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13 October, 2015
Medicine
1. Cardiac patient on Aspirin, no new complaints. He is having low platelet (less than 10) for
the last 6 months. What is your management?
a. Could not recall the choices

Answer: ?

2. Which medication will delay the surgery for chronic aortic regurgitation?
a. Could not recall the choices

Answer: ?

● In severe aortic valve insufficiency, the excess in afterload increases burden on the left side of
the heart. Theoretically, any medication that can reduce afterload could be expected to improve
left ventricular function and decrease regurgitant backflow from the aorta. This would provide a
temporizing measure by which surgical intervention can be postponed. One study showed that
the use of nifedipine in asymptomatic patients with severe aortic regurgitation who had normal
LV function could delay the need for surgery by 2-3 years. This result may also be expected with
the use of similar vasodilating agents. (Reference: Medscape)

3. Which of these anti HTN medications decrease afterload and preload?

a. ACEI

Answer: A (Reference: First Aid)

4. Which of the following hypoglycemic agents cause weakness?

a. glipizide
b. rosiglitazone
c. insulin
d. ???

Answer: ?

5. Most common cause of DKA in adult :

a. missing insulin
b. dietary
c. increase physical activity

Answer: A?

6. Why are we concern about anti HTN agents:

a. hypotension

Answer: A?

7. Patient with chest pain and ST changes, you will find elevation in:
a. ALT
b. AST
c. Troponin
 Answer: C

8. Mechanism of metformin on the cellular level :

a. decrease Muscle uptake
b. increase Muscle gluconeogenesis
c. Enhance muscle use of fatty acid
Answer: C?
9. Patient with COPD, DM and now Dx to have BPH, what medication will you use?
a. B-Blocker
b. Terazosin

Answer: A (Reference: First Aid)

● Terazosin is an alpha blocker

10. Child known case of DM 1, lost his consciousness at school. The last insulin injection is
unknown.
a. Take him to the hospital
b. IV ranger lactate
c. IV D5%
d. Insulin
Answer: ?

11. Asymptomatic Patient, Chest X ray shows a unilateral calcified nodule on the upper zone
of his lung.
a. Could not recall the choices

Answer: ?

12. Elderly female complaining of depression, bilateral shoulder and hip pain. Normal blood
workup.
a. polymyalgia rheumatica
b. fibromyalgia

Answer: A?

13. Which of the following is the the most specific for Rheumatoid arthritis?
a. anti ccp
b. RF
c. CRP

Answer: A (Reference: First aid)

14. Known case of DM and now he has typical symptoms and chest X ray of pneumonia, the
antibiotic which will be used will work on:
a. ribosome 30
b. ribosome 50
c. DNA gyrase

Answer: B or C? (Reference: First aid DM)

● fluoroquinolone or beta lactam + macrolides

15. Treatment for trigeminal neuralgia:

 a. carbamazepine

Answer: A (Reference: Toronto notes)

16. Schistosoma Antibiotics:
a. Praziquantel

Answer: A (Reference: Toronto notes)

17. Patient on central cath developed infection. Blood gram stain shows budding yeast.
a. Fluconazole

Answer: A (Reference: Toronto notes)

18. Most specific test for TB:
a. PCR
b. Chest X ray
c. sputum culture

Answer: C (Reference: Medscape)

19. Children who are living in a poor country with poor hygiene will have a high risk to
hepatitis:
a. A
b. D
c. E

Answer: A
20. 19 years old male can’t bring the spoon infront of himself to eat after a bike accident.
Where is the site of his lesion?
a. Parietal lobe
b. Temporal lobe
c. occipital lobe
d. cerebellum

Answer D (Reference: Al-Qassim MCQs > Q 342)

21. Medication for resistant hiccups:
a. Could not recall the choices

Answer: ?

● Chlorpromazine is the most thoroughly studied and appears to be the drug of choice.
(Reference: Medscape)

22. Which nerve is responsible for the gag reflex:

a. Glossopharyngeal

Answer: A

23. Which nerve is responsible for tongue movement :

a. Hypoglossal

Answer: A

24. Winging scapula:

 a. long thoracic nerve injury

Answer: A

25. Median nerve injury leads to :

a. complete claw hand
b. Ape hand
c. Partial claw
d. Ulnar Claw

Answer: C

26. Mid humerus shaft fracture :

a. radial nerve injury

Answer: A

27. Posterior vagal trunk supplies :

a. esophagus
b. jejunum
c. descending colon

Answer: A (Reference: Wikipedia)

● The posterior vagal trunk is a branch of the vagus nerve which contributes to the esophageal
plexus. It consists primarily of fibers from the right vagus, but also contains a few fibers from the
left vagus.

28. Pronator teres syndrome affect which nerve:

a. median nerve

Answer: A (Reference: Wikipedia)

● Pronator teres syndrome is a compression neuropathy of the median nerve at the elbow. It is rare
compared to compression at the wrist (carpal tunnel syndrome)

29. What is the gene responsible for neurofibromatosis?

a. Could not recall the choices

(Reference: Medscape)

● Type 1 : chromosome 17 q
● Type 2: chromosome 22 q

30. Features of neurofibromatosis:

a. Could not recall the choices
 (Reference: Medscape)

● Six cafe au lait, freckling in the axillary or inguinal area, optic glioma and lisch nodule.

31. Turner Features :

a. Thick skin neck

Answer: A

32. Vegetarian patient having angular cheilitis:

a. vit B6 deficiency

Answer: A

33. Prophylactic antiarrhythmic therapy:

a. procainamide
b. lidocaine
c. amiodarone

Answer: ?

34. In Atrial septal defect (ASD) there will be :

a. fixed S2 split

Answer: A

35. Patient on diuretics developed palpitation. Due to the disturbance of which of these electrolytes
lead to his presntation?
a. Na
b. K
c. Cl
d. Ca

Answer: B?

36. Patient ingested 20 gram of acetaminophen 8 hours ago, what is your next step?
a. Charcoal
b. N acetylcysteine
c. Gastric lavage

Answer: B

37. Asymptomatic patient, known case of chronic gastritis, has positive occult blood stool
and his Hb =9. You will manage him by :
a. IM iron
b. Oral iron
c. Erythropoietin
d. blood transfusion

Answer: ?
 38. Patient underwent orthopedic surgery. 2 days after the surgery he started to complain of
swelling, erythema and tenderness at the site of surgery. Which organism can cause the
wound infection?
a. Clostridium perfringens
b. Other choices included different subtypes of clostridium

Answer: A

39. Elderly patient is having bilateral Hydronephrosis:

a. BPH

Answer: A

40. Elderly patient presented with typical symptoms of multiple myeloma. x ray showed lytic
lesions, positive M protein and hypercellular bone marrow. What other findings can be
found in the blood?
a. increase peripheral blood B cell
b. Rouleaux formation

Answer: B

41. Patient ate from a restaurant. 2 days after that started to complain of diarrhea, vomiting
and urticaria.
a. food poisoning
b. food allergy

Answer: B?

42. Patient after road traffic accident developed chest pain. On examination: no lung sound
and hyperresonance on one side. What is the 1st thing to do?
a. needle decompression

Answer: A

● Tension pneumothorax

43. Clear question about pseudomembranous colitis (Abdominal pain and watery diarrhea
after clindamycin)

Answer: ?

44. Clear question about prostatitis.

Answer: ?

45. 3 clear questions about EBV.

Answer: ?

Surgery
1. 16 years old female complaining of abdominal pain for 2 days. It started in the
periumbilical area then it radiated to the right lower quadrant. It is associated with
anorexia. On examination, right lower mass was felt.
 a. surgery immediately
b. conservative
*Antibiotics weren’t mentioned in the choices.

Answer: A?

2. The most common cause of breast bloody discharge:

a. ductal papilloma

Answer: A

3. A mass at the middle of the Esophagus :

a. Adenocarcinoma
b. squamous

Answer B

4. Which of these supplements protect against colorectal cancer?

a. folic acid
b. vit E

Answer: A?

Pediatrics
1. Child presented with petechiae and his platelets is 15, otherwise healthy. What will you do
for him?
a. splenectomy
b. IVIG

Answer:

2. 4 weeks old boy with acute onset forceful non bilious vomiting after feeding. On
abdominal examination: There is olive mass at epigastric area. What is the 1st
investigation should you do?
a. PH monitoring
b. Abdominal US

Answer:

3. Most common site for mump:

a. parotid

Answer: A

4. A school did a screening test for their students and they found that there is a good
number of obese students. The school doctor wants to know more about these students
before educating their parents. What should you provide him with?
a. HDL\LDL
b. Girth measurement
c. dietary habits

Answer:
5. The most common chromosomal abnormality in new infant :
a. Down syndrome

Answer: A?

6. Child came with wheezing and cough, diagnosed to have asthma and his dr. prescribed
beclomethasone space inhaler or nebulizer?? twice daily. you will be worried about:
a. Growth'retardation
b. Extraocular'problem'

Answer: A (Reference: 3rd Edition UQU > Pediatrics > Q 58)

7. Child presented with Asthma exacerbation.The patient did not respond to B agonist. What
is your next step?
a. Aminophylline
b. systemic steroid

Answer: B

8. In an area where there is low iodine supplementation they had a lot of new infant with
cretinism. what is the initial therapy for these infants?
a. iodine supplementation
b. Thyroxin supplement

Answer: B (Reference: Medscape)

● The mainstay in the treatment of congenital hypothyroidism is early diagnosis and thyroid
hormone replacement.

9. Child was having rhinorrhea and then developed episodes of cough followed by vomiting.
Which of these vaccination may prevent him from having this disease?
a. DTaP

Answer: A

10. What is the mechanism of polio vaccine (Both types; oral and IV)?

Answer:

11. Child is complaining of severe throbbing unilateral headache, aggravated by light, what is
the most likely diagnosis:
a. migraine
b. Cluster Headache
c. Stress Headache

Answer: A (Reference: 3rd Edition UQU > Pediatrics > Q 20)

12. Mother brought her 2 years old child to the ER with history of upper respiratory tract
infection for the last 3 days with mild respiratory distress. This evening the child started to
have hard barking cough with respiratory distress. On examination:: RR 40/min,
 associated with nasal flaring, suprasternal & intercostal recessions. What is the most
likely diagnosis?
a. Viral Pneumonia
b. Bacterial Pneumonia
c. Bronchiolitis
d. Acute epiglottitis
e. Tracheobronchiolitis

Answer: E (Reference: 3rd Edition UQU > Pediatrics > Q 27)

13. Tetralogy of fallot findings:

a. VSD + overriding of the aorta + sub pulmonary stenosis + Right ventricular hypertrophy

Answer: A

14. 3-4 questions about croup and bronchitis (you should know physical examination signs)
15. 2 questions about developmental millstone.

OB/GYN
1. Lactating mother complaining of fever and breast tenderness and redness diagnosed to
have bacterial mastitis. What will you recommend for her?
a. Continue breast feeding, hot compressor and antibiotic.
b. Discontinue breast feeding and give antibiotic to mother and baby.
Answer: A (Reference: 3rd Edition UQU > Obstetrics and Gynecology > Q 385)

2. Multigravida in labor with 60% effacement and dilated cervix (5 cm). After 1 hour she still
has 60% effacement but the cervix dilates to 6 cm. What will you do for her :
a. expectant management
b. oxytocin
c. cervix ripening
d. Artificial rupture of membranes

Answer: ?

3. Primigravida week 16. She is RH negative. What is your next step?

a. US
b. RH Ig

Answer: ?

4. 42 years old female complaining of amenorrhea, night sweat and flushing for the last 6
months. What is the most likely diagnosis?
a. hypothyroid
b. hyperprolactinemia
c. Congenital adrenal Hyperplasia
d. pheochromocytoma

Answer:?
5. Swelling at the labia majora for 6 month. It was aspirated and now it relapsed. What is your
management?
a. Aspiration
b. incision and drainage
c. marsupialization

Answer: ?

● It is a Bartholin cyst

6. Multigravida 34 week , her baby is breech , what you will do for her :
a. expectant delivery
b. CS
c. External Cephalic Version

Answer: ?

7. What is the most common cause of vaginal bleed?

a. Could not recall the choices

Answer: ?

8. Mom wants to know if her baby is having thalassemia or not , how you will investigate her
antenatal :
a. Could not recall the choices

Answer:?

9. Which of the following supplements will decrease the hot flashes in postmenopausal
women?
a. Black Cohosh

Answer: A

10. Why postmenopausal women develop osteoporosis?

a. decrease Estrogen
b. decrease progestin
c. increase FSH

Answer: A

11. In polycystic ovarian syndrome, which of the following will be found on blood test?
a. FSH:LH 1:3

Answer: A

12. Young female complaining of whitish grey vaginal discharge. KOH test and clue test were
positive. What is the diagnosis?
a. Gonorrhea
b. Bacterial Vaginosis
c. Trichomonas Vaginalis

Answer: B (Reference: 3rd Edition UQU > Obstetrics and Gynecology > Q 61)
13. 21 years old Female with negative pap smear. You should advise her to repeat pap smear
every:
a. 6 months
b. 12 months
c. 18 months
d. no repeat

Answer: B (Reference: 3rd Edition UQU > Obstetrics and Gynecology > Q 201 and
Essential of obstetrics and gynecology)

● Annual pap smear screening starting at age 21 years or no more than 3 years after becoming
sexually active. Then every 3 years after 3 normal consecutive test.
● Women > 30 years old who have three consecutive normal tests screening (1 / 3 years).
● Screening should be discontinuing for women > 60-70 years who have had 3 or more normal Pap
smear

14. 23 years old women with cyclic bilateral nodularity in her breast since 6 months. On
examination there is tender 3 cm mobile subareolar mass on her right breast, What will
you do next?
a. FNA with cytology
b. Mammogram
c. Biopsy
d. Follow up for next cycle
e. Observation
Answer: D (Reference: Al-Qassim MCQs > Q 82)

15. How ectopic pregnancy occurs at the cellular level :

a. fertilization occur at the tube
b. Fast blastomeres division

Answer: ?

16. Nursing mom want to conceive but not at the coming two years. What will you recommend
for her?
a. vaginal ring
b. combined OCP
c. progestin injection
d. patch

Answer: C

17. 20 years old sedentary female complaining of amenorrhea for the last 6 months and her
BMI is 20 :
a. prolactinoma
b. Anorexia
c. depression

Answer: A

18. Which strain of HPV causes cervical cancer?

a. 16-18
 Answer: A

19. Lactating lady who didn't take the MMR. What will you advise her to do?
a. Take the vaccine and stop feeding for 72 hour
b. It is harmful for the baby
c. She can take the vaccine

Answer: C (Reference: 3rd Edition UQU > Obstetrics and Gynecology > Q 39)

Ophthalmology
1. A known case COPD and DM, diagnosed to have primary open angle glaucoma. What is
the optimal treatment for glaucoma?
a. topical timolol
b. topical carteolol
c. systemic Acetazolamide

Answer: C (Reference: 3rd Edition UQU > Ophthalmology > Q 40)

2. 24 years old female newly diagnosed type 2 DM, she is wearing glasses for 10 years, how
frequent she should follow with ophthalmologist?
a. 6 months
b. 12 months
c. 5 years
d. 10 years

Answer: B (Reference: 3rd Edition UQU > Ophthalmology > Q 78)

● For type 1 diabetic: retinal screening annually beginning 5 years after onset of diabetes, general
not before onset of puberty.
● For type 2 diabetic : screening at the time of diagnosis then annually.

3. Lacrimal gland tumor lead to proptosis in which direction?

a. Down \in

Answer: A

Anesthesia

1. What is the fasting duration for non-breast milk?

a. 8 hours
b. 6 hours
c. 4 hours
d. 2 hours
Answer: B (Reference: Torento notes)

● 8 hours (solid)
● 6 hours (formula)
● 4 hours (breast milk)
● 2 hours (clear liquid)
 2. Which of these analgesia has x10 the strength of morphine:
a. Fentanyl
b. Tramadol
c. NSAID

Answer: A?

● Common Side Effects of Opioids: Nausea and vomiting, Constipation, Sedation, Pruritus,
Abdominal pain, Urinary retention ,Respiratory depression)
● When prescribing opioids, consider: Breakthrough dose, Anti-emetics, Laxative

Family medicine
1. The most difficult method to prevent transmission:
a. Person to person
b. Vector
c. Droplet
d. Airborne
Answer: D (Reference: 3rd Edition UQU last touch > Family medicine and statistics > Q 3)

2. At a daycare center 10 out of 50 had red eye in the first week, another 30 developed the
same condition in the next 2 weeks. What is The attack rate?
a. 40%
b. 60%
c. 80%
d. 20%
Answer: C (Reference: 3rd Edition UQU > Family medicine and statistics > Q 15)

● Attack Rate = cases due to a specific cause in a short period of time divided by the population at
risk, often associated with an epidemic situation such as food borne disease (cumulative
incidence)

3. In a study they are selecting every 10th family in the city, what is the type of study
a. systematic study
b. stratified study
c. non randomised study
Answer: A (It differ from the one written in 3rd Edition UQU > Family medicine and
statistics > Q 19)

● Random sampling: preferred way of sampling, it is often difficult to do. It requires that a complete
list of every element in the population be obtained. Computer generated lists are often used with
random sampling.
● Systematic sampling: every kth element is taken. This is similar to lining everyone up and
numbering off "1,2,3,4; 1,2,3,4; etc". When done numbering, all people numbered 4 would be
used.
● Convenience sampling: readily available data is used. That is, the first people the surveyor runs
into.
● Cluster sampling: accomplished by dividing the population into groups called clusters -- usually
geographically. The clusters are randomly selected, and each element in the selected clusters
are used.
● Stratified sampling: divides the population into groups called strata. For instance, the population
might be separated into males and females. A sample is taken from each of these strata using
either random, systematic, or convenience sampling.
 4. Epidemiological study want to see the effect of smoking in lung cancer: 90% of smokers
have lung cancer while only 30% of non–smokers have the disease. The specificity of
smoking as a risk factor is:

a. 10%
b. 40%
c. 30%
d. 70%
e. 90%
Answer: E?

Specificity = 70/ (10+70) = 87.5%

Lung Cancer No Lung Cancer

Smoker A (90) B (10)

Non smoker C (30) D (70)

● Prevalence of Disease = People who have the disease / Total × 100

● Sensitivity = A/(A+C) × 100
● Specificity = D/(D+B) × 100
● Positive Predictive Value = A/(A+B) × 100
● Negative Predictive Value = D/(D+C) × 100

5. An example of secondary prevention is:

a. Detection of asymptomatic diabetic patient
b. Coronary bypass graft
c. Measles vaccination
d. Rubella vaccination
Answer: A (Reference: 3rd Edition UQU > Family medicine and statistics > Q 98)

● Primordial prevention: consists of actions to minimize future hazards to health and hence inhibit
the establishment factors (environmental, economic, social, behavioural, cultural) known to
increase the risk of disease, e.g. improving sanitation. It addresses broad health determinants
rather than preventing personal exposure to risk factors, which is the goal of primary prevention.
● Primary prevention: Action to protect against disease as immunization and to promote health as
healthy lifestyle.
● Secondary prevention (screening): Identifying & detecting a disease in the earliest stage before
symptoms appears.
● Tertiary prevention: Improves the quality of life of people with various diseases by limiting the
complications.

Psychiatry
1. Elderly patient his wife died recently. He’s been depressed and having difficulty sleeping
since that time, Which of the following is a short term medication that is suitable for him?
a. Diazepam
 Answer: A

2. Why SSRI is the drug of choice for depression?

a. effective and cost effective

Answer: A?

3. Patient turns to be erratic for 4 months, he said that people on TV know what he’s thinking
about and they are talking about him. In the last 2 month he started to claim that he has
special power that no one has. What is the most likely diagnosis?
a. Uni-polar...depression
b. Bipolar...Mania
c. Schizophrenia

Answer: C (Reference: 3rd Edition UQU > Psychiatry > Q 30)

4. Clear question about a patient with symptoms of obsessive compulsive disorder (washes
his hand a lot)

ENT

1. The most common site of malignancy in paranasal sinus:

a. Maxillary

Answer: A (Reference: 3rd Edition UQU > ENT > Q 92)

2. Child complaining of painless unilateral hearing loss. On examination, tympanic

membrane was opaque :
a. serous otitis media

Answer: A

3. 40 years old male, complaining of sudden dizziness attack for 30-40 min, associated with
nausea, vomiting ,unilateral tinnitus and hearing loss :
a. Acoustic neuroma
b. Neuritis
c. meniere disease

Answer: C (Reference: 3rd Edition UQU > ENT > Q 104)

● Meniere’s'disease:'a'cause'of'recurrent'vertigo'with'auditory'symptoms'more'common'
among'females.Hx/PE:'Presents'with'recurrent'episodes'of'severe'vertigo,'hearing'loss,'
tinnitus,'or'ear'fullness,'often'lasting'hours'to'days.'Nausea'and'vomiting'are'typical.'
Patients'progressively'lose'lowDfrequency'hearing'over'years'and'may'become'deaf'on'
the'affected'side.'
Dermatology
 1. Patient with psoriasis involving 15% of his body with nail involvement. What is the best
treatment for him?
a. methotrexate
b. laser

Answer: ?

Orthopedics
1. Knee Examination: + lachman test indicates injury of:
a. Anterior cruciate ligament

Answer: A (Reference: 3rd Edition UQU > Orthopedics > Q 62)