Residency Exam – KAUH, 2017

1. C3 is characteristically normal in which of the following glomerulonephritis conditions:

- poststrep GN
- membranoproliferative nephropathy (type 2)
- IgA nephropathy
- subacute endocarditis
- SLE
Answer: IgA nephropathy

2. the most common cause of stridor in infant:

- croup
- foreign body
- laryngomalacia
Answer: Laryngomalacia

3. Daily Caloric requirement for infant:

- 100-120 kc/kg
- 80-90 kc/kg
-90-100 kc/kg
Answer: 100-120 kc/kg

4. All of the following are features of PCOS, except:

- Acanthosis nigricans
-High LH:FSH
- low level of sex hormone binding globulin (SHBG)
- decreased rate of miscarriage
Answer: decreased rate of miscarriage

5. One is true about pre-eclampsia:

- Uric acid level is expected to be elevated
- hematocrit is expected to be low
- severe PET is when BP above 140/90
Answer: Uric acid level is expected to be elevated

6. True about IUGR except:

- IUGR babies should be delivered by C/S
- usually associated with oligohydramnios
- pre-eclampsia is a potential cause
Answer: IUGR babies should be delivered by C/S

7. All are risk factors for PPH except:

- APH
- Multiparity
- Instrumental delivery
- Previous PPH
- Meconium aspiration
Answer: Meconium aspiration

8. Which of the following is not used in management of hypertension in pregnancy:

- Hydralazine
- Methyldopa
- Labetalol
- Enalapril Acei ci
- Amlodipin
Answer: Enalapril

9. Most common cyanotic heart disease:

- tetralogy of fallot
-tricuspid atresia
-transposition of great vessels
Answer: tetralogy of fallot

10. 65 years old pt, in examination and investigation found pulsus alternas , the probable cause :
- Aortic stenosis
Pulsus alternans is a physical finding with arterial pulse
- Aortic regurge waveform showing alternating strong and weak beats. It is
- HOCM almost always indicative of left ventricular systolic impairment,
and carries a poor prognosis.
- severe LVF
Answer: severe LVF

11. Pt with stab wound in the 6th right intercostal space just lateral to the sternal border, bp 90/60,
pulse tachy, trachea centrally located, distended neck veins, Dx?!
- Pneumothorax
- Pericardial temponade
- Lung lacerations
- Esophageal injury
Answer: Pericardial tamponade

12. 54 female, presented with fever, RUQ pain and jaundice, not responding to IV antibiotics, what
is the next step:
- Cholecystectomy
- MRCP
- urgent decompression with ERCP
- Add gentamicin
Answer: urgent decompression with ERCP

13. Cholecystitis is defined as:

- Primary inflammatory disease with occasional secondary infection
- Primarily infection
- Inflammatory condition
Answer: Primary inflammatory disease with occasional secondary infection

14. A case with chest pain and wide mediastinum, diagnosed as aortic dissection type b, treatment:
- IV labetalol
- IV nitroprusside
- IV nitrate
Answer: IV labetalol
15. Signs found in 30-40% hemorrhage:
- HR >120, very narrow pulse pressure, hypotension

16. when do you expect a child height to be 1m:

- 4 years
- 1 year
- 3 years
Answer: 4 years

17. abnormal to see in a 1 month baby

- Moro reflex
- Head lag
- Fisting
- C-shaped ventral suspension
Answer: C-shaped ventral suspension
18. all cause hypovolemic shock except: PYQ
- extradural bleeding
- Lacerations of scalp
- Lung lacerations
- Pelvic fx
- Femur fx
Answer: extradural bleeding

19. Most common serious complication of DDH:

- Avascular necrosis of head of femur
- Severe Back pain
Answer: avascular necrosis
20. Baby with lumbar myelomeningiocele, you find all except:
- Distended bladder
- Microceph
- Hyporeflexia
- lower limb weakness
Answer: microceph

21. In spinal muscular atrophy, all present except:

- Clonus
- Fasciculation
- Hyporeflexia
- Weakness
Answer: clonus

22. Which of the following is most suggestive of meconium aspiration:

- Ground glass appearance on cxr
- Patchy infiltration on cxr
- Apgar score 5 on 5 min
Answer: Patchy infiltration on X-ray

23. Not a cause of QT prolongation

- Digitalis
- Hypothyroid
- Hypothermia Romano–Ward syndrome is the most common form of congenital Long QT
- Hypocalcemia syndrome (LQTS), a genetic heart condition that affects the electrical properties of
heart muscle cells. Those affected are at risk of abnormal heart rhythms which
- Romano-ward Syndrome can lead to fainting, seizures, or sudden death.
Answer: Digitalis

24. 16kg child with 10% isonatremia dehydration, calculate the total amount of fluids:
- 3400 cc/24 hrs
- 2900 cc/24 hrs
-3400/ 48 hrs
Answer: 2900 cc/24 hrs

25. Baby with pyloric stenosis presentation what type of IV fluids you should use:
- Ringer lactate
- NS
- NS with added potassium
Answer: NS with potassium
26. 5 yrs old female has vulvar itching , didn't change her underwear clothes nor using new
substances (and other complement info to inform that she is medically free) , the most likely dx:
- Pinworm
- Vaginitis
- scabies
- eczema
Answer: Pinworm

27. 22 yr old female recently travelled to Malta 1 week ago presented with generalized
lymphadenopathy and skin rash over trunk and lower limbs?
- Brucellosis
- Infectious mononucleosis
- TB
Anwer: Brucellosis

28. a question about anterior mediastinum mass + elevated AFP?

- Non-seminoma germ cell
- Seminoma germ cell
- Teratoma
- Lymphoma
Answer: non-seminoma germ cell tumor

29. Safe drug during pregnancy

- warfarin
- low molecular weight heparin
Answer: low molecular weight heparin

30. not an indication for dialysis in AKI?

Uremic encephalopathy
Uremic pericarditis
Creatinine 8
Hyperkalemia severe and irresponsive to medical therapy
Metabolic acidosis irresponsive to medical therapy
Answer: Creatinine 8

31. All of the following are causes of rash and vasculitis, except:
- lymphoma
- Subacute endocarditis
- drug reaction
Answer:

32. Most common cause of Encopresis in 4.5 years old child

- Long standing constipation
- Sexual abuse
- Celiac
Answer: Long standing constipation

33. 65 years old female nonsmoker and drinks more than 15 oz alcohol weekly. presented with
dysphagia to food and drinks for 18 months, physical examination was normal what's the most
likely cause?
- esophageal carcinoma
-achalasia
-esophageal web
-Zenker diverticulum
Answer: achalasia
34. Cause of bacterial trachiitis, which of the following doesn't support the diagnosis :
- High grade fever
- Toxic appearance
- Responding to steroid
- The cause is staph. Aureus
- Clindamycin and ceftriaxone is a good combination
Answer: Responding to steroid

35. The difference between absence seizure and complex partial seizure:
- absence seizure happens for many times a day
-absence seizure is characterized by hypsarrhthmia
- absence seizure has an aura
Answer: absence seizure happens for many times a day
36. young female has recurrent anemia , picture of hypochromic microcytic anemia, along with low
ferritin , b12 and folate deficiency and splenic atrophy , what is the antibody that is most likely to
be positive in this patient :
-anti glutamic acid decarboxylase
-anti intrinsic factor
-anti partial cells
-anti tissue transglutaminase
Answer: anti-tissue transglutaminase

37. Which of the following is right:

- Anti-sm is found in 25% of SLE patients
- Ant-histone is associated with high incidence of nephropathy
- Anti-scl 70 in CREST
- complete heart block in infant of SLE mother is caused by anti-URP crossing the placenta
Answer: Anti-sm is found in 25% of SLE patients

38. Wrong about parathyroid gland:

- hypoparathyroidism is a common complication for both thyroid and parathyroid surgeries
- surgery is always indicated in primary hyperparathyroidism
Answer: surgery is always indicated in primary hyperparathyroidism
39. Wrong about anorexia nervosa:
- Menorrhagia
- body image disorder
- hirsutism in face and hands
Answer: Menorrhagia

40. Not required preop to GERD surgery

- CT
- 24 ph
- Manometry
- Endoscope
Answer: CT

41. Anterior neck mass in the right lobe of thyroid, most appropriate diagnostic test:
- FNA
-US
- Technecium 99
Answer: FNA

42. Which of the following hormones doesn't increase in second trimester

- beta hcg
- estrogen
-progesterone
Answer: beta hcg

43. rest pain seen in chronic lower limb ischemia is located in:
- forefoot
- calf muscles
Answer: forefoot

44. wrong about the management of mitral stenosis in pregnancy:

- ergometrin to prevent pph
- pulmonary edema is a potential complication
- IUGR is a potential complication
Answer: ergometrin to prevent pph

45. doesn't need immediate intervention

- aspiration
- spinal injury at level of T6
Answer: spinal injury at level of T6
46. doesn't need emergency surgery
- acute pancreatitis
- ruptured Abdominal aortic aneurysm
Answer: acute pancreatitis

47. wrong about oxytocin side effects

- hypernatremia
- hyperbilirubinemia
- increased risk of rupture
Answer: Hypernatremia

48. wrong LHRH-analogs

- FSH is high in short term
- FSH is high in long term
Answer: FSH is high in longterm use

49. Which of the following is true about Precocious puberty:

- Occur more in males
- If constitutional no need for management
- It is defined as the presence of secondary sexual characteristic before 8 yrs old
Answer: It is defined as the presence of secondary sexual characteristic before 8 yrs old

50. Which of the following changes in the CTG indicates fetal hypoxia?
-poor variability in a 32 gestational age
-early decelerations in the 2nd stage of labor
- Poor Variability and variable decelerations
Answer: Poor Variability and variable decelerations

51. Most common early complication after splenectomy:

- Atelectasis
- Thrombosis
- stroke
- overwhelming postsplenectomy sepsis
Answer: Atelectasis

52. Which sign means malignant transformation of a wound:

- persistent granulation tissue which bleeds easily
- nonhealing wound
- overturned edges
Answer: overturned edges ( most probable answer )
53. a 12 year old male presented with symptoms of severe acne vulgaris, what's true about this
common disease:
- Topical antibiotics are of no value in the management
- Topical Benzoyl paroxide and retinoids are the first line in the management
- This disease solely affect adolescents
Answer: Topical Benzoyl paroxide and retinoids are the first line in the management

54. Which of the following is the least common cause of hyposplenism:

- Thalassemia
- Celiac disease
- Sickle cell anemia
Answer: thalassemia

55. All of following drugs match with their toxic effect except:
- Aspirin >> increase RR
- Paracetamol >> RUQ tenderness
- Morphine >> Dilated non-reactive pupils
Answer: Morphine >> Dilated non-reactive pupils

56. All of the following are true about GDM except :

- Diagnosed after 20 GA
- Increases the risk of congenital anomalies
- Increases the risk of fetal macrosomia
- OGTT should be done 8 weeks postpartum
Answer: Increases the risk of congenital anomalies

57. Patient with uncontrolled DM, the doctor increased his dose of Metformin after which he
presented with diarrhea, what's the cause of his new symptom:
- Bacterial overgrowth
- Infvective diarrhea
- Bile acid malabsorbtion
- Chronic pancreatitis
- Autonomic n europathy
Answer: Autonomic neuropathy

58. Which of the following is true about RF :

- SC nodules are very rare
- Polyarithritis is common in RF
- Arthritis affects mainly the small joints
Answer:
59. All are found in patient with nutritional rickets except:
- Low PTH
- Low Calcium
- Low Vit D
- High ALP
Answer: Low PTH

60. All causes bleeding after multiple blood transfusion except

- Dpg toxicity
- Hypothermia
- dilutional thrombocytopenia
Answer:

61. Which of the following is not a cause of bloody diarrhea:

- Cholera
- enterohemorrhagic E.coli
-Shigella
Answer: Cholera

62. a case of appendicitis , which of the following is the best indicator for ruling out appendicitis:
- not compressible at u/s
- not visualized on CT
- 2 cm long appendix on barium enema
- CT scan showing> 6 cm compressible appendix
Answer: - CT scan showing> 6 cm compressible appendix

63. Which doesn't improve with O2

- R to L shunt
- VQ mismatch
- Diffusion impairment
Answer: R to L shunt

64. a premature infant admitted to NICU because of SOB and cyanosis , his CXR shower air
bronchogram bilaterally, which of the following is the pathophysiology of his disease :
- decrease alveolar compliance
- inflammation
- interstitial edema
Answer: decrease alveolar compliance

65. which of following clotting factors is activated by both extrinsic and intrinsic coagulation
pathways ?
1- prothrombin(II)
2- factor X
3- factor VII
4- factor I
Answer: factor X

66. Which of the following tumors is commonly associated with ascites:

- Ovarian cancer

67. Which of the following would most likely increase the risk of breast cancer:
- age
- family history
- biopsy proven LCIS
- BRCA genes
Answer: BRCA genes

68. Doppler ultrasound may be useful in all of the following, except:

- Measurement of abdominal circumference
- Measurement of amniotic fluid pockets
- Detection of congenital heart defects
- Detection of the middle cerebral artery
- Detection of renal agenesis
Answer: Measurement of abdominal circumference

69. The most common indication for intubation in trauma is:

- Inhalational injury
- Altered level of consciousness
- Facial injury
- Hematoma in the cervical region
Answer: Altered level of consciousness

70. All of the following about uterine prolapse are true, except:
- Anterior and posterior colporrhaphy are the only effective treatment
- Rings can be used temporarily
- Sacrocolpopexy is a way of management
Answer: Anterior and posterior colporrhaphy are the only effective treatment

71. All of the following are signs of chorioamnionitis, except:

- Hyperreflexia
- fever
- abdominal pain
Answer: Hyperreflexia
72. which of the following is the cause of HUS ?
- Enterohemorrhagic E.coli

73. Which of the following statements is not true about Rh isoimmunization

- Middle cerebral artery Doppler is used in the followup of treated fetus
- Intrauterine blood transfusion is one treatment option
- Fetal hydrops is one of the fetal complications
- Anti-D should be given to all sensitized patients
- Sensitization can occur if patient didn’t take Anti-D after delivery of Rh-positive baby

Answer: Anti-D should be given to all sensitized patients