Professional Documents
Culture Documents
Medicine
1. The best investigation to differentiate iron deficiency anemia from other anemias of
chronic illness:
a) Serum iron
b) Serum ferritin
c) TIBC
d) ..
5. A 27 yo girl came to the ER, she was breathing heavily, RR 20/min. she had
numbness & tingling sensation around the mouth & tips of the fingers. What will
you do?
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a) Let her breath into a bag
b) Order serum electrolytes ??↓ ca+2
c) First give her 5ml of 50% glucose solution
d) ..
6. A pt was brought by his son. He was pulseless & ECG showed ventricular
tachycardia, BP 80/? Your action is:
a) 3 set shock
b) One D/C shock (cardioversion)
c) Amiodaron
d) CPR
8. An elderly female presented with history of bilateral hand stiffness that is worse in
the morning. On examination she had bony swellings in the distal interphalangeal
joints. These swellings are:
a) Heberden nodule
b) Buchard's nodule
c) Synovial thickening
d) Synovial cysts
9. An elderly male pt who is a known case of debilitating disease presented with fever,
productive cough. Sputum culture showed a growth of G-ve organisms on a
buffered charcoal yeast agar. The organism is:
a) Mycoplasma pneumoniae
b) Klebsiella pneumoniae
c) Ureaplasma
d) Legionella
10. An elderly lady presented with chronic knee pain bilaterally that increases with
activity & decreases with rest. The most likely diagnosis is:
a) Osteoarthritis
b) Rheumatoid arthritis
c) Septic arthritis
d) ..
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d) Parenchymal renal disease
e) Acute glomerulonephritis
13. One of the following is true about the home treatment of COPD:
a) Give O2 if SO2 is less than 88%
b) Give O2 if SO2 is 88-95%
c) Give O2 at night (nocturnal) only
d) ..
14. Which of the following indicate inferior wall MI (Inferior chest leads) in ECG are:
a) II, III, AVF
b) V1,V2,V3
c) V2, V3, V4
d) I, V6
e) I, aVL, VI
17. A pt had HBsAB +ve, but the rest of the hepatitis profile was negative. The
diagnosis is:
a) Immunization from previous infection, past exposure or vaccination
b) Carrier state
c) Chronic hepatitis
d) Active infection
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18. The drug with the least side effects for the treatment of SLE is:
a) NSAIDs
b) Methotrexate
c) Corticosteroid
d) Hydroxychloroquin
19. A young male who is a known case of sickle cell anemia presented with abdominal
pain & joint pain. He is usually managed by hospitalization. Your management is:
a) In-patient management & hospitalization
b) Out-patient management by NSAID
c) Hydration, analgesia, monitoring.
d) Narcotic opioids
20. A lot of bacteria produce toxins which are harmful. Which one of the following is
used in amiddirs:
a) Botulism
b) Tetanus
c) Diphtheria
d) Staph aureus
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23. Warfarin is given to all the following except:
a) Young male with Atrial fibrillation & mitral stenosis
b) Male with AF & cardiomyopathy
c) Male with AF & prosthetic heart valve
d) Elderly male with normal heart
25. A 24 Y/o man presented with 4 month Hx of diarrhea with streaks of blood &
mucous. Ulcerative colitis was confirmed by colonoscopy. The initial therapy for
this patient:
a) oral corticostreiod
b) azathioprine
c) infleximabe
d) 5-Aminosalicylic acid
e) Sulfasalazine
26. The typical ECG change associated with the first hour of acute pericarditis:
a) Q wave inversion
b) ST inversion
c) ST elevation
d) T wave inversion
e) prolong PR interval
27. A 20 years old male who is a known asthmatic presented to the ER with shortness
of breath. PR 120, RR 30, PEFR 100/min. examination revealed very quite chest.
What is the most propable management?
a) Nubelized salbutamol
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b) IV aminophyline
c) Pleural aspiration
d) Hemlich maneuver
e) Chest drain
29. A hypothyroid pt on thyroxin had anorexia, dry cough, dyspnea & left ventricular
dysfunction. She had normal TSH & T4 levels, Hyperphosphatemia &
hypocalcemia. The diagnosis is:
a) Primary hypoparathyroidism
b) Secondary hypoparathyroidism
c) Hypopituitaritism
d) Uncontrolled hyperthyroidism
33. A patient on IV line developed fever due to infection. The most common source of
bacterial contamination of IV cannula:
a. Contamination of fluid during manufacturing process
b. Contamination of fluid during cannula insertion
c. Contamination at site of skin entry
d. Contamination during injection of medication
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e. Seeding from remote site during intermittent bacteremia
Surgery
34. A 55 yr old man presenting with Hx of streakes of blood in stool and dull pain on
defecation that persists for half an hour after defecation, on examination there was a
3x2 cm thrombosed mass at 3 o’clock. What is the management?
a) Sitz bath 5 times/ day.
b) Application of local anesthetic and incision.
c) Application of antibiotic
d) Band ligation and wait for it to fall
e) Application of local anesthetic ointment
35. A 42 year old woman presented with a painful breast mass about 4 cm in the upper
lateral quadrant. It increases in size with the menstrual period. Examination showed
a tender nodularity of both breasts. What is the management:
a) Hormonal treatment with oral contraceptive pills
b) Hormonal treatment with danazol
c) Lumpectomy
d) Observation for 6 months
36. A 48 year old man complaining of right lower quadrant pain, bleeding per rectum,
nausea & vomiting. What is the best pre-operative investigation?
a) Air contrast enema
b) Fecal occult blood
c) CBC
d) colonoscopy
37. 17 year old young male presented with abdominal pain that started periumbilical
then became localized in the right iliac fossa. CBC showed high WBC count
(typical presentation of acute appendicitis). The best next step is:
a) CT
b) US
c) Serial 3 abdominal films
d) Sigmoidoscopy
e) Diagnostic laproscopy
38. A 26 year old woman had a perforated gallbladder post cholecystectomy. She
presented with right upper guadrant pain that was tender, with fever of 380C, a pulse
of 120 bpm & raised right diaphragm on CXR. The most probable diagnosis is:
a) Acute cholecystitis
b) Acute pancreatitis
c) Acute appendicitis
d) Subphrenic abscess
e) Perforated peptic ulcer
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39. A 10 year old boy came to the ER with Rt scrotal pain and swelling, on
examination: tender Rt testis, with decreased flow on Doppler study. Your
diagnosis is:
a) Hernia
b) Hematocele
c) Testicular torsion
d) Orchitis
40. A 17 year old man presented with a 12 hours history of central abdominal pain then
it became localized in the right iliac fossa. On examination he had pyrexia, guarding
& rebound tenderness (a case of acute appendicitis). The most appropriate
investigation is:
a) CT scan
b) Pelvic Ultrasound
c) Diagnostic laparoscopy
d) MRI
41. A 60 year old diabetic man presented with dull abdominal pain & progressive
jaundice. On examination he had a palpable gallbladder. The most probable
diagnosis is:
a) Chronic cholecystitis
b) Common bile duct stone
c) Carcinoma of the head of pancreas
d) Gallbladder stone
e) Hydrocele of the gallbladder
42. A 30 year old man presented with feeling of heaviness in the lower abdomen. On
examination he had a small bulge palpable at the top of the scrotum that was
reducible & increases with valsalva maneuver. The most likely diagnosis is:
a) Indirect inguinal hernia
b) Direct inguinal hernia
c) Femoral hernia
d) Hydrocele
e) Varicocele
43. A 48 year old woman presented with right abdominal pain, nausea & vomiting. On
examination she had tenderness in the right hypochondrial area. Investigations
showed high WBC count, high alkaline phosphatase & high bilirubin level. The
most likely diagnosis is:
a) Acute cholecystitis
b) Acute appendicitis
c) Perforated peptic ulcer
d) Acute pancreatitis
e) Inferior MI
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44. An elderly male pt came with bleeding per rectum & abnormal bowel habit. O/E
liver span was 20 cm. what is the next step?
a) Colonoscopy
b) ..
c) ..
d) ..
48. An 8 month old baby presented with a hx of recurrent crying with on & off jelly
stool. The diagnosis is:
a) Intussuception
b) Intestinal obstruction
c) Mickle's diverticulum
d) Strangulated hernia
Obstetrics
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50. A pregnant woman, multigravida, 38 weeks gestational age presented with
glucosuria. Gestational diabetes was confirmed by glucose tolerance test. The next
step is:
a) Repeat Glucose tolerance test
b) Cesarean section
c) Diet adjustment
d) Start sliding scale insulin
e) Start oral hypoglycemic medication
52. A pregnant lady, 8 weeks gestation, came with Hx of bleeding for the last 12 hours
with lower abdominal pain & she passed tissue. O/E the internal os was 1cm
dilated. The diagnosis is:
a) Complete abortion
b) Incomplete abortion
c) Missed abortion
d) Molar pregnancy
e) Threatened abortion
54. A 30 yo lady in the third trimester of her pregnancy developed a sudden massive
swelling of the left lower extremity extending from the inguinal ligament to the
ankle. The most appropriate sequence of work up & treatment:
a. Venogram, bed rest, heparin
b. Impedance plethysmography, bed rest, heparin
c. Impedance plethysmography, bed rest, vena caval filter
d. Impedance plethysmography, bed rest, heparin, warfarin
e. Clinical evaluation, bed rest, warfarin
Gynecology
55. A 55 year old lady on HRT is complaining of spotting on day 21 of the cycle. What
will you do?
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a) Pap smear
b) Endometrial sampling
c) Stop HRT
d) Add progesteron
56. Elderly female married since 30 years had fever, chills, dysurea, and diarrhea. No
back pain. The diagnosis is:
a) Acute bacterial cystitis
b) Acute pyelonephritis ??????????????
c) Bacterial gastroenteritis
d) Viral gastroenteritis
57. A young female patient who is an office worker presented with itching in the vagina
associated with the greenish-yellowish vaginal discharge. Examination revealed red
spots on the cervix. The diagnosis is:
a) Trichomoniasis
b) Candidiasis
c) Gonorrhea
d) Gardnerella vaginalis
58. A female pt presented with oligomenorrhea, she had 3 periods in the last year. She
also had acne & hirsutism. Her body weight was 60 kg. PV examination was
normal. The diagnosis is:
a) Polycystic ovary disease
b) Hyperprolactinemia
c) Adrenal tumor
d) Hypothyroidism
e) Premature ovarian failure
60. A couple is trying to have baby for the last 6 month of unprotected intercourse.
They wanted to know the possible cause of their infertility. What will you do?
a) Wait & see.
b) Send to fertility clinic
c) Semen analysis
d) Pelvic exam
e) Body temperature chart
61. A 34 year old lady presented with pelvic pain and menorrhagia. There is history of
infertility. On examinations the uterus was of normal size & retroverted. She had
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multiple small tender nodules palpable in the uterosacral ligament. The most likely
diagnsosis is:
a) Fibroid
b) Endometriosis
c) Adenomyosis
d) PID
62. A 50 year old woman (post menopausal woman) who is taking estrogen OCP every
month & stops at the 21st day of the cycle. She presented with vaginal bleeding in
the form of spotting 2-3 days after stopping the estrogen OCP (a case of
postmenopausal bleeding). The best management is:
a) Pap smear
b) Endometrial sampling (biopsy)
c) Stop estrogen
d) Continue estrogen
e) Add progestron
Pediatrics
63. A patient presented with fatigue, loss a petite & bloody urine. She gave History of
sore throat 3 weeks back. The most likely diagnosis is:
a) hemorragic pyelonephritis
b) Post streptococcal GN
c) Heamorragic cystitis
d) membranous GN
e) IgA nephropathy
64. A child of an HIV positive mother. He is not immunized. Which of the following
vaccines should not be given to him?
a) Live oral polio
b) DTP
c) MMR
d) Hepatitis B
65. A child swallowed his relative's medication. What is the best way of gastric
decontamination?
a) Gastric lavage
b) Total bowel irrigation (whole bowel wash)
c) Syrup ipecac
d) Activated charcoal
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b) Klinfelter syndrome
c) Turner's syndrome
d) ..
67. A young girl pt had URTI 1 week ago & received septra (trimethoprime +
sulphamethoxazole). She came with crampy abdominal pain & proximal muscle
weakness. The diagnosis is:
a) Polymyositis
b) Gullian parre syndrome
c) Intermittent porphyria
d) Periodic hypokalemic paralysis
e) Neuritis
69. A child presented with respiratory distress & accessory muscle contraction. What is
your treatment?
a) Oxygen
b) Bronchodilator
c) IV corticosteroid
d) IV Theophyllin
70. A child presented with dysphagia, sore throat, postnasal drip, drooling of saliva,
rhonchi & fever of 38.50c. The treatment is:
a) Hydrocortisone injection immediately
b) Call otorhinolaryngology for intubation
c) Admit to ICU
d) Give antibiotics & send him home
71. A child presented with respiratory distress & accessory muscle contraction. What is
your treatment:
a) Oxygen
b) Bronchodilator
c) IV corticosteroid
d) IV Theophyllin
72. A child was treated for otitis media with 3 different antibiotics for 6 weeks but
without improvement. Which antibiotic is the best treatment:
a) Amoxicillin
b) Penicillin
c) Cepahlosporin (ceprofloxacin)
d) Amoxicillin + Clavulonic acid
e) Erythromycin + sulfamethoxazol
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73. A baby came complaining of croup, coryza, air trapping, tachypnea & retraction.
The best management is:
a) Erythromycin
b) Penicillin
c) Ampicillin
d) …
74. A 15 yo boy had hx of URTI 2 weeks ago. Now he is complaining of fever, bilateral
knee pain with swelling & tenderness. The diagnosis is:
a) Sickle cell anemia
b) Post-streptococcal glomerulonephritis
c) Rheumatoid arthritis
d) Rheumatic fever
e) Septic arthritis
75. A 4 yo baby boy complaining of fever, chills, rigors & nuchal rigidity. O/E he had
positive Kurning's sign & petechial rash on his abdomen & lower limbs. The
diagnosis is:
a) Pneumococcal meningitis
b) Meningococcal meningitis
c) Aseptic meningitis
d) Brain tumor
e) Encephalitis
Psychiatry
76. A 70 year old female brought to your clinic by her daughter. The daughter said her
mother’s memory deteriorated in the last 2 years. She can cook for her self but
sometimes leave the oven on. She can dress herself but with difficulties. The
daughter mentioned that her mother’s personality changed into a more aggressive
person (pt has Alzehimer's disease). According to this history what is your
appropriate management?
a) Prescribe diazepam for the daughter and haloperidol for the mother
b) Refer the mother into chronic illness institute
c) Refer the mother to geriatric clinic
d) Immediate hospitalization
77. A man was intent as if he is listening to somebody, suddenly started nodding &
muttering. He is having:
a) Hallucination
b) Delusion
c) Illusion
d) Ideas of reference
e) Depersonalization
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78. A patient was intent as if he is listening to somebody, suddenly started nodding &
muttering. He is having:
a) Delusions
b) Illusions
c) Hallucinations
d) Ideas of reference
e) Depersonalization
ENT
79. A 45 yo lady was complaining of dizziness, sensory neural hearing loss on her left
ear (VIIIth nerve palsy), tingling sensation & numbness on her face, loss of corneal
reflex. MRI showed a dilated internal ear canal. The diagnosis is:
a) Acoustic neuroma
b) Glue ear
c) Drug toxicity
d) Herpes zoster
e) Cholesteatoma
80. A child presented with earache. On examination there was a piece of glass deep in
the ear canal. The mother gave a history of a broken glass in the kitchen but she
thought she cleaned that completely. The best management is:
a) Refer to ENT
b) Remove by irrigation of a steam of solution into the ear
c) Remove by forceps
d) Remove by suction catheter
e) Instill acetone into the external auditory canal
Ophthalmology
82. Which of the following is not a sign or symptom of central retinal artery occlusion?
a. Painful loss of vision
b. Painless loss of vision
c. Previous transient loss of vision
d. Dilated pupil with sluggish reaction to light
Orthopedics
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83. A foot ball player his knee was hit from the left lateral side, valgus test was
positive; drawer test & Laschman test were negative. Which of the following was
injured?
a) Anterior cruciate ligament
b) Posterior cruciate ligament
c) Medial collateral ligament
d) Lateral collateral ligament
e) Medial meniscus
84. A pt had hairline metatarsal fracture. The x-ray was normal. What is the 2nd line?
a) CT scan
b) MRI
c) US
d) ..
85. A pt presented with open tibial fracture. Which antibiotic you will give?
a) Cefazolin
b) Gentamycin
c) Cefazolin & gentamicin
d) Cefazolin, Gentamycin & metronidazol
Urology
86. A Case scenario about a male patient present with prostatitis (prostatitis was not
mentioned in the question), culture showed gram negative rodes. The drug of choice
is:
a) Ciprofloxacin
b) Ceftriaxone
c) Erythromycin
d) Trimethoprime
e) Gentamicin
87. A pt complaining of left flank pain radiating to the groin, dysurea, no fever. The
diagnosis is:
a) Pyelonephritis
b) Cystitis
c) Renal calculi
d) ..
88. A 3 weeks old baby boy presented with a scrotal mass that was transparent & non-
reducible. The diagnosis is:
a) Hydrocele
b) Inguinal hernia
c) Epidydimitis
d) ..
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89. A 29 year old man complaining of dysurea. He was diagnosed as a case of acute
prostitis. Microscopic ex showed G-ve rods which grow on agar yeast. The
organism is:
a) Chlamydia.
b) Legonella.
c) Mycoplasma
d) ..
90. An 80 year old male presented with dull aching loin pain & interrupted voiding of
urine. BUN and creatinine were increased. US revealed a bilateral hydronephrosis.
What is the most probable Dx?
a) Stricture of the urethra
b) Urinary bladder tumor
c) BPH
d) Pelvic CA
e) Renal stone
Dermatology
91. A 10 yo boy presented with a 5 days history of skin lesion which was scaly &
yellowish. The diagnosis is:
a) Tenia corporum
b) ..
c) ..
d) ..
92. A mother brought her baby & was complaining of diaper rash. She used
cornstarch, talc powder, zinc ointment & 3 different types of corticosteroids
prescribed by different physicians but with no benefit. The rash was well
demarcated & scaly with satellite lesions. The most likely diagnosis:
a) Candidal rash
b) Seborrhic dermatitis
c) Allergic contact dermatitis
93. A female pt presented with wheals over the skin with history of swollen lips. The
diagnosis is:
a) Chronic urticaria with angioedema
b) Solar dermatitis
c) Contact dermatitis
d) Cholinergic dermatitis
94. A child presented with honey comb crust lesion. Culture showed staph aureus. The
diagnosis is:
a) Impetigo
b) ..
c) ..
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d) ..
95. A pt presented with a 6 week history of itching & redness all over the body with
wheals. Which type of urticaria this pt has:
a) Chronic urticaria.
b) Solar urticaria
c) Allergic urtecaria
d) ..
Neurology/Neurosurgery
97. A middle age man presented with sever headache after lefting heavy object. His BP
was high. He was fully conscious. Examination was otherwise normal. The most
likely diagnosis is:
a) Subarachnoid hemorrhage
b) Central HTN
c) Tension headache
d) Migraine
e) Intracerebral hemorrhage
98. An 18 yo male who was involved in an RTA had fracture of the base of the skull.
O/E he had loss of sensation of the anterior 2/3 of the tongue & deviation of the
angle of the mouth. Which of the following nerves is affected?
a) I (Olfactory)
b) III (Occulomotor)
c) IV (Abducens)
d) VII (Facial)
Medical Ethics
99. You were working in a clinic with a consultant who prescribed a drug that was
contraindicated to the pt (the pt was allergic to that drug) but you didn't interfere &
assumed that he knows better than you do. Which of the following you have
violated:
a) Professional competence
b) Quality of caring of patient.
c) Honesty.
d) Pt relationship
e) Maintaining trust
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100. Physician's carelessness is known as:
a) Malpractice
b) Criminal neglect
c) Malfeasance
d) Nonfeasance
Statistics
101. You are reading a population study that states that 90% of lung cancer patients are
smokers while 30% of lung cancer patients are non-smokers. What is the specificity
of using smoking as a predictor of lung cancer?
a) 10%
b) 40%
c) 30%
d) 70%
e) 90%
102. The most important factor in attempt of successful cessation of smoking is?
a) The smoker’s desire to stop smoking.
b) The pharmacological agents used in the smoking cessation program.
c) Frequent office visits.
d) Physician’s advice to stop smoking
e) Evidence of hazards of smoking
Written by:
KFU Medical Interns
Athari AlOtibi , Munira AlSuwailem, Noof ALTurki, Zainab Al-Zayer, Zahra Al-Sanna,
Dalia Al-Jedawi, Laila Bubshait, Taghreed Al-Hindi, Mona Al-Awam, Doa’a Al-Saleh,
Noof Al-Abdulqader, Methal Al-Bayat, Maha Al-Madi, Bushra Al-Sogair, Dana Al-
Ja’afary, Zainab Al-Matar.
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