Residency Exam – 2018

1) the most common cause of stridor in infant:

- croup
- foreign body
- laryngomalacia

Answer: Laryngomalacia

2) Most common cyanotic heart disease:

- tetralogy of fallot
-tricuspid atresia
-transposition of great vessels

Answer: tetralogy of fallot

3) Abnormal to see in a 1 month baby

- Moro reflex
- Head lag
- Fisting
- C-shaped ventral suspension

Answer: C-shaped ventral suspension

4) Most common serious complication of DDH:

- Avascular necrosis of head of femur
- Severe Back pain

Answer: avascular necrosis of head of femur

5) In spinal muscular atrophy, all present except:

- Clonus
- Fasciculation
- Hyporeflexia
- Weakness
Answer: clonus

6) 5 yrs old female has vulvar itching , didn't change her underwear clothes nor
using new substances (and other complement info to inform that she is medically
free) , the most likely dx:
- Pinworm
- Vaginitis
-scabies
- eczema
Answer: Pinworm

7) Most common cause of Encopresis in 4.5 years old child:

- Long standing constipation
- Sexual abuse
- Celiac
Answer: Long standing constipation

8) The difference between absence seizure and complex partial seizure:

- absence seizure happens for many times a day
-absence seizure is characterized by hypsarrhthmia
- absence seizure has an aura

Answer: absence seizure happens for many times a day

9) Wrong about anorexia nervosa:

- Menorrhagia
- body image disorder
- hirsutism in face and hands

Answer: Menorrhagia
 10) Case of bacterial tracheitis, which of the following doesn't support the
diagnosis :
- High grade fever
- Toxic appearance
- Responding to steroid
- The cause is staph. Aureus
- Clindamycin and ceftriaxone is a good combination

Answer: Responding to steroid

11) All of the following are considered in management of a patient with
epiglottitis except:
- Intubation
- Antibiotics
- Steroids
- IV fluid
- ICU admission
Answer: Steroids
12) ADH is released from posterior pituitary gland in response to:
- Hypernatremia
- Hyperosmolarity and hypovolemia
- Loss of fluid
- Hyperosmolarity

13) Which one of these patients will become more symptomatic (shortness of
breath) if atrial fibrillation occurred?
- Hypothermia
- Hyperthyroidism
- HOCM
-Patient post thoracotomy

Answer: HOCM?????

14) A 12 year old male presented with symptoms of severe acne vulgaris, what's
true about this common disease:
- Topical antibiotics are of no value in the management
- Topical Benzoyl paroxide and retinoids are the first line in the management
- This disease solely affect adolescents

Answer: Topical Benzoyl paroxide and retinoids are the first line in the
management

15) All of the following are true about GDM except :

- Diagnosed after 20 GA
- Increases the risk of congenital anomalies
- Increases the risk of fetal macrosomia
- OGTT should be done 8 weeks postpartum

Answer: Increases the risk of congenital anomalies

16) Which of the following is not true about RF :

- SC nodules are very rare
- Polyarithritis is common in RF
- Arthritis affects mainly the small joints.
Answer: Arthritis affects mainly the small joints

17) All are found in patient with nutritional rickets except:

- Low PTH
- Low Calcium
- Low Vit D
- High ALP

Answer: Low PTH

18) Osteoporosis definition by WHO:

- Bone density < 1 SD compared to same race, gender, and age
- Bone density < 2.5 SD compared to same race and gender
- Bone density < 2.5 SD compared to same race, gender, and age
Answer: Bone density < 2.5 SD compared to same race, gender, and age
19) All of the following are involved in proinflammatory response except:
- IL-1
- IL-6
- IL-8
- IL-10
- TNF
Answer: IL-10

20) Which of the following is a sex-cord tumor:

- Granulosa-theca cell tumor
- Brenner
- Dysgerminoma
- Endodermal sinus tumor
Answer: Granulosa theca cell tumor

21) All are complications of multiple pregnancy except:

- Polyhydramnios
- Placenta Previa
- Abruptio Placenta
- Malpresentation
- Maternal thrombocytopenia
Answer: Maternal thrombocytopenia

22) All are features of life-threatening asthma except:

- Silent chest
- O2 sat < 75%
- HR > 120
- Hypotension
Answer: HR > 120

23) Which of the following increases the residual volume (RV)?

- Obesity
- Emphysema
- Idiopathic pulmonary fibrosis
Answer: Empyhsema

24) All of the following may cause chronic cough for 3 months in a non-smoker
except:
- GERD
- Asthma
- ACEI
- Post-nasal drip
- M. Pneumonia
Answer: M. Pneumonia

25) A case of urinary incontinence. All are initial investigations for the patient
except:
- Urinalysis
- Post-void residual volume U/S
- Voiding diary
- Urodynamic studies
Answer: Urodynamic studies

26) Most common encountered side effect of furosemide in clinics:

- Hypokalemia
- Ototoxicity
- Hypernatremia
-Hyperuricemia
Answer: Hypokalemia

27) Patient with hypertension. Prescribed with an anti-hypertensive. After 2

weeks his Na was 132. His previous blood chemistry was normal. What is the drug
prescribed?
- ACEI
- ARB
- Hydrochlorothiazide
- Furosemide
Answer: Hydrochlorothiazide

28) A woman who is a known case of scleroderma, presented with oliguria,

hypertensive crisis (BP= 200/120). What’s the tt of choice?
- Furosemide
- Captopril
- Hydrochlorothiazide
- Hydralazine
Answer: Captopril
29) A patient with Mid-systolic murmur (Crescendo-decresendo murmur). The
murmur decreases with squatting and, and increases with standing and valsalva.
What’s the diagnosis?
- Aortic Stenosis
- Aortic regurgiation
- HOCM
Answer: HOCM

30) All are features of cyanotic spells in TOF except:

- Decreased level of conciuosness
- Increase in intensity of murmur
- Starts at 4-6 months
Answer: Increase in intensity of murmur

31) The most common cause of uterine rupture in labor is:

- Previous CS
- Congenital uterine abnormalities
- Obstructed labor
- Induced labor
Answer: previous CS

32) One of following statements is NOT correct about fetal distress in labor:
- CS immediately performed
- Detected by CTG
- Confirmed by fetal scalp blood sampling
- Stop oxytocin
Answer: CS immediately performed
33) 60 years old patient postmenopausal, presented with mild vaginal bleeding
with normal pelvic examination. The next step is:
-Hysteroscopy & Biopsy
- TVUS
- Hysteroscopy

Answer: TVUS

34) Endometriosis can present with all the following except:

- Chronic pelvic pain
- Dyspareunia
- Post-coital bleeding
- Infertility

Answer: Post-coital bleeding

35) Which of the following is an antifibrinolytic commonly used in practice?

- tPa
- Tranexamic acid
- Heparin
- Protamine

Answer: Tranexamic acid

36) Which of the following is a mismatch?

Mefenamic acid – anti-estrogen
Danazol – Androgen effect

Answer: Mefenamic acid – anti-estrogen

37) All the following are routine tests in an antenatal care visit except:
- Blood sugar
- HBV
- Rubella IgG
- OGTT

Answer: OGTT
38) Diameter of flexed vertex presentation:
- Submentobregmatic
- Mentovertical
- Suboccipitobregmatic

Answer: Suboccipitobregmatic

39) Which of the following increases with IBD flare:

- Ankylosing spondilitis
- Arthritis
- Uveitis
- Renal stone

Answer: Arthritis?????

40) Which of the following causes pigmented gallbladder stones:

- A 27 year old female who did an ileal resection
- A 40 year old obese female
- A 50 year old female who lost weight after sleeve gastrectomy

Answer: A 27 year old female who did an ileal resection

41) All of the following are in the pathogenesis of GB stones except:

- Crystal formation
- Deconjugated bilirubin
- Supersaturation
- Cholseterol formation

Answer: Deconjugated bilirubin

42) All of the following are associated with increased AFP except:
- NTDs
- Gastroschisis
- Trisomy 13
- Trisomy 21

Answer: Trisomy 21

43) PDA: Which is wrong?

+ R to L shunt
44) Patient’s cervical smear showed HGSIL. What’s the next step?
- Cone biopsy
- Colposcopy & Biopsy
- Hysterectomy
- Observation

Answer: Colposcopy & Biopsy

45) Which of the following causes normal anion gap?

- Salicylate ingestion
- DKA
- Diarrhea
- Starvation

Answer: Diarrhea

46) Regarding bacterial vaginosis, which is wrong:

- Thin grayish discharge
- Penicillin is the drug of choice
- Wet mount is diagnostic

Answer: Penicillin is the drug of choice

47) Regarding direct hernia, which is true:

- Never comes with indirect hernia
- May come with indirect hernia
- The most common hernia to be strangulated

Answer: May come with indirect hernia

48) A patient complaining of headache and blurred vision since 2 weeks,

headache is on the left with tenderness. What is the best next step:
- CT scan
- LP
- Give Steroids

Answer: Give Steroids

49) Heart failure patient, feels comfortable at rest, but complains of palpitations
and SOB when he walks to his car. His New York Heart Association (NYHA)
classification is:
-I
- II
- III
- IV
-V

Answer: III

50) A patient complaining of mild abdominal pain, and edema in his lips, larynx,
and tongue, what’s the deficiency?
- C5 (complementary cascade)
- C1 esterase inhibitor
- IgE

Answer: C1 esterase inhibitor

51) All are side effects of infliximab except:

- Pulmonary fibrosis
- TB
- HF
- Demyelination

Answer: Pulmonary fibrosis

52) Regarding genital prolapse, which is true?

- Obesity is the main risk factor
- Constipation is a known risk factor

Answer: - Constipation is a known risk factor

53) Differentiation between distributive & hemorrhagic shock?

- CVP is used to differentiate
-Blood products are used in hemorrhagic shock and not usually needed in
distributive?
54) All take part in assessing ovulation except:
- LH surge
- Basal body temperature
- Day 2 LH: FSH
- Day 21 Progesterone

Answer: Day 2 LH: FSH

55) One of the following is a mismatch:

- Mefenamic acid – anti estrogen
- Danazol – Androgen
- Progesterone – Weight gain

Answer: Mefenamic acid – anti estrogen

56) Which of the following is the most common histological subtype of

malignant melanoma?
- Lentigo maligna
- Acral lentiginous melanoma
- Superficial spreading
- Nodular melanoma

Answer: Superficial spreading

57) A 40 year old man presented to the clinic with bilateral knee pain that is
increased with exercise and relieved by rest. He walks several times a week. He is
hypertensive and obese. Which of the following is most appropriate :
- Give low dose steroids
- Weight loss
- Reduce days of exercise

Answer: Weight loss

58) A case of esophageal rupture. What’s true?

Answer: high risk patients……..(memorize it)

59) Which of the following carries the worst prognosis in a patient suffering of
left subdural hematoma after a motor vehicle accident?
- right epidural hematoma
- Hip fracture
- Depressed skull fracture
- Blood pressure reading of 90/60 for 10 minutes until arriving to ER

Answer: Blood pressure reading of 90/60 for 10 minutes until arriving to ER

60) Which of the following doesn’t require admission in UTI patient?

- A boy with persistent vomiting
- Infant < 3 months of age
- Inability of patient to come for follow up
- ESBL- E.Coli
- 5 year old female with upper urinary tract infection

Answer: 5 year old female with upper urinary tract infection (mostly)

61) Regarding involution of uterus, all are true except:

- Subinvolution may be caused by infection
- Accelerated by lactation
- Fundus is palpable at umbilicus level after 2 weeks
- Subinvolution may be caused by hematoma in round ligament

Answer:

62) Which of the following causes cyanosis with poor pulmonary blood flow:
- TGA
- TOF
- TAVPR
- Tricuspid Atresia

Answer: Tricuspid Atresia

63) One of the following favors a benign feature in a thyroid nodule:

- Hard, fixed nodule
- Hot nodule
- Age < 45
- Weight loss

Answer: Hot nodule

64) What are the boundaries of Hasselbach’s triangle?

- External oblique, inferior epigastric vessels, inguinal ligament
- Rectus abdominis, inferior epigastric vessels, inguinal ligament
- Femoral canal, inferior epigastric vessels, inguinal ligament
Answer: Rectus abdominis, inferior epigastric vessels, inguinal ligament

65) A mobile mass is noted in the anterior triangle of the neck of a patient.
Aspiration it contains cholesterol crystals. What’s the Dx?
- Cystic Hygroma
- Dermoid cyst
- Branchial cyst

Answer: Branchial cyst

66) Which is true regarding infertility management:

- Clomiphene citrate increase risk of multiple pregnancy
- Oligospermia is best assessed by post coital count
- Oligospermia is treated by androgens

Answer: Clomiphene citrate increase risk of multiple pregnancy

67) In ileostomy patient, all are true except:

- Decreased urine output
- Increased bacterial overgrowth
- Increased renal stones risk
- Increased gallstone risk

Answer: Decreased urine output (mostly)

68) Acute hyperkalemia causes which of the following ECG changes:

- U wave
- Flat T wave
- Widened QRS

Answer: Widened QRS

69) Which of the following is seen on chest X-ray in a case of aortic rupture?
- Cardiac silhouette
- Widened mediastinum with apical cap
-Pneumomediastinum
Answer: Widened mediastinum with apical cap

70) What is the most common cause of hypercalcemia in a patient with a known
tumor?
- PTH- related substance
- Bone resorption
- Increased 1,25 dihydroxyvitamin D3

Answer: PTH- related substance

71) All of the following can cause diarrhea except:

- Metoclopromide
- Hypercalcemia
-

Answer: Hypercalcemia

72) The most sensitive indicator for DM nephropathy is:

- Creatinine clearance
- BUN
- Creatinine
- Albumin

Answer: Albumin

73) All are true regarding thrombophilia in pregnancy except:

- Protein C deficiency is congenital
- It may lead to IUFD
- Recognized cause of 1st trimester miscarriage
- Treated with steroids

Answer: Treated with steroids

74) A 24 year old female presented with cough and low grade fever for 7 days. On
exam she has mild inspiratory crackles. CXR shows patchy interstitial infiltrates.
What is the most appropriated treatment?
- Levofloxacin
- Azithromycin
- Ceftriaxone
- Acyclovir

Answer: Azithromycin

75) HBeAg +ve indicates:

- Immunization
- Resolved infection
- Active replication
- Chronic carrier

Answer: Active replication

76) A patient with elevated cortisol and ACTH. ACTH is not inhibited after low
dose nor high dose dexamethasone suppression test. What’s the diagnosis?
- Cushing syndrome
- Cushing disease
- Ectopic ACTH secretion
- Adrenal insufficiency

Answer: Ectopic ACTH secretion

77) A new case of AML (WBC= 170,000) is treated with danorubicin, cytorabin.
After treatment, the patient presents with renal failure and edema. Which of the
following could have been given to prevent this presentation?
- Steroids
- Allopurinol
- Colchicine
- NSAIDs

Answer: Allopurinol

78) IVIG mechanism in ITP :

- Prevents phagocytosis of platelets
- Prevents antibody adsorption of platelets
- Binds to Fc portion of antibodies

Answer: Prevents phagocytosis of platelets (mostly)

79) Regarding fever postoperatively:
- It is a normal finding
- Extensive workup should be done to define the cause, and it may also indicate
immuncompromised state
- It should be managed in operating room

Answer: Extensive workup should be done to define the cause, and it may also
indicate immuncompromised state

80) All are true regarding congenital malformations except:

- Incidence of major malformations is 30/1000
- Aneuploidy is the most common cause
- Not all are detected at birth
- May present as 1st trimester miscarriage

Answer: Aneuploidy is the most common cause

81) One of the following favors malignancy in the breast:

- Freely mobile mass
- Tenderness
- Tethering to underlying muscle

Answer: Tethering to underlying muscle

82) Stab wound patient, diaphoretic, his BP 90/60, his wound is not bleeding,
what is the best next step?
- Exploratory laparotomy
- CT scan for abdomen
- DPL
- Observation :P

Answer: Exploratory laparotomy

83) All of the following should be referred to burn unit except:

- A woman with 1% TBSA superficial partial thickness burn on her hand while
cooking
-25 year old man with 7% TBSA superficial partial thickness burn on chest
-a man with signs of inhalational injury (memorize them)

Answer: 25 year old man with 7% TBSA superficial partial thickness burn on chest

84) Pancreatitis patient with respiratory failure. What differentiates ARDS from
cardiogenic pulmonary edema:
-kidney function and excretion of sodium
-pulmonary artery catheter

Answer: pulmonary artery catheter (mostly)

85) Most common cause of mechanical intestinal obstruction:

- Hernia
- Intussussception
- Adhesions
- CA

Answer: Adhesions

86) A 5 year old boy presented to the ER with shock and circulatory collapse.
Venous access couldn’t be established. What’s the best management?
- Central intrajugular line
- Venous cut
- Give fluid intraosseous

Answer: Give fluid intraosseous