Jordan University Hospital

Residency entrance exam 2016

April 4, 2016.

Pediatrics:
1. Not a component of ToF > ASD
2. Correct about Milestones > draw circle at 3 years
3. All are manifestations of acute kidney injury except > Anemia
4. All are correct x-ray findings of CHD except:
- Transposition of great arteries >> wide mediastinum**
- TOF >> boot shape heart
- Large VSD >> cardiomegaly
5. Most specific urine analysis finding of Glomerular disease》 RBC casts
6. Hypotnoia + decreased reflexes + tongue fasciculation > spinal muscular
dystrophy
7. Incorrect about Migraine 》 EEG usually used for diagnosis
8. Correct about Rota virus 》 live attenuated vaccine
9. Incorrect about Kawasaki criteria 》 subcutaneous nodule
10. Must be present in HSP 》 Rash
11. In premature babies, at what age you stop correction of milestones 》 24 months
12. Not a symptom of DKA >> Diarrhea
13. Vit A deff causes → Night blindness
14. Not in Organophosphate poisoning→ Dry mouth
15. Not a cause for prolonged physiological Jaundice →
- Formula milk**
- Prematurity
- Polycythemia 
- Low calories intake
16. Wrong about Human Milk vs Formula milk>> lesser amount of Carbs.
17. Solid tumor, most common cause of mets to bone, bone morrow →
Neuroblastoma
18. Needs further evaluation → white pupillary reflex
19. Typical case of asthma asking for diagnosis
20. C/I to do Gastric lavage >
- sharp object ingestion
-  obtunded patient
21. Not a cause for Life long Hypothyroid>
- thyroid dysgenesis 
-TSH receptor deficiency
- Maternal antithyroid drug
- maternal antibodies
 22. Reflex that persist through the whole life > parachute reflex
23. common variable immunodeficiency :
- early childhood
- low IgG
- low B cells**
- low C3,C4
- IVIG is rarely useful
24. ..
25. ..

OBGYN:
1. Pregnant woman 37 GA, C/O abdominal pain, suspected appendicitis, after
opening her abdomen appendix not inflamed, what to do >
- Appendectomy + CS
- appendectomy alone
2. 58 postmenopausal woman diagnosed with ovarian cyst, what's you
management >
-Tumor marker then manage accordingly
3. woman with ovarian cyst, salpingo-oopherectomy done, found to be poorly-
differantiated teratoma, what's your management >
-
4. Antibiotic absolutely contraindicated during pregnancy>
- Doxycycline
- Trimethoprim_sulfamethaxazole
5. Valvular CA, What to pay attention before removal?
- Size of primary tumor
- Type of primary tumor
- site of primary tumor
- the condition of the surrounding area …
- marital status
6. Incorrect about Semen Analysis results>
- 20 million motile sperm
7. Pt with soft cervix, anterior, 75% effacement, -1 station. What’s the next step →
- IOL
- ARM then observe
- ARM+IOL
- C/S
- Amniotomy + oxytocin in saline
8. Not true about OCP mechanism of action→
- sterile inflammatory reaction in the uterus
9. Signs and symptoms of Pulmonary Embolism in pregnant lady, what is the most
important thing to do before going to surgery?
- pulmonary angiography
 - ABGs
- multiple X ray's
- Doppler u/s
- V/Q scan
10. Most common cause of Jaundice in pregnancy →
-Malignancy
-Acute viral hepatitis**
-Cholestasis of pregnancy
11. frothy greyish vaginal discharge with bad odor , is caused by which organism :
-candida albicans
-candida tropicals
-gardenella vaginalis
- Trichomonas vaginalis
-chlamydia
12. Most common presentation of uterine polyp
- Intermenstrual bleeding
- Irregular menses
- Heavy menses
13. Non-reactive CTG, what to do next?
- Reassure, repeat CTG later in the day
- Walk for 1 hour
- Give orange juice then repeat
- Give her IV dextrose
- Do contraction stress test
14. Major risk of external cephalic version When done in the appropriate time is >
- Abruptio placenta
- cord compression
- change the type of breach
15. not in the criteria for class 2 Abruptio placenta >
- fetal distress
16. when to start investigating 1ry Amenorrhea with +ve 2ry sexual char. >
- 16 y/o**
- 12 y/o
- 18 y/o
- 20 y/o
17. period of organogenesis from LMP >
- day 30-60
- day 21-60

18. 22 y/o female came with midcyclic dull lower abdominal pain found to have 5X5
bilocular ovarian cyst, what to do >
- give analgesics and follow-up
- laprascopy and aspirate the cyst
 19. Which of the following factors is most preventable/ modifiable risk factor to
decrease still birth
1-multiple gestation
2- old age
3- Pregnancy-induced HTN
4- post term> 42 weeks
5- Maternal overweight and obesity
20. Correct about ELISA for HIV >
- detects antibodies for HIV ** 
- detects capsule component of the virus
21. What don’t ensure lung maturity of fetus
- L:s ratio of 2:1
- Phosphatidyl glycerol
- Fetal heart activity by us at age of 30 wk
22. Do not increase at time of delivery?
- Prostaglandin dehyrogenase
- Estrogen 
- Interlukins
- Basal cortisol
23. 1 or 2 Questions about ethics

Internal Medicine
1. Female Individual with A-Antigen and B-Antibody, Blood Group is > A
2. Which coagulation factor is deficient in stored blood >
- factor 8
- factor 11
3. fever for 3 weeks, blood culture showed MRSA, what's your INITIAL
management>
- echocardiogram
4. most specific test to differentiate AKI from CKD >
- large kidney on u/s
5. One of the PFT measures is higher in asthma than COPD >
- DLCO
6. Metabolic syndrome not in the critiria >
- LDL>160
7. 1 hour hx of retrosternal chest pain, ST elevation in 2,3, avf leads. depressed ST
in V1-4, PR 55, BP 90/60, what is the diagnosis >
- inferior MI with right side infarction
8. Adult with dry cough, crackles on examination, middle lobe consolidation, what’s
not in your empirical treatment >
- Ciprofloxacin**
 - Levofloxacine
- cefriaxone
9. Wrong about Ulcerative colitis >
- rarely affects rectum
10. Diabetic BP goal >
- 130/80 (according to JNC 8)
- 140/90 (according to JNC 9)
11. All are causes of polyuria except
- AKI
- CKD
- Hypokalemia
- Hypercalcemia
12. Hypertensive, BP was 160/100 on atenolol 100 once daily, lisinopril once daily.
Amlodipine once daily, HCT 25mg. all are probable causes of resistant HTN
except >
- Nephrotic syndrome
- herbals
- OCPs
13. Patient with Hemoglobin = 8.2 , MCV = 112 , WBC= 3950 , plt=142,000, Blood
Film will show > hyper segmented neutrophils
14. About stroke prevention methods, according to multiple randomized trials what is
the most accurate one:
- aspirin > thrombotic ischemic stroke
- clopidogril > thrombotic ischemic stroke
- carotid endartectomy > stenosis of 80%
- warfarin > A.fib
- warfarin > .....
15. known case of AFib ....on warferin 3mg/day and digoxin ...came to ER with
nausea , vomiting , anorexia ,pulse=55 next step :
- troponin
- digoxin level
- ECG
- echo
16. One of the following is associated with increased risk of contrast-induced
nephropathy>
- pyelonephritis
- Nephrolithiasis
- hyperparathyroidism
- multiple myeloma

17. most common cause of death in kidney transplantation :

- operation complication
-atherosclerosis **
 -infection
-cancer
-graft rejection
18. The least to compare between asthma and COPD:
- effect of exercise **
- Cough character
- Symptoms variability
- smoking
- eczema
19. The most important to differentiate types of acquired community pneumonia >
- Patient history
- microbiology
20. wrong about blood transfusion >>
- to decrease complications , blood unit is transfused over 12 hrs
21. Specific for schizophrenia >
- Auditory Hallucinations
22. Female with Vocal cord dysfunction how to diagnose?
- Flexible laryngoscopy
23. DM patient on insulin for 10 years , with retinopathy and neuropathy and need
screening for nephropathy ...all may be found except :
-nephrotic rang proteinuria
-Microalbuminuria
-hypertension
-RTA type 4
-RBC casts**
24. One of these conditions is associated with the highest risk of VTE?
- anti phosphilipid syndrome
- OCP use
- Heterozygous of protein c deficiency
- Heterozygous carrier of factor 5 leiden
25. All are causes of positive troponin except>
- pulmonary embolism
- pulmonary edema
- septic shock
- chronic renal failure
- uncotrrolled HTN**

General Surgery
1.  In examining patients one is false: 
- Gowns should be for ALL patients considered blood infected
- hand wash is recommended after each patient
- needles and syringes should be discharged into the sharp container**?
- gloves should be worn during the examination regardless of anything
2. Which is not an indicator for acute pancreatitis severity?
- serum ca
- age
- serum amylase**
- LDH
- WBC
3. Not an indication for thyroid surgery :
-Toxic nodule
-Multinodular goiter
-exophthalmos**?
-Recurrent hyperthyroidism
-Large diffuse goiter
4. About Tumor of head of pancreas, which is wrong:
- Pale stool
- Palpable gall bladder
- Diabetes insipidus**
- back pain
- Weight loss
5. Young male with enlarged lymph node in post. triangle of neck what is the
management :
- antibiotics with observation (right answer)
- FNA
- excisional biopsy
- neck CT scan
6. Multiple fractures + Hypovolemic shock, What’s your initial fluid therapy >
- Ringer’s lactate**
- normal saline
- dextrose water
- albumin
7. The most common organism in acute cholecystitis >
- E.Coli**
- enterobacter
- enterococcus
- klebsella
- proteus

8. One of the following is not a clean contaminated surgery>

- thyroid surgery**
-billiary surgery
 -cholecystectomy
-gastric surgery
-appendectomy
9. The major cell type in wound healing >
- Fibroblast ?
- Macrophage ?
-lymphocyte
-endothelial
-neutrophill
10. Basal Cell Ca the least commonest site →
-Around Eyes
-Around Nose
-Lower lip**
-Cheeks
-scalp
11. Wrong about Anal fissure>
- Rarely posterior
12. About Small intestine malignancy all true except :
- carcinoid of appendex is usually asymptomatic
- Most tumors are malignant
- Carcinoid is always associated with hepatic mets
13. 70 y/o female + painless fresh bleeding per rectum + hypotension after
resuscitation.. Upper endoscopy is normal.. most likely diagnosis:
- Colon Cancer
- Diverticular bleeding **
- Hemorrhoid
- PUD
- Cancer
14. Most important factor in formation of cholestrol stones in gallbladde >
- supersaturation
- nucleation
15. Relative indication for mechanical vs tissue valve >
- Age less than 30**
- women of childbearing age
- patient with bleeding tendency 
- elderly patient
16. Regarding acute abdomen, which is wrong?
- intestinal obstruction pain increase with movement**
- elevated B-hcg level of less than 4000 can be associated with ectopic pregnancy
- midgut pain is periumbilical and vague
- parietal pain favors a surgical treatment
17. which is incorrect for acute abdomen >
- Amylase twice normal indicates pancreatitis
18. one of the following is not associated with Tension Pneumothorax
 - hypotension
- deviated trachea
- tachycardia
- tachypnea
- collapsed neck veins**

Finito

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