Medicine

1- 38-year-old with GN after Hodgkin's lymphoma, most likely?

- MCD *
- membranous
- FSGN
- amyloidosis

2- patient with inferior MI with hypotension, what to do next?

- IV fluids 100ml/hr rate * (maybe)
- Atropine

3- 65 year old patient with CURB-65 score of 3, most appropriate management?

- Admit to floor for IV antibiotics
- Admit to ICU for IV levofloxacin and cephalosporin *
- Admit to ICU for IV vancomycin and cephalosporin
- Discharge on azithromycin

4- 35 year old patient with pneumonia, CURB-65 score is 1, best management?

- Discharge on azithromycin with follow up

5- One of the following is a cause of high ammonia

- Lipid disease
- Urea cycle disturbance *

6- obese patient complaining of medial knee pain after standing and at the end of the day. No
Morning stiffness, what's the most likely diagnosis?
- Osteoarthritis *
- RA

7- patient with cluster headache, likely trigger?

- GTN *
- Aspirin
- ACEI

8- test to assess phagocytic function?

- NZT test
- flow cytometry *

10- Patient complains of joint pain, what's true about crohn's?

- arthritis is the most common EIN *
- treating GI symptoms resolves arthritis

11- Best parameter to distinguish ARDS from pulmonary edema from heart failure?
- Acute onset
- New bilateral infiltrate
- Hypoxia
- Pulmonary capillary wedge pressure <19 *
 12- Case of arthralgia on wrists , knees , ankles , and multiple tender points on examination
plus decreased sleep, dx :
- Polymyalgia rheumatica
- Fibromyalgia *
- RA
- Osteoarthritis

13- 35 y/o man , hyperlipidaemia , smoker , paroxysmal Afib , regarding anticoagulation :

- Aspirin
- No warfarin or aspirin *
- Warfarin
- Heparin

14- Most consistent with pericarditis?

- T inversion
- Absent p waves
- Friction rub *
- ST segment depression

15- Pt hx of DVT and anticoagulated for 6 months, now presented with another episode of
DVT , regarding anticoagulation :
- Warfarin for life with INR 2-3 *
- Direct acting anticoagulant for life
- Warfarin for another 6 months

16- COVID-19 m.c symptom:

- fever*
- cough
- Diarrhea
- sneezing

17- COPD with exacerbation, fever and wheezes bilaterally.. next step.
- CXR*
- spirometry
- CBC
- ABG

18- mismatch drug toxicity:

- iron/hematemesis..
- aspirin/metabolic alkalosis*

19- patient with seizure not responded to 2 trial of IV diazepam, what to do next?
- infusion midazolam
- infusion valproate
- infusion propofol
- infusion ketamine
- IV phenobarbital *

20- pt with Hx of sinusitis.. hematuria.. Dx?

- granulomatosis with polyangiitis*
- churg stauss
 21- In a study, 800 smokers in cases and 110 smokers in control, 2000 in case, 2000 in control,
calculate odds ratio of smoker having lung disease?
- 7.2

22- biostat question comparing two procedures for same outcome, which test to use?
- chi square (most likely)
- student t test
- paired t test

23- Nail onychomycosis, treatment?

- Topical antifungals
- Systemic antifungals*
- Remove nails

24- False about AIDs

- Viral load PCR for primary diagnosis?
-CD4 is important for diagnosis?
- Antibodies formed 3 weeks to 3 months after exposure
- Test confirmed by western blot

25- Lung mass with hypercalcemia, what to check?

- PTH
- PTHrP*

26- Optic neuritis (painful loss of vision in one eye), treatment?

- IV hydrocortisone

Surgery
1- You're a surgery junior at the ER, patient comes with eviscerated small bowel and pus
draining from the wound, what to do next?
- call senior
- put sterile gauze with normal saline on the bowel *

2- patient presents 7 days after surgery with fever, most likely diagnosis?
- UTI
- SSI *
- atelectasis
- peritoneal abscess
-thrombophelbitis

3- false about chylothorax:

- it is acidic and may injure pleural cavity (it is alkaline)

4- obese patient after laparoscopic surgery with high CO2, most likely cause?
- Absorption of CO2 from surgery causing pneumoperitoneum?
5- elderly with painless jaundice.. dilated biliary tree on US with no stone.. next
investigation:
- CT?
- ERCP
- PTC

6- Patient had acute pancreatitis 2 weeks ago. Came with pain and vomiting. Ct was done
showed an abscess 6*6cms. What's the management?
- Ct- guided aspiration
- Abx + Ct drainage + repeat Ct in 2 days
- Abx + Ct drainage
- abx alone
- Abx + percutaneous drainage *

7- Not a deficiency after gastric bypass?

- B12
- Thiamine
- Iron
- Calcium
- Protein *

8- Management of medullary thyroid CA. ?

- Thyroidectomy
- Hemithyroidectomy
- Thyroidectomy with neck dissection *

9- TPN for 13 days, most likely complication?

- refeeding syndrome
- Gallbladder sludge*

10- Young patient after RTA, has respiratory destress, hypotension and signs of tension
pneumothorax, what's the most appropriate next step?
- Endotracheal intubation *
- CXR
- IV hydration

11- HNPCC, what's wrong?

- Start screening at 25*
- Most patient at 50
- Mostly on right side
- More than one lesion

12- Painful mass in groin, most appropriate next step?

- Schedule for urgent laparotomy*
- NG tube and IV fluids and admit
- Observe

13- When to repair congenital inguinal hernia?

- Immediately after diagnosis*
- When complicated
- When he starts walking
 - At 1 year

14- Not a criteria of SIRS:

- PCO2
- HR >110
- Temp 35.5
- WBC 12K
- BP 90/55**

15- One of the following showed better prognosis in the treatment of sepsis?
- Giving albumin boluses early
- Early antibiotics *

16- which mammographic finding show breast CA?

- >5 microcalcifications/cm

17- 3 vessels coronary artery disease, 23% risk stratification, what's the management?
- CABG*
- PCI
- PCI + CABG

18- Trauma pt low GCS , traumatic brain injury:

- steroids are recommended for all moderate to severe brain injury

19- true about tetanus:

- Short incubation period indicates severe disease
- Give NBM to control rigidity?

20- true about stones: brown stones are calcium palmidate

21- most common site of aortic dissection: proximal cms of arch

22- confirm traumatic urethral transection with? Retrograde urethrogram

23- in the management of traumatic aortic transection, what factors to take into
consideration?
- Timing of repair?

Pediatrics
1- wrong about wilm's tumor?
- m.c bilateral *
- can be with WAGR syndrome,
- m.c presentation asymptomatic abd mass
- Hypertension is common..
- hematuria is common
 2- 5 y.o child with high Cr 2.5, least likely cause:
- AR PCKD
- dysplastic kidney
- reflux nephropathy
- HUS
- Neurogenic bladder*

3- baby with polyurea, hypokalemia, metabolic acidosis.. Hypophosphatemia, NL glucose, dx?

- Bartter syndrome
- DKA
- distal RTA *
- Fanconi syndrome
- Hyperaldosteronism

4- wrong about chronic diarrhea:

- rota cause osmotic diarrhea
- giardia can cause chronic diarrhea
- stool ph 5 indicate protein malabsorption
- ecoli 157 needs antibiotics*

5- DOC for absence seizures?

- Valproic acid*
- Carbamazepine
- Vigabatrin

6- Child with maculopapular rash, red tongue and lips and high fever, dx?
- Kawasaki

7- Apgar score for child with HR 110, irregular breathing, sneezing, flexed arms, blue
extremities
-7

8- pharyngitis all true except?

- GN only after PSGN*
- treating with abx decreases risk of rheumatic fever
- enlarged LNs more with bacterial
- hard to differentiate between viral and bacterial clinically

9- Pt with short stature and vomiting, W/H at 40th percentile, bone age less than
chronological age with otherwise normal examination most likely Dx :
- Endocrine disorder
- Constitutional delay *
- Malabsorption like celiac
- Genetic
- Chromosomal abnormalities
 10- All of the following cause polyhydramnios except:
- Esophageal atresia
- Pyloric stenosis
- Duodenal atresia
- Hirschsprung disease *
- Congenital diaphragmatic hernia

11- 12 y old male with morbid obesity, the best surgery is :

- Intra gastric ballon
- Banding
- Sleeve*
- Bypass

12- A baby with sunken eyes and depressed fontanelles. 4 kgs. What is the fluid 'didn't
specify if bolus maintenance or anything'
- 400cc
- 680cc*
- 1000cc

13- Male child. Which of the following cannot cause central precious puberty?
- Neurofibromatosis
- HCG secreting tumor *
- CNS trauma
- CNS Infection

14- typical case of meningitis with positive cocci organism, What to give in addition to ABx?
- Dexamethasone *
- Mannitol

15- baby w/ hx of HF & continuous murmur on left upper sternal border?

- PDA

16- not used to Dx muscular spinal atrophy:

- ck level*
- muscle bx
- electromyogram
- genetic study
- nerve conduct study

17- false about UTI:

- m.c age < 1y..
- asymptomatic bacteriuria treated for 5 days *

18- developmental milestone, hop on one leg?

- 4 years ?
-3 years
19- developmental milestone, knows their own name?
- 24 months
- 48 months
- 40 months*
- 30 months
 20- Child with nephrotic syndrome, dyspnea, edema, hematuria?? Which to give?
- ACEI, prednisolone, Furosemide
- ACEI, prednisolone, Albumin
- Furosemide and albumin. And prednisone*

21- Wrong about RDS?

- Apnea indicated mild disease*

Obs and Gyne

1- A marker for ovarian reserve:
- FSH
- LH
- AMH *
- Inhibin
- oestradiol

2- GI Physiological changes in pregnancy, all true except

- increased transit
- increased gastric acidity
- decreased LES tone
- decreased liver albumin *
- increased dental caries

3- Correct Physiologic changes during pregnancy?

- high GFR *
- Renal blood flow increased by 40%
- Decreased erythropoiesis

4- what's used to know progression of labor?

- frequency of contractions
- amplitude of contraction
- descent of baby *

5- Absolute contraindication to epidural analgesia?

- Narcotics
- Hypovolemia *
- Anticoagulation

6- Pt , 25 y/o with regular 28 days cycle presented with pain at the mid of the cycle , and
lasting for 24 hours then subside spontaneously , physical examination shows no abnormality?
- Mittelschmerz syndrome*
- Adenomyosis
- PCOS

7- What's not used in preterm labour?

- Labetalol *
- Atosiban
- Indomethacin
 - Nifedipine

8- wrong about placenta..

- Increased bore of decidual arteries is underlying cause of eclampsia *
- major endocrine organ
- Receives more blood supply than other parts of fetus

9- Correct about pregnancy dating:

- HC can be used up to 23 wk
- LMP can be used if irregular
- LMP more accurate than US
- Normal pregnancy is 280 days *

10- False about IDA in pregnancy:

- increased ferritin*
- avoid blood infusion
- treat with oral iron

11- young pt with complex ovarian cyst on US, contains fat & calcifications, diagnosis?
- dermoid cyst

12- cervical smear result with mild dyskaryosis, next step?

- LEEP
- Colposcopy and biopsy *
- repeat in 6 months

13- Young female patient with ectopic pregnancy 3 cms viable on the left side, she is stable.
She had a previous ectopic and salpingectomy on the right side. What's the. management?
- Methotrexate
- Laparoscopic Salpingostomy *
- Laparoscopic Salpingectomy
- Observation
- Laparotomy

14- Not an aim in detailed18 wks GA anomaly scan:

- placenta location*
- bonding of parents with fetus
- spinal anomaly
- Fetal anomalies

15- RF for preeclampsia?

- Previous renal disease*
- Multigravida
- Diabetes mellitus

16- Genetic testing which’s most correct

- sign consent before the test*
- only discuss termination if condition is serious
 17- not in PET management?
- Furosemide*
- Labetalol
- MgSO4

18- RH negative mother, what is true?

- Give routine dose at 23 wks GA
- No risk after two RH negative pregnancies
- if mother develops APH, kheil test will be done *

19- checked in biophysical profile: Amniotic fluid index

20-true about twins?

- Lambda sign in diamniotic monochorionic
- Risk of congenital malformation increases 4 times?

21- wrong about cardinal movements: Restitution following external rotation

22- wrong about pregnancy: 80% have diastolic murmur in 12th week