1- 30 y woman came to ER c/o sharp central pain and SOB 2 days ago with

normal lab and ecg (i think ischemic changes) diagnosis:

A.cardiomyopathy
B.pericardial effusion
C.pulmonary embolism

2- Best position to carry baby by mother:

A.head on the inener elbow and body on outer forearm.
B.body on inner eblow and head on outer forearm.

3- Young female patient with bipolar psychiateric dse on ssRI :

A.venalexidine is better ithink ?
B.sexual change will happen

4- Epileptic patient on medication want to be pregnant ..what the risk of being

pregnant on baby i think:
A.anticonvulsant
B.benzodiazepines
C.maternal epileptic fits during pregnancy

5- Ingesion of iron tablets will cause

A.resiratory acidosis with metabolic alkalosis
B.metabolic acidosis with respiratory alkalosis

6- male patient with vital signs shows high BP:170/100 i think with family hx of
hypertension will give him to control Bp:
A.losartan
B.b blocker i dont remember
C.amlodipine

7- phospho diesterase 5 inhibitors should not be given during

a. Nitrates
b. Pregnancy

8- A pregnant female came with complaints of vaginal bleeding and absent fetal
movements.
A usg was done and it revealed GROUND GLASS APPEARANCE...
diagnosis??
a. Amniotic fluid embolism
b. Ruptyre of adnexal cyst

9- In a psychotic disorder which among the following least contribute to an

organic cause.
a. Age less than 25 yrs
b. Family history of drug abuse
c. History of drug dependance
d. Alcoholism

10- a lady came with h/o consumption of INH (15 tabs).

No other details were given and asked wt will be your mode of action.
a. Pyridoxine
b.topiramate
C. naloxone
11- Allergic conjuctivitis what to give ??
a. antihistamin
b. tabromycin

12- A 17 year old patient presents to the ER with a history of Right Iliac Fossa
pain, anorexia, vomiting and nausea. The temperature is 38.3C. On
investigation the TLC is 12000/cu.mm. The most likely diagnosis is
A. Acute appendicitis
B. Acute salpingitis
C. Mesenteric lymphadenitis
D. Iliopsoas abscess

13- A fully breast feed baby, from a mother on a healthy, balanced diet, can have
deficiency of which vitamin?
a) Vitamin B complex
b) Vitamin C
c) Vitamin D
d) Vitamin K

14- the pediatric society or somtging in saudi arabia recommend brest feeding for
how long:
a6m
b 12- 24 m
c 48 m

15- pt known case of hiv develop eye redness on fundoscopy there is cotton-wool
or something like this (( and another finding )) dignosis is ??? a- toxoplasmosis
retinopathy b- HIV retinopathy c- T.B retinopathy

16- Alcoholic male with retching presented with sudden severe chest pain (CXR
was given)
a. Boerhaave (esophageal rupture)
b. Mallory-Weiss syndrome

17- Baby with salty taste,meconium ileus,Diagnosed cystic fibrosis .What is the
percentage of recurrence in the next infant
A.5%
B.15%
C.25%
D.50%

18- Case of pericarditis

a) Pain in chest increase with movement
b) Best investigation is ECG
c) Best investigation is Cardiac enzyme

19- A 32 year old woman comes to your clinic. She is worried about the possibility of
her developing a carcinoma in her breast. Her mother died of a breast cancer at
the age of 68. Her age of menarche is 14 years. She is on OC pills. She has a
one year old lactating healthy female child. Which is the strongest risk factor in
her history for developing breast cancer.
 A. Mother has cancer.
B. First childburth after age 30
C. OC pill use.
D. Menarche at age 14.
20- The following more common with type 2 DM than type 1 DM: a) Weight loss
b) Gradual onset c) Hereditary factors
d) HLA DR3+-DR4
21- Case of elderly with bilateral knee pain aggravated by physical activity and
worse at the end of the day
a. Osteoarthritis
b. Osteomalacia
c. Rheumatoid arthritis
22- pt diabetic for 5 yrs on metformin , presented with watery foul smelling diarrhea
for three wks, two wks ago she received clindamycin for dental problem, what is
the cause of her symptoms:
a clindamycin
b diabetic gastroparesis
c metformin
23- Question about Young lady tends to use DICLOFENAC for a long time came to
you with "hematuria"
Wt is the cause ??
The right answer is: nephrotic syndrome
24- 12 year old female presents to the ER with a history of vomiting, central
abdominal pain, colic, and obstipation. Small bowel obstruction is diagnosed
and the patiebt is taken up for laparotomy. Intraoperative findings suggest there
is a stricture of the distal ileum 10 cm proximal to the IC junction. There is a
fibrinous exudate with tubercles on the serosa surrounding the stricture. The
most appropriate management is
A. Right hemicolectomy
B. Ileal resection and anastomosis.
C. Strictureplasty and antitubercular treatment.
D. Local resection with infliximab.

25- A 30 year old patient presents with a history of road accident while driving and
not wearing a seat belt. On presentation his airway is patent and there is a
paradoxically moving section of the left chest wall with an underlying
hemopneumothorax. A chest tube is inserted that drains a lot of air and 500 ml
of blood. Other findings are pH 7.23, PaCO2 58, PaO2 50, SpO2 46, HCO3 25.
Pulse 100/min, BP 120/80, and RR 30/min. The next step in management is ;
A. IV sodium bicarbonate to correct the acidosis
B. Intubation and ventilation.
C. Thoracotomy
D. High flow oxygen
E. CECT chest and abdomen
26- Pregnant woman with high alpha fetoprotein..delivered a baby with depressed
nasal septum what investigation to do:
A. Echo
B.alpha fetoprotein of the baby
C.chromosomal study

27- pregnant lady G8 wks came with vaginal bleeding and lower abdominal pain
for last one day..O/E Ccervical os 3cm U/S showed a viable gestational
sac..diagnosis?
A/complete abortion.
B/incomplete.
C/inevitable.
D/thearten
28- this q about screening of AAA options are :
A/ once in 65-79 men who never smoked.
B/once in 65-79 men who ever smoked.
C/yearly in 65-79 men who ever smoked
D/ once in 66-79 women who never smoked.
29- vaccine given at birth, 2, 4,6 months:
A/polio
B/hepatitis B
c/ measles
D/rubella
30- pt had seizure.. now he c/o S.O.B, restlessness, O/E bilateral crackles (x-ray
attached showing pul-edema) his BP high 200/140
You will give him I.V drugs ..wt is the best:
A/ hydralazine.
B/metoprolol.
C/furosemide.
D/nitro
31- post MI.. pt developed palpitations ( there is ECG) the diagnosis VT
32- 45 yrs old man comes for routine check up..accidentally found RT thyroid lobe
enlargement..
TFS done and normal..(there pic of thyroid U/S)
Wt u will do next:
A/ reassurance and say this cystic no need further interference.
B/FNA
C/refer for surgery
33- childwith bloody diarrhea and mucus In stool analysis no cyst or ?
A/IBS
B/rotavirus
C/ulcerative colitis.
D/giardia
34- old patient found to have abdominal aortic aneurysm 5.5 cm in size during
medical checkup, you action :
A/ reassurance and tell him this is normal size
B/do U/S after 3 months
C/surgical referral
35- pt with positive PPD, the best test to rule out the possibility of false negative:
A/mantoux test
B/ CXR
C/ repeat PPD
36- first line for depresion:
A/SSRI
 B/TCA
C/ MAOI
37- 31y old female came to your clinic for collection of her pap smear for 6 m
back.. ..the result was normal , She had family Hx ..her mother had cervical
Ca..what will you do..
A/. stop the test .
B/ repeated after 3 y
C/ biopsy.
D/ repeated after 3-6 months
38- 15 old boy wants to involve in physical activity..his mother gave hx of his
brother died after walking.wt is the serious condition u want to exclude:
A/AS
B/HOCM
C/ASD
39- pt medically free ..O/E mid systolic murmur and radio-femoral delay. Wt is the
diagnosis?
A/ aortic sternosis.
B/coarctation of aorta.
40- pt admitted to hospital with end stage COPD .. you will find?
A/high Ca
B/erthrocytosis
c) Low K
41- pregnant lady with mild intermittent asthma on inhaler albuterol..her symptoms
become more worse ..she used her medication dially and had nt attack
once/week..How u will treat her?
A/inhaled steroid + oral prednisolone .
B/inhaled steroid + short B2 agonist
C/inhaled steroid +long B2 agonist
D/short + long B2 agonist
42- drug of choice for petit mal epilepsy:
A/phenytoin
B/carbamazepine.
43- bipolar pt with liver impairment.. best drug is?
A/ SSRI
B/TCAs
C/lithium.
44- Patient has a scaly hypopigmented macules on the chest and arms they seem
even lighter under the sunlight, wt is the ttt:
A/ Topical steroid
B/ selenium sulfide
C/ Topical antibiotics
D/ Oral antibiotics
45- female actor on TV..she has papules pustules.and swellingon her face,
telangiectasia..she becomes upset bcs of this (case of rosacea)ttt:
A/give her abs
B/vasoconstriction.
C/ laser
46- Pt with Chronic obstructive pulmonary disease (COPD) , which of this can
improved the prognosis?
A/O2 therapy .
B/ influenza vaccinations ..
C/ Smoking cessation
D/bronchodilator.
47- Pt. with Raynauds phenomena he is living with roommate smoker ..ttt:
A/ Anti-vibrating gloves
 B/ Keep core body temperature warm in cold
C/ Negative smoking is not a trigger of disease
48- case of pterygium: it may affect vision.
49- pt medically free came to u bcs he is wondering to have liver disease.. LFTs
done and result showed high liver enzymes wt is next?
A/ liver and gallbladder U/S
B/hepatitis serology.
C/reassurance.
50- female presented with large arm abcess..Managment :
A/oral antibiotics.
B/drainage under L.A then give antibiotics
C/drainage under G.A + antibiotics.
D/topical antibiotics.
51- picture of venous ulcer..mgt?
A/ biopsy
B/ Compression and elevate the leg
C/ Topical steroids
52- 9 yrs boy C/O limping ,pain on rt sole .mother gave hx that his classmate hit
him on his rt foot ..O/E tender and warm (there is x-ray attached..it seems to
be normal) What is next step?
A/physiotherapy
53- echanism of action of glipizide:
A/decrease insulin resistance
b/increase insulin release
54- Young pt came with unilateral headache lt sided..pounding increase with light
and noises ,ass with nausea..and he denied any eye symptoms ..wt is the
diagnosis:
A/cluster headache.
B/classic migraine.
c/common migraine
55- 6 yrs girl experienced some fresh dot on her underwear..pain during
defication She passed stool every 5-7 days..wt is the diagnosis?
A/anal fissure
56- child with symptoms suggest IBD -ulcerative colitis- initial treatment is:
A/antibiotics
B/corticosteroid
C/ 5 amino salicylates

57- child presented with cough , fever ,mother gave hx he had diarrhea on oral ORS
he is doing well O/E rt side crepitation ( x-ray attached .. rt side consolidation )
what yr mgt for this child?
A/ hospitalization
B/antibiotics
C/reassurance
58- mother came bcs her child will receive influenza vaccine..you will not give to him
if chid has:
A/heart problem
B/angioedema
59- drug not used in prophylactic of migraine :
A/propranolol
B/SSRI
C/TCA
60- pt with internal female organs and infusion labia and huge clitoris ..diagnosis:
A/male pseudohermaphraditism
B/female pseudohermaphraditism
61- female on phenytoin medication for last 5 yrs..she wants to stop it bcs S/E ( I
think hair loss) she is free attack for last year_same Q in umq_so wt will u tell
her:
A/ you can stop the medicine but she responsible for this.
B/continue for next 6 months
62- 9 yrs boy C/O limping ,pain on rt sole .mother gave hx that his classmate hit him
on his rt foot ..O/E tender and warm (there is x-ray attached..it seems to be
normal)
Wt is next step?
A/physiotherapy
B/immobilization
C/antibiotics
D/immediate operation
63- pt diagnosed with CRF..wt is annually investigation he sld do?
A/peripheral edema
B/oliguria
C/routine blood test
64- child c/o post-nausea ,vomiting and abdominal cramps following by watery
diarrhea ..mother said that he had similar condition when he was in camp ..
A/check diary hx
B/lactulose urease test
65- Acute angle glaucoma, you can use all of the following drug except?
A/ B blocker
B/Acetazolamide
C/Pilocarpine
D/Dipivefrin
66- Neonate with mucopurulent eye discharge lid swelling and culture positive for
gm ve diplococci , ttt :
A/ intravenous cephalosporin
B/ topical sulfonide
C/ oral floroquinolol
D/ IM aminoglycoside
67- hepatitis transmitted by feco oral ..found in young and children?
A/B
B/C
C/A
D/D
68- patient on anti T.B medication c/o of vertigo ..the drug responsible is:
A/INH
B/Sterptomycin
C/ethambutol
69- child came with congested throat,fever,,L.N enlargement ,,splenomegaly..EBV
+ve Wt is next?
A/paracetamol as needed
 B/Antibiotics
C/hospitaliziton
70- pregnant lady with HTN..best drug to give?
A/captopril.
B/hydralazine
C/B.B
D/methyldopa
71- tarsal tanal syndromenerve affected:
A/post tibia
B/ant tibia
72- pt with perforated tympanic membrane with foul whitish discharge wi is the
diagnosis?
A/ otitis media
B/cholesteatoma
C/otitis externa
73- antihypertensive drugs NOT recommended to give together:
A/ACEI + BB
B/BB +CCB
c/ARBS+ diuretics
74- pt C/O pain in his nose after head trauma (suspect nasal bone fracture)
Wt you will do?
A/ice and analgesia
B/antibiotics
C/refer to ENT
75- pt with hx of progressive hearing loss ..vertigo..tinnus..recently he developed
facial weakness (pic attached) diagnosis:
A/bell palsy
B/ tumor
C/acoustic neuroma
76- 18months with cough and inspiratory wheezehe is distressdiagnosis?
A/ Bronchiolitis
B/ Pneumonia
D/asthma
77- 19 yrs c/o sudden LF testicular pain over last one day ..progressive..hx of
unprotected sexual intercourse. No hx of testicular traumainvx normal apart of
epithelial cell in urine 4 , Wt you will do next?
A/urthral swab and culture.
B/give antibiotics.
c/testicular doupler.
78- common cause of injury in adolcense ?? a- fall b-sport c- motorcycle d- burn
79- pic of rubella/german - meseals ?? (bright dark red)
80- side effect of amitryptlyin ? weight gain , falldown , headache , confusion.
81- case of epiglotitis sever throat congestion + distress beside oxygen wht u want
to give ?? a- nasovaryngeal tube b- antibiotics c- cotisone d- endotracheal tube
(( true answer d i got high degree in eye ent )) epiglottitis is an emegency
intubation.
82- pt obese and dm on insulin and diet controll + exercise still high rbs wht u will
do ?? a- long acting insulin b- metformin (( true ))
83- pt 30 yrs married her first pap smear -ve , when to check again ?? a- 3 month b-
6 month c- 3 yr d- 5 yr (( true 5 yr , i got full mark in women helth and family
medicine ))
84- case of female come and explain that her child walk by four limb , and dignosed
with muscular disease (( duchein muscular atropy )) ,, he ask you wht is the risk
for next baby ?? a- 12.5% b- 25 % c-50% d- 100% - note : duchein muscular
atrop is x-linked recessive
85- pt fall on outstech hand develop colles fracture and ttt,, to know bone density
wht to do ??? a- vit d level b- calcium level c- x-ray of the pelvis d- there is
another x-ray strange name its ; DEXA (( i forgot it sorry ))
86- pt with hypothyrodism came for check up of LDL and it was normal ,, when to
check again ?? a- 3 month b- 6 month c- 1 yr d- 3 yrs
87- 45 yrs old came for check ,, no h/o chronic disease , bp 125/80 ,, when to check
bp again ?? a- 6 month b- 1 yr c- 3 yrs d- 5 yrs
88- pt pregnant came for 1st time , and she ask non invasive method >>>> answer
is ultrasound but also my freinds in the exam read the quetsion well
89- pt develop sore throat and readness behind the ear ,, after that develop
conjuctivitis (( red eyes )) wht is the cause >>> a, viral (( very sure ))
90- baby with bilious vomting what is the investigation ?? read well plz abt pyloric
stenosis ,, intussupsion ,, hurchsprung ,,, duodenal atresia ,,
91- case of cmv , hepatosplenomegaly and jaundice + may high LFT
92- case of cocakie ??
93- read well abt non-medical management of dementia and alzhimer >> i did not
remmber the q exactly
94- case about hpocalcemia >>>> i think - chvostek sign is a sign of hypocalcemia.
- patient had carpopedal spasm after measuring her BP.

95- case about paracetmol toxicity ,, it affect which organ ??? a.liver (( 100%))

96- case of lobar pneumonia ??? investigation x-ray

97- case of limb ischemeia >>> u can answer it just concentrate in the exam

98- case of pulmonary embolism >>> ttt sure heparin

99- case of skin allergy with itching and there is pic >>>> ask about ttt <<< a-
diphyndramine (( antihistamine ))

100 - straight forward case of scabies ?

101- prevention of amebia <<< by boiling

102- Signs of codeine intoxication :

a. Tremors and anxiety
b. CNS excitement and insomnia
c. Respiratory depression and bradycardia
d. Tachycardia and anxiety
 103- pt known case of gout and have nephrolithiasis develop 3-4 attacks in one
year and now symptomatic for gout wht is ur ttt ?? a- ibuprofin b- indomethacin c-
colchicin d- allopurinol (( d is true sure 100000% ))

104 - pt known case of HIV develop eye redness on fundoscopy there is cotton-
wool or something like this (( and another finding )) dignosis is ??? a-
toxoplasmosis retinopathy b- HIV retinopathy c- T.B retinopathy

i put the answer for Q no 35 (( B )) but m not sure

105 - case by explanation eye problem >>> diagnosis glucoma

106 - confusing case scenario abt mother bring her son 10 yrs old c/o neck
swelling ,, and she said his brother before hs same problem lab of TFT is normal
>>>> i answer this Q as Simple goiter

107 - Obese patient with DM and HTN, your advice regarding losing weight:
a. Decrease carbohydrate intake during day time
b. Decrease carbohydrate and increase fat intake
c. Decrease 500 kcal/kg/ week
d. Decrease caloric intake to 800 kcal/day

108 -one q abt ttt of iron overload >>> desfroxamine

109 - x-ray abdomin there is screw inside abdomin ,, the child with sever
abdominal pain + vomiting on ex there is sever tenderness >>> ttt laprotomy

110 - case of bacterial conjuctivitis with sever congestion there is table contain 4
choices >>>> select the table that contain antibiotic + topical steroid + analgesia ((
i think it is choice b )) cz i got high degree in eye and ent alhumdulelah

Qn from my exam dated 4 8 15

(Image of the neck showing a sinus opening in the midline above the cricoid
cartilage in the midline)
A 10 year old boy presents with a sinus opening in the central anterior neck with
intermittent pus discharge since 7 years. The most likely diagnosis is
A. Sebaceous sinus.
B. Dermoid cyst with sinus.
C. Branchial fistula.
D. Thyroglossal fistula.
E. Lymph nodal sinus.

A 7 year old child with bilateral peristernomastoid lymphadenopathy that is soft, non
tender, fluctuant and matted. Aspiration yeilds pus and smear cytology
Shows non tubercular mycobacteria. The correct management is
A. Antitubercular therapy
B. Incision and drainage.
C. Excision of nodes.
D. Observation and antibiotics
A 32 year old woman is admitted with right upper quadrant pain. On investogations
there is a 10 by 10 cm hypoechoic mass in the left lobe of liver with a right pleural
effusion. The most appropriate management would be
A. Initiation of imidazole treatment.
B. Laparotomy for abscess drainage.
C. Ultrasound guided aspiration of abscess.
D. Ultrasound guided pig tail drainage of the abscess.
E. Right chest tube insertion.

What is true of branchial cleft anomalies?

A. Presentation as a cyst is more common than presentation as a fistula in childhood
B. Third branchial cleft anomaly is the most common.
C. The first branchial cleft fistula will always pass through the substance of the
parotid gland.
D. The second branchial cleft fistula is superficial to the platysma

A middle aged man presents to the ER with a history of epigastric pain and fever. He
has a history of recent travel to Mexico. On exam he has a temp of 38.5 C with
tender hepatomegaly. Chest X ray shows a raised right hemidome with right pleural
effusion , Ultrasound detects a 7 by 6 cm hypoechoic lesion in the right lobe of the
liver. The most expected result on further workup would be
A. Positive blood culture.
B. Positive amebic serology.
C. Positive serum CEA.
D. positive serum AFP.
E. Positive widal for Salmonella.

A 46-year-old man, a known case of diabetes for the last 5 months. He is maintained
on Metformin 850 mg Po TID, diet control and used to walk daily for 30 minutes.On
examination: unremarkable. Some investigations show the following: FBS 7.4
mmol/L, 2 hr PP 8.6 mmol/L, HbA1c 6.6% , Total Cholesterol 5.98 mmol/L, HDLC
0.92 mmol/L, LDLC 3.88 mmol/L, Triglycerides 2.84 mmol/L (0.34-2.27), Based on
evidence, the following concerning his management is TRUE:
a) The goal of management is to lower the triglycerides first.
b) The goal of management is to reduce the HbA1c.
c) The drug of choice to reach the goal is Fibrates.
d) The goal of management is LDLC 2.6 mmol/L.
e) The goal of management is total cholesterol 5.2 mmol/L.

1/long case about aortic stenosis..typical case .elderly pt with chest pain &exertional
dyspnea .the aortic valve is clacified..and stenosis mesure about 0.7 to less than 2
cm..what the managment..
1 medical mang.
2 surgical valvoplasty.
3 valve replacement*

2/Female came from Kenia ..c/o of .wt loss, loss of appited,&Diarrhea

lymphadenopathy, and black lesion in the tounge..which diseas must be screening ..
HIV*
3/ saudi female want to go to Haje came to your clinic planning for receive menngo
ccocal & Haemophilus influenzae.which the important vaccine must be received..
1/ Meningococcal vaccines

15 y old male came to ER with wrist pan & swelling when fall on outstretched hand,
On examenation..the pain&tenderness increased when the thumb is held in a "hitch-
hiking" position. There is x-ray ; The finding no abnormality..mild swelling ..
What will do?
1/give analgesia and go home &came bake after 5 day.
2/ closed cast management.
3/open redaction .
The is case of scaphoid fracture

1/First line of defence in the skin is..

1 mucous membranes
2 collagenous cell.
3 keratinocytes.
4 areolar connective tissue

30y old female came to your clinic for collection of her pap smear for 6 m back.. ..the
result was normal. She had family Hx ..her mother had cervical Ca..what will you do..
1. stop the test .
2. repeated after 5 y
3 . biopsy.
4. .....

25 years old F ..C/O Hx of Amenorrhea for 6 w , and sever lower abdomenal pain
and gush of vaginal bleeding.. Which the common side of implantation..
1/ ovaries
2/ cervix.
3/ fallopian tube

25 year old pt C/O painless localized swellings at the wrist 2-3 cm in size..for 2 years
back..not effect in the movment .. Whate is this? "there is picture same to this .."
1/ Ganglion

Pt with Chronic obstructive pulmonary disease (COPD) , which of this can improved
the prognosis?
-O2 therapy .
- influenza vaccinations ..
- Smoking cessation..
- bronchodilator..

1. Healthy 27 y.o male coming for annual exam, which should u screen for:
A) DM
B) HTN* (sure)
C) Dyslipidemia
2. Colon cancer screening should start at what age:
40
45
50* (sure)
55
3. Child presented with his parents complain of walk on tip of his foot he start to walk
by age 13 month and he had normal development. His young brother died with
disease of muscles and his mother now pregnant and its a boy. what is the chance of
brother to get the same disease. Lab result: creatinine kinase 300 (high)?
(Duchenne muscle dystrophy inheritance):
a-12%
b-20%
c-50%*
d-75%
4. First immunologic defence of skin:
A) Keratinocytes*
B) Blast cells
C) Melanocytes
5. Painful genital ulcer, bleeding, lab confirmed Haemophilus Ducreyi;
A) Treat all close contacts
B) Treat all sexual partners* (sure)
C) Treat symptomatic sexual parteners only
6. (Picture of Vulvar lesion-not clear at all): Lady presented complaining of swelling in
her vulva, on right side, painless, freely mobile, Diagnosis:
A) Vulvar Varicosities
B) Bartholin Cyst*
C) another cyst name, I dont remember
7. Ganglion cyst: (pic) and scenario, recurrent painless swelling- what is diagnosis.
8. Scabies picture of mite/lesion + scenario of itching
9. Psoriasis picture, scaly pink lesion on extensor surfaces,
A) avoid trauma*
B) avoid sun
C) bathe daily
10. Herpes zoster image + ttt?
-Acyclovir 200mg oral 4 times a day for 7 days
-Famciclovir 500 mg 3 times a day for 7 days*
2 other not antiviral.
11. Typical Herpes zoster scenario (pain, parasthesia, vesicular eruption in single
dermatome distribution: diagnosis?
12. Ulcer base of the nose? Basal cell Carcinoma
13. Young girl 95th centile of wt and hight. What to council about wt?
A) Do not mention it
dont remember the scenario exactly.. sorry.
14. Baby can move his head from side to side while lying on his back, hands in fists..
how old? Answer: 1 month*
15. 17 years old girl missed her second dose of varicella vaccine, the first one about
1 y ago what you'll do
a) Give her double dose vaccine
b) Give her the second dose only
c) See if she has antibody and act accordingly
d) Revaccinate from the start
16. Gold standard for diagnosing bronchial asthma:
A) Peek expiratory flow rate
B) Inhalation challenge
C) CXR
D) Spirometry
17. Clear case of meningitis (neck stiffness..) , most appropriate next step:
-Steroids
-IV ceftriaxone
-LP
-CT
18. TB breakout, PPD positive, test to rule out false positive:
A) Mantoux
B) CXR
C) Repeat PPD
D) Tine test
19. Old female has Rheumatoid Arthritis for long time, now presented multiple joint
pain, (both hands X-ray) - appears to have multiple joint affection, most appropriate
ttt:
A) Azathioprine
B) Methotrexate
C) Hydoxychloroquine
D) Colchicine
20. Rheumatoid arthritis management:
A) Cold water therapy
B) physiotherapy
21. Ankylosing Spondylitis: (young adult with chronic buttock/low back pain)
ttt: Physiotherapy
22. Acute closed angle glaucoma scenario (typical presentation) red painful eye,
headache, nausea, vomiting, dilated fixed pupils.
23. Patient work in dusty environmental ,has red eyes, itching, no trauma not
mucopurulent, to relive has symptoms:
A) Tobramycine eye drop
B) Acyclovier drop
C) Trifluridine drop
D) Olopatadine drop
24. Brief attacks flashing lights, When to refer urgently to Ophthalmologist? when
patient develops: - Halos (not sure)
25. Pt complaining of decreased visual acuity for 24 hours, painful eye with
movement, fundus exam was normal.. I forgot options, but I chose: Multiple
Sclerosis*
26.Pt present with sudden painless loss of vision, Fundoscopy shows "Cherry Red
Spot (Central Retinal Artery Occlusion), management: Ocular Massage*
27. Otitis externa: I think Fungal, treatment, forgot options
28. Child having nasal discharge from left nostril, foul smelling, and bloody, for 6
weeks.
A) Foreign body
B) Polyp
C) maxillary sinusitis*
29. A Patient with raised JVP and tachycardia , she eats polish white rice, she has :
A) Wet beriberi*
B) Dry beriberi
C) Vitamin A deficiency
D) Folic acid deficiency
30. Male patient presented with burning in his feet, constipation, fatigue,
?(Hypothyroid) Best test test:
A) TSH*
B) B12
C) Folic acid
31. Another Hypothyroid case: fatigue, cold intolerance, has neurologic
manifestations.. what is the expected TSH:
A) 0.2
B) 0.5
C) 9.3
D) 47
32. Pregnant hyperthyroid ttt
- Propylthiouracil*
- Carbimazole
33. Glipizide mode of action: increase insulin secretion from pancreas
34. Chronic pancreatic disease == cancer pathophysiology?
something about Trypsin, cytokine release/inhibition, dont remember exactly.
35. Bone scan -3.5 = osteoporosis*
36. Type 1 DM, on NPH and regular insulin taking it before breakfast and dinner.. His
4 pm blood sugar is high, what to do?
A) increase NPH before breakfast*
B) increase regular insulin before breakfast
C) increase NPH before dinner
D) increase Regular insulin before dinner
37. Child, few months old, wheezing, shortness of breath, respiratory distress, 2
siblings have a cold, (RSV bronchiolitis) most specific test: nasopharyngeal swab*
38. Child episodes of crying, with drawing of his legs up to his chest.. Diagnosis?
Intussusception*
39. Bite management: after irrigation, Antibiotic: Amox+clavulinic*
40. G4P3, had previous C/S and 2 SVD, How to plan for next delivery?
A) oxytocin
B) plan c/s at 38 weeks
C) ARM
D) forgot..
41. Complication of placental abruption: Coagulopathy*
42. Pregnant lady 10 weeks GA, presenting with painless bleeding, uterine fundus at
15 cm.. Dx: low lying placenta*
43. Most major complication of D&C:
A) Uterine perforation*
B) Cervical laceration
C) Infection
D) Bleeding
44. Lady with back pain, after lifting heavy box:
A) avoid bed rest
B) Lumbar traction
C) Massage*
45. Meneirs disease food : low salt, no caffeine*
46. pregnant 38 weeks develops seizures, altered level of consciousness, short of
breath.. Vitals: fever, tachycardia,
A) PE
B) Anaphylaxis
C) MI
D) Amniotic fluid embolism*
47. GERD for 10 years, on PPIs which improved his condition, gastroscopy done
show columnar transformation scattered between remaining squamous epithelium,
there is finger like projections:
A) esophagitis
B) Barretts
C) adenocarcinoma*
D) squamous cell carcinoma
48. Benefits of using spacer in asthma:
A) Less oral adverse effects
B) Prolonged effect of inhalers
C) Better technique*
49. Long scenario about patio with Asthma on Fluticasone one puff BID, and
Montelukast one pill/day, her symptoms improved.. she only used Salbutamol one
last week. no night symptoms. Resume Montelukast for how long?: months?
A) 1
B) 2
C) 3
D) 4
50. Psych patient, after starting SSRI comes telling you he is planning suicide:
Admit patient*
51. More likely to commit suicide; 4 options, same in UQU,
the answer I chose was 60 yr old male recently started on SSRIs for depression.
52. Bereavement case : (mother sad after her son died one month back)
53. Pt always think there is alien in his back yard when he is out from home, even
though he knows its not possible, he's always thinking about the idea brought by this
aliens. pt came to you fear that he is going to be "insane" what is his condition
A) Obsessions
B) Compulsions
C) Hallucinations
D) Delusions*
54. 3 year old child brought by parents, he is obese.. What advice:
A) Decrease milk intake
B) increase protein
C) total fat per day less than 60% of total daily calories
D) fat less than 30% of total daily calories*
55. Saudi Paediatrics society suggest breast feeding for :
A) 4 month
B) 6-12*
C) 13
D) 25
56. Rheumatic fever prophylactic ttt in pt allergic to penicillin:
A) IV somehting
B) IM Ceftriaxone
C) Oral sulphadiazine*
57. Child presenting with weakness, fatigue, since one week, now has facial swelling
around eyes, and pitting edema in the lower limb +2, decreased urine output, and
dark color urine = Recent Impetigo Contagiosa* = (case of Acute post-streptococcal
glomerulonephritis)
58. Ring stage of malaria* + typical scenario; what is diagnosis.
59. Patient coming from Kenya, presenting with night sweats, lymphadenopathy,
hairy tongue, history of blood transfusion there.. What to test for.. HIV*
60. (Blood smear picture) nothing specific, scenario: old man with general good
health, presenting with fatigue, weakness, dizziness: Hb: 9, HCT: low
A) sickle cell
B) thalassemia minor
C) CRF
D) Gastrointestinal bleeding*
61. Child coming for routine check up, doctor found systolic murmur, high pitch,
crescendo-decresendo in character, best heard over mid- sternum;
A) systolic ejection*
B) innocent flow murmur

62. VT ECG PIC, pt presented with palpitation and dizziness, then collapsed, no
carotid pulse, ttt: defibrillator*
63. (Chronic stable angina presentation); Pt came to ER, retrosternal chest pain,
lasting for 15 min, relieved by rest, not compliant on his medications.. Vitally stable.
mild HTN. What is best..
A) Discharge home and plan ECG stress test next visit.
B) Cardiac enzymes and follow up in clinic.
64. Which one represents Hep B viral replication?
HBsAg
HBeAg*
HBsAb
HBcAb
65. Most common Hepatitis in poor sanitation, low social economic, crowded areas,
affecting children..
A) A*
B) B
C) C
D) D
66. Drug used for maintenance in Bipolar: Lithium*
67. Patient taking Sildenafil, what to avoid: Nitrates*
68. Drug poisoning : Mydriasis, Hallucinations, tachycardia
A) Anticholinergics
B) Amphetamines*
C) Anticonvulsant
D) Cholinergic
69. Child walking with inward toeing, sitting in W with his legs behind him,
Diagnosis
A) Metatarsus adductus
B) Tibial torsion
C) Inward torsion of femur*(sure)
D) Metatarsus Varus
70. Female 24 y.o., having amenorrhea for 5 months, BMI 20, stable for past 4 years;
A) Investigate for Eating disorder
B) Pituitary Adenoma*
71. Patient has Indirect Inguinal Hernia, what is pathophysiology?
A)
B) Something due to Constipation
C) Congenital Defect
72. Young female patient with unipolar depression on SSRI: what is most correct
A) Most patients will experience sexual adverse effects*
B) Venlafaxine is ok to use in case go HTN
73. Back pain assessment and importance of onset and duration
A) Short onset is important for biological origin.
B) Location and onset is important for the biological origin*
C) Location and onset are important for the outcome
74. Patient complaint of light-headedness, tachycardia, diarrhea, after meals, relieve
by laying down, history of gastrointestinal surgery before 2 month, what is the ur
provisional diagnosis
A) IBS
B) Dumping syndrome*
C) villous adenoma
D) Cronhn's disease
75. Male presenting with intermittent decrease in urine flow rate, urgency, hesitancy
= (BPH), PSA done, normal. everything else is normal, except DRE: slightly enlarged
median lobe of prostate.. What recommend for him now:
A) Cystoscopy
B) Periodic PSA*
C) Annual Renal Function Tests
76. Female presented with growth in genitalia, confirmed to be Wart; the organism is
also responsible for what?
A: Cervical Cancer* (HPV)
77. Female Patient, 40 y.o, had hx of DVT, normal menstrual history, she doesnt
want to use diaphragm, her husband wont use condom.. council about
contraception;
A) OCP wont increase risk of her condition
B) from Hx she is suitable for tube ligation
C) IUCD seems like a suitable alternative*
D) No need for contraception as shes unlikely to get pregnant at her age.
78. Old man presented by his children, they suspect his cognitive function is
impaired.. what can you tell them about trying to improve his condition.. (Dementia
advice)
A) Daily exercise will help
B) Brain exercise will help prevent dementia
C) New measure of conducting his daily activities will now be required*
(The options are as close as i can remember.. but not exact..)
79. Patient with lung cancer; best way to evaluate metastasis:
A) MRI
B)
D) PET scan*
80. Which vaccine to avoid if child has allergy to eggs: Influenza*
81. Fainting Scenario (man standing in line, drowsy, yawning, sweaty..)
82. Arterial insufficiency (Limb ischemia) clear scenario
83. Scenario of child falling, feeling pain in his leg + picture of X-ray leg, (clear
broken), before transfer of patient to hospital, what should you do:
A) High dose paracetamol
B) Morphine
C) Splint the leg*
D) Elevate the leg
84. Old lady, know HTN, DM, presented with epigastric pain radiating to the back,
and heart burn for past 2 months, not relieved by antacids (Ranitidine)..otherwise she
looks health, no abdominal tenderness + ECG pic, vitals BP 150/90
A) Aortic Dissection*
B) Perforated peptic ulcer
C) MI

85.Case of gestational diabetes 35wks ,G2P1, last still birth at term, now blood sugar
is controlled in this pregnancy, what to do:
A:deliver the baby now,
b: do c/s at 38wks
c: wait for spontaneous vaginal delivery

86.Patient with seasonal watery nasal discharge, sneezing and nasal block. What
should you give him as a treatment:
a) Topical steroid
b) Decongestants
c) Antihistamines
d) Systemic Steriods

87.Patient came with cough, wheezing, his chest monophonic sound, on x ray there
is patchy shadows in the upper lobe+ low volume with fibrosis, he lives in a crowded
place, What is the injection should be given to the patient's contacts?
a) Hemopheilus influanza type b
b) Immunoglobuline
c) Menngioc Conjugated
d) Basil calament

Surgery EXAM
1. Old man with left iliac fossa pain, guarding, tenderness, there is a mass felt on
palpation, temp 38C, diagnosis?
A. Acute diverticulitis
B. Appendicitis
C. Pancreatitis.
2. Picture of large central neck nodule and statement was mass moves with
swallowing, diagnosis? ( pic looks more like goitre)
A. Nodular goitre
B. Thyroglossal cys

3.Most major complication of D&C:

A) Uterine perforation

B) Cervical laceration
C) Infection
D) Bleeding

3.Young lady presented with vaginal bleeding and vaginal exam showed a white
cervical lesion and a cervical cancer diagnosis was made. The next step:
a) Cone Biopsy.
b) Incisional biopsy.
c) Excisional biopsy.
d) Colposcopy

4.Child with iron toxicity best way for mangement.

A. Gastric Lavage.
B. Ipecac syrup
C. Magnesium citra

5.lethal injury to the chest after motor accident :

a) puncture lung
b) spontaneous pneumothorax
c) rupture aorta
d) flail chest
e) All of the abov

6.Diabetic patient go for hernia surgery how to give insulin dose :

a) one dose at morning one on raising
b) omit the both dose
c) as previous schedule
d) sliding scale

7.RH-ve female deliver a healthy child previosly now she is pregnant ,her husband
RH+ve , the incidence of deliver RH-ve baby :
A-0%
B-25%
C-50%
D-100%

8.Old male bedridden with ulcer in his buttock 2 *3 cm ; involve muscle Which is
stage : pressure ulcer
a) 1
b) 2
c) 3
d) 4

96.study was done to assess the effect of alcohol on 5000 individual was started in
1985, then it assessed the incidence of liver cirrhosis between 2005-2008, what is
the type of study:
a-case controlled
b-retrospective study
c-concurrent cohort

d-cross sectional study

97.A 27 year old pregnant lady, 19 weeks gestation, smoker, presented with PV
bleeding followed by painless delivery. She was told nothing was wrong with her or
her baby. The diagnosis is:
a) Cervical incompetence
b) Fetal chromosomal anomaly
c) Molar pregnancy

98.pt taking antidepressant drugs works in an office ,, next day when he came ,he
told you that he have planned a sucide plan ,, ur action is
A-counceling
B-admit to hospital
C-call to police
D-take it as a joke

98.Treatment of herpes zoster in ophthalmic division:

a) Oral acyclovir alone
b) Acyclovir & Prednisolone
c) Prednisolone
d) IV Acyclovir

99.Most common cause of death in acute fulminant hepatitis?

A_electrolytes and fluid disturbance
B_cerebral edaema
C_hepatorenal syndrome
D_septeciemia

100.An infant of 6 month brought by his parents with history of repeated vomiting, his
pulse was (190), and he had dry mucous membrane, sunken anterior fontanel, what
is the appropriate volume of fluid given initially:
a-bolus 10 ml/kg of body weight
b-bolus 20 ml/kg of body weight
c-slow infusion 10 ml/kg of body weight
d-slow infusion 20 ml/kg of body weight

101.Ulcers in mouth round with yellow base diagnosis ?

A-Aphthus ulcer

b-Herpaginia

102.Pregnant after long stressed day in work fell there is no fetal movement come to
you wt you will do ?
A- stress relive test
B- stimulate fetal

103. Pt human bite take tetanus vaccine from years only punctured markes on hand
with no hemorrhage space ?
A , antibiotic cream and cover
B ,close the ends by strip
C ,tetanus booster dose
104.What help in transmission ? (It's plague ) Dog ,cattle ,big, rodent

- Dry beriberipolyneuritis, symmetrical muscle wasting

- Wet beriberihigh-output cardiac failure (dilated cardiomyopathy), edema

105. there were two qs realated to LDL cholesterold levels ? what should be in htn
pts ...values were like a. 2.6 b .3.1 etc....dont remeber normal = (3.3-4.1)

106.metformin cause in hig dose.....lactic acidosis,,metabolic acidose...metabloic

alkalosis

107. different between chron and ulcerative cholitis trans mural effect of chron.

Patient with long history of UC on endoscopes see polyp and cancer lesion on left
colon so ttt
a) treatment of anemia
b) total colectomy
c) Left hemicolectomy
d) remove polyp

108.Cellulitis occurring about the face in young children (6-24 months) and
associated with fever and purple skin discoloration is MOST often caused by
a) group A beta hemolytic streptococci
b) Haemophilus influenzae type B
c) streptococcus pneumonie
d) staphylococcus aureus
e) pseudomonas

109.An 18 years old male who was involved in an RTA had fracture of the base of
the skull. O/E he had loss of sensation of the anterior 2/3 of the tongue & deviation of
the angle of the mouth. Which of the following nerves is affected?
a) I (Olfactory)
b) III (Occulomotor)
c) V (Trigeminal)
d) IV (Abducens)
e) VII (Facial)

110.48 years old with irregular menses presented with fatigue and no menstruation
for 3 months with increased pigmentation around the vaginal area without other
symptoms. your next step would be
a) reassure the patient
b) Do a pregnancy test
c) do ultrasound

111.Middle age a cyanotic male with CXR showing increase lung marking & enlarged
pulmonary artery shadow, what is the most likely diagnosis?
a) VSD
b) Aorta coarctation
c) Pulmonary stenosis
d) ASD
e) Truncus arteriosus

112.menopause , what will be high ? A.high FSH and LH

113.CHF in children All except :

1Gallop rhythm
2 hepatomegaly
3 bounding pulse
4 periorbital oedema
5 basal creps

114.which of following associated with fetal congenital heart disease ;

1)rubella
2)toxoplasma
3)hiv
4)hsv

115.A case of helicopacter pylori you also screen for :

A bleeding .
B Gastric outlet obstruction.
C gastric carcinoma.

116.A case of roscea treated with multiple regimen .now painful rash (picture)
As petechi around the eye , What will you add :
A Topical sulfanide corticosteroid.
B Acyclovir.
C oral steroid.
D face mask of green materiak.i do not remmember.

117.Long scenario of a case of female with excessive exercise..complain of light

intermenstural bleeding ,TSH and pituitary are normal ...what is the cause:
A defect progestrone.
B inadequate estrogen.
C ovarian failure.
D i do not remember.

118.A case of nullipara came e amenorrhea , Complain polyuria ,fatigue some un

connected syptoms...no fever ...and lab +ve GnRH...What is the cause of syptoms:
1) GnRh
2) Progestrone.
3) Estrogen
4) Cant remember

119.Mechanism of action of glipizide:

Incr. Insulin availability.
Increase insulin receptor sensitivity.
Dec. Insulin resistance.
Incr. Insulin prod.

120.Mechanism of action of anti-deprssant drugs :

Incr. Availability of substance (serotonin)
Increase uptake by cells.
Decr. Renal excretion.
Decrese ...not rememb.

121.The most common cause of hypercalcaemia in a hospitalized patient is:

a) Dietary, such as milk-alkali syndrome
b) Drug related, such as the use of thiazide diuretics.
c) Granulomatous disease.
d) Cancer
e) Dehydration.

122.There is aquestion about Adolescent assesment called HEADSS..asking about

what better for patient discussion :
Discuss in presence of parents.
Discuss in private.

Discuss by doctor opposite gender.

123.NICU child suddenly developed distress with absent breath sound .

You will put Butterfly needle in :
2nd intercostal space.
3rd.
4th.
5th space.

124.Which lipid to screen fot ischemic heart disease:

Cholesterol.
Triglycerides

125.All the followings prolong INR except :

a. CLD
b. Vitamin K deficiency
c. Warfarin
d. Factor VIII deficiency
e. Factor VII deficiency

126.Which is not true In emergency management of stroke ;

a. Give IVF to avoid D5 50%
b. Give diazepam in convulsions
c. Anticonvulsants not needed in if seizures
d. Must correct electrolytes
e. Treat elevated blood pressure

127.Diabetic patient was presented by spastic tongue, dysarthria, spontaneous

crying what is the most likely diagnosis :
a. Parkinson .
b. Bulbar palsy .
c. Pseudobulbar palsy
d. Myasthenia gravis

128.All the Followings may mimic Guillian barre syndrome except:

a. Cord Compression
b. Cauda equina compression
c. Tetanus
d. Poliomyelitis
e. Tick palsy

129.What is the best diagnostic test for diabetic nephropathy:

Utine dipistic.
Kidney function test.
Albumin/creatinine spot ratio.
24h urinary protiens.

130.Patient with retro-sternal chest pain , barium swallow show corkscrew

appearance ;
a) Achalasia
b) GERD
c) Diffuse esophageal spasm

131.Diabetic patient with eye problems. Neuropathy and fungal infection .

On lab you found : RBS 300 mg/dl. Hb A1C 13%. Protinuria. He is on metformin 500
mg 2 times per day. What will you do :
Metformin 1gm 2 per day.
Add 1 dose of long acting insulin.
Switch to 2 doses of mixed insulin.
Add sulfonylurea drug.

132.Incidence is calculated by the number of:

a) Old cases during the study period.
b) New cases during the study period
c) New cases at a point in time
d) Old cases at a point in time.
e) Existing cases at a study period.

133.patient ...his father was diagnosed with pancreatic cancer and died...he did all
labs it was normal ...he goes to 3 doctors and not convencied with normal results.
Diagnosis:
Conversion disorder .
Somatizaion.
Hypochondriasis.
Delusion.

134.Pt came to emergency room after accident. He is in distress ;diaphoric but

consious. Vitals as follows:
Bl/p 100/70
Pulse 110
R.R 40
You found injuried chest e scatterd trauma sites aroud lt upper limb.You ordered x-
ray And came as the following.. What will you do:
Thoracocntesis.
Chest tube insertion.
Pericardiocentesis.
Thoracotomy.

135.A man had increase shoe size and jaw, the responsible is:
a. ACTH
b. Somatomedin
c. TSH
d. Cortisone

136.A young girl experienced crampy abdominal pain & proximal muscular weakness
but normal reflexes after receiving septra (trimethoprim sulfamethoxazole):
a. functional myositis
b. polymyositis
c. guillian barre syndrome
d. neuritis
e. porphyria

137.3 yrs has flu cough fever and in the buccal mucosa there r grey,white,lesions to
2nd molar diagnosis?
1-rubella
2-rubeola
3-chicken pox

138.There was aquestion about muscle pain,fatigue ,dysphagia and recurrent

pneumonia .In examination sluggish reflexes and spastic muscles.
Diagnosis:
Mysthenia gravis.
Motor neuron disease.
Dermatomyositis.
other option not remembered.

139.A fatty child come with his mother for evaluation as he eating more He is in 97
percentile , What will you do :
Screen for hyperlipidemia.
Life style modification.

140. A case of constipation in lt lower abdomen. On examination there was small

mass in lt lower quadrant. No history of weight loss.There was aother details
Diagnosis :
Chrons disease.
Diverticulosis.
Other 2 options.

141.A case of finger pain for 2 days. You prescribed antibiotics and NSAID.
after 2 days pain still present with picture like that..What will you do :
Regional anasthesia and drainage.
General anasthesia and drainage.
Add i.v antibiotics.
Add anti-crystal medication .

142.A case of child diagnosed with malaria (falciparum) Severe toxic pale
patient with high fever.Treatment with chloroquine Dose:
600 mg 1st then 600 after 6 hours.
600 then 300."
300 then 600."
300 then 300"

143.Female pt. G 3 p 2....14 weeks gestation came with lower abdominal pain and
bleeding.she looks anxious and pale..On ex :
Bl/p 100/70
RR 22
TEP 37.8
PULSE 100.
U/S show gestational sac and viable fetus. In pelvic examination : It show closed
cervix and copious bleeding , Diagnosis :
Missed abortion.
Inevitable abortion.
Threatened abortion.
Incomplete abortion.

144.Regarding D&C Which one is right :

A) Antibiotic is mandatory.
B) Use of Anasthesia decrease risk.
C) Small cuped probe is better than wide.
D) Broad cupped probe is better to decrease perforation.

E) Add blood and oxytocin prior to surgery.

145.Along scenario about pt. In day care presented with arthralgia, conjunctivitis,
And fatigue and temp 38 c..Treatment..
Antibiotic for 3 days then NSAID.
Single dose of corticosteroids.
Antiviral drugs if within 72 from start.
Nothing.

146.Regarding smoking cessation, the following are true EXCEPT:

a) The most effective method of smoking control is health education.
b) There is strong evidence that acupuncture is effective in smoking cessation.
c) Anti-smoking advice improves smoking cessation
d) Nicotine replacement therapy causes 40-50% of smokers to quit.
e) The relapse rate is high within the first week of abstinence.

147.64 years old man with painless hematuria and 40-years smoking..enlarged
prostate and normal urine analysis and kidney function test..What should you do
Give him alpha blockers.
Order cystodcopy.
Order ultrsound.
Nothing and periodic evsluation.

148.37 years old chronic renal pt came with muscle pain and irritability. On
examination tapping in front of ear Causing sudden jaw movment. You ordered lab
which came as the following :
Na 138
Cl 99
K 4.2
Ca 6.7
Creatinine 1.8
PTH high level
1(OH) cholecalciferol normal level.
What is the cause of this patient symptoms:
Vit D deficiency.
Parathyroid problem.
Renal disease.
Osteoporosis.
Defect calicium intake.

149.patient come for routine check-up..His BMI is 28 and no complain of any kind.
He just concerned about his blood pressure .When you checked him pressure was
135/89 And 137/90 in 2 repitive readings with 5 minutes apart.He asked you how can
he reduce his pressure. What is the most appropiate advice to him :
Reduce salt in your food .
Body weight reduction and exercise.
Eating healthy food.
Eating less sugars.

150. pt with eye pain vesicle in opthalmic devision : a post herpes zoster b post
herpes simplex
151.eye pain photophopia a keratites b uvetis

152. 6 years old co bleeding per rectum colonoscopy diagnose adenopathy Ca

colonoscopy done every a 3 m b 6 m c 1yr d 5 yr

153.Xray show big heart pt co central chest pain SOB diagnosis

A pleursy b pericardial effusion c CHF

154.Pt co SOB bloody sputum dusky rash in face PH of RF +AF diagnosis

A CHF B Mitral Stenosis C infective endocardies

155.Senario of pt e SOB +palpitation diagnosis tricuspid Regurgitation what

treatment to prevent complication to occur
A anticoagulant B neuroaxial C antibiotic

156. LBBB for dental proceeded prophylaxis

A no need
B antibotic before
C antibiotic after

157.DVT majer risk factor

A open knee operation
B fly 4 h

158. Pt e alchole abuse stop then devolped tremor nausa anxiety treatment
A diazepam b propranolol c nalexton

159. Pt haevy alchol co chest pain sever vomiting chest xray show wide mediasinum
on exam decreased unilateral breath sound treatment
A antibiotic
B NG suction
C surgical refer

160. 2 guestion about Migrain first treatment to abort attack

A sumtriptan B diazepam C acetaminophen

161. What antipsychotic cause drooling neutropenia ECG change

A respirdone B zolipedem C clozapine

162. Pt e hypertension on atenolol 50mg co of bilateral calf pain on examination

shiny skin leg weak dorslis pedis Bp 140/90
1 stop atenolol
2 add captopril 25
3 add hydrochorothizide 25 mg
4 reduce dose to 25mg

163.Pregnant lady co epigastric pain radiate to back lipase amylase high

Important management ;
A antibiotic
B nasogastric suction
C hydration
D analgesia

164.Child co fever drowsy investigation high total , What important next step
A LP
B ceftrixone IV

165. guestion child e fever tonslites devolped splenomegaly lymphadenopathy

A adenopathy virus
B EBV
C herpes simplex

166.long senario old male hypertension on examination mild cataract and mild
decreased vision ;
A urgent referral to opthalmologist
B urgent cataract surgery
C elective opthalmology refer for cataract

167.In hyperthyroid pt what investigation done to look for complication of excees

thyroid hormone ;
A Ct scan haed
B bone scan
C US liver

168. X-ray pelvis show pelvis bone increased density diagnosis ;

A osteomalcia
B Osteoporosis
C Paget disease
D normal

169. for colon Ca best screening ;

A colonoscopy annually
B senstive fecal occult blood annually
C CT scan annually

170. Child e bleeding tendency splenomegaly , Investigation all low pancytopenia

Diagnosis ;
A iron deficiency
B SCA
C aplastic anaemia

171.Senario child e peticheal splenomegaly pericarditea

A infectious mono neuclesis
B kwasaki disease

172.business man have proplem in company co anxiety diaphoric sweating irritability

diagnosis
A Mania
B grandiosity
C anxiety disorder
D panic

173. Pt involve in RTA dyspnea distended vein tracheal shift decreased breath sound
in Lt side
Bp 100/60
Immediate managment
A IV fluid
B needle in 2nd ICS lt side
C analgesi
D intubation

174. pt hysrectomy done co of mild pain in incision site

Hb mrmal
Tempreture 37.5
HTC normal
Bp 110/70
What cause to be still in hospital
A low Hb
B high tempreture
C high HTC
D because not oral feeding

175.pt e muscle cramp postive chevostock sign

Ca low creatinine high PTH high
A hyperprathyroidism
B CRF

176.guestion about when food eating and perstalsis occur this called ;
A gastrocolic
B gastroileal
C gastroanal
D gastrocolic

177. about girl 17 yrs old co all class freind tall and has small breast and pubic hair
scanty all investigation normal
A ovarian failure
B delay puberty
C Turner syndrome

178. old pt co Rt facial pain tenderness eye tearing salivation fluid from mouth clowdy
Total high Diagnosis
A bacterial sialdnites
B Sgoren syndrome
C parotid tumour

179. young male co of muscle weakness investigation

Low NA
High K
Low Ca
Which responsible
A hyponatraemia
B hypocalcaemia
C hyperkalaemia

180. young pt co of heart burn epigastric pain recurrence not respond to diet contol
A H2 blocker
B endoscopy
C biopsy

181. child dental caries

A systemic fluride
B deit modification

182. pregnant lady FBG 8.6 high risk of ;

A candidiasis
B trichomoniasis

183. young male many sexual behavior sexual practice 2 month ago devoloped
painless penile lesion + inguinal lymph node enlargment
A chancre
B syphilis
C gonorrhea

184. which study increased health worker bias ;

A cohort study
B case control
C cross sectional
D case report

185. pt suspected H pylori

A blood
B stool

C urea breath

186.pt Senario there is kiser flisher ring wilson copper dis , answer treatment.
Penicillamine

187. child e constipation for long time hypotonia hyporeflexia lower limb MRI attach
there is white lesion in lower back diagnosis
A Cyst
B cord infarction

188. exercise in CHD:

1 isitonic
2 anaerobic

189. 35 yrs female co Rt iliac fossa pain nausea vomiting sudden onset pt toxic ill on
pain grade 9/10 Bp 110/70 pulse 100 US mass 6cm , Diagnosis ;
A ovarian Cyst Torsion
B Rupture ovarian Cyst
C appendicitis

190. child 2yrs old mother said abnormal urine stream UG puc cell 10 RBC 15
VCUG done attached Diagnosis of primary proplem of this child . In emage die there
stricture then dei continue ;
A vesicouretric reflex
B posterior urethral valv

191. yrs female clear vaginal dicharge colurless odourless after intercourse
management :
1 meconazol ointment
2 douch
3 metronidazole

192. 25 yrs female co tender lump in upper part of breast associated e mensruation
A FNA
B NsAID
C watch next cycle

193. pt co anal pain sever in nature on examination mass in anal diagnosed as

Thrombosed pile Treatment ;
A analgesia
B laxative
C excision
D evacute haematoma

194. old pt co dispareunia lower abdominal pain this proplem affect her psychological
ly Treatment
A COP cream
B Nsaid 1 hr befor intercourse
C lubricant
D endometrical biopsy

195. Youg male e inguinal hernia

A urgent refer
B surgical operation now
C elective surgery If reducible

196. young male sudden scrotal pain increased e elevation. Urine General puc cell
increased TWBCs increased , What to do ;
A urethral swap
B doppler US of scrotum
C abd US

197. old pt e symptom of BPH on examination mild enlargement of prostate not firm
UG mild UTI
PSA normal
What next
A periodic PSA
B prostatectomy
C start alpha blocker
D admission

198. pt e knee pain e limitation of movement swelling in patellar region ;

A septic arthritis
B RA
C Osgood schalter disease
D osteoarthritis

199. child bring by mothers for screen of TB no contact e tuberculosis pt no

crowdness , Screening
A every 3 month
B every6 month
C once
D 1yr

200. pt e palpitation HR 180 , ECG show narrow complex tachycardia best treatment
A digoxin
B verapamil
C adenosine
D amiodaron

201. old pt fracture radius to assess bone density

A xray
B vit D
C bone scan
D DEXA

202. pt diabetic leg ulcer antibiotic 7 day not respond

A hydrogen dressing
B surgical depridment
C another course antibiotic

203. Lithium best treatment for

A bipolar depression
B mixed mania
C classic mania

204. diabetic pt came to clinic for follow up sudden collapsed

HR 96 & ECG show wide spread st elevation and narrow tachycardia inspite HR
given 96 , Diagnosis :
A SVT
B VT
C wolf parkinson white syndrome

205. typical senario of closed angle glucoma acute ask for treatment ;
A timolol eye drop+ iv acetszolamide
B Timolol eye drop and refer
C iv acetazolamide+ pylcarpine0.4%
206. Picture of ophthalmia neonatrum ,Treatment of choice (ceftriaxone&gentamycin)

207. Patient with flank pain , HTN haemtouria, abdominal mass dx

A abd CT scan
B abd US
C urine analysis
D cytoscopy

207. Patient with renal pain and vomiting

Na normal
K low
A metabolic alkalosis
B metabolic acidosis
C respiratory acidosis
D respiratory alkalosi

208. patient with Down syndrome, which ocular disease must be screened annually
A- gluocoma
B- uveitis
C- keratitis
D- cataract

209. which the following is the strongest risk factor of cerberal palsy
A- perinatal asphyxia
B- prematurely
C- low birth weight
D- hydrocephalus

210. phycision for wound closure what he do?

A drap,clean, irrigation, closure

B.clean, drap irrigation, closure

C.Irrigation, clean, drap, closure

D irrigation, drap, clean, closure

211.from psychiatry. A pt come to you he has depression loss of libido , appetite

sleep bla bla come to you how you use tool or scale to measure his depression , q
was like that

.A.zung self rating

B.primary care evaluation of mental disorder

C.Montigmory....

4. I forget option
212. 30 yrs old married pt had multiple joint pain and for That she taken ibuprofen
pain releived now she has severe pain with effusion un left knee joint, fever, she had
sex with new partner 2 wks before, she has erythma and swelling in cervix too.bla bla

A.gout

B.popliteal.

C.septic arthritis

213. about celiac disease ;

A.rice.

b.barlay.oats.wheat

214.There was graph about hearing , 17 years old pt since 2 years hearing is de
decreasing on exam tympanic membrane healthy diagnosis

A.OMB.otosclerosis

C.Ossicular disruption

D.otitis bysicus

215. A 4 years old boy pt of nephritic syndrome had got fever abdominl distension,
generalized abdominal tenderness , diagnosis ;

A.pertonitis

B.appendicitis

C.panreatitis

D.intestinal obstruction

216.yr old pt screened pap smear , there were higrade intraepithelial metaplasia next
step ;

A.cone biopsy

B.colnoscopy and direct biopsy

C.hystrectomy

217. there was question about human papillomavirus = syphilis

218. yrs old male co polyphagia polydepsia polyurea not ate since 5yr RBG high this
from
A increased insulin
B decreased insulin
C no Glucagon
D increased rennin
219. Male patient complain of excruciating headache, awaken him from sleep every
night with burning sensation behind left eye, lacrimation and nasal congestion. What
is effective in treating him :
a) Ergotamine
b) Sumatriptan SC
c) Methylprednisolone
d) NSAID
e) O2

220.Regarding infective Indocarditis pt. Have Penicillin allergic . And he wants

genitourinary surgical , Which from the following other select prophylaxis ;
A- Augmantin and ciprofloxacin I. V
B-erythromycin and gentamicin
C- amoxycillin only oral
D- chloramphenicol l.v and septran
DOC = Drug of choice
1. INH Poisoning = Pyridoxine
2. Congenital pure red cell aplasia = Prednisolone
3. Mycoplasma pneumonia = Erythromycin
4. Cystinosis = Cysteamine
5. Sydenham chorea = Phenobarbitone
6. West syndrome = ACTH nd Steroids
7. Wilsons = Zinc
8. Idiopathic hypercalciuria = Thiazide diuretics
9. Preventn of cyanotic spell = Propranolol
10. Chicken pox = Acyclovir

Anti dote :

1.Paracetamol toxicity=N-acetylcystine

2.opioid Toxicity=Nalaxone

3.benzodiazepines toxicity= Flumazen

4.organophosphate toxicity=Atropine

5.heparin= Protamine sulphate

6.oral anticoagulant= Vit K

7.Iron overload = desferoxamine

Most Commonly asked "THE MOST" in Surgery Please Correct and Contribute
1.Most common benign neoplasm of liver- hemangioma
2.Most common primary malignancy of liver- hepatocellular carcinoma
3.Most common hepatic neoplasms- metastasis
4.Most common primary hepatic malignancy in children- hepatoblastoma
5.Most common benign tumor of oesophagus-leiomyoma
6.Most common indication of liver transplantation in children-biliary atresia
7.Most common indication of liver transplantation in adults-cirrhosis of liver
8.Most common bone of the face that is fractured is-nasal bone
9.2nd most common bone of the face that is fractured is zygomatic bone
10.Most common benign tumor of spleen- hemangioma
11.Most common neoplastic enlargement of spleen- lymphoma
12.Most commo cancer caused as a risk of choledochal cyst carcinoma of biliary
tract
13.Most common type of gall stones- Mixed Stones (plz correct me if wrong)
14.Most common site of gall stone ileus-distal ileum proximal to ileocaecal junction
15.Most common site for gall stone impaction in CBD- ampulla fo water
16.Most common site for internal fistula of gall bladder-1st part of duodenum
17.2nd most common site for internal fistula of gall bladder-colon
18.Most common cause of supurative cholangitis- gall stones/?CBD stones
19.Most common type of stones among primary and secondary CBD stones-
secondary(cholesterol stones)
20.Most common metastasis to liver is from- stomach
21.most common part of CBD injured/prone to stricture during laparoscopic
cholecystectomy- upper CBD
22. most common pathological type of gall bladder carcinoma- adenocarcinoma
23.most common cause for hemobilia- blunt trauma
24.most common cause of hemobilia in western countries- hepatic trauma(trauma to
intrahepatic branch of hepatic artery)
25. most common cause of hemobilia in oriental countries-ductal parasitism(ascaris
lumbricoides)
26. most common cause of obstructive jaundice- CBD stones
27. most common cause of biliary stricture-trauma
28.most common malignancy after cholecystectomy occurs in- stomach
29.most common site of an intraperitoneal/intra- abdominal abscess-pelvis
30.most common organ involved in retroperitoneal fibrosis- ureter
31.most common site of ureteral obstruction-lower 1/3rd of ureter(at the level of
pelvic brim)
32.most common cause of abscess in midline/extra peritoneal space-amoebic
abscess
33.most common cause of small bowl obstruction and secondary infertility in
developed countries-peritoneal adhesions
34.most common cause of chylous ascites-malignancy(lymphoma)
35.most common variety of carcinoma peritonei- discrete nodules
36.most common variety of mesenteric cyet-chylolymphatic cysts
37.most common site for chylolymphatic cyst- mysentery of ileum
38.most common cause of peritonitis in adult male-perforated appendix
39.most common site from where psudomyxomaperitonei arise-appendix
40.most common organism causing (primary) spontaneous bacterial peritonitis-E.coli
41.2nd most common organism causing (primary) spontaneous bacterial peritonitis-
klebsiella
42. most common organism causing (secondary) acute suppurative peritonitis-E.coli
43. 2nd most common organism causing (secondary) acute suppurative peritonitis-
bacteriodes
44.most common organism causing CAPD cagualase negative staph.
(staph.epidermidis)
45.2nd most common organism causing CAPD- staph.aureus
46.most common site for intraabdominal abscess following laparotomy- subhepatic
47.most common cause of generalized peritonists in middle aged adult male-
duodenal ulcer
48.most common cause of acute mesenteric adenitis- idiopathic
49.the most common organism seen in peritonitis- E.coli
50.most common site of malignant change of lipoma is retroperitonium
51. MC and earliest symptom in rectal carcinoma - bleeding
52. 2nd MC symptom in rectal carcinoma - alteration in bowl habit
53. MC type of rectal and colon carcinoma - columnar cell adenocarcinoma
54. MC type of anal canal carcinoma - squamous cell ca.
55. 2nd MC type of anal canal carcinoma - basal cell ca.
56.MC site for anal fissure - midline posteriorly (90%)
57. 2nd MC site for anal fissure midline anteriorly
58. 3rd MC site for melanoma - anal canal (1st and 2nd skin and eye)
59. MC cause of lower GI bleed in adults - hemorroids
60. 2nd MC cause of lower GI bleed in adults - diverticulosis
61. MC cause of massive bleeding per rectum - diverticulosis
62. MC symptom of fissure in ano (anal fissure) - pain
63.MC site for blood borne metastasis of rectal ca - colorectal ca.
64. variety of rectal ca. is MC at recto sigmoid junction - annular variety
65. MC type of ano rectal abscess - perianal abscess
66. MC cause of ano rectal abscess - fistula in ano
67. MC symptom of rectal polyp - pain
68. 1st MC complication after haemorroidectomy - pain
69. 2nd MC complication after haemorroidectomy - urinary retention
70 .MC post operative nosocomial infection - urinary tract infection
71. 2nd MC post operative nosocomial infection - surgical site infection
77. 3rd MC post operative nosocomial infection - lower respiratory tract infection
78. MC testicular tumor - seminoma
79. MC type of testicular tumor seen in cryptorchid testis - seminoma
80. MC testicular tumor above 50 yrs - lymphoma
81. MC secondary neoplasm of testis - lymphoma
82. MC malignancy in older males - prostate cancer
83. MC side in which testis does not descend - right
84. MC side where varicocele occurs - left side
85. MC predisposing cause of torsion of testis - inversion of testis
86. MC symptom of tortion testis - pain
87. MC type of primary hydrocele - vaginal type
88. MC site of ectopic testis superficial inguinal ring
89. MC cause of surgically treatable infertility - varicocele
90. MC cause of upper GI bleeding - peptic ulcer disease
91. MC bladder stone - uric acid stone
92. 2nd MC bladder stone - struvite
93. MC tumor of urinary bladder transitional cell ca.
94. MC tumor of urinary bladder in a child - rhabdomyosarcoma
95. MC aetiological factor for transitional bladder cell ca. - cigarette smoking
96. MC bladder cancer that is prevalent in bilharzia endemic areas - sq. cell. Ca.
97. MC type of buccal ca. - sq. cell. Ca.
98. MC type of maxillary ca. - sq. cell. Ca
99. MC symptom of bladder ca. painless hematuria
100. MC primary tumor which gives secondary to penis - badder ca.