Mariams recalls , 11 Feb 2014

1. A woman came with her 6 year old girl shown in the picture and asks you when she
can return back to school
a. After a week
b. Tomorrow
c. Now
d. After 5 days
e. After beginning antibiotic treatment
2. A woman came with her 18 month old child anxious about pus surrounding the
meatus and the foresking is partially retractable, whats your next step ?
a. Circumcision
b. Betamethasone crem
c. Mipurocin cream
d. Oral phenoxymethyle penicillin
e. I.V benzathyne penicillin
3. 26 year old female , has dialysis 3 times a week , she is good and decent with the
ward nurses, shouts and speaks rudely with dialysis nurses, wts the defence
mechanism ?
a. Acting out
b. Splitting
c. Regression
d. Denial
e. Repression
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Mariams recalls , 11 Feb 2014

4. Parents came with there 4 year old child having breathlessness and palpitation and
this is his ECG , wts the next step ?

a.
b.
c.
d.
e.

reassure them it is sinus Tachycardia

put cold water on his face

IV adenosine
IV lignocain
IV beta blocker

5. Yasmin containing drosperinon and ethynyl estradaiol - is now released for usage
in Australia , wt makes it be prefered by women ?
a. It causes weight loss rather than weight gain
b. It has a good effect on acne
c. It causes less spotting even at the very beginning of the treatment
d. It has a failure rate less than other OCPs
e. It has a protective effect against cervical cancer
6. a 28 year old primi comes in labour at term , she told u she wants no interference
in the labour process whether medical or surgical , she was 3 cm dilated head at 0
station , after 4 hours she is 9 cm dilated and head at +1 station , she is ok , u gave
some analgesic only and the CTG is normal , wts the best next to be done ?
a. CS
b. Ventouse
c. Re examin her in an hour or 2
d. Give oxytocin drip
e. Episiotomy
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Mariams recalls , 11 Feb 2014

7. A 32 primi came at 28 weeks having contractions , her examination 3 weeks ago
was pretty normal so as the baby too , u did a CTG ,
What is the best test to be done to reveal the problem of the baby and give a clue
about early intervention to save it

a.
b.
c.
d.
e.

Fetal blood sampling

Mother serum for Ig anti D titration
B HCG
Ultrasound
Amniocentesis

8. A 34 year old primi came at term with rapture membranes and meconium stained
lecor , you did a CTG , in review of the CTG wts the next best step ?
a. CS
b. Fetal scalp ph
c. Induce labour at once with cintocynon
d. Wait for normal delivary
e. High forceps

Mariams recalls , 11 Feb 2014

9. A 68 year woman came with a 2 cm painful breast mass which she noticed a week
ago , whats the most common dx ?!!!!!!!!!!!!!! this is the q only :Da. Breast cancer
b. Mammary duct ectesia
c. Fibroadenoma
d. Fat necrosis
e. Fibroadenosis
10. A lawyer sent you a request to write a report about a patient and a signed conscent
from the patient is attached by the request , the patient came to u and said he
disagree for everything even his consent , wt will u do ?
a. Write the report anyway
b. Send the patient for mental status assessment
c. Write a report with only some info. and write the patient is not complient
d. Sorry I dont remember the rest
11. An 8 year old boy came with his mother because he is very rude with his
colleagues at the school and he has a bare area of hair at the parietal area, the skin
of the scalp is clean and the hairs remaining are in different legthes, what is the
diagnosis ?
a. Tricotillomania
b. ADHD
c. Depression
d. Conduct disorder
e. Austism
12. A mother came with her 7 year old girl because she never had friends and the
children in the school mock her always but she never gives any reaction , she is
developing very normally and had no language delay but she has very restrict
system of life and play with her dolls only , wts the dx ?
a. Austism
b. Asperger
c. ADHD
d. Depression
e. Oppositional defiat
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Mariams recalls , 11 Feb 2014

13. A mother came with her 12 old baby , which of the following is a sign for
developmental delay ?
a. He cant walk without suppost
b. He cant give his first and last name
c. He cant feed with spoon
d. He cant understand no
e. He cant build a tower of 2 cubes
14. A 70 year old man came with tirdness and fatigue , muscles pains all over and back
pain . he had a CBC I cant remember the whole things but there were rouloux
cells wts the dx ?
a. CLL
b. AML
c. MM
d. Paget disease
e. CML
15. a 68 year old man came with frequent flank pain and painless heamaturea, next
best step ?
a. CT abdomen
b. Ultrasound abdomen
c. Cystoscopy
d. Urine culture
e. Renal biopsy
16. Truck driver having on and off abdominal pain and bloating for the last 3 months ,
sometimes he has a foul smelling diarrea , he had a colonoscope since 1 year and it
was normal wts best nest step ?
a. Repeat colonoscopy
b. Stool culture
c. Abdominal ultrasound
d. Sigmoidoscopy
e. CBC

Mariams recalls , 11 Feb 2014

17. A 78 year old woman was OK , but a long one year she became forgetfull and not
herself , she became dirty and careless with her clothes also she has resting
tremors and now came with neighbours because she shouts and yells about the
snakes crowling on the floor everywhere. Wts the dx ?
a. Alzheimer
b. Parkinsons disease
c. Schezopherenia
d. Lewy body dementia
e. Senile dementia
18. a 34 year old woman has her PAP smear and it shows a definit CIN I , her last PAP 2
years ago was normal, wts the next best step ?
a. repeat PAP after 1 year
b. do colposcopy
c. do cone biopsy
d. refer to gynacologist
e. repeat PAP in 2 years
19. a 58 year old man with 40 years history of smoking 40 packs had an MI last year
and he stopped smoking then, now coming with exertional dyspnea, orthopnia,
basal lung crackles , a dull area over the middle lobe of the right lung, ankle edema
bilat. Wts the dx ?
a. congestive heart failure
b. COPD with congestive heart failure
c. COPD with cor palmonale
d. Some irrelevant options
20. A 35 year old man came with severe back pain over years that is worse when he
wakes up in the morning , the pain and stiffness makes him stays in the bed for at
least 30 min. then he gets better somehow along the day , it is getting worse now ,
whats the best initial treatment fot him ?

Mariams recalls , 11 Feb 2014

a.
b.
c.
d.
e.

Naproxen
Azathioprin
Paracetamol
Prednisolone
Methotrexate

21. A 50 year old heavy alcoholic man came with ascitis, enlarged liver 4 cm below
costal margin , his abdomen is tender and his temp. is 37.9 c his blood pressure is
100/60 which of the following is best treatment for current problem ?
a. IV metronindazole + amoxicillin
b. IV metronindazole + amoxicillin + gentamycin
c. Paracentesis
d. Oral amox. Clax.
e. IV albumin
22. A farmer had an injury while working in the farm , his knee fat is appearing out of
the wound and it is contaminated with soil, he had TT 3 months ago for a similar
injury, wt to give hime know ?
a. TT
b. TT and Igs
c. DTP
d. Antibiotics
e. Just clean and dress the wound

Mariams recalls , 11 Feb 2014

23. A 32 year old woman came in her second pregnancy asking about wt to do now as
she has had postpartum psychosis in her last pregnancy.
a. Review her late in pregnancy
b. Start prophylactic dose of antidepressants
c. Start her on antipsychotics now
d. Do abortion as she is not allowed to get pregnant anymore
e. Start antipsychotics after delivary
24. A 52 year old menopausal woman since 12 months, came with vaginal bleeding
after 24 hours of having sex, her last pap was normal , whats the most propable
diagnosis ??
a. Cancer endometrium
b. Cancer cervix
c. Vaginal atrophy
d. Cervical polyp
25. A diabetic 65 year old woman noticed an uler on her foot for 7 days she came to
hospital and u admitted her, surgical debridment was done and the ulcer is 1 cm
and oosing a clear fluid , next best step ?
a. Oral amox. Clax + metronidazole
b. IV ticracillin + metronidazole
c. MRI
d. Dressing and checking the wound everyday
e. Wound toitel with povidone iodine
26. A mother came with her child 3 years old , he cant eat because of oral small ulcers
he also has ulcer on his fingers and toes , his temp. is 38c wt is the causing
organism ?
a. HSV
b. Coxakie A virus
c. Adenovirus
d. Group b betaheolytic strept.
e. Corona virus

Mariams recalls , 11 Feb 2014

27. A 30 year old female with type 1 DM since 20 years came with painfull foot , she
had an x ray done and there was osteopenia and decreased joint space in the tarsal
joints what is the dx ?
a. Osteoarthritis
b. Neuropathic joint
c. RA
d. Osteoprosis
e. SLE
28. A couple came for they want to have a baby, the woman is a RA patient on
methotrxate and sulfasalazine , which regimine she should be on when she is
pregnant ?
a. Continue both methotrexate and sulfa
b. Stop methotrexate and continue sulfa
c. Stop sulfa and continue methotrexate
d. Shift to Adalimumab
e. Shift to liflonumide
29. A female paient had a long operation in lithotomy position , which muscle could be
affected ?
a. Flexor hallucis longus
b. Flexor hallucis brevis
c. Extensor hallucis longus
d. Bicepcs femoris
e. Soleus
30. A little todler came with parents because he ate his grandma pills , they dont know
which one he ate cuz she is taking many drugs for many things , the boy is drowzy

Mariams recalls , 11 Feb 2014

has bradycardia by examination and u did an ECG

Which drug did the boy ingested ?

a. beta blocker
b. Digoxin
c. K supplement
d. Metformin
e. Diuretic
31. A 22 year old man came with sudden onset of palpitaion and light headedness and
slight chest pain, u did an ECG , wts the diagnosis ?

a.
b.
c.
d.
e.

PSVT
Acute MI
Trossad de point
Hypertrophic cardiomyopathy
Sinus tachycardia
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Mariams recalls , 11 Feb 2014

32. A 79 year old woman came because of lightheadedness from time to time, she
feels like spinning, all her neuro examination are normal and optimal no nistagmus,
her blood pressure is ranging between 130/90 amd 125/80 in several occasions ,
she is not diabetic nor having any problems, wts the next best step ?
a. Hallpick manouver
b. Holter monitor
c. Cardiac enzymes
d. MRI head
e. Random blood glucose
33. a 68 year old man came with melena , anemia 9 , he had colonoscopy till hepatic
flexure and upper endoscopy and they both were normal, wts the best next step ?
a. repeat upper endoscopy
b. repeat colonoscopy
c. capsule endoscopy
d. no furthur investigation
e. repeat hemoglobin estimtion
34. NB. I had this q 2 times
35. a 30 year old man came back from Nipal he had a painless ulcer on the penis since
2 weeks now it healed without any scar and he has generalized rash and arthralgia
and some mouth ulcers, what is the causitive organism ?
a.
b.
c.
d.
e.

HIV virus
Treponema pallidum
Chlymedia tracomatis
HSV
Neisseria Gonorrhea

36. An 8 year old boy with enuresis going to a camp with school, wts the best
treatment that fits ?
a. Alarm bed
b. Nasal desmopressin
c. Restrict water intake in the night
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Mariams recalls , 11 Feb 2014

d. Programmed waking up in the night
37. A 75 year old man cant copy a diagonal shape where is the lesion ?
a. Frontal cortex
b. Dominant parietal lobe
c. Non dominant parietal lobe
d. Hypothalamus
e. Occipital lobe
38. A man came because he cant see the temporal side in his right eye and nasal side
of his eft eye field, where is the lesion ?
a. Optic chiasma
b. Right optic nerve
c. Left optic tract
d. Right visual cortex
e. Right Optic radiation
39. A 35 year old woman has hypercholestrolemia , which of the following findings
adds to the diagnosis of familial cause ?
a. Xanthelasma in the eye
b. Xanthoma in tendons
c. She is fat
d. She is hypertensive
40. A woman came with her 9 month old baby having dyspnia , cant feed , his chest is
hyperinflated and there are inspiratory and expiratory wheezes, wts the next best
step ?
a. Nebulised adrenaline
b. IV steroid
c. Oral cefriaxone
d. 100% O2 via facemask
e. 100% O2 via nasal catheter

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Mariams recalls , 11 Feb 2014

41. A 22 year old man came with this mass, it is there since one year , a little firm , not
painful and not attached to other structures . a FNAC was done and it was
incnclusive. Wts next best step ?

a.
b.
c.
d.

X ray chest
CT chest
CT neck
Excision of the mass

42. A 65 year old man with severe osteoarthritis in the right knee, how to help him
moving ?
a. A stick in the right hand with the left leg onwards
b. A stick in the left hand with right leg onwards
c. Wheel chair
d. Two sticks in both hands
e. Rest in bed as long as possible
43. A new drug is being tested for decreasing mortality in HTN patient by 1/4, in a
community of 100 you have 8 patient with the condition , what is the number
needed to treat ?
a. 100
b. 50
c. 33
d. 60
e. 10
44. A pregnant woman 20 weeks starts to have pain in the right iliac fossa specially
when she stands up or cough she had appendectomy when she was 12 year old ,
wts most likely the diagnosis ?
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Mariams recalls , 11 Feb 2014

a.
b.
c.
d.

Round ligament pain

Complex ovarian cyst
Ectopic pregnancy
Intestinal obstruction

45. Whats the long term management of angle closure glaucoma?

a. Trabeculotomy
b. Laser iridotomy
c. Acetazolamide
d. Pilocarpin
e. Timolol
46. A 70 year old woman has apper arm pain bilat. That has no offset, she also has
headache distressing her almost all lf the time with little benefit from analgesics,
which of the following investigations can help you diagnose her ?
a. CK level
b. Rheumatoid factor
c. Anti jo antibodies
d. ESR
e. Muscle biopsy
47. A woman gave a birth to a full term baby weighing only 2000 gm with head
circumference at 1st percentile, hepatomegaly and mixed severe jaundice, he has
deeply pigmented retina on fundoscopic examination , and bilateral basal crackles
in the lung, wts the causing organism ? :/
a. CMV
b. Toxoplasma
c. Leisteria
d. Herpes Zooster
e. Rubella
48. A smoker man with bilat. Leg cramps when walking for 100 m. distance, he has no
dorsalis pedis pulse on examination and his ABI in left leg is 0.8 and in the right leg
is 0.4, wts the next best step in management ?
a. Doppler ulrasound
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Mariams recalls , 11 Feb 2014

b. Angiography
c. IV heparine
d. Stop smoking
49. A 35 year old woman came for screaning for diabetes as her friend has been dx DM
few days earlier wts the best to be done ?
a. Fasting blood glucose every 3 years
b. Random blood glucose every 3 years
c. OGTT every year
d. Fasting blood glucose every year
e. HB A1C now
50. A baby born to Greek origin parents, is having an increasing jaundice, after 6 hours
he is feverish and vomits a green material, wts the best investigations to be done ?
a. Blood culture
b. Blood glucose
c. Upper endoscopy
d. Hemoglobin electrophoresis
e. E5M

This is wts in my mind now, I tried to simulate the exam for u as much as possible ,I wish
you all the best and please keep me in your prayers cuz I need it
Good luck to you all and too many thanks for goldstar group
Mariam G. Mikhael

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