1. Which of the following is correct regarding Wernikes Encephalopathy :
-Often develops into Korsakof's even when treated
-It has a mortality rate of 70 % to 80 % if untreated
-The treatment is thiamine 100 mg. PO daily for 5 days
-The symptoms include Nistagmus ataxia and opisthotonos
-None of the above *
2. Which is the most serious complication of the supra condilar fracture of the Humerus ?
-A compartment syndrome of forearm
-Failure to heal
-Healing in a non anatomic position
-Injury into the median nerve.
-Permanent restriction of the Elbow motion.
3. Which one of the following descriptors of a diagnostic test is Influenced by the prevalence of the disease being tested for :
-Specificity
-Sensitivity
-Accuracy
-Positive predictive value
-Reliability
4. A 43 years M admitted for Emergency Gastrectomey present confusion on the 3rd post-Op day. complains of lack of sleep due to cockroaches on the ceiling he is noted to be flashed & tremelus by the nurses during the day .. the most likely problem is :
-Post-Op Electrolites Inbalance
-Paranoid Schizophrenia
-Depression Psychosis
-Delerium Tremons
-Anoxic brain system
5. Pt. with known type II DM. treated with Clorpropamide present to ED in comma .. blood sugar = 1 mmol / L. .. you give the Pt 1 ampule of D50W & the Pt wakes up promptley . what is the next appropriate management :
-Give another ampule then discharge.
-Give 2 ampules then discharge.
-Give another ampule then observe the pt for 6 h. in the ED.
-Give one more ampule , admit the Pt. & start IV. Glucose Infusion with frequent ongoing glucose measurement
6. Pregnant 36 weeks with vaginal watery discharge , management :
-do sterile speculum exam
7. Barbiturate withdrawal = convulsion
8. Retrovarted uterus complain = asymptomatic
9. G5 P4 post-delivery, postpartum hemorrhage, most likely cause is :
-Uterine atony
10. Anal skin tag in child associated with ,
-chronic Anal Fissure
11. Child with abdominal pain attacks , drowning his legs up , mucouid bloody stool. Diagnosis ?
-Intussusception
12. 1st sign of foot gangrene is = rest pain
13. Pt. M pain in both lower limbs with week popletial artery pulsation , management ?
transvertebral angiogram
14. basket ball player averted his ankle joint during jumping at match , on Examination Pain with Increased Various range. Management ?
-Repair ligament surgery
-Below knee cast
15. clean wound cut with laceration & incomplete section of nerve , management ?
-Suture of wound Immediately
-Leave the wound open
16. pain on walking increase in 2nd & 3rd metatarsal bone of forefoot. Diagnosis ?
-Stress fracture
-Sesamoid bone
17. Pt. 68 years going to elective surgery , he has 4 mo. history of chest pain & got same attack at night before the day of surgery , what do u do ?
-Lignocaine before surgery
-Trinatreate during surgery
-Send him for ICU
-Postpone the operation & check function of the coronaries
18. collage student F 20 years presented with lower abdominal pain , PE bilateral lower abdominal tenderness , febrile Vaginal exam : tender with cervical mobilization , pregnant test (-). Diagnosis ?
-Acute salpengitis
-Ectopic pregnancy
-UTI
19. vaginal bleeding , stooped at the day of admission , pregnancy test is (+) US shows empty uterus & left adnexal mass. Diagnosis ?
-Ectopic pregnancy
20. young Pt with history of non productive cough but clinically well .. C-X ray shows bilateral basal Infiltration .. Diagnosis. ?
-Mycoplasma Pneumonia
21. Pt with Ulcer in sole of the foot , at 2nd & 3rd metatarsal joint X Ray necrotic & destroyed part of 2nd & 3rd metatarsal bone .. what to do ?
-Radical debridment
-Above knee amputation
-Daily sterile dressing
-Oral antibiotic
22. Problem which cause most work days = back pain
23. Nicotinic skin patchy is contraindicated in:
-Pregnancy
-CVA
-Ischemic Heart disease
-Alcoholic
NB. (not sure)
24. Psychotherapy is superior to medication in:
-Schizophrenia
-Bipolar disorder
-Alcoholic withdrawal
-Dysthimia
25. mother worried about her child because of history of myopathy in family .. what Investigation to be done 1st ?
-CPK
-Muscle biopsy
-Nerve biopsy
-EMG
26. Pt on Lithium therapy became weak, lethargic, Intolerant to heat. what Investigation must be done ?
-Lithium level
-BP
-Thyroid Function test
27. surgical nurse 25 years old is concerned that she is loosing her mind, for the past 6 months she is been preoccupied with contamination, on his ward she has been not touching any patient ,door knobs ...etc.
She was also washing her hand excessively, which of the following treatments will help in reducing her preoccupation and hand washing ?
-Fluxetine
-Lorazepam
-Perphenazine
-Insight-oriented psychotherapy
-Nifedipine
28. M 50 years with Prostatic Cancer with bone metastasis. Treatment ?
radical prostatectomy
-Radiotherapy
-Hormonal therapy in the form of total androgenic blockage
-IV chemotherapy
29. Pt with family history of urticaria, presented with urticaria ... investigation revealed C1 esterase inhibitor deficiency ... Diagnosis. ?
-Hereditary Angioedema
30. thickened upper Lt. lip with mild vesicles ... Diagnosis ?
-Urticaria
-Angioedema
-HSV infection
31. Erithematous Vulva with whitish lesion of Candida of Groin & Satellite lesions .. what is the predisposing disease ?
-DM
-CA. vulva
-Lichen sclerosis
32. Pt with sudden cough & pain in the Rt. side of the chest .. you suspect aspiration of foreign body .. what finding of the C-X ray ?
-Hyperlucent Rt. side
33. Defrentiaion between Maxilary & Zigomatic fractures ???????
34. calculation of the effectiveness of a vaccine
Incidence Non Vaccinate - Incidence Vaccinated
--------------------------------------------------------------- x 100
Incidence Non Vaccinate
35. child chalking during eating .. he became Cyanotic, agitated, with forceful breathing .. 1st action to do is :
-Hit him from his back while head downward
-Introduce your finger in his mouth
36. 17 years F. at stage 3 Tanner still not menses .. management ?
-Examination of the pelvis
-Chromosome analysis
-Estrogen Progesterone level
-Reassurance
37. asthmatic Pt. presented in the ER with Dyspnea , used to inhaled salbutamol with no Improvement.. PE shows dyspnea slit rhonchi at the upper chest & neck ... management. ?
-IV. fluid + Aminophine
-Coricosteroids Inhaled
-Inhaled Salbutamol + IV hydrocortisone + IV Fluid
38. Alfa fetoprotein Increased in
-Menengomyelocele
-Renal Agenesis
-Down Syndrome
39. pt with abnormal pap smear .. what is the next step ?
-Colposcopy
40. 60 years F. presented with 5 x 5 cm. adnexal mass .. management. ?
-Surgery
-Chemotherapy
-Radiotherapy
41. Pt. found unconscious on the floor behind the bar, alcoholic, ER agitated semiconscious ... PE shows laceration on the head, all the limbs can be moved, all the others are normal… what is your action?
-CT of the head
-IV. fluid + Observation
-Discharge
42. Pt. fail down from the 2nd floor on his back .. the following will be part of the Initial management EXCEPT :
-Cervical collar
-IV. fluid
-Spine X Ray
-Urinary catheter
43. tertiary prevention is
-Rehabilitation.
44. in the ER. young Pt treated with Procainamide his BP. decreased to 80\60 you tried another time with Procainamide .. his BP. still decreasing .. what to do ?
-Benztropine
-Saline perfusion
-Digitalis
-Defibrillation
-Intubation
NB. the Pt. had Arrhythmia with hypertension (that’s why we gave him procainamide) & because its not decreasing we have to defibrillate him ...
45. F 23 years present with fibroadenoma of the Lt. breast in the lower medial quadrant of the breast all are possible EXCEPT :
-Give Estrogen
-Give Progesterone
-Fine needle aspiration will bring clear liquid
-Mammography can show abnormality
-The growth of the Tumor following cycles
46. F. febrile with tumor in upper Rt. quadrant of the anus .. the mass is painful & red .. what to do ?
hot bandages
-Cold sitz baths
-Surgery
-Systemic Antibiotics
-Topical Antibiotics
47. child with juvenile poliposis .. possible complication :
-Diarrhea
-Painless bleeding
-Painful bleeding
-Malignancy (cancer)
-Non of the above
48. a mother brought hear 12 years daughter who present repetitive UTI temp. 38.5 , IVP & cystography are normal .. what is the best test to do :
-Urine culture
-US & voiding cystography
-Blood culture
-Cystoscopey
-None of the above
49. fibroadenoma of the breast what is false :
-The most common benign tumor
-Fine needle aspiration bring clear fluid
-True solid tumor
-Tumor easy to find because encapsulated
NB. check it alone
50. F pregnant 28 years .. with nocturnal numbness in hands & forearm which wakes hear up for 3 months .. she also have difficulty grasping objects .. what is the most likely etiology ?
-Dermatomiosis
-Abruptio placenta
-Multiple sclerosis
-Carpal Tunnel Syndrome
-Hyperventilation syndrome
-Often develops into Korsakof's even when treated
-It has a mortality rate of 70 % to 80 % if untreated
-The treatment is thiamine 100 mg. PO daily for 5 days
-The symptoms include Nistagmus ataxia and opisthotonos
-None of the above *
2. Which is the most serious complication of the supra condilar fracture of the Humerus ?
-A compartment syndrome of forearm
-Failure to heal
-Healing in a non anatomic position
-Injury into the median nerve.
-Permanent restriction of the Elbow motion.
3. Which one of the following descriptors of a diagnostic test is Influenced by the prevalence of the disease being tested for :
-Specificity
-Sensitivity
-Accuracy
-Positive predictive value
-Reliability
4. A 43 years M admitted for Emergency Gastrectomey present confusion on the 3rd post-Op day. complains of lack of sleep due to cockroaches on the ceiling he is noted to be flashed & tremelus by the nurses during the day .. the most likely problem is :
-Post-Op Electrolites Inbalance
-Paranoid Schizophrenia
-Depression Psychosis
-Delerium Tremons
-Anoxic brain system
5. Pt. with known type II DM. treated with Clorpropamide present to ED in comma .. blood sugar = 1 mmol / L. .. you give the Pt 1 ampule of D50W & the Pt wakes up promptley . what is the next appropriate management :
-Give another ampule then discharge.
-Give 2 ampules then discharge.
-Give another ampule then observe the pt for 6 h. in the ED.
-Give one more ampule , admit the Pt. & start IV. Glucose Infusion with frequent ongoing glucose measurement
6. Pregnant 36 weeks with vaginal watery discharge , management :
-do sterile speculum exam
7. Barbiturate withdrawal = convulsion
8. Retrovarted uterus complain = asymptomatic
9. G5 P4 post-delivery, postpartum hemorrhage, most likely cause is :
-Uterine atony
10. Anal skin tag in child associated with ,
-chronic Anal Fissure
11. Child with abdominal pain attacks , drowning his legs up , mucouid bloody stool. Diagnosis ?
-Intussusception
12. 1st sign of foot gangrene is = rest pain
13. Pt. M pain in both lower limbs with week popletial artery pulsation , management ?
transvertebral angiogram
14. basket ball player averted his ankle joint during jumping at match , on Examination Pain with Increased Various range. Management ?
-Repair ligament surgery
-Below knee cast
15. clean wound cut with laceration & incomplete section of nerve , management ?
-Suture of wound Immediately
-Leave the wound open
16. pain on walking increase in 2nd & 3rd metatarsal bone of forefoot. Diagnosis ?
-Stress fracture
-Sesamoid bone
17. Pt. 68 years going to elective surgery , he has 4 mo. history of chest pain & got same attack at night before the day of surgery , what do u do ?
-Lignocaine before surgery
-Trinatreate during surgery
-Send him for ICU
-Postpone the operation & check function of the coronaries
18. collage student F 20 years presented with lower abdominal pain , PE bilateral lower abdominal tenderness , febrile Vaginal exam : tender with cervical mobilization , pregnant test (-). Diagnosis ?
-Acute salpengitis
-Ectopic pregnancy
-UTI
19. vaginal bleeding , stooped at the day of admission , pregnancy test is (+) US shows empty uterus & left adnexal mass. Diagnosis ?
-Ectopic pregnancy
20. young Pt with history of non productive cough but clinically well .. C-X ray shows bilateral basal Infiltration .. Diagnosis. ?
-Mycoplasma Pneumonia
21. Pt with Ulcer in sole of the foot , at 2nd & 3rd metatarsal joint X Ray necrotic & destroyed part of 2nd & 3rd metatarsal bone .. what to do ?
-Radical debridment
-Above knee amputation
-Daily sterile dressing
-Oral antibiotic
22. Problem which cause most work days = back pain
23. Nicotinic skin patchy is contraindicated in:
-Pregnancy
-CVA
-Ischemic Heart disease
-Alcoholic
NB. (not sure)
24. Psychotherapy is superior to medication in:
-Schizophrenia
-Bipolar disorder
-Alcoholic withdrawal
-Dysthimia
25. mother worried about her child because of history of myopathy in family .. what Investigation to be done 1st ?
-CPK
-Muscle biopsy
-Nerve biopsy
-EMG
26. Pt on Lithium therapy became weak, lethargic, Intolerant to heat. what Investigation must be done ?
-Lithium level
-BP
-Thyroid Function test
27. surgical nurse 25 years old is concerned that she is loosing her mind, for the past 6 months she is been preoccupied with contamination, on his ward she has been not touching any patient ,door knobs ...etc.
She was also washing her hand excessively, which of the following treatments will help in reducing her preoccupation and hand washing ?
-Fluxetine
-Lorazepam
-Perphenazine
-Insight-oriented psychotherapy
-Nifedipine
28. M 50 years with Prostatic Cancer with bone metastasis. Treatment ?
radical prostatectomy
-Radiotherapy
-Hormonal therapy in the form of total androgenic blockage
-IV chemotherapy
29. Pt with family history of urticaria, presented with urticaria ... investigation revealed C1 esterase inhibitor deficiency ... Diagnosis. ?
-Hereditary Angioedema
30. thickened upper Lt. lip with mild vesicles ... Diagnosis ?
-Urticaria
-Angioedema
-HSV infection
31. Erithematous Vulva with whitish lesion of Candida of Groin & Satellite lesions .. what is the predisposing disease ?
-DM
-CA. vulva
-Lichen sclerosis
32. Pt with sudden cough & pain in the Rt. side of the chest .. you suspect aspiration of foreign body .. what finding of the C-X ray ?
-Hyperlucent Rt. side
33. Defrentiaion between Maxilary & Zigomatic fractures ???????
34. calculation of the effectiveness of a vaccine
Incidence Non Vaccinate - Incidence Vaccinated
--------------------------------------------------------------- x 100
Incidence Non Vaccinate
35. child chalking during eating .. he became Cyanotic, agitated, with forceful breathing .. 1st action to do is :
-Hit him from his back while head downward
-Introduce your finger in his mouth
36. 17 years F. at stage 3 Tanner still not menses .. management ?
-Examination of the pelvis
-Chromosome analysis
-Estrogen Progesterone level
-Reassurance
37. asthmatic Pt. presented in the ER with Dyspnea , used to inhaled salbutamol with no Improvement.. PE shows dyspnea slit rhonchi at the upper chest & neck ... management. ?
-IV. fluid + Aminophine
-Coricosteroids Inhaled
-Inhaled Salbutamol + IV hydrocortisone + IV Fluid
38. Alfa fetoprotein Increased in
-Menengomyelocele
-Renal Agenesis
-Down Syndrome
39. pt with abnormal pap smear .. what is the next step ?
-Colposcopy
40. 60 years F. presented with 5 x 5 cm. adnexal mass .. management. ?
-Surgery
-Chemotherapy
-Radiotherapy
41. Pt. found unconscious on the floor behind the bar, alcoholic, ER agitated semiconscious ... PE shows laceration on the head, all the limbs can be moved, all the others are normal… what is your action?
-CT of the head
-IV. fluid + Observation
-Discharge
42. Pt. fail down from the 2nd floor on his back .. the following will be part of the Initial management EXCEPT :
-Cervical collar
-IV. fluid
-Spine X Ray
-Urinary catheter
43. tertiary prevention is
-Rehabilitation.
44. in the ER. young Pt treated with Procainamide his BP. decreased to 80\60 you tried another time with Procainamide .. his BP. still decreasing .. what to do ?
-Benztropine
-Saline perfusion
-Digitalis
-Defibrillation
-Intubation
NB. the Pt. had Arrhythmia with hypertension (that’s why we gave him procainamide) & because its not decreasing we have to defibrillate him ...
45. F 23 years present with fibroadenoma of the Lt. breast in the lower medial quadrant of the breast all are possible EXCEPT :
-Give Estrogen
-Give Progesterone
-Fine needle aspiration will bring clear liquid
-Mammography can show abnormality
-The growth of the Tumor following cycles
46. F. febrile with tumor in upper Rt. quadrant of the anus .. the mass is painful & red .. what to do ?
hot bandages
-Cold sitz baths
-Surgery
-Systemic Antibiotics
-Topical Antibiotics
47. child with juvenile poliposis .. possible complication :
-Diarrhea
-Painless bleeding
-Painful bleeding
-Malignancy (cancer)
-Non of the above
48. a mother brought hear 12 years daughter who present repetitive UTI temp. 38.5 , IVP & cystography are normal .. what is the best test to do :
-Urine culture
-US & voiding cystography
-Blood culture
-Cystoscopey
-None of the above
49. fibroadenoma of the breast what is false :
-The most common benign tumor
-Fine needle aspiration bring clear fluid
-True solid tumor
-Tumor easy to find because encapsulated
NB. check it alone
50. F pregnant 28 years .. with nocturnal numbness in hands & forearm which wakes hear up for 3 months .. she also have difficulty grasping objects .. what is the most likely etiology ?
-Dermatomiosis
-Abruptio placenta
-Multiple sclerosis
-Carpal Tunnel Syndrome
-Hyperventilation syndrome
