pediatrics

1- Not in tumor lysis syndrome:

a. Hyperkalemia
b. Hypercalcemia **
c.hyperphospahtemia
d.lactic acidosis

2- AR inheritance: Cystic fibrosis

3- 12 kg Baby scheduled for a hypospadias surgery.. calculate maintenance fluids? 1100 ml

4- Apgar score for a baby with pink lips/blue hands, heart rate 120, sneezing, breathing regularly, flexed
arms and legs?

A.6
B.7
C.8
D.9 *
E.10

5- 3 year old Child with tonic clonic seizure presented to ER what drug do you give him: A.Phenytoin
B.valproate
C.diazepam*

6- true about the vaccine that is given at age of 1 year (they mean MMR):

- it is live attenuated*
- associated witj increased risk of autism
- given by oral route
- given as single vaccine

7- 4 month old baby presented to ER with vomiting of 2 days followed by waterry diarrhea, most
common cause:
- staph
- rota virus**

8- true developmental milestone in 4 month old baby:

- can sit alone
- says mama
- reach objects with hand**

9- treatment of meningitis beyond neonatal period: IV ceftriaxone + vancomycin

10- 6 year old child presented to ER with asthma exacerbation (cough and wheezes), SaO2 95%, what is
next step?
- b2 agonist nebulizer**

11- 9 year old female complains of urgency, frequency, and foul smelling urine, what is the most
causative organism of her disease?
- E.coli*
- proteus

12- 6 year old female child, presented to ER with abdominal pain, vomiting, and diarrhea, her classmates
have the same complaints, elevated liver enzymes (not sure if this was in the stem of the question), but
the main idea that it is hepatitis and they asked about the m.c.c in this case?
- hepatitis A**
- hepatits B
- hepatitis C
- CMV hepatitis

13- 7 year old female complains of recurrent abdominal pain, otherwise normal, normal exam, what is
the most common cause?

- functional abdominal pain**

14- 6 year old boy presented with migratory arthritis, fever, skin rashes, and posituve ASO titers, he had
a group A strept infection 1 week ago, what is the dx? rheumatic fever

15- what is the defect in common variable immune deficency? B-cell defect

16- previously healthy baby, presented to ER at 1 week of age with tachypnea and hypoactivity, what is
the dx?

- RDS
- TTN
- potential sepsis**

17- 1 week old baby with jaundice, allo of following could be part of treatment except:
- phototherapy
- double exchange
- stop breast feeding*

18- screening test for celiac disease? anti tissue transglutaminase antibody*

19- 18 month old baby brought by his mother because he is pale and doesn't eat solid food, he is on
breast feeding and formula, what would you expect to find on his labs?
- low MCV**

20- question about severity of dehydration, asks about the percentage, I don't remember the stem of
the question but I think it was about severe dehydration (baby was hypoactive and I think he was
hypotensive?) so the answer would be: 10%

21- G6PD patient with acute hemolysis after ingestion of fava beans, what to do?
- admitt to hospital and give blood transfusion and IV fluids

22- wrong about influenza vaccine?

- it is given annually
- it is not contraindicated in immunocompromised
- it shouldn't be given in pregnancy*

gyne

1- Female with abd pain .. definitive diagnostic tool: laparoscopy and Bx

2- Menopause defined as: amenorrhea for 12 months with no other causes (past papers)

3- teratogenic vitamin and not given in pregnancy: vit A

4- 49 y/o female G4P4 with heavy menstrual periods found to have intramural fibroid, management:

A. D&C
B.abdominal hysterectomy
C.BLS+abdominal hysterectomy+oophorectomy
D. myomectomy
E.

5- m.c.c of menstrual irregularites in young femal:

- PCOS
- anovulatory cycles*

6- on of following support the dx of premature ovarian failure:

- elevated FSH > 50 *
7- most common single cause of preterm labor:
- multiple gestation*
- iatrogenic
(idiopathic was not included in choices)

8- normal blood loss in vaginal delivery?

- 700 ml
- 500 ml*
- 250 ml
- 50 ml

9- female pt complains of itching and burning in vagina, PH > 5.5, what is the m.c cause?
- trichomonas vaginitis*

10- all of following are causes of 1ry amenorrhea except: ((they FORGOT to write the word EXCEPT so
this question will be omitted))
- ovarian agenesis
- excessive exercise
- anorexia nervosa
- craniopharyngeoma *

11- true about postpartum bleeding:

- it should always be investigated *?
I can't remember other choices

12- associated with sinusoidal deceleration? fetal anemia

13- wrong about ectopic pregnancy:

- gestational sac is always seen in fallopian tubes*

14- you are counselling pregnant woman with previous CS regarding induction of labor, what of
following will have the higher risk to cause uterine rupture?
- prostaglandin
- oxytocin*?

15- clue cells under microscope:

- squamous cells covered with bacteria*?
- columnar cells covered with bacteria

16- dx of endometriosis: laparoscopy

17- hypertensive pt on ACEI, wants to be pregnant, the dr switched her to labetalol, after that urine
protein to cr ratio increased, what to do?
- keep on labetalol
- add on diuretics
- switch to ARBs
- switch back to her previous drug and stop labetalol until pregnancy, then when she becomes pregnant
she switches again to labetalol

18- true about face presentation:

- mentoposterior is an indication for CS*

19- what is the type of twins would rise if cleavage occurs between 9 and 12 days?
- monochorionic monoamniotic*

20- question about PROM, asking about true in management:

- deliver at 34 weeks?
- give tocolysis

21- drug interaction with OCP: rifampicin

22- young female with dermoid cyst, what to do?

- ovarian cystectomy*
- observation

23- most common cause of breech presentation? prmaturity

24- combined OCPs can aggravate which condition?

- hypoamenorrhea
-

25- which of following can cause fetal tachycardia?

- maternal pyrexia*
- maternal hypothyroidism

Medicine

1- Patient took medication and then developed rash/ ulcer (picture of drug induced lupus) what is the
drug?

A. Carbamazepine
B. Hydralazine**
C.amiodarone
2- Young female with arthralgia / malar rash / photosensitivity , no proteniuria no other sx, what’s your
management:

A. Hydroxychloroquine**
B. Cyclophosphamide
C. cyclosporine

3- Patient had surgery and received 12 units of blood, on the second day he started bleeding from IV
lines and wound, what’s the cause?

- Diluted thrombocytopenia??
- hypocalcemia
- hypercalcemia
- unknown bleeding disorder in patient

4- patient recived blood transfusion for GI bleeding, and had transfusion reaction, what to do?
- give IV fluids
- give IV fluids + mannitol
(there wan no choice to stop the transfusion!)

5- Patient brought by his wife to the ER with confusion, he was hypertensive, all of following supports
malignant hypertension except:

- hematuria?
- proteinuria
- eye exudates*? (I don't remember if the choice was exactly like this or it was retinal somthing)

6- what is the stage of CKD according to KDOQI system if the GFR was 27 ? stage 4

7- case of acute pericarditis, what whould support your dx?

- diffuse ST deppression
- systolic and diastolic friction rub*

8- 35 year old male pt, a-fib, hyperlipidemia, what would you give to prevent future risk of
thromboembolism?
- antiplatelet therapy like aspirin?
- give new oral anticoagulnts like rivaroxaban
- give warfarin
- anticoagulation is not recommended in this pt *

9- which of following patients is the best candidate for CABG?

- pt with 3 vessel disease and EF 35% .. etc
10- 40 year old male pt, came to ER with hx of cough and fever, GCS was 12, urea was high, RR was 30,
BP was 110/70, CXR done and diagnosed to have pneumonia, what is your management?
- outpatient with oral azithromycin
- admit to floor and give levofloxacin
- admit to ICU ...

11- what is the m.c liver disease in developped countries?

- hepatitic C
- fatty liver disease*

12- patient in hospital has been managed for inferior MI, developed bradycardia and hypotension, what
is the best next action?
- give atropin
- IV fluids*

13- all of following can exacerbates hepatic encephalopathy in patient with liver cirrhosis except:
- metabolic alkalosia
- high carb diet*?
-

14- COPD patiet, had one exacerbation last year, can run 100 yard before taking rest (somrthing like
this), what is the best maintenance treatment to start on after cessation of smoking?
- ICS + LABA
- ICS alone
- LAMA*?

15- G6PD patient aith acute hemolysis, what would you find in labs?
- low haptoglobin

16- patient with long standing COPD, had lower limbs pain for 3 months, clubbing, radiology of lower
limbs showed hypertrophic osteoarthropathy, what is the most likely cause?
- osteosarcoma
- squamous cell carcinoma of the lung*

17- what lab reading would support chronic liver disease?

- high AST
- high ALT
- low albumin*?
- high INR?

18- infective endocarditis prophylaxis is given for which patient?

- pt with prosthetic valve
19- not assoaciated with dry cough? bronchiectasis

20- what do you do immediately after needle stick injury?

- wash your hand with water and soup*
- wash with alcohol
- inform your supervisor
- inform infection control unit
- squeeze your finger to let the blood goes out

21- case of kallman syndrome (man with anosmia, gynecomastia, hypogonadism), what is the
treatment?
- gonadotrophins?
- testosterone*?

22- long case in hemato asking about dx (leukocytosis, no blasts,... I can't remember the rest of question

23- when we do splenectomy?

-

24- pt with hypernatremia, hypokalemia, ....

- conn's syndrome
- cushing
- addison disease

surgery

1 - which of following will be the most to develop cardiac complication after surgery?
- age >70
- patient with CHF, anemic and EF 35%
-

2- true about gas gangrene?

- caused by clostridium botulinum
- manifested by pain, crepitus and toxemia*

3- 45 year old female, case of HNPC (her mother and maternal aunt had colorecatal carcinoma at age of
40), how to do screening and when?
- colonoscopy now and then every 2 years*
- colonoscopy at age of 50
- FOBT now
4- not found in gallstone ileus?
- air in biliary tree
- acholic stool*
- intestinal obstruction

5- 88 year old male with multiple chronic diseases, has acute cholysestitis, how to manage?
- laparoscopic cholecystectomy
- tubal something*

6- Baby comes with drooling and salivation, NG tube coiling in upper esophagus, dx?
- prosimal esophageal atresia with distal fistula*
- proximal esophageal atresia with proximal fistula
- esophageal atresia without fistula

7- most common complication of TPN after 13 weeks:

- steatohepatitis
- biliary sludge
- reffeding syndrome

8- breast cancer with ulceration in the skin, no metastasis.... :

- simple mastectomy
- modified radical mastectomy with radiation

9- obese patient to do bariatric surgery, he has daytime sleepiness and other features of OSA, what to
do before doing surgery?
- polysomnography *

10- which of following mamographic findings support the diagnosis of breast cancer:
- 6 microcalcifications per cm2 *

11- most to develop cardiac complication after surgery:

- harsh aortic systolic murmur
- age > 70
- HF with EF 35%

12- inguinal hernia pre-op evaluation, what would be an indication to delay the surgery?
- distended JVP*?
-

13- question about FAST (focused assessment with sonography in trauma),

14- best way to diagnose tension pneumothorax?

- clinical*
- chest X-ray

15- the vascular ligament of the spleen? lienorenal ligament

16-