‫اذكرونا بدعوة‬

UG-5 Medicine
Theory Final Exam
Prepared by:
Sarwar Sarkawt, Bakr Manaf, Bashar Khalil, Jwan AlSofi, Emad Hasan, Hakar Saman

*NOTE: Each question is not a carbon copy of the actual ones present in the final. They are a rough
view of them and at times, just the general idea of the question.
**NOTE: Answers are coloured in red with italic blue coloured for ones that are too unclear.
Explanations are noted in blue italics.
***NOTE: Every answer is just an overall opinion and are by no means the actual correct answers, so
please take the answers with a grain of salt.
Single Best Answer Questions:
1. A 33-year-old man weighs 159 kg at a height of 1.78 m. He has lost up to
45 kg on various diets but has always regained his lost weight after 1 to 2
years. He has been morbidly obese since he was 25 years old. He wishes
to discuss bariatric surgery. You reply that each of the following is true,
except for which one? (Osteoporosis is not associated with obesity as
being overweight is in fact a protective factor against osteoporosis. Thus,
it does not enter into the decision for bariatric surgery)
a. This patient is more than 110% above ideal weight.
b. Indications for bariatric surgery include being 45 kg overweight.
c. Indications for bariatric surgery include a BMI of > 40.
d. Indications for bariatric surgery include a BMI of 35 to 40 when
associated with sleep apnea.
e. Indications for bariatric surgery include osteoporosis.
2. Which one of the following vitamins is a well-established therapy for the
treatment of nausea and vomiting in pregnancy?
a. Vitamin A
b. Vitamin B6
c. Vitamin B12
d. Vitamin C
e. Vitamin E
3. A child is brought to the PHC with abnormal growth. Which of the
following is not a characteristic feature of Kwashiorkor’s?
a. Anemia
b. …
c. Hepatomegaly
d. Edema
e. Severe Muscle wasting
4. A 22-year-old gravida 1 para 0 was recently diagnosed with gestational
diabetes. Her fasting blood glucose levels have consistently been 120–
130 mg/dL since she began following nutrition and exercise
recommendations. Based on guidelines from the American Diabetes
Association and the American College of Obstetricians and
Gynecologists, which one of the following would be preferred at this
point?
a. No change in management
b. Loosening the calorie restrictions
c. Adding glyburide
d. Adding insulin
e. Adding metformin (Glucophage)
5. A 62-year-old male with hypertension and metabolic syndrome sees you
for follow-up. A fasting triglyceride level is 300 mg/dL. You address
 lifestyle and other potential causes of his elevated triglycerides, including
his current medications. If included in his current regimen, which one of
the following hypertension medications would be most likely to
contribute to his hypertriglyceridemia?
a. Amlodipine
b. Diltiazem
c. Lisinopril (Zestril)
d. Metoprolol
e. Valsartan
6. Which of the following statements regarding type-2 DM is false?
a. Impaired glucose tolerance is defined by a fasting blood glucose in
the range of 100 to 125 mg/dL
b. Elevated fasting blood glucose concentration provides the first
evidence of loss of glucose control
c. Lifestyle changes of increased physical activity and improved
nutrition can decrease the risk for development of DM by 50% or
more
d. Lifestyle changes are more effective than treatment with metformin
e. Metformin may be effective in decreasing the risk for development
of diabetes
7. A 28-year-old with a history of epilepsy presents for a preconception
consultation visit. Which of the following is the most important advice to
give to this patient?
a. Diabetes screening prior to pregnancy
b. EEG reading that is normal prior to conception
c. Preconception folate supplementation
d. Stop epilepsy medication prior to pregnancy and through the first
trimester
e. Add another medication to her epilepsy medication
8. A 24-year-old woman presents for an initial prenatal visit. She is at 9
weeks’ gestation based on her LMP but, on further questioning, she is not
certain of the first day of her LMP. Which of the following would be the
most accurate estimate of her gestational age?
a. Using her LMP if her uterine size is consistent
b. A first-trimester ultrasound
c. A second-trimester ultrasoumd
d. A quantitative hCG level
e. …
9. All of the followings are TRUE for family physicians at primary health
Care, Except:
a. Control of resources
b. Act as the physician of the first contact and provides the patient a
means of entry into the health care system
 c. Responsible for the prevention of diseases
d. Evaluates the patients' total health need
e. Deals mostly with differentiated cases
10.A 22-year-old student has muscle aches, malaise, headache, and anorexia
that started 2 days ago. Today he has a temperature of 39.4°C. Which is
the single most important direct question to ask him as part of history
taking in order to confirm the likely diagnosis? (Since malaria is a
differential diagnosis and this is an OXFORD question that has nothing
to do with what we studied…awja nazanm if the doctor realises that this
question is made for the UK, not IRAQ)
a. Has he been bitten by an animal recently?
b. Has he had close contact with anyone else with similar symptoms?
c. Has he recently eaten any food that he thinks might have ‘gone off
’?
d. Has he travelled overseas recently?
e. Is he taking any medication at present?
11.A mother who was on TB medication, recently delivered a baby and you
suspect congenital TB in the child. Which of the following is not a sign?
a. Large for gestational age
b. Fast breathing
c. Poor feeding
d. Fever
e. Splenomegaly
12.A 6-week-old infant was brought to the PHC. Which of the following is
not a criterion for serious bacterial infection? (should be severe in up to 2
months due to elasticity)
a. Poor feeding
b. …
c. Some chest indrawing
d. …
e. …
13.A 2-year-old child was brought to the PHC for difficulty breathing. He
had no wheezing or chest indrawing on examination. He had respiratory
rate of 43 breathes/min. He was promptly given a bronchodilator and
soon after his respiratory rate became 38 breathes/min. Which of the
following is the likely cause?
a. Common cold
b. Pneumonia
c. Severe pneumonia
14.An axillary temperature was taken for an infant brought to the PHC.
Which of the following is not a criterion for serious bacterial infection?
a. 35.3°C
b. 37.0°C
 c. 37.5°C
d. 38.0°C
e. 39.0°C
15.A women came to the PHC with a lower back pain after lifting weights.
Her pain had no radiation and no neurological symptoms. It would get
worse with bending forward. What is the best management for this case?
a. …
b. Confined to strict bed rest for 2 weeks
c. …
d. 3 times a week physiotherapy
e. NSAID for 5-to-7 days
16.A female patient who was hypertensive and started a new drug (thiazide)
3 months ago. Around 3 days ago, she developed pain in her foot, with
swelling and redness. What is the most likely cause?
a. Gout (podgra)
b. …
17.A 29-year-old woman presents to the ED with sudden onset of a severe
headache involving bilateral occipital pain associated with nausea. She
has a history of migraine headaches consisting of right-sided throbbing
pain that typically respond to sumatriptan but occasionally require IV
ketorolac and metoclopramide. The headache has not responded to her
sumatriptan (Imitrex) injection. She appears to be in moderate pain but
otherwise has a normal general and neurological examination. This is the
“worst headache of her life.” What is the next step in the management of
this patient?
a. Ketorolac (Toradol) and metoclopramide IV
b. Hot tea and soft pillow
c. Dihydroergotamine (DHE) IV
d. Head CT
e. Lumbar puncture
18.A 32-year-old male complains about fatigue and episodic abdominal pain.
His pain is located in the periumbilical region and the left lower quadrant.
It is cramp-like in nature and is associated with flatulence and diarrhea.
Passing gas alleviates his symptoms. He notes that milk and other dairy
products worsen his symptoms. His weight has remained stable. His prior
medical history, family and social history, and physical examination are
unremarkable. Laboratory tests reveal hemoglobin of 11.5 g/dL and a
normal glucose and TSH. What is the most appropriate next step in your
evaluation?
a. Lactose breath test
b. Dietary trial of strict lactose avoidance
c. Enteroclysis
d. Colonoscopy
 e. Tissue transglutaminase antibody titer
19.A woman whose mother had recently been diagnosed with osteoporosis,
was afraid that she would develop it to and came to the PHC to ask for
measure to help her prevent it. Which of the following exercises do you
recommend for her?
a. Tennis
b. Cycling
c. Swimming
d. Skiing
e. Skating
20.Which of the following is not used as a secondary prevention for
Osteoporosis?
a. …
b. …
c. Weight-bearing and stress exercise
d. …
e. Calcium 1500 in pre-menopause and 1000 in post menopause
21.…Which of the following is true regarding puerperal blues?
a. Usually has previous history of psychiatric illness
b. A psychiatric patient will usually improve during pregnancy
c. Puerperal blues are admitted in 2%
d. Panic attack disorder shouldn’t be regarding as part of normal
pregnancy
e. Stop all psychotropic agents during pregnancy
22.Which one of the following is not an indication for imaging?
a. Neurological deficit
b. History of cancer
c. Immunosuppression
d. …
e. Age > 30
23.A 55-year-old diabetic man asks for the vaccines he had last year against
flu and pneumonia. His records show that he had the influenza and
pneumococcal vaccines last year. Which is the single most appropriate
piece of advice to give him?
a. The influenza vaccine that he had last year will protect him against
influenza for another 5 years
b. He does not need another influenza vaccine this year but should
have it next year
c. He does not need another pneumococcal vaccine this year but
should have it next year
d. He is in a high-risk category for influenza and should have this
vaccine every year
 e. He is in a high-risk category for pneumonia and influenza and
should have both vaccines every year
24.Which of the following the reason behind giving folate in pregnancy?
a. Prevent megaloblastic anaemia
b. Decrease risk of fetal anomalies
c. …
25.Which of the following is false regarding breast feeding?
a. Breastfeeding in the first day is protective against…
b. Those who didn’t breastfeed or breastfed partially are at a higher
risk of mortality from diarrhoea.
c. Children and adolescent who have been breastfed are more
likely to be overweight and obese
26.Which of the following aspects of this case does not match the typical
user of complementary and alternative medicine (CAM) therapies?
a. A higher percentage of users are female
b. After prayer, use of “natural products” is the most common form of
CAM therapy
c. The majority of users have at least some college education
d. Despite the use of CAM, the majority of users continue to see
conventional practitioners
e. The majority of CAM users inform their physicians
27.A diagnosed case of SLE have arthralgia and mouth ulcer, no end organ
damage. What is the management?
a. Analgesia
b. Prednisolone
c. Cyclophosphamide
d. Hydrochloroquine
28.36 years old female diagnosed with SLE developed Renal involvement
causing proliferative Glomerulonephritis, what’s the treatment used?
a. Methotrexate
b. Azathioprine
c. Azathioprine+ Prednisone
d. Prednisone
e. IV cyclophosphamide+ Prednisone
29.A college student presented with painful mouth ulcer and joint swelling,
hand discoloration when exposed to cold followed by reactive hyperemia.
His blood revealed dSDNA and ANA positive. What is the diagnosis?
a. SLE
b. Bahçet disease
c. Rheumatoid arthritis.
30.A female patient presented with discoloration of her hands when exposed
to cold that was followed by hyperemia. Reynaud’s phenomenon is the
most common in which connective tissue disease?
 a. SLE
b. Systemic sclerosis
c. RA
31.Dose of methotrexate in adult:
a. 7.5-25 mg/kg B. wt/day
b. 7.5-25 mg/kg B. wt/week
c. 7.5-25 mg/day
d. 7.5-25 mg/week
e. 10mg/kg B.wt/week
32.Uveitis frequently seen in:
a. Systemic type JIA
b. Oligoarticular JIA
c. Polyarticular JIA
d. Psoriatic JIA
e. Sero-ve polyarticular JIA
33.A 62-year-old female patient complains of inability to walk upstairs and
has difficulty rising from her chair and on examination she has weakness
and proximal muscle wasting. What is the most likely diagnosis?
a. Polymyositis
b. Dermatomyositis
c. Polymyalgia rheumatica
d. Kawasaki disease
e. Giant cell arteritis
34.A 34-year-old female has paleness and bluish discoloration of fingers
when exposed to cold temperatures and also tightening of skin of hands.
What is the most probable diagnosis?
a. Systemic sclerosis
b. Polymyositis
c. Dermatomyositis
d. SLE
35.Radiological findings in grade 2 ankylosing spondylitis:
a. Pseudo widening.
b. Bone erosion.
c. Narrowing and osteosclerosis.
36.Polyarteritis Nodosa doesn’t affect where?
a. Kidney
b. Skin
c. Peripheral Neurons
d. Lung
e. GIT
37.Which of the followings is correct regarding RA?
a. RA is due to immune complex formation in joint?
b. It’s always inside synovial membrane
 c. RA is: can involve multiple organs and is due to immune
dysfunction
d. ESR is always elevated
38.A known case of RA, presented with shortness of breath and chest pain,
tachycardia, BP 80/70 and ECG change showed low voltage QRS. What
is the diagnosis?
a. Acute Pericarditis
b. Constrictive pericarditis
c. Cardiac tamponade
d. Hypertrophic cardiomyopathy
39.A female diagnosed with SLE, presents with headache, fever, neck pain
and CSF showed pleocytosis. She has been taking Hydroxychloroquine
and Ibuprofen for her SLE. Within 2 days, her condition resolved
spontaneously with just acetaminophen. What is the most likely cause of
her current presentation?
a. Reaction to Ibuprofen
b. Reaction to Hydroxychloroquine
c. Aseptic meningitis
d. Lupus Neuritis
40.Which of the following is found in normal adult hemoglobin?
a. A, F
b. A, gamma
c. A, A2, F
41.Which of the following is wrong about VWF?
a. May sometimes cause hemarthrosis
b. Mostly cases are severe
42.Which of the following is molecular diagnosis of hereditary
spherocytosis?
a. Weakened vertical interaction between proteins and cell
membrane
b. Weakened horizontal interaction between proteins and cell
membrane
c. …
d. Caused defective resistance to oxidative stress
e. Caused by a membrane defect in haemoglobin chain???
43.Which of the following is wrong about AML-M3?
a. It needs chemotherapy followed by bone marrow
transplantation
b. Peripheral WBC may be normal or low
c. t(15;17)
d. …
44.All of the following are characteristics of AML, except:
a. CNS infiltration
 b. Bone pain
c. Recurrent infection
d. Severe anaemia
e. May present with pneumonia
45.A female patient presented with confusion and fever. She had a creatinine
level of 4.8, and a low platelet. She had no other abnormal findings. What
is the most likely diagnosis?
a. Thrombotic Thrombocytopenic Purpura
b. Haemolytic Uraemic Syndrome
c. Immune Thrombocytopenic Purpura
d. Henoch-Schonlein Purpura
46.DIC is characterized by all, except:
a. Fatal outcome
b. Low fibrinogen
c. Thrombosis more common in acute DIC
d. Fragmented red cells in blood film
e. Most of them need fresh frozen plasma
47.A 65-year-old man presented with 3 months history of left hypochondrial
discomfort mild splenomegaly with cervical and axillary
lymphadenopathy CBC showed Haemoglobin 9 WBC 140000 (60%
lymphocyte) platelets 90000. Which of the following statements is wrong
about this condition?
a. Bone marrow biopsy is useful
b. Indirect combs test, LDH and ? is necessary
c. Rai III stage
d. Chemotherapy is always indicated in age > 65
e. Flow cytometry is diagnostic
48.A 65-year-old man presents with a 20-year history of DM and
Hypertension. He has now become increasingly pale and in the last 5
days he developed retrosternal pain under minimal exertion. Upon
examination, he had pallor, koilonychia and PR 100. CBC showed
haemoglobin 7.8, MCV 66, with WBC and platelets were normal. What’s
next step in management?
a. Coronary angiography
b. Blood transfusion
c. FOBT
d. Oral Iron
e. Colonoscopy
49.Which of following scenarios are diagnostic of Multiple Myeloma?
a. A 10-year-old boy with acute renal failure and urine was
positive with Bence-Jones
b. A 65-year-old man with hypercalcemia renal failure and rib pain
with no intact paraproteins
 c. A middle-aged woman with polyclonal immunoglobulin
d. …
e. A patient presented with sclerotic bone lesion
50.Which of the following is incorrect regarding treatment in haematology?
a. Fludarabine, cyclophosphamide and rituximab (FCR) for CLL
in age more than 65 years old
b. Imatinib is the first choice for CML
c. Eltrombopag is second line for ITP
d. …
51.A 68-year-old man who presented with severe anaemia and progressive
splenomegaly to the ED with small bowel infarction with a Hb count of
7mg/dL, MCV of 90, Plt of 70, and WBC of 30,000. A peripheral blood
smear showed 60% neutrophil, 15% metamyelocyte, some myelocyte,
8% basophil, 4% eosinophil and ? % … There were also misshaped
RBCs and most of them showed teardrop appearance with some
nucleated RBCs.
a. AML
b. CML
c. Primary Myelofibrosis
d. MDS
e. Leukemoid reaction
52.Iron deficiency anaemia is of concern in which of the following?
a. Pregnancy
b. Old age
c. Cardiac patients
d. Children
e. All of the above
53.Which of the following is false regarding nephrotic syndrome?
a. Urine protein less than 3.5mg/dl
b. Periorbital edema
c. Hyperlipidemia
d. Hypolipidemia (lipiduria?)
54.Which of the following is associated with nephrotic syndrome?
a. Hyperlipidemia
b. Urine protein 1gm/day
55.In which of the following condition there is red blood cell and red blood
cell cast in urine?
a. Interstitial Nephritis
b. Glomerulonephritis
56.What is the best indicator of early CRF?
a. Anorexia
b. Nocturia
c. Pruritus
 d. Bone Pain
e. Flapping tremor
57.Which of the following is a hormone responsible for red blood cell
reproduction?
a. …
b. …
c. …
d. Erythropoietin
e. …
58.Which one of the following isn’t an extrarenal manifestation of PCKD?
a. Hepatic cyst
b. Cerebral aneurysm
c. Pancreatic cyst
d. Renal cell carcinoma
59.Which of the following isn’t a side effect of Erythropoietin?
a. Bleeding
b. Infection
c. Pure red cell aplasia
60.Which one of the following occur in syndrome of inappropriate ADH
secretion?
a. Hypernatremia
b. Hyponatremia
c. Volume overload
d. Pseudo-hyponatraemia
e. Dehydration
61.Which of the following isn’t associated with secondary hypertension?
a. Conns syndrome
b. …
c. Barret syndrome
d. Pheochromocytoma
62.In case of Hypernatremia and low urine osmolality which of the
following is unlikely to be the cause?
a. Hypercalcemia
b. Hot Environment
c. Diabetes Insipidus
63.In which condition there will be Glycosuria?
a. Diabetes Insidious
b. Urinary tract infection
c. Fanconi Syndrome
64.Patient admitted to the dialysis unit, potassium 7.5 mol/L. Which of the
following is most useful to lower her potassium level?
a. Insulin with glucose
b. IV calcium gluconate
 c. Haemodialysis
65.A case presented with macroscopic haematuria, which was recurrent
many times previously. Which of the following is the correct diagnosis?
a. IgA Nephropathy
66.A 6 months infant with eczematous vesicle and crustation on both checks.
What medication will you use?
a. Hydrocortisone cream 1%
b. Betamethasone cream
c. Betamethasone ointment
67.A 35-year-old patient had dry well-defined scaly red plaques on his body.
Which form of topical steroids is preferred?
a. Ointment
b. Cream
c. Lotion
d. Gel
68.A patient who was diagnosed with chickenpox… Which of the followings
is the cause of scarring?
a. Ulcer
b. Vesicle
c. Erosion
d. Crust
69.A large buggy mass with multiple draining pus and sinuses on the scalp
in very ill person or staph. Carrier. Could be due to?
a. Carbuncle
b. Cutaneous leishmaniasis with secondary bacterial infection
c. Furunculosis
d. Folliculitis
e. Pilar cyst with secondary infection
70.Which one is not treatment of scabies:
a. Sodium stibogluconate antimony
b. Ivermectin
c. Benzyl benzoate
d. Crotamiton
71.A young man developed multiple comedones papules and pustules in the
face, back and shoulder. What’s the treatment?
a. Topical retinoic acid
b. Topical retinoic acid with oral doxycycline
c. Topical benzoic acid
72.Which of the following doesn’t occur in Rosacea?
a. Papule
b. Comedone
73.A case had scaring alopecia, purplish papules and painful oral ulcer.
Diagnosis:
 a. Lichen planus
74. Which of the following is most commonly associated with irregular nail
pitting and onycholysis?
a. Well-defined scaly plaque
75.Which of the following is not considered as predisposing lesion for SCC?
a. Chronic ulcer
b. Actinic keratosis
c. Bowen’s disease (Intra-epithelial hyperplasia)
d. Seborrheic Keratosis
76.Which of the following is treatment of choice for BCC?
a. Surgical excision
b. Electro-cauterization
c. CO2 Laser
77.A patient got diffuse weal for 3 weeks. Without significant past medical
or drug history. Which of the following is false?
a. The diagnosis is chronic urticarial
b. The edema in urticaria is found in the superficial dermis
c. The edema in angioedema is found in the deep dermis
d. Itching is usually absent in angioedema
78.A patient developed bilateral iris lesions on both hands. They were
pruritic (or not –don’t remember). Which of the following is true?
a. Erythema multiforme is life-threatening
b. The diagnosis is Erythema nodosum
c. Drugs never cause Erythema nodosum and Erythema multiforme
d. Herpes simplex virus is the major cause of Toxic Epidermal
Necrolysis
e. The typical target lesion has an inner ring of necrotic
epidermis
79.Which of the following is true regarding atopic dermatitis?
a. Facial and extensor involvement in infants and children is
major criteria
80.Which one is false regarding atopic dermatitis:
a. Topical steroids are part of the management
b. Adult phase begins from 18 years
c. Hand dermatitis may be the most common expression of the atopic
diathesis in the adult
d. Palmar hyperlinearity is a minor criterion
e. Eyelid involvement is a minor criterion
81.Which one is false regarding Seborrheic dermatitis?
a. It can be controlled by topical steroids and antifungal shampoos
b. It is caused by common bacterial flora
c. It can cause waxy scale
d. Postauricular is the commonest site in adults
82.A patient had multiple round red lesions on the trunk with peripheral
collarette and scaly at the peripheries. Diagnosis?
a. Pityriasis Rosea
83.A patient has been to the beach, he got skin tan. Except for few areas that
remained white. Some lesions are hypopigmented. What’s the treatment?
a. Topical terbinafine
b. Ketoconazole shampoo
c. Griseofulvin
d. Terbinafine
84.A patient had patch of alopecia that is scaly with broken-off hairs. What
is the systemic treatment of choice?
a. Itraconazole
b. Fluconazole
c. Griseofulvin
85.Which of the following is false regarding Trichotillomania?
a. Is ten times more common in females
b. Is treated by cognitive behaviour therapy
c. The pull test is negative
d. The presence of exclamation marks on clinical examination is
diagnostic
86.Which of the following is considered for differential diagnosis of
condyloma accuminata?
a. Chancre
b. Chancroid
c. Herpes simplex virus
d. Pearly Penile papules
87.Treatment of condyloma accuminata?
a. Imiquimod cream
b. Pencilline
c. Ceftriaxone
88.Which of the following is true regarding Telogen effluvium?
a. Pull test is positive and aids in diagnosis
b. Is an inflammatory alopecia
c. The most common form is due to premature conversion of
hairs to telogen induced by any systemic stressful event after 3-
5 months
Extended Matching Questions
REGARDING SMOKING CESSATION
A. 5 A’s
B. …
C. …
D. …
E. …
F. …
G. Nicotine and zyban replacement
H. 5 R’s and allylamine?
For each description below, choose the SINGLE most appropriate
answer from the above list of options. Each option may be used once,
more than once, or not at all.
1. A patient comes to you at the PHC with a cough. He says that he smokes 1
pack of cigarettes/day and that he has never been advised to quit.
a. 5 A’s
2. A patient comes who smokes 2 packs of cigarettes/day. His family have
forced him to come to the PHC so you can help to stop his smoking. He says
that he doesn’t think he can quite cigarettes. But he thinks that he may take
medication to stop him smoking.
a. 5 R’s and allylamine?
3. A patient comes to the PHC asking for help to stop smoking. He says that he
smokes 2 packs of cigarettes/day and the first thing he does when he wakes
up is light a cigarette. He really wants assistance as it is starting to affect his
life.
a. Nicotine or zyban replacement
REGARDING IMMUNIZATION
A. … + Rota 1
B. … + Rota 1
C. … + Rota 2
D. Measles + PENTA 1 + PREV13 1 + OPV 1 + IPV 1 + Vit. A 100 000 IU
E. … + Rota 1
F. BCG + PENTA 1 + PREV13 1 + OPV 1 + IPV 1
G. … + Rota 2
H. MMR 2 + DPT Booster 1 + OPV Booster 1 + Vit. A 200 000IU
I. MMR 1 + PENTA 3 + OPV 3 + PREV13 3 + Vit. A 200 000IU
For each description below, choose the SINGLE most appropriate drug
treatment from the above list of options. Each option may be used once, more
than once, or not at all.
4. A 4-month-old infant is brought to the PHC having never been given any
immunizations.
a. BCG + PENTA 1 + PREV13 1 + OPV 1 + IPV 1
5. A 9-month-old infant was brought to the PHC having only been given
immunization at birth.
a. Measles + PENTA 1 + PREV13 1 + OPV 1 + IPV 1 + Vit. A 100
000 IU
6. A 13-month-old child is brought to the PHC having been given
immunization at 0, 2, and 4 months
a. MMR 1 + PENTA 3 + OPV 3 + PREV13 3 + Vit. A 200 000 IU
REGARDING BACK PAIN
A. No management
B. Bed rest for 2 weeks
C. Analgesia and bed rest for 2 days
D. Physiotherapy
E. Investigations for tumours and other pathologies
F. Urgent referral to orthopaedic for decompression
G. Lumbosacral CT-Scan
For each description below, choose the SINGLE most appropriate answer from
the above list of options. Each option may be used once, more than once, or not
at all.
7. A patient developed back after picking up a heavy object. The pain does not
radiate and had no neurological symptoms…
a. Analgesia and bed rest for 2 days
8. A female with vertebral compression fracture and she had night pain…
a. Investigations for tumours and other bone pathologies
9. A patient with severe back pain, saddle-like pain, urinary incontinence and
loss of anal (sphincter) tone. (kindof looks like conus medullaris, but no MRI
in choices)
a. Urgent referral to orthopaedic for decompression
REGARDING ARTHRITIS
A. Ankylosing spondylitis
B. Cellulitis
C. Gout
D. Osteoarthritis
E. Pseudogout
F. Psoriatic arthritis
G. Reactive arthritis
H. Rheumatoid arthritis
I. Septic arthritis
J. Systemic lupus erythematosus
For each description below, choose the SINGLE most appropriate answer from
the above list of options. Each option may be used once, more than once, or not
at all.
10.A 76-year-old man has a severely painful left ankle. It has come on rapidly
over the last 3 days such that he can no longer put weight on it. He has
hypertension and says he has been started on a new tablet within the last 3
months. His foot is very swollen and erythematous.
a. Gout
11.A 78-year-old woman has noticed her left knee become increasingly swollen
over the last 2 weeks. She has had pain in the joint for many years now. She
takes alendronic acid 70mg PO weekly and calcium 500mg/colecalciferol 5
micrograms tablets PO at night. The joint is swollen and fluctuant with a
positive bulge test. It is held in fixed flexion at 20°.
a. Osteoarthritis
12.A 38-year-old man has extreme pain in his left foot. It has progressed rapidly
over the past 48h such that he is now struggling to stand. He says he has
suffered this type of pain before and confesses to regular IV drug use. His
foot is swollen and very inflamed, with erythema spreading proximally from
the toes to the medial malleolus.
a. Cellulitis
REGARDING HAEMATOLOGY
A. Aplastic Anaemia
B. AML-M3
C. ALL
D. MDS
E. Megaloblastic anaemia
F. Hodgkin’s Lymphoma
G. VWF

For each description below, choose the SINGLE most appropriate answer from
the above list of options. Each option may be used once, more than once, or not
at all.
13.A 30-year-old man with epistaxis and a productive cough for 7 days
duration. He had no lymphadenopathy or splenomegaly. His CBC showed
WBC 2.3, Hb 7.5, and Plt 20.
a. Aplastic Anaemia
14.A 30-year-old man with skin bruises and epistaxis. He had no
lymphadenopathy with mild splenomegaly. His CBC showed WBC 35, Hb
9, Plt 209, and blast cells were 10% (90% of them were promyelocytic).
a. AML-M3
15.A 30-year-old man with skin bruises and epistaxis. He had no
lymphadenopathy with no splenomegaly. He had PT 20, PTT 50, Bleeding
Time 12 minutes.
a. VWF
REGARDING TRANSFUSION
A. Acute haemolytic transfusion reaction
B. Acute non-haemolytic transfusion reaction
C. Acute febrile non-haemolytic transfusion reaction
D. Anaphylactic reaction
E. TRALI
For each description below, choose the SINGLE most appropriate answer from
the above list of options. Each option may be used once, more than once, or not
at all.
16.A patient was given 1 blood bag and after he had fever and headache.
a. Acute febrile non-haemolytic transfusion reaction
17.A patient was given 1 blood bag and after he had pruritis and …
a. Anaphylactic reaction
18.A patient was given 1 blood bag and after he had shortness of breath and
fever.
a. TRALI

REGARDING NEPHROLOGY
A. Post infectious glomerulonephritis
B. IgA nephropathy
C. Maintenance dialysis
D. Amyloidosis
E. Focal segmental glomerulonephritis
F. Membranous glomerulonephritis
For each description below, choose the SINGLE most appropriate answer from
the above list of options. Each option may be used once, more than once, or not
at all.
19.A 35-year-old man present with red color urine, has low serum IgA.
a. Post-infectious glomerulonephritis
20.A 40-year-old has diagnosed as focal segmental glomerulonephritis, now
creatinine
a. Maintenance dialysis
21.A 30-year-old present will bilaterally pitting leg edema, urine protein +++
a. Membranous Glomerulonephritis
REGARDING PRURITIS
A. Allergic contact dermatitis
B. Seborrheic dermatitis
C. Pityriasis alba
For each description below, choose the SINGLE most appropriate answer from
the above list of options. Each option may be used once, more than once, or not
at all.
22.A patient had sharply demarcated, erythematous with overlying vesicles. Is
confirmed to the site of the watch. He is wearing the watch for about one
year.
a. Allergic contact dermatitis
23.A patient had erythematous rash involving the centre of face, paranasal areas
and chest. It has waxy scale.
a. Seborrheic dermatitis
24.A 6-year-old boy who is asymptomatic found to have two lesions on the
check. They were hypopigmented.
a. Pityriasis alba

REGARDING STDS
A. Syphilitic Alopecia
B. Ceftriaxone + Azithromycin
C. Pox-virus infection
For each description below, choose the SINGLE most appropriate answer from
the above list of options. Each option may be used once, more than once, or not
at all.
25.Patient had unprotected sex. And he has moth-eaten alopecia.
a. Syphilitic alopecia
26.Patient had cloudy discharge from his peins. He has dysuria.
a. Ceftriaxone + Azithromycin
27.Patient with papules that are white and have dimple in the centre.
a. Pox-virus infection
REGARDING HAIR DISORDERS
A. Alopecia Areata
B. Androgenic Alopecia
C. Trichtollomania
For each description below, choose the SINGLE most appropriate answer from
the above list of options. Each option may be used once, more than once, or not
at all.
28.Case of down syndrome and atopic dermatitis. He had patchy hairy loss.
a. Alopecia areata
29.Female with thinning of hair in the vertex.
a. Androgenic alopecia.
30.A child has recently entered to the school. He is experiencing stress. Overall
hair is generally normal. There is irregular patch of hair loss with short,
broken hairs.
a. Trichotillomania