Pediatrics

1. All of the following in Kawasaki disease expect: subcutaneous nodule

2. Child can copy a triangle at age of: 5 years
3. all of the following risk for leukemia except:
turner
barter*
down
4. which of following needs PDA?
-transposition of great vessels
-tricuspid atresia without VSD*
5. Drug without pseudomonas coverage: ceftriaxone
6. Seizures + hypopigmentation + ash leaf: tuberous sclerosis
7. All are found in a healthy baby except:
- single crease*
- umbilical hernia
- spitting
- milk discharge
- erythema of umbilical skin with tissue
8. O2 affects which organs in an infant:
- lung, brain, eye , kidney
- brain, lung, eye*
9. 14 mo old baby with IDA he drinks 60 oz of cow milk daily and refuses food beside oral
iron what’s your management?
Give iron fortified milk
Give soy milk
Decrease milk to 30oz and add more iron rich food*
10. About development what’s wrong?
Child double birth weight at 4-5 months
Child double birth length at 2.5-3 years**
11. What’s the most related to PPD test in 15 months old?
Had DTP vaccine 8 weeks ago
Had BCG vaccine at birth*
Concomitant administration of Hib vaccine
12. What doesn’t need some sort isolation?
Pertussis
Measles
Tuberculosis
Pneumococcal bacteremia**
 13. True about meningococcal infxn?
Meningococcemia has better prognosis than meningitis
All contacts of pt needs to take prophylactic rifampin regardless of age **
14. Doesn’t cause hepatomegaly:
Mucopolysaccharide
Galactosemia
Lactase deficiency**
15. Type of inheritance if affected father has carrier daughters and not affected sons:
Autosomal dominant
Autosomal recessive
X linked recessive**

Gynecology/obstetrics

1. All are maternal factors that cause malpresentation in fetus except :

multiparity*
pelvic contracture
multiple gestations
uterine anomalies
pelvic mass
2. All maneuvers are used in shoulder dystocia delivery except:
suprapubic pressure
McRoberts maneuver
Gaskin maneuver
Woods maneuver
Zavanelli's maneuver
3. Pregnant lady exposed to teratogen at 17wk gestation, which two organs would be
spared :
heart and gonads?
brain and gonads
brain and heart
muscle and bone
bone and heart
4. According to the new guidelines, which test is recommended to be used at delivery in all
pregnants who are at high risk of sig fetomaternal hmg:
kleihauer test . quantitative
flow cytometry
 Rosette test*
direct coombs
indirect coombs
5. All are in the definition of normal vaginal delivery except:
output alive
cephalic presentation
occipitoanterior
attitude*
episiotomy may be present
6. Regarding B-hcg which one is incorrect
first HCG molecule is detected usually at 6-8 days post fetilization
B-hcg level is around 100 at the time of missed peroiod
fetal sac can be seen at 5 weeks when bhcg level around 1500
fetal pole can be seen at 6 weeks when bhcg level is around 5200
fetal heart activity can be detected at 5th or 6th week when bhcg level is around 6000*
7. Most common cause of antepartum hmg:
placenta previa
abruptio placenta*
placenta accreta
vasa accreta
8. Placenta accreta is best diagnosed using:
obestetric examination
MRI
CT
US*
9. Only drug approved for induction and augmentation of labor is:
Oxytocin*
methergine
cytotec
prostaglandin E2
10. Best way in the management of 3th stage of labor:
observation
apply traction to the cord
give oxytocin 40U *?
11. Endometriosis can cause all this types of pain except:
during intercourse
premenstrual
during cycle
 postcoital?
mid cycle
12. 22 Yr old female prested to the clinic complaining of dysmenorrhea. which of the
following questions is irrelevant to the diagnosis :

age of Menarche
relation of the pain to the days of cycle
if she does exercise regularly*
duration of her symptoms
13. least to cause preterm labor
APH
chronic hypertension
cervical incompetence/ uterine malformations
multiple gestations
14. one of the following conditions can cause ambiguous genitalia
swyer syndrome
gonadal dysgenesis
androgen insensitivity syndrome
15. most common congenital abnormality during mullarian duct formation and canalization:

vaginal septum
imperforate hymen*
Unicornuate uterus
16. most common fetal complication in shoulder dystocia

clavicular fracture
brachial plexus injury *
humerus fracture
17. abortion types definitions. which is the wrong statment
18. pick the mismatch between the type of tumor and its average age of presentation:
dysgerminoma 40-50 *
19. menopause is:
defined retrospectively after 12 mo from the last period*
if occurs before 45yr considered premature
2 readings of High FSH 6 months apart

20. most effective contraceptive method to prevent STD:

 condom*
OCP
implanon
IUCD
vaginal foam
21. change in the fetal head bone positions due to pelvic pressure is defined as : molding
22. which of the following is not a result of placenta insufficiency:
- fetal malformation*
- IUGR
- pre eclampsia
- preterm labor
23. what is the best way to diagnose cervical incompetence:
- hegars dilators
- transvaginal us*
24. cause of postpartum depression:
- elevated levels of prolactin
- vit d deficiency**
-low iron levels
- changing levels of serotonin

Surgery

1. Burns. which is the wrong statement:

burns that are diagnosed as first degree can progress to second degree the following day
second degree burns are blanchable
thrombosed vessels are seen in third degree burns
burn is treated as systemic condition
skin appendages in the face can be extended to the subcutaneous tissue?

2- Female presenting with tender and erythematous mass and skin changes in the axilla as well
as the left groin, most likely diagnosis :
carbuncle
Hydradenitis suppurativa*
mycosis fungoides
actinomyces

3- which is considered clean contaminated surgery:

elective upper GI*
perforated diverticulitis
penetrating abdominal trauma

4- Regarding sigmoid volvulus, which statement is incorrect:

caused by congenital redundancy of the colon
surgey is not needed usually after successful sigmoidoscopic reduction*

5- Child RTA with open femur fracture at the ER. best next step
10 cc bolus normal saline
20 cc bolus normal saline*
20 cc bolus colloid
start packed RBC infusion
start packed RBC. and fresh frozen plasma infusion

6- RTA. respiratory distress young pt. anesthesiologist inserted endotracheal tube with
increased resistance. now he is complaining of devated trachea to the rt and absent breath
sounds in the left side. most apporpriate next step:

needle decompression*
chest tube insertion

7- which is true about familial adenomatous polyposis :

autosomal recessive inheritance
best management proctocolectomy with the ileal pouch*
inherited on chromosome 15
risk of malignant transformation is 75%
most polyps presnt at late adulthood

8- most imp risk factor in pancreatic CA

alcohol
smoking*

9- one cause of thyrotoxicosis without high uptake on radioiodine scan

graves disease
thyroid adenoma
multinodular goiter
subacute thyroiditis*
10- Wrong about hemorrhoids
are natural cushions that help with stool control
pain is the most frequent presentation*
stage 3 and 4 are usually managed surgically
disease age group mostly 45-65

11- Thyroid nodue all trur except: FNA less than 10mm

12- Pyloric stenosis: hypokalemic hypochloremic metabolic alkalosis

13- A 35 yo male pt with a pictue of intestinal obstruction, hx of appendectomy at 18, most

likely cause: adhesions

14- Wrong about choleycystitis:

- emphysematous should be managed conservatively*?

- It is managed by cholecystectomy in some cases

15- Correct About UC :

- Fistula is common
- Pseudopolyps are associated with malignancy
- Less than 10% involves the ileum*

16- All are types of distributive shock except:

- anaphylactic
- hemorrhagic*
- septic
- neurogenic
- addisonian

17- Not cause of polyhydraminous :

-deudenal atresia
-Esophageal atresia
-Diaphragmatic hernia
-Hirshsprung*

18- Features of locally advanced breast ca except:

-cutaneous lymph block
-ulceration
-arm edema*
-inverted nipple
-Skin edema

19- The most important thing to differentiate between kelloid and hypertrophic scars:
Extension beyond the scar edges

20- About abdominal surface anatomy, what is wrong:-

-pyloric sphincter at level L1

-can be as 4 quadrants
-umbilicus mid way btw xyphoid and symphysis pubis
- the deep inguinal ring is located 1.5 cm below the mid part of inguinal ligament*

21- Femoral canal, which is wrong: it is medial to the lacunar lig.

22- True about vegetative state:

- sleep awake cycle*?
- fixed dilated pupil

23- False about appendicitis?? Both are wrong!

-20% are extraperitoneal retrocecal

-most common in children

Medicine

1. SLE pt has thrombocytopenia, normal hb , normal wbc what’s false

It could be due anti IIb/Ia antibody
ITP predates SLE
It’s due to ADAMTS13 deficiency *

2. Q about scleroderma hypertension crisis what’s true

Prophylactic ACEI given to prevent it
It indicates long standing disease
Anti scl70 is a predictor
3. Pt with Inferior wall MI after 12 hours he developed hypotension ,anuria, HR 110 ,
elevated JVP what’s your management:
Give noradrenaline
Give dopamine
Give 1000 bolus normal saline then maintenance *
4. 50s old pt HTN, asymptotic and do his daily activities normally found to have Aortic
stenosis 1 cm diameter, 20 mmhg pressure gradient, EF 50% what to do ?
Refer to cadiosurgeon
Refer to do valvuloplasty
Risk factor modification and medical management*
Do cath to asses accurately the valve size and Gradient
5. Case of pneumonia, temp 38.5 other vitals stable, urea normal , GCS normal:
-discharge on azithromycin and follow as out pt*
-in patient on oral levo.
-in patient iv ceftriaxon and vanco
-out on vit c and follow in clinic
6. Adult PCKD: intracerebral hmg
7. Wrong about nephrotic:
Hyponatremia
Increase urinary na*
8. An eldery woman with stage 3 CKD, on ACEI, thiazide , atenolol, acetaminophen
Baseline Cr 1.6
Started omeprazole 6 weeks ago due to gastritis.
Presented with cr:3.6 bp: 150/90 ua: +1 proteinuria pcr: 0.6 most likely cause:
Interstitial nephritis*
9. All of these are causes of dry cough except: bronchiectasis
10. A case of low hb, normal mcv, high reticulocytes and high nucleated rbcs:
Warm autoimmune hemolytic anemia
11. All causes low complements except: IgA nephropathy
12. Highest prevalence of suicide is :
-major depressive disorder*
-dissociative disorders
-delerium
13. Low ceruloplasmin>> Wilson
14. Minimum urine output in 70 kg patient: > 35 ml/ hour
15. All are water soluble vitamins except: vit k
16. most common neuroendocrine tumor of pancreas > insulinoma
17. pt come with hypoglycemia , c peptide and insulin with normal range.. next step:
-refer to psychiatry
-sulfa drug screen*