‫إختبار الباطنة دفعة ‪ 32‬بكالوريوس‬

‫مع اإلجابة‬

‫إعداد‪/‬‬
‫أسامه الكبش‬
 Sana’a university-faculty of medicine & health science
Department of internal medicine
MBBCh final exam October,30,2021
Time allowed: 2 hours only
1- A 20 years old women is referred from
the medical admissions unit .she has a
4-week history of spiking fever and has
Now developed a symmetrical polyarthritis
Her mother tells you she was treated for
Arthritis of her knees when she was a child.
On examination you notice she has a pink
macular rash. What is the most likely diagnosis?
a) Adult-onset still’s disease
b) Familial Mediterranean fever (FMF)
c) Sjogren’s disease
d) Mixed connective tissue disease
2- A 63-year-old lady presents with a flu-like
illness and myalgia . in the last few days , she
has noticed a rash across her back. She has
no other symptoms . on examination she looks
unwell. There is an erythematous rash across
her back. She has grade 4/5 weakness proximally.
You check her CK which is elevated at 1052 IU/I.
Her renal function is normal. You suspect dermatomyositis.
Which of the following investigations is most
Likely to help establish the diagnosis?
a) EMG
b) MRI quadriceps
c) Muscle biopsy
d) Skin biopsy
3- Rheumatoid factor is positive in high titer in the
Following except one :
a) Sjogren’s syndrome
b) Psoriatic arthritis
c) SLE
d) Rheumatoid arthritis
e) Polydermatomyositis
4- A 65-year-old diabetic women is febrile with chills
And rigors and has a 1 day history of pain in her
right knee what clinical diagnosis should be
considered most until excluded?
a) Gouty arthritis
b) Osteoarthritis
c) Pseudogout
d) Septic arthritis
5- Inflammatory arthritis is characterized by all of
Following symptoms and signs except one :
a) Pain occurs only on movement
b) Prolonged morning stiffness
c) Cardinal symptom and signs of inflammation
d) Presence of systemic symptom and sign
e) Waxing and waning of symptom
Page 2 of 10
6- what is the most common human leukocyte antigen ( HLA)
type in rheumatoid arthritis?
a) HLA B5
b) HLA B27
c) HLA DR2
d) HLA DR4
7- Which one of the following drugs is least likely to cause Gout?
a) lithium
b) hydrochlorothiazide
c) furosemide
d) alcohol
8-A 25-year-old female complains of intermittent pain in her
fingers . she describes episodes of numbness and burning of
the fingers . she wears gloves whenever she leaves the house.
What is the most probable diagnosis?
a) Kawasaki disease
b) Takayasu arteritis
c) Buerger’s disease
d) Embolism
e) Raynaud’s phenomenon
9- Criteria for diagnosis of autoimmune diseases included all of
the following except one :
a) CT scan and MRI
b) The presence of circulating antibodies against self-antigen
c) Histopathological evidence of inflammation of organs by immune
cells
d) The ability of these antibodies to interduce autoimmune diseases
to fetus of they cross placenta
e) Rapid response to steroid and immunosuppressive drugs
10- All of the following are functions of complement system
except one :
a) Opsonization of antigen to facilitate its phagocytosis
b) Cell lysis by membrane attack complex
c) Chemoattractant function
d) Play important rule for antigen presentation to the adaptive
immune system
e) Clearance function of immune complex and apoptotic
11- regarding Dengue hemorrhagic fever (DHF) and dengue
shock syndrome (DDS) which one of the following is correct?
a) DHF and DDS are interchangeable terms
b) DHF can progress to DSS
c) About 50% of those who have mild to moderate DF go on to DHF
or DSS
d) DHF/DSS are more likely after a first attack of dengue
e) A positive tourniquet test result is the appearance of <8 petechial
spots in a 2.5 cm square on the forearm in both DHF and DSS
12- The usual laboratory test for diagnosis visceral 20- Rasspberry tongue is typical for which one of the following?
Leishmaniasis in a remote area is : a) Scarlet fever
a) Enzyme-linked immunosorbent assay (ELISA) b) Chickenpox
b) Identification of promastigotes in blood c) Measles
c) The Formol Gel Test (FGT) d) Rubella
d) Direct agglutination Test (DAT)
e) The Lieshman tests 21- A 46-year-old female presents with bony aches. Her intact
parathyroid hormone level is 150 pg/dl (normal 14-65) , calcium
13- Which of the following people is not at risk of sever level is 8.3 mg/dl and creatinine is normal. Which one of the
Malaria in endemic area? following does the patient have ?
a) Infants and children under 5 years of age a) Primary hyperparathyroidism
b) Pregnant women b) Secondary hyperparathyroidism
c) Old inhabitant people c) Tertiary hyperparathyroidism
d) Mobile population d) Osteoporosis
e) Patients with HIV/AIDS
22- A 60-year-old female present to the clinic with a triglyceride
14- Co-infection of malaria and HIV patients lead to : level of 1500 mg/dl what other tests do you want to do for the
a) Enhancements of the efficacy of antimalarial treatment patient before start treatment ?
b) Increase in viremia a) FSH
c) Decline in CD4+T-cell count b) FBS
d) More frequent and more severe malaria c) Creatinine
e) Complex activation of immune cells d) Liver function test
e) All of above
15- Which fluid should be preferred in the treatment of
Cholera? 23- A 24-year-old female come complaining of fatigue and weight
a) Ringer-lactate gain. O/E the thyroid is not palpable. TSH was 22 m IU/L with a
b) Isotonic saline normal free T4 and free T3. Which one of the following is true?
c) Hypertonic saline a) There is no thyroid problem no need for treatment
d) A plasma expender b) She will need carbimazole 5 mg three times daily
e) Albumin infusion c) She should be starting on thyroxine
d) She need urgent thyroidectomy
16- First presentation of onchoccerciasis is :
a) An eosinophilic pneumonia 24- A 24-year-old women presented to her physician because of
b) Intractable itchy rash secondary amenorrhea and galactorrhea. Pregnancy test is
c) General lymphadenitis negative. What one test would help us the most?
d) Blindness a) FSH
e) Redundant skin b) TSH
c) Prolactin
17- The majority of PUOs are caused by : d) Cortisol
a) Malignancy
b) Connective tissue disorders 25- A 25-year-old female presented with polyuria and polydipsia
c) Infections following trauma to the head. Fasting blood sugar , calcium and
d) Unknown diagnosis creatinine were normal. What is the most likely diagnosis ?
a) Psychogenic polydipsia
18- Which virus is the most common cause of viral meningitis ? b) Nephrogenic diabetes insipidus
a) Enterovirus c) Central diabetes insipidus
b) HIV infection d) Inappropriate secretion of antidiuretic hormone
c) Adenovirus
d) Toscana virus 26- A 15-year-old male presented with abdominal pain and
vomiting. He had been ill for a while with weight loss and
19- The rash of meningococcemia is ( select one of the darkening of skin. His blood sugar level, sodium was low and
Following) : potassium was high. Blood pressure in presentation was low. In
a) Hemorrhagic necrotic, localized predominantly in lower addition in hydration with fluid which one of the following would
Limbs & buttocks you give?
b) Vesicular highly pruritic a) Potassium supplement
c) Vesicular diffuse b) Concentrated dextrose
d) Hemorrhagic necrotic, never localized in the lower limbs and c) Hydrocortisone
Buttocks d) Analgesics for the abdominal pain

Page 3 of 10
27- in diagnosis of DM, one of the following is diagnostic e) Affects young boys
Criteria:
a) Fasting blood sugar is more than 124 mg/dl 35- ulcerative colitis is manifested by which one of the following ?
b) Random blood sugar more than 180 mg/dl a) Mucous discharge and watery diarrhea
c) HbA1c more than 6.5 b) Mucosal inflammation on the GI tract confined to the colon and
d) Glucose tolerance test post 2 hr. more than 150 mg/dl rectum
e) Fasting blood sugar of 108 is normal c) Abdominal distention and conistipation
d) Increase flatus
28- All the followings are complications of DM except one: e) Weight loss and anal fistula
a) Retinopathy
b) Nephropathy 36- complications of portal hypertension involve all of the
c) Neuropathy following except one:
d) Microvascular disease a) Variceal bleeding
e) Hepatic encephalopathy b) Ascites
c) Abnormal growth of hair
29- A 40-year-old female presents with a new onset of hirsutism d) Hypersplenism
Associated with hypertension and hyperglycemia. What is the e) Hepatic encephalopathy
Most likely diagnosis?
a) Polycystic ovarian syndrome 37- extraintestinal manifestation of IBD are all of the following
b) Type 1 diabetes except one:
c) Adrenal tumor a) Osteoporosis
d) Ovarian tumor b) Ureteral obstruction
c) Ankylosing spondylitis
30- All of the following are symptoms of hyperthyroidism d) Endocarditis
Except one: e) Erythema nodosum
a) Palpitation
b) Fine tremor 38- A 35-year-old man presents with a history of jaundice. The
c) Weight loss underlying cause is suspected to be acute hepatitis B infection.
d) Nervousness Which of the following immunological tests result when found
e) Diarrhea ?!! would most support the diagnosis of acute hepatitis B infection?
a) HBsAg
31- in patient with alcoholic cirrhosis all of the following are b) HBeAg
True except one: c) HBV DNA
a) Normal lab. Investigation in early stage of cirrhosis d) IgM anti-HBc
b) Anemia of chronic diseases e) Anti-HBeAg
c) Total indirect bilirubin well be elevated
d) Platelet count will be reduce 39- A 50-year-old farmer presented with recurrent vomiting of
e) AST>ALT 2:1 blood and upper abdominal pain, tiredness and dizzy spells of
one day duration. O/E pale, sweaty, and tinge of jaundice. P 110
32- the followings are common upper GIT bleeding except one: /min, BP 85/60 mmHg. Chest clear, heart fast rate, abdomen is
a) Duodenal ulcer distended and splenomegaly 6 cm BCM. What is the principal
b) Gastric erosion next step of management ?
c) Oesophageal varices a) Barium meal
d) Gastric malignancy b) Colonoscopy and biopsy
e) Gastric ulcer c) Gastroscopy and band ligation
d) Urgent blood transfusion
33- liver cirrhosis due to autoimmune hepatitis is characterized e) Abdominal ultrasonography
by all the following except one:
a) Positive autoimmune markers ASMA and ANA 40- the most common cause of ascites is:
b) Chowing khat is one of the inducing factors a) Heart failure
c) Treatment can be stopped after remission of the elevated b) Malignancy
Liver enzymes c) Nephrotic syndrome
d) Liver transplantation is curative d) Pancreatitis
e) Portal hypertension one of the complications due to AIH e) Liver cirrhosis

34- hemochromatosis is characterized by which of the following?41- lumbar puncture (LP) should be performed only after clinical
a) Increase urinary cupper excretion evaluation of the patient in the diagnosis of the following except
b) Affect female only one:
c) Increase ferritin level and elevated trans ferritin level a) Tuberculous meningitis
d) Inherited disorder of glucose metabolism b) Suppurative meningitis

Page 4 of 10
c) Viral encephalitis e) Cervical spinal neurofibroma
d) Primary subarachnoid hemorrhage when CT is
Falsely negative 49) the most common site of the tuberculosis disease of the spine
e) Coma due to uncal herniation is:
a) Lower cervical region
42) Parkinson plus syndrome include all of the following except b) Thoracolumbar region
One: c) Lower lumbar region
a) Cortical basal ganglionic degeneration d) Coccygeal region
b) Dementia syndrome e) sacral region
c) Wilson disease
d) Multiple system atrophy syndromes 50) the most common cause of cerebral thrombosis is:
e) Progressive supranuclear palsy a) Hyperlipidemia
b) Hypertension
43) A 65-year-old right-handed gentleman has a 20-year-history c) Diabetes mellites
of tremor predominantly limited to activities such as writing, d) Increased coagulopathy
drawing or holding objects. There is also head tremor. The e) Polycythemia
history is significant for similar signs and symptoms in his
family members. The most likely diagnosis is : 51) The most common acute neurologic illness in adult is:
a) Parkinson disease a) Cerebral malaria
b) Essential tremor b) Acute meningitis
c) Cerebellar tremor c) Viral encephalitis
d) Huntington disease d) Cerebrovascular disease
e) Wilson disease e) Transverse myelitis

44) Sydenham chorea develops as consequence of : 52) Generalized seizures include all of the following except one:
a) Hereditary degeneration of the caudate nucleus a) Absence
b) Post traumatic degeneration of the substantia nigra b) Myoclonic seizures
c) Subacute endocarditis c) Tonic/clonic seizures
d) Auto-antibodies reaction with the caudate nucleus d) Atonic seizures
e) Degeneration of substantia nigra e) Simple motor seizures

45) the most common focal dystonia is : 53) A 55-years-old man with a history of poorly controlled
a) Blepharospasm hypertension presents with a history of sudden-onset central
b) Spasmodic torticollis chest pain. There are no diagnostic electrocardiogram (ECG)
c) Oromandibular torticollis abnormalities and an interval troponin concentration is not
d) Spasmodic dysphonia diagnostic of myocardial infraction. What diagnosis should be
e) Witter cramps confirmed or excluded next?
a) Anxiety
46) the extrapyramidal hyperkinetic features include the b) Aortic dissection
Following except one: c) Myocarditis
a) Tremor d) Pericarditis
b) Chorea e) Pneumothorax
c) Rigidity
d) Ballism 54) A 75-year-old woman presents to her family physician with a
e) Athetosis 24-hour history of rapid, irregular, palpitations accompanied by
fatigue. In an elderly patient. What is the most likely cause of
47) the most common autosomal recessive ataxias is: palpitations?
a) Friedreich ataxia a) Atrial ectopic (premature) beats
b) Ataxia telangiectasia b) Atrial fibrillation
c) Ataxia with ocular motor apraxia c) Supraventricular tachycardia
d) Ataxia with isolated vitamin E deficiency d) Ventricular ectopic ( premature) beats
e) Refsum disease e) Ventricular tachycardia

48) the progressive association of weak, wasted muscles and 55) A 74-year-old woman presents with breathlessness. She is
Fasciculations in upper limbs with spasticity and hyperreflexia found to have an elevated jugular venous pressure ( JVP ). Which
In lower limb and intact sensations is most suggestive of : of the following conditions is most likely to explain this physical
a) Cervical spondylomylopathy finding?
b) Syringomyelia a) Aortic stenosis
c) Transverse myelitis b) Dehydration
d) Amyotrophic lateral sclerosis c) Exacerbation of asthma

Page 5 of 10
d) Increased left atrial pressure 63) Which one of the following emergency drugs is used for the
e) Recurrent pulmonary embolism immediate management of supraventricular tachycardia?
a) Injection atropine
56) A 56-year-old man presents with a history of headache. He b) Injection heparin
is noted to have a loud second heart sound on auscultation. c) Injection adenosine
Which of the following pathologies could explain this finding? d) Injection nicorandil
a) Aortic incompetence
b) Essential hypertension 64) All of the following cardiovascular risks increase the risk of
c) Mechanical mitral valve replacement hypertension regardless of blood pressure grade except one:
d) Mitral incompetence a) Diabetes mellitus type 2
e) Postural hypotension b) Right ventricular hypertrophy
c) Left ventricular hypertrophy
57) Which one of the following pathologies can be associated d) Renal disease
with an early diastolic murmur?
a) Long QT syndrome type 1 65) One of the side effects of angiotensin converting enzyme
b) Marfan’s syndrome inhibitors (ACEI) is cough that’s due to:
c) Mitral valve prolapse a) Preventing degeneration of angiotensinogen
d) Myotonic dystrophy b) Preventing degeneration of renin
e) Wolff-Parkinson-White syndrome c) Preventing degeneration of bradykinin
d) Preventing degeneration of angiotensin 1
58) loop diuretics such as furosemide and bumetanide have
which one of the following effects? 66) Which one of the following conditions shifts the hemoglobin
a) Diuresis due to inhibition of potassium and water oxygen dissociation curve to the right (oxygen is given up more
reabsorption easily to tissue):
b) Diuresis due to inhibition of sodium and water reabsorption a) Thalassemia
c) Diuresis due to inhibition of water reabsorption only b) Hereditary spherocytosis
d) Increase serum potassium levels due to enhanced distal c) Hemolytic anemia
tubule function d) Paroxysmal nocturnal hemoglobinuria
e) Osmotic diuresis e) Sickle cell anemia

59) Which one of the following rhythms is NOT commonly 67) CBC showing an MCV of 105 fl occurs in the following
associated with sick sinus syndrome (sinoatrial disease)? except:
a) Atrial fibrillation a) Lead poisoning
b) Atrial tachycardia b) Vitamin B12 deficiency
c) Sinus bradycardia c) Folic acid deficiency
d) Sinus pauses d) Liver disease
e) Ventricular tachycardia e) Alcohol consumption

60) Which one of the following drugs in known to be effective in 68) Bone marrow examination is used to diagnosis the following
Preventing stroke in patients with atrial fibrillation? conditions except:
a) Amiodarone a) Aplastic anemia
b) Apixaban b) Hemoglobinopathies
c) Aspirin c) Acute leukemia
d) B-blockers d) Myelofibrosis
e) Clopidogrel e) Multiple myeloma

61) What is the appropriate initial treatment for the symptoms 69) In an elderly patient, which one of the following
Of acute pericarditis? investigations is the most important to diagnose the cause of iron
a) Intravenous glucocorticoids deficiency anemia:
b) Intravenous morphine a) Abdominal ultrasound
c) Oral amiodarone b) Stool occult blood test
d) Oral aspirin c) Tumor markers
e) Rectal diclofenac d) Upper and lower GIT endoscopy
e) Bone marrow examination
62) A 45-year man patient with grade 2 hypertension and type
2 DM. the recommended BP target with anti-hypertensive is: 70) One of the following is not regarded as a cause of
a) Office BP measurement < 150/95 mmHg pancytopenia:
b) Office BP measurement < 140/95 mmHg a) Visceral leishmaniasis
c) Office BP measurement < 130/80 mmHg b) Megaloblastic anemia
d) Office BP measurement < 140/90 mmHg c) Acute leukemia

Page 6 of 10
d) Evan’s syndrome d) Prolonged expiratory phase to respiration
e) Myelodysplastic syndrome e) Pursed lip breath

71) Which one of the following antibiotics is frequently 78) Sever acute respiratory syndrome (ARDS) is caused by which
Associated with aplastic anemia? one of the following?
a) Erythromycin a) Legionella pneumophila
b) Chloramphenicol b) A corona virus
c) Ceftriaxone c) Methicillin-resistant staphylococcus aureus (MRSA)
d) Imipenem d) A retrovirus
e) Levofloxacin e) Chlamydophila pneumonia

72) The following regarding polycythemia vera are true except
One:
a) Hgb > 18.5 g/dl (men), > 16.5 g/dl (women) is a major
Criterion
b) Neutrophil leucocytosis is a common laboratory feature
c) Presence of JAK2 V617F mutation is a major criterion
d) Markedly increased serum EPO level is a characteristic
Feature
e) Splenomegaly is a common clinical feature
73) Currently, the following is the most effective and tolerable
Treatment for chronic myeloid leukemia:
a) Tyrosine kinase inhibitor e.g. imatinib
b) Chemotherapy e.g. hydroxyurea
c) Immunotherapy e.g. alpha interferon
d) Allogenic bone marrow transplantation
e) Busulphan
79) A 65-year-old women presents with cough. Chest X-ray shows
bilateral upper zone consolidation. Sputum AFB stains are
positive. Standard treatment consists of :
a) Isoniazid, rifampicin, ethambutol and pyrazinamide for 6 months
b) Isoniazid for 6 months
c) Isoniazid and rifampicin for 3 months
d) Isoniazid and rifampicin for 6 months with ethambutol and
pyrazinamide for initial 2 months
e) Isoniazid and rifampicin for 9 months with ethambutol and
pyrazinamide for initial 2 months
80) Definitive diagnosis of bronchiectasis is made by:
a) High resolution CT scanning
b) Sputum microbiology
c) Bronchoscopy
d) Clinical history
e) Lung function test

74) Which of the following is the best treatment option for a 81) Most patients with asthma:
Young patient with severe aplastic anemia? a) Are overoptimistic in their expectation of what can achieved with
a) Cyclosporine treatment
b) Antithymocytic globulin b) Are fastidious about treatment compliance
c) Allogenic stem cell transplantation c) Can manage simple inhaler well
d) Androgens d) Need more than just the basics (inhaled corticosteroids and short-
e) Combined cyclosporine and antithymocytic globulin acting bronchodilator) to maintain good control
e) Are capable of managing the disease themselves
75) Causes of massive splenomegaly include the following
Except: 82) The pathological changes typically seen in COPD are :
a) Primary myelofibrosis a) Emphysema, perhaps showing some recovery with smoking
b) Lymphoma cessation
c) Visceral leishmaniasis b) Emphysema independent of airway obstruction
d) Thalassemia major c) Airway inflammation, causing airway obstruction (air trapping)
e) Infective endocarditis d) Chronic bronchitis, principally affecting the distal airways
e) Emphysema, resulting in increased elastic recoil of the lungs
76) A 26-year-old male presented for preadmission to military
Medical tests. He was mildly anemic. Hb level was 10g/dl. Hb 83) The most common cause of pneumonia developing in a
Electrophoresis was done and revealed: HbA= 45%, HbA2=4% patient undergoing prolonged ventilation for ARDS is :
HbS = 45% and HbF= 6%. What is the possible diagnosis? a) Legionella pneumophila
a) Sickle cell anemia b) Hemophillus influenza
b) Sickle cell trait c) Streptococcus pneumonia
c) Sickle cell trait and B-thalassemia minor d) Clostridium difficile
d) Sickle cell trait and B-thalassemia major e) Gram-negative bacteria
e) B-thalassemia minor
84) The characteristic features of a pneumothorax on chest X-ray
77) Signs of airways obstruction include all the following except are:
One: a) hyperinflated black lung
a) Tracheal tug b) A dense white shadow with a concave upper edge
b) Reduced expansion c) A cyst of air with in the lung
c) Lower costal margin paradox d) A black gas space between the margin of the lung and the

Page 7 of 10
chest wall, with a concave pleural line d) Normal K+
e)An area of consolidation with an associated pleural effusion e) Low Na+

85) A 26-year-old women who is 32-weeks pregnant presents 91) Which is not a criterion for diagnosis of nephrotic syndrome?
With pleuritic pain and breathlessness. Pulmonary embolism is a) Hypertension
Suspected. Chest X-ray is normal. The best next investigation is: b) Massive protein urea
a) Ultrasound of the leg c) Hyperlipidemia
b) D-dimer d) Anasarca
c) Isotope perfusion angiography e) Hypoalbuminemia
d) CT pulmonary angiography
e) Pulmonary angiography 92) Which of the following is not neuromuscular complication of
uremia?
86) COPD is defined as: a) Encephalopathy
a) Air flow limitation b) Myelopathy
b) Partially reversible by using bronchodilator c) Neuropathy
c) Chronic bronchitis, emphysema and asthmatic bronchitis are d) Myopathy
main causes e) Myoclonus
d)Complicated by pulmonary hypertension and cor-pulmonale
e) All of above 93) Recognized feature of minimal change glomerular disease is:
a) Hematuria
87) An 81-year-old man was admitted with renal failure due to b) Hypertension
Benign prostatic hypertrophy. His bladder was drained with a c) Absence of edema
Urethral catheter followed by a diuresis of >3L per day. After d) Response to corticosteroid
Two days became progressively drowsy. What is the most likely e) Decreased complement
Cause for his reduced level of consciousness?
a) Hyperglycemia 94) “Complete” anuria is found in which of the following?
b) Hypercalcemia a) Diffuse cortical necrosis
c) Hypomagnesemia b) Acute gastroenteritis
d) Hypernatremia c) Acute renal failure
e) Metabolic acidosis d) Chronic glomerulonephritis
e) Acute interstitial nephritis
88) A 62-year-old man with a longstanding history of
Hypertension is seen in the outpatient clinic. Investigations 95) Polyurea is produced by all of the following except one:
Showed creatinine 2.8 mg% and urine analysis show blood++ a) Diabetes insipidus
And protein 1.8 gm/l. ultrasound scan of kidneys both kidneys b) Congestive cardiac failure
Were 8.5 Cm. what is the best investigation to diagnose the c) Hyper calcemic nephropathy
Cause of his renal impairment: d) Chronic renal failure
a) Intravenous urogram (IVU) e) High protein tube feeding
b) Isotope renogram
c) Renal angiogram 96) The following are associated with an increased risk of vertical
d) Renal biopsy transmission of HIV except one:
e) Retrograde pyelogram a) Breast feeding
b) High titers of p24 antigen in maternal serum perinatally
89) A 68-year-old male diagnosed with nephrotic syndrome c) Low maternal CD4 counts during pregnancy
Receives steroid therapy without benefit. His investigations d) prolonged labor
Show an albumin of 20 g/l, total cholesterol of 320 mg/dl, e) HIV-1 compared to HIV-2
Dipstick urine analysis reveals +++ protein and renal biopsy
Shows focal segmental glomerulosclerosis. Which one of the 97) A 52-year-old man presented to ER with severe central chest
Following is most likely to preserve renal function? pain associated with vomiting & sweating for 4 hours. On
a) Dietary salt restriction examination PR=110/min regular. BP=150/100 mmHg.
b) Low dietary protein intake Immediate ECG shows ST elevation 4 mm in V1-V4. Patient gave
c) Ramipril a history of hypertension & diabetes mellitus for 5 years on
d) Simvastatin irregular treatment and poor follow up. Which of the following is
e) Warfarin the most likely diagnosis?
a) Angina pectoris
90) All of the following are true in acute renal failure (ARF) b) Pulmonary embolism
Except one: c) Lobar pneumonia
a) Normal urea d) Myocardial infraction
b) Normal H+ concentration e) Infective endocarditis
c) Normal calcium ions (Ca++)

Page 8 of 10
98) A 60-year—old women present to her GP with a two-month
History of lethargy and weakness. She mentions that she is
Finding it increasingly difficult to climb the stairs and do the
Housework. On examination, there is wasting and weakness of
The proximal muscles in the upper and lower limbs. What is
The most likely diagnosis?
a) Dermatomyositis
b) Polymyositis
c) Polymyalgia rheumatica
d) Kawasaki’s disease
e) Polyarteritis nodosa

99) Sero-negative arthritis include all of the following except

One:
a) Psoriatic arthritis
b) Juvenile idiopathic arthritis (JIA)
c) Arthritis associated with inflammatory bowel disease
d) Reiter’s disease
e) Rheumatic arthritis

100) A 20-year-old male presented with anemia, high grade

Fever, sore throat and joints pain. O/E patient looks well, pale
Multiple petechia and ecchymosis. No lymph nodes or
Organomegaly. Hb 8g/dl, WBC 3000 mm, 75% lymphocytes
And platelets count 50000 mm. which of the following is the
Most likely diagnosis?
a) Non-Hodgkin’s lymphoma
b) Hodgkin’s lymphoma
c) Chronic lymphocytic leukemia
d) Acute leukemia
e) Aplastic anemia

‫نسأل هللا لكم التوفيق‬

Page 9 of 10