SLE EXAM

MRCH 2006
‫ لذلك ال أضمن عدم وجود أخطاء و ووضعت بعض الشروح‬.‫ وبعضها مما أتذكره‬،‫ والسؤال‬،‫هذه حلول اجتهدت فيها بالرجوع للكتب‬
‫ محمد جمال حولدار‬/‫أخوكم‬ .‫ بها‬7‫واإلضافات أسأل اهلل أن ينفعكم‬
26/8/1427
1- evidence base medicine :-
a- practice medicine as in the book
b- practice according to the department policy
c- practice according to available scientific evidence
d- practice according to facility
e- practice according to latest publish data

2- 42 years old man presented with sudden eruption all over the
body with palm & foot ,, most likely Dx.:-
a- syphilis
b- erythema nodosam
c- erythema multiform
d- fixed drug eruption
e- pytriasis roscia

☺ Special thanks to Dr.noor

3- causes of 2ry hyperlipidemia all except:-

a- hypertension
b- nephrotic syndrome
c- hypothyroidism
d- obesity

4- non steroidal anti-inflammatory drug can cause all except

a- acute renal failure
b- tubular necrosis ?
c- hypokalemia
d- interstitial nephritis

☺ Special thanks to Dr. roa`a

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 5- obese 60 year lady " cholecystectomy " 5th day post-op she
complain of SOB & decreased BP 60 systolic ,, on exam
unilateral swelling of Rt. Leg the Dx is:-
a- hypovolomic shock
b- septic shock
c- pulmonary embolism
d- MI
e- Hag. Shock

6- 55 year old male with COPD he complain of 1 wk fever ,

productive cough on CXR showed Lt upper pneumonia ,, sputum
culture +ve H.influenza , most drug:
a- penicillin
b- doxecycline
c- cfuroxime
d- gentamycin
e- carbenicillin

7- 8 years old boy which is 6 year old height & bone scan of 5.5
years ,, Dx is:
a- steroid
b- genetic
c- hypochondriplasia
d- hypothyroidism

☺ Special thanks to Dr.Najla

8- the effectiveness of ventilation during CPR measured by:-

a- chest rise
b- pulse oximeter
c- pulse acceleration

☺ Special thanks to Dr. Dua`a

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 9- this signs & symptom of IBD except:-
a- bleeding per rectum
b- feeling of incomplete defecation
c- Mucus comes with stool
d- Wt. Loss
e- Abdominal distention
)b ‫ أما هذا السؤال فاحتمال‬،a ‫ الجواب يكون‬IBS ‫(لو كان السؤال عن‬
10- this suggest acute appendicitis except:-
a- fever 38.1
b- anorexia
c- vomiting
d- umbilical pain shifting to Rt LQ
e- pain improved with sitting & learning foreword

☺ Special thanks to Dr. Gada Al-Naseer

11- 15 years male with Hx. Of 3 days yellow sclera ,

anorexia , abdominal pain :
LFT: T.bilirubin = 253
Indirect = 98
ALT = 878
AST = 1005
The Dx is:
a- Gilbert disease
b- Infective hepatitis
c- Obst. Jaundice
d- Acute pancreatitis
e- Autoimmune hepatitis

12- 35 years G4P2+1 1year Hx of irregular heavy bleeding

O/E WNL ,,,, the most Dx is:
a- Early menopause
b- Narvouse uterus
c- Dysmenorrhea
d- DUB
e- Endometriosis

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 13- 30 year old male with Hx of pain & swilling of the Rt
Knee , synovial fluid aspiration showed yellow color , opaque
appearance , variable viscosity , WBC 150000 , 80% poor
mucin clot ,, Dx is:
a- Goutism Arthritis
b- Meniscal tear
c- RA
d- SA
e- Pseudogout arthritis

14- 30 years old teacher complaining of excessive water

drinking & freq. Urination ,, O/E WNL . you suspect DM &
request FBS = 6.8 the Dx is
a- DM
b- DI
c- Impaired fasting glucose
d- NL blood sugar
e- Impaired glucose tolerance

15- Hirisutism ass. With which of the following?

a- Anorexia
b- Juvinal hypothyroidism
c- Digoxin toxicity
d- c/o citrate ?

☺ Special thanks to Dr. Rana Al- Belwi

16- the most accurate diagnostic inv. For ectopic preg.:-

a- culdocetesis
b- pelvic U/S
c- endometrial biopsy
d- serial B-HCG
e- laparoscopy

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 17- 12 years old female non pruritic anular eruption Rt foot
for 8 month , Hx of pale , non scaling no response to 6 week of
miconazole:-
a- Discoid lupus erythematous
b- Erythema nodosum
c- Choricum marginatum
d- Granulomatus anular
e- Tinea carporis

18- 26 years female 6 month Hx of bilateral temporal

headache increased in morning & Hx of OCP last for 1 year ,
O/E BP 120/80 & papilloedema ,, Dx. is :-
a- Encephalitis
b- Meningitis
c- Optic nuritis
d- Benign intracranial hypertension
e- Intracerbral abscesses

☺ Special thanks to Dr. Susan Makhashen

19- 2ry prevention is last useful method of disease

controlled in :
a- Breast ca
b- DM
c- Leukemia
d- Malnutrition in children
e- Toxemia of pregnancy

20- one of your elderly , hypertensive pt's is well controlled

with diuretic regimen , the pt has attributed this NL BP to his
concomitant use of garlic water ,,
you will now:
a- allow pt to continue the same practice
b- order the pt to D/C garlic water
c- instruct the pt to D/C diuretic & continue the garlic
water

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 d- tell the pt that he is ignored & unscientific to believe in
garlic water
e- refer the pt to psychiatrist to evaluate his mental state

☺ Special thanks to Dr. Monera Al-Khaldi

21- A male presented with headache , tinnitus & nausea ,

thinking he has brain tumor he just secured a job in a
prestigious company he is thinks he might not meet it's
standards ,, CNS exam NL , CT = NL what is the Dx.:
a- Generalized anxiety
b- Panic attack
c- Hypochondriasis
d- Conversion reaction
e- Anxiety

☺ Special thanks to Dr. Hana`a Bawazear

22- Anal fisher more than 10 days whish of following is true:

a- Loss bowel motion
b- Conservative management (if it is acute. Is 10 days acute??)
c- Site of it at 12:00

23- 56 years old complaining of PR bleeding O/E external

hemorrhoid " management"
a- Excsional
b- Send hem home & follow up
c- Observation for 6 months
d- Rigid sigmoidoscopy if normal excise it

24- 12 months baby can do all except:

a- Walk with support one hand
b- Can catch with pincer grasp
c- Can open drawing " ‫" درج‬
d- Response to calling his name
e- Can play simple ball

25- fracture of rib can cause all except:

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 a- pneumothorax
b- hemothorax
c- esophageal injury
d- liver injury

☺ Special thanks to Dr. Aida Al-Jabri

26- hyperprolactinemia ass. With all of the following

except:
a- pregnancy
b- acromegaly
c- OCP
d- Hypothyroidism

27- after delivery start breast feeding :-

a- as soon as possible
b- 8 hrs
c- 24 hrs
d- 36 hrs
e- 48 hrs

28- 27 years old male with tonic colonic in ER , 20 mg

diazepam was giving & convulsion did not stopped will given :-
a- Diazepam till total dose Give
of 40 mg
diazepam tow times.
b- Phenytoin Then go to phenytoin. Then
c- Phenobarbitone go to phenobarbione

29- child pt's brought to ER with tonic clonic convulsion Hx

or recurrent febrile convulsion ,, will give him to continues in
his home with :
a- diazepam
b- phenytoin
c- phenobarbitone
d- clomizepam

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 30- 60 years old male complain of decreased libido ,
decreased ejaculation , FBS= 6.5 mmol , increased prolactin ,
NL FSH , LH , do next step:
a- Testosterone level
b- DM
c- NL FBG
d- CT of the head

31- osteoporosis with back pain:

a- vit. D decreased
b- R/O if the X ray is WNL

☺ Special thanks to Dr.Najla

32- 27 years old man have asymmetric oligoarthritis involve

Knee & elbow , painful oral ulcer for 10 years . he came with
form of arthritis , mild abdominal pain ,, dx is:
a- Bechjet diseased
b- SLE
c- Regional enteritis
d- Ulcerative colitise
e- Wipples disease

☺ Special thanks to Dr. Amani

33- 5 month old baby presented in ER with sudden

abdominal pain + vomiting , abdominal pain last fore 2-3 min
with interval of 10 – 15 min in between:-
a- Intussception
b- infantile colic
c- appendicitis

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34- 12 month old baby with:
Hb A1 58%
HbS 38%
HbA2 2% -Sickle trait because HbS < 50%
HbF 5%
-to be thal. HbA2 MUST be more than 3.5% (
Dx is :- ‫أسامة السلطان‬.‫)د‬
a- Thalasemia minor
b- Thalasemia major
c- Sickle cell trait
d- Sickle cell anemia
e- Sickle cell thal.

35- 42years old female presented with 6 month Hx of

malaise , nausea & vomiting
lab Na = 127 , K = 4.9 , urea = 15 , creatinine = 135 , HCO3 = 13
, glucose = 2.7 mmol
the most likely Dx:
a- hypothyroidism
b- pheochromocytoma
c- hypovolemia due to vomiting
d- SIADH
e- Addison's disease

36- 23 years old female presented with the finding of

hyperbilirubinemia , O/E WNL ,, lab: T.bili = 3.1 , direct =
0.4 ,, the most likely Dx:
a- Gilbert's disease *Gilbert's disease: asymptomatic,
discovered incidentally, no ttt required and
b- Crigler najjar syndrome 1
slight increase bilir.
c- Duben Johnson syndrome
d- Rotor's disease * Crigler najjar syndrome 1: this can't
survive adult life. Only type II survive
e- Sclerosing cholangitis
* Duben Johnson syndrome & Rotor's
disease: direct bilirubin (Q about indirect)

* Sclerosing cholangitis: 75% in men,

pruritis & Dx by ERCP (MRCP)

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 37- 15 years old girl menarche was at age of 13 years old
complaining of menstrual pain , not active sexually O/E pelvic
U/S WNL , treatment is:-
a- Laprostomy
b- Danazol
c- Cervical dilatation
d- NSAID

38- 3 years old boy in routine exam for surgical procedure in

auscultation discovered low pitch murmur continues in the Rt
2nd intercostals space radiate to the Rt sternal border
increased by sitting & decreased by supine ,,, what you want
to do after that ?
a- Send him cardiologist
b- Reassurance & till him this is innocent murmur
c- Do ECG

39- 17 year old male while play football felt on his knee
“tern over “ what do think the injury happened

a- medial meniscus lig,

b- Lateral meniscus lig.
c- Medial collateral lig.
d- Lat. collateral lig.
e- Antr. Crussate lig.

40- a full term baby boy brought by his mother weighing

3.8 kg. developed jaundice at 2nd day of life .
. coomb's test –ve ,Hb : 18 ,billrubin : 18.9 &
indirect: 18.4
O/E : baby was healthy and feeding well .. the most
likely diagnosis is :

a- physiological jaundice
b- ABO incompatibility
c- breast milk jaundice
d- undiscovered neonatal sepsis

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41- a 43 yrs. old female pt. presented to ER with H/O :
paralysis of both lower limbs and parasthesia in both upper
limbs since 2 hours ago .. she was seen lying on stretcher &
unable to move her lower limbs (neurologist was called but he
couldn't relate her clinical findings 2 any medical disease !!!
when history was taken , she was beaten by her husband
the most likely diagnosis is :
a- complicated anxiety disorder
b- somatization disorder
c- conversion disorder
d- psychogenic paralysis
e- hypochondriasis

42- the best treatment for the previous case is :

a- benzodiazepines
b- phenothiazine
c- monoamine oxidase inhibitor
d- selective serotonin reuptake inhibitor
e- supportive psychotherapy

☺ done by Dr. Khalid Shahat

============================================================

Collected & organized by Dr. Khalid

Shahat
Dr.khalid.s@hotmail.com
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‫ختاما نرجو من كل من استفاد من هذا الجهد الدعاء لنا بالتوفيق و‬

‫السداد في الدنيا و اآلخرة‬

‫اقسم باهلل على كل من **** أبصر جهدي حيثما أبصره‬

‫أن يدعو الرحمن لي مخلصا **** بالعفو و التوفيق و المغفرة‬

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‫مع خالص أمنياتي للجميع بالتوفيق والسداد‬

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