‫المـجلــس الطـبـــي السـودانـــي‬

Sudan Medical Council

Exam Name Exam 15 April 2009

Exam ID: 56 - Pass Mark : 59

Exam Paper: 1

Question number 1
(B739933)
Bank of Question ID: 1794
Question Mark: 1
A 26 year old man complains of abdominal distension , swelling of the legs
and easy fatigability . His blood pressure is 90/70 mm Hg and pulse becomes
difficult to feel on inspiration. He has oedema, ascites and tender
hepatomegaly. Precordium is quite with loud and somewhat early apical third
heart sound. The probable diagnosis is :
• Pulmonary stenosis F
• Mitral stenosis F
• Constrictive pericarditis T
• Tricuspid stenosis F
• Cor pulmonale F

Question number 2
(B73C96C)
Bank of Question ID: 1799
Question Mark: 1
Which one of the following drugs is nephrotoxic :
• ciprofloxacin. F
• metronidazole. F
• doxycycline. F
• frusemide . F
• amikacin. T
Question number 3
(B73F9A5)
Bank of Question ID: 1804
Question Mark: 1
In Brucellosis all the following are true except :
• the gold standard investigation is blood culture. F
• usually it is clinically difficult to differentiate a new
infection from a relapsing one in a patient who was F
treated in the past.
• neuro-brucellosis may presents like multiple sclerosis. F
• spinal tenderness is uncommon. T
• splenomegally usually indicates a chronic brucellosis. F
Question number 4
(B7429DE)
Bank of Question ID: 1810
Question Mark: 1
The most common cause of meningitis in an 18 year old healthy man is/are:
• listeria F
• staphylococcus F
• haemophilus influenzae type B F
• escherichia coli and streptococcus viridans F
• neisseria (meningococcus) and pneumococcus
T
(streptococcus)

Question number 5
(B745A17)
Bank of Question ID: 1833
Question Mark: 1
Which of the following is more characteristic of platelet abnormalities and not
coagulation defects?
• hematomas F
• hemarthrosis F
• petechiae T
 • minimal bleeding from small cuts F
• positive family history F
Question number 6
(B748A50)
Bank of Question ID: 1834
Question Mark: 1
When prophylactic antibiotic therapy is used for tooth extraction in a patient
with a ventricular septal defect:
• a second generation cephalosporin (cefuroxime) is the
F
therapy of choice
• therapy is started 24 hours prior to the procedure F
• a throat swab should be taken prior to the procedure F
• therapy is given for one week following the extraction F
• erythromycin is the drug of choice for those allergic to
T
penicillin
Question number 7
(B74BA89)
Bank of Question ID: 1841
Question Mark: 1
The following are considered in the treatment of sickle cell anemia except :
• HB vaccine. F
• gene therapy F
• Spleenectomy at the age of 8 years. T
• Bone marrow transplantation. F
• Hydroxyurea F

Question number 8
(B74EAC2)
Bank of Question ID: 1842
Question Mark: 1
Regarding typical febrile convulsions :
• It occurs during rising temperatures. F
• It occurs between the age of 5 months to 5 years. T
 • It occurs at temp. of 39 c F
• Prophylactic anti-convulsion treatment is mandatory. F
• EEG is mandatory for all cases. F

Question number 9
(B751AFB)
Bank of Question ID: 1847
Question Mark: 1
The following would make you suspect developmental delay
• A 3-month-old infant who does not fix gaze T
• A 4-month-old infant who does not transfer objects F
• A 6-month-old infant who does not sit alone F
• A 9-month-old infant who does not show pincer grip F
• A 15-month-old child who does not walk F
Question number 10
(B754B34)
Bank of Question ID: 1850
Question Mark: 1
Escherichia coli gastroenteritis is associated with the following complication
• Membranous Colitis F
• Pseudoappendicitis F
• Erythema Nodosum F
• Failure to thrive F
• Hemolytic Uremic Syndrome T
Question number 11
(B757B6D)
Bank of Question ID: 1925
Question Mark: 1
The initial investigation for a 3 year old child with a rounded mass in the left
side of the abdomen should be:
• ultrasound T
• barium enema F
 • splenoportogram F
• intravenous pyelogram F
• CT scan of the abdomen F

Question number 12
(B75ABA6)
Bank of Question ID: 1935
Question Mark: 1
All of the following can cause hypercalcaemia, except ?
• Prolonged immobilization F
• Tumor lysis syndrome T
• Sarcoidosis F
• Multiple myeloma F

Question number 13
(B75DBDF)
Bank of Question ID: 1949
Question Mark: 1
A 6 month old child with Tetralogy of Fallot develops cyanotic spell initiated
by crying. Which one of the following drugs you would like to avoid ?
• Sodium bicarbonate F
• Propranolol F
• Phenylephrine F
• Isoprenaline T

Question number 14
(B760C18)
Bank of Question ID: 1986
Question Mark: 1
The following statement is true about Marfan’s syndrome :
• it is inherited as an autosomal dominant trait F
• sublaxation of lens occurs in less than 30% of cases. T
• body proportions show a decreased upper to lower
F
segment for age.
• antibiotic prophylaxis is recommended for dental F
 extraction.
• dilation of the aortic root is the most common CVS
F
abnormality.

Question number 15
(B763C51)
Bank of Question ID: 1988
Question Mark: 1
Recognized causes of hypospleenism includes one of the following:
• hereditary spherocytosis F
• thalasemia major F
• sickle cell anemia T
• cystic fibrosis F
• glycogen storage disease F

Question number 16
(B766C8A)
Bank of Question ID: 1993
Question Mark: 1
All the following should be considered in the management of hyper cyanotic
spells except :
• Chest-knee position. F
• B-Blocker. F
• Oxygen. F
• Morphine. F
• Atropine. T

Question number 17
(B769CC3)
Bank of Question ID: 2006
Question Mark: 1
Which of the following marker in the blood is the most reliable indicator of
recent hepatitis B- infection?
• lgG anti – HBs. F
• lgM anti – HBc. T
 • lgM anti – Hbe. F
• HBsAg. F
Question number 18
(B76CCFC)
Bank of Question ID: 2009
Question Mark: 1
Which of the following is NOT true regarding the management of asthma
patients in the emergency room:
• peak flow meters are the best way to assess response
F
to therapy.
• anti-cholinegics are the first line agents in the
F
treatment of mild asthma.
• patients unable to speak with an O2 sat < 90% should
F
be intubated.
• a silent chest on auscultaton indicates an emergency
T
and requires immediate treatment.
• patient education about the proper use of puffers is an
F
important aspect of treatment.
Question number 19
(B76FD35)
Bank of Question ID: 2011
Question Mark: 1
Pulsus paradoxus is found in all of the following except :
• cardiac tamponade. F
• all of the answers. T
• airway obstruction. F
• superior vena cava (SVC) obstruction. F
• constrictive pericarditis. F

Question number 20
(B772D6E)
Bank of Question ID: 2019
Question Mark: 1
Which one of the following statements regarding liver failure is TRUE ?
 • a liver biopsy is a not required with a good history of
F
alcoholism.
• encephalopathy may be reversible. T
• SBP (spontaneous bacterial peritonitis) is usually a
F
result of blunt abdominal trauma.
• coagulopathy is a result of poor diet in most patients
F
with cirrhosis.
• the size a varix is proportional to the degree of portal
F
hypertension.

Question number 21
(B775DA7)
Bank of Question ID: 2025
Question Mark: 1
An elderly male develops fever 3 days after cholecystectomy. He becomes
short of breath, and chest x-ray shows a new right lower lobe infiltrate.
Sputum Gram stain shows gram-positive cocci in clumps, and preliminary
culture results suggest staphylococci. The initial antibiotic of choice is :
• Penicillinase-resistant penicillin such as nafcillin. F
• Vancomycin. F
• Quinolones have become the drug of choice for
F
pneumonia.
• Antibiotic therapy should be based on the incidence of
T
methicillin-resistant staphylococci in that hospital.
Question number 22
(B778DE0)
Bank of Question ID: 2033
Question Mark: 1
A 35-year-old alcoholic male is admitted for nausea, vomiting, and abdominal
pain that radiates to the back. The laboratory value that suggests a poor
prognosis in this patient is :
• Elevated serum lipase. F
• Diastolic blood pressure greater than 90 mmHg. F
• Leukocytosis of 20,000/μm. T
• Elevated serum amylase. F
Question number 23
(B77BE19)
Bank of Question ID: 2035
Question Mark: 1
A 50-year-old black male with a history of alcohol and tobacco abuse has
complained of difficulty swallowing solid food for the past 2 months. More
recently, swallowing fluids has also become a problem. He has noted black,
tarry stools on occasion. The patient has lost 10 lb. Which of the following
statements is correct ?
• The most likely diagnosis is peptic ulcer disease. F
• The patient has achalasia. F
• The patient’s prognosis is good. F
• Barium contrast study is indicated. T

Question number 24
(B77EE52)
Bank of Question ID: 2039
Question Mark: 1
A 25-year-old female with diabetes mellitus presents with hypertension. The
ideal target BP for pharmacologic control of hypertension is :
• ≤135/85. T
• ≤140/90. F
• ≤150/95. F
• ≤125/75. F

Question number 25
(B781E8B)
Bank of Question ID: 2046
Question Mark: 1
Among the following, the least likely risk factor for hearing impairment is :
• A family history of hearing impairmen. F
• Craniofacial abnormalities. F
• A maternal history of use of phenytoin during
T
pregnancy.
• Birth weight less than 1500 g. F
 • Neonatal hyperbilirubinemia. F

Question number 26
(B784EC4)
Bank of Question ID: 2048
Question Mark: 1
A 5-month-old child presents to the emergency room with generalized tonic
clonic seizure activity of about 30-min duration that stops upon the
administration of lorazepam. The most helpful information to gather from the
mother would be :
• Whether the child has had congestion without fever for
F
the past 3 days.
• Whether the mother has been diluting the infant’s
T
formula to make it last longer.
• The number of pets at home. F
• Whether the child is developmentally normal, as are
F
his siblings.
Question number 27
(B787EFD)
Bank of Question ID: 2054
Question Mark: 1
During a regular checkup on an 8-year-old child, you note a loud first heart
sound with a fixed and widely split second heart sound at the upper left
sternal border that does not change with respirations. The patient is
otherwise active and healthy. The mostly likely heart lesion to explain these
findings is :
• Tetralogy of Fallot. F
• Mitral valve prolapse. F
• Atrial septal defect . T
• Isolated tricuspid regurgitation. F
• Ventricular septal defect. F
Question number 28
(B78AF36)
Bank of Question ID: 2058
Question Mark: 1
 A 6-year-old boy is brought to the emergency room with a 3-h history of fever
to 39.5°C (103.1°F) and sore throat. The child appears alert but anxious and
toxic. He has mild inspiratory stridor and is drooling. You should immediately
:
• Prepare to establish an airway. T
• Obtain an arterial blood gas and start an IV line. F
• Examine the throat and obtain a culture. F
• Order a chest x-ray and lateral view of the neck. F
• Admit the child and place him in a mist tent. F

Question number 29
(B78DF6F)
Bank of Question ID: 2075
Question Mark: 1
In comparison to Hb A, Hb S has :
• an extra beta chains. F
• a shorter molecule. F
• less solubility. T
• special disulphide bonds. F
• more alpha chain. F

Question number 30
(B790FA8)
Bank of Question ID: 2168
Question Mark: 1
A 42-year-old man with acute renal failure is confused. His serum potassium
is 8.1 mEq/L . The most likely abnormal ECG finding is
• T wave inversion F
• PR interval of 300ms F
• QT interval of 0.4s F
• U wave F
• tall tented T waves T
Question number 31
(B793FE1)
Bank of Question ID: 2199
Question Mark: 1
A cephalhematoma in a newborn infant
• is caused by moulding of the newborn scalp by the
F
delivering cervix
• is limited by the suture lines of the skull bones T
• is most commonly found over the frontal bones F
• is not associated with neonatal jaundice F
• often needs surgical drainage F

Question number 32
(B79701A)
Bank of Question ID: 2205
Question Mark: 1
A 5-year-old boy presents to hospital with abrupt-onset petechiae and
ecchymoses over the trunk and the lower limbs. He is not anemic and has no
hepatosplenomegaly or lymphadenopathy. A complete blood count reveals a
normal white blood cell count; and a platelet count of 25,000. The parent
reports that the child had flu-like symptoms 2 weeks before presentation. The
most likely diagnosis is
• Isoimmune thrombocytopenia F
• Anaphylactoid Purpura F
• Acute Leukemia F
• Thrombasthenia F
• Autoimmune Thrombocytopenic Purpura T

Question number 33
(B79A053)
Bank of Question ID: 2213
Question Mark: 1
A child is referred to hospital for evaluation of growth and development.
Examination shows normal growth parameters. Assessment of development
reveals that the child can climb stairs with one foot on each step, build tower
of 9 cubes and name 2 colors, but she cannot skip rope or tell age. The
developmental age of this child is
• 2 Years F
 • 3 Years T
• 4 Years F
• 5 Years F
• 6 Years F

Question number 34
(B79D08C)
Bank of Question ID: 2351
Question Mark: 1
A newborn male spits up his first feeding and develops bilious emesis with
subsequent feedings. On physical exam he appears ill, has a scaphoid
abdomen and absent bowel sounds. Abdominal x-ray shows air in the
proximal small bowel, but a paucity of air in the distal digestive tract.The most
likely cause for this infant's vomiting and clinical finding is:
• Hirsch-sprung disease F
• volvulus T
• antral web F
• choledochal cyst F
• tracheoesophageal fistula F

Question number 35
(B7A00C5)
Bank of Question ID: 2352
Question Mark: 1
Which one of the following defects is not associated with Tetrology of
Fallot?
• pulmonary stenosis F
• atrial septal defect T
• right ventricular hypertrophy F
• over-riding dextroposed aorta F
• ventricular septal defect F

Question number 36
(B7A30FE)
Bank of Question ID: 2354
Question Mark: 1
 A woman who is positive for hepatitis B surface antigen (HBsAg), but
negative for hepatitis Be antigen (HBeAg), delivers at term. What would be
the best management for this woman's infant?
• administer gamma globulin intramuscularly
F
immediately and at 1 month of age
• advise mother that breastfeeding is contraindicated F
• administer hepatitis B (HB) vaccine immediately and
F
at 1 month and 6 months of age
• administer hepatitis B immune globulin (HBIG) if cord
F
blood is positive for HBsAg
• administer HBIG and HB vaccine immediately, and HB
T
vaccine again at 1 month and 6 months of age

Question number 37
(B7A6137)
Bank of Question ID: 2356
Question Mark: 1
Which of the following predisposes infants to chronic otitis media?
• environmental factors such as passive smoking T
• bottle-feeding in upright position F
• abnormal tympanic membrane formation F
• none of the answers F
• allergies F

Question number 38
(B7A9170)
Bank of Question ID: 2366
Question Mark: 1
A child presents with bilateral shin pain. Which of the following suggests that
this is NOT growing pains?
• pain abates with reassurance and massage F
• no fever or rash F
• pain is poorly localized F
• child may limp in the morning from stiffness T
• pain awakens the child at night F
Question number 39
(B7AC1A9)
Bank of Question ID: 2375
Question Mark: 1
Turner syndrome is associated with the following clinical features EXCEPT:
• wide carrying angle at elbows F
• primary amenorrhea F
• short stature F
• broad chest F
• major learning difficulties T

Question number 40
(B7AF1E2)
Bank of Question ID: 2376
Question Mark: 1
Which of the followng statements concerning minimal lesion
glomerulonephritis is correct?
• it is a common cause of nephrotic syndrome in
children, but it is a very rare cause of nephrotic F
syndrome in adulthood
• glomerular filtration rate is usually preserved T
• the urine typically shows red blood cell casts
F
(suggestive of proliferative glomerulonephritis)
• it is usually unresponsive to treatment such as
F
prednisone and cyclophosphamide
• it is most often accompanied by severe hypertension F
Question number 41
(B7B221B)
Bank of Question ID: 2384
Question Mark: 1
In tuberculous meningitis the following is found in cerebrospinal fluid:
• glucose 48mg/dI. T
• gram positive stain. F
• protein 60mg/dI. F
 • Polymorph predominance. F
• Presence of I gG. F
Question number 42
(B7B5254)
Bank of Question ID: 2388
Question Mark: 1
A 72 years old lady had been immobile for 3 weeks after total hip
replacement. She had sudden onset of crushing central chest pain
associated with dyspnoea. She had tachycardia with unremarkable
examination of the chest. She is suffering from:
• acute myocardial infarction. F
• acute pericarditis. F
• aortic dissection. F
• massive pulmonary embolism. T
• pneumthorax. F
Question number 43
(B7B828D)
Bank of Question ID: 2392
Question Mark: 1
A 46 year old woman discovered to have a 1.5 cm thyroid nodule during a
routine examination. She had no symptoms and her TSH, T4,T3 were
normal. Which one of the following would be the most appropriate
recommendation :
• thyroxine suppressive therapy. F
• fine needle aspiration. T
• unilateral thyroid lobectomy. F
• radioiodine therapy. F
• no intervention needed, wait and see. F

Question number 44
(B7BB2C6)
Bank of Question ID: 2396
Question Mark: 1
The following is found in systemic Lupus Erythematosus:
 • leucocytosis. F
• hirsutism. F
• thrombocytopenia. T
• sclerodactyly. F
• extensive subcutaneous calcification. F
Question number 45
(B7BE2FF)
Bank of Question ID: 2398
Question Mark: 1
The most serious complications of Diabetes in the eye is :
• background retinopathy. F
• maculopathy. F
• proliferative retinopathy. T
• cataract. F
• rubeosis iridis. F

Question number 46
(B7C1338)
Bank of Question ID: 2404
Question Mark: 1
In snake bite antivenom is most effective if given within :
• one hour. F
• four hours. T
• two days. F
• one week. F
• three weeks. F

Question number 47
(B7C4371)
Bank of Question ID: 2410
Question Mark: 1
Select the TRUE statement for HIV positive mothers (positive before and at
the birth of child):
 • Should not breast feed their children T
• Must insist their HIV positive child be immunized with
F
all vaccines scheduled for a non-HIV positive child
• Must not take zidovudine (AZT) due to its
F
teratogenicity
• 90-100% will infect the child during delivery F

Question number 48
(B7C73AA)
Bank of Question ID: 2414
Question Mark: 1
A 4 year old child presents with fever, vomiting, and shortness of breath on
exertion. Physical exam shows muffled heart sounds, fever, a gallop rhythm,
and tachycardia. The best diagnosis for this child is:
• costochondritis F
• mitral valve prolapse F
• none of the answers. F
• pericarditis F
• myocarditis T

Question number 49
(B7CA3E3)
Bank of Question ID: 2415
Question Mark: 1
A 5 year old comes to the ER with fever, sore throat, hoarseness, and stridor
developing over one to two days. He also appears to be drooling. Which of
the following is the most appropriate initial step in management?
• do a detailed history and physical exam F
• get a lateral cervical neck x-ray F
• send him home F
• draw a CBC and blood cultures T
• prepare for emergency intubation F
Question number 50
(B7CD41C)
Bank of Question ID: 2430
Question Mark: 1
Which of the following is a characteristic chest x-ray appearance of
respiratory distress syndrome (RDS)?
• atelectasis F
• fluid in fissure F
• patchy infiltrate F
• air bronchograms T
• enlarged heart F

Question number 51
(B7D0455)
Bank of Question ID: 2433
Question Mark: 1
A1 year-old child with a rapid pulse, slightly low blood pressure, cool
extremities, oliguria and dry oral mucosa should be considered:
• 5% dehydrated F
• 15% dehydrated F
• 20% dehydrated F
• 10% dehydrated T

Question number 52
(B7D348E)
Bank of Question ID: 2439
Question Mark: 1
An elevated level of hemoglobin A2 in a patient with mild microcytic anemia
suggests the diagnosis of:
• beta-thalassemia T
• hereditary spherocytosis F
• alpha-thalassemia F
• sickle trait F
• hereditary persistence of fetal hemoglobin F

Question number 53
(B7D64C7)
Bank of Question ID: 2440
Question Mark: 1
Hemolytic anemia is characterized by all of the following EXCEPT:
• increased reticulocytosis F
• lead poisoning F
• increased haptoglobin T
• increased unconjugated bilirubin F
• increased LDH F

Question number 54
(B7D9500)
Bank of Question ID: 2447
Question Mark: 1
A 30 year-old patient with asthma complains of daily wheezing and
occasional waking at night with cough and chest tightness for three weeks.
His usual medication is salbutamol two puffs tid-qid. The next step in
management is:
• increase salbutamol to two puffs q4h F
• add long-term theophylline F
• add beclomethasone two puffs qid T
• discontinue salbutamol and begin prednisone 50 mg
F
od and taper over 2 weeks
• add ipratropium bromide two puffs qid F
Question number 55
(B7DC539)
Bank of Question ID: 2453
Question Mark: 1
The following is true of malabsorption EXCEPT :
• high S Phosphate T
• low S.Calcium F
• osteamolacia F
• increased fat excretion in stools. F
• low S Potassium F
Question number 56
(B7DF572)
Bank of Question ID: 2531
Question Mark: 1
The following are recognised causes of body hair loss except
• hypothyroidism F
• anorexia nervosa F
• haemochromatosis F
• Cushing's syndrome T
• (Sheehan's syndrome) post partum pituitary necrosis F

Question number 57
(B7E25AB)
Bank of Question ID: 2589
Question Mark: 1
18 year-old female with initial onset of pruritic rash characterized by
excoriations, scaling and crusting and distributed on the extremities, neck
and eyelids. Past medical history is significant for asthma and hay fever. The
most likely diagnosis is:
• dyshydrotic eczema F
• atopic dermatitis T
• contact dermatitis F
• scabies F
• shingles F

Question number 58
(B7E55E4)
Bank of Question ID: 2590
Question Mark: 1
A74 year-old, right-handed man presents with a past medical history of
hypertension and dyslipidemia for 30 years. He is a retired banker who
recently has had trouble calculating his restaurant bill. He also notices that
his writing has deteriorated. On physical exam, he has difficulty naming his
fingers and is confused with distinguishing left from right. The lesion is most
likely in which part of the brain?
• right parietal F
 • right temporal F
• left parietal T
• frontal F
• left temporal F

Question number 59
(B7E861D)
Bank of Question ID: 2592
Question Mark: 1
Patient with mild left-sided hearing loss and absent left corneal reflex. Where
is the lesion?
• left cerebellar pontine angle T
• left CN V F
• left cochlea F
• lateral medulla F
Question number 60
(B7EB656)
Bank of Question ID: 2605
Question Mark: 1
Which one of the following is true about childhood tuberculosis?
• Ethambutol is one of the drugs used in treatment F
• It is easy to isolate the organism. F
• is highly infectous F
• history of contact is a majour feature T

Question number 61
(B7EE68F)
Bank of Question ID: 2612
Question Mark: 1
Which of the following is a cause of delayed bone age :
• Obesity. F
• Congenital adrenal hyperplasia. F
• Hyperthyroidism. F
 • Asthma. F
• Congenital hypothyroidism. T
Question number 62
(B7F16C8)
Bank of Question ID: 2619
Question Mark: 1
Which of the following is not true about Pica:
• Children are at increased risk of lead poisoning . F
• Parasitic infection is a recognized complication. F
• Screening for iron deficiency anemia is mandatory. F
• It is usually an abnormal phenomenon in a child less
T
than two years.
• it is more common in children with autism F

Question number 63
(B7F4701)
Bank of Question ID: 2661
Question Mark: 1
A 3-month-old female infant presents to the Accident & Emergency
Department unresponsive. She shows fever, tachypnea, bradycardia and
hypotension. You should follow the following order in your initial assessment
• Circulation, Airway, Breathing, Exposure, Disability F
• Airway, Breathing, Circulation, Disability, Exposure T
• Exposure, Airway, Breathing, Circulation, Disability F
• Breathing, Airway, Circulation, Disability, Exposure F
• Exposure, Breathing, Airway, Circulation, Disability F

Question number 64
(B7F773A)
Bank of Question ID: 2726
Question Mark: 1
Which of the following developmental milestones in not a cause for concern?
• 15 month old not walking F
• 12 month old not talking T
 • 12 month old who does not search for hidden objects F
• 3 year old unable to stand on one foot momentarily F
• 6 month old with a persistent grasp reflex F

Question number 65
(B7FA773)
Bank of Question ID: 2734
Question Mark: 1
A 24-year-old woman develops wheezing and shortness of breath when she
is exposed to cold air or when she is exercising. These symptoms are
becoming worse.Which of the following is the prophylactic agent of choice for
the treatment of asthma in these circumstances?
• inhaled β2-agonists T
• oral aminophylline F
• inhaled anticholinergics F
• inhaled sodium cromoglycate F
• oral corticosteroids F
Question number 66
(B7FD7AC)
Bank of Question ID: 2736
Question Mark: 1
Initial screening for hepatitis B should include which of the following?
• anti-hepatitis B surface antigen (HBsAg) and anti-HBc F
• hepatitis B early antigen (HBeAg) and anti HBe F
• HBsAg and anti-HBs F
• HBsAg and anti-HBc T
• anti-HBe and anti-HBc F

Question number 67
(B8007E5)
Bank of Question ID: 2745
Question Mark: 1
Pseudomembranous colitis is usually caused by toxins of which organism?
• Staph aureus F
 • Clostridium difficile T
• Clostridium perfringens F
• Clostridium botulinum F
• Bacteroides fragilis F

Question number 68
(B80381E)
Bank of Question ID: 2750
Question Mark: 1
Hyperkalemia is reduced by each of the following EXCEPT:
• administration of calcium gluconate intravenously T
• administration of glucose, insulin and sodium
F
bicarbonate intravenously
• oral administration of potassium-exchange resins with
F
sorbitol
• hemodialysis with low potassium dialysate F

Question number 69
(B806857)
Bank of Question ID: 2753
Question Mark: 1
Cautions and contraindications of NSAIDs include:
• a creatinine of 180 mmol/L F
• peptic ulcer disease F
• warfarin use F
• cirrhosis F
• all of the answers T

Question number 70
(B809890)
Bank of Question ID: 2789
Question Mark: 1
You examine a 78 year old right handed man who is dysphasic and has
suffered from a stroke. Which one of the following clinical signs would you
expect to find?
 • Left extensor plantar F
• Left homonymous hemianopia F
• Left sided hemiplegia F
• Right homonymous hemianopia T
• Right lower motor neurone VIIth nerve palsy. F
Question number 71
(B80C8C9)
Bank of Question ID: 2803
Question Mark: 1
The use of severe calorie-restricted diets (800 kcal/day) has been
responsible for many deaths. What is the most common cause of death in
these cases?
• sudden cardiac dealth, secondary to dysrhythmia T
• congestive cardiac failure, secondary to anemia F
• hepatic failure F
• renal failure F
• septicemia F

Question number 72
(B80F902)
Bank of Question ID: 2805
Question Mark: 1
A healthy 2/12 old infant was born at 32 weeks gestation. She has grown well
since birth. On physical examination of this infant, the most likely finding is :
• babbling and cooing vocalizations. F
• ability to reach a grasp an object. F
• ability to demonstrate a primitive grasp reflex. F
• presence of tonic neck reflex. F
• ability to fixate on a face and follow it briefly. T
Question number 73
(B81293B)
Bank of Question ID: 2806
Question Mark: 1
 A three year old boy suddenly developed paroxysmal cough as he was
playing. Apart from dyspnoea and local wheezes no other
abnormalities were detected. The most likely diagnosis is :
• foreign body inhalation. T
• bronchial asthma. F
• whooping cough. F
• interistitial pneumonia. F
• bronchiolitis F
Question number 74
(B815974)
Bank of Question ID: 2807
Question Mark: 1
The following statements are true about kerosene poisoning except :
• ingestion of a small amount less than 1ml is not known
F
to cause lung injury.
• pneumatoceles and abnormal CxR are an early
F
finding.
• large amount of kerosene ingested may cause
T
constipation.
• antibiotics are not routinely indicated. F
• steroids should be used to prevent seconry lung
F
infection.

Question number 75
(B8189AD)
Bank of Question ID: 2813
Question Mark: 1
In acute heart failure in children :
• raised JVP is a useful sign specially in small children. F
• presents with refusal of feeds in neonates as well as
T
increased heart rate.
• digoxin is the first line of management. F
• absence of a murmur excludes the diagnosis. F
• liberal rehydration helps the recovery. F
Question number 76
(B81B9E6)
Bank of Question ID: 2815
Question Mark: 1
Acute bronchiolitis is associated with all of the following except
• a higher incidence in infants than in school children F
• respiratory syncitial virus infection F
• widespread fine crackles F
• a polymorphonuclear leucocytosis T
• Tendency to recur F

Question number 77
(B81EA1F)
Bank of Question ID: 3905
Question Mark: 1
Megaloblastic anaemia due to vitamin B12 deficiency occurs in :
• Pregnancey. F
• Terminal ileitis (Crohn's disease). T
• Epileptic patients treated with phenytoin. F
• Tropical sprue. F
• The first 6 months after gastrectomy. F

Question number 78
(B821A58)
Bank of Question ID: 3907
Question Mark: 1
Clinical features of liver cirrhosis include :
• Cataracts. F
• Tylosis palmaris. F
• Osteoporosis. F
• Testicular atrophy. T
• Strawberry naevi. F
Question number 79
‫)‪(B824A91‬‬
‫‪Bank of Question ID: 4139‬‬
‫‪Question Mark: 1‬‬

‫توجب القوانين الطبية واألخالقية علي الطبيب المحافظة علي اسرار المريض بصفة عامة ‪ ,‬ولكن يجوز‬
‫للطبيب االستثناء في الحاالت األتية‬
‫•‬ ‫‪ F‬رضاء صاحب السر بإفشائه‬
‫•‬ ‫‪ F‬اإلخبار عن عن االمراض المعدية للسلطات الصحية‬
‫•‬ ‫‪ F‬اذا كان اإلفشاء في صالح صاحب السر نفسه‬
‫•‬ ‫‪ F‬التبليغ عن الجرائم‬
‫•‬ ‫جميع هذه الحاالت صحيحة‬ ‫‪T‬‬
‫‪Question number 80‬‬
‫)‪(B827ACA‬‬
‫‪Not from bank or edited‬‬
‫‪Question Mark: 1‬‬

‫من أهم شروط مزوالة مهنة الطب‬

‫•‬ ‫‪ F‬الحصول علي المؤهل األكاديمي الالزم‬
‫•‬ ‫‪ F‬إجتياز امتحان ممارسة المهنة الذي يجريه المجلس الطبي‬
‫•‬ ‫‪ F‬الحصول علي ترخيص مزاولة المهنة لألطباء عند التسجيل الدائم‬
‫•‬ ‫‪ T‬جميع هذه الشروط واجبة الحصول‬
‫•‬ ‫‪ F‬قضاء فترة االمتياز بنجاح‬
‫‪Exam Paper: 2‬‬

‫‪Question number 1‬‬

‫)‪(B82AB03‬‬
‫‪Bank of Question ID: 1863‬‬
‫‪Question Mark: 1‬‬
‫‪You were called to see an elderly man who is hospitalized for stroke. He did‬‬
‫‪not pass stools for ten days and is having abdominal distension now. His‬‬
‫‪abdomen is tympanitic and the bowel sounds are increased. A PR reveals a‬‬
‫‪rectum loaded with relatively hard faecal matter. The management will be‬‬
‫•‬ ‫‪Diverting colostomy‬‬ ‫‪F‬‬
 • Didgital evacuation T
• Soap/saline enema F
• Oral lactulose F
• Nill by mouth, NG tube, and suction F

Question number 2
(B82DB3C)
Bank of Question ID: 1872
Question Mark: 1
A 22 years old married female came to the accident and emergency
department, at 12 o’clock midnight, with acute right side lower abdominal
pain of eight hours duration. Her last menstrual period ended two days ago.
She vomited once and reports a slight pyrexia. On examination the abdomen
is soft but tender in right iliac fossa and suprapubic regions. There is also
rebound tenderness. Per vaginal examination shows a normal sized uterus.
The ovaries and tubes were difficult to palpate because of the pain. The next
course of action should be
• Reassure the patient, allow to go home, and come
F
with an ultrasound scan abdomen tomorrow
• Take the patient for an urgent exploration F
• Admit the patient, start metronidazole and
T
doxycycline, and order the ultrasound in the morning
• Admit the patient, start metronidazle and cefuroxime,
F
nill by mouth and i/v fluids and observe
• Refer the patient to the obstetric and gynaecology
F
department

Question number 3
(B830B75)
Bank of Question ID: 1884
Question Mark: 1
You are about to catheterize an adult male. You have available a whole tube
containing 30 ml of lignocaine 2% gel. You will
• Use some of it on the catheter tip F
• Squeeze out half of the contents of the tube down the
F
urethra through the external urinary meatus
 • Use some of it on the external urinary meatus F
• Squeeze out all the contents of the tube down the
T
urethra through the external urinary meatus

Question number 4
(B833BAE)
Bank of Question ID: 1893
Question Mark: 1
Amenorrhea in a 28 year-old with a high LH and high LH/FSH ratio is a most
recognized feature of:
• ovarian failure T
• hyperprolactinaemia F
• Sheehan's syndrome F
• Hypothyroidism F
• Asherman's syndrome F

Question number 5
(B836BE7)
Bank of Question ID: 1895
Question Mark: 1
A woman in the reproductive age suffering from infertility due to polycystic
ovary disease is best treated by:
• Cryosurgery of the ovary. F
• Climophine citrate tabs. T
• Rupture of the cyst by cautery. F
• Wedge resection of the ovaries. F
• Weight reduction. F

Question number 6
(B839C20)
Bank of Question ID: 1902
Question Mark: 1
One of the most common sexually transmitted diseases that may lead to
cervical carcinoma is caused by which of the following viruses
• Cytomegalovirus F
 • Papillomavirus T
• Epstein-Barr virus F
• Herpes simplex virus F
• Adenovirus F

Question number 7
(B83CC59)
Bank of Question ID: 1911
Question Mark: 1
Which of the following conditions is characterized by the classic syndrome of
amenorrhea with or without abnormal vaginal bleeding, pelvic-abdominal pain
and an adnexal mass?
• a tubo-ovarian abscess F
• intermenstrual pain (Mittelschmerz) F
• an ectopic pregnancy T
• a twisted ovarian cyst F
• diverticulitis F
Question number 8
(B83FC92)
Bank of Question ID: 1916
Question Mark: 1
The most important cause of maternal mortality in Sudan is.
• Thrombosis and thromboembolism. F
• Malaria and its related anemia. F
• Hypertensive disorder of pregnancy. F
• Amniotic fluid embolism. F
• Hemorrhage T

Question number 9
(B842CCB)
Bank of Question ID: 1930
Question Mark: 1
The chance of having babies with Down's syndrome in women less than 20
years of age is one in:
 • 550 live births F
• 1000 live births F
• 1550 live births T
• 2850 live births F

Question number 10
(B845D04)
Bank of Question ID: 1932
Question Mark: 1
Serum FSH and LH are increased in primary hypogonadism and in:
• menopause T
• pheochromocytoma F
• Addison's disease F
• Kallmann's syndrome F
• secondary hypogonadism F

Question number 11
(B848D3D)
Bank of Question ID: 2085
Question Mark: 1
In an eight week old infant with hypertrophic pyloric stenosis, which of the
following is considered to be a sign of severity, dictating urgent resuscitation?
• Acidic urinary pH T
• Visible peristalsis F
• Palpable epigastric mass F
• Projectile vomiting F
• Succussion splash F

Question number 12
(B84BD76)
Bank of Question ID: 2093
Question Mark: 1
A worker was rushed to you in the emergency department after having his
hand caught in an electric saw. His hand is badly contused and bleeding
heavily. He is anxious, in pain, sweaty, and has a weak rapid pulse the most
 important next step would be to
• Elevate the limb F
• Do an urgent exploration of the wound under general
F
anaesthesia
• Apply a tourniquet to the arm F
• Apply a pressure dressing to the wound T
• Compress the axillary artery F
Question number 13
(B84EDAF)
Bank of Question ID: 2099
Question Mark: 1
During your ward round you came by a diabetic patient who underwent
drainage of a massive gluteal and upper thigh abscess with a resulting large
wound and some deep pockets. He complained that the dressing was very
painful that he almost fainted. To ease his suffering, you are going to order
that his dressing be done under
• Local anaesthetic spray F
• An analgesic dose of ketamine T
• Pethidine and diazepam F
• Inhaled general anaesthesia F
• Intramuscular diclofenac F

Question number 14
(B851DE8)
Bank of Question ID: 2103
Question Mark: 1
You are following up a patient who underwent large bowel resection and
anastomosis following a right hemicolectomy. He is still fasting and on fluid
therapy. An early sign of underhydration in this patient would be
• Low urine output T
• Rapid small volume pulse F
• Feeling of thirst F
• Depressed JVP F
• Low blood pressure F
Question number 15
(B854E21)
Bank of Question ID: 2104
Question Mark: 1
A 25 years old patient came to you in the emergency department with
abdominal pain and fever. He underwent an appendicectomy one week ago
and was discharged in a good condition. He now complains of painful bouts
of mucoid diarrhoea and fever. On examination the patient is febrile, pulse
105/min, BP 110/80 mmHg. There is tenderness on PR and the sensation of
fullness anterior to the rectum. Urine shows uncountable pus cells. These
findings are consistent with the diagnosis of
• Rectal tumor F
• Acute amoebic dysentery F
• Generalized peritonitis F
• Acute UTI F
• Pelvic abscess T
Question number 16
(B857E5A)
Bank of Question ID: 2108
Question Mark: 1
A 20 years old lady, who is in her second year of medical school, came to
you complaining of pain and numbness in the right hand and forearm
following prolonged writing. You examine her after writing a two page
assignment and find that the right radial pulse is weaker, and she reports
parasthesia. The most likely diagnosis would be
• Carpal tunnel syndrome F
• Raynaud’s disease F
• Peripheral neuropathy F
• Right cervical rib T
• Vitamin B1, B6, B12 deficiency F
Question number 17
(B85AE93)
Bank of Question ID: 2111
Question Mark: 1
 You are examining a 60 years old male known diabetic for 20 years. He is
complaining of right leg pain and parasthesia that are worse after prolonged
standing. He also complains of back pain that is worse on stooping and
straining. Peripheral pulses are not palpable. You find that he is unable to
dorsiflex his right big toe. The left side is normal. The most likely cause for
his presenting symptoms would be
• Diabetic autonomic neuropathy F
• L5-S1 intervertebral disc prolapse T
• Peripheral neuropathy F
• Mononeuritis multiplex F
• Peripheral vascular disease F
Question number 18
(B85DECC)
Bank of Question ID: 2114
Question Mark: 1
A 28 years old male is a known case of a right duplication of his renal pelvis
and upper ureter. He developed numerous attacks of UTI since childhood.
This time he came because he developed severe right sided pain that was
colicky in nature and that made him turn around in bed. His urinalysis
revealed the following: dark colour, alkaline pH, ++ protein, uncountable
RBC’s, 8-10 pus cells/HPF, + crystals. You suspect that he has a stone.
Which type of stone you think this patient will be having?
• Calcium oxalate stone F
• Urate stone F
• Calcium-ammonium-magnesium phosphate stone T
• Calcium phosphate stone F
• Cysteine stone F

Question number 19
(B860F05)
Bank of Question ID: 2116
Question Mark: 1
When assessing a burn patient which of the following criteria would be a
strong indication for admission?
• Deep burn to one buttock F
 • If the burn was in a closed space T
• 7% burn in a ten years old child F
• Scalp burn of 2% F
• 10% burn in an adult F

Question number 20
(B863F3E)
Bank of Question ID: 2122
Question Mark: 1
Ultrasound is helpful in the diagnosis of all the following except
• Twins F
• Placenta praevia F
• Macrosomia F
• Contracted pelvis T
• Congenital anomalies F

Question number 21
(B866F77)
Bank of Question ID: 2129
Question Mark: 1
Compared with singleton pregnancies, twin pregnancy have a high risk of all
of the following except
• P.I.H F
• C/S delivery F
• Perinatal death F
• Shoulder dystocia T
• Congenital anomalies F

Question number 22
(B869FB0)
Bank of Question ID: 2135
Question Mark: 1
A 16 year-old primigravida presented with severe pre-eclampsia, she has
meconium stained liquor and foetal heart rate 110 beats per minute, the best
way to deliver her is
 • An elective c/s next day morning F
• Induction of labour F
• Acceleration of labour F
• Assisted vaginal delivery F
• An emergency c/s T
Question number 23
(B86CFE9)
Bank of Question ID: 2139
Question Mark: 1
Maternal mortality rate is defined as the number of maternal deaths per
• 1000 live-births F
• 10.000 live-births F
• 100.000 live-births T
• 1000 pregnancies F
• 100.000 pregnant women F

Question number 24
(B870022)
Bank of Question ID: 2160
Question Mark: 1
The following is not true with regard to ectopic pregnancy
• P I D may be a cause F
• May occur in the cervix F
• Can be treated with methotrexate F
• colpocentesis is diagnostic in intact ectopic pregnancy T
• Trans-vaginal ultrasound is helpful in conjuction with H
F
Cg

Question number 25
(B87305B)
Bank of Question ID: 2230
Question Mark: 1
A 30 years old para II lady is having a 5 cm incisional hernia in previous
caesarean section scar. She had two caesarean sections. The hernia is fully
 reducible. The choice of management would be
• Conservative or wait and see. T
• Anatomical repair with nylon stitches F
• Mesh plug repair F
• Mayo’s repair with nylon F
• only mesh repair now F

Question number 26
(B876094)
Bank of Question ID: 2234
Question Mark: 1
The most significant/relevant symptom of a tumor in the left colon is
• Bleeding per rectum T
• Alternating bowel habits F
• Constipation F
• Flatulence F
• Fever F
Question number 27
(B8790CD)
Bank of Question ID: 2243
Question Mark: 1
Which of the following conditions will benefit from transfusion of stored whole
blood?
• Hypoalbuminaemia F
• Preoperative correction of anaemia T
• Bleeding tendency secondary to obstructive jaundice F
• Bleeding tendency secondary to hyperspleenism F
• Leukopaenia secondary to chemotherapy F

Question number 28
(B87C106)
Bank of Question ID: 2246
Question Mark: 1
Which of the following symptoms is NOT likely to be caused by acute
 intervertebral disc prolapse?
• Parathaesia over the lateral and posterior aspect of
F
the leg
• Inability to dorsiflex the big toe F
• Exacerbation of the pain with coughing F
• Exacerbation of the pain with bending F
• Precipitation of the pain by walking and its immediate
T
relief by stopping for a while
Question number 29
(B87F13F)
Bank of Question ID: 2259
Question Mark: 1
With regards to fetal heart monitoring, which of the following is TRUE:
• Early decelerations are related to a vagal response to
T
head compression
• An acceleration is defined as an increase of at least
F
20 bpm lasting at least 20 seconds
• Normal range is 100-180 bpm F
• A variable deceleration is the least common change
F
seen during labour
• A late deceleration peaks at the same time as the
F
uterine contraction

Question number 30
(B882178)
Bank of Question ID: 2263
Question Mark: 1
A24 year-old female G1P0 is admitted to hospital at 34 weeks gestation. The
patient describes passing a large volume of clear fluid per vagina for 36
hours. Examination reveals the following: temp 38.5C, no uterine
contractions, vague lower abdominal tenderness, fetal heart rate 185 bpm.
Lab investigations reveal: Hb 120, WBC 19.0, + nitrazine test of vaginal fluid,
+ ferning of vaginal fluid. Which of the following is the most likely diagnosis?
• premature rupture of membranes and chorioamnionitis T
• premature labour F
 • acute pyelonephritis F
• acute vaginitis of pregnancy F
• premature rupture of membranes F

Question number 31
(B8851B1)
Bank of Question ID: 2265
Question Mark: 1
The commonest indication for amniocentesis is:
• chromosome anomaly of the mother F
• teenage pregnancy F
• advanced maternal age T
• family history of Down syndrome F
• family history of cystic fibrosis F
Question number 32
(B8881EA)
Bank of Question ID: 2267
Question Mark: 1
Causes of secondary amenorrhea include:
• Turner syndrome F
• anorexia T
• androgen insensitivity syndrome F
• gonadal dysgenesis F
• imperforate hymen F
Question number 33
(B88B223)
Bank of Question ID: 2270
Question Mark: 1
A55 year-old female presents with a "period-like" vaginal bleeding for 5 days
that stopped spontaneously. Your approach to the problem would be to:
• reassure the patient and manage expectantly F
• administer provera 10 mg od for 15 days F
 • administer cyclic estrogen plus progesterone F
• obtain endometrial tissue T
• perform a pap smear plus endocervical curretage F

Question number 34
(B88E25C)
Bank of Question ID: 2272
Question Mark: 1
The commonest cause of disseminated intravascular coagulation during
pregnancy is:
• amniotic fluid embolism F
• abruptio placentae T
• placenta previa F
• missed abortion F
• chorioamnionitis F
Question number 35
(B891295)
Bank of Question ID: 2287
Question Mark: 1
A middle aged man was brought to the accident and emergency department
by bystanders after being involved in a road traffic accident. He is clearly
unconscious as they put him on the couch. There is much blood on his cloth
with an apparent bleeding wound over his right thigh. Which of the following
steps would be your first task?
• Stabilizing the cervical spine and checking the airway T
• Administering i/v glucose F
• Checking the pulse and blood pressure F
• Checking airway patency F
• Applying pressure to the bleeding wound F
Question number 36
(B8942CE)
Bank of Question ID: 2291
Question Mark: 1
A 28 years old patient presented to you with a one day history of acute
 colicky generalized abdominal pain that later shifted to the right iliac fossa.
He vomited once. On examination he does not look ill, pulse is 96/min, BP
110/70 mmHg, and is not pale. There is tenderness and rebound tenderness
over the right iliac fossa. You took the patient to the operating theatre and
made a gridiron incision. You found the appendix to look quite normal. What
are you going to do next?
• Leave it, come out, and close the incision F
• Remove it, check the terminal ileum and pelvis T
• Remove it, extend the incision upward, and inspect
F
the rest of the abdomen
• Leave it, close the incision, and make a midline
F
incision
• Remove it, close the abdomen, and come out F

Question number 37
(B897307)
Bank of Question ID: 2295
Question Mark: 1
A 13 years old boy was brought to you in the emergency department with
acute severe scrotal pain following a football match, in which he remembers
being struck by a fast moving ball in his groin. The match was four hours ago.
On examination the right scrotum is slightly swollen and very tender and the
testicle is situated in the neck of the scrotum. The left testicle is not tender
and is lying somewhat horizontally. Your response would be
• To advise urgent scrotal exploration T
• To request a scrotal ultrasound with a high frequency
F
probe
• To request urinalysis and culture F
• To reassure the family and advise follow up after one
F
week
• To prescribe analgesics and bed rest for a few days F

Question number 38
(B89A340)
Bank of Question ID: 2298
Question Mark: 1
A 14 years old male fell down and fractured his left clavicle. Your
 management would be
• Refer him to another hospital for internal fixation F
• Prescribe him an arm sling/ holder as a definitive
T
treatment
• Take him to theatre for wiring of the fracture F
• Take him to theatre for fixation with a plate and screws F
• Take to theatre for the insertion of percutaneous K-
F
wires
Question number 39
(B89D379)
Bank of Question ID: 2305
Question Mark: 1
A patient was brought to you with a simple fracture tibia, which you plastered
and achieved excellent reduction on the check X-ray after applying the
plaster. When would you ask the patient to come for another check X-ray to
assure that the fracture did not displace?
• After 6 weeks F
• After one week F
• After 3 weeks F
• After 24 hrs F
• After 3 days T

Question number 40
(B8A03B2)
Bank of Question ID: 2307
Question Mark: 1
A 40 years old male presents with an inguinooscrotal swelling of three
months duration. After taking the history and examining the patient you
decide that it is an indirect inguinal hernia and plan the patient for surgery.
Which type of operation would you do to this patient?
• Herniotomy with strengthening of the posterior wall
F
with nylon stitches
• Herniotomy with strengthening of the posterior wall
F
with chromic catgut stitches
 • Simple herniotomy without repair F
• Herniotomy with reinforcement of the posterior wall
T
with a polyprolene mesh
• Herniotomy with tightening of the fascia transversalis F

Question number 41
(B8A33EB)
Bank of Question ID: 2308
Question Mark: 1
Which of the following suture materials is the most suitable to use for closing
the rectus sheath at the end of a laparotomy?
• Chromic catgut size 2 F
• Vicryl (polyglycolide & polylactide) size zero F
• Prolene size 2 T
• Prolene size zero F
• Vicryl (polyglycolide & polylactide)size 2 F

Question number 42
(B8A6424)
Bank of Question ID: 2310
Question Mark: 1
A lady presents to you with a lemon sized swelling in the middle of her
previous caesarean section scar. She underwent that surgery 18 months
ago. She first noticed the swelling three month ago. After examination you tell
her that it is an incisional hernia. She is blaming it on her husband for making
her do a lot of house work for his mother three months ago. You are trying to
convince her that this is not the reason because a surgical wound is most
weak and vulnerable to develop an incisional hernia in
• The first two years F
• The first month postoperatively F
• The immediate postoperative period T
• The first year F
• The first six month F
Question number 43
(B8A945D)
Bank of Question ID: 2320
Question Mark: 1
What is the desired duration of time that the patient should be fasting for prior
to elective surgery?
• Twelve hours F
• Eight hours F
• Three hours F
• Ten hours F
• Four hours T

Question number 44
(B8AC496)
Bank of Question ID: 2321
Question Mark: 1
The following is a cause of congenital malformation when taken during early
pregnancy:
• Testosterone. F
• Methotrexate. T
• 17 hydroxyprogesterone. F
• Tetracycline. F
• Folic acid. F

Question number 45
(B8AF4CF)
Bank of Question ID: 2334
Question Mark: 1
Preterm labour:
• is not related to physical trauma. F
• has no identifiable single specific cause. T
• can not be iatrogenic. F
• is related to foetal abnormal lie. F
• is labour before 39th week of gestation. F
Question number 46
(B8B2508)
Bank of Question ID: 2346
Question Mark: 1
When prescribing the oral contraceptive pill (OCP), which of the following
should be done:
• Perform breast, abdominal and pelvic exams and
T
assess blood pressure
• Perform a complete physical exam after taking a
F
thorough sexual history
• Inform patients that the OCP protects against STDs F
• Perform a Beta-HCG test prior to prescribing OCP F
• Warn patients that their risk of dysmenorrhea is
F
increased

Question number 47
(B8B5541)
Bank of Question ID: 2468
Question Mark: 1
A 25 years old female underwent excision of a 10 cm lipoma from her back
under local anaesthesia three weeks ago. Her card states that there was
slight ooze from the tissues that stopped with packing, the skin was closed in
asingle layer with obsorbable suture. Now she has a painless, soft, fluctuant
swelling with normal overlying skin at the site of surgery. The most likely
diagnosis would be
• Seroma formation T
• Haematoma formation F
• Recurrence of the lipoma F
• Abscess formation F
• Rolls of gauze left from the surgery F

Question number 48
(B8B857A)
Bank of Question ID: 2472
Question Mark: 1
A 45 years old female patient presented to you with jaundice, fever, nausea,
vomiting, right hypochondrial pain. An ultrasound scan reported enlarged
 liver with dilatation of the intrahepatic bile ducts, a common bile duct of 13
mm diameter, and a small gallbladder with thick wall but no stones. No other
pathology was detected. You would next request, after appropriate
resuscitation,
• Serology for viral hepatitis F
• Repeat ultrasound in a more reliable centre F
• ERCP T
• CT scan abdomen F
• MRCP F

Question number 49
(B8BB5B3)
Bank of Question ID: 2487
Question Mark: 1
A mother brought to you her four month old uncircumcised child with a
complaint that he cries when he passes urine, the urinary stream is weak,
and that the foreskin balloons during micturition. Your diagnosis is
• Congenital urethral stricture F
• Phimosis T
• Meatal stenosis F
• Paraphimosis F
• Posterior urethral valves F

Question number 50
(B8BE5EC)
Bank of Question ID: 2489
Question Mark: 1
A 26 year-old primigravida presents at 40 weeks in active labour with
contractions every 2 minutes. She is diagnosed as having a transverse lie
with the back up. Which of the following would be the most appropriate next
step?
• start isoxuprine (Vasodilan) F
• perform an external version F
• none of the answers F
• prepare for an immediate C-section T
 • rupture membranes and then perform an internal
F
version
Question number 51
(B8C1625)
Bank of Question ID: 2500
Question Mark: 1
The most likely differential diagnosis in a case of endomedriosis is
• Irritable bowel syndrome F
• Uterine fibroid F
• Pelvic inflammatory disease T
• Ulcerative colitis F
Question number 52
(B8C465E)
Bank of Question ID: 2501
Question Mark: 1
The most visible sign of placental separation in the third stage of labour is
• Gush of blood F
• Feeling the placenta in the vagina T
• Uterus rises up F
• Uterus become more mobile F
• Lengthening of the cord F
Question number 53
(B8C7697)
Bank of Question ID: 2508
Question Mark: 1
All the following are true regarding the management of sickle cell crises
during pregnancy except
• Transfusion of packet cells F
• Oxygen administration F
• Patial exchange transfusion F
• Iron administration T
• Using forceps in the second stage F
Question number 54
(B8CA6D0)
Bank of Question ID: 2536
Question Mark: 1
What is the earliest time when a multiple pregnancy can be detected by
ultrasonography?
• between the 4th and 6th week of gestation T
• between the 8th and 10th week of gestation F
• between the 14th and 15th week of gestation F
• between the 15th and 16th week of gestation F

Question number 55
(B8CD709)
Bank of Question ID: 2537
Question Mark: 1
Which of the following tests is unnecessary during the first trimester of
pregnancy?
• a urinalysis F
• blood pressure measurements F
• measurements of the body weight F
• measurements of the abdominal circumference T
• vaginal examinations F

Question number 56
(B8D0742)
Bank of Question ID: 2555
Question Mark: 1
All the following are types of inguinal herniae except
• Sliding F
• Rolling T
• Pantaloon F
• Congenital F
• Richter’s hernia F
Question number 57
(B8D377B)
Bank of Question ID: 2563
Question Mark: 1
The following operations necessitate the preparation of blood, except
• Mastectomy F
• Laparotomy F
• Above knee amputation F
• Repair of a huge inguinal hernia T
• Repair of a huge incisional hernia F

Question number 58
(B8D67B4)
Bank of Question ID: 2638
Question Mark: 1
Which of the following is a potential, associated risk in patients developing
eclampsia during their first pregnancy?
• diabetes mellitus F
• chronic hypertension T
• habitual abortion F
• chronic liver disease F
• delivery of a dead fetus in the third trimester of
F
pregnancy
Question number 59
(B8D97ED)
Bank of Question ID: 2644
Question Mark: 1
Which of the following is the presenting part in frank breech presentation?
• the buttocks T
• the buttocks and both feet F
• the buttocks and one of the feet F
• both knees F
• one of the knees F
Question number 60
(B8DC826)
Bank of Question ID: 2650
Question Mark: 1
In a patient whose blood group is O-Rh negative and whose husband has O-
Rh positive blood, Rh immune globulin (anti-D) should be given after all the
following EXCEPT:
• artificial rupture of membranes T
• full term delivery of a baby with O-Rh positive blood
F
group
• amniocentesis F
• spontaneous abortion F
• therapeutic abortion F

Question number 61
(B8DF85F)
Bank of Question ID: 2651
Question Mark: 1
A 35 year-old G0P0 has severe pain during menses which radiates into the
anal region. On bimanual exam, she has a small, retroverted uterus and
tender nodules can be felt on palpation of the uterosacral ligaments. Which of
the following conditions does she most likely have:
• chronic PID F
• adenomyosis F
• fibroids F
• endometriosis T
• uterine carcinoma F
Question number 62
(B8E2898)
Bank of Question ID: 2652
Question Mark: 1
The most common cause of early first-trimester abortion is :
• inadequate oestrogen production. F
• chromosomal abnormality in the foetus. T
 • incompetence of the internal cervical os . F
• maternal diabetes. F
• cytotoxic drugs. F

Question number 63
(B8E58D1)
Bank of Question ID: 2653
Question Mark: 1
Which of the following is an absolute indication for caesarean section :
• major degree placenta previa . T
• previous C/S scar. F
• breech presentation. F
• grandmultiparity. F
• severe pregnancy induced hypertension. F
Question number 64
(B8E890A)
Bank of Question ID: 2683
Question Mark: 1
Management of preterm labour does not include
• Dexamethasone. F
• Tocolytics. F
• Caesarean section. T
• Transfer to hospital with good neonatal facilities. F
• Treatment of associated UTI. F
Question number 65
(B8EB943)
Bank of Question ID: 2685
Question Mark: 1
The following statement is not true about renal disease in pregnancy
• Asymptomatic bacteruria should be treated . F
• Midstream urine analysis is helpful in diagnosis of
F
acute cystitis.
 • Acute pyelonephritis increases the risk of preterm
F
labour.
• There is high incidence of gestational diabetes in
T
cases of chronic renal disease.
• Delivery by caesarean section is indicated only for
F
obstetric causes.

Question number 66
(B8EE97C)
Bank of Question ID: 2706
Question Mark: 1
A 10 year old boy sustained laceration to his cheek. The best way to control
bleeding initially is :
• direct pressure. T
• clamps. F
• cautery. F
• suture ligation. F
• dissolving clips. F

Question number 67
(B8F19B5)
Bank of Question ID: 2708
Question Mark: 1
The initial maneuver to establish an airway in a patient with multiple injuries
is :
• orophoryngeal air way. F
• uncuffed endotracheal tube. F
• suctioning foreign debris and lifting up the mandible (
T
jaw lift)
• cuffed endotracheal tube. F
• tracheostomy. F

Question number 68
(B8F49EE)
Bank of Question ID: 2715
Question Mark: 1
 A young child started feeling severe abdominal pain with current jelly stools
with a palpable mass in the right hypochondrium with vomiting. The most
likely diagnosis is :
• acute appendicitis. F
• obstructed inguinal hernia. F
• congenital band obstruction. F
• intussusception. T
• mesenteric lymphadenitis. F
Question number 69
(B8F7A27)
Bank of Question ID: 2766
Question Mark: 1
Sterile pyuria is caused by all the following except
• Partially treated urinary tract infection F
• Urinary tract tuberculosis F
• Urinary calculi F
• Papillary necrosis F
• Fistula between the urinary bladder and colon T

Question number 70
(B8FAA60)
Bank of Question ID: 2775
Question Mark: 1
Which of the following materials is the most suitable to use when stitching the
skin of a below knee amputation in a diabetic?
• Prolene T
• Silk F
• Vicryl (polyamide and polylactide) F
• Catgut plain F
• Chromic Catgut F

Question number 71
(B8FDA99)
Bank of Question ID: 2827
Question Mark: 1
The following is a cause of congenital malformation when taken during early
pregnancy:
• Tetracycline. F
• 17 hydroxyprogesterone. F
• Methotrexate. T
• Folic acid. F
• Testosterone. F

Question number 72
(B900AD2)
Bank of Question ID: 2843
Question Mark: 1
When infusing potassium chloride to a patient without an ECG monitor, the
maximum safe rate would be
• 10 mmol/ hour F
• 20 mmol/ hour F
• 30 mmol/ hour F
• 40 mmol/ hour T
• 50 mmol/ hour F
Question number 73
(B903B0B)
Bank of Question ID: 2845
Question Mark: 1
The daily requirement of sodium and chloride can be given to a 70 kg fasting
surgical patient postoperatively in the form of
• One unit (500 ml) of normal saline per day T
• Two units of normal saline per day F
• Three units of normal saline per day F
• Four units of normal saline per day F
• Calculation of the deficit and giving it as sodium
F
bicarbonate by slow intravenous injection.
Question number 74
(B906B44)
Bank of Question ID: 3171
Question Mark: 1
A 40 years old patient is having calcular obstructive jaundice. He is
scheduled for ERCP after tomorrow. You were called to evaluate him
because of an acute attack of high grade fever with rigors and abdominal
pain. His TWBC count is 15,000/ml, BFFM is +ve for P.falciparum
gametocytes ; urinalysis is normal. Your choice of drugs would be
• Cefuroxime, metronidazole, artemether F
• Cefuroxime, gentamicin, artemether F
• Cefuroxime, metronidazole, primaquine T
• Metronidazole, primaquine, artemether F
• Artemether and primaquine F

Question number 75
(B909B7D)
Bank of Question ID: 3176
Question Mark: 1
A 25 years old boy was brought to you in the accident and emergency
department with a fractured left humerus secondary to a fall on the ground
during a basket ball game. You confirm the fracture with an X-ray. There are
no associated injuries and the skin is intact. Your choice of immobilisation
method will be
• Full upper limb cast F
• K-wires F
• Posterior slab T
• Fixation with an external fixator F
• Plate and screws F

Question number 76
(B90CBB6)
Bank of Question ID: 3178
Question Mark: 1
A 40 years old patient, who is a known case of prosthetic mitral valve, is
going to undergo elective inguinal hernia repair in the next list. He is on
 warfarin . Which of the following investigations would you like to order to
assess his coagulation profile?
• Partial thromboplastin time F
• Thrombin time F
• Prothrombin time T
• Bleeding time F
• Whole blood clotting time F
Question number 77
(B90FBEF)
Bank of Question ID: 4157
Question Mark: 1
All of the following symptoms are associated with ectopic pregnancy in the
fallopian tube EXCEPT:
• Rectal bleeding T
• Unilateral lower abdominal pain F
• Shoulder tip pain F
• Vaginal bleeding or spotting F
• Missed menstrual period F

Question number 78
(B912C28)
Bank of Question ID: 4258
Question Mark: 1
Nausea and vomiting are common in pregnancy. Hyperemesis gravidarum,
however, is a much more serious and potentially fatal problem. Finding that
should alert physician to the diagnosis of Hyperemesis gravidarum early in its
course include:
• Metabolic acidosis F
• Jaundice F
• Ketonuria T
• Electrocardiographic evidence of hypokalemia F

Question number 79
(B915C61)
Bank of Question ID: 4264
Question Mark: 1
Which of the following statements regarding management of labor in a low-
risk pregnancy is true?
• Amniotomy may shorten the length of labor slightly,
T
but not as much spontaneous rupture
• Universal electronic fetal monitoring improve prenatal
F
outcome
• Food and oral fluids are acceptable if labor is
F
progressing normally
• An indwelling catheter is frequently needed when the
F
patient is unable to void spontaneously

Question number 80
(B918C9A)
Bank of Question ID: 4268
Question Mark: 1
You are delivering a 26 year-old G3P2002 at 40 weeks. She has a history of
two previous uncomplicated vaginal deliveries and has had no complications
this pregnancy. After 15 min of pushing, the baby’s head delivers
spontaneously, but then retracts back against the perineum. As you apply
gently downward traction to the head, the baby’s anterior shoulder fails to
deliver. All of the following are appropriate next steps in the management of
this patient EXCEPT:
• Cut generous episiotomy F
• All of the answers T
• Instruct the nurse to apply supra-pubic pressure F
• Call for help F
• Instruct the nurse to flex the patient’s legs back to her
F
head
Exam Paper: 3
Question number 1
(B91BCD3)
Bank of Question ID: 3704
Question Mark: 1
 This child presented with this condition for thee last 2 months. What is the
most likely diagnosis?
• Inguinal hernia T
• Orchitis F
• Testicular tumour F
• Testicular torsion F
Question number 2
(B91ED0C)
Bank of Question ID: 3705
Question Mark: 1
 This is a CT scan of the brain. What is the most likely diagnosis?
• Subdural haematoma F
• Epidural haematoma T
• Subarachnoid haemorrhage F
• Intracerebral haemorrhage F

Question number 3
(B921D45)
Bank of Question ID: 3706
Question Mark: 1
 What is the most likely diagnosis of this acute condition ?
• Cellulitis T
• Exophthalmos F
• Retinoblastoma F
• Bells palsy F
Question number 4
(B924D7E)
Bank of Question ID: 3707
Question Mark: 1
 One of the following statements is true regarding the area of the renal
nephron indicated (by the red arrow) on this diagram:
• Bumetanide acts here to inhibit passive sodium
F
reabsorption.
• Furosemide exhibits its maximal diuretic effect here. F
• Spironolactone acts here to prevent aldosterone-
F
enhanced potassium reabsorption.
• Thiazides act here to affect the corticomedullary
F
concentration gradient.
• Thiazides act here to inhibit active sodium
T
reabsorption.
Question number 5
(B927DB7)
Bank of Question ID: 3717
Question Mark: 1

One of the following is not a cause of the abnormality shown in this gentle
man ?
• testicular cancer F
• drugs F
• ca prostate T
• lung cancer F
Question number 6
(B92ADF0)
Bank of Question ID: 3725
Question Mark: 1

What is the most important investigation to be done for this patient who
presented for the first time?
• Serum iron F
• Bleeding time T
• Prothrombin time F
• Factor VIII F
Question number 7
(B92DE29)
Bank of Question ID: 3726
Question Mark: 1
 Depending on the result of this CBC, what is the type of anaemia?
• Iron deficiency F
• Thalassemia F
• Macrocytic T
• Sickle cel F

Question number 8
(B930E62)
Bank of Question ID: 3729
Question Mark: 1
 Diagnosis of protein-calorie malnutrition in this child is suggested by:
• General misery F
• Fineness and depigmentation of hair F
• Wasting and oedema F
• All the answers T
Question number 9
(B933E9B)
Bank of Question ID: 3734
Question Mark: 1

The underlying pathology in this kidney is:

 • Hypernephroma. F
• Polycystic kidney disease. T
• Hydronephrosis. F
• Amyloidosis. F

Question number 10
(B936ED4)
Bank of Question ID: 3735
Question Mark: 1

What is the most important complication?

• Haemorrhage F
• Fat embolism F
 • Volkmann's contracture T
• malunion F
Question number 11
(B939F0D)
Bank of Question ID: 3740
Question Mark: 1

What is the most important investigation to be done for this patient?

• Skin biopsy F
• Culture and sensitivity F
• Blood glucose T
• urinalysis F
Question number 12
(B93CF46)
Bank of Question ID: 3743
Question Mark: 1
 Which cranial nerve is being tested ?
• Optic. T
• Occulomotor. F
• Abducent. F
• Trochlear. F
Question number 13
(B93FF7F)
Bank of Question ID: 3749
Question Mark: 1

This lady can't open her eyes at evening but she is quite normal at the
morning . What is the diagnosis?
• Myasthenia gravis T
• Gillian Barrie syndrome F
• Vitamin A deficiency F
• Hys F

Question number 14
(B942FB8)
Bank of Question ID: 3751
Question Mark: 1
 What is the cause of this abnormal placenta?
• Placenta previa. F
• Placental abruption. F
• Chorioamnionitis. T
• Congenital anomaly. F
Question number 15
(B945FF1)
Bank of Question ID: 3756
Question Mark: 1

What is the diagnosis ?

• Pathological fracture of the ulna. F
 • Pathological fracture of the radius . T
• Pathological fracture of the tibia. F
• Pathological fracture of the fibula. F

Question number 16
(B94902A)
Bank of Question ID: 3757
Question Mark: 1

What is this instrument ?

• Retractor. F
• Simms speculum. T
• Proctoscope. F

Question number 17
(B94C063)
Bank of Question ID: 3758
Question Mark: 1

One of the following is an indication for use of this instrument ?

 • biliary surgery. F
• intestinal obstruction. T
• urinary obstruction. F
• pleural effusion. F

Question number 18
(B94F09C)
Bank of Question ID: 3761
Question Mark: 1

What is the method of injection?

• Intramuscular F
• intravenous F
• subcutaneous T
• intradermal F

Question number 19
(B9520D5)
Bank of Question ID: 3762
Question Mark: 1
 These lesions started as painless papules for the last 4 months. What is the
most likely diagnosis?
• Eczema. F
• Cutanous leishmaniasis. T
• Lepromatus leprosy. F
• Sarcoidosis. F
Question number 20
(B95510E)
Bank of Question ID: 3786
Question Mark: 1

The best description for the state of this child with meningitis is:
 • Decorticate F
• Decerebrate T
• opithotonus F
• vegitative F

Question number 21
(B958147)
Bank of Question ID: 3790
Question Mark: 1

The following abnormality is shown in this plain x-ray abdomen:

• Dilated small bowel loops T
• Gas in the rectum F
• Multiple gas-fluid levels F
• Distended u-shape large bowel loop F

Question number 22
(B95B180)
Bank of Question ID: 3796
Question Mark: 1
 With which of the following is this physical sign associated?
• Tuberculoid leprosy T
• Lepromatous leprosy F
• Congestive heart failure F
• SLE F

Question number 23
(B95E1B9)
Bank of Question ID: 3808
Question Mark: 1
 One of the following is an indication for this drug:
• Heart failure F
• Atrial fibrillation F
• Heart block T
• Supraventricular tachycardia F

Question number 24
(B9611F2)
Bank of Question ID: 3811
Question Mark: 1
 What is the abnormality shown ?
• balanitis. F
• hypospadius. T
• circumsition. F
• meatal ulcer. F

Question number 25
(B96422B)
Bank of Question ID: 3819
Question Mark: 1
 What is the diagnosis?
• Cellulitis. F
• Dry gangrene. T
• Snake bite. F
• Foreign body F

Question number 26
(B967264)
Bank of Question ID: 3820
Question Mark: 1
 Depending on this plain x-ray of the abdomen, what is the diagnosis?
• Bilateral multiple renal stones F
• Renal calcification T
• gallbladder stones and left renal stones F
• artifact F

Question number 27
(B96A29D)
Bank of Question ID: 3823
Question Mark: 1
 A 74 year old man was admitted to hospital after he was found collapsed at
the roadside. Over the following hours he was noted to have a fluctuating
level of consciousness. Based on the above information and the brain
imaging what is the most likely diagnosis?
• large left sided infarct F
• subdural haemorrhage T
• extradural haemorrhage F
• subarachnoid haemorrhage F

Question number 28
(B96D2D6)
Bank of Question ID: 3824
Question Mark: 1
 An obese lady has this fundal appearance and a VI nerve palsy. How3 would
you describe this appearance?
• Optic atrophy F
• Papilloedema T
• Retinitis pigmentosa F
• Normal fundus F

Question number 29
(B97030F)
Bank of Question ID: 3825
Question Mark: 1
 This patient was suffering from a chronic condition(A). After starting drug
treatment which will continuo for life , her condition very much improved(B).
What is this chronic condition?
• Hypothyroidism T
• Acromegally F
• Cushing disease F
• Hypoparathyroidism F

Question number 30
(B973348)
Bank of Question ID: 3827
Question Mark: 1
 With which of the following is the physical sign shown associated ?
• myxedema F
• hyperthyroidism T
• hyperparathyroidism F
• hypopituitarism F
Question number 31
(B976381)
Bank of Question ID: 3835
Question Mark: 1
 What is the name of the top instrument ?
• kielland obstetric forceps. T
• wrigle obstetric forceps. F
• artery forceps F
• retractor F
Question number 32
(B9793BA)
Bank of Question ID: 3843
Question Mark: 1
 What is the abnormality shown ?
• pectus exacavatum. T
• pigeon chest. F
• surgical scar. F
• multiple fractures of ribs. F

Question number 33
(B97C3F3)
Bank of Question ID: 3850
Question Mark: 1
 This ECG indicates :
• Atrial fibrillation F
• Ischaemia T
• MI F
• Hyperkalaemia F
Question number 34
(B97F42C)
Bank of Question ID: 3852
Question Mark: 1

This patient presented with night sweats, weight loss and gradual increase of
the swelling shown over the last 3 months. There was no lymphadenopathy.
What is the likely diagnosis?
• Dental abscess F
• Burkitt's lymphoma T
• Tuberculous lymphadenitis F
• Typhoid fever F
Question number 35
(B982465)
Bank of Question ID: 3855
Question Mark: 1
 The most common cause of this condition in Sudan is :
• Onchocerciasis F
• Trauma F
• Wucheraria bancrofti T
• Congenital lympatic obstruction F
Question number 36
(B98549E)
Bank of Question ID: 3859
Question Mark: 1

With which of the following is the physical sign shown associated ?

• Rheumatic fever F
 • Motor neurone disease T
• Leprosy F
• Liver cirrhosis F

Question number 37
(B9884D7)
Bank of Question ID: 3863
Question Mark: 1

A 30 years old man presented with fever and cough for 3 days. This chest X-
ray is shown. What is the diagnosis?
• Rt. Sided lobar pneumonia. T
• Rt. Sided pleural effusion. F
• Congestive heart failure. F
• Bronchopneumonia. F

Question number 38
(B98B510)
Bank of Question ID: 3865
Question Mark: 1
 What is the most likely diagnosis ?
• Cellulitis F
• Cavernous sinus thrombosis F
• Ophthalmic zoster T

Question number 39
(B98E549)
Bank of Question ID: 3869
Question Mark: 1

This patient presented to the emergency department with this condition. Her
symptoms had been worsening over the past few hours. About 4 months
ago, she had had a similar episode, and the symptoms resolved
 spontaneously. What is the most likely diagnosis?
• Nephrotic syndrome F
• Angineurotic oedema T
• Heart failure F
• glomerulonephritis F
Question number 40
(B991582)
Bank of Question ID: 3876
Question Mark: 1

This patient developed gradually enlarging painless swelling in her right neck
for the previous four months. One month before, she had begun to note
similar symptoms on the left side. She denied fevers, chills, night sweats,
anorexia, weight loss, malaise, or cough. What is the appropriate next step?
• fine needle aspiration T
• chest x-ray F
• sputum for AAFB F
• bone marrow aspiration F