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اسئله باطني مدققه 740823
اسئله باطني مدققه 740823
اﺳﺌﻠﺔ وزارة اﻟﺼﺤﺔ ﻟﻼﻟﺘﺤﺎق وﺗﻌﻠﻤـﺖ ،ﻓـﺮده ﻟـﻲ ﻋﻨـﺪ ﺣﺎﺟﺘـﻲ اﻟﻴﻪ ,
) ( 2018 -2013
اﺧﻮﻛﻢ اﻟﺪﻛﺘﻮر :اﺳﺎﻣـﻪ اﻟﺨﺰاﻋﻠـﻪ
ﻗﻤﺖ ﺑﺎﻋﺎدة ﺟﻤﻊ وﺗﻨﺴﻴﻖ ﺑﻔﻀﻞ ا
0799430239
اﺳﺌﻠﺔ اﻟﺪورات اﻟﺴﺎﺑﻘﺔ ,اﻟﺼﺎدرة ﻣﻦ ﻃـــﺐ ﻋـــﺎم وﺟﺮاﺣــﻪ
وزارة اﻟﺼﺤﺔ ﻻﻣﺘﺤﺎﻧـــﺎت اﻻﻗﺎﻣـــﺔ
MEDICINE
eye with headache , investigation show high CRP
and high ESR . What is the diagnosis ?
A . Temporal arteritis .
B . SAH .
C . Migraine .
D . Herpes ophthalmicus .
E . Tension headache .
*****
chronic renal failure by which of the following ?
A . An increased Na excretion .
B . Left ventricular hypertrophy on ECG .
C . Hypophosphatemia .
D . Renal size on ultrasound scan .
E . Hyperkalemia .
* A patient of chronic diarrhea is having angular * In a patient with microscopic Hematuria , which
stomatitis and glossitis . The most likely cause of the following favours a glomerular source ?
of these signs is deficiency of ? A . Red cell casts and proteinuria .
A . Folic acid B . Blood at the beginning of the urinary stream .
B . Iron C . Blood at the end of the urinary stream .
C . Proteins D . Suprapupic pain .
D . Pyridoxine E . Abnormal urine cytology .
E . Thiamine
* An important physical sign of portal
hypertension in a patient of cirrhosis of liver is ?
A . Gynecomastia
B . Hepatomegaly
C . Palmer Erythema
* A 40 years old woman gives history of fever for D . Spider angioma
last three weeks accompanied by dry cough , E . Splenomegaly
night sweats and weight loss . Abdominal * An old patient presented in emergency ward
examination reveals hepatosplenomegaly , CXR with history of weakness of right side of body of
shows symmetrically distributed line nodules . rapid onest . The most helpful first line
The most likely diagnosis is ? management of this patient is ?
A . Pneumonia A . Cerebral angiography
B . Malaria B . Cerebrospinal fluid examination
C . Typhoid C . Computerised tomography scan brain
D . Chronic liver disease D . Fasting lipid profile
E . Miliary tuberculosis E . Nerve conduction study
* A 40 years old diabetic man presents with * A 50 years old man presents with Dysphagia .
history of sudden onest of pain in right loin which Which of the following characteristics suggests a
radiates towards the iliac fossa associated with benign strictures of esophagus ?
vomiting .On examination tenderness is present A . Anemia
in right loin . The most likely diagnosis is ? B . Weight loss
A . Appendicitis C . Cervical lymphadenopathy
B . Cholycystitis D . Hoarseness of voice
C . Diverticulitis E . Dysphagia worse for solids
D . Perforated peptic ulcer
E . Pyelonephritis * Which of the following is a cause of central
cyanosis ?
A . Exposure to cold
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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B . Heart failure C . Coal mining
C . Raynauds phenomenon D . Low socioeconomic status
D . Right to left cardiac shunts E . Tobacco smoke
E . Shock
* Which one of the following statements about
* A young girl complains of nocturnal cough and paracetamol poisoning is not true ?
shortness of breath which disturbs her sleep . It A . 15 tablets may be a fatal overdose .
was diagnosed as bronchial asthma . B . Oral methionine may be useful in treatment .
Investigation to confirm this diagnosis is ? C . Paracetamol levels should be checked at 4
A . CXR hours post ingestion .
B . Eosinophil count D . If liver function tests are normal at 4 hours
C . Lung function test post ingestion , the liver has not been damaged .
D . Serum IgG level E . Activated charcoal should be given with
E . Sputum examination laxatives .
* Which of the following does not form part of * A 35 years old man presents in a clinic with
the initial approach to investigating a fever of history of chronic productive cough that is worse
unknown origin ? in the morning and that occurs because
A . Early CT scan of abdomen and chest changing the position of patient . Sputum is
B . Serial blood cultures off antibiotics copious and yellow . The most likely diagnosis in
C . Careful history and examination this patient is ?
D . Autoantibody screen A . Bronchial asthma
E . Trial of antibiotics B . Bronchiectasis
C . Bronchogenic carcinoma
* An epileptic girl is found to have gum D . Pulmonary tuberculosis
hypertrophy . Anti epileptic drug which she is E . Chronic bronchitis
most likely taking is ?
A . Carbamazepine * A 50 year old man presents in emergency ward
B . Gabapentin with central chest pain . On examination his
C . Lamotrigine blood pressure 90/60 and pulse 106 , and he is
D . Phenytoin pale and sweating profusely . The most likely
E . Sodium valproate diagnosis is ?
A . Pericarditis
B . MI
C . Esophagitis
D . Pleural effusion
* A patient presents with tachycardia , wild E . Pneumothorax
swings in blood pressure , headache , * The following are complication of Nephrotic
diaphoresis , altered mental status , and a sense syndrome with the exception of ?
of panic The most likely diagnosis is ? A . Acute renal failure .
A . Hyperthyroidism . B . Accelerated HTN .
B . Generalized panic disorder . C . Venous thrombosis .
C . Angina pectoris . D . Hypocalcemia .
D . Panic attack . E . Pneumococcal infection .
E . Pheochromocytoma .
* Which of the following is a recognized feature
* A 16 year old Girl presents with chronic of massive pulmonary embolism ?
diarrhea , which of the following features suggest A . Reduced plasma lactate levels .
that she has irritable bowel syndrome ? B . Increase in serum troponin levels .
A . Abdominal pain relieved by defecation . C . An arterial PH less than 7.2 .
B . Anemia . D . Blood gases show increased PCO2 on air .
C . Weight loss . E . Normal D _ dimer levels .
D . Nocturnal symptoms .
E . Blood in stools . * A patient with embolic stroke is taking
warfarin . The most useful laboratory test to
* The most common risk factor for COPD is ? monitoring effect of warfarin ?
A . Air pollution A . PT
B . Infection B . PTT
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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C . Bleeding time depression , and T waves inversion on the ECG ,
D . Hematocrit there is no chest pain . In mean time what should
E . Platelet count you do ?
A . Stop Benzaepril and digoxin .
* A 68 year old patient with COPD was admitted B . Stop verapamil and lasix .
with a febrile exacerbation of his symptoms . C . Stop Nebivolol and lasix .
Laboratory showed arterial PH 7.21 , PCO2 60 D . Stop lasix and digoxin .
mmhg , HCO3 24 meq/L . Which is the underlying E . Stop verapamil and aspirin .
acid base disorder ?
A . Respiratory acidosis . * A 52 year old man comes to the emergency
B . Respiratory acidosis with metabolic department because he has had vomiting,
Alkalosis . nausea, and abdominal pain for the past 12
C . Respiratory acidosis with metabolic acidosis . hours . He says he attempted suicide . 3 days
D . Metabolic acidosis with respiratory alkalosis . ago by taking everything in the medicine cabinet .
E . Metabolic acidosis He was stuporous for approximately 12 hours
after the overdose . But felt better the following
* 35 years old man is admitted to the hospital day . At this time , he has jaundice and pain in the
and is undergo brain surgery . The patient is very RUQ . Which of the following drugs is most likely
anxious and worried of the upcoming surgery . to have caused the pain , vomiting and jaundice ?
He begins to hyperventilate and becomes dizzy A . Acetaminophen
and unconscious , the ABG reveal PH 7.61 , PCO2 B . Aspirin
22 mmhg , HCO3 24 meq/L . Most likely acid C . Cimetidine
base disorder is ? D . Diphenhydramine
A . Metabolic acidosis uncompensated . E . Triazolam
B . Respiratory Alkalosis compensated .
C . Respiratory Alkalosis uncompensated . * A patient present with weakness , nausea ,
D . Metabolic Alkalosis compensated . vomiting , weight loss and new skin pigmentation
E . Metabolic Alkalosis uncompensated Labs show Hyponatremia and Hyperkalemia ,
most likely diagnosis is ?
* Most common cause of Wallenberg syndrome A . Tinea versicolor
is occlusion of ? B . SIADH
A . Basilar artery . C . Addison disease
B . Anterior cerebral artery . D . Leprosy
C . Middle cerebral artery . E . Phenylketonuria
D . Posterior inferior cerebral artery .
E . Posterior cerebral artery
* An 70 year old man presents with palpitations . * In patient with microscopic Hematuria , which
He has history of MI in 1995 and was placed on of the following favours a glomerular source ?
nitroglycerin , Benzaepril , aspirin and verapamil . A . Red cell cast and protein in urine
In 2000 he was placed on digoxin after a B . Blood at the beginning of voiding
diagnosis of heart failure was made . Three C . Blood at the end of voiding
months ago he was placed on Nebivolol and lasix D . Suprapubic pain
( Furosemide ) . He presents with evidence of E . WBC in urine
premature ventricular contractions , ST
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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* A 25 year old man present to a rheumatologist
with complaints of joint pain involving the large * What is the m.common cause of bacterial UTI ?
joints of the legs . On questioning the patient A . Staphylococcus
indicates that exacerbations in the joint pain are B . Neisseria
frequently accompanied by diarrhea . Which of C . E coli
the following most likely diagnosis ? D . Streptococcus
A . Amebic colitis E . Pseudomonas
B . Chronic appendicitis
C . Diverticulosis * Which of the following is an appropriate initial
D . Pseudomembranous colitis treatment for pulmonary tuberculosis ?
E . Ulcerative colitis A . INH
B . INH and rifampin
* A 38 year old man has pulmonary tuberculosis , C . INH , rifampin and ethambutol
treatment with isoniazid , rifampin , ethambutol D . INH, rifampin , ethambutol and pyrazinamide
and pyrazinamide is started, which of the E . INH , rifampin , ethambutol and streptomycin
following should be added to the medication
regimen to prevent neurologic toxicity in this * The treatment of choice for recurrent transient
patient ? ischemic attack in patient on aspirin with new
A . Vitamin B9 onest atrial fibrillation is ?
B . Vitamin B3 A . Anticoagulation
C . Vitamin B12 B . Carotid endarterectomy
D . Vitamin B6 C . Clopidogrel
E . Vitamin C D . Corticosteroids
E . Carotid stent
* Major criteria of rheumatic fever are all except ?
A . Carditis * Chronic renal dialysis patient is brought to the
B .subcutaneous nodules emergency department incardiac arrest , the
C . Arthralgia most likely cause is ?
D . Erythema marginatum A . Pericardial effusion
E . Sydenham Chorea B . Hyperkalemia
C . Hypocalcemia
D . Malignant HTN
E . Post dialysis hypotension
* A 30 year old female is started on Carbimazole * All of the following are contraindications to
20 mg following a diagnosis of Graves disease . passing a nasogastric tube except ?
What is the best biochemical marker to assess A . Hx of esophageal varices
her response to treatment ? B . Basal skull fracture
A . Total T4 C . Suspected perforation of the esophagus
B . TSH D . Complete intestinal obstruction
C . Free T4 E . Presence of esophageal foreign body
D . ESR
E . Free T3 * All of the following are side effects of steroid
except ?
* A 75 years old woman has increasing shortness A . Elevated blood pressure
of breath on exertion . Findings on physical B . Acne
examination are unremarkable . X_Ray of the C . Skin bruises
chest show no abnormalities of the hear or lungs D . Hypoglycemia
Labs show HCT 28% , Hb 9 g/dl , MCV 70 . E . Cataract
Which of the following is most likely diagnosis ?
A . Acquired Hemolytic anemia * All of the following can cause acute renal
B . Chronic blood loss failure except ?
C . Folic acid deficiency A . Rhabdomyolysis
D . B _ thalassemia minor B . NSAIDs
E . Pernicious anemia C . Ethylene glycol
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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D . Penicillin B . Push fast more than 100 and less than 120
E . Iron compressions per minute .
C . Minimize interruptions in compressions and
* Which of the following is the most common give shock as soon as possible .
cause of Duodenal ulcer ? D . Compressions to ventilation ratio 30 : 2 .
A . NSAIDs E . Target of CPR quality are ETco2 > 10 mmhg
B . H pylori and diastolic BP > 20 mmhg .
C . Alcohol abuse
D . Chronic corticosteroids * All of the following are common causes of
E . Zollinger Ellison syndrome chest pain except ?
A . Angina
* All of the following forms of vaccine except ? B . Pericarditis
A . Killed vaccine C . PE
B . Attenuated vaccine D . Tension pneumothorax
C . Toxoid E . Esophageal reflux
D . Serum
E . Subunit * All of the following are true matching about
drugs and side effects except ?
* A 19 year old female presents with sudden A . Sulfa drugs _ Steven Johnson syndrome .
sever right sided chest pain that develops shortly B . Aminoglycosides _ nephrotoxicity .
after she had been placing heavy boxes on C . Acetaminophen _ GI upset and bleeding .
shelves in her garage physical examination D . Opiates _ constipation .
reveals an a febrile female in mild respiratory E . Atenolol _ Bradycardia.
distress . Breath sounds are markedly decreased
on the right , and the right lung is hyperresonant * All of the following are causes of DM except ?
to percussion . Which of the following is most A . Thyroid hormone
likely present in this individual ? B . Thiazides
A . Pneumoconiosis C . Pancreatic cancer
B . Pneumocystis infection D . Addison disease
C . Bacterial pneumonia E . Hemochromatosis
D . Viral pneumonia
E . Pneumothorax * All of the following are differential diagnosis of
ST segment elevation except ?
A . Acute Pericarditis
B . Early repolarization
C . Hyperthermia
D . Prinzmetal angina
E . Left ventricular aneurysm
* Tertiary prevention consist of ?
A . Crisis preparation * All of the following are rapid or short acting
B . Elimination of specific disease prandial bolus insulin except ?
C . Early diagnosis A . Insulin glargine
D . Rehabilitation after disability B . Insulin regular
E . Environmental sanitation C . Insulin lispro
D . Insulin glulisine
* Which of the following statement about E . Insulin aspart
Polyvalent anti_snake venom serum is true ?
A . It is to be given subcutaneously * Adverse consequences of obesity include all of
B . It is an example of passive immunization the following except ?
C . It is usually obtained from human's donor's A . Coronary artery disease
D . Should be stored at 0 Sep Celsius B . Hypertension pulmonary
E . It gives life long immunity C . DM type one
D . Osteoarthritis
* All are true about CPR quality in advanced E . Colorectal cancer
cardiac life support except ?
A . Push hard less than 2 inches and allow * NT_PRO BNP elevation is caused by all of the
complete chest recoil . following except ?
A . MI
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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B . CHF * All of the following are matching about
C . Atrial fibrillation hepatitis B serology except ?
D . PE A . Acute infection _ HBsAg , HBeAg , anti HBc
E . COPD exacerbation IgG are positive .
B . Chronic inactive infection _ HBsAg , HBeAg ,
* All are true about Hyperosmolar hyperglycemic anti HBc IgG are positive .
state except ? C . Chronic active infection _ HBsAg , anti HBe ,
A . Partial or relative insulin deficiency . anti HBc IgG are positive .
B . Characterized by hyperglycemia , D . Resolved infection _ anti HBs , anti HBe , anti
hyperosmolarity , dehydration and ketosis . HBc IgG are positive .
C . Occurs in DM type two . E . Immunized person _anti HBs positive .
D . Lower insulin requirement compared to DKA .
E . Overall mortality higher compared to DKA . * Auer rod white blood cell on blood film is
characteristic for ?
* All are causes of Acute bloody diarrhea except A . AML
A . Shigella B . CML
B . Campylobacter C . ALL
C . Bacillus cereus D . CLL
D . Yersinia E . Hodgkin lymphoma
E . Entamoeba histolytica
* Mode of transmission for all of the following by
* All of the following are indications for Enalapril food_water borne except ?
administration except ? A . MRSA
A . HTN B . Cholera
B . MI C . Salmonella
C . CHF D . HAV
D . DM E . HEV
E . Aortic stenosis
* Red currant jelly sputum is characteristic for ?
* All are risk factors for Barrett esophagus except A . Streptococcal pneumonia
A . Old age B . Staphylococcal pneumonia
B . Female C . Klebsiella pneumonia
C . Smokers D . Mycoplasma pneumonia
D . Obesity E . Legionella pneumonia
E . Hiatus hernia
* All of the following are causes of
Reticulocytosis except ?
A . SCA
B . Chronic blood loss
C . HUS
* All are true about Crohn disease except ? D . DIC
A . Usually affect terminal ileum . E . Malaria
B . Fever is very common . * All of the following are causes of cavitating
C . Palpable mass is rare compared to ulcerative lung nodule on CXR except ?
colitis . A . Wegener disease
D . Diarrhea less prevalent than ulcerative colitis B . Allergic alveolitis
E . Cobblestone mucosal appearance . C . Sarcoidosis
D . Tuberculosis
* All of the following are true about irritable E . Metastasis
bowel syndrome except ?
A . Onest of symptoms usually in young adults . * All of the following are true matching about the
B . Signs and symptoms relived with defecation , interpretation of urinary casts except ?
increased by stress . A . Fatty casts _ nephritic syndrome .
C . Bloody diarrhea . B . Pigmented epithelial granular cast _ ATN .
D . Inflammatory markers are negative . C . White blood cell casts _ interstitial nephritis .
E . 80% improve over time . D . Red blood cell casts _ glomerulonephritis .
E . Hyaline casts _ physiological during exercise
or fever
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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A . Protect health and lifestyle
* All of the following are true matching about B . Prevention of disease Onest
RBC inclusions except ? C . Early detection of disease
A . Erythroblasts _ Hemolytic anemia . D . Treat and rehabilitate of disease to prevent
B . Heinz bodies _ IDA progression , and disability .
C . Howell jolly bodies _ post splenectomy E . Stop of smoking .
D . Basophilic stippling _ lead poisoning .
E . Sideroblasts _ hypothyroidism * All of the following are causes of
Hyperglycemia except ?
* Westermark sign , Hamptons hump , enlarged A .DM
right ventricle and right atrium and atelectasis on B .Pheochromocytoma
CXR is characteristic for ? C .Thyrotoxicosis
A . Pulmonary edema D . DI
B . Pulmonary embolism E . Glucagonoma
C . Sarcoidosis
D . COPD * All of the following are causes of hypoglycemia
E . Pulmonary fibrosis except ?
A .Glucagonoma
* All of the following are causes of Hyponatremia B .Postprandial
except ? C .Addison disease
A . Nephrotic syndrome D . Glibenclamide
B . Hyperthyroidism E. Liver cirrhosis
C . SIADH
D . Furosemide * All of the following are causes of Hyponatremia
E . CHF except ?
A . SIADH
* Signs and symptoms of third cranial nerve B . Furosemide
palsy include all of the C . DKA
following except ? D . DI
A . Absent of light reflexes E . Addison disease
B . Ptosis
C . Eye deviated downward * About SIADH , all are true except ?
D . Eye deviated outward A . Euvolemic state
E . Mydriasis B . High urine specific gravity
C . High urine sodium
* Paresthesia , sensory ataxia , myopathy , D . Hypernatremia
subacute combined degeneration of spinal cord , E . Low serum osmolality
optic neuropathy are characteristic of ?
A . Vitamin B12 deficiency * Most c. cause of hypothyroidism worldwide ?
B . Vitamin B6 deficiency A . Hashimoto thyroiditis
C . Vitamin B1 deficiency B . Gravis disease
D . Folate deficiency C . Iodine deficiency
E . Niacin deficiency D . Subacute thyroiditis
* All are causes of Hypokalemia except ? E . Post_thyroidectomy
A . Bartter syndrome * The best laboratory test for follow up patient
B . Angelman syndrome with Hashimoto thyroiditis is ?
C . Hypomagnesemia A . T3
D . Conn syndrome B . T4
E . Cushing syndrome C . TSH
D . TRH
* One is true about Petit mal seizures ? E . ESR
A . Muscle rigidity
B . Tongue biting * All are true about hyperthyroidism except ?
C . Arrest of activity for 5 _ 10 seconds . A .Increased appetite
D . Flaccid limbs B . Heart rate 50 BPM
E . Loss of muscle tone C . Hypomenorrhea
D . TSH is very low
* The goal of tertiary level of prevention is ? E . Atrial fibrillation on ECG
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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E . Addison disease
* All are causes of hypercalcemia except ?
A .Thyrotoxicosis * All of the following are causes of Hyperkalemia
B .Multiple myeloma except ?
C . Lung cancer A . Nelson syndrome
D . Furosemide B . Rhabdomyolsis
E . Hyperparathyroidism C . Digoxin toxicity
D . Enalapril
* 55 years old male patient with with back pain , E . Conn syndrome
spine X_Ray shows fracture in body of lumbar
vertebrae . Lab findings : K 4.1 , Na 140 , Cl 101 , * One of the following statements is wrong ?
Ca 13 , Hb 8.5 , WBC 12.3 , platelets 150*10`9 , A . Patient with Pheochromocytoma must be
total protein 105 g/dl . Which of the following is treated by B_Blockers
the most likely diagnosis ? B . Pheochromocytoma is one of the causes of
A .Sarcoidosis resistant HTN .
B . Osteosarcoma C . Most common cause of secondary HTN is
C . Multiple myeloma renal disease .
D . Age related changes D . Conn syndrome is primary
E . Paget disease of the bone hyperaldosteronism .
E . Most common cause of Thyrotoxicosis is
* The main pathophysiology of Myasthenia Graves disease .
gravis is ?
A . Anti calcium channel bodies * Amlodipine is ?
B . Low level of acetylcholine A . Aldosterone antagonist .
C . Hyposensitivity to acetylcholine B . B blockers .
D . Acetylcholine receptor antibodies C . Muscle relaxants .
E . Neuromuscular degeneration changes D .Dihydropyridine CCB
E . Non Dihydropyridine CCB .
* All are causes of Polyuria except ?
A . DM * 50 years old male patient is presented with
B . DI fasting blood sugar 139 mg/dl , which of the
C . Renal failure following is most appropriate next step ?
D . Hypercalcemia A . GAD study .
E . SIADH B . Postprandial glucose tolerance test .
C . Start treatment right now as DM .
* All are true about resistant HTN except ? D . Another reading of fasting blood sugar
A . It is diuretics related condition E . Diet therapy .
B . Pheochromocytoma is underlying cause .
C . To put this diagnosis , patient must be on 3 * All are true about DKA except ?
drugs , one of them Thiazide . A . PH of the serum < 7.35
D . To put this diagnosis , patient must be take B . Hyponatremia
the optimal dose for HTN drugs . C . Ketones bodies in serum
E . Diet problems is underlying cause . D . Normal anion gap
E . Complicated by brain edema
* All are causes of Thrombocytosis except ? * The major deference between primary and
A . IDA secondary adrenal insufficiency is ?
B . Polycythemia rubra vera A . Na and k in serum
C . Hypersplenism B . Blood pressure
D . After Splenectomy C . Weight status
E . Collagen disorders D . Glucose in serum
E . Skin pigmentation
* All of the following are causes of Hypokalemia
except ? * Criteria of disease activity for rheumatoid
A . Cushing syndrome arthritis include all of the following except ?
B . Conn syndrome A . Rheumatoid factor
C .Thiazide B . ESR
D .Pyloric stenosis C . CRP
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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D . Thrombocytosis C . Varicose veins of esophagus
E . Anti_CCP D . Esophagitis
E . Gastric angiodysplasia
* All of the following about TB are true except ?
A . This disease is preventable and treatable . * Best tool for diagnosis of infective endocarditis
B . This disease is systemic A . ECG
C . This disease mainly affect the Lower lobes of B . CT angiography
the lung C . Mediastinoscopy
D . BCG vaccine is live attenuated vaccine for TB D . MRI
E . Most patients TB infections are due to E . Two dimensional echo
secondary infection
* All are causes of chronic liver disease except ?
* Obesity associated with all of the following A . Hepatitis B
except ? B . Hemochromatosis
A . Psychological disorders C . Alpha one antitrypsin deficiency
B . GIT disturbances D . Hepatitis A
C . Colorectal cancer E . Cystic fibrosis
D . Osteoporosis
E . Osteoarthritis * All are complications of cystic fibrosis except ?
A . Pancreatic insufficiency
* All are causes of Leucocytosis except ? B . Hypoglycemia
A . Dermatomyositis C . Recurrent lung disease
B . Polymyositis D . Recurrent sinusitis
C . Fibromyalgia E . Anal prolapse
D . Septic arthritis
E . Polyarteritis nodosa * All are causes of Bradycardia except ?
A . Metoprolol
* All are causes of microcytosis except ? B . Digoxin
A . Pernicious anemia C . Thyroxine
B . Sideroblastic anemia D . Athletic person
C . B thalassemia E . Neostagmine
D . Lead toxicity
E . Anemia of chronic disease * Risk of transmission of HIV to medical person's
from needle stick is ?
* 22 years old patient with celiac disease , A . 0.3%
admitted with chief complain of diarrhea for 2 B . 0.03%
weeks , the most likely cause is ? C . 3%
A . GIT infection D . 30%
B . IBS E . 10%
C . IBD
D . Carcinoid syndrome * About HIV , all are true except ?
E . No adherent to gluten free diet A . AIDS is the last stage of HIV infection .
B. HIV infection is not preventable by vaccination
C . Heterosexual type of transmission is the most
common
* 25 years old male patient present with multiple D . It is transmitted by blood transfusion .
psychological problems , which of the following * Paracetamol antidote is ?
disturbances is the most likely to see in this A . Protamine sulfate
patient ? B . N_acetylcysteine
A . Bloody diarrhea C . Flumazenil
B . GIT ulcers D . Bicarbonate
C . Occult blood in stool E . Vitamin K
D . Alternating diarrhea and constipation
E . IDA * About pulmonary embolism , all are true except
A . Past history of DVT support the diagnosis .
* Most common cause of upper GI bleeding is ? B . Heparin is used for treatment
A . Mallory Weiss syndrome C . Chest X_Ray usually normal without
B . PUD significant changes
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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D . It is a block in one or more of the pulmonary C . Edema
veins D . Hypercholesterolemia
E . Classical ECG finding is S1Q3T3 E . Hypoalbuminemia
* Most important risk factors for stroke * The most important finding in
development is ? Glomerulonephritis is ?
A .High blood pressure A . WBCs casts in urine
B . Low blood pressure B . Hyaline casts in urine
C . Aneurysm rupture C . RBCs casts in urine
D . Trauma D . Proteinuria
E . Vasculitis E . Bacteriuria
* All are causes of increased CVP except ? * Best drug that is used for prophylaxis and
A . Fluid overload treatment of diabetic nephropathy is ?
B . Right sided heart failure A . ARBs
C . Pulmonary HTN B . B blockers
D . Anaphylactic shock C . CCB
E . Pulmonary stenosis D . Furosemide
E . Nitrofurantoin
* All are used in treatment of Anaphylactic shock
except ? * Best way of the following to prevent diabetic
A . Adrenaline retinopathy is ?
B . IV fluid A . Optimal dose of insulin
C . 100 % oxygen B . Optimal dose of metformin
D . Hydrocortisone C . Annual visit to physician
E . Propranolol D . ACE_i administration
E . Good control of sugar
* The major deference between vitamin B12 and
folate deficiency anemia is ? * The most early and best laboratory finding for
A . MCV value diagnosis of diabetic nephropathy is ?
B . HCT value A . Urine analysis positive for Bacteria
C . Blood film findings B . Kidney biopsy
D . Foot Paresthesia C . RBCs casts in urine
E . MCHC value D . 24 hour protein /creatinine ratio in the urine
E . Kidney ultrasound
* All are true about Mycoplasma pneumonia
except ? * All of the following are causes of increasing
A . Patient is looking well . Triglycerides in serum except ?
B . Associated with Hemolytic anemia . A . Nephrotic syndrome
C . Common in younger age group . B . Ibuprofen
D . Good response for Macrolides antibiotics . C . DM
E . Associated with septic shock D . Alcohol
E . Lipoprotein lipase deficiency
* Highly severe pneumonia depends on all of the * All of the following represents targets for
following criteria except ? systemic HTN except ?
A . BUN > 7 mmol/l A . Retinopathy
B . Confusion B . Nephropathy
C . Age 20_30 years old C . Heart failure
D . R.R > 30/min D . Subdural hemorrhage
E . Systolic blood pressure < 90 mmHg E . Peripheral vascular disease
* All of the following are true about Nephrotic * All of the following are causes of exudative
syndrome except ? pleural effusion except ?
A . HTN A . PE
B . Proteinuria > 3.5 gram/day B . Hypoalbuminemia
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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C . Lymphoma B . Myelofibrosis
D . Mesothelioma C . Malaria
E . SLE D . Leishmaniasis
E . Tropical Splenomegaly
* All of the following are true about COPD ,
except ? * All of the following are risk factors for hepatic
A . FEV1< 80% of predicted encephalopathy except ?
B . Complicated by right heart failure A . GIT bleeding
C . High F:O2 is needed B . Benzodiazepine
D . Stop of smoking is beneficial in stop C . Rifampicine
progression of the disease D . Diuretics
E . In ABG PaO2 is low , PaCO2 is high . E . Neomycin
* All of the following are increases risk of DVT * All are true about acute renal failure except ?
except ? A . Pre_renal causes are the m. common causes
A . Malignancy B . ATN is the most common renal cause
B . Estrogen therapy C . It is rarely caused by enlarged prostate
C . Old age D . Small kidneys and increased echogenicity on
D . Protein C excess ultrasound
E . Protein S deficiency E . Usually no history of Co_morbidity
* In Hyperventilation syndrome , one is true ? * Long term steroid therapy can cause all of the
A . Increasing PH of the serum following except ?
B . Caused by severe attack of bronchial asthma A . Hypernatremia
C . Characterized by hypercapnia B . Hyperkalemia
D . Caused by poliomyelitis C . GIT ulcers
E . No relation to acute respiratory distress D . Suprarenal gland failure
syndrome E . Osteoporosis
* 65 years old male patient , present to * About DKA , all are true except ?
emergency room with chief complain of right A . Hyponatremia
sided weakness and speech inability , one B . Leucocytosis
physical examination, right side weakness 1/5 , C . Serum PH decreased
speech exam , patient obey command but can't D . PaCO2 decreased
speak any words , this type of dysphasias is E . Normal anion gap
most likely ?
A . Receptive aphasia * In severe bronchial asthma , all of the following
B . Conduction aphasia are true except ?
C . Expressive aphasia A . Cyanosis
D . Nominal aphasia B . Confusion
E . Dysarthria C . Hyperresonant chest
D . Exhaustion
All are components of Horner syndrome except ? E . Bradycardia
A . Proptosis
B . Myosis
C . Anhidrosis
D . Enophthalmos
* All of the following are decrease potassium in
Hyperkalemic patient except ? * The target HbA1c in diabetic patient is ?
A . Insulin and glucose A . < 6%
B . Ventolin nebulizer B . < 7%
C . Furosemide C . < 8%
D . Calcium gluconate D . < 9%
E . Kayexalate resin E . < 5%
* All of the following are causes of huge massive * All are causes of Hypokalemia except ?
Splenomegaly except ? A . Spironolactone
A . Hemolytic anemia B . Furosemide
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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C . Thiazide
D . Conn syndrome * Drug of choice to treat patient with HTN and
E . Cushing syndrome bronchial asthma is ?
ACE_i
* All are true about inflammatory diarrhea except B blockers
A .Stool PH is low with alkalosis . CCB
B .Stool usually watery . Statin
C.Consider IBD, c.Difficile infection .
D .Stool volume less than 500 ml . * All are true about Ankylosing spondylitis except
E .Continue during fasting, associated with A . More common in male .
anemia , urgency . B . Aortitis and AV block are manifestation .
C . Unilateral uveitis with painful red eye ,
* All are true about metformin except ? Photophobia .
Decreased insulin resistance , so it can be given D . Obstructive lung disease is manifestation .
in PCOS . E . Associated with HLA_B27 gen .
It teratogenic , so it can't be given in gestational
diabetes . * All of the following are characteristic of IDA
Most serious side effects is lactic acidosis , so it except ?
can't be given in renal failure . Anisocytosis
It inhibits gluconeogenesis in the liver . Spherocytosis
No effect on pancreas . Poikilocytosis
Hypochromia
* Which of the following causes of Potts disease Microcytosis
Primary TB
Skeletal TB * Most common cause of travelers diarrhea is ?
TB meningitis E coli
Miliary TB Cholera
GIT TB Shigella
Brucella
* Patient presents with COPD , Hepatomegaly, Staphylococcus aureus
peripheral edema , finger clubbing . ECG : peaked
P wave , most likely diagnosis ? * One of the following seen in esophageal
PE perforation ?
Cor pulmonale Courvoisier sign
LVF Grey sign
LAH Cullen sign
Sleep apnea Boerhaave syndrome
Achalasia
* All of the following are true about Sarcoidosis
except ? * All are signs and symptoms of hypothyroidism
More in black race . except ?
May cause complete heart block . Carpal tunnel syndrome
Involve mostly left hilar lymph nodes . Hyponatremia
Lupus pernio and Erythema nodosum are seen . Pericardial effusion
Hepatosplenomegaly is common . Hypolipidemia
Normochromic Normocytic anemia
* Most common cause of infective endocarditis ? * Most common valve disease causing
Streptococcus group A pulmonary HTN ?
Streptococcus group B Mitral stenosis
Streptococcus viridans Mitral regurgitation
Staphylococcus viridans Aortic stenosis
Staphylococcus group A Aortic regurgitation
Mitral valve prolapse
* The treatment of choice for infantile spasms * Which of the following disease are associated
( west syndrome ) ( Hypsarrhythmia on ECG ) is ? with both degeneration in
Carbamezipine upper motor neuron and lower motor neuron ?
Sodium Valproate Parkinson disease
Phenytoin Multiple sclerosis
Corticosteroids Alzheimer's disease
Clonazepam Amyotrophic lateral sclerosis
Duchenne muscular dystrophy
* Best way to differentiate between cerebral
infraction and hemorrhage is ? * ALL of the following are associated with SLE
CT scan except :
X Ray A) Treatment include methotrexate
MRI B ) Cardiovascular disease is the most common
Angiogram cause of death .
MRA C) erosive arthritis
D) Libman sacks endocarditis
* All are true about Parkinson disease except ? E) Malar butterfly rash
A . Degeneration of extrapyramidial pathway .
B . Decreased dopamine level in brain . * All of the following are causes hyperurecemia
C . Triad Akinesia , tremor resting , rigidity . except :
D . Mean age of onest 60 years old . A) Hypothyroidism
E . Pathology is found in substantia gelatinosa . B) Lesh Nyhan syndrome
C) Thiazide diuretic
* Most common cause of meningitis in epidemic D) Hyperthyroidism
area is ? E) INH
Neisseria meningitis
Streptococcus pneumonia * Miosis associated with all of the following
Tuberculosis except :
Hib A) Organophosphates poisoning
Staphylococcus aureus B) Morphine
C) Oculomotor nerve palsy
* Drug of choice for prevention of close contacts D) Horner syndrome
with patient with E) Cluster headache
meningococcal meningitis is ?
Corticosteroids * All of the following are associated with diarrhea
Ceftriaxone except :
Rifampicine A) Hyperparathyroidism
Benzylpenicillin B) Celiac disease
Vancomycin C) Inflammatory bowel disease
D) Gastrinoma
E) Cryptosporidium
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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D) Simvastatin
* All are true about multiple sclerosis except : E) Ramiprile
A) Occur in elderly * Which of the following valvular heart disease
B) Remission and relapse increase risk of angina :
C) Unilateral optic neuritis A) Aortic regurgitation
D) Antibodies to oligodendrocyte glycoprotein B) Mitral regurgitation
E) Lhermitts sign and uhthoffs sign are positive C) Aortic stenosis
D) Mitral stenosis
* Most common cause of early death E) Pulmonary stenosis
postoperative MI :
A) Ventricular extrasystole * All of the following are causes of chest pain
B) Myocardial rupture except :
C) Myocardial aneurysm A) Dissecting aortic aneurysm
D) Ventricular arrhythmia B) PE
E) Cardiac tamponade C) Pericarditis
D) Cardiomyopathy
* First line in management of ventricular E) Tietzes syndrome
fibrillation :
A) Adrenaline * All of the following associated with aortic
B) Atropine stenosis except :
C) Amiodarone A) Sudden death
D) DC shock B) Wide pulse pressure
E) Lidocaine C) Slow rising pulse
D) P mitrale and LAD on ECG
* All of the following feco_oral transmission E) Syncope
except :
A) HEV * All of the following are causes of huge
B) HDV Splenomegaly except :
C) Poliomyelitis A) CML
D) Gardiasis B) Kala_azar
E) Cryptosporidium C) Malaria
D) Sarcoidosis
* All of the following causes Polyuria except : E) Infectious mononucleosis
A) DI
B) Renal failure * All of the following are causes of Extrasystole
C) Insulin deficiency (PVCs) except :
D) SIADH A) Digoxin toxicity
E) Hypercalcemia B) MI
C) Lidocaine
* All are side effects of digitalis toxicity except : D) Heart failure
A) Nausea and vomiting E) HTN
B) Yellow vision
C) Short PR interval * All of the following are associated with
D) Gynecomastia Parkinsonism except :
E) Anorexia A) Bradykinesia
B) Mask like face
* All of the following are indication for liver C) Sensory defect
biopsy except : D) Shuffling gait
A) Hepatic tumor E) Lewy bodies
B) Wilson's disease
C) Prolonged PT * All are seen in DM type 1 except :
D) Fever unknown origin A) HLA DR3 and HLA DR4 association
E) Autoimmune hepatitis B) Obesity
C) Ketoacidosis
* Which of the following is CCB : D) Young age
A) Furosemide E) Autoimmune B cell damage
B) Diltiazem
C) Digoxin
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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* Most common symptom of Bronchogenic
carcinoma :
A) Chest pain * All are causes of chorea except :
B) Cough A) PRV
C) Hemoptysis B) Rheumatic fever
D) Dyspnea C) Carbamezipine
E) Wheeze and cough D) Huntington disease
E) Wilson disease
* Rate of transmission of HBV by contaminated
needles is : * All of the following are causes of hemoptysis
A) 0.3% except :
B) 0.03 % A) Mitral stenosis
C) 0.003 % B) TB
D) 3% C) PE
E) 30% D) Lung cancer
E) Bronchial asthma
* Green house effect of increased temperature by
increase production of : * All of the following are viral disease except :
A) CO2 A) Rabies
B) O2 B) Poliomyelitis
C) CO C) Yellow fever
D) N2o D) Lyme disease
E) NO E) Dengue fever
* All of the following are complications of obesity * All are true about Brucellosis except :
except : A) Neutrophil Leucocytosis
A) Hypothyroidism B) Fever of unknown origin
B) DM type 2 C) Brucella melitensis is the most virulent
C) Polycythemia D) Weight loss
D) Obstructive sleep apnea E) Hepatosplenomegaly
E) Hyperlipidemia
* All are true about Nephritic syndrome except :
* One of the following associated with Addison A) Oliguria
disease : B) Diastolic HTN
A) Hypokalemia C) Lipiduria
B) Hyponatremia D) Uremia
C) Hypoglycemia E) Oedema
D) HTN
E) Weight gain * All are investigation for Thrombophilia except :
A) Anticardio lipin antibodies
* Gold standard for diagnosis of erosive B) Factor 5 leiden mutation
gastritis : C) Protein S level
A) Gastric PH_metry D) Cholesterol level
B) Gastric biopsy E) D_dimer
C) Gastroesophageal endoscopy
D) History * All are causes of ejection sys murmur except :
E) Physical exam A) pregnancy
B) Aortic stenosis
* Most common cause of septic arthritis : C) Pulmonary stenosis
A) Intra_Articular injection D) HOCM
B) Trauma E) Mitral stenosis
C) Staphylococcus aureus
D) Osteoarthritis * The physical sign of chest exam , decreased
E) Cushing syndrome chest expansion , increased percussion note
( Resonant ) , decreased breath sound in left side
of the lung are mostly :
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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A) Left side pleural effusion A) Cefuroxime and metronidazole
B) Left side pneumothorax B) Amoxicillin and gentamycin
C) Left side lung fibrosis C) Vancomycin and ticaracillin
D) Left side consolidation D) Tetracycline and vancomycin
E) Left side collapse E) Gentamycin and metronidazole
* Ptosis , large pupils ,eye down and out are * All are causes of insulin resistance , DM type 2
characteristic for palsy of : except :
A) 2 C.N A) Wilson's disease
B) 3 C.N B) Pregnancy
C) 4 C.N C) Cushing disease
D) 5 C.N D) Metabolic syndrome
E) 6 C.N E) Acromegaly
* Chvostic sign is seen in one of the following : * Short 4th and 5th metacarpals bone is
A) Hypokalemia characteristic for :
B) Hyperkalemia A) Primary Hyperparathyroidism
C) Hypocalcemia B) Secondary Hyperparathyroidism
D) Hypercalcemia C) Tertiary Hyperparathyroidism
E) Hypermagnesemia D) Pseudohypoparathyroidism
E) Pseudopseudo_Hyperparathyroidism
* All are causes of finger clubbing except :
A) Empyema * All are causes of bloody diarrhea except :
B) Mesothelioma A) Cambylobacter
C) Celiac disease B) Shigella
D) Myocarditis C) Crohn disease
E) Graves disease D) E coli
E) IBS
* All are causes of Postural tremor except :
A) Parkinsonism * All are true about ATN except :
B) Hyperthyroidism A) Urine osmolarity > 500 mosm / L
C) Alcoholism B) Urine Na > 40 mmol / L
D) Anxiety C) Urine urea / plasma urea < 3:1
E) Pheochromocytoma D) Urine creatinine / plasma creatinine < 20:1
E) Fractional Na excretion > 2%
* All are true ECG sign for Hyperkalemia except
A) Tall tented T wave * All are causes of normocytic anemia except :
B) Wide QRS A) Chronic blood loss
C) Long QT interval B) Pregnancy
D) Absent P wave C) Hypothyroidism
E) Sine wave D) Alcoholism
E) Aplastic anemia
* All are sign and symptoms of digoxin toxicity
except : * All are true about IDA except :
A) Nausea and vomiting A) Low serum iron
B) Confusion B) Low TIBC
C) Decreased appetite C) Low serum ferritin
D) Hypokalemia D) Low hemosedrine
E) Edema E) High Transferrin
* All are true about complication of MI except : * All are causes of prolonged PT except :
A) Ventricular tachycardia A) DIC
B) Mitral stenosis B) Liver disease
C) VSD C) Warfarin
D) Dressler syndrome D) VWD
E) Heart block E) Factor 10 deficiency
* The best combination antibiotic for treatment * All are true matching about antibiotics and side
of aspiration pneumonia is : effect , except :
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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A) Doxycycline _ photosensitivity
B) Vancomycin _ Red man syndrome
C) Clindamycin _constipation
D) Chloramphenicol _ Aplastic anemia
E) Metronidazole _-Disulfiram reaction
* All are sign and symptoms of autonomic * The first step in management of patient with
neuropathy except : Hyperkalemia with tall tented T
A) Urine retention wave :
B) Nocturnal diarrhea A) Calcium Resonium
C) erectile dysfunction B) Dialysis
D) HTN C) Calcium gluconate
E) Horner syndrome D) Insulin and glucose
E) Nebulized Salbutamol
* All of the following are causes of
polyneuropathy except : * All are cardiovascular complication of
A) Guillain barre syndrome acromegaly except :
B) DM A) HTN
C) Lyme disease B) HOCM
D) Charcot Marie tooth syndrome C) High output heart failure
E) Carpal tunnel syndrome D) Right ventricular hypertrophy
E) Coronary artery disease
* All are true about spondyloarthropathy except
A) Asymmetrical oligo or monoarthritis * All are true about mild acute attack of bronchial
B) HLA B27 association asthma except :
C) Extra articular manifestation A) Audible wheeze
D) Rheumatoid factor positive B) Hyperinflated chest
E) Affect spine and sacroiliac joints C) Hyperresonant percussion
D) Respiratory acidosis
* All of the following are causes of Nodular E) Cough
shadowing on chest X_Ray except :
A) Lung hamartoma * All are causes of type one respiratory failure
B) Hydatid cyst except :
C) Sarcoidosis A) Pneumonia
D) Caplan syndrome B) Pulmonary edema
E) Atelectasis C) Obstructive sleep apnea
D) Fibrosing alveolitis
* All are indication for D/C cardioversion except : E) Emphysema
A) Ventricular tachycardia
B) Ventricular fibrillation * All are causes of diffuse goitre except :
C) Atrial fibrillation A) Graves disease
D) Asystole B) Hashimoto thyroiditis
E) SVT C) Plummer disease
D) De Quervain thyroiditis
* All are true about life threatening attack E) Subacute thyroiditis
bronchial asthma except :
A) FEV1 < 50% of predicted * All of the following are causes of constipation
B) Cyanosis except :
C) Hypotension and bradycardia A) Hyperkalemia
D) Normal or high PaCO2 B) Hypercalcemia
E) PH < 7.30 C) Hypothyroidism
D) Iron supplement
* The first step of management of patient with E) Systemic sclerosis
DKA is :
A) Insulin * All are therapeutic indication for colonoscopy
B) K replacement except :
C) Fluid replacement normal saline A) FAP
D) Fluid replacement ringer lactate B) Hyperplastic polyps
E) Bicarbonate C) Angiodysplasia
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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D) volvulus osmolarity in mosm/L H2o ?
E) Colonic pseudo_obstruction A . 24 , 314 .
B . 23 , 312 .
C . 32 , 321 .
D . 25 , 315 .
* The best screening test for hereditary E . 22 , 311 .
Hemochromatosis : * 50 years old male patient , with medical history
A) Serum iron of DM , free surgical history , social history of
B) Serum ferritin infertility , abdominal ultrasound showed cirrhotic
C) Serum Transferrin liver changes , most likely diagnosis ?
D) Serum Transferrin saturation A . HAV .
E) Serum TIBC B . Budd Chiari syndrome .
MED C . Wilson disease .
D . Hemochromatosis .
* A 34 years old female presents with vomiting E . Alpha one antitrypsin deficiency .
preceded by an headache of acute Onest . On
exam she was conscious , alert with photophobia * Each one of the following may raise ESR
but no neck stiffness . First brain CT scan is except ?
reported as normal . What is the most A . Female sex .
appropriate further management ? B . SLE .
A . CT brain with contrast . C . Polycythemia .
B . Repeat CT brain in 24 hours . D . Myeloma .
C . CSF examination . E . Increasing age .
D . Cerebral angiography .
E . MRI brain . * Where is the most common site for primary
cardiac tumors to occur in
* Most common causing microorganism of adult ?
spontaneous bacterial peritonitis ? A . Left atrium .
A . E coli . B . Left ventricle .
B . Streptococcus pneumonia . C . Left atrial appendage .
C . Listeria . D . Right ventricle .
D . Staphylococcus aureus . E . Right atrium .
E . Pseudomonas aeruginosa .
* All of the following can cause Hyperkalemia
* The best treatment of Wernicke Korsakoff except ?
syndrome is ? A . NSAIDs .
A . Thiamine . B . ACE inhibitors .
B . Folate . C . Spironolactone .
C . Cobaltammine . D . Furosemide diuretics .
D . Pyridoxine . E . Adrenal insufficiency .
E . Iron .
* All of the following are true about Long term
* Regarding secondary HTN , which is true ? oxygen therapy ( LTOT ) in
A . It account for 90% of the case's . COPD except ?
B . Addison disease is one of the causes . A . The goal is to maintaining SPo2 > 90% and
C . It can be easily controlled . PaO2 > 60 mmhg .
D . When associated with Hypokalemia , B . Main delivery devices include nasal cannula
hyperaldosteronism may be the cause . and venturi mask .
E . All patient should be investigated for C . Does not affect life expectancy in COPD
secondary causes at all ages . patient .
D . It is indicated in COPD who have PaO2 < 7.3
* A patient is seen in clinic complaining of kpa .
abdominal pain . Routine blood tests show Na = E . To get the benefits of LTOT , patients should
142 mmol /L , CL = 104 mmol/L , K = 4 mmol/L , breath supplemental oxygen for
HCO3 = 19 mmol/L , Ca = 2 mmol/L , PO4 = 1.5 at least 15 hours per day .
mmol/L , BUN = 28 mg/dl , creatinine = 112
mmol/L , Glucose = 180 mg /dl . What is the * All are risk factors for esophageal cancer
expected anion gap in mmol/L and except ?
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
Page 24
A . GERD . * Streptokinase therapy is recommended in acute
B . Achalasia . pulmonary embolism when ?
C . H pylori . A . Patient complains of shortness of breath .
D . Smoking . B . Patient complains of chest pain .
E . Alcohol . C . Blood pressure is 70/30 .
D . Pulmonary angiogram is positive .
E . Blood tinged sputum .
* All are causes of Pancytopenia except ?
A . Paroxysmal nocturnal hemoglobinuria . * All of the following are signs and symptoms of
B . Systemic lupus erythematosus . Acromegaly except ?
C . Megaloblastic anemia . A . Galactorrhea .
D . Iron deficiency anemia . B . Arthralgia .
E . Lymphoma . C . Excessive sweating .
D . Sleep apnea .
* In curative splenectomy , best time to give E . Hypergonadism .
pneumococcal vaccine ?
A . First week before surgery . * The best combined drugs for management of
B . 4 weeks before surgery . patient with HTN and history of MI is ?
C . Immediately after surgery . A . Thiazide and Amlodipine .
D . 2 weeks after surgery . B . Thiazide and virapamil .
E . At least one month after surgery . C . Atenolol and Ramipril .
D . Valsartan and Ramipril .
* A 25 years old woman complains of shortness E . Thiazide and Ramipril .
of breath after 10 hours of travel by air . RR = 30
BPM , BP = 110/70 , HR = 100 BPM . PE is * Causes of bilateral hilar lymphadenopathy are
suspected . The optimal duration of warfarin all of the following except ?
therapy is ? A . Sarcoidosis .
A . 6 weeks . B . Amyloidosis .
B . 3 months . C . Tuberculosis .
C . 6 months . D . Lymphoma .
D . 1 year . E . Extrinsic allergic alveolitis
E . Life long .
* All of the following are signs and symptoms of
* Woman with family history of cancer is at risk hyperparathyroidism primary type except ?
of all of the following except ? A . Confusion .
A . Endometrial cancer . B . Anorexia .
B . Ovarian cancer . C . Polyuria .
C . Colon cancer . D . Hypotension .
D . Gastric cancer . E . Short QT interval .
E . Breast cancer .
* All of the following are true about
* Numbers of death's with TB in one year over , pneumocystis carinii pneumonia except ?
the number of population in the middle of the A . It is caused by yeast like fungus
year is called ? pneumocystis jiroveci .
A . Mortality rate . B . It is seen in people with cancer ,
B . Crude death rate . chemotherapy , HIV and drug abusers .
C . Specific death rate . C . The risk of pneumocystis carinii pneumonia
D . Specific death ratio . increases when CD4 T_cell level
E . Case mortality rate . are less than 300 cells / ml .
D . X_Ray shows wide spread bilateral
* Site of action of Spironolactone is ? opacification with low grade fever , non
A . Proximal convoluted tubules . productive cough , loss of weight and night
B . Loop of henle ascending part . sweats .
C . Distal convoluted tubules . E . In HIV patient drug of choice is co _
D . Loop of henle descending part . trimoxazole .
E . Juxtaglomerular apparatus .
* All of the following is considered correct in the * All of the following are true about extrinsic
management of variceal bleeding except ? allergic alveolitis except ?
A . Patient should be resuscitated with IV fluid . A . Caused by hypersensitivity to inhaled organic
B . Monitoring of vital signs is a must . dusts .
C . Octreotide agonist should be added if variceal B . Type 2 or type 4 hypersensitivity .
bleeding if suspected . C . Pulmonary function test show restrictive loss
D . There is no need to add antibiotics for the of lung function .
treatment management GI bleeding caused by D . CBC show significant eosinophilia .
esophageal varices . E . Lymphocytic infiltration of alveoli and intra
E . TIPS procedure is an option. alveolar septa on lung biopsy .
* All of the following are true about Mycoplasma * Most common cause of upper GI bleeding is ?
pneumonia except ? A . Esophageal varices .
A . Autoimmune hemolytic anemia IgM . B . Gastric ulcer .
B . Ceftriaxone is the best treatment . C . Duodenal ulcer .
C . Most common primary atypical pneumonia . D . Erosive gastritis .
D . Bilateral lung consolidation with minimal E . Mallory weiss syndrome .
symptom .
E . Walking pneumonia and can cause epidemics * Diabetes mellitus diagnostic criteria include 2
hour glucose tolerance test , fasting glucose ,
* All of the following are true matching except ? and HbA1c respectively ?
A . Loud S2 in cor pulmonale and systemic HTN . A . > 140 mg/dL , > 110 mg/dL , > 6% .
B . Sof S2 in pulmonary stenosis , aortic B . >= 200 mg /dL , > 110 mg/dL , > 6.5% .
stenosis , and aortic regurgitation . C . >=200 mg/dL , > =126 mg/dL , >6% .
C. S3 is normal in youth , athletes , pregnants and D . >=200mg/dL , >=126 mg/dL , >=6.5% .
common pathological causes E . >=180 mg/dL , >=125 mg/dL , >=6.5% .
are LVF and mitral regurgitation .
D . Fixed splitting of S1 is heard with ASD . * ECG sign of hypothermia is ?
E . Loud S4 is sign of pathological state always A . Tachycardia .
like LVF , HTN , aortic stenosis . B . U wave .
C . Long QT interval .
* All are true about immune thrombocytopenic D . Short PR interval .
purpura except ? E . Peaked T wave .
A . Peak age 2 _ 6 years old and in adult 20 _ 40
years old . * All are causes of finger clubbing except ?
B . Minimal bruising and mucocutaneous bleed . A . Mesothelioma .
C . Splenomegaly and lymphadenopathy . B . Crohn disease .
D . Bone marrow aspirate shows increased C . Graves disease .
Megakaryocytes . D . COPD .
E . Non urgent treatment include corticosteroids , E . Idiopathic pulmonary fibrosis .
intravenous immunoglobulins , splenectomy ,
immunomodulators and no role of platelet * Which of the following make you suspect acute
transfusion . rather than chronic failure of kidneys ?
A . Anemia .
* All are causes of warm hemolytic anemia B . History of nephrotoxic drug .
except ? C . Small kidneys size .
A . CLL . D . Renal osteodystrophy .
B . Lung cancer . E . Peripheral neuropathy .
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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* Which of the following contains the highest
* All are causes of prerenal azotemia except ? calories contents ?
A . HTN A . Butter .
B . GI bleeding B . Bread .
C . CHF C . Meat .
D . Sepsis D . Sugar .
E . Liver cirrhosis E . Macaroni .
* 25 years old known case of tuberculosis on * Iron deficiency anemia can cause all of the
treatment , drop of INR from 3 to 1.2 , which of following except ?
the following drugs responsible for this ? A . Koilonychia .
A . Rifampin B . Onycholysis .
B . Isoniazid C . Atrophic glossitis .
C . Ethambutol D . Stomatitis .
D . Pyrazinamide E . Pica .
E . Streptomycin
* Causes of Hyperkalemia all of the following
* 25 years old tall man had suddenly rapid and except ?
shallow breathing . In left CXR found to have 2 A . Cyclosporine .
cm pneumothorax . What is the best next step ? B . Atenolol .
A . Needle aspiration . C . Digoxin .
B . Chest tube . D . Triamterene .
C . Intubation . E . Ethacrynic acid .
D . O2 therapy and observation .
E . Thoracotomy . * All are true about renal tubular acidosis except
A . Type 1 and type 4 affect distal convoluted
* Best time to take simvastatin is ? tubules .
A . At bed time . B . Type 2 affect proximal convoluted tubules .
B . Morning . C . Type 1 and type 2 associated with
C . Before each meal . Hypokalemia , but type 4 associated with
D . In the evening . Hyperkalemia .
E . After each meal. D . Nephrocalcinosis associated with type 1 ,
Fanconi syndrome associated with type 2 , Renal
* Cyclosporine side effects include all of the insufficiency associated with type 4 .
following except ? E . Type 4 RTA associated with
A . Gingival hyperplasia . hyperaldosteronism .
B . Alopecia .
C . Hyperglycemia . * A patient has a potassium level of 7 mmol/L .
D . Jaundice . Which of the following
E . Tremor . intervention is priority ?
A . Administer a laxative .
* All are true about cystic fibrosis except ? B . Administer a loop diuretics Furosemide .
A . Cor pulmonale C . Administer Spironolactone .
B . Rectal prolapse D . Prepare the patient for dialysis and place the
C . Abdominal aortic aneurysm patient on cardiac monitor .
D . Metabolic Alkalosis E . Give patient insulin and glucose .
E . Gallstones
* Incidence rate is defined as ?
* Activated charcoal is used in one of the A . Number of old case's in a population per unit
following poisoning ? of person _ time .
A . Aminophylline . B . Number of new case's in a population per unit
B . Lead . of person _ time .
C . Iron . C . Number of all case's in a population over a
D . Ethylene glycol . defined period of time .
E . Lithium . D . Number of old and new case's in a population
per unit of person _ time .
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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E . Number of new case's in a population per unit 2- It is contraindicated in patient with Guillain
of person over a defined period of one year . Barre syndrome
3- It is composed of three strains of influenza
* All of the following are Quantitative tests virus
hypothesis except ? 4- It is contraindication in immunocoprpmised
A . Why ? patients
B . What ? 5- It is safe in pregnancy
C . How much ?
D . How many ?
E . When ?
* All of the following are criteria for major * Which of the following is ture concerning sickle
depression except ? cell trait:
A . Decreased mood . 1- It is a cause of anemia
B . Decreased pleasure . 2- It protects against malaria
C . Hypersomnia . 3- It occurs mainly in female
D . Hallucinations . 4- It is a cause of frequent sikle cells in the
E . Suicidal ideation . peripheral blood
5- It is associated with hemoglobin H
* A 70 year old woman with a few months history
of leg pain ,gum bleeding and petechiae on the * Male was admitted with pneumonia caused by
arm after the application of a mycoplasma,all of the following are
sphygmomanomerter.which of the following characteristics of this type of pneumonia except:
vitamin defficiencies dose pateint have ? 1- Insidious onset of the disease
1- Vit A 2- Fever of 38 C
2- Vit B 3- Sever leukocytosis
3- Vit C 4- Good response to macrolides
4- Vit B 12 5- Hemolytic anemia
5- Vit E
* All of the following are considered anti-
* Regarding detection of H-pylori infection,the pseudomanal antibiotics except:
least useful test is : 1- Ceftazidime
1- Tissue culture of gastric biopsy 2- Ciprofloxacin
2- Urea breath test 3- Ceftriaxone
3- Histology of gastric biopsy 4- Gentamicin
4- Rapid urease test of gastric biopsy 5- Cefipime
5- Stool antigen test
* The activities of school health are except:
* Which of the following antibiotic has been 1- Screening of school children to detect and
particularly assciated with hemolytic disease are abnormality
reactions in patient with G6PD ? 2- Teaching students about health system
1- Amoxicillin 3- Providing treatment any student falls sick in
2- Clindamycin the school
3- Vancomycin 4- Health education
4- Cloxacillin 5- Immunization
5- Trimethoprim/sulfamthoxazole
* One of the following is not a systemic
* Which of the following antibiotics is absolutely complication of ulcerative colitis:
contraindication in pregnant 1- Erythema nodosum
wowen: 2- Pyoderma gangrenosum
1- Imipenem 3- Arthritis
2- Azithromycin 4- Malabsorption
3- Ceftriaxone 5- Sclerosing cholangitis
4- Cloxacillin
5- Tetracycillin * Inflammatoy diarrhea is characterized :
1- Absence of leucocytes in the stool
* All the following are true about influenza 2- Absence of fever
vaccine except: 3- Presence of leucocytes in the stool
1- It is given annually 4- Absence of blood in the stool
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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2- Controlling blood glucose levels
* The route of transmission of this virus is fecal 3- Smoking cessation
oral route: 4- Use of an ACE inhibitor
1- Hepatitis B virus 5- Use of aspirin
2- Hepatitis C virus
3- Hepatitis E virus
4- Hepatitis D virus
5- Human immune deficiency virus
* In the treatment of infective endocarditis ,all * Which of the following is most sensitive early
true except: sign for detecting diabetic nephropathy:
1- Persistent fever may indicate a nonbacterial 1- Serum creatinine
like fungal cause 2- urinary albumin/creatinine ratio
2- Cidal drugs rather than statics should be used 3- Serum urea level
3- Always await the culture results before giving 4- Ranal ultrasonography
any teatment 5- Creatinine clearance
4- Inrtvenous route is always perferred
5- Persistent fever may indicate a drug fever * The following are clinical features os restrictive
cardiomyopathy:
* The most common cause of upper 1- Presentation which mimics constrictive
gastrointestinal bleeding: pericarditis
1- Esophageal varices 2- Primarily characterized by impaired diastolic
2- GERD function
3- Peptic ulcer disease 3- Association with primary or secondary
4- NSAID induced erosive gastritis amyloidosis
5- Esophageal ulcer 4- Complication of conditions inducing marked
peripheral blood eosinophilla
* One of the following is not a presentation of 5- Gross cardiomegaly on CXR
liver cirrhosis
1- Gynecomatia * The risk of transmission of hepatitis B virus
2- Abdomianl collateral circulation followingpercutaneous needle stick injury is:
3- Asterixis 1- 0.3%
4- Cerebral edema and brain hernation 2- 3%
5- Ascites 3- 30%
4- 60%
* The diagnosis of live cirrhosis is established by: 5- 90%
1- Abdominal U/S
2- Prothrombin time and serum albumin * 70 year old man presents for health
3- Liver biopsy assessment. which Bp reading would indicate
4- Testing for HbsAg ,HCV Ab, ANA, iron and the highest risk for a cerebrovascular accidents:
urine cupper 1- 110/90
5- Platelets count to todoucumenthypersplenism 2- 120/90
3- 130/70
* In the coure of DKA ,which of the following is 4- 140/80
true about serum potasstum level: 5- 155/70
1- It remain unaffected
2- It can appear normal but total body potassium * All the following about Hepatitis A infection true
may actually be low except:
3- It can appear normal but total body potassium 1- Fecal oral transmission
may actually be high 2- It is a common cause of chronic liver disease
4- It will naturally be corrected by insulin 3- Mortality increases with advancing age
administration 4- Maximum infectivity of the disease is before
5- None of the above the onset of jaundice
5- Hepatitis A vaccine is protective from the
* The most effective method for preventing disease
diabetic retinopathy is :
1- Reducing triglyceride level
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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* In patient with macrocytic anemia,which one A. It's due to deficiency of cortisol hormone .
the following features B12 B . Enlarged extremities are commonly seen .
defieciency rather than folate deficiency : C . Osteoporosis is not a feature .
1- Mild jaundice D . Iatrogenic cause is uncommon .
2- Loss of weigh E . A moon face and buffalo hump are
3- Skin purpura characteristic .
4- Lower limb neuropathy
5- Recurrent throat infection
* Peripheral blood neurophil leucocytosis would * In hypercapnia are all true except ?
be an expected finding in all of A . Bounding pulse
the following except: B . Headache
1- Connective tissue diseases C . Peripheral vasoconstriction
2- Corticosteroid therapt D . Confusion
3- Pregnancy E . Flapping tremor
4- Whooping cough
5- Mesenteric infarction * To assist in the decision whether to hospitalize
a patient with community acquired pneumonia ,
* Regarding santitation barriers all the following each of the following may be a factor in favor of
are true except: hospitalization except which one ?
1- Protection of water supply A. The patient is confused
2- Protection of food B . Serum creatinine > 2.0 mg / dl
3- Personal hygiene C . Respiratory rate > 30
4- Control of flies D . Blood pressure < 90 mg hg
5- Using of spring water better than tap water E . Age > 64 years
* All the following are true about Hepatitis B virus * All of the following can be used in hypertensive
vaccine except: crisis except ?
1- It is given in three doses A. Sodium nitroprusside
2- Common schedule is: 0, 1 , 6 months B . Furosemide
3- It is safe in immunocompromised individuals C . Labetalol
4- Booster dose is routinely given after 10 years D . Clevidipine
from finishing the series(the three doses) E . Hydralazine
5- It is highly protective to hepatitis B virus
* Diarrhea may occur with all of the following
* Which of the following features suggests except ?
adrenal insufficiency : A . Food poisoning
1- Hypoglycemia B . Viral gastroenteritis
2- Hypokalemia C . Inflammatory bowel disease
3- Leukopenia D . Colonic Neoplasia
4- Anemia E . Hypothyroidism
5- Hypertension
* A 7 years old has severe microcytic anemia due
* 55 year old asymptomatic obese female to B Thalassemia major ( homozygous ) . He
presents to your clinic for checkup and requires frequent blood transfusion( once every
general advice,youadvice her all of the following sex week's ) To prevent the skeletal and
condition are strongly assciated with obesity developmental complications of thalassemia .
except one: Which of the following medication is also
1- Insulin resistance indicated in the treatment of patients
2- Hypertension requiring frequent blood transfusion ?
3- Osteoporosis A . Oral calcium supplement
4- Arteriosclerosis B . Fresh frozen plasma
5- Hypoventilation C . Desferrioxamine
D . Pencillamine
* Which of the following is true about Cushing E . Cryoprecipitate
syndrome ?
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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* One of the following vaccines is a killed vaccine C . Obesity and HTN are non modifiable risk
A . Measles vaccine factor .
B . Mumps vaccine D . Creatinine kinase can be raised due to other
C . Rubella vaccine non cardiac cause .
D . Pertussis vaccine E . Cardiac troponin remains elevated for 24 hour
E . Oral polio vaccine only .
* A 23 years old woman experienced watery * 60 years old male presented with massive
diarrhea , nausea, vomiting and abdominal hematemesis , examination revealed
cramps 6 hours after eating a salad and a Splenomegaly , clubbing and Palmar Erythema .
hamburger in a local restaurant . The most likely The cause of his hematemesis ?
organism causing her disease is ? A . Mallory Weiss syndrome
A . Vibrio vulnificus B . Gastric ulcer
B . Listeria monocytogenes C . Angiodysplasia
C . Yersinia enterocolitica D . Esophageal varices
D . Clostridium difficile E . Gastritis
E . Staphylococcus aureus
* A 63 years old man is involved in a motor
* Air conditioner repair worker is more likely to be vehicle accident and is brought to the hospital .
at risk of contracting ? On examination, his blood pressure is 90/60 mm
A . Hepatitis hg , pulse 110 / min , and his abdomen is
B . Brucellosis distendes and rigid , he has internal injuries and
C . Legionnaires disease bleeding on an abdominal CT scan , and requires
D . Histoplasmosis emergent blood transfusion on his way to the
E . Tuberculosis operating room . His blood group is AB , which of
the following statement is not correct ?
* A 19 year old woman present with daily acid A . He is a universal recipient .
reflux symptoms and intermittent dysphagia to B . He has anti A and anti B in his serum .
solid . Since onest of symptoms 3 months ago , C . If a cross match is not available, group O
she has lost 2 kg , she has sporadic rectal RBCs are universal .
bleeding . Her past medical history is negative . D . If insufficient AB blood is available , type A
Her father had stomach cancer at age 42 . What can be used .
would you recommend ? E . If insufficient AB blood is available , type B
A . EGD can be used .
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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Steroids are the cornerstone treatment .
* The study of the distribution of a disease or It is a curable disease .
condition in a population is PFT reversibility always present .
referred to as ? Can cause right sided heart failure .
A . Descriptive
B . Analytical * All of the following are cause of chronic cough
C . Experimental except ?
D . Prospective A . GERD
E . Retrospective B . Sodium valproate
C . ACE_i
D . Long term smoking
E . Postnasal drip
* All about irritable bowel syndrome are true * Which of the following antiarrhythmic drug
except ? mediates it's effect by interfering with movement
A . Abdominal pain relieved by defecation . of calcium through the slow channel ?
B . Symptoms can be increased by stress . A . Phenytoin
C . Waking at night with pain or diarrhea support B . Verapamil
the diagnosis . C . Lidocaine
D . Altered bowel habit is common . D . Amiodarone
E . Examination is often normal . E . Bretylium
* Regarding diabetic ketoacidosis which is true ? * 63 years old woman is seen in the emergency
A . Dehydration is less life threatening than room with acute shortness of breath . There is no
hyperglycemia . history of heart or lung problems in the past . She
B . Potassium level initially is high and falls down was recently diagnosed with breast cancer and is
with treatment . under going active treatment . On examination
C . Is a late complication of type one DM . her blood pressure is 120/80 mm hg , pulse 100 /
D . Can be managed as outpatient in most of the min , and heart and lungs are normal . There are
cases . no clinical sings of DVT . Which of the following
E . Elevated WBC count always indicates investigation is most likely to rule out a PE ?
infection . A . Normal CXR
B . Normal ECG
* All of the following are side effects of steroids C . Normal ventilation _ perfusion lung scan .
except ? D . Normal high resolution CT
A . Elevated blood pressure E . Normal MRI
B . Acne
C . Skin bruises * A 66 year old man has progressive shortness of
D . Hypoglycemia breath due to COPD . He is currently able to do
E . Cataract his activities of daily living , but has trouble
walking more than 50 m . His physical
* Blood gas analysis in type one respiratory examination reveals hyperinflation , increased
failure shows ? resonance to percussion , and bilateral expiratory
A . High PCO2 and normal PO2 . wheezes . He is in appropriate medical therapy
B . Low PCO2 and normal PO2 . for his stage of COPD . Which of the following is
C . Normal PCO2 and high PO2 . also indicated in the management of this
D . High PCO2 and low PO2 . condition ?
E . Normal PCO2 and low PO2 . A . Meningococcal vaccine
B . Yearly influenza vaccine
* In salmonellosis which is true ? C . Weight reduction obese
A . Positive blood culture occur in the second D . Haemophilus influenza B vaccination
week . E . Pneumococcal vaccination
B . Positive stool culture occur in the first week .
C . Splenomegaly doesn't occur . * A 39 year old woman with HTN , is taking
D . Can be complicated by Osteomyelitis . hydrochlorothiazide ,enalapril and diltiazem . She
E . The route of transmission is air borne . desires to become pregnant . The most
important step would be to ?
* One of the following is true about COPD ? A . Switch HCTZ to Furosemide
It is one of the cause restrictive PFT . B . Switch diltiazem to amlodipine
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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C . Discontinue diltiazem
D . Discontinue enalapril * Skin cancer result from exposure to one of the
E . Discontinue HCTZ following ?
A . Infrared rays
* Regarding Acromegaly all are true except ? B . X rays
A . Caused by tumor in adrenal gland in more than C . Solar ultraviolet
90 % . D . Ionizing radiation
B . Excessive sweating . E . Microwave
C . Large hand and feet .
D . Increased growth hormone .
E . Proganthism .
* A 24 year old man develops seizures following * Which of the following patients is most likely to
an emergent splenectomy after a car accident . be a candidate for bone mineral density
His serum sodium level is initially 116 mEq / L screening ?
and is corrected to 120 mEq/L over the next 3 A 65 year old, thin , white woman who smokes
hours with hypertonic saline . Which of the and is 15 years postmenopausal .
following factors most likely led to his B 40 year old white woman who exercises daily
Hyponatremia ? and still menstruates .
Elevation of serum vasopressin C healthy 75 year old white man who is
Administration of hypertonic solutions sedentary .
Volume depletion D 60 year old overweight black woman .
Seizures induced Hyponatremia E 35 year old asthmatic woman who took
prednisone 40 mg/d for a 2 week course 1 week
ago
اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ: اﻟﺪﻛﺘﻮر اﺳﺌﻠــــــــﺔ اﻟﺒﺎﻃﻨﻴــــــﺔ
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Factor 5 Leiden mutation
* During which of the following periods in a Antiphospholipid antibody syndrome
woman's life is the most bone mass Familial malignancy syndrome
accumulated
Ages 15 to 25 * A 54 year old woman is noted to have cervical
Ages 25 to 35 cancer and presents with significant vaginal
Ages 35 to 45 bleeding with a hemoglobin level of 7 g/dL . Her
Ages 45 to 55 left leg is swollen , which on Doppler
investigation reveals a DVT . Which of the
* A 60 year old woman presents with the results following is the best treatment for the
of her DEXA scan . She has a T score of _1.5 at thrombus ?
the hip and _2.5 at the spine . Which of the Intravenous unfractionated heparin .
following is the most accurate interpretation of Fractionated subcutaneous heparin .
these results ? Subcutaneous unfractionated heparin.
She has osteoporosis at the spine and osteopenia Oral warfarin ( Coumadin ) .
at the hip . Vena cava filter .
She has osteoporosis in both area's .
This is a normal examination .
She has osteoporosis of the hip and osteopenia
at the spine . * A 72 year old man develops severe pain and
You need to know the Z score . swelling in both knees , shortly after undergoing
an abdominal hernia repair surgery . Physical
* You see a 70 year old woman in your office for examination shows warmth and swelling of both
a routine checkup , and you order a DEXA scan knees with large effusions . Arthrocentesis of the
for bone mineral density screening . The T score right knee reveals the presence of intracellular
returns as 2.5 standard deviations SD in the and extracellular weakly positive birefringent
spine and _2.6 in the hip . Which of the following crystals in the synovial fluid . Gram stain is
statements is most accurate ? negative . Which of the following is the most
This patient has osteopenia . likely diagnosis ?
Estrogen replacement therapy should be started Gout
with an anticipated rebuilding of Septic arthritis
bone mass to near normal within 1 year . Calcium oxalate deposition disease
Swimming will help build bone mass . Reactive arthritis
Bisphosphonates would reduce the risk of hip Pseudogout
fracture by 50%
* A 65 year old man with a history of chronic
* A 35 year old woman complains of calf HTN , DM , and degenerative joint disease
tenderness and acute dyspnea . The arterial presents with acute onest of severe pain of the
blood gas reveals PO2 ( Partial pressure of metatarsophalangeal joint and swelling of the
oxygen ) of 76 mmHg . Which of the following is left first toe . Physical examination shows
the most common physical examination finding exquisite tenderness of the joint , with swelling ,
of pulmonary embolism ? warmth ,
Wheezing . and Erythema . The patient has no history of
Increased pulmonary component of the second trauma or other significant medical problems .
heart sound . Synovial fluid analysis and aspiration is most
Tachypnoea . likely to show which of the following ?
Calf swelling . Hemorrhagic fluid .
Pulmonary rales . Needle_ shaped , negatively birefringent crystals
Gram negative organisms .
* A 39 year old man is noted to have a DVT Noninflammatory fluid .
without any known risk factors . He notes that his Rhomboidal , positively birefringent crystals
brother also developed a pulmonary embolism at
age 45 years , and his mother developed a clot in * A 17 year old sexually active adolescent male
the leg when she was in her thirties . Which of the presents with a 5 day history of fever , chills , and
following is the most likely inherited disorder in persistent left ankle pain and swelling . On
this patient ? physical examination , maculopapular and
Protein S deficiency pustular skin lesions are noted on the trunk and
Antithrombin 3 deficiency
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extremities . He denies any symptoms of morning .She comes in now because she had
genitourinary tract infection . Synovial fluid fainted this morning . Which of the following is
analysis is most likely to show which of the the most likely cause of her syncope ?
following ? Carotid sinus Hypersinsivety
WBCs 75.000/mm3 with 95% polymorphonuclear PE
leukocytes . Autonomic neuropathy
RBCs 100.000/mm3 , WBCs 1000/mm3 . Critical aortic stenosis
WBCs 48.000/mm3 with 80% lymphocytes .
WBCs 500/mm3 with 25% polymorphonuclear * A 74 year old man with no prior medical
leukocytes . problems faints while shaving . He has a quick
recovery and has no neurologic deficits . His
* A 22 year old man presents with complaints of blood sugar level is normal , and ECG shows a
low back pain for 3 to 4 months and stiffness of normal sinus rhythm . Which of the following is
the lumbar area , which worsen with inactivity . the most useful diagnostic test of his probable
He reports difficulty in getting out of bed in the condition ?
morning and may have to roll out sideways , Carotid massage
trying not to flex or rotate the spine to minimize Echocardiogram
pain . A Lumbosacral spine X_Ray film would CT scan of head
most likely show which of the following ? Serial cardiac enzymes
Degenerative joint disease with spur
information .
Sacroiliitis with increased sclerosis around the
sacroiliac joints .
Vertebral body destruction with wedge fractures . * A 49 year old man is admitted to the intensive
Osteoporosis with compression fractures of care unit with a diagnosis of an inferior MI . His
L3_L5 . heart rate is 35 bpm and blood pressure 90/50
Diffuse osteonecrosis of the LS spine . mmHg . His ECG shows a mobitz type 1 heart
block . Which of the following is the best next
* A 36 year old woman was seen by her physician step ?
due to pain in her hands, wrists , and knees . She Atropine
is diagnosed with rheumatoid arthritis . Which of Transvenous pacer
the following treatments will reduce joint Lidocaine
inflammation and slow progression of the Observation
disease ?
NSAIDs * A 42 year old woman is being treated with
Joint aspiration infliximab for rheumatoid arthritis . After 6
Methotrexate months of therapy , she develops persistent
Systemic corticosteroids fever , weight loss , and night sweats , and
tuberculosis is suspected . Which of the
* An 18 year old adolescent female is brought to following is most likely location of the
the emergency room because she fainted at a tuberculosis ?
rock concert . She apparently recovered A Middle and lower lung zones .
spontaneously , did not exhibit any seizure B Pleural space .
activity , and has no medical history . Her heart C Apical segment of the upper lung lobes .
rate is 90 bpm and blood pressure 110/70 D Cervical or supraclavicular lymph nodes .
mmHg . Neurologic examination is normal . The
pregnancy test is negative . Which of the * A 24 year old man has been treated with INH ,
following is the most appropriate management ? Rifampicine ,and pyrazinamide for active
Admit to hospital for cardiac evaluation . pulmonary tuberculosis . After 3 months , he
Outpatient echocardiogram . states that he is having numbness and tingling of
Twenty four hour Holter monitor . both feet but no Back pain . He denies taking
Reassurance and discharge home . other medications . Which of the following is the
most appropriate next step ?
* A 67 year old woman has diabetes and mild A CT scan of the lumbar spine .
HTN . She is noted to have some diabetic B Initiate pyridoxine .
retinopathy , and she states that she cannot feel C Continue the tuberculosis agents and monitor
her legs . She has recurrent episodes of for further neurological problems .
lightheadedness when she gets up in the D Initiate a workup for tuberculosis Adenopathy
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E compression on the femoral nerve. A Oligoclonal bands in cerebrospinal fluid .
B Increased N_acetyl aspartate with MR
* A 25 year old woman is seen in the clinic spectroscopy .
because her father was diagnosed with and has C Abnormal peripheral nerve conduction by
been treated for tuberculosis . She denies a electromyograph ( EMG) / nerve conduction
cough and her chest radiograph is normal . A velocity ( NCV) studies .
PPD test shows 10 mm of induration . Her only D Meningeal enhancement on contrast MRI of
medication is an OCP . Which of the following is brain
the best next step ?
A Oral INH and barrier contraception . * A 33 year old man is noted to have
B Combination therapy including INH, exacerbations of weakness . He is diagnosed
Rifampicine and pyrazinamide . with MS . Which of the following findings is
C Observation . consistent with the diagnosis ?
D Induce three sputum samples . A The diagnosis of MS is based on clinical
lesions separated by time and space .
* Which of the following tests is the most B Oligo bands in the CSF are specific for multiple
appropriate to follow for a patient receiving sclerosis .
isoniazed and rifampin for tuberculosis C Steroids are effective in improving the course
treatment of disease .
A Renal function tests D This is a genetic disorder well characterized on
B Liver function tests chromosome 11
C Slit_lamp examinations
D Amylase and lipase tests