-1Which of the following is the most common cause of urethral

obstruction in females?
-pelvic organ prolapse

2-What is the initial assessment in a patient for urge incontinence after

prostatectomy?
a-urodynamics
b-bladder diary
c-urethroscopy
d-ultrasonography

3-A 78-year-old man is evaluated for the onset of dyspnea on exertion.

He has a long history of tobacco abuse ,obesity and diabetes mellitus his
current medication include metformin, aspirin and occasional ibuprofen.
On physical examination his peripheral pulse show a delayed peak and he
has a prominent left ventricular heave he is in a regular rhythm with
IV/VI mid-systolic murmur that is loudest at the base of the heart and
radiates to the carotid arteries. A fourth heart sound is present.
Echocardiography confirms severe aortic stenosis without other valvular
lesions. Which of the following most likely contribute to the
development of his cardiac lesion?
A-Congenital bicuspid aortic valve
b-Occult rheumatic heart disease
c- diabetes mellitus
d-underlying connective tissue disease

4-False about delirium TTTx?

-sedatives are the agents of choice

5-A 75-year-old man complains of 6 months of shortness of breath. He

has new dyspnea on exertion and orthopnea. Lung auscultation reveals
bilateral rales. He has bilateral firm pitting edema. Jugular venous
pressure is estimated to be 14 cm H2O at 45° angle. Chest radiograph
reveals pulmonary congestion and an enlarged cardiac silhouette. EKG
shows low voltage in the precordial and limb leads. An echocardiogram
shows a dilated left ventricle, ejection fraction of 20%, and mitral
regurgitation.
Which finding on cardiac examination would be consistent with this
patient diagnosis?
a-absent S2
b-narrow pulse pressure
c-pulsus bisferiens
d-accentuated S1

6-Which is true about neurological changes in aging ?

-there are individual variations

7- A patient has Holosystolic murmur heard in left sternal border ,

increased with inspiration with congested neck veins & congested tender
liver
This patient has:
- Tricuspid regurge

8-Early warning signs of Alzheimer's disease include all of the following

except..?
a-gradual loss of long-term memory
b-mood or personality changes
c-problems finding or speaking the right word
d-forgetting how to use simple, ordinary things such as pencils
e-loss of abstract thinking
9- A patient with delirium outside the ICU ,the next step is…?
a- Make the environment appropriate (light,sounds…)
b- Take history