1-Pt with mania and liver failure what to give:

Lithium
Atrax
Pregablin
Another choice i cant rermber

2-Long scenario and give you the diagnosis

osgood-schlatter synd
Pathogensis
3-Osteochondrosis of femur
Rupture curciate
Another choice about pateller tendon

4-2 months baby with pic of lesion in lower back average size spina bifida
Diagnosis
Spina bifida
Haemangioma

5-Allergic conjuctivitis what to give

All choices drugs with trade name uncommon drugs for gp
I only remeber tobramycin
And antihistamine i cant remeber the name

6-Pt unresponsive no pulse given ecg with v tach

Management
Defib
Propanlol
Digoxin
And other

7-Scenario of open angle glaucoma

Management
Betaxol
Refer to opthalmogist
Others

8-2 months infant with excessive tearing since birth

Recived phenicol 2 weeks ago due to yellow dicharge ithink from lacrimal gland
Managment
Antihistamine
Urgent refer to opthalmogy
Antibiotic drop
Nasolacrimal massage

9-Young Pt of asthma received maximum dose of inhaled steroid plus long and short acting b
agonist with chart curve of response to allergen
Next step
Treat Gerd
Leuketrine modifier
Theophylline
Observe and wait

10-Another question about pt had AF on warfarin presented with bacterial pharyngitis

Prescribe augmentin
Inr 2.7
What to do:
Low dose augmentin
Decrease the dose of warfarin
Stop warfarin for 4 days
Chech inr after 3 days

11-Glipizide mechanism
Increase secretion of insulin from pancreas
Increase sensitivty of cells to insulin
Others choices
12-Pic of ring stage malaria
Diagnosis :
Malaria
Others

13-Pic of ascaris with long scenario

Diagnosis :
Ascaris

Another exams
:
1-Cr clearance 85:
a stage 1
b stage 2 *
c stage 3
d stage 4
2-FBS test in normal subject (frequebcy in years)
a- annually *?
b- two
c- three
d- five
3- two cuople carrier of thallassemia, probability of child to have thalassemia:
a- 25% *
b- 50%
C- 100%
4- a case of a lady with gestationa diabetes, risk of:
a- IUGR
b- perinatal mortality
c- shoulder dytocia *?
d-.....
5- G3P2 previous deliveries normal vaginally ,present in labor ,cervix 4 cm dilated 60%
effacement ,after three hour cervix is 5 cm dilated 70% effacement, your action:
a- strip the cervix
b- oxytocin infusion *?
c- ARM
d- CS
6- old patient found to have abdominal aortic aneurysm 5 cm in size during medical checkup,
you action:
a- reassrance and tell him this is normal size
b- refer for surgery *?

c- observation
d- abd US every three months
7- middle age lady with hemorrhoid for 10 years that hase never bleed or thrombosed:
a- reassurance
b- refer for surgery *?
c- cleaning with (something)
d- .......
8- a child with pterygium in his eye:
a- associated with systimic disease.
b- may interfer with vision*?
c- .....
d- ......
9- after initiating SSRI, symptom will improve after:
a- 1-2 days
b- 1-2 hours
c- 2 weeks *?
d- 3-4 weeks
10- the greater risk for DVT:
a- open knee sugery *
b- flight for 4 hours
c- paternal Hx of DVT
d- maternal HX of pulmonary embolism
11- pt with positive PPD, the best test to rule out the possibility of false negative:
a- mantoux test
b- CXR *?
c- repeat PPD
d- tine test
12- pt with COPD and glaucoma, what to give:
a- timolol
b- oral acetazolamide *?
c- topical steroid
d- other topical B antagonist
13- young pt presented with renal colic, Ix showed high Ca low Po normal PTH, rest are
unremarkable, management:
a- low Ca diet
b- Parathyrioectomy
c- Calcitonin
d- pamidronate *
14- a child presented with fatigability,...., IX showed low HB (picture of peripheral blood film
showing target cells), the phycisian ordered blood transfusion, what else he should get:

a- methotrexate.
b- desferroxamine *
c-....
d-....
15- female with irritation under breast fold:
a- oral AB
b- Steroid
c- antifungal powder *
d- .....
16- how to diagnoses DVT:
a- duplex US *
b- venorphy
c- impedence plesythsmography
d- ....
17- pt with scaling skin lesion in the extensor surface of the foream( with picture), your advice:
a- avoid trauma. *
b- void sunlight.
c- .....
d-......
18- Pt with coloured swelling near the tip of the finger with black dot( with picture):
a- viral
b- fungal *?
c- ....
d-.....
19- pt has swelling near the base of the nail, given AB and no improvement hot red and tender:
a- repeat another course of AB
b- incision and drainage under GA
c- incision and drainage under LA *
d- .....
20- the finding in urine analysis to diagnose diabetic nephropathy:
a- protenuria *
b- ....
c-......
d-.....
21- drug addict present with respiratory complaints( CXR showed multiple caivties with air fluid
levels):
a- TB
b- P embolism
c- abscesses *
d- ....

22- annual screening for healthy saudi:

a- obesity, HTN, dyslipedemia
b- obesity,DM, HTN *
c- obesity, DM, HBV
d- ......
23- first line for depresion:
a- SSRI *
b- TAD
c- MAOI
25 - senario and rythm strip of wide comlex regular tachycardia:
a v tach *
b svt
c wpw
24 -side effect of labetalol in pregnancy:
a hyponatremia
b fetal acidosis
c .....
d ureteroplacental insufficien
26- pt present with centeal sharp cheat pain , list of Ix , )ryth strip showing narrow xomplex
tachycardia with alteranating voltage of qrs):
a percarditis
b mi
c pericardial effusion *

27- child sit without support , dont agraid from strangers but dont play peeka boo:
a 6-7m *?
b 8-9m

28- pt diabetic for 5 yrs on metformin , presented with watery foul smelling diarrhea for three
wks, two wks ago she received clindamucin for dental problem, what is the cause of her
symptoms:
a clindamycin *?
b diabetic gastroparesis
c metformin

29- serio about pt with previos infective endocarditis, going for urological surgery, it stated in

the question high risk for IE and penecillin allergic:

a iv vancomycin and gentamycin *
b oral vancomycin and tetracyclin
30- child presented with failure to thrive and skin lesion (picture showing bulla) , materanl side
hx of short stature and skin lesion:
a dyshydotic dermatitis
b bullous valgaris
c iga deposition in the dermis*
d epedermolysis bullosa
31- 4 yrs child was playing with his brother , then the mother found him crying and unable to
open his right eye, on examination he is tolerating light no redness or foreign body, next step:
a topical ab
b irrigation with normal saline
c florocine stain

32- the pediatric society or somtging in saudi arabia recommend brest feeding for how long:
a6m
b 12- 24 m
c 48 m
33- first immunological defense in the skin:
choices are the skin layers
34- pt with sadness poor self steem and depression for 2 years long,
a major depression
b dysthymia
c scizophrenia
d bipolar

Questions I remember from my GP prometric exam on 14/06/2015.

1. At which position is the hand most vulnerable to infection during a human bite?
a. Clenched fist
b. Extended fingers
c. Dependent
d. (cant remember)

2. Epidemiology question: what is the prevalence of DVT?

3. Straight forward case of diagnosis, otitis media in a child
4. Case of right ear deafness with past history of otitis media, rinne test negative, weber test
louder on the right, diagnosis:
a. Serous otitis media
b. Chronic otitis media
c. Otitis externa
d. Mastoiditis

5. Diabetic nephropathy. Chart showing micro and macro albuminuria and GFR (sorry couldnt find
anything close on google). How long after diagnosis did it start:
6. Case of multigravida with slow progress in labour (sorry couldnt recall figures)
7. Drug least effective for prophylaxis of migraine:
a. Beta blocker
b. Tricyclic antidepressant
c. SSRI
d. Antiepileptics

8. Case of uveitis

9. Similar chart, question asking for the serological marker disappearing just before the window
period and the one appearing straight after (HbsAg and antiHbs)

10. 20 year old male can for a routine checkup, everything was normal, how frequent should his eye
exams be?
a. Twice before 25
b. At least once before 30
c. Annual
d. When symptomatic

11. 32 year old male came with facial spasms (chvosteks sign). Labs: PTH (high) Ca (low) vitamin D
(normal) creatinine (high)
a. Digeorge syndrome
b. Pseudohypoparathyroidism
c. Chronic renal failure
d. Vitamin D deficiency

12. What is true regarding anorexia nervosa?

13. Young male presented with chest pain, improve with leaning forward aggravated by lying
supine. There was a CXR showing an enormous heart shadow
a. Pleurisy

b. Pericardial effusion
c. Hiatal hernia
d. (cant remember)
14. Varicella vaccine, patient received a single dose about a year ago, how to proceed?
15. Alcoholic male with retching presented with sudden severe chest pain (CXR was given)
a. Boerhaave (esophageal rupture)
b. Mallory-Weiss syndrome
c. (cant remember)

16. Young patient, status post renal transplantation, his mother was asking about the MMR, your
advice would be:
a. Its contraindicated
b. schedule an appointment
c. (cant remember)
17. Obese child, BMI of 32, your advice to the mother:
a. Life style modification
b. (cant remember)
18. Obese patient with DM and HTN, your advice regarding losing weight:
a. Decrease carbohydrate intake during day time
b. Decrease carbohydrate and increase fat intake
c. Decrease 500 kcal/kg/ week
d. Decrease caloric intake to 800 kcal/day
19. What maneuver to do on the pinna when examining the tympanic membrane in a child?
a. Inferior and posterior
b. Inferior and anterior
c. Superior and posterior
d. Superior and anterior

20. Signs of codeine intoxication:

a. Tremors and anxiety
b. CNS excitement and insomnia
c. Respiratory depression and bradycardia
d. Tachycardia and anxiety

21. Long case; pt. with Lt and Rt sided heart failure, wheres the fluid collecting?

a.
b.
c.
d.

Interstitial space
Venous
Arteriolar
Capillary
s
22. Causes of hyperuricemia (there was a table with several medical conditions and medications and
you have to choose the column with the correct combinations)

23. Case of elderly with bilateral knee pain aggravated by physical activity and worse at the end of
the day
a. Osteoarthritis
b. Osteomalacia
c. Rheumatoid arthritis
d. (cant remember)

24. Case of epistaxis, no past history of bleeding disorders, no petechiae. By examination it was
from the posterior nasal septum, management:
a. Coagulation studies
b. Posterior nasal tampon
c. Place the patient on recumbent position
d. Spray local anesthetic and vasoconstictive agent

**************
1) Most common cause of death in sickle cell anemia pt
i) Mi
ii) Infection
iii) Stork
iv) Renal failure
2) Pt post partum complain of easy fatigalbity and wt gain
Lab result as follow
Hg 12.5 heamatocret n TSH 8 free T4 0.5 total cholesterol 205 LDL 50 HDL 30
What is the most likely diagnosis
i) Iron difenecy anemia
ii) Postpartum depression
iii) Hypercholestermia

iv) Hypothyroidism
3) 35 years old male pt complain of sensory neural hearing loss and veritgo MRi brain show mass in
cereberpontin angle
What is most likely diagnosis
a) Acoustic neuroma
b) Glioblastoma
c) Heamangioma
d) ???????
4. primigrvida in 2 days of labor on oxytocin infusion the pt now with spontanous rubure membran
cervical ditaltion 8 cm an effacement 80% fetal heart rat 120- 130 uterine contraction every 2 minut
and last 90 second
What is your intial mangment
1)
2)
3)
4)

Discontinue oxytocin
Forcep delivery
CS
?????????

5. pt came confused lethargic bp 200|110 there is < image show renal artery stenosis >
Best ttt is
1)
2)
3)
4)

Prindopril
Furosmide
Hydralazine
Nitoprosside

6. A young child with a patch of hair loss on the scalp. Some small flakes of skin are present. What
is your diagnosis

a) Tinea capitis
b) Psoriasis
c) Alopecia areata
d) Trichotillomania
7.femal pt the spinal cord will stop grow after how many monthes from the start of menses
1) 6
2) 12

3) 24
4) 36
8. pt daignosed gullian barre syndrom
What the best ttt to stop the progresion
1)
2)
3)
4)

High dose corticosteroid

Iv imunoglobuline
???????
?????????

9. 8-year-old boy presents with photophobia, irritability & neck stiffness. Lumbar puncture
findings show 50 neutrophils, 100 lymphocytes, proteins normal, glucose normal. Which is the
most likely diagnosis
a) Tuberculosis meningitis
b) H. influenza
c) Echo virus
d) E. Coli
10. A middle-aged man is brought to your surgery with a history of being bitten by a black snake.
On examination there are scratch marks on the lower leg and no other symptoms. What is your
management?

a) Excise wound
b) Administer antivenin immediately
c) Apply Tourniquet
d) Observation and antivenom if necessary
11. resident Indian women 20 weeks gestation she come back from India after visit complain of
jaundice and fatigue lab result show ast >3200 alt >2900 most probably the pt ha hepatitis ?
1)
2)
3)
4)

A
C
D
E

12. mechanism of action of glibazid

1)
2)
3)
4)

Stimulate secretion of insulin

Increase sensitivity to insulin
?????????
?????????????

12.child complain from itching in the web of hands and feet and all contacts complain same what is
organism
i)
ii)
iii)
iv)

Sarcopets scabiei
?????????
???????????
??????????????

13. There is a large swelling at the center of the neck and no exophthalmos of the eyes.. its
moved when protrusion of the tongue . What is the most likely diagnosis? ***

a) Multinodular goiter
b) Ca thyroid
c) Sub acute thyroiditis
d) Thyroglossal cyst
14. pt with beri beri disease what is vitamin deficiency
1)
2)
3)
4)

B1
B2
Vitamin c
Niacin

15. pt complain pain in the big toe and heel diagnosed as tarsal tunnel syndrome what is the
affected nerve
1)
2)
3)
4)

Anterior tibial
Posterior tibial
Femoral
Popliteal

16A child with perorbital oedema and anararca, BP is normal. All of the following are true,
except? a) Steroids are useful in treatment
b) Focal glomerulonephrits is the commonest cause
c) Proteinuria more than 3 grams/day is usual

d) This is commonest between 1 and 4 years of age

17Distorted body image is found in all of the following disorders EXCEPT:
a) Hypochondriasis
b) Anorexia nervosa
c) Acromegaly
d) Body dysmorphic disorder

18. pt with dementia the relative ask u about metode to improve the condition
19. screen test for aortic aneurism
1)
2)
3)
4)

Ct ?
????
????
???

20 pt known case of CRF what the test for setect the severity of the disease
1)
2)
3)
4)

GFR
Creatnin clearance
Urine analysis
?????????

21 What it is most sign suggestive for acute appendicitis

1) Fever
2) Psoas sign
3) Tenderness
4)
22 Upper motor neurone lesions are characterised by all of the following EXCEPT:
a) Loss of voluntary movements
b) Increased stretch reflexes
c) Increased muscle tone
d) Rapid wasting of affected muscles

23A fully breast feed baby, from a mother on a healthy, balanced diet, can have deficiency of
which vitamin?
a) Vitamin B complex
b) Vitamin C
c) Vitamin D
d) Vitamin K
24Which of the following is the least likely cause of iron deficiency anaemia in children?
a) Cows milk
b) Thalassemia
c) Prematurity
d) Coeliac disease
2455year old patient with dysphagia for solids with a previous history of reflux
A. Carcinoma oesophagus
B. Stricture
C. Scleroderma
D. Achalasia
25. An infant came with pneumonia , X ray showed consolidation of a lobe with round translucencies
and a small pleural effusion. What is the treatment of choice?
A. Crystalline penicillin
B. Flucloxicillin
C. Amoxicillin / clavulanic acid
D. Tetracycline
26 All of the following are scaly lesions except
A. Keratoacanthoma
B. Squamous cell Ca
C. Pityriasis rosea

D. Psoriasis

July -2015
1/instructor worker has fatigue,loss of appetite, excercise intolerance...
1..SCABIES*

2/pt develops flushing,dizzines,after each meal,he did itestinal surgery befor ,Dx?
2/dumpling syndrom

3/25 years Femal ,K/C of hyperthyroidism stop OCP befor 2 m,complain of fine tremor&anxity ,want to
get pregnant ..TSH elevated, which medication must be started..
1. carbimazole
2. B blocker
3 propylthiouracil. *

3/pt recantly treated from H. pylori..the doctor must be screening ..

1 gastriec bleeding
2 gastric polyps
3gastric Ca*
4/ case of Hereditary spherocytosis it is ..
Autosomal dominant*
Autosomal recessive

5/pt with close angle glucoma ..complain with flu like syptoms..which medication can cause it..
1Timolol*
2 acetazolamid
3 piclocarpin.

6./level of LDL in control diabetic pt ..

7/Baby complain with fever ,otities media,pharingitis, tonsillitis,lymphadenopaty,with splenomegally..

A.
Infectious mononucleosis

8/54 years old male medically free..no eye problem when go to opthalmolegist ..

This pt need F/U every ..by month.

9/Case about Osgood schlatter disease.. what the causes of pain?

10/Antidepresent Ass with hypertensive crisis ..

MOAIs
11/case about AS..
12//Femal Dx with bacterial vaganosis ..which diseas shoud be excluded..
1/candedia
2/Trichomoniasis*
3/HSV

13/pt had Hx of ttt from chroinc pain..which disorder can be devoloped..

Anixaty disorder*

14/pt came to Er with vomiting, dizznes , dialeted pupil......ech

Which medication overdose can cause it..
SSRIs*

15/pt had Hx of ttt for TB ...live in crowded city ..which vaccin shoud be recived..
Haemophilus influenzae*

16/long case about aortic stenosis..typical case .elderly pt with chest pain &exertional dyspnea .the
aortic valve is clcified..and stenosis mesure about0.7 to less fhan 2 cm..what the managment..
1 medical mang.
2 surgical valvoplasty.
3 valve replacement*

17/Femal came from Kenia ..c/o of .wt loss, loss of appited,&Diarrhea

lymphadenopathy, and black lesion in the tounge..which diseas must be screening ..
HIV*

18/ saudi female want to go to Haje came to your clinic planning for receive menngo ccocal &
Haemophilus influenzae.which the important vaccine must be received..
1/ Meningococcal vaccines

19/15 y old male came to ER with wrist pan & swelling when fall on outstretched hand,
On examenation..the pain&tenderness increased when the thumb is held in a "hitch-hiking"
position. There is x-ray
The finding no abnormality..mild swelling ..
What will do?
1/give analgesia and go home &came bake after 5 day.
2/ closed cast management.*
3/open redaction .
The is case of scaphoid fracture

20/First line of defence in the skin is..

1 mucous membranes.
2 collagenous cell.
3 keratinocytes.*
4 areolar connective tissue

21/30y old female came to your clinic for collection of her pap smear for 6 m back.. ..the result was
normal ...
She had family Hx ..her mother had cervical Ca..what will you do..
1. stop the test .
2. repeated after 5 y
3 . biopsy.
4. .....

22/25 years old F ..C/O Hx of Amenorrhea for 6 w , and sever lower abdomenal pain and gush of vaginal
bleeding..
Which the common side of implantation...
1/ ovaries
2/ cervix.
3/ fallopian tube*

23/25 year old pt C/O painless localized swellings at the wrist 2to3 cm in size..for 2 years back..not
effect in the movment ..
Whate is this? "there is picture same to this .."
1/ Ganglion*

24/Pt with Chronic obstructive pulmonary disease (COPD) , which of this can improved the prognosis?
-O2 therapy .
- influenza vaccinations ..
- Smoking cessation..
- bronchodilator.
. ECG PIC << PT 45 yrs old known dm + htn c/o epigastric pain radiated to back for that she took
rantidine 2 wks ago , 2 days come c/o sob , epigastric pain ( st elevation 1,2, avf plz every one try to dnt
panic in the exam and take your time for reading QUESTION ))
2- COMMON CAUSE OF INJURY IN ADOLCENSE ??
A- FALL B-SPORT
B- MOTORCYCLE
C- BURN

9- PIC I THINK SHWING U RENAL ARTERY STENOSIS IN PT YOUNG AND KNOWN

DM FOR 20 YRS , CAME TO CLINC BP 159/90 FOR THAT SHE TOOK
ANTIHYPERTENSIVE TWO WEEKS AGO ,, CREATININE HIGH ,, WHT IS UR NEXT
STEP ?? A- RENEAL ANGIOGRAPHY B- US C- CT SCAN D- STOP
ANTIHYPERTENSIVE (( ANTI-HTN NOT MENTION IN THE Q AT ALL )

10- CASE OF EPIGLOTITIS SEVER THROAT CONGESTION + DISTRESS BESIDE

OXYGEN WHT U WANT TO GIVE ?? A- NASOVARYNGEAL TUBE B- ANTIBIOTICS CCOTISONE D- ENDOTRACHEAL TUBE (( TRUE ANSWER D I GOT HIGH DEGREE IN
EYE ENT )

11- PT OBESE AND DM ON INSULIN AND DIET CONTROLL + EXERCISE STILL HIGH
RBS WHT U WILL DO ?? A- LONG ACTING INSULIN B- METFORMIN (( TRUE ))

2- PT 30 YRS MARRIED HER FIRST PAP SMEAR -VE , WHEN TO CHECK AGAIN ??
A- 3 MONTH B- 6 MONTH C- 3 YR D- 5 YR (( TRUE 5 YR , I GOT FULL MARK IN
WOMEN HELTH AND FAMILY MEDICINE ))

13- CASE OF FEMALE COME AND EXPLAIN THAT HER CHILD WALK BY FOUR LIMB
, AND DIGNOSED WITH MUSCULAR DISEASE (( DUCHEIN MUSCULAR ATROPY )) ,,
HE ASK YOU WHT IS THE RISK FOR NEXT BABY ?? A- 12.5% B- 25 % C-50% D100% ,,

15- PT FALL ON OUTSTECH HAND DEVELOP COLLES FRACTURE AND TTT,, TO

KNOW BONE DENSITY WHT TO DO ??? A- VIT D LEVEL B- CALCIUM LEVEL C- XRAY OF THE PELVIS D- THERE IS ANOTHER X-RAY STRANGE NAME (( I FORGOT
IT SORRY ))

17- PT WITH HYPOTHYRODISM CAME FOR CHECK UP OF LDL AND IT WAS

NORMAL ,, WHEN TO CHECK AGAIN ?? A- 3 MONTH B- 6 MONTH C- 1 YR D- 3 YRS

18 - 45 YRS OLD CAME FOR CHECK ,, NO H/O CHRONIC DISEASE , BP 125/80 ,, WHEN TO CHECK
BP AGAIN ?? A- 6 MONTH B- 1 YR C- 3 YRS D- 5 YRS

19- PT PREGNANT CAME FOR 1ST TIME , AND SHE ASK NON INVASIVE METHOD >>>> ANSWER
IS ULTRASOUND BUT ALSO MY FREINDS IN THE EXAM READ THE QUETSION WELL

20- PT DEVELOP SORE THROAT AND READNESS BEHIND THE EAR ,, AFTER THAT DEVELOP
CONJUCTIVITIS (( RED EYES )) WHT IS THE CAUSE >>> A, VIRAL (( VERY SURE ))

21- BABY WITH BILIOUS VOMTING WHT IS THE INVESTIGATION ?? READ WELL PLZ ABT
PYLORIC STENOSIS ,, INTUSSUPSION ,, HURCHSPRUNG ,,, DUODENAL ATRESIA ,,

23- CASE OF COCAKIE ?? NOT SURE BUT READ ABT IT PLZ DNT FORGET OK ALL OF U

25- CASE ABOUT HPOCALCEMIA >>>> I THINK THE CAUSE IN THE CASE IT WAS (( CHRONIC
RENAL FALIURE ))

26- CASE ABOUT PARACETMOL TOXICITY ,, IT AFFECT WHICH ORGAN ??? A.LIVER (( 100%))

27- CASE OF LOBAR PNEUMONIA ??? INVESTIGATION X-RAY

28- CASE OF LIMB ISCHEMEIA >>> U CAN ANSWER IT JUST CONCENTRATE IN THE EXAM

30- CASE OF SKIN ALLERGY WITH ITCHING AND THERE IS PIC >>>> ASK ABOUT TTT <<< ADIPHYNDRAMINE (( ANTIHISTAMINE ))

33. Signs of codeine intoxication:

a. Tremors and anxiety
b. CNS excitement and insomnia
c. Respiratory depression and bradycardia
d. Tachycardia and anxiety

34-pt known case of gout and hv nephrolithesis develop 3-4 attacks in one year and now symptomatic for
gout wht is ur ttt ?? a- ibuprofin b- indomethacin c- colchicin d- allopurinol (( d is true sure 100000% ))

35- pt known case of hiv develop eye redness on fundoscopy there is cotton-weal or something like this ((
and another finding )) dignosis is ??? a- toxoplasmosis retinopathy b- HIV retinopathy c- T.B retinopathy

36- case by explanation eye problem >>> diagnosis glaucoma

37- confusing case scenario abt mother bring her son 10 yrs old c/o neck swelling ,, and she said his
brother before hs same problem lab of TFT is normal >>>> i answer this Q as Simple goiter

38- Obese patient with DM and HTN, your advice regarding losing weight:
a. Decrease carbohydrate intake during day time
b. Decrease carbohydrate and increase fat intake
c. Decrease 500 kcal/kg/ week
d. Decrease caloric intake to 800 kcal/day

One type of food is protective against colon cancer:

a) Vitamin D
b) Fibers

Irritable bowel syndrome all EXCEPT

a) Abdominal distention
b) Mucous PR
c) Feeling of incomplete defecation
d) PR bleeding

1-A case of soft enlarged prostate with urinary syptoms.

Best drugs is:
Indapemide.
Titracin
Prazocin.
Acetazolamide.
2- Acase of sudden abdominal pain....examination show diffuse abdominal pain and tenderness ..past
history of heart burn...
Diagnosis:
Acute intestinal obstruction
Perforated duodenal ulcer
Acute pancreatitis.
Myocardial infarction
3-Which lipid to screen for ischemic heart disease:
Cholesterol.
Triglycerides
4-Most common predisposing factor of UTI in femals:
Whipping from back to front.
Wearing wet tampons.
Tampons for avery long time.
Other i dont remember
5-Acase of generalized muscle pain cough and conjuctivits....she devloped red
Maculopapular rash all over the body ..on examination ill patient with low grade fever
multiple maculopapular rash allover his body .clear vesicles shown in back.Normal
muscle power and normal sensation....
Most likely diagnosis is:
Chicken pox.
Shingels.
Measles.
Guian baree syndrome.

6-37 years old chronic renal pt came with muscle pain and irritability.
On examination tapping in front of ear Causing sudden jaw movment.You ordered lab which came as
the following:
Na 138 Cl 99 K 4.2 Ca 6.7 Creatinine 1.8 PTH high level 1(OH) cholecalciferol normal level.
What is the cause of this patient syptoms:
Vit D deficiency.
Parathyroid problem.
Renal disease.
Osteoporosis.
Defect calicium intake
7-30 years old female G 3 PO ....12 weeks gestation.she had ahistory of 2 previous abortion.She done
agenetic counseling which show aneuploidy XO...
What is the possibility of this aneuploidy in current conception:
40%
50%
60%
70%
8-There was acase of major depression came to clinic and when you talked to him he told you about
detailed plan for suicide...
What are you going to do:
Increase dose of medication.
Admit to hospital.
Inform police.
Discharge and follow up
9-Female pt. G 3 p 2....14 weeks gestation came with lower abdominal pain and bleeding.she looks
anxious and pale...
On ex:

TEP 37.8 PULSE 100. U/S show gestational sac and

viable fetus. In pelvic examination :
It show closed cervix and copious bleeding. Diagnosis:
Bl/p 100/70 RR 22

Missed abortion.
Inevitable abortion.
Threatened abortion.
Incomplete abortion
Most Commonly asked "MOST COMMONs" in
Surgery
Please Correct and Contribute
1.Most common benign neoplasm of liverhemangioma
2.Most common primary malignancy of liverhepatocellular carcinoma
3.Most common hepatic neoplasms- metastasis
4.Most common primary hepatic malignancy in
children- hepatoblastoma
5.Most common benign tumor of oesophagus-leio

myoma
6.Most common indication of liver transplantation
in children-biliary atresia
7.Most common indication of liver transplantation
in adults-cirrhosis of liver
8.Most common bone of the face that is fractured
is-nasal bone
9.2nd most common bone of the face that is
fractured is zygomatic bone
10.Most common benign tumor of spleenhemangioma
11.Most common neoplastic enlargement of
spleen- lymphoma
12.Most commo cancer caused as a risk of
choledochal cyst carcinoma of biliary tract
13.Most common type of gall stones- Mixed
Stones (plz correct me if wrong)
14.Most common site of gall stone ileus-distal
ileum proximal to ileocaecal junction
15.Most common site for gall stone impaction in
CBD- ampulla fo water
16.Most common site for internal fistula of gall
bladder-1st part of duodenum
17.2nd most common site for internal fistula of
gall bladder-colon
18.Most common cause of supurative cholangitisgall stones/?CBD stones
19.Most common type of stones among primary
and secondary CBD stones-secondary(cholesterol
stones)
20.Most common metastasis to liver is fromstomach
21.most common part of CBD injured/prone to
stricture during laparoscopic cholecystectomyupper CBD
22. most common pathological type of gall
bladder carcinoma- adenocarcinoma
23.most common cause for hemobilia- blunt
trauma
24.most common cause of hemobilia in western
countries- hepatic trauma(trauma to intrahepatic
branch of hepatic artery)
25. most common cause of hemobilia in oriental
countries-ductal parasitism(ascaris lumbricoides)
26. most common cause of obstructive jaundiceCBD stones
27. most common cause of biliary stricture-traum
a
28.most common malignancy after
cholecystectomy occurs in- stomach
29.most common site of an intraperitoneal/intra-

abdominal abscess-pelvis
30.most common organ involved in
retroperitoneal fibrosis- ureter
31.most common site of ureteral obstruction-low
er 1/3rd of ureter(at the level of pelvic brim)
32.most common cause of abscess in midline/
extra peritoneal space-amoebic abscess
33.most common cause of small bowl obstruction
and secondary infertility in developed countriesperitoneal adhesions
34.most common cause of chylous ascites-maligna
ncy(lymphoma)
35.most common variety of carcinoma peritoneidiscrete nodules
36.most common variety of mesenteric cyetchylolymphatic cysts
37.most common site for chylolymphatic cystmysentery of ileum
38.most common cause of peritonitis in adult
male-perforated appendix
39.most common site from where psudomyxoma
peritonei arise-appendix
40.most common organism causing (primary)
spontaneous bacterial peritonitis-E.coli
41.2nd most common organism causing (primary)
spontaneous bacterial peritonitis-klebsiella
42. most common organism causing (secondary)
acute suppurative peritonitis-E.coli
43. 2nd most common organism causing
(secondary) acute suppurative peritonitis-bac
teriodes
44.most common organism causing CAPD
cagualase negative staph. (staph.epidermidis)
45.2nd most common organism causing CAPDstaph.aureus
46.most common site for intraabdominal abscess
following laparotomy- subhepatic
47.most common cause of generalized peritonists
in middle aged adult male- duodenal ulcer
48.most common cause of acute mesenteric
adenitis- idiopathic
49.the most common organism seen in peritonitisE.coli
50.most common site of malignant change of
lipoma is retroperitonium
51. MC and earliest symptom in rectal carcinoma
----- bleeding
52. 2nd MC symptom in rectal carcinoma ---alteration in bowl habit
53. MC type of rectal and colon carcinoma ---columnar cell adenocarcinoma

54. . MC type of anal canal carcinoma ---squamous cell ca.

55. 2nd MC type of anal canal carcinoma ---basal cell ca.
56.MC site for anal fissure ---- midline posteriorly
(90%)
57. 2nd MC site for anal fissure ---- midline
anteriorly
58. 3rd MC site for melanoma ---- anal canal (1st
and 2ndskin and eye)
59. MC cause of lower GI bleed in adults ---hemorroids
60. 2nd MC cause of lower GI bleed in adults ---diverticulosis
61. MC cause of massive bleeding per rectum ---diverticulosis
62. MC symptom of fissure in ano (anal fissure)
---- pain
63.MC site for blood borne metastasis of rectal ca.
----- colorectal ca.
64. ________ variety of rectal ca. is MC at recto
sigmoid junction ---- annular variety
65. MC type of ano rectal abscess ---- perianal
abscess
66. MC cause of ano rectal abscess ---- fistula in
ano
67. MC symptom of rectal polyp ------ pain
68. 1st MC complication after haemorroidectomy
----- pain
69. 2nd MC complication after haemorroidectomy
----- urinary retention
70 .MC post operative nosocomial infection ---urinary tract infection
71. 2nd MC post operative nosocomial infection
----- surgical site infection
77. 3rd MC post operative nosocomial infection
---- lower respiratory tract infection
78. MC testicular tumor ------ seminoma
79. MC type of testicular tumor seen in
cryptorchid testis ---- seminoma
80. MC testicular tumor above 50 yrs ----lymphoma
81. MC secondary neoplasm of testis ----lymphoma
82. MC malignancy in older males ---- prostate
cancer
83. MC side in which testis does not descend ---right
84. MC side where varicocele occurs ---- left side
85. MC predisposing cause of torsion of testis ---inversion of testis

86. MC symptom of tortion testis ---- pain

87. MC type of primary hydrocele ---- vaginal type
88. MC site of ectopic testis ------ superficial
inguinal ring
89. MC cause of surgically treatable infertility ----varicocele
90. MC cause of upper GI bleeding ---- peptic
ulcer disease
91. MC bladder stone ----- uric acid stone
92. 2nd MC bladder stone ---- struvite
93. MC tumor of urinary bladder ----- transitional
cell ca.
94. MC tumor of urinary bladder in a child ---rhabdomyosarcoma
95. MC aetiological factor for transitional bladder
cell ca. ----- cigarette smoking
96. MC bladder cancer that is prevalent in
bilharzia endemic areas ---- sq. cell. Ca.
97. MC type of buccal ca. ---- sq. cell. Ca.
98. MC type of maxillary ca. ---- sq. cell. Ca
99. MC symptom of bladder ca. ------- painless
hematuria
100. MC primary tumor which gives secondary to
penis --------- badder ca.
1. Healthy 27 y.o male coming for annual exam, which should u screen for:
A) DM
B) HTN* (sure)
C) Dyslipidemia
2. Colon cancer screening should start at what age:
40
45
50* (sure)
55
3. Child presented with his parents complain of walk on tip of his foot he start to walk by age 13 month and he
had normal development. His young brother died with disease of muscles and his mother now pregnant and its
a boy. what is the chance of brother to get the same disease. Lab result: creatinine kinase 300 (high)?
(Duchenne muscle dystrophy inheritance):
a-12%
b-20%
c-50%*
d-75%
4. First immunologic defence of skin:
A) Keratinocytes*
B) Blast cells
C) Melanocytes
5. Painful genital ulcer, bleeding, lab confirmed Haemophilus Ducreyi;
A) Treat all close contacts
B) Treat all sexual partners* (sure)
C) Treat symptomatic sexual parteners only
6. (Picture of Vulvar lesion-not clear at all): Lady presented complaining of swelling in her vulva, on right side,
painless, freely mobile, Diagnosis:

A) Vulvar Varicosities
B) Bartholin Cyst*
C) another cyst name, I dont remember
7. Ganglion cyst: (pic) and scenario, recurrent painless swelling- what is diagnosis.
8. Scabies picture of mite/lesion + scenario of itching
9. Psoriasis picture, scaly pink lesion on extensor surfaces,
A) avoid trauma*
B) avoid sun
C) bathe daily
10. Herpes zoster image + ttt?
-Acyclovir 200mg oral 4 times a day for 7 days
-Famciclovir 500 mg 3 times a day for 7 days*
2 other not antiviral.
11. Typical Herpes zoster scenario (pain, parasthesia, vesicular eruption in single dermatome distribution:
diagnosis?
12. Ulcer base of the nose? Basal cell Carcinoma
13. Young girl 95th centile of wt and hight. What to council about wt?
A) Do not mention it
dont remember the scenario exactly.. sorry.
14. Baby can move his head from side to side while lying on his back, hands in fists.. how old? Answer: 1
month*
15. 17 years old girl missed her second dose of varicella 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
d) Revaccinate from the start*
16. Gold standard for diagnosing bronchial asthma:
A) Peek expiratory flow rate
B) Inhalation challenge
C) CXR
D) Spirometry*
17. Clear case of meningitis (neck stiffness..) , most appropriate next step:
-Steroids
-IV ceftriaxone*
-LP
-CT
18. TB breakout, PPD positive, test to rule out false positive:
A) Mantoux
B) CXR*
C) Repeat PPD
D) Tine test
19. Old female has Rheumatoid Arthritis for long time, now presented multiple joint pain, (both hands X-ray) appears to have multiple joint affection, most appropriate ttt:
A) Azathioprine
B) Methotrexate*
C) Hydoxychloroquine
D) Colchicine
20. Rheumatoid arthritis management:
A) Cold water therapy
B) physiotherapy*
21. Ankylosing Spondylitis: (young adult with chronic buttock/low back pain)
ttt: Physiotherapy*

22. Acute closed angle glaucoma* scenario (typical presentation) red painful eye, headache, nausea, vomiting,
dilated fixed pupils.
23. PATIENT work in dusty environmental ,has red eyes, itching, no trauma not mucopurulent, to relive has
symptoms:
A) Tobramycine eye drop
B) Acyclovier drop
C) Trifluridine drop
D) Olopatadine drop*
24. Brief attacks flashing lights,
When to refer urgently to Ophthalmologist? when patient develops:
- Halos* (not sure)
25. Pt complaining of decreased visual acuity for 24 hours, painful eye with movement, fundus exam was
normal.. I forgot options, but I chose: Multiple Sclerosis*
Pt present with sudden painless loss of vision, Fundoscopy shows "Cherry Red Spot (Central Retinal Artery
Occlusion), management: Ocular Massage*
27. Otitis externa: I think Fungal, treatment, forgot options
28. Child having nasal discharge from left nostril, foul smelling, and bloody, for 6 weeks.
A) Foreign body
B) Polyp
C) maxillary sinusitis*
29. A Patient with raised JVP and tachycardia , she eats polish white rice, she has :
A) Wet beriberi*
B) Dry beriberi
C) Vitamin A deficiency
D) Folic acid deficiency
30. Male patient presented with burning in his feet, constipation, fatigue, ?(Hypothyroid)
Best test test:
A) TSH*
B) B12
C) Folic acid
31. Another Hypothyroid case: fatigue, cold intolerance, has neurologic manifestations.. what is the expected
TSH:
A) 0.2
B) 0.5
C) 9.3
D) 47
32. Pregnant hyperthyroid ttt
- Propylthiouracil*
- Carbimazole
33. Glipizide mode of action: increase insulin secretion from pancreas
34. Chronic pancreatic disease == cancer pathophysiology?
something about Trypsin, cytokine release/inhibition, dont remember exactly.
35. Bone scan -3.5 = osteoporosis*
36. Type 1 DM, on NPH and regular insulin taking it before breakfast and dinner.. His 4 pm blood sugar is high,
what to do?
A) increase NPH before breakfast*
B) increase regular insulin before breakfast
C) increase NPH before dinner
D) increase Regular insulin before dinner
37. Child, few months old, wheezing, shortness of breath, respiratory distress, 2 siblings have a cold, (RSV
bronchiolitis) most specific test: nasopharyngeal swab*
38. Child episodes of crying, with drawing of his legs up to his chest.. Diagnosis? Intussusception*
39. Bite management: after irrigation, Antibiotic: Amox+clavulinic*

40. G4P3, had previous C/S and 2 SVD,

How to plan for next delivery?
A) oxytocin
B) plan c/s at 38 weeks
C) ARM
D) forgot..
41. Complication of placental abruption: Coagulopathy*
42. Pregnant lady 10weeks GA, presenting with painless bleeding, uterine fundus at 15 cm..
Dx: low lying placenta*
43. Most major complication of D&C:
A) Uterine perforation*
B) Cervical laceration
C) Infection
D) Bleeding
44. Lady with back pain, after lifting heavy box:
A) avoid bed rest
B) Lumbar traction
C) Massage*
45. Meneirs disease food: low salt, no caffeine*
46. pregnant 38 weeks develops seizures, altered level of consciousness, short of breath..
Vitals: fever, tachycardia,
A) PE
B) Anaphylaxis
C) MI
D) Amniotic fluid embolism*
47. GERD for 10 years, on PPIs which improved his condition, gastroscopy done show columnar
transformation scattered between remaining squamous epithelium, there is finger like projections:
A) esophagitis
B) Barretts
C) adenocarcinoma*
D) squamous cell carcinoma
48. Benefits of using spacer in asthma:
A) Less oral adverse effects
B) Prolonged effect of inhalers
C) Better technique*
49. Long scenario about patio with Asthma on Fluticasone one puff BID, and Montelukast one pill/day, her
symptoms improved.. she only used Salbutamol one last week. no night symptoms. Resume Montelukast for
how long?: months?
A) 1
B) 2
C) 3
D) 4
50. Psych patient, after starting SSRI comes telling you he is planning suicide:
Admit patient*
51. More likely to commit suicide; 4 options, same in UQU,
the answer I chose was 60 yr old male recently started on SSRIs for depression.
52. Bereavement case: (mother sad after her son died one month back)
53. Pt always think there is alien in his back yard when he is out from home, even though he knows its not
possible, he's always thinking about the idea brought by this aliens. pt came to you fear that he is going to be
"insane" what is his condition
A) Obsessions
B) Compulsions
C) Hallucinations
D) Delusions*

54. 3 year old child brought by parents, he is obese.. What advice:

A) Decrease milk intake
B) increase protein
C) total fat per day less than 60% of total daily calories
D) fat less than 30% of total daily calories*
55. Saudi Paediatrics society suggest breast feeding for:
A) 4 month
B) 6-12*
C) 13
D) 25
56. Rheumatic fever prophylactic ttt in pt allergic to penicillin:
A) IV somehting
B) IM Ceftriaxone
C) Oral sulphadiazine*
57. Child presenting with weakness, fatigue, since one week, now has facial swelling around eyes, and pitting
edema in the lower limb +2, decreased urine output, and dark color urine = Recent Impetigo Contagiosa* =
(case of Acute post-streptococcal glomerulonephritis)
58. Ring stage of malaria* + typical scenario; what is diagnosis.
59. Patient coming from Kenya, presenting with night sweats, lymphadenopathy, hairy tongue, history of blood
transfusion there.. What to test for.. HIV*
60. (Blood smear picture) nothing specific, scenario: old man with general good health, presenting with fatigue,
weakness, dizziness: Hb: 9, HCT: low
A) sickle cell
B) thalassemia minor
C) CRF
D) Gastrointestinal bleeding*
61. Child coming for routine check up, doctor found systolic murmur, high pitch, crescendo-decresendo in
character, best heard over mid- sternum;
A) systolic ejection*
B) innocent flow murmur
C)
62. VT ECG PIC, pt presented with palpitation and dizziness, then collapsed, no carotid pulse, ttt: defibrillator*
63. (Chronic stable angina presentation); Pt came to ER, retrosternal chest pain, lasting for 15 min, relieved by
rest, not compliant on his medications.. Vitally stable. mild HTN.
What is best..
A) Discharge home and plan ECG stress test next visit
B) Cardiac enzymes and follow up in clinic
64. Which one represents Hep B viral replication?
HBsAg
HBeAg*
HBsAb
HBcAb
65. Most common Hepatitis in poor sanitation, low social economic, crowded areas, affecting children..
A) A*
B) B
C) C
D) D
66. Drug used for maintenance in Bipolar: Lithium*
67. Patient taking Sildenafil, what to avoid: Nitrates*
68. Drug poisoning: Mydriasis, Hallucinations, tachycardia
A) Anticholinergics
B) Amphetamines*
C) Anticonvulsant
D) Cholinergic

69. Child walking with inward toeing, sitting in W with his legs behind him, Diagnosis
A) Metatarsus adductus
B) Tibial torsion
C) Inward torsion of femur*(sure)
D) Metatarsus Varus
70. Female 24 y.o., having amenorrhea for 5 months, BMI 20, stable for past 4 years;
A) Investigate for Eating disorder
B) Pituitary Adenoma*
71. Patient has Indirect Inguinal Hernia, what is pathophysiology?
A)
B) Something due to Constipation
C) Congenital Defect
72. Young female patient with unipolar depression on SSRI: what is most correct
A) Most patients will experience sexual adverse effects*
B) Venlafaxine is ok to use in case go HTN
73. Back pain assessment and importance of onset and duration
A) Short onset is important for biological origin.
B) Location and onset is important for the biological origin*
C) Location and onset are important for the outcome
74. Patient complaint of light-headedness, tachycardia, diarrhea, after meals, relieve by laying down, history of
gastrointestinal surgery before 2 month, what is the ur provisional diagnosis
A) IBS
B) Dumping syndrome*
C) villous adenoma
D) Cronhn's disease
75. Male presenting with intermittent decrease in urine flow rate, urgency, hesitancy = (BPH), PSA done,
normal. everything else is normal, except DRE: slightly enlarged median lobe of prostate.. what recommend for
him now:
A) Cystoscopy
B) Periodic PSA*
C) Annual Renal Function Tests
76. Female presented with growth in genitalia, confirmed to be Wart; the organism is also responsible for what?
A: Cervical Cancer* (HPV)
77. Female Patient, 40 y.o, had hx of DVT, normal menstrual history, she doesnt want to use diaphragm, her
husband wont use condom.. council about contraception;
A) OCP wont increase risk of her condition
B) from Hx she is suitable for tube ligation
C) IUCD seems like a suitable alternative*
D) No need for contraception as shes unlikely to get pregnant at her age.
78. Old man presented by his children, they suspect his cognitive function is impaired.. what can you tell them
about trying to improve his condition.. (Dementia advice)
A) Daily exercise will help
B) Brain exercise will help prevent dementia
C) New measure of conducting his daily activities will now be required*
(The options are as close as i can remember.. but not exact..)
79. Patient with lung cancer; best way to evaluate metastasis:
A) MRI
B)
D) PET scan*
80. Which vaccine to avoid if child has allergy to eggs:
Influenza*
81. Fainting Scenario (man standing in line, drowsy, yawning, sweaty..)
82. Arterial insufficiency (Limb ischemia) clear scenario

83. Scenario of child falling, feeling pain in his leg + picture of X-ray leg, (clear broken), before transfer of
patient to hospital, what should you do:
A) High dose paracetamol
B) Morphine
C) Splint the leg*
D) Elevate the leg
84. Old lady, know HTN, DM, presented with epigastric pain radiating to the back, and heart burn for past 2
months, not relieved by antacids (Ranitidine)..otherwise she looks health, no abdominal tenderness + ECG pic,
vitals BP 150/90
A) Aortic Dissection*
B) Perforated peptic ulcer
C) MI

1-- pt e flue like symptom lymphoadenopathy sore throat most likely:

a viral
b bacterial
2- pt e eye pain vesicle in opthalmic devision :
a post herpes zoster
b post herpes simplex
3- pregnant lady complain of hypopigmented skin in the face:
a cloasma
b urticaria
4- 17 yrs old dysmenorhea pathophysiology
5- 2 question about female lose son breavment
6- eye pain photophopia
a keratites
b uvetis
7- 2 6yrs old co bleeding per rectum colonoscopy diagnose adenopathy Ca colonoscopy done every
a 3 m b 6 m c 1yr d 5 yr
8-Xray show big heart pt co central chest pain SOB diagnosis
A pleursy
b pericardial effusion
c CHF
9 Pt co SOB bloody sputum dusky rash in face PH of RF +AF diagnosis
A CHF
B MS
C infective endocardies
10-Senario of pt e SOB +palpitation diagnosis tricuspid Regurgitation what treatment to prevent
complication to occur
A anticoagulant
B neuroaxial ....
C antibiotic
11 LBBB for dental proceeded prophylaxis
A no need

B antibotic before
C antibiotic after
12 DVT majer risk factor
A open knee operation
B fly 4 h
13 Pt e alchole abuse stop then devolped tremor nausa anxiety treatment
A diazepam
b propranolol
c nalexton
14 Pt haevy alchol co chest pain sever vomiting chest xray show wide mediasinum on exam
decreased unilateral breath sound treatment
A antibiotic
B NG suction
C surgical refer
15 2 guestion about Migrain first treatment to abort attack
A sumtriptan B diazepam C acetaminophen

16 What antipsychotic cause drooling neutropenia ECG change

A respirdone B zolipedem C clozapine

17 Pt e hypertension on atenolol50mg co of bilateral calf pain on examination shiny skin leg

weak dorslis pedis Bp 140/90
1 stop atenolol
2 add captopril 25
3 add hydrochorothizide 25 mg
4 reduce dose to 25mg
18 Pregnant lady co epigastric pain radiate to back lipase amylase high
Important managment
A antibiotic
B nasogastric suction
C hydration
D analgesia
19 Child co fever drowsy investigation high total
What important next step
A LP
B ceftrixone Iv
20 guestion child e fever tonslites devolped splenomegaly lymphadenopathy

A adenopathy virus
B EBV
C herpes simplex
21 long senario old male hypertension on examination mild cataract and mild decreased vision
A urgent referral to opthalmologist
B urgent cataract surgery
C elective opthalmology refer for cataract
In hyperthyroid pt what investigation done to look for complication of excees thyroid hormone
A Ct scan haed
B bone scan
C US liver
23 Xray pelvis show pelvis bone increased density diagnosis
A osteomalcia
B Osteoporosis
C Paget disease
D normal
24 for colon Ca best screening
A colonoscopy annually
B senstive fecal occult blood annually
C CT scan annually
25 Child e bleeding tendency splenomegaly
Investigation all low pancytopenia
Diagnosis
A iron deficiency
B SCA
C aplastic anaemia
26 Senario child e peticheal splenomegaly pericarditea
A infectious mono neuclesis
B kwasaki disease
27 business man have proplem in company co anxiety diaphoric sweating irritability diagnosis
A Mania
B grandiosity
C anxiety disorder
4 panic
28 Pt involve in RTA dyspnea distended vein tracheal shift decreased breath sound inLt side
Bp 100/60
Immediate managment
A IV fluid
B needle in 2nd ICS lt side
C analgesi
D intubation
29 pt hysrectomy done co of mild pain in incision site

Hb mrmal
Tempreture 37.5
HTC normal
Bp 110/70
What cause to be still in hospital
A low Hb
B high tempreture
C high HTC
D because not oral feeding
30 pt e muscle cramp postive chevostock sign
Ca low creatinine high PTH high
A hyperprathyroidism
B CRF
31 guestion about when food eating and perstalsis occur this called
A gastrocolic
B gastroileal
C gastroanal
D gastrocolic
32 about girl 17 yrs old co all class freind tall and has small breast and pubic hair scanty all
investigation normal
B delay puberty
C Turner syndrome
33 old pt co Rt facial pain tenderness eye tearing salivation fluid from mouth clowdy Total high
Diagnosis
A bacterial sialdnites
B Sgoren syndrome
C parotid tumour
34 young male co of muscle weakness investigation
Low NA
High K
Low Ca
Which responsible
A hyponatraemia
B hypocalcaemia
C hyperkalaemia
35 young pt co of heart burn
epigastric pain recurrence not respond to diet contol
A H2 blocker
B endoscopy
C biopsy
36 child dental caries
A systemic fluride
B deit modification

37 pregnant lady FBG 8.6 high risk of

A candidiasis
B trichomoniasis
38 young male many sexual behavior sexual practice 2 month ago devoloped painless penile
lesion + inguinal lymph node enlargment
A chancre
B syphilis
C gonorrhea
39 which study increased health worker bias
A cohort study
B case control
C cross sectional
D case report
42 child e constipation for long time hypotonia hyporeflexia lower limb MRI attach there is white
lesion in lower back diagnosis
A Cyst
B cord infarction
43 exercise in CHD:
1 isitonic
2 anaerobic
44 35 yrs female co Rt iliac fossa pain nausea vomiting sudden onset pt toxic ill on pain grade
9/10 Bp 110/70 pulse 100
US mass 6cm
Diagnosis
A ovarian Cyst Torsion
B Rupture ovarian Cyst
C appendicitis
45 child 2yrs old mother said abnormal urine stream UG puc cell 10 RBC 15
VCUG done attached
Diagnosis of primary proplem of this child
In emage die there stricture then dei continue
A vesicouretric reflex
B posterior urethral valve
46 yrs female clear vaginal dicharge colurless odourless after intercourse management:
1 meconazol ointment
2 douch
3 metronidazole
47 25 yrs female co tender lump in upper part of breast associated e mensruation
A FNA
B NsAID

C watch next cycle

48 pt co anal pain sever in nature on examination mass in anal diagnosed as Thrombosed pile
Treatment
A analgesia
B laxative
C excision
D evacute haematoma
49 old pt co dispareunia lower abdominal pain this proplem affect her psychological ly
Treatment
A COP cream
B Nsaid 1 hr befor intercourse
C lubricant
D endometrical biopsy
50 Youg male e inguinal hernia
A urgent refer
B surgical operation now
C elective surgery If reducible
51 young male sudden scrotal pain increased e elevation. UG puc cell increased TWBCs
increased
What to do
A urethral swap
B doppler US of scrotum
C abd US
52 old pt e symptom of BPH on examination mild enlargement of prostate not firm
UG mild UTI
PSA normal
What next
A periodic PSA
B prostatectomy
C start alpha blocker
D admission
53 pt e knee pain e limitation of movement swelling in patellar region
A septic arthritis
B RA
C Osgood schalter disease
D osteoarthritis
56 child bring by mothers for screen of TB no contact e tuberculosis pt no crowdness
Screening
A every 3 month
B every6 month
C once
D 1yr

57 pt e palpitation HR 180
ECG show narrow complex tachycardia best treatment
A digoxin
B verapamil
C adenosine
D amiodaron
58 old pt fracture radius to assess bone density
A xray
B vit D
C bone scan
D DEXA

59 pt diabetic leg ulcer antibiotic 7 day not respond

A hydrogen dressing
B surgical depridment
C another course antibiotic
60 Lithium best treatment for
A bipolar depression
B mixed mania
C classic mania
61 diabetic pt came to clinic for follow up sudden collapsed
HR 96
ECG show wide spread st elevation and narrow tachycardia inspite HR given 96
Diagnosis
A SVT
B VT
C wolf parkinson white syndrome
62 typical senario of closed angle glucoma acute ask for treatment
A timolol eye drop+ iv acetszolamide
B Timolol eye drop and refer
C iv acetazolamide+ pylcarpine0.4%
Patient with renal pain and vomiting
Na normal
K low
A metabolic alkalosis
B metabolic acidosis
C respiratory acidosis
D respiratory alkalosis

Model female devoloped Rosecea affect her face then devoloped telangectasia treatment
A topical antibiotic
B topical steroid
C systemic antibiotic
D laser treatment