‫االمتحانات النهائية الشاملة للسنة الدراسية الخامسة –‬

‫‪2018/2017‬‬
‫كلية الطب‬

‫‪Written By :‬‬
‫‪Suleiman Khreshi‬‬
‫‪Firas Anaya‬‬

‫‪V 3.0‬‬

‫‪1‬‬
‫االجابات الموضوعة هي اجابات اجتهادية ‪ ،‬لربما يكون هناك بعض االخطاء ‪ ،‬حاولنا قدر االمكان ان تكون‬
‫االجوبة من المراجع المعتمدة والموثوقة للمادة ‪ ،‬واعذرونا على ما سقط سهوا من اخطاء امالئية ‪.‬‬

‫االطفال ‪UW , Kaplan , Step up , BRS , uptodate , last minute‬‬

‫التخصصات الباطنية المتخارة ‪ ، Medscape :‬دوسية الديرما واالسئلة السابقة‬
‫اسئلة طب العائلة ناقصة ‪ 4‬اسئلة واسئلة التخدير ناقصة ثالث اسئلة ( سؤال منهم كان مكتوب خطا في‬
‫االمتحان )‬
‫التخصصات الجراحية ‪:‬‬
‫العيون ‪Toronto, lecture notes‬وتلخيص ظافر لمحاضرة د الشنطي ‪uptodate ،‬‬
‫علم االعصاب ‪UW mainly , Step Up , Kaplan :‬‬
‫انف واذن وحنجرة ‪ :‬دوسية همة والكتاب المصري واالسئلة السابقة‬
‫العظام وطب الطوارئ وجراحة االعصاب ‪:‬‬
‫العظام ‪ :‬الساليدات ( اغلب االسئلة نسخ لصق ) ‪orthobullets ،‬‬
‫جراحة االعصاب ‪ ، Toronto notes :‬همة‬
‫الطب الشرعي ‪ :‬الساليدات واالسئلة السابقة و ال ‪ ، gradestack‬قمنا بكتابة ‪ 64‬سؤال من‪ 100‬فقط !‬

‫ونوجه الشكر لمن ساعدنا في تجميع االسئلة اواجابتها ‪:‬‬

‫احمد قشوع ‪ ،‬ثائر صويلح ‪ ،‬جهاد الكيالني ‪ ،‬سهام عاصي ( في جميع االسئلة )‬
‫ديمة يحيى ( في طب االطفال والطب الشرعي وكتابة اسئلة التخدير )‬
‫ريما صالح ( في التخصصات الباطنية والطب الشرعي )‬
‫والء ابو عليا ( في طب االطفال )‬
‫جنى خريم ( في التخصصات الباطنية )‬
‫نسمة غانم ( في الطب الشرعي )‬

‫بالتوفيق ‪،‬‬
‫سليمان ‪ ،‬فراس‬

‫‪2‬‬
 CONTENTS*

EXAM Page
Pediatrics 5
Medical minors 12
Anesthesia 12
Radiology 17
Dermatology 23
Family medicine 25
Surgical minors 27
Ophthalmology 27
Neurology 29
ENT 34
Orthopedics 37
Neurosurgery 41
ER 42
Forensic 47

* If you are using a pdf reader you can navigate the file through Bookmarks/Index

3
4
 PEDIATRICS
THE EXAM FOR EACH STUDENT HAD 110 QEUSTIONS ,
SOME OF THE QEUSTIONS WERE DIFFERENT FROM
ONE STUDENT TO ANOTHER , SO WE GATHERED
EVERYTHING WE COULD ( 125 Q TOTAL )

1- DDH typical case , pathology ? deformed acetabulum

2- Typical SCFE case with knee pain and normal knee xray – Bilateral hip xray

3- genu valgus / 9 degrees ? Reassurance

4- turner case , what do you expect to find on karyotyping ? 45 xo

5- vit k deficiency and bleeding , rx ? FFP

6- DM with microalbumniura , rx ? ACE-I

7- Blood sugar increase despite adequate mangment ? control suger

8- A girl was playing in the garden , comes back with eye swelling and a punctum ?
Insect bite

9- Pleural fluid aspirated , acidic , very high WBC ? empyema

10- Nephrotic syndrome with ascites , presents with fever and abdominal pain , next
step ? Paracentesis ( to exclude SBP )

11- Typical Cushing’s case , pathology ? increased corticosteroids

12- Jaundice and positive reducing substances in Urine ? Galactosemia

13- Case of GERD . Sandifer , next step ? PH monitoring

14- NG tube coiling , with hx of polyhydramnios ? Tracheoesophageal fistula

15- Typical Congenital hypothyroidism case

5
16- Developmental milestones - normal development

17- baby with gastrostomy , mother empties all stomach contents ? Metabolic
alkalosis

18- Posterior urethral valve case , hypertrophied bladder , next step ? vcug

19- infantile spasm and ash leaf ? tuberous sclerosis

20- Picture of palm and soles with rash , patient from south Carolina with typical
features ? rocky mountain spotted fever

21- Pathology of gynecomastia in klienfilter syndrome ?

According to golijan and uptodate the answer is Decreased perihral androgen
receptor sensitivity

22- Status epilepticus case ? IV diazepam

23- intussusception case . ( bloody stool , flex legs , pain )

24- fungal infection treatment ? Fluconazole

25- 17 yro boy , tanner 5 , 157 cm , asks if he will get any taller ?
no , reached terminal height

26- short with family history of constitutional delay ? reassure ( growth spurt is yet to
come )

27- Suspected Pseudotumer cerbri case , dx ? LP

28- newborn baby of mother who has HIV , baby has dermatitis , cheilosis , stomatitis
and neurological symptoms , cause of neuro sym ? Vit b6 / pyridoxine def.

29- Primary Enuresis – Behavioral therapy

30- sleeps at school and at home any where and everywhere ? Narcolepsy

31- Perianal night itching , dysuria , cause ? Pinworm

32- 16 yro . multiple sexual partners , what to do ? Chlamydia screening

33- Capillary hemangioma photo , rapid change in size then stops growing .

6
34- Rash after vaccine , vaccine responsible is ? MMR

35- burn patient , gives numbers for electrolytes , the correct answer contains
hypernatremia ( due to dehydration )

36- Recurrent sinopulmonary infection – B cell def. / Def in antibody production

37- Eczema , thrombocytopenia , abnormal IG – wiskott-aldrich syndrome

38- Periorbital ecchymosis ( bilateral raccoon eyes ) – Neuroblastoma mets

39- Calcified abdominal mass with sym. Of mets ? Neuroblastoma

40- 16 yro African American female with mcv 70 , hb 8 , cause of anemia ? IDA

41- intussusception mechanism ? Telescoping

42- Bronchiolitis typical case

43- smoker with clubbing – Alpha 1 antitrypsin def.

44- Child with Fractures at different healing stages - - non accidental fracture

45- Physiologic jaundice typical case ( see Kaplan table )

46- HbS 40% , hypochromic anemia – Sickle cell trait .

47- croup case , treatment ? racemic epinephrine

48- Most common complication of Kawasaki ? coronary aneurysms

49- erythema marinate photo , dx ? acute rheumatic fever

50- SLE cae

51- lower limbs and buttocks rash – Typical HSP

52- next step in a case nephritic syndrome ? C3 levels

53- leukemia patient , terminal with sever pain , family wants him to spend his last days
with them , what to do ? Send him home on morphine ?!

54- Infant of diabetic Mother features , cause of features ? Insulin excess

7
55- Recent contact with a friend who has impetigo , few days later , pain in a triangular
area in thorax ( a hint of dermatological distribution ) – herpes Zoster

56- Typical Marfan syndrome

57- Typical Diabetes insipidus case

58- HSV encephalitis with seizure

59- A child with caustic injury from ? Drain cleaners ( CMS question )

60- choanal atresia – intermittent cyanosis with feeding

61- Hematuria , teenager fell from bike , flank pain and fractured ribs , what to do ?
CT abdomen

62- rachitic rosary description in a case , dx ? rickets

63- fever 2nd day post op of renal transplant from father with improved creatinine (
preop 50 post op 20 ) => atelectasis

64- blood in anterior chamber - hyphemia

65- PUV typical case

66- IBD case - mesalamine

67- hepatitis A vaccination when travel

68- Baby with DDH , asymmetry in face - Intrauterine compression (UW )

69- stomach foreign body (coin swallowed ) => observation

70- a case of GER – voimts every 3 time he swallows – normal feeding for age

71- loss of gluteal fat , and malabsorption ? celiac disease

72- Mononucleosis typical case

73- idiopathic nephrotic syndrome typical case

74- HIV case, next ? Give granulocyte colony stimulating factor

8
75- patient with petechie and platelets 10k - ITP

76- dermatomyositiss typical case , late growers , Groton papules

77- duchenne muscular dystrophy case , child adopted from over seas, muscle
weakness , pseudohypertrophty in calf , mode of inheritance ? x linked

78- A girl went to Pakistan came back with vesicles and features of Chickenpox

79- Improving from bacterial infection then lymphocytosis ? viral

80- TGA then sudden deterioration ? DA closure

81- Thalassemia case

82- Neonate lower pneumonia Rx ?

83- scarlet fever pathophysiology ? erythrotoxin

84- pertussis

85-NEC xray , risk factor ? Prematurity

86- Multiple episode of syncope with funny heartbeat , free ecg , next ? holter

87-Most common complication of bicuspid aortic valve ? syncope vs endocarditis

88- cardiomyopathy / dilated / clinically

89- case , fixed splitting ? asd

90-Status asthmatics , rx ? Systemic steroid

91-foregin body , prolonged inspiration , with wheezing , site ? Trachea

92- Back pain , MRI shows prevertebral soft tissue enhancement - discitis

93-knee effusion without tenderness m no hx of trauma - chondromalcia patellae

94-3 weeks of watery diarrhea - giardia

95- peritonsiller abscess – strep

9
96- foot infection a week after trauma from a metal nail – pseudomonas vs staph
(Last minute )

97- lobar pneumonia => strep

98- UTI rx => 3rd generation cephalosporin

99- 40 respiration / min , O2 sat dec,acid base balance => respiratory alkalosis

100- dka, ketones => normal anion gap acidosis

101- Pathophysiology septic shock => Dec peripheral vascular resistant

102- dec HCO3, hyponatremia, hyperkalemia , history of chronic diarrhea , what is the
mechanism of decreased HCO3 => hypovolemia

103- cystic fibrosis case - give vit D

104- case of syphilis - treponema pallidum ( CMS )

105- hemorrhagic encephalitis / viral / Bacterial / Fungal

106- erythema multiforme , takes TMP/SMX next step ? stop the drug

107- neutropenia isolated - Nafacilin induced

108- cbc , all depleted ? aplastic anemia

109- Pneumonia with green sputum and black dots , culture results in the following
Gram negative & H2S negative & Lactose fermentation negative

110- blood film of hemolytic anemia – can’t rember answer ,see blood film finding in FA
step 1

111- systemic juvenile idiopathic arthritis typical case

112- septic arthritis - Kocher criteria

113- Hodgkin lymphoma case

114- the defect in dilated cardiomyopathy => sarcomere

115- Murmur increased overtime in diagnosed VSD => VSD is getting narrower

10
116- cortication of the aorta

117- leukemia case

118- SCIDS - IVIG

119- NF-1 typical case

120- Lyme case , most important step is - tick removal

121- Jaundice progressively increasing bilirubin even with phototherapy - exchange

transfusion

122- Tinea corporis

123 – Patient fever , and Influenza symp. , resolved , next week he started complaining
of calf pain – Influenza induced myositis

124 – Most infectious in HIV ? Recipient anal sex

125- Rash started after fever resolution ? Roseola

11
 MEDICAL MINORS
ANESTHESIA
1. all are true about intra-venous induction of anesthesia except:
a. IV induction begins with administration of a potent short acting hypnotic drug
b. intra-venous induction of anesthesia is fast, pleasant for the patient and easy
c. IV induction will cause airway obstruction
d. the dose of IV induction agent may be greatly reduced for patients who have lost
a lot of
blood
e. the choice of induction technique is based on the anesthesiologist wish
2. all are true about propofol except:
a. propofol injection is very painful
b. allergy to propofol is more common than pentothal
c. propofol increases the intracranial pressure
d. propofol causes a greater depression of laryngeal reflexes than thiopentone
e. propofol can be given as an infusion
3. all of the following is a complication of suxamethonium except:
a. anaphylaxis
b. malignant hyperthermia
c. tachycardia
d. muscle pain
e. rise intra-ocular pressure
4. which of the following is true regarding headache after spinal anesthesia?
a. is less likely with a 26G than with a 22G needle
b. is due to an increase in the CSF pressure
c. is unlikely to develop after 24 hour
d. may be accompanied with hypotension and bradycardia
e. is more frequent in the elderly
5. induction with ketamine is contraindicated in:
a. in an asthmatic patient
b. for cesarean section
c. in a patient with facial burn
d. in a hypertensive patient
e. in a shocked patient

12
6. the following is advantages for laryngeal mask airway except:
a. hand free
b. no laryngeoscope needed
c. less traumatic
d. less risk for aspiration
e. quick

7. all of the following are facts about hypothermia except:

a. infants are at increased risk because their body mass is small compared with
surface
area
b. hypothermic patient often exhibit increase CNS activity and causes hypotension
c. is causes moderate hyperglycemia
d. it causes mild coagulopathy
e. shivering can increase the O₂ consumption and CO₂ production by 200-300 times
8. all of the following factors decreases the risk of aspiration except:
a. decrease in gastric and intestinal motility
b. pain and anxiety
c. constriction in the lower esophageal sphincter tone
d. increase in abdominal pressure
e. obesity
9. all of the following are indications for CVP except:
a. chemotherapy
b. pulmonary hypertension
c. drugs, like nitroglycerin & dopamine
d. total parental nutrition
e. administration of fluid in severe hypovolemia
10. which of the following is not true?
a. inhalational induction of anesthesia will maintain spontaneous ventilation
b. MAC of halothane is 1.5% with 70% N₂O
c. people who are not skilled with airway management must not use IV induction
agents
d. positioning for surgery usually occur after the induction of anesthesia
e. high concentrations of N₂O is contraindicated in patients with closed air filled
compartments

13
11. all of the following are advantages of spinal anesthesia except:
a. produce fewer adverse effects on respiratory system as long as unduly high blocks
are
avoided
b. diabetic pt can usually return to their normal food and insulin regime soon after
surgery
as they experience less sedation, nausea and vomiting
c. blood loss during GA is the same as when the same operation is done under spinal
anesthesia
d. post-operative DVT and PE are less common following spinal anesthesia
e. spinal block provides good muscle relaxation to the lower limbs
12. all of the following are contraindications for spinal anesthesia except:
a. inadequate resuscitation drugs and equipments
b. clotting disorders
c. hypertension
d. patient refusal
e. psychiatric patient

13. which drug can be given safely in liver cirrhosis?

a. atracurium
b. vecuronium
c. rocuronium
d. pancuronium
e. mivacurium
14. which of the following is true about recovery room?
a. not all the patients need O₂
b. post-operative shivering can be treated with benzodiazepines

15. which inhalational anesthetic agent has the least analgesic properties?
a. sevoflurane
b. desflurane
c. isoflurane
d. enflurane
e. halothane
16. 70 Kg pt needs how much O₂?
a. 150 ml
b. 200 ml
c. 250 ml

14
 d. 300 ml
e. 350 ml
17. which drug is the most epileptic?
a. isoflurane
b. enflurane
c. fentanyl
d. halothane
e. desflurane
18. which of the following is least affected by pregnancy?
a. tidal volume
b. minute ventilation
c. minute oxygen intake
d. vital capacity
e. functional residual volume
19. which statement is false?
a. the most common complication of CVP is pneumothorax
b. isotonic saline is 9.0% NaCl

20. which solution contains 4 mEq of K⁺?

a. normal saline
b. 5% glucose solution
c. ringer lactate
d. ½ normal saline
e. none of the above
21. which of the following cause bradycardia in children?
a. enflurane
b. isoflurane
c. sevoflurane
d. halothane
e. all of the above
22. comparing the regional anesthesia to the general anesthesia, all are true
except:
a. regional anesthesia doesn't increase the risk of bleeding
b. regional anesthesia decrease the risk of DVT
c. regional anesthesia can be used in orthopedic surgery

15
Answers :
1 E 12 C
2 C 13 A
3 C 14
4 A 15 E
5 D 16 C
6 D 17 B
7 B 18 D
8 C 19 A
9 B 20 C
10 B 21 D
11 C 22 A

16
RADIOLOGY ( Images are identical or similar to those in exam)

1. Not an indication of IVU ? all answers were indications and mentioned in

slides !!
2. False about Salter Harris # ? Type 1 and 5 are easily diagnosed on Xray

3. Best study for acute ischemic infarction ? DWI

4. CT Phases ? all of the above ( memorize timeline from slides )

5. Which of the following is wrong ? Epidural hemorrhage is intra-axial

6. About C1 # , all are true except ? Hangman fracture

7. Monteggia fracture? proximal ulna fracture + proximal radial head

dislocation

8. Which of the following is true ? Geographic destruction is a benign process

9. PE

17
10. Fibrous dysplasia 11. Hiatal hernia

12. Medullary nephrocalcinosis 13. Anterior shoulder dislocation

18
14. Acute infarct

15. Acute pulmonary edema 16. SBO

19
17. Chronic pancreatitis 18. Uterine fibroid

19. Increased ICP

20
20. Ruptured AAA 21. Sigmoid volvulus

22. LT pleural effusion 23. SAH

21
24. Crohn’s disease 25. Brain atrophy

22
DERMATOLOGY
1. True about pemphigus except ? Old aged females

2. Description of Molluscum Contagiosum

3. True about alopecia arreata except ? Systemic steroids are used

4. Systemic Psoriasis more than 20% of body ? Systemic steroids are

contraindicated

5. Discoid lupus - cicatricial alopecia

6. No sebaceous glands in ? Palms

7. Not a subtype of Acne Rosacea ? Vesiculonodular

8. False about tinea capitis ? common in > 16 yro

9. Not true about P. Rosea ? systemic steroids are used in treatment

10. Not a histological findings in psoriasis ? Eosinophilic infiltrate

11. hutchinson's sign – melanoma of nail

12. Not and indication for skin biopsy ? Atopic dermatitis

13. Acute urticaria + dyspnea , rx ? Systemic steroids and Systemic

antihistamine
14. Not a side effect of Methotrexate ? Glaucoma

15. Retinoids are contraindicated with ? Tetracycline

16. Another question about retinoids and tetracycline

17. Orf description

18. Cryotherapy contraindication ? infected granuloma

19. Calculate dose of isotretinoin for a 60 kg pt ? 50

23
20. Which is a secondary skin lesion ? Lichenification

21. Not seen in Fungal skin infections ? Dermatomal blistering

22. PUVA mechanism of action ? DNA replication inhibition

23. Not DDx of Scabies ? Herpes Zoster

24. True about Lichen planus ? not seen in joints

25. Not a Herpes zoster DDx ? Acute urticaria

24
FAMILY MEDICINE
1. HTN work up includes ? TSH (Medscape according to JNC 7 ) Not ECG

2. HTN emergency – Retinopathy

3. Not a primary prevention in a pegnant woman ? screening for

something(‫)ناسي‬

4. True about retinopathy in DM ? Type 2 should be screened at dx

5. Not screened for ? Leukemia

6. DM renal involvement screening ? Microalbuminuria

7. Prediabetic pt , management ? Life style vs Metformin

8. Not a 1st line rx for HTN ? B-Blockers

9. What do you recommend for a pt taking Thiazide?

Drink alo of water vs Eat foods containing potassium

10. Minicog exam ? Three item recall and clock drawing ( a+ b)

11. Family has immunocompromised pt at home , recommended vaccine ? Polio

12. Non compliant pt with management , next step ?

Talk with the patient and understand his difficulties with committing to
plan and change plan accordingly ) ‫(بما معناه‬

13. Pt 67 year old , never vaccinated before , what should he vaccinated for ?
Tdap vs Pneumococal vs Hep B

14. Not associated with smoking ? Depression vs cervical ca

15. 79 , beast mamo and pap smear negative for last 10 years , has a first degree
relative with breast ca , appropriate step ?
continue mammogram and stop pap smear

16. Geriatrics age ? 65 yro

25
17. Not done in first visit ? Treatment plan vs Checking Previous medication
vs PE

18. Not a primary prevention ? genetic testing for anemia

19. Mechanism of DM 2 ?
decreased receptor sensitivity to insulin and decreased insulin

20. Early morning vomiting , headache – brain tumor

21. Old with back pain and weight loss – Cancer

26
 SURGICAL MINORS
OPTHALMOLOGY
Bold questions are debatable and depend on the writer ( books are ambiguous on the
correct answer )

1- not a feacture of orbital disease ? refractive error

2- prk superior to lasik except in ? myopia 2-5 ( Medscape )

not subepithleial infiltrates
3- Most common cause of leucocoria in an infant or a neonate ?
cong . cataract ( most likely ) vs Retinoblastoma .
Dr Abushanab said that most cases seen in the department are cong. Cataract , some
students say dr Akawi said RB .
Uptodate an the article below both support the answer ( cong. Cataract )
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5155001/
Various causes of leukocoria (white pupillary reflex) include congenital cataract (most
common), retinoblastoma, retinopathy of prematurity, vitreous haemorrhage, retinal
detachment and persistent foetal vasculature

4- least to affective vision or visual acuity ? cortical cataract

5- hyperdeviation with esotropia ? prism base out

6- optic tract lesion all except ? Heteronymous hemianopia

7- not correct – acute angle glaucoma is more in myopics than hypermetropics

27
8- blow out injury , not correct ? supra orbital nerve injury

9- cause of acute drop of vision in intermediate uveitis –

Floaters vs Vitritis vs Cystoid macular edema

10- most common ophthalmic presentation in ms ? retrobulber neuritis

11- contact lenses can be used in all except –infected corneal ulcer

12- diabetes mellitus – control decrease risk of retinopathy ??!

13- anti vgef not used in - dry age related maculo

14- not a symptom of acute uveitis ) ‫ ( النوع مش محدد‬- vision loss

15- diabetic retinopathy most important risk factor ? duration of dm

16- emergency , halo and headache – acute angle closure glaucoma

17- CRAO true except - pathognomic cherry spots ( not pathognomonic for CRAO )
Some answered patient may have experienced transient episodes in the past ( but
unfortunately it’s true , refer to Toronto notes )

28
18- CRVO most common rf – uncontrolled hypertension vs uncontrolled
dyslipidemia vs uncontrolled dm
Some students said that dr Akawi said it’s uncontrolled hypertension

19- 3 mm , strabismus is ? 45 prism diopter

20- superior oblique – 23 degree adduction

21- most common orbital tumor ? rhabdomyosarcoma

22- orbital cellulites ? ethmoid sinus

23- true about proptosis ? axial in meningioma of optic nerve

24- venereal conj. except – petrygium

( other choices were : cobblestone , ulcer , watery or mucoid secretion )

25- chemical injury , after copious irrigation next step ?

– Flip eyelid to look for foreign body
NOT Topical steroid ( see lecture notes , or Toronto notes , both state that after
irrigation you should flip the eyelid to look for a foreign body )

29
NEUROLOGY ( UW MAINLY )

‫اغلب االسئلة اما نسخ من اليوورد او فكرة السؤال ماخوذه من سؤال اليوورد او من شرح اليوورد‬

1- ALS – riluzole

2- als - upper and lower

3- GB case , acute , Rx ? – ivig

4- GB - campylobacter jejuni

5- Parkinson deficient substance – Dopamine

6-

30
colpi + aspirin ( pt already on aspirin , most likely answer according to uworld table )

7- NPH Typical case

8- not a symptom of PICA– hemiplegia

9- basal ganglia hemorrhage case

10- thiamine deficiency case

11- prosody in injury of - non dominant hemisphere

12- hemineglect - rt parital

13- Alzheimer – temporal atrophy

14- MG rx ? – pyridostigmine

15- RADIAL entrapment case

16- DM damage through – nerve ischemia

17- prions seen in - CJD

18- case cluster headache – 100% O2

19- pure sensory loss – thalamus

31
20- Parkinson < 65 –thyohexital ( see the text from Kaplan below )

21- drug causing psudotumor cerbri - danazole

22- pure motor – internal capsule

23- ms - interferon beta

24- caudate atrophy - Huntington

25- trigeminal nerve - cornea

26- trigeminal neurlagia rx ? – carbamazabine

27- HSV encephalitis

28- oligoclonal bands – ms with trigimnal neuralgia case

29- Not cerebellar ? slurred speed

30- hypothyroid case

31- essential tremor rx? – propnalol

32- figlomoid , before use screen for ? - TB

32
33- aspirin vs warfarin see uworld table

34- ct angio

35- restless leg syndrome rx ? pramipexole

36- hemanopsia

37- physical examination – best dx for Parkinson

38- pseudotumor rx ? acetazolamide

33
EAR NOSE THROAT
1- ethmoid ordinary papilloma

2- neonate stridor mc site ? larynx

3- maxillary polyp – antrochoanal

4- bilateral conductive hearing loss most common cause in children ? serous om

5- sphenopalatine from ? maxillary artery

6- epistaxis mc site - anterior septum

7- grandinego syndrome except - facial n. involvement

8- cholesteatoma , true about it - erodes bones

9- quinsy , true about it – medial to sup.

Constrictor

10- steroid oral , complications except ? glu /

cata / avascular necrosis -
all are true , the question was wrong

11- adenoid faces except - protruding

lounge

12- chronic sinusitis risk factors except - alcohol

13- mri better than ct except - bone viewd better

34
14- malignant otitis externa , true except – SNHL

15- csf rhinorrhea, most specific - beta integrin

16- Obstructive sleep apnea – absolute for tonsillectomy

17- palatopharyngeal – posterior pillar

18- not a complication of acute tonsillitis - chronic retro

19- taste - below stapedial facial nerve

20- tonsolectomy mc cx – hemorrhage

21- tracheostomy indication - bypass airway obstruction

22- atrophic rhinitis - ozaena.

23- true about safe csom – profound mucopurulent

24- water syringe not for ? vegetable foreign body

25- vocal cord parlysis cause except - abdominal surgery

26- nasal polyps rx - topical steroid

27- local cause of epistaxis except - HHT

28 - peritubal tonsils – gerlach

29- croup - steeple

35
30- not from 1st and 2nd pharyngeal ? foot plate of stapes

31- 2khz - cahart notch

32- – parapharyngeal space is medial to? medial pterygoid

33- allergic rhinitis except - null all above answeres were true

34- maryngotmy – hemotympany

35- all are snoring causes except ? -laryngal papillomatosis

36- maxillary - middle meatus

37- Meniere – SNHL + tinnitus + vertigo

36
 ORTHOPEDICS AND
NEUROSURGERY
ORTHOPEDICS

1- benign tumor best treated surgically - giant cell

2- soup-bubble appearance - giant cell

3- type of healing in skin traction - secondary , with callus

4- most common bone tumor - mets

5- type 2 nerve injury , nerve can heak because one of the following is not injured -
endonurium

6- carpal tunnel content except - flexor carpi radialis

7- not a complication of paget - arrythmia

8- boteneire diformity results from - central slip

9- Which of the following is most likely to undergo malignant degeneration? Maffucci

syndrome

11- speed test - biceptal tendinitis

12- Pain grade 2 description, and wants the type .

13- metatarsal adductus deformity in ? mid and forefoot

14- Not a form of displacement in long bone fractures t? sublaxation

15- most common trauma deaths occur in - peak 1

16- cause of pain in osteomyelitis -increased intraosseous pressure

17- position that relives joint pain by decreasing intracapsular pressure - abduction
flexion external rotation

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18- carpal bones order from proximal to distal , lateral to medial .

19- not a feature of osteoarthritis - codmann triangle

20- which of the following is not a lesion of posterior element of spine - bone mets

21- Which of the following shouldn't be treated with chemotherapy - chondrosarcoma

22- child 15 yro , fever thigh pain high esr - ewings sarcoma

23- typical perthes case and wants dx

25- normal angulation of knee by end of maturity? 5-7 valgus

26- heroin o.m in AC joint , suspected micro-organism ( question copied from

orthobullets ) ? Staph

27- alkaline phosphatase not increased in? fibrous dysplasia

28- not a multiple lesion - osteoid ostesarcoma

29- not true about OM in adults ? Well localized pain

30- transverse fracture mechanism? tension force

31- about compound fracture , which is false ? Wound should be closed

32- about open fracture , which is false ? Open reduction internal fixation is used

33- which of the following is a risk factor of o.a ? non of the above .

34- not a feature of direct trauma ? distant injury

35- malunion definition ? abnormal position

36- hypertrophic non union occurs in the setting of ?

hypermobility

37- median nerve ( B )

38- long thoracic ( A )

39- not supplied by axillary nerve ? teres major

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40- delayed ulnar palsy seen in ? lateral epicondyle

41- about radial injury , which is not true ? always causes wrist drop

41- nerve injured in humerus fracture ? radial

42- Muscle not involved in median nerve injury? Extensor

43- SCFE referred pain ? obturator

44- which of the following is false about bicipital tendonitis ?always not associated
with impingement

45- not an epiphyseal tumor ? adamintmoa

46- typical compartment syndrome case , next step ? remove cast

47- which of the following is false about neuropraxia ? only sensory

48- slater harris type 3 definition

49- Volar extrarticular radial fracture ? smith

50- ewings presentation can be confused with ? ahom

51- not a feature of club foot ? Hindfot vulgus

52- first deformitty to correct in club food ? Cavus

53- blount's disease , is ? posteromedial tibia hypoplasia

54- most common cause of pes cavus ? Poliomyelitis

55- typical house maids knee case , site of inflammation ? prepatellar bursa

56- dead bone apperance on xray ? obaque

57- synovial fluid viscousity ? high

58- not a complication of intertrochntric fracture ? AVN

59- most common complication of head of femur fracture ? AVN

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60- claudication - Muscular spasm

61- one of the following is a static stabilizer of the shoulder ? Labrum

62- fenkelstein test is positive in ? dequervain

63- golfer elbow ? flexer radialis

64- about leg fracture, which is false ? will impair all movement in leg

65- most important factor in fracture healing? soft tissue and blood supplly

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NEUROSURGERY
1- Not involved in cavernous sinus thrombosis ? v3

2- indication of surgery in spinal herniation ? myelopathy

3- cauda equina case , which of the following is false ? medical treatment

4- True about meningioma , except ? chemo and surgery are equaly effective

5- most commonly associated with Arnold Chiari type 1? syringomyelia

6- epidural hematoma can be from ? superior sagittal sinus

7- brain abscess hematogeniuos

8- measure gcs ? 8

9- mildest form of spina bifida ? meningocile

10- not seen in NPH imaging ? slit ventricles

11- pseudotumor cerebri initial treatment? acetazolamide

12- features pseudotumor cerebri in a case , what to do next - CT

to exclude brain mass

13- does not reduce icp ? hyperthermia

14- reversed herniation cause ? posterior fossa mass

15- not a feature of pituitary tumor ? hemonymous hemanopia

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EMERGECNY

‫ لكن هاي االسئلة الي كان المفروض تيجي‬، ‫الطوارئ الي اجا ان شاء هللا ما بيتكرر ما في داعي للكتابة‬
1-A 22 year old man in an injury due to motor cycle accident, which he was not wearing
a helmet, on admission to ER, he was in severe respiratory distress and hypotension
and appears cyanotic, he was bleeding from his nose and there is a femoral open
fracture, there is a decreased breath sounds in his right chest, the initial step in
management of this case is?
Endotracheal intubation with inline cervical traction.

2-A 6 months baby with intermittent periods of crying, with his legs being up, with
blood in rectal examination?
Intussusception.

3-Which of the following steps are part of the primary survey in trauma patient except?
Examination for the cervical spine.

4-Most common cause of massive lower GI bleeding is?

Diverticulosis

5-Patient with painful inguinal hernia, one is correct?

If reduction fails, do surgery.

6-Which of the following statements are true concerning the management of chest
trauma?
Persistent bleeding in penetrating injury is often due to injury to any artery
in systemic circulation.

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7-Which of the following is not correct about pancreatitis pain?
Not associated with nausea and vomiting

8-A 25 year old man is involved in a motor vehicle accident with significant head injury,
which of the following statements are true regarding his injury and management?
A single episode of systolic blood pressure <90 occurring during the early
period after injury, significantly increase the chance of mortality and
morbidity.

9-A 27 old driving car in high speed, not wearing a seatbelt, leaves the road and
crashes with a tree, all of the following injuries pattern maybe predictable from this
type of motor vehicle accident except?
Diaphragmatic rupture due to increase in intra-abdominal pressure.

10-The first complaint of compartment syndrome?

Pain

11-The following is a cause of painful goiter?

Acute Thyroiditis.

12-Nasotracheal intubation is preferred in?

C-spine injury

13-Concerning Cardiac tamponade?

Symptomatic relief requires removal of small volume of fluid from the
pericardial sac.

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14-The management of blood loss in a sudden crush injury with bleeding diathesis?
Give blood then cryoprecipitate

15-Concerning subarachnoid hemorrhage, which is not true?

CT is more sensitive diagnostic modality than LP.

16-All of the following drugs may abort an attack of migraine, except?

Pethidine (increased ICP).

Things to keep in mind:

- Heparin doesn’t cross placenta
- Head injury alone doesn’t result in shock

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45
46
 FORENSIC MEDICINE
The exam was 100 questions , all were MCQ’s and computerized , here is
what I’ve gathered so far … ) ‫( الصورة المعروضة مشابهه وليست مطابقة‬

A. Images

1. Range of Shot?
Intermediate

2. Mechanism?
Cadaveric spasm

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3. All cause this image except?
Congestive heart failure

4. The changes in heart ?

Hypertrophic

5. Fall on buttock , this is a ?

Ring fracture

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6. weapon used is ?
Shotgun

Not Dum-dum
( tiny whitish plaques are
Shotgun Pellets )

7. This is a ?
Calcified aortic valve

49
8. In the exam the picture was a kid’s back ,
Weapon is ?
Shotgun

9. Mechanism of death ?
Drowning/immersion

10. Mechanism of death ?

Strangulation

50
11. Mechanism of death ?
RTA

12. Mechanism of injury ?

Defense wounds

13. An image of skull vault from inside , asking about a bullet injury , answer was
: bullet inlet

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B. Other MCQs

14. Tache noire description

15. Hyoid Fx seen in ? Throttling

16. Café coronary syndrome? choking by bolus

17. True about pugilistic attitude ?

Can’t determine if death was ante or post mortem

18. Best bones to determine sex ? Pelvis

19. Amount of air for air embolus ? 100 ml

20. An injury at a site opposite to impact ? counter coup

21. Most common pattern of finger print ? loop

22. Main bacteria in putrefaction ? C. Welchii

23. Nutmeg liver ? chronic venous congestion

24. Rigor mortis starts in ? upper eyelid

25. Ulcer in 1st part of duodenum after burn ? curling’s

26. A case , with fibrofatty heart ?

Arrhythmogenic right ventricular dysplasia ( ARVD )

27. Beveling is seen in ? Firearm injury

28. Bumper fx is a ? primary injury

29. Tree disruption (Lichtenberg) ? Lighting injury

30. Not suffocation ? Chocking

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31. Right ventricle should be disectated under water to detect air embolus

32. Not a steering wheel injury ? whiplash

33. Important to determine weapon used ? Width

34. Paltauf spots seen in ? lungs

35. Close contact injury description

36. Heart ischemia caused by Cocaine

37. Ring like heart fibrosis ? Left circumflex ?!

38. Hypostasis not seen in ? cyanide poisoning

39. Death due to multiple shots , cranium exploded , scatterd brain , what to
dissect ?
1. Don’t dissect
2. Dissect chest
3. Dissect chest and abdomen
4. Dissect chest abdomen and cranium

40. Baby 3 mo died , at autopsy , a hypertrophic heart was found ? Explained

death

41. When to write autopsy report ?

a. In cases of natural death
b. If pt name unknown
c. In IHD
d. Whenever the physician can

42. Stocking and gloves is seen in? prolonged hanging

43. True about elastic hymen? ruptures during baginal birth

44. Langer lines ? Gaping

45. True about rifling ? Help determine gun type

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46. False about Riflling ? spinning not important ‫ بس‬، ‫( مش ذاكر الخيار بالزبط‬
) ‫كان اشي الو دخل بالسبيننج‬

47. Caliber is measured by ? Land to land distance

48. Placenta increta case

49. CVA after MI ? Mural thrombus

50. Kids trialed as adults ( or something like that ) after

16 yro

51. Cardiac Marker remains increased for a week ?

Troponin I , CK- MB ( remains increased for a couple of days )

52. Long bone fx then livedo reticularis and PE ? Fat embolus

53. Cushing’s syndrome case with onion skin in renal artery’s and BP 190/110 ?
Malignant HTN

54. Abortion surgery without sedation ? neurogenic shock

55. Entomology helps determine ? Time of death

56. Not a feature of brainstem death ?

57. Epigastric trauma then arrest? Vasovagal stimulation

58. Removal of which is a permanent infirmity ?

Functional hydronephrotic kidney

59. DNA can’t be collected from ? Mature RBC

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 60. Which of the following indicate death was antemortem ? Weed and grass in
hand

61. C2/C3 fx , spinal laceration result from ?

Judicial hanging

62. Heat hematoma? between skull and dura

63. Raccoon eyes – basal skull fracture

64. Caput succedaneum

‫ بس ما كتبتهم‬gradestack ‫في اسئلة مكررة من‬

https://gradestack.com/Dr-Bhatia-Medical/Not-a-feature-of-brain/0-3042-
3166-15605-sf

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The End
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