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SLE EXAM
SEPTEMBER 2005
‫ كككك‬.‫ككك كككك كككككك كككك ككككككك كككككك كككككككك كككككك ككك كككككك‬
‫كك كككك ككك كككك ككككك ك ككككك ككك كككككك ككككككككك كككك كككك كك كككككك‬
‫ كككك كككك كككككك‬/‫ككككك‬ .‫ككك‬
- For health education programs to be successful all are true
except :

a- human behavior must be well understood

b- Information should be from cultural background
c- Doctors are only the health educators
d- Methods include pictures and videos (mass media)
e- Involve society members at early stage

- a 29 yrs. Old female has a breast lump in the upper outer

quadrant of the left breast , firm , 2 cm. in size but no L.N
involvement … what is the most likely diagnosis ?

a- fibroadenoma

- What is the management for the above patient?

a- mammogram (true if patient > 35 years)

b- excisional biopsy
c- FNA
d- breast US
e- follow up in 6 months
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- a 27 yrs. old female C/O abdominal pain initially

periumbilical then moved to Rt. Lower quadrant … she was
C/O anorexia,nausea and vomiting as well ..
O/E : temp.38c , cough , tenderness in Rt lower quadrant
but no rebound tenderness.
Investigations : slight elevation of WBC's otherwise
insignificant ..
The best way of management is:

a- go to home and come after 24 hours

b- admission and observation
c- further lab investigations
d- start wide spectrum antibiotic
e- paracetamol

- what is the most likely diagnosis for the above patient ?

a- mesenteric lymph adenitits

b- acute appendicitis
c- peptic ulcer

- a 24 yrs old pt. came for check up after a promiscuous

relation 1 month ago .. he was clinically unremarkable,
VDRL : 1/128 … he was allergic 2 penicillin other line of
management is :

a- ampicillin
b- amoxicillin
c- trimethoprim
d- doxycyclin
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- a 24 years old female pt. C/O : gray – greenish

discharge , itching .. microscopic examination of discharge
showed : flagellated organism … most likely diagnosis is :

a- trichomoniasis ( trichomonas vaganalis )

- a 43 yrs. old female pt. presented to ER with H/O :

paralysis of both lower limbs and parasthesia in both upper
limbs since 2 hours ago .. she was seen lying on stretcher &
unable to move her lower limbs (neurologist was called but he
couldn't relate her clinical findings 2 any medical disease !!! )
when history was taken , she was beaten by her husband …
the most likely diagnosis is :

a- complicated anxiety disorder

b- somatization disorder
c- conversion disorder
d- psychogenic paralysis
e- hypochondriasis

- the best treatment for the previous case is :

a- benzodiazepines
b- phenothiazine
c- monoamine oxidase inhibitor
d- selective serotonin reuptake inhibitor
e- supportive psychotherapy

- a 58 yrs. old male pt. came with HX of fever, cough with

purulent foul smelling sputum and CXR showed : fluid filled
cavity … the most likely diagnosis is :

a- abscess
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b- TB
c- bronchieactesis
- a 28 yrs. old lady , C/O: chest pain, breathlessness and
feeling that she'll die soon .. O/E : just slight tachycardia ..
otherwise unremarkable .. the most likely diagnosis is:

a- panic disorder

- a patient ( known case of DM ) presented to u with

diabetic foot ( infection) the antibiotic combination is :

a- ciprofloxacin & metronedazole

- a young pregnant lady (Primigravida) , 32 weeks of

gestation came to you C/O : lower limbs swelling for two
weeks duration .. she went to another hospital and she was
prescribed ( thiazide & loop diuretic ) .. O/E : BP : 120/70 ,
mild edema , urine dipstick : -ve and otherwise normal…. The
best action is :

a- continue thiazide & stop loop diuretic

b- cont. loop diuretic & stop thiazide
c- stop both
d- continue both and add potassium sparing diuretic
e- cont. both & add potassium supplement

- a 17 yrs. old football player gave HX of Lt. knee giving

off .. the most likely diagnosis is :

a- Lat. Menisceal injury

b- medial menisceal injury
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c- lateral collateral ligament

d- medial collateral ligament
e ant. Curciate ligament

- a 10 yrs. old boy presented to clinic with 3 weeks HX of

limping that worsen in the morning .. this suggests which of
the following :

a- septic arthritis
b-leg calve parthes disease
c- RA
d- a tumor
e- slipped capital femoral epiphysis

- a full term baby boy brought by his mother weighing 3.8

kg. developed jaundice at 2nd day of life .. coomb's test –ve
,Hb : 18 ,billrubin : 18.9 & indirect : 18.4
O/E : baby was healthy and feeding well .. the most likely
diagnosis is :

a- physiological jaundice
b- ABO incompatibility
c- breast milk jaundice
d- undiscovered neonatal sepsis

- a 62 yrs. old female pt. a known case of osteoporosis & on

1 alpha + Ca supplement .. her lab works shows normal level
of PO4, Ca & ALP … her X-ray shows osteopenia with SD =
-3.5 …. The best action is to :

a- continue on same medications

b- start estrogen
c- start estrogen & progesterone
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d-add alevdonate ( bisthmus phosphate)

- a 38 yrs old female … came to you at your office and her

pap smear report was unsatisfactory for evaluation .. the
best action is :

a- consider it normal & D/C the pt.

b- Repeat it immediately
c- Repeat it as soon as possible
d- Repeat it after 6 months if considered low risk
e- Repeat it after 1 year if no risk

- a 17 yrs. old school boy was playing foot ball and he was
kicked in his Rt. eye .. few hours later he started to
complain of : double vision & echymoses around the eye ..
the most likely Dx. Is :

a- cellulites
b- orbital bone fracture
c- global eye ball rupture
e- subconguctival hemorrhage

- a 35 yrs old female pt. C/O : acute inflammation and pain

in her Lt. eye since 2 days .. she gave Hx of visual blurring
and use of contact lens as well … O/E : fluorescence stain
shows dentritic ulcer at the center of the cornea .. the most
likely diagnosis is :

a- corneal abrasion
b- herpetic central ulcer
c- central lens stress ulcer
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d- acute episcleritis
e- acute angle closure glaucoma

- a 65 yrs old lady came to your clinic with Hx of 5 days

insomnia and crying ( since her husband died ) the best Tx.
For her is :

a- lorazipam
b- floxitein
c- chlorpromazine
d- haloperidol

- a 25 yrs old Saudi man presented with Hx of mild icterus ,

otherwise ok .. hepatitis screen : HBsAg +ve , HBeAg +ve ,
anti HBc Ag +ve (this should be core anti body, because core antigen
doesn’t leave hepatocyte to the blood "prof. Yasawi" ) , the diagnosis :

a- acute hepatitis B
b- convalescent stage of hep. B
c- recovery with seroconversion Hep . B
d- Hep B carrier
e- chronic active Hep. B

- 25 yrs. old man presented to ur clinic with one month HX

of aching pain in the elbow , radiates down to the lateral
forearm ..the pt. frequently plays squash … O/E:
Pain increases with dorsiflexion of the wrist performed under
resistance specially with elbow extended … the most likely
diagnosis :

a- olecranon stress fracture

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b- olecranon bursitis
c- lateral tennis elbow
e- radial tunnel syndrome
e- ligament sprain

☺ Special thanks to Dr.Fahad Abdul Jabbar & his colleague in King

Abdul Aziz University
- 8 wk Primigravida came to you with nausea & vomiting choose
the statement that guide you to hyperemmesis gravidarm :
a- ketonia
b- ECG evidence of hypokalemia
c- Metabolic acidosis
d- Elevated liver enzyme
e- Jaundice

☺ Special thanks to Dr. Khalid Al-Qurashi KFU

- Injury of the hand leads to median nerve injury:

a- claw hand
b- wrist drop ‫ل يوجد إجابة صحيحة‬
c- sensory defect only

- 60 year old male was refer to you after stabilization

investigation show
Hgb 8,5 g/l , hect. 64% , RBC 7.8 , WBC 15.3
& Plt. 570 Diagnosis :
a- iron def. Anemia
b- Hgb pathy
c- CLL
d- 2ry polycythemia
e- Polycythemia rubra Vera

- Pregnant women G4P3+1 on GA 10 wk came to you with

IUCD inserted & the string is out from O.S what is the
most important measure :
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a- leave the IUCD & give A.B

b- leave the IUCD & send to Ob/ Gynaecologist to remove
c- leave the IUCD
d- do laparoscopy to see if there is ectopic preg.
e- Reassurance the pt

☺ done by Dr. Khalid Shahat KFU

- 17 year old male while play football felt on his knee “tern
over “ what do think the injury happened

a- medial meniscus lig,

b- Lateral meniscus lig.
c- Medial collateral lig.
d- Lat. collateral lig.
e- Antr. Crussate lig.

☺ Special thanks to Dr. Rizg Al-amri KFU

- For health education programme to be effective all true

except :
-
a- Human behaviour should be well understood.
b- Procedures used include illustration & picture.
c- Doctors should be the only educator.
d- Community member should be involved in early stage.
e- ………….

☺ Special thanks to Dr. Abdulmonem Al-hussain

- Placenta previa excludes :

a- Pain less vaginal bleeding
b- Tone increased of uterus
c- Lower segmental abnormality
d- Early 3rd trimester
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- Pregnancy test +ve after :

a- one day post coital

b- 10 day after loss menstrual cycle ??
c- One wk after loss menstrual cycle

☺ Special thanks to Dr. Soud Al-Shalowi KFU

- 45 year old female complaining of itching in genitalia for

certain period, a febrile, -ve PMH, living happily with here
husband since 20 year ago on examination no abdominal
tenderness , erythema on lower vagina , mild Gray discharge
no hx of UTI . pyleonephritis
Most probable diagnosis:

a- Vaginitis
b- Cystitis
c- CA of vagina
d- Urithritis ( non gonococal )

☺ Special thanks to Dr. Faisl Battwil KFU

- 20 year lady come to ER with Hx of Rt sever lower abdominal

pain with Hx of amenorrhea for about 6 wk the most serious
diagnosis of your deff. Diagnosis could reach by:

a- CBC
b- ESR
c- U/S of the pelvis
d- Plain X-ray
e- Vaginal swab for C/S

☺ Special thanks to Dr. Ali Al-Khathami

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- Pt had arthritis in tow large joint & pansystolic murmur

( carditis )
Hx of URTI the most important next step:

a- ESR
‫أتذكر من أحد المحاضرات أن أغلب الناس تعرض للصابة بالتهاب في البلعوم‬
b- ASO titre ‫ لذلك ما يمكن‬،ASO ‫وعالجها بالمضادات الحيوية وبالتالي موجود عنده أجسام مضادة‬
c- Blood culture .‫ بعكس مزرعة الدم والتي تدل على وجود اللتهاب الن‬.‫يعتمد عليها في التشخيص‬

- 35 years prime 16 wk gestation PMH coming for her 1st

cheek up she is excited about her pregnancy no hx of any
previous disease.
Her B/P after since rest 160/100 after one wk her B/P is
154/96
Most likely diagnosis :

a- Pre eclempsia (‫ أسبوع من الحمل‬20 ‫)لزم بعد‬

b- Chronic HTN
c- Lable HTN
d- Chronic HPT with superimposed pre eclampsia
e- Transit HPT??

☺ Special thanks to Dr. Hamza Qtrangy

- women complain of non fluctuated tender cyst for the vulva .

came pain in coitus & walking , diagnosed Bartholin cyst .
what is the ttt:

a- incision & drainage

b- refer to the surgery to excision (after you reassure her)
c- reassurance the pt
d- give AB

☺ Special thanks to Dr. Naif Al-Qahtani

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- 42years old male presented with history of sudden

appearance of rash – maculopapular rash – including
the sole,& the palm, the most likely diagnosis is :

a- syphilis
b- erethyma nodosum
c- erythema marginatum
d- pitryasis rocae
e- drug induced

☺ Special thanks to Dr.Mai

- A mother calls you about her 8 years old son , known case
of DM-1 fell comatose . she is not sure if he took the night
7 morning dose of insulin. You will advice her to :

a- bring the child immediately to the ER

b- call an ambulance
c- give him IV glucagons (of course IV glucagons is first
d- give him IV insulin then ER, but Q doesn’t indicate
that the mother can do it!!)
e- give him drink contains sugar

☺ Special thanks to Dr. Reem

- years old lady on …….., feels dizzy on standing, resolves

after 10-15 minutes on sitting, decrease on standing, most
likely she is having :

a- orthostatic hypotension
b-
☺ Special thanks to Dr.Fatima

- what is the most appropriate treatment for the above

patient :
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a- antiemetic
b- antihistamine
c- change the antidepressant to SSRI
d- thiazide diuretics
e- audiometry

☺ Special thanks to Dr.Nada

- 23 years old lady with one month history of nasal discharge
& nasal obstruction, she complained of pain on the face,
throbbing in nature , referred to the supraorbital area,
worsen by head movement, walking,& stopping. On - --
--------- examination , tender antrum with failure of
transillumination ( not clear ), the most likely the diagnosis
is:

a- frontal sinusitis (we can NOT trannsiiluminate it)

b- maxillary sinusitis
c- dental abscess
d- chronic atrophic rhinitis
e- chronic sinusitis

☺ Special thanks to Dr.Dua'a

============================================================

Collected & organized by Dr. Khalid

Shahat
Dr.khalid.s@hotmail.com
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