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1) 25 year teacher have fear attack and worry before enter the
class ( l forgot all the scenario) what is the initial treatment:
a. Selective serotonin reuptake inhibitor
b. Tricyclic depressant
c. Beta blocker
d. -----
e. ------
-Ths s a case of soca phoba and the nta treatment s
answer a (SSRIs).
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................
2) The best initial TTT for depression is:
a. SSRls
b. Tricyclic depressant
c. MAO inhibitors
d. Beta blocker
e. -----------
-The correct answer s a (SSRIs).
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................
3) Using the following classification :
Risk factor Case (disease) Non case total
Present A B A+b
Absent C D C+d
Total A+C B+D
Relative risk of those with risk factor to those without risk
factor is:
a. A/A+B , C/C+D
b. A}A+B
c. C}C+D
-The correct answer s a.
Postve predctve vaue (PPV) : a} (a+b)
Negatve predctve vaue (NPV) : d } (C+d)
Senstvty : proporton of peope wth dsease who have a postve test:
a } (a+c)
Specfcty : proporton of peope wthout dsease who have a negatve
test : d} (b+d)
Reatve rsk ( RR ) : ncdence n expose ncdence n unexposed: ( a }
(a+b) ) } (c} (c+d) )
Attrbutabe rsk : ncdence n expose --- ncdence n unexposed: ( a }
(a+b) ) -- (c} (c+d) )
Odd rato ( OR ) : Odds that a dsease person s exposed Odds that a
nondsease person s exposed : ad } bc
4) 50 year old Man presented to ER with sudden headache,
blurred of vision, and eye pain. The diagnosis is:
a. Acute glaucoma
b. Acute conjunctivitis
c. Corneal ulcer
d. -----
-The correct answer s a.
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5) Which heart condition is tolerable during pregnancy:
a. Eisenmenger syndrome
b. Aortic stenosis
c. Severe mitral regurge
d. Dilated cardiomyopathy with EF 20%
e. Mitral stenosis and the mitral area is 1 cm (or mm).
-the correct answer s c.
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6) Diffuse abdominal pain "in wave like" and vomiting. The
diagnosis is:
a. Pancreatitis
b. Appendicitis
c. Bowel obstruction
d. Cholelithiasis
The correct answer s c. (cocky pan: s the pan that comes n
waves "wave-ke" and t s assocated wth bowe obstructon,
choethass, nephrothass)
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7) Which type of contraceptive is contraindicative in lactation:
a. OCPs
b. Mini pills (progesterone-only birth control pills)
c. lUD
d. Condom
e. Depo-Provera (progesterone-only birth control injection)
-The correct answer s a. because combned OCPs decrease the
quantty of mk. Progesterone -ony contraceptve are not
beeved to decrease the quantty of mk.
8) A long scenario about patient with polydipsia ad polyuria. l
don't remember the scenario but they mention osmolality in
urine and serum, measurement of Na.
l encourage you to read about central VS nephrogenic diabetes
insipidus.
- lS NOT COMPLETE .
(Dabetes Inspdus) : faure to concentraton of urne as a resut of
centra or nephrogenc ADH. Present wth poyurea, poydepsa and
hyponatrema.
Dagnoss centra or nephrogenc by admnstraton of Desmopressn
acetate (DDAVP) , synthetc anaog of ADH, can be used to dstngush
centra from nephrogenc DI.
1- Centra DI : DDAVP chaenge w decrease urne output and
ncrease urne osmarty
2- Nephrogenc DI : DDAVP change w not sgnfcant decrease urne
output
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9) A 5 year old child came with earache on examination there is
fluid in middle ear and adenoid hypertrophy. Beside
adenoidectomy on management, which also you should do:
a. Myringotomy
b. Grommet tube insertion
c. Mastidectomy
d. Tonsillectomy
e. -----
- The correct answer s a.
- Myringotomy (s used for bugng acute otts meda)
-Grommet tube insertion (s used for recurrent acute otts
meda)
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................
10) How the randomized control study become strong or of
good validity: ( sorry l forgot the answers)
O IS NOT COMPLETE
-By dong bndng and aocaton conceament. The best way to
ncrease the power of the study s to ncrease the sampe sze.
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11) Woman with postpartum depression, beside the medical
TTT, whch should be include in therapy:
a. Family therapy or support
b. -------
-Nonpharmacoogca treatment strateges are:cogntve
behavora therapy,psycho educatona or support
group,ncrease partner support,addtona hep wth chd care.
12) Classic Scenario of stroke on diabetic and hypertensive
patient. What is the pathopysiology of stroke:
a. Atherosclerosis
b. Anyresm
c. -----
-The correct answer s a.
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13) Middle aged patient with an acyanotic congenital heart
disease the X-ray show ventrical enlargement and pulmonary
hypertension:
a. VSD
b. ASD
c. Trancus arteriosus
d. Pulmonary stenosis
-The correct answer s b, bcause the pt. n mdde age and
acynotc.
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14) Best food in travelling is:
a. Boiling water
b. Water
c. lce
d. Partial cocked fish and meat
e. ---
-The correct answer s a.
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................
15) Mechanism of vitamin C in wound healing :
a. Epithiliazation
b. Aerobic fibroblast synthesis
c. Collagen synthesis
d. Enhance vascularization
e. ----
-The correct answer s c.
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................
16) Open globe injury . TTT is:
a. Contineuos antibiotic drops
b. Continuous wate and NS drops
c. Continuous steroids drops
d. Sterile cover and the refered
e. -----
-The correct answer s d.
17) Adolescent female counseling on fast food. What you
should give her:
a. Ca + folic acid
b. Vit C + folic acid
c. Zinc + folic acid
d. Zinc + Vit C
-The correct answer s a.
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................
18) What is the TRUE about backache with osteoporosis:
a. Normal x ray vertebra exclude the diagnosis
b. Steroid is beneficial TTT
c. Vit D defiency is the cause
d. Another TTT l don't remember
-The correct answer s c , because vt. D defcency s cause
osteomaca. Osteomaca s consderng secondary causes of
osteopoross. Choce d not menton may be more accurate
answer.
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................
19) Adolescent female with eating disorder and osteoporosis
a. Weight gain
b. Vit D
c. Bisphosphonates
d. --------
- The correct answer s a.
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20) Fourth degree hemorrhoids, Management is:
a. Hemoridectomy
b. band ligation
c. sclerotherapy
d. fiber diet
-The correct answer s a.
- Classification of internal hemorrhoid :
First degree: hemorrhod do not proapsed
Second degree: hemorrhod proapsed upon defecaton but
spontaneousy reduce
Third degree: hemorrhod proapsed upon defecaton, but must be
manuay reduce
Fourth degree: hemorrhods are proapsed and cannot be manuay
reduce
-treatment:
First & Second: fe stye modfcaton (fber dte)
Third: fe stye modfcaton wth (band gaton, scerotherapy or
cryotherapy) , f
Faed go to surgery.
Fourth: surgery (hemorrhodectomy)
21) nulligravida at 8 weak gestational age, follow up for
genetic screening, she refused the invasive procedure but she
agree for once screening , what is the appropriate action now:
a. do ultrasound
b. 1
st
screening
c. 2
nd
screening
d. 3
rd
screening
e. Amncentesis
-The answer s correct B
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22) 70 year old male with chronic Hepatitis B virus antigen
carrier. The screening of choice is:
a. Alfaprotien + liver ultrasound
b. Alfaprotien + another tumor marker
c. Abdominal CT + abdominal ultrasound
d. ----
-The correct answer s a.
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................
23) 35 year old smoker , on examination sown white patch on
the tongue, management:
a. Antibiotics
b. No ttt
c. Close observation
d. ---------
-Ths s a case of eukopaka and the management ncudes:ask
the pt. to stop smokng, do a bopsy for the eson; f there s pre-
cancerous changes or cancer n the bopsy ; surgca excson
shoud be done.
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................
24) Regarding GDM:
a. Screening for GDM at 24 t0 28 weeks
b. Diet control is always successful TTT
c. Screening at 8 weeks
d. ---------
-The correct answer s a.
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................
25) After doing CPR on child and the showing asystole:
a. Atropine
b. Adrenaline
c. Lidocane
d. ------
-The correct answer s b.
26) Scenario of trauma , on face examination there is shifted
mouth angle, loss of sensation of ant. Third of tongue, which
CN is affected:
a. Facial nerve
b. Trigeminal nerve
c. ----
-The correct answer s b , faca nerve for taste ant. Thrd of
tongue, but trgemna nerve for sensaton .
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27) On examination of newborne the skin show papules or
(pastules) over erythema base:
a. transient neonatal pustular melanosis
b. erythema toxicum neonatorum
c. ----
- The correct answer s b.
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28) The most common causes of precocious puberty:
a. ldiopathic
b. Functional ovary cysts
c. Ovary tumor
d. Brain tumor
e. Adenoma
-The correct answer s a .
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29) Mother worry about radiation from microwave if exposed
to her child. What you tell her:
a. Not all radiation are dangerous and microwave one of
them
b. Microwave is dangerous on children
c. Microwave is dangerous on adult
d. ----
- In nternatona study : a mcrowave s dangerous on chdren
( very vague O )

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................
30) Earlier sign of puberty in male is:
a. Appearance of pubic hair
b. lncrease testicular size
c. lncrease penis size
d. lncrease prostate size
e. ---
-The correct answer s b.
31) uestion about nutritional marasmus on definition.
(protein energy malnutrition).
Marasmus s a form of severe proten-energy manutrton
characterzed by energy defcency. A chd wth marasmus ooks
emacated. Body weght may be reduced to ess than 80% of the
average weght that corresponds to the heght. Marasmus
occurrence ncreases pror to age 1, whereas Kawasak
occurrence ncreases after 18 months. It can be dstngushed
from Kawasak n that Kawasak s proten wastng wth the
presence of edema. The prognoss s better than t s for
Kawasak.
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32) What is the most risk of antihypertensive drugs on
elderly patient:
a. Hypotension
b. Hypokalemia
c. CNS side effect
d. -
-The correct answer s a. because orthostatc hypotenson w
ncrease the rsk of fa and fractures n edery.
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................
33) Asymptomatic woman with trichomonas:
a. Treat if symptomatic
b. Treat if she is pregnant
c. Treat her anyway
d. -
-The correct answer s c.
Snge dose of metradnazoe for symptomatc and asymptomatc pt.
and treatment partner (because t s sexua transmtted dsease).
But, not treatment of asymptomatc trchomnass n frst trmester
of pregnancy. (Contrandcaton n pregnancy)
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................
34) What is the risk of GDM on her life later:
a. DM type 1
b. DM type 2
c. lmpaired fasting glucose
-The correct answer s b.
35) What is the major sign that can tell you that patient have
polycythemia vera rather than secondary polysythemia:
a. Hepatomegaly
b. Splenomegaly
c. Venous engorgement
d. Hypertension
e. ----
-The correct answer s b.
n poycythema vera there s cona proferaton of a purpotent
marrow stem ce. Aso, eve of erythropetne may be usefu
dstngush PCV, eve are ow, from other causes of poycythema.
Secondary poycythema s assocated wth excessve druss,
severe gastroenterts and burn.
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36) What is the deficient vitamin in infantile beri beri :
a. B1(thiamine)
b. C
c. E
d. Niacine
-The correct answer s a.
* VlTAMlNES DEFlClENCY :
Vit. A : nght bndness & dry skn
Vit, B1 (thiamine): Berber (poyneurts, dated
cardomayopathy, edema)
Vit. B2 (riboflavin): anguar stomatts, cheoss. Cornea
vascuarzaton.
Vit. B3 (nacine) : peagra ( Darrhea, Dermatts, Dementa )
Vit. B5 (pantothenate): dermatts, enterts, aopeca, adrena
nsuffcency
Vit. B6 (pyridoxine): convuson, hyperrrtabty
Vit B12 (cobalamin): macrocytc megaobastc anema,
neuroogc symptoms
FOLlC AClD : macrocytc megaobastc anema wthout
neuroogc symptoms.
Vit C : scurvy ( swoen gums, brusng, anema, poor wound
heang)
Vit D : rckets n chdren , osteomaasa n adut
Vit. E : ncrease fragty of RBC
Vit. K : neonata hemorrhage, ncrease PT & PTT, norma BT
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37) 17 year boy admit to involve in recurrent illegal drug
injection , what the screening test to do:
a. HlV
b. Hepatitis B
c. Hepatitis C
d. -----
-A of the above choces are correct.?
38) 20 year old male found to have hepatitis b surface
antibodies :
a. Previous vaccination
b. Previous infection
c. Active infection
d. ----
-The correct answer s a.
HBsAg : ndcate carrer state.
HBsAb : ndcate provde mmunty to HBV
HBcAg: assocated wth core of HBV
HBcAB: durng wdow perod, HBcAb-IgM ndcate recent dsease

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39) Most common cause of secondary hypertension in female
adolescent is:
a. Cushing syndrome
b. Hyperthyroidism
c. Renal disease
d. Essential HTN
e. Polycystic ovary disease
-The correct answer s c.
Most common causes of secondary HTN n young femae s
rena artery stenoss ( caused by fbromuscuar dyspasa )
40) clomiphene citrate:
a. induce ovulation
b. ------
-The correct answer is a.
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41) Scenario about perimenstrual depression syndrome 7777
Premenestral syndrome : defne as a symptoms compex of
physoogca emotona symptoms sever enough to nterfere wth
everyday fe and occur cycca durng utea phase of menses
Premenestral dysphoric disorder : s a sever form of pf
premenestra syndrome characterzed by severe recurrent depressve
and anxty symptoms wth premenestra ( utea phase) onest that
remt a few days after the start of menses.

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42) Child present with stiffing neck, fever, headach. You
suspect meningitis what is your initial TTT should be:
a. Tobramycin
b. Levoflaxicine
c. Peneciline(ampicillin)
d. Doxycycline
l remember there is no vancomycine, ceftriaxone or
dexamethasone on the choices.
-The correct answer is c.
AGE Causative organism Treatment
< 1 MONTH GBS, E co Ampcn + cefotaxme or
gentamcn
1-3 MONTHS S.pneumona,
H.nfuenza
menngocc
Vancomycn + cefotaxme or
cefraxone
3 MONTHS -
ADULT
Pneumoccoc,
menngococc
Vancomycn + cefotaxme or
ceftaxone
>60
YEAR\acoholism
Pneumococ,
menngococc
Gram -ve bac
Ampcn + vancomycn +
ceotaxme or ceftaxone
43) A patient have tender, redness nodule on lacriminal duct
site. Before referred him to ophthalmologist what you will do:
a. Topical steroid
b. Topical antibiotics
c. Oral antibiotics
d. Nothing
e. -
The correct answer s c.(ths s a case of dacrocystts).
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44) About DM in KSA:
a. about < 10 %
b. Most of the pt of insulin dependant type
c. female more affected with type 2 DM
d. most of NlDDM are obese
-The correct answer s d.
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45) Major aim of PHC in Saudi Arabia :
a. To provide comprehensive maternal & child health
b. ------------
-other ams are:communty partcpaton, mmunzaton, referra,
chronc dsease management, prescrbng, heath educaton,
management of communcabe dsease and envronmenta
heath.
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46) 17 y.o,she missed her second dose of varecila
vaccine,the first one about 1 y ago what you'll do:
a. give her double dose vaccine
b. give her the second dose only
c. revaccinate from start
d. see if she has antibody and act accordingly
-The correct answer s b.
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47) there is outbreak of difteria and tetanus in community ,
regaring to pregnant woman:
a. contraindication to give DT vaccine
b. if exposed , terminate pregnancy immediately
c. if exposed , terminate after 72 hour
d. give DT vaccine anyway
-The correct answer s d.
48)All of the following are live vaccine except:
a. MMR
b. Oral plio
c. Varicella
d. Hepatitis B vaccine
e. BCG
-The correct answer s d.
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49) Pt with scoliosis, you need to refer him to the ortho when
the degree is:
a. 5
b. 10
c. 15
d. 20
-The correct answer s d.
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50) 87 year old who brought by his daughter, she said he is
forgettable, doing mess thing in room , do not maintain
attension , neurological examination and the investigation
are normal
a. Alzheimer disease
b. Multi-lnfarct Dementia
c. ---
-The correct answer s a .
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51) Mechanical intestinal obstruction
a. Nasogastric tube decompression

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52) Patient with cancer. You want to break bad news, which
of the following is the answer:
a. lnform his family
b. Find out how much the patient know about it
c. Let social service inform him
d. Don't tell him
-The correct answer s b.
53) HlV patient has hemorrhagic lesion in the mouth and
papules in the face. Skin biopsy show spindle cells and
vascular structures:
a. Kaposi sarcoma
b. ........
Kaposi sarcoma : magnant mutfoca neopasm characterzed by
vascuar tumors of skn and vscera , caused by Human herpesvrus
8 (HHV8) , most commom assocated wth AIDS patent. Leson
usay papues . n bobsy show spnde shape of ce.

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54) Patient with retrosternal chest pain , barium swallow
show corkscrew appearance
a. Achalasia
b. Esophagitis
c. GERD
d. Diffuse esophageal spasm

-The correct answer s d.
- Alchalasia : show esophagus daton wth (brd beak) taperng of
dsta esophagus
-Diffuse esophagus spasm: show corkscrew appearance.
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55) Most common cause of intra cerebral hemorrhage:
a. ruptured aneurysm
b. Hypertension
c. Trauma
d. -
-The correct answer s b.
56) Rt upper qudrent pain and tenderness , fever, high WBC ,
jaundice, normal hepatic marker
a. Acute cholecyctitis
b. Pancreatitis
c. Acute hepatitis
d. -
-The correct answer s a.
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57) 5 y.o child with h.o fever and swelling of the face ant to
the both ears (parotid gland enlargement) what is the most
common complication:
a. Labrynthitis
b. meningitis
c. encephalitis
d. orchitis.
-The correct answer s b.
Orchts: (ths one s the most common compcaton n
postpuberta maes-adoscents and aduts-). This pt. is
prepuberty .
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58) classic symptoms of tension headache .
Tension headach : s the most common type of headach
dagnosed n adut. Present wth tght, band-ke pan . may be
generazed or most ntense n the fronta, occpta, and neck
regon. Usuay occurs at the end of day. Treatmet avodance of
exacerbatng factors, NSAID and acetamnophen.

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59) prophylaxis of Asthma
a. oral steroid
b. inhaler steroids
c. inhaler bronchodilator B agonists
-The correct answer s b.
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60) 30 year woman with dysmenorrhea, menorrhagea,
infertility, and on examination found immobile mass on
uterosacral ligaments :
a. uterine fibroid
b. endometriosis
c. ---
-The correct answer s b
61) Classic symptoms of primary dysmenorrheal
Primary dysmenorrhea: menestra pan assocated wth ovuatory
cyce n abcense of pathoogca fndng.
Secondary dysmenorrhea: Menestra pan wch organc causes
exst, most common cused by endometross, adenomyoss, tumor
and fbrod.
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62) Newly married woman complain of no pregnancy for 3
month with unprotective sexual intercourse :
a. Try more ( infertility is defined as no pregnancy for
one year)

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63) Younger diabetic patient came with abdominal pain,
vomiting and ketones smelled from his mouth. What is
frequent cause:
a. lnsulin mismanagement
b. Diet mismanagement
c. ----
-The correct answer s a.. But f the nfecton s one of the
answers , you shoud choose t because the most common cause
of DKA s nfecton.
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64) Cause of syncope in aortic stenosis
a. Systemic hypotension
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65) On stroke management: except
a. lV fluid not include dextrose
b. Diazepam for convulsion
c. No indication of anticonvulsive drugs
d. ----
-The correct answer s c.
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66) Patient use illegal drug abuse and the blood show RNA
virus. Which hepatitis
a. A
b. B
c. C
d. D
-The correct answer s c.
67) Classic symptoms and signs of infectious mononucleosis
(EBV) 7
Most common occur n young adut, usuay cused by EBV ,
transmsson through exchange of body fud ncude sava. Present
wth trad ( fever, sorethroat, ymphadenopathy) , aso, may present
tonsar exudates, spenomegay, macuopapuar rash and batera
upper eyed edema. Management s mosty supportive and
cortcosterods are ndcated for arway compromse due to tonsar
enargement.

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68) Treatment of EBV ( in scenario there patent with tonsiller
exudates, lymphadenopathy, splenomegaly) :
a. Oral acyclovir
b. Oral antibiotic
c. lM or lV acyclovir
d. Supportive TTT
e. Observation
-The correct answer s d.
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69) 25 year old woman with weight loss, heat intolerance,
irritable ..
a. Hyperthyroidism

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70) Patient with coloured pastules around his mouth,
organism show herpes simplex type 1, what is the
treatment:
a. Oral antiviral
b. lv antiviral
c. Supportive
d. -
-The correct answer s a .
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71) Acute otitis media , initial TTT:
a. Amoxicilline
72) Man with sudden onset of scrotal pain , also had Hx of
vomiting, on examination tender scrotom and there is
tender 4 cm mass over right groin, what you will do:
a. Consult surgeon
b. Consult urologist
c. Do sonogram
d. Elective surgery
-The correct answer s b , f expected torton of tests , don't
wast tme on radoogca study
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73) Most common symptoms of renal cell carcinoma is
a. Hematuria
b. Abdominal mass
c. Flank pain
-The correct answer s a.
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74) Link the ttt with organism:
a. Shegella metronidazole
b. Salmonella erythromycin
c. Combylobacter amoxacilline
d. Gardia l foregut ( but l remember it is antibiotic)
-All of the above answers are wrong.7
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75) Medical student had RTA systolic pressure is 70 mmhg,
what you will do next in management:
a. lV fluid therapy
b. ECG
c. Abdominal U}S
d. ---
-The correct answer s a.
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76) 20 year old male had been stabbed on midtriceps , - --
-- _' =-- _- = - ~' .
On microscopic examination of this greenish fluid show
gram positive cocci in chains:
a. Streptococcal gangrene
b. Chlostrideal gangrene
c. Fournier's gangrene
d. meningocemia
e. -
-The correct answer s a.
77) Patient around his nose there are pastules, papules and
telangiectasia lesions. The diagnosis is:
a. Rosacea

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78) Child with radial head dislocation, what is the next in
management:
a. Reduction
b. x ray
c. MRl
d. -
-The correct answer s a.
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79) ln cervical LNs there are well differentiated thyroid cells,
during operation you find no lesion on thyroid what will you
do next
a. Total thyroidectomy
b. Total thyoidectomy + radical cervical LNs dissection
c. Total thyroidectomy + specific LNs dissection
d. Thyoid lobectomy with -----
-The correct answer s b.
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80) lrritable bowel syndrome , ( they mention a specific
mechanism" l do not remember" that produce which
symptom
a. Vomiting
b. Diarrhea
c. Constipation
d. Abdominal pain
777777777777 lS NOT CLEAR
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81) Free fluid accumulate in abdominal cavity cause:
a. Hypovolemic shock
b. Cardigenic shock
c. Sepsis
d. Emesis
e. ---
-The correct answer s c.
82) Woman with cyclic bilateral nodularity in her breast since
6 month, on examination there is 3 cm tender mobile mass
in her breast : what you will do next
a. FNA with cytology
b. Mammogram
c. Biopsy
d. Follow up for next cycle
e. Observation
-The correct answer s d. ( I'm not sure )
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83) Most common symptoms of soft tissue sarcoma :
a. Paralysis
b. Ongrowing mass
c. Pain
d. ---
-The correct answer s b.
Ongrowing mass: paness and sow-growng.

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................
84) the most common symptom in placenta abruption is
a. Vaginal bleeding
b. Uterine tenderness
c. Uterine contractions
d. Fetal distress
The correct answer s a
Placental abruption s many a cnca dagnoss wth a the
above fndngs. the most common symptom s dark red vagna
beedng wth pan durng the thrd trmester of pregnancy (80%)
and abdomna or uterne tenderness (70%). Beedng may occur at
varous tmes n pregnancy Beedng n the frst trmester of
pregnancy s qute common and may be due to the foowng:
mscarrage (pregnancy oss) ectopc pregnancy (pregnancy n the
faopan tube) . Beedng n ate pregnancy (after about 20 weeks)
may be due to the foowng: pacenta preva or pacenta
abrupton.
85) Female presented with vaginal discharge, itching, and
on microscope showed mycoleous cells and spores. This
medical condition is most likely to be associated with:
a. TB
b. Diabetes
c. Rheumatoid Arthritis
The correct answer s b
Vagna thrush s a common nfecton caused by a yeast caed
Candida albicans. Vuvovagna canddass s usuay secondary to
overgrowth of norma fora Candida speces n the vagna. Condtons
that nterrupt the baance of norma vagna fora ncude: antbotc
use, ora contraceptves, contraceptve devces, hgh estrogen eves,
and mmunocompromsed states such as dabetes metus and HIV.
Women are prone to vagna thrush between puberty and the
menopause because, under the nfuence of the hormone estrogen, the
ces nng the vagna produce a sugar and yeasts whch Candida
albicans are attracted to. That s why thrush s rare before puberty.
........................................
...............
86) Primigravida in her 8
th
week of gestation, presented to
your clinic wanting to do genetic screening, she declined
invasive procedure . the best in this situation is
a. Amniocentesis
b. 1
st
trimester screening
c. 2
nd
trimester screening
d. Ultrasound
The correct answer s b
........................................
...............
87) Trichomoniasis is classically have:
a. Clue cells
b. Greenish frothy discharge
The correct answer s b
Trichomoniasis s caused by the fageated protozoan
Trchomonas vagnas; t's the most common curabe sexuay
transmtted dsease n the word. It usuay presents wth frothy
yeow-green vagna dscharge, strong-unpeasant odor, pan
durng urnaton and sexua ntercourse.
........................................
...............
87) Obsessive neurosis:
a. Treatment is east
b. Clomipramine doesn't not work
c. Mostly associated with severe depression
d. Can be cured spontaneously
the correct aswer s c
88) Patient came to you complaining of hearing voices, later
he started to complain of thought get into his mind and can
be taken out
a. SCZ
b. Mood
c. Mania
d. Agoraphobia
The correct answer a
........................................
...............
89) Female had history of severe depression, many episodes,
she got her remission for three months with Paroxitine
( SSRls) .. now she is pregnant .. your advise
a. Stop SSRi's because it cause fetal malformation
b. Stop SSRi's because it cause premature labor
c. Continue and monitor her depression
d. Stop SSRls
The correct answer s c or a
In genera, SSRI have the east sde effects then other casses of
antdepressants. Some SE: Seep dsturbance, dzzness, sexua
dysfuncton, Nervousness, and darrhea
........................................
.............
90) Hallucinations and Paranoia:
a. SCZ
b. Mood
c. Mania
d. Phobia
The correct answer s a

.......................................
................
91) Female presented with thirst and polyurea.. all medical
history is negative and she is not know to have medical
issues.. .she gave history of being diagnosed as Bipolar and
on Lithium but her Cr and BUN is normal. What is the cause
of her presentation
a. Adverse affect of lithium
b. Nephrogenic Dl
c. Central Dl
The correct answer s a
Nephrogenic diabetes insipidus s characterzed by a decrease
n the abty to concentrate urne due to a resstance to ADH
acton n the kdney. Nephrogenc dabetes nspdus can be
observed n chronc rena nsuffcency, thum toxcty,
hypercacema, hypokaema.
92) Most common medical problems encountered in Primary
care is:
a. Coryza
b. UTl
c. HTN
The correct answer s a
........................................
...............
93) Regarding diabetes mellitus in pregnancy :
a. Prevelance of diabetes mellitus in pregnancy is 10%
b. Glucose screeing is best in 24-28 week
c. Diabetic and non diabetic have same perinatal
mortality
d. Gestational diabeted can be diagnosed by abnormal
FGS test
The correct answer s b

.......................................
................
94) Left red eye, watery discharge, photo phobia, peri-
auricular non-tender lymph nodes .. Dx
a. Bacterial conjctvitis
b. Viral conjctvitis
The correct answer s b

.......................................
................
95) One of the Anti-psychotics causes ECG changes ,
Leukopenia, drooling :
a. Respiredone
b. Colzapine
c. Amisulpride
The correct answer s b
........................................
...............
96) One of the following decrease chance of colon cancer :
a. Zinc
b. Vit. E
c. Vit C
d. Folic acid
????????
Both C, E, Beta carotene a are Antoxdants, they are correct
but C s more key. A bg dose of vtamn C fghts the bg "C."
some others: Fber ,Vtamn C, Cacum, Vtamn E, Seenum.
97) Best sentence to describe specifity of screening test,is
the population of people who :
a. Are negative of disease, and test is negative
b. Are positive of disease, and test is negative
c. Are positive comparing to total other people
d. Negative disease , positive test
e. Positive disease , negative test
The correct answer s a
Specificity measures the proporton of negatves whch are
correcty dentfed (e.g. the percentage of heathy peope who
are correcty dentfed as not havng the condton).
Sensitivity (aso recall rate) measures the proporton of actua
postves whch are correcty dentfed (e.g. the percentage of
sck peope correcty dentfed as havng the condton).
........................................
...............
98) Heavy smoker came to you asking about other cancer,
not Lung cancer, that smoking increase its risk:
a. Colon
b. Bladder
c. Liver
The correct answer s b
smokng-assocated cancers are ung, head &neck (ke
esophagus and arynx), badder and kdney, pancreatc, cervca
and stomach.

.......................................
................
99) Mid clavicle fracture :
a. Surgery is always indicated if fracture is displaced
b. Figure-8-dressing has better outcomes than simple
sling
c. Figure-8-dressing is strongly indicated in patient with
un-union risk
d. Both figure-8 and simple sling has similar outcomes
the correct answer s d
- smpe sng has been to gve the same resut as a fgure-8
(more comfort and fewer skn probem).
.......................................
................
100) patient complains of "can't breathe air in one nostril "; on
examination showed edematoud mucosa structure, best to
give initially :
a. Corticosteroids
b. Decongestants
c. Alfa-adrenergic blockers
The correct answer s a
101) Pediatric came to you in ER with wheezing, dyspnea,
muscle contraction ( most probably asthma), best to give
initially is :
a. theophillin
b. Albuterol neubelizors
c. oral steroids
the correct answer s b
........................................
..............
102) Female presented with complain of neck pain and
occipital headache , no other symptoms , on X-ray has
cervical spine osteophyes and narrow disks :
a. cervical sponylosis 7
777777

.......................................
................
103) Patient complaining of pain at night when he elevated
his arm, tingeling on lateral arm side and lateral three
fingers , Dx
a. brachial plexus neuropathy
b. shoulder impengment syndrom
c. brachial artery thrombophebitis
d. thoracic outlet problem
the correct answer s d
Branchial plexus neuropathy s characterzed by acute onset of
ntense pan n the shouder or arm foowed shorty by foca musce
weakness.
lmpingement syndrome, swimmer's shoulder, and thrower's
shoulder, s a cnca syndrome whch occurs when the tendons of
the rotator cuff muscles become irritated and inflamed. This can
result in pain, weakness and oss of movement at the shouder. The
pan s often worsened by shouder overhead movement and may
occur at nght, especay f the patent s yng on the affected
shouder.
Thoracic outlet syndrome: numbness and tingling in the fingers;
pan n the neck, shouder, and arm; weakness of the arm and
droppng thngs from the hand; worsenng of the symptoms when
eevatng the arm to do such thngs as comb or bow dry one's har
or drve a car; and codness and coor changes n the hand. The
symptoms are often worse at nght or when usng the arm for work
or other actvtes.
104) Young adult presented with pain on lateral elbow,
tingeling of lateral arm, he plays Squash:
a. carbel tunnel
b. tennis elbow
the correct answer s b
-Lateral epicondylitis( nfammaton of common extensor
tendon ) aso known as (tenns ebow, shooter's ebow and
archer's ebow s a condton where the outer part of the ebow
becomes sore and tender. It s commony assocated wth
payng tenns and racquet sports.
-Medial epicondylitis (nfammaton of common fexor ebow)
aso know (gofer ebow)
.......................................
................
105) male came to you complaining of sudden progressive
decreasing in vision of left eye over last two}three days,
also pain on the same eye, on fundoscopy optic disk
swelling was sees , Dx :
a.central retinal artery occlusion
b.central retinal vein occlusion
c.optic neuritis
d.macular degeneration
they sad the correct answer s c
Ask about symptoms of temporal arteritis n the oder popuaton.
Patents compan of sudden, paness, nonprogressve vson oss n
one eye. Hstory of headaches, |aw caudcaton, scap tenderness,
proxma musce and |ont aches, anorexa, weght oss, or fever may
be ected.
Some patents may revea a hstory of amaurosis fugax nvovng
transent oss of vson astng seconds to mnutes but whch may ast
up to 2 hours. The vson usuay returns to basene after an epsode of
amauross fugax.
Central retinal Artery occlusion: presentng compant s an acute
sudden paness unatera oss of vson. Shows a cassc cherry red
spot
Central retinal vein occlusion: usuay sudden paness varabe
vsua oss; the fundus may show retna hemorrhages, dated tortuous
retna vens, cotton-woo spots, macuar edema, and optc dsc edema.
Optic neuritis: Ma|or symptoms are sudden oss of vson (parta or
compete), or sudden burred or "foggy or washed out" vson, and pan
on movement of the affected eye. Many patents wth optc neurts
may ose some of ther coor vson n the affected eye (especay red).
The optc dsk becomes swoen
Macular degeneration s a eadng cause of permanent paness
rreversbe vson oss n the edery.
Retinal Detachment; Symptoms are decreased perphera or centra
vson, often descrbed as a curtan or dark coud comng across the
fed of vson. Assocated symptoms can ncude paness vson
dsturbances, ncudng fashng ghts and excessve foaters.
106) unilateral headache, exaggerated by excersice and light ,
Dx :
a. migraine
b. cluster headach
c. stress headache
the correct answer s a
.......................................
................
107) 70 years old with progressive demntia , no personality
changes , neurological examination was normal but there is
visuodeficit , on brain CT shower cortex atrophy and
ventricular dilatations :
a. multi micro infract dementia
b. alzehimer demenita
c. parkinsonism dementia
the correct answer s b
alzehimer dementia :
most common cause of dementa. age and famy hstory are rsk
factors for AD. Etoogy unknown but toxc b-amyod depost n
bran. Present wth amnesa for newy acqured nformaton s
usuay the frst presentaton, foowed by anguage defct ,
acaua, depresson, agtaton and fnay apraxa(nabty to
perform sked movement). Dagnoss by excuson that can be
defntve dagnoss ony on autopsy: suggested by cnca feature
and by progressve cogntve course wthout substanta motor
mparment. MRI & CT may show atrophy , ventcue enargement
and can rue out other causes. On bran mcroscopy amyod
paques and neurofbray tange. Death usuay occurrng
secondary to aspraton pneumona . treatment by supportve
therapy for Pt. and famy , and chonesterase nhbtor .
multi mico infarct dementia ( vascular demensia )
dementa assocated wth hstory of strok. Crtera for vascuar
dementa ncude presence of dementa and 2 or more of the
foowng:
1- foca neuroogca sgns
2- symptoms onset that was abrupt , stepwse, or reated to strok
3- bran magng showng evdence of fod nfarcton or extensve
deep whte matter changes secondary to chronc schema.

.......................................
................
108) 70 years old with progressive dementia , on brain
microscopy amyloid plaques and neurofibrillary tangles are
clearly visible also Plaques are seen : Dx
a. lewy dementia
b. Parkisonism
c. Alzehimer
The correct answer c
109) after bite, pediatric patient presented with abdominal
pain and vomiting , stool occult blood , rash over buttock
and lower limbs , edema of hands and soles , urine function
was normal but microscopic hematurea was seen:
a. Lyme
b. Henoch-Schonlein Purpura
The correct answer s b
Henoch-Schnen purpura (HSP) s a sma-vesse vascuts
characterzed by purpura, arthrts, abdomna pan, and
hematura.
.......................................
................
110) for the above disorder ( 109 ), which one is considered
pathological
a. gross hematurea
b. microscopic hematurea
c. rashes
d. ..

The correct answer s a (I'm not sure )

.......................................
................
111) Young adult presented with painless penile ulcer rolled
edges .. what next to do :
a. CBC
b. Darkfeild microscopy
c. Culturing
The correct answer s b
Syphilis aso known as "great mtator" s a sexuay
transmtted dsease caused by the sprochete bactera
Treponema pallidum. Casscay presents as snge paness non-
tchy skn uceraton wth sharp borders. T pallidum s too sma
to be seen under the ght mcroscope. So use darkfed
mcroscopy when sores are present. Bood tests can confrm the
presence of antbodes. The antbodes reman n your body for
years, so the test can be used to determne a current or past
nfecton.
.......................................
................
112) Diabetic female ger 24h-urine proteinn is 150mg ,,
a. start on ACEls
b. refer to nephrologist
c. do nothing , this is normal range
the correct answer s a
113) which prevent or decrease incidence of getting post
herpetic neuralgia
a. Amitriptylin
b. Acyclovir
c. Varicella vaccination
The correct answer s c
A are true, but f I have to choose the best t w be varcea
vaccnaton, because t competey prevents.

.......................................
................
114) Adult Polycystic kidney mode of inheritance:
a. Autosomal dominant
.......................................
................
115) Female came with complain of diahrrea in the last 6
months, she lost some weight, she reported that mostly
was bloody , when you preformed sigmoidoscopy you found
fragile mucosa with bleeding ,Dx
a. colon cancer
b. Chron's
c. Ulcerative colitis
d. Gastroenteritis
e. Hemrrohids
The correct answer s c

.......................................
................
116) Anal fissure commonest site
a. Posteriorly
.......................................
................
117) mother gave bitrh of baby with cleft lip and palate, she
want to get pergnant again what is the percentage of
recurrence
a. 1%
b. 4%
c. 15%
The correct answer s b
118) 4 years old girl presented with her parents to er with
sore throat and seroangious vaginal discharge with no pain
what is most propable cause,
a. Candida
b. Foreign body
c. Chlamedia
d. Gonococci
e. streptococcus
The correcr answer s e
Pediatric vaginal discharge:
1 - infectious vulvovaginitis: present wth maodorous , yeow green, most
common caused by group A streptococcus. ( may be present wth sexua
abus "STDs" ) 2-foreign body
3-candidal infection: may assocated wth dabetes . measure gucose.
4-Sarcoma botryoids (rhabdomyosarcoma ): magnant eson
appearance of "bunches of graps" wthn vagna
.......................................
...............
119) patient coplaining of pain along median nerve ditribution
, And positive tinel sign treatment include casting of both
hand in what position
a. Dorsiflexion
b. plantar flexion
c. extention
d. Dduction

The correct answer s c
.......................................
................
120) dermatomyosistis what is true
a. distal muscle weakness
b. Underlying malignancy
c. Generalized 777 Skin rash
The correct answer s c
Polymositis & dermatomyositis :
Polymyositis : progressve , systemc tssue dsease characterzed
by mmune-medate strated musce nfammaton, present wth
symmetrc progressve proxma musce weaknes and pan .
DERMATOMYOSlTlS : present poymyosts pus cutaneous
nvovement, heiotrop rash (voaceous perorbta rash) , shawl
sign ( rash nvovng the shouder, upper chest and back ) ,
Gottron"s papule ( popuar rash wth scae ).
-both : ncrease serum CK and ant-|o antbodes . musce bopsy usce
fber and nfammaton.
121) pt with hypertrophic subaortic stenosis referred from
dentist before doing dental procedure what is true
a. 50 % risk of endocarditis
b. 12 % risk of endo carditis
c. No need for prophylaxis
d. post procedure antibiotic is enough
the correct answer s c
.......................................
................
122) pt want to quit smoking you till him that symptoms of
nicotine withdrawal appear after
a. 1-2 days
b. 2-4 days
c. 5-7 days
d. 8- 10 days
The correct answer s a
.......................................
................
123) pt taking bupropion to quit smoking what is SE
a. Arrythmia
b. Seizure
c. xerostomia
d. Headache
The correct answer s b
.......................................
................
124) 14 years old girl complaining of painless vaginal bleeding
for 2-4 days every 3Weeks to 2 months ranging from
spotting to 2 packs per day; she had 2ry sexual ccc 1 year
ago and had her menstruation since 6 months on clinical
examination she is normal sexual ccc, normal pelvic exam
appropriate action
a. OCP can be used
b. You should ask for FSH and prolactin level
77777777777777
125) pt want to do dental procedure , he was dx to have
mitral valve prolapse clinically by cardiologist, he had never
done echo before what is appropriate action
a. Do echo
b. No need for prophelaxis
c. give ampicillin
d. Give amoxicillin calvulinic
I thnk I w do Echo, but ths are some of the nformaton I found so I
cant decde.
Ths s from MYO cnc
Doctors used to recommend that some peope wth mtra vave
proapse take antbotcs before certan denta or medca procedures
to prevent endocardts, but not anymore. Accordng to the Amercan
Heart Assocaton, antbotcs are no onger necessary n most cases for
someone wth mtra vave regurgtaton or mtra vave proapse.
St, f you've been tod to take antbotcs before any procedures n the
past, check wth your doctor to see how these new recommendatons
appy to you.
Ths s from MedcnNet
The vast ma|orty of patents wth mtra vave proapse have an
exceent prognoss and need no treatment. For these ndvduas,
routne examnatons ncudng echocardograms every few years may
suffce. Mtra regurgtaton n patents wth mtra vave proapse can
ead to heart faure, heart enargement, and abnorma rhythms.
Therefore, mtra vave proapse patents wth mtra regurgtaton are
often evauated annuay. Snce vave nfecton, endocardts, s a rare,
but potentay serous compcaton of mtra vave proapse, patents
wth mtra vave proapse are usuay gven antbotcs pror to any
procedure whch can ntroduce bactera nto the boodstream. These
procedures ncude routne denta work, mnor surgery, and procedures
that can traumatze body tssues such as coonoscopy, gynecoogc, or
uroogc examnatons. Exampes of antbotcs used ncude ora
amoxcn and erythromycn as we as ntramuscuar or ntravenous
ampcn, gentamycn, and vancomycn.
.......................................
................
126) ttt of cyclical mastalgia
a. OCP, analgisc, NSAlD, Fat reduction, and magnisuem
Mastalagia : panfu breast tssue that can be cycc and usuay
assocated wth hormona change, often batera .
management : stop current hormona therapy , reassurance,
stop smokng, fat reducton, anagesc, NSAID, OCP.
127) 4years old child what can he do
a. Copy square and triangle
b. Speak in sentences
b. ..
The correct answer s a
.......................................
................
128) baby can sit without support, walk by holding fourniture.
Pincer grasp, pull to stand how old is he
a. 8 months
b. 10 months
c. 12 month
d. 18 month
The correct answer s b
.......................................
................
129) repeated question about Alzheimer disease
alzehimer dementia :
most common cause of dementa. age and famy hstory are rsk
factors for AD. Etoogy unknown but toxc b-amyod depost n
bran. Present wth amnesa for newy acqured nformaton s
usuay the frst presentaton, foowed by anguage defct ,
acaua, depresson, agtaton and fnay apraxa(nabty to
perform sked movement). Dagnoss by excuson that can be
defntve dagnoss ony on autopsy: suggested by cnca feature
and by progressve cogntve course wthout substanta motor
mparment. MRI & CT may show atrophy , ventcue enargement
and can rue out other causes. On bran mcroscopy amyod
paques and neurofbray tange. Death usuay occurrng
secondary to aspraton pneumona . treatment by supportve
therapy for Pt. and famy , and chonesterase nhbtor .
.......................................
................
130) repeated also about multiinfarct dementia
multi mico infarct dementia ( vascular demensia )
dementa assocated wth hstory of strok. Crtera for vascuar
dementa ncude presence of dementa and 2 or more of the
foowng:
1- foca neuroogca sgns
2- symptoms onset that was abrupt , stepwse, or reated to strok
3- bran magng showng evdence of fod nfarcton or extensve
deep whte matter changes secondary to chronc schema.
131) 73 year patient complain of progressive loses of memory
with decrees in cognition function . C.T reveal enlarge
ventricle and cortical atrophy , diagnosis is
a- Alzheimer
b-multi infarct dementia
c- multiple sclerosis
d-77777777
The correct answer is a
Alzheimer (Dx by exclusion. Its associated with progressive memory loss,
decreased cognition function , & enlarged ventricles with cortical atrophy)
multi infarct dementia (NOT progressve & t has foca
neuroogca abnormaty)
multiple sclerosis (recurrent reapsed & compete remsson.
Its assocated wth demyenaton of gray-matter)
.......................................
................
132) 62 female with -ve pap smear you should advice to
repeat pap smear every:
A- 6m
b- 12m
c- 18m
d- no repeat
The correct answer s d
Screening pap smear:
1- startng at age 21 years or no more than 3 years after becomng
sexuay actve. 2- women > 30
years who have three consecutve norma test screenng ( 1 /
3yeasr). 3- screenng shoud be dscontnue for
women > 60-70 years who have had 3 or more norma pap smear.
.......................................
................
133) all following are criteria of chronic fatigue syndrome
except
b-???????
chronic fatigue syndrome:
characterzes by profound menta and physca exhauston. In
assocated wth mutpe system and neurospsychatrc symptoms
that ast at east 6 mounth. Must be new ( not fe ong ) , must not
be reved by rest, and must resut n greater than 50% reducton n
prevous actvty. Presentaton wth 4 or more of the foowng :
poor memory / concentraton, myaga, arthaaga, sore throat,
tender ymph node, recent onset headach, unrefreshng seep,
excessve tredness wth exercse. Treatment by : cognitive and
excercise therapy .also, diet, physiotherapy, dietary supplements, antidepressants
134) 12 year boy with sinsoneurl hear loose , C.T scan show
mass (site in brain777) so diagnosis is
a- aqustic neroma
b-meningioma
c- barotraumas
d77777777
The correct answer is a (l'm not sure )
- aqustic neroma (bengn tumor of crana nerve VIII. Mosty occur between
age of 30-60 years. , Mosty unatera except f t's assocated wth
neurofbromatoss n whch ts batera)
-meningioma (mosty bengn, wth age, more wth femae. Its occur n the
cerebeopontn)
- barotraumas (mosty n the dvers. The damage occur due to pressure)
.......................................
..................
135) 50 y with uncontrolled diabetes ,complain of black to
brown nasal discharge. So diagnoses is
a- mycomyosis
b- aspirglosis
c-foreign body
d77777777
The correct answer s a
- mycomyosis (funga nfecton caused by Mycoraes, affect
nasa snus & ungs, . ........ characterzed by back
nasa dscharge, Dx by bopsy).
.......................
................................
136) 55 y complain of dyspnea, PND with past history of mitral
valve disease diagnosis is
a-LT side HF
b- RT side HF
c- pnemothrax
d-P.E
The correct answer s a
...................................
...............
137) clonidin is decrease effect of
a- benzotropin (anticholinirgic for Parkinson. Not affected
by Clonidin)
b-levo dopa (for Parkinson. Changed in the brain to
Dopamen. Clonidin the effect of Levodopa through
Unknown mechanism)
c-rubstin77777

the correct answer s b
Conodn s o2 agonst used to TTT hypertenson. o2 receptor n the
bran cause of both COP & perphera resstant .
138) 2 y baby with gray to green patch in lower back, no
redness or hotness, diagnosis is
a- child abuse
b-no ttt need
c- bleeding tendency
d7777
The correct answer s b (I'm not sure )
I thnk t s " Mongoan spot " , vsbe n 6 month and normay
dsappear to 3-5 years. No need treatment.
.......................................
................
139) 15y boy with unilateral gyncomastia your advice is
a- my resolve spontiniously
b-there is variation from person to person
c-decrease use of soda oil or fish oil
d-77777777777
the correct answer s a
- un- or batera gynecomasta occur normay n newborn & at
puberty

.......................................
................
140) 6m baby with mild viral diarrhea , ttt by ORS as
a-100m/kg for 4 hour then 50 m/kg /day after
b-50>>>>>>>>>>>>>>>>.50>>>>>>>>>>
c-100>>>>>>>>>>>>>>>>100>>>>>>>>
d-50>>>>>>>>>>>>>>>>>100>>>>>>
141) 36 y female with breast mass mobile and change with
menstrual cycle , no skin dimple or fathering. Your advice is
a-repeat exam after 2 cycle
b-make biopsy
c-fine needle aspiration (there is NO singe of breast cancer.
lt is Fibroadenoma. ]ust do FNA to exclude cancer & relive
the pt)
d-oral contraception
The correct answer s a (I'm not sure )
.......................................
................
142) 50y female with breast cancer and CA125 elevate. So
elevation due to
a-breast cancer
b-associate with ovarian cancer
c-due to old age
d-normal variation
The correct answer s a , beause ths pt. hgh rsk of breast cancer.
- CA125 s a tumor marker mosty used for ovaran Ca, but t's aso
used wth endometra, faopan, breast, & GIT Ca
.......................................
................
143) 25y female with bradicardia and palpitation. ECG normal
except HR130 and apical pulse is 210 .past history of full ttt
ovarian teratoma, so your advice is
a- struma ovari should be consider
b-vagal stimulate should be done
c- referred to cardiology
The correct answer is a
.......................................
................
144) pt with alcohol drinked complain of headache , dilated
pupil hyperactivity, agitation .he had history of alcohol
withdrawal last week so ttt is
a-diazepam
b-naxtrol
c-haloperidol
d777777777
the correct answer s a
-diazepam (for sezure gven 1st occur n the 1st 12h).
-haloperidol (for haucnaton gven 2nd occur n the 1st 2
days).
145) 50y man with chronic psychosis and not complains for ttt
.your advice
a- depot haloperidol or floxtin
b-oral lorasepam
c-oral buspiron
d-7777777
The correct answer s a
.......................................
................
146) 15y boy appear patch in rt lower leg these patch is clear
center , red in peripheral, no fever no other complain so
diagnosis
a-contact dermatitis
b-tinea corpora
c- lyme disease
d-7777777
The correct answer s b
-tinea corpora: worm funga nfecton whch transmtted by
contact skn & has cnca pcture as n the queston .
.......................................
................
147) old pt with of lHD complain for 2 mon of redness in lower
leg and pulse dim- inched in dorsalis pedis these redness
increase in dependant position and limp is cold and no
swelling ,diagnosis is:
a-arterial inssuficncy
b-thrmbophibitis
c-cellulites
d777777
the correct answer s a
-thrombophilibitis: present wth pan, sweng and redness .
-celluitis: present wth redness, hotness and tender.
.......................................
................
148) pt with heart disease complain of LL ischemia your
advice
a-referred to cardiology
b-""""""""""""vascular surgery
c- start heparin
d-7777777777}

777777777
149) female after sexual attack on exam hymen tear in
a-2 o'clock
b-4"""""""
c-6""""""
d-8""""""""
the correct answer s c
-tear appear between 5 and 7 o'cock
.......................................
................
150) 7y boy complain of limb. CT show a vascular necrosis in
epiphysis of femur your advice
a- surgical ttt
b-splint for 6m
c- physiotherapy
d77777777
not complete : but wth these MCOs , the correct answer s b
This case is "perth's diseas" : vascuar necross of femora head. 5-
10 years . usuay sef mtng wth symptoms astng< 18 months.
Present wth paness mb , mted abducton and nterna rotaton.
Treatment: 1- observation f there s mted femora head
nvovement or fu ROM . 2- f extensve or f decrease ROM,
consder bracng, hp abducton wth cast.
.......................................
................
151) pt with trachoma in eye . for prevention you should
a- water
b- """""""""""""""""+eradication of organism
c- mass ttt
d77777777777
the correct answer s a
-trachoma n the eye s a bactera nfecton caused by Chamyda
trachomats whch s transmtted by poor haygen & contamnated
H2O. TTT by antbotc as erythromycn & Doxycycne. Surgery to
prevent scar
.......................................
................
152) your advice to prevent plaque disease is
a-hand washing
b-rodent eradication
c-spry insect side
d-7777777777 77777
153) pt with severe headache and decrease in visual acuity
,pupil is dilated, so ttt
a-pilocarpin drop and ophthalmology referred
b-ergotamine
c-NSlD
d7777777
the correct answer s a
- ths s closed angle glaucoma whch characterzed by sudden
severe headache, red eye, vsua acuty, & dated pup.
Pocarpn s parasympathommmc whch hep n reve the pan
.......................................
................
154) main ttt of non inflammatory acne is
a-ritonic acid
b-clindmycin;
c-azalic acid
d-erythromycin
the correct answer s a
-clindamycine & erythromycin are treatment of
nfammatory acne.
. -azalic acid : treatment of non-nfammatory & nfammatory
acne. .
- ritonic acid : treatment of sever acne & non-nfammatory
.......................................
................
155) pregnant with insulin dependant with good control, so to
decrease risk of congenital disease
a-good metabolic control before pregnancy
b-"""""""""""""""""""""""1st trimester
c-""""""""""""""""""""""""2nd """""
d-""""""""""""""""""""""""3rd """""""
the correct answer s b(I'm not sure )
.......................................
................
156) female not married with normal investigation except
FBS=142. RBS196. so ttt
a-give insulin subcutaneous
b-advice not become married
c-barrier contraceptive is good
d- BMl control
the correct answer s d
157) diapetic pt come to you with disturbance in conscious
RBS : 65. so main drug that cause hypoglycemia:
a-sulphnylurea
b-bugunid
c-acabos o-glucosidase inhibitor
d-pheniform
the correct answer a
-sulphnylurea ( nsun secreton, so, t can cause
hypogycema)
-bugunid ( nsun senstzaton, so, can not cause
hypogycema)
-acabos o-glucosidase inhibitor ( used for postpranda
hypergycema, so, can . . not cause hypogycema)
-pheniform ( nsun senstzaton, so, can not cause
hypogycema)
.......................................
................
158) 6m boy with fever you should give antipyretic to
decrease risk of
a-febrile convulsion
b- epilepsy
c- disseminate bacteria
d777777777777777
The correct answer s a
.......................................
................
159) picture in computer appear vesicle , bulla and erythama
in chest skin so ttt
a- acyclovir cream
b-betamethzone cream
c-floclvir
d- erythromycin
mutpe choce not cear.

Ths case s "herpes zoster" . treatment of herpes zoser are
antvra, anagesc. Antvra are ( systemc ) and ncude:
acycovre, famccovre, acycovre. In mutpe choce there s
"focvr" and there s not drug have ths name. I thnk the wrter O
wrtten n wrong speng. I thnk the choce c s famccovre and t
s correct answer. Famccovr: 500 mg T.I.D for 7 days
160) pt with scale in hair margin and nasal fold and behind
ear with papule and irregular erythema so ttt is
a-nzora cream
b- atovt
c- acycovr
d-antbotc
the correct answer is a ( this is seborrheic dermatitis )
.......................................
................
161) 14y girl with athralgia and photosensitivity and malar
flush. And protinurea so diagnosis is
a-RA
b-lupus nephritis
c-UTl
d-7777777777
The correct answer s b
.......................................
................
162) question about diarrhea and Yesinia bacteria
Yersiniosis : t s nfectous dsease caused by Yesna bactera.
There are 3 types of Yesna bactera : 1- Y.entercots , 2-
Y.pseudotubercuoss, 3-Y. pests. Y.enetercots cause boody
darrhea, termna ets and mesenterc adents. Dagnoss by
seroogca : rse n antbody tter . Treatment : usuay sef mtng
and tetracycne for sever nfecton.
.......................................
................
163) paraplegia pt with ulcer in lower back 2+2 cm and lose
of dermis and epidermis these ulcer in stage
a- l
b-ll
c-lll
d-lV
the correct answer s b
-stage l : non-banchabe redness that NOT subsde after reve
of the pressure
-stage ll : damage to epderms & derms but NOT deeper
-stagelll : subcutaneous tssue nvovement
-stagelV : deeper than subcutaneous tssue as musces & bones
164) PREGNANT LADY prim at labor pain , on exa cervical in
stage l of labor so pain management is
a-morphine lM
b-epidural anesthesia
c-general"""""""""
d-local"""""""
The correct answer s b
.......................................
................
165) Psycatric pt on antipsychotic drug most drug that lead to
impotence with antipsychotic is
a- proprnlol
b-NSAl
c-ACEl
d-777777777
the correct answer s a
.......................................
................
166) man present with painless ulcer in his penis with
indurate base and everted edge so diagnosis is
a- syphilis
b- gonorrhea
c- choncroid
d- HSV
The correct answer s a
- syphilis : paness ucer n the pens
- gonorrhea: STD by bactera nfecton cause pan &
dscharge but NO ucer
- choncroid: STD by bactera nfecton cause pan &
dscharge but NO ucer
- HSV : STD by vrus that cause panfu ucer wth
dscharge.
.......................................
................
167) man have long history of urethral stricture present with
tender right testis and WBC in urine so diagnosis is
a-epddimorchitis
b- testicular torchin
c- varicosel
d-777777
the correct answer s a
-epddimorchitis : occur wth UTI & urnary retenson)
- testicular torchin : sudden acute severe testcuar pan
wth eevated
. transversey ng testes)
- varicosel : due to ntra-abdomena pressure.
168) man use saldinafil (Viagra), to prevent hypotension you
should not use
a-nitrate
b-B blocker
c-AClE
d-CCB
the correct answer s a
.......................................
................
169) female complain of painless odorless and colorless
vaginal discharge that appear after intercourse so ttt
a-give antibiotic
b-douche after intercourse
c- cervical cancer should be consider
d-may be due to chronic salpingitis
the correct answer s b
Color Smell
Pain OR
ltching
Other
Normal
vaginal
discharge
Cear OR
mky
Odoress NO
durng
ovuaton,
sex,
breastfeedng
Bacterial
vaginosis
Whte-gray
OR yeow
Fshy Yes durng sex
Trichomonia
sis
Watery Or
yeow
Yes especay
durng
urnaton
Candida
Whte-cheesy
thck stcky
Yes especay
durng sex
.......................................
................
170) UTl>14 day, most probably cause pylonphritis
a-,05%
b-,5%
c-5%
d-50%
Difficult , This referral to urologist.
.......................................
................
171) patient complain of right iliac fossa mass so diagnosis
a-diverticulitis
b-appendicitis
c-pancrtitis
d-chrons disease
- the correct answer s d
172) pt with long history of UC on endoscopes see polyp and
cancer lesion on left colon so ttt
a-ttt of anemia
b-left hemicolctomy
c-total colctomy
d- remove polyp
.......................................
................
173) female with hair on different site of body and refuse
intake of food and BMl<18 and feel as body is fat so
diagnosis
a-anorexia nervosa
b-bulimia nervosa
c-body dismorphic syndrome
d- anxiety
the correct answer s a
-anorexia nervosa: decrease body wt. amenorrhea and anugo
(har ).
-bulimia nervosa: norma or ncrease body wt. restrct eatng
foowng by overeatng then gut.
.......................................
................
174) obese female, insulin resistance and hairstisim so
diagnosis
a-poly cystic ovary
b-hyperprolctinmia
c-familial
d-7"77777777
the correct answer s a
.......................................
................
175) boy 3 day after flue symptom develop conjunctivitis with
occipital and neck L.N enlarged so diagnosis is
a-adenoviruses
b-streptococcus
c-HSV
D7777777777
the correct answer s a
.......................................
................
176) child with asthma use betamethazone, most common
side effect is
a-increase intraocular pressure
b-epilepsy
c-growth retardation
d-7777777777777
. the correct answer s c
177) curve of HBV marker
answered in 38
.......................................
................
178) sickling pt after acute attack , discharge on
a- penicillin
b-iron
c-vitamin
d77777777777
the correct answer s a
prophyactc of pneumococca nfecton by vaccnaton
and ora pencn
.......................................
................
179) 6m with cough and wheezy chest .diagnosis is
a- asthma
b- broncholitis
c-pneumonia
d-F.B aspiration
The correct answer s b
- asthma : after 2 years od)
- broncholitis : before 2 years od)
-pneumonia : assocated wth cryptaton
-F.B aspiration : sudden wheezng
.......................................
................
180) 15y old with pilonidal sinuse so ttt
a-incision surgery
b- local antibiotic
c-daily clean
d-777777777
The correct answer s c
. pilonidal sinus : snus tract wtch commony contan hars.
Treatment , frsty conservatve ttt n md case remove a har,
washng ceanng . f not reve: surgery

181) Female pt 8 wks postpartum,not smoker diagnosed to
have asthma,her asthma was not controlled she attended
ER 3 times last month,on B2 agonist and oral steroid,she
came c}o wheezing and s.o.b mildly cyanosed using her
intercostal muscles,wheezy chest,BP:160}100 P:120 PO2:72
PEF:36,there is oedema in her foot up to the knee,the most
likely diagnosis:
a. COPD
b. pulmonary embolism
c. Acute asthma attack
d. Angioedema
The correct answer s a or c
.......................................
.................
182) Female pt developed sudden loss of vision(both eyes)
while she was walking down the street,also c}o numbness
and tingling jn her feet ,there is discrepancy b}w the
complaint and the finding,
O}E reflexes and ankle jerks preserved,there is decrease in
the sensation and weakness in the lower muscles not going
with the anatomy,what is your action:
a. Call ophthalmologist
b. Call neurologist
c. call psychiatrist
d. reassure her and ask her about the stressors
the correct answer s : d
..............................................
...............................................
183) same scenario in .182 what is the diagnosis:
a. Conversion disorder
b. Somatoform disorder
The correct answer s a
1 - somatization disorder: femae before age 30 years .
symptoms ncude: . . two GIT , four ste of pan , one
sexua dysfuncton , one pseudoneuron .
. 2- conversion disorder: symptoms ncude vountary or
sensory . . 3- hypochondriasis: fear
from fe threatenng dsease. .
4- body dysmorphic disorder: aware from hs magng.
. 5- somatoform pain disorder: ntensty pan s man
symptoms

184) male pt developed corneal ulcer in his Rt eye after
trauma what is the Mx:
a. Antibiotic and cycloplagia is mydrasis and refer to
ophthalmology
b. topical steroid
the correct answer s a
Because nfecton s a common occurrence n cornea ucers, your
ophthamoogst w prescrbe antbotc eyedrops. If the nfecton
appears very arge, you may need to use these drops as often as
one drop an hour. -Ora pan medcatons w be prescrbed to
contro the pan. Pan can aso be controed wth speca eyedrops
that keep your pup dated (Antchonergcs such as atropne,
hyoscyamne, and scopoamne)
...........................................................................................................................
................................
185) female pt with Rt eye pain and redness with watery
discharge,no h.o trauma,itching,O}E there is diffuse
congestion in the conjunctiva and watery discharge what
you'll do:
a. give Ab
b. give antihistamine
c. topical steroid
d. refer her to the ophthalmologist
???????????????
.......................................
...................
186) Epidemic disease in poor sanitation areas affecting
children and young adults:
a. hep A
b. B
c. C
d. D
The correct answer s a
187) mths baby with crying episodes+current jelly stool,looks
slightly pale,signs of obstruction wht is your Mx:
a. barium enema
b. immediate surgery
c. l.v fluid & wait for resolution
The correct answer s a
lntussusceptions :
Condton n whch one porton of bowe nvagnates nto an
ad|acent segment "usuay proxma to eoceca vave" . most
common n frst two years of fe " usuay between 3 months and 3
years of fe" . Abrupt -onest , cocky abdomna pan , often
accompaned by fexed knee and vomtng , ( one-off pan ) chd
may appear we between epsodes. Cassc trad : abdomna pan ,
vomtng , bood per rectum" ony one thrd of pt." . Late sgns :
boody mucus n stoo "currant |ey stoo" , abdomna tenderness ,
papabe "sausage- shape " . RUO abdomna mas.
lnvestigation & treatment :
-correct any voume and eectroyte abnormaty and check ( cbc)
Abdomna fm may be norma n eary stage , and see
obstructon , perforaton n ate stage, US see " target sgn"
In settng of hgh cnca suspcon >>> ar-contrast barum
enema, shoud be performed wthout deay. As dagnostc n 95% of
cases and curatve n 80% of cases perform surgca reducton of
gangrenous bowe.
.......................................
......................
188) 17 y.o adolescent, athletic ,with h}o Rt foot pain planter
surface,diagnosis is:
a. planter fasciaitis
b. valux..
c. valux...
O not compete.
Planter fasciitis( heel spur syndrome ) :
Repettve stran n|ury causng mcro tears and nfammaton of
panter fasca. Common n athetes , aso assocated wth D.M ,
obesty , seronegatve and seropostve arthrts.
Clinical feature: mornng pan and stffness , ntense pan when
wakng from rest and that subsdes as pt. contnuous to wak.
Sweng and tenderness over soe, greatest at medca cacanea
tuberce and 1-2 cm dsta to aong panter fasca . pan wth toe
dorsfexon
189) pregnant lady 16 wks presented with vaginal bleeding
,enlarged abdomen,vomiting ,her uterus is smaller than
expected for the gestational age,BhCG 80,U}S snowstorm
appearance,diagnosis:
a. complete hydatiform mole
b. partial hydatiform mole
The correct answer s a
.......................................
.....................
190) 10. 12 y.o boy c}o abdominal pain after playing football,
he denied any h}o trauma, the pain is in the Lt
paraumbilical region what inx you want to do:
a. CXR
b. ultrasound kidney
not complete
.......................................
.....................
191) 5 y.o child with h.o fever and swelling of the face ant to
the both ears (parotid gland enlargement) what is the most
common complication:
a. Labrynthitis
b. meningitis
c. encephalitis
d. orchitis
The correct answer s b
- most common compcaton of mumps after puberty . but t s
rare occur pre-puberty.
.......................................
................
192) . what is the meaning of difficulty breathing:
a. dyspnia
b. tachycardia
The correct answer s a

193) A female patient on the 3
rd
week postpartum. She says to
the physician that the frequently visualizes snakes crawling
to her baby's bed. She knows that it is impossible but she
cannot remove the idea from her head. She says she wakes
up around 50 times at night to check her baby. This
problem prevents her from getting good sleep and it
started to affect her marriage. What is this problem she is
experiencing7
a. An obsession
b. A hallucination
c. A postpartum psychosis
d. A Delusion
The correct answer s a ( 100 % correct )
-obsession : persstent, unwanted, and ntrusve deas , thoughts,
mpuses or mages
-hallucination: percepton of ob|ectve or event wthout exstng
externa stmuus -illusion: fase percepton of actua externa
stmuus. - delusion: fxed
fase dosyncratc beef.
.......................................
...................
194) female pt c}o sever migraine that affecting her work,she
mentioned that she was improved in her last pregnancy,to
prevent that:
a. biofeedback
b. propranolol
The correct answer s b
- migraine prophylactic :
1- b-bocker (propranoo) : frst ne treatment (note: contndcaton
n pregnancy)
2- TCA (amtrptyne )
3- antcovusant
4- cacum channe bocker
.......................................
...................
195) About DM in KSA:
a.. most of NlDDM are obese ( correct )
.......................................
..................
196) Flu vaccine not given to the baby who is allergic to:
a. egg
contraindication of flu vaccine are egg allergic and
hypersensitivity to thimerosal
197) 17. Pt with asymptomatic Trichomniasis:
a. treat her anyway regardless
b. treat her if she is symptomatic only
The correct answer s a
-treatment of trichomnias :
Snge dose of metradnazoe for symptomatc and
asymptomatc pt. and treatment partner ( because t s
sexua transmtted dsease )
But not treatment of asymptomatc trchomnass n frst
trmester of pregnancy. (contrandcaton n pregnancy )
.......................................
...................
198) 7 y.o,she missed her second dose of varecila vaccine,the
first one about 1 y ago what you'll do:
a. give her double dose vaccine
b. give her the second dose only
c. see if she has antibody and act accordingly
The correct answer s b
.......................................
..................
199) pt with gonorrhea infection what else you want to check
for
a. Clamydia trachomatis

.......................................
..................
200) female pt with Aortic stenosis,she developed syncope
while she was in the class and she recovered
immediately,what is the cause of syncope:
a. valvular rupture
b. systemic hypotension
The correct answer s b
.......................................
...................
201) diabetic pt well controlled,she came with h.o dizziness
and sweating after taking a medication BS:60 what drug
that cause her prob:
-Sufanyurea can cause ths sde effects.
202) male pt with acute urine retention what is your action:
a. insert folly's cath and ask him to come back to the
clinic
.......................................
..................
203) ln battered women which is true:
a. mostly they come from poor socioeconomic area
b. usually they marry a second violent man
c. mostly they come to the E}R c}o.....
d. mostly they think that the husband respond like this
because they still have . strong feeling for them
Answer ( d )
Battered women s Women who are physcay and mentay
abused over an extended perod, usuay by a husband or other
domnant mae fgure. Characterstcs of the battered woman
syndrome are hepessness, constant fear, and a perceved nabty
to escape. So l think choice d is correct answer
.......................................
...................
204) smoking withdrawal symptoms peak at:
a. 1-2 days
b. 2-4 days
c. 5.7 days
d. 10-14 days
The correct answer s a
.......................................
...................
205) Mother who is breast feeding and she want to take MMR
vaccine what is your advice:
a. can be given safely during lactation
b. contain live bacteria that will be transmitted to the
baby
c. stop breast feeding for 72 hrs after taking the vaccine
The correct answer s a
MMR : contrandcaton durng pregnancy , and women shoud
be avod pregnant n 4 weeks foowed MMR vaccne . MMR s
safe durng actaton.

206) male pt c}o pain in his Rt elbow,he said that he is using
the hummer a lot in his work diagnosis:
a. lateral epichondylitis
-Lateral epicondylitis( nfammaton of common extensor tendon )
aso known as (tenns ebow, shooter's ebow and archer's ebow s a
condton where the outer part of the ebow becomes sore and tender.
It s commony assocated wth payng tenns and racquet sports.
-Medial epicondylitis (nfammaton of common fexor ebow) aso
know (gofer ebow)
.......................................
.................
207) 50 y.o male with difficulty swallowing food with wt loss:
1. Oesophageal cancer
queston not compete . but most key s cancer.
causes of dysphaga food than qud are :
1- carcnoma . 2- strcture . 3- pummer vson syndrome = web (
ron defceny anema + gossts )
.......................................
.................
208) . young female with pain in her elbow(lateral
epichondylitis) best treatment is :
a. .....+NSAlD
b. electric .....
queston not compete .
- treatment of lateral epichondylitis:
1- frst ne : NSAID +rest + ce
2- second ne : cortcosterod n|ecton
3- thrd ne : surgery .percutaneous reease of common tendon

.......................................
....................
209) what drug that improve the survival in CHF
1. digoxin
2. Hydralazin
queston s not compete .
Improve mortaty n CHF : B-bocker + ACE + ARB ( most
important is ACE )
210) old man with bilateral knee pain and tenderness that
increase with walking and relieved by rest;
a. RA
b. OA
The correct answer s b
OA: pan wth actvty and weght bearng . and mprove wth rest .
RA: mornng stffness > 1 hour . panfu and warm sweng of
mutpe symmetrc |ont .
.......................................
.................
211) Regarding peritonitis:
a.Complicated appendectomy the cause is anerobe
organism
b. rigidity and the cause is paralytic ileus
c. can be caused by chemical erosions
d. ......
The correct answer s c
.......................................
...................
212) regarding Ml all of the following true except:
a. unstable angina,longer duration of pain and can occur
even at rest.
b. stable angina,shorter duration and occur with excertion
c. there should be q wave in Ml
d. even if there is very painful unstable angina the cardiac
enzymes will be normal
e. ......
all of the above are correct 777
.......................................
.................
213) Pt with scoliosis, you need to refer him to the ortho when
the degree is:
a. 5
b. 10
c. 15
d. 20
The correct answer s d
214) 6 mths baby with undescending testis which is true:
a. till the mother that he need syrgery
b. in most of the cases spontaneous descent after 1 year
c. surgery indicated when he is 4 years
d. unlikely to become malignant
The correct answer s a
-after 1 year testes not desendng. And surgery(orchopexy) do
from 6 -18months
.......................................
.................
215) 24 y.o Pt with asymptomatic congenital inguinal hernia:
a. immediate surgery
b. surgery indicated when he is >35 y
c. elective surgery if it is reducible
d. ......
The correct answer s c
.......................................
..................
216) the most effective thing regarding counseling:
a. family rapport
b. well adjusted appointment before counseling
c. .......
77777
.......................................
..................
217) 5 years old C}O limping in CT there is a venous necrosis
ttt is:
a. surgery
b. splent
c. physiotherpy
not complete:
This case is "perth's diseas" : vascuar necross of
femora head. 5- 10 years . usuay sef mtng wth
symptoms astng< 18 months. Present wth paness mb ,
mted abducton and nterna rotaton.
Treatment: 1- observation f there s mted femora
head nvovement or fu ROM . 2- f extensve or f
decrease ROM, consder bracng, hp abducton wth cast.
218) Pt. has DM and renal impairment when he had diabetic
nephropathy:there is curve for albumin
a. 5y
b. 10y
c. 20y
d. 25y
.......................................
...........
219) Pt has alzahimar disease and halusination and delusion ttt:
a. Halopridole
Psychotc symptoms (e.g. haucnatons and deusons),
agtaton and aggressve behavor are common n patents wth
Azhemers Dsease. A study suggests that haoperdo at a
dose of 2-3 mgs/day s effectve and we toerated by most
patents.
220) Generalize anexity disorder best ttt:
a. SSRls
b. tricyclic A D
The correct answer s a
...................................
...............
221) Major depression management:
a. lntial therapy even sever
Management of major depression disorder:
1-pharmacotherapy: effectve n 50 - 70% .aow for 2-6 weeks to
take effect , treat more than 6 months ( SSRI, TCAs, MAOIs).
2-psycotherapy: psychotherapy combned wth antdepressant s
more effect than ether treatment aone.
3- Electroconvulsion ( ECCT ).
4- phototherapy: effectve for pt. who has a seasona pattern.
...................................
...............
222) Psychiatric pt with un compliance of drugs ttt:
a. depro halopredol
...................................
...............
223) Strongest risk factor for strok:
a. Hypertension
b. Atrial fibrillation
The correct answer s a
224) Pt. with salpingitis and there is swelling in pelvis in
posterior fornex and it is fluctuant m:
a. Colpotomy
b. Laproscopic
The correct answer s a (I'm not sure )
colpotomy, aso known as a vagnotomy, s a procedure by
whch an ncson s made n the vagna.
Purpose: A copotomy s performed ether to vsuaze pevc
structures or to perform surgery on the faopan tubes or
ovares.

...................................
...............
225) Child swallowing battery in the oesophegus,
management7
a. broncoscoby
226) ln the appendisits the histology is:
a. leukocyte in muscle
b. layer of lymphoid
c. tumor
d. plasma cell
the correct answer s a
in appendicitis : neutroph exudaton throughout mucus,
submucus, and muscuars

...................................
...............
227) water in the body:
a. 40%
b. differ depend on age and sex
the correct answer s b
Guyton's Textbook of Medical Physiology states that "the tota
amount of water n a man of average weght (70 kograms) s
approxmatey 40 ters, averagng 57% of hs tota body weght. In
a newborn nfant, ths may be as hgh as 75% of the body weght,
but t progressvey decreases from brth to od age, most of the
decrease occurrng durng the frst 10 years of fe. Aso, obesty
decreases the percentage of water n the body, sometmes to as
ow as 45%".
...................................
...............
228) Corneal ulcer ttt:
a. Antibiotic and cycloplagia is mydrasis and refer to
ophthalmology
-Because nfecton s a common occurrence n cornea ucers,
your ophthamoogst w prescrbe antbotc eyedrops. If the
nfecton appears very arge, you may need to use these drops as
often as one drop an hour. -Ora pan medcatons w be
prescrbed to contro the pan. Pan can aso be controed wth
speca eyedrops that keep your pup dated (Antchonergcs such
as atropne, hyoscyamne, and scopoamne)
229) regarding drainage of the abscess one of the following is
true:
a. Carbuncle and frunculosis need drainage
b. Usually give ciphtriaxon and penicillin post draing
the correct answer s a
Fruncuoss and carbunces are pus-fed nfected umps on the
skn. They usuay occur as a one-off n a heathy person.
Treatment commony nvoves dranng the pus and takng a course
of antbotcs. If you have recurrng bos you may be advsed to
have tests to check for an underyng cause.

...............................
...................
230) Salpingitis and PlD on penicillin but not improve the
most likely organism is :
a. Chlamydia trachomatis
b. Neisseria gonorrhoeae
The correct answer s b
Emprc antbotc regmens shoud be amed at treatng key
causatve agents, that s, N. gonorrhoeae, C. trachomatis, genta
mycopasmas, and bactera vagnoss-assocated endogenous
mcrofora. The atter ncude anaerobc (acteroides and Pre!otella
speces and anaerobc streptococc) as we as aerobc organsms
(". !aginalis, #. coli, and facutatve streptococc). Except for N.
gonorrhoeae and some anaerobes, resstance s not yet a cnca
probem.

...................................
...............
231) Wound at end inflammatory phase when:
a. Epithelial tissue formation
b. Angiogenisis
c. when the wound clean
d. Scar formation
The correct answer s b
232) ]uvenile RA ttt:
a. Aspirine
b. Steroid
c. Penicillamine
d. dydrocloroquin
The correct answer s a
The treatment of |RA focuses on suppressng nfammaton,
preservng and maxmzng functon, preventng deformty, and
preventng bndness. NSAIDs are the frst choce n the treatment
of |RA.
...................................
...............
233) Pt. has hemorrhoid with 4 degree ttt:
a. Hemoridectomy
b. band ligation
c. sclerotherapy
d. fiber diet
-The correct answer s a.
- Classification of internal hemorrhoid :
First degree : hemorrhod do not proapsed
Second degree : hemorrhod proapsed upon defecaton but
spontaneousy reduce
Third degree : hemorrhod proapsed upon defecaton , but must
be manuay reduce
Fourth degree : hemorrhods are proapsed and cannot be
manuay reduce
-treatment:
First & Second : fe stye modfcaton ( dte)
Third : fe stye modfcaton wth (band gaton, scerotherapy or
cryotherapy ) , f
Faed go to surgery.
Fourth : surgery ( hemorrhodectomy )
234) Pt. come with history of tinia capitis ttt:
a. tar shampoo
b. Fluconazol
The correct answer s b
Newer antfunga medcatons, such as ketoconazoe,
traconazoe, terbnafne, and fuconazoe, have been reported
as effectve aternatve therapeutc agents for tnea capts. Of
these agents, traconazoe and terbnafne are used most
commony.
...................................
...............
235) Pt. with history of COPD the most action to prevent
complication is:
a. Pnemoccoccal vaccine
b. Smoking stop
c. Oral steroid
d. B2 agonist
The correct answer s b or a
...................................
...............
236) Pt. with congenital hip dislocation :
a. abducting at flexed hip can causes click or tali
Congenta hp dsocaton (CHD) occurs , more commony n grs than n
boys. The eft hp s twce as often nvoved as the rght and batera
dsocaton occurs n more than 25 percent of affected chdren. The crtera
for the dagnoss of congenta dsocaton of the hp ncude both physca and
radographc fndngs. Certan cnca sgns have been dentfed that are
hepfu n the evauaton of newborns and nfants for possbe CHD, whch
ncude the foowng:
mted abducton of the fexed hp, due to shortenng and contracton
of the hp adductors;
ncrease n depth or asymmetry of the nguna or thgh sknfods;
shortenng of one eg;
As' or Gaeazz's sgn -- ower poston of knee of the affected sde
when knees and hps are fexed, due to ocaton of femora head
posteror to acetabuum n ths poston;
Ortoan's "|erk" sgn ("cunk of entry" or reducton sgn);
Barow's test ("cunk of ext" or dsocaton sgn);
teescopng or pstonng acton of thghs, due to ack of contanment of
femora head wth acetabuum;
Trendeenburg's test -- drop of norma hp when chd, standng on both
feet, eevates unaffected mb and bears weght on affected sde, due
to weakness of hp abductors;
waddng type of gat.
There are characterstc radographc presentatons whch are present n each
of the stages of CHD. The term congenta hp dyspasa generay refers to
deayed or defectve deveopment of the hp |ont eadng to a deranged
artcuar reatonshp between an abnorma acetabuum and a deformed
proxma end of the femur. Ths condton s consdered a precursor of the
cnca enttes of subuxaton and dsocaton of the hp. In congenta
subuxaton of the hp, there s an abnorma reatonshp between the femora
head and acetabuum, but the two are n contact. Congenta dsocaton of
the hp, on the other hand, s assocated wth a compete oss of contact of
the femora head wth the acetabuar cartage. Unfortunatey, the femora
head and acetabuum n the newborn cannot be assessed by drect
vsuazaton, snce the femora head s not ossfed and s a cartagnous
body whch s not vsuazed on pan fms. The ossfcaton center for the
femora head generay appears between three and sx months; a deay n ts
appearance s an ndcaton of congenta hp dyspasa. The neck of the
femur s used for ascertanng the reatonshp between the acetabuum and
the femora head unt the ossfcaton center appears. The measurement
used to evauate the reatonshp of the femora head and acetabuum ncude
Hgenrener ne, acetabuar ndex, Perkn-Ombredanne ne, Shenton-Menard
ne, and Andren-von Rosen ne.
The prncpa treatment for CHD s conservatve, especay f dagnosed eary.
The most common technque s to reduce the dsocaton of the femora head
by means of a fexon/abducton maneuver, for a suffcent perod of tme to
permt proper growth of the head and acetabuum, whch n turn assures a
congruent and stabe hp |ont. Ths technque s usuay performed on
patents n the very eary stages of CHD and n nfants under two years of
age; whch ncude spntng, wth a Fre|ka spnt or Pavk harness. Coonna or
Buck's skn tracton s used n chdren 2 to 12 years of age, wth a we-
padded spca cast apped smutaneousy to the unaffected sde
237) Colon cancer with stage 3 give the chemotherapy:
a. As soon as possible
b. 1 month
The correct answer s a (I'm not sure because MCOs not
compete )
Treatment for Stage 3 Coon Cancer
Treatment for stage 3 coon cancer generay conssts of a surgca
resecton foowed by chemotherapy. In a surgca resecton, a
surgeon removes the part of the coon affected by the tumor and
|ons the remanng heathy sectons together to form one ong,
heathy pece.
The standard chemotherapy regmen used to be sx months of
treatment wth 5-FU and eucovorn, but that "cockta" was
deveoped decades ago and s sedom used anymore. there are
many new chemotherapy regmens avaabe for stage 3 coon
cancer.
...................................
...............
238) 56 y old present with vasomotor rhinitis
a. Local anti histamine
b. Local decongestion
c. Local steroid
d. Systemic antibiotic
The correct answer s b
Vasomotor rhnts s a nonaergc condton that causes a
constant runny nose, sneezng, and nasa congeston.

...................................
...............
239) Sickle Cell Anemia give prophlaxis:
a. Penicillin
b. lron
The correct answer s a
TREATMENT
@ Acute crisis: Anagesa and hydraton.
@ Hydroxyurea to the amount of feta hemogobn.
@ $. influen%ae and pneumococca vaccnes; prophyactc pencn
for
Chdren 5 years of age.
@ Acute chest syndrome: Respratory support and exchange
transfuson.
240) diagnosis of thalasimia minor:
a. Hb A2 and Hb f
b. Microcytosis
the correct answer s a
...................................
...............
241) Pt. with MCV decrease and reticulocyt decrease iron
deficiency anaemia investigation:
a. Ferritin level and TlBC and serum iron
...................................
...............
242) Born BCG
a. 1month hepatitis b oral polio dpt
b. 2month s
c. 3month s
d. 9 to 12 month mmr
77777 l can't understand th ( may the writer missed
some information )
243) E.histolytica cyst is destroyed by:
a. Freezing
b. Boiling
c. lodine treatment
d. Chlorine
The correct answer s b
Amebass (or amoebass) s the name of the nfecton caused by E.
hstoytca.
To hep prevent nfecton:
Avod raw vegetabes when n endemc areas as they may have been
fertzed
usng human feces.
Bo water or treat wth odne tabets
.......................................
.................
244) Patient after accident, the left ribcage move inward
during inspiration and outward during expiration:
a. Fa chest
Fa chest s a cnca anatomc dagnoss noted n bunt trauma
patents wth paradoxca or reverse moton of a chest wa
segment whe spontaneousy breathng. Ths cnca fndng
dsappears after ntubaton wth postve pressure ventaton,
whch occasonay resuts n a deayed dagnoss of the condton.
.......................................
.................
245) Greatest risk of stroke:
a. DM
b. Elevated blood pressure
c. Family history of stroke
d. Hyperlipedemia
e. Smooking
the correct answer s b
246) Child has pallor , eats little meat , by investigation
:microcytic hypochromic anemia . what will you do:
a. Trial of iron therary
b. Multivitamin with iron daily
the correct answer s a ( I'm not sure vecause O s not
compete )
.......................................
.................
247) Treatment of mania that does not cause hepatotoxicity
a. Lithium
b. carbamazepine
c. valporic acid
d. lamotrigine
The correct anser s a
Treatment of mood dsorder :
Lithium : hepatotoxcty
carbamezapine : agrnuocytoss
valporic asid : neura tube defect
.......................................
.................
248) Sickle cell anemia patient , the macula is cherry red ,
and absence of afferent papillary light reflex
a. Retinal artery occlusion.
. b. veine artery occlusion
the correct answer s a , cherry red spot s sgn of retna
atery occuson.

249) lnflammatory bowel disease is idiopathic but one of
following is possible underlying cause
a. lmmunological
lnflammatory Bowel Disease Causes
Researchers do not yet know what causes nfammatory bowe
dsease. Therefore, IBD s caed an dopathc dsease (dsease wth
an unknown cause).
An unknown factor/agent (or a combnaton of factors) trggers
the bodys mmune system to produce an nfammatory reacton n
the ntestna tract that contnues wthout contro. As a resut of the
nfammatory reacton, the ntestna wa s damaged eadng to
boody darrhea and abdomna pan.
.......................................
.................
250) Patient present with high blood pressure (systolic 200) ,
tachycardia , mydriasis , sweating . what is the toxicity:
a. Anticholenergic
b. Sympathomimetic
c. Tricyclic antidepressant
d. Organophosphorous compounds
the correct answer b
ses o! "ympathomimetics# To treat and pre!ent
re!ersible bronchospasm associated with bronchial and
nocturnal &nighttime' asthma, chronic bronchitis,emphysema,
exercise-included bronchospasm and other obstructi!e airway
disease of the lungs.
To treat serious allegoric reactions &epinephrine in(ection only'
251) Treatment of Chlamydia with pregnancy:
a. Azithromycin
b. Erythromycin base
the correct answer b
$or treatment o! chlamydia d%rin& pre&nancy, the CDC
recommends: -erythromycn base, 500
mg oray, four tmes a day for seven days; or amoxcn (Amox), 500
mg, three tmes a day for seven days.
Alternatives include:
-Erythromycn base 250 mg, four tmes a day for 14 days;
-erythromycn ethysuccnate 800 mg oray, four tmes a day for seven
days; or -erythromycn ethysuccnate 400 mg oray,
four tmes a day for 14 days.
.......................................
.................
252) the maximum body lenght will be reached after menarch
by
a -6 months
b. 1 year
A child 'ill have also reached her final adult height about two
years a!ter menarche .
.......................................
.................
253) Patient developed sudden loss of vision bilaterally while
she was walking in the street , followed by numbness , the
subjective symptoms are different from objective , and
does not match anatomical , what is your diagnosis:
a. Conversion syndrome
Converson dsorder:
Symptoms or defcts of vountary motor or sensory functon (e.g.,
bndness, sezure) suggest a condton ncompatbe wth medca
processes. Cose tempora reatonshp to stress or ntense
emoton. More common n young femaes and n ower
socoeconomc and ess educated groups.
.......................................
.................
254) After inflammatory phase of wound , there will be wound
healing by: a. lf the wound is
clean
b. Angiogenesis
c. Epithelial tissue
. the correct answer s b
255) Old male with tender knee , pain , crepitus . the
diagnosis:
a. Osteorhritis
b. Ankylosin spondylitis
c. Rheumatoid
the correct answer a
Osteorhritis
OARTHRlTlS (OA)
A chronc, nonnfammatory arthrts of movabe |onts (e.g., DIP
|onts).
Characterzed by deteroraton of the artcuar cartage and
osteophyte
formaton at |ont surfaces.
Rsk factors ncude a _ famy hstory, obesty, and a hstory of
|ont
trauma.
Hx/PE: Creptus; decrease range of moton (ROM); pan that
worsens wth actvty
and weght bearng but mproves wth rest.
.......................................
.................
256) Mother has baby with cleft palate and asks you what is
the chance of having a second baby with cleft palate or
cleft lip ,
a. 25%
b. 50%
c. %1
d. 4%
the correct answer s d
.......................................
.................-
257) 1 liter fluid deficit equals :
. a.1 kg
. Lter of fud defct equa 1 kg of fud as hydraton protoco
............
.........................................
.................
258) After accident patient with tachycardia, hypotension,
what will be your initial step:
a. Rapid lVF crystalloid
b. CT
not complete . management ABC then rapid lVF
crystalloid.
259) 6 years child was born to HBS positive mother is HBS
positive , he was only vaccinated by BCG after birth , what
you will give him now : a.
HBV + oral polio + DTP + hib
b. HBV + oral polio + dt + MMR +hib
c. HBV + oral polio + Dt + MMR
7777777777 all the above are wrong
.......................................
.................
260) Treatment of non inflammatory acne
a. Retinoic acid
Retinoids: Medcnes structuray smar to vtamn A are usefu
n preventng severa types of acne esons. Topca retnods are
effectve n treatng the nonnfammatory types of acne
(backheads and whteheads).
.......................................
.................
261) Treatment of comedones:
a. Topical retinoids.
Comedones: The pura of comedo, the prmary sgn of acne,
consstng of a dated (wdened) har foce fed wth keratn
squamae (skn debrs), bactera, and sebum (o). Comedones may
be cosed or open.
.......................................
.................
262) Treatment of papules or pustules:
a.Topical benzoyl
b.Peroxide plus topical antibiotics, mainly clindamycin or
erythromycin. c. ln severe cases,
intralesional steroid injection or oral antibiotics, such as
tetracycline or erythromycin may be added.
The correct answer b
TREATMENT
Mild acne: Topca cndamycn or erythromycn; benzoy
peroxde; topca
retnods.
Moderate acne: The above regmen pus oral antibiotics such
as tetracycne.
Severe nodulocystic acne: Ora isotretinoin (Accutane).
263) Which is not true ln emergency management of stroke
a.Give lVF to avoid D5 50%
b.Give diazepam in convulsions
. c.Anticonvulsants not needed in if seizures
d.-Must correct electrolytes
e. Treat elevated blood pressure
the correct answer s c
.......................................
.................
264) SCA complications in adults
a. Cerebral infarction
b. Cerebral hemorrhage
Ne%rolo&ical compcatons occur n 25% of patents, wth transent
schaemc attacks, fts, cerebra nfarcton, cerebra haemorrhage and coma.
Strokes occur n about
11% of patents under 20 years of age. The most common fndng s
obstructon of a dsta ntracrana nterna carotd artery or a proxma mdde
cerebra artery. 10% of chdren
wthout neuroogca sgns or symptoms have abnorma bood-fow veocty
ndcatve of cncay sgnfcant artera stenoss; such patents have very
hgh rsk of stroke. It has now been demonstrated that f chdren wth
stenotc crana artery esons, as demonstrated on transcrana Dopper
utrasonography, are mantaned on a reguar programme of transfuson that
s desgned to suppress erythropoess so that no more than 30% of the
crcuatng red ces are ther own, about 90% of strokes n such chdren
coud be prevented.
.......................................
.................
265) The most common risk for intracerebral stroke
a. Hypertension
266) The antidepressant used for secondary depression that
cause sexual dysfunction
a.Sertatline (SSRls)
b. lmapiramine
c. Levofluxine
the correct answer a
.......................................
.................
267) Previously healthy female patient presented to ER with
dysnea , anexiety , tremor , and she breath heavily , the
symptoms began 20 minutes before she came to ER , in the
hospital she developed numbness periorbital and in her
fingers , what you will do
a. Ask her to breath into a bag
. b. Take blood sample to look for alcohol toxicity
MCOs not compete
.......................................
.................
268) What is the most important in councling
a. Exclude physical illness
b. Establishing rabbot
c. Family
d. Schedule appointement
77777
269) ln breaking bad news
a. Find out how much the patient know
b. Find out how much the patient wants to know
the correct answer a
Robert Buckman's Six Step Protocol for Breaking Bad
News
). "etting started .
2. *inding out how much the patient knows.
+. *inding out how much the patient wants to know .
,. -haring the information .
.. /esponding to the patients feelings .
0. Planning and follow-through .
.......................................
................
270) Patient with chest pain that aggrevated by couphing,
there is added sound on left sternal border .in ecg you will
find
a. St changes
b. Pr prolongation
c. Hypervoltage
the correct answer a . (percardts)
.......................................
................
271) The most common site for visceral hemangioma is
a. Liver ( most common site for visceral hemangioma )
A hepatc hemangoma s the most common noncancerous tumor
of the ver. It s beeved to be a brth defect. Hepatc
hemangomas can occur at any tme, but are most common n
peope n ther 30s - 50s. Women are affected more often than
men, and usuay have bgger tumors than men. Babes may
deveop a type of hepatc hemangoma caed bengn nfante
hemangoendotheoma (aso caed mutnoduar hepatc
hemangomatoss). Ths rare, noncancerous tumor has been nked
to hgh rates of heart faure and death n nfants. Infants are
usuay dagnosed by the tme they are 6 months od.
272) Child with large periorbital hemangioma , if this
hemangioma cause obstruction to vision , when will be
permenant decrease in visual acuity
a. After obstruction by one day
b. By 1 week
c. By 3 months
d. By 6 months
777777777
.......................................
................
273) The symptoms of soft tissue sarcoma
a. Progressive enlarging mass ( on growing )
ln their early stages, soft tissue sarcomas usually do not
cause symptoms. Because soft tissue is relatively elastic,
tumors can grow rather large, pushing aside normal tissue,
before they are felt or cause any problems. The first
noticeable symptom is usually a painless lump or swelling.
As the tumor grows, it may cause other symptoms, such as
pain or soreness, as it presses against nearby nerves and
muscles. lf in the abdomen it can cause abdominal pains
commonly mistaken for menstrual cramps, indigestion, or
cause constipation
.......................................
................
274) 35 year female with bilateral breast pain , that decrease
after menstruation , the breast is nodular with prominent 3
cm mass subareolar , axillary lymph nodes are not enlarged
, what you will do
a. Mammography followed by US
b. See her next cycle
c. Fine needle biopsy followed by tissue studies
the correct answer s b
275) Pregnant with bleeding for 12 hours and tissue , the
cervix is 1 cm
a. Complete abortion
. b. lncomplete abortion
. c. Molar pregnancy
the correct answer s b
276) 2 month infant with vomiting after each meal , he is in
50 centile , He passed meconium early and stool , diagnosis
is
a. Midgut volvulus
b. Meconium ileus (not passing early meconium and
stool)
c. Hischsprung disease (not passing early meconium
and stool)
I thnk ths case s pyorc stenoss. If not menton choose a
.......................................
................
277) Patient with dysphagia to solid and liquid , and regurg ,
by barium there is non peristalsis dilatation of osophagus
and air-fluid level and tapering end.diagnosis is
a. Osophageal spasm
b. Achalasia
c. Osophageal cancer
the correct answer s b
.......................................
................
278) The most common cause of cough in adults is
a. Asthma
b. GERD
c. Postnasal drip
The correct answer c
The most common causes of acute cough s respratory vra
nfecton. The most common cause of chronc cough are postnasa
drp, asthma, and acd refux from the stomach. These three causes
are responsbe for up to 90 percent of a cases of chronc cough.
279) Girl with amenorrhea for many months . BMl is 20 and is
stable over last 5 years . diagnosis
a.Eating disorder
b.Pituitary adenoma
.......................................
................
280) Old female with itching of vulva , by examination there
is pale and thin vagina , no discharge . what is management
a. Estrogen cream
b. Corticosteroid cream
c. Fluconazole
the correct answer s a
Some women w opt for prescrpton medcatons as they go
through menopause. The most common prescrptons ncude:
1 -Hormone repacement therapy or ant-depressants to mnmze
hot fashes. 2 -Fosamax or Actone (non-hormona
medcatons) to reduce bone oss and reduce the rsk of fractures .
3 -Seectve estrogen receptor moduators (SERMs), whch mmc
estrogen's benefca effects on bone densty.
4-Vagna estrogen, admnstered ocay, to reeve vagna dryness
and dscomfort durng ntercourse
.......................................
................
281) Patient with dysuria , frequency , urgency , but no flank
pain , what is the treatment
a. Ciprofloxacin po od for 3-5 days
b. Norfocin po od for 7 - 14 days
the correct answer s b
282) Patient with flank pain , fever , vomiting , treatment is
a. Hospitalization and intravenous antibiotics and fluid
Ths s most key a case of pyeonephrts whch need urgent
hosptazaton
.......................................
................
283) Patient present with mid face pain , erethematous
lesions and vesicles on periorbital and forehead , the pain
is at nose , nose is erythematous . what is diagnosis
a. Roseola
. b. HSV
. c. Herpes zoster
the correct answer s c

.......................................
................
284) Male with itching in groin erythematous lesions and
some have clear centers , what is diagnosis :
a. Psoriasis
b. Tinea curis
c. Erythrasma
the correct answer s b
Patents wth tnea crurs report prurtus and rash n the gron. A
hstory of prevous epsodes of a smar probem usuay s ected.
Addtona hstorca nformaton n patents wth tnea crurs may
ncude recenty vstng a tropca cmate, wearng tght-fttng
cothes (ncudng bathng suts) for extended perods, sharng
cothng wth others, partcpatng n sports, or coexstng dabetes
metus or obesty. Prson nmates, members of the armed forces,
members of athetc teams, and peope who wear tght cothng
may be sub|ect to ndependent or addtona rsk for
dermatophytoss.Large patches of erythema wth centra cearng
are centered on the nguna creases and extend dstay down the
meda aspects of the thghs and proxmay to the ower abdomen
and pubc area.-
285) Vasoconstrictive nasal drops complication
a. Rebound phenomenon

.......................................
................
286) The useful excurcise for osteoarthritis in old age to
maintain muscle and bone Low resistance and high repetion
weight training:
a. Conditioning and low repetion weight training
b. Walking and weight exercise
the correct answer s b
Exercse s one of the best treatments for osteoarthrts. The
best exercses for osteoarthrts suffers depend on what |onts
are affected. Swmmng, wakng, and cycng are often the best
exercses for peope wth osteoarthrts. Try to get thrty
mnutes of exercse fve tmes per week. The key s to start
sowy.
.......................................
................
287) Unilateral worsening headach , nausea , excacerbeted by
movement and aggrevated by light in 17 old girl.
a. Migraine (Photophobia, vomiting)
b. Cluster
the correct answer s a
288) Diet supplement for osteoarthritis
a. Ginger
A arge number of detary suppements are promoted to patents
wth osteoarthrts and as many as one thrd of those patents have
used a suppement to treat ther condton. Gucosamne-contanng
suppements are among the most commony used products for
osteoarthrts. Athough the evdence s not entrey consstent,
most research suggests that gucosamne sufate can mprove
symptoms of pan reated to osteoarthrts, as we as sow dsease
progresson n patents wth osteoarthrts of the knee. Chondrotn
sufate aso appears to reduce osteoarthrts symptoms and s often
combned wth gucosamne, but there s no reabe evdence that
the combnaton s more effectve than ether agent aone. S-
adenosymethonne may reduce pan but hgh costs and product
quaty ssues mt ts use. Severa other suppements are
promoted for treatng osteoarthrts, such as
methysufonymethane, Harpagophytum procumbens (dev's
caw), Curcuma onga (turmerc), and Zingiber officinale
(ginger), but there s nsuffcent reabe evdence regardng ong-
term safety or effectveness.
.......................................
...............
289) Old male with abdominal pain , nausea , WBC 7. What is
true about appendicitis in elderly7
a. Ct not usefull for diagnosis.
b. WBC is often normal.
c. Rupture is common
d. lf there is no fever the diagnosis of appendicitis is
unlikely e. Anemia is
common
the correct answer s c
Appendicitis in eIderIy
ppendicitis is a less common cause of abdominal pain in elderly patients than in younger patients, but
the incidence among elderly patients appears to be rising. !nly approximately "#$ of cases of acute
appendicitis occur in patients older than %# years, whereas one half of all deaths from appendicitis
occur in this age group. &he rate of perforation in elderly patients is approximately '#$, ' times higher
than in younger adults. &his is largely because ('$ of elderly patients wait more than )* hours to
see+ medical attention. &he diagnosis can be difficult to ma+e, since more than one half of patients in
this age group do not present with fever or leu+ocytosis. ,urther confusing the picture, approximately
one third do not locali-e pain to the right lower .uadrant, and one fourth do not have appreciable right
lower .uadrant tenderness. !nly )#$ of elderly patients present with anorexia, fever, right lower
.uadrant pain, and leu+ocytosis. &he initial diagnosis is incorrect in *#/'#$ of patients in this age
range . 0 perforation is the most common compIication of appendicitis )

290) Old patient with bilateral enlarged knee , no history of
trauma , no tenderness , normal ESR and C-reactive
proteins . the diagnosis is
a. Osteoarthritis
b. Gout
c. lnfectous arthritis
the correct answer s a ( I'm not sure )
.......................................
...............
291) Patient has decrease visual acuity bilateral , but more in
rt side , visual field is not affected , in fundus there is
irregular pigmentations and early cataract formation .
a. Refer to ophthalmologist for laser therapy
b. Refer to ophthalmologist for cataract surgery
??????????
the correct answer s a
.......................................
...............
292) What is the most common treatment for juvenile
rheumatoid arthritis
a. lntraarticular injection of steroid
b. Oral steroid
c. Paracetamol
d. penicillamine
e. Asprin
the correct answer s e
the most common mportant for |RA s ( NSAID )

.......................................
..............
293) Which of the following decrease mortality after Ml
a. Metoprolol
b. Nitroglycerine
c. Thiazide
d. Morphine
the correct answer s a
ony b-bocker ans ASA are mortaty beneft for treatment of
angna
294) The cardiac arrest in children is uncommon but if occur it
will be due to
a. Primary
b. Respiratory arrest
c. hypovolemic shock
d. neurogenic shock
the correct answer s b
Progressve respratory nsuffcency accounts for 60% of
a paedatrc arrests.
.......................................
...............
295) Old female with recurrent fracture , Vitamen D
insufeciency and smoker . which exogenous factor has the
gretest exogenous side effect on osteoporosis.
a. Old age
b. Smoking
c. . Vit D insufeciency
d. Continue smoking
e. Recurrent fracture
the correct answer s b
.......................................
...............
296) patient presented with sudden chest pain and dysnea ,
tactile vocal fremitus and chest movemebt is decreased , by
x-ray there is decreased pulmonary marking in left side ,
diagnosis
a. atelectasis of left lung
b. spontaneous pneumothorax
c. pulmonary embolism
7777777777
297) boy after running for hours , has pain in knee and mass
on upper surface of tibia
a. Osgood scatter disease
b. lliotibial band
the correct answer s a
.......................................
...............
298) pancreatitis
a. Amylase is slowly rising but remain for days
b. Amylase is more specific but less sensitive than
lipase
c. Ranson criteria has severity (predictive) in acute
pancreatitis
d. Pain is increased by sitting and relieved by lying
down
e. Contraceptive pills is associated
the correct answer s c
The Ranson and Glasgow scoring systems are based on such
parameters and have been shown to have an 80% senstvty for
predctng a severe attack, athough ony after 48 hours foowng
presentaton.
risk mortality is 20% with 3-4 signs, 40% with 5-6 signs,
100% 7 signs.
299) Patient has fever , night sweating , bloody sputum ,
weight loss , ppd test was positive . x-ray show infiltrate in
apex of lung , ppd test is now reactionary , diagnosis
a. Activation of primary TB
b. sarcoidosis
c. Case control is
d. Backward study
the correct answer s a
The tubercuoss skn test (aso known as the tubercun test or
PPD test) s a test used to determne f someone has deveoped
an mmune response to the bacterum that causes tubercuoss
(TB).
.......................................
...................
300) patient with DM presented with limited or decreased
range of movement passive and active of all directions of
shoulder
a. frozen shoulder
b. impingment syndrome
c. osteoarthritis
the correct answer s a
.......................................
...................
301) 48 years old with irregular menses presented with
fatigue and no menstruation for 3 months with increased
pigmentation around the vaginal area with no other
symptoms. ur next step would be
a. reassure the patient
b. do a pregnancy test
c. do ultrasound
the correct answer b
302) 3 years old presented with shortness of breath and
cough at night which resolved by itself in 2 days. he has Hx
of rash on his hands and allergic rhinitis. he most likely had
a. croup
b. bronchial asthama
c. epilotitis
????????

1roup 2piglottitis
!nset Days 3ours
,lu/li+e symptoms 4es 5o
1ough 6ever bsent
ble to drin+ 4es 5o
Drooling saliva 5o 4es
,ever 789 :89
6tridor 3arsh 6oft
;oice 3oarse muffed
.......................................
................
303) a man went on vacation. he noticed a white patch in his
chest which became more clear after getting a sun tan
which was spread on his chest.ur Dx is
a . pytriasis versicolor
b. vitilligo
c. pytriasis roscea
the correct answer a
.......................................
...................304) a 4 years old presented
with 2 day history of shortness of breath a seal like cough with
no sputum and mild fever. on examination he did not look l'll
or in distress
a. acute epilossitis
b. croup
c. angioedema
The correct answer b
304)65 years old came with knee pain. and limited movement.
on examination had crepition on knee. dx
a. rhuematiod arthritis
b. osteoporosis
c. osteoarthritis
the correct answer c
.......................................
...................
305) which vitamin is given to new born to stop bleeding
a. vit. A
b. vit. D
c. vit. K
d. vit E
e. vit C
the correct answer c
.......................................
...................
306) a child came with congested throught and mild bulging of
tympanic membrane ur Dx was URTl. The
777777777

.......................................
...................
307) a child presented with erythematous pharynx, with
cervical lymph nodes and rapid strplysin test negative and
low grade fever with positive EBV. it next step
a. give antibiotics and anti pyretic
b. give anti pyretic and fluids
d. culture and sensitivity
the correct answer a
.......................................
...................
308) child with low grade fever and congested throat, negative
ASO and positive EBV. he has
a. infectous mononucleosis
b. URTl
the correct answer s a
.......................................
...................
309) the most common cause of intracerebral or
intraparynchimal bleeding is.
a. Hypertensive angiopathy
b. annurysm
c. AV malformation
the correct answer s a
310) young adult Sickle cell patients are commonly affected
with
a. dementia
b. multiple cerebral infarcts
the correct answer b
.......................................
...................
311) 80 years old living in nursing home for the last 3 months.
his wife died 6 months ago and he had a cornary artery
disease in the last month. he is now forgetful especially of
short term memory and decrease eye contact with and loss
of interest. dx
a. alzihiemer
b. depression
c. hypothyroidism
the correct answer a , I thnk O s not compete
.......................................
...................
312) thyroid cancer can be from
a. hypothyroidism
b. graves disease
c. toxic nodule
777777777
.......................................
...................
313) a mother came with her son who is 7 years old very active
never sitting in class and with poor concentration. ur
management would be.
a. olanzipine
b. amitilyne
c. aloxane
the correct answer s b ( I'm not sure )
ths case s "attention -deficit hyperactivity disorder"
treatment:
1- Methyphendate
2- Dextroamphetamne
3- Adera
4- Atomoxetne
5- Pemone
6- Antdepressant ( SSRI )
314) from the graph above which of the following statement is
true
a. osteoprosis affecting majority of women above 80
b. 20% of women under 70 are affected
777777777
.......................................
...................
315) a patient presented with progressive weakness on
swollowibg with diplopia and fatigability. the most likely
underlying cause of her disease is.
a. antibody against acetylcholine receptors
.......................................
...................
316) an 69 year old non diabetic. with mild hypertension and
no hx of Coronary heart desease. the best drug in
treatment is.
a. thiazides
b. ACEl
c. ARB
d. CCB
the correct answer a
.......................................
...................
317) which of the following anti hypertensive is
contraindicated for an uncontrolled diabetic patient
a. hydrochlorothiazide
b. Losartan
c. hydralszine
d. spironolactone
the correct answer s a
-sde effect of thazde : hypergycema
.......................................
...................
318) a wound stays in it's primary inflammation untill
a. Escher formation
b. epitheliazation
c. after 24 hours
d. wound cleaning
the correct answer d
.......................................
...................
319) 70 years old male patient with mild urinary dripping and
hesitency ur Dx is mild BPH. ur next step in management is
a. transurethral retrograde prostatectomy
b. start on medication
c. open prostatectomy
the correct answer b
320) most common cause of secondary HTN is
a. Renal disease - Renal parenchymal disease
.......................................
...................
321) one of the following food is known to reduce cancer
a. fibers
.......................................
...................
322) smoking is a definitive risk of
a. sq.c.ca of bladder
b. liver
c. breast
the correct answer s a

.......................................
...................
323) exercise recommended for patients with CAD. is
a. isometric
b. isotonic
c. yoga

.......................................
...................
324)what is the definitive treatment of frostbites
a, Rewarming
.......................................
...................
325) the most common cause of failure to thrive in pediatric is
a. malnutrition
.......................................
...................
326) which of the following causes the highest maternal
mortality in pregnancy
a. toxoplasma
b. hyperbilirubenia
c. 7777

" The ma|or causes of materna death are bactera nfecton,
varants of gestatona hypertenson ncudng pre-ecampsa and
HELLP syndrome, obstetrca hemorrhage, ectopc pregnancy,
puerpera sepss (chdbed fever),
327) Ttt of frostbite
a. lmmersion in water 40-45 C
b. Debridement
c. Leave it at room tepmrature
The correct answer s a
.......................................
...................
328) Case about a child both RBS, FBS are elevated so he has
DM1.what's the type of HLA
a.DR3
b.DR4
c.DR5
d.DR6
e.DR7
the correct answer s a
Types of HLA :
DR2 : Good's pasture syndrome & mutpe myeoma
DR3 : D.M , SLE , & grave's dsease
DR27 : ankyosng spondyats & reter's syndrome
B51 : behceat's dsease
D11 : hashmot's dsease
...
.......................................
................
329) Definition of PPV 7
Predictive positive value ( PPV ) : proportion of people with a
positive test who have s a disease : a} (a+b)
.......................................
...................
330) What's the most common case in PHC centers
a.UTl
b.HTN
c. Coryza
the correct answer s c
331) all of the following will decrease pt compliance except:
a. involve pt in the plan
b. make simplified regimen
c. give easy written instructions
d. make appointments flexible
e. warn the patient about the danger of missing a pill
the correct answer s e
.......................................
...................
332) Case about old diabetic patient who still have
hyperglycemia despite increase insulin dose.the problem with
insulin in obese patients is
a. Post receptor resistance
?????? O NOT COMPLETE
.......................................
..................
333) Case about a child with drooling, fever, barking cough in
sitting position, dx:
a. Croup
b. Broncholities
c. Pneumonia
The correct answer s a
.......................................
...................
334) Mother came to you after her son had hematoma under
the nail dt injury:
a. Send home with a pad on the head
b. Send home with acetaminophen
c. Do wedge resection
d. Evacuate the hematoma
The correct answer s d
Ths case s ( subungua hematoma )
335) What vaccine u'll give to a SCD ( sickle cell disease ) child
a.HBV
b. H.influenza
c. pneumococcal
d. both A and B
e. all of the above
the correct answer s c
.......................................
...................
336) a mother with HBsAg positive came with her child 6 yrs
old who has HBsAg +ve what will you give him:
a. oral polio, DTP, MMR
the correct answer s a
other choces a had HBV vaccne whch u' not gve
.......................................
...................
337) Patient wil LL pain, vomiting, fever, high WBC (17.000),
tenderness and rebound tenderness
a. Diverticulitis
b. Sigmoid volvulus
c. Appendicitis
d. Toxic enteritis
The correct answer s a

.......................................
...................
338) What's the organism responsible for psuedomembranous
colitis:
a. Pseudomonas
b. Colisteridum
c. E.coli
d. Enterococcus fecalis
The correct answer s b
339) Mother came with her child who had botillism, what you
will advice her:
a. Never eat canned food again
b. Store canned food at home
c. Boil canned food for 40-50 min
d. Check expiry date of canned food
The correct answer s d
.......................................
...................
340) Old pt presented with abdominal pain, back pain,
pulsatile abdomen what's the step to confirm dx: this is a case
of aortic aneurysm
a. Abdominal US
b. Abdominal CT
c. Abdominal MRl
The correct answer s a b
-nta nvestgaton US - CONFIRM by CT

.......................................
...................
341) 18 months old came with bite by her brother, what you
will do:
a. Give augminten
b. Give titunus toxoid
c. Suture
O not compete
.......................................
...................
342) 19 yrs old after bike accident, he cant bring the spoon
infront of himself to eat, lesion is in:
a. Temporal lobe
b. Cerebellum
c. Parietal lobe
d. Occipital lobe
The correct answer s b
343) How to dx DVT:
a. Contrast venography
b. Duplex US
The correct answer s b
.......................................
...................
344) Pt came after RTA, GCS 14, near complete amputation of
the arm, 1
st
step:
a. Secure air way
b. Tourniquet on the arm
The correct answer s a
.......................................
...................
345) Pt with hx of prolonged heavey bleeding 2 hrs post
partum, you will give:
a. Ringers lactate
b. NS
c. NS+ packed erythrocytes
The correct answer s c ( O NOT COMPLETE )
.......................................
...................
346) What is special about placenta abruption:
a. Abnormal uterine contractions
b. PV bleeding
c. Fetal distress
The correct answer s b , PA : dark , panfu vagna beedng and
compcaton s feta hypoxa
.......................................
...................
347) Pt 34 wks, hx of PV bleeding for many hrs, dark blood,
abdominal tenderness, FHR 120, uterine contractions every 3
min, Dx:
a. Abruption placenta
348) One of the steps in managing epistaxis:
a. Packing the nose
b. Press the fleshy parts of nostrils
c. Put patient of lateral lying position
The correct answer s b
.......................................
...................
349) Pt with hx of diarrhea, abdominal pain, agitation,
headache, dizziness, weakness, pulstile thyroid, unsteady gate.
Examination was normal. Dx:
a. Hypochondriasis
b. Somatization disorder
c. Thyroid Ca
d. Anxiety
The correct answer s b
.......................................
...................
350) Child with headache that increase by changing head
postion, unilateral, photophobia
a. Sinus headache
b. Migraine
c. Cluster headache
d. Tension headache
The correct answer s b
.......................................
...................
351) Ttt of isolated fracture of femur (repeated) 777
.......................................
..................
352) Younge pt with pain in LL after running 3 kgs, more at
night, swelling, XR was NL
a. Stress fracture
353) HTN pt, with decrease vision, fundal exam showed
increase cupping of optic disc dx:
a. Open angle glaucoma
b. Closed angle glaucoma
c. Cataract
d. HTN changes
The correct answer s a ( I'm not sure )
.......................................
...................
354) Pt with unilateral red eye, tearing, clear tears no
swelling or discharge:
a. Give topical antihistamin
b. Give topical AB
c. Give systemic AB
d. Reassurance
The correct answer s d
.......................................
...................
355) Business man went to Pakistan, came with bloody
diarrhea, stool examination showed trophozoite with RBC
inclusion, Dx:
a. Amebic desyntry (entamoeba histlolytica )
.......................................
...................
356) 5 yrs old child with abdominal pain after 2 wks of URTl,
HB 8, retics 12% WBC NL peripheral blood smear showed target
cells, RBC inclusions dx:
a. SCA (the only hemolytic anemia in the answers)
77777
.......................................
...................
357) Child had hb electrophoresis showed hb 2%
a. HBA 40 HBS 35 HBF 5 HBA2
b. Sickle cell trait
c. Thalacemia major
d. Minor
77777
358) Younge pt with hx of cough, chest pain, fever CXR
showed RT lower lobe infiltrate:
a. Amoxicillin
b. Ceferuxim
c. Emipenim
d. Ciprofloxacin
777777
The correct answer s d (I'm not sure )
.......................................
...................
359) Best thing to reduce mortality rate in COPD:
a. Home O2 therapy
b. Enalipril
c. Stop smoking
The correct answer s c
.......................................
...................
360) Drug that will delay need of surgery in AR:
a. digoxin
b. verapamil
c. nefidipin
d. enalpril
the correct answer s c
.......................................
...................
361) Child with skin rash, pericarditis, arthritis dx:
Kawasaki
.......................................
...................
362) Pic of skin with purple flat topped polygonal papules, dx:
a. Lichen plannus
.......................................
...................
363) Child with atopic dermatitis, what you will give other
than cortisone
a. There were many drugs, steroids and AB and only one
strange name maybe moisturizer. That's the answer
364) A man had increase shoe size and jaw, the responsible is:
a. ACTH
b. Somato77
c. TSH
d. Cortisone
The correct answer s b
.......................................
...................
365) The best advice to patient travelling is:
a. Boiled water
b. lce
c. Water
d. Salad and under cooked sea shells
The correct answer s a
.......................................
...................
366) Seldinfil is contraindicated with:
a. Nitrate
b. Methyldopa
c. Gabapentine
The correct answer s a
.......................................
...................
367) Pt with TB, had ocular toxicity symptoms, the drug
responsible is:
a. lNH
b. Ethambutol
c. Rifampicin
d. Streptomycin
The correct answer s b
lNH : perphera neurts and hepatts . so add ( B6 )
Ethambutol : optc neurts
Rifampicine : body fud organe
368) Another pt treated for TB started to develop numbness,
the vit deficient is:
a. Thiamin
b. Niacin
c. Pyridoxine
d. Vit C
THE correct answer s c

.......................................
...................
369) Pt with bilateral breast disease, dx:
a. Paget
b. Papilloma
c. Meduallary
d. Lobular
.......................................
...................
370) Child fell on her elbow and had abrasion, now swelling is
more, tenderness, redness, swelling is demarcated (they gave
dimensions) child has fever. Dx:
a. Gonoccal arthritis
b. Synovitis
c. Cellulitis of elbow
The correct answer s c
.......................................
...................
371) About burn
a. You will give 1\2 fluid in the 1
st
8 hrs
b. 1\4 in the 1
st
8 hrs
The correct answer s a
Parkland formula : fud n frst 24 hours = 4 * wt. n kg * % BSA
50% n frst 8 hours and another n next 16 hours
372) You r supposed to keep a child NPO he's 25 kgs, how
much you will give:
a. 1300
b. 1400
c. 1500
d. 1600
The correct answer s d
For the first 10 kg of weight, a chd needs 100 mL per kg of
weght.
For the next 10 kg of weight (11-20 kg), a chd ony needs 50 mL
per kg of weght.
for anything over 20 kg (21 kg of weight and higher), the chd
ony needs 20 mL per kg of weght.
Take a 35 kg chd, for exampe. He needs 1000 mL for hs frst 10 kg of
weght (10 kg x 100 mL), 500 mL for hs second 10 kg of weght (10 kg
x 50 mL), and 20 mL/kg for any weght above 20 kg (15 kg x 20 mL). A
35 kg chd, therefore, needs approxmatey 1800mL of water or free
quds.
.......................................
...................
373) Young patient with pharyngitis, inflammation of oral
mucosa and lips that has whitish cover and erythmatous base,
febrile, splenomegaly. Dx: (this is infectious mono)
a. Scarlet fever
b. EBV
c. HZV
The correct answer s b
.......................................
...................
374) Female with greenish vaginal discharge, red cervix. Dx:
Trchimoniosis
.......................................
...................
375) Another female with malodorous discharge and pain
maybe. Dx:
Bacterial vaginosis
.......................................
...................
376) The best way to reduce the weight in children is:
a. stop fat intake
b. Decrease calories intake
c. Drink a lot of water
The correct answer s b
377) You have to advice a teenager that mainly eats fast food
to take:
a. Folic acid and Ca
b. Vit C and Ca
c. Ca alone
The correct answer s c ( I'm not sure )
.......................................
...................
378) Patient has symptoms of infection, desquamation of
hands and feet, BP 170\110 dx:
a. Syphilis
b. Toxic shock syndrome
c. Scarlet fever
The correct answer s b
Toxic shock syndrome :
Caused by S.aureus , often wth 5 days of onset of menestra
perod n women who have used tampons. Feature: abrupt fever
( 39 c or more ), vomtng, dffuse macuar erythematous rash,
desquamaton especay n pams and soes, nonpuruent
con|unctvts. Diagnosis : bood cuture are -ve .so, dagnoss by
cnca. Treatment : 1
st
step rehydraton and antbotc
.......................................
...................
379) Snellin chart, if patient can read up to line 3, how much
is his vision loss :
O not compete:
but ths pt. see etters at 20 feet , where norma person see t at 70
feet.

380) l cant remember the case but gram +ve cocci were
isolated, dx is sterpt bcz it was the only gm +ve cocci.
.......................................
...................
381) Diabetic mother asking about risk of diabetes related
congenital defect. lt will be in:
a. 1
st
trimester
b. 2
nd
trimester
c. 3
rd
The correct answer s a (I'm not sure )
.......................................
...................
382) lf diabetic mother blood sugar is always high despite of
insulin, neonate complication will mostly be:
a. Maternal hyperglycemia
b. Maternal hypoglycemia
c. Neonatal hypoglycemia
d. Neonatal hyperglycemia
The correct answer s c
.......................................
...................
383) Obssive neurosis patients will have:
a. Major depression
b. Lake of insight
c. Schizophrenia
The correct answer s a
.......................................
...................
384) Before giving bipolar patient lithium you will do all of the
following except:
a. TFT
b. LFT
c. RFT
d. Pregnancy test
The correct answer s b
385) Patient came with PV small bleeding (she fell down and
felt decrease in fetal movement but on examination baby was
ok) all her 3 previous pregnancies were normal, you will do:
a. lmmediate CS
b. Careful observation of the bleeding
c. Medication (strange name)
d. Mg sulphate
O not compete , depend on date of gestaton.
.......................................
...................
386) Pt came to you missing her period for 7 wks, she had
minimal bleeding and abdominal pain, +ve home pregnancy
test, 1
st
thing to order is:
a. BHCG
b. US
c. Drugs maybe
The correct answer s a
.......................................
...................
387) Patient came to you and you suspect pre eclampisa,
which of the following will make it most likely:
a. Elevated blood pressure
b. Decrease fetal movement
c. 77
The correct answer s a
.......................................
...................
388) Old patient male, hematuria, passing red clots and RT
testicular pain:
a. Testicular Ca
b. RCC ( renal cell carcinoma )
c. Cystitis
The correct answer s b
389) to get more information from the pt
a. open end question
( avod eadng queston to get more nformaton )
.......................................
...................
390) gingivits most likely cause
a.HSV
( q not compete but : The most common cause of gngvts s poor
ora hygene that encourages paque to form.)
.......................................
...................
391) watery discharge from eye , conjunctivitis treated by
a. topical corticosteroid
(Its symptoms ncude watery dscharge and varabe tch. The
nfecton usuay begns wth one eye, but may spread easy to the
other
Ttt: cod compresses
|
and artfca tears)
.......................................
...................
392) blow out fracture eyelid swelling , redness other syptoms
a. present air fluid level
b. enopthalmos
The correct answer s b
ts enophaoms , other name of bow out orbta foor fracture
.......................................
...................
393) drinking of dirty water causes
a. heptitis A
b. B
c. C
d. D
The correct answer s a
.......................................
...................
394) giemsa stained blood film
a. malaria

395) regarding peritonitis
a.Complicated appendectomy the cause is anerobe
organism
b. rigidity and the cause is paralytic ileus
c. can be caused by chemical erosions.
The correct answer s c
.......................................
...................
396) fraucture of humerus associated with
a. radial N injury
b. median nerve injury
the correct answer s a ( rada groove )
.......................................
...................
397) there is case i cant remember they asked about diagnosis
of acute lymphocytic leukemia ALL
The tota number of whte bood ces may be decreased, norma, or
ncreased, but the number of red bood ces and pateets s amost
aways decreased. In addton, very mmature whte bood ces
(basts) are present n bood sampes examned under a
mcroscope.
A bone marrow bopsys amost aways done to confrm the
dagnoss and to dstngush ALL from other types of eukema
.......................................
...................
398) diagnosis of hemochromatosis
a. serum ferritin7!
Hemochromatoss s suggested by a persstenty eevated
transferrn saturaton n the absence of other causes of ron
overoad. It s the nta test of choce .
Ferrtn concentraton can be hgh n other condtons, such as
nfectons, nfammatons, and ver dsease .
Ferrtn eves are ess senstve than transferrn saturaton n
screenng tests for hemochromatoss .
399) kawasaki disease associated with
a.strawberry tongue
Kawasaki disease
Mutsystem acute vascuts that prmary affected young
chdren. Fever pus four or more of the foowng crtera for
dagnoss:
1-fever > 40 C for at east fve days
2-batera, nonexudatve, paness con|unctvts
3-poymorphous rash ( prmary trunca )
4-cervca ymphadenopathy ( often panfu and unatera )
5- dffuse mucous membrane erythema ( strawberry
tongue ) , dry red
6- erythema of pam and soe
7- other mandfestaton : gabadder hydrops, hepatts, arthrts
Untreated Kawasak dease can ead to coronary aneurysms and
even MI
Treatment :
1-hgh dos ASA ( for fever and nfammaton) & IVIG ( to prevent
aneurrysma )
2-referra to pedatrc cardoogst
.......................................
...................
400) most common tumor in children
a.ALL
b. rabdomyosarcoma
c. wilm's tumor

the correct answer s a
-ALL : most common chdhood tumor
-rabdomyosarcoma : most common soft tssue tumor
-wilm's tumor: most common ntra- abdomna chdhood tuomr
.......................................
...................
401) Most common intra- abdominal tumor in children:
a.wilm's tumor
b. lymphoma

the correct answer s a
the most common ntra-abdomna tumor n chdren are
neruobastoma and wm's tumor.
402) pt c}o of hypopigmentful skin , nerve thicking diagnosis
a.leprosy
Leprosy : chronc granuomatous nfecton caused by
Mycobacterum eprae, acd-fast bacus preferentay affectng cooer
regons of body ( e.g skn , mucousmembrane, perphera nerve) .
dagnoss by skn eson ( hypopgmentaton or hyperpgmentaton
macue ) and enarge nerves eth sensory oss.
.......................................
...................
403) regrading COPD to reduce complication we should give
a. theophyline
b. pneumococcal vaccine
c. smoking cessaton.
The correcr answer s c
.......................................
...................
404) pseud-gout its
a. CACO3
b. CACL3
The correct answer s a
Gout : deposton of ( MSUM ) monosodum urate monohydrate -ve
of brefrngent , neede shape,
Psudogout : deposton of ( cppd ) cacum pyrophosphates
dehydrate crysta , +ve brefrngent , rhombod shape, ( CACO3)
.
405) man with history of alcohol assocation with
a. high MCV
b. folic acid deficiency
c. B12 deficieny
e. hepatitis
The correct answer s b
.......................................
...................
406) neanate 9 days on breast feed develop jandice
a. breast feed jaundice
b. pathological jaundice
c. physiological jaundice
the correct answer s a
1-pathological jaundice : con|ugated ( drect ) brubn, start n 1
st

24 hours, brubne > 15 mg / d , persstent 1 week n term nfant and
2 weeks n preterm nfant
2-physilogical jaundice: uncon|ugated ( ndrect ) brubne , start n
2- 3 days, brubne < 15 mg/d , persstent 1 week n term nfant and
2 weeks n preterm nfant.
3-breast feeding jaundice : uncon|ucated ( ndrect ) brubne ,
start n 7 days of fe , persstent to one or more months.
.......................................
...................
407) lady c}o headche bandlike pain
a. tension headache
.......................................
...................
408) regarding breast screening
a. self breast examination early detection of tumor
b. mammogram not advise before 35 y
777777
.......................................
...................
409) 19 yrs old c}o abdo pain within menestration for last 6
years diagnosis
a. primary dysmenorrhea
b. secondary dysmenorrheal
The correct answer s a
Prmary dysmenorrhea :
Onset wthn 6 months after menarche . Lower abdomna/pevc
pan begns wth onset of menses and asts 8-72 hours
410) bilateral breast mass diagnosis
a. ductal carcinoma
b. pagets disease
t coud be Intraducta papoma ??????
.......................................
...................
411) beriberi cause of deficiency
a. VlT B1
b. VlT B2
c. VlT B3
The correct answer s a
.......................................
...................
412) chronic uses of estrogen association 77777
.......................................
...................
413) Asystole
a. adrenalin
b. atropine
The correct answer s
asysto has ony 3 durgs epnephrne-vasopressne-atropn
.......................................
...................
414) pt has diarrhea , dermatitis and dementia diagnosis
a. peagra
.......................................
...................
415) regarding injectable progestron
a . an cause skin prob 7!!
In|ected progesterone ( medroxy-progestrone ) : advantages : ght
or no perods, safe wth breastfeedng, IM n|ecton every 3 months.
Dsadvantages: rreguar beedng, wt. gan, decrease bone mnera
densty ( reversbe ) , deay fertty dscontnue .
.......................................
...................
416) sencodary prevention is
a. coronary bypass gaft
Secondary preventon generay conssts of the dentfcaton and
nterdcton of dseases that are present n the body, but that have
not progressed to the pont of causng sgns, symptoms, and dys-
functon
417) 22 yrs old c}o insomina} sleep disturb treatment
a. SSRl
Short hstory ,
But the nta management of nsomna : good seep hygene .
.......................................
...................
418) celluitis in children most commin causes
a. group A steptoccus
In chdren, the most common cause of ceuts s - aureus or
group A streptococcus.

.......................................
...................
419) antideprssants associated with hypertensive crisis
treatment
a. SSRl
b. MOAls
c. TCAs
the correct answer s b
esp hydraznes ( phenezne )
.......................................
...................
420) pt his MBl = 24 kg he is
a. noramal weight
b. over weight
c. morbid weight
d. mild weight
The correct answer s a
.......................................
...................
421) baby c}o fever , chills , rigors and head rigidity +ve
kurnings sign rash on his lower limb diagnosis :
- meningoccal meninigits
7777777
.......................................
...................
422) 48 yrs pt with abdo pain , neusea, vominting tenderness in
right hypochondrial
- acute cholecysitis
Fever 7!
423) 29 pt c}o dysurea his microscopic showed G -ve organism is
a. legonealla
b. E. coli
the correct answer s b
.......................................
...................
424) 30 yrs pt c}o feeling heaviness in the lower abdomen
having pulge papable at the top scrotum that was
reducible and icreasing in valsalva maneuver diagnosis
a. hydrocele
b. variocele
c. indirect inguinal hernia
d. direct inginal hernia
The correct answer s c
.......................................
...................
425) anticoagulation prescrib for
a. one month
b. 6 months
c. 6 weeks
d. one year
The correct amswer s b
.......................................
...................
426) cushing syndrome best single test to confirm
a. palsma cortison
b. ATCH
c. Dexamethasone Suppression Test
The correct answer s c
.......................................
...................
427) 23 yrs old history of URTl then he developed ecchomysis
best treated
a. local AB
b. local antiviral
c. steroid
The correct answer s c
428) chronic psycotic disorder manged by
a. haoperdo
.......................................
...................
429) 29 yrs old lady B-HSG 160 c}o vomiting , abdomenal pain
which is more accurate to diagnosis
a. BHCG serial
b. pelvic US
c. laprascopy
O not compete, but may be ths case s moar and chooce s a .
.......................................
...................
430) 70 yrs old man c}o fever , vesicular rash over forehead
mangement
a. lV AB
b. lV antiviral
c. Acyclovir
the correct answer s c ( "m npt sure )
.......................................
...................
431) celiac disease involves :
a. proximal part of small intestin
b. distal part of small intestin
c. proximal part of large intesin
d. distal part of large intensin
The correct answer s a
.......................................
...................
432) 6 yes old pt cyanosis past history of similar attack 6 month
ago u will do for him
a. CxR
b. PFT
c. secure airway
d. CBC
O s not cear or not compete , f pt. came wth fe threatenng
cyanoss don't waste tme wth nvestgaton and start wth ABC
( scure arway ) , but f pt. came wth past hstory cyanoss choose
b .

433) side affect of diazepam
Sedaton , depence, respratory supresson , anterograde amnesa ,
confuson (especay pronounced n hgher doses) and sedaton
.......................................
...................
434) endemic means:
Endemic :is the constant presence of a disease or infectious agent in a certain
geographic area or population group. ( usually rate of disease )
Epidemic : is the rapid spread of a disease in a specific area or among a
certain population group. ( excessive rate of disease )
Pandemic : is a worldwide epidemic; an epidemic occurring over a wide
geographic area and affecting a large number of people.
.......................................
...................
435) Epidemic curve :
a graph n whch the number of new cases of a dsease s potted
aganst an nterva of tme to descrbe a specfc epdemc or
outbreak .
436) Pt with hodgkin's lymphoma , and red strunberg cell in
pathology and there is esinophil lymphocyte in blood so
pathological classification is:
a. Mixed-cellularity subtype
b. nodular sclerosis subtype of Hodgkin's lymphoma
the correct answer is b
Cassca Hodgkn's ymphoma can be subcassfed nto 4
pathoogc subtypes based upon Reed-Sternberg ce morphoogy
and the composton of the reactve ce nftrate seen n the
ymph node bopsy specmen (the ce composton around the
Reed-Sternberg ce(s))
.
Name descreption
Noduar scerosng
CHL
Is the most common subtype and s composed of arge tumor nod%les
showng scattered acunar cassca RS ces set n a background of
reactve ymphocytes, eosnophs and pasma ces wth varyng
degrees of coagen fbross/sclerosis.
Mxed-ceuarty
subtype
Is a common subtype and s composed of numerous cassc RS ces
admxed wth numerous nfammatory ces ncudng ymphocytes,
hstocytes, eosnophs, and pasma ces. wthout sceross. Ths type s
most often assocated wth EBV nfecton and may be confused wth the
eary, so-caed 'ceuar' phase of noduar scerosng CHL
Lymphocyte-rch or
Lymphocytc
predomnance
Is a rare subtype, show many features whch may cause dagnostc
confuson wth noduar ymphocyte predomnant B-ce Non-Hodgkn's
Lymphoma (B-NHL). Ths form aso has the most favorabe prognoss
Lymphocyte depeted Is a rare subtype, composed of arge numbers of often peomorphc RS
ces wth ony few reactve ymphocytes whch may easy be confused
wth dffuse arge ce ymphoma. Many cases prevousy cassfed
wthn ths category woud now be recassfed under anapastc arge
ce ymphoma

437) 62 y male with DVT and lVC obstruction due to thrombosis
so most like dd is
a. neohrotic syndrome
b. SLE
C. Chirstm disease
D. 7!
.......................................
...................
438) Pt with bdominal pain heamatutea , HTN, and have
abnormalty in chromosm 16 , diagnosis is
a. POLY CYCTlC KlDNEY
.......................................
...................
439) 17 year pt with dyspnea Po2 , PCO2 ,Xray normal PH
increase so dd is:
a. acute attack of asthma
b. P E
c. pneumonia
d. pnemothrax
the correct answer s a
.......................................
...................
440) A long scenario about patient with polydipsia ad polyuria.
Serum osmolrity high . desmoprsin inductin no change
urine omolarity and plasma osmolrity so dd is
a. nphrognic type
b. central tupe
The correct answer s a
.......................................
...................
441) 50 year old Man presented to ER with sudden headach,
blurred of vision and eye pain. The diagnosis is:
a. Acute glaucoma
b. Acute conjunctivitis
c. Corneal ulcer
d. -----
The correct answer s a
442) RTA with hip dislocation and shock so causes of shock is
a. blood lose
b. urtheral injery
c. nurogenic
The correct answer s a
.......................................
...................
443) most common causes of hand infection
a. truma
b. imunocrombromise
c. ...
the correct answer s a
.......................................
...................
444) ttt of cholestatoma is
a. antibiotic
b. steroid
c. surgery
d. Grommet tube
the correct answer s c
-Cholesteatoma s a destructve and expandng growth consstng
of keratnzng squamous eptheum n the mdde ear and/or
mastod . treatment : Surgery s performed to remove the sac of
squamous debrs and a mastodectomy s performed.

445) twins one male and other female . his father notice that
femle become puberty before male so what you say to
father
a. female enter puberty 1-2 year before male
b. female enter puberty 2-3 year before male
c. female enter puberty at the same age male
the correct answer s b
.......................................
...................
446) in devolping countery to prevent dental carise , it add to
water
a. florid
b. zink
c. copper
d. iodide
the correct answer s a
.......................................
...................
447) 12 y.o boy c}o abdominal pain after playing football,he
denied any h}o trauma ,the pain is in the Lt paraumbilical
region what inx you want to do:
a. CXR
b. ultrasound kidney
The correct answer s b , l'm not sure because MCs are not
compete.
.......................................
...................
448) pt child with back pain that wake pt from sleep
So diagnosis
a. lumber kyphosis
b. osteoarthritis
c. RA
d. Scoliosis
the correct answer s d
449) child with papule vesical on oropharnx and rash in palm
and hand so dd:
a. CMV
b. EBV
c. MEASLS
d. ROBELLA
???? Coxsacke A vrus. Vesical in buccal mucusa is
measls.
.......................................
...................
450) chid with dental caries and history of bottle feading
So dd
a. nurse milk caris
.......................................
...................
451) Generalize antxity disorder best ttt: -19
a. Ssri
b. tricyclic a d
d. MAOl
The correct answer s a

.......................................
...................
452) Major depression management:
a. lntial MONOTHERABY even sever sever deprisson
b. Ttt should be change if no response during 2wk (AT
LEAST 6 . WEEKS )
7777
.......................................
...................
453) psychotherapy, medication, and electroconvulsive therap
Psychiatric pt with un compliance of drugs ttt:
a. depro halopredol injection
b. oral colonazepam
the correct answer s a
454) mild diarrhea mangement :
a. oral antibiotis
b. lVF
c. ORS
the correct answer s c
.......................................
...................
455) salpingitis and pid on penicillin but not improve the most
likely organism is :
a. chlamydia
b. nessiria
c. SYPHLlS
d. HSV
the correct answer b
.......................................
...................
456) Used for treatment of pseudomembranous colitis:
PO metrondazoe s the emprc treatment of choce (500 mg TID
for 10-14 days). For severe nfectons, ora Vancomycn s the
treatment of choce (125 mg OID 10-14 days).
.......................................
...................
457) Lady with of right hypochondrial pain, fever and slight
jaundice. What is your diagnosis7
a. Acute cholecystitis.
O not compete.
Most common presentng symptom of acute choecystts s
upper abdomna pan often radatng to rght scapua.
Nausea and vomtng generay present. Patents may report
fever.
458) Deep jaundice wit palpable gallbladder 7
i . a. Cancer head of pancreas .
not complete
Pancreatc cancer presents wth abdomna pan radatng toward
the back, as we as wth
|aundce, oss of appette, nausea, vomtng, weght oss,
weakness, fatgue, and ndgeston.
Examnaton: may revea a papabe, nontender gabadder
(Courvoisier's sign) or mgratory thrombophebts
(Trousseau's sign). Dagnose by CT. treatment usuay
paatve (due to metastass at Dx).
.......................................
...................
459) Patient with perforated gallbladder underwent
cholecystectomy. Return to you with fever. On abdominal
X-ray, there is elevation of right hemidaiaphragm. What is
the possible diagnosis7
a. Subphrenic abcess
......................................
....................
460 ( 460 ( Patient with acute perianal pain since 2 days
with black mass 2*3 pain 4increase with defecation
Rx :
a. Evacuation under local anesthesia
not complete
.......................................
...................
461) Rhumatoid arthritis distal interphalengial nodules
a. Hebrerden's nodes
Heberden's nodes are at the DIP whe Bouchard's
nodes are at PIP.

462) Elderly patient with RL fullness, weight loss, changed
bowel habit, anemic and pale. What is the investigation of
choice7
a. Colonoscopy.
Ths s now the nvestgaton of choce f coorecta cancer s
suspected provded the patent s ft enough to undergo the bowe
preparaton. It has the advantage of not ony pckng up a prmary
cancer but aso havng the abty to detect synchronous poyps or
even mutpe carcnomas, whch occur n 5% of cases.
......................................
....................
463) lnvestigation of choice in lron deficiency anemia7
a. serum iron
b. ferritin
c. TlBC
the correct answer s b
Serum ferrtn s the most senstve ab test for ron defcency
anema.
......................................
....................
464) ln patients with hypertension and diabetes, which
antihypertensive agent you want to add first7
a. -blockers
b. ACE inhibitor
c. o-blocker
d. Calcium channel blocker
the correct answer s b
Duretcs (nexpensve and partcuary effectve n Afrcan-
Amercans) and -bockers (benefca for patents wth CAD) have
been shown to reduce mortaty n uncompcated hypertenson.
They are frst-ne agents uness a comorbd condton requres
another medcaton. (see tabe)
Popuaton Treatment
Diabetes with
proteinuria
ACEIs.
CHF -bockers, ACEIs, duretcs (ncudng
spronoactone).
lsolated systolic
hypertension
Duretcs preferred; ong-actng
dhydropyrdne cacum channe
bockers.
Ml -bockers wthout ntrnsc
sympathommetc actvty, ACEIs.
Osteoporosis Thazde duretcs.
BPH o-antagonsts.
465) Patient presented with retinal artery occlusion, which of
the following is wrong:
a. painful loss of vision
b. painless loss of vision
the correct answer s a
The most common presentng compant of retna artery
occuson s an acute persstent paness oss of vson.
......................................
....................
466) ECG finding of acute pericarditis7
a. ST segment elevation in all leads
Cassc ECG fndngs n percardts: Low-votage, dffuse ST-
segment eevaton.
......................................
....................
467) Epidemiological study want to see the effect of smoking in
the bronchogenic carcinoma, they saw that is 90% of
smokers has bronchogenic carcinoma.
30% of non-smokers has the disease, the specificity of the
disease as a risk factor is:
a. 70 %
b. 30 %
c. 90 %
MCs not complete
Sensitivity: The probabty that a dseased patent w have a
postve test resut.
Specificity: The probabty that a nondseased person w have a
negatve test resut.
Disease
Presen
t
No
Disea
se
Positive
test
a b
Negative
test
c d
Sensitivity = a } (a + c) Specificity = d } (b + d)
Note:
- A senstve test s good for rung out a dsease.
- Hgh senstvty = good screenng test ( fase negatves).
- Hgh specfcty = good for rung n a dsease (good confrmatory
test).
468) Baby present with pain in the ear, by examination there is
piece of a glass deep in his ear canal, the mother mention
a history of a broken glass in the kitchen but she clean
that completely. We treat that by:
a. By applying a stream of solution to syringing the ear.
b. Remove it by forceps.
c. Refer her to otolaryngology
* Foreign bodies in the ear canal:
Technques approprate for the remova of ear foregn bodes ncude
mechanca extracton, rrgaton, and sucton. Irrgaton s
contrandcated for organc matter that may swe and enarge
wthn the audtory cana (e.g seeds). Insects, organc matter, and
ob|ects wth the potenta to become frabe and break nto smaer
evasve peces are often better extracted wth sucton than wth
forceps. Lve nsects n the ear cana shoud be mmobzed before
remova s attempted.

Consultations: Consut an ENT specast f the ob|ect cannot be
removed or f tympanc membrane perforaton s suspected.
......................................
....................
469) Treatment of open tibial fracture:
a. cephazolin
b. cephazolin+gentamycin
c. gentamicin
d. cephazolin+gentamicin+metronidazole
treatment of open fracture
1- Frst-generaton cephaosporns (Gram-postve coverage) such
as cephaexn (1-2 g q6-8h) suffce for Gusto type I open fractures.
2- An amnogycosde (Gram-negatve coverage) such as
gentamycn (120 mg q12h; 240 mg/d) s added for types II and III
n|ures.
3- Addtonay, metrondazoe (500 mg q12h) or pencn (1.2 g
q6h) can be added for coverage aganst anaerobes.
4- Tetanus prophyaxs shoud be nsttuted.
5- Antbotcs generay are contnued for 72 hours foowng wound
cosure.

Open fracture classification
Gusto cassfcaton
I Low energy, wound ess than 1 cm
II Wound greater than 1 cm wth moderate soft tssue damage
III
Hgh energy wound greater than 1 cm wth extensve soft
tssue damage
IIIa Adequate soft tssue cover
IIIb Inadequate soft tssue cover
IIIc Assocated wth artera n|ury
470) Which of the following found to reduce the risk of
postherpetic neuralgia:
a) corticosteroids only
b) corticosteroids + valacyclovir
c) valacyclovir only
The correct answer s c
Patents wth herpes zoster shoud receve treatment to contro
acute symptoms and prevent compcatons. Patents over the age
of 50, rrespectve of other rsk factors, are at much greater rsk of
deveopng postherpetc neuraga and shoud be offered
treatment. By nhbtng repcaton of varcea zoster vrus, the
antvra agents acycovr, famccovr, and vaaccovr attenuate
the severty of zoster-specfcay, the duraton of vra sheddng s
decreased, rash heang s hastened, and the severty and duraton
of acute pan are reduced. Attenuaton of the severty of the acute
nfecton and the neura damage t causes shoud reduce the
kehood of postherpetc neuraga.
......................................
....................
471) 8 months old infant with on & off recurrent crying
episodes & hx of current jelly stools:
a) intussception
b) intestinal obstruction
c) mickel's diverticulitis
d) strangulated hernia
The correct answer s a
472) a man with oblong swelling on top of scrotum increase in
size with valsalva maneuver most likely Dx:
a) direct inguinal hernia
b) indirect inguinal hernia
c) varicocele
d) femoral hernia
the correct answer s b
* lndirect hernia: Hernaton of abdomna contents through the
nterna and then externa nguna rngs and eventuay nto the
scrotum (n maes).
- The most common herna n both genders.
- Due to a congenta patent processus vagnas.
- Indrect nguna herna ncreases n sze t becomes apparent
when the patent coughs, and perssts unt reduced.
* Direct hernia: Hernaton of abdomna contents through the
foor of Hessebachs
Trange. (Hessebachs trange s an area bounded by the nguna
gament, nferor epgastrcartery, and rectus abdomns)
- Herna sac contents do not traverse the nterna nguna rng;
they hernate drecty through the abdomna wa and are
contaned wthn the aponeuross of the externa obque musce.
- Most often due to an acqured defect n the transversas fasca
from mechanca breakdown that wth age.
......................................
....................
473) 3 weeks old male newborn with swelling of scrotum
transparent to light & irreducible:
a) epidydemitis
b) hydrocele
The correct answer s b
.......................................
...................
474) a young girl experienced crampy abdominal pain &
proximal muscular weakness but normal reflexes after
receiving septra (trimethoprim sulfamethoxazole) :
a) functional myositis
b) polymyositis
c) guillian barre syndrome
d) neuritis
the correct answer is d
475) Which drug causes SLE like syndrome:
a) hydralazine
b) propranolol
c) amoxicillin
The correct answer s a
- Drug-nduced SLE causes: Chorpromazne, Hydraazne,
Isonazd, Methydopa, Pencamne, Procanamde, Oundne,
Sufasaazne.
......................................
....................
476) When to give aspirin and clopidogrel7
a) pt with a hx of previous Ml
b) Acute Ml
c) hx of previous ischemic stroke
d) hx of peripheral artery disease
e) after cardiac capt
The correct answer s b

......................................
....................
477) 17 years with history of right iliac fossa pain rebound
tenderness +ve guarding what is the investigation that
you will do7
a. Laparoscopy
b. US
c. CT scan
the correct answer s c
In appendcts, CT scan wth contrast has 95-98% senstvty whch
shows perappendcea streakng.
478) Child with history of URTl before 3 weeks now has both
knees tender, red and inflamed. What is your diagnosis7
a. Rheumatoid arthritis
is not complete
The dagnoss of |RA s estabshed by the presence of arthrts,
the duraton of the dsease for at east 6 weeks, and the excuson
of other possbe dagnoses. Athough a presumptve dagnoss of
systemc-onset |RA can be estabshed for a chd durng the
systemc phase, a defntve dagnoss s not possbe unt arthrts
deveops. Chdren must be younger than 16 years od at tme of
onset of dsease; the dagnoss of |RA does not change when the
chd becomes an adut. Because there are so many other causes of
arthrts, these dsorders need to be excuded before provdng a
defntve dagnoss of |RA (Tabe 89-2). The acute arthrtdes can
affect the same |onts as |RA, but have a shorter tme course. In
partcuar, |RA can be confused wth the spondyoarthropathes,
whch are assocated wth spna nvovement, and enthests, whch
s nfammaton of tendnous nsertons. A of the pedatrc
spondyoarthropathes can present wth perphera arthrts before
other manfestatons and ntay may be dagnosed as |RA (Tabe
89-3).
* |uvene rheumatod arthrts: mono- and poyarthropathy wth
bony destructon that occurs n patents 16 years of age and
asts > 6 weeks. Approxmatey 95% of cases resove by puberty.
Subtypes: Pauciarticular: 5 joints involved, assocated wth
an rsk of iridocyclitis that ead to bndness f eft untreated.
Polyarticular: >5 sma |onts. Systemc features are ess
promnent; carres a rsk
of rdocycts. Acute febrile: The east common subtype;
manfests as arthrts wthdaily high, spiking fevers and an
evanescent, salmon-colored rash. Hepatospenomegay and
serosts may aso be seen. No rdocycts s present; remsson
occurs wthn one year.
......................................
....................
479) Old female came complain from pan in her joint increase
with walking, what is your diagnosis7
a. Osteoarthritis
Physca sgns of OA: Creptus, range of moton, pan that
worsens wth actvty
and weght bearng but mproves wth rest.

480) Patient came with history of neck discomfort, palpitation,
cold sweat, TSH low, T4 high, tender neck. What is your
diagnosis7
a. Subacute thyroiditis .
- Thyroiditis: Infammaton of the thyrod gand. Common types
are subacute granuomatous, radaton, ymphocytc, postpartum,
and drug-nduced (e.g., amodarone) thyrodts.
- Hx}PE: In subacute and radaton, presents wth tender thyrod,
maase, and URI symptoms.
- Dx: Thyrod dysfuncton (typcay hyperthyrodsm foowed by
hypothyrodsm),
a wth J uptake on RAIU.
- Rx:
- -bockers for hyperthyrodsm; evothyroxne for hypothyrodsm.
- Subacute thyrodts: Ant-nfammatory medcaton.
......................................
....................
481) ln ulcerative colitis, what you will start treatment with7
a. Cortcosterods ??
- Sufasaazne or 5-ASA (mesaamne).
- Crtcosterods and mmunosuppressants ndcated f no refractory
dsease.
......................................
....................
482) Treatment of prostatitis7
a. Ciprofloxacin
treatment s for 4-6 weeks wth drugs that penetrate nto the prostate,
such as trmethoprm or cprofoxacn.

.......................................
...................
483) ln lV canula and fluid:
a.Site of entry of cannula is a common site of infection.
......................................
....................
484) Patient with neck rigidity, rigor, fever, petechial rash over
extremities. The causative m\o is:
a. Meningococcal meningitis
Dscuss menngts !
......................................
....................
485) Female patient works in office came with vulva itching,
yellow vaginal discharge:
a. Trichomoniasis
486) another one old c}o bilateral knee pain with mild joint
enlargement
ESR and CRP normal dx:
a. Osteoarthritis
b. Rheumatoid arthritis
c. Gout7
The correct answer s a
.......................................
...................
487) .Scitica increased incidence of :
a. Lumbar lordosis
b. Parasthesis

O not compete but wth these MCOs , correct answer s b
.......................................
...................
488) old male c}o knee pain on walking with crepitus xray show
narrow joint space and subchondoral sclerosis:
a. Rheumatoid arthritis
b. Osteoarthritis
c. Gout
The correct answer s b
.......................................
...................
489) 14y f with BMl 32.6 (associated big chart):
a. Overweight
b. Obese
c. Normal weight
The correct answer s b
BMI < 16 : severe under WT.
BMI 16 - 20 : under wt.
BMI 20 - 25 : norma
BMI 25 - 30 : over wt.
BMI 30 - 35 : obese cassc 1
BMI 35 - 40 : obese cassc 2
BMI > 40 : obese cassc 3
490) vaginal discharge odorless watry microscopy show clue
cells :
a. Bacterial vaginosis
b. Candidiasis
The correct answer s a
.......................................
...................
491) Pregnant women on 3
rd
trmester nfected wth meases can I gve
her MMR?????
.......................................
...................
492) lactating women infected with rupella ....management is
:
a. MMR
b. Stop lactation
The correct answer s a
MMR s safe durng actatng
.......................................
...................
493 ) which of following not live vaccine:
a. BCG
b. Hepatitis B
c. Oral polio
d. MMR
The correct answer s b
.......................................
...................
493) the most commone cause of community acquired
pneumonia:
a. Hemophilus influenza
b. Strept.pneumonia
c. Mycoplasma
d. Kliebsella
The correct answer s b
494) female after vaginal hesterectomy she complain of urin
come from vagina...dx:
a. Vesicovaginal fistula
b. Urethrovaginal fistula
c. Ureterovaginal fistula
The correct answer s a
.......................................
...................
495) child rt ear pain and tenderness on pulling ear , no fever ,
O}E inflamed odemateous rt ear canal with yellow
discharge >>>>>>>>>>dx:
a. Otitis media
b. Otitis externa
c. Cholesteatoma
The correct answer s b
......................................
....................
496) male with perianal pain ,tenderness ,fluctuant (perianal
abscess)
a. lncision and drainage
b. Warm bath
The correct answer s a
......................................
....................
497) . pregnant 34w with vaginal bleeding.... what would
you ask about :
a. Cigarette smoking
b. Recent sexual intercourse
O not compete , but wth theses MCOs may be correct
answer s a
......................................
....................
498) ln duodenal obstruction of neoborn what is the sign that
apper in xray:
a. Double bubble
499) the following more commone with type2 DM than type1
DM:
a. Weight loss
b. Gradual onset
c. Hereditary factors
d. HLA DR3+-DR4
The correct answer s c
.......................................
...................
500) pt with open angle glaucoma and k}c of COPD and DM ttt:
a. Timelol
b. betaxolol
c. Acetazolamide
The correct answer s c
.......................................
...................
501) pt child with back pain that wake pt from sleep So
diagnosis
a. lumber kyphosis
b. osteoarthritis
c. RA
d. Scoliosis
The correct answer s a or d
.......................................
.............
502) 59 y}o presented with new onset supraventicular
tachycardia with palpitation,no Hx of SO Or chest pain
,chest examination normal , oxygen sat in room air = 98%
no peripheral edemaOthers normal, the best initial
investigation:
a. ECG stress test
b. Pulmonary arteriography
c. CT scan
d. Thyroid stimulating hormone
the correct answer s d
503) Lactating women presented with breast engorgment and
tendress Your managements:
a. Warm compressor and continoue breast feeding
b. Dicloxacillin and continoue breast feeding
c. Dicloxacillin and milk expression
d. Discontinoue breast feeding and cold compressor
the correct answer s a . ts case s ( engorgement of breast ) . but
f there are redness , sweng , fever ths case s ( mastts ) and
choose b
504) The Fastest route of antipsychotic is:
a. lM
b. lV
c. Oral
d. Sublingual
the correct answer s b
505) While you are in the clinic you find that many patients
presents with red follicular conjactivitis (Chlamydia ) your
management is:
a. lmprove water supply and sanitation
b. lmprove sanitation and destroying of the vector
c. Eradication of the reservoir and destroying the vector
d. Destroy the vector and improve the sanitation

the correct answer s a
506) The most important exogenous risk factor for
osteoporosis is:
a. Alcohol intake
b. Age
c. Smoking
d. Lack of exercise
the correct answer s c
507) Patient with family history of coronary artery disease his
BMl= 28 came to you asking for the advice:
a. Start 800 calorie intake daily
b. Decrease carbohydrate daytime
c. lncrease fat and decrease protein
d. Start with decrease ... K calorie per kg per week
the correct answer s d
508) Lactating mother newly diagnosed with epilepsy , taking
for it phenobarbital you advice is:
a. Discontinue breastfeeding immediately
b. Breastfeed baby after 8 hours of the medication
c . Continoue breastfeeding as tolerated
the correct answer s c
-very vague queston , some books avod Phenobarbta durng
breast feedng f possbe. And n Amercan academy of pedatrc
cassfed Phenobarbta as adrug that cause ma|or advers effect
n some nursng nfant, and shoud be gven to nursng women
wth caton .
509) Pregnant women has fibroid with of the following is True:
a. Presented with severe anemia
b. Likely to regress after Pregnancy
c. Surgery immediately
d. Presented with Antepartum He
the correct answer s b
Fbrods may aso be the resut of hormones. Reproductve
hormones ke estrogen and progesterone can stmuate ce
growth, causng fbrods to form. Durng pregnancy, your nfux
of hormones may cause your fbrods to grow n sze. After
pregnancy and durng menopause most fbrods begn to shrnk,
due to a ack of hormones.
510) A known case of chronic atrial fibrillation on the warfarin
5 mg came for follow up you find lNR 7 but no signs of
bleeding you advice is:
a. Decrease dose to 2.5 mg
b. Stop the dose and repeat lNR next day
c. Stop warfarin
d. Continoue same and repeat lNR
the correct answer s b
lNR ACTlON
>10 Stop warfarn. Contact patent for examnaton. MONITOR INR
7-10 Stop warfarn for 2 days; decrease weeky dosage by 25% or by 1 mg/d
for next week (7 mg tota); montor INR
4.5-
7
Decrease weeky dosage by 15% or by 1 mg/d for 5 days of next week (5
mg tota); repeat montor INR
3-
4.5
Decrease weeky dosage by 10% or by 1 mg/d for 3 days of next week (3
mg tota); repeat montor INR.
2-3 No change.
1.5-
2
Increase weeky dosage by 10% or by 1 mg/d for 3 days of next week (3
mg tota);
<1.5 Increase weeky dose by 15% or by 1 mg/d for 5 days of next week (5 mg
tota);
511) Patient is a known case of CAD the best exercise:
a. lsotonic exercise
b. lsometric exercise
c. Anerobic exe
d. Yogha
the correct answer s c
1-anerobc exercse ( endurance ) : for mprove cardac functon
2- weght bearng excercse ( sometrc ) : for bud musce strength
, bone densty
3- stretchng excercse : for prevent cramp , stffness and back pan
512) The mechanism of action of Aspirin:
a. lnhibit cycloxgenase
b. lnhibit phospholipase A2
c. lnhibit phospholipid D
the correct answer s a
513) The absolute contraindication of breastfeeding is :
a. Asymptomatic HlV patient
b. Active hepatitis C
c. Pulmonary TB on treatment 3 months
The correct answer s a
Absolute contraindication of breastfeeding :
1-Infants with galactosemia.
-!others who use illegal drugs.
"-!others infected with #I$% human &-cell lymphotropic virus type I
or type II% or who have an active herpes lesion on the breast.
'-!others ta(ing any of the following medications: radioactive
isotopes% cancer chemotherapy agents% such as antimetabolites
.
514) A boy felt down on his elbow , the lateral x-ray shows:
a. Anterior Pad sign
b. Posterior pad sign
c. Anterior line of humerous intersecting the cubilium
d. Radial line forming 90 degree with cubilium

the correct answer s b
515) A known case of treated hodgkin lymphoma(mediastinal
mass) with radiotherapy Not on regular follow up presented
with gradual painless difficulty in swallowing and SOB ,
There is facial swelling and redness : DX
a. SVC obstruction
b. lVC obstruction
c. Thoracic aortic aneurysm
d. Abdominal aortic aneursm
The correct answer s a
________________________________________________________________________
516) Patient is presented with hand cellulitis and red streaks
in the hand and tender axillary lymphadenopathy. This
condition is more likely to be associated with:
a. Malignancy
b. Pyoderma
c. Neuropathy
d. Lymphangitis
the correct answer s b (l'm not sure )

516) Young aged male presented to ER after blunt trauma to
Abdomen, CT scan shows intramural hematoma: your
management is
a. Lapratomy with evacuation of the hematoma
b. Dissection of duodenum
c. Observation
the correct answer s c
517) Patient presented with sore throat, anorexia, loss of
appetite , on throat exam showed enlarged tonsils with
petechi on palate and uvula , mild tenderness of spleen and
liver :DX
a. Group A strep
. b. EBV
The correct answer s b
518) Patient with GERD has barret esophagus , this metaplasia
increase risk of :
a. Adenocarcinoma
b. Squmaou cell carcinoma
the correct answer s a
519) Complication of Sleep apnea is :
a.CHF
b. ..
the correct answer s a
sleep apnea : Hypoxic pulmonary vasoconstriction PAH
Cor Pulmonale CHF
complication of sleep apnea : sleep apnea increases health risks such as
cardiovascular disease, high blood pressure, stroke, diabetes, clinical depression, weight
gain and obesity. The most serious consequence of untreated obstructive sleep apnea is to
the heart. In severe and prolonged cases, there are increases in pulmonary pressures that
are transmitted to the right side of the heart. This can result in a severe form of congestive
heart failure (cor pulmonale.
520) Which of the following medication can be used as
prophylaxis in appendectomy:
a. Cephalexin
b. Ceftriaxone
c. Metronidazole
d. Vancomycin
e. Ampicillin
The correct answer s b
1
st
ne of antbotc : 1- cefoxtn 2- cefotetan
2
nd
ne of treatment : 1- metradnazoe 2- ampckkn-subactam
521) Which of the following prognostic factor for SLE:
a. ANA levels
b. Sex
c. Age
d. Renal involvement
The correct answer s d
522) The most common site for osteomyelitis is:
a. Epiphysis
b. Diaphysis
c. Metaphysis
d. Blood flow
The correct answer s c
523) ln "holding breath holding" which of the following True:
a. Mostly occurs between age of 5 and 10
b. lncrease Risk of epilepsy
c. A known precipitant cause of generalized convulsion
d. Diazepam may decrease the attack
Breath holding spells are the occurrence of epsodc apnea n chdren,
possby assocated wth oss of conscousness, and changes n postura tone.
They are most common n chdren between 6 and 18 months and usuay not
present after 5 years of age. They are unusua before 6 months of age. A
postve famy hstory can be ected n 25% of cases. It may be confused
wth a sezure dsorder.
There are four types of breath holding spells.
1-The most common s termed simple (reath holdin& spell, n whch the
manfestaton s the hodng of breath n end expraton. There s no ma|or
ateraton of crcuaton or oxygenaton and the recovery s spontaneous.
2-The second type are the Cyanotic (reath)holdin& spells. They are
usuay precptated by anger or frustraton athough they may occur after a
panfu experence. The chd cres and has forced expraton sometmes
eadng to cyanoss (bue n coor) , oss of musce tone, and oss of
conscousness. The ma|orty of chdren w regan conscousness. The chd
usuay recovers wthn a mnute or two, but some fa aseep for an hour or
so. Physoogcay, there s often hypocapnea (ow eves of carbon doxde)
and usuay hypoxa (ow eves of oxygen. There s no "post cta" phase (as s
seen wth sezures), no ncontnence, and the chd s fne n between spes.
EEGs are norma n these chdren. There s no reatonshp to the subsequent
deveopment of sezures or cerebra n|ury as a consequence of breath
hodng spes.
3-In the thrd type, known as *allid (reath)holdin& spells, the most
common stmuus s a panfu event. The chd turns pae (as opposed to bue)
and oses conscousness wth tte f any cryng. The EEG s aso norma, and
agan there s no post cta phase, nor ncontnence. The chd s usuay aert
wthn a mnute or so. There may be some reatonshp wth aduthood
syncope n chdren wth ths type of spe.
4- A fourth type, known as Complicated (reath)holdin& spells, may
smpy be a more severe form of the two most common types. Ths type
generay begns as ether a cyanotc or pad spe that then s assocated
wth sezure ke actvty. An EEG taken whe the chd s not havng a spe s
st generay norma.
DX: cnca , good hstory ncude sequence of event , ack of ncontnence
and no post cta phase. Treatment : reassurance and ron.
524) lnfant brought by the mother that noticed that the baby
has decreasing feeding , activity and lethargic On
examination febrile(39), tachycardic ,his bp 75}30, with
skin rash . DX:
a.Septic shock
not complete
525) Old patient newly diagnosed with hyperthyroidism
presented with (hyperthrodism symptoms) The best initial
symptomatic treatment is:
a. BB ( beta-blocker )
b. PTU
The correct answer s a
_______________________________________________________________________
526) lnfant presented with hemangioma on the back . your
management is:
a. lntralesional injection of corticosteroids
b. Topical corticosteroids
c. Excise of the lesion
527) Pregnant lady , 34 wk GA , presented with vaginal
bleeding more than her menstruation. On examination ,
cervix is dilated 3 cm with bulging of the membrane, fetal
heart rate = 170 bpm . The fetus lies transverse with back
facing down . us done and shows that placenta is attached
to posterior fundus and sonotranulence behind placenta.
Your management is :
a. C}S
b. Oxytocin
c.Tocolytics
d.Amniotomy
the correct answer s a
528) lnfant with congenital hip dislocation:
a. +ve click in flexion ,abduction
b. The only treatment is surgery
c. Not reduced with flexion and abduction of the hip
the correct answer s a . ths s ortoan test

529) ln irritable bowel S. the following mechanism 7
contraction and slow wave myoelectricity seen in:
a.Constipation
b. Diarrhea
the correct answer s a
529) Which is not found in coarctation of the aorta:
a. Upper limb hypertension
b. Diastolyic murmur heard all over precordium
c. Skeletal deformity on chest x-ray
the correct answer is a (l'm not sure )
530) Female patient presented with tender red swelling in the
axilla with history of repeated black head and large pore
skin in same area: ttt is
a. lmmidate surgery
b. Topical antibiotic
c. Cold compressor
d. Oral antibiotic
531) ln indirect hernia the relation of the sac to the cord
structure is:
a. Anteromedial
b. Anterolateral
c. Posteromedial
d.Postrolateral
the correct answer s b
532) The most common cause of croup is:
a. Parainfluenza
b. lnfluenza
the correct answer s a
533) kwashikor disease usually associated with :
a. decrease protein intake, decrease carbohydrate
b. increase protein , increase carbo
c. decrease protein , increase carbo
the correct answer is c. in the book, written there is
decrease protein and adequate amount of carbohydrate,
but with this only MCs the answer is c
534) in cachectic patient, the body utilize the proteins of the
muscles :
a. to provide Amino acid and protein synthesis
b. to maintain bloodflow to vital organ
c. to increase body fat
the correct anwser s a ( I'm not sure )
535) patient is complaining of memory loss. Alzehimer disease
is diagnosed what is the cause of this:
a. brain death cell
not complete
536) Parents brought their baby to you who is on bottle
feeding. On exam whitish lesion on either side of teeth
seen with blackish lesion on maxillary incisors and second
molar teeth. There is history of leaving the baby with bottle
in his mouth during sleeping. The Dx:
a. Nursery dental caries
b.Gingvostomatis
the correct answer s a
537) Which of the following medication if taken need to take
the patient immidiatly to the hospital:
a. Penicillin
b. diphenhydramine
c. OCPs
d. uinine or uinidine
the correct answer s d (I'm not sure ) , qundne s
antarrhythma .
538) 43 y}o female presented with severe DUB other
examination normal . your management is
a. D &C
b. Ocps
c. Hysterectomy
d. Blood transfusion
the correct answer is a
539) Baby with vesicles on the face and honey comb crust
which of the following organism cause it: Staph aureus
540) Female patient presented with migraine headache which
is pulsatile, unilateral , increase with activity . Dosn't want
to take medication. Which of the following is appropriate:
a. Bio feedback
b. TCA
c. BB
the correct answer s a
Bofeedback has been shown to hep some peope wth
mgranes. Bofeedback s a technque that can gve peope better
contro over body functon ndcators such as bood pressure, heart
rate, temperature, musce tenson, and bran waves. The two most
common types of bofeedback for mgranes are therma
bofeedback and eectromyographc bofeedback.
541) lnfant born with hemangioma on the rt eyelid what is
appropriate time to operate to prevent amylopia:
a. 1 day
b. 1 week
c. 3 months
d. 9 months
dffcut O. but may be the correct answer s b or c
542 ) Young patient on anti TB medication presented with
vertigo which of the following drug cause this:
a. Streptomycin
b. Ethambutol
c. Rifampcin
the correct answer s a , streptomycn cause 8
th
nerve damage.

543) The CPR for child is
a. 30 chest compression 2 ventilation . (Lone rescuer)
b. 15 chest c 2 ventilation . (2 or more rescures)
c. m15 chest compression 1 ventilation
the correct answer s a
544) Picture show large ulcer over medial side of the leg . what
is your management
a. Shave biobsy
b. Elevate the legs and stocking
c. Topical steroids
the correct answer s b
.......................................
...................
545) 2months infant with white plaque on tongue and
greasy ,past h}o clamydia conjunctivitis after birth treated
by clinamycin what is ttt:
a. Oral nystatin
b. Topical steroids
c. Topical acyclovair
d. Oral tetracycline
the correct answer s a. ora nystatn : antfunga
.......................................
...................
546) child rt ear pain and tenderness on pulling ear , no
fever , O}E inflamed odemateous rt ear canal with yellow
discharge >>>>>>>>>>dx:
a. Otitis media
b. Otitis externa
c. Cholesteatoma
the correct answer s a
.......................................
...................
547) 34y female with HlV pap smear negative, about cervical
cancer screening :
a. After 3m if negative repeat after 6m
b. After 6m ........... annually
c. After 1y..............annually
The correct answer s b ( I'm not sure , confuse wth choce c )
548) female about 30y with breast cancer (given cbc -chem.
And reavel low hb and hematocrite..) what is the next step
in mangment:
a. Staging
b. Lumpectomy
c. Mastectomy
d. chemotherapy

the correct answer s a
.......................................
...................
549) child with moderate persistant BA On bronch.dilat
inhaler. Presented with acute exacerbation what will you
add in ttt:
a. Corticosteroid inhaler
b. lpratropum bromide inhaler
the correct answer s b
.......................................
...................
550) about head and neck injury :
a. Hoarsness of voice and stridor can occure with mid
facial injury
b. Tracheostomies contraindicated
c. Facial injury may cause upper air way injures
.......................................
...................
551) lactating women 10 days after delivary developed
fever ,malaise, chills tender Lt breast with hotness and
small nodule in upper outer quadrant with axillary LN
.Leucocytic count was 14 *10}L dx:
a. lnflammatory breast cancer
b. Breast abscess
c. Fibrocystic disease
the correct answer s b

552) 70y male with osteoporosis the T score of bone
densometry would be :
a. -3.5
b. -2.5
c. 1
d. 2
e. 3.5

the correct answer s b
.......................................
...................
553) child with epistaxis.... management:
a. Compression on nose and leaning forward
b. ....................backward
the correct answer is a
.......................................
...................
554) scenario about female underwent abdominal operation
she went to physician
For check..... U}S reveal metal thing inside abdomen (a.e
missed during operation)
What will you do :
a. Call the surgeon and ask him what to do
b. Call attorney and ask about legal action
c. Tell her what you found
d. Tell her that is one of possible complications of
operation
e. Don't tell her what you found
The correct answer s c
.......................................
...................
555) male ptn with scaly fine papular rash on fornt of
scalp,nose and retroauricular....(i think tinea capitis) ttt
is:
a. Ketoconazole cream.
b. Oral augmentin
c. ... cream
the correct answer s a
556) All can cause gastric ulcer except:
a- Tricyclic antidepressant.
b- Delay gastric emptying.
c- Sepsis.
d- Salicylates.
e- Gastric outlet incompetent.

The correct answer s a
Trcycc antdepressant use n treatment of peptc ucer.
.......................................
...................
557) 48year old female lost her menstruation for 2 cycles, the
method of contraception is condom, examination was
normal except for dusky discoloration of the cervix. What u
will do next:
a.Progesterone challenge.
b.Beta HCG.
c.Pelvic u}s
The correct answer s b
.......................................
...................
558) ttt of yeast vaginitis: Clotrimazole , Fluconazole ,
Ketokonazole
Treatment of yeast vaginitis ( candida albicans ) : topical
azole or PO fluconazole , oral azole should be avoided in
pregnant.

.......................................
...................
559) 15 y}o female complaining of pain during menstruation,
not sexually active, medical hx unremarkable, physical
examination normal, how to treat:
a- NSAlD.
b- Danazole.
c-
The correct answer s a
.......................................
...................
560) What is true about alpha blocker:
a. Causes hypertension.
b. Worsen benign prostatic hyperplasia.
c. Cause tachycardia.
d-
the correct answer s c
apha bocker :cause orthostatc hypotenson and tachycarda.
561) cyclic menstruation that increase in frequency:
a. Polymenorrhea.
b. Hypermenorrhea.
c. Menorrhagia.
d. Dysmenorrhea.
e.

The correct answer s a
Polymenorrhea : frequent menestraton ( < 21 day cyce )
Hypermenorrhea or menorrhagia : abnormay heavy and
proonged menstrua perod at reguar ntervas . more than 80 m
of bood oss per cyce or proonged beedng , more than 8 days.
Oligomenorrhea : ncrease ength of tme between menses ( 35-
90 days b\w cyce)
Metrorrhagia : beedng bwteen perod.
Menometrorrhagia : exessve and rregar beedng.

.......................................
...................
562) A pregnant lady came to you to screen her fetus for down
syndrome, what is the best method:
a. Amniocentesis. + Karyotyping
b. Choriocentesis.
c.
the correct answer s a

.......................................
...................
563) What is the most common chromosomal abnormality7
a. Trisomy 13
b. Trisomy 21
the correct answer s b
-down syndrome ( trsomy 21 ) s the most common
chromosoma abnormaty.
.......................................
...................
564) Best 2 test to screen for hepatocellular carcinoma:
a. Liver biopsy and alpha-fetoprotein.
b. Liver ultrasound and alpha-fetoprotein.
c. Abdomen CT and
d.
The correct answer s b
565) A child came to ER with fever, stridor, . , x-ray showed
swollen epiglottis, in addition to oxygen, what u will do7
a. Throat examination.
b. An emergency tracheostomy.
c. Endotracheal intubation.
d. Nasopharyngeal intubation.
The correct answer s c
.......................................
...................
566) 24 y}o female newly diagnosed type 2 DM, she is wearing
glasses for 10 years, how frequent she should follow with
ophthalmologist:
a. Every 5 years.
b. Annually
The correct answer s b
-for type 1 diabetic : retna screenng annuay begnnng 5
years after onset of dabetes, genera not before onset of puberty.
- for type 2 diabetic : screenng at the tme of dagnoss then
annua
.......................................
...................
567) What is the initial management for a patient newly
diagnosed knee osteoarthritis.
a. lntra-articular corticosteroid.
b. Reduce weight.
c. Exercise.
d. Strengthening of quadriceps muscle.
The correct answer s b
.......................................
...................
568) A lady came to your clinic said that she doesn't want to
do mammogram and preferred to do breast self-
examination, what is your response7
a- Mammogram will detect deep tumor.
b- Self-examination and mammogram are complementary.
c- Self-examination is best to detect early tumor

answer s b ( I'm not sure because MCOs not compete and depend
on age of pt.
.......................................
...................
569) What is the best frequency for breast self-examination7
a. Daily.
b. Weakly.
c. Monthly.
d. Annually.

The correct answer s c
570) Patient with left bundle branch block will go for dental
procedure , regarding endocarditis prophylaxis:
a. No need
b. Before procedure.
c. After the procedure.
d.
The correct answer s a
.......................................
...................
571) classical characteristic for genital herpes.
Painful ulcers & vesicles
.......................................
...................
572) most common vaginal bleeding :
a. cervical polyps
b. menstruation
c. 7777
ony wth these MCOs , the correct answer s b
.......................................
...................
573) best stimulant for breast milk secretion:
a. breast feeding
b. oxytocin
c. 777
the correct answer s a
.......................................
...................
574) child with aspirin intake overdose ...what kind of acid
base balance:
a. metabolic alkalosis wt respiratory
b. metabolic acidosis wt respiratory alkalosis
c. respiratory alkalosis with metabolic acidosid
d. respiratory acidosis with metabolic alkalosis
The correct answer s c
Aspirin toxicity < in early stages, salicylate will stimulate respiratory center
== respiratory al+alosis that will be compensated by metabolic acidosis. In
late stage, it will interfere with 1!3, fat, & protein metabolism as well as
!xidation phosphorylation lead to lactate, pyrovate, & +eton bodies. ll will lead
to p3. 6igne & symptoms includes< nausea, vomiting, ==, temp, 3=,
sweating, cerebral or pulmonary edema, & coma. >ve anion gap. &&&< hydration,
correct ?>, gastric lavage or activated charcoal, urine al+ali-ation, hemodialysis)
575) therapeutic range of lNR :
a. 2.5-3.5
b. 2.0-3.0
c. 777
The correct answer s b
.......................................
...................
576) q about antidepressant:
a. start single type even patient have sever depression
b. start any one of them they all have the same efficacy
c. stop the medication after 2 weeks if no improvement
The correct answer s a
.......................................
...................
577) patient with depression started on amitryptaline , he had
headache or dizzness , vomitting77 im not sure what
exactly was the symptoms
a. change to SSRl
b. 77
not complete , but amitriptyline is TCA .
.......................................
...................
578) patient had horsenss of voice for 3 weeks... next to do:
a. throat swab
b. laryngoscopy
c. 777
The correct answer is b , l'm not sure because MCs
are not complete.
.......................................
...................
579) single diagnostic for stroke:
a. high cholesterol
b. high systolic blood pressur
the correct answer s b , I'm not sure , but wth these mcqs , b s
correct.
580) unfaivrable prognosis for schezophrenia:
a. family Hx
b. failed marrige
c. adolscen age77 not sure
d. presence of psychosis
the correct answer s a
.......................................
...................
581) Rt lung :
a. have 1 fissure
b. contain 7 segment
c. 777 read about lung anatomy segment names!!
Rt ung has 3 obes & 10 segments (meda basa segment ony n nf.
Lobe of Rt ung)
Lft ung has 2 obes & 9 segments (Lnguar segments n ft ung)
.......................................
...................
582) q about specifity:
a. test is +ve in disese population
b. test is +ve in healthy poplation
c. test is -ve in diseased population
d. test is -ve in healthy population
The correct answer s d
.......................................
...................
583) stage 3 colon ca Give Chemo ASAP
.......................................
...................
584) patient with upper abdominal pain, nausea vomitting,with
back pain, he is smoker for long time daily, fecal fat was
+ve
a. acute pancreatitis
b. chronic pancreatitis
c. pancreatic CA

The correct answer s b
585) in school, 10 of patient had the dis of the first week ,
then 30 pt. had the dieses the next week , the percentage
infection of this school is:
a. 10%
b. 20%
c. 30%
d. 40%
is not clear or not complete, but l think the correct
answer is b.
.......................................
...................
586) patient had headche describe it as aband around his
head, increase with stress and , i dont remeber the ques
DX is:
a. tension headache
b. migraine
c. cluster headache
The correct answer s b
.......................................
...................
+,-. *atient 'as presented (y (oll%s in his !oot , (iopsy
sho'ed s%( dermal lysis , !l%orescent stain sho'ed /&0 ,
'hat is the most li1ely dia&nosis #
A. Bolus epidermolysis .
B. Pemphigoid vulgaris .
C. Herpetic multiform .
D. Bullous pemphigoid .
The correct answer s d
.......................................
...................

588) Patient was presented by difficulties of breathing from
one side of his nose , on examination there was
erythramatus swelling , what is the best initial treatment :
A. Decongestant .
B. Steroid .
C. Sympathomimetics . 77
The correct answer is c ( l'm not sure )
Explain: ths sweng mght be nasopharyngea angofbroma whch s
hghy vascuar sweng & prone to epstaxs, so to decrease the
sze we mght use oca or systemc decongestants whch are
sympathommetcs, so answer s not cear.
589) Patient with cystic nodule (acne) and scars , what is the
best treatment :
A. Retinoin .
B. Erythromycin .
C. Doxycyclin .
The correct answer s a ( I'm not sure )
ths seems to be an advanced nfammatory stage of acne snce
there r scars so f the retnoD meant here s systemc (sotretnn)
so t w be the choce. If topca t w not be effectve as t s
effectve ony n the non-nfammatory stage (comedones). Both
erythromycn (oca) & doxycycn (systemc) can be used but n
advanced stage systemc s better.
.......................................
...................
590) Patient was presented by constipation, vomiting ,
abdominal distension , with old scar in the lower abdomen ,
x ray showed dilated loops with air in the rectum , what is
the best initial management :
A. NGT decompression , and lV line .
B. Rectal decompression and antibiotics .
C. Suppositories .
The correct answer s a
ths s a case of ntestna obstructon due to adhesons from
prevous abdomna surgery (commonest cause) so the nta
treatment woud be decompresson of the ntestne & repace ost
fuds
.......................................
...................
591) Which of the following is not living vaccine :
A. Hepatitis B .
B. MMR .
C. Oral polio
D. BCG
The correct answer s a
Hepatts B s the ony vaccne prepared by genetc engneerng so ts
not vng vaccne.
592) Six years old child was born to a mother with hepatitis
B , he does not received any vaccines before , what you will
give now :
A. DTP , MMR , Hib
B. DTP , MMR .
C. DT , MMR , Hib
D. DT, MMR .
The correct answer s d
both Pertusss & H.nfuenza vaccne are not needed after 1 year
of age.
.......................................
...................
593) Which of the following describes the end of the early
inflammatory phase .
A. Formation of eschar .
B. Formation of ground base of collagen .
C. The end of angiogenesis .
The correct answer s c
.......................................
...................
594) Female patient , known case of VitD deficiency ,
smoking , and recurrent fall, which of the following is the
greatest exogenous risk for osteoporosis :
A. Advanced age .
B. Recurrent fall .
C. Vit D .
D. Smoking .
The correct answer s d
Advanced age & femae gender are the most mportant factors
for osteopoross but they are endogenous. Smokng s an
ndependent exogenous rsk factor for osteopoross
595) Blood sugar in DM type 1 is best controlled by :
A. Short acting insulin .
B. Long acting .
C. lntermediate .
D. Hypoglycemic agents .
E. Basal and bolus insulin .
The correct answer s e
Very vague queston. We can excude hypogycemc agents.
Short acting insulin s best n emergences ke DKA as t can be
gven IV. We can use ether ong actng aone day or a mxture of
short & ntermedate actng nsun day. Basal & bolus , ( short
acting + intermediate or long ), bous of short-actng or very-
short-actng nsun before meas to dea wth the assocated rse n
bood-sugar eves at these tmes. In addton, they take an evenng
n|ecton of ong- or ntermedate-actng nsun that heps
normase ther basa (fastng) gucose eves. Ths offers greater
fexbty and s the most commony adopted method when
ntensfed nsun therapy s used to provde optma gycaemc
contro.
.......................................
...................
596) Which of the following is true regarding perths disease :
A. Commonly seen between 11-16 years of age .
B. Always unilateral .
C. May present by painless limp .
D. Characteristically affect the external rotation of hip .
E. More in female .
The correct answer s c
Perthes dsease (Leg-Cave perthes dsease) s a condton
affectng the hp |ont where there s degeneratve avascuar
necross of the femora head. It affects chdren aged 3-12 years &
s more common n maes. It s most commony but not aways
unatera ( 85% s unatera ). It presents many by severe hp
pan & mpng that ncreases by movement but t can present by
paness mp. It characterstcay affects the nterna rotaton &
abducton of the hp & mts these movements.
597) Which of the following is true regarding gastric lavage :
A. Patient should be in the right lateral position .
B. lt is not effective after 8 hours of aspirin ingestion .
The correct answer s b
avage s effectve ony 1 hour after ngeston of any poson. After
that ts neffectve
.......................................
...................
598) SSRl was prescribed to a patient with depression , the
effect is suspected to be within :
A. One day .
B. Two weeks .
C. Three to four weeks .
The correct answer s c
Aow 2 - 6 weeks to take effect , and treat for > 6 months
.......................................
...................
+22. Randomi3ed controlled st%dy 'ill (e stron&er (y #
A. Systemic >>>>
B. Following at least 50 % of the participant .
7777777
.......................................
...................
600) Partner lost his wife by AMl 6 months ago , presented by
loss of appetite , low mood , sense of guilt , what is the
diagnosis :
A. Beverament .
B. Major depression episode .
The correct answer s a
- Ma|or depresson s a psychatrc condton that occurs regardess
of events that happen n fe, whe normay most peope woud
have beverament after death of a cose person.
601) An adult was presented by sore throat , congestion ,
fatigue , petechia in soft palate , tender spleen , and liver ,
what is the most likely diagnosis :
A. EBV .
Only 1 choice7
This could be Rubella infection as petechia in soft palate
(Forschheimer spots) occur in rubella also. But liver &
spleen affection are more common in EBV. Also since it is
an adult then we might suspect leukemia as the cause.
.......................................
...................
602) Patient was presented by blepharitis , acne roseca , but
no keratitis , what is the best treatment :
A. Topical chlorophenicol .
B. Topical gentamicin .
C. Oral doxycyclin .
The correct answer s c
.......................................
...................
603) Diabetic patient was presented by spastic tongue ,
dysarthria , spontenous crying what is the most likely
diagnosis :
A. Parkinson .
B. Bulbar palsy .
C. Pseudobulbar .
D. Myasthenia gravis .
The correct answer s c
Ths s a bt trcky. Bubar pasy s the LMNL of the ast 4 CN, whe
pseudobubar pasy s the UMNL of the ast 4 CN. So spastcty of
tongue s UMNL. But Dabetes causes LMNL of crana nerves due to
perphera neuropathy. So maybe the cuase here s CNS affecton
due to atherosceross from macroangopathy of dabetes.
604) Which of the following is describe the normal
developmental stage for 6 months old child :
A. Sits without support .
B. Rolls front to back . (7-8 months)
C. No head lag . (3 months)
D. Stand alone . (1 year)
The correct answer s a
.......................................
...................
605) Which of the following personality is characterized by
inflexibility , perfectionism 7
A. OCD .
B. Not otherwise specified .
C. Narcissistic .
The correct answer s b
Obsessve compusve personaty dsorder s dfferent from
obsessve compusve dsorder and s characterzed many by
perfectonsm whe OCD s characterzed by repettve actons due
to compuson. if OCPD is present in the choices it would be
the answer.
.......................................
...................
606) What is the commonest cause of otorrhea :
A. Acute otitis media .
B. Basal skull fracture .
C. External otitis .
The correct answer s a
.......................................
...................
607) Patient was presented by ear pain , red tympanic
membrane , apparent vessels , with limited mobility of the
tympanic membrane , what the most likely diagnosis :
A. Acute otitis media .
B. Tympanic cellulitis .
C. Mastoditis .
The correct answer s a
608) What is the management of acute congestive glaucoma :
A. lV acetazolamide and topical pilocarpine . (true)
.......................................
...................
609) Eight years old child with late systolic murmur best
heard over the sterna border , high pitch , crescendo ,
decrescendo ,>> diagnosis is :
A. Physiological murmur .
B. lnnocent murmur .
C. Ejection systolic murmur .
D. Systolic regurgitation murmur .
The correct answer s c ( I'm not sure )
.......................................
...................
610) Child was presented by coryza , skin rash ,
conjunctivitis , and multiple spots in the mouth :
A. Measles .
B. Rubella .
The correct answer s a.
Meases : due to con|unctvts whch s not present n rubea
.......................................
...................
611) Which of the following could be seen in patient with
bulimia :
A. Hypokalmeia .
B. Metabolic acidosis .
The correct answer s a
buma s aka bng eatng whch means the patent eats a ot
then does forced vomtng so there s oss of acds & eectroytes
whch eads to hypokaema & metaboc akaoss.

612) Maximum spinal height is reached after menarche by
how many years 7
A. Months .
B. Two years .
C. Three years .
The correct answer s c
menarche s at 12-14 years and maxmum heght s about 17 years
.......................................
...................
613) Pregnant lady 34 weeks of gestation presented by
vaginal bleeding , which of the following is relevant to ask
about :
A. Smoking .
B. Desire of future pregnancy .
C. The result of last pap smear .
D. Hx of vaginal irritation .
The correct answer s a , because smokng s an mportant rsk
factor for antepartum he
.......................................
...................
614) Female patient with marginal placenta previa , with 6 cm
dilated cervix , what is your management :
A. Fetal monitoring .
B. Delivery if fully dilated .
C. Tocolytics >
The correct answer s a ( I'm not sure )
I coudnt fnd the answer correcty so based upon the gven
data, feta montorng s a must n any case of hgh rsk pregnancy.
Aso as the PP s margna, there s possbty of devery wthout
severe PPH and the cervx s aready dated.
615) Which of the following drugs increase the survival in a
patient with heart failure :
A. Beta blocker .
B. ACE inhibitors .
C. Digoxin .
D. Nitrites .
The correct answer s b
New updated nformaton. As ACE nhbtors nhbt adosterone
whch f present n hgh concentratons causes modfcaton of the
cardac myocytes n the ong term.
.......................................
...................
616) Elderly patient presented by SOB , rales in auscultation ,
high ]VP , +2 lower limb edema , what is the main
pathophysiology :
A. Left ventricular dilatation .
B. Right ventricular dilatation .
C. Aortic regurgitation.
D. Tricuscpid regurgitation .
The correct answer s a ( cofuuuuuuuse )
Difficult question. Here we have both symptoms of Lft
ventrcuar faure (SOB, Raes) & Rt ventrcuar faure (Hgh |VP &
LL edema). So, more commony ft ventrcuar faure eads to rt
ventrcuar faure due to overoad and not vce versa . so the most
correct s Lft ventrcuar dataton.
.......................................
...................
617) Patient with high output fistula , for which TPN was
ordered , after 2 hours of the central venous
catheterization , the patient become comatose and
unresponsive , what is the most likely cause :
A. Septic shock .
B. Electrolytes imbalance .
C. Delayed response of blood mismatch .
D. Hypoglycemia .
E. Hypernatremia .
The correct answer s a
618) Female patient presented by tender mass below the
axilla , with previous history of pores and black heads in
that's area <<< what is your management :
A. Go to surgery immediately .
B. Oral antibiotics .
C. Topical antibiotics .
D. Steroid .
The correct answer s a , Ths s mosty an nfected abscess.
.......................................
...................
619) Child was presented by erythema , and swelling in his
hand after 18 hours of bee sting , what is your management
in this case :
A. Epinephrine .
B. Antihistaminic drugs .
C. Hospitalization .
The correct answer s b
18 hours s a ong duraton so ts unkey to be anaphyactc shock
& more key a reguar reacton to bee stngs so anthstamncs s
the best souton
.......................................
...................
620) Which of the following is true regarding metformin :
A. Main complication is hypoglycemia .
B. Can lead to weight gain .
C. lt suppress the hepatic glauconeogenesis .
The correct answer s c
.......................................
...................
621) Child was presented by congested throat , coryza , high
grade fever , which of the following is true regarding this
condition :
A. Viral > bacterial .
B. Bacterial > viral .
C. Antibiotics should be given any way .
D. lt is most likely due to EBV .
The correct answer s b ??????
622) Benign tumors of stomach represent almost :
A. 7 %
B. 21 %
C. 50 %
D. 90 %
The correct answer s a
.......................................
...................
623) 60 years old patient presented by recurrent venous
thrombosis including superior venous thrombosis , this
patient most likely has :
A. SLE .
B. Nephrotic syndrome .
C. Blood group O .
D. Antiphospholipid syndrome .
The correct answer s d
.......................................
...................
624) Elderly male patient was presented by left lower
abdomen tenderness , fever , elevated WBC count , what is
the most likely diagnosis :
A. lnflammatory bowel .
B. Diverticulitis .
The correct answer s b
.......................................
...................
625) 22 years old male patient was presented by recurrent
attacks of diarrhea , constipation , and abdominal pain
relieved after defecation , but no blood in the stool , no
weight loss : what is the diagnosis :
A. lrritable bowel Syndrome
626) Patient was presented by back pain relieved by
ambulation , what is the best initial treatment :
A. Steroid injection in the back .
B. Back bracing .
C. Physical therapy .
The correct answer s c
.......................................
...................
627) Patient with long history of constipation presented by
painful defecation , followed by bleeding , pain persist for
hours after defecation what is the diagnosis :
A. Anal fissure .
B. Thrombosed external piles .
C. lnternal hemorrhoid .
The correct answer s a
.......................................
...................
628) Elderly male patient underwent colectomy for colon
cancer in which micrometastais was detected in the lymph
nodes , what is the best explaniation :
A. Good prognosis .
B. Liver metastasis .
C. lt is sensitive to chemotherapy . (Dukes class C cancer best
for chemotherapy)
D. lt is locally advanced .
The correct answer s c
.......................................
...................
629) lV drug abuser was presented by fever , arthralgia ,
conjunctival hemorrhage , what is the diagnosis :
A. Bacterial endocarditis .
.......................................
...................
630) Female patient was presented by dysurea , epithelial
cells were seen urine analysis , what is the explanation in
this case :
A. Contamination .
B. lnfection .
The correct answer s b
631) Patient was presented by tremor , fever , palpitation ,
diagnosed as case of hyperthyroidism , what is your initial
treatment :
A. Surgery .
B. Radio iodine .
C. Beta blockers . Propylthioracil .
The correct answer s c , frsty B-bocker then Prophythourac
because we are afrad of arrhythmas
.......................................
...................
632) Young female patient presented by pain during the first
2 days of menses , menarche was 2 years back , what is
your initial treatment :
A. OCP .
B. NSAlD .
The correct answer s b , NSAID t s the best nta treatment for
dysmenorrhea
.......................................
...................
633) Female is planning to get pregnant , she want to get
MMR vaccine also , what is your action :
A. Delay the pregnancy 2-3 months after vaccination .
B. lt is safe during pregnancy .
The correct answer s a
.......................................
...................
634) Which of the following is true regarding varicella vaccine
during breast feeding :
A. lt is safe .
B. No breast feeding except after 3 days of the immunization .
Couldn't find the answer
.......................................
...................
635) Patient underwent abdominal surgery due to intestinal
perforation many years back , presented by abdominal pain
, distension , constipation , what is the best investigation in
this case :
A. Barium enema .
B. Ultrasound .
C. Small bowel barium study .
The correct answer s c
636) True negative test is best described as following :
A. Not suspected to have the disease who actually do not have
.
.......................................
...................
45-. *atient 'ith AM/ and m%ltiple *6C , is yo%r treatment !or
this arrhythmia #
A. Amiadrone .
B. No treatment .
.......................................
...................
638) Adenosine dose should be reduced in which of the
following cases :
A. Chronic renal failure .
B. Patients on thiophyline .
The correct answer s a
.......................................
...................
639) Which the following is the commonest complication of
patient with chronic atrial fibrillation :
A. Sudden death .
B. Cerebra vascular accidents .
The correct answer s b , due to mutpe atra thromb
.......................................
...................
640) Which of the following is most likely seen in case of
active glomerlonephritis :
A. RBC casts .
.......................................
...................
641) Target HbA1c is less than :
A. 6.5
B. 8
C. 9
The correct answer s a
642) Female patient with candida most likely has :
A. DM .
B. SLE .
The correct answer s a
.......................................
...................
643) Which of the following indicates good prognosis in
schizophrenia :
A. Family history of schizophrenia .
B. Gradual onset .
C. Flat mood .
D. Prominent affective symptoms .
E. No precipitating factors .
The correct answer s d
.......................................
...................
644) Pregnant woman with suspected DVT , what is the best
initial investigations :
A. Duplex US .
B. D dimer .
C. Platysomgraphy .
D. Venogram .
The correct answer s a
.......................................
...................
645) Which of the following is true regarding crohns disease :
A. Partial thickness involvement .
B. Fistula formation .
C. Continuous area of inflammation .
D. Mainly involve the recto sigmoid area .
The correct answer s b
646) Patient serology showed antibodies to the surface
antigen for hepatitis B , what is your diagnosis :
A. Previous infection or immunization .
B. Chronic carrier .
C. Highly infective .
The correcr answer s a
.......................................
...................
647) Young male patient presented by acute scrotal pain , US
showed reduced blood flow , what is the diagnosis :
A. Testicular torsion .
B. Trauma .
C. lnfection .
D. Hernia .
The correct answer s a
.......................................
...................
648) Female patient is sure that she is pregnant for 2
months , on examination , the uterus is larger than
suspected , B-hcg is very high , the doctor diagnosed her as
having tumor which is chemo sensitive , what is the
diagnosis :
A. Ovarian cancer
B. Endometrial cancer .
C. Gestational trophoblastic .
The correct answer s c
.......................................
...................
649) Which of the following is true regarding infertility :
A. lt is Failure to conceive withing 6 months . (1 year)
B. Male factor > female factors . (the reverse)
C. lt could be due to high prolactin levels .
D. Rare to be due anovulotion . (common)
E. Only diagnosed by HSG . (need full lab & imaging
investigations)
The correct answer s c
650) 32 years old female patient presented by irregular
menses , menses occurs every two months , on examination
every thing is normal , which of the following is the LEAST
important test to ask about first :
A. CBC .
B. Pelvic US .
C. Coagulation profile .
D. DHES .
The correct answer s c
.......................................
...................
651) Patient with early rheumatoid arthritis , what is your
management to decrease the limitation of movement :
- Do not use analgesics or steroids, use DMARDs like
methotrexate or antiTNF, hydroxychloroquine
.......................................
...................
652) Patient with truncal obesity , easy bruising ,
hypertension , buffalo hump , what is the diagnosis :
A. Cushing .
.......................................
...................
653) Patient is known case of cervical spondylolysis ,
presented by parasthesis of the little finger , with atrophy
of the hypothenar muscles , EMG showed cubital tunnel
compression of the ulnar nerve , what is your action now :
A. Ulnar nerve decompression .
B. Steroid injection .
C. CT scan of the spine .
The correct answer s a
654) Well known case of SCD presented by plueritic chest pain
, fever , tachypnea , respiratory rate was 30 , oxygen
saturation is 90 % what is the diagnosis :
A. Acute chest syndrome .
B. Pericarditis :
C. VOC .
The correct answer s a , or pneumona woud be more correct f t
was the answer
.......................................
...................
655) Child with hemangioma around the eye , operation
should be done within ... :
A. 1 Week
B. 3 months .
C. 6 months .
The correct answer s a ( I'm not sure )
We ony fear of reducton n the functon of the eye due to
hemangoma so t shoud be removed.
.......................................
...................
656) Which of the following is the recommended diet to
prevent lHD :
A. Decrease the intake of meat and dairy .
B. Decrease the meat and bread .
C. lncrease the intake of fruit and vegetables .
7777
The correct answer s c
.......................................
...................
657) Which of the following can lead to polyhydrmnios :
A. Duodenal atresia .
B. Renal agenesis . Oligohydramnios
C. Post term pregnancy . Oligohydramnios
D. Diabetes inspidious .

The correct answer s a
658) Adult polycystic kidney disease is inherited as:
A. Autosomal dominant .
B. Autosomal recessive .
C. X linked .
The correct answer s a
.......................................
...................
659) The best treatment for bacteroid :
A. Clindamycin .
.......................................
...................
660) You have an appointment with your patient at 10 am who
is newly diagnosed DM , you came late at 11 am because
you have another complicated patient , what are you going
to say to control his anger :
A. Do not say any thing .
B. Told him that there is another patient who really need your
help .
O not compete, but may be The correct answer s b
.......................................
...................
661) Well known case of DM was presented to the ER with
drowsiness , in the investigations : Blood sugar = 400
mg}dl , pH = 7.05 , what is your management 7
A. 10 units insulin + 400 cc of dextrose .
B. 0.1 unit}kg of insulin , subcutaneous .
C. NaHCO .
D. One liter of normal saline .
The correct answer s d
.......................................
...................
662) What is the best method for history taking :
A. Yes or no questions .
B. Open ended .
C. Silent listening .
The correct answer s b
663) What you will give to prevent hemorrhagic disease of
newborns :
A. Vitamin K .
.......................................
...................
664) Arterial injury is characterized by :
A. Dark in color and steady .
B. Dark in color and spurting .
C. Bright red and steady .
D. Bright red and spurting .
The correct answer s d
.......................................
...................
665) 14 years old girl complaining of painless vaginal bleeding
for 2-4 days every 3Weeks to 2 months ranging from
spotting to 2 packs per day; she had 2ry sexual ccc 1 year
ago and had her menstruation since 6 months on clinical
examination she is normal sexual ccc, normal pelvic exam
appropriate action
a. OCP can be used
b. You should ask for FSH and prolactin level
c. Don't do anything & explain this is normal
the correct answer s c
.......................................
...................
666) 4 years old child what can he do
a. Copy square and triangle
b. Speak in sentences
the correct answer s a , f copy square 4 years , but f copu crce 3
years
.......................................
...................
667) baby can sit without support, walk by holding fourniture,
Pincer grasp, pull to stand how old is he
a. 8 months
b. 10 months
c. . 12 month
d. 18 month
The correct answer s b
668) Patient came after deep laceration at the anterior part
of the wrist:
a. Wrist drop
b. Sensory loss only
c. Claw hand
d. Unable to do thumb opposition
The correct answer s d
2- Radial nerve injury : wrst drop , common wth humers n|ury
(humers groove)
3- Unlar nerve injury : caw hand , common wth ebow n|ury
4- Median nerve inury :unabe to do thumb opposton , common
wth wrst n|ury
.......................................
...................
669) Best way to diagnose post streptococcus
glomerulonephritis (spot diagnosis):
a) Low C3
b) 7or RBC casts
c) 7
The correct answer s a ( I'm not sure )
Wth these MCOs , I thnk the correct answer s a , but most
senstve n dagnoss of post streptococcus gomeruonephrts s
increase ASO titer : umpy-bumby mmunofuorescence. or
(streptozyme test, which tests antibodies to ASO) ( f ASO
tter wrtten wth MCOs , t s correct answer .
......................................
....................
670) COPD patient with emphysema has low oxygen prolonged
chronic high CO2, the respiratory drive is maintained in this
patient by:
a. Hypoxemia
b. Hypercapnemia
c. Patient effort voluntary
d. 7
The correct answer s a ( I'm not sure )
.......................................
...................
671) Child with ear pain with positive pump test for tympanic
membrane, treatment is:
a. Maryngiotomy
b. Amoxicillin}Potassium ...
7
The correct answer s a
672) Patient has fatigue while walking last night. He is on
atrovastatin for 8 months, Ciprofluxacin, Dialtizem and
alphaco... the cause of this fatigue is:
a. Dialtizem and Atrovastatin
b. Atrovastatin and Ciprovluxacin
c. Atrovastatin and Alphaco
d. 7
the correct answer s b ( I'm not sure )
.......................................
...................
673) Patient with ischemic stroke present after 6 hours, the
best treatment is:
a) ASA
b)TPA
c) Clopidogril
d)lV heparin
e) Other anticoagulant
The correct answer s a
1- TPA : admnstered wthn 3h of symptoms onset ( f no
contrandcaton)
2- ASA: use wth 48h of schemc stroke to reduce rsk of
death.
3- Calopidogril : can be use n acute schemc
4- Heparin & other anticoagulant : n patent has hgh rsk of
DVT or AF

.......................................
...................
674) Patient with lateral and vertical diplobia, he can't abduct
both eyes, the affected nerve is:
a) ll
b)lll
c) Vl
d)V
I thnk ths s dpopa because nerve 4 , but wth ths O I choose
c

675) lnfant with heamangioma on forehead obscuring the
vision, best thing to do is to remove the lesion to avoid
amblyobia, after:
a) One day
b)One week
c) One month
d)6 months
e) One year
The correct answer s b ( I'm not sure )
.......................................
...................
676) Photophobia, blurred vision, keratic 77 behind cornea
and cells in anterior chamber, the best treatment is :
a) Topical antifungal
b)Topical Acyclovir
c) Antibiotic
d)7
The correct answer s b
.......................................
...................
677) Most common medical problems faced in primary health
care is:
a) Coryza
b)UTl
c) Hypertension
d)Diabetes
The correct answer s a
.......................................
...................
678) Old lady afraid of Osteoprosis, to avoid the risk, you
should advise her to do:
a) Weight bearing exercise
b)7
c) 7
d)7
O s not compete.
679) Obese lady with essential hypertension, lab work
showed: high Na, High K, The reason for Hypertension is:
a) Obesity
b)High Na intake
c) High K intake
d)7
The correct answer s a , more than 85% of essenta
hypertenson wth BMI > 25 .
......................................
....................
680) Patient with eruptive purpuric rash,
hepatosplenomegaly, ....
a) 7
b) 7
c) 7
d) 7
.......................................
...................
681) Single thyroid nodule showed high iodine uptake, best
treatment is:
a) Radio lodine 131
b)Send home
c) Antithyriod medication
d)Excision if present
The correct answer s c
.......................................
...................
682) Athletic with tina pedis best treatment is:
a) Topical antifungal
b)Systemic antifungal
c) Drug starts with trebenafine
d)7
The correct answer s a
683) Young patient with congested nose, sinus pressure,
tenderness and green nasal discharge, has been treated
three times with broad spectrum antibiotics previously,
what is your action7
a) Give antibiotic
b)Nasal corticosteroid
c) Give anti histamine
d)Decongestant
The correct answer s b
.......................................
...................
684) Thyrotoxicosis include all of the following, Except:
a) Neuropathy
b)Hyperglycemia
c) Peripheral Proximal myopathy
d)
O s not compete , a MCOs are wrong , may be choce d s
correct f menton .
.......................................
...................
685) Male patient has hair loss started as fronto-temporal and
moving toward the vertex (top of the head) the diagnosis
is:
a) Androgenic alopecia
b)Tinea Captus
c) 7
d)7
The correct answer s a
.......................................
...................
686) Young healthy male has abdominal pain after basketball.
Examination fine except for Left paraumbilical tenderness,
what to do:
a) Abdominal US
b)Flat plate graph
c) Send home & reassess within 48 hours
d)7
The correct answer s c ( I'm not sure ) , confuse wth choce a
687) 10 year-old boy with ..to tell that spinal cord length will
stop after:
a) 7
b) 7
Length stop at L1 \ L2
.......................................
...................
688) Child with atopic dermatitis at night has stridor plus
barking cough on and off from time to time, diagnosis is:
a) BA
b)Croup
c) Spasmadic Croup
d)7
The correct answer s c
Spasmadic croup : recurrent sudden upper arway
obstructon whch present as srdor and cough . approxmatey
50% of chdren have atopc dsease.
.......................................
...................
689) Sickle cell anemia patient presented with asymptomatic
unilateral hip pain, most likely diagnosis is:
a) Septic arthritis
b)Avascular Necrosis
c) 7
The correct answer s b
.......................................
...................
690) Best drug to treat depression in children and adolescent
is:
a) Fluxetine (Prozac)
b)7
.......................................
...................
691) Old male with neck stiffness, numbness and parasthesia
in the little finger and ring finger and positive raised hand
test, diagnosis is:
a) Thoracic outlet syndrome
b)lmpingement syndrome
c) Ulnar artery thrombosis
d)Do CT scan for Cervical spine
The correct answer s a
692) Patient diagnosed with obstructive jaundice best to
diagnose common bile duct obstruction:
a) ERCP
b)US
c) 7
The correct answer s a
.......................................
...................
693) Endometriosis best diagnosed by
a) US
b)Laproscopy
c) Lapratomy
d)7
The correct answer s b
.......................................
...................
694) Child was sick 5 days ago culture taken showed positive
for meningococcal. Patient now at home and asymptomatic
your action will be:
a) Rifampicin
b)lM Ceftrixone
c) 7
d)7
O not compete ( .m ceftraxon snge dose or ora rfampcn
2-5 days )
.......................................
...................
695) lnfant with bright blood, black stool and foul smelling
stool. Best way to know the diagnosis:
a) US
b)Radio lsotop scan
c) Angiogram
d)7
A MCOs are wrong , f stoo anayss s present , t s correct.
696) Primary hyperaldosteronism associated with:
a) Hypernatremia
b)Hypomagnesemia
c) Hypokalemia
d)Hyperkalemia
The correcr answer s c
.......................................
...................
697) A vaccination for pregnant lad with DT
a) Give vaccine and delivery within 24 hrs
b)Contraindicated in pregnancy
c) Not contraindicated in pregnancy
d)7
The correct answer s c
.......................................
...................
698) A study done to assess the risk of long taking Ca in two
groups the diseased group with long Ca plus control
according to geographical location, site, and population. lt
adds (77) this type of study:
a) Cohort
b)Case Control (retrospective)
c) Correlation study
d)7
The correct answer s a
Cross-Sectional Study:
status of ndvdua wth respect to presence and absence of
both exposure and dsease assessed at one pont n tme
case control study ( retrospective ) :
sampes a group of peope who aready have a partcuar
outcome (cases) and
compares them to a smar sampe group wthout that outcome
(contros)
cohort study : ( prospective, incidence , longitudinal )
sub|ects are samped and as a group are cassfed on the bass
of presence or
absence of exposure to a partcuar rsk factor
.......................................
...................
699) Define Epidemiology
a) 7 "The study of the distribution and determinants of
disease prevalence in man"
700) Case Control description
a) Start with the outcome the FU risk factors
b) 7
......................................
....................
701) Using gastric lavage :
a) Useless after 8 hours of ASA ingestion
b)No benefit after 6 hours of TCA ingestion
c) 7
The correct answer s a
.......................................
...................
702) 10 years old child with rheumatic fever treated early, no
cardiac complication. Best to advice the family to continue
prophylaxis for:
a) 1 month
b)3 ys
c) 4 ys
d)15 ys
The correct answer s d ( I'm not sure , f there s 11 years
choose t )
Amercan heart assocated has recommended a patent wth
hstory rheumatc fever be paced on onge term pencn
prophyaxc. Duraton of prophyaxs depends on presence or
absent of cardts, but for chdren wthout cardts , duraton
mnmum 5 years or at age 21, whchever s onger.
703) Picture of large neck mass only no other manifestations
or organomegaly or lymphadenopathy, diagnosis is:
a) Mononucleosis
b)l would say Goiter
c) 7
d)Lymphoma
The correct answer s b
.......................................
...................
704) Patient with nausea, vomiting, and diarrhea developed
postural hypotension. Fluid deficit is:
a) lntracellular
b)Extracellular
c) lnterstitial
The correct answer s b
.......................................
...................
705) Cardiac syncope:
a) Gradual onset
b)Fast recovery
c) Neurological sequence after
d)7
The correct answer s b
.......................................
...................
706) Best way to decrease pain in elderly with bilateral knee
pain and crepitation is:
a) NSAlD
b)Decrease weight
c) Exercise
d)7
The correct answer s b , (I'm not sure )
707) Young female with whitish grey vaginal discharge KOH
test 77 smell fish like diagnosis is:
a) Gonorrhea
b)Bacterial Vaginosis
c) Trachomanous Vaginalis
d)7
The correct answer s b
.......................................
...................
708) Old lady with osteoporosis asked for treatment for
prevention:
a) VlT. D
b)VlT. E
c) Retonic Acid
d)7
The correct answer s a
.......................................
...................
709) Young male with morning stiffness at back relieved with
activity and uveitis:
a) Ankylosing Spondylitis
b)7
.......................................
...................
710) Best way to prevent infection in medical practice in
pediatric
a) Wear gloves
b)Wash hand
c) Wear mask
d)Wear gown
The correct answer s b
.......................................
...................
711) High risk for developing colon cancer in young male is:
a) Smoking, high alcohol intake, low fat diet
b) Smoking, low alcohol intake, high fat diet
c) Red meat diet, garden's disease (Gardner syndrome)
d) lnactivity, smoking
The correct answer s c
712) Alternative therapy for severe depression and resistance
to anti-depressant medications are:
a) SSRl
b)TCA
c) ECT
The correct answer s c
.......................................
...................
713) Patient had history of pancreatic cancer on
chemotherapy then improved completely, came to doctor
concerning about recurrence of cancer and a history of
many hospital visits. This patient has:
a) Malingering
b)Hypochondriasis
c) Factitious
d)Conversion
The correct answer s b
.......................................
...................
714) Patient came with neck swelling, ,moves when patient
protrude his tongue. Diagnosis is:
a) Goiter
b)Tyroglossus Cyst
c) Cystic Hygroma
d)7
The correct answer s b
.......................................
...................
715) Pregnant patient came with neck swelling and multiple
nodular non-tender goiter the next evaluation is:
a) Thyroid biopsy
b)Give anti-thyroid medication
c) Radiation lodine
d)TSH & Free T4, or just follow up
The correct answer s d
716) Young patient with HTN came complaining of high blood
pressure and red, tender, swollen big left toe, tender
swollen foot and tender whole left leg. Diagnosis is:
a) Cellulitis
b)Vasculitis
c) Gout Arthritis
d)77
The correct answer s a , because tender and swoen whoe eft
eg.
.......................................
...................
717) What is the injection that is routinely given to newborn
to inhibit hemorrhage:
a) Vit. K
b)Vit. C
c) Vit. D
d)Vit. E
The correct answer s a
.......................................
...................
718) Patient with strong genetic factor for colon cancer, what
is the medication that could decrease the risk of colon
cancer:
a) Folic Acid.
b)Vit. C
c) Vit. K or A
d)Vit. E
The correct answer s a ( foac acd and vt. C both are prevent
coon cancer , but foat reduce rsk n peope who genc
predsposng )
.......................................
...................
719) Patient with asthma, well controlled by albutarol, came
complaining of asthma symptoms not respond to albutarol,
what medication could be added:
a) Corticosteroid inhaler
b) Long acting B-agonist
c) Oral corticosteroid
d) Theophyline
The correct answer is a
720) Henosch-Scholen purpura affect:
a) Capillary
b)Capillary and venule
c) Arteriole, capillary and venule
d)Artery to vein
The correct answer s c
.......................................
...................
721) Contraceptive pill that contain estrogen increase risk of:
a) Breast Ca
b)Ovary Ca
c) Cervical Ca
d)7
The correct answer s a
.......................................
...................
722) Patient came with upper respiratory tract infection with
red conjunctiva, the cause is:
a) Viral infection
b)Bacterial infection
c) Fungal infection
d)7
The correct answer s a
.......................................
...................
723) Healthy patient with family history of DM type 2, the
most factor that increase chance of DM are:
a) HTN and Obesity
b)Smoking and Obesity
c) Pregnancy and HTN
d)Pregnancy and Smoking
The correct answer s a
724) Patient complaining of back pain and hypersensitive skin
of the back, on examination, patient had rashes in the
back, tender, red base distributed as blunt shape on the
back, diagnosis is:
a) Herpes Zoster
b)CMV
c) 7
d)7
The correct answer s a ( q not compete )
.......................................
...................
725) Old patient complaining of hematuria, on investigation,
patient has bladder calculi, most common causative
organism is:
a) Schistosoma
b)CMV
c) 7 virus
d)7 virus
The correct answer s a
.......................................
...................
726) Blood culture show gram negative rod shape that grow
only on charcoal free fungal organism is:
a) Staph. Aureus
b) Chlamydia
c) Klebsiella
d) Mycoplasma
A above are wrong , le&ionella : grame negatve rod growth on
charcoa agar
.......................................
...................
727) Klebesilla feacalis cause the following disease:
a) Pneumonia
b) 7
c) 7
d) 7
Enterococcus faecalis Cause Gastroenteritis
.......................................
...................
728) Dermatomyositis came with the following symptoms:
a) Proximal muscle weakness
b)Proximal muscle tenderness
c) 7
d)7
The correct answer s a
.......................................
...................
729) Bursitis of the elbow joint caused by:
a) Elbow trauma
b)Autoimmune disease
c) Staph. Aureus
d)7 rupture of bursa
The correct answer s a
.......................................
...................
730) Patient came with symptoms of anxiety including
palpitation, agitation, and worry. The first best line for
treatment is:
a) SSRl
b)TCA
c) B-blocker
d)MAOl
The correct answer s a , I'm not sure
May be the correct answer s b because there s agtaton ( aso,
sde effect of SSRI)
.......................................
...................
731) Pregnant diagnosed with UTl. The safest antibiotic is:
a) Ciprofloxacin
b)Ampiciln
c) Tetracycline
d)7
Wth these MCOs , the correct answer s b , but f present
nitrofurantion s more accurate answer . UTI n pregnancy
treated by : nitrofurantion or cephalosporine ( 3- 7 days ) n
symptomatc or asymptomatc UTI . avod furoroqunoone
( whch ncude : cprofoxacn, gatfoxacne, evofoxacn,
norfoxacn ).
732) Patient is complaining of right side pharynx tenderness
on examination patient had inflamed right tonsil and
redness around tonsil with normal left tonsil. The diagnosis
is:
a) Parenchymal tonsillitis
b)uinse parapharyngeal abscess
c) 7
d)7
The correct answer s b
.......................................
...................
733) Patient came complaining of fever, night sweating, and
hemoptysis with positive PPD test. Examination was
normal, CXR shows infiltrate of left apical lung but in lateral
X-ray showed nothing the repeated PPD test showed
normal result diagnosis is:
a) Sarcoidosis
b)Reactivated TB
c) Mycoplasma infection
d)Viral infection
The correct answer s b
......................................
....................
734) Femal patient came with lower abdominal pain, fever on
exam patient has lower abdominal tenderness and tender
cervical fornix, the most appropriate way to diagnose the
problem is:
a) Laproscopy
b)Heterosalpingography
c) Abdominal CT
d)Radionuclar Study
The correct answer s a
.......................................
...................
735) The best non-medical therapy is proven to be of benefit
for osteoarthritis is:
a) Muscle strength exercise
b) Give NSAlD
c) Back slap
d)7
The correct answer s a
736) Hematological disease occurs in children, treated with
heparin and fresh frozen plasma what is the disease:
a) Hemophilia A
b)Hemophilia B
c) Von-wille brand disease
d)DlC thrombosis
The correct answer s d
.......................................
...................
737) Child with URTl is complaining of bleeding from nose,
gum and bruising the diagnosis is:
a) Hemophilia A
b)lTT
c) 7
d)7
The correct answer s b
.......................................
...................
738) Patient came complaining of vague abdominal pain for 6
hours then shifted to right lower quadrant diagnosis is :
a) Acute appendicitis
b)Diverticulitis
c) 7
d)7
The correct answer s a
.......................................
...................
739) Female patient is complaining of abdominal distension,
fever and nausea abdominal x-ray showed (Ladder sign)
management is:
a) Colostomy
b)lleus treatment
c) Rectal de-obstruction
d)7
The correct answer s b ( I'm not sure because O IS NOT
COMPLETE )
740) The best stimulus for breast milk secretion is :
a) Estrogen
b)Breast feeding
c) 7
The correct answer s b
.......................................
...................
741) Female patient did urine analysis shows epithelial cells in
urine, it comes from:
a) Vulva
b)Cervix
c) Urethra
d)Ureter
The correct answer s c
.......................................
...................
742) All of the following are risk factors for heart disease
except:
a) High HDL
b)Male
c) Obesity
The correct answer s a
.......................................
...................
743) The most signs and symptoms of abruption of placenta
is:
a) Vaginal bleed
b)Fetal distress
c) Uterus pain and back pain
d)Abnormal uterine contraction
The correct answer s a
744) Sign of severe hypokalemia is:
a) P-wave absence
b)Peak T-wave
c) Wide RS complex
d)Seizure
The correct answer s d , ( I'm not sure , may be choce e f
menton , s corect )
severe hypokalemia is defined as a level less than 2.5
mEq}L.
Severe hypokalemia is not linked with any symptoms,
but may cause:
1- musce
2- myaga or musce pan
3- dsturbed heart rhythm ncudng ectopy (dsturbance of the
eectrca conducton system of the heart where beats arse from
the wrong part of the heart musce)
4- serous arrhythmas (eectrca faster or sower than norma)
5- greater rsk of hyponatrema (an eectroyte dsturbance n
humans when the sodum concentraton n the pasma decreases
beow 135 mmo/L) wth confuson and sezures
ECG changes in hypokalemia :
1-T-wave fattenng
2-U-wave : ( addtona wave after the T wave )
3-ST - segment depresson
ECG changes in hyperkalemia :
1- peak T wave
2- wde ORS ( n severe case )
3- PR proong ( n severe case )
4- oss of P wave
.......................................
...................
745) Child came with his father and high BMl and look older
than other children with same age, on exam child has >95
th
percentile of weight and tall, management is:
a) Observe and appoint
b)Life style change
c) Give program to decrease the weight
d)7
The correct answer s a

746) Pregnant on 36
th
week came with 7 cm cervical width at 0
station. During birth, CTG shows late deceleration,
management is:
a) Give Oxytocin
b)O2 and change mother position
c) Give Mg sulfate
d)7
The correct answer s b
Type of
deceleration
etiology management
early Head compresson
from uterne
contracton (norma )
No treatment
late Uteropacenta
nsuffcency and feta
hypoxma
Pace patent on sde
Dscontnue oxytocn.
Correct any hypotenson
IV hydraton.
If deceeratons are assocated wth
tachysystoe consder terbutane 0.25
mg SC
Admnster O2
If ate deceeratons persst for more
than 30 mnutes despte the above
maneuvers, feta scap pH s ndcated.
Scap pH > 7.25 s reassurng, pH 7.2-
7.25 may be repeated n 30 mnutes.
Dever for pH < 7.2 or mnma
basene varabty wth ate or
proonged deceeratons and nabty to
obtan feta scap pH
variable Umbca cord
compresson
Change poston to where FHR
pattern s most mproved.
Trendeenburg may be hepfu.
Dscontnue oxytocn.
Check for cord proapse or mmnent
devery by vagna exam.
Consder amnonfuson
Admnster 100% O2
747) The way to determine the accuracy of occult blood test
for 11,000 old patients is by measuring:
a) Sensitivity
b)Specificity
c) Positive predictive value
d)Negative predictive value
The correct answer s a
.......................................
...................
748) Sickle cell patient, asymptomatic with history of
recurrent gall-stones and recurrent crisis the management
is:
a) Cholecystectomy
b)Hydroxyurea
The correct answer s a
.......................................
...................
749) Patient came with HTN, KUB shows small left kidney,
arteriography shows renal artery stenosis, what is the next
investigation:
a) Renal biopsy
b)Renal CT scan
c) Renal barium
d)Retrograde pyelography
The correct answer s
.......................................
...................
750) The way to differentiate between low iron level from iron
deficiency anemia and anemia of chronic disease is:
a) Ferritin
b)TlBC
c) Serum lron
d)Serum Transferrin
The correct answer s a
751) Patient came with hallucination and illusion the
medication that should be given is:
a) Carbamezapin
b)7 Haloperidol
c) 7
O not compete, but wth ths scenaro and MCOs , the correct
answer s b
.......................................
...................
752) As doctor if you see patient and you face difficulty to get
accurate information from him the best tactic to do it is:
a) Ask direct question
b)Ask open question
c) Control way of discussion
d)7
The correct answer s a
.......................................
...................
753) (long question) patient came with MDD so during
communication with patient you will find :
a) Hypomania
b)Late morning awake
c) Loss of eye contact
d)7
The correct answer s b
.......................................
...................
754) Child patient after swimming in pool came complaining of
right ear tenderness on examination patient has external
auditory canal redness, tender, and discharge the
management is:
a) Antibiotics drops
b)Systemic antibiotics
c) Steroid drops
d)7
The correct answer s a
755) Child came with inflammation and infection of the ear the
most complication is:
a) Labrynthitis
b)Meningitis
c) Encephalitis
d)Mastoiditis
The correct answer s d
.......................................
...................
756) Elderly patient complaining of urination during night and
describe when he feel the bladder is full and need to wake
up to urinate, he suddenly urinate on the bed this is:
a) Urgency incontinence
b)Urge incontinence
c) Stress incontinence
d)Flow incontinence
The correct answer s d
types Hx of urine loss mechanism treatment
total Uncontroed oss at
a tmes and n a
poston
Loss of sphncter
effcency or abnorma
connecton b\w urnary
tract and skn( fstua)
surgery
stress After ncrease
abdomna pressure
(coughng, sneezng,
ftng )
Urethra sphncter
nsuffcency due to
axty of pevc foor
muscuature , common
n mutparous women
Kega
exercseand
pessary
surgery
urge Strong, unexpected
urge to vod that s
unreated to poston
or actvty
Detrusor hyperrefexa
or sphncter
dysfuncton or
neuroogc dsorder
Antchonergc -
medcaton or
TCA : behavor
tranng
overflo
w
Chronc urnary
retenton
Increase ntravesca
pressure that |ust
exceed the outet
Pacement of
urethra
catheter , treat
resstance , aow sma
amount of drbbe out
underyng
causes
757) Newborn came with red-lump on left shoulder, it is:
a) Hemangioma
b)7
c) 7
is not complete
.......................................
...................
758) Child came to ophthalmology clinic did cover test, during
eye cover , his left eye move spontaneously to left, the
most complication is:
a) Strabismus
b)Glaucoma
c) Myobloma
d)7
The correct answer s a
.......................................
...................
759) Newborn came with congenital hepatomegaly, high LFT,
jaundice the most organism cause this symptoms is:
a) Congenital TB
b)Rubella
c) HlV
d)CMV
The correct answer s d
.......................................
...................
760) Gross motor assessment at age of 6 months to be asked
is:
a) Sitting without support
b)Standing
c) Role from prone to supine position
d)Role from supine to prone position
The correct answer s a
761) Female child came with precocious puberty the most
cause is:
a) ldiopathic
b)Adrenal tumor
c) Brain tumor
d)7 ovarian tumor
The correct answer s a
.......................................
...................
762) Hemorrhoid usually occurs in:
a) Pregnancy and portal HTN
b) ?
c) ?
d) ?
O s not compete
Most common causes of hemorrhoid : ncrease stranng
( constpaton ) , porta HTN , ncrease abdomna pressure
( chromng cough , pevc tumor ) , obesty , pregnancy ,
smokng
.......................................
...................
763) The immediate urgent referral of child that take
a) 10 pills contraceptive
b) 10 pills antibiotics7
c) 75 mg 7
77777
.......................................
...................
764) Most unwanted side effect of anti-cholinergic drugs is :
a) Constipation
b) 7
c) 7
more than 50% of patents takng antchonergc have sde
effects : dry mouth , burry vson , constpaton and urnary
retenton .
765) Patient with DM ll with good vision, to prevent eye
disease (Retinal back ground) to develop is to avoid:
a) HTN, Smoking
b)Obesity, Smoking
c) HTN, Obesity
d)7
The correct answer s c
The risk factors that increase diabetic retinopathy
background are:
1- HTN
2- Poor gucose contro or ong case D.M
3- Rased eve of fat ( choestero)
4- Rena dsease
5- Pregnancy ( but not n dabetes caused by pregnancy )

.......................................
...................
766) Best medication to be given for GDM (gestational) is:
a) lnsulin
b)Metformin
c) 7
The correct answer s a

767) A child is complaining of severe headache which is
unilateral, throbbing and aggravated by light, diagnosis is:
a) Migraine
b)Cluster Headache
c) Stress Headache
d)7
The correct answer s a
.......................................
...................
768) The most important factor for smoker to quit is :
a) Patient desire
b)Give nicotine pills
c) Give programmed plan
d)Change life style
The correct answer s a
.......................................
...................
769) Patient is complaining of irritation, tachycardia, night
sweating, labs done showed TSH: Normal, T4: High,
diagnosis is:
a) Grave's disease
b)Secondary Hypothyriodism
c) Hashimoto's thyroiditis
d)7
A MCOs are wrong , choce d may be correct f menton
Normal TSH and increase T4 : in thyroid tropin
secretary pitutay adenoma = thyroid resistance .
.......................................
...................
770) The most active form is:
a) T4
b)T3
c) TSH
d)TRH
The correct answer s b
771) Middle age man found to have heaviness in his groin. On
physical examination there was swelling just above his
testis which apparent with valsalva maneuver. What is the
diagnosis:
a) Direct inguinal hernia
b)lndirect inguinal hernia
c) Femoral Hernia
d)Testicular mass
e) Hydrocele
f) Varicocele
The correct answer s b
.......................................
...................
772) Gardener has recurrent conjunctivitis. He can't avoid
exposure to environment. ln order to decrease the
symptoms in the evening, GP should advise him to:
a) Cold compression
b)Eye irrigation with Vinegar Solution
c) Contact lenses
d)Antihistamines
The correct answer s d
.......................................
...................
773) 48 year-old male complaining of lower back pain with
morning stiffness for 30 minutes only. On exam he was
having spasm centrally on the lower back. What is the
appropriate management :
a) Epidural steroids injection
b)Back brace
c) Facet lysis
d)Physiotherapy
The correct answer s d
.......................................
...................
774) 41 weeks pregnant lady last biophysical profile showed
oligohydroamnios. She has no complaints except mild HTN.
What is the appropriate management :
a) Wait
b)lnduce labor post 42 wks
c) lnduce labor
d)Do biophysical profile twice weekly
The correct answer s c
775) Full term wide pelvis lady, on delivery station +2, vertex,
CTG showed late deceleration, the most appropriate
management:
a) C}S
b)Suction
c) Forceps Delivery
d)Spontaneous Delivery
The correct answer s c (I'm not sure )
.......................................
...................
776) Recent study revealed that anti psychotic meds cause the
following complication:
a. wt gain
b. alopecia
c. cirrhosis
the correct answer s a
.......................................
...................
777) compilication of rapid correction of hypernatremia :
a.brain edema
in hypernatremia : graduay correcton to prevent
cerebra edema
in hyponatremia : graduay correcton to prevent
,myenoyss ( ncude paraparess \ quadrparess , dysarthra
and coma
.......................................
...................
778) prophylaxis of cholera :
Cholera s an nfecton of the sma ntestne that s caused by the
bacterum 6i(rio cholerae. The man symptoms are profuse
watery darrhea ( rce-watery darrhea ) vomtng and
dehydraton . nfecton by feca-ora rout .
treatment : 1- rehydraton , 2-antbotc : young & adut :
doxcycne or tetracycne , for chdren : SMX-TMP , for pregnant :
furazodone .
prphylaxis : good hygene and santaton and ora vaccne , n
epdemc pubc : mass snge dose of vaccne and tetracycne.

778)which one of the anti TB medications cause tinnitus,
imbalance..
a. streptomycin
b. isoniazide
c. pyrizinamide
the correct answer s a , sterptomycne : cause 8
th
nerve
damage
......................................
....................
779) the following combination drug should be avoided :
a. levodopa & digoxin
O s not compete
.......................................
...................
780)young male had pharyngitis,then cough ,fever,most likely
org
a. staph aureus
b. strept pneumonia
the correct answer s b
.......................................
...................
781)most effective measure to prevent spread of infection
among health care workers & pts in a nursery:
a. wash hand befor and after examining each pt
b. wear gown and gloves before entering the nursery
c. wear shoe cover
the correct answer s a

782) 27 yrs old female with perianal pain for 4 days tender
erythematous fluctuating
a. Abx
b. local CS
c . Sitz bath
e. evac & drain
the correct answer s e
.......................................
...................
783)female pt developed extreme from zoo,park, sporting
events, the fear prevented her from going out:
a. agoraphobia
b. social phobia
c. schizophrenia
the correct answer s a , ( agoraphopia : fear gong out from
the home )
.......................................
...................
784)child starts to smile:
a. at birth
b. 2month
c. 1month
The correct answer s b
......................................
....................
785)child recognize 4 colors, 5 words, hops on one foot,
consistent with which age:
a. 12 mons
b. 24 mons
c. 36 mons
d. 18 mons
the correct answer s c
786)pt with hx of 5 yrs HTN on thiazide, came to ER midnight
screaming holding his Lt foot, o}e pt afebrile,Lt foot tender
erythema, swollen big toe most tender and painful, no
other joint involvement
a. cellulitis
b. gouty arthritis
c. septic arthritis
the correct answer s b
.......................................
...................
787)23 yrs old married for 3 mons, c}o not getting pregnant,
they have intercourse 3-4 times}week, normal gynecologic
hx, husband 25 yrs old healthy wt would you advice:
a. cont. trying
b. obtain sperm analysis
c. study of tubes patency
the correct answer s a
.......................................
...................
788)pt with AF what is the most common complication:
a. cerebrovascular events
b. v.tach
c. AMl
d. v.fib
the correct answer s a
.......................................
...................
789)case scenario : oral+genital ulcer +arthritis
a. behcet disease
b. syphilis
c.herpes simplex
the correct answer s a
790) 20 yrs old lady, pregnant, exposed to rubella virus since 3
days , never was vaccinated against rubella mumps or
measles , what's the best thing to do:
a. give lG
b. vaccine
c. do nothing
d. terminate the pregnancy
the correct answer s c , ony supportve . ( 100 % correct )
.......................................
...................
790)which of the following not compatible with head
engagement:
a. vertex at zero station
b. crowning of the head
c. 3}5 head felt in the abdomen
d. BPD at ischial spines
the correct answer s c , When the fetal head is engaged,
2}5 or less of the head is palpable above the pelvic
791)58 yrs old female, known case of osteopenia, she's asking
you abt the best way to prevent compression vertebral
fracture, what would you advice her:
a. avoid obesity
b. vit.D daily
c. wt bearing exercise
the correct answer s c , cnfuse wth choce b
mild osteopenia ( T score -1 to -2 ): fe stye modfcaton
( stop smokng ) , day cacum ntak ( 1500 mg day ) ,
exercse , and reassessed after 3 - 5 years .
severe osteopenia ( T score -2 to - 2.5 ) and osteoporosis
( T score > 2.5 ) : same md pus pharmacoogca .
.......................................
...................
792) Mother complains of sharp pain on radial styloid when
carrying her baby. The pain increase with extension of the
thumb against resistance, Finkelstein test was positive,
Dx :
a. Osteoarthritis of radial styloid
b. De uervain Tenosynovitis
the correct answer s b
......................................
....................
793) 1
st
line in Trigeminal Neuralgia management:
a. Carbamazepine
......................................
....................
794) Contraindicated in acute glaucoma management:
a. Pilocarpine
b. Timolol
c. B-blockers, CA inhibitors, NSAlD, Mannitol
d. 7
A of MCOs can be use n acute gaucoma . may be choce d s
correct f menton.
795) True about systolic hypertension:
a. could be caused by mitral Regurg
b. More serious than diastolic hypertension
c. systolic>140 and diastolic <90
d. 7
the correct answer s c
......................................
....................
796) Pregnant 38GA, presented in labor, dilated cervix,
station 42, late deceleration on CTG, management:
a. continuo spontaneous labor
b. Forcep delevary
c. Vacuum Delevary
d. CS
The correct answer is a ( l'm not sure )
.......................................
...................
797) Pt, febrile, tender prostate on PR:
a-Acute Prostitis
.......................................
...................
798) Proven to prevent some cancers:
a. Ca
b. Folic Acid
c. Vit.D
the correct answer s c
.......................................
...................
799) Patient with cont. Murmur:
a. PDA
b. Coarctation of Aorta
the correct answer s a
800) Old man, post OR, Complains of unilateral face swelling:
a. Sjorjan syndrome
b. Sarcoidosis
c. Salivary gland tumor
d. Salivary gland stone
the correct answer s d
.......................................
...................
801) At what level LP done:
a. L2-L3
b. L3-L4
c. L5-S1
The correct answer s b
.......................................
...................
802) 2months old with scaling lesion on scalp and forehead,
Dx:
a. Seberrhoic Dermatitis
b. Erythema multiforme
the correct answer s a
.......................................
...................
803) Pt have high Blood Pressure on multible visits, so he was
diagnosed with hypertension, what is the Pathophysiology:
a. increased peripheral resistance
b. increased salt and water retention
the correct answer s a
.......................................
...................
804) 13years old with hx of pneumonia and managed with abx
2 weeks back, now he came with diarrhea, abdominal pain,
and +ve WBC in stool, the causative organism is:
a. Clostridium dificile
.......................................
...................
805) Best Manag. Of Clost.Deficile is:
a. Metronidazole
b. Doxacycline
the correct answer s a
806) Prophylaxis of arrhythmia post Ml :
a. uinidine
b. uinine
c. Lidocaine
d. Procainamide
the correct answer s c , f b-bocker s present choose t
.......................................
...................
807) Chronic Diarrhea is a feature of:
a. HyperNatremia
b. HyperCalcemia
c. HypoMagnesemia
d. Metabolic Alkalosis
The correct answer s d
.......................................
...................
808) Pt with have Polyuria and thirst, he had Hx of bipolar on
lithium, Dx:
a. Nephrogenic Diabetes lnsipidus
b. central Diabetes lnsipidus
the correct answer s a
.......................................
...................
809) ln city with population of 15000 people & 105 birth }yr ,
4 are still birth ,3 died within months ,2 died before their 1
st
birthday , with 750 p come out & 250 come in what is the
birth mortality rate in this city :
a. 4
b. 6
c. 8
d. 9
not complete ( l did't finde any thing about bierth
mortality rate )
810) Female with recently inserted lUCD coming with watery
brownish vaginal discharge & abdominal pain what is the
most likely Dx :
a. Uterine rupture
b. Ovarian torsion
c. Bacterial vaginosis
d. Ectopic pregnancy
The correct answer s d
.........................................
.................
811) 38 y}o male calling you complaining of fear from going
outside & fear from seeing the front door & don't sit in the
room containing the front door what is most likely Dx:
a. Depression
b. Agoraphobia
c. Malingering
d. Anti-social personality
The correct answer s b
........................................
..................
812) 60 y}o male known to have ( BPH) digital rectal
examination shows soft prostate with multiple nodularity &
no hard masses , the pt request for ( PSA) for screening for
prostatic ca what will you do :
a. Sit with the pt to discuss the cons & rods in PSA test
b. Do trans-rectal US because it is better than PSA in
detection
c. Do multiple biopsies for different sites to detect
prostatic ca
d. .........
The correct answer s a
.........................................
.................
813) What is the most effective ttt for rocasea :
a. Clindamycine
b. Erythromycin
c. Topical steroids
d. ....
O s not cear or not compete. ( f menton tetracycne choose t )
Treatment of Rosacea : Ora tetracycnes & topca
metrondazoe or topca erthyromycn or topca cnamycne . for
severe case : sotretnon . surgical treatment for
rhinophyma .
814) 7 y}o child coming with SOB and wheezing he was sitting
in bed , leaning forward , with drooling & strider what is
Dx :
a- Epiglottits
b- Bronchial asthma
c- ...
d- ...
The correct answer s a
.........................................
.................
815) 10 y}o child brought by his parents because they where
concern about his weight , he eats a lot of fast food and
French fries , your main concern to manage this pt is :
a- His parents concerning about his weight
b- His BMl > 33
c- Family Hx of heart disease
d- Eating habit ( fast food , French fries )
.........................................
.................
816) What is an absolute contraindication of OCP :
a. Hx of previous DVT
b. Ovarian ca
c. Breast ca
d. ....
The correct answer s a , both hx of DVT and breast cancer are
absoute contrandcaton , but n hx DVT s more accurate
.........................................
.................
817) OCP is proven to :
a. Decrease ovarian ca
b. Decrease endometrial ca
c. lncrease breast ca
d. lncrease risk of ectopic pregnancy
The correct answer s c

818) Baby born & discharge with his mother , 3weeks later he
started to develop difficulty in breathing & become
cyanotic what is most likely DX :
a- VCD
b- Hypoplastic lt ventricle
c- Coarctaion of aorta
d- Subaortic hypertrophy
The correct answer s b
......................................
....................
819) 60 y}o male Dx to have acute pancreatitis ( there was
values for ranson criteria that l couldn't memorize ) what is
the appropriate nutrition :
a- TPN
b- Regular diet with low sugar
c- High protein ,high ca , low sugar
d- Naso-jujenal tube
The correct answer s d
.......................................
...................
820) 15 y}o boy brought by his mother with lab values shows
microcytic hypochromic anemia what is most likely Dx :
a- Thalassemia
b- lDA ( iron deficiency anemia )
c- SCD
d- ...
The correct answer s b
.......................................
...................
821) Female with Hx of lt flank pain radiating to groin ,
symptoms of UTl & N+V what is DX:
a- Appendicitis
b- Diverteculitis
c- Renal colic
d- ....
The correct answer s c
822) Old pt with neck swelling , nodular ,disfiguring , with Hx
of muscle weakness , cold intolerance , hoarseness , what is
your management :
a- Levothyroxine
b- Carbamazole
c- Thyroid lobectomy
d- Radio-active iodine
The correct answer s a
.......................................
...................
823) Pregnant woman with symptoms of hyperthyroidism ,
TSH low :
a- Propylthyiouracil
b- Radio-active iodine
c- Partial thyroidectomy
d- .....
The correct answer s a
.......................................
...................
824) Pt with thyroid mass , firm ,2x2 cm what is most
appropriate for Dx :
a- Neck US
b- FNA
c- Neck CT
d- Surgery
The correct answer s b
.......................................
...................
825) 56 y}o female complaining of back pain , her mother
suffer from vertebral compression Fx , investigation shows
early osteoporosis what is the best ttt :
a- Advice with exercise
b- Vit D , ca supplement , ...
c- ......
d- .....
The correct answer s b
.......................................
...................
826) What is the most common non-traumatic Fx caused by
osteoporosis :
a- Colle's Fx
b- Femoral Fx
c- Vertebral compression Fx
The correct answer s c , because most common non traumatc .
827) 4 or 5 ( not sure ) brought by his parents with weight >
95
th
percentile , height < 5
th
percentile & bowing of both
legs what is the appropriate management :
a- Liver & thyroid function tests
b- Lower limb X-ray
c- Pelvis X-ray
d- Thyroid or ( liver not sure ) function test
The correct answer s a
......................................
....................
828) At which stage sapration of chromatoids occur :
a- Metaphase
b- Telophase
c- .....
d- .....
The correct answer s a
.......................................
...................
829) Elderly pt with DM2 , HTN , smoker , sedentary lifestyle ,
inestigation low HDL, high LDL , ( - ,' - '- ^-- ) which of
what will be effective in this pt :
a- Level of HDL , smoking , obesity
b- Triglyceride level , ........
c- ....................
d- ....................( all were long sorry )
MCs are not complete.
.......................................
...................
830) pt known case of ulcerative colitis with erythematous
rash in lower limb what is most likely DX:
a- erythema nodusum

831) Pt known to have ulcerative colitis coming with skin
lesion around Tibia which is with irregular margins what is
most likely Dx:
a- Pyoderma gangirenosum

......................................
....................
832) Young pt victim of RTA coming with SOB ( or not
breathing not sure ) absent of breath sound & chest
movement in RT side but resonance in percussion what is
your next step :
a- Do stat chest X-ray
b- Emergency surgery
c- ............
d- ............
Neede aspraton then chest tube
.......................................
...................
833) Psychiatric pt non-compliance to his medication what is
the ttt :
a- ..... Given lM
b- ......... given lV
c- ........oral
d- .........oral
is not complete
.......................................
...................
834) Which psychiatric disease is treated with
electroconvulsive therapy :
a- Paranoia
b- ...........
The correct answer is : Major depression
835) Pt with bilateral eye discharge , watery , red eyes,
corneal ulceration what is the most common cause :
a- Dust & pollen
b- Hypertension & .....
c- Ultra-violet light & stress
d- ..............
The correct answer s a
.......................................
...................
836) 4 y}o baby felt down his mother pulled him by his arm &
since then he kept his arm in pronation position what is
your management:
a- Splint .....
b- Do x-ray for the arm before any intervention
c- Orthopedic surgery
d- .............
The correct answer s b
.......................................
................. ..
838) diabetic pt on medication found un conscious his blood
suger was 60 what is the most common to cause this
problem:
a- Sufonylurease
b- Bigunides
c- ........
The correct answer s a
.......................................
...................
839) what is most sensitive indicator for factitious fever :
a- Pulse rate
b- .........
c- ..........
Factitious fever: Fever produced artfcay by a patent. Ths s
done by artfcay heatng the thermometer or by sef-
admnstered pyrogenc substances. An artfca fever may be
suspected f the puse rate s much ess than expected for the
degree of fever noted. Ths dagnoss shoud be consdered n a
patents n whom there s no other pausbe expanaton for the
fever. Patents who pretend to have fevers may have serous
psychatrc probems.
840) young male ( l think he was a student ) with headache
involving the whole head & bilateral eye glob that increase
with stress what is most likely DX:
a- Tension headache
b- Migraine
c- .........
d- ..........
not cmplete
.......................................
...................
841) pt turns to be erratic , for 4 month he said that's people
in TV knows what people are thinking about , in last 2
month he claim that he has special power that no one has
what is the most likely DX :
a- Uni-polar ... depression
b- Bipolar .. Mania
c- SCZ
d- ........
The correct answer s c
.......................................
...................
842) common site of anal fissure is :
a- Anterior
b- Posterior
c- Lateral
d- .........
The correct answer s : b
.......................................
................. ..
843) common site of hernia sac in relation to the cord content :
a- Antro-lateral
b- Medial
c- Anywhere
d- Posterior
The correct answer s a
844) what a 4 years child can do :
a- Draw square & triangle
b- Say complete sentence
c- Tie his shoes
d- .............
The correct answer s a
.......................................
...............
845) You received a call from a father how has a son diagnosed
recently with DM-l for six months, he said that he found his
son lying down unconscious in his bedroom, What you will
tell him if he is seeking for advise:
a. Bring him as soon as possible to ER
b. Call the ambulance
c. Give him his usual dose of insulin
d. Give him lM Glucagone
e. Give him Sugar in Fluid per oral
The correct answer s e
.......................................
...................
846) factor which determine recurrence of breast cancer :
a- Site & size of breast mass
b- No of lymph nodes
c- Positive estrogen receptor
d- Positive progesterone receptor
The correct answer s b
.......................................
...................
847) teacher in school presented with 3 days Hx of jaundice
( they wrote it ictric as if it will a differacne) & abdominal
pain , N+V , 4 of school student had the same illness in lab
what is true regarding this pt :
a- Positive for hepatitis A lgG
b- Positive hepatitis A lgM
c- Positive hepatitis B core
d- Positive hepatitis B c anti-body
The correct answer s b
848) regarding weight gain in pregnancy what is true :
a- Pregnant woman should consume an average calorie 300-
500 per day
b- Regardless her BMl or body weight she should gain from
1.5 - 3 lb which represent the baby's growth
c- ........................
d- .........................
is not complete
Weight gain during pregnancy :
- 100 - 300 Kcal } day , 500 Kcal } day in breastfeeding
- Wt. gain : 1 - 1.5 kg } month , 11 - 16 kg gain during
pregnancy.
( for change from Ib to Kg : dvded by 2.2)
.......................................
...................
849) what condition is an absolute contraindication of lactation
:
a- Mother with open pulmonary TB for 3 month
b- Herpes zoster in T10 drematome
c- Asymptomatic HlV
d- ..................
The correct answer s c
.......................................
...................
850) what is most sensitive for DX of duodenal ulcer :
a- Epigasteric pain starting 30-60 min after the meal
b- Epigasteric pain staring immediately after a meal
c- lncreasing of pain when lying supine
d- Pain radiating to the back
The correct answer s d
.......................................
...................
851) female at 40 yr with BMl >28 what is your management :
a- Reduce calorie in take to 800 }day
b- ln general reduce calorie intake
c- ..............
d- .................
O s not compete, but wth these MCOs , the correct answer s b
852) 70 y}o female say that she play puzzle but for a short
period she can't play because as she develop headache
when playing what u will exam for
a. astigmatism
b. glaucoma
the correct answer s a
.......................................
...................
852) prophylaxis for meningitis ttt contact
a. cimitidine
b. rifampicin
the correct answer s b
.......................................
...................
853)rheumatic fever pt has streptococcal pharingitis risk to
develop another attack
a. trimesmore than normal
b. 100%
c. 50%
the correct answer s c
.......................................
...................
854)child with unilateral nasal obstruct with bad odor
a. unilateral adenoid hypertrophy
b. FB
the correct answer s b
.......................................
...................
855)PT. do colectomy for colon cancer routine follow up every
a. 6 months
b. 3 months
c. 9 months
d. 1 years
the correct answer s d
856) for patient with osteoarthritis , what is your initial action :
a. lntraarticular corticosteroid
b. uadriceps strengthening exercise
c. Climb stairs exercise
The correct answer s b
.......................................
...................
857) 70-y old female patient with osteoporosis , what is her T
score :
a. (-2.5)
b. (-1)
c. (1)
d. (2)
The correct answer s a
.......................................
...................
858 ) diabetic patient , diagnosed 2 weeks back came to your
clinic at scheduled appointment supposed to be at 10:00
AM but because you were having another complicated
case , he had to wait for more than an hour , and he was
extremely angry , what u will do :
a. be empathetic as this anger is mostly because of the new
morbidity diagnosed at this patient
b. you start your talk with him by saying "l was having a
hard case "
c. Don't say anything regarding being late unless he brings
it up
d. you star YOUR TALK WlTH HlM BY SAYlNH "you seem
furious"
.......................................
...................
859) 1
st
step in epidemic study is :
a. verifying diagnosis
O s not compete
860) Randomized control trials become stronger if :
a. you follow more than 50% of those in the study
b. systematic assignment predictability by participants
O s not compete , but wth these MCOs , the correct answer s
b
.......................................
...................
861) child with multiple painful swellings on the dorsum of
hands , feet , fingers and toes ,his CBC showed Hb =7,RBC's
on peripheral smear are crescent shaped , what is your
long-term care :
a. corticosteroids
b. penicillin V
c. antihistaminic
the correct answer s b , ths pt. s scke ce anema
.......................................
...................
862) 54 y old patient , farmer , coming complaining of dry eye ,
he is smoker for 20 years and smokes 2 packs} day , your
recommendation :
a. advise him to exercise
b. stop smoking
c. wear sunscreen
The correct answer s b , smokng ncrease rsk of dry eye
(nternatona study )
.......................................
...................
863) patient is wearing contact lenses for vision correction
since ten years , now coming c}o excessive tearing when
exposed to bright light , what will be your advice to him :
a. wear hat
b. wear sunglasses
c. remove the lenses at night
d. saline eye dros 4 times } day
The correct answer s d ( I'm not sure )

864) management of mild epistaxis :
a. pinching the fleshy part of nose while telting head
foreword
.......................................
...................

865) most common site of malignancy in paranasal sinuses :
a. Maxillary sinus ( correct )
......................................
....................
866) patient with hypertension , what is the best non-
pharmacological method to lower the elevated blood
pressure :
a. weight reduction ( correct )
.......................................
...................
867) newly diagnosed patient with hyper tension having
Na=147 , K=3 , what is the most likely cause of his
secondary hypertension :
a. hyperaldosteronism ( correct )
.......................................
.................
868) 50 year old patient , diagnosed with hypertension , he is
used to drink one glass of wine every day , he is also used
to get high Na and high K intake , his BMl is 30kg}m , what
is the strongest risk factor for having hypertension in this
patient :
a. wine
b. high Na intake
c. high K intake
d. BMl=30
the correct answer is d , ( l'm not sure )
869) all of the following tests are necessary to be done before
initiating lithium except:
a. liver function tests
.......................................
...................
870) in dementia , best drug to use :
a. haloperidol
b. galantamine
the correct answer s b
treatment of dementa s chonesterase nhbtor ( gaantamne,
donepez, rvastgmne, and tracng )
.......................................
...................
871) most important point to predict a prognosis of SLE patient
: 77
a. degree of renal involvement
b. sex of the patient
c. leucocyte count
the correct answer s a
......................................
....................
872) what is the antibiotic that you will give if you will do
appendectomy :
a. doxycycline
b. ceftriaxone
c. metronidazole
d. cefuroxime
The correct answer is d


873) most common site for ectopic pregnancy :
a. fallopian tubes
......................................
....................
874)child with low grade fever , rash , pharingitis , and tender
splenomegally , +ve EBV , Dx :
a. infectious mononeucleosis
......................................
....................
875) best early sign to detect tension pneumothorax :
a. tracheal shift
b. ditended neck veins
c. hypotensionv
the correct answer s b , I'm not sure , I thnk trachea shft s
the ate sgn .
.......................................
...................
876) First sign of magnisium sulfate toxicity is :
a. Loss of deep tendon reflex
.......................................
...................
877) Patient with mashroom toxicity will present with
a. Constipation
b. Hallucination
c. Anhydrosis
the correct answer s b
878) Child ate overdose of iron , best immediate management
a. Gastric lavage
b. lnduce vomiting manually
c. Emetic drugs
d. lpecac
the correct answer s a
.......................................
...................
879) Status epilepticus is :
a. Continuous sizure activity more than 30 min without
regaining consciousness
......................................
....................
880) First sign of increased lCP is :
a. contralateral papillary dilatation
b. lpsilateral papillary dilatation
c. Decrease level of consciousness
the correct answer s c
.......................................
...................
880) Patient with history of head trauma unable to move the
fork to his mouth , where is the lesion:
a. cerebellum
b. frontal lobe
c. temporal
the correct answer s a
.......................................
...................
881) Patient with lumbar canal stenosis , l forget the
presentation , what is the ttt:
a. Physiotherapy
b. Lumbar dicsectomy
O IS NOT COMPLETE
Mild to moderate : NSAlD + physiotherapy
Advance : epidural corticosteroid
Refractory : surgical laminectomy
882) Most common cause of otorrhia :
a. Csf leak
b. Acute otitis media
c. Cerumen leak
The correct answer s b
.......................................
...................
883) Most common symptoem of acute otitis media :
a. Pain
b. Discharge
c. Tinnitus
d. Vertigo
The correct answer s a
.......................................
...................
884) 12 yo boy is mocked at school because he is obese , ate a
lot of pill to sleep and never wake up again , best
management is :
a. Refer to mental professional
b. Tell him that most kid grow out before they grow up
c. Advice healthy food
.......................................
...................
885) 12 yo boy brought by his parent for routine evaluation ,
his is obese but otherwise healthy , his parents want to
measure his cholesterol level , what is the best indicator of
measuring this child cholesterol :
a. His parent desire
b. Family hx of early cva
c. High bmi
The correct answer s b
886) Diabetic pt. have neovasclarization and vetrous
hemorrhage , next step :
a. Refer to ophthalmologist
.......................................
...................
887) Histopatholgy of resected inflamed appendix will show :
a. Neutrophil in muscular wall
b. Lymphoid hyperplasia with multineucleated gaint cel
The correct answer s a
.......................................
...................
888) A child had bee bite presented after 18 hour with left
arm erythema and itching and.. Long scenario , what to
do:
a. Antihistaminic
b. Oral steroid
c. Subcutaneous epinephrine
The correct answer s a
.......................................
...................
889) Old man with urinary incontinence , plapable bladder
after voiding , urgency and sense of incomplete voiding dx;
a. Stress incontenece
b. Overflow
c. Reflex
The correct answer s b
.......................................
...................
890) Ttt of scabis :
a. Permethrin
891) Picture , hyperkeratotic , scaly lesion over the extensor
surface of knee and elbow , what to do to avoid
exacerbation :
a. Steroid
b. Avoid sun exposure
c. Avoid trauma
The correct answer s a
.......................................
...................
892) Which is true about allopuranol :
a. Good if given during acute gout
b. Uricisoric
c. Reduce the chance of uric acid stone
d. Can be antagonize by salysilate
The correct answer s c
.......................................
...................
893) man walking in street and saying bad words to stranger ,
he is not aware of his conditiond , what is the description :
a. flight of idea
b. insertion of idea
c. loosening of association
.......................................
...................
894) which of the following suggest that thyroid nodule is
bengin rather that malignant:
a. history of childhood head and neck radation
b. hard consistency
c. lemphadenopathy
d. presense of multiple nodules
the correct answer s d
thyrod cancer : ( cod and sod nodue )
895) child presented after sting bite with abd pain ,
arthalgia , lower extremity and buttock rash , normal RFT ,
+ve fecal occult stool , dx :
a. HSP
b. Lyme diases
The correct answer s a
.......................................
...................
896) best indicator for labor progress is :
a. frequency of contractions
b. strength of contractions
c. descent of the presenting part
the correct answer s c
.......................................
...................
897) lactating mother is taking Phenobarbital for sizure
prophylaxsis , what to advice her :
a. stop breast feeding immediately
b. breast feed after taking the pill by 8 hour
c. start weaning
d. does not matter
the correct answer s a
.......................................
...................
898) best single way to reduce high blood pressure is :
a. smoke cessation
b. decrease lipid level
c. reduce weight
the correct answer s c
.......................................
...................
899) drug of choice for supraventricular tachycardia is :
a.adenosine

900) patient with blood group A had blood transfusion group B
, the best statement that describe the result is :
a. type lV hypersensitivity
b. inflammatory reaction ..
c. ....
The correct answer s : It s type 2 hypersenstvty
.......................................
...................
901) a nurse gave blood transfusion through CVP , 2 hours
later the patient is comatose and unresponsive , dx :
a. Septic shock
b. Blood group mismatch
The correct answer s a ( I'm not sure )
.......................................
...................

902) 100% O2 given for prolonged periods can cause all
except:
a. Retrosternal Pain
b. Seizures
c. Depression
d. Ocular Toxicity
e. 777
The correct answer s c ( I'm not sure because choce e s not
menton )
903) Organophosphorus poisoning, what is the antidote7
a. Atropine
b. Physostigmine
c. Neostigmine
d. Pilocarpine
e. Endrophonium
The correct answer s a
.......................................
...................
904) Which of the following pulse character goes with the
disease7
a. Collapsing pulse Severe anemia
b. Pulsus Alternans Premature ventricular complexes
c. Slow rising Pulse Mitral stenosis
d. Pulsus Bisferens Mitral Regurgitation
e. Pulsus paradoxus l think Aortic stenosis or
regurgitation
The correct answer s a
PLUSE DEFlNlTlON CAUSES
Collapsing
pulse
Puse wth fast upstroke and
fast downstroke
1- Sever anema
2- Aortc regurge
3- Thyrotoxcoss
Pulse alternans Atrnans weak and strong puse 1- LV dysfuncton
Pulsus
paradoxus
Decne systoc more than 10
mm Hg durng nspraton
1- Cardac
tamponade
2- Asthma & COPD
Pulsus parvus
et tardus
Weak and deayed puse 1- Aortc stenoss
Slow rising
pulse
Sow upstroke puse 1- Aortc stenoss
Pulsus
bisferiens
puse characterzed by two
strong systoc peaks separated
by a mdsystoc dp
1- Aortc regurge
2- AR + AS
905) Entamoeba histolytica cysts are destroyed best by:
a. Boiling
b. lodine added to water
c. Chlorine added to water
d. Freezing
The correct answer s a
.......................................
...................
906) A scenario about an old male with symptoms suggesting
parkinsonism such as difficulty walking, resting tremors
and rigidity in addition to hypotension. Then he asks about
what is the most common presenting symptom of this
disease
a. Rigidity
b. Tremors
c. Unsteady Gait
d. Hypotension
e. 777
The correct answer s b
.......................................
...................
907) Regarding postpartum Psychosis:
a. Recurrences are common in subsequent pregnancies
b. lt often progresses to frank schizophrenia
c. lt has good prognosis
d. lt has insidious onset
e. lt usually develops around the 3
rd
week postpartum
The correct answer s a
.......................................
...................
908) A pregnant female develops lesions on the vulva and
vagina and she was diagnosed as genital herpes, what
should be included in her future health care7
a. Cesarian section should be done if the lesions did not
disappear before 2 weeks of delivery date
b. Oral acyclovir to treat herpes
c. Termination of pregnancy because of the risk of fetal
malformations
d. Avoidance of sexual intercourse for 1 month after the
healing of the lesions
e. 77777
The correct answer s b
HSV in pregnant treated by : ora acycovr 400 mg TID for 5-7
days . if HSV was present at time of labor : c - secton
909) A picture of 2 warts in the index finger.
Diagnosis is Viral Warts
.......................................
...................
910) What is the most common sequalae of acute
pancreatitis 7
a. Abscess
b. Pseudocyst
c. Bowel obstruction
The correct answer s b
Most common complication of acute pancreatitis:
pancreatc pseudocyt and fstua formaton
.......................................
...................
911) An old patient with history of cerebrovascular disease &
lschemic heart disease, presents with a pattern of
breathing described as: A period of apnea followed by slow
breathing which accelerates & becomes rapid with
hyperpnea & tachycardia then apnea again. What is this
type of breathing7
a. Hippocrates
b. Chyene-stokes breathing
c. Kussmaul breathing
d. One type beginning with O letter and contains 3 letters
only
e. 7777
The correct answer s b
1- Chyene-stokes respiration : rapd deep breathng phase
foowed by perod of apnea , present wth heart faure , stroke,
bran trauma , aso can be wth seep or hgh attude
2-kusmmaul's breathing : rapd and deep breathng . present
wth metaboc acdoss partcuary n dabetc ketoacdoss
912) A patient with mixed 1
st
& 2
nd
degree burns in head &
neck region, what is the most appropriate management7
a. Apply silver sulfadiazine and cream to all burned
areas,cover them and admit to hospital
b. Apply cream to 2
nd
degree burns and cover them, give lV
fluids
c. Debridement of 2
nd
degree burns and ..
d. Apply silver sulfadiazine then Vaseline ointment to all
areas then discharge the patient
The correct answer s a
1sr degree : epderms + panfu ( no bster )
2
nd
degree : epderms + parta derms + panfu _ bster
3
rd
degree : epderms + fu thckness derms + paness
Rule of nine to estimate BSA :
1- Head and neck : 9%
2- Each upper arm : 9%
3- Each oer mb : 18%
4- Each post. & ant. Trunk : 18%
5- Perneum & gentaa : 1%
-Sver sufadazne and mafende used for a types of burn
-supportve : tetanus and I.V nacrotc can be used for a types of
burn
- I.V fud use ony n ( > 10% of BSA) n 2
nd
& 3
rd
degree of burn
accordng parkand formua : ( fud n frst 24h = 4 * wt. n kg *
BSA . 50% n frst 8 hours and another n next 16 hours )
In ths patent 1
st
deree and 2
nd
degree < 10% ( head and neck
9%) : so, not use fud
.......................................
...................

913) 2 years old child with ear pain & bulging tympanic
membrane, what is the diagnosis7
a. Otitis media
b. Otitis externa
c. Otomycosis
d. Bullous myringitis
The correct answer s a
914) Besides lV fluids, what is the most important drug to be
given in anaphylaxis7
a. Epinephrine
b. Steroids
c. 777 Other choices
The correct answer s a
.......................................
...................
915) An adult patient in 20s or 30s of age presents by history
of 1 month of fever, 5 days of headache & 2 days of altered
sensorium. On examination there is nuchal rigidity, then
there is a table showing investigations which include
Hb: 10 g}dl
Blood WBC: 18,000
CSF Examination: WBCs elevated: 77% lymphocytes, 33%
Neutrophils. Protein 777. Glucose77
What is the diagnosis7
a. Viral meningioencephalitis
b. Tuberculous meningitis
c. Ph.. Meningitis
d. 777
O s not compete , but wth ths scenaro and MCOs , The
correct answer s b
916) Regarding chronic fatigue syndrome, which is true7
a. Antibiotics may reduce the symptoms
b. Antidepressants may reduce the symptoms
c. Rest may reduce the symptoms
d. 777
e. 7777
O IS not compete , but wth these MCOs , the correct answer s
b.
chronic fatigue syndrome:
characterzes by profound menta and physca exhauston. In
assocated wth mutpe system and neurospsychatrc
symptoms that ast at east 6 mounth. Must be new ( not fe
ong ) , must not be reved by rest, and must resut n greater
than 50% reducton n prevous actvty. Presentaton wth 4 or
more of the foowng : poor memory / concentraton, myaga,
arthaaga, sore throat, tender ymph node, recent onset
headach, unrefreshng seep, excessve tredness wth exercse.
Treatment by : cogntve and excercse therapy .aso, det,
physotherapy , detary suppements , antdepressants .
.......................................
...................
917) A patient complains of dry eyes, a moisturizing eye drops
were prescribed to him 4 times daily. What is the most
appropriate method of application of these eye drops7
a. 1 drop in the lower fornix
b. 2 drops in the lower fornix
c. 1 drop in the upper fornix
d. 2 drops in the upper fornix
.......................................
...................
918) A patient with penetrating abdominal stab wound. Vitals
are: HR 98, BP 140}80, RR 18. A part of omentum was
protruding through the wound. What is the most
appropriate next step:
a. FAST Utrasound
b. DPL (Dagnostc pertonea avage)
c. Expore the wound
d. Arrange for a CT Scan
e. Exporatory aparotomy
The correct answer s e
919) A patient presents with loin pain radiating to the groin.
Renal stones are suspected. What is the test that has the
most specificity & sensitivity in diagnosing this condition7
a. Noncontrast spiral CT scan of the abdomen
b. Ultrasound
c. KUB
d. lntravenous pyelography (lVP)
e. Nuclear Scan
The correct answer s a
.......................................
...................
920) An old patient presents with history dizziness & falling
down 1 day ago accompanied by history of Epigastric
discomfort. He has very high tachycardia l think around
130-140 and BP 100}60. What is the diagnosis7
a. Peptic ulter
b. GERD
c. Leaking aortic aneurysm
d. 777
The correct answer s c
.......................................
...................
921) A child is about to be given flu vaccine, what allergy
should be excluded before giving the vaccine7
a. Chicken
b. egg
c. Fish
d. 777
The correct answer s b
.......................................
...................
922) Which of the following is proven to reduce the incidence
of cancer7
a. Salt
b. Mineral water
c. Vitamin D
d. Fiber
The correct answer s c
923) A female patient with history of cyclic abdominal pain,
inability to conceive, heavy menses, and examination
showed tenderness & nodularity in uterosacral ligaments.
What is the diagnosis7
a. Endometriosis
.......................................
...................
924) A female patient on the 3
rd
week postpartum. She says to
the physician that the frequently visualizes snakes crawling
to her baby's bed. She knows that it is impossible but she
cannot remove the idea from her head. She says she wakes
up around 50 times at night to check her baby. This
problem prevents her from getting good sleep and it
started to affect her marriage. What is this problem she is
experiencing7
a. An obsession
b. A hallucination
c. A postpartum psychosis
d. A Delusion
The correct answer s a
Obsession : persstent, unwanted, and ntrusve deas ,
thoughts, mpuses or mages
.......................................
...................
925) Regarding screening for cancer, which of the following is
true7
a. Screenng for cervca cancer had decreased n recent years
b. Screenng for breast cancer had decreased n recent years
c. Screenng for Coorecta cancer s nadequate for the hgh-rsk
groups
d. Screenng for ung cancer has reduced the mortaty rate of
ung cancer
e. Screenng for tobacco use s now adequatey done by heath
professonas
.......................................
...................
926) Regarding postpartum depression, what is the most
appropriate intervention to reduce the symptoms7
a. lnclude family in the therapy
b. lsolation therapy
c. Add very low doses of impiramine
d. Encourage breastfeeding
The correct answer s a
927) Which of the following is a side effect of Buprione, a drug
used to help smoking cessation:
a. Arrhythmia
b. Xerostomia
c. Headache
d. Seizure
The correct amswer s d
.......................................
...................
928) A 60 years old patient with history of heart attack 6
weeks ago, complaining of not getting enough sleep.
Psychiatric evaluation is unremarkable for depression or
anxiety, what should be given to this patient7
a. Amytrptne
b. Busprone
c. Buprone
d. Zobdm
The correct answer s d
.......................................
...................
929) A patient is asked to face the wall, bend his waist, and
let his hands hang down without support. This test is used
as a screening tool for which of the following7
a. Lower limb asymmetry
b. Rectal prolapsed
c. Scoliosis
d. 7777
The correct answer s c
Ths test s caed for (Adam's Forward Bend Test )

930) A patient presents with sore throat, cervical
lymphadenopathy, mild splenomegaly, EBV antibodies are
+ve. What is the diagnosis7
a. lnfectious Mononucleosis (EBV )
.......................................
...................
931) An old patient presents with knee pain, limitation of
movement and quadriceps muscle atrophy. On examination
there is limited range on movement, pain on movement &
Crepitus. What is the diagnosis7
a. Osteoarthritis
b. Rheumatoid arthritis
c. Ankylosing Spondylitis
The correct answer s a
.......................................
...................
932) A patient presents with long time history of knee pain
suggestive of osteoarthritis. Now he complains of unilateral
lower limb swelling and on examination there is +ve pedal
& tibial pitting edema. What is the next appropriate
investigation7
a. CXR
b. ECG
c. Echocardiography
d. Duplex ultrasound of lower limb
The correct answer s d
Osteoarthritis relief by rest . So, immobility pt. can
lead to DVT
.......................................
...................
933) Alopecia is a side effect of which antiepileptic7
a. Phenytoin
b. Carbamazepine
c. Na Valproate
d. 777
The correct answer s c
1-phenytoin : gngva hyperpasa, hrsutesm, ataxa
2-carbamazepine : agranuocytoss, hepatotoxcty, apastc
anema
3- Na Valproate : transent har oss.

934) Which of the following is an indication for tonsillectomy7
a. Sleep apnea
b. Asymptomatic large tonsils
c. Peripharygeal abscess
d. Retropharyngeal abscess
The correct answer s a
.......................................
...................
935) Which of the following is a gram -ve rods that grow on
charcoal yeast agar7
a. Legionella
.......................................
...................
936) A 7 years old child had history of chest infection which
was treated with antibiotics. The patient presented 6 weeks
after cessation of antibiotics with abdominal pain, fever
and profuse watery diarrhea for the past month. Which of
the following organisms is responsible for the patient's
condition7
a. Giardia Lamblia
b. Clostridium Difficile
c. Escherichia coli
d. Clostridium Perfringens
The correct answer s b
.......................................
...................
937) Which of the following features of ulcerative colitis
distinguishes it from crohn's disease
a. Possible malignant transformation
b. Fistula formation
c. Absence of granulomas
d. Colon involvement
The correct answer s a
938) A very very long scenario about a female patient with
vaginal discharge "malodorous watery in character" with
pH of 6 & +ve clue cells but there is no branching
pseudohyphe. (He is telling you the diagnosis is vaginosis &
there is no fungal infection) Then he asks about which of
the following drug regimens should NOT be used in this
paitent:
a. Metronidazole (PO 500 gm for 7 days)
b. Metronidazole (PO 2 large dose tablets for 1 or 2 days)
c. Metronidazole (lV or lM ...)
d. Miconazole ( PO ...)
e. Clindamycin (PO ...)
The correct answer s d
Ths case s " bacteria vaginosis" and treatment by :
metradnazoe or cndamycne . avod mconazoe because t s
antfunga
.......................................
...................
939) What is the condition that produces malodorous watery
vaginal discharge with +ve clue cells in wet mount
preparation slides:
a. Bacterial vaginosis
b. Vaginal Candidiasis
c. Trichomonas vaginalis
d. Gonorrhea
The correct answer s a
.......................................
...................
940) Which of the following is the best treatment for
Giardiasis:
a. Metronidazole
.......................................
...................
941) A woman with 9weeks History of elevated erythematous
wheals overall her body , she also has lip swelling. There is
no History of recent travel or food allergy or drug ingestion,
Diagnosis:
a. Chronic Angioedema & Urticaria
b. Contact Dermatitis
c. Solar Urticaria
d. Cholinergic Urticaria
e. Cold Urticaria
The correct answer s a
Chronic urticaria : f more than 6 months
Solar urticaria : due to sunght
Cholinergic urticariae : due to bref ncrease n body
temperature.
Cold urtiaria : due to exposure to cod
942) A 17 years old male with history of mild intermittent
asthma. Attacks occur once or twice weekly in the morning
and no attacks at night. What should be the initial drug to
give7
a. lnhaled short acting B2 agonist as needed
b. lnhaled high dose corticosteroid as needed
The correct answer s a
.......................................
...................
943) A child presented with sore throat. Culture from the
throat revealed +ve meningiococci. The patient is now
asymptomatic. Which of the following should be done7
a. Reassurance
b. Rifampicin oral for 7 days
c. lM ceftriaxone 1 dose
d. Ceftriaxone oral
e. 777777
The correct answer s c ( I'm not sure )
2-day regmen of ora rfampn or a snge dose of IM ceftraxone
or a snge dose of ora cprofoxacn).
.......................................
...................
944) Which of the following increases the quality of the
randomized controlled study & make it stronger:
a. Systemic Assignment predictability by participants
b. Open Allocation
c. lncluding only the participants who received the full
intervention
d. Following at least 50 % of the participants
e. Giving similar intervention to similar groups
The correct answer s a
.......................................
...................
945) A scenario about an infant who presented with difficulty
breathing and sweating, examination shows hyperactive
precordium with loud S2 and pansystolic murmur grade 3}6
best heard in the left 3rd parasternal region. What is the
Diagnosis7
a. VSD
b. Mitral Regurgitation
c. PDA
d. Large ASD
The correct answer s a

946)Post lHD , your advise :
a. Yoga
b. isotonic exercise
???????????
.......................................
...................
947)very obese girl , what's the first step to reduce weight :
a. increase water intake
b. decrease calorie intake
the correct answer s b
.......................................
...................

948) 40 y}o male , presented with large hands , hepatomegaly
... diagnosis :
a. acromegaly
b. gigantism
the correct answer s a
......................................
....................
949) cousre of facial nerve when comes out from stylomastoid .
a. Deep to parotid gland & lateral to external carotid &
retromandibular vein
.......................................
...................
950) old female with hemorrhoids for 10 years , no
complication , your action 7
a. observe
b. surgery
c. increase fiber diet
the correct answer s c
.......................................
...................
951) femal about 30y c}o abdominal pain related to menses
(scenario going with endometriosis)....next step in dx:
a. Laparoscopy
b. U}S
c. CT
The correct answer s a
Confrm dagnoss by aparoscopy , US & MRI can use but f
norma can not excude endometross .
952) femae about 30y wth breast cancer (gven cbc -chem. And
reave ow hb and hematocrte..) what s the next step n
mangment:
a. Stagng
b. Lumpectomy
c. Mastectomy
d. Chemotherapy
.......................................
.....................

953) pt with open angle glaucoma and k}c of COPD and DM ttt:
a. Timelol
b. betaxolol
c. Acetazolamide
the correct answer s c
.......................................
.....................

954) infant with runny nose and fever after that develop
dysnea ,wheezing with working accessory muscles and
chest retractions with cyanosis, temp 38 dx:
a. Viral pnumonia
b. Bacterial pneumonia
c. Bronchiolitis
The correct answer s c
955) 34y female with HlV pap smear negative, about cervical
cancer screening :
a. After 3m if negative repeat after 6m
b. After 6m ........... annually
c. After 1y..............annually
The correct answer s b (I'm not sure ), may be c .
!creening should begin no later than age "#.
!creening should begin earlier than age "# if the patient is sexually active. In this
case, it should start $ years after initiation of vaginal intercourse.
%nce initiated, screening should be performed annually if a traditional, glass&
slide&based technique is used. If liquid medium is used, 'ap smear screening may
be performed every other year.
(fter age $), for women who have had $ consecutive, normal 'ap smears,
screening frequency may be reduced to every two to three years.
*omen who are +I, positive, immunocompromised due to disease or
medication, or are -.! daughters, should continue annual screening.
!creening may stop following a total hysterectomy (including the cervix, if the
the patient is at low risk, and has had three consecutive normal 'ap smears within
the last #) years.
+igh risk patients, including those with a history of cervical cancer, -.!
exposure in&utero, +I, positive, immunocompromised from medication, and
those tested positive for +',, should continue to be screened indefinitely.
!creening may stop after age /), if the patient is low risk, and has had three
normal 'ap smears over the last #) years.
!creening may be omitted in the case of women with life&threatening or other
serious illness
.......................................
.....................
956) which drug increase incidence of reflux oesophagitis:
a. Theophylline
b. Amoxicilline
c. Metoclopramide
d. Rantidine
e. Lansoprazole
The correct answer s a

957) most effective ttt of cluster headach:
a. Ergotamine nebulizer
b. S}C Sumatriptan
c. 100% O2
d. lV Verapamil
The correct answer s c
.......................................
.....................
958) old pt. with HTN and migraine ttt:
a. B blockers
b. ACE l
c. Ca blockers
The correct answer s a
.......................................
.....................
959) lactating women 10 days after delivery developed
fever ,malaise, chills tender Lt breast with hotness and
small nodule in upper outer quadrant with axillary LN
.Leukocyte count was 14 *10}L dx:
a. lnflammatory breast cancer
b. Breast abscess
c. Fibrocystic disease
d. 7777
7777777
.......................................
.....................
960) newborn with fracture mid clavicle what is true:
a. Most cases cause serious complication
b. Arm sling or figure 8 sling used
c. Most patient heal without complications
The correct answer s c
-most cavces fracture n newborn no need to treatment
apart from carefu handng. If the fracture s dspaced and
baby n pan, smpe sng s requre.
961) 70y male with osteoporosis the T score of bone
densometry would be :
a. 3.5
b. -2.5
c. -1
d. 2
e. 3.5
The correct answer s b
- The T score s the number of standard devaton (SD ) a
patent's BMD devated from the mean.
- T score > (- 1) : norma BMD
- T score (-1 to -2.5) : ostopena
- T score < ( -2.5 ) : osteopross
.......................................
.....................
962) what is the most complication after hesterectomy:
a. Ureteral injury
b. Pulmonary embolism
c. Haemorrhage
The correct answer s c
.......................................
.....................
963) young female with BMl 18 , fine hair allover body ,
feeling of she is fat ,doesn't eat well with excessive
exercise........
a. Anorexia nervosa7
b. Body dysmorphic disorder
c. Bulimia nervosa
The correct answer s a
.......................................
.....................
964) what's advantage of mature human milk over cow's milk:
a. More protein
b. More lron content
c. More calories
d. More fat
The correct answer s b
.......................................
.....................
965) young male c}o of deformity of jaw .past h}o of
nasoplasty and blepharoplasty O}E nothing abnormal
.....dx:
a. Body dysmorphic syndrome
966) the most common cause of non-traumatic subarachnoid
haemorrhage:
a. Rupture aneurysm
b. Vessels abnormality
c. Hypertension
The correct answer s a
-Most common causes of subarachnod hemorrhage are trauma
and berry aneurysm
.......................................
.....................
967) Pt. with chest pain and s.o.b decreased by leaning forword
. O}E friction rub and increased ]VP >>>> (a case of
pericardial effusion) ECG will show:
a. ST changes
b. Low voltage
c. lncrease PR interval
ECG changes durng percardts : dffuse ST eevaton , PR
depresson foowed by t-wave nterventon , and ow votage.
.......................................
.....................
968) The causative organism of psudomembranous colitis is:
a. Clostridium difficile
.......................................
.....................
969) scenario about arthritis (l couldn't remember the details )
but ]oint aspirate reveal Gram negative diplococci ...dx:
a. Nisseria gonorrhea
N. gonorrhoeae 0 gram negative diplococci and can also cause con1unctivitis,
pharyngitis, proctitis or urethritis, prostatitis and orchitis.
.......................................
....................
970) Vertigo & .... is caused by which of the following drug 7
a. Aphotercine B
b. Pnicilline reaction
c. lNH
.......................................
....................
971) Baby with red macule & dilated capillary on the rt side of
the face
"turge-Weber Syndrome or Nevus Flammeus 7one o!
them 'ill come.
Don8t choose milia or caverno%s haeman&ioma
972) A 25 year old secondary school teacher that every time
enters the class starts sweating and having palpitation, she
is a fired to give wrong information and be unparsed. What
is the diagnosis:
a. Specific Phobia
b. Social Phobia
The correct answer s b
.......................................
....................
973) At which chromosome is the cystic fibrosis gene:
a. Long arm chromosome 7
b. Short arm chromosome 7
c. Long arm chromosome 8
d. Short arm chromosome 8
e. Long arm chromosome 17
The correct answer s a
.......................................
....................
974) Regarding hepatocellular carcinoma (Hepatoma) Which is
true:
a. More common in females
b. ..
c. ..
d. The most common cancer in Africa and Asia
e. lncrease risk in chronic liver disease
The correct answer s e , chronc dsease especay Hepatts B
.......................................
....................
975) A patient is having a 2 year history of low interest in live,
he doesn't sleep well and can't find joy in life, What is the
most likely diagnosis:
a. Dysthymia
b. Major depressive disorder
c. Bipolar disorder
d. ..
e. ..
The correct answer s a
976) What is the mechanism of OCD drugs:
a. lncrease availability of Serotonin
b. Decrease production of Serotonin
c. lncrease production of Serotonin
d. .. Serotonin
e. .. Serotonin
The correct anser s a
.......................................
....................
977) What is the MOST accurate test to detect early
pregnancy:
a. ..Serum BHCG
b. ..
c. Urine pregnancy test
d. Ultrasound
e. ..
The correct answer s a
.......................................
....................
978) A case of a patient with thin cervix and little amount of
cervical mucus, how would you treat her: 77777
a. Estrogen injections

...............................
............................
979) The most common cause on chronic interrupted rectal
bleeding is:
a. Diverticulosis
b. Hemorrhoids
The correct answer s b
.......................................
....................
980) A child is having a croup early morning, the most
common cause is:
a. Post nasal drip
981) A burn patient is treated with Silver Sulfadiazine, the
toxicity of this drug can cause:
a. Lycosytosis
b. Neutropenia
c. Electrolyte disbalance
d. Hypokalemia
e. ..
The correct answer s b , sde effect of sufadazne
.......................................
....................
982) A case scenario about a patient who had appendectomy,
after that he has abdominal pain and constipation and
absent bowel sound, the most likely cause is:
a. llus paraticus
O s not compete
.......................................
....................

983) A case scenario describing a patient who had a right
chest trauma than developed tension pneumothorax, the
immediate management is:
a. lnsert a needle in the second intercostal space
b. lnsert a needle in the fifth intercostal space
c. Give lV antibiotics
d. ..
e. lnsert a tube in the fifth intercostal space
The correct answer s a
.......................................
....................
984) A patient that have a penile ulcer that healed after that
he developed a palm and sole rash, the most likely cause is:
a. Syphilis
O s not compete
985) A case scenario about a patient who has on and off
episodes of abdominal pain and was found to have multiple
gallstones, the largest is 1 cm and they are not blocking
the duct, What will you do:
a. Give pain killers medication
b. Remove gallbladder by surgery
O s not compete , but wth these MCOs , the correct answer s b

...............................
............................
986) Most common symptoms of soft tissue sarcoma :
a. Paralysis
b. On growing mass
c. Pain
d. ..
The correct answer s b
.......................................
....................
987) Patient use illegal drug abuse and the blood show RNA
virus. Which hepatitis
a. A
b. B (DNA)
c. C
d. E
The correct answer s c , RNA vrus transmtted by bood d HCV
.......................................
....................
988) A case scenario about bronchial carcinoma, which is true:
7777
a. The most common cancer in females
b. Squamous cell carcinoma spreads faster
c. Adenocarcinoma is usually in the upper part
d. Elevation of the diaphragm on the x-ray means that the
carcinoma has metastasize outside the chest
e. Bronchoscopy should be done
The correct answer s c
989) old female with pubic itching with bloody discharge, then
she developed pea shaped swelling in her labia, most likely:
a. Bartholin cyst
b. Bartholin gland carcinoma
c. Bartholin abscess
d. ..
The correct answer s c
.......................................
....................
990) Patient has decrease visual acuity bilateral , but more in
rt side , visual field is not affected , in fundus there is
irregular pigmentations and early cataract formation . what
you will do
a. Refer to ophthalmologist for laser therapy
b. Refer to ophthalmologist for cataract surgery
c. ..
The correct answer s a
.......................................
....................
991) lnflammatory bowel disease is idiopathic but one of
following is possible underlying cause:
a. lmmunological

...............................
............................
992) pregant lady deliverd Anencephalytillbirth occurance of
neural tube defect in next pregnancy
a. 8%
b. 2%
c. 10%
d. 20%
The correct answer is b , ( 2 - 4 % )
.......................................
................
993) typist theaner atrophy ,+ve tephlen sign
a. Median nerve
b. Ulnar
c. Brachial
The correct answer is a
994) painful pile
a. Exison daringe
b. Sitz path and steriod supp
c. Ab
d. Fiber food and analgesics
The correct answer is a
.......................................
................
995) 39 years old HlV patient with TB recive 4 drugs of tt after
one month
a. Continue 4 drugs for 1 years
b. Cintinue isoniazide for 9months
c. Contiue isonizide for 1 year
The correct answer is a
.......................................
................
996) femaIe not married with normaI investigation except FBS=142.
RBS196. so ttt
a. give insIin sctaneos
. advice not ecome married
c. arrier contraceptive is good
d. B controI
The correct answer is d

.......................................
................
997) Entamoeba histolytica cysts are destroyed best by:
a. Boiling
b. lodine added to water
c. Chlorine added to water
d. Freezing
The correct answer s a
998)A scenario about an old male with symptoms suggesting
parkinsonism such as difficulty walking, resting tremors and
rigidity in addition to hypotension. Then he asks about what is
the most common presenting symptom of this disease
a. Rigidity
b. Tremors
c. Unsteady Gait
d. Hypotension
E. 777
The correct answer s b
.......................................
...................
998) Regarding postpartum Psychosis:
a. Recurrences are common in subsequent pregnancies
b. lt often progresses to frank schizophrenia
c. lt has good prognosis
d. lt has insidious onset
e. lt usually develops around the 3
rd
week postpartum
The correct answer s a
.......................................
...................
999) Gastrictomy post-op 1 day. He have temperature 38.8 &
pulse 112. What is the most common cause 7
a. wound infection.
b. inflammatory mediator in the circulation.
c. UTl
d. normal
the correct answer s a or b
most common causes of post-operaton fever : ( 6 w )
1- W ound
2- Wne = pneumona or atectasa
3- Water = UTI
4- What happen = transfuson
5- Wak = DVT
6- Wonder drug = asprn,erythromycn , sonzde
Immedatey ( 24 h ) : post-op nfammaton , wound nfecton ,
transfuson , streptococcus
Acute ( 3 - 7 days ) : pneumona

1000) Malaria 7
- the most common cases is caused by Plasmodium
falciparum.
......................................
....................
1001 ) Polyartheralgia rhumatica. What is the thing that
suggest it rather than ESR & C-reactive protein:
a. proximal muscle weakness
b. proximal muscle tenderness
the correct answer s a
.......................................
...................
1002) The cause of insulin resistance in obese is:
a. insulin receptors kinase activity
b. number of insulin receptor
c. circulation of anti-insulin
d. insulin production from the pancreas
e. post-receptor action
the correct answer s e (I'm not sure )

1003) Pt came with total bilirubin: 5.8 & direct bilirubin: 0.4
a. Guillain-Barre syndrome
b. Dubin-junson syndrome
c. Biliary sclerosis
d. Crigler-Najjar syndrome
e. Gilbert Syndrome
the correct answer s e
.......................................
.................
1004) Pt complaining of hypotension & bradycardia.
Electrolytes show: Na, K, Cl, Urea. So the cause of this
is:
a. hyponatremia
b. hyperkalemia
c. hyperchloremia
d. uremia
the correct answer s a ( not sure )

:
Orthopaedic Qassim University