:
a- Appendicitis
b- Diverteculitis
c- Renal colic
d- ....
The correct answer ís c
822) Old pt with neck swelling , nodular ,disfiguring , with Hx
of muscle weakness , cold intolerance , hoarseness , what is
your management :
a- Levothyroxine
b- Carbamazole
c- Thyroid lobectomy
d- Radio-active iodine
The correct answer ís a
.......................................
...................
823) Pregnant woman with symptoms of hyperthyroidism ,
TSH low :
a- Propylthyiouracil
b- Radio-active iodine
c- Partial thyroidectomy
d- .....
The correct answer ís a
.......................................
...................
824) Pt with thyroid mass , firm ,2x2 cm what is most
appropriate for Dx :
a- Neck US
b- FNA
c- Neck CT
d- Surgery
The correct answer ís b
.......................................
...................
825) 56 y}o female complaining of back pain , her mother
suffer from vertebral compression Fx , investigation shows
early osteoporosis what is the best ttt :
a- Advice with exercise
b- Vit D , ca supplement , ...
c- ......
d- .....
The correct answer ís b
.......................................
...................
826) What is the most common non-traumatic Fx caused by
osteoporosis :
a- Colle's Fx
b- Femoral Fx
c- Vertebral compression Fx
The correct answer ís c , because most common non traumatíc .
827) 4 or 5 ( not sure ) brought by his parents with weight >
95
th
percentile , height < 5
th
percentile & bowing of both
legs what is the appropriate management :
a- Liver & thyroid function tests
b- Lower limb X-ray
c- Pelvis X-ray
d- Thyroid or ( liver not sure ) function test
The correct answer ís a
......................................
....................
828) At which stage sapration of chromatoids occur :
a- Metaphase
b- Telophase
c- .....
d- .....
The correct answer ís a
.......................................
...................
829) Elderly pt with DM2 , HTN , smoker , sedentary lifestyle ,
inestigation low HDL, high LDL , ( مهم-ا ,' ل- يس'م-ا ^-- ) which of
what will be effective in this pt :
a- Level of HDL , smoking , obesity
b- Triglyceride level , ........
c- ....................
d- ....................( all were long sorry )
MCÇs are not complete.
.......................................
...................
830) pt known case of ulcerative colitis with erythematous
rash in lower limb what is most likely DX:
a- erythema nodusum

831) Pt known to have ulcerative colitis coming with skin
lesion around Tibia which is with irregular margins what is
most likely Dx:
a- Pyoderma gangirenosum

......................................
....................
832) Young pt victim of RTA coming with SOB ( or not
breathing not sure ) absent of breath sound & chest
movement in RT side but resonance in percussion what is
your next step :
a- Do stat chest X-ray
b- Emergency surgery
c- ............
d- ............
Needíe aspíratíon then chest tube
.......................................
...................
833) Psychiatric pt non-compliance to his medication what is
the ttt :
a- ..... Given lM
b- ......... given lV
c- ........oral
d- .........oral
Ç is not complete
.......................................
...................
834) Which psychiatric disease is treated with
electroconvulsive therapy :
a- Paranoia
b- ...........
The correct answer is : Major depression
835) Pt with bilateral eye discharge , watery , red eyes,
corneal ulceration what is the most common cause :
a- Dust & pollen
b- Hypertension & .....
c- Ultra-violet light & stress
d- ..............
The correct answer ís a
.......................................
...................
836) 4 y}o baby felt down his mother pulled him by his arm &
since then he kept his arm in pronation position what is
your management:
a- Splint .....
b- Do x-ray for the arm before any intervention
c- Orthopedic surgery
d- .............
The correct answer ís b
.......................................
................. ..
838) diabetic pt on medication found un conscious his blood
suger was 60 what is the most common to cause this
problem:
a- Sufonylurease
b- Bigunides
c- ........
The correct answer ís a
.......................................
...................
839) what is most sensitive indicator for factitious fever :
a- Pulse rate
b- .........
c- ..........
Factitious fever: Fever produced artífícíaííy by a patíent. Thís ís
done by artífícíaííy heatíng the thermometer or by seíf-
admínístered pyrogeníc substances. An artífícíaí fever may be
suspected íf the puíse rate ís much íess than expected for the
degree of fever noted. Thís díagnosís shouíd be consídered ín aíí
patíents ín whom there ís no other píausíbíe expíanatíon for the
fever. Patíents who pretend to have fevers may have seríous
psychíatríc probíems.
840) young male ( l think he was a student ) with headache
involving the whole head & bilateral eye glob that increase
with stress what is most likely DX:
a- Tension headache
b- Migraine
c- .........
d- ..........
Ç not cmplete
.......................................
...................
841) pt turns to be erratic , for 4 month he said that's people
in TV knows what people are thinking about , in last 2
month he claim that he has special power that no one has
what is the most likely DX :
a- Uni-polar ... depression
b- Bipolar .. Mania
c- SCZ
d- ........
The correct answer ís c
.......................................
...................
842) common site of anal fissure is :
a- Anterior
b- Posterior
c- Lateral
d- .........
The correct answer ís : b
.......................................
................. ..
843) common site of hernia sac in relation to the cord content :
a- Antro-lateral
b- Medial
c- Anywhere
d- Posterior
The correct answer ís a
844) what a 4 years child can do :
a- Draw square & triangle
b- Say complete sentence
c- Tie his shoes
d- .............
The correct answer ís a
.......................................
...............
845) You received a call from a father how has a son diagnosed
recently with DM-l for six months, he said that he found his
son lying down unconscious in his bedroom, What you will
tell him if he is seeking for advise:
a. Bring him as soon as possible to ER
b. Call the ambulance
c. Give him his usual dose of insulin
d. Give him lM Glucagone
e. Give him Sugar in Fluid per oral
The correct answer ís e
.......................................
...................
846) factor which determine recurrence of breast cancer :
a- Site & size of breast mass
b- No of lymph nodes
c- Positive estrogen receptor
d- Positive progesterone receptor
The correct answer ís b
.......................................
...................
847) teacher in school presented with 3 days Hx of jaundice
( they wrote it ictric as if it will a differacne) & abdominal
pain , N+V , 4 of school student had the same illness in lab
what is true regarding this pt :
a- Positive for hepatitis A lgG
b- Positive hepatitis A lgM
c- Positive hepatitis B core
d- Positive hepatitis B c anti-body
The correct answer ís b
848) regarding weight gain in pregnancy what is true :
a- Pregnant woman should consume an average calorie 300-
500 per day
b- Regardless her BMl or body weight she should gain from
1.5 - 3 lb which represent the baby's growth
c- ........................
d- .........................
Ç is not complete
Weight gain during pregnancy :
- 100 - 300 Kcal } day , 500 Kcal } day in breastfeeding
- Wt. gain : 1 - 1.5 kg } month , 11 - 16 kg gain during
pregnancy.
( for change from Ib to Kg : dívíded by 2.2)
.......................................
...................
849) what condition is an absolute contraindication of lactation
:
a- Mother with open pulmonary TB for 3 month
b- Herpes zoster in T10 drematome
c- Asymptomatic HlV
d- ..................
The correct answer ís c
.......................................
...................
850) what is most sensitive for DX of duodenal ulcer :
a- Epigasteric pain starting 30-60 min after the meal
b- Epigasteric pain staring immediately after a meal
c- lncreasing of pain when lying supine
d- Pain radiating to the back
The correct answer ís d
.......................................
...................
851) female at 40 yr with BMl >28 what is your management :
a- Reduce calorie in take to 800 }day
b- ln general reduce calorie intake
c- ..............
d- .................
O ís not compíete, but wíth these MCOs , the correct answer ís b
852) 70 y}o female say that she play puzzle but for a short
period she can't play because as she develop headache
when playing what u will exam for
a. astigmatism
b. glaucoma
the correct answer ís a
.......................................
...................
852) prophylaxis for meningitis ttt contact
a. cimitidine
b. rifampicin
the correct answer ís b
.......................................
...................
853)rheumatic fever pt has streptococcal pharingitis risk to
develop another attack
a. trimesmore than normal
b. 100%
c. 50%
the correct answer ís c
.......................................
...................
854)child with unilateral nasal obstruct with bad odor
a. unilateral adenoid hypertrophy
b. FB
the correct answer ís b
.......................................
...................
855)PT. do colectomy for colon cancer routine follow up every
a. 6 months
b. 3 months
c. 9 months
d. 1 years
the correct answer ís d
856) for patient with osteoarthritis , what is your initial action :
a. lntraarticular corticosteroid
b. Çuadriceps strengthening exercise
c. Climb stairs exercise
The correct answer ís b
.......................................
...................
857) 70-y old female patient with osteoporosis , what is her T
score :
a. (-2.5)
b. (-1)
c. (1)
d. (2)
The correct answer ís a
.......................................
...................
858 ) diabetic patient , diagnosed 2 weeks back came to your
clinic at scheduled appointment supposed to be at 10:00
AM but because you were having another complicated
case , he had to wait for more than an hour , and he was
extremely angry , what u will do :
a. be empathetic as this anger is mostly because of the new
morbidity diagnosed at this patient
b. you start your talk with him by saying "l was having a
hard case "
c. Don't say anything regarding being late unless he brings
it up
d. you star YOUR TALK WlTH HlM BY SAYlNH "you seem
furious"
.......................................
...................
859) 1
st
step in epidemic study is :
a. verifying diagnosis
O ís not compíete
860) Randomized control trials become stronger if :
a. you follow more than 50% of those in the study
b. systematic assignment predictability by participants
O ís not compíete , but wíth these MCOs , the correct answer ís
b
.......................................
...................
861) child with multiple painful swellings on the dorsum of
hands , feet , fingers and toes ,his CBC showed Hb =7,RBC's
on peripheral smear are crescent shaped , what is your
long-term care :
a. corticosteroids
b. penicillin V
c. antihistaminic
the correct answer ís b , thís pt. ís síckíe ceíí anemía
.......................................
...................
862) 54 y old patient , farmer , coming complaining of dry eye ,
he is smoker for 20 years and smokes 2 packs} day , your
recommendation :
a. advise him to exercise
b. stop smoking
c. wear sunscreen
The correct answer ís b , smokíng íncrease rísk of dry eye
(ínternatíonaí study )
.......................................
...................
863) patient is wearing contact lenses for vision correction
since ten years , now coming c}o excessive tearing when
exposed to bright light , what will be your advice to him :
a. wear hat
b. wear sunglasses
c. remove the lenses at night
d. saline eye dros 4 times } day
The correct answer ís d ( I'm not sure )

864) management of mild epistaxis :
a. pinching the fleshy part of nose while telting head
foreword
.......................................
...................

865) most common site of malignancy in paranasal sinuses :
a. Maxillary sinus ( correct )
......................................
....................
866) patient with hypertension , what is the best non-
pharmacological method to lower the elevated blood
pressure :
a. weight reduction ( correct )
.......................................
...................
867) newly diagnosed patient with hyper tension having
Na=147 , K=3 , what is the most likely cause of his
secondary hypertension :
a. hyperaldosteronism ( correct )
.......................................
.................
868) 50 year old patient , diagnosed with hypertension , he is
used to drink one glass of wine every day , he is also used
to get high Na and high K intake , his BMl is 30kg}m , what
is the strongest risk factor for having hypertension in this
patient :
a. wine
b. high Na intake
c. high K intake
d. BMl=30
the correct answer is d , ( l'm not sure )
869) all of the following tests are necessary to be done before
initiating lithium except:
a. liver function tests
.......................................
...................
870) in dementia , best drug to use :
a. haloperidol
b. galantamine
the correct answer ís b
treatment of dementía ís choíínesterase ínhíbítor ( gaíantamíne,
donepezíí, rívastígmíne, and tracíng )
.......................................
...................
871) most important point to predict a prognosis of SLE patient
: 77
a. degree of renal involvement
b. sex of the patient
c. leucocyte count
the correct answer ís a
......................................
....................
872) what is the antibiotic that you will give if you will do
appendectomy :
a. doxycycline
b. ceftriaxone
c. metronidazole
d. cefuroxime
The correct answer is d


873) most common site for ectopic pregnancy :
a. fallopian tubes
......................................
....................
874)child with low grade fever , rash , pharingitis , and tender
splenomegally , +ve EBV , Dx :
a. infectious mononeucleosis
......................................
....................
875) best early sign to detect tension pneumothorax :
a. tracheal shift
b. ditended neck veins
c. hypotensionv
the correct answer ís b , I'm not sure , I thínk tracheaí shíft ís
the íate sígn .
.......................................
...................
876) First sign of magnisium sulfate toxicity is :
a. Loss of deep tendon reflex
.......................................
...................
877) Patient with mashroom toxicity will present with
a. Constipation
b. Hallucination
c. Anhydrosis
the correct answer ís b
878) Child ate overdose of iron , best immediate management
a. Gastric lavage
b. lnduce vomiting manually
c. Emetic drugs
d. lpecac
the correct answer ís a
.......................................
...................
879) Status epilepticus is :
a. Continuous sizure activity more than 30 min without
regaining consciousness
......................................
....................
880) First sign of increased lCP is :
a. contralateral papillary dilatation
b. lpsilateral papillary dilatation
c. Decrease level of consciousness
the correct answer ís c
.......................................
...................
880) Patient with history of head trauma unable to move the
fork to his mouth , where is the lesion:
a. cerebellum
b. frontal lobe
c. temporal
the correct answer ís a
.......................................
...................
881) Patient with lumbar canal stenosis , l forget the
presentation , what is the ttt:
a. Physiotherapy
b. Lumbar dicsectomy
O IS NOT COMPLETE
Mild to moderate : NSAlD + physiotherapy
Advance : epidural corticosteroid
Refractory : surgical laminectomy
882) Most common cause of otorrhia :
a. Csf leak
b. Acute otitis media
c. Cerumen leak
The correct answer ís b
.......................................
...................
883) Most common symptoem of acute otitis media :
a. Pain
b. Discharge
c. Tinnitus
d. Vertigo
The correct answer ís a
.......................................
...................
884) 12 yo boy is mocked at school because he is obese , ate a
lot of pill to sleep and never wake up again , best
management is :
a. Refer to mental professional
b. Tell him that most kid grow out before they grow up
c. Advice healthy food
.......................................
...................
885) 12 yo boy brought by his parent for routine evaluation ,
his is obese but otherwise healthy , his parents want to
measure his cholesterol level , what is the best indicator of
measuring this child cholesterol :
a. His parent desire
b. Family hx of early cva
c. High bmi
The correct answer ís b
886) Diabetic pt. have neovasclarization and vetrous
hemorrhage , next step :
a. Refer to ophthalmologist
.......................................
...................
887) Histopatholgy of resected inflamed appendix will show :
a. Neutrophil in muscular wall
b. Lymphoid hyperplasia with multineucleated gaint cel
The correct answer ís a
.......................................
...................
888) A child had bee bite presented after 18 hour with left
arm erythema and itching and.. Long scenario , what to
do:
a. Antihistaminic
b. Oral steroid
c. Subcutaneous epinephrine
The correct answer ís a
.......................................
...................
889) Old man with urinary incontinence , plapable bladder
after voiding , urgency and sense of incomplete voiding dx;
a. Stress incontenece
b. Overflow
c. Reflex
The correct answer ís b
.......................................
...................
890) Ttt of scabis :
a. Permethrin
891) Picture , hyperkeratotic , scaly lesion over the extensor
surface of knee and elbow , what to do to avoid
exacerbation :
a. Steroid
b. Avoid sun exposure
c. Avoid trauma
The correct answer ís a
.......................................
...................
892) Which is true about allopuranol :
a. Good if given during acute gout
b. Uricisoric
c. Reduce the chance of uric acid stone
d. Can be antagonize by salysilate
The correct answer ís c
.......................................
...................
893) man walking in street and saying bad words to stranger ,
he is not aware of his conditiond , what is the description :
a. flight of idea
b. insertion of idea
c. loosening of association
.......................................
...................
894) which of the following suggest that thyroid nodule is
bengin rather that malignant:
a. history of childhood head and neck radation
b. hard consistency
c. lemphadenopathy
d. presense of multiple nodules
the correct answer ís d
thyroíd cancer : ( coíd and soííd noduíe )
895) child presented after sting bite with abd pain ,
arthalgia , lower extremity and buttock rash , normal RFT ,
+ve fecal occult stool , dx :
a. HSP
b. Lyme diases
The correct answer ís a
.......................................
...................
896) best indicator for labor progress is :
a. frequency of contractions
b. strength of contractions
c. descent of the presenting part
the correct answer ís c
.......................................
...................
897) lactating mother is taking Phenobarbital for sizure
prophylaxsis , what to advice her :
a. stop breast feeding immediately
b. breast feed after taking the pill by 8 hour
c. start weaning
d. does not matter
the correct answer ís a
.......................................
...................
898) best single way to reduce high blood pressure is :
a. smoke cessation
b. decrease lipid level
c. reduce weight
the correct answer ís c
.......................................
...................
899) drug of choice for supraventricular tachycardia is :
a.adenosine

900) patient with blood group A had blood transfusion group B
, the best statement that describe the result is :
a. type lV hypersensitivity
b. inflammatory reaction ..
c. ....
The correct answer ís : It ís type 2 hypersensítívíty
.......................................
...................
901) a nurse gave blood transfusion through CVP , 2 hours
later the patient is comatose and unresponsive , dx :
a. Septic shock
b. Blood group mismatch
The correct answer ís a ( I'm not sure )
.......................................
...................

902) 100% O2 given for prolonged periods can cause all
except:
a. Retrosternal Pain
b. Seizures
c. Depression
d. Ocular Toxicity
e. 777
The correct answer ís c ( I'm not sure because choíce e ís not
mentíon )
903) Organophosphorus poisoning, what is the antidote7
a. Atropine
b. Physostigmine
c. Neostigmine
d. Pilocarpine
e. Endrophonium
The correct answer ís a
.......................................
...................
904) Which of the following pulse character goes with the
disease7
a. Collapsing pulse  Severe anemia
b. Pulsus Alternans  Premature ventricular complexes
c. Slow rising Pulse  Mitral stenosis
d. Pulsus Bisferens  Mitral Regurgitation
e. Pulsus paradoxus  l think Aortic stenosis or
regurgitation
The correct answer ís a
PLUSE DEFlNlTlON CAUSES
Collapsing
pulse
Puíse wíth fast upstroke and
fast downstroke
1- Sever anemía
2- Aortíc regurge
3- Thyrotoxícosís
Pulse alternans Aítrnans weak and strong puíse 1- LV dysfunctíon
Pulsus
paradoxus
Decííne systoííc more than 10
mm Hg duríng ínspíratíon
1- Cardíac
tamponade
2- Asthma & COPD
Pulsus parvus
et tardus
Weak and deíayed puíse 1- Aortíc stenosís
Slow rising
pulse
Síow upstroke puíse 1- Aortíc stenosís
Pulsus
bisferiens
puíse characterízed by two
strong systoííc peaks separated
by a mídsystoííc díp
1- Aortíc reguírge
2- AR + AS
905) Entamoeba histolytica cysts are destroyed best by:
a. Boiling
b. lodine added to water
c. Chlorine added to water
d. Freezing
The correct answer ís a
.......................................
...................
906) A scenario about an old male with symptoms suggesting
parkinsonism such as difficulty walking, resting tremors
and rigidity in addition to hypotension. Then he asks about
what is the most common presenting symptom of this
disease
a. Rigidity
b. Tremors
c. Unsteady Gait
d. Hypotension
e. 777
The correct answer ís b
.......................................
...................
907) Regarding postpartum Psychosis:
a. Recurrences are common in subsequent pregnancies
b. lt often progresses to frank schizophrenia
c. lt has good prognosis
d. lt has insidious onset
e. lt usually develops around the 3
rd
week postpartum
The correct answer ís a
.......................................
...................
908) A pregnant female develops lesions on the vulva and
vagina and she was diagnosed as genital herpes, what
should be included in her future health care7
a. Cesarian section should be done if the lesions did not
disappear before 2 weeks of delivery date
b. Oral acyclovir to treat herpes
c. Termination of pregnancy because of the risk of fetal
malformations
d. Avoidance of sexual intercourse for 1 month after the
healing of the lesions
e. 77777
The correct answer ís b
HSV in pregnant treated by : oraí acycíovír 400 mg TID for 5-7
days . if HSV was present at time of labor : c - sectíon
909) A picture of 2 warts in the index finger.
Diagnosis is  Viral Warts
.......................................
...................
910) What is the most common sequalae of acute
pancreatitis 7
a. Abscess
b. Pseudocyst
c. Bowel obstruction
The correct answer ís b
Most common complication of acute pancreatitis:
pancreatíc pseudocyt and fístuía formatíon
.......................................
...................
911) An old patient with history of cerebrovascular disease &
lschemic heart disease, presents with a pattern of
breathing described as: A period of apnea followed by slow
breathing which accelerates & becomes rapid with
hyperpnea & tachycardia then apnea again. What is this
type of breathing7
a. Hippocrates
b. Chyene-stokes breathing
c. Kussmaul breathing
d. One type beginning with O letter and contains 3 letters
only
e. 7777
The correct answer ís b
1- Chyene-stokes respiration : rapíd deep breathíng phase
foííowed by períod of apnea , present wíth heart faííure , stroke,
braín trauma , aíso can be wíth síeep or hígh aítítude
2-kusmmaul's breathing : rapíd and deep breathíng . present
wíth metaboííc acídosís partícuíaríy ín díabetíc ketoacídosís
912) A patient with mixed 1
st
& 2
nd
degree burns in head &
neck region, what is the most appropriate management7
a. Apply silver sulfadiazine and cream to all burned
areas,cover them and admit to hospital
b. Apply cream to 2
nd
degree burns and cover them, give lV
fluids
c. Debridement of 2
nd
degree burns and ..
d. Apply silver sulfadiazine then Vaseline ointment to all
areas then discharge the patient
The correct answer ís a
1sr degree : epídermís + paínfuí ( no bííster )
2
nd
degree : epídermís + partíaí dermís + paínfuí _ bííster
3
rd
degree : epídermís + fuíí thíckness dermís + paíníess
Rule of nine to estimate BSA :
1- Head and neck : 9%
2- Each upper arm : 9%
3- Each íoer íímb : 18%
4- Each post. & ant. Trunk : 18%
5- Períneum & genítaíía : 1%
-Sííver suífadíazíne and mafeníde used for aíí types of burn
-supportíve : tetanus and I.V nacrotíc can be used for aíí types of
burn
- I.V fíuíd use oníy ín ( > 10% of BSA) ín 2
nd
& 3
rd
degree of burn
accordíng parkíand formuía : ( fíuíd ín fírst 24h = 4 * wt. ín kg *
BSA . 50% ín fírst 8 hours and another ín next 16 hours )
In thís patíent 1
st
deree and 2
nd
degree < 10% ( head and neck
9%) : so, not use fíuíd
.......................................
...................

913) 2 years old child with ear pain & bulging tympanic
membrane, what is the diagnosis7
a. Otitis media
b. Otitis externa
c. Otomycosis
d. Bullous myringitis
The correct answer ís a
914) Besides lV fluids, what is the most important drug to be
given in anaphylaxis7
a. Epinephrine
b. Steroids
c. 777 Other choices
The correct answer ís a
.......................................
...................
915) An adult patient in 20s or 30s of age presents by history
of 1 month of fever, 5 days of headache & 2 days of altered
sensorium. On examination there is nuchal rigidity, then
there is a table showing investigations which include
Hb: 10 g}dl
Blood WBC: 18,000
CSF Examination: WBCs elevated: 77% lymphocytes, 33%
Neutrophils. Protein 777. Glucose77
What is the diagnosis7
a. Viral meningioencephalitis
b. Tuberculous meningitis
c. Ph.. Meningitis
d. 777
O ís not compíete , but wíth thís scenarío and MCOs , The
correct answer ís b
916) Regarding chronic fatigue syndrome, which is true7
a. Antibiotics may reduce the symptoms
b. Antidepressants may reduce the symptoms
c. Rest may reduce the symptoms
d. 777
e. 7777
O IS not compíete , but wíth these MCOs , the correct answer ís
b.
chronic fatigue syndrome:
characterízes by profound mentaí and physícaí exhaustíon. In
assocíated wíth muítípíe system and neurospsychíatríc
symptoms that íast at íeast 6 mounth. Must be new ( not íífe
íong ) , must not be reííved by rest, and must resuít ín greater
than 50% reductíon ín prevíous actívíty. Presentatíon wíth 4 or
more of the foííowíng : poor memory / concentratíon, myaígía,
arthaíagía, sore throat, tender íymph node, recent onset
headach, unrefreshíng síeep, excessíve tíredness wíth exercíse.
Treatment by : cognítíve and excercíse therapy .aíso, díet,
physíotherapy , díetary suppíements , antídepressants .
.......................................
...................
917) A patient complains of dry eyes, a moisturizing eye drops
were prescribed to him 4 times daily. What is the most
appropriate method of application of these eye drops7
a. 1 drop in the lower fornix
b. 2 drops in the lower fornix
c. 1 drop in the upper fornix
d. 2 drops in the upper fornix
.......................................
...................
918) A patient with penetrating abdominal stab wound. Vitals
are: HR 98, BP 140}80, RR 18. A part of omentum was
protruding through the wound. What is the most
appropriate next step:
a. FAST Uítrasound
b. DPL (Díagnostíc perítoneaí íavage)
c. Expíore the wound
d. Arrange for a CT Scan
e. Expíoratory íaparotomy
The correct answer ís e
919) A patient presents with loin pain radiating to the groin.
Renal stones are suspected. What is the test that has the
most specificity & sensitivity in diagnosing this condition7
a. Noncontrast spiral CT scan of the abdomen
b. Ultrasound
c. KUB
d. lntravenous pyelography (lVP)
e. Nuclear Scan
The correct answer ís a
.......................................
...................
920) An old patient presents with history dizziness & falling
down 1 day ago accompanied by history of Epigastric
discomfort. He has very high tachycardia l think around
130-140 and BP 100}60. What is the diagnosis7
a. Peptic ulter
b. GERD
c. Leaking aortic aneurysm
d. 777
The correct answer ís c
.......................................
...................
921) A child is about to be given flu vaccine, what allergy
should be excluded before giving the vaccine7
a. Chicken
b. egg
c. Fish
d. 777
The correct answer ís b
.......................................
...................
922) Which of the following is proven to reduce the incidence
of cancer7
a. Salt
b. Mineral water
c. Vitamin D
d. Fiber
The correct answer ís c
923) A female patient with history of cyclic abdominal pain,
inability to conceive, heavy menses, and examination
showed tenderness & nodularity in uterosacral ligaments.
What is the diagnosis7
a. Endometriosis
.......................................
...................
924) A female patient on the 3
rd
week postpartum. She says to
the physician that the frequently visualizes snakes crawling
to her baby's bed. She knows that it is impossible but she
cannot remove the idea from her head. She says she wakes
up around 50 times at night to check her baby. This
problem prevents her from getting good sleep and it
started to affect her marriage. What is this problem she is
experiencing7
a. An obsession
b. A hallucination
c. A postpartum psychosis
d. A Delusion
The correct answer ís a
Obsession : persístent, unwanted, and íntrusíve ídeas ,
thoughts, ímpuíses or ímages
.......................................
...................
925) Regarding screening for cancer, which of the following is
true7
a. Screeníng for cervícaí cancer had decreased ín recent years
b. Screeníng for breast cancer had decreased ín recent years
c. Screeníng for Coíorectaí cancer ís ínadequate for the hígh-rísk
groups
d. Screeníng for íung cancer has reduced the mortaííty rate of
íung cancer
e. Screeníng for tobacco use ís now adequateíy done by heaíth
professíonaís
.......................................
...................
926) Regarding postpartum depression, what is the most
appropriate intervention to reduce the symptoms7
a. lnclude family in the therapy
b. lsolation therapy
c. Add very low doses of impiramine
d. Encourage breastfeeding
The correct answer ís a
927) Which of the following is a side effect of Buprione, a drug
used to help smoking cessation:
a. Arrhythmia
b. Xerostomia
c. Headache
d. Seizure
The correct amswer ís d
.......................................
...................
928) A 60 years old patient with history of heart attack 6
weeks ago, complaining of not getting enough sleep.
Psychiatric evaluation is unremarkable for depression or
anxiety, what should be given to this patient7
a. Amytríptíííne
b. Buspírone
c. Bupríone
d. Zoíbídím
The correct answer ís d
.......................................
...................
929) A patient is asked to face the wall, bend his waist, and
let his hands hang down without support. This test is used
as a screening tool for which of the following7
a. Lower limb asymmetry
b. Rectal prolapsed
c. Scoliosis
d. 7777
The correct answer ís c
Thís test ís caííed for (Adam's Forward Bend Test )

930) A patient presents with sore throat, cervical
lymphadenopathy, mild splenomegaly, EBV antibodies are
+ve. What is the diagnosis7
a. lnfectious Mononucleosis (EBV )
.......................................
...................
931) An old patient presents with knee pain, limitation of
movement and quadriceps muscle atrophy. On examination
there is limited range on movement, pain on movement &
Crepitus. What is the diagnosis7
a. Osteoarthritis
b. Rheumatoid arthritis
c. Ankylosing Spondylitis
The correct answer ís a
.......................................
...................
932) A patient presents with long time history of knee pain
suggestive of osteoarthritis. Now he complains of unilateral
lower limb swelling and on examination there is +ve pedal
& tibial pitting edema. What is the next appropriate
investigation7
a. CXR
b. ECG
c. Echocardiography
d. Duplex ultrasound of lower limb
The correct answer ís d
Osteoarthritis relief by rest . So, immobility pt. can
lead to DVT
.......................................
...................
933) Alopecia is a side effect of which antiepileptic7
a. Phenytoin
b. Carbamazepine
c. Na Valproate
d. 777
The correct answer ís c
1-phenytoin : gíngívaí hyperpíasía, hírsuteísm, ataxía
2-carbamazepine : agranuíocytosís, hepatotoxícíty, apíastíc
anemía
3- Na Valproate : transíent haír íoss.

934) Which of the following is an indication for tonsillectomy7
a. Sleep apnea
b. Asymptomatic large tonsils
c. Peripharygeal abscess
d. Retropharyngeal abscess
The correct answer ís a
.......................................
...................
935) Which of the following is a gram -ve rods that grow on
charcoal yeast agar7
a. Legionella
.......................................
...................
936) A 7 years old child had history of chest infection which
was treated with antibiotics. The patient presented 6 weeks
after cessation of antibiotics with abdominal pain, fever
and profuse watery diarrhea for the past month. Which of
the following organisms is responsible for the patient's
condition7
a. Giardia Lamblia
b. Clostridium Difficile
c. Escherichia coli
d. Clostridium Perfringens
The correct answer ís b
.......................................
...................
937) Which of the following features of ulcerative colitis
distinguishes it from crohn's disease
a. Possible malignant transformation
b. Fistula formation
c. Absence of granulomas
d. Colon involvement
The correct answer ís a
938) A very very long scenario about a female patient with
vaginal discharge "malodorous watery in character" with
pH of 6 & +ve clue cells but there is no branching
pseudohyphe. (He is telling you the diagnosis is vaginosis &
there is no fungal infection) Then he asks about which of
the following drug regimens should NOT be used in this
paitent:
a. Metronidazole (PO 500 gm for 7 days)
b. Metronidazole (PO 2 large dose tablets for 1 or 2 days)
c. Metronidazole (lV or lM ...)
d. Miconazole ( PO ...)
e. Clindamycin (PO ...)
The correct answer ís d
Thís case ís " bacteria vaginosis" and treatment by :
metradínazoíe or cííndamycíne . avoíd míconazoíe because ít ís
antífungaí
.......................................
...................
939) What is the condition that produces malodorous watery
vaginal discharge with +ve clue cells in wet mount
preparation slides:
a. Bacterial vaginosis
b. Vaginal Candidiasis
c. Trichomonas vaginalis
d. Gonorrhea
The correct answer ís a
.......................................
...................
940) Which of the following is the best treatment for
Giardiasis:
a. Metronidazole
.......................................
...................
941) A woman with 9weeks History of elevated erythematous
wheals overall her body , she also has lip swelling. There is
no History of recent travel or food allergy or drug ingestion,
Diagnosis:
a. Chronic Angioedema & Urticaria
b. Contact Dermatitis
c. Solar Urticaria
d. Cholinergic Urticaria
e. Cold Urticaria
The correct answer ís a
Chronic urticaria : íf more than 6 months
Solar urticaria : due to sunííght
Cholinergic urticariae : due to bríef íncrease ín body
temperature.
Cold urtiaria : due to exposure to coíd
942) A 17 years old male with history of mild intermittent
asthma. Attacks occur once or twice weekly in the morning
and no attacks at night. What should be the initial drug to
give7
a. lnhaled short acting B2 agonist as needed
b. lnhaled high dose corticosteroid as needed
The correct answer ís a
.......................................
...................
943) A child presented with sore throat. Culture from the
throat revealed +ve meningiococci. The patient is now
asymptomatic. Which of the following should be done7
a. Reassurance
b. Rifampicin oral for 7 days
c. lM ceftriaxone 1 dose
d. Ceftriaxone oral
e. 777777
The correct answer ís c ( I'm not sure )
2-day regímen of oraí rífampín or a síngíe dose of IM ceftríaxone
or a síngíe dose of oraí cíprofíoxacín).
.......................................
...................
944) Which of the following increases the quality of the
randomized controlled study & make it stronger:
a. Systemic Assignment predictability by participants
b. Open Allocation
c. lncluding only the participants who received the full
intervention
d. Following at least 50 % of the participants
e. Giving similar intervention to similar groups
The correct answer ís a
.......................................
...................
945) A scenario about an infant who presented with difficulty
breathing and sweating, examination shows hyperactive
precordium with loud S2 and pansystolic murmur grade 3}6
best heard in the left 3rd parasternal region. What is the
Diagnosis7
a. VSD
b. Mitral Regurgitation
c. PDA
d. Large ASD
The correct answer ís a

946)Post lHD , your advise :
a. Yoga
b. isotonic exercise
???????????
.......................................
...................
947)very obese girl , what's the first step to reduce weight :
a. increase water intake
b. decrease calorie intake
the correct answer ís b
.......................................
...................

948) 40 y}o male , presented with large hands , hepatomegaly
... diagnosis :
a. acromegaly
b. gigantism
the correct answer ís a
......................................
....................
949) cousre of facial nerve when comes out from stylomastoid .
a. Deep to parotid gland & lateral to external carotid &
retromandibular vein
.......................................
...................
950) old female with hemorrhoids for 10 years , no
complication , your action 7
a. observe
b. surgery
c. increase fiber diet
the correct answer ís c
.......................................
...................
951) femal about 30y c}o abdominal pain related to menses
(scenario going with endometriosis)....next step in dx:
a. Laparoscopy
b. U}S
c. CT
The correct answer ís a
Confírm díagnosís by íaparoscopy , US & MRI can use but íf
normaí can not excíude endometríosís .
952) femaíe about 30y wíth breast cancer (gíven cbc -chem. And
reaveí íow hb and hematocríte..) what ís the next step ín
mangment:
a. Stagíng
b. Lumpectomy
c. Mastectomy
d. Chemotherapy
.......................................
.....................

953) pt with open angle glaucoma and k}c of COPD and DM ttt:
a. Timelol
b. betaxolol
c. Acetazolamide
the correct answer ís c
.......................................
.....................

954) infant with runny nose and fever after that develop
dysnea ,wheezing with working accessory muscles and
chest retractions with cyanosis, temp 38 dx:
a. Viral pnumonia
b. Bacterial pneumonia
c. Bronchiolitis
The correct answer ís c
955) 34y female with HlV pap smear negative, about cervical
cancer screening :
a. After 3m if negative repeat after 6m
b. After 6m ........... annually
c. After 1y..............annually
The correct answer ís b (I'm not sure ), may be c .
• !creening should begin no later than age "#.
• !creening should begin earlier than age "# if the patient is sexually active. In this
case, it should start $ years after initiation of vaginal intercourse.
• %nce initiated, screening should be performed annually if a traditional, glass&
slide&based technique is used. If liquid medium is used, 'ap smear screening may
be performed every other year.
• (fter age $), for women who have had $ consecutive, normal 'ap smears,
screening frequency may be reduced to every two to three years.
• *omen who are +I, positive, immunocompromised due to disease or
medication, or are -.! daughters, should continue annual screening.
• !creening may stop following a total hysterectomy (including the cervix, if the
the patient is at low risk, and has had three consecutive normal 'ap smears within
the last #) years.
• +igh risk patients, including those with a history of cervical cancer, -.!
exposure in&utero, +I, positive, immunocompromised from medication, and
those tested positive for +',, should continue to be screened indefinitely.
• !creening may stop after age /), if the patient is low risk, and has had three
normal 'ap smears over the last #) years.
• !creening may be omitted in the case of women with life&threatening or other
serious illness
.......................................
.....................
956) which drug increase incidence of reflux oesophagitis:
a. Theophylline
b. Amoxicilline
c. Metoclopramide
d. Rantidine
e. Lansoprazole
The correct answer ís a

957) most effective ttt of cluster headach:
a. Ergotamine nebulizer
b. S}C Sumatriptan
c. 100% O2
d. lV Verapamil
The correct answer ís c
.......................................
.....................
958) old pt. with HTN and migraine ttt:
a. B blockers
b. ACE l
c. Ca blockers
The correct answer ís a
.......................................
.....................
959) lactating women 10 days after delivery developed
fever ,malaise, chills tender Lt breast with hotness and
small nodule in upper outer quadrant with axillary LN
.Leukocyte count was 14 *10}L dx:
a. lnflammatory breast cancer
b. Breast abscess
c. Fibrocystic disease
d. 7777
7777777
.......................................
.....................
960) newborn with fracture mid clavicle what is true:
a. Most cases cause serious complication
b. Arm sling or figure 8 sling used
c. Most patient heal without complications
The correct answer ís c
-most cíavícíes fracture ín newborn no need to treatment
apart from carefuí handííng. If the fracture ís díspíaced and
baby ín paín, símpíe sííng ís requíre.
961) 70y male with osteoporosis the T score of bone
densometry would be :
a. 3.5
b. -2.5
c. -1
d. 2
e. 3.5
The correct answer ís b
- The T score ís the number of standard devíatíon (SD ) a
patíent's BMD devíated from the mean.
- T score > (- 1) : normaí BMD
- T score (-1 to -2.5) : ostopenía
- T score < ( -2.5 ) : osteoprosís
.......................................
.....................
962) what is the most complication after hesterectomy:
a. Ureteral injury
b. Pulmonary embolism
c. Haemorrhage
The correct answer ís c
.......................................
.....................
963) young female with BMl 18 , fine hair allover body ,
feeling of she is fat ,doesn't eat well with excessive
exercise........
a. Anorexia nervosa7
b. Body dysmorphic disorder
c. Bulimia nervosa
The correct answer ís a
.......................................
.....................
964) what's advantage of mature human milk over cow's milk:
a. More protein
b. More lron content
c. More calories
d. More fat
The correct answer ís b
.......................................
.....................
965) young male c}o of deformity of jaw .past h}o of
nasoplasty and blepharoplasty O}E nothing abnormal
.....dx:
a. Body dysmorphic syndrome
966) the most common cause of non-traumatic subarachnoid
haemorrhage:
a. Rupture aneurysm
b. Vessels abnormality
c. Hypertension
The correct answer ís a
-Most common causes of subarachnoíd hemorrhage are trauma
and berry aneurysm
.......................................
.....................
967) Pt. with chest pain and s.o.b decreased by leaning forword
. O}E friction rub and increased ]VP >>>> (a case of
pericardial effusion) ECG will show:
a. ST changes
b. Low voltage
c. lncrease PR interval
ECG changes duríng perícardítís : díffuse ST eíevatíon , PR
depressíon foííowed by t-wave ínterventíon , and íow voítage.
.......................................
.....................
968) The causative organism of psudomembranous colitis is:
a. Clostridium difficile
.......................................
.....................
969) scenario about arthritis (l couldn't remember the details )
but ]oint aspirate reveal Gram negative diplococci ...dx:
a. Nisseria gonorrhea
N. gonorrhoeae 0 gram negative diplococci and can also cause con1unctivitis,
pharyngitis, proctitis or urethritis, prostatitis and orchitis.
.......................................
....................
970) Vertigo & .... is caused by which of the following drug 7
a. Aphotercine B
b. Pnicilline reaction
c. lNH
.......................................
....................
971) Baby with red macule & dilated capillary on the rt side of
the face
"turge-Weber Syndrome or Nevus Flammeus 7one o!
them 'ill come.
Don8t choose milia or caverno%s haeman&ioma
972) A 25 year old secondary school teacher that every time
enters the class starts sweating and having palpitation, she
is a fired to give wrong information and be unparsed. What
is the diagnosis:
a. Specific Phobia
b. Social Phobia
The correct answer ís b
.......................................
....................
973) At which chromosome is the cystic fibrosis gene:
a. Long arm chromosome 7
b. Short arm chromosome 7
c. Long arm chromosome 8
d. Short arm chromosome 8
e. Long arm chromosome 17
The correct answer ís a
.......................................
....................
974) Regarding hepatocellular carcinoma (Hepatoma) Which is
true:
a. More common in females
b. ..
c. ..
d. The most common cancer in Africa and Asia
e. lncrease risk in chronic liver disease
The correct answer ís e , chroníc dísease especíaííy Hepatítís B
.......................................
....................
975) A patient is having a 2 year history of low interest in live,
he doesn't sleep well and can't find joy in life, What is the
most likely diagnosis:
a. Dysthymia
b. Major depressive disorder
c. Bipolar disorder
d. ..
e. ..
The correct answer ís a
976) What is the mechanism of OCD drugs:
a. lncrease availability of Serotonin
b. Decrease production of Serotonin
c. lncrease production of Serotonin
d. .. Serotonin
e. .. Serotonin
The correct anser ís a
.......................................
....................
977) What is the MOST accurate test to detect early
pregnancy:
a. ..Serum BHCG
b. ..
c. Urine pregnancy test
d. Ultrasound
e. ..
The correct answer ís a
.......................................
....................
978) A case of a patient with thin cervix and little amount of
cervical mucus, how would you treat her: 77777
a. Estrogen injections

...............................
............................
979) The most common cause on chronic interrupted rectal
bleeding is:
a. Diverticulosis
b. Hemorrhoids
The correct answer ís b
.......................................
....................
980) A child is having a croup early morning, the most
common cause is:
a. Post nasal drip
981) A burn patient is treated with Silver Sulfadiazine, the
toxicity of this drug can cause:
a. Lycosytosis
b. Neutropenia
c. Electrolyte disbalance
d. Hypokalemia
e. ..
The correct answer ís b , síde effect of suífadíazíne
.......................................
....................
982) A case scenario about a patient who had appendectomy,
after that he has abdominal pain and constipation and
absent bowel sound, the most likely cause is:
a. llus paraticus
O ís not compíete
.......................................
....................

983) A case scenario describing a patient who had a right
chest trauma than developed tension pneumothorax, the
immediate management is:
a. lnsert a needle in the second intercostal space
b. lnsert a needle in the fifth intercostal space
c. Give lV antibiotics
d. ..
e. lnsert a tube in the fifth intercostal space
The correct answer ís a
.......................................
....................
984) A patient that have a penile ulcer that healed after that
he developed a palm and sole rash, the most likely cause is:
a. Syphilis
O ís not compíete
985) A case scenario about a patient who has on and off
episodes of abdominal pain and was found to have multiple
gallstones, the largest is 1 cm and they are not blocking
the duct, What will you do:
a. Give pain killers medication
b. Remove gallbladder by surgery
O ís not compíete , but wíth these MCOs , the correct answer ís b

...............................
............................
986) Most common symptoms of soft tissue sarcoma :
a. Paralysis
b. On growing mass
c. Pain
d. ..
The correct answer ís b
.......................................
....................
987) Patient use illegal drug abuse and the blood show RNA
virus. Which hepatitis
a. A
b. B (DNA)
c. C
d. E
The correct answer ís c , RNA vírus transmítted by bíood íd HCV
.......................................
....................
988) A case scenario about bronchial carcinoma, which is true:
7777
a. The most common cancer in females
b. Squamous cell carcinoma spreads faster
c. Adenocarcinoma is usually in the upper part
d. Elevation of the diaphragm on the x-ray means that the
carcinoma has metastasize outside the chest
e. Bronchoscopy should be done
The correct answer ís c
989) old female with pubic itching with bloody discharge, then
she developed pea shaped swelling in her labia, most likely:
a. Bartholin cyst
b. Bartholin gland carcinoma
c. Bartholin abscess
d. ..
The correct answer ís c
.......................................
....................
990) Patient has decrease visual acuity bilateral , but more in
rt side , visual field is not affected , in fundus there is
irregular pigmentations and early cataract formation . what
you will do
a. Refer to ophthalmologist for laser therapy
b. Refer to ophthalmologist for cataract surgery
c. ..
The correct answer ís a
.......................................
....................
991) lnflammatory bowel disease is idiopathic but one of
following is possible underlying cause:
a. lmmunological

...............................
............................
992) pregant lady deliverd Anencephalytillbirth occurance of
neural tube defect in next pregnancy
a. 8%
b. 2%
c. 10%
d. 20%
The correct answer is b , ( 2 - 4 % )
.......................................
................
993) typist theaner atrophy ,+ve tephlen sign
a. Median nerve
b. Ulnar
c. Brachial
The correct answer is a
994) painful pile
a. Exison daringe
b. Sitz path and steriod supp
c. Ab
d. Fiber food and analgesics
The correct answer is a
.......................................
................
995) 39 years old HlV patient with TB recive 4 drugs of tt after
one month
a. Continue 4 drugs for 1 years
b. Cintinue isoniazide for 9months
c. Contiue isonizide for 1 year
The correct answer is a
.......................................
................
996) femaIe not married with normaI investigation except FBS=142.
RBS196. so ttt
a. give ins•Iin s•€c•taneo•s
€. advice not €ecome married
c. €arrier contraceptive is good
d. B•‚ controI
The correct answer is d

.......................................
................
997) Entamoeba histolytica cysts are destroyed best by:
a. Boiling
b. lodine added to water
c. Chlorine added to water
d. Freezing
The correct answer ís a
998)A scenario about an old male with symptoms suggesting
parkinsonism such as difficulty walking, resting tremors and
rigidity in addition to hypotension. Then he asks about what is
the most common presenting symptom of this disease
a. Rigidity
b. Tremors
c. Unsteady Gait
d. Hypotension
E. 777
The correct answer ís b
.......................................
...................
998) Regarding postpartum Psychosis:
a. Recurrences are common in subsequent pregnancies
b. lt often progresses to frank schizophrenia
c. lt has good prognosis
d. lt has insidious onset
e. lt usually develops around the 3
rd
week postpartum
The correct answer ís a
.......................................
...................
999) Gastrictomy post-op 1 day. He have temperature 38.8 &
pulse 112. What is the most common cause 7
a. wound infection.
b. inflammatory mediator in the circulation.
c. UTl
d. normal
the correct answer ís a or b
most common causes of post-operatíon fever : ( 6 w )
1- W ound
2- Wíne = pneumonía or atíectasía
3- Water = UTI
4- What happen = transfusíon
5- Waík = DVT
6- Wonder drug = asprín,erythromycín , ísonízíde
Immedíateíy ( 24 h ) : post-op ínfíammatíon , wound ínfectíon ,
transfusíon , streptococcus
Acute ( 3 - 7 days ) : pneumonía

1000) Malaria 7
- the most common cases is caused by Plasmodium
falciparum.
......................................
....................
1001 ) Polyartheralgia rhumatica. What is the thing that
suggest it rather than ↑ ESR & C-reactive protein:
a. proximal muscle weakness
b. proximal muscle tenderness
the correct answer ís a
.......................................
...................
1002) The cause of insulin resistance in obese is:
a. ↑ insulin receptors kinase activity
b. ↑ number of insulin receptor
c. ↑ circulation of anti-insulin
d. ↓ insulin production from the pancreas
e. ↓ post-receptor action
the correct answer ís e (I'm not sure )

1003) Pt came with total bilirubin: 5.8 & direct bilirubin: 0.4
a. Guillain-Barre syndrome
b. Dubin-junson syndrome
c. Biliary sclerosis
d. Crigler-Najjar syndrome
e. Gilbert Syndrome
the correct answer ís e
.......................................
.................
1004) Pt complaining of hypotension & bradycardia.
Electrolytes show: ↓Na, ↑K, ↑Cl, ↑Urea. So the cause of this
is:
a. hyponatremia
b. hyperkalemia
c. hyperchloremia
d. uremia
the correct answer ís a ( not sure )
يتاينمت عيمجلل قيفوتلاب
: دمحم مكوخأ يبرحلا
Orthopaedic – Qassim University