SLE march 2010(prometric)

1 .Female pt 8 wks postpartum,not smoker diagnosed to have asthma,her asthma was not controlled she attended ER 3 times last month,on B2 agonist and oral steroid,she came c/o wheezing and s.o.b mildly cyanosed using her intercostal muscles,wheezy chest,BP:160/100 P:120 PO2:72 PEF:36,there is oedema in her foot up to the knee,the most likely diagnosis:

1 .COPD2 .pulmonary embolism

3 .Acute asthma attack4 .Angioedema

2 .Female pt developed sudden loss of vision(both eyes) while she was walking down the street,also c/o numbness and tingling jn her feet ,there is discrepancy b/w the complaint and the finding,

O/E reflexes and ankle jerks preserved,there is decrease in the sensation and weakness in the lower muscles not going with the anatomy,what is your action:

1 .Call ophthalmologist2 .Call neurologist3 .call psychiatrist

4 .reassure her and ask her about the stressors

3 .same scenario in Q.2 what is the diagnosis:

1 .Conversion disorder 2 .Somatoform disorder

4 .male pt developed corneal ulcer in his Rt eye after trauma what is the Mx:1 .topical Ab & analgesia

2 .topical steroid 5 .female pt with Rt eye pain and redness with watery discharge,no h.o

trauma,itching,O/E there is diffuse congestion in the conjunctiva and watery discharge what you'll do:

1 .give Ab 2 .give antihistamine

3 .topical steroid 4 .refer her to the ophthalmologist

6 .Epidemic disease in poor sanitation areas affecting children and young adults:

1 .hep A2 .B3 .C

4 .D

7 .6 mths baby with crying episodes+current jelly stool,looks slightly pale,signs of obstruction wht is your Mx:

1 .barium enema 2 .immediate surgery

3 .I.v fluid & wait for resolution

8 .17 y.o adolescent, athletic ,with h/o Rt foot pain planter surface,diagnosis is:1 .planter fasciaitis

2 .valux……3 .valux..…

9 .pregnant lady 16 wks presented with vaginal bleeding ,enlarged abdomen,vomiting ,her uterus is smaller than expected for the gestational age,BhCG 80,U/S snowstorm appearance,diagnosis:

1 .complete hydatiform mole 2 .partial hydatiform mole

10 .12 y.o boy c/o abdominal pain after plauing football,he denied any h/o trauma ,the pain is in the Lt paraumbilical region what inx you want to do:

1 .CXR2 .ultrasound kidney

11 .5 y.o child with h.o fever and swelling of the face ant to the both ears (parotid gland enlargement) what is the most common complication:

1 .Labrynthitis 2 .meningitis

3 .encephalitis 4 .orchitis

12 .what is the meaning of difficulty breathing:1 .dyspnia

2 .tachycardia

13 .female pt complaining that she always visualize that snakes crowling to her baby crib,and this is affecting her marriage,diagnosis is:

1 .Hallucination

14 .female pt c/o sever migraine that affecting her work,she mentioned that she was improved in her last pregnancy,to prevent that:

1 .biofeedback2 .propranolol

15 .About DM in KSA:1 .about < 10%

2 .Most of the pt of insulin dependant type 3 .female more affected with type 2 DM

4 .most of NIDDM are obese

16 .Flu vaccine not given to the baby who is allergic to:1 .egg

17 .Pt with asymptomatic Trichomniasis:1 .treat her anyway regardless

2 .treat her if she is symptomatic only

18 .17 y.o,she missed her second dose of varecila vaccine,the first one about 1 y ago what you'll do:

1 .give her double dose vaccine 2 .give her the second dose only

3 .see if she has antibody and act accordingly

19 .pt with gonorrhea infection what else you want to check for1 .Clamydia trachomatis

20 .female pt with Aortic stenosis,she developed syncope while she was in the class and she recovered immediately,what is the cause of syncope:

1 .valvular rupture2 .systemic hypotension

21 .diabetic pt well controlled,she came with h.o dizziness and sweating after taking a medication BS:60 what drug that cayse her prob:

22 .male pt with acute urine retention what is your action:1 .insert folly's cath and ask him to come back to the clinic.

23.In battered women which is true:1 .mostly they come from poor socioeconomic area

2 .usually they marry a second violent man 3 .mostly they come to the E/R c/o..………

4 .mostly they think that the husband respond like this because they still have strong feeling for them

24 .smoking withdrawal symptoms peak at:1 .1-2 days

2 .2-4 days3 .5.7 days

4 .10-14 days

25 .Mother who is breast feeding and she want to take MMR vaccine what is your advice:

1 .can be given safely during lactation 2 .contain live bacteria that will be transmitted to the baby

3 .stop breast feeding for 72 hrs after taking the vaccine

26 .male pt c/o pain in his Rt elbow,he said that he is using the hummer a lot in his work diagnosis:

1 .lateral epichondylitis

27 .50 y.o male with difficulty swallowing food with wt loss:1 .Oesophageal cancer

28 .young female with pain in her elbow(lateral epichondylitis) best treatment is :

1+.………… .NSAID2 .electric..…………

29 .what drug that improve the survival in CHF1 .digoxin

2 .Hydralazin3 .diuretic (can't remember the name )

30 .old man with bilateral knee pain and tenderness that increase with walking and relieved by rest;

1 .RA2 .OA

31 .Regarding peritonitis:1.Complicated appendectomy the cause is anaerobe organism

2 .rigidity and the cause is paralytic ileus3 .can be caused by chemical erosions

4..………… .5.…………… .

32 .regarding MI all except:1 .unstable angina,longer duration of pain and can occur even at rest.

2 .stable angina,shorter duration and occur with excertion 3 .there should be q wave in MI

4 .even if there is very painful unstable angina the cardiac enzymes will be normal

5……………… .

33 .Pt with scoliosis, you need to refer him to the ortho when the degree is:1 .5

2 .10 3 .15 4 .20

34 .6 mths baby with undescending testis which is true:1 .till the mother that he need syrgery

2 .in most of the cases spontaneous descent after 1 year 3 .surgery indicated when he is 4 years

4 .unlikely to become malignant

35.24 y.o Pt with asymptomatic congenital inguinal hernia:1 .immediate surgery

2 .surgery indicated when he is >35 y3 .elective surgery if it is reducible

4..………… .

36 .the most effective thing regarding counseling:1 .family rapport

2 .well adjusted appointment before counseling3.……………… .

37 .In a certine study they are selecting the 10th family in each group,ahat is the type of study:

1.systemic study 2 .non randomized study

3.……………… .

38 .Deep laceration in the ant aspect of the wrist,causing injury to the median nerve,the result is:

1 .claw hand 2 .drop hand

3 .inability to oppose the thumb to other fingrs

39 .50 y.o male with numbness in the little finger and he has degenerative cervicitis with restriction in the neck movement,also there is numbness in the ring finger and atrophy of the thenar muscle+compression in the elbow,what you'll do:

1 .surgical decompression 2 .CAT scan for survical spine

3……… .4………… .

40 .young pt with liver cirrhosis and ascitis what diuretic to give:1 .spironolactone

2..………… .3.………… .

41 .60 y/o male with hematuria and bladder calculi what organism mostly involved:

1 .schistosoma hematopium2..……………

42 .Pt with cough ,X rayshowed upper lobe ……….+fibrosis and he is working in a crowded area(case of TB I guess)What you'll give the family contact:

1 .Bacilli……………2..………… .

43 .baby with face cellulitis and erythema what is the causative organism:1 .H influenza type b

44 .the best indicator for progression of labour:1 .descent of the head2 .uterine contractions

45 .baby with white papules in his face what is your action:1 .reassure the mother and it will resolve spontaneously

2 .give her antibiotic 3…………… .

46 .old man with generalized abdominal pain T:38.2,abscent bowel sound,x ray:dilated small bowel and part of the transverse colon,no no fluid level:

1 .pancreatitis2 .perforated peptic ulcer

3 .bacterial colitis 4.……… .

47 .pt with pepti ulcer using anti acid,presented with forceful vomiting that contains food particle:

1 .gastric outlet obstruction 2 .……………… .

48 .pregnant lady with cardiac disease presented in labour,you'll do all except:1 .epidural anesthesia

2 .C/S3 .diuretic4 .digitalis

5 .O2

49 .Antibiotic for community acquired pneumonia1 .Gentamicin+Amoxicillin

2 .Erythromycin 3.…………… .

50 .baby presented with skin lesion in his shoulder since birth:1 .strawberry…………

2……………… .

51 .pt with rheumatic fever after untreated strep infection after many years presented with Mitral regurge,the cause of massive regurge is dilatation of:

1 .Rt atrium2 .Rt ventricle

3 .Lt atrium 4 .Lt ventricle

52 .old female with pubic itching with bloody discharge,then she developed pea shaped swelling in her labia,most likely:

1.Bartholin cyst

2 .Bartholin gland carcinoma 3 .Bartholin abscess

53 .male pt with HTN on medication,wel controlled,the pt is using garlic water and he is convenced that it is the reason for BP control,what you'll do as his physician:

1 .tell him to continue using it 2.to stop the medication and continue using it

3 .tell him that he is ignorant4 .to stop using garlic water

54 .forcing the child to go to the toilet before bedtime and in the morning,you'll contro the problem of;

1 .enuresis2……… .

55 .the wound will heal when:1 .become sterile

2 .formation of epithelium3..……… .

56 .which of the following is a disease improving drug for RA:1 .NSAID

2 .Hydroxychloroquine3……………

57 .adolescent female came to you in the clinic just for followup what you'll give her:

1 .Ca+folic acid2 .Ca+ zinc

3 .folic acid+zinc4..……… .

58 .50 y.o male with rectal bleeding,O/E there is external hemorrhoid,your action:

1 .Excision of the hemorrhoid2 .rigid sigmoidoscopy and excision of the hemorrhoid

3+..…………… .colonscopy4.………… .

59 .baby with tonic clonic convulsions,what drug you'll give the mother to take home if ther is another seizure:

1 .Diazepam 2 .phenytoin 3 .phenobarb

60 .female pt with DM well controlled and she wants to get pregnant,and she asked you about the risk of congenital abnormality,to avoid this diabetes contro should start in:

1 .before pregnancy2 .1st trimester3 .2nd trimester4 .3rd trimester

61 .pregnant lady, she wants to do a screening tests,she insist that she doesn't want any invasive procedure,you'll do:

1 .U/S2 .amniocentesis

3…………… .

63 .pt complaining that urine is coming out from her vagina,the cause is:1 .vesico vaginal fistula

2 .vesico cutaneous fistula3………… .

64 .a mother brought her 10 y/o obese boy to the family practice clinic ,what is your advice:

1 .same dietry habbits only exercise2 .fat free diet

3 .multifactorial interventions4.………… .

65 .male pt with a cyanotic heart disease…………….(incomplete Q)1 .ASD2 .VSD3 .PDA

4 .truncus arteriosus

66 .pt c/o pain when moving the eye,fundoscopy:normal:1 .optic neuritis

2 .papillodema3.………………… .

4……………… .

i remember one q

case of sudden death in athlete ans is:

obstructive hypertophic cardiomyopathy

SLE march 2010(prometric)

E.histolytica cyst is destroyed by:FreezingBoilingIodine treatmentChlorine

Patient after accident , the left ribcage move inward during inspiration and outward during expiration:

Flial chest

Greatest risk of stroke:DMElevated blood pressureFamily history of strokeHyperlipedemiaSmooking

Child has pallor , eats little meat , by investigation :microcytic hypochromic anemia . what will you do:

Trial of iron theraryMultivitamin with iron daily

Treatment of mania that doesnot cause hepatotoxicityLithium

SCA patient , the macula is cherry red , and absence of afferent papillary light reflexRetinal artery o cclusion

Inflammatory bowel disease is idiopathic but one of following is possible underlying causeImmunological

Patient present with high blood pressure (systolic 200) , tachycardiaMydriasis , sweating . what is the toxicity:

AntichlenergicSympathomemiticTricyclic antidepressantOrganophosphorous compounds

i think the answer is sympathomimetic

Treatment of Chlamydia with pregnany:AzithromycinErythromycin base

the maximum body lenght will be reached after menarch by6 months

1 year2 years

Patient developed sudden loss of vision bilaterally while she was walking in the street , followed by numbness , the subjective symptoms are different from objective , and does not match anatomical , what is your diagnosis:

Conversion syndrome(i think this is the answer

After inflammatory phase of wound , there will be wound healing by :If the wound is cleanAngiogenesisEpithelial tissue

Old male with tender knee , pain , crepitus . the diagnosis:OsteorhritisAnkylosin spondylitis

Rheumatoid

Mother has baby with cleft palate and asks you what is the chance of having a second baby with cleft palate or cleft lip,

25%50%%14%i think the answer is 25

1 liter fluid deficit equals1 kg

After accident patient with tachycardia , hypotension , what will be your initial stepRapid IVF crystalloidCT.……

6 y child was born to HBS positive mother is HBS positive , he was only vaccinated by BCG after birth , what you will give him now:

HBV + oral polio + DTP + hibHBV + oral polio + dt + MMR +hib

HBV + oral polio + Dt + MMR

Treatment of non inflammatory acneRetinoic acid

Treatment of comedones: Topical retinoids.2 .Treatment of papules or pustules: Topical benzoyl

peroxide plus topical antibiotics, mainly clindamycinor erythromycin.

3 .In severe cases, intralesional steroid injection ororal antibiotics, such as tetracycline or erythromycinmay be added.

Which is not true In emergency management of strokeGive IVF to avoid D5 50%Give diazepam in convulsionsAnticonvulsants not needed in if seizuresMust correct electrolytesTreat elevated blood pressure

SCA complications in adultsCerebral infarctionCerebral hemorrhage

The most common risk for intracerebral strokeHypertension.…………………

The antidepressant used for secondary depression that cause sexual dysfunctionSertatlieAmypramineLevofluxine

Previously healthy female patient presented to ER with dysnea , anexiety , tremor , and she breath heavily , the symptoms began 20 minutes before she came to ER , in the hospital she developed numbness periorbital and in her fingers , what you will do

Ask her to breath into a bagTake blood sample to look for alcohol toxicity

What is the most important in counclingExclude physical illnessEstablishing rabbotFamilySchedule appointement

In breaking bad news Find out how much the patient knowFind out how much the patient wants to know

Patient with chest pain that aggrevatedby couphing, there is added sound on left sternal border .in ecg you will findSt changesPr prolongationHypervoltage

The most common site for visceral hemangioma isLiverChild with large periorbital hemangioma , if this hemangioma cause obstruction to vision , when will be permenant decrease in visual acuityAfter obstruction by one dayBy 1 weekBy 3 monthsBy 6 months

The symptoms of soft tissue sarcomaProgressive enlarging mass

35 year female with bilateral breat pain , that decrease after menstruation , the breast is nodular with prominent 3 cm mass subareolar , axillary lymph nodes are not enlarged , what you will do

Mammography followed by usSee her next cycleFine needle biopsy followed by tissue studies

Pregnant with bleeding for 12 hours and tissue , the cervix is 1 cm Complete abortion

Incomplete abortionMolar pregnancy

2 month infant with vomiting after each meal , he is in 50 centile, He passed meconium early and stool , diagnosis isMidgut volvulusMeconium ileusHischsprung disease

Patient with dysphagia to solid and liquid , and regurg , by barium there is non peristalsis dilatation of osophagus and air-fluid level and tapering end . diagnosis isOsophageal spasmAchalasiaOsophageal ca

The most common cause of cough in adults isAsthmaGerd

Postnasal drip

Girl with amenorrhea for many months . bmi is 20 and is stable over last 5 years . diagnosisEating disorderPituitary adenoma

Old female with itching of vulva , by examination there is pale and thin vagina , no discharge . what is managementEstrogen creamCorticosteroid creamFluconazole

Patient with dysuria , frequency , urgency , but no flank pain , what is the treatmentCiprofloxacin po od for 3-5 daysNorfocin po od for 7 – 14 days

Patient with flank pain , fever , vomiting , treatment isHospitalization and intravenous antibiotics and fluid

Patient present with mid face pain , erethematous lesions and vesicles on periorbital and forehead , the pain ia at nose , nose is erythematous . what is diagnosisRoseolaHsvHerpes zoster

Male with itching in groin erythematous lesions and some have clear centers , what is diagnosis:

PsoriasisTinea curisErythrasma

Vasoconstrictive nasal drops complicationRebound phenomenon

The useful excurcise for osteoarthritis in old age to maintain muscle and boneLow resistance and high repetion weight trainingConditioning and low repetion weight trainingWalking and weight exercise..…………………………

Unilateral worsening headach , nausea , excacerbeted by movement and aggrevated by light in 17 old girlMigraineCluster

Diet supplement for osteoarthritisGinger

Old male with abdominal pain , nausea , wbc 7 . what is true about appendicitis in elderlyCt not usefull for diagnosisWbc is often normal Rupture is common

If there is no fever the diagnosis of appendicitis is unlikelyAnemia is common

Old patient with bilateral enlarged knee , no history of trauma , no tenderness , normal esr and c-reactive proteins . the diagnosis isOsteoarthritisGoutInfectous arthritis

Patient has decrease visual acuity bilateral , but more in rt side , visual field is not affected , in fundus there is irregular pigmentations and early cataract formation . what you will doRefer to ophthalmologist for laser therapyRefer to ophthalmologist for cataract surgery

What is the most common treatment for juvenile rheumatoid arthritisIntraarticular injection of steroidOral steroidParacetamolD-penicillamineAsprin

which of the following decrease mortality after MImetoprololnitroglycerinethiazidemorphine

the cardiac arrest in children is uncommon but if occur it will be due toprimaryrespiratory arresthypovolemic shock

neurogenic shock

old female with recurrent fracture , vit d insufeciency and smoker . which exogenous factor has the gretest exogenous side effect on osteoporosisold agesmokingvit d insufeciencycontinue smokingrecurrent fracture

patient presented with sudden chest pain and dysnea , tactile vocal fremitus and chest movemebt is decreased , by x-ray there is decreased pulmonary marking in left side , diagnosis

atelectasis of left lungspontaneous pneumothoraxpulmonary embolism

boy after running for hours , has pain in knee and mass on upper surface of tibiaosgood scatter disease

iliotibial bandOsgood-Schlatter diseaseOsgood-Schlatter (say: "oz-good shlot-ter") disease is one of the most common causes of knee pain in young athletes. It causes swelling, pain and tenderness just below the knee, over the shin bone (also called the tibia). Osgood-Schlatter commonly affects boys who are having a growth spurt during their pre-teen or teenage years. One or both knees may be affected.

pancreatitisamylase is slowly rising but remain for days

amylase is more specific but less sensitive than lipaseranson criteria has severity (predictive) in acute pancreatitispain is increased by sitting and relieved by lying downcontraceptive pills is associated

patient has fever , night sweating , bloody sputum , weight loss , ppd test was positive . x-ray show infiltrate in apex of lung , ppd test is now reactionary , diagnosisactivation of primary tBsarcoidosis

case control isbackward study