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A 30 years old man presented with generalized fatigue ability for 2 months. On examination he has found to have generalized lymph adenopathy. Differential diagnosis of this case includes all of the following except: A. Lymphoma. T B. HIV infection. C. Hepatitis C virus infection. D. Infectious mononucleosis. E. Toxoplasmosis. Q.2. Obstructed jaundice is associated with all of the following except: A. Elevated indirect serum bilirubinaemia. B. Elevated direct serum bilirubinaemia. C. Presence of bilirubinuria. D. Urobilinogenuria is almost always present. E. Raised alkaline phosphatase. Q.3. In rheumatoid arthritis all of the following are true except: A. Causes destruction of articular cartilage. B. Is frequently associated with the HLA antigen DR4. C. Is equally common in males & females. D. Is characterized by the presence of nodules. E. Can involve any synovial joint in the body. Q.4. Which of the following indicate pre-renal failure: A. Cast in the urine. B. Low urine osmolality [< 400 mosmmol/kg] C. Low urine sodium concentration [< 20mmol/L] D. Low free water excretion. E. Microscopic hematuria. Q.5. Hyponatremia occurs in the following conditions except: A. Primary adrenocortical insufficiency. B. Congestive heart failure. C. Diabetic ketoacidosis with very high blood sugar. D. Excessive production of vasopressin. E. Diabetic insipidus. Q.6. A 50 years old man was found unresponsive 3 hours after abdominal surgery. Arterial blood gas analysis on room air showed: pH 7.2, PCO2 65, HCO3 28, PO2 50, the most likely metabolic abnormality is: A. Metabolic acidosis. B. Respiratory & metabolic acidosis. C. Metabolic acidosis.

D. Both respiratory acidosis & metabolic alkalosis. E. Respiratory acidosis. Q.7. A 35 years old lady, who acquired HIV infection after blood transfusion 10 years ago. Total CD4 lymphocyte count is < 100 cells/mm3. She is at high risk to develop any of the following problems except: A. Tuberculosis. B. CNS lymphoma. C. Esophageal carcinoma. D. Recurrent pneumonia. E. Non-Hodgkins lymphoma. Q.8. A 60 years old man presented with chest pain of 2 hours duration. ECG showed ST elevation in V1-V4 and frequent PVCs with a short run [6 beats] of ventricular tachycardia. Which of the following is an appropriate management? A. Quinidine sulfates 200mg P.O. QID. B. Digoxin 2mg IV push then 0.25mg IV OD for 3 days. C. No anti arrhythmic therapy should be given until there is recurrent ventricular tachycardia. D. Lidocane 75mg IV push followed continuous infusion at 2 mg/min. E. Oxygen, Morphine sulfate and lasix. Q.9. Which of the following is a usual feature of interstitial lung disease like fibrosing alveolitis: A. Fever. B. Hemolysis. C. Generalized wheezes. D. Purulent sputum. E. Fine crepitations. Q.10. Which of the following statements regarding the management of an acute sever asthma attack is correct: A. Measurement of arterial blood gasses is important only in those who fail to respond to treatment. B. Inhale glucocorticoids are indicated in large doses. C. Rise of PaCO2 from low to normal value is a sign of good response. D. IV aminophyline has a narrow therapeutic range. E. Fluid restriction is indicated to relieve pulmonary edema. Q.11. A young man took refrigerated food. 3 hours later he developed watery diarrhea. Which of the following organisms most likely caused the diarrhea? A. Shigella. B. Salmonella. C. Campylobacter. D. Staphylococci. E. Giardia.

Q.12. In mitral stenosis, the following may be seen except? A. P. mitral on ECG. B. Double contour of right border of the heart [due to left atrial enlargement]. C. Left ventricular failure. D. Right ventricular failure. E. Atrial fibrillation. Q.13. Giardiasis? A. Involves mainly the terminal ileum & colon. B. It is more common in hypogammaglobinimic patient. C. Liver abscess is a recognized complication. D. Is best treated by mebendazole. E. May cause lower GI bleeding. Q.14. The commonest cause of acute pancreatitis in adult in our community is? A. Unknown. B. Parasites. C. Mumps virus. D. Billiary stones. E. Ethanol. Q.15. All of the following are true about graves disease except? A. Opthalmopathy invariably responds to anti-thyroid therapy. B. Pre-tibial myxedema is a feature. C. Atrial fibrillation may occur. D. Patient may have difficulty in climbing stairs. E. There is often a bruit heard over the thyroid gland. Q.16. A 65 years old man present with difficulty in swallowing food. Causes of this condition include all of the following except? A. Carcinoma of esophagus. B. Reflux oesophagitis. C. Achalasia of the cardia. D. Motor neuron disease. E. Herpes oesophagitis. Q.17. Plasma ferritin is a reflection of? A. Red cell mass. B. Total body iron stores. C. Bone marrow iron stores. D. Hepatic iron content. E. None of the above.

Q.18. A 26 years old man presented with headache & fatigue. Investigation revealed Hb 8gm/dl, MCV-85, Reticulocytes 10%. The following investigations are useful except? A. Coombs test. B. Sickling test. C. Serum bilirubin. D. Serum iron. E. Hemoglobin electrophoresis. Q.19. The following may induce seizures except: A. Hypoxia. B. Hypourecaemia. C. Hypocalcaemia. D. Hyponatremia. E. Hypocalcaemia. Q.20. A20 years old man presented with one-day history of headache & fever. On examination, he was restless, avoid light & his neck was resistant to flexion. Which of the following lines of management is correct? A. X-ray of cervical spine. B. Electroencephalogram. C. Antinuclear antibodies. D. Phenytoin. E. None of the above. Q.21. The following disease are recognized cause of high output cardiac Failure except? A. Pagets disease. B. Thyrotoxicosis. C. Hypertension. D. Arterio-venous fistula. E. Iron deficiency anemia. Q.22. All of the pharmacological agents may be useful in the treatment of the acute manifestations of anaphylaxis except? A. Diphenhydramine. B. Hydralazine. C. Oxygen. D. Epinephrine. E. Aminophyline. Q.23. In ulcerative colitis? A. Fistula is common finding. B. Involve small& large bowel. C. Pyoderma gangrenosum can occur. D. Toxic mega colon should be diagnosed by colonoscopy.

E. Usual manifestation is diarrhea alternating with constipation. Q.24. Appropriate management of patients with adrenal insufficiency secondary to hypo-pituitarism include all of the following except? A. Glucocorticoids replacement. B. Mineral corticoid therapy. C. Steroid coverage for surgical procedures. D. Instruction in self-injection of soluble glucocorticoids. E. Wearing of identification bracelet bearing medical information. Q.25. When a disease lasts 2 to 3 weeks with a fatality rate of 80%, then its incidence? A. Is higher than its prevalence. B. Is equal to its prevalence. C. Is lower than its prevalence. D. Has no relationship to its prevalence. E. Is one half of its prevalence? Q.26. The most common complication & the most common cause of death in transplant recipients is: A. Rejection. B. Steroid overdose. C. Cardiac failure. D. Toxic effects of immunosuppressive drugs. E. Infection. Q.27. A 40-years old women presented with bloody nipple discharge, no Family history of the same problem. The commonest cause is? A. Breast carcinoma. B. Intraductal papilloma. C. Glactocoele. D. Cystic hyperplasia. E. Pagets disease of the breast. Q.28. Management of burn wound includes the following except? A. Early debridement. B. Skin grafting. C. Escharotomy. D. Tetanus immunization. E. Topical application of penicillin powder. Q.29. Clinical feature of toxic goiter includes the following except? A. Restlessness. B. Arrhythmias. C. Hoarseness of voice. D. Clammy palms.

E. Tremors of fingers. Q.30. A 20 year's old male patient had a stab wound in the neck. All are true except? A. A lacerated carotid artery [ies] is [are], better ligated because of sever bleeding. B. False aneurysm may develop. C. Injured major lymphatics are ligated. D. Tracheal injury is closed primarily & tracheostomy performed. E. Subcutaneous emphysema may performed. Q.31. Veins of the legs affected in varicose veins are the following Except? A. Long saphenous veins. B. Short saphenous veins. C. Inter communicating veins. D. Venae perforantes. E. Popliteal vein. Q.32. Complication of surgical excision of abdominal aneurysm include the following except? A. Paralytic ileus. B. Ischemia of lower extremities. C. Paraplegia. D. Hepatic failure. E. Renal failure. Q.33. Torsion of testis. All are correct except? A. Is treated with large doses of antibiotics. B. Is torsion of the spermatic cord? C. Is the result of Bell clapper deformity? D. Occurs spontaneously in young males. E. May occur as a result of physical & sexual activities. Q.34. Presentation of benign prostatic hyperplasia include the following except? A. Nocturia. B. Diminished size & force of urinary stream. C. Prostatitis. D. Hematuria. E. Urinary retention. Q.35. The pain of uretric calculus is referred? A. To the flank. B. To the tip of the penis. C. To the anal area. D. To the region of the bladder. E. To the sacral area.

Q.36. In tracheo-esophageal fistula, management include the following Except? A. Insertion of a chest tube. B. Performing a gastrostomy. C. Pulmonary toileting. D. Insertion of a naso-esophageal stump catheter. E. Intravenous antibiotics. Q.37. On a ventilator, recommended tidal volume is? A. 500cc. B. 1 liter. C. 1.5 liters. D. 2 liters. E. 2.5 liters Q.38. A 70 years old women presented with a 3 days history of Perforated duodenal ulcer. She was febrile, semi comatose & dehydrated on admission. The best treatment is? A. Transfuse with blood, rehydrated & perform vagotomy & drainage urgently. B. Insert a nasogastric tube & connect to suction, hydrate the patient, give systemic antibiotic & observe. C. Insert a nasogastric tube & connect to suction, hydrate the patient, give systemic antibiotic & and perform plication of the perforation. D. Hydrate the patient, give blood, give systemic antibiotics& perform hemigastrectomy. E. None of the above. Q.39. A 2 months old child was found to be jaundice, to have an enlarged cirrhotic liver & ascites. The most likely diagnosis is? A. Gilberts disease. B. Criglar-Najjar disease. C. Dubin-Johnson syndrome. D. Congenital Billiary atresia. E. Sickle cell disease. Q.40. An important clinical finding in acute pancriatitis is? A. Rebound tenderness. B. Presence of some relief on bending forward or on maintaining a sitting position. C. Guarding of the abdomen. D. Hypoactive bowel sound. E. Abdominal pain. Q.41.Two weeks after cholecystectomy a patient present with progressive jaundice & possible ascites. The most indicate investigation is? A. CT scan. B. Intravenous cholangiography. C. Blood for hepatitis. D. Needle liver biopsy.

E. Endoscopic retrograde cholangio-pancreatography [ERCP] Q.42. In blunt trauma to the abdomen the most commonly injured organ Is? A. The small intestine. B. The spleen. C. The bladder. D. The kidney. E. The liver. Q.43. A 20 years old boy sustained a blunt trauma to the abdomen in an automobile accident. Intraperitoneal bleeding is suspected. The most informative investigation is? A. Plain X-ray of the abdomen. B. Diagnostic peritoneal lavage. C. PCV estimation. D. Intravenous urogram. E. Celiac angiography. Q.44. The following are complication of laparoscopic cholecystectomy Except? A. Bile leak. B. Persistent pneumoperitoneum. C. Shoulder tips pain. D. Ascites. E. Supraumblical incisional hernia. Q.45. Differential diagnosis of acute appendicitis includes the Following except? A. Mittleschmerz disease. B. Carcinoma of caecum. C. Pelvic inflammatory disease. D. Diverticulitis. E. Mesenteric lymphadenitis. Q.46. Complication of colostomy include the following except? A. Malabsorption of water. B. Retraction. C. Prolapse. D. Excoriation of skin. E. Obstruction. Q.47. The greatest metabolic activity of thyroid hormone is due to? A. Thyroxin. B. Monoiodotyrosine. C. Diiodotryrosine. D. Triiodothyronine. E. Thyroglobulin.

Q.48. Complication of osteomyelitis include the following except? A. Septic arthritis. B. Arrest of bone growth. C. Pyomyositis. D. Septicemia. E. Destruction of epiphyseal plate. Q.49. An incomplete lesion on the side of the spinal cord produces? A. Decorticate rigidity. B. Decerebrate rigidity. C. Absence of spino-ciliary cortex. D. Brown-sequard syndrome. A. E. All the above. Q.50. The standard deviation is: A. A measure of location. B. Equivalent to the range. C. A measure of normality of the data. D. A measure of variability. E. A measure of central tendency. Q.51. Factors that is important in the patho-physiology of pelvic inflammatory disease include the following except? A. Menstruation. B. Sperm. C. Cervical mucus. D. Uterine fibroids. E. Anaerobic bacteria. Q.52. All of the following factors is necessary for the menstruation to occur except? A. Hypothalamic releasing hormones. B. An endometrium response to sex steroids. C. Gonadotrophin. D. Patent fallopian tube. E. Ovarian steroid hormones. Q.53. Gross microscopic feature of myomas include all of the following Except? A. A whorled like appearance. B. Bundles of smooth muscle fibers. C. High mitosis figure. D. Central degeneration. E. Peripheral vascularity.

Q.54. S/S associated with a hydatidiform mole include all of the following except? A. First trimester bleeding. B. A uterus large than the expected gestational age. C. Hypothyroidism. D. Pre-eclampsia at 14 weeks gestation. E. Nausea & vomiting. Q.55. Correct statements regarding the respiratory distress syndrome Include all of the following except? A. There is deficiency of surfactant in the lung. B. Hypoxia & acidosis stimulate the production of the lung phospholipids. C. It is the most common problem of the pre-term neonate. D. There is a ground-glass appearance on X-ray. E. Positive & expiratory pressure is useful treatment modalities. Q.56. A women States that her last menstruation period was 7 weeks ago & that she had several days of light bleeding & lower abdominal discomfort. She ahs previously had a positive home pregnancy test. Which of the following studies would you request at this time? A. Human chorionic Gonadotrophin. B. Human placental lactogen. C. Progesterone. D. Estriol. E. Prolactin. Q.57. The main health hazard of menopause is? A. Cardiovascular disease. B. Pelvic relaxation. C. Endometrial cancer. D. Depression. E. Osteoporosis. Q.58. Postpartum hemorrhage could be a reasonable possibility in all of the following situations except? A. Hydromnios. B. Triplets. C. Prolong labour. D. Erythroblastosis. E. Thrombocytopenia. Q.59. Which of the following S/S needs not to be reported immediately as a potential danger signal in a pregnant woman? A. Vaginal bleeding. B. Sever headache. C. Swelling of the ankle & feet. D. Blurring of the vision.

E. Escape of fluid from the vagina. Q.60. Deficiency of which of the following substances is likely in a pregnant vegetarian? A. Folic acid. B. Vitamin B12. C. Protein. D. Calcium. E. Iron. Q.61. Naegeles for estimating a womens due date is based on all of the following factors except? A. Regular monthly menstrual cycles. B. A pregnancy of 280 days. C. Ovulation about day 14. D. Cycle regulation with birth control pills prior to conception. E. Conception at mid-cycle. Q.62. Appropriate screening tests in an early, uncomplicated pregnancy include all of the following except? A. Repeat serum HCG level. B. Hemoglobin. C. Serology. D. Cervical cytology. E. Blood type & Rh. Q.63. Factors that can contribute to an acute urinary Tract infection during pregnancy, delivery, or the puerperium include all of the following except? A. Compression of the ureter by the large uterus at the pelvic brim. B. Increased urethral tone & peristalsis. C. Asymptomatic bacteriuria. D. Decreased bladder sensitivity after epidural anesthesia. E. Bladder catheterization following delivery. Q.64. Appropriate form of management for the pre-eclemptic patient [B.P of 140/95 & 1+ proteinuria] include all of the following except? A. Bed rest. B. Non-stress tests. C. Hospitalization. D. Serial sonography of the fetus. E. Diuretics. Q.65. The most accurate & definitive documentation of fetal life is made by? A. Fetoscope. B. Leopoid maneuver. C. Pelvic X-ray.

D. Real time. E. Doppler ultrasound. Q.66. The average length of the menstrual cycle is? A. 22 days. B. 25 days. C. 28 days. D. 35 days. E. 38 days. Q.67. All of the following factors is associated with an increased risk of pelvic inflammatory disease except? A. Onset of intercourse at age 15. B. An elective abortion. C. Oral contraceptive. D. Hystero-salphingography. E. Used of copper IUD. Q.68. All of the following procedures can aid in the diagnosis of pelvic inflammatory disease except? A. Laparoscopy. B. Ultrasound. C. Coldocentesis. D. Rectal examination. E. Hystero-salphingography. Q.69. If a women present with chronic yeast infection, it is important to elicit a history of all of the following except? A. Diabetes. B. Pregnancy. C. Use of antibiotics. D. Use of oral contraceptive. E. Use of vinegar douches. Q.70. Atrophic vaginitis would be expected in all of the following Clinical situation except? A. Menopause. B. Lactation. C. Oral contraceptive use. D. Surgical castration in young women. E. Psuedo-menopause during endometriosis therapy. Q.71. For women over 35 years of age with abdominal uterine bleeding, the most accurate diagnostic procedure is? A. Basal body temperature. B. Endometrial biopsy.

C. Fractional dilatation & curettage. D. Hysteroscopy. E. Hormone therapy. Q.72. All of the therapeutic procedures are recommended for ectopic pregnancies except? A. Salpingectomy. B. Salphingo-oophorectomy. C. Linear Salpingectomy. D. Segmental resection of the portion of the tube containing the ectopic pregnancy. E. Milking the enrapture pregnancy from the tube. Q.73. What is the most accurate method of diagnosing an ectopic pregnancy? A. Pelvic ultrasound. B. Culdocentesis. C. Laparoscopy. D. Measurement of serial B-HCG levels. E. Endometrial biopsy. Q.74. All the following factors are evidence that ovulation has Occurred except? A. Rise in basal body temperature. B. Pregnancy. C. Progesterone level above 3 ng/ml. D. Secretary endometrium. E. The occurrence of menses. Q75. Incidence is calculated by the number of? A. Old case during the study period. B. New case during the study. C. New case at a point in time. D. Old case at a point in time. E. Existing cases at a study period. Q.76. Which of the following would be the most valuable measurement in the monitoring the clinical response of a patient with acute hemorrhage? A. Hematocrit. B. Hemoglobin. C. Vital signs. D. Platelet count. E. Volume of blood lost. Q.77. The most important cause of epistaxis in children is? A. Trauma. B. Polyp. C. Sinusitis. D. Thrombocytopenia.

E. Dry air. Q.78. The combination of Ataxia, a positive Babinski sing & absence of deep tendon reflexes of ankle indicate? A. Ataxia telangiectasia. B. Friedreich ataxia. C. Ganglioneuroblastoma. D. Parinaud syndrome [pinealoma] E. Lead poisoning. Q.79. All of the following are true in pyloric stenosis except? A. Incidence in male is higher than in female. B. Onset is generally late in the first month of life. C. Jaundice occurs in association. D. Vomitus is bile stained. E. Appetite is good. Q.80. Children are expected to walk alone without support by age? A. 6 months. B. 9 months. C. 15 months. D. 18 months. E. 20 months. Q.81. Gastric lavage is contraindicated after Ingestion of? A. Aspirin. B. Diazepam. C. Castor beans. D. Drain-cleaning solution. E. Vitamin D. Q.82. Apgar score takes all of the following except? A. Blood pressure. B. Heart rate. C. Respiratory effort. D. Color. E. Muscles tone. Q.83. Which statement is true about bacterial pneumonia in children? A. It occurs following most upper respiratory infections. B. It is unusual event in normal children. C. Staphylococcus pneumonia is the leading cause. D. Physical examination in infant is diagnostic. E. The mortality rate of pneumococcal pneumonia approaches 3-5%.

Q.84.The treatment of children with cleft palate may be complicated by? A. Speech disorder. B. Dental caries. C. Malocclusion. D. Otitis media. E. Obstructed apnea. Q.85. A new born Exhibits respiratory distress, low blood pressure, hyper resonance & diminished breath sounds over side of the chest. The most likely diagnosis is? A. Staphylococcus pneumonia. B. Hyaline membrane disease. C. Pneumothorax. D. Primary atelectasis. E. Diaphragmatic hernia. Q.86. Central cyanosis is present in the following except? A. Transposition of great arteries. B. Tricuspid atresia. C. Total anomalous pulmonary venous drainage. D. Isolated pulmonary stenosis. E. Pulmonary atresia. Q.87. Each of the following statements regarding oral rehydration therapy is true except? A. It can be used to treat acute diarrhea in patients of all age. B. Oral rehydration solution should contain 5 to 7% glucose. C. Oral rehydration solution containing 45 mEq/l of sodium & those with 75 mEq/l of sodium generally is equally efficacious. D. It has been used successfully to treat patients with Hyponatremia. E. All of the above. Q.88. A healthy infant is born at 30 weeks gestation. Size & development is appropriate for gestational age. Her mother wants to breast feed her. A true statement about breast-feeding for the preterm infant is? A. The volume of the breast milk will be greater in mothers who have breast feed previously. B. Human milk production is optimal if the mother expresses milk once daily until the infant begins nursing. C. After only 30 weeks gestation, maternal milk production rarely is sufficient to permit breast-feeding. D. The mother should begin expressing milk as soon as possible. E. None of the above.

Q.89. Examination of the CSF of a 2 years old child supports the diagnosis of bacterial meningitis. The child is moderately dehydrated. The best approach to prescribing fluid therapy for this child would be to? A. Restrict fluid to prevent the syndrome of inappropriate antidiuretic hormone [SIADH]. B. Treat the dehydration immediately. C. Consider the possibility of SIADH only if the childs urine sodium concentration is greater than 60 mEq/l. D. Treat the dehydration after antibiotic therapy has been provided for 24 hours. E. None of the above. Q.90. A 2 years old patient is brought to you because of snoring & Disturb sleep. You suspect upper airway obstruction with sleep apnea. Each of the following statements about this condition is true except? A. Death can occur. B. Cardiac failure may occur. C. Systemic hypertension is an associated finding. D. Pulmonary hypertension is an irreversible side effect. E. None of the above. Q.91. Of the following problems, the most common bleeding diathesis that would present as recurring epistaxis is? A. Hemophilia A [factor VIII] B. Hemophilia B [factor IX] C. Hemophilia C [factor XI] D. Hageman factor deficiency. E. Von Willebrand disease. Q.92. The control of blood sugar in juvenile diabetes mellitus is usually achieved by? A. Short & intermediate insulin. B. Long acting insulin. C. Intermediate insulin. D. Oral hypoglycemic. E. Short acting insulin. Q.93. The best source of iron for the 3 months old infant is? A. Iron fortified cereals. B. Yellow vegetable. C. Fruits. D. Breast milk. E. 2% low fat cows milk. Q.94. Among the following, the least likely risk factor for hearing loss is: A. A maternal history of use of Phenytoin during pregnancy. B. A family history of hearing impairment. C. Craniofacial abnormality.

D. Birth weights less than 1500 Gms. E. Neonatal hyperbilirubinemia. Q.95. Protein losing gastro-enteropathy has been associated with all of the following except? A. Cow milk protein. B. Lymphangiectasia. C. Granulomatous disease of intestine. D. Ulcerative colitis. E. Soy protein formula. Q.96. Cellulites occurring about the face in young children [6 to 24 months] & associated with fever & a purple skin discoloration is most often caused by? A. Group A beta hemolytic streptococci. B. Haemophilus influenzae. C. Streptococcus pneumoniae. D. Staphylococcus aureus. E. None of the above. Q.97. All of the following might be possible etiologies for discoloration of the teeth of a 15 months old infant except? A. Iron medication. B. Dental decay. C. Tetracycline given to mother during pregnancy. D. Lactose free formula. E. Important fluoride administration.