PROMETRIC

EXAM 23/11/2016



1. young man, newly divorced, he ate too much and become fat, he always say no taste or
smell. All his routine investigations are normal, all brain images are normal. What is the
cause for loss of taste and smell sensations?

A. Malyringing
B. Aneurysm
C. Meningioma
D. Liver caricinoma


2. best and rapid management for specific anxiety?
A. Benzodiazipines
B. Sertraline
C. Imipramine
D. Bupropion


3. patient with major depression on SSRI for one week, presents with no improvements in
his mood. What is your action?
A. Increase the dose
B. Change medication
C. ECT
D. Follow after 3 weeks


4. patient diagnosed with depression on SSRI presented after week with some
improvements in her mood, what is your action?
A. Add another SSRI
B. Change to another class of antipsychotic
C. ECT
D. Follow up after 3 weeks


5. 30 years old male presented with following behavior: he is covering the TV because he
believes that govt is spyig him and God talks to him through the lamp. Diagnosis
A. Schizophrenia
B. Bipolar disorder
C. Mania
D. Depression



6. Douchen muscular dystrophy, asking about other ix you will do rather CPK and muscle
biopsy
A. AST
B. ESR
C. RF
D. ANA
E. Genetic testing


7. Duchenne muscular dystrophy percentage of recurrence
A. 50%
B. 25%
C. 2%
D. 7%


8. question about cyanide poisoning



9. common viral infections associated with CHF during pregnancy:
A. measles
B. herpes
C. rubella
D. chicken pox


10. anyone of the following viral infection you will treat immediately if pregnant itsmother
infected

A. hep B
B. hep C
C. CMV
D. HPV


11. pt with migraine, now she is pregnant, stopped alcohol, and smoking after getting
pregnant. Her symptoms improved with pregnancy, what is the cause/
A. Biofeedback
B. No smoking
C. No alcohol
D. Pregnancy hormones




12. term pregnant lady in delivery room, cervix dilated 8cm, station +2, CTG showed late
deceleration. Your action will be?
A. Forceps
B. Ventose
C. Spontaneous vaginal
D. CS



13. pt known case IDDM, presented with epigastric pain, polyyrea, acetone smell, what is
cause of this condition:
A. Diet mismanagement
B. Insulin mismanagement
C. Liver failure


14. pt with DM on glicazide, RBS 200, HbA1c 8, the mechanism of action of drug:
A. Increase insulin secretion
B. Increase insulin sensitivity
C. Decrease gluconeogenesis
D. Decrease carbohydrate metabolism


15. 9 year old IDDM on isulin 30/15, he take his insulin at 7 am, 7 pm. His RBS reading as
follows
SAT 11
Sun 10
Mon 9
Tues 11
Wed 10
The rest of schedule shows normal measures during the day and before sleeping. What is
this phenomenon

A. Somogyi
B. Down
C. Honeymoon


16. pt with COPD presented with recurrent episodes of dyspnea. His SPO2 92% at room air.
What is your action:
A. Penicillin
B. Salbutamol
C. Theophylline
D. Atrovent


17. 40 yrs old male presented with symptoms of DM ( polyuria, polyphagia, polydipsia) BMI
30, FBS 180, RBS 200, HbA1c 8.6, what drug you will start first:
A. Gliciazide
B. Metformin
C. Insulin
D. Acarobase



18. you study two groups with Prostrate BP, you want to see the effect of Increase weight
on BPH. Both groups are 1000 participants.
1st group with BPH you find 50 persons with increase weight
2nd group you found , 10 persons without BPH
A. OR 5
B. OR 15
C. RR 5
D. RR15


19. Elderly female with pain in right iliac fossa. On exam there is mass. She is febrile. What is
your diagnosis:
A. Acute diverticulitis
B. Crohons disease
C. Pregnancy


20. old patient with internal hemorrhoids. Her CBC show s iron deficiency anemia. What is
next to do:
A. Stool occult blood
B. US
C. Colonoscopy


21. old pt with ruptured bollus on leg, histopath shows subderaml lysis. Image attached

A. Pemphigus vulgaris
B. Empidermolysis bullosa
C. Bullous pamphigoid


22. female pt presented with 2nd degree burn in her face and neck. What is you mx:

A. Apply sulfadiazine cream, iv fluids, topical antibiotics and covrer
B. Dressing wih NIS, sulfadiazine cream and cover
C. Admit pt, sulfadiazine cream, Vaseline guaze


23. elderly male with heaviness in Rt iliac fossa. By palpastion there is no tender mass. He is
afebrile and stable, while waiting for lab results and radiology what is your action:
A. Call for general surgeon
B. Admit of evaluation
C. Send home


24. 40 yrs old multipara, she did tubal ligation 2 yrs ago after CS delivery. She has painful
nodular breast increase with menstrual cycle, she claims she eats chocolate and drink milk
during menstrual day. What is your mx:
A. OCP
B. Decrease chocolate and milk intake
C. Mammography


25. 21 yrs old female presented with painless lump in lt upper quadrant of breast. O/E firm
rubbery and mobile, no axillary lymph nodes, no skin changes, no nipple discharge, no
changes with menstrual cycle:
A. Lymphadenitis
B. Ca breast
C. Fibroadenoma


26. 55 yrs old female presented with painful axillary mass, this mass is hot and tender 5cm
in size, now pt is febrile, what is your mx:
A. Excision and drainage under GA
B. Excision and drainage under LA
C. Antibiotics and PAracetamol


27. elderly man asking for meningitis prophylaxis because his son diagnosed with
meningitis:
A. IV penicillin
B. Oral erythromycin
C. Oral rifampicin 600 mg for 4 days
D. Doxycycline


28. pt with recurrent submandibular swelling increase with chewing of food, what to do for
diagnosis:
A. Xray Neck
B. CT neck
C. FNAC



29. 42 yrs old female with 5 days postcoital vaginal discharge, white in color, no smell, no
itching. She changed her work as receptionist because of dermatitis as she used to sit for
long time on chair. What you will advise:
A. To do postcoital vaginal dousch
B. Ask about latex allergy
C. To put topical antifungal
D. To advise for antibiotics





30. what is the best eye exam for school children:
A. Fundoscope
B. Retinoscope
C. Snellen chart
D. Cover and uncover test


31. child presented with red inflamed auditory canal and pain when you pull tragus, normal
tympanic membrane. Your MX:
A. Oral penicillin
B. IV gentamycin
C. Topical antiboitcs
D. analgesia



32. A farmer presented with heaviness and dull pain in right hypochondruim, CT abdomen
shows well defined cystic mass in rt lobe of live. What is your advise:
A. pasturised milk
B. cooked meat
C. boiling water use
D. avoid handling with dogs


33. same scenario as above with same ct, pt afebrile, stable vitals with normal ix. What is
your diagnosis:

A. amoebic liver abcess
B. hydatid liver disease
C. hepatocellular Ca
D. liver cirrhosis


34. elderly male known HPT/HTN presented with spleenomegally otherwise stable, they
take biopsy from spleen the punctured side continue to bleed. His CBC shows Hb 19,
platelet 5000, what is your diagnosis?
A. Polycythemia??? Rubravera
B. Spleenomegally
C. Abdominal aneurysm


35. which of those pt you will not admit with pneumonia:
A. 60 yrs old, T 39C, RR, 30/MIN, PR 160/MIN, BP 80/60
B. 50YRS OLD, T 40C, RR35/MIN, PR 140, BP 80/60
C. 80YRS OLD T37.4C, BP 160/100, RR 20/ MIN, PR 100/MIN
D. 80 YRS OLD, TEMP 39.5 C, RR 30/MIN, BP 130/70


36. 19 yrs old male sexually active, presented with sudden and severe pain in right testis
with scrotal swelling, no penile discharge, vitally stable, all routine ix normal. What is next
step in mx:
A. start IV antibiotics
B. start oral antibiotics
C. Doppler US for testis
D. Start analgesia


36. elederly male, chronic heavy smoker, presented with heavy hematuria, rest all normal,
what you will do?
A. Renal US
B. Cystoscopy
C. CT abdomen


37. what is the first cancer you will exclude in heavy smokers:
A. Lung Ca
B. Bladder Ca
C. Colon Ca


37. elderly female presented with chest pain, diagnosed as posterior MI, then she presented
with palpitation. What is your diagnosis:

A. SVT
B. AF
C. HEART BLOCK




38. Elderly female known case of HTN/HPT presented with MI symptoms and Palpitation,
your MX:
A. Propranolol
B. Adenosine
C. Nifidipine


39. child with upper respiratory infection, presented with ear pain. O/E red tympanic
membrane, Febrile. Your first step in MX will be:
A. Antibioitcs for 10 days
B. Analgesics
C. Tympanometry
D. Gormet tube insetion




40. Child with Hx of URTI before 2 week now he is febrile ,vomiting O/E there is
RIF mass 2*3 cm what is the best imaging study to confirm diagnosis :
A. Abd CT
B. Abd U/S
C. Barium enema


41. Blood sugar in DM type 1 best controlled by :
A. short acting insulin
B. long acting insulin
C. intermediate insulin
D. Hypoglycemic agents 

E. Basal and bolus insulin