Arab Board 2012

Dr. Wesaam Ghafouri S.B.
Family Medicine
Arab Board Exam --{Papers I & II}-- (19/12/2012 -- 6/2/1434)

PAPER ONE (M.C.Q.s) – 150 MCQs single best answer – 3 hours duration
1) A 28-year-old male recreational runner has a mid-shaft posteromedial tibial stress fracture. Although
he can walk without pain, he cannot run without pain. The most appropriate treatment at this point
includes which one of the following?
a) A short leg walking cast.
b) A non–weight-bearing short leg cast.
c) A non–weight-bearing long leg cast.
d) An air stirrup leg brace (Aircast).
e) Low-intensity ultrasonic pulse therapy.
Answer D. ABFM 2011 , Q 6 , P 2.
2) When prescribing an inhaled corticosteroid for control of asthma, the risk of oral candidiasis can be
decreased by:
a) Using a valved holding chamber.
b) Limiting use of the inhaled corticosteroid to once daily.
c) Adding nasal fluticasone propionate (Flonase).
d) Adding montelukast (Singulair).
e) Adding salmeterol (Serevent).
Answer A. ABFM 2011 , Q 18 , P 5.
3) A 30-year-old female asks you whether she should have a colonoscopy, as her father was diagnosed
with colon cancer at the age of 58. There are no other family members with a history of colon polyps
or cancer. You recommend that she have her first screening colonoscopy:
a) Now and every 5 years if normal.
b) Now and every 10 years if normal.
c) At age 40 and then every 5 years if normal.
d) At age 40 and then every 10 years if normal.
e) At age 50 and then every 5 years if normal.
Answer C. ABFM 2011 , Q 31 , P 9.
4) Patients with rheumatoid arthritis should be screened for tuberculosis before starting which one of
the following medications?
a) Gold.
b) Hydroxychloroquine.
c) Infliximab.
d) Methotrexate.
e) Sulfasalazine.
Answer C. ABFM 2011 , Q 37 , P 10.
5) A 42-year-old male with a history of intravenous drug use asks to be tested for hepatitis C. The
hepatitis C virus (HCV) antibody enzyme immunoassay and recombinant immunoblot assay are both
reported as positive. The quantitative HCV RNA polymerase chain reaction test is negative. These test
results are most consistent with:
a) Very early HCV infection.
b) Current active HCV infection.
c) A false-positive antibody test.
d) Past infection with HCV that is now resolved.
Answer D. ABFM 2011 , Q 38 , P 10.
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Dr. Wesaam Ghafouri S.B. Family Medicine
6) A 58-year-old white male reports having a productive cough for several months. He gets breathless
with exertion and notes that every time he gets a cold it “goes into my chest and lingers for months.”
He has been smoking for 30 years. A physical examination is negative except for scattered rhonchi. A
chest radiograph done 4 months ago at an urgent care visit was negative except for hyperinflation
and flattened diaphragms. Which one of the following would be best for making the diagnosis?
a) A chest radiograph.
b) CT of the chest.
c) Peak flow measurement.
d) Spirometry.
e) α-1-antitrypsin level.
Answer D. ABFM 2011 , Q 29 , P 8.
7) Metformin (Glucophage) should be stopped prior to which one of the following, and withheld until
48 hours after completion of the test?
a) An upper GI series.
b) Abdominal ultrasonography.
c) CT angiography.
d) MRI of the brain.
e) Colonoscopy.
Answer C. ABFM 2011 , Q 40 , P 11.
8) You examine an 11-month-old male who has had several paroxysms of abdominal pain in the last 2
hours. The episodes last 1–2 minutes; the infant screams, turns pale, and doubles up. Afterward, he
seems normal. A physical examination is normal except for a possible fullness in the right upper
quadrant of the abdomen. The most likely diagnosis is:
a) Pyloric stenosis.
b) Choledochal cyst.
c) Meckel’s diverticulum.
d) Intussusception.
e) Intestinal malrotation.
Answer D. ABFM 2011 , Q 44 , P 12.
9) A painful thrombosed external hemorrhoid diagnosed within the first 24 hours after occurrence is
ideally treated by:
a) Appropriate antibiotics.
b) Office banding.
c) Office cryotherapy.
d) Thrombectomy under local anesthesia.
e) Total hemorrhoidectomy.
Answer D. ABFM 2011 , Q 91 , P 25.
10) A 25-year-old male presents to your office for evaluation of pain in the right index finger that has
been present for the past 4 days. The pain has been getting progressively worse. On examination the
finger is swollen and held in a flexed position. The pain increases with passive extension of the finger,
and there is tenderness to palpation from the tip of the finger into the palm. Which one of the
following is the most appropriate management of this patient?
a) Surgical drainage and antibiotics.
b) Antiviral medication.
c) Oral antibiotics and splinting.
d) Needle aspiration.
e) Corticosteroid injection.
Answer A. ABFM 2011 , Q 63 , P 17.
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11) A 52-year-old male has had a chronic course of multiple vague and exaggerated symptoms for which
no cause has been found despite extensive testing. Which one of the following is the most effective
management approach for this patient?
a) Reassure the patient that his symptoms are not real.
b) Schedule the patient for regular appointments every 2–4 weeks.
c) Prescribe opioids for the pain.
d) Order additional diagnostic tests.
e) Advise the patient to go to the emergency department if the symptoms occur after office hours.
Answer B. ABFM 2011 , Q 50 , P 14.
12) A previously healthy 82-year-old male is brought to your office by his daughter after a recent fall
while getting up to go to the bathroom in the middle of the night. The patient denies any history of
dizziness, chest pain, palpitations, or current injury. He has a history of bilateral dense cataracts. On
examination, he is found to have an increased stance width and walks carefully and cautiously with
his arms and legs abducted. A timed up-and-go test is performed, wherein the patient is asked to rise
from a chair without using his arms, walk 3 meters, turn, return to his chair, and sit down. It takes the
patient 25 seconds and he is noted to have an “en bloc” turn. Which one of the following is the most
likely cause of this patient’s gait and balance disorder?
a) Visual impairment.
b) Cerebellar degeneration.
c) Frontal lobe degeneration.
d) Parkinson’s disease.
e) Motor neuropathy.
Answer A. ABFM 2011 , Q 47 , P 13.
13) Which one of the following is the greatest risk factor for abdominal aortic aneurysm (AAA)?
a) Cigarette smoking.
b) Diabetes mellitus.
c) Hypertension.
d) African-American race.
e) Female gender.
Answer A. ABFM 2011 , Q 67 , P 18.
14) A 2-year-old child stumbles, but his mother keeps him from falling by pulling up on his right hand. An
hour later the child refuses to use his right arm and cries when his mother tries to move it. The most
likely diagnosis is:
a) Dislocation of the ulna.
b) Dislocation of the olecranon epiphysis.
c) Subluxation of the head of the radius.
d) Subluxation of the head of the ulna.
e) Anterior dislocation of the humeral head.
Answer C. ABFM 2011 , Q 106 , P 29.
15) You treat a 65-year-old white female for a clean minor laceration. Her chart reveals that she has
received two previous doses of tetanus toxoid. The last dose was 12 years ago. Which one of the
following is the preferred treatment?
a) Reassurance that her tetanus immune status is adequate.
b) Tetanus immune globulin (TIG) and tetanus toxoid (TT).
c) Tetanus toxoid only.
d) Tdap.
e) DTaP.
Answer D. ABFM 2011 , Q 107 , P 29.
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16) Which one of the following is most characteristic of patellofemoral pain syndrome in adolescent
females?
a) Posterior knee pain.
b) Pain exacerbated by walking on a flat surface.
c) Inadequate hip abductor strength.
d) A high rate of surgical intervention.
Answer C. ABFM 2011 , Q 92 , P 25.
17) A 73-year-old white female with a long history of rheumatoid arthritis has a normocytic normo-
chromic anemia. Her hemoglobin level is 9.8 g/dL (N 12.0–16.0) with decreased serum iron,
decreased total iron-binding capacity, and increased serum ferritin. Which one of the following is the
most appropriate treatment for this patient?
a) Oral iron.
b) Intramuscular iron dextran (DexFerrum, InFeD).
c) Treatment of the rheumatoid arthritis.
d) Transfusion.
e) Folic acid.
Answer C. ABFM 2011 , Q 109 , P 29.
18) The most appropriate advice for a 50-year-old female who has passed six calcium oxalate stones over
the past 4 years is to:
a) Restrict her calcium intake.
b) Restrict her intake of yellow vegetables.
c) Increase her sodium intake.
d) Increase her dietary protein intake.
e) Take potassium citrate with meals.
Answer E. ABFM 2011 , Q 111 , P 30.
19) A 60-year-old male has a drug-eluting stent placed in his right coronary artery. He will require
treatment to prevent stent thrombosis, and once his initial treatment period is completed he will be
placed on aspirin, 75–165 mg/day indefinitely. Which one of the following is the preferred initial
regimen for preventing stent thrombosis in this situation?
a) Aspirin/dipyridamole (Aggrenox) for 3 months.
b) Aspirin, 162–325 mg/day for 3 months.
c) Aspirin, 162–325 mg/day, plus clopidogrel, both for 3 months.
d) Aspirin, 162–325 mg/day, plus clopidogrel, both for 12 months.
e) Warfarin (Coumadin) for 3 months.
Answer D. ABFM 2011 , Q 115 , P 31.
20) A 12-year-old male is brought to your office with an animal bite. After talking with the patient, you
learn that he was bitten on his left hand as he attempted to pet a stray cat a little over 24 hours ago.
He says that the bite was very painful, and that it bled for a few minutes. His parents cared for the
bite by rinsing it and covering it with a bandage. His chart indicates that he received a tetanus shot
last year. On examination, the patient is afebrile with stable vital signs. The site is warm and tender
to light palpation, with surrounding erythema measuring approximately 3 cm in diameter. Which one
of the following is the most likely infectious agent in this situation?
a) Candida albicans.
b) Capnocytophaga canimorsus.
c) Methicillin-resistant Staphylococcus aureus (MRSA).
d) Pasteurella multocida.
e) Streptococcus pneumonia.
Answer D. ABFM 2011 , Q 130 , P 36.
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21) Which one of the following is consistent with spinal stenosis but not with a herniated vertebral disk?
a) Numbness.
b) Muscle weakness.
c) Pain relieved by sitting.
d) Pain relieved by standing.
Answer C. ABFM 2011 , Q 120 , P 33.
22) A 35-year-old male consults you about vague chest pain he developed while sitting at his desk earlier
in the day. The pain is right-sided and was sharp for a brief time when it began, but it rapidly
subsided. There was no hemoptysis and the pain does not seem pleuritic. His physical examination,
EKG, and oxygen saturation are unremarkable. A chest film shows a 10% right pneumothorax. Which
one of the following should you do next?
a) Admit the patient to the hospital for observation.
b) Admit the patient to the hospital for chest tube placement.
c) Obtain a repeat chest radiograph in 24–48 hours.
d) Obtain an expiratory chest radiograph.
Answer C. ABFM 2011 , Q 132 , P 36.
23) A 45-year-old male sees you for a routine annual visit and is found to have atrial fibrillation, with a
ventricular rate of 70–75 beats/min. He is otherwise healthy, and a laboratory workup and
echocardiogram are normal. Which one of the following would be the most appropriate
management?
a) Aspirin, 325 mg daily.
b) Warfarin (Coumadin), with a target INR of 2.0–3.0.
c) Clopidogrel (Plavix), 75 mg daily.
d) Amiodarone (Cordarone), 200 mg daily.
e) Observation only.
Answer A. ABFM 2011 , Q 140 , P 38.
24) The best management of localized, well-differentiated prostate cancer in men older than 65 is:
a) Radiation implants.
b) External beam radiation therapy.
c) Watchful waiting.
d) Primary androgen deprivation therapy.
e) Robot-assisted prostatectomy.
Answer C. ABFM 2011 , Q 164 , P 45.
25) A 56-year-old white male reports lower leg claudication that occurs when he walks approximately
one block, and is relieved by standing still or sitting. He has a history of diabetes mellitus and
hyperlipidemia. His most recent hemoglobin A1c level was 5.9% and his LDL-cholesterol level at that
time was 95 mg/dL. Current medications include glyburide (DiaBeta), metformin (Glucophage),
simvastatin (Zocor), and daily aspirin. He stopped smoking 1 month ago and began a walking
program. A physical examination is normal, except for barely palpable dorsalis pedis and posterior
tibial pulses. Femoral and popliteal pulses are normal. Noninvasive vascular studies of his legs show
an ankle-brachial index of 0.7 bilaterally, and decreased flow. Which one of the following would be
most appropriate for addressing this patient’s symptoms?
a) Fish oil.
b) Warfarin.
c) Cilostazol.
d) Dipyridamole.
e) Clopidogrel.
Answer C. ABFM 2011 , Q 221 , P 59.
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26) A 28-year-old white male comes to your office complaining of pain in the right wrist since falling 2
weeks ago. On examination, he is tender in the anatomic snuffbox. A radiograph reveals a
nondisplaced fracture of the distal one-third of the carpal navicular bone (scaphoid). Which one of
the following is the most appropriate management at this time?
a) A bone scan.
b) Physical therapy referral.
c) A Velcro wrist splint.
d) A short arm cast.
e) A thumb spica cast.
Answer E. ABFM 2011 , Q 148 , P 41.
27) A 72-year-old male with COPD presents to the emergency department with an acute exacerbation
marked by increased sputum production and shortness of breath. His oxygen saturation is 88% on
room air and he has diffuse inspiratory and expiratory wheezes bilaterally. In addition to oxygen and
bronchodilators, which one of the following is most appropriate for this patient?
a) No additional treatments.
b) Systemic corticosteroids only.
c) Inhaled corticosteroids only.
d) Systemic corticosteroids and antibiotics.
e) Inhaled corticosteroids and antibiotics.
Answer D. ABFM 2011 , Q 173 , P 47.
28) The FDA issued a boxed warning describing an increased risk of tendinopathy and tendon rupture
associated with the use of which class of antibiotics?
a) Macrolides.
b) Aminoglycosides.
c) Fluoroquinolones.
d) Tetracyclines.
e) Polypeptides.
Answer C. ABFM 2011 , Q 170 , P 47.
29) About a month after returning from Yemen, the patient develops a papule on his forearm that
subsequently ulcerates to form a shallow annular lesion with a raised margin. The lesion shows no
signs of healing 3 months after it first appeared. He has no systemic symptoms. The most likely
diagnosis is:
a) Leishmaniasis.
b) Schistosomiasis.
c) Malaria.
d) Trypanosomiasis.
e) Syphilis.
Answer A. ABFM 2011 , Q 230 , P 62.
30) A 22-year-old male presents to your office with a 2-hour history of a painful right scrotal mass. The
physical examination raises concerns that the patient may have testicular torsion. The imaging study
of choice would be:
a) A plain film.
b) Color duplex Doppler ultrasonography.
c) CT.
d) MRI.
e) A nuclear scan.
Answer B. ABFM 2011 , Q 183 , P 50.
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31) When added to compression therapy, which one of the following has been shown to be an effective
adjunctive treatment for venous ulcers?
a) Warfarin.
b) Enoxaparin.
c) Clopidogrel.
d) Pentoxifylline.
e) Atorvastatin.
Answer D. ABFM 2011 , Q 171 , P 47.
32) At the 18-month visit, which one of the following is the most specific sign of autism?
a) Delayed or odd use of language.
b) Repetitive behaviors.
c) Stereotypic movements.
d) Delayed attainment of social skill milestones.
e) Self-injurious behaviors.
Answer D. ABFM 2011 , Q 193 , P 52.
33) In patients with pes anserine bursitis, tenderness is most likely to be noted:
a) Over the medial epicondyle.
b) Over the lateral pelvic/hip region.
c) Over the medial proximal tibia.
d) Just posterior to the medial malleolus.
e) Just distal to the lateral malleolus.
Answer C. ABFM 2011 , Q 203 , P 55.
34) Screening for osteoporosis should be done in which one of the following groups?
a) Postmenopausal women.
b) Women over age 50 with a BMI > 30 kg/m2.
c) Men over age 50 with type 2 diabetes mellitus.
d) Men over age 70.
Answer D. ABFM 2011 , Q 227 , P 61.
35) A 28-year-old white female consults you with a complaint of irregular heavy menstrual periods. A
general physical examination, pelvic examination, and Papanicolaou test are normal and a pregnancy
test is negative. A CBC and chemistry profile are also normal. The next step in her workup should be:
a) Endometrial aspiration.
b) Dilatation and curettage.
c) LH and FSH assays.
d) Administration of estrogen.
e) Cyclic administration of progesterone for 3 months.
Answer E. ABFM 2010 , Q 113 , P 31.
36) A 26-year-old female presents with a 1-year history of recurring abdominal pain associated with
intermittent diarrhea, 5–7 days per month. Her pain improves with defecation. There has been no
blood in her stool and no weight loss. Laboratory findings are normal, including a CBC, chemistry
profile, TSH level, and antibodies for celiac disease. Which one of the following would be most
appropriate at this point?
a) Colonoscopy.
b) An upper GI series with small-bowel follow-through.
c) Abdominal CT with contrast.
d) A gluten-free diet.
e) Loperamide.
Answer E. ABFM 2008 , Q 6 , P 2.
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37) A 47-year-old female presents with progressive difficulty hearing. She is employed as an office
worker, has no significant past medical history, and takes no medications. Physical examination
shows no gross abnormalities of her outer ears. The external ear canals are free of cerumen, and the
tympanic membranes move well to insufflation. Weber’s test and the Rinne test have results that are
compatible with a conductive hearing loss. Which one of the following is the most likely cause of this
patient’s hearing loss?
a) Noise-induced hearing loss.
b) Meniere’s disease.
c) Otosclerosis.
d) Acoustic neuroma.
e) Perilymphatic fistula.
Answer C. ABFM 2009 , Q 123 , P 34.
38) Which one of the following is appropriate and effective treatment for genitourinary gonorrhea in a
20-year-old male with a purulent urethral discharge?
a) Amoxicillin, 3.5 g orally once.
b) Ciprofloxacin, 500 mg orally once.
c) Ceftriaxone, 125 mg intramuscularly once.
d) Doxycycline, 100 mg 2 times daily for 3 days.
e) Erythromycin, 500 mg 4 times daily for 7 days.
Answer C. ABFM 2008 , Q 7 , P 2.
39) A 54-year-old white female has been taking amoxicillin for 1 week for sinusitis. She has developed
diarrhea and has had 6–8 stools per day for the past 2 days. Examination shows the patient to be
well hydrated with normal vital signs and a normal physical examination. The stool is positive for
occult blood, and a stool screen for Clostridium difficile toxin is positive. The most appropriate
treatment at this time would be:
a) Vancomycin (Vancocin) intravenously.
b) Metronidazole (Flagyl) orally.
c) Trimethoprim/sulfamethoxazole (Bactrim, Septra) orally.
d) Ciprofloxacin (Cipro) orally.
Answer B. ABFM 2008 , Q 132 , P 36.
40) A three-year-old, previously healthy child has become increasingly lethargic over the past three
weeks. Periorbital edema is present on physical examination. Urinalysis results are 4+ for protein. A
subsequent spot, first-morning urine sample shows a urine protein/creatinine ratio of 0.24 and no
blood, ketones, or glucose. Which one of the following statements is correct?
a) A repeat urine sample should be obtained at least four to six hours after the first while the patient
is in the upright position to rule out orthostatic proteinuria.
b) A renal biopsy should be performed.
c) Further evaluation with history, physical examination, and additional blood work is essential.
d) The family can be reassured that the proteinuria is transient.
Answer C. AAFP journal , 15 sep 2010.
41) A 14-year-old girl is diagnosed with major depressive disorder. It is her first episode and the clinical
assessment is that it is mild depression. Which one of the following treatment choices is appropriate?
a) Tricyclic antidepressant..
b) SSRI.
c) St. John's wort.
d) Cognitive-behavioral therapy.
e) Lithium.
Answer D. dr. Sebiany MCQs MOCK exam , 3rd December 2010 , Q 6.
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42) The most frequently used indicator for the quality of life is:
a) The life expectancy rate at birth.
b) The life expectancy rate without chronic disease and disability.
c) The life expectancy rate at 60 years of age.
d) The raw mortality rate.
e) Infant mortality rate.
Answer B. StarSmiley 3rd edition , 2007 , Q 2 , P 14.
43) Several patients present at your office simultaneously, with symptoms occurring 2-3 hours after a
meal. Their complaints include malaise, nausea and vomiting although they have no fever. Which of
the following food-poisonings is the likely cause of this condition?
a) Botulism.
b) Salmonellosis.
c) Staphylococcal aureus food poisoning.
d) Clostridium perfringens food poisoning.
e) E. coli.
Answer C. StarSmiley 3rd edition , 2007 , Q 91 , P 18.
44) A 22-year-old woman is seeing her physician with complaints of breast pain. It is associated with her
menstrual cycle and is described as a bilateral “heaviness” that radiates to the axillae and arms.
Examination reveals groups of small breast nodules in the upper outer quadrants of each breast.
They are freely mobile and slightly tender. Which of the following statements is most correct?
a) The patient has bilateral fibroadenomas, and reassurance is all that is necessary.
b) The patient has bilateral fibroadenomas, and a mammogram is necessary for further evaluation.
c) The patient has bilateral fibrocystic changes, and reassurance is all that is necessary.
d) The patient has bilateral fibrocystic changes, and a mammogram is necessary for further evaluation
e) The patient has bilateral mastitis, and antibiotic therapy is needed.
Answer C. Pre Test Family Medicine , 1st Edition , 2008 , P 66 , Q 120.
45) You are evaluating a 14-year-old female patient whose mother brought her in for evaluation. Despite
the fact that all of her friends have started menstruating, the daughter has not. On examination, she
has no breast development, no axillary or pubic hair, and her pelvic examination reveals normal
appearing anatomy. She has not lost weight recently and is not excessively thin. What is the most
likely cause of her primary amenorrhea?
a) Gonadal dysgenesis.
b) Hypothalamic failure.
c) Pituitary failure.
d) Polycystic ovarian syndrome.
e) Constitutional delay of puberty.
Answer A. Pre Test Family Medicine , 1st Edition , 2008 , P 104 , Q 241.
46) A healthy 60-year-old woman is seeing you to evaluate vaginal bleeding. She has not had a menstrual
period for approximately 7 years, but 3 months ago noted occasional pink spotting. Since then, it has
increased in amount and has become almost continuous. She is currently sexually active with her
husband. On examination, she appears well, her pelvic examination is normal, and screens for
sexually transmitted infections are negative. What would be your next step?
a) Pelvic ultrasound to evaluate for fibroids.
b) Pelvic CT scan to evaluate for pelvic tumor.
c) Laparoscopy to evaluate for endometriosis.
d) Endometrial biopsy.
e) Begin hormone replacement therapy to regulate bleeding.
Answer D. Pre Test Family Medicine , 1st Edition , 2008 , P 105 , Q 244.
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47) You are seeing a 4-year-old male 2 weeks after being diagnosed with left acute otitis media. He
completed his therapy, is afebrile, acting well, and apparently back to normal. On examination, he
has a persistent effusion in the left ear. There is no erythema, purulence or hearing loss. Of the
following, which is the most appropriate next step?
a) Reassurance and reevaluation in 2–4 weeks.
b) A 10-day course of a second-line antibiotic.
c) Regular use of a decongestant and reevaluation in 2 weeks.
d) Regular use of an antihistamine and reevaluation in 2 weeks.
e) Referral to an otolaryngologist.
Answer A. Pre Test Family Medicine , 1st Edition , 2008 , P 83 , Q 174.
48) A 13-year-old boy comes to your office for follow up of his reactive airway disease. He describes his
symptoms as daily and also experiencing nocturnal symptoms approximately 2 times per week.
Spirometry performed in your office reveals that his FEV1/PEFR is 75% of his predicted value. These
results classify his severity of asthma as:
a) Severe persistent.
b) Moderate persistent.
c) Mild persistent.
d) Mild intermittent.
Answer B. Pre Test Family Medicine , 1st Edition, 2008 , P 207, Q 370.
49) A 26-year-old elementary school teacher presents to you with an itchy rash. You note pruritic
erythematous papules in between her fingers, on her wrists, and around her waist at the belt line.
Which of the following is the most likely cause?
a) Chigger bites.
b) Bedbugs.
c) Flea infestation.
d) Scabies.
e) Body lice.
Answer D. Pre Test Family Medicine , 1st Edition , 2008 , P 64 , Q 116.
50) A 16-year-old woman comes to your office complaining of unpredictable menstrual periods. She
began her periods at age 14, and they have never been predictable. She denies sexual activity in her
lifetime, has no systemic illness, uses no medications regularly, and her physical examination is
normal. What is her most likely diagnosis?
a) Pregnancy
b) Ovulatory bleeding
c) Anovulatory bleeding
d) Uterine leiomyoma
e) Endometrial polyposis
51) You are evaluating a 32-year-old woman complaining of amenorrhea. She has mild hypertension,
hypothyroidism, gastroesophageal reflux disease, and depression. On evaluation, her prolactin level
was found to be 89 ng/mL (H). Which of the following medications would be most likely to cause the
elevated prolactin level?
a) Proton pump inhibitors.
b) Selective serotonin reuptake inhibitors.
c) Thiazide diuretics.
d) ACE inhibitors.
e) Thyroid hormone replacement.
Answer B. Pre Test Family Medicine , 1st Edition , 2008 , P 106 , Q 247.
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52) You are evaluating 32-year-old woman who has not menstruated in 4 months. She has a long history
of irregular menstrual periods, but has never gone this long without a period in the past. She is not
pregnant, her laboratory evaluation is normal, and you decide to perform a progestin challenge test.
The week after she takes 10 mg of medroxyprogesterone acetate (Provera) for 7 days, she reports
having a period. Which of the following is the most likely cause of her amenorrhea?
a) Premature ovarian failure.
b) Ovarian neoplasm.
c) Turner’s syndrome.
d) Asherman’s syndrome.
e) Polycystic ovarian syndrome.
Answer E. Pre Test Family Medicine , 1st Edition , 2008 , P 106 , Q 248.
53) You are discussing recurrent vaginal discharge with a patient. She has been evaluated three times in
the last 6 months, and has had a vaginal candidiasis each time. She has symptom-free intervals, but
the infection seems to be recurrent. She is sexually active, takes birth control pills, and denies other
complaints or known illnesses. Which of the following is most likely to improve this patient’s
condition?
a) Test her for diabetes, and control her elevated glucose level.
b) Ask her to discontinue her birth control pills.
c) Treat her sexual partner.
d) Test her for HIV, and begin therapy.
e) Ask her to add fiber to her diet.
54) You are seeing a patient who has end-stage liver disease with cirrhosis due to hepatitis C. What will
be her most likely cause of death?
a) Liver failure.
b) Myocardial infarction.
c) Bleeding varices.
d) Hepatocellular carcinoma.
e) Renal failure.
55) A 66-year-old diabetic man comes to your office with acute monoarticular arthritis. You suspect gout.
Which of the following tests is the most helpful in establishing the diagnosis?
a) Sedimentation rate.
b) C-reactive protein.
c) Serum uric acid levels.
d) Evaluation of joint aspirate.
Answer D. Pre Test Family Medicine, 2nd edition, 2009 , Q 363 , P 211.
56) A 17-year-old girl is seen in the emergency room. She reports high fever, nausea, vomiting, myalgias,
and lethargy. On examination, she is found to have hypotension and a generalized erythematous
rash and desquamation of the hands and feet. Laboratory tests show an increased white blood cell
count, increased blood urea nitrogen, and increased serum creatinine with decreased urine output.
The most likely diagnosis is:
a) Gonorrhea.
b) Lyme disease.
c) Toxic shock syndrome.
d) Tertiary syphilis.
e) PID.
Answer C. Bratton's , 3rd edition , 2007 , Q 61 , P 195.
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57) A 48-year-old woman presents to your office complaining of blurred vision and pain associated with
the right eye. The patient also reports seeing halos around light sources as well as nausea, abdominal
pain, and vomiting. The most likely diagnosis is:
a) Angle-closure glaucoma.
b) Graves' disease.
c) Digoxin toxicity.
d) Hyphema.
e) Atropine poisoning
Answer A. Bratton's , 3rd edition , 2007 , Q 76 , P 25.
58) A 65-year-old woman presents with glossitis, weight loss, paresthesias, and diarrhea. Laboratory
tests show a macrocytic anemia. The most likely cause is:
a) Iron deficiency anemia.
b) Thalassemia.
c) Pernicious anemia.
d) Multiple myeloma.
e) Colon cancer.
Answer C. Bratton's , 3rd edition , 2007 , Q 82 , P 26.
59) A major risk factor for shoulder dystocia includes which of the following?
a) Young maternal age.
b) Gestational diabetes.
c) Precipitous delivery.
d) Preterm delivery.
Answer B. Bratton's , 3rd edition , 2007 , Q 151 , P 218.
60) A 36-year-old woman has a history of a prior deep venous thrombosis (DVT). She is pregnant for the
first time. In view of her prior history of DVT, you should recommend:
a) Warfarin.
b) Heparin.
c) Aspirin.
d) Clopidogrel.
e) No prophylaxis is necessary.
61) An 18-year-old woman has noted darkened areas of skin on her face following the initiation of oral
contraceptives. The most likely diagnosis is:
a) Melasma.
b) Lupus pernio.
c) Malignant melanoma.
d) Sebaceous hyperplasia.
e) Adrenal hyperplasia.
62) A 33-year-old woman who delivered last week presents to your office with questions about her
gestational diabetes that developed during the first trimester. You explain:
a) Her risk of developing type 2 diabetes in the future is no different than anyone else.
b) She should be checked yearly for diabetes.
c) No further monitoring is necessary unless she develops symptoms of diabetes.
d) She should be tested for diabetes 6 months after delivery via fasting blood glucose measurements
on two occasions or a 2-hour oral 75-g glucose tolerance test.
12
63) The drug of choice for controlling eclamptic seizures is:

a) Hydralazine.
b) Phenobarbital.
c) Phenytoin.
d) Diazepam.
e) Magnesium sulfate.
Answer E. Bratton's , 3rd edition , 2007 , Q 14 , P 184.
64) Which of the following medications is contraindicated for the management of hypertension in
pregnancy?
a) Methyldopa.
b) Hydralazine.
c) Labetalol.
d) Nitroprusside.
e) Losartan.
Answer E. Bratton's , 3rd edition , 2007 , Q 69 , P 197.
65) A 24-year-old woman is noted to have the presence of Trichmonas found on a routine Pap smear. she
is entirely asymptomatic. Appropriate management should be to:
a) Reassure patient that no treatment is necessary.
b) Repeat cultures after the next menstrual cycle and treat if the organism is present.
c) Treat only if the patient is pregnant.
d) Treat regardless of symptoms.
e) Treat only if symptoms are present.
Answer D. Bratton's , 3rd edition , 2007 , Q 79 , P 199.
66) A 27-year-old asymptomatic pregnant woman is found to have hyperthyroidism. Which of the
following medications is the drug of choice for treatment?
a) Propylthiouracil.
b) Radioactive iodine.
c) Methimazole.
d) Propranolol.
e) Levothyroxine.
67) A Pap smear result shows atypical cells of undetermined significance (ACS-US). HPV typing is negative
for high-risk HPV. Appropriate management at this time includes:
a) Repeat Pap smear at one year.
b) Repeat Pap smear at 6 months.
c) Colposcopy.
d) LEEP procedure.
e) Cervical cryotherapy.
68) A 20-year-old college student presents to her dentist. Her vital signs are normal, and her weight is
120 lb. On examination, extensive upper dental erosion is noted. The most likely diagnosis is:
a) Obsessive-compulsive disorder.
b) Anorexia nervosa.
c) Hypothyroidism.
d) Bulimia nervosa.
e) Binge-eating disorder.
Answer D. Bratton's , 3rd edition , 2007 , Q 36 , P 237.
13
69) A 40-year-old lady came to health clinic, you will do all of the following EXCEPT:
a) Mammogram.
b) Endometrial biopsy.
c) Pap smear.
d) Cholesterol.
Answer B. Family Medicine Certification Review, 1st edition, 2004
70) A 16-year-old complains of pain in his knees, which increase with exercise. A physical examination
reveals, in addition to tenderness, a swollen and prominent tibial tubercle. Radiographs of the area
are unremarkable. The most likely diagnosis is:
a) Legg-Calve-Perthes disease.
b) Osgood-Schlatter disease.
c) Slipped capital femoral epiphysis.
d) Popliteal cyst.
Answer B. Pre Test Pediatrics, 10th edition, 2004, Q 21 , P 13.
71) A mother brings an 18-month-old to the emergency center with the concern that the child may have
ingested a substance. Which of the following is a contraindication to the use of ipecac in this child:
a) Age less than 5 years.
b) Breast-feeding.
c) Ingestion of alkali.
d) Ingestion of iron.
e) Concurrent administration of intravenous glucose.
Answer C. Pre Test Pediatrics, 10th edition, 2004, Q 11 , P 7.
72) During a physical examination for participation in a sport, a 16-yearold girl is noted to have a late
apical systolic murmur, which is preceded by a click. The rest of the cardiac examination is normal.
She states that her mother also has some type of heart “murmur” but knows nothing else about it.
The most likely diagnosis is:
a) Atrial septal defect.
b) Aortic stenosis.
c) Tricuspid regurgitation.
d) Mitral valve prolapsed.
e) Ventricular septal defect.
Answer D. Pre Test Pediatrics, 10th edition, 2004, Q 192 , P 118.
73) A full-term newborn infant is having episodes of cyanosis and apnea, which are worse when he is
attempting to feed, but he seems better when he is crying. The most important next step to quickly
establish the diagnosis is:
a) Echocardiogram.
b) Ventilation perfusion scan.
c) Passage of catheter into nose.
d) Hemoglobin electrophoresis.
e) Bronchoscopic evaluation of palate and larynx.
74) The mother of a 7-day-old infant has developed chickenpox. Which of the following is the most
appropriate measure?
a) Isolate the infant from the mother.
b) Hospitalize the infant in the isolation ward.
c) Administer acyclovir to the infant.
d) Administer varicella-zoster immunoglobulin to the infant.
e) Advise the mother to continue regular well-baby care for the infant.
Answer E. Pre Test Pediatrics, 10th edition, 2004, Q 111 , P 62.
14
75) A 14-year-old girl has a 9-month history of diarrhea, abdominal pain (usually periumbilical and
postprandial), fever, and weight loss. She has had several episodes of blood in her stools. Which of
the following is the most likely diagnosis in this child?
a) Chronic appendicitis.
b) Chronic pancreatitis.
c) Crohn disease.
d) Bulimia.
e) Gallstones.
76) What is the key diagnostic test in making the diagnosis of congestive heart failure?
a) Chest x-ray.
b) Electrocardiogram.
c) Cardiac catheterization.
d) Echocardiogram.
e) Shortness of breath.
Answer D. Family Medicine Certification Review, 2nd edition, 2007 , P 10 , Q 109.
77) A 6-year-old girl presents with her first episode of otitis media. She has been treated with antibiotics
on one prior occasion for a urinary tract infection. She has no known drug allergies. Which of the
following is the most appropriate antibiotic to treat this patient?
a) Cefuroxime.
b) Azithromycin.
c) Amoxicillin.
d) Cephalexin.
e) Amoxicillin/clavulanic acid.
Answer C. Family Medicine Certification Review, 2nd edition, 2007 , P 67 , Q 6.
78) Which of the following is appropriate therapy for treating an adolescent with chlamydial cervicitis?
a) Azithromycin 1 g in a single dose
b) Doxycycline 100 mg twice daily for 3 days
c) Ceftriaxone 250 mg as a single IM dose
d) Metronidazole vaginal gel twice daily for 5 days
e) Penicillin 500 mg orally three times daily for 7 days
Answer A. Family Medicine Certification Review, 2nd edition, 2007 , P 67 , Q 7.
79) Rifampin is the drug of choice for post exposure prophylaxis for household contacts of a patient with:
a) Escherichia coli sepsis.
b) Haemophilus influenza type B disease.
c) West Nile virus.
d) Streptococcal meningitis.
e) Staphylococcal skin infections.
Answer B. Family Medicine Certification Review, 2nd edition, 2007 , P 295 , Q 65.
80) A child can do babbling and crawling around the office. She poked her fingers at the outlet covers
and could use a pincer grasp to pick up a raisin. These behaviors are developmentally appropriate for
a child at age:
a) 6 months.
b) 9 months.
c) 15 months.
d) 24 months.
Answer is B. Family practice examination & board review, 2nd edition, 2009 , 1st case , P 441.
15
81) An 18-year-old presents with fever up to 102°F and ear pain. You find that she has a left acute otitis
media and treat her with amoxicillin. You schedule a follow-up in 3 weeks. When you see her at that
time, the physical exam shows fluid behind the tympanic membrane (TM). The TM moves a little
with insufflation and is not erythematous. What type of medication has been shown to be helpful in
this situation?
a) Antibiotics.
b) Antihistamines.
c) Corticosteroids.
d) Decongestants.
e) Watchful waiting.
Answer E. Family Medicine Certification Review, 2nd edition, 2007 , P 12 , Q 126.
82) The mother of an 18-month-old presents reporting that the child has had a fever to 103°F for 3 days.
He is doing better today with no fever, but he has developed a rash. There are no other localizing
symptoms. On exam, he appears well, his temperature is 98.6°F, and his examination is normal
except for a maculopapular rash on the trunk and neck along with some shotty posterior cervical
lymphadenopathy. Which of the following is the likely diagnosis?
a) Roseola infantum.
b) Fifth disease
c) Measles
d) Kawasaki's disease
e) Allergic reaction
Answer A. Family Medicine Certification Review, 2nd edition, 2007 , P 78 , Q 117.
83) A 71-year-old male complains of a 2-month history of neck and bilateral shoulder pain and stiffness,
which tends to be worse in the morning. Pain is worsened by movement but is not palpable on
examination. There is no noticeable joint redness or swelling. His ESR is 63. Which diagnosis is likely?
a) Fibromyalgia.
b) Polymyositis.
c) Polymyalgia rheumatica.
d) Rheumatoid arthritis.
e) Scleroderma.
Answer C. Family Medicine Certification Review, 2nd edition, 2007 , P 24 , Q 266.
84) A newborn infant is noted to have the stigmata of Down's syndrome. In regard to telling the parents
the presumed diagnosis, which of the following would be most appropriate?
a) Delay any discussion with either parent until the diagnosis is confirmed by chromosomal analysis.
b) Permit the mother to bond to the infant (1 to 5 days) before discussion the diagnosis.
c) Explain the diagnosis to the father and have him tell the mother, either privately or with a physician
present, as he prefers.
d) Inform both parents of the presumed diagnosis as soon as possible.
e) Explain the diagnosis to the father at once, but delay discussion with the mother for 48 to 72 hours.
Answer D. Appleton's Pediatrics 5th Edition, 1993 , P 16 , Q 7.
85) On a routine examination, a newborn infant is found to have epiphora, photophobia, blepharospasm
and enlarged and cloudy corneas. The infant probably has:
a) Congenital cataract.
b) Congenital glaucoma.
c) Galactosemia.
d) Intraocular hemorrhage.
e) Retrolental fibroplasias.
Answer B. Appleton's Pediatrics 5th Edition, 1993 , P 39 , Q 42.
16
86) A 24-hour-old infant weighing 1,7oo g is noted to have irritability , apnea , cardiac arrhythmias , and
finally seizures. Of the following metabolic derangements, which would be the most likely to cause
these symptoms?
a) Hypercalcemia.
b) Hypocalcemia.
c) Hyperglycemia.
d) Hypoglycemia.
e) Hyponatremia.
Answer B. Appleton's pediatrics 5th Edition, 1993 , P 39 , Q 52.
87) A 3 weeks old male infant is admitted because of vomiting for 12 days. Birth weight was 2925 g.
vomiting began on the 10th day of life and persisted despite discontinuation of the prepared formula.
The child appears poorly nourished. Weight 2850. A firm, 3 cm olive-shaped mass is palpated deep,
just to the right of the mid-epigastium. The most likely cause of the abdominal mass is:
a) Adrenal hemorrhage.
b) Intussusception.
c) Neuroblastoma.
d) Pancreatic pseudocyst.
e) Pyloric stenosis.
Answer E. Appleton's pediatrics 5th Edition, 1993 , P 193 , Q 114.
88) A 7-year-old boy developed URT infection two weeks ago. He was complaining of fever, mayalgia and
chills, then he received aspirin and anti congestion medications for two weeks. Later on, after 3 days
he became lethargic and irritable with decrease level of consciousness. On examination he looks
irritable, confuse, semi-comatose and combative. Which investigation you will order now?
a) Serum level of ammonia.
b) Urine exam for substance abuse.
c) BUN.
d) Serum organophosphorus.
e) Serum lead.
Answer A. Repeated from Saudi board 2nd part , November 2012.
89) A 22-year-old male develops fever, malaise, sore throat, and a dry hacking cough over several days.
He does not appear to be particularly sick, but his chest examination is significant for diffuse rales
and rhonchi. The chest radiograph shown has reticulonodular opacities in the right upper lobe and
prominence of the right hilum. The most likely pathogen is
a) Pneumocystic jiroveci.
b) Mycobacterium tuberculosis.
c) Haemophilus influenza.
d) Streptococcus pneumonia.
e) Mycoplasma pneumonia.
Answer E. Pre Test Pediatrics, 10th edition, 2004, Q 217 , P 137.
90) A 9-month-old boy brought by his mother to see you in the clinic. Her main concern that her son did
not have teeth eruption till now. He is developmentally normal. His height and weight are normal.
What will be your advice to her?
a) Tell her don't worry except after 1 month.
b) It is not unusual for the first deciduous teeth to erupt before 12 months.
c) Investigate for hypothyroidism.
d) Do roentgenogram for mandible and maxillary X ray.
e) Tell her that because her son have a nails, so he will also have teeth eruption.
Answer B. Repeated from pediatric end of rotation , 2010 , Jeddah.
17
91) During consultation when the doctor said to the patient "Ohh my dear really it is difficult situation,
you really spend a difficult time". What is the doctor show?
a) Sympathy.
b) Empathy.
c) Patient centeredness.
d) Collaboration.
Answer B. Preparatory course for family medicine (MCQ Mock Exam II), at 28 May 2011, Q 4.
92) A 30-year-old white male presents to an urgent care clinic with a sever, penetrating pain behind the
right eye associated with tearing. This intense headache occurred each of the last three nights and
lasting from 2 to 3 hours. This occurred also several month before. This is most likely:
a) Migraine headache.
b) Tension headache.
c) Cluster headache.
d) Chronic glaucoma.
e) Sinus headache.
Answer C. dr. Sebiany MCQs MOCK exam , 2008 , Q 14.
93) A 5-year-old child is brought to the ER with his mother. The mother tells you that for the past 24
hours, the child has been "talking strangely" and drooling. He has had no appetite and has not been
drinking. Based on this history, what is the diagnostic procedure that can substantiate the diagnosis
of the patient described?
a) A WBC count.
b) An ESR.
c) A chest x-ray.
d) A lateral x-ray of the neck.
e) A CT scan of the head and the neck.
Answer D. dr. Sebiany MCQs MOCK exam , 10th May 2005 , Q 56.
94) A 35-year-old Female volleyball coach consults you about a pruritic, vesicular eruption on the medial
aspect of both feet, which she says has spread to her hands, causing a vesicular eruption resembling
dyshidrosis. She is not using any drugs internally or topically. The most likely diagnosis is:
a) Psoriasis.
b) Erythema multiform.
c) Contact dermatitis.
d) Tenia pedis.
e) Neurodermatitis.
Answer D. dr. Sebiany MCQs MOCK exam , 7th April 2005 , Q 14.
95) This is the rhythm strip of A 72-year-old male patient who presents with palpitation, breathlessness
and chest pain for three hours duration. What does it show:
a) Atrial flutter.
b) Atrial fibrillation.
c) Supra-ventricular tachycardia.
d) Multifocal ventricular ectopics.
Answer B. MRCGP for trainees 2010 , (On Examination) , P 487 , Q 13.
18
96) A 65-year-old male patient complaining of severe headache. Which of the following is the best
investigation to detect an intracranial hemorrhage:
a) Non contrast brain CT scan.
b) Contrast brain CT scan.
c) Non contrast brain MRI.
d) Contrast brain MRI.
Answer A.
97) A 41-year-old male trips on a curb while running, sustaining an inversion ankle injury. According to
the Ottawa ankle rules, which one of the following would be an indication for radiographic
evaluation?
a) Tenderness at the anterior talofibular ligament.
b) Point tenderness over the cuboid.
c) Inability to take four steps either immediately after the injury or while in your office.
d) Bony tenderness at the anterior aspect of the distal tibia.
e) Point tenderness over the base of the fourth metatarsal.
Answer C. ABFM 2009 , Q 126 , P 34.
98) A 35-year-old white male presents with dyspepsia. He has had no symptoms that suggest
gastroesophageal reflux or bleeding, but a test for Helicobacter pylori is positive. After 2 weeks of
treatment with omeprazole (Prilosec), amoxicillin, and clarithromycin (Biaxin), he is asymptomatic.
Which one of the following is recommended to test for the eradication of H. pylori in this patient?
a) Immunoglobulin G serology.
b) A urea breath test.
c) Upper endoscopy with a biopsy.
d) Biopsy urease test.
e) Stool antigen test.
Answer B. ABFM 2009 , Q 214 , P 58. ‫سؤال مشابه‬
99) A 7-year-old boy not talking too much at the school, but he is talking well at the OPD with normal
development. What is the most likely diagnosis?
a) Asperger syndrome.
b) Elective mutism.
c) Autism.
d) ADHD.
Answer B. (Pretest Psychiatry, 12th edition, 2009, P 79 , Q 145 ‫)سؤال مشابه‬
100) A 25-year-old smoker male patient complaining of sudden onset of chest pain for 12 hours. On
examination RR 30/min, Pulse 100/min. On chest exam there is decrease chest expansion, hyper-
resonant on percussion on right side, with decrease breath sound on right side. What is the most
likely diagnosis?
a) Pneumonia.
b) Pleural effusion.
c) Pneumothorax.
d) Pulmonary embolism.
Answer C. Bratton's 3rd edition, 2007
101) A 5-year-old boy presents 3 days post fever with macular rash. The most likely diagnosis is:
a) Henoch-purpura schoenlein.
b) Idiopathic thrombocytopenia purpura.
c) Measles.
Answer A.
19
102) A 57-year-old male has become forgetful, preoccupied, withdrawn and suspicious. His physical
examination was normal. The patient has been with his company for 22 years and was considered an
excellent employee. Which of the following is most likely diagnosis?
a) Multi-infarct dementia.
b) Schizophrenia..
c) Vascular dementia.
d) Alcoholism.
e) Alzheimer.
Answer E. dr. Sebiany MCQs MOCK exam , 3rd December 2009 , Q 49.
103) A 63-year-old female with a 12year history of hypertension, and diabetes has been treated with
metformin 1 g bd, gliclazide 80 mg bd, rosuvastatin 10 mg daily, ramipril 10 mg daily, aspirin 75 mg
daily and amlodipine 10 mg daily for the last 2 years. At annual review her BP is 138/82 mmHg, fundi
reveal background diabetic retinopathy. Her results show : HbA1c 7.2% , Urea 12.5 mmol/L ,
Creatinine 176 μmol/L , cholesterol 4.8 mmol/L. Which of the following drugs should be withdrawn?
a) Aspirin.
b) Gliclazide.
c) Metformin.
d) Ramipril.
e) Rosuvastatin.
Answer C. MRCGP for trainees 2010 , (On Examination) , P 735 , Q 18.
104) A 77-year-old male presents with sudden of loss of vision in his right eye, associated with a
relative afferent papillary defect. He has poorly controlled systemic hypertension and raised
cholesterol. What is the most likely aetiology of the presentation?
a) Cataract.
b) Chronic open angle glaucoma.
c) Macular degeneration.
d) Retinal vascular occlusion.
e) Retinitis pigmentosa.
Answer D. MRCGP for trainees 2010 , (On Examination) , P 689 , Q 18.
105) Child took some tablets, present to ER with pinpoint pupil, confusion, and decrease respiration.
Which of the following drugs is most likely he took?
a) Atropine.
b) Paracetamole.
c) Opiate.
d) Benzodiazepine.
Answer C. MRCGP for trainees 2010 , (On Examination) , P 647 , Q 19.
106) Female patient present with paralysis of the lower limbs, and inability to move her legs. She was
beaten by her husband last night. What is the most likely diagnosis?
a) Psychogenic paralysis.
b) Conversion disorder.
c) Somatization.
Answer B.
107) Child with trauma on eye with edema and proptosis with painful eye movement. The diagnosis is:
a) Preseptal cellulitis.
b) Cavernous hemangioma.
c) Viral infection.
d) Orbital cellulitis.
Answer D.
20
108) During a regular checkup on an 8-year-old child, you note a loud first heart sound with a fixed
and widely split second heart sound at the upper left sternal border that does not change with
respirations. The patient is otherwise active and healthy. The mostly likely heart lesion to explain
these findings is
a) Atrial septal defect.
b) Ventricular septal defect.
c) Isolated tricuspid regurgitation.
d) Aortic stenosis.
e) Mitral valve prolapsed.
Answer A. Pre Test Pediatrics, 10th edition, 2004, Q 182 , P 115.
109) Which of the following is the primary reason that lithium is important in the treatment of mood
disorders?
a) No dosage adjustment is necessary in the elderly or in patients with kidney disease.
b) Is effective in both mania and depression.
c) It can be administered orally or parenterally, making it useful in both outpatients and severely
agitated hospitalized patients.
d) It has a favorable side-effect profile and minimal toxicity.
Answer B. AAFP Journal , 1995.
110) In a study to assess the relation between smoking and specific gynecological cancer, 29,031
sample size had been collected. Among 15,219 had been exposed to smoking, 451 had cancer. Among
13,812 had not been exposed to smoking, 57 had cancer. Calculate the relative risk:
a) 1
b) 2
c) 5
d) 7
e) 9
Answer D. )‫(األرقام في السيناريو كانت قريبة من كذا‬
111) Which of the following murmurs considered as a pathological murmur:

a) Diastolic murmur.
b) Murmur with fever then disappear after fever subside.
c) Soft murmur.
d) Grade II murmur in elderly patient with chronic diseases.
Answer A.
112) A 12-year-old male presents with left hip pain. He is walking with a limp and his BMI is 30. On
examination he is afebrile and has limited internal rotation of the left hip. What is the most likely
cause of the hip pain?
a) Septic arthritis.
b) Juvenile rheumatoid arthritis.
c) Transient synovitis.
d) Slipped capital femoral epiphysis.
e) Legg-Calvé-Perthes disease.
Answer D. ABFM 2011 , Q 27 , P 8.
113) Treatment of a patient with obsessive compulsive disorder is:

a) SSRI (venlafaxine).
b) Tricyclic antidepressant.
c) MAO inhibitor.
d) Propranolol.
Answer A.
21
114) Which one of the following can cause a sensory-neural hearing loss?
a) Otosclerosis.
b) Presbycusis.
c) Otitis media.
d) Wax.
e) Fluids in the middle ear.
Answer B.
115) Alcoholic patient presents to the ER with confusion and weakness. Investigations showed low
potassium and low calcium levels. What you will look for?
a) Sodium.
b) Protein.
c) Magnesium.
d) Zinc.
Answer C.
116) A 15-year-old female patient, distressed adolescent with comedonal acne. What is the treatment
of first choice?
a) Topical tretinoin.
b) Topical benzoyl peroxide.
c) Topical antibiotic.
d) Intralesional corticosteroids.
e) Oral isotretinoin.
Answer B. Swanson's 5th edition , 2005, P 154 , Q 2.
117) Which one of the following is disadvantage of cohort studies:

a) Because of rare outcomes; it need large sample size.
b) Because the patients need to remember what happened before long time; there will be a recall
bias.
c) Cannot estimate incidence.
d) Cannot use in rare diseases.
Answer A.
118) Young male patient complaining of facial pain for 2 weeks. On examination there is facial
tenderness on palpation. What is the most likely diagnosis?
a) Temporal arteritis.
b) Viral infection.
c) Migraine headache.
d) Maxillary sinusitis.
Answer D.
119) A 22-year-old female patient presents with watery tearing of the left eye for 2 days. Associated
with few purulent discharge and pre-auricular lymph node enlargement. No history of fever or upper
respiratory tract infection. The most likely diagnosis is:
a) Viral conjunctivitis.
b) Bacterial conjunctivitis
c) Glaucoma.
d) Chlamydia conjunctivitis.
Answer A.
120) Pregnant present with PROM, what you will do:

 Ferning under microscope.
22
121) Young female patient presents with picture of Cushing , hirsutism, striae marks, and abdominal
obesity. What lab result you will see?
a) Increase vanillylmandelic acid.
b) Hyperkalemia.
c) .
Answer A.
122) Hypertensive patient on ACE inhibitor, and developed cough. What is the mechanism?
a) Increase level of angiotensin.
b) Increase level of bradykinin.
c) .
Answer B.
123) Child with tourette's syndrome; usually can present with all of the following EXCEPT:
a) Depression.
b) Anxiety.
c) Psychosis.
d) Hyperactivity.
e) Obsession.
Answer C. Information written in Pre test pediatrics.
124) Which of the following medications improve survival after myocardial infarction in hypertensive
patient?
a) Nitrate.
b) Morphine.
c) ACE inhibitors.
d) Calcium channel blockers.
e) Aspirin.
Answer C.
125) A 30-year-old female patient present with scaly silver plaques on flexor surfaces. Associated with
nail changes and hair loss. What is the most likely diagnosis?
a) Psoriasis.
b) Seborrheic dermatitis.
c) Lichen planus.
d) Tinea corporis.
Answer A.
126) Patient present with multiple gastric ulcers in the last few months. CT abdomen showed mass on
the head of the pancreas. The most likely diagnosis is:
a) Pancreatic lymphoma.
b) Gastrinoma.
c) .
Answer A.
127) The most specific test for diagnosing myocardial infarction is:
a) CK-MB.
b) Troponin I.
c) ALT.
d) ECG.
e) CK.
Answer ?B. from Up-To-Date.
23
128) Regarding pregnant patient with carpal tunnel syndrome. All are true EXCEPT:
a) Surgery can be done if there is hand weakness.
b) Maximum at second trimester.
c) .
Answer B.
129) Regarding iritis, which one of the following need referral to ophthalmologist:
a) Purulent discharge.
b) Cilliary flush.
c) .
Answer B.
130) Patient with dyslipidemia and high LDL. Before start treatment you should screen for:
a) Hypothyroidism.
b) Hyperparthyroidism.
c) .
Answer A.
131) Regarding capacity and power, which one of the following is TRUE:
a) When the patient able to refuse your management even if he did not understand what you tell him.
b) When the patient able to retain the information you gave to him.
c) .
Answer B.
132) Carbone monoxide act by:

a) Decrease oxygen to peripheral circulation.
b) Shift oxyhemoglobin curve to right.
c) Decrease affinity of hemoglobin.
Answer ?A. from Wikipedia.
133) Couple consult you regarding post partum psychosis. The mother had post partum psychosis in
the last time and they ask about percentage of recurrence:
a) 1 %
b) 10 %
c) 20 %
d) 30 %
Answer ?C.
134) Pregnant at 8 weeks by LMP, but pelvic exam showed fundal height about 12 weeks. Pelvic U/S
showed an 8 weeks gestational sac with multiple fibroids. What is your action?
a) Wait for full term and then probable normal delivery.
b) Wait for full term and do elective caesarian section.
c) Termination of the pregnancy.
Answer ?A
135) Pregnant at 34 weeks gestation present with painless bleeding and placenta previa. There is one
contraction every 30 minute. Blood pressure is normal, and fetal monitoring is normal. On
examination she still bleed slowly. What is your NEXT step:
a) Hospitalization.
b) Cesarean section.
c) Vaginal delivery.
d) Dexamethazone.
Answer
24
136) A 35-year-old lady present with diffuse swelling of the neck. Thyroxin was high, iodine uptake
was low. On exam, the swelling was hard and tender on palpation. The most likely diagnosis is:
a) Thyroid cancer.
b) Subacute thyroiditis.
c) Gravis disease.
d) .
Answer
137) Asthmatic patient with moderate persistence attacks, on corticosteroid inhaler 200 μg/day and
ventolin. Still not controlled. What you will do to his management?
a) Increase inhaled corticosteroid dose.
b) Add leukotriene inhibitor.
c) Add LABA.
d) Add oral prednisone.
e) Continue same treatment.
Answer
138) Child was unrestrained in motor vehicle accident. Complaining of neck pain. X-ray normal. The
best next step is:
a) Observation.
b) CT.
c) MRI.
Answer
139) Old diabetic patient. In order to assess the chronic kidney impairment, what investigation you
will ask to assess between kidney and proteinurea:
a) 24-hour urine collection of protein.
b) Albumin-Creatinine ratio.
c) Protein-Creatinine ratio.
Answer
140) Young female patient, known case of depression. She did not slept for the whole night because of
insomnia. You expect from her to present with:
a) Worsening of her depression.
b) Mania.
c) Daytime somnolence.
Answer
141) Patient treated from gastroenteritis before 1 day. Present with muscle spam and neck twitching.
This is most likely due to:
a) Metoclopromide.
b) Hyoscine.
c) Ciprofloxacin.
d) .
Answer
142) You are doing clearance for patient who will do tibio-femoral bypass surgery. Which of the
following will you order before the operation:
a) Pulmonary function test.
b) Carotid angiography.
c) Coronary angiography.
Answer ?A.
25
143) Patient known case of WPW syndrome present with SVT. On examination he is hemodynamically
stable. Which medication you will give:
a) Adenosine
b) Procinamide
Answer ?A.
144) MCQ about bronchial asthma:

 Give albuterol PRN.
145) An 18 months old boy with recurrent UTI. What investigation help in determining the cause?
a) Ultrasound.
b) IVP.
c) Retrograde pyelograph.
d) Retrograde cystouretrograph.
Answer
146) A 15-year-old female patient present with deviation of her spine. What is most important next
test?
a) Forward bending test.
b) Inspect buttocks from behind.
c) Chest x ray.
d) Referral.
Answer
147) .
148) .
149) .
150) .
26
PAPER TWO (Clinical cases) – 14 cases contain 60 MCQs – 2 hours duration
Case 1 :
The patient is a 2,400-g male infant born to a type O Rh-positive woman after an uneventful 40 week
pregnancy. The infant is normal at birth but is noted to be jaundiced at about 48 hours of age. The infant
is feeding and acting well, and physical examination is entirely within normal limits except for the
presence of jaundice of the skin and sclera. Serum bilirubin at 48 hours is found to be 14.5 mg/dl.
1) The serum bilirubin concentration in this child is:

a) Within physiologic limits and requires neither investigation nor monitoring.
b) Within physiologic limits and requires no investigation but should be monitored.
c) About physiologic limits and should be investigated but requires no monitoring at this time.
d) Above physiologic limits and should be monitored but requires no diagnostic investigation at this
time.
e) Above physiologic limits and requires both investigation and monitoring.
Answer is E. Appleton's pediatrics 5th Edition, 1993 , P 160 , Q 61.
2) All of the following tests should be included in the first battery of investigation EXCEPT:
a) Determination of the infant's blood type.
b) Examination of peripheral blood smear.
c) Hemoglobin electrophoresis.
d) Determination of hemoglobin and hematocrit.
e) Count of nucleated red blood cells and/or reticulocyte count.
Answer is C. Appleton's pediatrics 5th Edition, 1993 , P 160 , Q 62.
3) Of the following additional tests, which would be most important at this time:
a) Sickle prep.
b) Coombs's test.
c) Glucose-6-phosphate dehydrogenase level.
d) Liver biopsy.
e) Serum AST , ALT.
Answer is B. Appleton's pediatrics 5th Edition, 1993 , P 160 , Q 63.
4) The results of the tests ordered above are all negative or within normal limits. Repeat bilirubin at 54
hours of life is 16.5 mg/dL with a conjugated fraction of 1.1 mg/dL. At this time it would be advisable
to:
a) Perform an exchange transfusion.
b) Initiate phototherapy.
c) Order an abdominal ultrasound.
d) Administer ampicillin and gentamycin.
e) Wait for repeat bilirubin in 6 hours.
Answer is B. Appleton's pediatrics 5th Edition, 1993 , P 160 , Q 64.
27
Case 2 :
A 21-year-old woman presents to your office with complaint of pelvic pain seems worse over the last 2
weeks. She also complains of not getting pregnant. She started her periods around 14 years but has only
had a couple of periods since then. Finally, she wants something to treat facial hair and acne, both of
which have been worse lately. On physical exam, you note the patient is a centrally obese young woman,
afebrile, with excess hair noted down the side of her face and under her chin.
5) Which of the following lab results would be most appropriate?
a) Urine pregnancy test.
b) TSH level.
c) CA-125 level.
d) LH : FSH.
e) Prolactin level.
Answer D. Family practice examination & board review, 2nd edition, 2009 , case 16 , P 542.
6) On closer inspection, you see slightly hyperpigmented areas of roughened skin in her axilla, which
she states appeared in the last 6 months. Which of the following lab values would correlate with this
finding?
a) Elevated testosterone level.
b) Elevated dehydroepiandrosterone sulfate (DHEAS) level.
c) Elevated serum 17-hydroxyprogesterone (17-OHP) level.
d) Prolactin level 3 times normal.
e) Elevated fasting insulin level.
Answer E. Family practice examination & board review, 2nd edition, 2009 , case 16 continue, P 542.
7) The most common internal malignancy with this finding is:
a) Stomach cancer.
b) Ovarian cancer.
c) Breast cancer.
d) Thyroid cancer.
Answer A.
8) You have her return in a week. She is noted to have lower abdominal tenderness, cervical motion
tenderness, and a vaginal discharge. She has a low grade fever of 100.5°F (38.0°C). You review her lab
results: HIV and RPR negative; gonorrhea positive. Which of the following is the best therapy for her?
a) Ampicillin orally and azithromycin orally.
b) Metronidazole orally as a single dose.
c) Ciprofloxacin orally as a single dose.
d) Ceftriaxone 250 mg IM and doxycycline 100 mg twice daily for 7 days.
e) Ceftriaxone 250 mg IM.
Answer D. Case files family medicine, 2nd edition, 2010 , Q 22.3 , P 238.
9) You next see her for a health maintenance examination, including pelvic examination. She complains
of a vulvar “itching” due to recurrent yeast infections, and her symptoms have worsened over the
last few months. She is sexually active with her new husband and has experienced dyspareunia with
penetration lately. On examination, you find complete loss of the borders of the labia minora,
constriction of the vaginal outlet, and several thin white plaques (like parchment paper) on the vulva.
There is no other skin or mucosal involvement. What is the most likely diagnosis?
a) Lichen planus.
b) Lichen simplex.
c) Lichen sclerosus.
d) Vulvovaginal candidiasis.
e) Squamous carcinoma.
Answer C. Family practice examination & board review, 2nd edition, 2009 , case 16 continue, P 546.
28
Case 3 :
A 79-year-old female patient, well known to you from 5 years of treating her hypertension, presents to
your office with concerns about her vision and hearing. Over the last year, she has noticed worsening
vision in her left eye. She denies eye pain, tearing, and redness. She wears bifocals and last had an eye
exam 3 years ago. At that time, she recalls her eye doctor said her vision was “stable.” Also, her
gynecologist recently retired and she would now like you to assume that care. On exam there was
decreased visual acuity and central visual field distortion.
10) Which of the following is the most likely diagnosis?

a) Macular degeneration.
b) Cataracts.
c) Open-angle glaucoma.
d) Central retinal artery occlusion.
e) Retinal detachment.
Answer A. Family practice examination & board review, 2nd edition, 2009 , case 2 , P 694.
11) She then complains that she is less socially active in the last year. Her son thinks she is depressed
because she talks on the phone with him less than she did a year ago. Your patient thinks these
problems are related to a loss of hearing. Regarding her diagnosis, which of the following is true?
a) Results in unilateral hearing loss.
b) Results in low-frequency hearing loss.
c) Results in loss of speech discrimination.
d) Results in major depression.
e) Sensorineural hearing loss does not respond to hearing aid use.
Answer C. Family practice examination & board review, 2nd edition, 2009 , case 2 continue, P 695.
12) Your patient is an overweight white female with no history of bone fracture. She has never had a
bone mineral density test and asks if she should have one. You are unaware of any risk factors in her
other than white race and postmenopause status. What do you tell her?
a) “You are not at risk for osteoporosis and should not be screened.”
b) “All women > 65 years should be screened for osteoporosis regardless of risk.”
c) “Take 1,000 mg of calcium per day to prevent osteoporosis.”
d) “Because of your risk factors, you should start a bisphosphonate, vitamin D, and calcium
supplementation.”
e) “Alcohol use will help decrease your risk of osteoporosis.”
Answer B. Family practice examination & board review, 2nd edition, 2009 , case 2 continue, P 696.
13) The patient present after few months with low back pain, you think its muscular. Which of the
following you will NOT prescribe to her?
a) Diclofenac gel.
b) Paracetamol.
c) Cox-2 inhibitor.
d) Codeine.
Answer D.
14) The patient present in a follow-up after one year with stroke. In addition to ACE inhibitor, what
medication you will recommend?
a) Hydrochlorthiazide.
b) Amlodipine.
c) Calcium channel blockers.
Answer A.
29
Case 4 :
A 21-year-old sexually active female presents with acute pelvic pain of several days’ duration. Her LMP 8
weeks ago and no history of vaginal discharge. A pelvic examination reveals right-sided tenderness and a
general fullness in that area, but free from pain at the left side.
15) What is the most important question in the history you have to ask about it?
a) Recent sexual intercourse.
b) History of bleeding.
c) Dyspareunia.
d) .
Answer B. Repeated from arab board 2007.
16) In addition to laboratory testing, you decide to order an imaging study. Which one of the following is
the best choice at this time?
a) Transabdominal ultrasonography.
b) Transvaginal ultrasonography.
c) Contrast CT of the abdomen and pelvis.
d) Hysteroscopy.
e) Hysterosalpingography.
Answer B. ABFM 2011, Q 98 , P 26.
17) What is the most likely diagnosis?

a) Ectopic pregnancy.
b) Gonorrhea.
c) Appendicitis
d) Abortion.
Answer A. Repeated from arab board 2007.
18) Now she is febrile with temperature of 38 0C , and blood pressure of 90/50 , and pulse 110/minute.
On examination, she is drowsy with severe abdominal pain. In addition to fluid resuscitation, what is
your next step?
a) Rush to do surgery.
b) laparoscopy.
c) Antibiotics.
d) .
Answer A.
30
Case 5 :
A 12-year-old boy brought to the clinic by his mother. His father died from acute coronary syndrome at
age of 28 years. His last vaccination was before 6 years and he received at that time 2 nd MMR vaccine. No
other vaccine had been given.
19) What you will give at this visit?

a) Tetanus and diphtheria.
b) Influenza.
c) H. influenza.
d) Pneumococcal.
e) Meningococcal.
Answer A.
20) What investigation you will ask?

a) Homocystinuria.
b) CBC.
c) ECG.
d) Echocardiography.
Answer A.
21) When reviewing his history you note decrease in his performance at the school. Also he complained
from bullying by his friends at the school. What you will do at this visit?
a) Inform parents and leave them to react.
b) Star antidepressant.
c) Talk to the school teacher and parents.
d) .
Answer C.
22) By further history, you discover that the patient have an atopic dermatitis. Which one of the
following reduces the incidence of atopic dermatitis in children?
a) Prolonged breastfeeding.
b) Prenatal ingestion of probiotics by the mother.
c) Delayed introduction of solid food until after 6 months of age.
d) Excessive application of emollients.
e) decrease exposure to dust mites.
Answer E. ABFM 2011, Q 197 , P 53. ‫سؤال مشابه‬
23) What is the most common scales use in practice for screening in adolescence?
a) HEADSS.
b) CAGE methods.
c) Adolescence list.
d) Good history and examination.
Answer A. Repeated from arab board 2009.
31
Case 6 :
A 45-year-old male present with exertional chest pain for few weeks. He is a heavy smoker but stooped
smoking before 4 weeks. He is diabetic with hyperlipidemia with strong family history of coronary artery
disease. He is taking metformin 1000 mg BID, and simvastatin 20 mg OD. On examination his BP 135/75
mmHg, and pulse 80/minute. His baseline ECG is unremarkable.
24) Which of the following investigation is recommended as a next step?

a) Stress ECG.
b) Echo.
c) Thallium test.
d) Angiography.
Answer A.
25) Studies ordered by the cardiologist showed no indication for any coronary artery procedures. His BMI
is 27.5 kg/m2 and his blood pressure 2 is 130/70 mm Hg. Laboratory tests reveal a fasting blood
glucose level of 85 mg/dL, a total cholesterol level of 195 mg/dL, and an LDL-cholesterol level of 95
mg/dL. What is the next step?
a) Decrease fat in diet.
b) Increase simvastatin from 20 mg to 40 mg.
c) Daily walk for 30 min.
d) Continue same treatment.
Answer B.
26) At follow-up after one month the patient returned with BP 135/88 mmHg. What you will do as a next
step?
a) Add ACE Inhibitor.
b) Decrease fat in diet.
c) Increase exercise.
d) .
Answer A.
27) Which one of the following secondary prevention measures would be LEAST likely to improve this
patient’s cardiovascular outcome?
a) A weight reduction diet.
b) A _β blocker.
c) A statin.
d) An antiplatelet agent.
e) Smoking cessation.
Answer A. ABFM 2011, Q 123 , P 34.
32
Case 7 :
A 6-years old boy brought by his parents because of enuresis. They complained of bed wetting of their
son since the age of 3 years. The father also was complaining of nocturnal enuresis during his childhood
until the age of 8 years.
28) What is the most likely cause of enuresis?

a) Immature bladder.
b) If the parents had enuresis at their childhood, unlikely the baby to be enuretic.
c) Bladder capacity is higher or more than normal.
d) Shallow sleep leads the child to be unaware when he urinate during sleep.
Answer A.
29) If all other behavioral changes failed to improve enuresis. What is the best treatment?
a) Desmopressin.
b) Methylphenidate.
c) Paroxetine.
d) .
Answer A. Swanson's 6th edition , 2009, Q 5 , P 628.
30) Secondary enuresis define as recurrence of enuresis after dryness for:

a) 2 weeks.
b) 1 month.
c) 2 month.
d) 4 month.
e) 6 months.
Answer E.
31) Mechanism of action of imipramin, a tricyclic antidepressant is:

a) Anti-spasmodic.
b) Anti-cholinergic.
c) Anti-dopaminergic.
d) Anxiolytic.
Answer B.
32) Which one of the following investigations is mandatory in a child with enuresis?
a) Urine analysis.
b) Cystourethrogram.
c) Vasico-urethral reflux.
d) IVP.
e) Complete cystometric evaluation.
Answer A. Swanson's 6th edition , 2009, Q 4 , P 628.
33
Case 8 :
Couple with Infertility for 5 years. The wife is completely normal, and she had children from previous
husband. The husband has normal height but overweight. Husband Investigations showed normal CBC
and chemistry with low testosterone level.
33) What is the most common cause of male infertility?

a) Hydrocele.
b) Varicocele.
c) Inguinal hernia.
d) Klinefelter syndrome.
Answer B.
34) What is the NEXT investigation you will order:

a) Chromosomal analysis.
b) Testicular ultrasound.
c) Sperm analysis.
d) .
Answer C.
35) Semen analysis done and showed sperm count 15 millions, with 35 % motility. What is most likely
cause:
a) Primary hypogonadism.
b) Vas deference obstruction.
c) Gonorrhea.
d) Kallmann syndrome.
e) Klinefelter syndrome.
Answer A.
36) What is your action?

a) Empiric treatment with testosterone injection.
b) Give ceftriaxone.
c) Cannot be treated.
d) Refer to infertility unit.
e) None of the above.
Answer ?D.
34
Case 9 :
A 60-year-old male patient present with tremor on the right hand, and rigidity on the right arm. His gate
is normal.
37) Which of the following symptoms is usually present in a systemic review of this patient?
a) Constipation.
b) Urinary incontinence.
c) Falls.
d) .
Answer
38) When you examine the patient, you expect to see which one of the following:
a) Decrease swinging of the right arm during walk.
b) Numbness on lower limbs.
c) Ataxia on finger-nose test.
d) Decrease reflexes.
e) Right arm apraxia.
Answer
39) After the examination you find the rigidity in right arm and normal reflexes. Which one of the
following is the most likely diagnosis?
a) Parkinson's.
b) Brain tumor.
c) Essential tremor.
d) .
Answer A.
40) Which of the following action required to diagnose the condition above:
a) Brain CT scan.
b) Brain MRI.
c) No need for further investigations.
d) Referral to neurologist to confirm the diagnosis.
Answer B.
35
Case 10 :
You received a call from one of your patients at the end of the day. She said she has severe pain in left
flank 10 out of 10 in severity. This occurred after she had dysuria, and fever in the past 2 days, but no
vomiting.
41) What is the next action you will consider:

a) Ask her to come to ER immediately.
b) Give her name of antibiotic and ask her to come if no response.
c) Ask her to do investigation then come to you tomorrow.
d) Reassurance.
Answer A.
42) You met the patient at the ER after one hour. After evaluation you examine her, you find tenderness
in the left costovertebral region. By this history and examination you can EXCLUDE which one of the
following:
a) Renal stone.
b) Pyelonephritis.
c) Kidney tumor.
d) Cystitis.
e) Interstitial nephritis.
Answer C.
43) You will perform which one of the following investigation:

a) CT.
b) Urine analysis.
c) Abdominal ultrasound.
d) Abdominal and pelvic ultrasound.
Answer
44) You did a urine analysis and it showed RBC 10 , WBC 2 , and few bacteria. What treatment you will
give NOW:
a) 3 liters of fluid.
b) IV cefroxime.
c) .
d) .
Answer A.
36
Case 11 :
A 35-year-old lady complain of heart burn for 2 years which was relieved with antacid and H2 blocker.
But it seems to get worse in the last few months.
45) Which of the following symptoms is most important to ask about it?
a) Vomiting.
b) Acidic taste.
c) Difficulty swallowing.
d) .
Answer
46) You exclude the red flags by the history. Which medication you will give?
a) Tricyclic antidepressant.
b) .
c) Trial of omeprazole.
d) .
Answer C.
47) At follow-up after one month the patient improve but still have symptoms. Which medication you
will give at this time?
a) Metoclopromide.
b) Hyoscine.
c) .
d) .
Answer ?A.
48) You refer the patient to gastroenterologist who perform endoscopy with biopsy. The result of biopsy
showed Barrett's esophagitis. Which of the following statement is TRUE:
a) Its risk to become adenocarcinome is high.
b) Its due to change in mucosal layer of the esophagus.
c) Its presentation like that of GERD.
d) .
Answer
37
Case 12 :
A 10-year-old boy with history of fits for about 10 minutes duration. Brought in tremlons movement of
all 4 limbs and drowsy.
49) What is the most important next step?

a) Take witness history.
b) Refer to ER.
c) Observation in observation room.
d) Valium IV.
Answer A.
50) What is the most important point in the history:

a) Tonic clonic activities.
b) Simple activity.
c) .
d) .
Answer A.
51) What is the LEAST important step in epilepsy management?

a) Change the dose monthly.
b) Refer to specialist.
c) Talk about driving regulations.
d) .
Answer A.
52) Epileptic patient can play freely:

a) Boxing.
b) Football.
c) Swimming.
d) Horse riding.
Answer B.
53) In addition to neurological examination, which system you will examine:

a) Cardiac examination.
b) Musculoskeletal.
c) Abdominal examination.
d) .
Answer
38
Case 13 :
A 30-year-old G1 P0 pregnant lady at 8 weeks gestation. She was in party last night. Presents to ER today
complain of palpitation and anxiety. You suspect Cannabis abuse from the party last night. But she
denied using Cannabis.
54) Which of the following will present with Cannabis?

a) Dilated pupils.
b) Congested eyes.
c) .
d) .
Answer A. from Up-To-Date
55) Which one of the following is the most cost effective and rapid reliable investigation in diagnosis of
Cannabis:
a) Urine analysis.
b) CAGE.
c) Breath cannabis test.
d) .
Answer
56) At the end the lady admit that she took Cannabis. Which of the following is TRUE:
a) It is not affect on pregnancy if taken in small amount and occasional.
b) Cannot lead to addiction.
c) No relation between Cannabis and smoking.
d) Patient will respond when you tell her about the harm of Cannabis.
Answer D.
57) The patient is known bronchial asthma, now she develop acute attack of shortness of breath and
inability to complete a sentence during talk. On examination her RR 30/minute, and oxygen
saturation 90%. Chest exam reveals wheeze all over her chest. What you will do as a next step:
a) Intubate the patient.
b) Refer to ER.
c) Give ventolin nebulizer.
d) Assess pulses and circulation.
Answer
39
Case 14 :
A mother brings her 2 years old son because of diarrhea. The staff recognize her because of multiple
admissions of her son and 5 year-old daughter to the hospital because of diarrhea also. They remember
her because of usual marked improvement after each admission immediately. The child and his sister
looks normal. The mother work as a nurse.
58) What is the most likely diagnosis?

a) Child abuse.
b) Munchausen syndrome by proxy.
c) Physical abuse.
d) Failure to thrive.
Answer B.
59) The child developed fever and rash at the second day of admission. On exam, there were palatal
petechiae and hepatomegally. What is the most likely diagnosis?
a) Glandular fever.
b) Cytomegalovirus.
c) .
d) .
Answer
60) .
Done by :
Dr. Wesaam Ghafouri .

Dr. Areej Mounshi .
Dr. Abdulraheem Bayameen .
) ‫( أرجو الدعاء بالتوفيق لجميع من ساهم في جمع األسئلة واإلجابات‬
40

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Dr. Wesaam Ghafouri S.B.

Arab Board Exam --{Papers I & II}-- (19/12/2012 -- 6/2/1434)

63) The drug of choice for controlling eclamptic seizures is:

111) Which of the following murmurs considered as a pathological murmur:

113) Treatment of a patient with obsessive compulsive disorder is:

117) Which one of the following is disadvantage of cohort studies:

120) Pregnant present with PROM, what you will do:

132) Carbone monoxide act by:

144) MCQ about bronchial asthma:

PAPER TWO (Clinical cases) – 14 cases contain 60 MCQs – 2 hours duration

1) The serum bilirubin concentration in this child is:

10) Which of the following is the most likely diagnosis?

17) What is the most likely diagnosis?

19) What you will give at this visit?

20) What investigation you will ask?

24) Which of the following investigation is recommended as a next step?

28) What is the most likely cause of enuresis?

30) Secondary enuresis define as recurrence of enuresis after dryness for:

31) Mechanism of action of imipramin, a tricyclic antidepressant is:

33) What is the most common cause of male infertility?

34) What is the NEXT investigation you will order:

36) What is your action?

41) What is the next action you will consider:

43) You will perform which one of the following investigation:

49) What is the most important next step?

50) What is the most important point in the history:

51) What is the LEAST important step in epilepsy management?

52) Epileptic patient can play freely:

53) In addition to neurological examination, which system you will examine:

54) Which of the following will present with Cannabis?

58) What is the most likely diagnosis?

Dr. Wesaam Ghafouri .

) ‫( أرجو الدعاء بالتوفيق لجميع من ساهم في جمع األسئلة واإلجابات‬

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