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13 October, 2015
Medicine
1. Cardiac patient on Aspirin, no new complaints. He is having low platelet (less than 10) for
the last 6 months. What is your management?
a. Could not recall the choices
Answer: ?
2. Which medication will delay the surgery for chronic aortic regurgitation?
a. Could not recall the choices
Answer: ?
● In severe aortic valve insufficiency, the excess in afterload increases burden on the left side of
the heart. Theoretically, any medication that can reduce afterload could be expected to improve
left ventricular function and decrease regurgitant backflow from the aorta. This would provide a
temporizing measure by which surgical intervention can be postponed. One study showed that
the use of nifedipine in asymptomatic patients with severe aortic regurgitation who had normal
LV function could delay the need for surgery by 2-3 years. This result may also be expected with
the use of similar vasodilating agents. (Reference: Medscape)
Answer: ?
Answer: A?
Answer: A?
7. Patient with chest pain and ST changes, you will find elevation in:
a. ALT
b. AST
c. Troponin
Answer: C
10. Child known case of DM 1, lost his consciousness at school. The last insulin injection is
unknown.
a. Take him to the hospital
b. IV ranger lactate
c. IV D5%
d. Insulin
Answer: ?
11. Asymptomatic Patient, Chest X ray shows a unilateral calcified nodule on the upper zone
of his lung.
a. Could not recall the choices
Answer: ?
12. Elderly female complaining of depression, bilateral shoulder and hip pain. Normal blood
workup.
a. polymyalgia rheumatica
b. fibromyalgia
Answer: A?
13. Which of the following is the the most specific for Rheumatoid arthritis?
a. anti ccp
b. RF
c. CRP
Answer: A
20. 19 years old male can’t bring the spoon infront of himself to eat after a bike accident.
Where is the site of his lesion?
a. Parietal lobe
b. Temporal lobe
c. occipital lobe
d. cerebellum
Answer: ?
● Chlorpromazine is the most thoroughly studied and appears to be the drug of choice.
(Reference: Medscape)
Answer: A
Answer: A
Answer: A
Answer: C
Answer: A
● The posterior vagal trunk is a branch of the vagus nerve which contributes to the esophageal
plexus. It consists primarily of fibers from the right vagus, but also contains a few fibers from the
left vagus.
● Pronator teres syndrome is a compression neuropathy of the median nerve at the elbow. It is rare
compared to compression at the wrist (carpal tunnel syndrome)
(Reference: Medscape)
● Type 1 : chromosome 17 q
● Type 2: chromosome 22 q
● Six cafe au lait, freckling in the axillary or inguinal area, optic glioma and lisch nodule.
Answer: A
Answer: A
Answer: ?
Answer: A
35. Patient on diuretics developed palpitation. Due to the disturbance of which of these electrolytes
lead to his presntation?
a. Na
b. K
c. Cl
d. Ca
Answer: B?
36. Patient ingested 20 gram of acetaminophen 8 hours ago, what is your next step?
a. Charcoal
b. N acetylcysteine
c. Gastric lavage
Answer: B
37. Asymptomatic patient, known case of chronic gastritis, has positive occult blood stool
and his Hb =9. You will manage him by :
a. IM iron
b. Oral iron
c. Erythropoietin
d. blood transfusion
Answer: ?
38. Patient underwent orthopedic surgery. 2 days after the surgery he started to complain of
swelling, erythema and tenderness at the site of surgery. Which organism can cause the
wound infection?
a. Clostridium perfringens
b. Other choices included different subtypes of clostridium
Answer: A
Answer: A
40. Elderly patient presented with typical symptoms of multiple myeloma. x ray showed lytic
lesions, positive M protein and hypercellular bone marrow. What other findings can be
found in the blood?
a. increase peripheral blood B cell
b. Rouleaux formation
Answer: B
41. Patient ate from a restaurant. 2 days after that started to complain of diarrhea, vomiting
and urticaria.
a. food poisoning
b. food allergy
Answer: B?
42. Patient after road traffic accident developed chest pain. On examination: no lung sound
and hyperresonance on one side. What is the 1st thing to do?
a. needle decompression
Answer: A
● Tension pneumothorax
43. Clear question about pseudomembranous colitis (Abdominal pain and watery diarrhea
after clindamycin)
Answer: ?
Answer: ?
Answer: ?
Surgery
1. 16 years old female complaining of abdominal pain for 2 days. It started in the
periumbilical area then it radiated to the right lower quadrant. It is associated with
anorexia. On examination, right lower mass was felt.
a. surgery immediately
b. conservative
*Antibiotics weren’t mentioned in the choices.
Answer: A?
Answer: A
Answer B
Answer: A?
Pediatrics
1. Child presented with petechiae and his platelets is 15, otherwise healthy. What will you do
for him?
a. splenectomy
b. IVIG
Answer:
2. 4 weeks old boy with acute onset forceful non bilious vomiting after feeding. On
abdominal examination: There is olive mass at epigastric area. What is the 1st
investigation should you do?
a. PH monitoring
b. Abdominal US
Answer:
Answer: A
4. A school did a screening test for their students and they found that there is a good
number of obese students. The school doctor wants to know more about these students
before educating their parents. What should you provide him with?
a. HDL\LDL
b. Girth measurement
c. dietary habits
Answer:
5. The most common chromosomal abnormality in new infant :
a. Down syndrome
Answer: A?
6. Child came with wheezing and cough, diagnosed to have asthma and his dr. prescribed
beclomethasone space inhaler or nebulizer?? twice daily. you will be worried about:
a. Growth'retardation
b. Extraocular'problem'
7. Child presented with Asthma exacerbation.The patient did not respond to B agonist. What
is your next step?
a. Aminophylline
b. systemic steroid
Answer: B
8. In an area where there is low iodine supplementation they had a lot of new infant with
cretinism. what is the initial therapy for these infants?
a. iodine supplementation
b. Thyroxin supplement
● The mainstay in the treatment of congenital hypothyroidism is early diagnosis and thyroid
hormone replacement.
9. Child was having rhinorrhea and then developed episodes of cough followed by vomiting.
Which of these vaccination may prevent him from having this disease?
a. DTaP
Answer: A
10. What is the mechanism of polio vaccine (Both types; oral and IV)?
Answer:
11. Child is complaining of severe throbbing unilateral headache, aggravated by light, what is
the most likely diagnosis:
a. migraine
b. Cluster Headache
c. Stress Headache
12. Mother brought her 2 years old child to the ER with history of upper respiratory tract
infection for the last 3 days with mild respiratory distress. This evening the child started to
have hard barking cough with respiratory distress. On examination:: RR 40/min,
associated with nasal flaring, suprasternal & intercostal recessions. What is the most
likely diagnosis?
a. Viral Pneumonia
b. Bacterial Pneumonia
c. Bronchiolitis
d. Acute epiglottitis
e. Tracheobronchiolitis
Answer: A
14. 3-4 questions about croup and bronchitis (you should know physical examination signs)
15. 2 questions about developmental millstone.
OB/GYN
1. Lactating mother complaining of fever and breast tenderness and redness diagnosed to
have bacterial mastitis. What will you recommend for her?
a. Continue breast feeding, hot compressor and antibiotic.
b. Discontinue breast feeding and give antibiotic to mother and baby.
Answer: A (Reference: 3rd Edition UQU > Obstetrics and Gynecology > Q 385)
2. Multigravida in labor with 60% effacement and dilated cervix (5 cm). After 1 hour she still
has 60% effacement but the cervix dilates to 6 cm. What will you do for her :
a. expectant management
b. oxytocin
c. cervix ripening
d. Artificial rupture of membranes
Answer: ?
Answer: ?
4. 42 years old female complaining of amenorrhea, night sweat and flushing for the last 6
months. What is the most likely diagnosis?
a. hypothyroid
b. hyperprolactinemia
c. Congenital adrenal Hyperplasia
d. pheochromocytoma
Answer:?
5. Swelling at the labia majora for 6 month. It was aspirated and now it relapsed. What is your
management?
a. Aspiration
b. incision and drainage
c. marsupialization
Answer: ?
● It is a Bartholin cyst
6. Multigravida 34 week , her baby is breech , what you will do for her :
a. expectant delivery
b. CS
c. External Cephalic Version
Answer: ?
Answer: ?
8. Mom wants to know if her baby is having thalassemia or not , how you will investigate her
antenatal :
a. Could not recall the choices
Answer:?
9. Which of the following supplements will decrease the hot flashes in postmenopausal
women?
a. Black Cohosh
Answer: A
Answer: A
11. In polycystic ovarian syndrome, which of the following will be found on blood test?
a. FSH:LH 1:3
Answer: A
12. Young female complaining of whitish grey vaginal discharge. KOH test and clue test were
positive. What is the diagnosis?
a. Gonorrhea
b. Bacterial Vaginosis
c. Trichomonas Vaginalis
Answer: B (Reference: 3rd Edition UQU > Obstetrics and Gynecology > Q 61)
13. 21 years old Female with negative pap smear. You should advise her to repeat pap smear
every:
a. 6 months
b. 12 months
c. 18 months
d. no repeat
Answer: B (Reference: 3rd Edition UQU > Obstetrics and Gynecology > Q 201 and
Essential of obstetrics and gynecology)
● Annual pap smear screening starting at age 21 years or no more than 3 years after becoming
sexually active. Then every 3 years after 3 normal consecutive test.
● Women > 30 years old who have three consecutive normal tests screening (1 / 3 years).
● Screening should be discontinuing for women > 60-70 years who have had 3 or more normal Pap
smear
14. 23 years old women with cyclic bilateral nodularity in her breast since 6 months. On
examination there is tender 3 cm mobile subareolar mass on her right breast, What will
you do next?
a. FNA with cytology
b. Mammogram
c. Biopsy
d. Follow up for next cycle
e. Observation
Answer: D (Reference: Al-Qassim MCQs > Q 82)
Answer: ?
16. Nursing mom want to conceive but not at the coming two years. What will you recommend
for her?
a. vaginal ring
b. combined OCP
c. progestin injection
d. patch
Answer: C
17. 20 years old sedentary female complaining of amenorrhea for the last 6 months and her
BMI is 20 :
a. prolactinoma
b. Anorexia
c. depression
Answer: A
19. Lactating lady who didn't take the MMR. What will you advise her to do?
a. Take the vaccine and stop feeding for 72 hour
b. It is harmful for the baby
c. She can take the vaccine
Answer: C (Reference: 3rd Edition UQU > Obstetrics and Gynecology > Q 39)
Ophthalmology
1. A known case COPD and DM, diagnosed to have primary open angle glaucoma. What is
the optimal treatment for glaucoma?
a. topical timolol
b. topical carteolol
c. systemic Acetazolamide
2. 24 years old female newly diagnosed type 2 DM, she is wearing glasses for 10 years, how
frequent she should follow with ophthalmologist?
a. 6 months
b. 12 months
c. 5 years
d. 10 years
● For type 1 diabetic: retinal screening annually beginning 5 years after onset of diabetes, general
not before onset of puberty.
● For type 2 diabetic : screening at the time of diagnosis then annually.
Answer: A
Anesthesia
● 8 hours (solid)
● 6 hours (formula)
● 4 hours (breast milk)
● 2 hours (clear liquid)
2. Which of these analgesia has x10 the strength of morphine:
a. Fentanyl
b. Tramadol
c. NSAID
Answer: A?
● Common Side Effects of Opioids: Nausea and vomiting, Constipation, Sedation, Pruritus,
Abdominal pain, Urinary retention ,Respiratory depression)
● When prescribing opioids, consider: Breakthrough dose, Anti-emetics, Laxative
Family medicine
1. The most difficult method to prevent transmission:
a. Person to person
b. Vector
c. Droplet
d. Airborne
Answer: D (Reference: 3rd Edition UQU last touch > Family medicine and statistics > Q 3)
2. At a daycare center 10 out of 50 had red eye in the first week, another 30 developed the
same condition in the next 2 weeks. What is The attack rate?
a. 40%
b. 60%
c. 80%
d. 20%
Answer: C (Reference: 3rd Edition UQU > Family medicine and statistics > Q 15)
● Attack Rate = cases due to a specific cause in a short period of time divided by the population at
risk, often associated with an epidemic situation such as food borne disease (cumulative
incidence)
3. In a study they are selecting every 10th family in the city, what is the type of study
a. systematic study
b. stratified study
c. non randomised study
Answer: A (It differ from the one written in 3rd Edition UQU > Family medicine and
statistics > Q 19)
● Random sampling: preferred way of sampling, it is often difficult to do. It requires that a complete
list of every element in the population be obtained. Computer generated lists are often used with
random sampling.
● Systematic sampling: every kth element is taken. This is similar to lining everyone up and
numbering off "1,2,3,4; 1,2,3,4; etc". When done numbering, all people numbered 4 would be
used.
● Convenience sampling: readily available data is used. That is, the first people the surveyor runs
into.
● Cluster sampling: accomplished by dividing the population into groups called clusters -- usually
geographically. The clusters are randomly selected, and each element in the selected clusters
are used.
● Stratified sampling: divides the population into groups called strata. For instance, the population
might be separated into males and females. A sample is taken from each of these strata using
either random, systematic, or convenience sampling.
4. Epidemiological study want to see the effect of smoking in lung cancer: 90% of smokers
have lung cancer while only 30% of non–smokers have the disease. The specificity of
smoking as a risk factor is:
a. 10%
b. 40%
c. 30%
d. 70%
e. 90%
Answer: E?
● Primordial prevention: consists of actions to minimize future hazards to health and hence inhibit
the establishment factors (environmental, economic, social, behavioural, cultural) known to
increase the risk of disease, e.g. improving sanitation. It addresses broad health determinants
rather than preventing personal exposure to risk factors, which is the goal of primary prevention.
● Primary prevention: Action to protect against disease as immunization and to promote health as
healthy lifestyle.
● Secondary prevention (screening): Identifying & detecting a disease in the earliest stage before
symptoms appears.
● Tertiary prevention: Improves the quality of life of people with various diseases by limiting the
complications.
Psychiatry
1. Elderly patient his wife died recently. He’s been depressed and having difficulty sleeping
since that time, Which of the following is a short term medication that is suitable for him?
a. Diazepam
Answer: A
Answer: A?
3. Patient turns to be erratic for 4 months, he said that people on TV know what he’s thinking
about and they are talking about him. In the last 2 month he started to claim that he has
special power that no one has. What is the most likely diagnosis?
a. Uni-polar...depression
b. Bipolar...Mania
c. Schizophrenia
4. Clear question about a patient with symptoms of obsessive compulsive disorder (washes
his hand a lot)
ENT
Answer: A
3. 40 years old male, complaining of sudden dizziness attack for 30-40 min, associated with
nausea, vomiting ,unilateral tinnitus and hearing loss :
a. Acoustic neuroma
b. Neuritis
c. meniere disease
● Meniere’s'disease:'a'cause'of'recurrent'vertigo'with'auditory'symptoms'more'common'
among'females.Hx/PE:'Presents'with'recurrent'episodes'of'severe'vertigo,'hearing'loss,'
tinnitus,'or'ear'fullness,'often'lasting'hours'to'days.'Nausea'and'vomiting'are'typical.'
Patients'progressively'lose'lowDfrequency'hearing'over'years'and'may'become'deaf'on'
the'affected'side.'
Dermatology
1. Patient with psoriasis involving 15% of his body with nail involvement. What is the best
treatment for him?
a. methotrexate
b. laser
Answer: ?
Orthopedics
1. Knee Examination: + lachman test indicates injury of:
a. Anterior cruciate ligament