Threshold of a screening test is increased. How it will affect sensitivity and specificity?
a) Sensitivity increase & specificity decrease
b) Sensitivity decrease and specificity increase
2. A child has ingested overdose of iron tablets- first symptom?
a) Nausea and abdominal pain
b) Hyperventilation
c) Seizure
3. Rheumatoid arthritis patient develops tinnitus. Cause?
a) Due to ASA
4. WHO conference in 1978 in Alma Mata, Russia- declaration on
a)
5.Rheumatoid arthritis patient develops swelling left calf and ankle. Thigh normal. Cause?
a) DVT
b) Rupture of popliteal cyst
6. Child 3years with swelling of scrotum. Testis can be palpated through the swelling Fluctuant, painless. Observed for few months. Translucent. Definitive Management?
a) examine regularly
b) aspirate only
c) surgery
d) injecting sclerosant
7. Question on probability- probability of finding one disease is A and other is B. (Independent). Probability on finding the 2 diseases in one pt.
a) AX B
b) A+B
c) AXB- A+B ???
8. Most common occupational disease in Canada.
a) silicosis
b) dermatitis
c) asthma
d) asbestosis
9. Most common cancer in Canada/
a) lung
b) breast
c) prostate
d) brain
10. 23 year old lady presented with cramping abdominal pain and heavy bleeding. Pregnancy test positive. Bleeding stopped today morning. Pregnancy symptoms disappeared one week ago. USG shows empty uterus and 3 cm mass in adnexa. Diagnosis?
a) ectopic pregnancy
b) complete abortion with corpus luteal cyst
c) ves. Mole with corpus luteum
d) twin gestation- one aborted and one ectopic
11. Child with inguinal hernia. Presentation
a) scrotal swelling
b) thickening of spermatic cord
12. A mother brought to her son to your clinic with red spots around eye. You confirmed it as petechiae. What other finding is of concern to you
a) petechiae all over body
b) subconjunctival hemorrhage
c) he developed vomiting after few hours
13. A lady 50 years with swelling medial to femoral pulse. Firm and smooth. Diagnosis?
a) femoral hernia
b) inguinal hernia
c) saphena varix
14. galactorrhoea . cause?
a) pituitary infarction
b) hyperthyroidism
c) danazol
d) thoracic nerve stimulation
e) dopamine agonist
15. Mechanism of action typical antipsychotics
a) + dopamine receptors
16.a patient on antipsychotics, cannot sit still……
a] akathisia
17.best way to prevent benzodiazepine dependence
a) use the one with short half-life
b) use for short duration
c) use at nighttime only
d)
18. Most common gynecological infection in Canada
a) candidiasis
b) bacterial vaginosis
c) gonorrhea
d)
19. Most common cause for premenstrual itching (cyclical itching)
a) candidiasis
b) bacterial vaginosis
c) non specific vaginitis
d)
20. Most specific site to collect swab for gonococci
a) vulva
b) vagina
c) cervix
d) endometrium
21. Pap smear swab collected from
a) endo cervical and recto cervix
b) endocervical and endometrial
c) endo cervical
22. A patient presented with an ulcer near medial malleolus. Cause
a) ischemia
b) perforator incompetence
23. A patient with chronic bronchitis PaO2 60 mmHg. What advise you will give EXCEPT
a) no need for continuous O2 therapy
b) maintain healthy food hygiene
c) annual influenza vaccination
d) no need for prophylactic antibiotics
e) avoid hypnotics or sedatives
24. HIV positive patient, CD4 count 250 Presented with cold. What will you do
a) start multiple drug antiretroviral treatment
b) TMP+ Sulpha
c)
25. Full term child. Birth weight 3000. Develops respiratory distress. Xray shows air bronchogram. Diagnosis
a) Transient tachypnoea of newborn
26. Baby 8 hours after birth, staring and severe Cyanosis. Hypotonia of muscles. What investigation you will do?
a) CK
b) Echocardiogram
c) EEG
27. A child had headache, vomiting, and abdominal pain. Then he sleeps. What is your diagnosis?
a) migraine
b) temporal lobe epilepsy
28. A child 3 years presented with abdominal pain and Bleeding PR for 12 hours. What is your diagnosis?
a) meckel’s diverticulum
b) intussusception
c)
29.elderly –sensorineural hearing loss. Most common Cause
a) presbyacusis
b)
30. Occupational deafness. Usually caused by
a) high frequency loss
b) low frequency loss
c)
31. A passenger in bus got an injury in his eye with the newspaper of the neighboring person. Diagnosis
a) corneal abrasion
b)
32. Benzodiazepam. Cross-tolerance with which drug
a) chlorpromazine
b) alcohol
c) tricyclics
d)
33. A child has ingested 30 tablets of imipramine. What should be done mean while contacting the toxicology center.
a) forced diuresis
b) give ipecac syrup
c) drug to prevent convulsions.
d)
34. A child has ingested an overdose of imipramine. Pt. is stable. What investigation is done to monitor sign of toxicity.
a) ECG
b) EEG
c) Blood level of drug
35. Which combination should not be used?
a) tranyl cypramine-sertraline
36. A child with tic disorder- what is the first thing in management
a) benzodiazepine
b) family psychotherapy
37. Behavior therapy least useful
a) hallucination
b) depression with strong suicidal ideation
c) generalized anxiety
d)
38. Anti depressant drugs most useful in which of the following conditions?
a)
39. Which of the following is the most common condition in Canada?
a) cervical malignancy
b) endometrial malignancy
c) endometrial polyp
d) septulum uterus
40. Toxic shock syndrome. Not true
a) exo toxin
b) tampons
c) skin necrosis
d) fever
e) rash
41. A lady 50 years, 2 years nocturnal cough. Now develops fever sweats weight loss purulent sputum. X-ray shows consolidation apex of lower lobe. Diagnosis
a) tuberculosis
b)
42. Asian 53 years. Weight 93 kg. Arthritis. Now c/o head ache. Striae on abdomen, thinning of skin. What investigation to be done?
A) CT scan head
B) Random plasma cortisol
C) Enalapril enhanced renal angiogram
D)
43. Commonest cause of broncheolitis
RSV
44. Which of the following diseases can be prevented by a live attenuated vaccine except?
a) typhoid
b) measles
c) polio
d) rubella
e) diphtheria
44. If a child develops diphtheria now the mortality is almost the same as it was 50 years ago. But now the disease is not so common because
a) incidence decreased
b) prevalence decreased
c) effective antibiotics developed
d)
45. CAD is more in men compared to women. Which of the following is true?
a) MI investigation and treatment more effective in men
b) Chest pain in women is less frequently attributed to non cardiac causes
c) Awareness about MI is same in men and women
d) Hypertension is a strong risk factor in men compared to women
46. Which of following is the most important risk factor for CVA
a) systolic hypertension
b) smoking
c) elevated serum cholestrol
47. A child with proptosis, swelling and redness around eye, movement of eye painful. Diagnosis
a) orbital cellulites
b) preorbital cellulitis
48. Elderly people
a) prefer to live alone and like their children to visit them
b) live alone because of geographical distribution children have to live away
c) like to live alone and don’t like visitors
49. A man 65 years labile mood, depression forgetful for 2 years. He has long standing hypertension. O/E Cognitive functions partial impairment, absent ankle jerk. Diagnosis
a) alzhiemer’s
b) pseudo dementia
c) multiinfarct dementia
50. A man presented with injury of hand after a fight in beer parlor. Most likely injury
a) dorsal dislocation of 5th metacarpal
b) palmar dislocation of 5th metacarpal
c) radial dislocation of 5th metacarpal
d) ulnar dislocation of 5th metacarpal
e)
51. Which of the following antipsychotic has got least extrapyramidal side effects
a) chlorpromazine
b) haloperiodol
c) resperidone
d) clozapine
e) loxapine
52. Which of the following antipsychotic produce extrapyramidal SE in therapeutic dose?
a)chlorpromazine
b) haloperiodol
c)resperidone
d)clozapine
e)loxapine
53. A lady 33 years had a pregnancy with anencephaly and undergone abortion at 15 weeks. She wants to conceive in 6 months. What advise you will give
a) start folic acid now
b) she has to do amniocentesis at 16 weeks
c) neural tube defects are unlikely to recur in subsequent pregnancies
d)
54. Diabetic lady advice regarding risk of congenital anomalies.
a) risk is same for gestational diabetes and other diabetes
b) risk can be reduced to that of general population if strict control of sugar is maintained through out the pregnancy.
c) Sacral agenesis is the most common anomaly
d) USS for congenital anomaly is done at 32 weeks
56. Prostate cancer; most important in diagnosis
a) PSA
b) DRE
c) CT
59. Soldier returning from peacekeeping force. He has nightmares anxiety. Etc. what is the initial step in management
a) psychoanalysis
b) benzodiazepine for 1year
c) a trial of behavior therapy for s assort period
60. A 23 year old girl develops watery diarrhea after a picnic, 2 days later she develops purpuric rashes, oliguria, what is most likely
a) 2 other picnic mates developed rashes the next day
b) they made lemonade using water from a near by pond
c) many of the picnic people developed bite marks bitten by mosquito
d) few of the picnic people were returning from usa
61. Toddler’s diarrhea what seen
a) indigested food particles
b) fecal occult blood
c) vomiting
d)
62. hirshsprung’s most imp. Inv
a) Barium enema
b) Colonic transit time with radio opaque markers
c) X ray
d)
63. hirshsprung .diff from constipation
a) from birth
b) fecal soiling
c)
64. Male pain left lower quad. Mass. Neutrophilia. Inv?
a) rigid sigmoidoscopy
b) barium. Enema
c) colonoscopy
d) X-ray
65. Child ingested cleaning liquid with Iye. Lips & mouth corroded what is least useful
a) oeso.scopy
b) X ray chest
c)
66. Tension pneumothorax. All are features except
a) hyper translucent
b) mediastinal shift
c) inspiratory stridor
d) subcutaneous crunchy sound
e) decreased breath sounds
67. What is the first management of tension pneumothorax?
a) needle thoracotomy
b) needle thoracostomy
c) chest tube
68. Epiglottitis with mild stridor. all are true except
a) intubation
b) ABG to monitor prognosis
c)
69. Child with sore throat red tongue lymphadenopathy. How to differentiate viral etiology
a) throat swab,
b) white cell count
70. Man with gonorrhea. Treated with cef. Still symptoms. Urine microscopy no organism, cause
a) chlamydia
71. Gonococci
a) intracellular diplococci
b) extra cellular diplococci
72. RTA- blood at urinary meatus, what to do next?
a) urethrogram
b) catheterize
c)
73. Child h/o fall. Pain lumbar region with ecchymoses, gross hematuria. Renal CT shows peri renal hematoma. Child stable renal pedicle normal. Management?
a) surgical repair
b) close monitoring in ICU
c) catheterize and rest for 7-10 days
d) send home
74. Man 56 years. Father died of prostate ca. o/e a small nodule right lobe. PSA 2.2. What advice
a) follow up in 6 months DRE and PSA
b) foloow up in 3 months PSA
c) uss guided Biopsy now
d)
75. Post menopausal bleeding. What inv.
a) endometrial biopsy
b)
76. severe premenstrual syndrome. Definitive management
a) b/l oopherectomy
b) hysterectomy
c) prog
d) oes
e) NSAID
77. Girl 5 years. H/o vomiting since birth. Now complaints of dysphagia for solids. Cause
a) esophagitis
b) bazoar
c) hiatus hernia
d) duo ulcer
78. A man with tertiary syphilis. Which of the following is going to alter his management plan?
a) AIDS
b)
79. A man presented with contracture of PIP. He cannot flex Dip. Which s the pathology
a) flexor digitorum
b) extensor pollicis
c) extensor carpi
d)
80. Case control study useful in
a) study of rare disease.
81. Ethics- a man suspects to be having probable gonorrhea. His wife works in lab. He doesn’t want her to know his specimen. What to do.
a) ask him to tell his wife
b) put a code no. on the sample, not his name.
c) Don’t listen to him
d) Send him to the public sexually transmitted disease clinic
82. A couple comes to you. Husband wants to end the relation what the wife thinks to be a happy marriage. She is crying. What to next?
a) spend one and a half hours to each of them to psychotherapy
b) try to find out what made the crisis
c) send to lawyer
d)
83. For which of the following is behavior modification is best?
a) phobic anxiety
b) generalized anxiety
c) affective disorder
d) bipolar disorder
84. A man 50 years hp 156/95 sweating, palpitation, one of his relative had thyroid ca. what inv. To be done?
a) urine catecholamine
b) urine VMA
c) CT adrenal
85. A man 10 days after pancreatitis complains of abdominal pain, firm swelling
a) pseudocyst,
b) a/c hepatitis
c) cholangitis
d)
86. Peptic ulcer patient complaints of pain radiating to back. Diagnosis
a) perforation
b) penetration
87. Gastric ulcer patient. Treated for12 weeks. Asymptomatic now. When gastroscopy done ulcer is still present. Negative for malignancy and H.pylori. What to do?
a) treat for 8 more weeks
b) life long H2 receptor blocker
c) follow up only
d) partial gastrectomy with excision of ulcer
88. Known MI patient now presents with palpitation. He says he is on quinide, propranolol and digoxin 0.125
mg. O/e- PR-96,irregularly irregular. What should be done to prevent any complications?
a) increase the dose of digoxin
b) anti coagulant for long time
c) give digoxin and quinide togather
89. All are true about carbamazepine except
a) starting dose 200mg
b) causes leucocytosis
90. Mitral stenosis patient goes to a dentist for some procedure. He is asking for prophylactic antibiotics. Which of the following decides which to given?
a) type of procedure
b) presence of atrial fibrillation
c) presence of cardiac failure
d) type of procedure
91. Bier block (regional IV anesthesia). Which is true?
a) bupivacaine is better
b) effect lasts longer even after the procedure , giving adequate post op analgesia
c) suitable for all procedures in hand
92. Elderly lady, pain on hand and upper arm. Wasting of thenar eminence. Severe pain at night. Cannot carry shopping bag. Diagnosis
a) carpal tunnel syndrome
b) cervical spondylosis
c)
93. 75 year old man, sudden onset of back pain, severe pain right buttock, hamstrings, micturition problem. He was having UTI 2 weeks back Cause
a) multiple myeloma involving spinal cord
b) lung ca with metastasis
c) archnoiditis
94. A baby with birth wt.3.5kg now 4 weeks weighs 3.6 kg. Mother worried not drinking enough milk. What will you advise?
a) Tell her that nothing to worry, as some kids don’t gain much weight in the first month
b) start formula feeding
c) investigate the kid
95. A lady 33 weeks of gestation, admitted with uterine cramps and moderate bleeding. Nurse started IV line and blood taken for grouping and cross matching. What to do next?
a) start another IV line
b) arrange for CS
c) start tocolysis
d) examine for cervical dialtaton
e) USS
96. Triple screening done in the antenatal period. Which is true?
a) should be only offered to women who are willing for termination if any abnormality is found
b) should be offered only if proper pre test counseling is given
97. Regarding HRt, a lady ha h/o migraine and strong family history of osteoporosis what should be done/
a) offer oes-prog.HRT
b) progesterone only
c) biphosphonate only
d) oes only
98. Raloxifine, which is true
a) contraindicated in peptic ulcer
b) effective for hot flushes
c) effective for osteoporosis
d) breast ca increased risk
99. Infertility with c/c salpingitis. Which is not done?
a) laparoscopy
b) laparotomy
c) hysteroscopy
d)
100. Ophthalmoplegia with pupillary sparing. Cause?
a) diabetes
b) canernous aneurysum
c)
101.herpes simplex corneal ulcer. What is not done?
a) patching
b) corticosteroids use
c)
102. Otosclerosis.
normal ear drum
103. A child with sinusitis and otitis media. Treated with antibiotics. Serous effusion still present in middle ear. What to do?
a) another course of antibiotics
b) myringostmy with tube
c) myringoplasty
104. A lady gave birth to a cleft palate baby. You are going to send her home after counseling. For what reason she is going to come to your office more often?
a) feeding problem
b) recurrent otitis media
c) teeth problem
d)
105. You gave a new drug to your patients with dementia. Those suffering from multi infarct dementia improved while those with Alzheimer’s not.. What should you do before prescribing this to your patient
106. What type of trial is this?
107. In the Er you are planning to do a new trial on pts with retrosternal chest pain
108. A lady for laparoscopic tubal ligation on the way to theater asks for removal of a mole on her forearm while she is under GA. What you will tell?
109. Jehovah witness signed card
110. hemophilia A
Xlinked recessive
111. A carrier lady for an X linked recessive disease marries a normal man. They have 2 daughters. What is the probability of each of them to become carrier?
a) 1in 4
b) 1 in 8
c) 1 in 16
d) 1in 64
112. Which is not a cause for occupational asthma.
vinyl chloride
113. Which causes nasal sinus ca?
a) nickel
b)
114. condyloma accuminata, pregnant lady what is used
a) podophyllin
b) flurouracil
c) trichloracetic acid
d) imiquimod
115. Picture of tinea cruris. Treatment.
a) topical steroids
b) amphoterecin b
c) tolnaftate
d) grieseofulvin
116. A man presented with headache, photophobia, menigism. CSF_ cells increased, neutrophils 95% What is the most common cause
a) menigococci
b) s.pneumoniae
c) viral
117. Viral meningitis. Which is not true?
a) sugar normal
b) protein elevated
c) chloride high
118. A man with dark skin, liver 20 cm. Cirrhosis. Diagnosis
a) hemochormatosis
119. What inv. In the above patient
a) transferrin saturation
120. A child with necrotizing enterocolitis. All are true except
a) air in portal vein
b) pneumoperitonium
c) peritoneal calcification
121. a man presented with a mass right to his rectus below umbilicus while standing and straining. Disappears while lying down. Diagnosis
a) Richter’s hernia
b) spigelian hernia
c) desmoid’s tumor
122. Which of the following is toxic in overdose?
a) vit.A
b) vit.E
c) vit.K
d) vit.C
e) vit.B12
123. c/f of congenital hypertrophic pyloric stenosis.
Diagnosis.(2 questions)
124. A lady 50 years presented with mild hypercalcemia X-ray chest normal. Diagnosis.
a) sarcoidosis
125. A child had a/c sinusitis and you treated with a course of penicillin. His blood inv shows- TC increase, s.ca decrease others normal. You supplement with ca, what inv. To be done
a) s PTH
b) X-rays of hands
c)
126. A man presented with pain in flanks radiating to groin. He had similar episodes 2 times previously. And was diagnosed to have hyper calciuria. What should be done?
a) thiazides
b) allopurinol
c) reduce dietary calcium
d)
127.post appendicectmy pt develop s-subphrenic abscess
128.which of the following is most likely to be a drug reaction
a) IMN patient treated with pencillin produces rash
b) Sulpha
c) patient with sore throat treated with pen. Has rash
129. Intoxication. –Which one causes oliguria?
a) ethylene glycol
b) cannabis
c) cocaine
d) LSD
130. Intoxication- dry skin. Pupil sluggish reacting. Agitated. Paranoid
a) cannabis
b) cocaine
c) LSD
131. Child electrocuted. What is the cause of death?
a) cardiac arrest
132. A child has features of meningitis. Which is poor prognostic factor?
a) temp.38.5
b) generalized seizure
c) localizing sign
d) neck stiffness
134. Neonatal sepsis.a feature
a) hypothermia
135. A man complaints of severe headache for the last 12 hours. Vomiting + photophobia. Diagnosis
a) subarchnoid hemorrhage
136. A child had a fall and he was drowsy. While waiting in the ER he becomes more and more drowsy .one pupil dilated diagnosis
a) extradural hematoma
b) subdural hematoma
137. A man with a swelling in the right scrotum. O/e- tender mass above testis. skin of scrotum red and inflamed. Prostate enlarged He has pyuria. What is the diagnosis?
a) epididymitis
b) epididymitis and prostatitis
c) gonococcal urethritis
138. How to look for clue cells.
a) vaginal secretion with KOH and cover
b) vaginal secretion with saline and cover
c) cervical secretion with saline and cover
d) cervical secretion with KOH and cover
e) vaginal secretion with KOH and dry
139. Multiple pregnancy-cause of perinatal mortality
a) prematurity
140. Tocolysis contraindicated in all except
a) twins at 33 weeks
b) cervix 4 cm
c) chorioamnionitis
141. Persistent bradycardia in fetus due to
a) head compression
b) AV block
c)
142. Which is true about congenital anomalies?
a) congenital anomalies rarely affect growth
b) if symmetrical IUGR is detected look for congenital anomalies
c) trisomy 13&18 will not cause growth retardation
143. A child 3 years has BP 138/95. He has a systolic murmur right 2nd space, femoral pulse not palpable. Diagnosis ?
a)coarctation
144. apgar score
145. A pregnant lady with GCT 10.3 mmol/l, what is most imp.
Strict maintenance of euglycemia through out the pregnancy
146. A lady prepared for hysterectomy. What will you tell her regarding risk of thromboembolism
a) risk is highest after 72 hours
b) thromboembolism mostly originate from pelvic veins
c)
147. A lady post partum develops DVT. What is the management?
a) warfarin for 3 months
b) heparin IV for 1 week and warfarin for 3 months
c) heparin IV for 1 week and low molecular wt. Heparin for 3 months
148. A pregnant lady 20 weeks. Uterus 26 weeks. Beta HCG 30000.what is the management
a) suction curettage
b)
149. Which of the following is not poor prognosis in melanoma)
a) color change
b) spreading
c) bleeding
d) tuft of hair
e) irregular surface
150. C/f of thrombosed external pile. Diagnosis?
151. Same scenario. Management
152. c/f ischirectal abscess . management
153. A girl c/o continuous pain in the vulva for the last 8 hours. O/e a red tender swelling is seen on the post 1/3 of lab minora. What is the diagnosis?
a) bartholin’s cyst
b) bartholin’s duct abscess
c) skene’s gland abscess
154. A group of people returning from Rocky Mountains developed diarrhea. Cause
a) Rocky mountain spotted fever
b) giardiasis
155.esophageal atresia with tracheo esophageal fistula at the lower end. What is true?
a) gastric aspiration common
b) gastric air shadow not seen
c)
156. A man sustained a stab wound on the thigh anteriorly. He is bleeding profusely. What is the first thing to do?
a) apply tourniquet above the wound
b) press femoral artery
c) direct pressure
d) on wound
e) fill the wound with clothes
157. A child with 15% burns On face and chest. What is done?
a) oral midazoalm and i/v morphine
b) i/v midazolam and burn dressing
c) i/v cef.and morphine
d)
158. 2 year old child. burns 15% calculate fluid replacement
159. A lady brings her son to you saying that he is alcoholic who denies that . what question is least relevant
a) do you need an eye opener in the morning
b) do you hate criticism
c) do you drink only on social occasions
160. Features of anaphylaxis-treatment
a) epinephrine
161. Laryngeal nodule- not a risk factor-
medication
162. A man 64 years c/o hoarseness. What is the first thing to be done?
a) chest X ray
b) laryngoscopy
c)
163. Uncomplicated intestinal obstruction. All are seen except
a) increased bowel sounds
b) distension
c) guarding
d) tympanitic
164. Idiopathic thrombocytopenia
165. Most common cause of syncope in a young man
a) vasovagal
b) hypoglycemia
166. A man presented to Er after a party. Intoxicated. Blood values- HCO3 very low. All others normal. What other inv
a) urine osmolality
b) serum osmolaity
c)
167. Mallory weis – what inv.
a) senstaken tube
b) OG scopy
c) balloon
168. Clinical features suggestive of intestinal ischemia
169. Crohn’s. C/f given. Diagnosis?
170. Right upper quadrant pain, fever, jaundice. Diagnosis
a) a/c cholecystitis
b) cholangitis
c) hepatitis
d)
171. A/c cholecystis. Cause.
a) obstruction of cystic artery
b) onstruction of CBD
c) obstruction of GB by stone
172. post op 36 hours. Cause of fever,
a) atelectasis
b) UTI
c) Wound infection
173. Most common cause of incontinence in women
a) stress incontinence
b) urge incontinence
c) detrusor instability
174. Dementia patient. Treatment of which of the following could have prevented
a) Alzheimer’s
b) pernicious anemia.
c)
175. Another question on dementia.
176. What is the most imp. Thing to differentiate Alzheimer’s from pseudo dementia
a) Short duration
b) mental status examination
c)
177. Treatment for seasonal rhinitis
a) nonsedative antihistamines
b) oral steroids
178. Picture of a child. Mouth open.
a) adenoid hypertrophy.
179. Couple comes to you. Husband hypertensive says impotence 6 months but erection occurs in the morning and while reading the magazine. What should you do?
a) counseling
180. Cause for recurrent UTI in child
a) VU reflux
181. Treatment of nephritic syndrome. All except
a) diuretics
b) salt restriction
c) fluid restriction
d) prednisolone
e) protein restriction
182. Elderly lady fecal occult blood. All are true except.
183. Case of DUB.
184. All the following can be given to improve sexual function. Except
a) sildenafil
b) estrogen
c) testosterone
d) gonadotrophin analogues
e)
185. ADHD
186. A lady with previous h/o cs for footling breech is kept for trial. During labor she develops bleeding PV, fetal tachycardia. …. Diagnosis
a) rupture uterus.
187.a lady at 41 weeks of gestation likes to wait for spontaneous onset of labor. Which of the following require immediate delivery?
a) oligohydramnios
b) macrosomia
c) glycosuria
d)
188.CPS
a) interest of public is most
189. Which of the following is the most effective way to prevent dental caries in children?
a) fluoridation of water
b) dental flossing
c)
190. Periodic health examination not true
a) detection of chronic diseases
b) behaviour change and hygiene
c) more focused annual physical examination
191. ECG
a) LBBB
b) RBBB with RAD
c) RVH
d) WPW
192. Picture of a hand with a lump on the dorsal surface MCP jt.
a) h/o renal calculi
193. A lady develops dry cough. Treated with ampicillin few days later Develops rash, elevated liver enzymes. Cause
a) mycoplasma
b)
194. Bacterial vaginosis. All true except
a) PH-
b) Flagellated organism
195. Malaria treated. Recurrence after 1 year
a) dormant liver schizhont
196. Features of meningitis. What inv.
a) lumbar puncture
197. Features of multiple sclerosis all except
a) dysphagia
b) anosmia
c)
198. Horner’s with dysphagia.
a) PICA
b) ACA
199. Paranoid schizhoprenia- features given,
200. Psychotherapy
201. Elderly wife abusing husband who is suffering from arthritis what is not done
a) send hem to daycare
b) support to wife
c)
202. Status asthmaticus
a) hydration, inhaled beta agonist, IV steroid
203. Strawberry angiomas. Treatment.
a) spontaneous regression
b) excision
c) injection of sclerosant.
204. Ocd treatment
a) fluoxamine
205. Abruption placenta. Cause of DIC
a) fribrinolysis.
Thursday, August 21, 2008
MCCEE- Bank of sample questions
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
51. 72 years old with heart failure with high blood pressure treated for long time. He was brought to E R for hypotension 80\60 HR 110, what to give ?
-Procaine
-Lidocaine
-Cardioversion
-Digitaline
-Furosemide
52. Post-op. of Pancreas .. what is the cause of hypovolemic shock ?
-Initial necrosis of acute pancreatitis has produced tripsine
-Septic shock
-Loss of liquids
-Side effect of anesthesia
NB. not sure
53. 68 years F. with history of Hysterectomy, came to see u because of micturation trouble at effort, no digestive trouble, she has a feeling of a painless mass intravaginaly, she has to try twice in order to void her bladder what is the diagnosis ?
-Rectocele
-Cystocele
-Prolapse (Prosedentia)
-Urethral sphincter spasm
-Post-surgical stricture
54. young M. feels sudden crack in his calf, what is the best clinical sign to diagnose Achilles tendon rupture ?
-Decreased dorsal flexion
-Impossibility to walk on the toes
-Increased passive dorsiflection of the foot
-Squeezing calf does not passively planter flex foot
55. farmer 74 years M. present with bilateral semetrical neaurosensorial defenses , PE is normal . diagnosis ?
-Autosclerosis
-Professional defenses
-Acustic neuroma
-Presbiacusis
-Circulatory deficit
NB. Most common cause of hear losing in elderly is presbiacusis
56. F. 45 years with decreased visual acuity, no pain , no tears. what do u exam first ?
-Tonometry
-Refraction
-Angiography
-Neurologic test
-Rheumatoid factor screening
57. Burned Infant 2nd degree in the upper limb, what do u do ?
-Debrid & skin graft.
-Debrid & bandage
-Debrid & topic cream
-Clean the wound & systemic antibiotic
-Local care only
58. Cyclist attacked by bee comes to emergency with hypotension 80\60 , Heart rate 115 .. what do u do first ?
-Antihistamine H1 & H2
-Saline perfusion
-Epinephrine Injection
-Intubation
-IV. steroid
NB. we also give it by subcutaneous or IM. & in children IV or Endotracheal tube
59. child 5 years bitten by the neighbors dog .. the dog received all the vaccines. what do u do ?
-Observe the dog 10 days & anti rabbi serum
-Observe the dog & anti rabbis serum & vaccine
-Kill the dog
-Vaccinate the kid
-Observe the dog
60. F. 28 years present with chronic rhinorrhea , in the exam you found mucousal nasal atrophy .. diagnosis ?
-Sinusitis
-Cocaine intake
-Nasal poliposis
-Allergic rhinitis
61. F. 45 years back from a plane travel , complains vertigo, tenitus, moderate hearing loss, BP is 160\110 .. Diagnosis ?
-Hypertensive crise
-Miners disease
-Migraine
-Acustic neuroma
-Barotaruma
62. what is the most common cause of lung abscess in post-Op pt.
-Bacterial discrimination from operative site
-Atelectasia
-Pneumonia
-Aspiration
63. M. 25 years when he goes to toilet, he complains of painful defecation in the anal region, at the exam you will find bluish mass at the anal margin.. what is the Diagnosis ?
-Hemorrhoids internal sclerosed
-Hemorrhoids external strangulated
-Hemorrhoids external thrombosed
-Pyelonedle cyst
-Poliposis
64. all the following tumors favorized by TOBACCO Except...
-Bladder
-Esophagus
-Liver
-Cervix
-Lung
65. 5 years child have been beaten by a dog .. he had a deep wound, the dog is in a safe place .. what do u do ?
-Disinfect & clean the wound & put bandage
66. breast feeding women with DVT. treatment. ?
-Warferin
-IV. heparin
-Antistreptocinase
-Bandage
67. immediate post-op presents sudden hallucination , agitation & pretend that was miss treated .. Diagnosis ?
-Psychosis
-Depression
-Post-op delirium
-Analgesic withdrawal syndrome
68. a pt consult u for painless testicular swelling , transilumination was (-) after minor trauma ... Diagnosis ?
-Spermatocele
-Epidedimitis
-Varicocele
-Hydrocele
-Germinoma
69. F. 47 years present with sudden strong pain of the Rt. upper quadrant with fever 38.5 vomiting, no jaundice ... Diagnosis ?
-Colidutal obstruction
-CA of pancreas
-Acute cholicystitis
-Acute hepatitis
-Biliary lithiasis
70. Pt refared to u by his dentist because of whitish lesion at the base of the tongue .. what is your attitude ?
-Biopsy
-Identification of germs
-Ask for a correction of his dental prostheses
-Treat him by anti micotic oral bath
71. young boy present with frequent episode of rhinitis with purulent discharge & fever, from a maxillary sinus, what is the most likely complication if untreated ?
-Purulent meningitis
-Ethmoidal sinusitis
-Orbital cellulitis
-Frontal sinusitis
72. F pt. PE. painless mobile mass on Rt. upper quadrant without fever or Jaundice, what is the most likely diagnosis ?
-Tumor of Lt. inferior lobe of the Liver
-Hydrocholecyst
-Tumor of superior pole of the Rt. kidney
-Liver metastasis
73. child 13 years obese present with painful Rt. knee & pain of Rt. hip with difficulty walking & reduced abduction & Internal rotation , what is your diagnosis ?
-Juvenile Arthritis
-Septic arthritis of the hip
-Avascular necrosis of femoral head
-Cartilage dysplasia
-Slipped capital epiphysis
74. Pt. fell on his hand , Emergency X Ray was normal , but the pt. complain from painful wrist at abduction. management. ?
-Cast
-Explain him that the pain will disappear after 2 weeks, its normal.
-Bandage
-Short cast plus X Ray in 15 days
-NSAID's
NB. diagnosis is Scaphoid fracture & its very difficult to see it in X Ray.
75. Indication of elastic band in Hemorrhoids is :
-Thrombosed Hemorrhoids
-Type II bleeding Internal Hemorrhoids
-External Hemorrhoids
-Angioma
76. 65 years obese Pt. complains of strong & sudden mid abdominal pain radiating to Lt. flank, what is your diagnosis ?
-Acute pancreatitis
-Cholecystitis
-Ureteral stone
-Mesenteric Infarctus
-Rupture of abdominal aorta
77. Pt. complains of Rt. upper quadrant pain & fever , PE shows slight abdominal tenderness, what investigation do u do to comfirme the diagnosis ?
-Biopsy
-Barium meal
-Peritoneal Aspiration
-Rectosigmoidoscopy
-Echography
78. most common complication of Epidural Anesthesia in a pregnant woman:
-Fetal hypoxia
-Hypotension
-Decrease in contraction
-Arrest of labor
79. Child pulled by his mother from his arms .. PE shows that one arm is adducted & the forearm is on pronation. what is the most likely diagnosis ?
-Humeral fracture
-Laxation of the Inferior extremity of the ulna
-Subluxation of ulnar head
-Rupture of rotator cuff
80. defense mechanism in phobia = displacement, avoidance
81. defense mechanism in borderline PD. = splitting
82. Pt. doing the opposite of what he believes is good = reaction formation.
83. Pt. on lithium therapy complain of fatigue , increased weight , heat intolerance , what test would you order ?
-Thyroid stimulating hormone level test
84. Pt. presented with pulmonary edema & BP. 180\95 , what is the best treatment ?
-Furesemide
85. 47 years F. with jaundice & history of nausea & vomiting , anorexia & depression , she is on Rifampicine, INH, Pyridoxine. PE Hepatomegaly + tenderness, Investigation reveal :SGOT, SGPT increased x 5, ALP slightly increased . the most likely diagnosis is :
-Drug induced hepatitis
-Viral hepatitis
-Acute pancreatitis
-Liver CA.
86. Pt. complain from visual spatial defect , where is the lesion ?
-Rt. cerebral hemisphere
-Lt. cerebral hemisphere
87. 4 years African boy on septrine for tonsillitis presented with Jaundice , Investigations : Hb. 9.8 gm % , reticulocytes count 8 % , Hb. electrophoresis : Hb.A . what is the most likely diagnosis ?
-Sickle cell anemia
-Thalassemia
-Spherocytosis
-G6PD deficiency
88. F. 65 years present with recurrent painless lower GI bleeding, colonoscopy, gastroscopy, barium enema, endoscopy & upper GI series all are normal, what is the dig. ?
-Rt. colon angiodysplasia
89. F. 50 years operated for cholicistectomy presented with heavy wound bleeding , she gives you a history of massive bleeding when she had a tooth extraction , what will you find ?
-Increased PTT + Increased BT
-Increased PTT + decreased BT
-Normal PTT + Increased BT
NB. diagnosis is Von Willebrand disease
90. pregnant woman with abruptio placenta, developed echymosis & bleeding , your diagnosis is DIC. what is the most specific test to confirm it ?
-Increased FDP (fibrine degradation product)
91. RTA (road traffic accident) Pt. with multiple fracture & trauma, 24 h later he develop tachypnea, PCO2 = 32, PaO2 = 50. X Ray shows bilateral infiltrates what is the next step to do ?
-Lung scan
-Ventilator
92. all the following are primary prevention except :
-Immunization
-Health related education
-Pap smear
93. pregnant lady developed postpartum hemorrhage after vacuum delivery , what is the most likely cause ?
-Uterine atony
-DIC
94. primigravida after delivery of a 4000 gm baby, after a prolonged labor could not urinate. What is the most likely cause ?
-Bladder atony
95. Child RTA present with urethral bleeding & urinary retention. Management ?
-Retrograde urethrogram
96. M. 25 years RTA, 4 h. Later developed Rt. Flank pain with heamaturia. What to do ?
-IVP.
97. F. 65 years complains heamaturia with clotting, frequency, nocturia & no dysuria. Diagnosis. ?
-Bladder CA.
98. What is the most likely cause of no changing in variability in fetal heart on NST (non stress test) ?
-Fetal sleep
99. NST indicated in all except :
-IUGR
-DM
-HT.
-40 weeks Pregnancy
100. The most specific test in UTI in infants is :
-Sample obtained by catheter
101. How do u calculate the natural growth of a country ?
-Crude birth rate - death rate
102. Child 4-5 years can do all of the following except :
-Imitation
-Group play
-Autonomy
-Abstract thinking
103. All of the following are normal during pregnancy except :
-Spider telangiectasia
-Heart rate of 90
-Decreased BP.
-Palmar erythema
-White blood cell 3000
NB. The WBC is increased in pregnant But with impaired function
104. What is the best treatment of mild toxemia of pregnancy ?
-Bed rest & Lt. Lateral position
105. F. 16 years old complaining of loss of weight of 10 Kg. All of the following suggest non organic cause except :
-Does not worry about weight loss
-Engaged in athletic activity
-Family history of eating disorder
-Persistent complain of fatigue
NB. Its a case of Anorexia Nervosa
106. Which of the following suggest a DM in a 20 years M. ?
-Loss of weight despite good eating
107. All of the following suggest thyrotoxicosis except :
-Loss of weight
-Meanorrghe
-Diarrhea
-Sweating
108. Young lady present a feature of hypothyroidism (cold intolerance, fatigue, anorexia, weight gain, meanorraghe, dry & rough skin, hair dry & coarse .... ) TSH is increased & T4 is low. What is your treatment ?
-Start L-thyroxine
109. Lady develop severe PPH (post partum heamorrage), she present after 6 wks with fatigue an inability to breast feed (absence of breast milk). All will be decreased except .
-Prolactin
-TSH
-LH
-T4
NB. Diagnosis. is Sheehan’s syndrome (postpartum pituitary infarct)
The T4 has got a long 1\2t ..
110. Lady 15 days after delivery complain of epigastric pain radiating to the back with nausea & vomiting , history of group B strep. Infection. The pain is relieved by leaning forward, PE. reveal an epigastric tenderness what is the diagnosis ?
-Pancreatitis
NB. The pain is relieved by leaning forward (Inglefinger’s sign)
111. Lady who delivered after prolonged labor present to you after 2 days. All of the following suggest Endometritis Except :
-Tender uterus
-Foul smelling
-Uterus 9 cm. below umbilicus
-Pyrexia
112. Lady after delivery develops fever. She still febrile after 5 days of antibiotic therapy. PV exam is normal. Diagnosis. ?
-Pelvic-thrombo-phlebitis
113. Young M. Complains of pain after defecation. PE reveal a blue mass , tender . Diagnosis. ?
-External thrombosed Hemorrhoid
-Internal thrombosed Hemorrhoid
114. Recurrent perineal abscess associated commonly with :
-Perianal fistula
115. All of the following are contraindicated to epidural anesthesia except :
-Decrease platelet
-Bleeding diathesis
-Sepsis at site of injection
-Decreased BP.
-Labor at 35 wks.
116. M. came after 24 h. of attack of renal colic. IVP done shows stone 0.5 cm. at L4, the kidney is slightly enlarged. Management ?
-Observation
-Tranurethral removal of the stone after cystoscopy
NB. Conservative treatment if the stone is less than 5 mm & no complication.
117. M. 55 years with painless mass in scrotum (2 cm) transillumination is (+ve) . Diagnosis. ?
-Hydrocele
-Spermatocele
-Hernia
-Varicocele
-Testiular CA.
118. M. 25 years presented with solid scrotal mass, after minor trauma to the testis. Diagnosis. ?
-Seminoma
119. Experimental study done with 2 drugs, shows that the result is significant, the epidemiologist wrote in his report that “p” is less than 0.5. What does that mean ?
-The association is less than 1\20 (5%) likely to be due to chance alone
120. Ultrasound will diagnose all the following at 20 wks EXCEPT :
-Twin pregnant
-Poyhydramnios
-Trisomy 21
121. Alfa feto protein is increased in :
-Edward syndrome
-Down’s syndrome
-Myelomeningocele
122. Psoriasis ... All except :
-Decreased C3 , C4
123. Old man complain of low back pain, X Ray shows decreased joint space & osteophytes diagnosis ?
-Degenerative joint disease (osteoarthritis)
124. Boy 2 years, complain of knee pain, PE tender but not swollen knee, slightly warmer than the other joint. What is the best investigation to do ?
-Xray of the knee
-Bone scan
125. Pt. present with fracture, you want to make a caste. You advise him about compartment syndrome. What will appear first ?
-Pallor
-Coldness
-Numbness
-Decreased pulse
-Paralysis
126. The most effective treatment in Osteoporosis is :
-Exercise
-Analgesics
-Vitamins
-Estrogen
127. Pt. On OCP complain of amenorrhea 3 months after using the pills. What is true about amenorrhea?
-Due to high progesterone
-Due to Estrogen
128. Definition of potential years of life lost (PYLL) : .................................
129. Sexually active lady present with dysuria & vaginal discharge. All the following can cause this condition EXCEPT :
-Gonorrhea
-Chlamydia
-Trichomonasis
-Condyloma Accuminata
130. Bacterial vaginosis EXCEPT :
-Clue cells
-Fishy odour with KOH test
-Decreased lactobacilli
-Vaginitis
-Frothy offensive discharge
131. Pt. complain of vertigo, how can you diagnose labyrinthitis ?
-Nystagmus
132. Pt. Operated for pituitary tumor, then he developed polyuria, dehydration inspite of receiving 4 L IV fluid. What will u give ?
-Give more IV fluid
-Start oral rehydration
-Give vasopressin (DDAVP)
NB. This is a case of SIADH
133. Alcoholic Pt. Complain of instability in gait, he uses a cane to avoid frequent fall. Romberg test is (+ve). what is your diagnosis ?
-DT.
-Alcoholic withdrawal
-Alcoholic cerebellar syndrome
134. Pt. complain of Tinnitus in Rt. ear, on Exam u found sensorineural deafness. Diagnosis. ?
-Acustic neuroma
135. New born, all the following are increasing risk factors of deafness EXCEPT:
-Family history
-Used of gentamycin
-History of CMV infection
-Delayed speaking
136. What will be your management. For a 3 years boy with stuttering ?
-Reassurance
137. All the following neonates are prone to hypoglycemia EXCEPT:
-IUGR
-Diabetic mother
-Normal infant born at 36 wks
-Hypothermia
-Non of the above
138. 32 years F. consult u for inability to conceive for 2 years, she is married who has 3 children from another woman. Temperature chart shows ovulation. What to do first ?
-B-HCG
-Hysterosalpingogram
-Progesterone at 21 day
-Semen analysis
139. F. 18 years height 158 cm , normal breast, with primary amenorrhea , PE small uterus, all of the following to be done EXCEPT :
-TFT (Thyroid) & Prolactin level
-Progesterone test
-FSH, LH level
-Laparoscopy
-Skull X Ray
NB. MCCQ 2001 (GY 11) we normally do the others in the same order as it is ..
140. F. 21 years , with 2 months history of fibroid mass, asymptomatic. Management ?
-Reassess after one year
-Myomectomy
-Hysterectomy
-Hormonal therapy
141. What is the most common source of mercury poisoning in Canada ? & who are the most exposed group of people in Canada ?
-Fish - (native Indians)
142. Which of the following you should not notify the police about ?
-Child abuse
-Spouse abuse
-Child neglect
-None of the above
143. You do a stress test ECG for a Pt. All are significant EXCEPT :
-ST decreased by more than 2 mm
-Chest pain
-ST increased (upward slopping)
-Decreased in BP by more than 50 mmHg.
144. All are true with post infectious GN. Except :
-Normal C3 , C4
-Hypoalbuminemia
-Increased cholesterol
-Proteinuria is more than 2 gm.
145. M. 65 years , present with low back pain anemia & hypocalcemia. What will you do to confirm the diagnosis ?
-WBC. Count
-Bone marrow aspiration
-Platelet count
146. HIV Pt. With fever & weight loss , he may have all of the following EXCEPT :
-Esophageal candidosis
-Mycobacterium Avium
-Mycoplasma pneumonia
-CMV infection
-Mycoplasma cellulari
147. F. 35 years with ataxia, weakness of the Lt. Side of body , dysphagia & visual trouble . PE reveals diplopia & nystagmus. What is the Diagnosis. ?
-Multple Sclerosis.
148. What is the most common complication of Juvenile Rheumatoid Arthritis:
-Iridocyclitis
-Hepatitis
-Nephritis
-vasculitis
149. M. Brought to u by police, for assaulting a 12 years old boy. When asked his name by the police , he said that he don’t know , & when u ask him how many legs does the horse have , he said 5 . What is the diagnosis ?
-Malingering
-Factitious disorder
-Antisocial personality
-Fugue
150. In which pathology you have gloves & stocking anesthesia ?
-DM.
151. M. With bipolar disorder came with agitation & aggressive behavior. Best treatment ?
-IV Haloperidol
-Lithium & Antipsychotics
152. All are seen in DT. Except :
-HT.
-Fever
-Tachycardia
-Fixed hallucination
153. Best prophylaxis for a Canadian traveling to a Malaria area with no resistant train is :
-Chloroquine
154. Pt. Diagnosed with dysthymia what is the best treatment :
-Psychotherapy
-Fluoxetine
-Imipramine
155. In cardiac arrest due to Ventricular Fibrillation , what is true ?
-NaHCO3 should be given every 5-10 minutes unless blood gas are known
-Lignocaine must be given
-DC cardioversion first
156. Dyspepsia, all are helpful EXCEPT:
-Antacids
-Elevate bed head
-Cimetidine
-Misoprostol
157. Asthmatic Pt. On steroids , has to go for operation for perforated duodenal ulcer . What will u do ?
-100-200 mg Hydrocortisone IV before the surgery
-Beta-agonist inhalor before the surgery
158. Chinese restaurant food poisoning. All are true EXCEPT :
-Symptoms within 1\2 h.
-Resolves after 24 h
-Symptoms of ashma + ataxia + dyspnea
NB. Monosodium glutamate is the cause of this syndrome (its a pharmacological but not allergic reaction. Dose related symptom of burning sensation throughout the body, facial pressure, anxiety & chest pain)
159. RA. Pt. On aspirin present with a normocytic normochromic anemia . All are true except:
-Respond to treatment with B.12
-Feritine maybe Increased
-Decreased serum Iron
-Normal total Iron binding capacity
160. What is the most common cause of congenital heart failure in NB.
-VSD
-ASD
-TGA
-Tetralogy of Fallot
161. A nurse with hypoglycemia & decreased C-peptide. What to do ?
-Refer to Psychiatrist
162. All are feature of TSS Except :
-Fever
-Decreased BP.
-Pustular skin lesion
-Erythroderma
163. All are feature of KAWASAKI disease EXCEPT:
-Fever for 5 days
-Purulent conjunctivitis
-Skin rash
-Fissure of lip
-Strawberry tongue
164. Variable deceleration commonly seen in :
-Uteroplacental Insufficiency
-Cord compression
-Sleeping fetus
165. All increase the level of carbamazepin EXCEPT :
-Cimetidine
-Estrogen
-Phenobarbital
166. M. Present with Rt. Side horner’s syndrome & contralateral loss of sensation of the body. Where is the site of the lesion ?
-PICA
-ICA
-Internal Carotid
167. Pt. With hypokalemia . All true EXCEPT :
-Diarrhea
-Paralytic ileus
-Hypotension
-Hypoventilation
-Muscular weakness
-Polyuria & polydepsia
168. All are live attenuated vaccine except :
-BCG.
-Vaccine of yellow fever
-Polio
-Measles
-Diphtheria
169. How often do u give a booster in people previously adequately immunized against tetanus :
-Every 10 years
170. All are included in the routine immunization EXCEPT:
-Measles
-Pneomococus vaccination
-Mumps
-Rubella
171. Heamophilus Influenza contact, prophylaxis is :
-Refampicine
172. Pregnant , 8 wks, came into contact with a boy suspected of having Rubella infection . Management ?
-Rubella vaccination
-Give Rubella IgG.
-Do antibody titre in the pregnant lady
-Therapeutic abortion
173. Farmer came with a nail in his foot & temp. of 38.2 . Management :
-Antibiotics
-Tetanus toxoids + antititanus Ig. + antibiotic
-Antitetanus Ig.
174. F. Young present with Meanorrhagea. Commonest cause is :
-Deficient luteal phase
-Short secretory phase
-Prolonged secretotey phase
NB. Anovulation is the best answer if there.
175. Postmenopausal lady with MI. & she is an active smoker. She does not want to stop smoking. She is on Hormonal Replacement Therapy. What advice do u give ?
-Stop Estrogen & start exercise
176. Post-Op continued to bleed despite 10 units of packed RBC. Transfusion. What is the cause ?
-Hypercalcemia
-Hyperkalemia
-Dilutional thrombocytopenia
177. RA. Pt. On ASA. Developed ITP . What is the treatment ?
-Steroids
178. Pt. Developed excessive menstrual bleeding & purpura . All the following lab. Finding are expected EXCEPT:
-Decreased Hb.
-Decreased platelets
-Increased platelets
-Prolonged bleeding time
179. Bartholinitis abscess. What is the treatment ?
-Antibiotics
-Marsupialization
NB. I & D is a good answer as well.
180. Pt. With lymphadenopathy & splenomegaly & raised WBC . What is the confirmatorey test ?
-CBC deferential
-Bone marrow aspiration
NB. Leukemia case
181. Pt. With bilateral hilar lymphadenopathy with micronodular infiltrates. All can give this feature EXCEPT ?
-Sarcoidosis
-TB.
-Transbrbronchial bronchogenic carcinoma
182. Pt. With painful bluish mass protruding from the anus. Diagnosis. ?
-Prolapsed anal piles
-Thrombosed external piles
-Internal piles
183. All can Cause Pruritis ani EXCEPT:
-Laxative
-Hemorrhoids
-Fecal incontinence
-Colorectal CA
184. F. 24 years with (+ve) preg test , present with 2 days vaginal bleeding, US shows 3 cm mass in the Lt. Adnexa & empty uterus, pregnant Sympt & signs of preg has disapeared & the cervix is closed. Diagnosis. ?
-Complete abortion + luteal cyst.
NB. u consider ectopic pregnancy until otherwise proven.
185. Indication of C-section in breech presentation is:
-Footling
-Frontbreech presentation
186. Prevalence definition: total number of cases in a population at a given time.
life birth
187. Crude birth rate = ------------------------------- x 1000
Total medial population
188. The tree of autosomal dominant transmission
189. F. Consult you because of a possibility of her offsprings (kids) having Huntington’s Chorea. Her father is affected. Her husband family don’t have this disease What is the possibility that her children will develop the disease ?
-50 %
-0 %
-25 %
-100 %
190. F. With pregnancy like symptoms, US shows grape like masses in the uterus. All true EXCEPT:
Multiple gestation
-Bilat. Ovarian cyst
-Hyperthyroidism
-Hypothyroidism, coma, preorbital myxedema
191. All have risk factor to develop preeclampsia:
-Nulipara
-DM
-History of preeclampsia
-Multiparity
192. Pregnant Pt. 20 weeks The uterus size is 25 cm. All true EXCEPT:
-Normal pregnant
-Wrong estimation of gestational age
-Twin pregnant
-Bilat. Renal dysgenesis
193. Old lady with ankle edema at the right medial malleulus, with superficial ulcer & surrounding scar. Diagnosis. ?
-Venus insufficiency
-Venus valvular insufficiency
194. Preg. Lady with known fibroid, complaining from abdominal pain
-Red degeneration
195. M. 16 years old complain from loss of weight, he is passing bloody diarrhea, Investigation show normal upper indoscopy & segmoidoscopy. What to do next ?
-Upper GI series
196. Child 4 years old, presented with post. Mediastinal tumor. What is the commonest germ cell tumor ?
-Thymoma
-Neuroblastoma
-lymphoma
197. PT. With fat malabsorption, passing floating stools + loss of weight & easy bruising. Diagnosis. ?
-GI lymphoma
-GI TB
-Glutane antheropathy (celiac disease)
-Repeated episode of pancreatitis
198. Pt. With DKA. All occur EXCEPT:
-Increased Amylase
-Abd. Pain
-Increased K.
-Increased osmolarity
-Leukocytosis
NB. Merck 1999 (p.178) in DKA. serum amylase typically elevated while K is Increased or normal
199. F. Pt. On Insulin therapy, she has a baby. You will suggest her the following about Insulin Except:
-Hold insulin until the baby start eating
NB. (always Insulin & Heparin are SAFE during pregnancy & lactation)
200. Best site to obtain smear for Gonorrhea in a woman is:
-Vulva
-Vagina
-Cervix (mouth of the wound)
201. Which stage of sexual excitement according to Tonom criteria when the female is having clitoral erection, increased vaginal secretion, nipple erection ?
-Early excitement
-Resolution
-Late excitement
-Latent phase
202. F. With difficulty caring shopping bag, weak abduction of the thumb + minor wasting of the thumb (minor thenar atrophy) Diagnosis. ?
-Carpal tunnel syndrome
203. Radial nerve injury at the level of the head of Radius. What will u find ?
-Dropping wrist
NB. Merck 1999 (p.1493) The Saturday night palsy is another name for the Radial nerve palsy.
204. Which of the following is a sexual desire abnormality
-Does not imagine sexual fantasies
-No sexual activity for more than 2 wks
-Nervous about sexual act
-Try to avoid partner contact
205. Transvestitism disorder, all true EXCEPT
-Dressing clothes of other sex for sexual excitement
-More common in male
-They are female
206. All are known to cause depression EXCEPT:
-Clonidine
-Cimetidine
-Cyclosporine
NB. The drugs which cause depression are : Anti-HT, Anti-Parkinsonian, Hormones, Steroids, Anti-TB, Anti-Neoplastic
207. Pt. Brought to u mute & inaccessible to examination. Diagnosis.
?-Catatonia MCCQ PS6 (2001).
208. M. 35 years Found in the street wandering, he doesn't know his name, talk to him self. All are possible etiology EXCEPT:
-Schizophrenia
-Fugue
-Alzheimer disease
209. Girl came with midline neck cyst, which moves while protruding the tongue (with swallowing). Diagnosis.
?-Dermoid cyst
-Brachial cyst
-Thyroglossal duct cyst
210. All are routine investigation for an old lady with urinary incontinence EXCEPT:
-Urine analysis
-Cystogram
-Urinary diary
-Direct visualization of incontinence when Pt. with full bladder while coughing
211. Definitive test for chronic pancreatitis is-CT -ERCP-MRI
212. Pt. With pruritis & progressive jaundice, with increased ALP. & total bilirubine. What is the next investigation u do ?
-US.
-PTC (percutaneous tranhepatic cholangiography).
-ERCPNB.
Always start with the less invasive investigation.
213. In Necrotizing Enterocolitis. All feature exists EXCEPT:
-Pneumatosis Intestinalis (X Ray)
-Peritonitis-Peritoneal calcification
-Portal venous gas (X Ray)
-Pneumo peritonium (X Ray)
214. What is the commonest cause of non scarring alopecia on a young girl ?
-Alopecia Areata
-Tenia Capitis-Chemotherapy
215. During insertion of IUD. The Pt. Develop hypotension. What will u do ?
-Elevation of the legs
216. IUD. Tread seen dangling outside the cervical os during an examination of a pregnant Pt. What will happen if removed
-Normal pregnancy 55%
217. Pt. In the ER. With fracture of the femur , develop sudden hypotention. What is the cause ?
-hemorrhage
218. Verapamile given IV for treatment of SVT. The Pt. Develop hypotention. What will u do?
-Defibrillation (elictrical cardioversion)
219. Pt. With psychostimulant intoxication. What is the best management. When the Pt. Will be discharged ?
-Benzodiazepines
-Daily follow up in support group
220. All occur in DT. EXCEPT:-Tremor-Visual hallucination-Delusion -Psychomotor activity
221. About contact dermatitis. All true EXCEPT:
-Mostly with plant exposure
-Systemic steroids could be used-Local steroids are not useful
-Skin test is useful
222. All can cause inverted uterus EXCEPT:
-IV oxytocin stimulation
-Atonic uterus-Pressure on soft fundus
-Pull cord forcefully
223. Who is responsible for the ultimate (standard) health care quality ?
-Bord of directors -Staff -Chief physician
-Chief of staff
224. What is the rule of Royal collage of Canada ?
-Credentialing body (certification of specialist)
225. Pregnant Pt. With bicornuate uterus. What is the likely outcome of pregnant ?
-Abortion
-Preturm delivery
-Normal pregnancy outcome
226. Pt. With plasmodium vivax malaria, treated & recurrence. Most likely cause ?
-No Eradication of liver forms
227. The best screening for hyperaldosteronism in HT. (conn diseaseis):
-Serum renin activity levelNB.
Renin will be increased in secondary & decreased in primary
228. ASA use + alcohol abuse over weekend, the pt. Developed GI bleeding. Gastroscopy shows multiple areas of erosions. All can be done EXCEPT:
-NG tube
-H2 blocker
-Gastrectomy
-Vasopressin
229. F. Pt with (+ve) ANA, presented with ankle edema & arthralgia, protein + in urine. Diagnosis. ?
-SLE
-Scleroderma
230. Diagnosis. Of Condyloma Acuminata in pregnancy. You give all EXCEPT:
-Podophyllin
231. Elderly Pt. : Prefer to sit home & to be visited by relatives.
232. In Wolf Parkinson White syndrome : shortening of PR interval & Delta wave.
233. Child complain of headache, abdominal pain, nausea, vomiting then he sleeps. Diagnosis. ? -Abd. Migraine
234. Vit. K. Deficiency in new born will result into :-Increased PT. & PTT.NB. Vit. K. (Menadione) Toxicity will present with hemolytic anemia & kernikterus235. Which one of the following affect the outcome & feature planning of Canadian health program ?-Accident-Age
236. Post-partum psychosis EXCEPT:-Can cause residual effect
237. Best treatment for shigellosis is:-Septrim (cotrimoxazol)
238. Photo of down's syndrome baby. What will confirm the diagnosis ?-Kariotypes -Total blood count
239. Epileptic Pregnant Pt. Controlled on phenitoin asked for your advice about continuing the drug which she use ?-the benefit of risk out weight of it's teratogenicity (To continue using it)
240. Best screening test for hypothyroidisim :-TSH
241. Man had fighting problem at work. Now he complains from back pain. PE shows no pathological finding but the man is depressed & obsessed with it. Diagnosis. ?-Malingering -Hypochodriasis-Somatoform pain disorder
242. Charming manipulative does not learn from experience with lack of remorse (guilt). What PD is it:
-Antisocial PD
-Border line PD
-Histrionic-Narcissistic NB. The key is lack of remorse (guilt).
243. What is hypochondriasis ?-Its a belief of having chronic disease despite good reassurance
NB. The Pt. is stable & has no social problem & he will visit many doctors for the same problem, he recognizes that his reaction is exaggerated 244. Mother brought her baby to u , he is non sensitive to other feelings , having problem with learning & speech. Diagnosis. ?
-Autism
-Specific learning disorder
245. ADHD. What is true ?
-Persistent to adulthood
-Antisocial
-Increase criminal rate
246. Which are associated with highest risk of sudden death:
-Multiple Ventricular Arrhythmia on 24 h. Holter monitor-Ejection fraction less than 20 %
-Family history of sudden death
-Atrial fibrilation on aprevious AMI
-Severe narrowing of more than 1 coronary art.
247. Regarding suicide all are increased risk of successful attempt EXCEPT:
-Depression-Malignancy
-Female gender
-Lonely white old man
248. Most imp. Dietary modification of middle aged group is :
-Total calorie content
-Fiber diet-CHO content
-protein
249. In MS. All commonly occur EXCEPT:
-Diplopia
-Nystagmus
-Scotoma
-Anosmia
-Tremor
250. Treatment or drug of choice for cyclothymia
-Lithium
-Psychotherapy
-Haloperidol
251. In BN. All occur EXCEPT:-Dental caries
-GI reflux
-Parotid enlargement
-Stomach rupture
-Metabolic acidosis
252. Stridor is present in all EXCEPT:
-Retropharengeal abscess
-Acute asthmatic attack
-Tracheolaryngobronchitis
-Acute Epiglotitis
253. Pt. With diazepam withdrawal. Which one can't u give him ?
-Chlordiazepoxide
-Diazepam
-Lorazepam
-Buspirone
254. All are measure to avoid Botulinism, EXCEPT:
-Antiacid
-Below freezing temperature
-Vacuum
-Nitric preservation
255. DVT in postpartum period lady. All can be given EXCEPT:
-Coumadin
-Heparin
-Early mobilization
NB. We can use it to avoid the DVT & not after...
256. Which is true about mastitis ?
-Gram (-ve) commonest
-I&D is the treatment
-Associated with lactation
257. What is the commonest cause of pseudomembranous colitis ?
-Clostridium dificile toxin
258. Relation between asbestosis & smoking is called :
-Additive
-Synergistic
-antagonist
259. Defense mechanism in phobia is :
-Avoidance
-splitting
260. Defense mechanism is border line PD. is :
-Avoidance
-Splitting
261. Rt. Handed lady complains of feeling of being dissociated from environment, expressive dysphasia & automatism. Where is the lesion ?
-Lt. Temporal
-Rt. Temporal
-Lt. Parietal
-Rt. Parietal
-Frontal
262. Boy fell doun from a tree, he started abdominal Pain & heamturia. What will be your next investigation ?
-Renal scan
-IVP
-Retrograde urography
-Surgical exploration
263. Lady complains from bilateral abdominal Lower Quadrant pain with tenderness after the end of cycle by 2-3 days. What is the diagnosis ?
-Endomettriosis
-Salpingitis
264. What is the commonest cause of intestinal obstruction in males over 65 years. ?
-postsurgical adhesion
265. Child swallow a 2.5 cm screw, X Ray shows it in the upper quadrant region. What will be the management. ?
-Surgery
-Reassure & follow up Xrays after few days
-Endoscopy
266. Premature rupture of membrane associated with all EXCEPT:
-Pneumonitis
-Septisemia
-RDS
267. Gonorrhea treated with spectinomicin , after there is recurrence of symptoms. What is the diagnosis & what will be the management. ?
-Chlamydia & give tetracycline
268. What is the diagnostic test for myasthenia gravis ?
-Tensilon test
269. What is the diagnostic test for cushing syndrome ?
-DST (dexamethasone supression test)
270. Hypertensive Pt. PE. shows bilateral Femoral bruits. Diagnosis. ?
-Renal stenosis
271. F. Pt. Complains from severe headache, shoulder pain & bilateral Wrist weakness. Diagnosis. ?
-RA.
-Temporat Arteritis
-Polymyositis
-Sarcoidosis
272. Maximum time fro primary syphilis to be seen after sexual contact is :
-Three months
273. All are features of sexual arousal EXCEPT:
-Tumescence
-Pelvic congestion
-Uterine contraction
274. Pt. Has lower limb lymphedema following pelvic radiotherapy. What is your management. ?
-ASA regularly + diuretics occasionally
-Compression stocking + raising leg at bed time
275. Child with bilateral Burns of his lower limb, his mother said that crawling near the heater. What is the diagnosis ?
-Shaken baby syndrome
-Child abuse
276. Pt. With history of HT. & DM. , get acute MI. & died due to cardiac arrest. In writing the death certificate, what is the immediate cause of death. ?
-DM.
-HT.
-MI.
-Cardiac arrest
277. Pt. Complains of painful swelling on the face with fever & malaise. PE: erythematous swelling on the cheeks & nose. What do u expect to find on examination ?
-Vesicles on the ipsilateral ear
-Well demarcated sharp margin
NB. The diagnosis is Erysipelas
278. A woman came to your clinic claming that she is seeing creatures form the space, trying to kill her. Her husband denies the story. She was uncooperative. What should you do ?
-Admit & start antipsychotic treatment
-Send her home, ask husband to put her treatment in coffee & give it to her
NB. Diagnosis. is schizophrenia
279. Thiazide diuretics are the first choice for:
-HT alcoholic with malnutrition
-HT + DM
-HT + gout
-HT in elderly Pt.
-HT + LVF
280. Young F. Pt. with acne on face. PE: open & closed comedones + 2 papules on chin. What is the treatment ?
-Benzoyl peroxid
-Oral tetracyclin
-steroids
NB. Diagnosis. Is Acne vulgaris
281. Child present with severe dehydration with hypotension, investigation shows:
Na 120 mmol.\L.
K 3.0 mmol\L.
BUN 15mmol\L.
You decided to rehydrate orally. What will you give ?
-20 ml. Na 50% + K 10%
-50% normal saline + glucose 50% + 20 mmol KCl.
-Pure Water
-5% sugar in water
-milk.
282. M. 25 years. Histoty of diarrhea for 15 days, he has lost 5 kg., barium enema & rectosigmoidoscopey were normal. What is your next management. ?
-Stool culture
-Stool microscopy
-Plain abdominal X Ray
-Upper GI series
283. What is true Regarding smoking restriction in public places?
-Decreases the incidence of chronic respiratory disease
-Decreases the incidence of allergic respiratory disease
-Decreases the incidence of cardio vascular disease
-Shortens hospital stay
284. Regarding conversion disorder. All are true EXCEPT:
-Aphasia
-La belle indifference
-Involuntary character of the syndrome
-Can cause social or professional hindrance
-Can be induced voluntarily
285. A new vaccine against measles is being evaluated. The following results of one full year of study :
Diseased Healthy Total % age
nonvaccinated 137 --------- 378 36.30
Vaccinated less 1 yr 51 --------- 266 17.28
Vaccinated more 1 yr ----- --------- 408 --------
What is the Vaccine efficacy for the vaccinated before one year
- 0.6 %
-17.9 %
-49.0 %
-21.8 %
-36.3 %
NB. The efficacy = incidence of non-vac - vac
286. In a small town. The incidence of disease A is (iA) 8\1000 . The disease B not related to disease A has an incidence of (iB) 12\1000 . What is the probability that the Pt will have both of the disease In the same time ?
-iA + iB
-iA X iB
-(iA + iB) \ 1 - (iA + iB)
-(iA + iB) \ 2
-(iA + iB) \ (iA - iB)
287. The following disease are more frequent in poor than in rich Canadians EXCEPT:
-Suicide
-Coronary art. disease
-Lung CA
-Stroke
-Breast CA
288. The mother of a 12 years old child has to be admitted to the hospital for 2 wks. The boy present with loss of appetite, he remains in his bedroom & has insomia, his stool frequency is reduced. PE: soft abdominal & all the rest of the exam is normal. Diagnosis. ?
-GI infection
-Early schizophrenia
-Flu
-Separation anxiety
-neglect
289. Child 10 years with pyrexia & JRA (still's disease) What is the most common complication?
-Endocarditis
-Knee & hip arthritis
-Aseptic meningitis
-Iridocyclitis
-Nephrotic syndrome
290. Which of the following vaccine causes more side effect :
-Pertussis
-Measles
-Diphtheria
Yellow fever
291. Of the following CA. Which one is caused by vinylchloride :
-Lungs
-Esophagus
-Rhinopharynx
-Liver
-Bladder
292. F. 37 years has problems at work for several months, she also has episodes of hyperactivity & euphoria. These were preceded by episodes of sadness & inability to cooperates with her colleagues inspite trying hard to do her best. Diagnosis. ?
-Bipolar disorder
-Dysthymia
-Cyclothimia
-Masked depression
-Factitious disorder
293. A new test for CA Cervix allows better detection. Statistically all can be modified EXCEPT:
-Prevalence
-Incidence
-PPV
-NPV
-Survival rate
294. Propranolol can be used in all EXCEPT:
-Lithium induced tremor
-Panic attack
-Hyperglycemia
-HT.
-Angina
295. Newborn 2 wks old brought by mother, she complains of decreased milk secretion. The baby weights 4.9 kg. The birth weight was 3.7 kg. This problem is particularly marked in the evening. What is the most appropriate treatment
-Prolactine 2 mg. Bid to the mother
-Supplement the baby with one spoon of solid food every evening
-Supplement with formula every evening
-Reassure the mother
-No breast feeding in the evening to allow more milk to the next morning
296. F. 17 years with severe menorrhagea. Investigation reveals Hb 8.0 gm\dL. Pulse 110 BP. 80\60. BhCG (-ve). Initial management. ?
-IV Oxytocin
-Blood transfusion
-D&C
-IM. Medroxyprogesteron
-IV. Estrogen
297. Child with bronchospasm after hockey game. All can be given EXCEPT:
-Aminophylin
-Salbutamol
-Cromoglycate
-Betamethasone
-Oxygen (facial mask)
298. Pt. 65 years with COPD treated with oxygen (FiO2 44%) present with the following test results:
PaO2 PaCO2 pH.
65% 35% 7.30
52% 48% 7.26
48% 52% 7.21
What is management. ?
-O2 100%
-Increase FiO2 to 65%
-Stop O2
-Intubate
-IV Aminophylin
299. The following are carcinogenic EXCEPT:
-Fat
-Monosodium glutamate
-Benzene
-Nickel
-arsenic
300. Child 18 m. Old with dyspnea. X Ray shows normal Rt. Lung, Lt. Lung distention. mediastinum deviated to the Rt. With translucent Lt. lung. Diagnosis. ?
-RSV infection
-Pneumonia
-Foreign body
-Congenital anomaly
-Congenital pulmonary aplasia
301. All are carcinogenic EXCEPT:
-Uranium
-Arsenic
-Radon
-Chromium
-Lead
302. Which of the following radiation has the deepest penetration in human tissue:
-Alpha
-Gamma
-Xray
-Delta
-UV
303. Which is true regarding the side effects of radiation ?
-Microwaves cause superficial burns
-Laser radiation can cause retinal burns
-UV can cause Alopecia Areata
-Beta ray can cause Leukemia
-Delta ray are dangerous for the central grey nucleus
304. Characteristic of placebo effect. All true EXCEPT:
-50% effective
-Pt. Believes in treatment efficacy
-Its greater in IM than in PO.
-It decreases if used frequently because of dependence
-Naloxone effect shows that placebo effect occurs by inhibition by morphinic receptors
305. All are true about Turner syndrome EXCEPT:
-Short stature
-Ammenorrhea
-Coarctation of the Aorta
-Hirsutism
-Acne & micrognatia
-Low set hair
306. All are routinely done in infertility investigation EXCEPT:
-Semen analysis
-Temperature chart
-FSH. LH.
-HSG
-Post coital test
9
307. F. 74 years old admitted with urinary catheter, she has UTI. Urinanalysis shows 10 \ high power field. Culture shows sensitivity to nitrofurantoine, TMP\SMX, gentamycin, tetracyclin. PE: asymptomatic & no fever. What is your management. ?
-Nitrofurantoin 3 tab.\day for 20 days
-Gentamycin 2 injection IM. \ day for 10 days
-TMP\SMX 1 tab.\day for 14 days
-Doxycyclin 4 tab.\day for 10 days
-No treatment
308. In which case occupational deafness is mostly suspected
-Unable to hear the bell sound at 3 m.
-Decreased in hearing high intensity voices
-Decreased peak at 4000 hertz on the audiogram
-Deafness at speaking voice
309. The difference between M. & F. Sexuality is:
-F. Have more inhibition
-F. Have more erogenous zone
-F. Orgasm is less intense
-F. Refractory period is shorter
-F. Orgasm is shorter
310. Picture of old F. With temporal arthritis asking about which is common in these Pt. :
-Jaw claudication
-Headache
-blindness
311. Picture of a lady with goittrons papules & proximal muscle weakness. Diagnosis. ?
-Dermatomyositis
-Mixed Connective Tissue disease
-Scleroderma
312. Picture of a lady genitalia showing vesicles around vulva. Diagnosis. ?
-Syphilis
-Comdiloma acuminata
-Herpes simplex genitalia
313 picture of clubbing. Which is not causing it ?
-Chrons's disease
-Chronic bronchitis
-Ciliac disease
314. A child with fever , irritability & drooling. PE: there are numerous small ulcers on tongue + ant. Cervical Lymph node enlargement :
-Herpangina
-Herpes simplex stomatitis
-leucoplakia
315. Pt. With schizophrenia & on treatment. With akathisia (he cant sit still) What is the best treatment is ?
-Lorazepam
316. Which of the following drugs is the safest is Pt. With depression & heart problem ?
-Fluvoxamine
-Imipramine
-Doxepine
-Despiramine
-Phenelzine
317. Pt. With fatigue & no pleasure & decrease sleep. Diagnosis. ?
-Depression
-Anxiety
-Bipolar
318. Pt with DM. & HT. On propranolol, complains of progressive impotence & he didn't have sexual intercourse with his wife for more than 6 months He came to u with his wife, she told u privately that he has morning erection specially when he see adult magazine. What is your reaction ?
-Do night tumescence test (REM test)
-Marital psychotherapy
-Stop propranolol
-Impotence due to DM. (vascular problem)
319. Best treatment for DT.
-Lorazepam
-H’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@
323. Pregnant during delivery (full term), cephalic-occiputoposterior, head of the baby at station (-1) Pt. Is exhausted & takes long time in 2nd stage of labor. What is your management.
-Symsons
-Kjelands forceps
-Vacuum delivery
-C-section
324. Pt with retain placenta. All are associated EXCEPT:
-Vaginal bleed
-Infection (endometritis)
-Purpura around umbilicus
325. Child with microcytic anemia with Nausea, vomiting, anorexea & costipation also has sleep disturbances & irritability. Diagnosis. ?
-Hg. Poisoning
-Thalassemia
-BPC poisoning
-Lead poisoning
-Vit. A poisoning
326. Most common source of silicosis exposure in Canada is:
-Sandblasting
-Coal dust
-Brake lining
-High consentration of Gases
327. Which of the following is the most common trigger of Asthma in children ?
-Dust housing
-Rugs
-Parental smoke
-Pets
328. What is the mode of transmission of Hydrocephalus ?
-Trisomy
-Monosomy
-Euploidy
329. The most Common cause of non reactive NST (non stress test) is :
-Sleeping fetus
-Multiple gestation
-Intrauterine death
-Morphine
330. Commonest cause of hirsutism in reproductive age group:
-Constitutional
-Polycystic Ovary disease
-Congenital Adrenal Hyperplasia
331. Ediopathic heamaturia with no other abnormality. Management ?
-Prednisolon
-Follow up the Pt. After one year
-LEEP
332. Which of the following is true regarding Chromoglycate ?
-Contraindicated with steroids
-Necessary in acute attack of asthma
-Prevent binding of IgE with cells
-Prevents histamin from synthesized cells
333. M. 42 years with glucosuia, dark skin, palpable liver. Which will help u in the diagnosis ?
-Ferittin level
-Ceruloplasmin
-Alphatrypsine
-Electrophoresis
334. Which will increase day care load in the next decade ?
-Heart disease
-CA.
-Dementia
-Accident
335. Which one is most suggestive of thyroid malignancy ?
-Solid cold nodules
-Cystic cold nodules
-Increased thyroxin level
-Increase TSH level
336. Young Pt. Came to u after electric shock due to falling down on subway. Burn was treated. ECG is normal. Management ?
-Send home if ECG is normal
-Keep monitoring the ECG for 24h.
-Cariad enzyme should be checked
-ECG must be monitored for three days
337. The most important cause of difference between M. & F. mortality rate is due to :
-Accident
-Puerperal
-suicide
338. Lower abdominal pain with tender abdominal mass in the cole-de-sac. Diagnosis. ?
-TOA (tubo-ovarian abscess)
-Infected endometrioma
-Teratoma
NB. Scenario is incomplete
339. F. 42 years hypothyroid Pt. with 8 month ammenorrhea asking u about osteoporosis. Your advice will be EXCEPT:
-Cyclical Est. & Prog.
-Vit. D.
-Ca supplement
-Continuos Est. & Progesterone
340. Pt. With chronic bronchitis and PaO2 of 60 mmHg. all are true EXCEPT:
-Continuos home O2 is not indicated
-Antibiotic prophylactics is helpful
-Bronchodilators can be used
-Corticosteroids may be useful
-Non of the above
341. Smoking withdrawl which of the following is the most common symptom:
-Insomnia
-Tachycardia
-Anorexia
342. Life expectancy is increased in canada due to:
-Decreased infant mortality rate
-Availability of Diagnosis and treatment
-Increased of socioeconmic status
343. The vaccine which is given to adults is:
-DT pertusis
-DT
-T
-DT and Polio
344. Middle aged lady came to you complaining of not sleeping at night because she finished her diazepam tablets which she used to take before sleeping now her Family physician is away .What will be your action:
-Assurance
-Give her diazepam
345. Pt. With frost bit, best treatment is:
-Put hands in warm water 38-40 degrees for 30 min.
-IV antibiotics
-Local antibiotics and debridments
346. Pt. Post M .I no more pain ,B P 90 over 60 mmhg , pulse is normal and regular.
Whats your management. ?
-Close observation in I C U
-Dopamin I V
-Dobutamin I V
-Digoxin
347. Pt. Came to you with cercumferencial burn on Lt. Forearm, complain of pain. PE: no radial pulsation. Best treatment is:
-Escharectomy
-Debridment
-fasciatomy
348. Mitral stenosis question: loud 1st heart sound, mid diastolic murmur at the apex, parasternal heave.
349. Young female presented with visual impairment in one eye which improve, in neck flexion an electric like shock is felt at the back & upper limb. Diagnosis. ?
-Mysthenia gravis
-Multiple sclerosis
-GBS (Guillain-Barre syndrome)
NB. The electric shock is called : Lhermitte's sign
350. Pt. Present with enlarged LN. In cervical inguinal & axillary regions, night sweat, fever & weight loss. X Ray shows widen mediastinum. Diagnosis. ?
-NHL (Non Hodgkin Lymphoma)
-AML
-IMN (Infec. Mono. N)
351. Typical case of large cervical LN. What will be your next step?
-Abdominal US
-Excisional biopsy
352. Old hypertensive lady with DM. What is the best treatment ?
-B-blocker
-Diuretics
-ACEI
NB. MCCQE FM 14. (2001)
353. F. With breast CA. complains of dyspnea & fatigue. PE: shows pulsus paradoxus. C-X ray shows large globular heart. Diagnosis. ?
-Pericardial effusion
354. Pt. with VonWillebrand disease Type I. Which is true ?
-Prolonged bleeding time
-Decreased platelet
-Increased PT.
355. Pt. on platelet transfusion developed anaphylaxis. What is the initial management. ?
-IV steroids
-Stop transfusion
-anti-histamine
356. Pt. in ICU post MI developed bradycardia, pulse at 32 \ min. What is the best management. ?
-Cardioversion
-Pacemaker
-IV Dobutamine
357. M. 72 years present with one year history of heamoptysis. X Ray shows infiltration of the lung. Diagnosis. ?
-Recurrent Pulmonary Embolism
-Bronchiectasis
-Foreign body
358. What is the drug of choice of mycoplasma pneumonia ?
-Tetracycline
-Bactrim
-Erythromycin
359. Typical case of heamolytic anemia. What is the most characteristic finding ?
-Reticulocytosis
-Increased haptoglobin
NB. findings Other than Reticulocytosis are:
Reduced haptoglobin
Increased LDH
Increased unconjugated bilirubine
Increased urine bilinogen
360. Pt with history of alcohol intake present with icteric sclera, Bad mouth smell (fetor hepaticus). Diagnosis. ?
-Hypoglycemia
-DKA
-Hepatic encephalopathy
-Viral hepatitis
361. Pt. With history of unilat. Loss of vision in the Lt. Side which completely recovered within 5 min. What is the most likely association ?
-Lt. Internal Carotid Art. Stenosis
NB. The Diagnosis is Amaurosis fugax
362. Which is false ?
-Cefazoline & Bacteroides
-Gentamicin & E-coli
-Metronidazol & Bacteroides
-Vancomycin & C. difficile
363. Young lady with anorexia, generalized fatigability, weight loss & intermittent fever for 2 wks. PE: multiple splinter heamorragea are noted on the finger nails. The most imp. Next spet is:
-Urine C & S
-Blood culture
-C-Xray
NB. Diagnosis is Subacute Endocarditis
364. A group of doctors preparing the EE. Develop nausea , vomiting, diarrhea, few hours after having lunch at a restaurant. The symptoms subside after 24h. Most likely cause is :
-E-coli FP (food poisoning)
-Staph. FP
-Salmonella FP
365. Obese Pt. With heart burn, progressive difficulty of swallowing & Epigastric pain which gets worse more in recumbency. Diagnosis. ?
-Achalasia
-Hiatus hernia & reflux esophagitis with stricture
-Esophageal CA.
366. F. Pt. With history of anorexia, weight loss, vomiting, diarrhea. BP show postural hypotension, Na 130, K 5.8 , what is the best initial investigation ?
-Measurment of ACTH in plasma in the morning
-ACTH stimulation test
-Abd. CT for adrenal
-Water deprivation test
NB. A case of Addison's dis (adrenocortical insufficiency).
367. Typical case of hepatic encephalopathy. What is the LEAST effective in the initial management. ?
-Look for signs of GI bleeding
-Take history of drug from relatives
-Look for signs of infection
-Order lactulose
368. Typical case of migraine. What is the most likely visual symptoms ?
-Scintillating scotoma (the cotton like scotoma)
369. All are sexually transmitted EXCEPT:
-EBV
-HBV
-HIV
370. All are transmitted feco-oraly EXCEPT:
-HAV
-EBV
-Norwalk virus
-Polio virus
NB. Kissing disease (EBV)
371. Typical case of irritable bowel syndrome. All are true EXCEPT:
-Nocturnal diarrhea
-Abdominal pain
-constipation
372. Young F. With supraventricular tachycardia. Complain of chest pain, palpitation & fainting. The best initial management. is :
-IV verapamil
-Cardioversion
-Increase vagal tone
-B blocker
373. A nurse injured by a needle of a pt. Who is HBV (+ve) & HIV (-ve) . management.?
-Give HB. Ig. Now & HB. Vaccine after 2 wks.
-Reassurance
-Give HB. Ig. & HB. Vaccine now
374. G2 P2 with history of lower segment C-section because of footling breech. During labor she present a sudden profuse gush of bright red blood. The fetal head is engaged. Diagnosis. ?
-Placenta Previa
-Ruptured uterus
-Placenta Abruptio
375. All are complication of copper IUD EXCEPT:
-Uterine perforation
-Infertility
-PID
-Liver toxicity
376. Young pregnant Pt. Diagnosed to have placenta previa at 20 wks. Where the placenta covers the internal os completely. What advise do u give ?
-Avoid sexual intercourse
-Reassesment US at 28 wks
-Inform the Pt. That she needs a C-section at delivery time.
377. Increase FSH is associated with all of the following EXCEPT:
-Turner syndrome
-Bilat. Dermoid cyst
-Post radiation to the pelvis
378. Which is responsible for decrease Oxygen delivery to the fetus during uterine contraction ?
-Decrease art. Supply to the intervillous space
-Decrease uterine venous outflow during contraction
379. The most common indication for amniocentesis is :
-Maternal age is more than 35 years
-Past history of down syndrome
-Past history with baby with NTD
380. Pt. With amenorhea, She was using BCP. Which is helpful test to check the endometrial function ?
-Progesterone challenge test
381. Young lady in labor, PV shows cervical dilatation of 3 cm. partially effaced cervix, uterine contraction every 5-10 min. & lasting 20-30 sec. What is true ?
-This is an active phase
-This is a latent phase
-Active phase arrest
382. Pregnant Pt. Did not feel the fetal movement for the last 2 days. PE: no heart sound could be heard. What is the next step to do ?
-Non stress test
-Obstetric US
-Biophysical profile
383. Primigravida in labor. All can be given EXCEPT:
-Oxytocin
-Narcotic analgesic
NB. You can give it only in early stage of labor
384. Pt. 20 wks Pregnant with fibroid present with abdominal Pain. PE: tenderness of the lower abdominal Best management. ?
-Analgesia & reassurance
-Myomectomy
NB. Red degeneration of fibroid.
385. All are risk factors for IUGR EXCEPT:
-Absence of weight gain by the mother
-Fetal weight 2000 gm at 32 wks
-Maternal malnutrition
386. Pt. 38 wks pregnant Presented with history of clear watery vaginal discharge 2 hours ago. Management ?
-US
-Sterile speculum examination & take swab for C & S (culture & sensitivity)
-Induce labor
387. Young girl after brake up of her relationship took 18 tab. of lorazepam, she only complains of dizziness & drowsiness. After 6 h. of observation she is well, feel remorse & want to be discharged. Management ?
-Discharge her & follow up as out pt.
-Futher 24 h. observation
-Call her boyfriend
388. Young girl found in coma in the street. PE: constricted pupils (pin point) & multiple marks of IV injection. Most likely cause is :
-Heroin
-Cocaine
-Diazepam
389. Case of drug over dose with fever, tachycardia, dilated pupils & BP: 220\110. Most likely cause is:
-Cocaine
-LSD
-Heroin
-Barbiturates
390. Psychic structure that relate desire to external environment is :
-ID
-Ego
-Superego
-Self
-Personality
NB. To be checked ...
391. All are true regarding OCD. EXCEPT:
-Ego dystonic
-Ego syntonic
NB. Dystonic = OC Disorder.
Syntonic = OC Personality.
392. Which is true regarding Alzheimer's disease ?
-Apraxia, agnosia, dysphasia
-Sudden onset
-More common in male
NB. Alzheimer's F. are more than M. & its not with sudden onset
393. Which of the following cause drug induced dementia ?
-Diazepam
-Imipramine
-Triazolam
394. Psychotherapy superior to medication in
-Schizophrenia
-Alcoholism
-Drug induced delirium
-dysthimia
395. Which is true regarding suicide in adolescent ?
-More common in summer
-Attempt to suicide is more common in F. Than in M.
-More common in F.
396. Child 9 years old studing in kindergarten, is unable to read, write or even to color a picture. He becomes happy when he answers simple questions. What is your diagnosis ?
-Autism
-Mental retardation
-Specific learning disability
397. What is the best management. of school phobia ?
-Force him to go to school
-Keep him at home until he miss his friends in school
-Give him anxiolytics
398. Which is regarded as an arousal symptom of PTSD:
-Restricted affect
-Feeling of detachment
-Hypervegilance
399. Pt. With multiple trauma came to hospital shocked but he is agitated & violent. Management Regarding treatment ?
-Wait until he becomes more shocked
-Sedate him & treat
-Treat him immediately even if you may physically restrain him
400. M. 33 years present with sudden onset of mood & memory changes, mute.on admission he developed convulsions. Diagnosis. ?
-AIDS Dementia complex
401. The most imp. Cause of increased complications of measles in developed countries is :
-Inadequate immunization
-Inadequate nutrition
402. Study has been done between risk factor & a disease, Ods ratio was 2.3. what is true ?
-There is significant association between risk factor & disease.
-The disease is 2.3 times more in those having risk factor
403. Which is the most practical measure to reduce occupational deafness ?
-The usage of daily prophylactic ear plugs during duty
-Measuring the noise frequency
-Usage of ear protection
404. All are true regarding incidence EXCEPT:
-Take only the new case in consideration
-Estimate the risk of acquiring the disease In community
-Useful measure of disease Problem in community
-Useful for both acute & chronic disease
405. Which of the following is true regarding non Ionizing radiation ?
-Can cause Chronic bronchitis
-Can cause Loss of vision
-Can cause cataract
406. Which is not true regarding O3 ?
-Increased around photocopy machine
-Can be harmful at ground level
-Its mainly due to incomplete combustion of fossil fuels
407. In placebo treatment . All are true EXCEPT:
-Response to placebo indicate that the cause is psychogenic
-Repeated use decreases its efficacy
-1\3 of those with organic causes respond to the placebo
408. All are true regarding the role of physician in trauma pt. EXCEPT:
-Assess the pt. Condition clinically
-Can determine the duration of treatment
-Estimate the compensation of the pt.
409. Information about mortality in Canada can be obtained from
-Canada statistics
-Public health center
-Out pt. clinic
410. Child 4 months old age. He must get his second vaccination. His mother is worried about the risk of fever. What is your advice ?
-Give antibiotic if temp. More than 39 C .
-ASA if temp. rises
-Give acetaminophen now & qid later .
-Call the doctor if temp. Rises more than 39 C
411. Baby 4 months of age. Microcytic hypochromic anemia. What is the
Cause ?
-Breast feed only
-His mother was taking erythromycin during pregnant
-Prematurity
412. Child with microcytic hypochromic anemia. His mother blood film shows basophilic stippling & microcytic hypochromic anemia. Similar finding were found in the father. Next step ?
-CBC
-Serum ferritin
-Packed plasma
-HB electrophoresis
413. An African 4 years old child, with dark urine, treated for a respiratory tract infection by Septrim, present with jaundice & pallor. What is the diagnosis. ?
-G6PD
-Cycle cell anemia
-Thalassemia
414. A Chlid with ALL. Will present with all of the following EXCEPT:
-Anemia
-Infection
-Thrombocytopenia
-Heamoglobinuria
415. Newborn 4 days old, with poor feeding, mottling skin, temp. 36.5, after stabilizing the baby, what is the next step ?
-ABG (art. blood gas)
-LP
-Electrolytes
416. Child with sever vomiting & diarrhea , became lethargic with sunken eyes, mottling skin, low BP, Increase pulse, Na 150 mmol ,what is your management. ?
-Plasma 10 cc\kg within 1st h.
-5% dextrose 20 cc\kg. Within 1st h.
-0.9 normal saline 20 cc\kg. Within 1st h.
417. Child with moderate to severe dehydration. Which of the following investigation helps in your management ?
-CBC
-Blood urea
-Electrolytes
418. Child with severe dehydration Na 170 mmol. What is the complication expected during your management. ?
-Shock
-Death
-Convulsions
NB: convulsions may happen due the rapid correction of hypernitremia. In hyponitremia cerebral edema may be developed due to rapid correction
419. All can cause abdominal Mass in neonate EXCEPT:
-Wilm's tumor
-Hydronephrosis
-Neuroblastoma
-Meckl's diverticulum
420. What is true regarding congenitla pyloric stenosis ?
-Commonly present at 3 months
-Associated with metabolic acidosis due to vomiting
-Visible peristalsis is seen in abdomen
421. Child with nephrotic syndrome presented with fever, abd. Pain & ascitis. What is your next step ?
Abd. Xray
US
Parasynthesis
422. A child presented with fever & small white lesion on the mucous memb. of the mouth followed by generalized macular papular rash. What is the manag. ?
Give ASA to decrease fever
Give gamma Ig.
Notify the public health unite
Isolation of the family member
NB: diag. Is Measles
423. Child 15 yrs present with BP. 155\90 mmHg. What is your manag. ?
Restrict salt in diet
Diuretics
Repeat measurement of BP at different times
Haloperidol
424. How can you diag. A 2 yrs old child with an HIV (+ve) mother ?
Urine analysis
CBC
CD4\CD8 ratio
ELISA
425. Child 12 yrs present with constipation , decreased school performance & suppressed growth for the last 12 months. Diag. ?
School phobia
Hyperthyroidism
Hypothyroidism
426. Newborn 10 days developed unconjugated hyperbilirubinemia, he was born at term. & he is otherwise well. Diag. ?
Galactosemia
Kernicterus
Breast milk jaundice
427. Child present with sore throat, fever & diagnosed as Infectious mononucleosis. He was treated conservatively but he returned to u with a severe pain in the throat. Manag. ?
Give ampicciline for 10 days
Throat swab for C&S
Xray
428. Child 18 months old present with generalized convulsions for 20 minutes. He has history of UTI, no history of similar attack before. After he was given O2 what will be the appropriate step in the mana. ?
Rectal diazepam
Rectal paraldehyde
Phenobarbital IM.
429. Preterm baby with feature suggest Iron def. Anemia. When will u give Iron supplement ?
3 months of age
5 months of age
4 wks of age
430. Child 9 yrs old with enuresis. Its usually associated with:
a part of generalized anxiety disorder.
UTI
431. How to differentiate between diverticulosis & proximal CA in narrowed segment of colon ?
-Colonoscopy & biopsy
-Sigmoidoscopy
-Barium enema
432. Pt. Complains of constipation, abdominal pain & frequent diarrhea mainly in the morning & with NO other problems. Diag. ?
-IBS (irritable bowel syndrome)
-Diverticulosis
433. Pt. With pleural effusion on the Rt. Side with no apparent lesion. Manag. ?
-Thoracocentesis
-Thoracotomy & biopsy
-CT
434. Drug causing mania EXCEPT:
-Steroid
-Cimetidine
-Imipramine
435. What is the most helpful sign in diagnosing inguinal hernia in children ?
-Thickening of the cord
-Wide external ring
-Bulging at the groin
436. Pt. Complain of headache, vomiting following Rt. Hemianopsia. Diag. ?
-Migraine
-Amaurosis fugax
-Rt. Retinal art. stenosis
437. Liver cirrhosis pt. Comes with massive heamatemesis. What is the best next step ?
-Vit. K IV.
-Factor II , VII , IX , X
-Give packed (whole) blood transfusion
438. Which is not true in a pt. With mycoplasma pneumonia ?
-Fever , persistent hacking cough
-Headache, diarrhea & non exudative pharyngitis
-Associated with erythema multiformis
-Associated with bullous myringitis
-Can cause rapid progressive pneumonia with cyanosis
NB. Its the walking pneumonia in young man ...
439. Newborn pale, HR = 80\min. Respiration is Irregular & slow, flabby, lazy, & he is weak for irritability. What is the APGAR score ?
-2
-3
-4
-5
-1
440. Pt. With syphilis & (+ve) VDRL 1:20 before. He receives penicillin for 2 months & the titer is 1:6 now. Which of the following is true ?
-Good response to treatment
-Decreasing in titer should be more faster
-Pt. Is immunosupressed
-Bacteria develop resistance to penicillin
441. Which of the following benefits from vasodilatation ?
-Cor pumonale
-Subaortic stenosis
-Mitral insufficiency
-Mitral stenosis
-ASD
442. Absolute contraindication of BCP. Is :
-History of Pulmonary embolism
-Migraine
-HT.
443. Which is true regarding the diag. of brain death for organ transplantation ?
-Absence of all spinal reflex
-EEG completely for 48 h.
-Could be diagnosed clinically
444. Vit.D deficiency associated with all EXCEPT:
-Hypocalcemia
-Hyperphosphatemia
-High ALP (alkaline phosphatase)
445. Vietnamese Pt. Has 15 mm. (+ve) Mantoux test (Tuberculin test) & (-ve) cytology. Manag. ?
-Treat the pt. without regard to sputum cytology
-Repeat Mantoux test after 3 years
446. Treatment of pt. With dystonia is :
-TCA
-MAOI
-Benztropine
-Haldol
447. Newborn with small head, small palpebral fissure, small philtrium & small eyes & flattened meat facial area. Diag. ?
-Fetal alcohol synd.
-Down synd.
-Edward synd.
-Turner synd.
448. 20 wks Pregnant with family history of Down synd. Which of the following should be done to rule out Down synd. ?
-Amniocentesis
-Chorionic villous sampling
-Abd. US
449. Which of the following is the treatment of choice of Rheumatic Fever ?
-Aspirin orally
-Benzathine penicillin G (1.2 million IU) IM.
-Penicillin IV.
-Ceftriaxone IV.
450. Sickle cell anemia with fever & severe abd. Pain. Manag. ?
-IV fluid, blood culture, antibiotics
-IV fluid, narcotic, blood culture
-Blood transfusion
451. Pt. With bilat. Lower limb pain exaggerated by night, nocturia & no history of urine incontinence. Investigation reveals glucosuria. Diag. ?
-Massive cord compression
-Diabetic peripheral neuropathy
-Herniation of spinal disk
452. All are true regarding folate deficiency EXCEPT:
-MCV = 96
-Normal serum folate
-Thrombocytopenia
NB: MCV has to be more than 100
We check the RBC folate & not the serum folate.
453. The company need to change the dipstick for detection of proteinuria because it was detecting it in low threshold (No. of false positive was high). Now it increases the threshold of the screening test to detect proteinuria. This will affect the test in terms of :
-Increased sensitivity & specificity
-Increased No. of FP.
-Increased No. of FN.
NB. Increasing the threshold will result in decreased sensitivity & increased specificity.
454. Best treatment for DM. type I is:
-Short acting insulin + NPH
-Short acting insulin + long acting insulin
-Utra acting insulin
-NPH + long acting insulin
NB. MCCQ E6. (2001)
456. Pt. Returned from vacation he is hypertensive on thiazide. He now complains of pain, swelling of Rt. Knee joint & fever. Best manag. Is ?
-Knee aspiration
-Serum uric acid level
NB: thiazide may cause increase level of Uric acid which can cause the swelling of the joint
457. RA. Pt. on gold salt + hydrochloroquine develop proteinuria & ascitis. What is the cause of his condition ?
-Due to his chronic dis.
-Due to Gold salt
-Due to hydrochloroquine
458. Which is true regarding Acoustic neuroma ?
-Decrease bone conduction in the same side
-Increase bone conduction in the same side
-Increase bone conduction in the same side
459. In Rt. Serous otitis media, Webber will give :
-Decrease bone conduction in the Rt. Ear
-Decrease bone conduction in the Lt. Ear
-Increase bone conduction in the Rt. Ear
460. The most predisposing factor to HT. is :
-Alcohol
-Hereditary
-Smoking
-Obesity
461. Which is the least cause of HIV infection :
-Homosexuality
-Prostitution
-Drug abuse (1999)
-Blood transfusion (1988)
462. Hypotonia, hypoglycemia, hepatosplenomegaly & poor feeding infant. Diag. ?
-Septicemia
-Glycogen storage dis.
463. Pregnant 14 wks with hydatid mole. Best treatment is ?
-Dilatation suction curettage
-Hysterectomy
-Hysterotomy
-Methotrexate
464. Pt. Came with multiple trauma. Which will u treat 1st ?
-Tension pneomothorax
-Cardiac tamponade
-Aortic rupture
-Skull fracture with visible brain
465. Pt. With multiple fracture in ICU. He developed dyspnea, increased CO2, decreased O2. Xray shows bilat. Infiltration (ARDS). Manag. ?
-Intubation & ventillation
-O2 mask
-HCO3 IV.
466. In sexually abused Child. Which will be the most suggestive sign:
-Vulva bruise
-Laceration on the labia
-Ruptured hymen
-Labial agglutination
467. Pt. With breast CA underwent operative surgery & chemoradiotherapy, she developed pneumonia followed by death. What is the underlying cause of death?
-Cytotoxic chemotherapy
-Breast CA
-Pneumonia
468. What is the most dangerous complication of maxillary sinusitis ?
-Periorbital cellulitis
-Cervical adenitis
469. What is the treatment of Tourettes syndrome ?
-Haldol
-Fleuxetine
-Lithium
-Cognitive behavioral therapy
470. Which is true regarding a childhood Schizophrenia ?
-Diagnostic criteria like adults
-Hallucinations & delirium are rare
471. Dysmenorrha in an 18 yrs old is mostly associated with:
-Normal pelvic exam
472. Retroverted uterus is mostly associated with
-Endometriosis
-Low back pain
-Infertility
473. All of the the following can be in the manag. hypercholestorelemia EXCEPT:
-Conservative for 4 to 6 months
-Simvastatin
-Serevastatin
-Lovastatin
-Liposuction
NB. Withdrawn from the market in Canada in August 2001 due to increase risk of death with this Serevastatin.
474. Which of the following will be a good treatment for ovarian tumor according to its adequacy ?
-Surgery
-Radiotherapy
-Chemotherapy
475. Post-pelvic radiation pt with diarrhea. What is the most common cause ?
-proctitis
476. Hydronephrosis associated with all EXCEPT:
-Post-uretral valve
-Obstructive uropathy
-BPH
-Nephrotic syndrome
477. Which is associated with dysuria but no pus cells in urine ?
-UTI
-Vulvovaginitis
478. Which is not associated with occupational asthma ?
-Polyvinyl chloride
-Isocyanate
-Anhydride
-Antibiotics
-resin
NB: polyvinyl chloride causes liver & brain CA.
479. Sexual abuse is associated with all of the following EXCEPT:
-Development of secondary sexual characteristics
-Most of assailants are known to the victim
-More common in F. Than in M.
-Specific or generalized fears, depression & night mares
480. Which is false regarding anencephaly in pregnancy:
-Sampling of umbilical art. Will not reveal the diag.
-4 mg. Folic acid is prophylactic
-Higher dose given for a pregnant who has history of anencephaly
-Amniocenthesis used in diag.
-Associated with high alpha fetal protein in mothers serum
NB: the correct dose should be (0.4 - 1 mg) in all pregnant women & we increase the dose to 4 mg if the pregnant has a history of NTD.
481. Which is contraindicated in the last trimester ?
-Sulfonamide
-Ampicillin
-Diazepam
-Heparin
NB: increased risk of kernicterus
482. What will be the effect of Diazepam taken by a breast feeding mother on -her child ?
-Hypotonia
-Hyper ventilation
-Intra ventricular hemorrhage
483. Which of the following is contraindicated on pertusis vaccine ?
-Egg allergy
-Encephalitis after the previous dose
-Upper respiratory tract infection with slight fever
484. Child with bloody Diarrhea with dehydration can be managed by all EXCEPT:
-Loperamid
-Metronidazol
-Rehydration
-Stool culture
485. What is the complication caused by forceps delivery ?
-Cephalohematoma
-Caput succidanum
486. Complications caused by Vaccum delivery is :
-Cephalohematoma
-Caput sucidanum
-All of the above
None of the above
487. Which is not true in IUGR (Intrauterine Growth Retardation) :
-Absence of weight gain
-Maternal short stature
-Low fundal height
488. A study reveal that 10 yrs experienced driver contributed to 60% of accident. 5 yrs experienced driver contribute to 30%. & those with 2 yrs contribute to 10%. The conclusion was that the more experienced driver are more careless in driving. This conclusion is not right because of :
-It's not measuring the incidence of accident
-It's not standardized to the age
-Because there is no control group
489. Study about the benefit of exercise in decreasing the risk of heart dis. Applied to a group of voluntaries in the factory with a control group of the rest of the factory. Follow up was regular. The check up shows lower rate of IHD. Ischemic Heart Dis. In exercising group (voluntaries). The conclusion that exercise protect against IHD. may be rejected because of:
-Selection bias
-Only M. Were included
-Only one company was involved
-Some IHD may be silent
490. Differentiation between schizophrenia & mania:
-Thought broadcasting
-Flight of ideas
491. Which is false about Down syndrome ?
-Rocker Bottom Foot
-Brushfield spot
-Upward standing palpebrale fissure
-Brachiocephaly
492. In 15 wks. Normal pregnancy u will find all EXCEPT:
-Increased BP
-Fundal height midway between symphysis pubis and umbilicus
-Increased heart rate
493. Opiate abuse is commonly associated With:
-Miosis
-Euphoria
-Perforation of nasal septum
494. Old pt. Abused by his wife complain to u, you will do all the following EXCEPT:
-Send the pt. To day care
-Frequent visit to house
-Reassurance
495. Pt. Died after suffering from TB, what will you write in death certificate as cause of death ?
-Cardiac arrest
-TB
-Fever
-Loss of weight
496. ADHD associated with all the following EXCEPT:
-Stereotyped movement
-Short attention span
-Hyperactivity
-Impulsivity
-Interference with family & social functioning
497. Which of the following is contraindicated with tyramine rich food (cheese) ?
-Imipramine
-Phenelzine
-Fleuxitine
498. Which increases the risk of MI. ?
-History of father with MI
-History of smoking
-History of high animal fat diet
499. Pt. With chronic pain, can be treated with all EXCEPT:
-Biofeed back
-Operant conditioning
-Desensitization
500. Which of the following is most compatible with interstitial lung dis. ?
-Severe hypoxia on exercise (decreased PaO2)
-Emphysema
-Increase CO2 & O2
501. What will be your next step on a pt. with normal breast at PE. & -Abnormal mammogram ?
-Biopsy guided by wires
-Exisional biopsy
-Repeat after one year
502. All are part of the normal vaginal flora EXCEPT:
-Peptostreptococus
-Lactobacillus
-Staphylococus
-CMV
503. Which is the most likely to be associated with Leukemia ?
-Aromatic hydrcarbones
-Ionized radiation
-Benzoalphaperines
504. Surveillance in medical worker for radiation hazard include all EXCEPT:
-Heamatological examination
-Annual PE.
-Labelled panding
-Total body radiation count
505. All are true regarding aseptic meningitis EXCEPT:
-Increased chloride
-Normal blood sugar
-Increased lymphocyte
-Slight protein increase
506. Dysplastic nevi associated more with:
-Subungual
-Elevated
-Hypertrichosis
507. Drainage of lymph in lower vulva:
-Inguinal LN.
-Internal iliac LN.
-ParaAortic LN.
508. BCP reduces risk of which of the following ?
-Breast CA
-Endometrial CA
509. The most common complication of low dose of BCP is:
-Brake through bleeding
510. Pt stop her BCP & ask your advice for time of conceiving. What will u tell her ?
-Body tepm. Chart
-Pregnancy after 6 months
-Bleeding will occur within 28 days
-Try to conceive after she got the menstruation
511. Which is the best source of information for pt. With poisoning by a toxic substance ?
-Public health unit
-Environmental health protection unit
-Toxicology unit
512. Which is true regarding urticaria ?
-In 80% of cases the cause is not apparent & It'll resolve spontaneously
513. Regarding smoking cessation. All are true EXCEPT:
-Decreased lung CA occurrence as other nonsmoking population by 2-3 years of cessation
-Improvement of claudication
514. Gun shot to the lower abdomen, pt. Is in shock with BP 70\30 what is your immediate management. ?
-Laparotomy
-Peritoneal lavage
515. In cushing syndrome you find all EXCEPT:
-Low BP.
-Obesity
-Striation of skin
-Trunk obesity
516. Old pt. With history of head trauma, he has changes in behavior with frequent vomit & headache. U do All EXCEPT:
-Head CT
-Catheter
-IV. Fluid
-LP
517. (Case of Invalid consent eg.) Taking consent from a premedicated pt. On the way to theater for some procedure.
518. Thiazide is best ro be given to old hypertensive pt. With :
-Vasovagal attack
-DM.
-Gout
519. Pt. With suprachondilar fracture with splint & he is in complete flexion. He develops ischemia. What will be the initial management. ?
-Remove splint & flex the arm
-Keep splint & extend the arm
-Remove the splint & extend the arm
-Angiogram of brachial art.
520. Pt. Who ate BBQ. Developed diarrhea. Blood count shows eosinophelia. The best investigation to be done to reach the diagnosis ?
-Muscle biopsy
-Stool culture
-Stool microexamination
521. Pregnant came with breech presentation at 39 wks. All other parameters are normal. Management ?
-Continue ANC (antenatal care)
-C-section
-Normal vaginally delivery
522. Which is the most indicative of fatal distress:
-Base line heart rate at 115 beat\min
-Occasional late deceleration
-Early deceleration
523. Pt. On 100% O2 & ventilator.
PaO2 = 93%
PaCO2=56%
pH=7.3 HCO3=31
What will be your management. ?
-Decrease O2 saturation
-Increase respiratory rate
-Increase tidal volume
524. Laryngeal polyp can be caused by all of the following EXCEPT:
-Present medication
-Smoking
-Allergy
525. A secretary complains of painful lesion 7.5 cm above the anus in the anal cleft. Diagnosis. ?
-Infected pilonidal sinus cyst
NB. MCCQ 2001 (GS26)
526. Pt. With sigmoid volvulus. Management ?
-Sigmoidectomy
-Decompression by sigmoidoscope
-Hydrostatic barium enema
527. Pt. Present with dyspnea & fever 38.5 , 36h. Post-op. Diagnosis. ?
-DVT
-Atelectasis
-Pulmonary Embolism
528. What is true regarding mastitis ?
-Usually treated by I&D
-Temp. Never more than 39
-Associated with supressed lactation
-Usually start 2-4 wks. Postpartum
529. Which of the thyroid CA. Has the best prognosis ?
-Folicullar
-Papillary
-Anaplastic
-Medullary
-Embrionic
530. Burned Pt. Presented unconscious to ER. PE: smoke in the mouth, black tongue, intact pharynx & he was NOT cyanotic. What do u expect to find ?
-Low PaO2
-Carboxyheamoglobine more than 35%
-PaCO2 = 56 mmHg.
NB. To be checked ...
531. Post-op pt. Present with hypotension & central venous pressure 16 cm H2O. Diagnosis. ?
-Hypovolemic shock
-Cardiogenic shock
532. All are true regarding thoracic dissecting aortic aneurysm EXCEPT:
-Severe chest pain
-Systolic murmur, when present, is of great significant
-Involvement of aortic arch may lead to stroke
-Asymmetrical peripheral pulses
533. Most common indication of cricothyroidotomy is:
-Multiple severe facial injury
-Fracture C5-C6 with dislocation
534. Anal skin tags in a child is commonly associated with:
-Crohn's disease
-Chronic anal fissure
-Hemorrhoids
535. Lady 20 years presented with 3 cm mobile breast mass, it was increasing in size for the last 4 months. Diagnosis. ?
-Fat necrosis
-Fibroadenoma
-Firocystic disease of the breast
536. F. pt. Presented with history of abdominal Pain , fever , vomiting , the pain shifted to the Rt. Lower quadrant. The pt. Improved after a conservative treatment. 10 days after he present with R. abdominal Mass. Diagnosis. ?
-Appendicitis
-Apendicular abscess
-Acute sulpingitis
537. Which of the following is true regarding extraintestinal manifestation of an IBD of unknown origin ?
-Total colectomy result in relief of extraintestinal signs & symptoms
-Extraintestinal symptoms may precede gastrointestinal symptoms
-Arthritis usually involve small joints
-Arthritis are more cþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@
-Stop antihistamine 2-4 wks before
-Stop BCP 4-6 wks before
-Continue both drugs
NB: BCP will increase the risk of hypercoagulable state
541. What is Mallet finger ?
-Fixed flexion of DIP. With loss of active extension caused by rupture of the extensor tendon.
NB: MCCQ 2001 (PL9)
542. All the following occurs in intestinal obstruction EXCEPT:
-Distention
-Increased bowel sounds
-Guarding
543. Post-op lady complain of red painful swelling, calf is free of pain. Diagnosis. ?
-DVT
-Superficial thromboflebitis
544. The most consistent finding in Fetal Alcohol Synd. is:
-Microcephaly
545. Young boy with abdominal Mass not moving with respiration. All can be diagnosed EXCEPT:
-Wilm's tumor
-Neuroblastoma
-Double jejunum
-Meckel's diverticulum
546. Cholostrom protects infection by:
-IgM
-IgA
-IgG
547. Child have ingested 20 tablets of Iron. All can appear EXCEPT:
-Necrotizing Enterocolitis
-Shock
-Metabolic acidosis
-Coma & death
-Cerebellar involvement is an early symptom
548. Pt. Present increased ALP (alkaline phosphatase) & normal Ca++ . Diagnosis. ?
-Pagets dis of the bone
-Scurvy
-Hyperphosphatemia
549. All are irritant to mucus memb. EXCEPT:
-SO2
-NO2
-CO
550. In coarctation of the aorta we find all EXCEPT:
-Delayed radial femoral pulse
-Increase upper limb BP.
-Continues mumur in the chest
551. What is the most imp. risk factor for stroke ?
-Smoking
-Systolic HT.
552. What population group is expected to increase in Canada next years ?
Neonates
-10-15 years.
-20-40 years.
-40-65 years.
-Above 65 years.
553. The prevalence of a recessive gene is 1:40000. What is the prevalence of the disease In community ?
-1:200
-1:400
-1:4000
NB: square root of the 1:40000 = 1:200
554. What is the policy of Canada to decrease the health expenditure ?
-Advise the health professional to use the health resources
555. Pt. Presented with cardiac arrest. Which describes the best action ?
-IV lidocaine routinely given
-IV Adrenaline every 10 min.
-Chest compression will keep circulation for cerebral flow
-Atropine every 2 min.
556. F. Pt. Comlain of paralysis of the Rt. Side of body after divorce. What is your diagnosis ?
-Conversion disorder
-Malingering
-Factitious disorder
557. Nurse with repeated attack of hypoglycemia. Investigation reveal increased serum insulin but low serum C-peptide. Management ?
-GH test
-GTT (glucose tolerance test)
-Psychiatric assessment
558. Erb's palsy associated with
Shoulder distocia
559. The maneuver of Flexion of the thighs against the hips is helpful in the delivery of:
-Shoulder dystocia
560. The most common cause of late postpartum hemorrhage is
-Uterine atony
-Evacuation of vaginal hematoma
-Subinvoluted uterus
-Cervical laceration
561. Lady after a prolonged labor she delivered a 4 kg. Neonate. She is not able to urinate. Diagnosis. ?
-Urethral trauma
-Maternal dehydration
-Uterine atony
-Bladder atony
562. Postpartum lady present with failure to lactate, generalized weakness, you do all the following EXCEPT:
-TSH
-T4
-FSH & LH
-prolactine
563. Individual % of infertility, what is the highest ?
-Uterine abnormality
-Male factor
-Ovarian cause
-Cervical cause
564. Primigravida in labor, fetus at 0 station, cephalic presentation, occiputo-transverse, cervix 4 cm dilated for 6 h. Efficient uterine contractions every 5-10 min. lasting 10 sec. What is your diagnosis ?
-Obsructed labor
-Normal latent phase
565. Propranolol is used in all EXCEPT:
-Bipolar disorder
-Aggressive violent disorder
-Social phobia
-Lethium tremor
-Acathesia
566. The natural growth rate =
-Birth rate - immigration rate
-Birth rate - death rate + immigration
-Birth rate + immigration rate
567. While you are waiting for Culture & sensitivity test. What will you treat shigellosis with ?
-Ampicillin
-TMP\SMX
-Erythromycin
568. Child with BP 150\90 mmHg. You suspect coarctation of Aorta. What is the most common finding ?
-Increase BP. In Rt. Upper limb than in the Lt. Upper limb
-Increase BP. In lower limb more than Upper limb
-Increase BP. In the Upper limb more than the lower
569. Pt. With DM. Presented with history of diarrhea. What is the most likely cause ?
-Autonomic diarrhea
-Infectious diarrhea
-Inflammatory diarrhea
570. Young single M. With history of dementia, ataxia & cognitive disorder. Diagnosis. ?
-Depression
-AIDS related dementia
-Alzheimer's disease
571. F. Came with history of fever 39 , abb. pain. PE: febrile, bilateral lower abdominal pain with Lt. side Mass tender. One week ago pt. was diagnosed with clamedia by culture & sensitivity. Whats your approach to treat her ?
-Ceftriaxone
-Oral Doxycycline
-Out patien oral Doxycycline & IM. Ceftriaxone
-Inpatient oral Doxycycline & IV. Ceftriaxone
572. Pt. With repeated abortion. All are possible causes EXCEPT:
-Decreased lutheal phase
-Septate uterus
-Incompetent cervix
-Rupture heamorrhagic corpus luthium
573. Pt. came with an acute episode Lt. Renal colic, IVP shows Lt. Calculi at the ureter at the level of L.4 . There is small dye leak beyond the calculi, Lt. Kidney enlargement. Management ?
-Hydration
-Observation
-Remove the stone by retrograde cystoscopy
-Lithotripsy
574. Young man came with history of automobile accident, multiple anterior chest fracture and hoarseness , chest x-ray shows widened mediastinum, whats your immediate management?
-Intubation
-Support the anterior chest fracture
-Pericardial synthesis
-Aortic angiogram
575. Schizophrenic Pt. on phenothiazine came with history of gremacing, purposeless movements of the limbs, Diagnosis. ?
-Tar dive Dyscanasia
-Acathesia
-Neurolyptic Malignant Syndrome
576. A known Pt. With bipolar disorder brought to u with history of agitation , paranoid, delusion, and grandiosity . Whats your action ?
-Benzodiazepen
-Lithium and Antisycotic
-Antisycotic
-Antidepressant
577. Pt. Came to u after he divorced his wife, he has history of depressed mood, which of the following factors prompts you to start antidepressant ?
-History of divorcing before
-History of mother and sister treated with antidepressant
-History of alcohol
578. What is the commonest complication of DT. ?
-Heart failure
Renal failure
Respiratory failure
579. All are true regarding Hantington disease EXCEPT:
Onset at mid 60's
Autosomal dominant
Progressive disease
Associated with depression
Association with dementia
NB. The normal age of onset is between 40's & 60's
580. In thyrotoxicosis all are true EXCEPT:
Amenorrhoea
Weight loss
Change of appetite
581. The best time to amniosenthesis is:
16 wks
12 wks
20 wks
30 wks
582. F. Pt. 82 years, she has been on digoxin 25 mg & hydrochlorothiazide 50 mg daily for chronic congestive heart failure. Now she has increasing dyspnea. Lab finding:
Heamoglobin 12.5 gm\100 ml
BUN=18 mg\100 ml
Na=135 mEq\L
K=3.1 mEq\L
Cl=90 mEq\L
HCO3=30 mEq\L
C-X ray shows evidence of pulmonary congestion and ECG shows an atriel rate of 250\min, variable A-V block and a ventricular rate of 100\min. management. ?
-Continue digoxin & increase hydroclorothiazide to 50 mg\day
-Continue both the Digoxin and hydrochlorothizideand begin Furosenamid 40 mg daily.
-Stop Digoxin & Hydrochlorothiazid and begin potassium supplements
-Continue digoxin & stop hydrochlorothiazide & add K suplements
-Stop all drugs & immediatly carry on electrical rhythm reversion
583. Which of the following abnormalities is not true paradoxical:
-Paradoxical respiration
-Paradoxical Embolism
-Paradoxical Pulse
-Paradoxical Splitting of the 2nd Heart sound
584. A child with known Juvenile polyposis. What will be the most likely complication ?
-Diarrhea
-Painless bleeding
-Painful bleeding
-Cancer
-None of the above
585. All are associated with oligohydramnios EXCEPT:
-Renal agenesis
-Polycystic kidney
-Meningiocele
-Potter's syndrome
-Amniom nodosom
586. Neonate 1 month with pneumonia. What is the most likely causative agent ?
-E. Coli
-GBS
-S. Pneumoniae
-H. Influenza
-N. Meningetidis
587. Pt. Present with convulsion after she has been on IV fluid for a long time. Investigation shows
Na=120
K=3
HCO3=16
What will be the best treatment ?
-Normal saline
-Hypertonic saline + diuretics
-5% dextrose
-Furosemide
-Phenytoin
NB: MCCQ 2001 (NP11)
588. You can do ALL Regarding shoulder dystocia EXCEPT:
-Oxytocin
-Flex the mothers leg
-Break the clavicle
-Rotate the shoulders
-Suprapubic pressure
589. The most common complication in Epidural anasthesia is:
-Hypotension
590. All are side effects of B agonists during preterm labor EXCEPT:
Acute Pulmonary Edema
-Tachycardia
-Angina
-Increase of glycemia
-None of the above
591. Pt. Complains of pain in the LLQ. & fever. PE: slight abd tenderness. What do u do to confirm the diagnosis ?
-Biopsy
-Barium enema
-Peritoneal Lavage
-Rectosigmoidoscopy
-US
NB: diagnosis Is diverticulitis
592. Known alcoholic arrived to ER with large bilious vomiting, then he vomited large amount of red blood & complains of pain. What is the most likely diagnosis ?
-Perforated ulcer
-Esophageal junction rupture
-Ruptured Esophageal varice
-Acute gastritis
NB: (Mallory-Weiss tears)
593. After you insure vital function (ABC) what will be your initial step in the management. of a known alcoholic pt. brought in coma ?
-Vit. B1 (thiamine)
-Lorazepam
-Look for the subdural heamatoma
-Quick control of glycemia (finger prick)
-Administer K
594. What is the most imp. Side effect of CLOMIPHENE ?
-Ovarian cyst
-Stimulation of ovulation
-Treatment of anovulation
-Anti Estrogen
595. In all there is increased IgE. EXCEPT:
-Asthma
-Chronic bronchitis
-Allergic rhinitis
-Eczema
596. In Acute colicystitis what is the pathophysiology ?
-Bacterial invasion of gallbladder
-Obstruction of the common bile duct
-Obstruction of the cystic duct
-Obstruction of the common hepatic duct
597. With HPV infection you may find:
-Purulent discharge
-Nonpurulent discharge
-Condyloma accuminata
-Condyloma lata
598. Study shows that specific mortality rate for stomach CA tends to decrease. What is the most likely explanation ?
-Decreased Prevalence
-Decrease Incidence
-Better screening
-Better treatment
599. All the following will help you to suspect menopause in a 57 years lady EXCEPT:
-Vaginal mucous atrophy
-HT
-Flush
-Sleep disturbances
-Osteoporosis
600. All are indications of chorion villous sampling EXCEPT:
-Tay-Sachs disease
-Hygroma Coli
-Turner syndrome
-Translocation
-Myelomeningeocele
601. All the following can cause bloody diarrhea EXCEPT:
-Yersinia Enterolitica
-E. Coli
-Shigella
-Campylobacter
-Giardia lamblia (Rocky M.)
602. Which germ is found in uncooked eggs ?
-E. Coli
-Staph. Aureus
-Shigella
-Giardia
-Salmonella
603. 32 years old lady with agitation, hyperthermia, palpitation , loss of weight
And sweating. What is the initial test to do ?
-Thyroxin (T4)
-TSH
-Thyroid scintigraphy
-Thyroid U\S
-Triiodothyronin (T3)
604. Postpartum Pt. Wishes to stop lactation for personal reasons , how will you prevent the pain resulting from breast engorgement?
-Prescribe Oxytocin
-Apply bandage to protect clothes
-Medical treatment is useless most of the time
-Antiprolactin
605. 45 years old male 3 months after car accident, presents with agitation, insomnia and nightmares. He is anxious and there is deterioration in the sexual relationship with his wife. Whats your diagnosis?
-Impaired intimacy with his wife
-Depression
-Masked anxiety
-PTSD
-Sexual dysfunction
606. Female 60 years old with constipation for many months, she has not passed stools for the last 3 days. On examination the abdomen is distended but non tender. What is your management ?
-Laxative
-High fiber diet
-Mineral oil
-Enema
607. Following a gun shot a Pt. Presents with a swollen right leg, distal pulse is weak, veins are distended. What is the likely cause?
-Unilateral vein thrombosis
-Arterial emboli
-Femoral nerve injury
-Post traumatic superficial vein insufficiency
-Arteriovenous fistula
608. Female 60 years old on multiple drug treatment for breast cancer with bone metastasis. Lately she had severe pain and increased dose of opioid x 3,
now she presents with constipation ,lethargy ,and apathy. Whats the likely diagnosis?
-Gastroenteritis
-Gastrointestinal metastasis
-Drug intoxication
-Fecal impaction
609. Alpha Fetoprotein is increased in all of the following except?
-Omphalocele
-Potter syndrome
-Anencephaly
-Meningomyocele
-Spina bifida
610. Which test will help to objectively diagnose fetal heart beat at 16 weeks ?
-US
-NST (non stress test)
-Doppler
-Abdominal x-ray
611. Female 18 years old complaining of primary amenorrhoea, BhCG is negative .Which test will you do to diagnose an hypothalmopituatary disease?
-Pelvic examination
-Prolactin and TSH
-CT of the sella tursica
-Provera challenge test
-FSH and LH
612. Regarding symmetrical Intrauterine growth restriction , what is the most likely cause?
-Intrauterine infection
-Maternal renal disease
-Maternal diabetes
-Drug abuse
613. Rheumatoid factor will be found in all of the following EXCEPT:
-RA & Juvenile RA
-SLE
-Sjogren's disease
-Dermatomyositis
-None of the above
614. A child with hepatosplenomegaly and mental retardation, he has positive reducing substances in the urine ,Diagnosis?
-Galactosemia
-Cystinuria
-Von Gierke disease
-Fructose intolerance
615. Child 13 years old, obese with painful right knee and right hip, he is limping. On examination there is reduced abduction and internal rotation, diagnosis?
-Juvenile arthritis
-Septic arthritis
-Avascular necrosis of the femoral head
-Slipped femoral capital epiphysis
616. A known alcoholic man admitted in the E R with fever ,coughing off profuse and purulent sputum . On examination ronchi on the right lower lung, diagnosis ?
-Lobar pneumonia
-Lung abscess
-COPD
-TB
617. A lady with occasional severe attack of dyspnea with facial edema. On examination severe respiratory distress, red and inflamed pharynx. what is your management ?
-Adrenalin for out pt. usage
-Cortison I.V
-Lateral x- Ray of larynx
-Epinephrine SC (subcutaneous)
-Intubation
618. A carpenter has difficulties holding things with hypoesthesic trouble of fingers of the the Rt. Hand. Which exam will help u to establish the diagnosis ?
-Xray of the cervical spine
-Xray of hand
-EMG
-Examination of the rotator cuff
-Neurologic exam of the hand
619. F. 70 years present with muscle weakness with dysphagia & change of the skin color of the hand induced by cold weather, with telangiectasia. Diagnosis. ?
-Dermatomyositis
-Fibromyositis
-Sclerodermia
-SLE
620. Asiatic man recently came as immigrant to Canada. He took chloroquine 4 wks & 2 days before his arrival (to treat his Malaria infection). 2 years later he develops fever of unknown origin. What is the most likely cause ?
-Malaria reinfection
-1st episode of malaria was not treated sufficiently
-The strain was resistant to treatment
-Remnant active schizontes in the liver
621. All the following are characteristics of a narcotic intoxication EXCEPT:
-Myosis
-Bradycardia
-Dry mouth
-Constipation
-Orthostatic hypotension
622. Pt. 3 days postpartum develops Endometritis. Which is not a finding in this case ?
-Low abdominal pain
-Oliguria
-Tachycardia
-Purulent lochia
-Uterus below symphysis
623. Newborn 3 wks. Hypotonic & totally constipated, his abdominal seems distended but not painful. Diagnosis. ?
-Hirschprung disease
-Hypothyroidism
-Volvulos
-Intususception
-Milk intolerance
624. What is the sign which allows you to make a difference between -ankylosing spondylitis & RA.
-Joint deviation
-Joint nodules
-Joint effusion
-Sacroiliac involvement
625. Child 9 years brought by his mother, present headache, nausea & vomiting. He feels tired & easily falls asleep. Diagnosis. ?
-Migraine
-Cerebral tumor
-Temporal epilepsy
-Simulation (faking)
626. All are characteristics of Alzheimer’s disease EXCEPT:
-Aphasia, Apraxia, Agnosia
-Loss of acquisition of recent facts
-Loss of abstract thinking
-Loss of consciousness of his environment
-Loss of old imp. facts
627. All may cause epiglotitis in a child EXCEPT:
-Hemophilus influenza
-Tobacco smoke
-Parainfluenza virus
-Hydrocarbure ingestion
-Acute allergy
628. The most common cause of PP (precocious puberty) in a girl is:
-Gonadic tumor
-Von Reclinghausen disease
-Idiopathic PP
-Adrenogenital syndrome
-Pituitary Tumor
629. Which is the commonest cause of mortality in children aged 5 A 9 years in Canada ?
-Leukemia
-Cancer
-Accident
-Congenital malformation
630. Comparing characteristics of Infectious mononucleosis in a child Vs. Adult, which of the following is true ?
-Its more severe in children
-Typical form is rare in children
-Immunization is better
-Dis. last longer
-Need to do throat culture & sensitivity
-Mono spot test is negative.
631. What will be the effect of increasing the prevalence of a disease for a screen test ?
-Increase in the sensitivity of the test
-Increase in the specificity of the test
-Increase in the PPV.
-Increase in the NPV.
-Increase in the sensitivity & PPV. of the test
632. Which is contraindicated for forceps delivery ?
-The presenting part at station -1
-3rd degree laceration
-Breech presentation
-Large caput
633. Pt. In labor after delivery of 1st twin has the other twin in vertex presentation & at station -1, memb. are ruptured. There is no contraction for 20 minutes. What will u do ?
-Oxytosin drip
-C-section
-Forceps
-Vacuum
-Wait
634. F. Came from Greece complaining from fatigue & weakness, she is pale. Investigation shows
Hb.= 10 gm \ dl.
MCV=70
What are you going to do next to reach the diagnosis ?
-Bone marrow aspiration
-Reticulocyte level
-Hb. Electrophoresis
-Serum iron level
-Trial treatment with B.12
635. Pt. 17 years with factitious disorder. All can be found EXCEPT:
-Family history of similar episode
-The pt. knows about medical treatment
-He wishes to attract attention on him
-He has a particular interest in medical profession
-Works in medical profession
636. Pt. 23 years with single thyroid nodule. What will make u suspect malignancy ?
-Thyroid US
-Cold nodule on thyroid scan
-Hot nodule on thyroid scan
-CT of the cervical spine
637. An infant present with inflamed pharynx & fever. He was treated with antibiotics. A week later he presents again with trismus. Diagnosis. ?
-Tetanus
-Pharyngitis
-Infectious mononucleosis
-Peritonsillar abscess
-Streptococal tonsillitis
638. Why is chorionic vilous sampling not commonly done in Canada ?
-Its expensive
-Doctors dont have enough experience
-Results are not reliable
-Its dangerous
-Because the prevalence of the diseases that it can detect is low
639. All can cause mania EXCEPT:
-Phenelzine
-Trazodone
-Methyphenidate
-Cortisone
-Levodopa
640. A 74 years old pt. With whitish asymptomatic urethral discharge. The investigation of the germ will reveal :
-Chronic prostatitis and gonococcal urethritis
-Non specific urethritis
-Urinary infection
-Acute prostatitis
641. What is the allowed amount of GNP (gross national product) to health in Canada ?
-4% A 8%
-8 % A 12 %
-12 % A 15 %
-16 % A 24 %
-25 % A 36 %
642. Hyperglycemic Pregnant Pt. with level 9.8 gm\L. after OGTT (oral glucose tolerance test) with 50 gm. Which of the following should not be done ?
-Prescribe chlorpopramide
-Give Insulin
-Administer B blocker
-Do a OGTT at 75 gm. at 2 h.
-Diet
NB: screening with 50 gm OGTT :
# If blood glucose between 7.8 & 10.3 mmol\L then repeat with 2 hrs. 75 gm. OGTT
# If blood glucose more than 10.3 mmol\L then diagnosis of diabetes is made ...
# Oral hypoglycemics are contraindicated in pregnancy
643. Child 6 years old brought by his mother with fever and red throat, lips fissures ,cervical adenopathies and rash of extremities. You found a fine peeling at the hands, palms and soles of the feet. you will think of:
-Streptococcal infection
-Rubeolla
-Infectious mononucleosis
-Kawasaki disease
-Measles
644. Child 12 months old adopted from eastern Europe. He presents with loss of weight and multiple adenopathies plus splenomegaly associated with skin lesion. What is the diagnosis?
-Proteino\caloric malnutrition
-Acute leukemia
-Infection with pneumocystis carinii
-Child abuse
-HIV infection
645. Form 1971 A 1992 life expectancy for men has increase from 68 A 73 years ,women 73-81 years. What is the most likely cause of these changes ?
-Vaccination
-Better management of ischemic diseases
-Use of antibiotics
-Improvement of life style
-Generalization of health care
646. All the following are a part of diagnosing leukemia in children EXCEPT:
-Thrombocytopenia
-Anemia
-Hemoglobinuria
-Granulocytopenia
-Neutropenia
647. You can do all of the following investigations in a pregnant pt. Post term EXCEPT:
-U\S for examination of amniotic fluid
-Amniocentesis for dosage of alpha fetoprotein
-BPP
-Fetal biometry
-Non stress Test
648. F. 55 years old presents for 1 month memory trouble plus hallucination, agitation, hypotension, and hot flashes. She has visual trouble with pupils fixed in mydriasis, what is the most likely causative substance ?
-Haloperidol
-Benztropin
-TCA
-Fluxotin
-Phenelzine
649. Upon the lung cancers which one is the most sensitive to radiotherapy?
-Dermoid carcinoma
-Squamous cell carcinoma
-Adenocarcinoma
-Small cell carcinoma
-Undifferentiated small cell carcinoma
650 which of the following is the main complication of dermoid ovarian cyst ?
-Infection
-Necrosis
-cancerisaton
-Torsion
651. Which of the following is a characteristic of a person with somatization trouble ?
-The person knows that he has psychological trouble
-Multiple somatization trouble
-Hypochondria
-Feeling of malformation
-Knows that his troubles are not true but he can’t avoid them
652. What’s the best criteria for estimating population health?
-Amount of money spent on health
-GDP
-Ratio of physicians per habitant
-Number of hospitals
653. What is the best way to appreciate health care quality during pregnancy and delivery in Canada?
-Neonatal mortality rate
-Perinatal mortality rate
-Infant mortality rate
-Maternal mortality rate
654. Regarding child schizophrenia which is true ?
-Signs are identical to the adults
-Risk is 10 % if one of the parents has schizophrenia
-Pronostic is good if it appears early
-Complete presentation from the beginning
-Hallucinations are more frequent
655. A couple went for holiday in Mexico, they severe diarrhea. Diagnosis. ?
-E. Coli
-Giardia lambia
-Enterobacter
-Salmonellosis
NB. The treatment of choice for traveler’s diarrhea caused by Enterotoxigenic E. Coli is : Cyprofloxacin.
656. Pt. 27 years. Known to have manic trouble for many years, he is brought to the ER. Agitated & Excited. What is the most appropriate treatment ?
-Carbamazepin
-Imipramine
-Clonazepam
-Lorazepam
-Phenelzine
657. All are part of KAWASAKI EXCEPT:
-Coronary heart disease
-Lips fissures
-Peeling of extremities
-Generalized adenopathy
-Strawberry tongue
658. Pt. Presents with lumbar pain after lifting a heavy object. Lumber X Ray shows lesions at L5-S1 level. Waht will u find on examination ?
-Absent knee jerk reflex & paresis of gastrocnemius muscle
-Absent knee jerk reflex & achiles reflex & paresis of quadriceps
-Absent achiles (ankle jerk) reflex & paresis of gastrocnemius muscle
-Absent achiles (ankle jerk) reflex & paresis of peroneal muscle
659. B agonist used for preterm labor, may cause all EXCEPT:
-Headache
-Respiratory distress
-Tachycardia
-Hyperglycemia
-Angina
NB: to be checked
660. Which of the following CA is caused by vinyl chloride ?
-Lung CA
-Esophagus CA
-Rhinopharynx CA
-Liver CA
-Bladder CA
661. Proparonol may be given in ALL the following EXCEPT:
-Hypertension
-Hyperglycemia
-Lithium induced tremors
-Panic disorder
-Chest Angina
Good Luck in the real exam ..
Done by ;
Dr. Athir Ghanim
Dr. Firas Al-Hanafi
Dr. Roger
Dr. J. C.
Dr. Tariq Al-Qubaty
1. D
2. A
3. D
4. D
5. D
6. A
7. A
8. A
9. A
10. A
11. A
12. A
13. A
14. B
15. A
16. A
17. D
18. A
19. A
20. A
21. A
22. A
23. A
24. D
25. A
26. C
27. A
28. B
29. A
30. C
31. A
32. A
33.
34.
35. A
36. D
37. C
38. A
39. A
40. A
41. B
42. D
43. A
44. D
45.
46. B
47. C
48. B
49. B
50. D
51. D
52.
53. B
54. D
55. D
56. A
57. C
58. C
59. E
60. D
61. B
62. D
63. C
64. C
65. A
66. B
67. C
68. C
69. C
70. A
71. B
72. B
73. E
74. D
75. B
76. D
77. E
78. B
79. C
80. A
81. A
82. A
83. A
84. A
85. A
86. A
87. D
88. A
89. A
90. A
91. B
92. C
93. A
94. A
95. A
96. A
97. A
98. A
99. D
100. A
101. A
102. D
103. E
104. A
105. D
106. A
107. B
108. A
109. D
110. A
111. C
112. A
113. A
114. A
115. E
116. B
117. A
118. A
119. A
120. C
121. C
122. A
123. A
124. B
125. C
126. D
127. A
128.
129. D
130. D
131. A
132. C
133. C
134. A
135. D
136. A
137. E
138. B
139. E
140. A
141. A
142. B
143. C
144. A
145. B
146. C
147. A
148. A
149. A
150. A
151. B
152. D
153. A
154. B
155. C
156. D
157. A
158. C
159. A
160. A
161. A
162. C
163. B
164. B
165. C
166. A
167. A
168. E
169. A
170. B
171. A
172. C
173. B
174. A
175. A
176. C
177. A
178. C
179. B
180. B
181. C
182. B
183. D
184. A
185. A
186.
187.
188.
189.
190. D
191. D
192. D
193. B
194. A
195. A
196. B
197. C
198. D
199. A
200. C
201. A
202. A
203. A
204. A
205. C
206. C
207. A
208. C
209. C
210. D
211. A
212. A
213. C
214. A
215. A
216. A
217. A
218. A
219. B
220. C
221. C
222. A
223. D
224. A
225. C
226. A
227. A
228. C
229. A
230. A
231. A
232. A
233. A
234. A
235. B
236. A
237. A
238. A
239. A
240. A
241. A
242. A
243.
244. A
245. A
246. B
247. C
248. A
249. D
250. B
251. E
252. B
253. D
254. C
255. C
256. C
257. A
258. B
259. A
260. B
261. A
262. B
263. B
264. A
265. B
266. C
267. A
268. A
269. A
270. A
271. B
272. A
273. C
274. B
275. B
276. C
277. B
278. A
279. D
280. A
281. B
282. D
283. B
284. E
285. C
286. B
287. E
288. D
289. D
290. A
291. D
292. C
293. B
294. C
295. D
296. E
297. C
298. C
299. B
300. C
301. E
302. B
303. B
304. D
305. D
306. E
307. E
308. C
309. D
310. A
311. A
312. C
313. B
314. A
315. A
316. A
317. A
318. B
319. A
320. A
321. A
322. A
323. D
324. C
325. D
326. A
327. D
328. C
329. A
330. A
331. B
332. D
333. A
334. C
335. A
336. B
337. A
338. B
339. A
340. E
341. A
342. A
343. D
344. A
345. A
346. A
347. A
348. A
349. B
350. A
351. A
352. C
353. A
354. A
355. B
356. B
357. B
358. C
359. A
360. C
361. A
362. A
363. B
364. B
365. B
366. B
367. B
368. A
369. A
370. B
371. A
372. C
373. C
374. B
375. D
376. B
377. B
378. A
379. A
380. A
381. B
382. B
383. B
384. A
385. B
386. B
387. B
388. A
389. A
390.
391. B
392. A
393. C
394. A
395. B
396. B
397. A
398. C
399. C
400. A
401. B
402. A
403. C
404. D
405. C
406. A
407. A
408. C
409. A
410. D
411. C
412. D
413. A
414. D
415. B
416. C
417. C
418. C
419. D
420. C
421. C
422. C
423. C
424. D
425. C
426. C
427. B
428. A
429. A
430. B
431. A
432. A
433. A
434. B
435. A
436. A
437. C
438. E
439. B
440. A
441. C
442. A
443. C
444. B
445. A
446. C
447. A
448. A
449. B
450. B
451. B
452. A
453. V
454. .C
455. A
456. A
457. B
458. A
459. C
460. D
461. D
462. B
463. A
464. A
465. A
466. C
467. C
468. A
469. A
470. A
471. A
472. A
473. C
474. A
475. A
476. D
477. B
478. A
479. A
480. B
481. A
482. A
483. B
484. A
485. A
486. C
487. B
488. C
489. A
490. A
491. A
492. A
493. A
494. A
495. B
496. A
497. B
498. A
499. A
500. A
501. A
502. D
503. B
504. C
505. A
506. B
507. A
508. B
509. A
510. D
511. C
512. A
513. A
514. A
515. A
516. D
517. A
518. A
519. C
520. A
521. A
522. B
523. B
524. A
525. A
526. A
527. B
528. D
529. B
530. B
531. B
532. B
533. B
534. B
535. B
536. B
537.
538.
539.
540.
541. A
542. C
543. A
544. A
545. C
546. B
547. E
548. A
549.
550. C
551. A
552. D
553. A
554. A
555. C
556. A
557.
558. A
559. A
560.
561. D
562. B
563. B
564. A
565. A
566. B
567. B
568. C
569. A
570.
571.
572. D
573. C
574. A
575. A
576. B
577. C
578. A
579. A
580. A
581. A
582. C
583. C
584. B
585. C
586. B
587. B
588. A
589. A
590. D
591. E
592. B
593. D
594. A
595. B
596. C
597. C
598. B
599. B
600. E
601. E
602. E
603. B
604. C
605. D
606. D
607. E
608. C
609. B
610. A
611. E
612. A
613. E
614. A
615. D
616. B
617. D
618. C
619. C
620. D
621. C
622. E
623. B
624. D
625. C
626. D
627. B
628. C
629. C
630. B
631. C
632. A
633. A
634. C
635. A
636.
637. D
638. D
639. D
640. B
641. B
642. A
643. D
644. E
645. D
646. C
647. B
648. B
649. B
650. D
651. B
652. B
653. B
654. B
655. A
656. A
657. D
658. C
659.
660. D
661. B
662.
663.
664.
665.
666.
667.
668.
669.
670.
671.
672.
673.
674.
675.
676.
677.
678.
679.
680.
681.
682.
683.
684.
685.
686.
687.
688.
689.
690.
691.
692.
693.
694.
695.
696.
697.
698.
699.
700.
701.
702.
703.
704.
705.
706.
707.
708.
709.
710.
711.
712.
713.
714.
715.
716.
717.
718.
719.
720.
721.
-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
51. 72 years old with heart failure with high blood pressure treated for long time. He was brought to E R for hypotension 80\60 HR 110, what to give ?
-Procaine
-Lidocaine
-Cardioversion
-Digitaline
-Furosemide
52. Post-op. of Pancreas .. what is the cause of hypovolemic shock ?
-Initial necrosis of acute pancreatitis has produced tripsine
-Septic shock
-Loss of liquids
-Side effect of anesthesia
NB. not sure
53. 68 years F. with history of Hysterectomy, came to see u because of micturation trouble at effort, no digestive trouble, she has a feeling of a painless mass intravaginaly, she has to try twice in order to void her bladder what is the diagnosis ?
-Rectocele
-Cystocele
-Prolapse (Prosedentia)
-Urethral sphincter spasm
-Post-surgical stricture
54. young M. feels sudden crack in his calf, what is the best clinical sign to diagnose Achilles tendon rupture ?
-Decreased dorsal flexion
-Impossibility to walk on the toes
-Increased passive dorsiflection of the foot
-Squeezing calf does not passively planter flex foot
55. farmer 74 years M. present with bilateral semetrical neaurosensorial defenses , PE is normal . diagnosis ?
-Autosclerosis
-Professional defenses
-Acustic neuroma
-Presbiacusis
-Circulatory deficit
NB. Most common cause of hear losing in elderly is presbiacusis
56. F. 45 years with decreased visual acuity, no pain , no tears. what do u exam first ?
-Tonometry
-Refraction
-Angiography
-Neurologic test
-Rheumatoid factor screening
57. Burned Infant 2nd degree in the upper limb, what do u do ?
-Debrid & skin graft.
-Debrid & bandage
-Debrid & topic cream
-Clean the wound & systemic antibiotic
-Local care only
58. Cyclist attacked by bee comes to emergency with hypotension 80\60 , Heart rate 115 .. what do u do first ?
-Antihistamine H1 & H2
-Saline perfusion
-Epinephrine Injection
-Intubation
-IV. steroid
NB. we also give it by subcutaneous or IM. & in children IV or Endotracheal tube
59. child 5 years bitten by the neighbors dog .. the dog received all the vaccines. what do u do ?
-Observe the dog 10 days & anti rabbi serum
-Observe the dog & anti rabbis serum & vaccine
-Kill the dog
-Vaccinate the kid
-Observe the dog
60. F. 28 years present with chronic rhinorrhea , in the exam you found mucousal nasal atrophy .. diagnosis ?
-Sinusitis
-Cocaine intake
-Nasal poliposis
-Allergic rhinitis
61. F. 45 years back from a plane travel , complains vertigo, tenitus, moderate hearing loss, BP is 160\110 .. Diagnosis ?
-Hypertensive crise
-Miners disease
-Migraine
-Acustic neuroma
-Barotaruma
62. what is the most common cause of lung abscess in post-Op pt.
-Bacterial discrimination from operative site
-Atelectasia
-Pneumonia
-Aspiration
63. M. 25 years when he goes to toilet, he complains of painful defecation in the anal region, at the exam you will find bluish mass at the anal margin.. what is the Diagnosis ?
-Hemorrhoids internal sclerosed
-Hemorrhoids external strangulated
-Hemorrhoids external thrombosed
-Pyelonedle cyst
-Poliposis
64. all the following tumors favorized by TOBACCO Except...
-Bladder
-Esophagus
-Liver
-Cervix
-Lung
65. 5 years child have been beaten by a dog .. he had a deep wound, the dog is in a safe place .. what do u do ?
-Disinfect & clean the wound & put bandage
66. breast feeding women with DVT. treatment. ?
-Warferin
-IV. heparin
-Antistreptocinase
-Bandage
67. immediate post-op presents sudden hallucination , agitation & pretend that was miss treated .. Diagnosis ?
-Psychosis
-Depression
-Post-op delirium
-Analgesic withdrawal syndrome
68. a pt consult u for painless testicular swelling , transilumination was (-) after minor trauma ... Diagnosis ?
-Spermatocele
-Epidedimitis
-Varicocele
-Hydrocele
-Germinoma
69. F. 47 years present with sudden strong pain of the Rt. upper quadrant with fever 38.5 vomiting, no jaundice ... Diagnosis ?
-Colidutal obstruction
-CA of pancreas
-Acute cholicystitis
-Acute hepatitis
-Biliary lithiasis
70. Pt refared to u by his dentist because of whitish lesion at the base of the tongue .. what is your attitude ?
-Biopsy
-Identification of germs
-Ask for a correction of his dental prostheses
-Treat him by anti micotic oral bath
71. young boy present with frequent episode of rhinitis with purulent discharge & fever, from a maxillary sinus, what is the most likely complication if untreated ?
-Purulent meningitis
-Ethmoidal sinusitis
-Orbital cellulitis
-Frontal sinusitis
72. F pt. PE. painless mobile mass on Rt. upper quadrant without fever or Jaundice, what is the most likely diagnosis ?
-Tumor of Lt. inferior lobe of the Liver
-Hydrocholecyst
-Tumor of superior pole of the Rt. kidney
-Liver metastasis
73. child 13 years obese present with painful Rt. knee & pain of Rt. hip with difficulty walking & reduced abduction & Internal rotation , what is your diagnosis ?
-Juvenile Arthritis
-Septic arthritis of the hip
-Avascular necrosis of femoral head
-Cartilage dysplasia
-Slipped capital epiphysis
74. Pt. fell on his hand , Emergency X Ray was normal , but the pt. complain from painful wrist at abduction. management. ?
-Cast
-Explain him that the pain will disappear after 2 weeks, its normal.
-Bandage
-Short cast plus X Ray in 15 days
-NSAID's
NB. diagnosis is Scaphoid fracture & its very difficult to see it in X Ray.
75. Indication of elastic band in Hemorrhoids is :
-Thrombosed Hemorrhoids
-Type II bleeding Internal Hemorrhoids
-External Hemorrhoids
-Angioma
76. 65 years obese Pt. complains of strong & sudden mid abdominal pain radiating to Lt. flank, what is your diagnosis ?
-Acute pancreatitis
-Cholecystitis
-Ureteral stone
-Mesenteric Infarctus
-Rupture of abdominal aorta
77. Pt. complains of Rt. upper quadrant pain & fever , PE shows slight abdominal tenderness, what investigation do u do to comfirme the diagnosis ?
-Biopsy
-Barium meal
-Peritoneal Aspiration
-Rectosigmoidoscopy
-Echography
78. most common complication of Epidural Anesthesia in a pregnant woman:
-Fetal hypoxia
-Hypotension
-Decrease in contraction
-Arrest of labor
79. Child pulled by his mother from his arms .. PE shows that one arm is adducted & the forearm is on pronation. what is the most likely diagnosis ?
-Humeral fracture
-Laxation of the Inferior extremity of the ulna
-Subluxation of ulnar head
-Rupture of rotator cuff
80. defense mechanism in phobia = displacement, avoidance
81. defense mechanism in borderline PD. = splitting
82. Pt. doing the opposite of what he believes is good = reaction formation.
83. Pt. on lithium therapy complain of fatigue , increased weight , heat intolerance , what test would you order ?
-Thyroid stimulating hormone level test
84. Pt. presented with pulmonary edema & BP. 180\95 , what is the best treatment ?
-Furesemide
85. 47 years F. with jaundice & history of nausea & vomiting , anorexia & depression , she is on Rifampicine, INH, Pyridoxine. PE Hepatomegaly + tenderness, Investigation reveal :SGOT, SGPT increased x 5, ALP slightly increased . the most likely diagnosis is :
-Drug induced hepatitis
-Viral hepatitis
-Acute pancreatitis
-Liver CA.
86. Pt. complain from visual spatial defect , where is the lesion ?
-Rt. cerebral hemisphere
-Lt. cerebral hemisphere
87. 4 years African boy on septrine for tonsillitis presented with Jaundice , Investigations : Hb. 9.8 gm % , reticulocytes count 8 % , Hb. electrophoresis : Hb.A . what is the most likely diagnosis ?
-Sickle cell anemia
-Thalassemia
-Spherocytosis
-G6PD deficiency
88. F. 65 years present with recurrent painless lower GI bleeding, colonoscopy, gastroscopy, barium enema, endoscopy & upper GI series all are normal, what is the dig. ?
-Rt. colon angiodysplasia
89. F. 50 years operated for cholicistectomy presented with heavy wound bleeding , she gives you a history of massive bleeding when she had a tooth extraction , what will you find ?
-Increased PTT + Increased BT
-Increased PTT + decreased BT
-Normal PTT + Increased BT
NB. diagnosis is Von Willebrand disease
90. pregnant woman with abruptio placenta, developed echymosis & bleeding , your diagnosis is DIC. what is the most specific test to confirm it ?
-Increased FDP (fibrine degradation product)
91. RTA (road traffic accident) Pt. with multiple fracture & trauma, 24 h later he develop tachypnea, PCO2 = 32, PaO2 = 50. X Ray shows bilateral infiltrates what is the next step to do ?
-Lung scan
-Ventilator
92. all the following are primary prevention except :
-Immunization
-Health related education
-Pap smear
93. pregnant lady developed postpartum hemorrhage after vacuum delivery , what is the most likely cause ?
-Uterine atony
-DIC
94. primigravida after delivery of a 4000 gm baby, after a prolonged labor could not urinate. What is the most likely cause ?
-Bladder atony
95. Child RTA present with urethral bleeding & urinary retention. Management ?
-Retrograde urethrogram
96. M. 25 years RTA, 4 h. Later developed Rt. Flank pain with heamaturia. What to do ?
-IVP.
97. F. 65 years complains heamaturia with clotting, frequency, nocturia & no dysuria. Diagnosis. ?
-Bladder CA.
98. What is the most likely cause of no changing in variability in fetal heart on NST (non stress test) ?
-Fetal sleep
99. NST indicated in all except :
-IUGR
-DM
-HT.
-40 weeks Pregnancy
100. The most specific test in UTI in infants is :
-Sample obtained by catheter
101. How do u calculate the natural growth of a country ?
-Crude birth rate - death rate
102. Child 4-5 years can do all of the following except :
-Imitation
-Group play
-Autonomy
-Abstract thinking
103. All of the following are normal during pregnancy except :
-Spider telangiectasia
-Heart rate of 90
-Decreased BP.
-Palmar erythema
-White blood cell 3000
NB. The WBC is increased in pregnant But with impaired function
104. What is the best treatment of mild toxemia of pregnancy ?
-Bed rest & Lt. Lateral position
105. F. 16 years old complaining of loss of weight of 10 Kg. All of the following suggest non organic cause except :
-Does not worry about weight loss
-Engaged in athletic activity
-Family history of eating disorder
-Persistent complain of fatigue
NB. Its a case of Anorexia Nervosa
106. Which of the following suggest a DM in a 20 years M. ?
-Loss of weight despite good eating
107. All of the following suggest thyrotoxicosis except :
-Loss of weight
-Meanorrghe
-Diarrhea
-Sweating
108. Young lady present a feature of hypothyroidism (cold intolerance, fatigue, anorexia, weight gain, meanorraghe, dry & rough skin, hair dry & coarse .... ) TSH is increased & T4 is low. What is your treatment ?
-Start L-thyroxine
109. Lady develop severe PPH (post partum heamorrage), she present after 6 wks with fatigue an inability to breast feed (absence of breast milk). All will be decreased except .
-Prolactin
-TSH
-LH
-T4
NB. Diagnosis. is Sheehan’s syndrome (postpartum pituitary infarct)
The T4 has got a long 1\2t ..
110. Lady 15 days after delivery complain of epigastric pain radiating to the back with nausea & vomiting , history of group B strep. Infection. The pain is relieved by leaning forward, PE. reveal an epigastric tenderness what is the diagnosis ?
-Pancreatitis
NB. The pain is relieved by leaning forward (Inglefinger’s sign)
111. Lady who delivered after prolonged labor present to you after 2 days. All of the following suggest Endometritis Except :
-Tender uterus
-Foul smelling
-Uterus 9 cm. below umbilicus
-Pyrexia
112. Lady after delivery develops fever. She still febrile after 5 days of antibiotic therapy. PV exam is normal. Diagnosis. ?
-Pelvic-thrombo-phlebitis
113. Young M. Complains of pain after defecation. PE reveal a blue mass , tender . Diagnosis. ?
-External thrombosed Hemorrhoid
-Internal thrombosed Hemorrhoid
114. Recurrent perineal abscess associated commonly with :
-Perianal fistula
115. All of the following are contraindicated to epidural anesthesia except :
-Decrease platelet
-Bleeding diathesis
-Sepsis at site of injection
-Decreased BP.
-Labor at 35 wks.
116. M. came after 24 h. of attack of renal colic. IVP done shows stone 0.5 cm. at L4, the kidney is slightly enlarged. Management ?
-Observation
-Tranurethral removal of the stone after cystoscopy
NB. Conservative treatment if the stone is less than 5 mm & no complication.
117. M. 55 years with painless mass in scrotum (2 cm) transillumination is (+ve) . Diagnosis. ?
-Hydrocele
-Spermatocele
-Hernia
-Varicocele
-Testiular CA.
118. M. 25 years presented with solid scrotal mass, after minor trauma to the testis. Diagnosis. ?
-Seminoma
119. Experimental study done with 2 drugs, shows that the result is significant, the epidemiologist wrote in his report that “p” is less than 0.5. What does that mean ?
-The association is less than 1\20 (5%) likely to be due to chance alone
120. Ultrasound will diagnose all the following at 20 wks EXCEPT :
-Twin pregnant
-Poyhydramnios
-Trisomy 21
121. Alfa feto protein is increased in :
-Edward syndrome
-Down’s syndrome
-Myelomeningocele
122. Psoriasis ... All except :
-Decreased C3 , C4
123. Old man complain of low back pain, X Ray shows decreased joint space & osteophytes diagnosis ?
-Degenerative joint disease (osteoarthritis)
124. Boy 2 years, complain of knee pain, PE tender but not swollen knee, slightly warmer than the other joint. What is the best investigation to do ?
-Xray of the knee
-Bone scan
125. Pt. present with fracture, you want to make a caste. You advise him about compartment syndrome. What will appear first ?
-Pallor
-Coldness
-Numbness
-Decreased pulse
-Paralysis
126. The most effective treatment in Osteoporosis is :
-Exercise
-Analgesics
-Vitamins
-Estrogen
127. Pt. On OCP complain of amenorrhea 3 months after using the pills. What is true about amenorrhea?
-Due to high progesterone
-Due to Estrogen
128. Definition of potential years of life lost (PYLL) : .................................
129. Sexually active lady present with dysuria & vaginal discharge. All the following can cause this condition EXCEPT :
-Gonorrhea
-Chlamydia
-Trichomonasis
-Condyloma Accuminata
130. Bacterial vaginosis EXCEPT :
-Clue cells
-Fishy odour with KOH test
-Decreased lactobacilli
-Vaginitis
-Frothy offensive discharge
131. Pt. complain of vertigo, how can you diagnose labyrinthitis ?
-Nystagmus
132. Pt. Operated for pituitary tumor, then he developed polyuria, dehydration inspite of receiving 4 L IV fluid. What will u give ?
-Give more IV fluid
-Start oral rehydration
-Give vasopressin (DDAVP)
NB. This is a case of SIADH
133. Alcoholic Pt. Complain of instability in gait, he uses a cane to avoid frequent fall. Romberg test is (+ve). what is your diagnosis ?
-DT.
-Alcoholic withdrawal
-Alcoholic cerebellar syndrome
134. Pt. complain of Tinnitus in Rt. ear, on Exam u found sensorineural deafness. Diagnosis. ?
-Acustic neuroma
135. New born, all the following are increasing risk factors of deafness EXCEPT:
-Family history
-Used of gentamycin
-History of CMV infection
-Delayed speaking
136. What will be your management. For a 3 years boy with stuttering ?
-Reassurance
137. All the following neonates are prone to hypoglycemia EXCEPT:
-IUGR
-Diabetic mother
-Normal infant born at 36 wks
-Hypothermia
-Non of the above
138. 32 years F. consult u for inability to conceive for 2 years, she is married who has 3 children from another woman. Temperature chart shows ovulation. What to do first ?
-B-HCG
-Hysterosalpingogram
-Progesterone at 21 day
-Semen analysis
139. F. 18 years height 158 cm , normal breast, with primary amenorrhea , PE small uterus, all of the following to be done EXCEPT :
-TFT (Thyroid) & Prolactin level
-Progesterone test
-FSH, LH level
-Laparoscopy
-Skull X Ray
NB. MCCQ 2001 (GY 11) we normally do the others in the same order as it is ..
140. F. 21 years , with 2 months history of fibroid mass, asymptomatic. Management ?
-Reassess after one year
-Myomectomy
-Hysterectomy
-Hormonal therapy
141. What is the most common source of mercury poisoning in Canada ? & who are the most exposed group of people in Canada ?
-Fish - (native Indians)
142. Which of the following you should not notify the police about ?
-Child abuse
-Spouse abuse
-Child neglect
-None of the above
143. You do a stress test ECG for a Pt. All are significant EXCEPT :
-ST decreased by more than 2 mm
-Chest pain
-ST increased (upward slopping)
-Decreased in BP by more than 50 mmHg.
144. All are true with post infectious GN. Except :
-Normal C3 , C4
-Hypoalbuminemia
-Increased cholesterol
-Proteinuria is more than 2 gm.
145. M. 65 years , present with low back pain anemia & hypocalcemia. What will you do to confirm the diagnosis ?
-WBC. Count
-Bone marrow aspiration
-Platelet count
146. HIV Pt. With fever & weight loss , he may have all of the following EXCEPT :
-Esophageal candidosis
-Mycobacterium Avium
-Mycoplasma pneumonia
-CMV infection
-Mycoplasma cellulari
147. F. 35 years with ataxia, weakness of the Lt. Side of body , dysphagia & visual trouble . PE reveals diplopia & nystagmus. What is the Diagnosis. ?
-Multple Sclerosis.
148. What is the most common complication of Juvenile Rheumatoid Arthritis:
-Iridocyclitis
-Hepatitis
-Nephritis
-vasculitis
149. M. Brought to u by police, for assaulting a 12 years old boy. When asked his name by the police , he said that he don’t know , & when u ask him how many legs does the horse have , he said 5 . What is the diagnosis ?
-Malingering
-Factitious disorder
-Antisocial personality
-Fugue
150. In which pathology you have gloves & stocking anesthesia ?
-DM.
151. M. With bipolar disorder came with agitation & aggressive behavior. Best treatment ?
-IV Haloperidol
-Lithium & Antipsychotics
152. All are seen in DT. Except :
-HT.
-Fever
-Tachycardia
-Fixed hallucination
153. Best prophylaxis for a Canadian traveling to a Malaria area with no resistant train is :
-Chloroquine
154. Pt. Diagnosed with dysthymia what is the best treatment :
-Psychotherapy
-Fluoxetine
-Imipramine
155. In cardiac arrest due to Ventricular Fibrillation , what is true ?
-NaHCO3 should be given every 5-10 minutes unless blood gas are known
-Lignocaine must be given
-DC cardioversion first
156. Dyspepsia, all are helpful EXCEPT:
-Antacids
-Elevate bed head
-Cimetidine
-Misoprostol
157. Asthmatic Pt. On steroids , has to go for operation for perforated duodenal ulcer . What will u do ?
-100-200 mg Hydrocortisone IV before the surgery
-Beta-agonist inhalor before the surgery
158. Chinese restaurant food poisoning. All are true EXCEPT :
-Symptoms within 1\2 h.
-Resolves after 24 h
-Symptoms of ashma + ataxia + dyspnea
NB. Monosodium glutamate is the cause of this syndrome (its a pharmacological but not allergic reaction. Dose related symptom of burning sensation throughout the body, facial pressure, anxiety & chest pain)
159. RA. Pt. On aspirin present with a normocytic normochromic anemia . All are true except:
-Respond to treatment with B.12
-Feritine maybe Increased
-Decreased serum Iron
-Normal total Iron binding capacity
160. What is the most common cause of congenital heart failure in NB.
-VSD
-ASD
-TGA
-Tetralogy of Fallot
161. A nurse with hypoglycemia & decreased C-peptide. What to do ?
-Refer to Psychiatrist
162. All are feature of TSS Except :
-Fever
-Decreased BP.
-Pustular skin lesion
-Erythroderma
163. All are feature of KAWASAKI disease EXCEPT:
-Fever for 5 days
-Purulent conjunctivitis
-Skin rash
-Fissure of lip
-Strawberry tongue
164. Variable deceleration commonly seen in :
-Uteroplacental Insufficiency
-Cord compression
-Sleeping fetus
165. All increase the level of carbamazepin EXCEPT :
-Cimetidine
-Estrogen
-Phenobarbital
166. M. Present with Rt. Side horner’s syndrome & contralateral loss of sensation of the body. Where is the site of the lesion ?
-PICA
-ICA
-Internal Carotid
167. Pt. With hypokalemia . All true EXCEPT :
-Diarrhea
-Paralytic ileus
-Hypotension
-Hypoventilation
-Muscular weakness
-Polyuria & polydepsia
168. All are live attenuated vaccine except :
-BCG.
-Vaccine of yellow fever
-Polio
-Measles
-Diphtheria
169. How often do u give a booster in people previously adequately immunized against tetanus :
-Every 10 years
170. All are included in the routine immunization EXCEPT:
-Measles
-Pneomococus vaccination
-Mumps
-Rubella
171. Heamophilus Influenza contact, prophylaxis is :
-Refampicine
172. Pregnant , 8 wks, came into contact with a boy suspected of having Rubella infection . Management ?
-Rubella vaccination
-Give Rubella IgG.
-Do antibody titre in the pregnant lady
-Therapeutic abortion
173. Farmer came with a nail in his foot & temp. of 38.2 . Management :
-Antibiotics
-Tetanus toxoids + antititanus Ig. + antibiotic
-Antitetanus Ig.
174. F. Young present with Meanorrhagea. Commonest cause is :
-Deficient luteal phase
-Short secretory phase
-Prolonged secretotey phase
NB. Anovulation is the best answer if there.
175. Postmenopausal lady with MI. & she is an active smoker. She does not want to stop smoking. She is on Hormonal Replacement Therapy. What advice do u give ?
-Stop Estrogen & start exercise
176. Post-Op continued to bleed despite 10 units of packed RBC. Transfusion. What is the cause ?
-Hypercalcemia
-Hyperkalemia
-Dilutional thrombocytopenia
177. RA. Pt. On ASA. Developed ITP . What is the treatment ?
-Steroids
178. Pt. Developed excessive menstrual bleeding & purpura . All the following lab. Finding are expected EXCEPT:
-Decreased Hb.
-Decreased platelets
-Increased platelets
-Prolonged bleeding time
179. Bartholinitis abscess. What is the treatment ?
-Antibiotics
-Marsupialization
NB. I & D is a good answer as well.
180. Pt. With lymphadenopathy & splenomegaly & raised WBC . What is the confirmatorey test ?
-CBC deferential
-Bone marrow aspiration
NB. Leukemia case
181. Pt. With bilateral hilar lymphadenopathy with micronodular infiltrates. All can give this feature EXCEPT ?
-Sarcoidosis
-TB.
-Transbrbronchial bronchogenic carcinoma
182. Pt. With painful bluish mass protruding from the anus. Diagnosis. ?
-Prolapsed anal piles
-Thrombosed external piles
-Internal piles
183. All can Cause Pruritis ani EXCEPT:
-Laxative
-Hemorrhoids
-Fecal incontinence
-Colorectal CA
184. F. 24 years with (+ve) preg test , present with 2 days vaginal bleeding, US shows 3 cm mass in the Lt. Adnexa & empty uterus, pregnant Sympt & signs of preg has disapeared & the cervix is closed. Diagnosis. ?
-Complete abortion + luteal cyst.
NB. u consider ectopic pregnancy until otherwise proven.
185. Indication of C-section in breech presentation is:
-Footling
-Frontbreech presentation
186. Prevalence definition: total number of cases in a population at a given time.
life birth
187. Crude birth rate = ------------------------------- x 1000
Total medial population
188. The tree of autosomal dominant transmission
189. F. Consult you because of a possibility of her offsprings (kids) having Huntington’s Chorea. Her father is affected. Her husband family don’t have this disease What is the possibility that her children will develop the disease ?
-50 %
-0 %
-25 %
-100 %
190. F. With pregnancy like symptoms, US shows grape like masses in the uterus. All true EXCEPT:
Multiple gestation
-Bilat. Ovarian cyst
-Hyperthyroidism
-Hypothyroidism, coma, preorbital myxedema
191. All have risk factor to develop preeclampsia:
-Nulipara
-DM
-History of preeclampsia
-Multiparity
192. Pregnant Pt. 20 weeks The uterus size is 25 cm. All true EXCEPT:
-Normal pregnant
-Wrong estimation of gestational age
-Twin pregnant
-Bilat. Renal dysgenesis
193. Old lady with ankle edema at the right medial malleulus, with superficial ulcer & surrounding scar. Diagnosis. ?
-Venus insufficiency
-Venus valvular insufficiency
194. Preg. Lady with known fibroid, complaining from abdominal pain
-Red degeneration
195. M. 16 years old complain from loss of weight, he is passing bloody diarrhea, Investigation show normal upper indoscopy & segmoidoscopy. What to do next ?
-Upper GI series
196. Child 4 years old, presented with post. Mediastinal tumor. What is the commonest germ cell tumor ?
-Thymoma
-Neuroblastoma
-lymphoma
197. PT. With fat malabsorption, passing floating stools + loss of weight & easy bruising. Diagnosis. ?
-GI lymphoma
-GI TB
-Glutane antheropathy (celiac disease)
-Repeated episode of pancreatitis
198. Pt. With DKA. All occur EXCEPT:
-Increased Amylase
-Abd. Pain
-Increased K.
-Increased osmolarity
-Leukocytosis
NB. Merck 1999 (p.178) in DKA. serum amylase typically elevated while K is Increased or normal
199. F. Pt. On Insulin therapy, she has a baby. You will suggest her the following about Insulin Except:
-Hold insulin until the baby start eating
NB. (always Insulin & Heparin are SAFE during pregnancy & lactation)
200. Best site to obtain smear for Gonorrhea in a woman is:
-Vulva
-Vagina
-Cervix (mouth of the wound)
201. Which stage of sexual excitement according to Tonom criteria when the female is having clitoral erection, increased vaginal secretion, nipple erection ?
-Early excitement
-Resolution
-Late excitement
-Latent phase
202. F. With difficulty caring shopping bag, weak abduction of the thumb + minor wasting of the thumb (minor thenar atrophy) Diagnosis. ?
-Carpal tunnel syndrome
203. Radial nerve injury at the level of the head of Radius. What will u find ?
-Dropping wrist
NB. Merck 1999 (p.1493) The Saturday night palsy is another name for the Radial nerve palsy.
204. Which of the following is a sexual desire abnormality
-Does not imagine sexual fantasies
-No sexual activity for more than 2 wks
-Nervous about sexual act
-Try to avoid partner contact
205. Transvestitism disorder, all true EXCEPT
-Dressing clothes of other sex for sexual excitement
-More common in male
-They are female
206. All are known to cause depression EXCEPT:
-Clonidine
-Cimetidine
-Cyclosporine
NB. The drugs which cause depression are : Anti-HT, Anti-Parkinsonian, Hormones, Steroids, Anti-TB, Anti-Neoplastic
207. Pt. Brought to u mute & inaccessible to examination. Diagnosis.
?-Catatonia MCCQ PS6 (2001).
208. M. 35 years Found in the street wandering, he doesn't know his name, talk to him self. All are possible etiology EXCEPT:
-Schizophrenia
-Fugue
-Alzheimer disease
209. Girl came with midline neck cyst, which moves while protruding the tongue (with swallowing). Diagnosis.
?-Dermoid cyst
-Brachial cyst
-Thyroglossal duct cyst
210. All are routine investigation for an old lady with urinary incontinence EXCEPT:
-Urine analysis
-Cystogram
-Urinary diary
-Direct visualization of incontinence when Pt. with full bladder while coughing
211. Definitive test for chronic pancreatitis is-CT -ERCP-MRI
212. Pt. With pruritis & progressive jaundice, with increased ALP. & total bilirubine. What is the next investigation u do ?
-US.
-PTC (percutaneous tranhepatic cholangiography).
-ERCPNB.
Always start with the less invasive investigation.
213. In Necrotizing Enterocolitis. All feature exists EXCEPT:
-Pneumatosis Intestinalis (X Ray)
-Peritonitis-Peritoneal calcification
-Portal venous gas (X Ray)
-Pneumo peritonium (X Ray)
214. What is the commonest cause of non scarring alopecia on a young girl ?
-Alopecia Areata
-Tenia Capitis-Chemotherapy
215. During insertion of IUD. The Pt. Develop hypotension. What will u do ?
-Elevation of the legs
216. IUD. Tread seen dangling outside the cervical os during an examination of a pregnant Pt. What will happen if removed
-Normal pregnancy 55%
217. Pt. In the ER. With fracture of the femur , develop sudden hypotention. What is the cause ?
-hemorrhage
218. Verapamile given IV for treatment of SVT. The Pt. Develop hypotention. What will u do?
-Defibrillation (elictrical cardioversion)
219. Pt. With psychostimulant intoxication. What is the best management. When the Pt. Will be discharged ?
-Benzodiazepines
-Daily follow up in support group
220. All occur in DT. EXCEPT:-Tremor-Visual hallucination-Delusion -Psychomotor activity
221. About contact dermatitis. All true EXCEPT:
-Mostly with plant exposure
-Systemic steroids could be used-Local steroids are not useful
-Skin test is useful
222. All can cause inverted uterus EXCEPT:
-IV oxytocin stimulation
-Atonic uterus-Pressure on soft fundus
-Pull cord forcefully
223. Who is responsible for the ultimate (standard) health care quality ?
-Bord of directors -Staff -Chief physician
-Chief of staff
224. What is the rule of Royal collage of Canada ?
-Credentialing body (certification of specialist)
225. Pregnant Pt. With bicornuate uterus. What is the likely outcome of pregnant ?
-Abortion
-Preturm delivery
-Normal pregnancy outcome
226. Pt. With plasmodium vivax malaria, treated & recurrence. Most likely cause ?
-No Eradication of liver forms
227. The best screening for hyperaldosteronism in HT. (conn diseaseis):
-Serum renin activity levelNB.
Renin will be increased in secondary & decreased in primary
228. ASA use + alcohol abuse over weekend, the pt. Developed GI bleeding. Gastroscopy shows multiple areas of erosions. All can be done EXCEPT:
-NG tube
-H2 blocker
-Gastrectomy
-Vasopressin
229. F. Pt with (+ve) ANA, presented with ankle edema & arthralgia, protein + in urine. Diagnosis. ?
-SLE
-Scleroderma
230. Diagnosis. Of Condyloma Acuminata in pregnancy. You give all EXCEPT:
-Podophyllin
231. Elderly Pt. : Prefer to sit home & to be visited by relatives.
232. In Wolf Parkinson White syndrome : shortening of PR interval & Delta wave.
233. Child complain of headache, abdominal pain, nausea, vomiting then he sleeps. Diagnosis. ? -Abd. Migraine
234. Vit. K. Deficiency in new born will result into :-Increased PT. & PTT.NB. Vit. K. (Menadione) Toxicity will present with hemolytic anemia & kernikterus235. Which one of the following affect the outcome & feature planning of Canadian health program ?-Accident-Age
236. Post-partum psychosis EXCEPT:-Can cause residual effect
237. Best treatment for shigellosis is:-Septrim (cotrimoxazol)
238. Photo of down's syndrome baby. What will confirm the diagnosis ?-Kariotypes -Total blood count
239. Epileptic Pregnant Pt. Controlled on phenitoin asked for your advice about continuing the drug which she use ?-the benefit of risk out weight of it's teratogenicity (To continue using it)
240. Best screening test for hypothyroidisim :-TSH
241. Man had fighting problem at work. Now he complains from back pain. PE shows no pathological finding but the man is depressed & obsessed with it. Diagnosis. ?-Malingering -Hypochodriasis-Somatoform pain disorder
242. Charming manipulative does not learn from experience with lack of remorse (guilt). What PD is it:
-Antisocial PD
-Border line PD
-Histrionic-Narcissistic NB. The key is lack of remorse (guilt).
243. What is hypochondriasis ?-Its a belief of having chronic disease despite good reassurance
NB. The Pt. is stable & has no social problem & he will visit many doctors for the same problem, he recognizes that his reaction is exaggerated 244. Mother brought her baby to u , he is non sensitive to other feelings , having problem with learning & speech. Diagnosis. ?
-Autism
-Specific learning disorder
245. ADHD. What is true ?
-Persistent to adulthood
-Antisocial
-Increase criminal rate
246. Which are associated with highest risk of sudden death:
-Multiple Ventricular Arrhythmia on 24 h. Holter monitor-Ejection fraction less than 20 %
-Family history of sudden death
-Atrial fibrilation on aprevious AMI
-Severe narrowing of more than 1 coronary art.
247. Regarding suicide all are increased risk of successful attempt EXCEPT:
-Depression-Malignancy
-Female gender
-Lonely white old man
248. Most imp. Dietary modification of middle aged group is :
-Total calorie content
-Fiber diet-CHO content
-protein
249. In MS. All commonly occur EXCEPT:
-Diplopia
-Nystagmus
-Scotoma
-Anosmia
-Tremor
250. Treatment or drug of choice for cyclothymia
-Lithium
-Psychotherapy
-Haloperidol
251. In BN. All occur EXCEPT:-Dental caries
-GI reflux
-Parotid enlargement
-Stomach rupture
-Metabolic acidosis
252. Stridor is present in all EXCEPT:
-Retropharengeal abscess
-Acute asthmatic attack
-Tracheolaryngobronchitis
-Acute Epiglotitis
253. Pt. With diazepam withdrawal. Which one can't u give him ?
-Chlordiazepoxide
-Diazepam
-Lorazepam
-Buspirone
254. All are measure to avoid Botulinism, EXCEPT:
-Antiacid
-Below freezing temperature
-Vacuum
-Nitric preservation
255. DVT in postpartum period lady. All can be given EXCEPT:
-Coumadin
-Heparin
-Early mobilization
NB. We can use it to avoid the DVT & not after...
256. Which is true about mastitis ?
-Gram (-ve) commonest
-I&D is the treatment
-Associated with lactation
257. What is the commonest cause of pseudomembranous colitis ?
-Clostridium dificile toxin
258. Relation between asbestosis & smoking is called :
-Additive
-Synergistic
-antagonist
259. Defense mechanism in phobia is :
-Avoidance
-splitting
260. Defense mechanism is border line PD. is :
-Avoidance
-Splitting
261. Rt. Handed lady complains of feeling of being dissociated from environment, expressive dysphasia & automatism. Where is the lesion ?
-Lt. Temporal
-Rt. Temporal
-Lt. Parietal
-Rt. Parietal
-Frontal
262. Boy fell doun from a tree, he started abdominal Pain & heamturia. What will be your next investigation ?
-Renal scan
-IVP
-Retrograde urography
-Surgical exploration
263. Lady complains from bilateral abdominal Lower Quadrant pain with tenderness after the end of cycle by 2-3 days. What is the diagnosis ?
-Endomettriosis
-Salpingitis
264. What is the commonest cause of intestinal obstruction in males over 65 years. ?
-postsurgical adhesion
265. Child swallow a 2.5 cm screw, X Ray shows it in the upper quadrant region. What will be the management. ?
-Surgery
-Reassure & follow up Xrays after few days
-Endoscopy
266. Premature rupture of membrane associated with all EXCEPT:
-Pneumonitis
-Septisemia
-RDS
267. Gonorrhea treated with spectinomicin , after there is recurrence of symptoms. What is the diagnosis & what will be the management. ?
-Chlamydia & give tetracycline
268. What is the diagnostic test for myasthenia gravis ?
-Tensilon test
269. What is the diagnostic test for cushing syndrome ?
-DST (dexamethasone supression test)
270. Hypertensive Pt. PE. shows bilateral Femoral bruits. Diagnosis. ?
-Renal stenosis
271. F. Pt. Complains from severe headache, shoulder pain & bilateral Wrist weakness. Diagnosis. ?
-RA.
-Temporat Arteritis
-Polymyositis
-Sarcoidosis
272. Maximum time fro primary syphilis to be seen after sexual contact is :
-Three months
273. All are features of sexual arousal EXCEPT:
-Tumescence
-Pelvic congestion
-Uterine contraction
274. Pt. Has lower limb lymphedema following pelvic radiotherapy. What is your management. ?
-ASA regularly + diuretics occasionally
-Compression stocking + raising leg at bed time
275. Child with bilateral Burns of his lower limb, his mother said that crawling near the heater. What is the diagnosis ?
-Shaken baby syndrome
-Child abuse
276. Pt. With history of HT. & DM. , get acute MI. & died due to cardiac arrest. In writing the death certificate, what is the immediate cause of death. ?
-DM.
-HT.
-MI.
-Cardiac arrest
277. Pt. Complains of painful swelling on the face with fever & malaise. PE: erythematous swelling on the cheeks & nose. What do u expect to find on examination ?
-Vesicles on the ipsilateral ear
-Well demarcated sharp margin
NB. The diagnosis is Erysipelas
278. A woman came to your clinic claming that she is seeing creatures form the space, trying to kill her. Her husband denies the story. She was uncooperative. What should you do ?
-Admit & start antipsychotic treatment
-Send her home, ask husband to put her treatment in coffee & give it to her
NB. Diagnosis. is schizophrenia
279. Thiazide diuretics are the first choice for:
-HT alcoholic with malnutrition
-HT + DM
-HT + gout
-HT in elderly Pt.
-HT + LVF
280. Young F. Pt. with acne on face. PE: open & closed comedones + 2 papules on chin. What is the treatment ?
-Benzoyl peroxid
-Oral tetracyclin
-steroids
NB. Diagnosis. Is Acne vulgaris
281. Child present with severe dehydration with hypotension, investigation shows:
Na 120 mmol.\L.
K 3.0 mmol\L.
BUN 15mmol\L.
You decided to rehydrate orally. What will you give ?
-20 ml. Na 50% + K 10%
-50% normal saline + glucose 50% + 20 mmol KCl.
-Pure Water
-5% sugar in water
-milk.
282. M. 25 years. Histoty of diarrhea for 15 days, he has lost 5 kg., barium enema & rectosigmoidoscopey were normal. What is your next management. ?
-Stool culture
-Stool microscopy
-Plain abdominal X Ray
-Upper GI series
283. What is true Regarding smoking restriction in public places?
-Decreases the incidence of chronic respiratory disease
-Decreases the incidence of allergic respiratory disease
-Decreases the incidence of cardio vascular disease
-Shortens hospital stay
284. Regarding conversion disorder. All are true EXCEPT:
-Aphasia
-La belle indifference
-Involuntary character of the syndrome
-Can cause social or professional hindrance
-Can be induced voluntarily
285. A new vaccine against measles is being evaluated. The following results of one full year of study :
Diseased Healthy Total % age
nonvaccinated 137 --------- 378 36.30
Vaccinated less 1 yr 51 --------- 266 17.28
Vaccinated more 1 yr ----- --------- 408 --------
What is the Vaccine efficacy for the vaccinated before one year
- 0.6 %
-17.9 %
-49.0 %
-21.8 %
-36.3 %
NB. The efficacy = incidence of non-vac - vac
286. In a small town. The incidence of disease A is (iA) 8\1000 . The disease B not related to disease A has an incidence of (iB) 12\1000 . What is the probability that the Pt will have both of the disease In the same time ?
-iA + iB
-iA X iB
-(iA + iB) \ 1 - (iA + iB)
-(iA + iB) \ 2
-(iA + iB) \ (iA - iB)
287. The following disease are more frequent in poor than in rich Canadians EXCEPT:
-Suicide
-Coronary art. disease
-Lung CA
-Stroke
-Breast CA
288. The mother of a 12 years old child has to be admitted to the hospital for 2 wks. The boy present with loss of appetite, he remains in his bedroom & has insomia, his stool frequency is reduced. PE: soft abdominal & all the rest of the exam is normal. Diagnosis. ?
-GI infection
-Early schizophrenia
-Flu
-Separation anxiety
-neglect
289. Child 10 years with pyrexia & JRA (still's disease) What is the most common complication?
-Endocarditis
-Knee & hip arthritis
-Aseptic meningitis
-Iridocyclitis
-Nephrotic syndrome
290. Which of the following vaccine causes more side effect :
-Pertussis
-Measles
-Diphtheria
Yellow fever
291. Of the following CA. Which one is caused by vinylchloride :
-Lungs
-Esophagus
-Rhinopharynx
-Liver
-Bladder
292. F. 37 years has problems at work for several months, she also has episodes of hyperactivity & euphoria. These were preceded by episodes of sadness & inability to cooperates with her colleagues inspite trying hard to do her best. Diagnosis. ?
-Bipolar disorder
-Dysthymia
-Cyclothimia
-Masked depression
-Factitious disorder
293. A new test for CA Cervix allows better detection. Statistically all can be modified EXCEPT:
-Prevalence
-Incidence
-PPV
-NPV
-Survival rate
294. Propranolol can be used in all EXCEPT:
-Lithium induced tremor
-Panic attack
-Hyperglycemia
-HT.
-Angina
295. Newborn 2 wks old brought by mother, she complains of decreased milk secretion. The baby weights 4.9 kg. The birth weight was 3.7 kg. This problem is particularly marked in the evening. What is the most appropriate treatment
-Prolactine 2 mg. Bid to the mother
-Supplement the baby with one spoon of solid food every evening
-Supplement with formula every evening
-Reassure the mother
-No breast feeding in the evening to allow more milk to the next morning
296. F. 17 years with severe menorrhagea. Investigation reveals Hb 8.0 gm\dL. Pulse 110 BP. 80\60. BhCG (-ve). Initial management. ?
-IV Oxytocin
-Blood transfusion
-D&C
-IM. Medroxyprogesteron
-IV. Estrogen
297. Child with bronchospasm after hockey game. All can be given EXCEPT:
-Aminophylin
-Salbutamol
-Cromoglycate
-Betamethasone
-Oxygen (facial mask)
298. Pt. 65 years with COPD treated with oxygen (FiO2 44%) present with the following test results:
PaO2 PaCO2 pH.
65% 35% 7.30
52% 48% 7.26
48% 52% 7.21
What is management. ?
-O2 100%
-Increase FiO2 to 65%
-Stop O2
-Intubate
-IV Aminophylin
299. The following are carcinogenic EXCEPT:
-Fat
-Monosodium glutamate
-Benzene
-Nickel
-arsenic
300. Child 18 m. Old with dyspnea. X Ray shows normal Rt. Lung, Lt. Lung distention. mediastinum deviated to the Rt. With translucent Lt. lung. Diagnosis. ?
-RSV infection
-Pneumonia
-Foreign body
-Congenital anomaly
-Congenital pulmonary aplasia
301. All are carcinogenic EXCEPT:
-Uranium
-Arsenic
-Radon
-Chromium
-Lead
302. Which of the following radiation has the deepest penetration in human tissue:
-Alpha
-Gamma
-Xray
-Delta
-UV
303. Which is true regarding the side effects of radiation ?
-Microwaves cause superficial burns
-Laser radiation can cause retinal burns
-UV can cause Alopecia Areata
-Beta ray can cause Leukemia
-Delta ray are dangerous for the central grey nucleus
304. Characteristic of placebo effect. All true EXCEPT:
-50% effective
-Pt. Believes in treatment efficacy
-Its greater in IM than in PO.
-It decreases if used frequently because of dependence
-Naloxone effect shows that placebo effect occurs by inhibition by morphinic receptors
305. All are true about Turner syndrome EXCEPT:
-Short stature
-Ammenorrhea
-Coarctation of the Aorta
-Hirsutism
-Acne & micrognatia
-Low set hair
306. All are routinely done in infertility investigation EXCEPT:
-Semen analysis
-Temperature chart
-FSH. LH.
-HSG
-Post coital test
9
307. F. 74 years old admitted with urinary catheter, she has UTI. Urinanalysis shows 10 \ high power field. Culture shows sensitivity to nitrofurantoine, TMP\SMX, gentamycin, tetracyclin. PE: asymptomatic & no fever. What is your management. ?
-Nitrofurantoin 3 tab.\day for 20 days
-Gentamycin 2 injection IM. \ day for 10 days
-TMP\SMX 1 tab.\day for 14 days
-Doxycyclin 4 tab.\day for 10 days
-No treatment
308. In which case occupational deafness is mostly suspected
-Unable to hear the bell sound at 3 m.
-Decreased in hearing high intensity voices
-Decreased peak at 4000 hertz on the audiogram
-Deafness at speaking voice
309. The difference between M. & F. Sexuality is:
-F. Have more inhibition
-F. Have more erogenous zone
-F. Orgasm is less intense
-F. Refractory period is shorter
-F. Orgasm is shorter
310. Picture of old F. With temporal arthritis asking about which is common in these Pt. :
-Jaw claudication
-Headache
-blindness
311. Picture of a lady with goittrons papules & proximal muscle weakness. Diagnosis. ?
-Dermatomyositis
-Mixed Connective Tissue disease
-Scleroderma
312. Picture of a lady genitalia showing vesicles around vulva. Diagnosis. ?
-Syphilis
-Comdiloma acuminata
-Herpes simplex genitalia
313 picture of clubbing. Which is not causing it ?
-Chrons's disease
-Chronic bronchitis
-Ciliac disease
314. A child with fever , irritability & drooling. PE: there are numerous small ulcers on tongue + ant. Cervical Lymph node enlargement :
-Herpangina
-Herpes simplex stomatitis
-leucoplakia
315. Pt. With schizophrenia & on treatment. With akathisia (he cant sit still) What is the best treatment is ?
-Lorazepam
316. Which of the following drugs is the safest is Pt. With depression & heart problem ?
-Fluvoxamine
-Imipramine
-Doxepine
-Despiramine
-Phenelzine
317. Pt. With fatigue & no pleasure & decrease sleep. Diagnosis. ?
-Depression
-Anxiety
-Bipolar
318. Pt with DM. & HT. On propranolol, complains of progressive impotence & he didn't have sexual intercourse with his wife for more than 6 months He came to u with his wife, she told u privately that he has morning erection specially when he see adult magazine. What is your reaction ?
-Do night tumescence test (REM test)
-Marital psychotherapy
-Stop propranolol
-Impotence due to DM. (vascular problem)
319. Best treatment for DT.
-Lorazepam
-H’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’ñþ’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@
323. Pregnant during delivery (full term), cephalic-occiputoposterior, head of the baby at station (-1) Pt. Is exhausted & takes long time in 2nd stage of labor. What is your management.
-Symsons
-Kjelands forceps
-Vacuum delivery
-C-section
324. Pt with retain placenta. All are associated EXCEPT:
-Vaginal bleed
-Infection (endometritis)
-Purpura around umbilicus
325. Child with microcytic anemia with Nausea, vomiting, anorexea & costipation also has sleep disturbances & irritability. Diagnosis. ?
-Hg. Poisoning
-Thalassemia
-BPC poisoning
-Lead poisoning
-Vit. A poisoning
326. Most common source of silicosis exposure in Canada is:
-Sandblasting
-Coal dust
-Brake lining
-High consentration of Gases
327. Which of the following is the most common trigger of Asthma in children ?
-Dust housing
-Rugs
-Parental smoke
-Pets
328. What is the mode of transmission of Hydrocephalus ?
-Trisomy
-Monosomy
-Euploidy
329. The most Common cause of non reactive NST (non stress test) is :
-Sleeping fetus
-Multiple gestation
-Intrauterine death
-Morphine
330. Commonest cause of hirsutism in reproductive age group:
-Constitutional
-Polycystic Ovary disease
-Congenital Adrenal Hyperplasia
331. Ediopathic heamaturia with no other abnormality. Management ?
-Prednisolon
-Follow up the Pt. After one year
-LEEP
332. Which of the following is true regarding Chromoglycate ?
-Contraindicated with steroids
-Necessary in acute attack of asthma
-Prevent binding of IgE with cells
-Prevents histamin from synthesized cells
333. M. 42 years with glucosuia, dark skin, palpable liver. Which will help u in the diagnosis ?
-Ferittin level
-Ceruloplasmin
-Alphatrypsine
-Electrophoresis
334. Which will increase day care load in the next decade ?
-Heart disease
-CA.
-Dementia
-Accident
335. Which one is most suggestive of thyroid malignancy ?
-Solid cold nodules
-Cystic cold nodules
-Increased thyroxin level
-Increase TSH level
336. Young Pt. Came to u after electric shock due to falling down on subway. Burn was treated. ECG is normal. Management ?
-Send home if ECG is normal
-Keep monitoring the ECG for 24h.
-Cariad enzyme should be checked
-ECG must be monitored for three days
337. The most important cause of difference between M. & F. mortality rate is due to :
-Accident
-Puerperal
-suicide
338. Lower abdominal pain with tender abdominal mass in the cole-de-sac. Diagnosis. ?
-TOA (tubo-ovarian abscess)
-Infected endometrioma
-Teratoma
NB. Scenario is incomplete
339. F. 42 years hypothyroid Pt. with 8 month ammenorrhea asking u about osteoporosis. Your advice will be EXCEPT:
-Cyclical Est. & Prog.
-Vit. D.
-Ca supplement
-Continuos Est. & Progesterone
340. Pt. With chronic bronchitis and PaO2 of 60 mmHg. all are true EXCEPT:
-Continuos home O2 is not indicated
-Antibiotic prophylactics is helpful
-Bronchodilators can be used
-Corticosteroids may be useful
-Non of the above
341. Smoking withdrawl which of the following is the most common symptom:
-Insomnia
-Tachycardia
-Anorexia
342. Life expectancy is increased in canada due to:
-Decreased infant mortality rate
-Availability of Diagnosis and treatment
-Increased of socioeconmic status
343. The vaccine which is given to adults is:
-DT pertusis
-DT
-T
-DT and Polio
344. Middle aged lady came to you complaining of not sleeping at night because she finished her diazepam tablets which she used to take before sleeping now her Family physician is away .What will be your action:
-Assurance
-Give her diazepam
345. Pt. With frost bit, best treatment is:
-Put hands in warm water 38-40 degrees for 30 min.
-IV antibiotics
-Local antibiotics and debridments
346. Pt. Post M .I no more pain ,B P 90 over 60 mmhg , pulse is normal and regular.
Whats your management. ?
-Close observation in I C U
-Dopamin I V
-Dobutamin I V
-Digoxin
347. Pt. Came to you with cercumferencial burn on Lt. Forearm, complain of pain. PE: no radial pulsation. Best treatment is:
-Escharectomy
-Debridment
-fasciatomy
348. Mitral stenosis question: loud 1st heart sound, mid diastolic murmur at the apex, parasternal heave.
349. Young female presented with visual impairment in one eye which improve, in neck flexion an electric like shock is felt at the back & upper limb. Diagnosis. ?
-Mysthenia gravis
-Multiple sclerosis
-GBS (Guillain-Barre syndrome)
NB. The electric shock is called : Lhermitte's sign
350. Pt. Present with enlarged LN. In cervical inguinal & axillary regions, night sweat, fever & weight loss. X Ray shows widen mediastinum. Diagnosis. ?
-NHL (Non Hodgkin Lymphoma)
-AML
-IMN (Infec. Mono. N)
351. Typical case of large cervical LN. What will be your next step?
-Abdominal US
-Excisional biopsy
352. Old hypertensive lady with DM. What is the best treatment ?
-B-blocker
-Diuretics
-ACEI
NB. MCCQE FM 14. (2001)
353. F. With breast CA. complains of dyspnea & fatigue. PE: shows pulsus paradoxus. C-X ray shows large globular heart. Diagnosis. ?
-Pericardial effusion
354. Pt. with VonWillebrand disease Type I. Which is true ?
-Prolonged bleeding time
-Decreased platelet
-Increased PT.
355. Pt. on platelet transfusion developed anaphylaxis. What is the initial management. ?
-IV steroids
-Stop transfusion
-anti-histamine
356. Pt. in ICU post MI developed bradycardia, pulse at 32 \ min. What is the best management. ?
-Cardioversion
-Pacemaker
-IV Dobutamine
357. M. 72 years present with one year history of heamoptysis. X Ray shows infiltration of the lung. Diagnosis. ?
-Recurrent Pulmonary Embolism
-Bronchiectasis
-Foreign body
358. What is the drug of choice of mycoplasma pneumonia ?
-Tetracycline
-Bactrim
-Erythromycin
359. Typical case of heamolytic anemia. What is the most characteristic finding ?
-Reticulocytosis
-Increased haptoglobin
NB. findings Other than Reticulocytosis are:
Reduced haptoglobin
Increased LDH
Increased unconjugated bilirubine
Increased urine bilinogen
360. Pt with history of alcohol intake present with icteric sclera, Bad mouth smell (fetor hepaticus). Diagnosis. ?
-Hypoglycemia
-DKA
-Hepatic encephalopathy
-Viral hepatitis
361. Pt. With history of unilat. Loss of vision in the Lt. Side which completely recovered within 5 min. What is the most likely association ?
-Lt. Internal Carotid Art. Stenosis
NB. The Diagnosis is Amaurosis fugax
362. Which is false ?
-Cefazoline & Bacteroides
-Gentamicin & E-coli
-Metronidazol & Bacteroides
-Vancomycin & C. difficile
363. Young lady with anorexia, generalized fatigability, weight loss & intermittent fever for 2 wks. PE: multiple splinter heamorragea are noted on the finger nails. The most imp. Next spet is:
-Urine C & S
-Blood culture
-C-Xray
NB. Diagnosis is Subacute Endocarditis
364. A group of doctors preparing the EE. Develop nausea , vomiting, diarrhea, few hours after having lunch at a restaurant. The symptoms subside after 24h. Most likely cause is :
-E-coli FP (food poisoning)
-Staph. FP
-Salmonella FP
365. Obese Pt. With heart burn, progressive difficulty of swallowing & Epigastric pain which gets worse more in recumbency. Diagnosis. ?
-Achalasia
-Hiatus hernia & reflux esophagitis with stricture
-Esophageal CA.
366. F. Pt. With history of anorexia, weight loss, vomiting, diarrhea. BP show postural hypotension, Na 130, K 5.8 , what is the best initial investigation ?
-Measurment of ACTH in plasma in the morning
-ACTH stimulation test
-Abd. CT for adrenal
-Water deprivation test
NB. A case of Addison's dis (adrenocortical insufficiency).
367. Typical case of hepatic encephalopathy. What is the LEAST effective in the initial management. ?
-Look for signs of GI bleeding
-Take history of drug from relatives
-Look for signs of infection
-Order lactulose
368. Typical case of migraine. What is the most likely visual symptoms ?
-Scintillating scotoma (the cotton like scotoma)
369. All are sexually transmitted EXCEPT:
-EBV
-HBV
-HIV
370. All are transmitted feco-oraly EXCEPT:
-HAV
-EBV
-Norwalk virus
-Polio virus
NB. Kissing disease (EBV)
371. Typical case of irritable bowel syndrome. All are true EXCEPT:
-Nocturnal diarrhea
-Abdominal pain
-constipation
372. Young F. With supraventricular tachycardia. Complain of chest pain, palpitation & fainting. The best initial management. is :
-IV verapamil
-Cardioversion
-Increase vagal tone
-B blocker
373. A nurse injured by a needle of a pt. Who is HBV (+ve) & HIV (-ve) . management.?
-Give HB. Ig. Now & HB. Vaccine after 2 wks.
-Reassurance
-Give HB. Ig. & HB. Vaccine now
374. G2 P2 with history of lower segment C-section because of footling breech. During labor she present a sudden profuse gush of bright red blood. The fetal head is engaged. Diagnosis. ?
-Placenta Previa
-Ruptured uterus
-Placenta Abruptio
375. All are complication of copper IUD EXCEPT:
-Uterine perforation
-Infertility
-PID
-Liver toxicity
376. Young pregnant Pt. Diagnosed to have placenta previa at 20 wks. Where the placenta covers the internal os completely. What advise do u give ?
-Avoid sexual intercourse
-Reassesment US at 28 wks
-Inform the Pt. That she needs a C-section at delivery time.
377. Increase FSH is associated with all of the following EXCEPT:
-Turner syndrome
-Bilat. Dermoid cyst
-Post radiation to the pelvis
378. Which is responsible for decrease Oxygen delivery to the fetus during uterine contraction ?
-Decrease art. Supply to the intervillous space
-Decrease uterine venous outflow during contraction
379. The most common indication for amniocentesis is :
-Maternal age is more than 35 years
-Past history of down syndrome
-Past history with baby with NTD
380. Pt. With amenorhea, She was using BCP. Which is helpful test to check the endometrial function ?
-Progesterone challenge test
381. Young lady in labor, PV shows cervical dilatation of 3 cm. partially effaced cervix, uterine contraction every 5-10 min. & lasting 20-30 sec. What is true ?
-This is an active phase
-This is a latent phase
-Active phase arrest
382. Pregnant Pt. Did not feel the fetal movement for the last 2 days. PE: no heart sound could be heard. What is the next step to do ?
-Non stress test
-Obstetric US
-Biophysical profile
383. Primigravida in labor. All can be given EXCEPT:
-Oxytocin
-Narcotic analgesic
NB. You can give it only in early stage of labor
384. Pt. 20 wks Pregnant with fibroid present with abdominal Pain. PE: tenderness of the lower abdominal Best management. ?
-Analgesia & reassurance
-Myomectomy
NB. Red degeneration of fibroid.
385. All are risk factors for IUGR EXCEPT:
-Absence of weight gain by the mother
-Fetal weight 2000 gm at 32 wks
-Maternal malnutrition
386. Pt. 38 wks pregnant Presented with history of clear watery vaginal discharge 2 hours ago. Management ?
-US
-Sterile speculum examination & take swab for C & S (culture & sensitivity)
-Induce labor
387. Young girl after brake up of her relationship took 18 tab. of lorazepam, she only complains of dizziness & drowsiness. After 6 h. of observation she is well, feel remorse & want to be discharged. Management ?
-Discharge her & follow up as out pt.
-Futher 24 h. observation
-Call her boyfriend
388. Young girl found in coma in the street. PE: constricted pupils (pin point) & multiple marks of IV injection. Most likely cause is :
-Heroin
-Cocaine
-Diazepam
389. Case of drug over dose with fever, tachycardia, dilated pupils & BP: 220\110. Most likely cause is:
-Cocaine
-LSD
-Heroin
-Barbiturates
390. Psychic structure that relate desire to external environment is :
-ID
-Ego
-Superego
-Self
-Personality
NB. To be checked ...
391. All are true regarding OCD. EXCEPT:
-Ego dystonic
-Ego syntonic
NB. Dystonic = OC Disorder.
Syntonic = OC Personality.
392. Which is true regarding Alzheimer's disease ?
-Apraxia, agnosia, dysphasia
-Sudden onset
-More common in male
NB. Alzheimer's F. are more than M. & its not with sudden onset
393. Which of the following cause drug induced dementia ?
-Diazepam
-Imipramine
-Triazolam
394. Psychotherapy superior to medication in
-Schizophrenia
-Alcoholism
-Drug induced delirium
-dysthimia
395. Which is true regarding suicide in adolescent ?
-More common in summer
-Attempt to suicide is more common in F. Than in M.
-More common in F.
396. Child 9 years old studing in kindergarten, is unable to read, write or even to color a picture. He becomes happy when he answers simple questions. What is your diagnosis ?
-Autism
-Mental retardation
-Specific learning disability
397. What is the best management. of school phobia ?
-Force him to go to school
-Keep him at home until he miss his friends in school
-Give him anxiolytics
398. Which is regarded as an arousal symptom of PTSD:
-Restricted affect
-Feeling of detachment
-Hypervegilance
399. Pt. With multiple trauma came to hospital shocked but he is agitated & violent. Management Regarding treatment ?
-Wait until he becomes more shocked
-Sedate him & treat
-Treat him immediately even if you may physically restrain him
400. M. 33 years present with sudden onset of mood & memory changes, mute.on admission he developed convulsions. Diagnosis. ?
-AIDS Dementia complex
401. The most imp. Cause of increased complications of measles in developed countries is :
-Inadequate immunization
-Inadequate nutrition
402. Study has been done between risk factor & a disease, Ods ratio was 2.3. what is true ?
-There is significant association between risk factor & disease.
-The disease is 2.3 times more in those having risk factor
403. Which is the most practical measure to reduce occupational deafness ?
-The usage of daily prophylactic ear plugs during duty
-Measuring the noise frequency
-Usage of ear protection
404. All are true regarding incidence EXCEPT:
-Take only the new case in consideration
-Estimate the risk of acquiring the disease In community
-Useful measure of disease Problem in community
-Useful for both acute & chronic disease
405. Which of the following is true regarding non Ionizing radiation ?
-Can cause Chronic bronchitis
-Can cause Loss of vision
-Can cause cataract
406. Which is not true regarding O3 ?
-Increased around photocopy machine
-Can be harmful at ground level
-Its mainly due to incomplete combustion of fossil fuels
407. In placebo treatment . All are true EXCEPT:
-Response to placebo indicate that the cause is psychogenic
-Repeated use decreases its efficacy
-1\3 of those with organic causes respond to the placebo
408. All are true regarding the role of physician in trauma pt. EXCEPT:
-Assess the pt. Condition clinically
-Can determine the duration of treatment
-Estimate the compensation of the pt.
409. Information about mortality in Canada can be obtained from
-Canada statistics
-Public health center
-Out pt. clinic
410. Child 4 months old age. He must get his second vaccination. His mother is worried about the risk of fever. What is your advice ?
-Give antibiotic if temp. More than 39 C .
-ASA if temp. rises
-Give acetaminophen now & qid later .
-Call the doctor if temp. Rises more than 39 C
411. Baby 4 months of age. Microcytic hypochromic anemia. What is the
Cause ?
-Breast feed only
-His mother was taking erythromycin during pregnant
-Prematurity
412. Child with microcytic hypochromic anemia. His mother blood film shows basophilic stippling & microcytic hypochromic anemia. Similar finding were found in the father. Next step ?
-CBC
-Serum ferritin
-Packed plasma
-HB electrophoresis
413. An African 4 years old child, with dark urine, treated for a respiratory tract infection by Septrim, present with jaundice & pallor. What is the diagnosis. ?
-G6PD
-Cycle cell anemia
-Thalassemia
414. A Chlid with ALL. Will present with all of the following EXCEPT:
-Anemia
-Infection
-Thrombocytopenia
-Heamoglobinuria
415. Newborn 4 days old, with poor feeding, mottling skin, temp. 36.5, after stabilizing the baby, what is the next step ?
-ABG (art. blood gas)
-LP
-Electrolytes
416. Child with sever vomiting & diarrhea , became lethargic with sunken eyes, mottling skin, low BP, Increase pulse, Na 150 mmol ,what is your management. ?
-Plasma 10 cc\kg within 1st h.
-5% dextrose 20 cc\kg. Within 1st h.
-0.9 normal saline 20 cc\kg. Within 1st h.
417. Child with moderate to severe dehydration. Which of the following investigation helps in your management ?
-CBC
-Blood urea
-Electrolytes
418. Child with severe dehydration Na 170 mmol. What is the complication expected during your management. ?
-Shock
-Death
-Convulsions
NB: convulsions may happen due the rapid correction of hypernitremia. In hyponitremia cerebral edema may be developed due to rapid correction
419. All can cause abdominal Mass in neonate EXCEPT:
-Wilm's tumor
-Hydronephrosis
-Neuroblastoma
-Meckl's diverticulum
420. What is true regarding congenitla pyloric stenosis ?
-Commonly present at 3 months
-Associated with metabolic acidosis due to vomiting
-Visible peristalsis is seen in abdomen
421. Child with nephrotic syndrome presented with fever, abd. Pain & ascitis. What is your next step ?
Abd. Xray
US
Parasynthesis
422. A child presented with fever & small white lesion on the mucous memb. of the mouth followed by generalized macular papular rash. What is the manag. ?
Give ASA to decrease fever
Give gamma Ig.
Notify the public health unite
Isolation of the family member
NB: diag. Is Measles
423. Child 15 yrs present with BP. 155\90 mmHg. What is your manag. ?
Restrict salt in diet
Diuretics
Repeat measurement of BP at different times
Haloperidol
424. How can you diag. A 2 yrs old child with an HIV (+ve) mother ?
Urine analysis
CBC
CD4\CD8 ratio
ELISA
425. Child 12 yrs present with constipation , decreased school performance & suppressed growth for the last 12 months. Diag. ?
School phobia
Hyperthyroidism
Hypothyroidism
426. Newborn 10 days developed unconjugated hyperbilirubinemia, he was born at term. & he is otherwise well. Diag. ?
Galactosemia
Kernicterus
Breast milk jaundice
427. Child present with sore throat, fever & diagnosed as Infectious mononucleosis. He was treated conservatively but he returned to u with a severe pain in the throat. Manag. ?
Give ampicciline for 10 days
Throat swab for C&S
Xray
428. Child 18 months old present with generalized convulsions for 20 minutes. He has history of UTI, no history of similar attack before. After he was given O2 what will be the appropriate step in the mana. ?
Rectal diazepam
Rectal paraldehyde
Phenobarbital IM.
429. Preterm baby with feature suggest Iron def. Anemia. When will u give Iron supplement ?
3 months of age
5 months of age
4 wks of age
430. Child 9 yrs old with enuresis. Its usually associated with:
a part of generalized anxiety disorder.
UTI
431. How to differentiate between diverticulosis & proximal CA in narrowed segment of colon ?
-Colonoscopy & biopsy
-Sigmoidoscopy
-Barium enema
432. Pt. Complains of constipation, abdominal pain & frequent diarrhea mainly in the morning & with NO other problems. Diag. ?
-IBS (irritable bowel syndrome)
-Diverticulosis
433. Pt. With pleural effusion on the Rt. Side with no apparent lesion. Manag. ?
-Thoracocentesis
-Thoracotomy & biopsy
-CT
434. Drug causing mania EXCEPT:
-Steroid
-Cimetidine
-Imipramine
435. What is the most helpful sign in diagnosing inguinal hernia in children ?
-Thickening of the cord
-Wide external ring
-Bulging at the groin
436. Pt. Complain of headache, vomiting following Rt. Hemianopsia. Diag. ?
-Migraine
-Amaurosis fugax
-Rt. Retinal art. stenosis
437. Liver cirrhosis pt. Comes with massive heamatemesis. What is the best next step ?
-Vit. K IV.
-Factor II , VII , IX , X
-Give packed (whole) blood transfusion
438. Which is not true in a pt. With mycoplasma pneumonia ?
-Fever , persistent hacking cough
-Headache, diarrhea & non exudative pharyngitis
-Associated with erythema multiformis
-Associated with bullous myringitis
-Can cause rapid progressive pneumonia with cyanosis
NB. Its the walking pneumonia in young man ...
439. Newborn pale, HR = 80\min. Respiration is Irregular & slow, flabby, lazy, & he is weak for irritability. What is the APGAR score ?
-2
-3
-4
-5
-1
440. Pt. With syphilis & (+ve) VDRL 1:20 before. He receives penicillin for 2 months & the titer is 1:6 now. Which of the following is true ?
-Good response to treatment
-Decreasing in titer should be more faster
-Pt. Is immunosupressed
-Bacteria develop resistance to penicillin
441. Which of the following benefits from vasodilatation ?
-Cor pumonale
-Subaortic stenosis
-Mitral insufficiency
-Mitral stenosis
-ASD
442. Absolute contraindication of BCP. Is :
-History of Pulmonary embolism
-Migraine
-HT.
443. Which is true regarding the diag. of brain death for organ transplantation ?
-Absence of all spinal reflex
-EEG completely for 48 h.
-Could be diagnosed clinically
444. Vit.D deficiency associated with all EXCEPT:
-Hypocalcemia
-Hyperphosphatemia
-High ALP (alkaline phosphatase)
445. Vietnamese Pt. Has 15 mm. (+ve) Mantoux test (Tuberculin test) & (-ve) cytology. Manag. ?
-Treat the pt. without regard to sputum cytology
-Repeat Mantoux test after 3 years
446. Treatment of pt. With dystonia is :
-TCA
-MAOI
-Benztropine
-Haldol
447. Newborn with small head, small palpebral fissure, small philtrium & small eyes & flattened meat facial area. Diag. ?
-Fetal alcohol synd.
-Down synd.
-Edward synd.
-Turner synd.
448. 20 wks Pregnant with family history of Down synd. Which of the following should be done to rule out Down synd. ?
-Amniocentesis
-Chorionic villous sampling
-Abd. US
449. Which of the following is the treatment of choice of Rheumatic Fever ?
-Aspirin orally
-Benzathine penicillin G (1.2 million IU) IM.
-Penicillin IV.
-Ceftriaxone IV.
450. Sickle cell anemia with fever & severe abd. Pain. Manag. ?
-IV fluid, blood culture, antibiotics
-IV fluid, narcotic, blood culture
-Blood transfusion
451. Pt. With bilat. Lower limb pain exaggerated by night, nocturia & no history of urine incontinence. Investigation reveals glucosuria. Diag. ?
-Massive cord compression
-Diabetic peripheral neuropathy
-Herniation of spinal disk
452. All are true regarding folate deficiency EXCEPT:
-MCV = 96
-Normal serum folate
-Thrombocytopenia
NB: MCV has to be more than 100
We check the RBC folate & not the serum folate.
453. The company need to change the dipstick for detection of proteinuria because it was detecting it in low threshold (No. of false positive was high). Now it increases the threshold of the screening test to detect proteinuria. This will affect the test in terms of :
-Increased sensitivity & specificity
-Increased No. of FP.
-Increased No. of FN.
NB. Increasing the threshold will result in decreased sensitivity & increased specificity.
454. Best treatment for DM. type I is:
-Short acting insulin + NPH
-Short acting insulin + long acting insulin
-Utra acting insulin
-NPH + long acting insulin
NB. MCCQ E6. (2001)
456. Pt. Returned from vacation he is hypertensive on thiazide. He now complains of pain, swelling of Rt. Knee joint & fever. Best manag. Is ?
-Knee aspiration
-Serum uric acid level
NB: thiazide may cause increase level of Uric acid which can cause the swelling of the joint
457. RA. Pt. on gold salt + hydrochloroquine develop proteinuria & ascitis. What is the cause of his condition ?
-Due to his chronic dis.
-Due to Gold salt
-Due to hydrochloroquine
458. Which is true regarding Acoustic neuroma ?
-Decrease bone conduction in the same side
-Increase bone conduction in the same side
-Increase bone conduction in the same side
459. In Rt. Serous otitis media, Webber will give :
-Decrease bone conduction in the Rt. Ear
-Decrease bone conduction in the Lt. Ear
-Increase bone conduction in the Rt. Ear
460. The most predisposing factor to HT. is :
-Alcohol
-Hereditary
-Smoking
-Obesity
461. Which is the least cause of HIV infection :
-Homosexuality
-Prostitution
-Drug abuse (1999)
-Blood transfusion (1988)
462. Hypotonia, hypoglycemia, hepatosplenomegaly & poor feeding infant. Diag. ?
-Septicemia
-Glycogen storage dis.
463. Pregnant 14 wks with hydatid mole. Best treatment is ?
-Dilatation suction curettage
-Hysterectomy
-Hysterotomy
-Methotrexate
464. Pt. Came with multiple trauma. Which will u treat 1st ?
-Tension pneomothorax
-Cardiac tamponade
-Aortic rupture
-Skull fracture with visible brain
465. Pt. With multiple fracture in ICU. He developed dyspnea, increased CO2, decreased O2. Xray shows bilat. Infiltration (ARDS). Manag. ?
-Intubation & ventillation
-O2 mask
-HCO3 IV.
466. In sexually abused Child. Which will be the most suggestive sign:
-Vulva bruise
-Laceration on the labia
-Ruptured hymen
-Labial agglutination
467. Pt. With breast CA underwent operative surgery & chemoradiotherapy, she developed pneumonia followed by death. What is the underlying cause of death?
-Cytotoxic chemotherapy
-Breast CA
-Pneumonia
468. What is the most dangerous complication of maxillary sinusitis ?
-Periorbital cellulitis
-Cervical adenitis
469. What is the treatment of Tourettes syndrome ?
-Haldol
-Fleuxetine
-Lithium
-Cognitive behavioral therapy
470. Which is true regarding a childhood Schizophrenia ?
-Diagnostic criteria like adults
-Hallucinations & delirium are rare
471. Dysmenorrha in an 18 yrs old is mostly associated with:
-Normal pelvic exam
472. Retroverted uterus is mostly associated with
-Endometriosis
-Low back pain
-Infertility
473. All of the the following can be in the manag. hypercholestorelemia EXCEPT:
-Conservative for 4 to 6 months
-Simvastatin
-Serevastatin
-Lovastatin
-Liposuction
NB. Withdrawn from the market in Canada in August 2001 due to increase risk of death with this Serevastatin.
474. Which of the following will be a good treatment for ovarian tumor according to its adequacy ?
-Surgery
-Radiotherapy
-Chemotherapy
475. Post-pelvic radiation pt with diarrhea. What is the most common cause ?
-proctitis
476. Hydronephrosis associated with all EXCEPT:
-Post-uretral valve
-Obstructive uropathy
-BPH
-Nephrotic syndrome
477. Which is associated with dysuria but no pus cells in urine ?
-UTI
-Vulvovaginitis
478. Which is not associated with occupational asthma ?
-Polyvinyl chloride
-Isocyanate
-Anhydride
-Antibiotics
-resin
NB: polyvinyl chloride causes liver & brain CA.
479. Sexual abuse is associated with all of the following EXCEPT:
-Development of secondary sexual characteristics
-Most of assailants are known to the victim
-More common in F. Than in M.
-Specific or generalized fears, depression & night mares
480. Which is false regarding anencephaly in pregnancy:
-Sampling of umbilical art. Will not reveal the diag.
-4 mg. Folic acid is prophylactic
-Higher dose given for a pregnant who has history of anencephaly
-Amniocenthesis used in diag.
-Associated with high alpha fetal protein in mothers serum
NB: the correct dose should be (0.4 - 1 mg) in all pregnant women & we increase the dose to 4 mg if the pregnant has a history of NTD.
481. Which is contraindicated in the last trimester ?
-Sulfonamide
-Ampicillin
-Diazepam
-Heparin
NB: increased risk of kernicterus
482. What will be the effect of Diazepam taken by a breast feeding mother on -her child ?
-Hypotonia
-Hyper ventilation
-Intra ventricular hemorrhage
483. Which of the following is contraindicated on pertusis vaccine ?
-Egg allergy
-Encephalitis after the previous dose
-Upper respiratory tract infection with slight fever
484. Child with bloody Diarrhea with dehydration can be managed by all EXCEPT:
-Loperamid
-Metronidazol
-Rehydration
-Stool culture
485. What is the complication caused by forceps delivery ?
-Cephalohematoma
-Caput succidanum
486. Complications caused by Vaccum delivery is :
-Cephalohematoma
-Caput sucidanum
-All of the above
None of the above
487. Which is not true in IUGR (Intrauterine Growth Retardation) :
-Absence of weight gain
-Maternal short stature
-Low fundal height
488. A study reveal that 10 yrs experienced driver contributed to 60% of accident. 5 yrs experienced driver contribute to 30%. & those with 2 yrs contribute to 10%. The conclusion was that the more experienced driver are more careless in driving. This conclusion is not right because of :
-It's not measuring the incidence of accident
-It's not standardized to the age
-Because there is no control group
489. Study about the benefit of exercise in decreasing the risk of heart dis. Applied to a group of voluntaries in the factory with a control group of the rest of the factory. Follow up was regular. The check up shows lower rate of IHD. Ischemic Heart Dis. In exercising group (voluntaries). The conclusion that exercise protect against IHD. may be rejected because of:
-Selection bias
-Only M. Were included
-Only one company was involved
-Some IHD may be silent
490. Differentiation between schizophrenia & mania:
-Thought broadcasting
-Flight of ideas
491. Which is false about Down syndrome ?
-Rocker Bottom Foot
-Brushfield spot
-Upward standing palpebrale fissure
-Brachiocephaly
492. In 15 wks. Normal pregnancy u will find all EXCEPT:
-Increased BP
-Fundal height midway between symphysis pubis and umbilicus
-Increased heart rate
493. Opiate abuse is commonly associated With:
-Miosis
-Euphoria
-Perforation of nasal septum
494. Old pt. Abused by his wife complain to u, you will do all the following EXCEPT:
-Send the pt. To day care
-Frequent visit to house
-Reassurance
495. Pt. Died after suffering from TB, what will you write in death certificate as cause of death ?
-Cardiac arrest
-TB
-Fever
-Loss of weight
496. ADHD associated with all the following EXCEPT:
-Stereotyped movement
-Short attention span
-Hyperactivity
-Impulsivity
-Interference with family & social functioning
497. Which of the following is contraindicated with tyramine rich food (cheese) ?
-Imipramine
-Phenelzine
-Fleuxitine
498. Which increases the risk of MI. ?
-History of father with MI
-History of smoking
-History of high animal fat diet
499. Pt. With chronic pain, can be treated with all EXCEPT:
-Biofeed back
-Operant conditioning
-Desensitization
500. Which of the following is most compatible with interstitial lung dis. ?
-Severe hypoxia on exercise (decreased PaO2)
-Emphysema
-Increase CO2 & O2
501. What will be your next step on a pt. with normal breast at PE. & -Abnormal mammogram ?
-Biopsy guided by wires
-Exisional biopsy
-Repeat after one year
502. All are part of the normal vaginal flora EXCEPT:
-Peptostreptococus
-Lactobacillus
-Staphylococus
-CMV
503. Which is the most likely to be associated with Leukemia ?
-Aromatic hydrcarbones
-Ionized radiation
-Benzoalphaperines
504. Surveillance in medical worker for radiation hazard include all EXCEPT:
-Heamatological examination
-Annual PE.
-Labelled panding
-Total body radiation count
505. All are true regarding aseptic meningitis EXCEPT:
-Increased chloride
-Normal blood sugar
-Increased lymphocyte
-Slight protein increase
506. Dysplastic nevi associated more with:
-Subungual
-Elevated
-Hypertrichosis
507. Drainage of lymph in lower vulva:
-Inguinal LN.
-Internal iliac LN.
-ParaAortic LN.
508. BCP reduces risk of which of the following ?
-Breast CA
-Endometrial CA
509. The most common complication of low dose of BCP is:
-Brake through bleeding
510. Pt stop her BCP & ask your advice for time of conceiving. What will u tell her ?
-Body tepm. Chart
-Pregnancy after 6 months
-Bleeding will occur within 28 days
-Try to conceive after she got the menstruation
511. Which is the best source of information for pt. With poisoning by a toxic substance ?
-Public health unit
-Environmental health protection unit
-Toxicology unit
512. Which is true regarding urticaria ?
-In 80% of cases the cause is not apparent & It'll resolve spontaneously
513. Regarding smoking cessation. All are true EXCEPT:
-Decreased lung CA occurrence as other nonsmoking population by 2-3 years of cessation
-Improvement of claudication
514. Gun shot to the lower abdomen, pt. Is in shock with BP 70\30 what is your immediate management. ?
-Laparotomy
-Peritoneal lavage
515. In cushing syndrome you find all EXCEPT:
-Low BP.
-Obesity
-Striation of skin
-Trunk obesity
516. Old pt. With history of head trauma, he has changes in behavior with frequent vomit & headache. U do All EXCEPT:
-Head CT
-Catheter
-IV. Fluid
-LP
517. (Case of Invalid consent eg.) Taking consent from a premedicated pt. On the way to theater for some procedure.
518. Thiazide is best ro be given to old hypertensive pt. With :
-Vasovagal attack
-DM.
-Gout
519. Pt. With suprachondilar fracture with splint & he is in complete flexion. He develops ischemia. What will be the initial management. ?
-Remove splint & flex the arm
-Keep splint & extend the arm
-Remove the splint & extend the arm
-Angiogram of brachial art.
520. Pt. Who ate BBQ. Developed diarrhea. Blood count shows eosinophelia. The best investigation to be done to reach the diagnosis ?
-Muscle biopsy
-Stool culture
-Stool microexamination
521. Pregnant came with breech presentation at 39 wks. All other parameters are normal. Management ?
-Continue ANC (antenatal care)
-C-section
-Normal vaginally delivery
522. Which is the most indicative of fatal distress:
-Base line heart rate at 115 beat\min
-Occasional late deceleration
-Early deceleration
523. Pt. On 100% O2 & ventilator.
PaO2 = 93%
PaCO2=56%
pH=7.3 HCO3=31
What will be your management. ?
-Decrease O2 saturation
-Increase respiratory rate
-Increase tidal volume
524. Laryngeal polyp can be caused by all of the following EXCEPT:
-Present medication
-Smoking
-Allergy
525. A secretary complains of painful lesion 7.5 cm above the anus in the anal cleft. Diagnosis. ?
-Infected pilonidal sinus cyst
NB. MCCQ 2001 (GS26)
526. Pt. With sigmoid volvulus. Management ?
-Sigmoidectomy
-Decompression by sigmoidoscope
-Hydrostatic barium enema
527. Pt. Present with dyspnea & fever 38.5 , 36h. Post-op. Diagnosis. ?
-DVT
-Atelectasis
-Pulmonary Embolism
528. What is true regarding mastitis ?
-Usually treated by I&D
-Temp. Never more than 39
-Associated with supressed lactation
-Usually start 2-4 wks. Postpartum
529. Which of the thyroid CA. Has the best prognosis ?
-Folicullar
-Papillary
-Anaplastic
-Medullary
-Embrionic
530. Burned Pt. Presented unconscious to ER. PE: smoke in the mouth, black tongue, intact pharynx & he was NOT cyanotic. What do u expect to find ?
-Low PaO2
-Carboxyheamoglobine more than 35%
-PaCO2 = 56 mmHg.
NB. To be checked ...
531. Post-op pt. Present with hypotension & central venous pressure 16 cm H2O. Diagnosis. ?
-Hypovolemic shock
-Cardiogenic shock
532. All are true regarding thoracic dissecting aortic aneurysm EXCEPT:
-Severe chest pain
-Systolic murmur, when present, is of great significant
-Involvement of aortic arch may lead to stroke
-Asymmetrical peripheral pulses
533. Most common indication of cricothyroidotomy is:
-Multiple severe facial injury
-Fracture C5-C6 with dislocation
534. Anal skin tags in a child is commonly associated with:
-Crohn's disease
-Chronic anal fissure
-Hemorrhoids
535. Lady 20 years presented with 3 cm mobile breast mass, it was increasing in size for the last 4 months. Diagnosis. ?
-Fat necrosis
-Fibroadenoma
-Firocystic disease of the breast
536. F. pt. Presented with history of abdominal Pain , fever , vomiting , the pain shifted to the Rt. Lower quadrant. The pt. Improved after a conservative treatment. 10 days after he present with R. abdominal Mass. Diagnosis. ?
-Appendicitis
-Apendicular abscess
-Acute sulpingitis
537. Which of the following is true regarding extraintestinal manifestation of an IBD of unknown origin ?
-Total colectomy result in relief of extraintestinal signs & symptoms
-Extraintestinal symptoms may precede gastrointestinal symptoms
-Arthritis usually involve small joints
-Arthritis are more cþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@’÷¿ÿÿÿÿ¨ñþ”@’÷¿ÿÿÿÿ¨ñþ“@
-Stop antihistamine 2-4 wks before
-Stop BCP 4-6 wks before
-Continue both drugs
NB: BCP will increase the risk of hypercoagulable state
541. What is Mallet finger ?
-Fixed flexion of DIP. With loss of active extension caused by rupture of the extensor tendon.
NB: MCCQ 2001 (PL9)
542. All the following occurs in intestinal obstruction EXCEPT:
-Distention
-Increased bowel sounds
-Guarding
543. Post-op lady complain of red painful swelling, calf is free of pain. Diagnosis. ?
-DVT
-Superficial thromboflebitis
544. The most consistent finding in Fetal Alcohol Synd. is:
-Microcephaly
545. Young boy with abdominal Mass not moving with respiration. All can be diagnosed EXCEPT:
-Wilm's tumor
-Neuroblastoma
-Double jejunum
-Meckel's diverticulum
546. Cholostrom protects infection by:
-IgM
-IgA
-IgG
547. Child have ingested 20 tablets of Iron. All can appear EXCEPT:
-Necrotizing Enterocolitis
-Shock
-Metabolic acidosis
-Coma & death
-Cerebellar involvement is an early symptom
548. Pt. Present increased ALP (alkaline phosphatase) & normal Ca++ . Diagnosis. ?
-Pagets dis of the bone
-Scurvy
-Hyperphosphatemia
549. All are irritant to mucus memb. EXCEPT:
-SO2
-NO2
-CO
550. In coarctation of the aorta we find all EXCEPT:
-Delayed radial femoral pulse
-Increase upper limb BP.
-Continues mumur in the chest
551. What is the most imp. risk factor for stroke ?
-Smoking
-Systolic HT.
552. What population group is expected to increase in Canada next years ?
Neonates
-10-15 years.
-20-40 years.
-40-65 years.
-Above 65 years.
553. The prevalence of a recessive gene is 1:40000. What is the prevalence of the disease In community ?
-1:200
-1:400
-1:4000
NB: square root of the 1:40000 = 1:200
554. What is the policy of Canada to decrease the health expenditure ?
-Advise the health professional to use the health resources
555. Pt. Presented with cardiac arrest. Which describes the best action ?
-IV lidocaine routinely given
-IV Adrenaline every 10 min.
-Chest compression will keep circulation for cerebral flow
-Atropine every 2 min.
556. F. Pt. Comlain of paralysis of the Rt. Side of body after divorce. What is your diagnosis ?
-Conversion disorder
-Malingering
-Factitious disorder
557. Nurse with repeated attack of hypoglycemia. Investigation reveal increased serum insulin but low serum C-peptide. Management ?
-GH test
-GTT (glucose tolerance test)
-Psychiatric assessment
558. Erb's palsy associated with
Shoulder distocia
559. The maneuver of Flexion of the thighs against the hips is helpful in the delivery of:
-Shoulder dystocia
560. The most common cause of late postpartum hemorrhage is
-Uterine atony
-Evacuation of vaginal hematoma
-Subinvoluted uterus
-Cervical laceration
561. Lady after a prolonged labor she delivered a 4 kg. Neonate. She is not able to urinate. Diagnosis. ?
-Urethral trauma
-Maternal dehydration
-Uterine atony
-Bladder atony
562. Postpartum lady present with failure to lactate, generalized weakness, you do all the following EXCEPT:
-TSH
-T4
-FSH & LH
-prolactine
563. Individual % of infertility, what is the highest ?
-Uterine abnormality
-Male factor
-Ovarian cause
-Cervical cause
564. Primigravida in labor, fetus at 0 station, cephalic presentation, occiputo-transverse, cervix 4 cm dilated for 6 h. Efficient uterine contractions every 5-10 min. lasting 10 sec. What is your diagnosis ?
-Obsructed labor
-Normal latent phase
565. Propranolol is used in all EXCEPT:
-Bipolar disorder
-Aggressive violent disorder
-Social phobia
-Lethium tremor
-Acathesia
566. The natural growth rate =
-Birth rate - immigration rate
-Birth rate - death rate + immigration
-Birth rate + immigration rate
567. While you are waiting for Culture & sensitivity test. What will you treat shigellosis with ?
-Ampicillin
-TMP\SMX
-Erythromycin
568. Child with BP 150\90 mmHg. You suspect coarctation of Aorta. What is the most common finding ?
-Increase BP. In Rt. Upper limb than in the Lt. Upper limb
-Increase BP. In lower limb more than Upper limb
-Increase BP. In the Upper limb more than the lower
569. Pt. With DM. Presented with history of diarrhea. What is the most likely cause ?
-Autonomic diarrhea
-Infectious diarrhea
-Inflammatory diarrhea
570. Young single M. With history of dementia, ataxia & cognitive disorder. Diagnosis. ?
-Depression
-AIDS related dementia
-Alzheimer's disease
571. F. Came with history of fever 39 , abb. pain. PE: febrile, bilateral lower abdominal pain with Lt. side Mass tender. One week ago pt. was diagnosed with clamedia by culture & sensitivity. Whats your approach to treat her ?
-Ceftriaxone
-Oral Doxycycline
-Out patien oral Doxycycline & IM. Ceftriaxone
-Inpatient oral Doxycycline & IV. Ceftriaxone
572. Pt. With repeated abortion. All are possible causes EXCEPT:
-Decreased lutheal phase
-Septate uterus
-Incompetent cervix
-Rupture heamorrhagic corpus luthium
573. Pt. came with an acute episode Lt. Renal colic, IVP shows Lt. Calculi at the ureter at the level of L.4 . There is small dye leak beyond the calculi, Lt. Kidney enlargement. Management ?
-Hydration
-Observation
-Remove the stone by retrograde cystoscopy
-Lithotripsy
574. Young man came with history of automobile accident, multiple anterior chest fracture and hoarseness , chest x-ray shows widened mediastinum, whats your immediate management?
-Intubation
-Support the anterior chest fracture
-Pericardial synthesis
-Aortic angiogram
575. Schizophrenic Pt. on phenothiazine came with history of gremacing, purposeless movements of the limbs, Diagnosis. ?
-Tar dive Dyscanasia
-Acathesia
-Neurolyptic Malignant Syndrome
576. A known Pt. With bipolar disorder brought to u with history of agitation , paranoid, delusion, and grandiosity . Whats your action ?
-Benzodiazepen
-Lithium and Antisycotic
-Antisycotic
-Antidepressant
577. Pt. Came to u after he divorced his wife, he has history of depressed mood, which of the following factors prompts you to start antidepressant ?
-History of divorcing before
-History of mother and sister treated with antidepressant
-History of alcohol
578. What is the commonest complication of DT. ?
-Heart failure
Renal failure
Respiratory failure
579. All are true regarding Hantington disease EXCEPT:
Onset at mid 60's
Autosomal dominant
Progressive disease
Associated with depression
Association with dementia
NB. The normal age of onset is between 40's & 60's
580. In thyrotoxicosis all are true EXCEPT:
Amenorrhoea
Weight loss
Change of appetite
581. The best time to amniosenthesis is:
16 wks
12 wks
20 wks
30 wks
582. F. Pt. 82 years, she has been on digoxin 25 mg & hydrochlorothiazide 50 mg daily for chronic congestive heart failure. Now she has increasing dyspnea. Lab finding:
Heamoglobin 12.5 gm\100 ml
BUN=18 mg\100 ml
Na=135 mEq\L
K=3.1 mEq\L
Cl=90 mEq\L
HCO3=30 mEq\L
C-X ray shows evidence of pulmonary congestion and ECG shows an atriel rate of 250\min, variable A-V block and a ventricular rate of 100\min. management. ?
-Continue digoxin & increase hydroclorothiazide to 50 mg\day
-Continue both the Digoxin and hydrochlorothizideand begin Furosenamid 40 mg daily.
-Stop Digoxin & Hydrochlorothiazid and begin potassium supplements
-Continue digoxin & stop hydrochlorothiazide & add K suplements
-Stop all drugs & immediatly carry on electrical rhythm reversion
583. Which of the following abnormalities is not true paradoxical:
-Paradoxical respiration
-Paradoxical Embolism
-Paradoxical Pulse
-Paradoxical Splitting of the 2nd Heart sound
584. A child with known Juvenile polyposis. What will be the most likely complication ?
-Diarrhea
-Painless bleeding
-Painful bleeding
-Cancer
-None of the above
585. All are associated with oligohydramnios EXCEPT:
-Renal agenesis
-Polycystic kidney
-Meningiocele
-Potter's syndrome
-Amniom nodosom
586. Neonate 1 month with pneumonia. What is the most likely causative agent ?
-E. Coli
-GBS
-S. Pneumoniae
-H. Influenza
-N. Meningetidis
587. Pt. Present with convulsion after she has been on IV fluid for a long time. Investigation shows
Na=120
K=3
HCO3=16
What will be the best treatment ?
-Normal saline
-Hypertonic saline + diuretics
-5% dextrose
-Furosemide
-Phenytoin
NB: MCCQ 2001 (NP11)
588. You can do ALL Regarding shoulder dystocia EXCEPT:
-Oxytocin
-Flex the mothers leg
-Break the clavicle
-Rotate the shoulders
-Suprapubic pressure
589. The most common complication in Epidural anasthesia is:
-Hypotension
590. All are side effects of B agonists during preterm labor EXCEPT:
Acute Pulmonary Edema
-Tachycardia
-Angina
-Increase of glycemia
-None of the above
591. Pt. Complains of pain in the LLQ. & fever. PE: slight abd tenderness. What do u do to confirm the diagnosis ?
-Biopsy
-Barium enema
-Peritoneal Lavage
-Rectosigmoidoscopy
-US
NB: diagnosis Is diverticulitis
592. Known alcoholic arrived to ER with large bilious vomiting, then he vomited large amount of red blood & complains of pain. What is the most likely diagnosis ?
-Perforated ulcer
-Esophageal junction rupture
-Ruptured Esophageal varice
-Acute gastritis
NB: (Mallory-Weiss tears)
593. After you insure vital function (ABC) what will be your initial step in the management. of a known alcoholic pt. brought in coma ?
-Vit. B1 (thiamine)
-Lorazepam
-Look for the subdural heamatoma
-Quick control of glycemia (finger prick)
-Administer K
594. What is the most imp. Side effect of CLOMIPHENE ?
-Ovarian cyst
-Stimulation of ovulation
-Treatment of anovulation
-Anti Estrogen
595. In all there is increased IgE. EXCEPT:
-Asthma
-Chronic bronchitis
-Allergic rhinitis
-Eczema
596. In Acute colicystitis what is the pathophysiology ?
-Bacterial invasion of gallbladder
-Obstruction of the common bile duct
-Obstruction of the cystic duct
-Obstruction of the common hepatic duct
597. With HPV infection you may find:
-Purulent discharge
-Nonpurulent discharge
-Condyloma accuminata
-Condyloma lata
598. Study shows that specific mortality rate for stomach CA tends to decrease. What is the most likely explanation ?
-Decreased Prevalence
-Decrease Incidence
-Better screening
-Better treatment
599. All the following will help you to suspect menopause in a 57 years lady EXCEPT:
-Vaginal mucous atrophy
-HT
-Flush
-Sleep disturbances
-Osteoporosis
600. All are indications of chorion villous sampling EXCEPT:
-Tay-Sachs disease
-Hygroma Coli
-Turner syndrome
-Translocation
-Myelomeningeocele
601. All the following can cause bloody diarrhea EXCEPT:
-Yersinia Enterolitica
-E. Coli
-Shigella
-Campylobacter
-Giardia lamblia (Rocky M.)
602. Which germ is found in uncooked eggs ?
-E. Coli
-Staph. Aureus
-Shigella
-Giardia
-Salmonella
603. 32 years old lady with agitation, hyperthermia, palpitation , loss of weight
And sweating. What is the initial test to do ?
-Thyroxin (T4)
-TSH
-Thyroid scintigraphy
-Thyroid U\S
-Triiodothyronin (T3)
604. Postpartum Pt. Wishes to stop lactation for personal reasons , how will you prevent the pain resulting from breast engorgement?
-Prescribe Oxytocin
-Apply bandage to protect clothes
-Medical treatment is useless most of the time
-Antiprolactin
605. 45 years old male 3 months after car accident, presents with agitation, insomnia and nightmares. He is anxious and there is deterioration in the sexual relationship with his wife. Whats your diagnosis?
-Impaired intimacy with his wife
-Depression
-Masked anxiety
-PTSD
-Sexual dysfunction
606. Female 60 years old with constipation for many months, she has not passed stools for the last 3 days. On examination the abdomen is distended but non tender. What is your management ?
-Laxative
-High fiber diet
-Mineral oil
-Enema
607. Following a gun shot a Pt. Presents with a swollen right leg, distal pulse is weak, veins are distended. What is the likely cause?
-Unilateral vein thrombosis
-Arterial emboli
-Femoral nerve injury
-Post traumatic superficial vein insufficiency
-Arteriovenous fistula
608. Female 60 years old on multiple drug treatment for breast cancer with bone metastasis. Lately she had severe pain and increased dose of opioid x 3,
now she presents with constipation ,lethargy ,and apathy. Whats the likely diagnosis?
-Gastroenteritis
-Gastrointestinal metastasis
-Drug intoxication
-Fecal impaction
609. Alpha Fetoprotein is increased in all of the following except?
-Omphalocele
-Potter syndrome
-Anencephaly
-Meningomyocele
-Spina bifida
610. Which test will help to objectively diagnose fetal heart beat at 16 weeks ?
-US
-NST (non stress test)
-Doppler
-Abdominal x-ray
611. Female 18 years old complaining of primary amenorrhoea, BhCG is negative .Which test will you do to diagnose an hypothalmopituatary disease?
-Pelvic examination
-Prolactin and TSH
-CT of the sella tursica
-Provera challenge test
-FSH and LH
612. Regarding symmetrical Intrauterine growth restriction , what is the most likely cause?
-Intrauterine infection
-Maternal renal disease
-Maternal diabetes
-Drug abuse
613. Rheumatoid factor will be found in all of the following EXCEPT:
-RA & Juvenile RA
-SLE
-Sjogren's disease
-Dermatomyositis
-None of the above
614. A child with hepatosplenomegaly and mental retardation, he has positive reducing substances in the urine ,Diagnosis?
-Galactosemia
-Cystinuria
-Von Gierke disease
-Fructose intolerance
615. Child 13 years old, obese with painful right knee and right hip, he is limping. On examination there is reduced abduction and internal rotation, diagnosis?
-Juvenile arthritis
-Septic arthritis
-Avascular necrosis of the femoral head
-Slipped femoral capital epiphysis
616. A known alcoholic man admitted in the E R with fever ,coughing off profuse and purulent sputum . On examination ronchi on the right lower lung, diagnosis ?
-Lobar pneumonia
-Lung abscess
-COPD
-TB
617. A lady with occasional severe attack of dyspnea with facial edema. On examination severe respiratory distress, red and inflamed pharynx. what is your management ?
-Adrenalin for out pt. usage
-Cortison I.V
-Lateral x- Ray of larynx
-Epinephrine SC (subcutaneous)
-Intubation
618. A carpenter has difficulties holding things with hypoesthesic trouble of fingers of the the Rt. Hand. Which exam will help u to establish the diagnosis ?
-Xray of the cervical spine
-Xray of hand
-EMG
-Examination of the rotator cuff
-Neurologic exam of the hand
619. F. 70 years present with muscle weakness with dysphagia & change of the skin color of the hand induced by cold weather, with telangiectasia. Diagnosis. ?
-Dermatomyositis
-Fibromyositis
-Sclerodermia
-SLE
620. Asiatic man recently came as immigrant to Canada. He took chloroquine 4 wks & 2 days before his arrival (to treat his Malaria infection). 2 years later he develops fever of unknown origin. What is the most likely cause ?
-Malaria reinfection
-1st episode of malaria was not treated sufficiently
-The strain was resistant to treatment
-Remnant active schizontes in the liver
621. All the following are characteristics of a narcotic intoxication EXCEPT:
-Myosis
-Bradycardia
-Dry mouth
-Constipation
-Orthostatic hypotension
622. Pt. 3 days postpartum develops Endometritis. Which is not a finding in this case ?
-Low abdominal pain
-Oliguria
-Tachycardia
-Purulent lochia
-Uterus below symphysis
623. Newborn 3 wks. Hypotonic & totally constipated, his abdominal seems distended but not painful. Diagnosis. ?
-Hirschprung disease
-Hypothyroidism
-Volvulos
-Intususception
-Milk intolerance
624. What is the sign which allows you to make a difference between -ankylosing spondylitis & RA.
-Joint deviation
-Joint nodules
-Joint effusion
-Sacroiliac involvement
625. Child 9 years brought by his mother, present headache, nausea & vomiting. He feels tired & easily falls asleep. Diagnosis. ?
-Migraine
-Cerebral tumor
-Temporal epilepsy
-Simulation (faking)
626. All are characteristics of Alzheimer’s disease EXCEPT:
-Aphasia, Apraxia, Agnosia
-Loss of acquisition of recent facts
-Loss of abstract thinking
-Loss of consciousness of his environment
-Loss of old imp. facts
627. All may cause epiglotitis in a child EXCEPT:
-Hemophilus influenza
-Tobacco smoke
-Parainfluenza virus
-Hydrocarbure ingestion
-Acute allergy
628. The most common cause of PP (precocious puberty) in a girl is:
-Gonadic tumor
-Von Reclinghausen disease
-Idiopathic PP
-Adrenogenital syndrome
-Pituitary Tumor
629. Which is the commonest cause of mortality in children aged 5 A 9 years in Canada ?
-Leukemia
-Cancer
-Accident
-Congenital malformation
630. Comparing characteristics of Infectious mononucleosis in a child Vs. Adult, which of the following is true ?
-Its more severe in children
-Typical form is rare in children
-Immunization is better
-Dis. last longer
-Need to do throat culture & sensitivity
-Mono spot test is negative.
631. What will be the effect of increasing the prevalence of a disease for a screen test ?
-Increase in the sensitivity of the test
-Increase in the specificity of the test
-Increase in the PPV.
-Increase in the NPV.
-Increase in the sensitivity & PPV. of the test
632. Which is contraindicated for forceps delivery ?
-The presenting part at station -1
-3rd degree laceration
-Breech presentation
-Large caput
633. Pt. In labor after delivery of 1st twin has the other twin in vertex presentation & at station -1, memb. are ruptured. There is no contraction for 20 minutes. What will u do ?
-Oxytosin drip
-C-section
-Forceps
-Vacuum
-Wait
634. F. Came from Greece complaining from fatigue & weakness, she is pale. Investigation shows
Hb.= 10 gm \ dl.
MCV=70
What are you going to do next to reach the diagnosis ?
-Bone marrow aspiration
-Reticulocyte level
-Hb. Electrophoresis
-Serum iron level
-Trial treatment with B.12
635. Pt. 17 years with factitious disorder. All can be found EXCEPT:
-Family history of similar episode
-The pt. knows about medical treatment
-He wishes to attract attention on him
-He has a particular interest in medical profession
-Works in medical profession
636. Pt. 23 years with single thyroid nodule. What will make u suspect malignancy ?
-Thyroid US
-Cold nodule on thyroid scan
-Hot nodule on thyroid scan
-CT of the cervical spine
637. An infant present with inflamed pharynx & fever. He was treated with antibiotics. A week later he presents again with trismus. Diagnosis. ?
-Tetanus
-Pharyngitis
-Infectious mononucleosis
-Peritonsillar abscess
-Streptococal tonsillitis
638. Why is chorionic vilous sampling not commonly done in Canada ?
-Its expensive
-Doctors dont have enough experience
-Results are not reliable
-Its dangerous
-Because the prevalence of the diseases that it can detect is low
639. All can cause mania EXCEPT:
-Phenelzine
-Trazodone
-Methyphenidate
-Cortisone
-Levodopa
640. A 74 years old pt. With whitish asymptomatic urethral discharge. The investigation of the germ will reveal :
-Chronic prostatitis and gonococcal urethritis
-Non specific urethritis
-Urinary infection
-Acute prostatitis
641. What is the allowed amount of GNP (gross national product) to health in Canada ?
-4% A 8%
-8 % A 12 %
-12 % A 15 %
-16 % A 24 %
-25 % A 36 %
642. Hyperglycemic Pregnant Pt. with level 9.8 gm\L. after OGTT (oral glucose tolerance test) with 50 gm. Which of the following should not be done ?
-Prescribe chlorpopramide
-Give Insulin
-Administer B blocker
-Do a OGTT at 75 gm. at 2 h.
-Diet
NB: screening with 50 gm OGTT :
# If blood glucose between 7.8 & 10.3 mmol\L then repeat with 2 hrs. 75 gm. OGTT
# If blood glucose more than 10.3 mmol\L then diagnosis of diabetes is made ...
# Oral hypoglycemics are contraindicated in pregnancy
643. Child 6 years old brought by his mother with fever and red throat, lips fissures ,cervical adenopathies and rash of extremities. You found a fine peeling at the hands, palms and soles of the feet. you will think of:
-Streptococcal infection
-Rubeolla
-Infectious mononucleosis
-Kawasaki disease
-Measles
644. Child 12 months old adopted from eastern Europe. He presents with loss of weight and multiple adenopathies plus splenomegaly associated with skin lesion. What is the diagnosis?
-Proteino\caloric malnutrition
-Acute leukemia
-Infection with pneumocystis carinii
-Child abuse
-HIV infection
645. Form 1971 A 1992 life expectancy for men has increase from 68 A 73 years ,women 73-81 years. What is the most likely cause of these changes ?
-Vaccination
-Better management of ischemic diseases
-Use of antibiotics
-Improvement of life style
-Generalization of health care
646. All the following are a part of diagnosing leukemia in children EXCEPT:
-Thrombocytopenia
-Anemia
-Hemoglobinuria
-Granulocytopenia
-Neutropenia
647. You can do all of the following investigations in a pregnant pt. Post term EXCEPT:
-U\S for examination of amniotic fluid
-Amniocentesis for dosage of alpha fetoprotein
-BPP
-Fetal biometry
-Non stress Test
648. F. 55 years old presents for 1 month memory trouble plus hallucination, agitation, hypotension, and hot flashes. She has visual trouble with pupils fixed in mydriasis, what is the most likely causative substance ?
-Haloperidol
-Benztropin
-TCA
-Fluxotin
-Phenelzine
649. Upon the lung cancers which one is the most sensitive to radiotherapy?
-Dermoid carcinoma
-Squamous cell carcinoma
-Adenocarcinoma
-Small cell carcinoma
-Undifferentiated small cell carcinoma
650 which of the following is the main complication of dermoid ovarian cyst ?
-Infection
-Necrosis
-cancerisaton
-Torsion
651. Which of the following is a characteristic of a person with somatization trouble ?
-The person knows that he has psychological trouble
-Multiple somatization trouble
-Hypochondria
-Feeling of malformation
-Knows that his troubles are not true but he can’t avoid them
652. What’s the best criteria for estimating population health?
-Amount of money spent on health
-GDP
-Ratio of physicians per habitant
-Number of hospitals
653. What is the best way to appreciate health care quality during pregnancy and delivery in Canada?
-Neonatal mortality rate
-Perinatal mortality rate
-Infant mortality rate
-Maternal mortality rate
654. Regarding child schizophrenia which is true ?
-Signs are identical to the adults
-Risk is 10 % if one of the parents has schizophrenia
-Pronostic is good if it appears early
-Complete presentation from the beginning
-Hallucinations are more frequent
655. A couple went for holiday in Mexico, they severe diarrhea. Diagnosis. ?
-E. Coli
-Giardia lambia
-Enterobacter
-Salmonellosis
NB. The treatment of choice for traveler’s diarrhea caused by Enterotoxigenic E. Coli is : Cyprofloxacin.
656. Pt. 27 years. Known to have manic trouble for many years, he is brought to the ER. Agitated & Excited. What is the most appropriate treatment ?
-Carbamazepin
-Imipramine
-Clonazepam
-Lorazepam
-Phenelzine
657. All are part of KAWASAKI EXCEPT:
-Coronary heart disease
-Lips fissures
-Peeling of extremities
-Generalized adenopathy
-Strawberry tongue
658. Pt. Presents with lumbar pain after lifting a heavy object. Lumber X Ray shows lesions at L5-S1 level. Waht will u find on examination ?
-Absent knee jerk reflex & paresis of gastrocnemius muscle
-Absent knee jerk reflex & achiles reflex & paresis of quadriceps
-Absent achiles (ankle jerk) reflex & paresis of gastrocnemius muscle
-Absent achiles (ankle jerk) reflex & paresis of peroneal muscle
659. B agonist used for preterm labor, may cause all EXCEPT:
-Headache
-Respiratory distress
-Tachycardia
-Hyperglycemia
-Angina
NB: to be checked
660. Which of the following CA is caused by vinyl chloride ?
-Lung CA
-Esophagus CA
-Rhinopharynx CA
-Liver CA
-Bladder CA
661. Proparonol may be given in ALL the following EXCEPT:
-Hypertension
-Hyperglycemia
-Lithium induced tremors
-Panic disorder
-Chest Angina
Good Luck in the real exam ..
Done by ;
Dr. Athir Ghanim
Dr. Firas Al-Hanafi
Dr. Roger
Dr. J. C.
Dr. Tariq Al-Qubaty
1. D
2. A
3. D
4. D
5. D
6. A
7. A
8. A
9. A
10. A
11. A
12. A
13. A
14. B
15. A
16. A
17. D
18. A
19. A
20. A
21. A
22. A
23. A
24. D
25. A
26. C
27. A
28. B
29. A
30. C
31. A
32. A
33.
34.
35. A
36. D
37. C
38. A
39. A
40. A
41. B
42. D
43. A
44. D
45.
46. B
47. C
48. B
49. B
50. D
51. D
52.
53. B
54. D
55. D
56. A
57. C
58. C
59. E
60. D
61. B
62. D
63. C
64. C
65. A
66. B
67. C
68. C
69. C
70. A
71. B
72. B
73. E
74. D
75. B
76. D
77. E
78. B
79. C
80. A
81. A
82. A
83. A
84. A
85. A
86. A
87. D
88. A
89. A
90. A
91. B
92. C
93. A
94. A
95. A
96. A
97. A
98. A
99. D
100. A
101. A
102. D
103. E
104. A
105. D
106. A
107. B
108. A
109. D
110. A
111. C
112. A
113. A
114. A
115. E
116. B
117. A
118. A
119. A
120. C
121. C
122. A
123. A
124. B
125. C
126. D
127. A
128.
129. D
130. D
131. A
132. C
133. C
134. A
135. D
136. A
137. E
138. B
139. E
140. A
141. A
142. B
143. C
144. A
145. B
146. C
147. A
148. A
149. A
150. A
151. B
152. D
153. A
154. B
155. C
156. D
157. A
158. C
159. A
160. A
161. A
162. C
163. B
164. B
165. C
166. A
167. A
168. E
169. A
170. B
171. A
172. C
173. B
174. A
175. A
176. C
177. A
178. C
179. B
180. B
181. C
182. B
183. D
184. A
185. A
186.
187.
188.
189.
190. D
191. D
192. D
193. B
194. A
195. A
196. B
197. C
198. D
199. A
200. C
201. A
202. A
203. A
204. A
205. C
206. C
207. A
208. C
209. C
210. D
211. A
212. A
213. C
214. A
215. A
216. A
217. A
218. A
219. B
220. C
221. C
222. A
223. D
224. A
225. C
226. A
227. A
228. C
229. A
230. A
231. A
232. A
233. A
234. A
235. B
236. A
237. A
238. A
239. A
240. A
241. A
242. A
243.
244. A
245. A
246. B
247. C
248. A
249. D
250. B
251. E
252. B
253. D
254. C
255. C
256. C
257. A
258. B
259. A
260. B
261. A
262. B
263. B
264. A
265. B
266. C
267. A
268. A
269. A
270. A
271. B
272. A
273. C
274. B
275. B
276. C
277. B
278. A
279. D
280. A
281. B
282. D
283. B
284. E
285. C
286. B
287. E
288. D
289. D
290. A
291. D
292. C
293. B
294. C
295. D
296. E
297. C
298. C
299. B
300. C
301. E
302. B
303. B
304. D
305. D
306. E
307. E
308. C
309. D
310. A
311. A
312. C
313. B
314. A
315. A
316. A
317. A
318. B
319. A
320. A
321. A
322. A
323. D
324. C
325. D
326. A
327. D
328. C
329. A
330. A
331. B
332. D
333. A
334. C
335. A
336. B
337. A
338. B
339. A
340. E
341. A
342. A
343. D
344. A
345. A
346. A
347. A
348. A
349. B
350. A
351. A
352. C
353. A
354. A
355. B
356. B
357. B
358. C
359. A
360. C
361. A
362. A
363. B
364. B
365. B
366. B
367. B
368. A
369. A
370. B
371. A
372. C
373. C
374. B
375. D
376. B
377. B
378. A
379. A
380. A
381. B
382. B
383. B
384. A
385. B
386. B
387. B
388. A
389. A
390.
391. B
392. A
393. C
394. A
395. B
396. B
397. A
398. C
399. C
400. A
401. B
402. A
403. C
404. D
405. C
406. A
407. A
408. C
409. A
410. D
411. C
412. D
413. A
414. D
415. B
416. C
417. C
418. C
419. D
420. C
421. C
422. C
423. C
424. D
425. C
426. C
427. B
428. A
429. A
430. B
431. A
432. A
433. A
434. B
435. A
436. A
437. C
438. E
439. B
440. A
441. C
442. A
443. C
444. B
445. A
446. C
447. A
448. A
449. B
450. B
451. B
452. A
453. V
454. .C
455. A
456. A
457. B
458. A
459. C
460. D
461. D
462. B
463. A
464. A
465. A
466. C
467. C
468. A
469. A
470. A
471. A
472. A
473. C
474. A
475. A
476. D
477. B
478. A
479. A
480. B
481. A
482. A
483. B
484. A
485. A
486. C
487. B
488. C
489. A
490. A
491. A
492. A
493. A
494. A
495. B
496. A
497. B
498. A
499. A
500. A
501. A
502. D
503. B
504. C
505. A
506. B
507. A
508. B
509. A
510. D
511. C
512. A
513. A
514. A
515. A
516. D
517. A
518. A
519. C
520. A
521. A
522. B
523. B
524. A
525. A
526. A
527. B
528. D
529. B
530. B
531. B
532. B
533. B
534. B
535. B
536. B
537.
538.
539.
540.
541. A
542. C
543. A
544. A
545. C
546. B
547. E
548. A
549.
550. C
551. A
552. D
553. A
554. A
555. C
556. A
557.
558. A
559. A
560.
561. D
562. B
563. B
564. A
565. A
566. B
567. B
568. C
569. A
570.
571.
572. D
573. C
574. A
575. A
576. B
577. C
578. A
579. A
580. A
581. A
582. C
583. C
584. B
585. C
586. B
587. B
588. A
589. A
590. D
591. E
592. B
593. D
594. A
595. B
596. C
597. C
598. B
599. B
600. E
601. E
602. E
603. B
604. C
605. D
606. D
607. E
608. C
609. B
610. A
611. E
612. A
613. E
614. A
615. D
616. B
617. D
618. C
619. C
620. D
621. C
622. E
623. B
624. D
625. C
626. D
627. B
628. C
629. C
630. B
631. C
632. A
633. A
634. C
635. A
636.
637. D
638. D
639. D
640. B
641. B
642. A
643. D
644. E
645. D
646. C
647. B
648. B
649. B
650. D
651. B
652. B
653. B
654. B
655. A
656. A
657. D
658. C
659.
660. D
661. B
662.
663.
664.
665.
666.
667.
668.
669.
670.
671.
672.
673.
674.
675.
676.
677.
678.
679.
680.
681.
682.
683.
684.
685.
686.
687.
688.
689.
690.
691.
692.
693.
694.
695.
696.
697.
698.
699.
700.
701.
702.
703.
704.
705.
706.
707.
708.
709.
710.
711.
712.
713.
714.
715.
716.
717.
718.
719.
720.
721.
Qx / Sample Questions from MCCEE January 2004
1. Wrist drop, which nerve is affected?
a) median nerve
b) radial nerve
c) ulnar nerve
answer: b
2. Characteristic of borderline personality disorder is:
Answer: splitting
3. Femur fracture with angulation, lower leg is pale, pulseless and cold, what’s the first management?
a) straighten the leg and traction
b) immediate operation
4. In designing a community prevention program, which one should be undertaken first?
a) obtain guarantee of funding
b) estimate the cost-benefit of intervention
c) quantify objectives
d) carry out a community needs assessment
e) formulate possible strategies of screening
answer: d
5. All can cause depression except:
a) cimetidine
b) corticosteroids
c) cephalosporines
answer: c
6. cricothyroidectomy is indicated for
a) foreign body in the trachea
b) severe facial injuries
c) C5-C6 spine injuries
7. child with yellow skin, which one is indication of carotenemia?
a) no discoloration of the sclera
8. patient said his boss let him come to see u because he always cannot keep good relationship with his colleagues, he thinks his boss is harassing him, what’s the probable diagnosis?
a) borderline personality discorder
b) dependent personality discorder
c) schizotypal personality discorder
9. young lady with sudden onset right lower quadrant pain, pregnancy test is negative. Pelvic examination reveals 6cm severe tender right adnexal mass, diagnosis?
a) adnexal torsion
b) ruptured ovarian cyst
c) ectopic pregnancy
10. old patient referred by his dentist with white lesion in his mouth, management?
Answer: biopsy
11. old patient with whitish thickening lip, management?
a) biopsy
12. child bitten by some kind of insect came with symptoms of anaphylactic shock, management?
Answer: SC epinephrine
13. picture shown whitish lesions on the tongue (oral thrush) of an old woman after taking antibiotics for 10 days. Management?
a) mycostatin gurgle
b) coticosteroids
c) amphotericin
answer: a
14. all drugs r teratogenic except:
answer: heparin
15. typical senario of trigeminus neuralgia, what do u give?
Answer: carbamazepine
16. all of the following is true about incidence except:
a) estimate the risk of acquiring the disease in community
b) useful for etiology analysis for both acute and chronic diseases
answer: b
17. most common irritant for child asthma at home:
a) rugs
b) pets
c) plants
d) smoking
18. best diagnosis of chronic pancreatitis:
a) CT
b) ERCP
c) serum amylase
answer: b
19. common symptom of cardial tamponade and pneumothorax:
a) hypotension
b) bradycardia
c) decreased venous pressure
answer: a
20. which of the folloing most suggests a pneumothorax?
a) deviation of trachea
b) paradoxical respiration
21. 30 y.o. female patient, her father has huntinton chorea, how big is the chance that she also has the disease?
Answer: 50%
22. patient after big operation develops suddenly dyspnea, chest pain (probably PE), the most likely finding on chest x-ray is:
answer: normal
23. patient with obstructive pulmonary disease, which of the following ABG finding suggests oxygen therapy may be dangerous:
a) pH=7.34, pCO2=60, bicarbonate=30
b) pH=7.4, pCO2=40, bicarbonate=24
c) pH=7.19, pCO2=25, bicarbonate=forgotten
answer: a (primary respiratory acidosis and compensation with metabolic alkalosis)
24. imperforated hymen is associated with all of the following except:
a) abdominal mass
b) limb paralysis
c) obstruction of venous return
d) hydronephrosis
25. police took a man who sexually assaulted a boy. When u asked him how many legs does the horse have, he answered ‘5’. Dignosis?
Answer: factitious disorder
26. followings r characteristics of psychoanalysis except:
a) contertransference
b) resistance
c) rehearsal
27. 18 y.o. freshman came to u asking about the best way to prevent HIV transmission, your best answer is:
a) combination use of condom and spermacide
b) sexual abstinence
c) judicious use of condom
d) HIV test of partners
28. patient taking many drugs including ACEI, TCA and… complaints of impotence, which drug is most likely to cause this symptom?
a) ACEI
b) TCA
29. female patients presents with palpitation, EKG shows occasional premature ventricular beats, management?
Answer: reassurance
30. young lady complaints of hopelessness, decreased in concentration especially at the end of the day. management?
a) time off work
b) antidepressant
c) psychosocial support and return visit
d) psychosocial support and lorazepam
31. young female patient with genital herpes, what do u suggest?
a) she can not conceive in the future
b) she can conceive but she should tell her obstetrics about her herpes history
answer: b
32. newborn with hart rate 40/min, irregular respiration, some flexion of the extremities, grimace to nasal catheter. He is pale and blue. Apgar score is?
a) 2
b) 3
c) 4
d) 5
e) 6
33. newborn with congestive heart failure, is acyanotic, most likely cause?
a) TOF
b) ASD
c) aoteric stenosis
34. patient on warfarin for phlebitis presents with spontaneous bruises and petechiae. INR is also increased. Management?
a) reduce warfarin
b) stop warfarin
c) stop warfarin + vitamin K
d) stop warfarin + fresh frozen plasma
35. scenario of endometriosis, definitive diagnostic method?
Answer: laparoscopy
36. female patient presents with right lower quadrant pain. Now she also complains of epigastric and left abdominal pain. On examination, she has tenderness on epigastrium and left abdomen. Fever 38C, labor:… your management within 30 min includes all of the following except:
a) repeat abdominal examination
b) check BP and pulse on standing
c) pelvic examination
d) requisition of ultrasound which is scheduled in next week
37. one disease family tree, ask what inheritance type
a) autosomal recessive
b) autosomal dominant
c) X linked recessive
d) X linked dominant
e) multifactorial
38. patient on lithium presents with fatigue, weight gain and constipation. Investigation?
a) serum electrolytes
b) serum lithium level
c) TSH
answer: c
39. black woman, nullipara, jogs 30 minutes three times a week. She smokes for 20 years. Height 150cm, weight 50kg. which of the factors increase the osteoporosis?
a) her race
b) her BMI
c) exercise
d) smoking
e) nullipara
answer: d
40. an evidence of decreasing osteoporosis in post-menopausal woman who are taking calcium supplement can be strongest obtained from
a) a randomized control trial of giving calcium tablets and follow up for fractures for 10 years
b) comparison of fracture incidence in postmenopausal women who are living in high and low diary products available
answer: a
41. the most common cause of absence from work is
answer: back strain
42. most important bias factor in cohort study is
a) follow up
b) recall
answer: a
43. patient presents with hematuria and albuminuria. Which test can confirm the diagnosis of acute glomerolonephritis?
a) abdomen US
b) ASO titre
44. all of the following are associated with posterior hip dislocation except:
a) avascular necrosis of femoral hear
b) sciatic nerve injury
c) femoral nerve injury
45. your colleague was preparing to do a surgery. You found out his gait is abnormal and you got smell from him. You let him not to do the surgery but he said it was not your business. What should you do?
a) inform the chief of staff on the next morning
b) inform the CEO immediately
c) let another colleague help to talk to him
46. patient on clozapine, important side effect of this drug:
answer: agranulocytosis
47. pap smear is
a) primary prevention
b) sencondary prevention
c) tertiary prevention
answer: b
48. scenario of acute pyelonephritis, the most common cause is:
a) staphylococcus aureas
b) E. coli
c) Chlamydia trachomatis
answer: b
49. woman with breast cancer was treated with radiotherapy. She was responding well but developed depression. Then, she got pneumonia and died. What is the cause u should write on her death certificate?
a) pneumonia
b) depression
c) brest cancer
answer: a
50. your neighbor called u because their child was choking during eating. U should do:
answer: put the child facing down and give blows on the back at the interscapular area
51. best treatment of bullous impetigo:
a) penicillin
b) amoxicillin
c) cloxacillin
52. patient with lower back pain, x-ray: anterior osteophytes at L4-L5 and subchondral sclerosis, diagnosis:
a) degenerative spondylitis
53. middle aged female patient with gastroesophageal reflux complaints of dysphagia for liquid and solid food. Cause?
a) barrett esophagus
b) squamous cell carcinoma of esophagus
c) adnocarcinoma of esophagus
d) peptic stricture
54. picture shown 6-month-old infant with umbilical hernia. Your management?
Answer: reassurance and recheck at 1 year of age
55. in postoperative period, a patient demanded for morphine for relief of his pain every 4 hours. The attending nurse thought that this patient was lying and told you that the patient should be treated with placebo. What will u do?
a) give placebo
b) not give placebo
c) tell the patient’s relatives for consent to give placebo
56. U are family physician of a lab technician. He always drinks. U will report all the conditions except:
a) you know that a lab technician disturbs his lab works
b) he drives car during drunk
c) he occasionally drives his private airplane during drunk
d) has sexual relationship with his 14-year-of daughter
57. patient presents with recurrent gouty arthritis attack, urinary uric acid is increased, you will prescribe:
a) colchicine
b) allupurinol + colchicines
c) benzbromaron
58. patient post-MI, develops bradycardia with pulse 32/min, the best management
a) atropine
b) pacemaker
answer: b
59. scenario of neuroleptic malignant syndrome, treatment?
a) benzodiazepine
b) bromocriptine
c) benztropine
d) buspirone
answer: b
60. which neurotransmitter in schizophrenia?
Answer: dopamine
61. definition of ergonomics?
Answer: concerned with human factors in the design and operations of machines and the physical environment
62. patient postoperative presented with heavy wound bleeding, she also gave a history of massive bleeding when she had a tooth extraction. Blooding time is increased. You will give:
a) DDAVP
b) factor XIII
c) fresh frozen plasma
answer: a
63. KOH is used to diagnose:
a) candidiasis
b) bacterial vaginosis
c) thichomoniasis
answer: a
64. young male patient with painless scrotal mass, transilumination –ive, management?
Answer: refer to surgery
65. hepatitis B can be transmitted through the following ways except:
answer: fecal-oral
66. the best screening test of primary hyperaldosteronism in hypertension:
answer: serum rennin activity level
67. male patient had problem at work. Now he complains of back pain. Physical exam shows no pathological finding but he obsessed with it. Diagnosis?
Answer: malingering
68. patient with deceitfulness, impulsivity and lack of remorse. Diagnosis?
a) antisocial PD
b) borderline PD
69. boy fell from a tree, presented with abdominal pain and hematuria. U will do:
a) renal scan
b) CT
note: there were no option like ‘IVP’ so I chose CT
70. central tendency: mean systolic pressure: 115mmHg with standard deviation of 15mmHg, ask 95% of the population will have SP of:
Answer: 85-145mmHg
71. incidence of a disease in the exposure group is 137, in the non-exposure group is 8, ask 137/8 is called:
Answer: relative risk
72. decreased mortality rate of stroke is due to:
a) better control of blood pressure
b) regular use of aspirin
c) improvement of surgery process
73. patient treated with amoxicillin for 10 days developed diarrhea, how to confirm your diagnosis?
a) stool culture for clostridium dificile
b) coloscopy
c) test of clostridium dificile toxin
74. newborn needs:
a) 75 kcal/kg/day
b) 115 kcal/kg/day
c) 200 kcal/kg/day
answer: b
75. female with adenomyosis is likely to present with
Answer: bulky uterus
76. scenario of angle closure glaucoma, your first management:
a) miotic eye drop
b) mydriatic eye drop
Answer: a
77. 75 years old man presented with bilateral loss of vision, he gave history of herpes zoster. What is the most likely cause of his visual loss
a) bilateral corneal opacity due to herpes zoster
b) macular degeneration
c) glaucoma
Answer: b
78. post trauma, which of the following signs enforces you to admit the patient?
a) corneal abrasion
b) conjunctival tear
c) soft eye
answer: c
79. shock baby syndrome
answer: you may find intraocular hemorrhage
80. picture shown clubbing fingers, which is NOT the cause?
a) lung cancer
b) chronic bronchitis
c) infective endocarditis
81. child with 2 years history of tourette’s syndrome, now developed obsessive compulsive disorder, what would your give?
a) haloperidol
b) fluvoxamine
82. which cancer can caused by vinyl chloride?
Answer: liver CA
83. which one is not a symptom of lead poisoning?
Answer: liver cirrosis
84. which of the following trauma must be treated first?
Answer: pneumathorax
85. picture of female newborn shown vaginal bleeding, management?
Answer: reassurance
86. patient with anxiety, dysphoria, muscle pain, accasionally convulsion, these are the withdrawal symptoms of which of the followings?
a) benzodiazepine
b) cocain
c) cannabis
87. the difference between male and female sexuality is:
Answer: female has shorter refractory period
88. most common source of silicosis exposure is:
Answer: sandblasting
89. 12 months infant only with breast feeding till now is most on risk of what deficiency?
a) vitamin D
b) iron
c) folic acid
90. child with knee pain, swelling and redness of the knee joint, management?
Answer: knee aspiration
91. Down’s syndrome is associated with the followings except:
Answer: rocker bottom foot
92. patient had barbecue, developed muscle pain, diarrhea, eosinophelia. Best investigation to confirm the diagnosis?
Answer: muscle biopsy
93. scenario of vaginal candidiasis and groin skin candidiasis, the patient probably has:
Answer: DM
94. patient presented with inability to dorsiflex the foot and loss of sensation over the dorsum of the foot, diagnosis?
a) peripheral neuropathy
b) disc compression
Answer: b
95. conversion disorder, all are true except:
a) la belle indifference
b) unconsciousness of the symptoms
c) defence mechanism of projection and intellectualization
96. female vaginal lubrication during sexual excitement period is due to secretion of:
a) cervical glands
b) vaginal glands
c) vaginal transudat
Some Important topics from where maximum questions came in MCCEE May 2005:
1. Gynaecology: cervical cancer, Pap smear, endometrial cancer, menopause etc.
2. Obstetrics: placenta praevia, ectopic pregnancy, PID, abortions, complications at delivery, eclampsia, pre-eclampsia etc.
3. Paediatrics: Don’t leave anything. Study everything, esp. child psychology.
4. Psychiatry: Read whole of Psychiatry very thoroughly esp. the Personality disorders, childhood disorders.
5. Social Medicine & ethics: read " doing right" by Philip c. Hebert very thoroughly. A lot of questions were covered from PSM & ethics.
1. Diabetic foot
2. Treatment of bacterial infection of SKIN.
3. Patient had AIDS. He died of pneumonia. What will u write as the cause of his death in the death certificate?
4. Side effects of SSRIs?
5. Treatment of ADHD?
6. Source of Vit.D?
7. Pre-eclampsia
8. Prevalence & incidence of disease.
9. Positive predictive value of disease.
10. Pedigree of autosomal dominant disease.
11. Huntington’s chorea- AD, AR?
12. Schizophrenia
13. Alcohol abuse.
14. Toddler’s diarrhoea
15. Alcoholic dementia.
16. Crohn’s disease vs. ulcerative colitis
17. When can behavioural psychotherapy be started?
18. Ectopic pregnancy
19. OCPs
20. Endometrial carcinoma
21. Menopause
22. Cancer of cervix
23. Relationship problems- husband wife. (Counselling question)
24. Duties of a psychiatrist towards his patient
25. Some questions on accident & trauma.
26. Universal antidotes
27. Burns in children
28. Twin pregnancy-one in breach other in transverse lie. How to proceed with delivery?
29. Ethics: pt. has terminal stage of cancer. Should we discuss his condition with him or his relatives only?
30. pt. has terminal illness & is in hospital. Death is near. He acquires pneumonia in hospital. Should he be treated for pneumonia or not since he has to die anyways.
31. Elderly abuse
32. Child abuse
33. Acoustic neuroma
34. Pneumothorax
2. Obstetrics: placenta praevia, ectopic pregnancy, PID, abortions, complications at delivery, eclampsia, pre-eclampsia etc.
3. Paediatrics: Don’t leave anything. Study everything, esp. child psychology.
4. Psychiatry: Read whole of Psychiatry very thoroughly esp. the Personality disorders, childhood disorders.
5. Social Medicine & ethics: read " doing right" by Philip c. Hebert very thoroughly. A lot of questions were covered from PSM & ethics.
Some remembered topics of questions:
1. Diabetic foot
2. Treatment of bacterial infection of SKIN.
3. Patient had AIDS. He died of pneumonia. What will u write as the cause of his death in the death certificate?
4. Side effects of SSRIs?
5. Treatment of ADHD?
6. Source of Vit.D?
7. Pre-eclampsia
8. Prevalence & incidence of disease.
9. Positive predictive value of disease.
10. Pedigree of autosomal dominant disease.
11. Huntington’s chorea- AD, AR?
12. Schizophrenia
13. Alcohol abuse.
14. Toddler’s diarrhoea
15. Alcoholic dementia.
16. Crohn’s disease vs. ulcerative colitis
17. When can behavioural psychotherapy be started?
18. Ectopic pregnancy
19. OCPs
20. Endometrial carcinoma
21. Menopause
22. Cancer of cervix
23. Relationship problems- husband wife. (Counselling question)
24. Duties of a psychiatrist towards his patient
25. Some questions on accident & trauma.
26. Universal antidotes
27. Burns in children
28. Twin pregnancy-one in breach other in transverse lie. How to proceed with delivery?
29. Ethics: pt. has terminal stage of cancer. Should we discuss his condition with him or his relatives only?
30. pt. has terminal illness & is in hospital. Death is near. He acquires pneumonia in hospital. Should he be treated for pneumonia or not since he has to die anyways.
31. Elderly abuse
32. Child abuse
33. Acoustic neuroma
34. Pneumothorax
Monday, August 18, 2008
Medical Ethics/ 5 Questions
1- In the ER you are planning to do a new trial of a new treatment on patients with retrosternal chest pain. Which of the following is true
a) Such studies should not be done on emergency patient as they need immediate management b) Take consent only from patient if capable.
c) Take consent from patient if capable or from SDM if not.
2- A lady for laparoscopic tubal ligation on the way to theater asking you for removal of a mole on her forearm while she is under GA. She is already on premedication. What you will tell her?
a) You cannot do the procedure, as consent should be taken before coming to theatre before giving premedication.
b) Agree to do the procedure
3- A 35- year old male, one of your patients’s for four years, has contacted you and asked you to sign a form for him that he was sick last week. He has to present the form to his employer and mention that during this time he had flu and it was not severe enough to make him come to you and he did not want to abuse the health system. You believe your patient. what will be your action?
A. Tell him that this is illegal and you can not sign the form
B. Sign the form but indicate that you did not see the patient
C. Sign the form because you know your patient very well
D. Call his employer and explain what was the situation
4- A 58-year old patient was admitted to the hospital for appendicectomy. During the surgery his condition deteriorated and he passed into coma. You started tube feeding. The patient has no family member or friends around and no advanced directive. When can you stop the tube feeding?
A. You can not stop it except by the court order
B. You stop it according to the need of his bed for another patient
C. appoint legal guardian to take decision
D. You can stop it according to the opinion of another physician
E. You consult CEO of the hospital to take a legal action.
5- 40-year old patient of yours comes to you and tells you that he is separated from his wife and his wife filed a case that he is sexually abusing their child. He was found guilty and was in jail and just released. He said he has got gun and immediately after leaving the hospital he is going to their house to shoot his wife , he knows the time when his wife is coming back from office What will you do?
A. Inform the police
B. Inform the wife
C. You don’t have to breech the confidentiality of your patient
D. persuade him not to kill his wife
E. asks him to give the gun to you.
a) Such studies should not be done on emergency patient as they need immediate management b) Take consent only from patient if capable.
c) Take consent from patient if capable or from SDM if not.
2- A lady for laparoscopic tubal ligation on the way to theater asking you for removal of a mole on her forearm while she is under GA. She is already on premedication. What you will tell her?
a) You cannot do the procedure, as consent should be taken before coming to theatre before giving premedication.
b) Agree to do the procedure
3- A 35- year old male, one of your patients’s for four years, has contacted you and asked you to sign a form for him that he was sick last week. He has to present the form to his employer and mention that during this time he had flu and it was not severe enough to make him come to you and he did not want to abuse the health system. You believe your patient. what will be your action?
A. Tell him that this is illegal and you can not sign the form
B. Sign the form but indicate that you did not see the patient
C. Sign the form because you know your patient very well
D. Call his employer and explain what was the situation
4- A 58-year old patient was admitted to the hospital for appendicectomy. During the surgery his condition deteriorated and he passed into coma. You started tube feeding. The patient has no family member or friends around and no advanced directive. When can you stop the tube feeding?
A. You can not stop it except by the court order
B. You stop it according to the need of his bed for another patient
C. appoint legal guardian to take decision
D. You can stop it according to the opinion of another physician
E. You consult CEO of the hospital to take a legal action.
5- 40-year old patient of yours comes to you and tells you that he is separated from his wife and his wife filed a case that he is sexually abusing their child. He was found guilty and was in jail and just released. He said he has got gun and immediately after leaving the hospital he is going to their house to shoot his wife , he knows the time when his wife is coming back from office What will you do?
A. Inform the police
B. Inform the wife
C. You don’t have to breech the confidentiality of your patient
D. persuade him not to kill his wife
E. asks him to give the gun to you.
Thursday, August 14, 2008
Common 10 Questions for Family Medicine for QE1 exam
1. Which one of the following statements about antithyroid drug therapy is correct?
A. Methimazole (Tapazole) should not be given with a beta blocker.
B. The medication of choice for patients who are pregnant is methimazole.
C. The most serious complication of antithyroid drug therapy is agranulocytosis.
D. Relapse is more common in nonsmokers.
2. Which one of the following is the best modality for initially evaluating patients with suspected gallstones?
A. Magnetic resonance imaging.
B. Cholecystography.
C. Plain radiography.
D. Ultrasonography.
E. Computerized axial tomography.
3. The highest cure rates for cutaneous warts are achieved when cryotherapy is administered at which one of the following time intervals?
A. Seven to 10 days.
B. Two to three weeks.
C. Four to five weeks.
D. Seven to eight weeks.
4. A patient with hepatitis C virus (HCV) infection presents with a detectable RNA viral load higher than 50 copies per mL and portal fibrosis and necrosis on liver biopsy. Which one of the following is the recommended treatment?
A. Pegylated interferon (PEG-Intron) plus ribavirin (Rebetol).
B. Ribavirin alone.
C. Pegylated interferon alone.
D. Interferon alfa-2a recombinant plus ribavirin.
E. Interferon alfa-2a recombinant alone.
6. A 24-year-old man has stabbing tendon pain during increased activity. Which one of the following factors points to a diagnosis of tendinosus rather than tendonitis?
A. The initial pain should resolve in three days.
B. The likelihood of a full recovery is greater than 95 percent.
C. Surgical excision of abnormal tendon tissue is effective if conservative treatment fails.
D. A and C is correct
E. The focus of conservative therapy is anti-inflammatory agents.
7. A Wood's light examination can help identify which of the following?
A. Erythrasma.
B. Candida species.
C. Pseudomonas infection.
D. Group A beta-hemolytic streptococcus.
E. A and C is correct
f. all of the above
8. A 67-year-old woman presents with a list of herbal therapies she has been using for her hot flashes. She states that she does not believe in taking prescription medicines but wants guidance about which herbal therapies are safe and effective. Which one of the following is the best herbal therapy option for hot flashes based on current evidence?
A. Black cohosh.
B. Ginseng.
C. Dong quai.
D. Evening primrose oil.
9. Which one of the following is the most accurate noninvasive screening method for peripheral arterial disease (PAD)?
A. Palpation of peripheral pulses.
B. Validated PAD questionnaire.
C. History taking.
D. Ankle-brachial index.
E. History taking and physical examination combined.
10. Which one of the following findings suggests a diagnosis of functional constipation?
A. Fecal soiling.
B. Absence of pain with defecation.
C. Soft, small-caliber stools.
D. Abnormal anal sphincter tone.
A. Methimazole (Tapazole) should not be given with a beta blocker.
B. The medication of choice for patients who are pregnant is methimazole.
C. The most serious complication of antithyroid drug therapy is agranulocytosis.
D. Relapse is more common in nonsmokers.
2. Which one of the following is the best modality for initially evaluating patients with suspected gallstones?
A. Magnetic resonance imaging.
B. Cholecystography.
C. Plain radiography.
D. Ultrasonography.
E. Computerized axial tomography.
3. The highest cure rates for cutaneous warts are achieved when cryotherapy is administered at which one of the following time intervals?
A. Seven to 10 days.
B. Two to three weeks.
C. Four to five weeks.
D. Seven to eight weeks.
4. A patient with hepatitis C virus (HCV) infection presents with a detectable RNA viral load higher than 50 copies per mL and portal fibrosis and necrosis on liver biopsy. Which one of the following is the recommended treatment?
A. Pegylated interferon (PEG-Intron) plus ribavirin (Rebetol).
B. Ribavirin alone.
C. Pegylated interferon alone.
D. Interferon alfa-2a recombinant plus ribavirin.
E. Interferon alfa-2a recombinant alone.
6. A 24-year-old man has stabbing tendon pain during increased activity. Which one of the following factors points to a diagnosis of tendinosus rather than tendonitis?
A. The initial pain should resolve in three days.
B. The likelihood of a full recovery is greater than 95 percent.
C. Surgical excision of abnormal tendon tissue is effective if conservative treatment fails.
D. A and C is correct
E. The focus of conservative therapy is anti-inflammatory agents.
7. A Wood's light examination can help identify which of the following?
A. Erythrasma.
B. Candida species.
C. Pseudomonas infection.
D. Group A beta-hemolytic streptococcus.
E. A and C is correct
f. all of the above
8. A 67-year-old woman presents with a list of herbal therapies she has been using for her hot flashes. She states that she does not believe in taking prescription medicines but wants guidance about which herbal therapies are safe and effective. Which one of the following is the best herbal therapy option for hot flashes based on current evidence?
A. Black cohosh.
B. Ginseng.
C. Dong quai.
D. Evening primrose oil.
9. Which one of the following is the most accurate noninvasive screening method for peripheral arterial disease (PAD)?
A. Palpation of peripheral pulses.
B. Validated PAD questionnaire.
C. History taking.
D. Ankle-brachial index.
E. History taking and physical examination combined.
10. Which one of the following findings suggests a diagnosis of functional constipation?
A. Fecal soiling.
B. Absence of pain with defecation.
C. Soft, small-caliber stools.
D. Abnormal anal sphincter tone.
MCCEE Practice Questions/ sections 1, 2,3 & 4
Question: 1
A 20-year-old white man was stabbed in the chest in a bar fight and arrived at the emergency room within 30 minutes. You noticed that the trachea is deviated away from the side of the chest that suffered the puncture. Which one of the following would you find upon physical examination of the traumatized side?
1) increased fremitus
2) increased breath sounds
3) dullness to percussion
4) hyperresonant percussion!
5) wheezing and stridor
Question: 2
A 25-year-old Jehovah's Witness man is scheduled for emergency surgery following a motor vehicle accident in which he sustained pelvic fractures. The patient is competent and lucid before the surgery and refuses the administration of blood products. Which course of action is most appropriate in the event of significant intra-operative blood loss?
1) administration of packed red cells in the recovery
2) use of a cell saver
3) administration of hydroxyethyl starch
4) administration of packed cells after obtaining consent!
5) intra-operative autologous blood donation
Question: 3
A 58-year-old man presents to your office with a history of having an episode of sudden visual loss in his right eye. The patient describes the loss of vision as similar to someone pulling a cover over his right eye. Vision returned to the right eye after 10 minutes. This visual-field defect is secondary to which one of the following?
1) scotoma
2) amaurosis fugax!
3) strabismus
4) esotropia
5) night blindness
Question: 4
Two hours after application of the plaster cast for supracondylar fracture, a patient comes back to emergency room with a complaint of severe pain in the hand. Examination revealed swelling of the fingers and cyanosis. Which one of the following is the best management?
1) to observe the patient
2) to administer vasodilators
3) to administer analgesics
4) cut open the plaster near the fingers
5) cut open the entire plaster cast immediately!
Question: 5
A 40-year-old woman presents with a self-detected hard breast mass. Which one of the following is the procedure of choice for confirming the diagnosis?
1) mammography
2) thermography
3) ultrasonography
4) aspiration cytology
5) incisional biopsy histology!
Question: 6
A 48-year-old man complains of a 6-month history of shortness of breath and cough. Physical examination reveals clubbing with coarse crackles in both lung bases. Which one of the following is the most likely diagnosis?
1) asthma
2) reflux-induced cough
3) chronic bronchitis
4) idiopathic pulmonary fibrosis
5) sarcoidosis!
Question: 7
Within minutes of a bee sting, a 23-year-old woman develops generalized pruritus and hyperemia of the skin, followed shortly by swelling of the face and eyelids, dyspnea, and laryngeal edema. This reaction is mediated by which one of the following?
1) antigen-antibody complexes
2) cytotoxic T cells
3) IgA antibodies
4) IgE antibodies!
5) IgG antibodies
Question: 8 A 70-year-old woman presents to your office with a lump in her breast. Which one of the following is the greatest risk factor for cancer?
1) nulliparity
2) positive family history
3) use of hormone replacement therapy
4) early menarche
5) advanced age!
Question: 9
A 35-year-old woman is brought to the Emergency Department in severe distress. She has had the "flu" for three days. Past history reveals a six month history of fatigue and malaise. Physical exam reveals BP 120/65 mm Hg supine, 90/58 mm Hg standing, and darkened areas of skin on the knuckles, creases of the palm, elbows and on an abdominal scar. Laboratory values are Na 122 mmol/L, K 5.8 mmol/L, Cl 95 mmol/L, CO2 18 mmol/L. Which one of the following laboratory tests is most likely to assist in confirming your diagnosis?
1) Plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
2) 24 hour urine metanephrines and vanillylmundelic acid (VMA)
3) Plasma catecholamines, total and fractionated
4) Plasma cortisol and adrenocorticotropic hormone (ACTH)!
5) Plasma 17OH progesterone
Question: 10
A 24-year-old man is brought to the emergency room after being found unresponsive in a city park. Physical examination reveals pinpoint pupils unresponsive to light and a respiratory rate of 7 breaths per minute. Which one of the following is the most likely cause?
1) tricyclic antidepressant overdose
2) morphine overdose!
3) arsenic poisoning
4) lead intoxication
5) alcohol intoxication
Question: 11
A 21-year-old man presents with a recent suicide attempt. You are asked to assess him in the emergency room. Which one of the following statements concerning the suicide assessment of this patient is TRUE?
1) Discussing suicide with persons suspected of feeling suicidal may increase their risk of suicide. 2) Persons with a recent suicide attempt are at less risk for eventually killing themselves.
3) Depressed persons who commit suidide can do so as they begin to improve.!
4) Persons with schizophrenia are at less risk for suicide.
5) Persons with schizophrenia do not usually communicatE their intentions.
Question: 12
A patient is convinced that an intravenous (IV) injection he received has made him immortal. This is an example of which one of the following?
1) an illusion!
2) a delusion
3) a hallucination
4) a perseveration
5) a projection
Question: 13
A 41-year-old man reports that he washes his hands 50 times a day. In the evening, he will check the doors, windows, and stove at least a dozen times before retiring for the night. Which one of the following is the most likely diagnosis?
1) paranoid disorder
2) paranoid schizophrenia
3) schizotypal personality disorder
4) obsessive-compulsive disorder!
5) presenile dementia
Question: 14
A mother brings her 10-year-old son to your office because he lost consciousness the day before while running. She says that he had had similar episodes in the past, but has never been seen by a doctor. She also states that he does not seem to be able to play as long as most of his friends. On physical examination you detect a systolic ejection murmur and find that the apical impulse is lateral to the mid clavicular line. Which one of the following is the most likely diagnosis?
1) mitral valve stenosis
2) aortic stenosis!
3) coarctation of the aorta
4) aortic insufficiency
5) patent ductus arteriosus
Question: 14
A mother brings her 10-year-old son to your office because he lost consciousness the day before while running. She says that he had had similar episodes in the past, but has never been seen by a doctor. She also states that he does not seem to be able to play as long as most of his friends. On physical examination you detect a systolic ejection murmur and find that the apical impulse is lateral to the mid clavicular line. Which one of the following is the most likely diagnosis?
1) mitral valve stenosis
2) aortic stenosis
3) coarctation of the aorta
4) aortic insufficiency
5) patent ductus arteriosus
Question: 15 A healthy 4-year-old girl presents with the following symptoms: rapidly progressing respiratory distress, high fever, muffled voice, and drooling. Which one of the following measures is most appropriate in the initial management of this problem?
1) endotracheal intubation!
2) ribavirin aerosol
3) bronchodilators
4) racemic epinephrine aerosol
5) high doses of intravenous steroids
Question: 16
A 3-year-old girl has had a low-grade fever, "raspy" cough, and clear rhinorrhea for 3 days. She is brought to the emergency room when she begins to develop difficulty breathing. On physical examination her vital signs include a temperature of 39.7°C, a pulse of 160 beats per minute, and respirations of 36 breaths per minute. Auscultation reveals bilateral rhonchi, wheezing, and some mild stridor. Which one of the following is the most likely diagnosis?
1) asthma
2) epiglottitis
3) laryngotracheobronchitis!
4) tonsilitis
5) pneumonia
Question: 17
A few hours after eating a dinner of stuffed turkey, a previously well 7-year-old boy and his parents develop vomiting, abdominal cramps, and diarrhea. Differential diagnosis of the cause of these gastrointestinal symptoms should include which one of the following?
1) Clostridium difficile
2) Campylobacter
3) pinworms
4) Staphylococcus aureus exotoxin!
5) Clostridium botulinum
Question: 18
A 30-year-old woman presents with a long standing history of irregular menstrual periods which are often associated with severe pelvic pain and menorrhagia She has also been experiencing dysparunia and pain during defecation. Which one of the following is most likely to assist you in diagnosing this patient's condition?
1) clinical history
2) laparoscopy!
3) pelvic examination
4) hysterosalpingogram (HSG)
5) culdocentesis during menses
Question: 19
A 28-year-old woman has a 3-year history of primary infertility. She presents with increasing symptoms of steady, aching lower abdominal pain at the time of menses. The pain persists throughout menstruation and often after, and radiates into the rectum. Tender nodules in the uterosacral ligaments are noted on pelvic examination. Which one of the following would be the most contributory investigation?
1) postcoital test
2) diagnostic laparoscopy!
3) hysterosalpingogram on day 9 of her cycle
4) endometrial biopsy on day 26 of her cycle
5) basal body temperature charting
Question: 20
A 72-year-old woman complains of a lump protruding through the vagina with local pressure symptoms. On examination, there is a visible uterine prolapse. All of the following may be etiologic factors, EXCEPT
1) multiparity.
2) chronic smoking.
3) history of large babies.
4) stress urinary incontinence.!
5) postmenopausal status.
Question: 21
Five physicians are deliberating over whether the patient they have examined is exhibiting the auscultatory signs of mitral valve prolapse or not. Assuming that there would be agreement by chance of 50%, but, in fact, four of the five physicians actually agree on the findings, what is the choice-corrected agreement (kappa) for the clinical findings?
1) 0.8
2) 0.75
3) 0.6!
4) 0.7
5) 0.5
Question: 22
Several studies have indicated that, in large urban areas, there is a higher prevalence of schizophrenia in the lower socioeconomic class. Epidemiologic studies tend to support the hypothesis that
1) unsatisfactory social circumstances "breed" an excess incidence of schizophrenia.
2) the fathers of schizophrenics also tend to come from a lower socioeconomic class.
3) people with schizophrenia tend to "drift" down the social scale, because of their illness.!
4) both intelligence and schizophrenia are negatively associated with social class.
5) schizophrenia "runs" in families and is primarily an inherited disorder.
Question: 23
To qualify for federal contributions, provincial health insurance plans must guarantee all of the following, EXCEPT
1) benefits include all necessary hospital care and physicians' services.
2) universal coverage on uniform terms and conditions.
3) portability of coverage from province to province.
4) benefits include all necessary out-of-hospital drugs, dental care and prostheses.!
5) administration on a non-profit basis.
Question: 24
A 68-year-old man develops acute renal failure after surgery for ruptured aortic aneurysm. He refuses dialysis. Psychiatric consultation reveals him to be fully alert and oriented, cognitively intact, and not psychotic or clinically depressed. He says he is refusing dialysis because he has "lived a full life" and does not want to be "tied to a machine, even if this means I'll die." The psychiatrist should tell the man's internist that the man
1) is temporarily incompetent to decide on treatment, so treatment should be started.
2) is competent to decide on treatment, but his refusal should be overruled because of the existence of a medical emergency.
3) his refusal of dialysis must be respected because he is competent to decide on treatment.!
4) is behaving in a self-destructive manner, so he should be committed for treatment against his will.
5) shows no evidence of a major psychiatric illness but assessment of competency is required.
Question: 1
A 28-year-old pregnant woman develops sudden onset of dyspnea and tachycardia. Which one of the following is the most likely explanation?
1) acute mitral valve regurgitation
2) pulmonary embolism!
3) myocardial infarction
4) acute respiratory distress syndrome
5) lobar pneumonia
Question: 2
A 50-year-old man comes to the emergency room with a history of vomiting for three days' duration. His past history reveals that for approximately 20 years, he has been getting epigastric pain, lasting for two to three weeks. He remembers getting relief from pain by taking milk and antacids. Physical examination showed a fullness in the epigastric area with visible peristalsis, absence of tenderness and normal active bowel sounds. Which one of the following is the most likely diagnosis?
1) gastric outlet obstruction!
2) small bowel obstruction
3) volvulus of the colon
4) incarcerated umbilical hernia
5) cholecystitis
Question: 3 A 40-year-old man complains to his doctor of impotence. Which one of the following medication could be implicated?
1) ranitidine.
2) sertraline!
3) clarithromycin
4) enalapril
5) hydrochlorthiazide
Question: 4
A 34-year-old female keyboard operator develops pain and numbness in her hands that radiates up her arms. Which of the following is most likely to have been injured?
1) axillary nerve
2) median nerve!
3) ulnar nerve
4) radial nerve
5) brachial plexus / triceps muscle
Question: 5
A 60-year-old man presents with a small lesion on his nose. On examination of the lesion you note the following: the lesion is 3-mm in diameter, slightly elevated with a waxy appearance, and has a slight vascular pattern on top. This lesion is most characteristic of which one of the following?
1) basal cell carcinoma!
2) squamous cell carcinoma
3) melanoma
4) varicella-zoster lesion
5) actinic keratosis
Question: 6
A 30-year-old woman presents with a headache, gradual development of a partial bitemporal hemianopia, and a history of cessation of menses several years ago. Which one of the following is the most likely cause?
1) dilated third ventricle
2) craniopharyngioma
3) saccular aneurysm of the circle of Willis
4) pituitary adenoma!
5) meningioma of the tuberculum sellae
Question: 7
A 30-year-old man has a history of recurrent pneumonias and chronic cough dating from early childhood. The cough, which is worse in the morning and on lying down, is productive of foul-smelling purulent sputum which is occasionally bloody-tinged. The patient is chronically ill and has clubbed fingers. Rales are heard over the lung bases posteriorly. Which one of the following is the most likely diagnosis?
1) chronic bronchitis
2) pulmonary aspergillosis
3) pulmonary neoplasm
4) chronic obstructive emphysema
5) bronchiectasis!
Question: 8
A 22-year-old woman presents with fever, malaise, generalized arthralgias, and a skin rash, over the nose and malar eminences. Which one of the following possible findings has the greatest relative significance in the overall prognosis for the patient?
1) immune complexes at the dermal-epidermal junction in skin
2) pleuritis
3) atypical verrucous vegetations of the mitral valve
4) perivascular fibrosis in the spleen
5) glomerular subendothelial immune complex deposition!
Question: 9
A 38-year-old woman presents to you convinced that she has chronic fatigue syndrome. The history reveals no evidence of fever or swollen glands, and no other symptoms other than fatigue and difficulty sleeping. Her physical examination is completely normal. She has a high thyroid-stimulating hormone level. You would then suspect and subsequently confirm
1) hyperthyroidism secondary to pituitary adenoma.
2) hypothyroidism.!
3) Grave disease.
4) thyroiditis.
5) chronic fatigue syndrome.
Question: 10
A 29-year-old quadriplegic woman (who is mentally intact) is shifted in bed every 2 hours to prevent pressure (decubitus) ulcers. The clinician examines her at the end of 2 hours on her right side. She is feeling well, not coughing, and is afebrile. Examination of the lungs reveals dullness and crackles in the lateral half of the right lung field. Which one of the following is the most reasonable interpretation of their cause?
1) atelectasis secondary to mucus plugging
2) pulmonary edema, which has localized due to gravitational forces
3) compressive atelectasis
4) aspiration pneumonitis
5) chronic pulmonary fibrosis
Question: 11
You are called to see an elderly hospitalized patient with mild obstructive lung disease who was roused one morning with difficulty and appeared confused. Which of the following drug orders is most likely associated with this episode?
1) trimethoprim-sulfamethoxazole (Septra®) D.S. x 2 daily
2) hydrochlorothiazide 50 mg once daily!
3) flurazepam 30 mg h.s.
4) theophylline 200 mg x 2 daily
5) senna (Senokot®) 1 - 2 tablets as required
Question: 12
An 11-year-old girl has become markedly withdrawn during the past 8 months and has complained of persisting abdominal pain and constipation, for which no organic cause has been found. Which one of the following is the most likely diagnosis?
1) depressive disorder!
2) schizophrenia
3) conduct disorder
4) attention deficit hyperactivity disorder
5) infantile autism
Question: 13
A 30-year-old woman complains of episodic faintness, tingling sensation in her hands, shortness of breath, and severe anxiety. Thorough medical workup reveals no pathologic condition. During an episode of these symptoms, chemical analysis of the serum will probably reveal which one of the following?
1) decreased chloride
2) increased urea (BUN)
3) decreased protein
4) increased serum amylase!
5) increased pH
Question: 14
A 27-year-old man is suspicious of others, superstitious, believes he possesses telepathic powers, and has no friends. Which one of the following is most likely to be associated with this clinical description?
1) passive-aggressive personality disorder
2) histrionic personality disorder
3) schizotypal personality disorder!
4) avoidant personality disorder
5) compulsive personality disorder
Question: 15
A 2-year-old boy with visible abdominal distention is found to have a large left-sided flank mass. Which one of the following is the most likely diagnosis?
1) renal cell carcinoma
2) polycystic kidney
3) transitional cell carcinoma
4) Wilms' tumour!
5) hydronephrosis
Question: 16
A 3-year-old with a history of asthma is brought to the Emergency Department in acute respiratory distress. His mother relates that she stopped his twice daily sodium cromoglycate 1 week ago. Physical examination reveals a distressed child with a harsh cough. On auscultation of the chest, there are areas of reduced air entry and diffuse expiratory wheezes. Which one of the following is the most appropriate initial management?
1) aerosolized ipratropium bromide by nebulization
2) aerosolized sodium cromoglycate by nebulization
3) aerosolized budesonide
4) subcutaneous epinephrine, 1:1000 dilution
5) aerosolized salbutamol by nebulization!
Question: 17
A 13-year-old boy states that he is growing breasts and that they hurt. He has been growing taller this past year. He has no other complaints. On physical examination you note some acne on his face, his testes and phallus are appropriate for age, and he has fine sparse pubic hair. Which one of the following is the most likely diagnosis?
1) normal puberty!
2) Klinefelter's syndrome
3) pituitary tumor
4) adrenal tumor
5) gonadal tumor
Question: 18
A full-term infant presents to your office at 7 days of age with bilateral purulent conjunctive discharge, erythema and swelling at the medial aspect of the eyes. Which one of the following is the most likely diagnosis?
1) Neisseria gonorrhoeae infection
2) herpes simplex infection
3) nasolacrimal duct inflammation due to Staphylococcus aureus
4) chemical irritation from eye oinment received at delivery
5) chlamydia infection!
Question: 19
A 30-year-old primigravida presents at 34 weeks gestational age with blood pressure of 160/90 mmHg, headache, epigastric pain, visual abnormalities and 3 proteinuria. Biophysical profile of the fetus is 8/8. Which one of the following is the best course of action?
1) Induce labour and attempt vaginal delivery.
2) Start magnesium sulfate intravenously.!
3) Perform an emergency C-section.
4) Give betaclomethasone to induce fetal lung maturity.
5) Perform an amniocentesis to assess fetal lung maturity.
Question: 20
All of the following are considered possible indications for cesarean section, EXCEPT
1) placenta previa.
2) fetal distress.
3) genital herpes.
4) carcinoma in situ of the cervix.!
5) prior urethropexy.
Question: 21
The statistical measure of the degree of relationship between two sets of numbers is
1) the average
2) the standard deviation
3) the normal distribution
4) the standardized scores
5) the correlation coefficient!
Question: 22
When interpreting a diagnostic test, the term "gold standard" refers to a definitive diagnosis obtained by some independent means. All of the following would be examples of gold standards useful in clinical practice, EXCEPT
1) coronary angiography in evaluating a cardiac stress test.
2) bacteriologic culture in testing a rapid diagnostic kit for gonorrhea.
3) bronchoscopy with biopsy in evaluating sputum cytology.
4) autopsy results in evaluating electrocardiography.
5) results of long-term follow-up in a test for early rheumatoid arthritis.!
Question: 23
A new screening test for a type of cancer is carried out on 10,000 subjects. One hundred and sixty have a positive result, of whom eight are determined to actually have the disease. These eight subjects survive longer than other persons suffering from the same type of cancer diagnosed by other means. Which one of the following statements is correct?
1) The sensitivity of this test is [snip].4% (10,000-160)/10,000.
2) The incidence of the disease in this population is 80 per 100,000.
3) Early detection by this test improves survival.
4) The predictive value of a positive test is 5% (8/160).!
5) The predictive value of a negative test is 95% (152/160).
Question: 24
An active 75-year-old woman relocates to your town. She has hypertension, arthritis, and diabetes. Her medication regimen includes hydrochlorothiazide, potassium elixir, diltiazem, acetaminophen, ibuprofen and glyburide. Which factor is most related to compliance with the medication regimen?
1) age
2) number of drugs in the regimen!
3) gender
4) number of comorbid diseases
5) use of tablets versus use of elixirs
Section: 3
Question: 1
A gunshot wound to the upper arm causing shock-wave damage to the median nerve may leave the patient with which one of the following?
1) easily provoked pain in the hand!
2) weakness on wrist extension
3) atrophy in the first dorsal interosseous muscle
4) numbness over the fifth digit
5) radial deviation of the hand
Question: 2
A 9-year-old boy is brought to the hospital with a history of having fallen from his bike. He fainted and is now complaining of abdominal pain and thirst. There is general abdominal tenderness and rebound tenderness. Approximately 4 hours after the accident, the white blood count is 20 x 109/L and the hemoglobin is 80 g/L. What is the most likely diagnosis?
1) renal contusion
2) acute pancreatitis
3) ruptured spleen!
4) retroperitoneal hematoma
5) ruptured bowel
Question: 3
A 50-year-old man presents to the emergency room with severe epigastric pain, low-grade fever, tachycardia, and mild hypotension. The patient relates a history of moderate to heavy social drinking. The chief resident suspects acute pancreatitis. Which one of the following is the single most important laboratory finding to confirm the diagnosis of pancreatitis?
1) hyperlipidemia
2) hyperbilirubinemia
3) elevated serum amylase!
4) elevated serum phospholipase A
5) elevated serum alkaline phosphatase
Question: 4
A 22-year-old male, working as a waiter in a nightclub, noticed a gradual hearing loss. He admitted that the noise level in his job is very high and that he was not advised to wear ear defenders. Which one of the following does he most likely suffer from?
1) sensory hearing loss and vertigo
2) both sensory and conductive hearing loss
3) conductive hearing loss and ataxia
4) sensory hearing loss and tinnitus!
5) conductive hearing loss and nystagmus
Question: 5
A 68-year-old man presents with a chief complaint that solid food gets stuck in the middle of his chest. In addition, he admits to a 11 kg weight loss over the last 3 months. Which one of the following is the most likely diagnosis?
1) esophagitis
2) lower esophageal ring
3) esophageal carcinoma!
4) cerebrovascular accident
5) myocardial infarction
Question: 6
A 52-year-old man with a long history of alcohol use comes to the emergency room of a general hospital. He is confused and on examination is noted to have palsies of conjugate gaze, horizontal nystagmus, and ataxia. Which one of the following is the most likely diagnosis?
1) conversion reaction
2) alcohol intoxication
3) alcohol hallucinosis
4) delirium tremens
5) Wernicke's encephalopathy!
Question: 7
A 71-year-old woman with a history of coronary artery disease presents to her family physician for a routine check-up. The physician notices that she has lost 10 kg since her last visit 6 months ago. When questioned, she gives a history of intermittent periumbilical pain that always begins 30 minutes after eating and lasts about 2 hours. She claims that the pain is worse after large meals and so she has begun to eat less out of fear of pain. Which one of the following is the most likely diagnosis?
1) pancreatitis
2) cholecystitis
3) small bowel obstruction
4) intestinal ischemia
5) peptic ulcer disease!
Question: 8
In a woman under 40 years of age, which one of the following breast abnormalities would have the highest predictive value for malignancy?
1) painful, moveable mass
2) painless, moveable mass
3) blood nipple discharge
4) clear nipple discharge
5) breast skin edema with dimpling!
Question: 9
A 68-year-old man presents with cardiac arrest due to ventricular rupture. Which one of the following myocardial changes is the most frequent cause?
1) Abscess formation and tissue destruction due to infective endocarditis .
2) Fatty change due to interaction of diphtheria exotoxin and carnitine .
3) Aschoff bodies associated with rheumatic fever.
4) Inflammation due to coxsackie B infection .
5) Necrosis due to coronary artery obstruction .!
Question: 10
A 49-year-old man who smokes two packs of cigarettes a day presents with a lung mass on x-ray and recent weight gain. Laboratory examination shows hyponatremia with hyperosmolar urine. The patient probably has which one of the following diagnoses?
1) renal failure
2) pituitary failure
3) Conn's syndrome
4) cardiac failure
5) inappropriate ADH (secretion)!
Question: 11
Which one of the following types of hallucination is normal?
1) hypnagogic!
2) lilliputian
3) tactile
4) olfactory
5) auditory
Question: 12
A 20-year-old college student presents to you with a history of intermittent chest pain for about 6 months. He states that the pain can occur at any time, but often occurs late in the day. The pain can be sharp, dull, or aching and may last for hours. He is physically active and is carrying a full academic load. The pain is unrelated to exercise and does not restrict his activities. His father and paternal uncle have both had myocardial infarctions within the past year. Physical examination is normal, although the patient appears restless and has a heart rate of 100/min. Which one of the following is the most likely diagnosis?
1) feflux esophagitis!
2) generalized anxiety disorder
3) transient myocardial ischemia
4) myocardial infarction
5) costochondritis
Question: 13
A 25-year-old man is hospitalized after weeks of worsening psychosis. He is given thiothixene, an antipsychotic medication. Five days later, he develops a fever of 39.8 °C, becomes delirious and lies stiffly in his bed. His family reports that he had been physically well prior to his admission. Which of the following diagnosis is of most immediate concern?
1) tardive dyskinesia
2) viral meningitis
3) neuroleptic malignant syndrome!
4) ruptured cerebral aneurysm
5) unsuspected opioid dependence
Question: 14
A 31-year-old man is shy, socially withdrawn, low in self-esteem, yet eager to please when called on by persons in authority. Which one of the following personality disorders is most likely to be associated with this clinical description?
1) passive-aggressive personality disorder
2) histrionic personality disorder
3) schizotypal personality disorder
4) avoidant personality disorder!
5) compulsive personality disorder
Question: 15
A 5-year-old girl is admitted to the Children's Hospital after swallowing an undisclosed number of her mother's ASA tablets. She is hypotensive, flushed and tachypneic. Which of the following acid-base disturbances would be most likely?
1) pH low ; HCO3 low ; pCO2 high
2) pH normal ; HCO3 high; pCO2 low
3) pH low; HCO3 low; pCO2 high
4) pH low; HCO3 high; pCO2 low
5) pH high; HCO3 high; pCO2 high
Question: 16 A 5-year-old patient has axillary freckling, several firm subcutaneous masses on both arms and seven light-brown macules on his trunk which are greater than 1.5 cm. Which one of the following is the most likely diagnosis?
1) Peutz-Jeghers syndrome
2) tuberous sclerosis
3) Sturge-Weber syndrome
4) Albright's disease
5) neurofibromatosis!
Question: 17
A 13-year-old girl sustains a minor injury to the left side of her back in a school basketball game. On examination little is found except for asymmetric shoulder levels. While she bends over, the right posterior chest is elevated. Which of the following are these findings most readily suggestive of?
1) an accessory rib
2) an iliopsoas muscle spasm
3) rhabdomyosarcoma
4) scoliosis!
5) hematoma
Question 18
A 24-year-old woman is seen because of high fever, prostration, vomiting, and diarrhea. Her pulse is rapid and thready, and her blood pressure is recorded at 60/40 mmHg. A diffuse generalized macular rash is noted. Following stabilization with fluid and vasoactive medications, culture of which of the following specimens will most likely lead to the correct diagnosis?
1) sputum
2) urine
3) stool!
4) cervicovaginal secretions
5) cerebrospinal fluid
Question: 19
Which one of the following hormones is responsible for the proliferation of the milk ducts during pregnancy?
1) human chorionic gonadotropin
2) progesterone
3) prolactin
4) estrogen!
5) human placental lactogen
Question: 20
Amniocentesis is used in the diagnosis of all of the following conditions, EXCEPT
1) trisomy 21 (Down syndrome).
2) metabolic errors.
3) neural tube defects.
4) genitourinary anomalies.!
5) trisomy 18.
Question: 21
From information recorded at school A it was found that, out of a total of 400 missed 'person days' during November, 100 were due to measles; 200 to "flu"; and the rest to various other causes. At school B in the same neighborhood, during the same period of time, a total of 75 children were absent for 1 or more days. Of these, 25 had suffered from measles; 25 from "flu" and the rest from various other causes. It can be concluded that
1) the incidence of measles was greater in school "B" than in school "A".
2) the incidence of "flu" was greater in school "A" than in school "B".
3) the overall morbidity rate was higher in school "A" than in school "B".!
4) the incidence of "other causes" was greater in school "A" than in school "B".
5) none of the above conclusions can be reached with the data provided.
Question: 22
Exposure to lead can cause all of the following, EXCEPT
1) anemia.
2) cirrhosis of the liver.!
3) paresis.
4) abdominal pain.
5) porphyrinuria.
Question: 23
A case control study was conducted in which 50 cases and 50 controls were interviewed to inquire about their history of exposure to substance 'X'. The following 2 X 2 table resulted: Cases Controls Totals Exposed 40 20 60 Not exposed 10 30 40 Totals 50 50 100 The 'odds ratio' (estimate of the relative risk) is
1) 0.17
2) 1.50
3) 2.00
4) 3.00
5) 6.00!
Question: 24
Under certain circumstances, it may be legitimate to detain individuals in an institution against their wishes, for their own good and to protect others. This situation may arise when
1) a person has bizarre fantasies and actions
2) persons are mentally incompetent and unable to manage their own affairs
3) a close relative submits a petition that an individual is actually and presently insane
4) the individual's continued liberty poses a danger!
5) a person has visual and aural hallucinations
Section: 4
Question: 1
A 27-year-old carpenter dropped his circular saw and severed his lower leg. Which one of the following would be indicative of a severed tibial nerve?
1) paralysis of the plantarflexors of the foot!
2) paralysis of all the muscles in the posterior compartment of the leg
3) anesthesia of most of the sole of the foot
4) paralysis of the muscles in the lateral crural compartment
5) anesthesia to the medial aspect of the lower leg
Question: 2
A middle-aged woman is admitted unconscious to the Emergency Department following a head injury in a car accident. There is bruising over the upper abdomen. Blood pressure is 80 mm Hg systolic, pulse 120/minute. What is the most important initial step in the management of this patient?
1) x-ray (three views) of abdomen
2) immediate laparotomy
3) draw blood sample and start IV fluids!
4) perform emergency burrholes
5) diagnostic peritoneal lavage
Question: 3
On examining a 51-year-old man with chest pain who was just involved in a motor vehicle accident, you find that at the end of expiration his blood pressure is 130/90 mmHg and at the end of inspiration it is 110/92 mmHg. Which one of the following conditions is most likely?
1) cardiac tamponade!
2) pneumothorax
3) multiple rib fractures
4) acute myocardial infarction
5) aortic rupture
Question: 4
A 78-year-old man complains of 3 months of fatigue and a 10 kg weight loss. Physical examination reveals jaundice without abdominal tenderness or organomegaly. Which one of the following is the most likely diagnosis?
1) cholecystitis
2) pancreatitis
3) hemochromatosis
4) hepatic vein thrombosis
5) pancreatic carcinoma!
Question: 5
A 55-year-old man presents to the hospital with the complaint of severe intermittent pain in his right lower back that radiates around his trunk into his lower quadrant and upper right thigh. Which one of the following is the most likely diagnosis?
1) hepatitis
2) appendicitis
3) a ureteral stone!
4) pyelonephritis
5) biliary obstruction
Question: 6
You are performing pulmonary function tests on a 80-year-old male with persistent cough . Which one of the following would occur normally with age?
1) fall in vital capacity
2) fall in FEV1/FVC!
3) fall in arterial p02
4) increase in arterial pCO2
5) decrease in arterial pH
Question: 7
A 26-year-old man developed hemoptysis and dyspnea over the course of 3 months. His physician suspected tuberculosis and started him on triple therapy with isoniazid, rifampin, and ethambutol. After 2 months, the patient complained of pins-and-needles sensations in his feet. Neurologic examination was otherwise unremarkable. Strength was good in all limbs. Which one of the following nutritional deficiencies is most likely responsible?
1) vitamin B12 deficiency
2) vitamin B6 (pyridoxine) deficiency!
3) vitamin E (alphatocopherol) deficiency
4) vitamin D deficiency
5) vitamin B1 (thiamine) deficiency
Question: 8
A 56-year-old patient presents with polycythemia. He is found to have low oxygen saturation, increased red blood cells mass, normal plasma volume and increased erythropoietin levels. Which one of the following is the most likely diagnosis?
1) polycythemia rubra vera
2) chronic obstructive pulmonary disease (COPD)!
3) stress polycythemia
4) renal adenocarcinoma
5) congenital spherocytosis
Question: 9
While being investigated for long-standing hypertension, a 55-year-old woman is found to have the following serum laboratory test values: normal creatinine, total protein, albumin, and globulin; increased calcium and alkaline phosphatase; and decreased phosphorus. Which of the following do these findings suggest the presence of?
1) carcinoma metastatic to bone
2) excessive dietary calcium intake
3) multiple myeloma
4) parathyroid adenoma!
5) sarcoidosis
Question: 10
A 40-year-old woman presents with painful swelling of the joints of her fingers, excessive fatigue and a malar rash. Which one of the following diseases is is most likely?
1) psoriasis
2) pseudogout
3) systemic lupus erythematosus (SLE)!
4) rheumatoid arthritis
5) serum sickness
Question: 11
A 32-year-old married woman describes experiencing panic attacks every time she goes to the local store. These have been getting more frequent and she is finding it increasingly difficult to leave her home. Which one of the following should form part of her treatment?
1) psychodynamic therapy
2) interpersonal psychotherapy
3) family therapy
4) supportive psychotherapy
5) cognitive behavioral therapy!
Question: 12
A 38-year-old woman tells her physician that for several months she has been experiencing palpitations, dizziness, shortness of breath, a feeling of impending doom and a fear of dying. Which of the following would be the most appropriate initial step in managing this patient?
1) offer psychotherapy
2) prescribe benzodiazepines
3) perform a physical examination!
4) refer the patient to a psychiatrist
5) teach relaxation techniques
Question: 13
A patient reports that, on his way to your office he saw a man feeding two squirrels in the park. He says that this means that his future will be decided within 2 weeks. Which one of the following terms best describes this mode of thinking?
1) illusion
2) hallucination
3) delusion
4) loose association!
5) neologism
Question: 14
A 3-year-old boy presents to the emergency room with a history of recurrent cough. A review of his previous records reveals recurrent episodes of right lower lobe pneumonia. An x-ray chest in the current admission also confirms a right lower lobe pneumonia. He has no other major health issues. What is the most likely diagnosis?
1) cystic fibrosis!
2) congenital lung abnormality
3) chronic granulomatous disease
4) asthma
5) bronchiectasis of the lingula
Question: 15
Haemophilus influenzae Type B vaccine has been recommended for which one of the following groups?
1) All children at the time of their first birthday.
2) Any child with impaired immunity or chronic disease.
3) All children after the age of 5 years.
4) Siblings and daycare contacts of children who develop systemic Haemophilus influenzae Type B infections, regardless of age.
5) All children at age 2 months.!
Question: 16
A 26-year-old pregnant woman delivers a male infant at 40 weeks, with a birthweight of 2.0 kg. His head circumference is 34 cm and there are no dysmorphic features. Antenatal ultrasounds have been normal until 32 weeks, when intrauterine growth restriction has been diagnosed. Which one of the following is the most likely cause of the low birth weight?
1) congenital intrauterine infection
2) chromosomal or genetic abnormality
3) placental insufficiency!
4) congenital hydrocephalus
5) maternal age
Question: 17
A 4-year-old child presents with an enlarged submandibular node that is 4 cm in diameter, nontender, and not fluctuant. The node has been enlarged for about 4 weeks and there is no history of fever or contact with any person who was ill. A complete blood count (CBC) is normal, and a Mantoux test with 5 tuberculin units of purified protein derivative shows 6 mm of induration. Which one of the following is the most likely diagnosis?
1) cat-scratch fever
2) acute pyogenic lymphadenitis
3) acute lymphoblastic leukemia!
4) tuberculous lymphadenitis
5) atypical mycobacteria lymphadenitis
Question: 18
A 23-year-old woman in her first trimester of pregnancy is diagnosed as having deep venous thrombosis in her right lower extremity. Which one of the following is the most appropriate therapy?
1) warfarin
2) heparin!
3) clopidogrel
4) dipyridamole
5) streptokinase
Question: 19
A 27-year-old multiparous woman is admitted to the case room at 31 weeks' gestation with a 1-hour history of vaginal bleeding. She has painful uterine contractions, with poor uterine relaxation. The most probable diagnosis is
1) blood-stained show.
2) vasa previa.
3) placenta previa.
4) abruptio placentae.!
5) uterine rupture.
Question: 20
A 30-year-old menstruating woman presents at the Emergency Department with a high fever, vomiting and diarrhea of 24 hours' duration. Her blood pressure is 90/50 mm Hg and there is a diffuse erythematous rash. All of the following laboratory results are in keeping with a diagnosis of toxic shock syndrome, EXCEPT
1) creatine kinase 290 U/L.
2) calcium (total) 1.66 mmol/L.!
3) white blood cell count 18 x 109/L.
4) aspartate aminotransferase 100 U/L.
5) glucose 2.2 mmol/L.
Question: 21 The incidence of a particular disease is greater in men than in women, but the prevalence shows no sex difference. The most probable explanation is that
1) the mortality rate is higher in women.
2) the case fatality rate is higher in women.
3) the duration of the disease is longer in women.!
4) women receive less adequate medical care for the disease.
5) this diagnosis is more often missed in women.
Question: 22
All of the following are responsibilities of local public health units in Canada , EXCEPT
1) communicable disease control.
2) health education.
3) investigation of sudden death.!
4) immunization.
5) health promotion.
Question: 23
All of the following are characteristics of provincial voluntary health organizations, EXCEPT
1) provincial governments contribute to their funding in proportion to the number of members.!
2) they are governed by volunteers rather than by professionals.
3) they often carry out programs of education for the public, patients, their families, or health professionals.
4) they may provide direct services to patients.
5) they may conduct research or provide funds to others for research.
Question: 24
The causative organism of cholera, Vibrio cholerae, has been recognized for 100 years. Outbreaks of cholera often reach epidemic proportions; the history of seven pandemics can now be traced. The most recent only just now appears to be subsiding. Which one of the following is the spread of this infection, enhanced by modern transportation?
1) fomites
2) mosquitoes
3) contaminated food sources!
4) person-to-person
5) domestic flies
A 20-year-old white man was stabbed in the chest in a bar fight and arrived at the emergency room within 30 minutes. You noticed that the trachea is deviated away from the side of the chest that suffered the puncture. Which one of the following would you find upon physical examination of the traumatized side?
1) increased fremitus
2) increased breath sounds
3) dullness to percussion
4) hyperresonant percussion!
5) wheezing and stridor
Question: 2
A 25-year-old Jehovah's Witness man is scheduled for emergency surgery following a motor vehicle accident in which he sustained pelvic fractures. The patient is competent and lucid before the surgery and refuses the administration of blood products. Which course of action is most appropriate in the event of significant intra-operative blood loss?
1) administration of packed red cells in the recovery
2) use of a cell saver
3) administration of hydroxyethyl starch
4) administration of packed cells after obtaining consent!
5) intra-operative autologous blood donation
Question: 3
A 58-year-old man presents to your office with a history of having an episode of sudden visual loss in his right eye. The patient describes the loss of vision as similar to someone pulling a cover over his right eye. Vision returned to the right eye after 10 minutes. This visual-field defect is secondary to which one of the following?
1) scotoma
2) amaurosis fugax!
3) strabismus
4) esotropia
5) night blindness
Question: 4
Two hours after application of the plaster cast for supracondylar fracture, a patient comes back to emergency room with a complaint of severe pain in the hand. Examination revealed swelling of the fingers and cyanosis. Which one of the following is the best management?
1) to observe the patient
2) to administer vasodilators
3) to administer analgesics
4) cut open the plaster near the fingers
5) cut open the entire plaster cast immediately!
Question: 5
A 40-year-old woman presents with a self-detected hard breast mass. Which one of the following is the procedure of choice for confirming the diagnosis?
1) mammography
2) thermography
3) ultrasonography
4) aspiration cytology
5) incisional biopsy histology!
Question: 6
A 48-year-old man complains of a 6-month history of shortness of breath and cough. Physical examination reveals clubbing with coarse crackles in both lung bases. Which one of the following is the most likely diagnosis?
1) asthma
2) reflux-induced cough
3) chronic bronchitis
4) idiopathic pulmonary fibrosis
5) sarcoidosis!
Question: 7
Within minutes of a bee sting, a 23-year-old woman develops generalized pruritus and hyperemia of the skin, followed shortly by swelling of the face and eyelids, dyspnea, and laryngeal edema. This reaction is mediated by which one of the following?
1) antigen-antibody complexes
2) cytotoxic T cells
3) IgA antibodies
4) IgE antibodies!
5) IgG antibodies
Question: 8 A 70-year-old woman presents to your office with a lump in her breast. Which one of the following is the greatest risk factor for cancer?
1) nulliparity
2) positive family history
3) use of hormone replacement therapy
4) early menarche
5) advanced age!
Question: 9
A 35-year-old woman is brought to the Emergency Department in severe distress. She has had the "flu" for three days. Past history reveals a six month history of fatigue and malaise. Physical exam reveals BP 120/65 mm Hg supine, 90/58 mm Hg standing, and darkened areas of skin on the knuckles, creases of the palm, elbows and on an abdominal scar. Laboratory values are Na 122 mmol/L, K 5.8 mmol/L, Cl 95 mmol/L, CO2 18 mmol/L. Which one of the following laboratory tests is most likely to assist in confirming your diagnosis?
1) Plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
2) 24 hour urine metanephrines and vanillylmundelic acid (VMA)
3) Plasma catecholamines, total and fractionated
4) Plasma cortisol and adrenocorticotropic hormone (ACTH)!
5) Plasma 17OH progesterone
Question: 10
A 24-year-old man is brought to the emergency room after being found unresponsive in a city park. Physical examination reveals pinpoint pupils unresponsive to light and a respiratory rate of 7 breaths per minute. Which one of the following is the most likely cause?
1) tricyclic antidepressant overdose
2) morphine overdose!
3) arsenic poisoning
4) lead intoxication
5) alcohol intoxication
Question: 11
A 21-year-old man presents with a recent suicide attempt. You are asked to assess him in the emergency room. Which one of the following statements concerning the suicide assessment of this patient is TRUE?
1) Discussing suicide with persons suspected of feeling suicidal may increase their risk of suicide. 2) Persons with a recent suicide attempt are at less risk for eventually killing themselves.
3) Depressed persons who commit suidide can do so as they begin to improve.!
4) Persons with schizophrenia are at less risk for suicide.
5) Persons with schizophrenia do not usually communicatE their intentions.
Question: 12
A patient is convinced that an intravenous (IV) injection he received has made him immortal. This is an example of which one of the following?
1) an illusion!
2) a delusion
3) a hallucination
4) a perseveration
5) a projection
Question: 13
A 41-year-old man reports that he washes his hands 50 times a day. In the evening, he will check the doors, windows, and stove at least a dozen times before retiring for the night. Which one of the following is the most likely diagnosis?
1) paranoid disorder
2) paranoid schizophrenia
3) schizotypal personality disorder
4) obsessive-compulsive disorder!
5) presenile dementia
Question: 14
A mother brings her 10-year-old son to your office because he lost consciousness the day before while running. She says that he had had similar episodes in the past, but has never been seen by a doctor. She also states that he does not seem to be able to play as long as most of his friends. On physical examination you detect a systolic ejection murmur and find that the apical impulse is lateral to the mid clavicular line. Which one of the following is the most likely diagnosis?
1) mitral valve stenosis
2) aortic stenosis!
3) coarctation of the aorta
4) aortic insufficiency
5) patent ductus arteriosus
Question: 14
A mother brings her 10-year-old son to your office because he lost consciousness the day before while running. She says that he had had similar episodes in the past, but has never been seen by a doctor. She also states that he does not seem to be able to play as long as most of his friends. On physical examination you detect a systolic ejection murmur and find that the apical impulse is lateral to the mid clavicular line. Which one of the following is the most likely diagnosis?
1) mitral valve stenosis
2) aortic stenosis
3) coarctation of the aorta
4) aortic insufficiency
5) patent ductus arteriosus
Question: 15 A healthy 4-year-old girl presents with the following symptoms: rapidly progressing respiratory distress, high fever, muffled voice, and drooling. Which one of the following measures is most appropriate in the initial management of this problem?
1) endotracheal intubation!
2) ribavirin aerosol
3) bronchodilators
4) racemic epinephrine aerosol
5) high doses of intravenous steroids
Question: 16
A 3-year-old girl has had a low-grade fever, "raspy" cough, and clear rhinorrhea for 3 days. She is brought to the emergency room when she begins to develop difficulty breathing. On physical examination her vital signs include a temperature of 39.7°C, a pulse of 160 beats per minute, and respirations of 36 breaths per minute. Auscultation reveals bilateral rhonchi, wheezing, and some mild stridor. Which one of the following is the most likely diagnosis?
1) asthma
2) epiglottitis
3) laryngotracheobronchitis!
4) tonsilitis
5) pneumonia
Question: 17
A few hours after eating a dinner of stuffed turkey, a previously well 7-year-old boy and his parents develop vomiting, abdominal cramps, and diarrhea. Differential diagnosis of the cause of these gastrointestinal symptoms should include which one of the following?
1) Clostridium difficile
2) Campylobacter
3) pinworms
4) Staphylococcus aureus exotoxin!
5) Clostridium botulinum
Question: 18
A 30-year-old woman presents with a long standing history of irregular menstrual periods which are often associated with severe pelvic pain and menorrhagia She has also been experiencing dysparunia and pain during defecation. Which one of the following is most likely to assist you in diagnosing this patient's condition?
1) clinical history
2) laparoscopy!
3) pelvic examination
4) hysterosalpingogram (HSG)
5) culdocentesis during menses
Question: 19
A 28-year-old woman has a 3-year history of primary infertility. She presents with increasing symptoms of steady, aching lower abdominal pain at the time of menses. The pain persists throughout menstruation and often after, and radiates into the rectum. Tender nodules in the uterosacral ligaments are noted on pelvic examination. Which one of the following would be the most contributory investigation?
1) postcoital test
2) diagnostic laparoscopy!
3) hysterosalpingogram on day 9 of her cycle
4) endometrial biopsy on day 26 of her cycle
5) basal body temperature charting
Question: 20
A 72-year-old woman complains of a lump protruding through the vagina with local pressure symptoms. On examination, there is a visible uterine prolapse. All of the following may be etiologic factors, EXCEPT
1) multiparity.
2) chronic smoking.
3) history of large babies.
4) stress urinary incontinence.!
5) postmenopausal status.
Question: 21
Five physicians are deliberating over whether the patient they have examined is exhibiting the auscultatory signs of mitral valve prolapse or not. Assuming that there would be agreement by chance of 50%, but, in fact, four of the five physicians actually agree on the findings, what is the choice-corrected agreement (kappa) for the clinical findings?
1) 0.8
2) 0.75
3) 0.6!
4) 0.7
5) 0.5
Question: 22
Several studies have indicated that, in large urban areas, there is a higher prevalence of schizophrenia in the lower socioeconomic class. Epidemiologic studies tend to support the hypothesis that
1) unsatisfactory social circumstances "breed" an excess incidence of schizophrenia.
2) the fathers of schizophrenics also tend to come from a lower socioeconomic class.
3) people with schizophrenia tend to "drift" down the social scale, because of their illness.!
4) both intelligence and schizophrenia are negatively associated with social class.
5) schizophrenia "runs" in families and is primarily an inherited disorder.
Question: 23
To qualify for federal contributions, provincial health insurance plans must guarantee all of the following, EXCEPT
1) benefits include all necessary hospital care and physicians' services.
2) universal coverage on uniform terms and conditions.
3) portability of coverage from province to province.
4) benefits include all necessary out-of-hospital drugs, dental care and prostheses.!
5) administration on a non-profit basis.
Question: 24
A 68-year-old man develops acute renal failure after surgery for ruptured aortic aneurysm. He refuses dialysis. Psychiatric consultation reveals him to be fully alert and oriented, cognitively intact, and not psychotic or clinically depressed. He says he is refusing dialysis because he has "lived a full life" and does not want to be "tied to a machine, even if this means I'll die." The psychiatrist should tell the man's internist that the man
1) is temporarily incompetent to decide on treatment, so treatment should be started.
2) is competent to decide on treatment, but his refusal should be overruled because of the existence of a medical emergency.
3) his refusal of dialysis must be respected because he is competent to decide on treatment.!
4) is behaving in a self-destructive manner, so he should be committed for treatment against his will.
5) shows no evidence of a major psychiatric illness but assessment of competency is required.
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Section: 2
Question: 1
A 28-year-old pregnant woman develops sudden onset of dyspnea and tachycardia. Which one of the following is the most likely explanation?
1) acute mitral valve regurgitation
2) pulmonary embolism!
3) myocardial infarction
4) acute respiratory distress syndrome
5) lobar pneumonia
Question: 2
A 50-year-old man comes to the emergency room with a history of vomiting for three days' duration. His past history reveals that for approximately 20 years, he has been getting epigastric pain, lasting for two to three weeks. He remembers getting relief from pain by taking milk and antacids. Physical examination showed a fullness in the epigastric area with visible peristalsis, absence of tenderness and normal active bowel sounds. Which one of the following is the most likely diagnosis?
1) gastric outlet obstruction!
2) small bowel obstruction
3) volvulus of the colon
4) incarcerated umbilical hernia
5) cholecystitis
Question: 3 A 40-year-old man complains to his doctor of impotence. Which one of the following medication could be implicated?
1) ranitidine.
2) sertraline!
3) clarithromycin
4) enalapril
5) hydrochlorthiazide
Question: 4
A 34-year-old female keyboard operator develops pain and numbness in her hands that radiates up her arms. Which of the following is most likely to have been injured?
1) axillary nerve
2) median nerve!
3) ulnar nerve
4) radial nerve
5) brachial plexus / triceps muscle
Question: 5
A 60-year-old man presents with a small lesion on his nose. On examination of the lesion you note the following: the lesion is 3-mm in diameter, slightly elevated with a waxy appearance, and has a slight vascular pattern on top. This lesion is most characteristic of which one of the following?
1) basal cell carcinoma!
2) squamous cell carcinoma
3) melanoma
4) varicella-zoster lesion
5) actinic keratosis
Question: 6
A 30-year-old woman presents with a headache, gradual development of a partial bitemporal hemianopia, and a history of cessation of menses several years ago. Which one of the following is the most likely cause?
1) dilated third ventricle
2) craniopharyngioma
3) saccular aneurysm of the circle of Willis
4) pituitary adenoma!
5) meningioma of the tuberculum sellae
Question: 7
A 30-year-old man has a history of recurrent pneumonias and chronic cough dating from early childhood. The cough, which is worse in the morning and on lying down, is productive of foul-smelling purulent sputum which is occasionally bloody-tinged. The patient is chronically ill and has clubbed fingers. Rales are heard over the lung bases posteriorly. Which one of the following is the most likely diagnosis?
1) chronic bronchitis
2) pulmonary aspergillosis
3) pulmonary neoplasm
4) chronic obstructive emphysema
5) bronchiectasis!
Question: 8
A 22-year-old woman presents with fever, malaise, generalized arthralgias, and a skin rash, over the nose and malar eminences. Which one of the following possible findings has the greatest relative significance in the overall prognosis for the patient?
1) immune complexes at the dermal-epidermal junction in skin
2) pleuritis
3) atypical verrucous vegetations of the mitral valve
4) perivascular fibrosis in the spleen
5) glomerular subendothelial immune complex deposition!
Question: 9
A 38-year-old woman presents to you convinced that she has chronic fatigue syndrome. The history reveals no evidence of fever or swollen glands, and no other symptoms other than fatigue and difficulty sleeping. Her physical examination is completely normal. She has a high thyroid-stimulating hormone level. You would then suspect and subsequently confirm
1) hyperthyroidism secondary to pituitary adenoma.
2) hypothyroidism.!
3) Grave disease.
4) thyroiditis.
5) chronic fatigue syndrome.
Question: 10
A 29-year-old quadriplegic woman (who is mentally intact) is shifted in bed every 2 hours to prevent pressure (decubitus) ulcers. The clinician examines her at the end of 2 hours on her right side. She is feeling well, not coughing, and is afebrile. Examination of the lungs reveals dullness and crackles in the lateral half of the right lung field. Which one of the following is the most reasonable interpretation of their cause?
1) atelectasis secondary to mucus plugging
2) pulmonary edema, which has localized due to gravitational forces
3) compressive atelectasis
4) aspiration pneumonitis
5) chronic pulmonary fibrosis
Question: 11
You are called to see an elderly hospitalized patient with mild obstructive lung disease who was roused one morning with difficulty and appeared confused. Which of the following drug orders is most likely associated with this episode?
1) trimethoprim-sulfamethoxazole (Septra®) D.S. x 2 daily
2) hydrochlorothiazide 50 mg once daily!
3) flurazepam 30 mg h.s.
4) theophylline 200 mg x 2 daily
5) senna (Senokot®) 1 - 2 tablets as required
Question: 12
An 11-year-old girl has become markedly withdrawn during the past 8 months and has complained of persisting abdominal pain and constipation, for which no organic cause has been found. Which one of the following is the most likely diagnosis?
1) depressive disorder!
2) schizophrenia
3) conduct disorder
4) attention deficit hyperactivity disorder
5) infantile autism
Question: 13
A 30-year-old woman complains of episodic faintness, tingling sensation in her hands, shortness of breath, and severe anxiety. Thorough medical workup reveals no pathologic condition. During an episode of these symptoms, chemical analysis of the serum will probably reveal which one of the following?
1) decreased chloride
2) increased urea (BUN)
3) decreased protein
4) increased serum amylase!
5) increased pH
Question: 14
A 27-year-old man is suspicious of others, superstitious, believes he possesses telepathic powers, and has no friends. Which one of the following is most likely to be associated with this clinical description?
1) passive-aggressive personality disorder
2) histrionic personality disorder
3) schizotypal personality disorder!
4) avoidant personality disorder
5) compulsive personality disorder
Question: 15
A 2-year-old boy with visible abdominal distention is found to have a large left-sided flank mass. Which one of the following is the most likely diagnosis?
1) renal cell carcinoma
2) polycystic kidney
3) transitional cell carcinoma
4) Wilms' tumour!
5) hydronephrosis
Question: 16
A 3-year-old with a history of asthma is brought to the Emergency Department in acute respiratory distress. His mother relates that she stopped his twice daily sodium cromoglycate 1 week ago. Physical examination reveals a distressed child with a harsh cough. On auscultation of the chest, there are areas of reduced air entry and diffuse expiratory wheezes. Which one of the following is the most appropriate initial management?
1) aerosolized ipratropium bromide by nebulization
2) aerosolized sodium cromoglycate by nebulization
3) aerosolized budesonide
4) subcutaneous epinephrine, 1:1000 dilution
5) aerosolized salbutamol by nebulization!
Question: 17
A 13-year-old boy states that he is growing breasts and that they hurt. He has been growing taller this past year. He has no other complaints. On physical examination you note some acne on his face, his testes and phallus are appropriate for age, and he has fine sparse pubic hair. Which one of the following is the most likely diagnosis?
1) normal puberty!
2) Klinefelter's syndrome
3) pituitary tumor
4) adrenal tumor
5) gonadal tumor
Question: 18
A full-term infant presents to your office at 7 days of age with bilateral purulent conjunctive discharge, erythema and swelling at the medial aspect of the eyes. Which one of the following is the most likely diagnosis?
1) Neisseria gonorrhoeae infection
2) herpes simplex infection
3) nasolacrimal duct inflammation due to Staphylococcus aureus
4) chemical irritation from eye oinment received at delivery
5) chlamydia infection!
Question: 19
A 30-year-old primigravida presents at 34 weeks gestational age with blood pressure of 160/90 mmHg, headache, epigastric pain, visual abnormalities and 3 proteinuria. Biophysical profile of the fetus is 8/8. Which one of the following is the best course of action?
1) Induce labour and attempt vaginal delivery.
2) Start magnesium sulfate intravenously.!
3) Perform an emergency C-section.
4) Give betaclomethasone to induce fetal lung maturity.
5) Perform an amniocentesis to assess fetal lung maturity.
Question: 20
All of the following are considered possible indications for cesarean section, EXCEPT
1) placenta previa.
2) fetal distress.
3) genital herpes.
4) carcinoma in situ of the cervix.!
5) prior urethropexy.
Question: 21
The statistical measure of the degree of relationship between two sets of numbers is
1) the average
2) the standard deviation
3) the normal distribution
4) the standardized scores
5) the correlation coefficient!
Question: 22
When interpreting a diagnostic test, the term "gold standard" refers to a definitive diagnosis obtained by some independent means. All of the following would be examples of gold standards useful in clinical practice, EXCEPT
1) coronary angiography in evaluating a cardiac stress test.
2) bacteriologic culture in testing a rapid diagnostic kit for gonorrhea.
3) bronchoscopy with biopsy in evaluating sputum cytology.
4) autopsy results in evaluating electrocardiography.
5) results of long-term follow-up in a test for early rheumatoid arthritis.!
Question: 23
A new screening test for a type of cancer is carried out on 10,000 subjects. One hundred and sixty have a positive result, of whom eight are determined to actually have the disease. These eight subjects survive longer than other persons suffering from the same type of cancer diagnosed by other means. Which one of the following statements is correct?
1) The sensitivity of this test is [snip].4% (10,000-160)/10,000.
2) The incidence of the disease in this population is 80 per 100,000.
3) Early detection by this test improves survival.
4) The predictive value of a positive test is 5% (8/160).!
5) The predictive value of a negative test is 95% (152/160).
Question: 24
An active 75-year-old woman relocates to your town. She has hypertension, arthritis, and diabetes. Her medication regimen includes hydrochlorothiazide, potassium elixir, diltiazem, acetaminophen, ibuprofen and glyburide. Which factor is most related to compliance with the medication regimen?
1) age
2) number of drugs in the regimen!
3) gender
4) number of comorbid diseases
5) use of tablets versus use of elixirs
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Section: 3
Question: 1
A gunshot wound to the upper arm causing shock-wave damage to the median nerve may leave the patient with which one of the following?
1) easily provoked pain in the hand!
2) weakness on wrist extension
3) atrophy in the first dorsal interosseous muscle
4) numbness over the fifth digit
5) radial deviation of the hand
Question: 2
A 9-year-old boy is brought to the hospital with a history of having fallen from his bike. He fainted and is now complaining of abdominal pain and thirst. There is general abdominal tenderness and rebound tenderness. Approximately 4 hours after the accident, the white blood count is 20 x 109/L and the hemoglobin is 80 g/L. What is the most likely diagnosis?
1) renal contusion
2) acute pancreatitis
3) ruptured spleen!
4) retroperitoneal hematoma
5) ruptured bowel
Question: 3
A 50-year-old man presents to the emergency room with severe epigastric pain, low-grade fever, tachycardia, and mild hypotension. The patient relates a history of moderate to heavy social drinking. The chief resident suspects acute pancreatitis. Which one of the following is the single most important laboratory finding to confirm the diagnosis of pancreatitis?
1) hyperlipidemia
2) hyperbilirubinemia
3) elevated serum amylase!
4) elevated serum phospholipase A
5) elevated serum alkaline phosphatase
Question: 4
A 22-year-old male, working as a waiter in a nightclub, noticed a gradual hearing loss. He admitted that the noise level in his job is very high and that he was not advised to wear ear defenders. Which one of the following does he most likely suffer from?
1) sensory hearing loss and vertigo
2) both sensory and conductive hearing loss
3) conductive hearing loss and ataxia
4) sensory hearing loss and tinnitus!
5) conductive hearing loss and nystagmus
Question: 5
A 68-year-old man presents with a chief complaint that solid food gets stuck in the middle of his chest. In addition, he admits to a 11 kg weight loss over the last 3 months. Which one of the following is the most likely diagnosis?
1) esophagitis
2) lower esophageal ring
3) esophageal carcinoma!
4) cerebrovascular accident
5) myocardial infarction
Question: 6
A 52-year-old man with a long history of alcohol use comes to the emergency room of a general hospital. He is confused and on examination is noted to have palsies of conjugate gaze, horizontal nystagmus, and ataxia. Which one of the following is the most likely diagnosis?
1) conversion reaction
2) alcohol intoxication
3) alcohol hallucinosis
4) delirium tremens
5) Wernicke's encephalopathy!
Question: 7
A 71-year-old woman with a history of coronary artery disease presents to her family physician for a routine check-up. The physician notices that she has lost 10 kg since her last visit 6 months ago. When questioned, she gives a history of intermittent periumbilical pain that always begins 30 minutes after eating and lasts about 2 hours. She claims that the pain is worse after large meals and so she has begun to eat less out of fear of pain. Which one of the following is the most likely diagnosis?
1) pancreatitis
2) cholecystitis
3) small bowel obstruction
4) intestinal ischemia
5) peptic ulcer disease!
Question: 8
In a woman under 40 years of age, which one of the following breast abnormalities would have the highest predictive value for malignancy?
1) painful, moveable mass
2) painless, moveable mass
3) blood nipple discharge
4) clear nipple discharge
5) breast skin edema with dimpling!
Question: 9
A 68-year-old man presents with cardiac arrest due to ventricular rupture. Which one of the following myocardial changes is the most frequent cause?
1) Abscess formation and tissue destruction due to infective endocarditis .
2) Fatty change due to interaction of diphtheria exotoxin and carnitine .
3) Aschoff bodies associated with rheumatic fever.
4) Inflammation due to coxsackie B infection .
5) Necrosis due to coronary artery obstruction .!
Question: 10
A 49-year-old man who smokes two packs of cigarettes a day presents with a lung mass on x-ray and recent weight gain. Laboratory examination shows hyponatremia with hyperosmolar urine. The patient probably has which one of the following diagnoses?
1) renal failure
2) pituitary failure
3) Conn's syndrome
4) cardiac failure
5) inappropriate ADH (secretion)!
Question: 11
Which one of the following types of hallucination is normal?
1) hypnagogic!
2) lilliputian
3) tactile
4) olfactory
5) auditory
Question: 12
A 20-year-old college student presents to you with a history of intermittent chest pain for about 6 months. He states that the pain can occur at any time, but often occurs late in the day. The pain can be sharp, dull, or aching and may last for hours. He is physically active and is carrying a full academic load. The pain is unrelated to exercise and does not restrict his activities. His father and paternal uncle have both had myocardial infarctions within the past year. Physical examination is normal, although the patient appears restless and has a heart rate of 100/min. Which one of the following is the most likely diagnosis?
1) feflux esophagitis!
2) generalized anxiety disorder
3) transient myocardial ischemia
4) myocardial infarction
5) costochondritis
Question: 13
A 25-year-old man is hospitalized after weeks of worsening psychosis. He is given thiothixene, an antipsychotic medication. Five days later, he develops a fever of 39.8 °C, becomes delirious and lies stiffly in his bed. His family reports that he had been physically well prior to his admission. Which of the following diagnosis is of most immediate concern?
1) tardive dyskinesia
2) viral meningitis
3) neuroleptic malignant syndrome!
4) ruptured cerebral aneurysm
5) unsuspected opioid dependence
Question: 14
A 31-year-old man is shy, socially withdrawn, low in self-esteem, yet eager to please when called on by persons in authority. Which one of the following personality disorders is most likely to be associated with this clinical description?
1) passive-aggressive personality disorder
2) histrionic personality disorder
3) schizotypal personality disorder
4) avoidant personality disorder!
5) compulsive personality disorder
Question: 15
A 5-year-old girl is admitted to the Children's Hospital after swallowing an undisclosed number of her mother's ASA tablets. She is hypotensive, flushed and tachypneic. Which of the following acid-base disturbances would be most likely?
1) pH low ; HCO3 low ; pCO2 high
2) pH normal ; HCO3 high; pCO2 low
3) pH low; HCO3 low; pCO2 high
4) pH low; HCO3 high; pCO2 low
5) pH high; HCO3 high; pCO2 high
Question: 16 A 5-year-old patient has axillary freckling, several firm subcutaneous masses on both arms and seven light-brown macules on his trunk which are greater than 1.5 cm. Which one of the following is the most likely diagnosis?
1) Peutz-Jeghers syndrome
2) tuberous sclerosis
3) Sturge-Weber syndrome
4) Albright's disease
5) neurofibromatosis!
Question: 17
A 13-year-old girl sustains a minor injury to the left side of her back in a school basketball game. On examination little is found except for asymmetric shoulder levels. While she bends over, the right posterior chest is elevated. Which of the following are these findings most readily suggestive of?
1) an accessory rib
2) an iliopsoas muscle spasm
3) rhabdomyosarcoma
4) scoliosis!
5) hematoma
Question 18
A 24-year-old woman is seen because of high fever, prostration, vomiting, and diarrhea. Her pulse is rapid and thready, and her blood pressure is recorded at 60/40 mmHg. A diffuse generalized macular rash is noted. Following stabilization with fluid and vasoactive medications, culture of which of the following specimens will most likely lead to the correct diagnosis?
1) sputum
2) urine
3) stool!
4) cervicovaginal secretions
5) cerebrospinal fluid
Question: 19
Which one of the following hormones is responsible for the proliferation of the milk ducts during pregnancy?
1) human chorionic gonadotropin
2) progesterone
3) prolactin
4) estrogen!
5) human placental lactogen
Question: 20
Amniocentesis is used in the diagnosis of all of the following conditions, EXCEPT
1) trisomy 21 (Down syndrome).
2) metabolic errors.
3) neural tube defects.
4) genitourinary anomalies.!
5) trisomy 18.
Question: 21
From information recorded at school A it was found that, out of a total of 400 missed 'person days' during November, 100 were due to measles; 200 to "flu"; and the rest to various other causes. At school B in the same neighborhood, during the same period of time, a total of 75 children were absent for 1 or more days. Of these, 25 had suffered from measles; 25 from "flu" and the rest from various other causes. It can be concluded that
1) the incidence of measles was greater in school "B" than in school "A".
2) the incidence of "flu" was greater in school "A" than in school "B".
3) the overall morbidity rate was higher in school "A" than in school "B".!
4) the incidence of "other causes" was greater in school "A" than in school "B".
5) none of the above conclusions can be reached with the data provided.
Question: 22
Exposure to lead can cause all of the following, EXCEPT
1) anemia.
2) cirrhosis of the liver.!
3) paresis.
4) abdominal pain.
5) porphyrinuria.
Question: 23
A case control study was conducted in which 50 cases and 50 controls were interviewed to inquire about their history of exposure to substance 'X'. The following 2 X 2 table resulted: Cases Controls Totals Exposed 40 20 60 Not exposed 10 30 40 Totals 50 50 100 The 'odds ratio' (estimate of the relative risk) is
1) 0.17
2) 1.50
3) 2.00
4) 3.00
5) 6.00!
Question: 24
Under certain circumstances, it may be legitimate to detain individuals in an institution against their wishes, for their own good and to protect others. This situation may arise when
1) a person has bizarre fantasies and actions
2) persons are mentally incompetent and unable to manage their own affairs
3) a close relative submits a petition that an individual is actually and presently insane
4) the individual's continued liberty poses a danger!
5) a person has visual and aural hallucinations
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Section: 4
Question: 1
A 27-year-old carpenter dropped his circular saw and severed his lower leg. Which one of the following would be indicative of a severed tibial nerve?
1) paralysis of the plantarflexors of the foot!
2) paralysis of all the muscles in the posterior compartment of the leg
3) anesthesia of most of the sole of the foot
4) paralysis of the muscles in the lateral crural compartment
5) anesthesia to the medial aspect of the lower leg
Question: 2
A middle-aged woman is admitted unconscious to the Emergency Department following a head injury in a car accident. There is bruising over the upper abdomen. Blood pressure is 80 mm Hg systolic, pulse 120/minute. What is the most important initial step in the management of this patient?
1) x-ray (three views) of abdomen
2) immediate laparotomy
3) draw blood sample and start IV fluids!
4) perform emergency burrholes
5) diagnostic peritoneal lavage
Question: 3
On examining a 51-year-old man with chest pain who was just involved in a motor vehicle accident, you find that at the end of expiration his blood pressure is 130/90 mmHg and at the end of inspiration it is 110/92 mmHg. Which one of the following conditions is most likely?
1) cardiac tamponade!
2) pneumothorax
3) multiple rib fractures
4) acute myocardial infarction
5) aortic rupture
Question: 4
A 78-year-old man complains of 3 months of fatigue and a 10 kg weight loss. Physical examination reveals jaundice without abdominal tenderness or organomegaly. Which one of the following is the most likely diagnosis?
1) cholecystitis
2) pancreatitis
3) hemochromatosis
4) hepatic vein thrombosis
5) pancreatic carcinoma!
Question: 5
A 55-year-old man presents to the hospital with the complaint of severe intermittent pain in his right lower back that radiates around his trunk into his lower quadrant and upper right thigh. Which one of the following is the most likely diagnosis?
1) hepatitis
2) appendicitis
3) a ureteral stone!
4) pyelonephritis
5) biliary obstruction
Question: 6
You are performing pulmonary function tests on a 80-year-old male with persistent cough . Which one of the following would occur normally with age?
1) fall in vital capacity
2) fall in FEV1/FVC!
3) fall in arterial p02
4) increase in arterial pCO2
5) decrease in arterial pH
Question: 7
A 26-year-old man developed hemoptysis and dyspnea over the course of 3 months. His physician suspected tuberculosis and started him on triple therapy with isoniazid, rifampin, and ethambutol. After 2 months, the patient complained of pins-and-needles sensations in his feet. Neurologic examination was otherwise unremarkable. Strength was good in all limbs. Which one of the following nutritional deficiencies is most likely responsible?
1) vitamin B12 deficiency
2) vitamin B6 (pyridoxine) deficiency!
3) vitamin E (alphatocopherol) deficiency
4) vitamin D deficiency
5) vitamin B1 (thiamine) deficiency
Question: 8
A 56-year-old patient presents with polycythemia. He is found to have low oxygen saturation, increased red blood cells mass, normal plasma volume and increased erythropoietin levels. Which one of the following is the most likely diagnosis?
1) polycythemia rubra vera
2) chronic obstructive pulmonary disease (COPD)!
3) stress polycythemia
4) renal adenocarcinoma
5) congenital spherocytosis
Question: 9
While being investigated for long-standing hypertension, a 55-year-old woman is found to have the following serum laboratory test values: normal creatinine, total protein, albumin, and globulin; increased calcium and alkaline phosphatase; and decreased phosphorus. Which of the following do these findings suggest the presence of?
1) carcinoma metastatic to bone
2) excessive dietary calcium intake
3) multiple myeloma
4) parathyroid adenoma!
5) sarcoidosis
Question: 10
A 40-year-old woman presents with painful swelling of the joints of her fingers, excessive fatigue and a malar rash. Which one of the following diseases is is most likely?
1) psoriasis
2) pseudogout
3) systemic lupus erythematosus (SLE)!
4) rheumatoid arthritis
5) serum sickness
Question: 11
A 32-year-old married woman describes experiencing panic attacks every time she goes to the local store. These have been getting more frequent and she is finding it increasingly difficult to leave her home. Which one of the following should form part of her treatment?
1) psychodynamic therapy
2) interpersonal psychotherapy
3) family therapy
4) supportive psychotherapy
5) cognitive behavioral therapy!
Question: 12
A 38-year-old woman tells her physician that for several months she has been experiencing palpitations, dizziness, shortness of breath, a feeling of impending doom and a fear of dying. Which of the following would be the most appropriate initial step in managing this patient?
1) offer psychotherapy
2) prescribe benzodiazepines
3) perform a physical examination!
4) refer the patient to a psychiatrist
5) teach relaxation techniques
Question: 13
A patient reports that, on his way to your office he saw a man feeding two squirrels in the park. He says that this means that his future will be decided within 2 weeks. Which one of the following terms best describes this mode of thinking?
1) illusion
2) hallucination
3) delusion
4) loose association!
5) neologism
Question: 14
A 3-year-old boy presents to the emergency room with a history of recurrent cough. A review of his previous records reveals recurrent episodes of right lower lobe pneumonia. An x-ray chest in the current admission also confirms a right lower lobe pneumonia. He has no other major health issues. What is the most likely diagnosis?
1) cystic fibrosis!
2) congenital lung abnormality
3) chronic granulomatous disease
4) asthma
5) bronchiectasis of the lingula
Question: 15
Haemophilus influenzae Type B vaccine has been recommended for which one of the following groups?
1) All children at the time of their first birthday.
2) Any child with impaired immunity or chronic disease.
3) All children after the age of 5 years.
4) Siblings and daycare contacts of children who develop systemic Haemophilus influenzae Type B infections, regardless of age.
5) All children at age 2 months.!
Question: 16
A 26-year-old pregnant woman delivers a male infant at 40 weeks, with a birthweight of 2.0 kg. His head circumference is 34 cm and there are no dysmorphic features. Antenatal ultrasounds have been normal until 32 weeks, when intrauterine growth restriction has been diagnosed. Which one of the following is the most likely cause of the low birth weight?
1) congenital intrauterine infection
2) chromosomal or genetic abnormality
3) placental insufficiency!
4) congenital hydrocephalus
5) maternal age
Question: 17
A 4-year-old child presents with an enlarged submandibular node that is 4 cm in diameter, nontender, and not fluctuant. The node has been enlarged for about 4 weeks and there is no history of fever or contact with any person who was ill. A complete blood count (CBC) is normal, and a Mantoux test with 5 tuberculin units of purified protein derivative shows 6 mm of induration. Which one of the following is the most likely diagnosis?
1) cat-scratch fever
2) acute pyogenic lymphadenitis
3) acute lymphoblastic leukemia!
4) tuberculous lymphadenitis
5) atypical mycobacteria lymphadenitis
Question: 18
A 23-year-old woman in her first trimester of pregnancy is diagnosed as having deep venous thrombosis in her right lower extremity. Which one of the following is the most appropriate therapy?
1) warfarin
2) heparin!
3) clopidogrel
4) dipyridamole
5) streptokinase
Question: 19
A 27-year-old multiparous woman is admitted to the case room at 31 weeks' gestation with a 1-hour history of vaginal bleeding. She has painful uterine contractions, with poor uterine relaxation. The most probable diagnosis is
1) blood-stained show.
2) vasa previa.
3) placenta previa.
4) abruptio placentae.!
5) uterine rupture.
Question: 20
A 30-year-old menstruating woman presents at the Emergency Department with a high fever, vomiting and diarrhea of 24 hours' duration. Her blood pressure is 90/50 mm Hg and there is a diffuse erythematous rash. All of the following laboratory results are in keeping with a diagnosis of toxic shock syndrome, EXCEPT
1) creatine kinase 290 U/L.
2) calcium (total) 1.66 mmol/L.!
3) white blood cell count 18 x 109/L.
4) aspartate aminotransferase 100 U/L.
5) glucose 2.2 mmol/L.
Question: 21 The incidence of a particular disease is greater in men than in women, but the prevalence shows no sex difference. The most probable explanation is that
1) the mortality rate is higher in women.
2) the case fatality rate is higher in women.
3) the duration of the disease is longer in women.!
4) women receive less adequate medical care for the disease.
5) this diagnosis is more often missed in women.
Question: 22
All of the following are responsibilities of local public health units in Canada , EXCEPT
1) communicable disease control.
2) health education.
3) investigation of sudden death.!
4) immunization.
5) health promotion.
Question: 23
All of the following are characteristics of provincial voluntary health organizations, EXCEPT
1) provincial governments contribute to their funding in proportion to the number of members.!
2) they are governed by volunteers rather than by professionals.
3) they often carry out programs of education for the public, patients, their families, or health professionals.
4) they may provide direct services to patients.
5) they may conduct research or provide funds to others for research.
Question: 24
The causative organism of cholera, Vibrio cholerae, has been recognized for 100 years. Outbreaks of cholera often reach epidemic proportions; the history of seven pandemics can now be traced. The most recent only just now appears to be subsiding. Which one of the following is the spread of this infection, enhanced by modern transportation?
1) fomites
2) mosquitoes
3) contaminated food sources!
4) person-to-person
5) domestic flies
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