SLE AUGUST 2011 ANSWERS NOT SURED* 1- Statistics of a village in 2008: Total number of population: 2500 Total number

of still birth: 10 Total number of live birth: 18 Total number of dead: 25 Total number of marriage: 15 The crude death rate in this village in 2008 is: - 10% - 14% - 25% - 30% 2- 25 y/o pt with 1 day history of dysuria & increase frequency & suprapubic pain, PR: 102, BP: 110/60 Temp: 38 C Urine analysis showed 50-60 leukocytes, gram negative bacilli. The best way of management: - Oral ciprofloxacin, review after 2 days - Oral amoxicillin, review after 2 weeks - Intravenous Amikacin - Intravenous Piperacillin 3- A female patient considering getting pregnant came asking for chicken pox vaccine (varicella vaccine). You will: - Tell her that this vaccine does not protect pregnant ladies. - Tell her that 1st trimester is not a contraindication. - Ask her to delay her pregnancy at least 1-3 months. - Tell her that the vaccine is a life attenuated bacteria. 4- A young patient presented with dysuria urine microscopy showed epithelial cells. Most likely diagnosis is: - Chlamydia Trachomatis - Renal calculi - Interstitial nephritis - !!!

5- )) picture of purulent urethral discharge (( A patient presented complaining of this urethral discharge and dysuria. He had a history of unprotected sexual contact with a female 10 days ago. Urine examination showed gram -ve diplococcic. The most likely diagnosis is: - Gonococcal urethritis. - Candida infection. - Syphilis infection. - Herpes infection.

6- 30 y/o female came to you for pre-pregnancy advice. She had history of one pregnancy with anencephaly. The percentage of recurrence of neural tube defects in this patient is: - 2% - 8% - 10% - 20% 7- Within 6 hours after attending a dinner party, 10 participants developed severe nausea and vomiting, abdominal cramps and diarrhea. The most probable cause is: - Salmonella food poisoning. - Gardiasis. - Staphylococcal food poisoning. - Clostridium perfringens food poisoning. 8- Which one of the following drugs increases the severity of erectile dysfunction caused by selective serotonin reuptake inhibitors (SSRI): - Propranolol - Amantadine - Verapamil - Lorazipam 9- 45 y/o pt with chronic renal failure. His GFR was found to be 12 which stage is this? - Stage 1 - Stage 3 - Stage 5 - Stage 7

10- 5 y/o child is found to have a parent with TB. Tuberculin skin test was done to the child and gave an induration of 10 mm. The interpretation of this test is: - Indeterminate - Negative test - Weak positive - Strong positive 11- A patient presenting with severe jaw pain on the left side. The pain is knife-like lasting several seconds, usually starts at the mandible then spread to the maxilla and periorbital area. The best management is: - Analgesia. - Olanzapine. - Corticosteroids. - Carbamazepine. 12- ((Picture of swelling around the fingernail, the swelling is red, inflamed with pus in the corner of the nail)) A patient presented with painful inflammation of the fingernail 10 days ago and was given oral antibiotics and warm compresses. Now he came with this condition. Best treatment is: - Repeat the oral antibiotics for 2 weeks. - Incision and drainage under regional anesthesia. - Incision and drainage under general anesthesia. - Topical antibiotics. 13- A 13 y/o boy was given Retin-A cream for treatment of his acne. The doctor should mention to him that: - The cream can make the skin more oily. - The cream can make the skin sensitive to light. - One side effect is mild gynecomastia. -May cause nausea. 14- 21 y/o female came complaining of failure to conceive after 3 months of trying. She is healthy with normal BMI. Her periods are regular with average amount of bleeding & she had never used contraceptive pills. She had appendicectomy at the age of 11 y/o. Her husband is 27 y/o healthy man who did not fathered any children. They have intercourse 3-4 times a week. The action of the doctor should be: - Get sperms count. - Check tubal patency. - Advice to continue trying. - Do hormonal analysis (Estrogen- FSH- LH) 15- Pregnant female developed gestational diabetes. Diet control failed & she needed to take insulin to control her blood sugar. This makes her at high risk in the future to develop: - Hypoglycemia. - Insulin resistance. - Type 1 DM. - Type 2 DM. 16- 55 y/o male with an ulcer over the lateral malleolus of the right leg. The ulcer is painful and the lower limb is pale, cold, with absence of peripheral pulses. The most likely diagnosis is: - Venous ulcer - Arterial ulcer - Pyoderma gangrenosum - Erythema multiform 17- Television actress suffering from rosacea. Because she thinks that the appearance affects her career your choice of treatment will be: - Oral antibiotic. - Antihistamine. - Topical antibiotic. - Laser. 18- Patient presented with vesicular rash on his left forehead and eyelid with corneal ulceration. Treatment is by: - Acyclovir. - Antibiotics. - Varicella vaccine. - Topical steroids. 19- 40 y/o male with hyperthyroidism was found to have a single thyroid nodule with over uptake of iodine. The best management is by: - Nodule excision. - Anti thyroid drugs. - Radioactive iodine. - Decrease iodine intake.

20- 15 y/o post- pubertal female came to the clinic complaining of excessive hair growth in the face, abdomen and axillae. Her puberty was at 13 y/o, her periods are irregular, every 3 months and the exact dates are not predictable. The bleeding is scanty. Physical examination revealed the presence of acne in her face but was otherwise normal. Normal secondary sex characteristics & normal breast development. The most probable cause of her condition is: - Ovarian failure - Peripheral androgen resistance - High androgen level - Low androgen level 21- Patient presented with fatigability. His CBC was: Hb: 9.6 g/dl, WBC: 5800 (Neutrophils: 68% , Lymphocytes: 38% , Monocytes: 4%, Eosinophils: 2% , Basophils: 0.5%, Myeloblasts: 4%, is: - Leukemia - Thalassemia - Sickle cell anemia - Chronic myeloid leukemia

Myelocytes: 1%, Metamyelocytes: 0.3%). The most likely diagnosis

22- 35 y/o male with palpitations, nervousness, sweating and fever. Examination showed tender anterior neck swelling the most likely diagnosis is: - Graves disease - Hyperthyroidism - de Quervaine's thyroiditis - Toxic nodule 23- A patient was diagnosed to have Hodgkin's lymphoma with the characteristic Reed-Sternberg cells. Peripheral blood film also showed lymphocytes, eosinophils and plasma cells. The classification is: - Mixed-cellularity. - Lymphocyte predominant. - Lymphocytes deplete. - Nodular sclerosing. 24- Which one of these drugs is not available as emergency tranquilizer in psychiatric clinics: - Haloperidol - Phenobarbital - Lorazepam

25- ((Picture of a huge ulcer in the leg, the ulcer is red with raised edges)). Best option of management: - Topical steroids - Biopsy - Radiotherapy - Topical antibiotics 26- 45 y/o female complaining of sore tongue, peripheral parasthesia and slight jaundice. Her investigations are: Bilirubin 3.4 (normal between 0.2 - 1.9), B12 (low), Folate (normal), Serum ferritin (normal). The most probable diagnosis is: - Iron deficiency anemia. - Liver Cirrhosis. - Pernicious anemia. - Peripheral neuropathy. 27- 65 y/o male known to have atrial fibrillation came complaining of recurrent attacks of head lightness over the last 3 months. He used to take Digoxin but he had not used it for many years. His carotid examination was normal. Physical examination was normal apart from tachycardia. What would you consider to give this patient? - Preparation from Digitalis. - Propranolol. - Cardiac rehabilitation. - Cardiac conversion. 28- What is the best type of exercise to keep muscle bulk and bone density with aging? - Low resistance weight-bearing exercise. - Conditioning and low resistance load-bearing. - Long distance walking and conditioning. - High resistance weight-bearing exercise. 29- 4 y/o child with diarrhea for 2 days is complaining of anal discomfort. Your advice to the mother is: - Wash with soap and water after each episode of diarrhea. - Wash with cotton in warm water.

- Put a clean napkin in the underwear. - Change the underwear to a highly absorbent diaper. 30- A female patient complaining of palpitations, nervousness and inability to stand heat. On examination the patient's peripheries were warm. TFT was: TSH: low Free T3: high Free T4: high The diagnosis is: - Peripheral T4 resistance . - Pituitary gland tumor. - Thyrotoxicosis. - Graves disease. 31- Young man was walking around the streets asking an inappropriate question. He was asking strangers and he did not stop when he was told to. He did not understand why his question was inappropriate. The pt is most likely having: - Flight of ideas. - Preservation. - Thought insertion. - Loss of association. 32- A patient with type 2 diabetes mellitus presented with fatigue, abdominal pain and nausea. On examination the pulse was 95/min, T: 38.2, BP: 130/85. RBG was found to be 430 mg/dl. The initial management of this pt is: - 0.1U/kg insulin subcutaneously. - 1 L of normal saline infusion. - Oral hypoglycemic drugs. - Metoclopramide. 33- 60 y/o male with Hypertension for 10 years. He's on Lisinopril, Thiazide and Nifedipine, developed sudden severe pain in the first metatarsophalangeal joint. Examination showed redness and swelling in the joint. The most appropriate change in the treatment would be: - Thiazide. - Bisoprolol. - Lisinopril. - Nifedipine. 34- The best drug used in treating schizophrenia, mania and schizophreniform disorders is: Risperidone Amitriptyline Olanzapine Paroxetine 35- A male patient presented with fatigue, myalgia, abdominal pain and diarrhea. He was diagnosed to have Addison's disease. Lab investigations were: Na: 129 (135 - 145 mmol/l) K: 5.9 (3.5 - 5 mmol/l) RBG: 88 mg/dl The immediate management is: - l L normal saline over 1 hour + 10 mg hydrocortisone I.V - 1 L normal saline over 1 hour + fludrocortisone orally. - 1 L normal saline over 8 hours + 10 mg hydrocortisone I.V - 1 L normal saline over 8 hours + fludrocortisone oraly Other questions were about: - ear infections - alopecia - peptic ulcer - mania GOOD LUCK TO U ALL!