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5th stage final medicine exam questions

2020-2021

Multiple Choice Questions

Family Medicine

1.A person has postive family Hx for colorectal cancer, when he should
do screening:
A.40 y
B.50 y
C.60 y
D.65 y

2.Risk of heart attack will reduce to 50% after how much from smoking
cessation ?
A.6 months
B. 1 year
C. 2 years
D.10 years

3.You are going to advice a woman about risks of smoking on

pregnancy , which one is true ?
A.it causes congenital infection
B. it causes preterm labor
C.it causes gestational diabetes
D.it causes gestational HTN
4.You are going to advice a woman about risks of smoking during
pregnancy , which one is true ?
A.it causes sudden infantile death
B.it causes Preclampsia
C.it causes vaginal bleeding
D.it causes macrosomia

5.After checking fasting blood sugar for a woman it was 150mg in two
occasion and she has family hx of DM-2, what will be the treatment:
A.Therapeutic life stayle change
B.Therapeutic lifestyle change and metformin.
C.Combination drugs
D. no need for treatment

6.A middle age man works at office his blood preasure was
160/100mmHg , which one is not true :
A.one reading of 100mmHg diastolic is diagnostic.
B.Repeat after 1 week
C.recheck after a period of office rest

7.An old woman diagnosed with osteoporosis by DEXA scan what will be
the initial treatment :
A.Vit.D and Calcium
B.NSAIDs
C.Bisphosphonate
D.Hormonal therapy

8.Which one is not true about falling in elderly?

A.more common in male than female
B.those with daily physical activity are less suseptable .
C.functional impairment has less effect on risk of falling

9.A 3 years old child with diarrhea and there is cholera in your area what
is the first choice antibiotic?
A.Erythromycin
B.Ceftriaxone
C.Ceprofloxacin
D.Gentamycin

10.A child respiratory symptoms diagnosed as pneumonia, what is first

line treatment:
A. IM ampicillin and gwntamycin
B. oral amoxicillin or amoxiclave
C.oral methoprim
D.Ceftriaxone

11.A 5 years old child has cough with no fever no dyspnea no stridor no
wheezing no chest indrowing, respiratory rate was 40/min, diagnosis
will be :
A.Pneumonia
B.No pneumonia
C.severe pneumonia
D.asthma

12.Best treatment for-acute and chronic back pain

A.Regular activity
B.NSAIDs
C.Steroid
D.Surgery

13.A patient with vertigo,tenitus and discharge from ear, what will be the
Dx:
A.sinusitis
B.labrynthitis
C.Minier disease
D.BPPV

14.A patient presented with acute sign and symptoms of migrane what
is the fist line management?
A.intranasal triptan
B.if he didn't so take Asprin/caffien
C.rest
D.CT scan

15.All of are true about migrane except:

A. man will get in longar duration than woman
B.75% are females
C. patient will get exacerbate by light and sound.
D.most of the patients have family Hx

16.A patient presented with persistent severe headache in temporal

area, fever, fatigue, visual disturbance and scalp tenderness, next step
in management:
A.Temporal artery biopsy
B.ESR
C.start glucocorticoid
D.CT-scan

17.A patient presented with features of giantcell artritis, ESR=110, next

step in management:
A.Temporal artery biopsy
B.ESR
C.start glucorticoid
D.CT-scan

18.According to Europian/Ammerican guidline for management of

dyslipidemia the medical coarse of treatment depend on:
A.LDL and age
B.HDL/LDL ratio
C.Total colesterol
D.LDL and gender

19.Which of the following drugs is contraindicated in pregnancy ?

A.Citrizin
B.Amoxicillin
C.Asprin
D.Acetaminophen

20.Best lab investigation to support the diagnosis of appendicitis is :

A.high CRP
B.high ESR
C.high WBC
D.Urinalysis

21.Which of the following is the physiological cause of fatigue

A.Grief
B.Nursing mother
C.Alcohol
D.gestational disorders

22.A patient with hyperlipidemia on statin which of the following indicate

rhabdomiolysis due to statin :
A.CPK elevation by 10 times
B.low AST
C.high ALP
D.proteinuria

23.A 75 years old diabetic man came to primary health center for
vaccination , he recieved influenza and pneumococcal vaccin last year
what should you advice him?
A. He should take influza and pneumococcal vaccination every year
B.He should take only pneumococcal vaccine every year
C.He should take only influenza vaccine every year.
D.He didn't need to take vaccination any more

24. A young female patient presented with fatigue, weight gain ,

constipation, hoarsness of voice, lab test showed high TSH, low T3 what
will be the cause?
A.Benign thyroid tumor
B.Pitutary gland dysfunction
C.Carcinoma of thyroid
D.Autoimmune

25.A 19 lady with 6 weeks hx of amenorrhea and lower abdominal

discomfort, pregnancy test was positive (bHCG=916) , US shows empty
uterus with normal both adnexa, next step will be:
A.repeat BhcG after 48hrs
B.repeat BhcG and US after 48hrs
C.prepare for laparotomy

Hematology

26.A patient diagnised with follicular lymphoma, all are true about
follicular lymphoma except:
A.characteristic chromosomal change t(14:18)
B.slow growing non tender lymph node enlargement.
C.it make about 20% of NHL
D.it is agressive tumor

27.A patient with diffuce large B cell lymphoma, all are true except:
A.it is most common in our region
B.it is an agresdive tumor
C. it is a curable tumor
D.it is indolent
E.weight loss, night sweat, bone pain indicate extra nodal dissemination
of tumor.

28.In AML usually of the following may be detected except:

A.CNS infiltration
B.M5 present with gingival hyperplasia
C.Bone pain
D.Severe anemia
E.Oral candidiasis

29.A case senario and investigations of ALL, which one is bad

prognostic sign:
A.t(9:22)
B.t(8:21)
C.t(15:17)
D.t(12:21)

30 A patient presented with purpura, which of the following not cause

platelet distruction thrombocytopenia
A. Henoch-Schonlein purpura
B.ITP
C.TTP
D.HUS

31.All of the following cause mgaloblastic anemia except:

A.folate deficiency
B.liver disease
C.metabolic disease
D.amoxicillin
E.Methotrexate

32.Hypersplenism is not caused by:

A.Splenomegaly
B.Iron deposition inside the spleen with liver with portal HTN
C.Cirrhosis
D.Lymphoma

33.After pleenectomy which of the following will be detected in the

blood:
A.Target cell
B.Microcytic cells
C.Neutopenia
D.toxicity

34.A patient present with pallor, lab investigations showed low Hb, low
MCV, S.iron=15mcg/dl TIBC=550mcg/dl :
A.Iron deficiency anemia
B.Seidroblastic anemia
C.Hymolytic anemia
D.Anemia of chronic disease
35.Iron absorption will increase in all of the following except except —-
A.Iron deficiency anemia
B.alkaline gastric juice
C.pregnancy
D.hypoxia

36.In distrusted RBCs by hymolysis , there will be .......

hyperkalemia
hypocalemia
hypernatremia
hyponatremia
hyper cloridemia

37.A 25 years old female presented to ED because of pallor ,skin

bruising, fever and confusion, on CBC there is only low platelet count,
normal PT, PTT,D-dimer, fibrinogen with schistocytes on peripheral
blood:
A.ITP
B.TTP
C.HUS
D.HIT
E.DIC

38.A patient presented with recurrent episodes of deep venous

thrombosis, which of the following should be checked:
A.Protein S
B. WBC count
C.vWF
D.Platelet count
39.A case senario of CML (you should already know the diagnosis )
which of the following is wrong:
A.Bone marrow biposy is mandatory for diagnosis
B.Imatinib is the first line treatment
C.Karyotype analysis shows Philadelphia chromosome
D.there is a very high WBC count on peripheral blood.

40.Which of the following is not mandetary to be screened in donor

blood :
A.Typhoid
B.Malaria
C.VDRL
D.HCV-Ab
E.HBV-Ag

Nephrology

41.A petient present with hyperkalemia, which is the urgent way to

decrease pottasium level?
A.calcium gluconate
B.insulin and glucose
C.Normal saline

42.In which patient asymptomatic bacteriuria may present ?

A.pregnancy
B.male
C.children
D.Diabetic patient

43.A pregnant patient has complicated UTI, the culture shows gram
negative cocci, what is the treatment?
A.nitrofurantoin
B.gentamicin
C.trimethoprim
D.ciprofloxacin

44.A patent diagnosed with polycystic kidney disease with positive

family history , what the best way to diagnose familial polycystic kidney
disease ?
A.CT of abdomen
B.genetic study of PKD1 of the patient
C.genetic study of the pateint and two family memeber.
D.US

45.On urineanalysis if leukoesterase is posistive, what does that mean?

A.presence of wbc
B.suggests of presence of bacteria
C.indicate that the bacteria changes nitrate to nitrite
D.excluding the wbc.

46.Blood test shows the following range:

a.albumin 51g/l
b.postasium 3.5-3.6 mmol/l
c.sodium 135-145 mol/l.

47.in asymptomatic chronic kidney disease there is :

a.increased liver senzyme due to liver isoenzyme.
b.normal calcium level.
c.Increased phaspahate.

48.what is the best way to prevent of progression of chronic kidney

disease:
a.glycemic control.
b.lipid control.
c.smoking cessation.
d.LDL control.

49.A Urine dipstick postive for blood could be caused by:

A.exercise
B.ramipril
C.eating red meats
D,smoking

50.Which of the following are not a side effect of Erythropoietin therapy:

A.bleeding
B.infection
C.pure red cell aplasia

51.A case that diagnosed with membranous glomerulonephritis, the

indication for starting immunosuppresive therapy include all except:
-
-
-female

Dermatology

52.A csae that has a Round scaly red well demarcated lesion on dorsum
of his left foot, it could be :
a.discoid eczema
b.contact dermatitis
C.psoriasis
D.
e.all above

53.A case with generalized body itching after showering , he is on

bronchodilator and his borther has the same condition, which of the
following is true :
a.chronic relapsing is the major criteria.
b.systemic glucorcorticoid is the main line of treatment
C.xerosis is the major criteria
D.lichenification is a common feature of infantile type

54.A case that has fatures of atopic dermatitis like generalized body
itchiness after taking shower, history of asthma and family history of the
same condition, which of the following is true about this condition:
a. no single test to diagnose
b. systemic glucorcorticoid is the main line of treatment
C.xerosis is the major criteria
D.lichenification is a common feature of infantile type
E.extensor surface involvemnet is common in childeren

55.a csae that diagnosed woth psoriases and treaed steroid and got
rismission, then her physician stoped steroid therapy and after stoping
it, she developed multile erythymatous and pustular skin rashes, what is
the diagnosis?
a.pustular psoriasis
b.erthymatous psoriasis
c.gutate psoriasis
d.lichen planus
e.drug eruption

56.A patient got generalized erythematous body plaque after taking

steroid : A.erythrodermic psoriasis
B.Plaque psoriasis
C.Pustular psoriasis
D.Guttate psoriasis

57.A man has complain of reccurrent nodule in his axilla that every
develops, will heal with scarring, what is the most appropriate
diagnosis?
a.recurrent frunculosis
b.tinea incognito
c.candida incognito(?)
d.foliculitis
e.scabies(?)

58.A child that developed vesicles around his lip that has yellow color
and crusted, if his condition left untreated what will be the complication:
a.ecthyma
b.cyst
c.abcess
d.foliculitis
e.curbuncle

59.A pregnant pateint has generalised very itchy rash, that is worse at
night and her child also has the same complain, which of the following
treatments is contraindicated:
a.permethrin 2.5%
b.permethrin 5%
c.lindane
d.sulfer powder
E.crotamition

60.A female pateint developed very itchy round well circumcribed

erythematous papule of her lower abdomen, become worse at night and
she got married 4 months ago, and her husband has the same
complaint but he has it about 6 months ago, which of the following is
not true about the complication :
a.scabies increased risk of HIV
b. nowrwegian scabies
c.crusted scabies.
d.secondary eczematization
e.

61.A male patient around 50 years old, has complain of hair loss that is
prominent in his frontotemporal area, on further investigation lab results
show he has low vitamine D level, so what could be the underlying
cause of his hair loss?
a.androgenic alopecia
b.telogen effluvium
c.anagen effluvium
d.alopetia areata
E.syphilitic alopetia

62.which one wrong about hirsutism:

A.it is synonym for hypertrichosis
B. Virilization is the combination of hirsutism plus other signs of
masculinization, such as deepening of the voice and temporal balding.
C. Oral contraceptives pills are the first line treatment then after 6
months if no response can use spironolactone .

63.A child developed multiple skin rashes around his mouth and right
side of cheeck, the rashes are Pink papules and there are dimples in
their middle, what is the most appropriate diagnosis?
a.pox virus
b.herpes simplex virus
c.impitigo
d.herpis zoster

64.case with purulent discharege at penis and painful, gram stain shows
gram negative diplococci, what the diagnosis:
a.nisseria gonorrhea.
b.troponema pallidum.
c.syphilis
d.herpis simplex

65.a male case with sore at dorsum of penis indurated ulcer no

exudate , what is the diagnosis?
a.herpes simplex.
b.chancroid.
c.primary syphilis.
d.secondary syphilis.

66.Which of the following is not true about kerion:

a.should not be excised
b.develop due to inflammatory reaction.
c.Griseofulvin is the drug of choice
d.Topical anti fungal used to decrease fungal shedding .

67.a case with multiple comedones and papulopustles, what is the

treatment?
a.topical tretenoin.
b.topical steroid.
c.topical benzoilperoxide + oral doxicylcline.
d.oral doxycycline.
68.A pateint has acne vulgaris and developed nodules and cysts, what
systemic treatment you add?
a.oral isotretinoin
b.oral doxycylcin
c.oral erythromycin
d.oral steroid

69.A case diagnosed with Basal cell carcinoma on face, what is the Best
treatment :
a.excision
b.cryotherapy
c.5 flourouracil
d.Conservative

70.A case with features of Herps simplex infection that has vesicular
rashes around mouth, which of the following is not true about his
condition?
a.neuralgia is frequent
c.became dormant in the nerves
d.may appear in immunocompramised patients.

71.A 9 year old child developed generalized erythematous skin rash on

his trunk, face, and back, it is very itchy, also the child has mild fever,
mayalgia, so what is the most appropriate management of his condition?
a.symptomtic treatment is a rule
b.he needs systemic antiviral therapy like acyclovir

72.A case diagnosed with seborric keratosis, which of the following is

danger sign in seborric keratosis?
a.sudden multiple seboric keratosis
b.change in color of lesion
c.irregular borders
d.asymmetry
E.bleeding

73.A case of seborric dermatistis, what is not correct:

a.postaurical involvment is common.
b.it yellow plaque and waxe scale.
c.in infancy it will resolve by itself within one year of life.
d. topical steroid and topical antifungal make cure of the disease

74.Which of the following skin lesion will heal with scar:

a.Nodule
b.erosion
c.ecthyma
d.excoriation
e.furunculosis

Rheumatology

75.a child case complain of right knee pain, previously he got right ankle
pain and swelling then when his ankle pain resolved, his right knee pain
started, what is the diagnosis?
A- Septic arthritis
B- Rhaumatoid arthritis
C- Reactive arthritis
D- Rheumatic fever

76..A case with red swallon joint pain that he cannot move his leg and
has fever, A needle aspiration of his joint shows wbc of 150,000 :
A- infectious arthritis.
B-gout
C-pseudogout
D-rheumatoid arthritis

77.a case with painful Red swollen tender joint next step will be:
A.CBC
B.Antibiotic
C.X-ray
D.arthrocemtesis

78.a case Red swellon kneee X-ray shows calcinosis:

A.psudogout
B.gout
C.septic joint
D.rheumatoid arthritis

79.In rheumatoid arthritis the test for TB is mandatory before starting

which of the followings:
A.infliximab.
B.methotrexate.
C.hydroxyqlorquine.
D.indomethacine.

80.A case has bluish discoloration of fingers when exposed to cold

temperatures, and hypertension 170/100 (?), and also hardening of skin
of hands, had esophageal problem that not resolved after taking a
course of PPI, what drug is prefered for controling her blood pressure?
A.amlodipine.
B.ramipril.
C.Thiazide.
D.metoprolol.
81..A 62 years old female pateint complain of inability to upstairs and
has difficulty of (?) and on examination she has Weakness and proximal
muscles wasting what is the most likely diagnosis?
A.polymyositis
B.dermatomyositis
C.polymyalgia rheumatica
D.kawasaki disease
E.giant cell arteritis

82.A ~32 years Female patient has recurrent transient ischemic attack,
and imaging shows aneurysms of arch of aorta and it is branches, what
is the most likely diagnosis?
A.Takayasu arteritis
B.giant cell arteritis
C.behćet disease
D.burger’s disease

83.A female patient had been diagnosed with systemic lupus

erythymatosus and recently presented with chest pain and on
examination she has pleurtic rub, and ECG shows diffuse st elevation,
what the cause of her complain?
A.pericarditis
B.mayocardia infarction
C.pleurisy
D.pneumonia

84.A 82 years old patient that had been on warfarin therapy with INR of
2.4 that he did two days ago, now he has red swollen left knee pain, that
limit his movement, also he has fever, his physician wants to do
arthrocentesis for him, which of the following below is true regarding
arthrocentesis in this case?
A.because of warfarin therapy he should not do arthrocentesis.
B.because of his age, arthrocentesis is contraindicated.
C.he should procede with arthrocentesis and there is no
contraindication.

85.A patient with chronic hx of rheumatoid arthritis who has ulnar wrist
divination, presented with painful red swollen knee joint the joint tap
showed very high WBC and diplococci, which of the following is not a
line in management:
A.Antibiotics
B.Joint needle aspiration
C.Orthopedic consultation
D.glucocorticoid
E.culture

Extended Matching Questions:

Immunization

91.An 18 months old infant was brought to the health center for routine
immunization, his vaccination is up to date.

A/ MMR2 , Vitamin A 200,000 , OPV booster 1 , DTaP booster 1

92.A 2 months old infant brought to the health center by her mother for
the first time, she wasn't recieved any vaccination. (catch up)

A/ BCG, ROTA1, OPV1, PENTA1, Pneumococcal 1

93.A 7 months old infant brought by her mother for vaccination, he
wasn't recieved any vaccination.(catch up)

A/BCG,OPV1,PENTA1,Pneumococcal 1

Nephrology

94.A pateint with Kideny failure that diagnosed with focal segmental
glomerulosclerosis, recently has 6.7 potasium level (?) ⸻>> initiation
of hemodialysis .
95.A case with features of Nephrotic syndrome(membranous GN) next
step ⸻>> renal biopsy
96.A case that has Deep color urine, periorbital edema, and low c3, has
a history of sore throat 3 weeks ago⸺post streptococcal
glomerulonephritis

Nephro-Hypertension matchings:
97.A young female pateint that has Palpitations, sweating, high blood
pressure, and positive urine catecholamines ⸺>>pheochromocytoma
98.A female patient has Obesity, bruising, stretch marks, hersutism,
high blood pressure ⸺>>cushing syndrome
99.A pateint that has hypertension and Peripheral artery disease—-
>>renal artery stenosis

Dermatology

Choose the appropriate treatment for each dermatological conditions:

100.A case with features of rocesea ⸻>> oral isotrtinoin
101.A case with features of luchen planus⸺>>topical steroid
102.A case with features of Pytriasy rossea ⸺>> oral isotretinone
Choose appropriate diagnosis of each condition:
103.A case that has recurrent Hypopigmentation in summmer⸺
>>pytriasis vercicolor
104.Alopecia with scaly patch on head with loss of hair ⸺>> favus
105.a case with itchy Round well demarcated lesion on lower abdomen,
history of same condition in another member in family ⸺>> tinea
corporis

Hematology :

106.Microcytic hypochromic low ferritin ⸺>> Iron deficiency anemia

107.Microcytic hypochromic RBC with high ferritin ⸺>> animea of

chronic disease

108.Macrocytic anemia with reticulocutosis ⸺>> autoimmune

hymolytic anemia

109.Bruising with pancytopenia ⸺>> Myelodysplasia

110.A patient presented with skin bruising Low platelet, normal PT/PTT/
D-dimer/Fibrinigen/ LDH and normal peripheral blood smear ⸺>> ITP

111.A patient with Bruising and epistaxis, peripheral blood shows

increased WBC and blast cells and normal other cells ⸺>> AML3

Rheumatology

112.40 years old female patient with chronic joint disease present witg
seperation of nail plate from underlaying bed ⸺>> psoriatic arthritis

113.A patient presented with joint pain, red eye and dysuria ⸺>> Reiter
syndrom

114.A patient with chronic history of multiple ioint pain and pitting nail
⸺>> psoriasis arthritis

115.A 40 years old woman hypertensive and hs tight skin ⸺>>

Systemic sclerosis

116.A young patient presented with joint pain, and generalized itchy
body rashes with fever ⸺>> Still’s disease

Family Medicine

117.A 15 years old child presented with sore throat, cough and anterior
non tender cervical lymphadenopathy and mild fever ⸺>> viral

118.A child presented with sore throat, fever and trismus ⸺>>
peritonslar abscess

119.A middle age patient presented with headache, unilateral neck

tenderness, blood pressure decreases with head rotation ⸺>>
carotidynia

Prepared by:
Khalis Ziyad Peshbeen Hiwa
Mustafa Mukaram Muhammad Hasib