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Promotion MCQ

1- 24y old man has noted for the last 2 m that his face is swollen in the
morning. He has lost 10kg in weight over 6 m. O/E his external jugular veins
are dilated. CXR shows mediastinal mass. Which one of the following is the
most likely diagnosis of superior vena caval obstruction :
a- Aden carcinoma of the lung.
b- Hodgkin's dis
c- sarcoidosis
d- seminomas
e- TB

2- which one of the following is the most typical feature of adult SCA
a- aplastic anemia
b- neonatal spherocytic haemolytic anemia
c- pulmonary emphysemia
d- splenomegaly with hypersplenism
e- polyarthritis

3- which of the following coz increase in the gastric motility

a- anorexia nervosa
b- gastrinoma
c- vestibular neuronitis
d- acute intermittent porphyria
e- partial gastrectomy

4- which of the following m innervated by my 4th cranial n

a- MR
b- LR
c- SO
d- IO
e- SR

5- which of the following m supply by median n

a- external pollicis longus
b- flexor carpi ulnaris
c- abductor pollicis
d- the medial 2 lumbricalis
e- external pollicis brevis

6- 55y woman presented to emergency with C/o pain & tinnitus in the RT
Ear facial numbness, one day history of facial asymmetry and abnormal
Vesicles the most likely diagnosis is
a- pemphogus vulgaris
b- ramsay hunt syndrome
c- lyme disease
d- malignant OM
e- bells palsy
7-the following vial haemorrhagic fever has been reported in SA except:
a- rift valley fever
b- alkhomra fever
c- dengue fever
d- yellow fever
e- crernian congo hemorrhagic fever

8- 15y girl is admitted with palpitation & easy bruises. Her Menarche
was 2y ago since then she is having heavy blood loss during her period O/E
she was pale, few ecchymotic patches on lower limbs. Investigation shows
microcytic anemia normal WBC & PLT renal, PT. PTT prolonged, serum
feritin is markedly decreased.
The following test are likely to reveal the etiology:
a- serum iron, TIBC, U/S examination
b- bone marrow aspirate & biopsy
c- mixing study, anticardiolopin
d- PLT function test, VWF
e- Factor 8 & 9

9- in pre marital clinic the ELISA test for HIV is positive & there is no
risk factor
for HIV infection
before reporting the test result we should do Weston blot because the ELISA
test for HIV in this settings has :
a- low positive predictability
b- low negative predictability
c- low sensitivity
d- low specifity
e- low reproducibility

10- autoimmune hemolytic anemia is a feature of the following diseases

except :
a- mycoplasma pneumonia
b- Evans syndrome
c- hemolytic uremic syndrome
d- lymphoma
e- SLE

11- 55y old Saudi female returned from Philippines after non related kidney
Transplant with no post op complication 3m ago. She presented to ER C/O dry
Cough, fever, SOB for 15 days. She is on prednisone, cellcept, trim-sulfa. CXR
revealed bilat Interstitial markings with effusion. Creatinine was normal.O2 sat
90% RR22 which of the following will most likely establish the diagnosis:
a- blood culture
b- VAL for M.tuberculosis complex
c- CMV antigenemia & culture
d- sputum induction for pneumocystis carinii stain
e- urinary antigen for legionella
12- 57y old female is admitted with G- septicemia IV antibiotics & NS was
started. 2 days later she get worse CXR bilateral infertilities. PMH
HTN on regular antihypertensive she has never had any evidence of CHF
She was diagnosed as ARDS. which of the following can be done to
Distinguish btw cardiogenic & noncardiogenic pul edema :
a- measurement of the central venous pressure
b- calculation of AA gradient
c- measurement of pulmonary arterial wedge pressure
d- measurement of lung compliance
e- measurement of EF

13- in the evaluation of venous thromboembolism D Dimer testing is :

a- it has high sensitivity
b- it is usually negative in sub segmental PE
c- it is positive only in VTE
d- it has high negative predictive value.

14- 60 y old man underwent a coronary angiogram for unstable angina

Recovering in hospital he C/O severe pain in his RT foot. and loss of sight in
the LF eye O/E there is Gangrene of the lateral two toes. Fundoscopy reveals
cholesterol emboli . the lower limb peripheral pulses are normal
which of the following is The most possible Dx :
a- atheroembolic disease.
b- Polyarteritis nodosa
c- Buergers disease
d- Arterial thromboembolism
e- DIC

15- 72y old woman in the cardiology clinic Dx CHF with EF 35% which
of the
Following treatment would be expected to achieve the greatest reduction in
cardiovascular mortality:
a- atenolol
b- digoxin
c- furosemide
d- spironolactone
e- valsartan

16- 45y old man attends the ER C/O fatigue, SOB, fever joints pain, for 4
O/E LL edema, raised JVP giant V waves, bil pulm creps,
what is the Dx
a- alcohol-related cardiomyopathy
b- bacterial endocarditis
c- pul HTN
d- pulm stenosis
e- sarcoidosis with cardiac involvement

17- middle aged man with a varied occupation history O/E there is fine
inspiratory crepitations & central cyanosis CXR predominantly lower zone
reticular nodular infiltrates which of the following disorders is the most
likely explanation :
a- silicosis
b- sarcoidosis
c- asbestosis
d- ankylosing spondylitis
e- TB

18- 58y old woman with known aortic stenosis C/O chest tightness & SOB
Which of the following investigation would be most helpful
a- cardiac cath
b- CXR
c- Exercising ECG
d- Pulmonary function tests
e- Repeat echo

19- 30y old male has one year H/O palpitation, dizziness but no syncope.
positive H/O Alcohol. He is no regular medication Dx WPW
The most appropriate treatment
a- amiodarone
b- flecainide
c- radiofrequency ablation of the accessory pathway
d- radiofrequency modification of the
e- sotalol

20- 70 y old lady presents with severe chest pain & nausea. Pulse rate
BP120/60 ECG shows significant inf MI & complete HB. she has received
300mg ASA which of the following is the next step:
a- external pacing
b- isoprenaline infusion
c- thromblysis with streptokinase
d- thrombolysis with tissue plasminogen activator
e- temporary pacing wire insertion

21- 66y old smoker presents with H/O wt loss, cough, O/E finger clubbing.
Showed a cavitating mass in the RT mid zone which of the following
disoreders is the most likely Dx
a- squamouse cell carcinoma
b- small cell carcinoma
c- adenocarcinoma
d- large cell carcinoma
e- carcinoid tumour

22- 45y old woman is admitted to hospital confused, O/E respiratory

distress RR
35. centeral cyanosis PH 7.4 PO2 6.5 PCO2 5.5 which of the following
most likely the Dx
a- DKA
b- heroin overdose
c- motor neron disease
d- asthma
e- anemia

23- 43y old man consults you as he is C/O productive purulent foul
smelling sputum. O/E there is digital clubbing
What is the most likely Dx
a- bronchectesis
b- acute lung abscess
c- bronchoalveolar cell carcinoma
d- sarcoidosis
e- fibrosing alveolitis

24- 35y old man with fever, cough, night sweating Dx pul TB which of the
following statement is true :
a- all pt should be managed in a negative pressure room
b- corticosteroids are contraindicated
c- ethambutol should not be used in
d- multi drugs resistant TB requires addition of 2 or more antiTB
e- rifampcin & INH must not be used in HIV pt

25- Which of the following statement is not true

a- in diaphragmatic paralysis it occurs immediately after lying flat
b- when it improves during exercise psychogenic
c- in asthma shortly after cessation of exercise
d- in pul venous congestion it occurs during sleep
e- in hypersensitivity pneumonitis its worse after noon and
improves in weekend

26- which one of the following pathological abnormality occur in

Parkinson's dis
a- Mallory bodies
b- Lewy bodies
c- Neurofibrilary tangles
d- Pick bodies
e- Negri bodies
27- 62y old man presents with TIA LF side he had carotid Doppler U/S
Which of the following is true
a- bilateral endarterectomy is indicated if there are bilat stenosis
b- carotid bruit indicates severe underlying stenosis
c- carotid stenosis more then 80% inicates an annual stroke
d- endarterectomy is ass with .5-1% risk
e- endarterectomy is indicated if RT CR stenosis more then 80%

28- 42y old female C/O unilateral proptosis, O/E BP 148/76 pulse 98
Which of the following most likely the Dx
a-cavernous sinus thrombosis
b- Graves dis
c- lipoma
d- myasthenia gravis
e- retro orbital lymphoma

29- 34y old woman C/O expressive aphasia which area of the brain is
a- Lf parietal lobe
b- Lf temporal lobe
c- Occipital lobe
d- Rt parietal lobe
e- RT temporal lobe

30- 58y old man presents to the ER C/O SOB, haemoptysis, anorexia and
Generalized fatigability, arthralgias. he is found to have a purpuric rash,
peripheral edema . CXR reveals diffuse opacification
investigation Na 135 k 5 WBC 14.2 PLT 448 creat 200 normal liver
function test which of the following is the most likely Dx
b- Hepatitis c
c- Mixed cryoglobulinemia
d- Sepsis
e- Toxic shock syndrome

31- 42y old man with long standing SCA presented with H/O morbilliform
overlying his trunk, face and neck, Polyarteritis. His Hb dropped from 9 to 5
which of the following is the most likely the Dx
a- anemia of chronic renal failure
b- blast cell crisis
c- blood loss due to multiple hemarthroses
d- parvovirus B19 infection
e- tuberculosis bone marrow infiltration
32- 24y old pt Dx with pulmonary sarcoidosis all of the following is not
true except
a- corticosteroids are of benefit in virtually in all types of
b- lupus pernio is a recognized skin lesion
c- neuro ophthalmic involvement require steroid treatment
d- pulm sarcoidosis is commonly complicated by heart
involvement mainly conduction defects
e- the kveim test is gold standard

33- which of the following is complication of streptococcal skin infection

a- amyloidosis
b- GN
c- Liver failure
d- Rheumatic fever
e- Toxic shock syndrome

34- metformin therapy all true except

a- reduces absorption of carbohydo from the gut
b- stimulate the pancreatic to release the insulin
c- reduce hepatic glucogenesis
d- clinical hypoglycemia rare
e- increase the utilization of glu in the peripheral

35- which of the following

a- food drop
b- HB
c- Lymphadenopathy
d- Parotid swelling
e- Polycythaemia

36- which of the following drug coz neutropenia

a- acute gout
b- bacterial skin infection
c- oral prednisolone
d- respiratory viral infection
e- Vit B12

37- 79y old man lives alone he came to ER C/O fatigability his Hb 10 MCV 92
What is the most likely explanation :
a- BM infiltrate
b- Folate deficiency
c- Iron deficiency
d- Mixed iron & B12 deficiency
e- Sub clinical IBD
37- 25y old presents with an acute swelling of the RT knee, fever, night
sweats of several days duration. Which of the following statement consistent
with the diagnosis of gonococcemia
a- clinical features are more likely to occur in male than female
b- tenosynovitis is likely to occur
c- joint involvement is flitting rather than additive
d- culture of the synovial fluid is likely to grow gonococci
e- the development of erythema nodosum is likely

38-which one of the following features is most typical of the fibromyalgia

a- elevation of the ESR
b- coexistent symptoms of nocturnal diarrhea
c- symptoms of insomnia & tiredness
d- rapid spontaneous resolution
e- musculoskeletal pain without local tenderness

39- 45 y old female attends her GP C/O tiredness, wt loss, rash over her face in
malar distribution. Which of the following support ur diagnosis
a- high neutrophil count is a common finding
b- high complement common feature
c- ANA are specific for this diagnosis
d- GN is a common renal complication
e- it is a recognized complication of rifampicin treatment

40- 59y old woman presents to the ER with an acute swelling and tender
RT knee
Microscopy of aspiration of the joint shows a neutrophil count of 3280
Rhomboid crystals that are weakly positive birefringent. What is the Dx
a- acute gout
b- chrondrocalcinosis
c- pseudo gout
d- RA
e- Septic arthritis

41- 18y old man presents with a three month H/O generalized joint pain
dominantly affecting the lower back & sacroiliac joints & urethritis
Which of the following is a recognized feature of non specific urethritis
a- benzyl penicillin is the treatment of choice
b- Chlamydia trachomatis is the most commonly identified cause
c- Lower than 25% of pt are HLA-B27
d- Iritis is a common recognized feature
e- Septic arthritis is a commonly recognized ass
42- which of the following statement is true about graves disease &
a- neonatal hyperthyroidism is unlikely if the maternal TFT well
controlled during pregnancy
b- carbimazole is absolutely contraindicated.
c- Surgery can be safely conducted in the second trimester
d- The presence of persistent exophthalmoses indicates poor
control of the disease
e- Anti thyroid drugs do not enter breast milk

43- 53y old woman C/O galactorrhea. No other symptoms

Which of the following drug is most likely the cause
a- bromocriptine
b- co careldopa
c- cyclizine
d- metoclopramide
e- tamoxifen

44- which of the following diseases dose not cause bilateral parotid gland
a- lymphoma
b- alcoholic liver disease
c- primary hypothyroidism
d- sarcoidosis
e- sjogren's syndrome

45- which of the following is a side effect of cyclophosphamide

a- absorbed poorly through the gut
b- dermal photosensitivity
c- hemorrhagic cystitis
d- hirsuitism
e- inhibition of folic acid synthesis

46- which of the following drugs cause infertility

a- prednisolone
b- penicillamine
c- sulfasalazine
d- gold
e- hydroxycobalamin

47- which of the following is the most likely feature of beta thalassemia
a- macrocytic anemia
b- absence of Hepatomegaly
c- absence of pigment gallstones
d- neonatal hemolytic anemia
e- chronic leg ulceration

48- 47y old man presents to ER 10 h after taking 28x 500mg paracetamol
C/O nausea, vomiting. What is the next step
a- acute alcohol intake increase the side effect of paracetamol
b- cimetidine increase the risk of toxicity
c- measure paracetamol level immediately & accordingly start N-
d- measure paracetamol level in 4 hours
e- start N-acetylcysteine immediately

49- 30 y old woman with essential HTN came to the antenatal clinic 6
weeks after conception. She is concern about her BP what anti hypertensive
treatment you should start to lower here BP
a- atenolol
b- bendroflunethiazide
c- lisinopril
d- methyldopa
e- valsartan

50- which one of the following feature is most commonly ass with carpal
a- remission during pregnancy
b- wasting of the dorsal interossei & lumbricalis
c- pain in the hand which is worse by day & improve at night
d- association with hyperthyroidism
e- complication of both rheumatoid arthritis & amyloidosis

51- which one of the following statements about generalized seizure is true
a- all pts should be admitted to hospital following the first attack
b- pts may safely return to care driving after 1 year of free seizure
c- a heavy goods vehicle driving license will be allowed after
3years of free seizure
d- anticonvulsant therapy should be started after the first attack
e- the use of two or more anticonvulsant during the attack is the
best way to control the seizure.

52- 72y old woman C/O dizziness & she remembers feeling faint then
losing consciousness, she now feels completely well. There is laceration on
Forehead & examination otherwise normal which of the following
explanation for here collapse
a- middle cerebral artery occlusion
b- subarachnoid hemorrhage
c- subdural hematoma
d- total anterior circulation stroke
e- TIA
53- Which of the following drugs you should be careful when u prescribe
it to an elderly
a- amoxicillin
b- beclmetasone
c- bumetanide
d- nifedapine
e- omeprazole

54- you see a 32y old woman with RA C/O pain in her wrist which of the
following is true about NSAIDs
a- SE occur in around
b- NSAIDs reduce the relapse in RA
c- Therapeutic & SE are dose related
d- They enhance the antihypertensive effects
e- They are implicated in around

55- 34y old male farmer presents to ER as over dose which of the
Is true regarding organophosphorous poisoning
a- dilated pupils
b- bradycardia
c- hyper salivation
d- pulmonary edema
e- muscle fasciculation

56- 42y old man with a 20y H/O poorly controlled IBD involving the
whole colon
Attends the clinic for a follow up on azathioprine for three m ,he reports
intermittent rectal bleeding, bilirubin 35, alb 35 , ALK 200 , transamnase 50 ,
ANCA + , antimitrochondrial - , the most likely explanation is
a- alcoholic hepatitis
b- drug induce azathioprine
c- metastasis from CA colon
d- primary biliary cirrhosis
e- primary sclerosing cholangitis

57- 55y old man with zolinger elison syndrome which of the following
statement is true
a- it is ass with MEN 2
b- it is ass with necrolytic migratory erythema
c- it is most commonly benign disease
d- pts commonly present with diarrhea & flushing
e- secretin infusion has no effect on serum gastrin level

58- you are asked to check over a 36y old man who has been admitted for
biopsy later in the day . Which of the following would be most strongly ass
with increase risk of complication
a- Creatinine > 300
b- INR 2.5
c- Persistent hematouria
d- Proteinuria +++ on dipstick urinalysis
e- Systolic BP 146

59- 42 y old woman has aware of passing dark urine dipstick shows Bl ++
Protein +, urine microscopy shows dysmorphic red blood cells & red cells casts
Which of the following most likely explanation
a- ATN
b- Amyloidosis
c- Cystitis
d- GN
e- Pyelonephritis

60- You have been evaluating a 54 y old man for unexplained bleeding &
easy bruising . investigation shows abnormally prolonged bleeding time.
which of the following is most likely the diagnosis
a- autoimmune thrombocytopenic purpura
b- henoch-schonlein purpura
c- herediatary hemorrhagic telangiectasia
d- MM
e- scurvy

61- 40y old man presents with gynecomastia which of the following
diagnosis can be excluded as the cause
a- bronchogenic carcinoma c- XYY karyotype
b- spironolactone therapy d- Digoxin therapy e- Klinefelter's syndrome

62- A man of 50y old with wt loss & malaise of 6m, Na of 120 , which
of the following findings support the Diagnosis of SIADH
a- urinary osmolality persistently less than 300
b- serum K 6
c- nocturia & polyuria
d- collapsed RT upper lobe on CXR
e- blood urea 40

63- an obese 55y old man presents with a 6wks H/O polyuria, polydypsia
fasting blood sugar is 7.6 . which of the following is the best next step
a- advise that result are satisfactory & offer repeat the result
b- institute lifestyle modification to lose wt & excersie
c- start glipizide
d- start metformin
e- start rosiglitazone

64- 34y old woman C/O intermittent crampy abdominal pain. O/E
glossitis, tongue ulceration & angular stomatitis. Which of the following
most likely to cause these physical findings
a- celiac disease
b- erythema multiform
c- peutz jeghers syndrome
d- porphyria
e- ulcerative colitis

65- a 56y old woman is investigated for symptoms suggestive of benign

esophageal stricture which is most likely to have caused this disorder
a- accidental ingestion of bleach 6y before
b- achalasia
c- barretts esophagus
d- longstanding GER
e- prolonged nasogastric tube insertion 1y ago

66- which of the following is the best test can be used in GEI with
a- blood culture & sensitivity
b- 13C-urea breath test
c- IgG antibody titers
d- IgM antibody titres
e- Stool culture

67- Which of the following statement about pt with severe

encephalopathy is true
a- dietary protein intake should be restricted to 60g / day
b- the use of sedatives is recommended to control the pt
c- neomycin therapy should be given to reduce risk of SBP
d- diuretic therapy often helps to prevent the encephalopathy
e- enteral or parenteral glucose up to 300g / day

68- 54y old pt with DM is admitted for toe ulcer. Culture of wound swab
demonstrates multiple colony o staph aureus . what is the best Tx
a- benzylpenicilline
b- cipro
c- erythromycin
d- flucloxacillin
e- gentamycine

69- which of the following statement regarding herpes simplex virus is

a- encephalitis complicates primary or recurrent infection
b- HSV type 2 causes only genital infection
c- Recurrent infection is caused by repeated viral exposure
d- Serology is the most useful means of diagnosis
e- Ulcerative ………….. is a rare complication

70- 35y old woman has been diagnosed with HIV 18m ago. Which of the
following disorders most strongly indicates the progression of the disease
a- basal cell carcinoma overlying the nasal bridge
b- CMV retinitis
c- Pulmonary TB
d- RT basal pneumonia
e- Oral Candida

71- 25y old man with longstanding SCA presents with fever, rash
overlying his trunk, face and neck. His Hb dropped from 9.8 to 6.6 . what is
the most likely explanation
a- anemia of CRF
b- a plastic cell crisis
c- parvovirus B19 infection
d- BM infiltration
e- Multiple hemarthroses

72- 19y old female university student presents with fever & headache O/E
she is conscious but has neck stiffness the cerebrospinal stain shows
intracellular Gram negative diplococci. The most probable diagnosis is
a- meningococcal meningitis
b- hemophilus influenza meningitis
c- streptococcus pneumonia meningitis
d- listeria monocytogenes
e- E coli meningitis

73- 35y old man returns from a holiday in Egypt with a fever, headache,
limb pains. Which of the following features most suggests dengue
a- H/O a rat bite 2 weeks previously
b- Marked peripheral blood leucocytosis
c- Erythema nodosum
d- Yellow fever vaccination prior to trvelling
e- Cervical lymphadenopathy

74- Pneumocystis carinii infection in an HIV positive pt is

a- the commonest cause of respiratory infection in African pt
b- characterized by copious sputum production
c- characterized by widespread fine pulmonary crackles
d- more likely to occur when the CD4 count is <200
e- excluded by the finding of a normal CXR

75- 54y old man presents to the local ER C/O acute onset severe &
swelling of this LT knee O/E thee is erythema and limitation of movement.
Plain XR
Which of the following diagnosis is most likely
a- acute osteoarthritis
b- hemarthroses
c- reactive arthritis
d- RA
e- Septic arthritis

76- 36y old woman with RA C/O increasing difficulty with supination,
were is the lesion
a- auxiliary nerve lesion
b- C5,C6 nerve root lesion
c- C8 nerve root lesion
d- Median nerve lesion
e- Ulnar nerve lesion

77- Which of the following true about Wilson disease

a- AD
b- Cerebellar in coordination
c- Lens dislocation
d- Serum copper level is high
e- Urinary copper levels is low

78- Which of the following disease cause hyperkalemia

a- Addison's disease
b- Anorexia nervosa
c- Bartter's syndrome
d- Conn's syndrome
e- Cushing's syndrome

79- Which of the following is true about mast cell

a- activated by complement
b- derived from eosinophils
c- do not contain lytic lesion
d- release histamine
e- stimulate IgG mediated

80- 65y old male C/O sudden onset LT side weakness, RT ptosis, diplopia
Were is the lesion
a- Hypothalamus d- LT medulla
b- LT midbrain e- RT medulla
c- RT midbrain

81- 45y old man C/O LF facial weakness, what well strongly suggests a
diagnosis of belt's palsy more then upper motor
a- impaired sensation over the LF side
b- inability to fully close LF eye
c- increased chin jerk reflex
d- loss of LF frontals m activity
e- unable to close lips together

82- how to diff between ARF & CRF

a- Hb level of 11.6
b- Kidney size s of 6cm & 5cm on U/S
c- LVH on ECG
d- PTH level 7.9
e- PO4 2.39

83- Which of the following is typical of a renal biopsy in a pt with DM

a- diffuse glomerular capillary thickening & BM
b- green birefringence on staining Congo red
c- intracapillary hyaline thrombi
d- mesangial hypercellularity & fibrinoid necrosis
e- mesangial widening, BM thickening

84- which of the following feature suggests Good pasture disease

a- circulating C- ANCA
b- mesangial IgA deposition
c- presenting with nephritic syndrome
d- haemoptysis & pulmonary infiltrate is common finding
e- ass with HLA-DR3

85- in multiple drug resistant TB which one is not accurate

a- usually coz by mycobacterium avium intracellular
b- AIDS has increased the incidence of MDR-TB
c- Sputum AFB is often positive
d- Directly observed therapy or supervised therapy is
e- Qinolones such as cipro have an anti TB effect

86- An 18 y old male with known type 1 DM presented with general

malaise. dipstick urine & ABG confirms a metabolic ketoacidosis. Which of
the following would suggest an alternative diagnosis
a- CRP 50
b- WBC 16.2
c- Serum glu 36
d- Serum NA 162
e- Urea 13.8

87- 61y old male ALP 234, ALT 39, CA 1.88 . most likely Dx is
a- alcoholic liver disease b- oseomalacia
c- osteoporosis d- paget's disease e- BPC

88- 46y old man C/O sharp stabbing chest pain get worse by lying supine
ECG 1mm ST segment elevation in lead 1,2,3, AVR,AVL, V5, V6 what is
the most likely the diagnosis
a- acute MI
b- acute pericarditis
c- atypical angina
d- prinzmetal's angina
e- PE

89- A previously asymptomatic woman become pregnant. An echo show

Which of the following statement is true
a- the lesion has been unmasked by the changes occurring during
b- a dilated cardiomyopathy of pregnancy………..
c- most new cardiac murmurs detected during pregnancy
d- she should be treated aggressively by termination of the
e- pulmonary edema due to MS need urgent valvotomy

90- 19y old wan is admitted for suicidal attempt which of the following
underlying problem increase the risk of recurrence
a- alcohol ingestion at the same time with the overdose
b- background depression
c- antisocial personality
d- family H/O drug overdose
e- recent bereavement ……..

91- 42y old female Dx anxiety disorder. Which of the following support
our diagnosis
a- SOB & palpitation
b- Early morning wakening
c- Fatigue & lack of interest
d- Loss of libido
e- ………………..

92- Which of the following is best prescribe

a- cutaneous target lesion
b- necrotic genital ulcer
c- preceding streptococcus infection
d- sparing of the mucous
e- underlying TB

93- 47y old woman

a- allergic vasculitis
b- polyarteritis nodosa
c- henoch schonline purpura
d- SLE
e- Urticarial vasculitis