2019-07-05

ESA S4 MCQ Collection

Urinary

1. What is the acid/base disturbance?

pH = 7.5
pCO2 = 4.0 kPa
Bicarbonate = 24 mmol/L
pO2 = 14.0 kPa
a. Respiratory acidosis
b. Wide anion gap metabolic acidosis
c. Compensated metabolic alkalosis
d. Compensated respiratory alkalosis
e. Respiratory alkalosis

2. pH 7.30
pCO2 4.6 kPa
Bicarbonate 15 mmol/L
pO2 14.0 kPa
a. Metabolic acidosis
b. Metabolic alkalosis
c. Compensated metabolic alkalosis
d. Partially compensated metabolic acidosis pH near normal
e. Partially compensated respiratory acidosis
3. One of the following causes hypercalcemia:
a. Malignancy
b. Renal failure
c. Primary hypoparathyroidism
d. Vitamin D deficiency
e. ………

4. Woman has lion pain in the right side and mild fever, weight loss,
hematuria. CT shows large mass in the lower pole of right kidney
without pelvic dilation. Which of the following diagnosis is most
likely?
a. Acute pyelonephritis
b. Renal cell carcinoma
c. Transitional cell carcinoma
d. Renal stone

5. In the normal voiding, which nerve is responsible for contraction

of the detrusor muscle
a. Sympathetic T10-L2
b. Parasympathetic T10-L2
c. Parasympathetic S2-S4
d. ......

6. In a normal patient, the type of fluid found in the glomerular tuft

is:
a. Plasma
b. Intra-cellular fluid
c. Ultra filtrate
d. Urine
e. Blood
7. A patient present with PSA 27 (normal < 4) and long history of
back pain. In digital rectal examination there was large mass in the
prostate, but when performed midstream urine test was negative.
What is the next step to take?
a. Ultrasound
b. Prostatectomy
c. Prostate biopsy
d. Observation
e. .......

8. What of the following affect K+?

a. Aldosterone increase renal K secretion
b. Acidosis increase K secretion
c. .......

9. Chemoreceptors described as
a. Chemoreceptors located in the arteries
b. Central chemoreceptors sensed PO2
c. Peripheral chemoreceptors weak potent but less adapted
d. ...........

10. The loop of Henle is characterized by:

a. The absorption of water and solute is not separated
b. The descending limb absorbs water and sodium
c. The NaCL is absorbed form the lumen into the cell through
NKCC2
d. The ascending limb absorbs water, but not sodium
e. The fluid that leaves the loop of Henle is isotonic compared
to plasma
11. What is the treatment given to a person with detrusor
hyperactivity?
a. Antiadrenergic
b. Antimuscurinic
c. Ephedrine
d. ……

12. A patient uses the anti-hypertensive drug Thiazides diuretic.

All of the following are side effects of thiazide diuretics EXCEPT:
a. Hypokalemia
b. Hyperuricemia
c. Increased intracranial pressure
d. ……

13. The site of action for loop diuretics is:

a. Loop of Henle
b. Proximal convoluted tubule
c. Distal convoluted tubule
d. ……….
 Psychology

1. Faisal is nonverbal. He tries to make things in sense movement,

and performance. According to Piaget's model, he is:
a. Pre operational
b. Concert operational
c. Sensory motor
d. ….

2. You are playing with your neighbor’s child. He picks up a stick

and starts to swing it in the air thinking it is an airplane. He grabs
the stick and lower it to the ground saying that it is a car. The child
denies by saying that it is an ‘airplane’. According to Piaget’s
model, which stage is this child in?
a. Concert stage
b. Formal stage
c. None formal
d. Pre operational

3. Makaton is language program for deaf patient contain:

a. Speech, signs, symbols
b. Speech, maps, symbols
c. ……..
d. None of the above
4. You try to make your action match others in a group. This is an
example of:
a. Norms
b. Standerization
c. Make social contact
d. ….

5. Fatima is a 25-year-old British women that came to Imam

Hussain’s holy shrine. She was admitted to Al Sadeir hospital. She
is admitted to hospital for chest pain. She is deaf. What is the best
way to communicate with her?
a. English / BSL interpreter
b. Arabic / BSL interpreters
c. Speak louder
d. Loud voice
e. None of the above

6. CASE. Which of the following health care services will be the

most troubling for a deaf patient?
a. Use of prescription drugs
b. Diagnosis
c. Consent
d. Follow up
e. None of the above
7. A woman has multiple sclerosis and is experiencing mobility
problems. The doctor talks to her about the coping strategies she is
using to deal with her situation. Give an example of a problem
focused coping strategy:
a. Accept help with household tasks.
b. Focus on positive aspects of her life.
c. Join a support group for emotional support.
d. Take up a new hobby as a distraction.
e. Talk to her family about how she feels.

8. A 70-year-old woman puts up lots of makeup and denies her

grandchildren to call her a grandmother. According to the Erikson
development theory, which stage is she in?
a. Integrity versus despair
b. Generation vs stagnation
c. ……

9. A teacher hates one of her students, although she thinks that she
should be completely impartial, she makes efforts to hide her
resentment and be less critical of the student. Which one of these
coping mechanisms best describes this?
a. Rationalization
b. Anticipation
c. Sublimation
d. Identification with the aggressor
e. Reaction formation
10. One Cognitive behavioral therapy technique targeting
behavior is:
a. Graded exposure
b. Education
c. Monitoring of thoughts
d. Reappraisal of situations
e. Challenging negative thoughts

11. All of the following are indirect measurements of adherence

to the treatment Except:
a. Patient self-report
b. Second hand report
c. Pill count
d. Urine test
e. Mechanical or electrical measures

12. A nine months old girl was known to be very nice with
people, lately she had been bursting to tears whenever a stranger
holds her. This is an example of:
a. Separation anxiety
b. Autism
c. Stranger anxiety
d. ...

13. Regarding the above condition

a. It is normal in young infants
b. It may progress to lifelong diseases
c. It is a sign of insecure attachment
d. ...
14. Client-centered therapy is not indicated in:
a. Life events (illness, loss)
b. Subclinical depression
c. Mild anxiety
d. Psychotic episodes
e. Marital/ relationship difficulties

15. A man was being questioned for not paying with his taxes,
when asked why, he said that the Government would already waste
it anyway. Which coping mechanism best describes this?
a. Rationalization
b. Anticipation
c. Sublimation
d. Identification with the aggressor
e. Reaction formation

16. Doctors have high levels of?

a. Work related stress and pressures on family life
b. Work related stress and no pressures on family life
c. Work unrelated stress and pressures on family life
d. Risk of burnout if stress managed
e. Risk of burnout if stress not managed

17. Ethnocentrism and racism would lead to:

a. Discrimination
b. ……..
18. In the ‘SPIKES’ model of breaking bad news, what specific
principle does the letter ‘P’ relate to?
a. Check the patients’ perception about what they already know
b. Ensure privacy when breaking badness
c. Prepare the patient with a warning shot
d. Prepare the setting for breaking bad news
e. Provide as much information as the patient wants

19. What pattern of behavior is observed in young children

separated from their carers?
a. Anxiety –Distress –Adjustment
b. Avoidance –Ambivalence–Disorganization
c. Insecurity –Withdrawal –Recovery
d. Protest –Despair –Detachment
e. Proximity seeking–Contact maintaining–Attachment

20. In an RTA (road traffic accident) 10 cases appear in the

Emergency unit. 7 of the patients died. What type of death is this?
a. Sudden
b. Catastrophic
c. Gradual
d. Unexpected
e. Premature
21. Manager of Al Sadr teaching hospital can be developing
competence of his office in view of human diversity by:
a. Develop adaptation of services based on understanding of
multiculturalism
b. Increase salary of staff
c. All staff full-time duty
d. Useful of planning of other countries
e. Develop nursing staff competence
 Respiratory

1. Wheezing in asthma is:

a. During Breath secretion
b. During Inspiration and expiration
c. Nonmusical sound
d. In bronchial obstruction occurs during the inspiration equal
to the expiration

2. CO2 is transported in all of the following forms Except:

a. HCO3
b. CO2
c. H+
d. Carbamino compounds

3. All of the following are symptoms in asthma Except:

a. Wheeze
b. Hemoptysis
c. Chest tightness
d. Cough

4. Asthma can be described as

a. Affect 10% of the population
b. Socioeconomic development decreases the prevalence
c. Asthma prevalence decrease in worldwide
d. Avoid exposed the child to allergic and infection decrease
occurrences of asthma in later life
5. FEV1 is reduce a lot and FVC is reduced slightly. The result of
spirometer show
a. Obstructive
b. Restrictive
c. Combined obstructive and restrictive
d. Normal

6. All these are function of respiratory system Except:

a. Reserve of blood
b. Filter circulation
c. Angiotensin II inactivation
d. Insulin metabolism

7. What is the percentage of smokers that develop COPD with time?

a. 100%
b. 95%
c. ….

8. Upper respiratory tract function includes all of the above Except:

a. Minor air exchange
b. Humidification
c. Smell
d. Speech

9. Upper respiratory tract border is above

a. The lower end of cricoid cartilage
b. Upper end of cricoid cartilage
c. ….
10. A patient after retrosternal thyroidectomy, comes with
sudden shortness of breath. On examination, there is decreased air
entry sound in right lobe and increase resonance. Res. Rate 24
/min, SPO2 92 % in room air. What should you do first?
a. CXR
b. Furosemide
c. Insert chest drain tube
d. Intercostal thoracentesis

11. The most common type of lung cancer is:

a. Adenocarcinoma
b. Squamous cell carcinoma
c. Large cell carcinoma
d. Small cell carcinoma

12. Smoking is risk factor for all the following except:

a. Chronic obstructive pulmonary disease (COPD)
b. Asthma
c. Sudden pneumothorax
d. Mesothelioma

13. Vocal cord function is:

a. Abduct in respiration
b. Abduct in swallowing
c. High abduct in speech
d. .....
14. The minute-to-minute action of ventilation is controlled by
a. Arterial PO2
b. Arterial Pco2
c. Cerebrospinal fluid Po2
d. Cerebrospinal fluid pco2
e. ….....

15. Transverses thoraces is a muscle of the:

a. External intercostal muscle
b. Internal intercostal muscle
c. Innermost intercostal muscle
d. Secondary intercostal muscle

16. A foreign body enters the trachea. Where will it most likely
be going next?
a. Left bronchus
b. Right bronchus
c. Secondary right bronchus
d. Esophagus

17. Children with respiratory distress syndrome will have

a. Increased surface tension
b. Increased lung volume
c. Increased lung elasticity
d. …………
18. Which of the following will not determine the prognosis of a
lung cancer?
a. Cell type
b. Disease stage
c. Biochemistry of the patient
d. Co-morbidity (cardiac, chronic respiratory disease)
 GIT

1. The midgut loop normally herniates through the primitive

umbilical ring into the extra-embryonic coelom during week 6.
Failure of the intestinal loop to return to the abdomen cavity by
week 11 result in the formation of:
a. Omphalocele
b. Gastroschisis
c. Megacolon
d. Ileal diverticulum
e. Intestinal stenosis

2. Fat extrude from mucosal cell to the lymph in the form of:
a. Monoglyceride
b. Diglyceride
c. Triglyceride
d. Chylomicrons

3. One of the following arteries run along the superior border of

pancreas:
a. Gastroduodenal artery
b. Left gastroepiploic
c. Splenic artery
d. ………..

4. Absorption of vitamins B12 occurs in:

a. Stomach
b. Duodenum
c. Jejunum
d. Ileum
5. How to differentiate between direct and indirect hernia?
a. Femoral artery
b. Inguinal ligament
c. Inferior epigastric vessels
d. …..

6. The Lamina propria and submucosa are derived from:

a. Paraxial mesoderm
b. Visceral layer of lateral mesoderm
c. Parietal layer of lateral mesoderm
d. Extra-embryonic mesoderm
e. Endoderm

7. The enzyme that converts trypsinogen into the active form

(trypsin) is:
a. Enteropeptides
b. ….

8. Which of the following conditions most likely causes obstructive

jaundice?
a. Obstruction of the main pancreatic duct
b. Cancer in the body of the pancreas
c. Cancer in the head of the pancreas
d. ……
9. HCO3 absorption in the small intestine is coupled with:
a. Na-glucose cotransport
b. Na/H exchanger
c. Electrogenic Na
d. Na/cl symporter

10. The organs present in the abdomen and related to the thoracic
cavity are:
a. Ascending and transverse colon
b. Duodenum and sigmoid colon
c. Liver and spleen
d. …….

11. Which of the following is the main papilla of the tongue?

a. Circumvallated papilla
b. Fungiform papilla
c. Filiform papilla
d. Filciform papilla

12. Tumor in the uncinate process will mostly affect which of the
following:
a. Inferior vena cava
b. Portal vein
c. Superior mesenteric artery
d. Splenic artery
13. Child with projectile vomiting after eating and develops
intolerance from oral feeding. Examination revealed a node. What
is the most likely diagnosis?
a. Annular pancreas
b. Hypertrophic pyloric stenosis
c. Intestinal stenosis
d. ……..

14. Gastric emptying will increase with the increase in:

a. Intra-gastric volume
b. Fat in the duodenum
c. Osmolarity of the duodenum
d. Amino acids in the duodenum
e. Carbohydrates in the duodenum

15. The following is true about Meckel’s diverticulum:

a. Located two feet from the ileocecal valve
b. Affects 20% of the population
c. Remnant of the vitilointestinal tract
d. May contain renal or adrenal gland

16. Criteria of the quadrate lope includes:

a. Supplied by right renal artery
b. Located between IVC and legumentum venousm
c. Drained into the left bile duct
d. Functionally it is part of the right lope
e. Located in the medium superiorly
 17. The most common type of anorectal malformation is:
a. Imperforated anus
b. Anal agenesis
c. Rectal atresia
d. Anorectal agenesis

Credits:
I thank all participants for their time and effort in sharing the
information was essential for the development of this document. Special
thanks to group:

ESA S4 Question collection with their telegram link below.

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