Autosomal Dominant:

· Marrfan syndrome
· NF (Chormosome 17 q11.2)
· Ehler Danlos syndrome
· Familial Adenomatous Polyposis (APC gene in 5q21)
· ADPKD adult (Chromosome 16)
· Otosclerosis
· Hereditary spherocytosis
· Hereditary chronic pancreatitis
· Huntington disease: Chromosome 4, CAG trineucleotide repeat, Low GABA
in Striatum

Autosomal recessive:

· Anemias (Fanconi, SCA, thalassemia, vWb disease). SCA, thalassemia

(Point mutation)
· Familial intrahepatic cholestasis
· Crigler-Najjar syndrome ( UGT1A1)
· Wilson (Chromosome 13)
· Cystic fibrosis (Chromosome 7, long q arm)
· Congenital chloride diarrhea
· Congenital liver fibrosis associated with AR polycystic kidney disease
Others:

· Wiskott-Aldrich syndrome: X-linked recessive.

· RA: HLA-DR4, HLA-DR1
· TTP: ADAMTS13
· Familial Dilated Cardiomyopathy: TTN gene
· Hypertrophic Cardiomyopathy: MYH7
· Digoarge syndrome (Chromosome 22)
· Kidney tumor oncogene: MET in hereditary RCC and P53
· DM1 (DR4). DM2(Chromosome 20)
· IBD (Chromosome 16, gene: NOD2, ATG16L1)
· Gilbert syndrome: Chromosome 2, q37, UGT1A1 gene.
· X- Linked agammaglubenemia: CD19, CD20
· Chronic granulomatosis syndrome: Decrease NADPH oxidase
· Hereditary Angioedema à SERPING1 gene, C1 esterase deficiency
· P53 (Appoptosis gene, gene of ductal carcinoma)
· Early onset Alzheimer, (age 30 to 60):3 major genes for autosomal dominant
AD: chromosomes 21, 14, 1.
· Late onset Alzheimer (mid60s and later): chromosome 19.
· Xeroderma pigmentosa à Defect in DNA repair gene
· CML and ALL à bcr (in chromosome 22) and abl1 (in chromosome 9)
resulting in bcr-abl1 fusion gene (Philadelphia chromosome)
· Burkett’s lymphoma à C-MYC gene (Chromosome 8)
· HLA DQ-2 & HLA DQ-8 à Celiac disease
· Carriers of HLAKB51/HLAKB5 have an increased .risk .of developing Behçet
disease compared with non carriers.

DECEMBER

DECEMBER 27
1-Uncontrolled Dm , with symptoms of decrease of vision what will you find in
the ophthalmoscopy?

Neovascularization ✅

2-p value of .013 what is it mean ?

3- ‫ﺟﺎﻧﻲ ﺳؤال ﻟﯾش ﻣﺎﻧﻘدر ﻧﻌﺎﻟﺞ ﻣﯾﺎه اﻟﺻرف اﻟﺻﺣﻲ‬

4- in splenic injury surgon ligate a splenic artery which part of stomach will be
affected?
Fundus ✅

5- external laryngeal n. Injury will affect ?

Adduction
Abduction
Tension of vocal cord✅

6- antipsychotic cause brownish discoloration of the eyes?

Thioridazine ✅

7- asthmatic pt in the er how can you assess the severity of it ?

Blood oxygen
Abg
Forced expiratory volume ✅

8- asthmatic pt in the er received oxygen and salbutamol what's your next step "
no hydration in the options ".
Iv abx
Iv steroid✅ " not sure "
Iv aminophyline

9- asthmatic pt in er his history reveals 3-4 night symptoms of cough and

dyspnea .. he is on salbutamol only what will you add.?

Inhaled steroids ✅
" beclomethasone "

10- infant 6-24 months what is the most common organism may cause orbital
cellulitis ?

Hemophilus influenza ✅

11- infant have oral thrush for one week .. he received abx after 5 days of birth
because of conjunctivitis, now how will you treat the thrush?
Iv acyclovir
Oral steroid
Topical steroid
Nystatin✅

12- new born delivered , his mother have HBsAg positive, what will you do for the
baby?

Hb vaccine and hb imunoglobulin✅

Hb vaccine only
Imunoglobulin only

13-long senario for female came from africa have cough fever general malaise
and salmon like blanching rash and maculopapular rash all over her trunk ?
No stills disease in the options 🤕

14- pt with hyperthyrodism signs and symptoms , by fna there was hurthle cell so
what is you suspect ?

Papillary thyroid ca ✅

15- scenario of atypical pneumonia how you will treat?

Cipro✅
Azithro
Pencillin
16- colorectal cancer screening for male aged 55 yo
( 50-75 ) ✅

17- enzyme in case of multiple myeloma٨

ADAR1 ✅
DECEMBER 26

Q1/ Newborn has tetany after delivery. he has recurrent upper respiratory
infection with HiB HSVPneumocystis jirovecii aspergillus What is his underlying
condition? (Digeorge#syndrome)#
1 22q11.2.deletion.

2 Depletion.of.cd4.lymphocytes.
3 Wiskott.Aldrich.syndrome.

4.NADPH.oxidation.

Answer:.A.

Q2-/ 14y girl developed abdominal pain - mimcs appendicitis - after URTI what is
the diagnoses ?
- Appendicitis
-mesenteric adenitis
-meckel diverticulosis
Answer : b

Q3- man was engaged in a fight and sustained a trauma with Iron
stick. presented to ER unconscious with some vomting remnant in his t-shirt
what to do next ?
Answer : intubation

Q5-/ only a pic of fundscopy with no senrio, what is the diagnosis ?

- I think it was cupping of the disk

Q6/: pic of fluorescein stain for a child exposed to a fingernail injury the patient
will have ?
A-Purulent tearing
B-photophobia
C-vision loss

Answer: b

Q7/ : pic of patients with secliosis ( very clear one ) he has no symptoms and
upon examination there is no tenderness or change in temperature
what would be the next step for evaluating this patient ?
- X-ray
- Adam’s test
Answer : I choose Adam’s bcz I think it is the appropriate next step as it is part of
the examination before preceding to investigation

Q8/ : post test probabiliy is plotted in

-Forest plot
-Nomogram
-ROC plot
Answer : C?

Q9/ A patient who works as typist, he came complaining of numbness and

tingling sensation of 3 and a half fingers of both hands (thumb, index, middle, &
half of the ring fingers). On examination, he has Thenar muscle wasting.
What
nerve is most likely injured?

A. Median
B. Brachial plexus

C. Cervical C5
Answer: A

Q10/ 38. Patient with schizophrenia complaining of constipation. He recently

changed his medications. What is most likely the cause?
A. Olanzapine +
Benztropine
B. Olanzapine + bupropion
C. Bupropion + Benzotropine
Answer: A


Q11/- How to calculate the relative risk of a positive something in comparison

with something something bla bla bla...
A. A/(A+B)/C/(C+D)
B. A/(A+B)
C. C/(C+D) D. A*D/C*B
Answer : A

Q12/- Hyperthyroid Pt and on medication presented with recurrent sore throat

what is the drug he is using ?
Answer : Methimazole

Q13/- A depressed patient on medication, but he had weight gain and erectile
dysfunction. What is the medication responsible for these side effects?
Answer : sertraline
Q15/ which part of esophagus has smooth and skeletal muscles?
-Upper third
-Middle third
-Lower third
-lower sphincter
Answer : B

-A klineflter syndrome case it was was about a man who has enlarged breast
with no pubic hair

-adrenal insufficiency- i don't remember it-

-A case with patient who seems to be in a good condition? But lab results
show High ptt and pt, but decrease fibrinogen
Answer: DIC

-A lot of weird questions about thyroid! Read about!

Q20/ year old male with painless testicular swelling for 1 month. He noticed that it
is increasing in size every day with no urinary changes. On examination: afebrile,
no warmth no tenderness and negative transillumination. Management?
A. Laparoscopic / open Biopsy < as written exactly
B. US and surgical option
C. Antibiotics for 2 weeks
D. Do nothing

Answer: A? B?
DECEMBER 25

What immune cell is high during viral infection ?

Monocytes
Lymphocytes
Etc

Child 6 y/o leg pain during night only .. No findings in examination?

Normal growing

Lung cancer 70%

Tongue in nerve respnsible for loss of sensation ? Trigemenal

Pt rh - when to give her the anti rh ? A- after delvery within 3 days

B- before preg
C- in labor and after delivery

‫ ﺟﺎت ﺻوره‬cornal abrasion

Osgood ‫ﺟﺎت ﺻورﺗﯾن‬

Rehmatic fever case ‫وﻣطﻠوب ﺗﺧﺗﺎر اﻟﺳﻣﺑﺗوﻣز ؟‬

-urinary urgency and freq and fever
-fever and small joint pain
-knee and pelvic pain and fever

Croup ‫ﺟﺎ ﻛﺛﯾر‬

‫اﻛﺛر دوا ﯾﺳﺗﺧدم ﻟل‬generlized anxiety disorder makes abuse ?

Pt with mania ‫وﻣو راﺿﻲ ﯾﮭدء ﻛﯾف ﻧﺗﺻرف؟‬

1-lithum
2- ssri
3-halopradol
4- attach him to the bed (using robe)
Statistics ‫ﻛﺛﯾر ﺗﻛرر وﻛﺎن ﻓﻲ ﻛﯾﺳﺎت ﺟدﯾده ﻣﺎ اﻧذﻛرھﺎ‬
Abortion mangement‫ﺟﺎ ﻛﺛﯾر‬

Child with 3 months watery diarrhea , foul smelling flatus

1-ameba
2-gardisis
3-shigela

Pt in er after car accident with gasp breathing they went to call the team to
resuscitation him what you will do
Give 2 breath
Check carotid
Give o2
Check if there is foreign body in his throat

Percent of prolong delivery ? 5-10

Pt pap smear abnormal after one week also abnormal next step?

Check after 6 m
Biopsy
Hpv
Colposcopy
Pt pregnant with sever bleeding 3 hours admitted in speculum ex blood and soft
tissue and open cervix ? Type of abortion

Pt after tan machine has a redness all over the chest and arms tender and
blench
Prodromal
1st degree
2nd
Etc

Pt pregnant with pb 160/100

In 32 weeks next step?
Steroid and delivery
Call the anesthetic
Mgso4 and delivery
Stabilize her with analgesic

Give mg and wait until 34 "although she's in the 34 week " the q was weird

Risk factor of placenta abruption

Pt pregnant with bleeding since 2 hours what's important to ask ?

Last intercourse
Hematological disease

Pt has a daily headache improve after 2 paracetamol or asprin i forget

Type of headache ?

Pt with headache sice 1 year he take nsads and tca and asprin (didnot describe
the headache )
Typer of headache ?

Pt after accident agitated and some memory loss no headache

Next step ?
Ct
Angiography
Ecg

Child took antibiotic present with rash on the trunk ? What's the medication
should be avoided
lichen planus common site
Scalp
Behind ear

Pt had glaucoma took aceta and develop high alt and ast and hepatomegaly
?acetaminophen liver toxicity
autoimmune

Pt with low pt and fatigue with fever ?

Ttp
autoimmune thrombocytopenic purpura

Pt leg pain at night only and improve when she shake her legs !
Patient had mi and develop later with sever pain and pale limp?
Artery thrombus
Dvt

Pathophysiology of croup and dm

Diabetic with ulcer non healing what is the reason ?

Decrease phagocytosis
Decrease immunity

Pt after accident had coma after 12 hours low na in serum and high urin
osmolarity ?
Central diabetes di
Nephro di
Overload from the iv fluid

Pt after hysterectomy most common complication ? Injury to the bladder or urthra

Pt child with abdomen bloating and pain and mass in left flank
Polycystic kidney
Pyelonephritis

Pt with eye i think in the iris and kidney problems? Nephroblastoma ?

30 year old male with painless testicular swelling for 1 month. He noticed that it is
increasing in size every day with no urinary changes. On examination: afebrile,
no warmth no tenderness and negative transillumination. Management?
A. Laparoscopic / open Biopsy
B. US and surgical option
C. Antibiotics for 2 weeks
D. Do nothing
Q. 57 years old came for checkup he has normal BP. Elevated cholesterol and
blood sugar.
Regarding his BP when do you want to see him again?
A. 3 months
B. 6 months
C. 12 months
D. 24 months
Ans: C?

Q. Prostatic cancer marker (No PSA)

A. Acid phosphatase
B. AFP
C. CEA
Ans: A

Q. Patient with left thyroid mass, biopsy was done and showed amyloid. What is
the most likely diagnosis?
A. Follicular carcinoma
B. Medullary carcinoma
C. Papillary carcinoma
Ans: B

Q. 36 year old female has depression symptoms for the last 3 months. She has
been escalated to menagerian level at her work and she has conflicts with 2 of
her colleagues. What would you do to her?
A. TCA
B. Psychotherapy
C. SSRI
Ans:

Q. Patient with cancer changes in pap smear. What is the most likely
presentation?
A. Sever pain
B. Vaginal bleeding and painful Intercourse
Ans:

Q. Posterior hip dislocation. How the patient will present?

A. External rotation and adduction
B. External rotation and abduction
C. Internal rotation and adduction
D. Internal rotation and abduction
Ans: C

Q. Patient with meningococcal meningitis. What would you give his nursery
classmates? (No rifampin in the choices).
A. Penicillin G
B. Ciprofloxacin
C. Ceftriaxone
D. Doxycyclin
Ans:

Q. Patient had renal transplant, presented 1 month later with rejection class 1
MHC. What are the cells responsible for that?
A. CD4
B. CD8
C. Macrophages
Ans:

Q. Patient with left supraclavicular mass. X ray showed left hilar mass. What is
the next thing to do?
A. Biopsy
B. Chest MRI
C. Chest CT
Ans:

Q. Patient with viral infection, what is the most commonly found peripheral blood
cell.
A. Basophils
B. Esinophils
C. Leukocyte
Ans: C

Q. Patient with sever viral conjunctivitis what to give topically?

A. Antibiotics
B. Corticosteroid
C. Antiviral
Ans:

Q. Patient with neuroblastoma occupying most of the eye. MRI showed no

involvement of the bone or optic nerve. How to manage?
A. Left eye Enucleation
B. Systemic chemotherapy
C. Radiotherapy
Ans:

Q. Child with typical case of meningitis. Blood culture was done. What is the best
next step in management? (No Abx in the choices)
A. Brain CT
B. Lumbar puncture
Ans:

Q. What’s the chromosome in DM2?

A. Chromosome 14
B. Chromosome 16
C. Chromosome 20
Ans: C

Q. The most common intraabdominal tumor in children?

A. Wilms tumor

Q. Patient is used to use Heroin now comes with withdrawal symptoms. What to
give?
Ans: Methadone

Q. Girl with vitiligo comes with well circumscribed area of hair fall. What is the
most likely diagnosis?
A. Alopecia areata
B. Trichotillomania
Ans: A

DECEMBER 24

1Q/ after knee injury, the doctor is examining the patient by applying lateral
pressure on the hip and medial on the leg, he is examining?
-tibial collateral
-fibular collateral
-anterior ligament
-posterior ligament

2Q/ parents brought their child to pediatric worried about his infrequent bowel
motion and fatigue, on examination the liver was one finger below the lower
costal margin, labs showed low Na, K, (forgot rest of labs), what's the reason for
this condition?
-impaired hydrogen ion execration
-impaired chloride absorption
3Q/ which of the following can present with clinical dementia?
-spinocerebellar ataxia
-idiopathic Parkinsonism
-Vit B12 deficiency

4Q/ research q about typhoid fever, in population you have 8 patient each 4
years in average population of 20,000 so what's the incidence in 1 year with
100,000 population?
-16
-100
-160
-400

5Q/ research q about which is more precise, they listed 4 numbers of relative risk
with confide interval

6Q/ case with CXR showing coin lesion surrounded by crescent shape?
-aspergillosis
-TB
-pneumonia

7Q/doctor want to close PDA with surgery, which nerve can be affected?
-recurrent laryngeal
-vagus
-phrenic

8Q/ what's the embryology of endocardial duct?

-extra-embryonic
-endoderm (not sure)
9Q/what passes in the inguinal canal?
-round ligament
-broad ligament

10Q/ 2 years old boy with 2mm VSD, asymptotic for regular F/U, what will you
do?
-surgery
-observe
-give medications that decreases the afterload

11Q/ most common cause of brain abscess?

-skull injury
-nasal infection
12Q/ECG and scenario? sick sinus syndrome

13Q/ 18 months child, 1 week earlier had regular vaccines except hepatitis A
wasn't available, but now they have it, when to give?
-now
-6 weeks
-8 weeks

14Q/ child with EBV infection, what to do?

-paracetamol
-steroids
-acyclovir

15Q/ pt asymptomatic had hepatitis B surface antibodies positive all other

serology negative, what does she have?
-chronic
-acute
-immunization then infected
-carrier

16Q/ child with mumps description, commonest complication?

-meningitis
-encephalitis
-orchitis

17Q/ which can indelicate lung cancer regional involvement?

-cough
-hemoptysis
-hepatomegaly
-horner's syndrome
18Q/ patient with PE, what to give?
-streptokinase
-warfarin
-heparin

19Q/ what bones form the ankle joint?

20Q/ MG? Ach antibodies

21Q/ most common brain tumor in adults?

-astrocytoma
-ependymoma
-medulblastoma
22Q/ which colon cancer is associated with microsatellite instability?
-familial polyposis
-non polyposis cancer
-Gartner

23Q/ what's C/I in glaucoma

24Q/ DM patient with bilateral lower limbs pain with crusts?

-stasis dermatitis
-pyoderma
-cellulitis

25Q/ husband has HepB, wife has jaundice, confusion and something, her
serology for HepB all negative, what to test?
-ceruloplasmin
-serum copper

26Q/ comments presentation of renal cell cancer?

-abdominal mass
-hematourea

27Q/ by investigating they found adrenal mass, what to test?

-VHL

28Q/ how to treat pheochromocytoma

29Q/ case description want the diagnosis? achalasia

30Q/ case of female had 3 children and dilatation and curettage before, now has
low estrogen signs described with labs showing high FSH and LH, diagnosis?
Ovarian failure

31Q/ pregnant in labor baby has face presentation, which can deliver?
-mento-anterior
-mento-posterior
-mento-transverse-right
-mento-transverse-left

32Q/ when to do nuchal translucency?

-14 to 18
-12 to 16

33Q/ female with thyroid nodule, TSH normal, you did FNA but wasn't conclusive,
what to do?
-repeat FNA
-thyroid scan
-surgical removal

34Q/ pregnant taking iron throughout her pregnancy has anemic signs, labs
showed microcytic anemia?
-iron deficiency
-Beta thalassemia

35Q/ pt with blast +ve for mylogenic and -ve for something (not sure of age and
they listed leukemia types)

36Q/ mentioned an experiment on mice they found the Protozoa increases with a
change, what change in humans can have same affect (not sure of the Q but the
same choices)?
-IL10
-IL6
-TNF
-INF

37Q/ child with knee pain and high ESR and CRP the diagnosis?

38Q/ a case of valve disease that lead to increase pressure in left atria, what will
happen to overcome this?
-LA hypertrophy and dilation
-RV hypertrophy and construction
-LA hypertrophy and decreased pulmonary pressure

39Q/ which thyroid medication causes leukopenia?

40Q/ what to tell a patient about intradermal combined contraception?

-increased risk of DVT
41Q/ which part of esophagus has smooth and skeletal muscles?
-Upper third
-Middle third
-Lower third
-lower sphincter

42Q/ research Q, exposed and control 2 & 3? PEER (patient expected event
rate) is 2
Which one of the following is contraindicated in obstructive dilated
cardiomyopathy?
Aspirin
Digoxin
Acetaminophen

What is the definition of primary dilated cardiomyopathy?

4 year old Child came for routine checkup, he drinks a lot of milk, but doesn't eat
meat. He looks pale, other examinations normal. Hg is 8 low mcv low mch. What
would you do?
Multivitamins with iron
Trail of iron and follow up
Prbc transfusion
Bone marrow biopsy

Child presented to the ER with fever and abdominal pain. After a fall 1 day ago,
the mother noticed abdominal distention mainly on the right side. On examination
he is pale and hypertensive.
Liver contusion
Pyelonephritis
Wilm's tumor
Neuroblastoma

Wernicke's area damage leads to?

Milestone: baby is holding his head 45 degree on prone position, laughs and
coos when doctor plays with him, can follow your finger with his eyes, but no
sitting position yet.
2 months
3 months
6 months
9 months

40 year old female complaining of painful menstruation for the past 6 months
associated with pain during coitus and defecation. On examination: painful rectal
exam and uterus is retroverted.
Endometriosis
Adenomyosis
Uterine tumor

Patient with blepharitis, known to have acne rosacea but did not develop
keratitis. Treatment?
Oral doxycycline
Oral erythromycin
Topical gentamicin
Topical ...

Milestone: Baby can run, say 3 words sentences, doesn't know his full name and
cannot climb stairs.
1 year
2 years
3 years
4 years

24 year old female with incontinence associated with urgeny, frequency, dysuria
day and night. On examination tenderness over Supra pubic area.
Stress
Hypoactive
Hyperactive
Sensory / Irritant

Female with urge incontinence what's the treatment?

NSAIDs
Antibiotics
Urethropexy
Kegel exercise

30 year old male with painless testicular swelling for 1 month. He noticed that it is
increasing in size every day with no urinary changes. On examination: afebrile,
no warmth no tenderness and negative transillumination. Management?
Laparoscopic / open Biopsy
US and surgical option
Antibiotics for 2 weeks
Do nothing

Newly married female came for preconception counseling. She had chickenpox
when she was young otherwise unremarkable.
Rubella titer
Calcium daily
Varicella immunoglobulins
What is the most frequent sing and symptom with abruptio placenta?
Uterine tenderness
Fetal distress
Vaginal bleeding
22 year old male drug addict, visits the hospital several times with multiple
complaints that are exaggerated. When he is not focused he seems
asymptomatic?
Somatization
Malingering

24 year old male after he failed his exam, he started to talk about the details in
his exam?
Intellectualization
Repression

Newborn with apgar score 3 management?

Volume expansion
Ventilation

Asthmatic came to ER with difficulty breathing, he is on 10 ml oxygen and

received beta 2 agonist
RR is 30
ABG PO2 is low
What is next?
Intubation and ventilation
IV steroid
IV theophylline

1 year old with hepatosplenomegaly, blue skin nodules and neck mass,
investigation?
MRI of the thorax
EBV serology
Plain xray

Pregnant in her 1st trimester, not immunized before with measels, mumps, and
rubella. Got exposed to rubella 3 days ago. How will you manage?
1. No therapy
2. MMR vaccine
3. Immunoglobulin
4. Termination of pregnancy

28 YO with loss of energy, heat intolerance, ..... labs: high free T4, NL TSH, .....
What to order next?
1. Total T4
2. Free T3
3. TRH
4. TPO

C/I for circumcision?

1. Phimosis
2. Hypospadius
3. Cryptorchidism
4. Posterior urethral valve

Female in her 20’s hx of syncope that proceeded by arrythmia, she also gave hx
of dizziness multiple times before specially when she stand.. ECG picture
attached (showed left axis deviation and high voltage QRS, query delta waves).
What is the dx?
1. ....
2. LBBB
3. WPW syndrome
4. Postural orthostatic tachycardia syndrome

Female with pleural effusion, ascites, and ovarian mass. Origin of this tumor is
from?
1. Sex cord tumor
2. Germ cell tumor
3. ...
4. ...

Most common cause of bloody vaginal discharge?

1. Cervical polyps
2. Endometrial ca
3. Mensuration
4. Vaginitis

Child (9 months old?) with anemia despite iron supplements given and increased
dose multiple times. Labs shows: low Hb, low MCV, ..... (no iron studies).
Peripheral smear attached (hypocytic hypo-chromic)
What to order?
1. Iron studies
2. Hb electrophoresis

Child with anemia, mother states that he chew his toys and eat the wall-paint.
What is the dx?
1. Aplastic anemia
2. IDA
3. Sideroblastic anemia
4. B12 deficiency
Cold agglutination what immunoglobulin?
1. IgG
2. IgM

Case of Multinodular goiter. How to treat?

1. Antithyroid meds.
2. Surgery
3. Radio-iodine.

Child with abdominal pain, vomiting, diarrhea, ?fever, .... where is the pathology?
1. Brunner cells
2. Peyer’s patches

Child with fever, abdominal pain, diarrhea and vomiting. Gram stain showed G-ve
rods, oxidase -ve. What is the MOA of the given antibiotic?
1. Inhibit DNA gyrase
2. Inhibit 50S subunit

Treatment of acne rosacea?

3. Erythromycin
4. Clindamycin

8 year-old came with hip pain, limbing, xray showed collection of fluid in hip joint.
What is your management?
1. Aspiration
2. Conservative

Longest phase of cell cycle?

1. Cytokinesis
2. Interphase
3. Prophase
4. Anaphase

Most common nerve injured in humerus #?

1. Radial
2. Ulnar
3. Median
4. Accessory

9 year-old child with hx of hip pain, limbing, fixed flexion and internal rotation,
xray attached. What is the dx?
1. legg calve perthes disease

Old woman with labia majora lesion (0.5x0.5). What is the most likely dx?
1. Adenocarcinoma
2. SCQ

Old male with uneven teeth, and lateral tongue whitish lesion, that doesn’t go off
when scraped. A higher magnification of his lesion showed bla bla bla and
ulceration. What is the cause?
1. Heavy-metal ingestion
2. Cancer of the tongue

Case of septic arthritis of knee in a child. How will you manage?

1. Aspiration and Abx
2. Oral abx for 7 days
3. IV abx for 14 days

9 year-old with signs and symptoms of OM. For how long will you give abx in
days?
1. 3
2. 5
3. 7

Treatment of cholesteatoma?
1. Abx
2. Surgery

Female in her 20’s with lower abdominal pain, irregular menses, right iliac fossa
tenderness..... negative pregnancy test. What is most likely dx?
1. Ovarian torsion
2. Ectopic pregnancy
3. Appendicitis

Victim of MVA (long scenario) resuscitated, IV fluid controlled his BP, CT showed
1st degree splenic laceration. How will you manage?
1. laparoscopic splenectomy
2. Conservative management in ICU
3. Conservative management in surgical ward

What indicates an uncomplicated large pneumothorax?

1. Click sound synchronized with heart sound.
2. Tracheal deviation to contralateral side
3. Increase breath sounds over the pneumothorax
4. Equal chest expansion

Where to insert the needle for aspiration of pleural effusion?

1. Mid-clavicular line
2. Mid-axillary line 5th intercostal space
3. Mid-axillary line 6th intercostal space
4. Parasternal

Vaccine contraindicated in egg allergy?

1. MMR
2. Varicella
3. Tetanus
4. Hemophilus influenza
Child with abdominal pain... (only mentioned GI symptoms with no social hx).
Which type of hepatitis is he having?
1. A
2. B
3. C
4. D

Newborn with jaundice.. after some times the color changed to green. How do
you explain this?
1. Oxidation of bilirubin

Picture :pedia with kwasaki ask about treatment

Picture ecg showed letaral mi
Picture ecg showd PE
Pregnant lady with s&s of dvt ask about investigation
RR formula :
Blood smear of scd ~~hollyJollybodies
Treatment of adenomysis~~hysterectomy
Picture of spoon shape nail~~~IDA
Blood supply of great maximum muscle
X ray showed ~~Perth’s disease
X ray shows pleural effusion
Ecg ~~shows AF
Ask about the causes~~hyperthyroidism
Pic of black nodule on the lower lip ask about the lymphatic drainage

Q about the fanconi syndrome

Picture Shows mouth ulcer and penis ulcer ask about the Dx~~~bechet disease
Pic shows eye with corneal abrasion ask about treatment
Q the type of hip joint
Ankle joint

Picture :pedia with kwasaki ask about treatment

Picture ecg showed letaral mi
Picture ecg showd PE
Pregnant lady with s&s of dvt ask about investigation
RR formula :
Blood smear of scd ~~hollyJollybodies
Treatment of adenomysis~~hysterectomy
Picture of spoon shape nail~~~IDA
Blood supply of great maximum muscle
X ray showed ~~Perth’s disease
X ray shows pleural effusion
Ecg ~~shows AF
Ask about the causes~~hyperthyroidism
Pic of black nodule on the lower lip ask about the lymphatic drainage

Q about the fanconi syndrome

Picture Shows mouth ulcer and penis ulcer ask about the Dx~~~bechet disease
Pic shows eye with corneal abrasion ask about treatment
Q the type of hip joint
Ankle joint

DECEMBER 21

The incidence of prolonged labor is ??

1-5 %
5-10 %
>15%

Patient had rheumatoid arthritis , he used IL drug , what he will had as a most
common side effect of this medication ??
TB flaring
Rheumatoid arthritis
HBV

Patient had hemophilia A , his wife is carrier , new baby will had hemophilia?
25%
50%
Uveitis on pic , and they asked about diagnosis?
Ant. Uveitis
Post.uveitis

** pic of chalasion
* pic of cutaneous lechmania asked about treatment ?
* pathophysiology of planus ?
* gene of Alzheimer disease?
* Most cutaneous side effects of anti malaria medication ?
* patient had grown abnormal hair around face ? Side effect of which medication,
* patient comes with multiple symptoms which ones will be contraindications of
external cephalic version ? ‫اﻟﺟواب ﻛﺎن اوﻟﯾﻔوھﯾدروﻣﯾﻧوس‬
*pregnant with HTN on 25 week she admitted to hospital because of nausea,
headache, vomiting, blurring of vision, what the cause ?
Placenta previa
Placenta abruptly
Renal failure **
**Patient had , HTN , Reduced GFR to 25 had azotemia , what cause ?
Medication
Acidosis
Renal artery stenosis
**First thing happened during puberty??
Pubic hair
Size of penile
Etc ??
** First medication to give bipolar patient??
** Pic ofECG , RBBB,
Pic of ectropion
** Pic of CXR and symptoms of Outlets thoracic syndrome??
Tumor on SVC
** injury of posterior branch of vagus what structure will be affected??
Esophagus
** case of anxiety of performance ?
** obese patient had Severe left chest pain , he had family history of coronary
artery diseases, they did ECG and Look normal what to do next?
Coronary angiogram

* patient had diarrhea, abdominal pain , after 2 days he developed constipation ,

antibiotics was given . What mechanism of that antibiotic,
Organism is salmonella because diarrhea then constipation ,
,??
DNA gyres
30 ribosomes

Case of HSP and asked about treatment??

** mechanism of warfarin??
* treatment if TTP ??
** case of glaucoma asked about immediate medication??
** baby turned blue when feeding, what structures of cardio involved??

What is meant by a confidence interval of 95%?

-Long scenario of a mother with her 4 month old baby, telling you about
milestones. Which of the following is expected at his age?
A) Holds head steadily
B) Rolls in both directions

-A man complaining of reduced hours of sleep after having an MI 6 weeks back.

What is the medication of choice?
A) Bupropion
B) Some SSRI
C) amitryptaline
-A man with gastric ulcer on GED. Biopsy is negative for malignancy and
negative for H. Pylori. Which of the following is the most appropriate
recommendation?
A)
B) H. Pylori serology
C) PPI for 1 month
D) Follow up with the endoscopy 6-8 weeks after therapy

-A long scenario of a child with signs and symptoms of salmonella. Microbiology

report consistent with salmonella. What is the mechanism of action of the
appropriate antibiotic?
A) DNA gyrase
B) 50 S ribosome
(No cell wall/Beta lactam in the options)

-A pregnant lady at 28 weeks is complaint of weakness and lower back pain. US:
anterior low lying placenta. Which of the following is a risk factor?
A) White race.
B) Young maternal age
C) previous placenta previa

-A patient with symptoms of color art artery disease. Report: atherosclerotic

plaques.
Which of the following is responsible for this condition?
A)LDL
B)HDL
C) Oxidized LDL
D) Oxidized HDL

-A child with difficulty swallowing, sore throat, high fever, drooling saliva, stomach
ache and vomiting. He is unable to eat or drink anything due to pain on
swallowing. Examination shows tonsils with exudate and discharge. Which of the
following will help the patient to swallow?
A) Aspirin
B) Paracetamol
C) Ibuprofen
D) Steroids

Dec 20
-Which of the following has interstitial pneumonitis as a characteristic
histopathological feature?
A) Viral pneumonia
B) Lobar pneumonia
C) bronchopneumonia
D) pulmonary TB

-A patient with alcohol withdrawal syndrome. Which of the following is the most
appropriate treatment?
A) disulfiram
B)
C) Acamprosate
D) chlordiazepoxide (correct)

-A 24 year old lady with a breast mass that is fluctuant and mobile. Which of the
following tests is of highest diagnostic value?
A) MRI
B) Mammogram
C) Ultrasound
D) Fine needle biopsy

-A 15 year old boy with brown color urine and other sings of nephropathy. Which
of the following tests is of highest diagnostic value?
A) Kidney Biopsy
B) Creatinine
C)
D) Urinary sediment microscopy

-A long scenario of a lady with congestive heart failure. She has severe SOB and
PND. She is currently on ACEI, BB and furosemide. What other medication
would you like to add?
A)Spiromoloactone (correct)
D) Hydralazine dinitarate

-Scenario of a man with SOB and chest pain. ECG report: RBBB, S1 Q3 T3
pattern. What is the diagnosis?
Pulmonary embolism

1- neonate with apgar scor of 3 what ja the most useful step in resuscitation?
A- ventilation
B- volume expantion
C- chest expantion
D- warming and drying

2- what is true about errosive gastritis?

A- symptoms appear after 12 hours from trigger
B- symptoms appear after 48 hours from trigger
C- present with abdominal pain and peritonitis

3- patient with mania and liver disease what medication will you choose? All the
options were name of drugs

4- scenario of patient with depression was started on ssris then after a while
developed symptoms of mania what is the treatment?
A- lithium

5- patient complaing of headache for 15 days per month that is band like, slightly
limiting his activity. Works for very longs hours and take paracetamol every other
day. What is the type if headache?
A- cluster
B- migrane
C- tension
D- drug overuse headache

6- risk of schizophrania if father has it?

A- 5
B- 10
C- 15
D- 20

7- 8 month old boy starts crying and screaming when stranger comes near him
what is the cause?
A- simple phobia
B- stranger anxiety
C- seperation anxiety

8- patient has painful eye, red tearing, with sensitivity to light. He had similar
episodes of these symptoms in past. On examintaion there is inflammation of
cornea and ulcer. Which of the following can trigger the symptoms again?
A- dust and pollens
B- uv light
C- driving at night

9- patient taking antidepressant coming unconscious and with metabolic acidosis

what is the cause?
A- aspirin
B- ssri
C- antipsychotic

10- child with facial edema when waking up with scrotal edema. On auscultation
there is a pansystolic murmur heard in the left lower sternal edge. Labs shows
anemia, low albumin, high cholesterol, high AST
What is the diagnosis?
A- heart failure
B- nephrotic syndrome
C- liver failure

11-patient with hypertension came to clinic three times with high blood pressure.
He is not taking any medication. Labs sodium is 147. Potassium is 3. What is the
diagnosis?
A- addison
B- essential hypertension
C- primary hyperaldosteronism

12- patient came for regular check up. His blood pressure reading was high.
What will you do?
A- tell him to come in 6 months
B- ambulatory blood preasure monitoring
C- reassure
13- patient 60 years did pap smear showed ASC-US. She took a course of
estrogen then she came a week later the pap smear still showed ASC-US. What
is the next step?
A- colposcope
B- HPV test

14- patient hypertensive, obese with high bmi and his father died of coronary
artery disease at 54 years. What is the most important risk factor?
A- family history
B- obesity
C- hypertension
15- patient was hit by a lead pipe. He is unconscious with vomitus on his clothes.
What is the most approriate immidiate actions?
A- oral tracheal intubation
B- oxygen face mask
C- lateral cervical spine
D- fluids

16- what is the most sensitive and specific diagnostic test for various types of
malaria?
A- rapid diagnostic test
B- malaria antibodies
C- blood film
D- something in the spleen

17- multiparous women just gave birth. She is clinically stable. What is the most
anticipated complication in the first 24 hours?
A- primary post partum hemorrhage
B- secondary post partum hemorrhage
C- uterine inversion
D- uterine rupture

18- a protein with start sequence but no membrane trafficking signals. What is
the fate of this protein?
A-lysosome
B- endoplasmic reticulum

19- stool showing ancylostoma duodenale eggs. What will be increased in the
blood?
A- eosinophils
B- basophils
C- lymphocytes
D- neutrophils
20- patient came with muscle weakness and pain. Can not stand on his leg.
Biopsy showed glycogen complex compounds with absence of myofilimants and
sacroplaamic organelles. What is deficient?
A- aldolase
B- 1,a glucosidase
C- tyrosin kinase

21- patient comig with high lactic acid and hyperalananemia. What is the
deficiency?
A- pyruvate kinase
B- pyruvate carboxylase
C pyruvate dehydrogenase

Dec 19
Q: What will support your dx of infective endocarditis?
-Roth spot
-Erythema marginatum
-Subcutaneous nodules

Q: Dyslexia definition?

Q: 20 yo case of meningitis with rash, what is the caustive oragnism?

-Meningococcal
-Pneumococcal

Q: Indication for tonsillectomy?

- OSA
- Parapharyngeal abscess

Q: Contraindication for IUD?

Acute PID

Q: How to differntiate between acute and chronic hep C?

-Duration of sx
-Severity of sx including jaundicel
-genotype

Q: Pt with uti started on cloxacillin, after three days culture showed bacteria
resistant to cephalosporin, What is the next step?
- continue cloxacillin
- stop antibiotic
- start vanco

Q: whats the minimum interval to give another dose of hepatitis a vaccine?

-2 wks
-4 w
-6 w
-8 w

Q: Baby born at 32 weeks and having all sx of RDS,

xray report: granularity (no pic), diagnosis?
-Surfctant deficiency
-congenital pneumonia

Q: Pt post radical tongue resection, with loss of sensation of anterior 2/3

nerve injury?
-Trigeminal
-Facial
-Hypoglossal

Q: Pt with tongue deviation to the right, nerve injury?

-Right hypoglossal
-Left hypoglossal

Q: What is the serology that indicates acute hepatitis B?

-HbsAg
-IgG HbcAg
-IgM HbcAg

Q: 35 yo pt came for her pap smear swab screening, during exam you found
10×12 mm irregular mass,
What is the next step?
-Tissue biopsy
-Do nothing
-HPV test

Q: 36 weeks of gestation with headache, nausea and vomiting.

Normal CTG and US
Normal vitals except Bp160/100
Reason for admission in labor room?
-rupture of amniotic fluid
-fetal distress
-renal failure
Q: commom presenting sx of acute gastritis?
-Melena
-Pain

Q: Pregnant with diffuse goiter, sx of hyperthyroid

TSH low
Anti TPO negative
Management ?
-thyroid biopsy(not FNA)
-iodine scan
-subtotal thyroidectomy
-anti thyroid drug

Q: dog bite on his hand, his previous rabis vaccine was year and half ago:
-Ig rabis
-Two rabis vac
-Vac and ig

Q: String of pearls and hairsutism(no pic), dx?

Pcos

Q: Pregnant with hx of having an infant with neural tube defect,

Whats the folic acid dose?
- .2
-2
- .4
-4

Q: which part of bone is affected in hematogenous osteomylitis?

-metaphysis
-epiphysis

Q: what is more present in cow milk than breast milk?

- protein
- iron

Q: 30 yo male with scenario of infertilty, decrease muscle mass, and decrease

pubic hair
Testisterone =low
FSH= low
Prolactine=normal
Investigation?
- testicular biopsy
- brain mri
- tesitcular ultrasound

Q: blaader ca after surgical removal with no remenant tumor tissue found, what is
the next step?
- f/u
- intravesical BCG
- intravesical mitomycin c

Q: pt kc of recurrent depression on citalopram, brought to ER after suicidal

attempt.
She is having high anion gap metabolic acidosis, what could be the overdose
drug?
- aspirin
- citalopram
Q: what is the main aim of antipsychotic drug in schezophrenia?
- reduce delusions
- improve thinking ability
Case of placenta pevia 23 week

Admit till delivery

Cs
Toclitic
Follow up weekly

Generalized anxiety disorder ttt

‫ ﻣﺎﻓﻲ‬SSRI
‫ ﻣﺎﻋرﻓت اﻷدوﯾﺔ ﺑس اﻟﻠﻲ أﺗذﻛره‬buprion

‫ﺟﺎ اﻟﻠﻲ رﺳب ﻓﻲ اﻻﺧﺗﺑﺎر وﻗﺎم ﯾﺑرر‬

‫وﺟﺎ اﻟطﺎﻗﺔ ﻣن واﻟﻰ اﻟﻧواة‬

Pink macpulae rash ,, still or Kawasaki

Gram negative Non lactose fermenting

Motile urease negative
Produce hydrogen sulfide ttt
Cipro < sure
* Normal age of menopause:
48, 51, 53, 55?

* treatment of PCOS

* treatment of htn in pregnant woman

* 37 yo presented with 10 weeks GA 1st pregnancy, BP 140/90, next week also

similar reading. She never went to a doctor in the past years, asymptomatic,
works in an office, exercises 3 times a week. So what is the cause of her high BP
reading: anxiety, chronic htn?

* gravida 6 lady w/ distended abdomen: came out to be uterine fibroid. What is

the most possible cause: multiparity, smoking, obesity, african race?

* vegetarian patient lab results: the answer was Iron deficiency anemia & b12
deficiency was there also in the choices

* pediatric patient with fracture in the ER with hx of fall of the stairs, by

examination you saw multiple bruises with different colors. What will you do? I
chose: admit and contact social workers. Other choices were consult ortho,
consult pedia, or manage in ER

* 6 yo patient received only BCG, what will you give now?

* traveled and after 2 months got bloody diarrhea and cramps, while traveling she
bought fruits and salads from the street and ate them, but been conscious about
her drinking water. What is the organism: salmonella, shigella, giardia,
entameboe histolytica?

* DM + htn patient what will you give to protect the kidneys: ACEi, thiazides, b
blockers... ?

* pediatric patient with white layer on his tongue, can be scrapped, dx:
erythematous candidiasis, oral thrust, leukoplakia ?

* why do we randomize the sample in research? To make sure outcome is

actually a result of our intervention, to have minimal difference in variables
between the groups (or something like that)... i forgot the other choices.

* 13 years old short stature and no puberty signs, what is the cause?
Chromosomal, hormonal, familial....

* patient with turner syndrome (wasn’t mentioned in the question but her
appearance was described) what will you look for? Cardiovascular abnormalities

* pregnant woman in labor, 2 hours of heavy bleeding, she has 4 other children .
What will you ask her? I chose: whether she wants more children or not

* most common site of uterine fibroids

* ‫ اﯾش ﻣﺷﻛﻠﺗﮫ؟‬.‫ﺳﯾﻧﺎرﯾو اﻟطﻔل اﻟﻠﻲ ﯾﺑﻛﻲ ﻣﻊ اﻻﺳﺗﺣﻣﺎم وﻣﺎﻋﻧده ﻟﻌﺑﺔ ﻣﻔﺿﻠﺔ وﻣﺎﯾﺷﺎرك ﻣﻊ ﺑﺎﻗﻲ اﻷطﻔﺎل‬
- Attention
- Concentration
- Intelligence
- internal personalization ‫ ﻣدري‬personal internalization ‫😅 ﺷﻲ ﻛذا‬
I chose the last one by exclusion, I don’t remember the term exactly nor do I
know the meaning of it

* father with brown skin lesions > 12, and his cousin with the same problem, what
is the mode of inheritance? “I think it’s cafe au lait spots”: autosomal mode, x-
linked, ...

* mother mentioned fever and redness of the injection site after previous vaccine.
Now she came for the next vaccine, what to do: just reassurance, admit and
observe after vaccine, don’t give DTP, ...

* old patient in the ER agitated & confused & disturbed speech for 3 days:
delirium, dementia, TIA,...

* initial step to do for epistaxis: pressure on the carotids, tampon on the nostrils,
press the anterior part of the nose ....

* most common presentation of hemophilia: gum bleeding, skin petechia, joint

bleeding ?

* pediatric hx of multiple respiratory infections, what is the chromosome/mode of

inheritance? I guess it was Cystic fibrosis

* most common organism responsible of meningitis in neonates and infants?

* why do we give epinephrine in anaphylactic patients (mechanism of action)

* many questions about urgency and urine incontinance investigations and

treatment
* pediatric patient aggressive behavior hits his mother and destroys stuff,
symptoms started since 3 months after his parents divorced because of child
neglect. 🤔
‫ و أﺣد اﻟﺧﯾﺎرات ﻣو ﻣوﺟود ﺑﺎﻟﺗﺟﻣﯾﻌﺎت‬،‫اﻟﺳؤال ﻣﻛرر ﺑس ﻧﺎﻗص‬:
Reactive attachment ‫ ھو اﻟﻠﻲ اﺧﺗرﺗﮫ ﻷن ﻣﺎاﻗﺗﻧﻌت ﺑﺑﺎﻗﻲ اﻟﺧﯾﺎرات ﻣﻊ اﻧﻲ ﻣﺎ اﻋرف‬..‫ﺷﻲء ﻣن ھﺎﻟﻘﺑﯾل‬
‫😅 ﻣﻌﻧﺎه ﺑﺎﻟﺿﺑط‬

* IUCD contraindication

* white thick vaginal discharge, will you do gram stain or fungal study, I don’t
remember the other choices.

* what are the components of HELPP ?

* neonate passed meconium and now 3 days hx of yellowish seedy stool

* mixture of goblet cells and intestinal cells where was the tissue taken from?
Duodenum, ileum, esophagus, colon
* most effective treatment of cluster headache? 100% o2 mask,

* patient came after 24 hrs of sexual intercourse afraid of pregnancy, what will
you do? Prescribe postcoital OCP,

* after hysterectomy patient is doing fine vitally stable, what would be a reason
for keeping her in the hospital: fever, decreased urine output...

* pediatric fall on his right side complaining of abd pain and dizziness and
fatigue... what is your dx? liver laceration, Willms tumor, other 2 tumors choices

* alcoholic patient complains of bones pain progressive for 2 years, there is lab
results and xray findings in the question. what is your dx: osteoporosis,
osteomalacia, cancer metastasis to the bones, paget disease of the bone?

* what is characteristic about non-Hodgkin lymphoma’s way of spreading in the

body?

* which anti-acid will cause constipation?

* many case scenarios about alcoholic patients having anemias and abdominal
pains and disturbed liver enzymes and vitamins deficiency so read about it.
1)Pregnant, 16 weeks, discovered to be RH-
What to do next?
-ultrasound
-amniocentesis
-IV RH antibodies

2)Pregnant, 23 weeks, presented with painless vaginal bleeding, on examination

found to have placenta covering more than 20 mm Internal OS.
What your next step?
-admit until she delivers (correct based on obgyn resident)
-follow up every 1 week
-plan for C section

3)Female with history of abdominal pain and mood swings every time before her
menses and now she is been having cramps abdominal pain for 6 months.
What's your explanation?
-prolonged follicular phase duration
-abnormal response to gonadotropins

4)Preterm (23-25) weeks, successfully resuscitated. His birth weight 0.9 kg

Labs:
Ph slightly acidic by one point
Pco2 normal
Po2 normal
They didn't mention the LFT or jaundice
What's the appropriate management:
-Enteral feeding
-phototherapy
-bicarbonate infusion

5)Man complaining of headache, left side, throbbing in nature, lasting for 1-2
hours after playing soccer and similar attacks after intercourse.
-primary exertional headache
-migraine

6)72 years old man diagnosed with gastroenteritis and has been vomiting for the
past 72 hours.
What's released in the body?
-CRP
-cytokines
-apoprotien
7)Old man with hepatospleenomegaly, shortness of breath, tired and eye vision
disturbance
WBC normal
RBC high
Platelets normal
-Leukemia
-polycythemia (correct)

8)Old man, smoker, complaining of swelling of the face and redness, shortness
of breath
-TB
-squamous cell carcinoma
-adenocarcinoma

9)Old man with prostate cancer and sudden sever back pain. Was not started on
any pain medication before.
What's appropriate initial therapy?
-Paracetamol
-diclofenac
-Morphine
-Tramadol

10)Old man, diabetic, complaining of shoulder pain, increases at night, on

examination significant reduction in abduction and external rotation.
What's your diagnosis?
-adhesive capsulitis
-rotator cuff tear
-bursitis
Another scenario in the exam but with pain in passive and active movement and
the options were the same as above.

11)What's the graph used to describe pretest post test probability

-Nomogram
-Funnel
-ROC
-Fosner blot (high chance the word is wrong)

12)Pregnant with preeclampsia and was given magnesium sulfate.

What is the earliest sign of hypermagnesemia?
-decrees deep tendon reflexes
-hypotension
-flaccid paralysis
-respiratory arrest
13)In brief: Randomized control studies between 2 populations with coronary
artery disease. What's the first question you should ask?
-was the age standardized?
-are the medical facilities in both cities equal?
-if the price of cigarettes cheaper in any of the cities?

14)Man with cough, SOB, hemoptysis and occasional hematuria

On examination: Saddle nose and perforated septum and necrosis, on chest
examination added sounds.
What's your diagnosis?
-Wegener granulomatosis (correct)

15)Patient in the ICU with end stage liver disease developed infection and culture
showed budding yeast.
What's your treatment:
-Fluconazole
-Micocnazole
-Flocytosine
-Capsofungin

16)Man came from Sudan since two weeks with fever, Heath and vomiting.
What's your next best step?
-stool culture
-blood culture
-peripheral smear (correct)

17)How to potentiate the effect of amoxicillin against B-lactamase?

-add clavulanic acid

18) female with PCO, she is in risk of developing?

-ovarian cancer
-endometrium cancer (correct)
-breast cancer

19) patient with increased lipid profile and high hemoglobin A1c
What's your next step?
-order TSH
-order LFT

20) pregnant underwent oral glucose tolerance test 50 mg and result post 1 hour
was 8.3
Then took 100 mg and was measured after 1,2,3 hours
Results
1 hour: normal
2 hours: elevated
3 hours: normal
What's your management?
-metfornin
-diet

21)Patient with sarcoidosis and labs showed

Hypochromic microcytic anemia
Retics normal
RDW normal
What's the type of the anemia?
-Iron deficiency anemia
-Chronic diseases anemia
-Sideroblastic anemia

22)Old patient with hepatosplenomegaly

Labs showed
WBC high
Coombs test positive
What's your diagnosis?
-CML
-CLL (correct)
-AML
-Luekemoid reaction

23)Patient with recurrent renal stones (urate stones ) with normal uric acid blood
level.
What's your management to prevent recurrence?
-allopurinol
-probenecid
-Citrate Na

24)Female found to have squamous cell carcinoma on Pap smear.

What's your next step?
-colposcopy and biopsy
-total hysterectomy
-cone biopsy

25) patient coming with abnormal movement. Signs of metoclopromide toxicity.

What's your management?
-Benzotropine or diphenhydramine (correct)

26) patient coming with watery diarrhea days ago he was discharged from the
hospital after receiving antibiotics.
What's your management?
-Metronidazole (correct)
-fluroquinlones

27) long scenario about Mycobacterium TB.

What makes the macrophages super active and killing?
-IL2
-IFN Y
-TGF B

27) patient with lichen planus on the flexors with with no mucosal involvement.
What's the prognosis?
-resolve on its own
-multiple remissions and relapses
-turns into malignancy
-stays on the same condition forever

28) highest energy?

Cytoplasmic GTP

29) which if following correct about delusions?

-rare in mania disorder
-only in schizophrenia
-disturbance in perception
-disturbance in thought content (correct)

30) a kid with sore throat and sever ear pain for the past two days with
erythematous tympanic membrane.
What's your management?
-Amoxicillin
-other antibiotics

31) anxious father brought his son who is immunocompromised after he was in
contact with his brother who developed chicken pox. Upon examination the by
was asymptomatic and no further findings.
What to do next?
-Reassure
-give acyclovir
-give varicella immunoglobulins
32) 27 years old man with oral/genital ulcers, abdominal pain/diarrhea and
arthritis of large joints
Your diagnosis? Behcet
Your treatment? Steroids
If resistant to steroids? Azathioprine
33) 17 years old boy, runner, developed pain over his knee, the pain increases at
night.
Underwent x-ray and found to have swelling in the proximal tibia.
What's your diagnosis?
-osteoid osteoma
-stress fracture

34) child fell on outstretched hand.

Diagnosis?
-Supracondylar fracture
-colle's fracture (correct)

23) a 30 year old man presented with a painful mouth ulcer that started 2 days
ago, the pain increases with eating and drinking. You confirmed it was a 1 cm
mouth ulcer. Which of the following is the appropriate management?
1) oral antibiotics
2) oral steroids
3) Triamcinolone dental paste
4) refer to oral surgery

24) How does a protein enter a peroxisome?

1) folded using a C terminal (correct)
2) unfolded using an N terminal
3) unfolded using a C terminal
4) folded using an N terminal

25) which of the following is the longest phase in the cell cycle?
Interphase

26) Typical scenario of appendicitis (periumbilical pain that shifted to RLQ) with
positive rebound tenderness and positive psoas and obturator signs. Which of
the following is the most likely diagnosis?
1) acute appendicitis (correct)
2) acute cholecystitis
3) ovarian torsion

27) a 50 year old patient with history of peptic ulcer presented with acute right
knee pain and swelling. Upon examination, the knee was tender and swollen and
erythematous. He has a positive history of 1st metatarsal joint swelling multiple
times. He also recently started a new antihypertensive drug. Which of the
following will be of most diagnostic value?
1) knee aspiration (correct answer)
2) anti CCP
3) anti dDNA

28) scenario of an RH-ve mother that gave birth to an RH+ve baby. Which of the
following explains the anemia in the baby?
1) maternal antibodies again fetal antigens that cause RBC agglutination
(correct)
2) fetal antibodies against maternal antigens that cause RBC agglutination
3) fetal antibodies against fetal antigens

29) scenario of a patient with long thoracic nerve injury (presented with inability
to abduct the arm and winging of the scapula). Which of the following parts is
injured?
1) roots (correct answer)
2) lower plexus
3) middle plexus

30) scenario of a female with typical symptoms of SLE (malar rash,

photosensitivity, oral ulcers...etc). ANA was +ve. Which of the following will
confirm your diagnosis?
1) anti centromere
2) anti dDNA (correct answer)
3) anti CCP

31) How will the heart increase its blood supply when it's working extra hard?
1) by dilating the coronary arteries
2) by beating fasting
3) by increases the pulmonary resistance

32) which of the following will decrease during hypovolemic shock?

1) venous capacitance (correct)

33) a pregnant lady presented at 37 weeks with regular contractions every 2-3
mins and lasting up to 45-60 seconds and rupture of the membranes with clear
fluid which turned the nitrazine paper to a greenish-blue color. Good fetal heart
rate and the mother is stable. She had a history of low transverse C/S. the
presentation of twin A is breech and twin B is cephalic. The doctor decided to go
for a C/S. Which of the following is an indication of C/S in this delivery?
1) twin presentation (correct answer)
2) previous C/S

23) a 30 year old man presented with a painful mouth ulcer that started 2 days
ago, the pain increases with eating and drinking. You confirmed it was a 1 cm
mouth ulcer. Which of the following is the appropriate management?
1) oral antibiotics
2) oral steroids
3) Triamcinolone dental paste
4) refer to oral surgery

24) How does a protein enter a peroxisome?

1) folded using a C terminal (correct)
2) unfolded using an N terminal
3) unfolded using a C terminal
4) folded using an N terminal

25) which of the following is the longest phase in the cell cycle?
Interphase

26) Typical scenario of appendicitis (periumbilical pain that shifted to RLQ) with
positive rebound tenderness and positive psoas and obturator signs. Which of
the following is the most likely diagnosis?
1) acute appendicitis (correct)
2) acute cholecystitis
3) ovarian torsion

27) a 50 year old patient with history of peptic ulcer presented with acute right
knee pain and swelling. Upon examination, the knee was tender and swollen and
erythematous. He has a positive history of 1st metatarsal joint swelling multiple
times. He also recently started a new antihypertensive drug. Which of the
following will be of most diagnostic value?
1) knee aspiration (correct answer)
2) anti CCP
3) anti dDNA

28) scenario of an RH-ve mother that gave birth to an RH+ve baby. Which of the
following explains the anemia in the baby?
1) maternal antibodies again fetal antigens that cause RBC agglutination
(correct)
2) fetal antibodies against maternal antigens that cause RBC agglutination
3) fetal antibodies against fetal antigens

29) scenario of a patient with long thoracic nerve injury (presented with inability
to abduct the arm and winging of the scapula). Which of the following parts is
injured?
1) roots (correct answer)
2) lower plexus
3) middle plexus
30) scenario of a female with typical symptoms of SLE (malar rash,
photosensitivity, oral ulcers...etc). ANA was +ve. Which of the following will
confirm your diagnosis?
1) anti centromere
2) anti dDNA (correct answer)
3) anti CCP

31) How will the heart increase its blood supply when it's working extra hard?
1) by dilating the coronary arteries
2) by beating fasting
3) by increases the pulmonary resistance

32) which of the following will decrease during hypovolemic shock?

1) venous capacitance (correct)

33) a pregnant lady presented at 37 weeks with regular contractions every 2-3
mins and lasting up to 45-60 seconds and rupture of the membranes with clear
fluid which turned the nitrazine paper to a greenish-blue color. Good fetal heart
rate and the mother is stable. She had a history of low transverse C/S. the
presentation of twin A is breech and twin B is cephalic. The doctor decided to go
for a C/S. Which of the following is an indication of C/S in this delivery?
1) twin presentation (correct answer)
2) previous C/S

1) Which of the following treatments used in primary biliary cirrhosis helps in

improving the histology?
1) azathioprine
2) steroids
3) ursidiol
4) interferon

2) Scenario of a pediatric patient with persistent pink colored elevated lesions on

her foot. They're non pruritic and not scaly. She used topical antifungal for 6
weeks with no benefit. What's the diagnosis?
1) erythema chronicum migrans
2) granuloma
3) discoid lupus
4) erythema nodosum

3) How to diagnose acute hepatitis B?

1) IgG core antibody
2) IgM core antibody (correct)
3) HBV surface antigen
4) 6 year old child with a weight of 14 kg and a hight of 94 cm presented with a
history of bloody stool mixed with mucus. Stool microscopy did NOT show
parasite and ova and antigen for E. histolotica was negative. What is the likely
cause of her symptoms?
1) irritable bowel syndrome
2) giardiasis
3) Rota virus
4) ulcerative colitis

5) female 36 weeks of gestation presented with typical symptoms of

uncomplicated cystitis for 3 days. Urine analysis also indicated infection. How are
you going to treat her?
1) nitrofurantoin
2) TMP-SMX
3) doxycycline
4) ciprofloxacin

6) 30 year old patient with no history of smoking underwent chest X-ray which
showed a solitary nodule with popcorn calcification. She then did a CT scan
which showed areas of fat and calcification. Which of the following is the likely
diagnosis?
1) hamartoma (correct)
2) lung cancer

7) scenario of a child with RSV lung infection. Which of the following is used in
the treatment of this infection?
1) ribavirin (correct)
2) lamivudin
3) ganciclovir

8) scenario of a man that presented after a dog bite. They could not catch the
dog. 18 months ago he took rabies vaccine before going to South Africa. Upon
examination his wound looked deep. Which of the following is the best
management?
1) give 2 doses of rabies vaccine (correct)
2) give rabies immunoglobulin
3) give immunoglobulin and vaccine

9) a scenario about a child diagnosed with meckels diverticulum. Which of the

following is the most likely involved site?
1) lower jejunum
2) lower ilium (correct)
10) scenario of a patient with duodenal ulcer. Which of the following
characterizes duodenal ulcer pain?
1) increase with food
2) relieved with food
3) increased when lying down

11) scenario of a pregnant lady with contractions and there was a CTG pic
provided which showed late deceleration (this was not mentioned in the scenario,
you have to know how early, variable and late decelerations look like on the CTG
so u can solve this q). Which of the following is the likely cause?
1) head compression (choose this if the CTG showed early decelerations)
2) cord prolapse (choose this if the CTG showed variable decelerations)
3) placental insufficiency (choose this if the CTG showed late decelerations)

12) 65 year old man who had progressive decline in his vision for 6 months.
Presented to the ED complaining of sudden right eye pain associated with
redness. Upon examining the visual field, he was only able to see the doctor's
hand motion. His pupils were dilated, fixed and white in color. Which of the
following explains his symptoms?
1) malignant glaucoma
2) advanced rubeosis iridis
3) optic atrophy
4) intumescent cataract

13) which of the following organisms cause flask shaped ulcers in the colon?
1) entamoeba histolytica (correct)

14) postmenopausal patient taking estrogen therapy. Presented with dysuria,

frequency, urgency and other UTI symptoms. Her symptoms started 1 year ago
and are progressively getting worse. She tried multiple courses of antibiotics
without improvement. Upon examination, the cervix and vagina looked normal.
Which of the following is the likely cause?
1) Candida albicans
2) traumatic urethritis
3) interstitial cystitis

15) scenario of a diabetic lady with overflow incontinence (full bladder, feeling of
incomplete voiding) And investigations showed residual urine. Which of the
following is the underlying cause?
1) diabetic neuropathy
2) hypertrophic bladder
3) hyperglycemia
16) a scenario of a pediatric patient with recurrent infections and failure to thrive,
his brother who died had a similar presentation. Which of the following vaccines
you will not give this patient?
1) varicella (correct)
2) influenza
3) PCV
4) IPV

17) Scenario of a pediatric patient with typical symptoms of otitis media (painful
and otoscope showed bulging tympanic membrane of the affected ear...etc). The
patient had a history of impetigo infection a few weeks ago with was treated with
antibiotics. Which of the following drugs will you choose to treat this patient?
1) amoxicillin
2) ceftriaxone
3) another type of cephalosporins
4) erythromycin
(No augmentin in the choices)

18) lacrimal gland tumor will cause proptosis in the eye in which direction?
1) down and in (correct)
2) down and out
3) up and in
4) up and out

19) scenario of a pediatric patient who overdosed on isoniazid and presented

with seizures. What's the best management?
1) pyridoxine (correct)
2) the rest of the options were other type of anticonvulsant medications

20) you were conducting a randomized control trial, some of the participants left
your study. How will you deal with this situation?
1) ask people from the other randomized group to leave
2) abandon the study if more than 5% of the participants leave
3) include the values of the participants that left in you final statistical analysis

21) postpartum lady presented to you with bilateral engorged and tender breasts.
What will you advice her to do?
1) continue breast feedings and warm compressors (correct answer)
2) stop breast feeding and antibiotics

22) a 50 year old man with history of dyslipidemia presented with typical
symptoms of acute pancreatitis. Labs were provided which showed anemia with
HIGH MCV. And his lipid profile showed mildly elevated TG (2.9 and normal
levels were below 2.5). Other labs showed high amylase and high GGT. Which of
the following is the most likely cause?
1) alcohol (most likely)
2) gallstones
3) dyslipidemia (mildly elevated levels don't cause pancreatitis)

* The T-score is a comparison of a person's bone density with that of a healthy

30-year-old of the same sex.

* The Z-score is a comparison of a person's bone density with that of an average

person of the same age and sex.

DEXA scan interpretations:

* A T-score of -2.5 or lower qualifies as Osteoporosis.

* A T-score of -1.0 to -2.5 signifies Osteopenia, meaning below-normal bone

density without full osteoporosis.

"Established osteoporosis" is the preferred term for those with osteoporosis (a T-

score less than -2.5 at the hip or spine), and one or more fragility fractures.

Fragility fractures include:

- Colles’
- Hip.
- Vertebral.
- Low-trauma fractures at the ankle.

December 18, 2017

70-year-old patient with osteoporotic thoracic spine fracture. DEXA: spine T zone
-2.6, spine H zone -1.2, hip T zone -1.4, hip H zone -0.9. According to the WHO
classification what is the possible diagnosis?
A. Osteopenia
B. Severe osteopenia
C. Osteoporosis
D. Established osteoporosis

Answer: D
Child with fever, headache and nuchal rigidity, CFS showed gram positive cocci.
Which of the following is the most likely finding?
A. Numerous neutrophils, decreased glucose and increased protein
B. Numerous neutrophils, increased glucose, normal protein
C. Numerous lymphocytes, normal glucose, decreased protein
D. Numerous lymphocytes, decreased glucose, normal protein

Answer: A

Most significant risk factor of cerebral palsy?

A. Prematurity
B. Perinatal asphyxia
C. Genetic abnormalities
D. Low birth weight

Answer: B

Pregnant with symmetrical nontender brown discolouration over the chin and
cheeks, diagnosis?
A. Chloasma
B. Lentigos
C. Urticaria pigmentosa
D. Peutz–Jeghers syndrome

Answer: A

Management of hirschsprung disease?

A. Surgical resection
B. Dietary modification
C. Antibiotics
D. Immune suppressive medication

Answer: A
Most common presentation of valvular cancer?
A. Unifocal vulvar plaque, ulcer or mass of the labia majors
B. Unifocal vulvar plaque, ulcer or mass on the perineum
C. Unifocal vulvar plaque, ulcer or mass on the clitoris
D. Unifocal vulvar plaque, ulcer or mass on the mons pubis

Answer: A

Infectivity period in Rubella before the after the rash in days?

A. Three
B. Five
C. Seven
D. Nine

Answer: B

Which of the following pneumoconiosis will increase the risk of getting pulmonary
TB?
A. Silicosis
B. Asbestosis
C. Anthcinosis
D. Farmer’s lung

Answer: A

Five year old child, repeated episodes of jaundice and history of multiple blood
transfusion, normocytic hypochromic anemia, blood film showed anisocytosis,
spherocytosis, neuleated RBC and polychromasia, positive osmotic fragility test
and negative DAT. What is the cause?
A. G6PD deficiency
B. Antibody mediated destruction of the RBCs
C. Ankyrin and spectrin deficiency
D. Beta chain abnormality

Answer: C
45 year old man, looking toxic, presented stuprose and with weakness, blood
culture showed step pneumonia, he is hypotensive, tachycardiac and his
temperature is 35.8.
What is the most likely complication?
A. Meningitis
B. Pneumonia
C. Endocarditis
D. Septic shock

Answer: D (not sure)

Child with asthma treated with steroid for four weeks and stopped one week ago.
Which of the following vaccines can be given to him?
A. Measles
B. MMR
C. Rota virus vaccine
D. Varicella
Answer: B (not sure)

Which of the following can be used for the management of secondary

hemoarthrosis?
A. Interferon
B. Phlebotomy
C. Corticosteroid

Answer: not sure

- Genetics of syndromes related to unconjugated hyperbilirubinemia.

- Genetics of ankylosing spondylitis.
- Lymph nodes to examine for patient with breast cancer in the upper lateral
quadrant.
- DDx of blood film with anisocytosis and poikilocytosis
- DDx of blood film with tear shaped RBC

December Questions
In which stage Chromatides are separated
Initial screen for 15 years old child suspected to have coarction on aorta:
A. Echo
B.MRI
C. Cardiac Catherization

Antipsychotic drug overdose gives Parkinson’s like symptoms

Eye disease with absent red reflex

Deficncy in what makes Primiquine causes sever anemia? G6PD was in choices

MOA of lansoprazole

Most serious consequence after acute pancreatitis:

fistula
abscess.
phlegmon

P value 0.13: 2 groups has no different between them? Different is 13%? If 2

groups participants increased the value will increase ?

Bones form ankle joint

Patient asked to stand on his toes what nerve is being examined?

Woman with 5*6 fibroids:
US every year?
US with CBC in 2 moths ?
Hysterectomy?
Myomectomy

45 yo woman removed ovaries, uterus and Fallopian tubes how u will give HRT?
Cyclic or continues and what hormones?

7 years old girl with phobic hair and everything is healthy: premature adenarch ?
Normal puberty?

So many questions about anemia (target cell in one of them)

Antidepressants or antipsychotic drugs: start with whatever they r all the same.

Start with one for 2 weeks and then follow up.

Woman uses phyntoin for 6 years and she’s free off symptoms ever sine,
complained of hair growth:
A. Continue with it indifintlhy.
B. Continue for 10 years and stop it if asymptomatic.
C. Shit to another new drug.
D. Stop using the drug

Man complains of pressure (sinus), congestion and green discharge for the last 4
moths he was treated with antibiotics for three times before for the same
complain (the q doesn’t say if he became better of no), he came for u for second
opinion:
A. Antibiotics.
B.antihistamin.
C. Steroids.
D. Decongestant

Young woman complains of pain during urination, increase frequency on

urination, difficulty initiating ruination and she reported blood color urine recently.
On physical examination she had no suprpubic tenderness:
A. Give antibiotics
B.urine culture
C. 24 hours urine sample
D. I forgot but there was not urinalysis in the options
Man with right testicular mass increases everyday that is not transilumatied:
A. Do ultrasound and refer to surgery
B. Take open or precutaneous biopsy

There is so many research regarding the association between smoking tobacco

and lung cancer, which research is done as conclusion of all researches and
facts?
A.meta analysis
B. Case control
C. Cohort
D. I forgot

Pt (long scenario) with mental abnormality, rufuses to move and fully extended
left arm and flexed right arm on his waist what’s this position called: I closed
catatonia
placenta previa and adherent (low laying) what is the noninvasive test to do?
A) MRI
B) Transvaginal US
C) Doppler ulsasound
D) CT

-Patient with Right side heart failure , impaired diastolic filling , there was no
hypertrophy , what is the cause ?
Coxaci
Constrictive pericarditis
Amyloidosis

-Autopsy result of patient after sudden cardiac death

-read about changes in ca , p and alkaline phosphatase with different causes

-Antihypertensive medication cause ankle edema ?

-Aldosterone produced by ? Zona glumerulosa

-ask about location of Brunner gland ? Mucosa or ........ ?

-Which cell in the liver Secrete extracellular matrix ? Hepatocytes, endothelium ,

kupffer , or stellate

-with Duke criteria , U need ? Answer is 1 major and 3 minors

-baby with Clef palate and they ask about the risk to have 2nd child with cleft
-patient diagnosed with Colon adenocarcinoma and they ask about gene

-patient with leukemia "Auer rod " and they ask about chemotherapy? Answer is
ATRA

-patient with mild spinal stenosis ? Managment is physiotherapy

- 2 cases about crhon ? They mention " transmural inflammation " asking about
the diagnosis

- what is associated with ankylosing spondylitis ? Anterior uvitis or IBD or ......

-patient with COPD and open angle glucoma , best managment ? Answer is
acetazolamide

-treament of trigeminal neuralgia ?

-Treatment of absence seizure ? Ethosuximide

-case about patient with peptic ulcer and high gastrin and acid ? Answer
was Zollinger syndrome

-mechanism of action of metformin

-baby brought last week and took his vaccination polio , pneumococcal ....except
MMR becuase it was not available , would U give it now to him or after 4 week , 2
week ,.....

-baby with Sickle cell , has penile pain and swelling in glans penis ? And they ask
about the cause of that ? priapsm or ....

-which organism cause recurrent infection in chronic granulomatous disease ?

Staph auerus , pyogens or entrococcus fecalis , .....

-patient with bladder cancer 2cm , removed , what is next step ? Intravesical bcg
or intravesical mytomycin or frequent cystoscopy and follow up , ......

-neurofibromatosis gene ? 17q11.2

-baby with cystic fibrosis , parents are healthy , asking about carrier risk in next
pregnancy ? It is 2/4 because it is autosomal recessive

-patient with psoriasis 15% , ask about management ? Topical steroid ,

methotrexate , UV light , .......
-thenar atrphy but sensation not affected ? Which nerve ? Median

- patient with numbness in lateral 3 and 1/2 digit ? Carpal tunnel

- Patient with cluster headache asking about prophylaxis
- Cancer in the upper pole of kidney , asking about its name
- How to prevent recurrent rheumatic fever ?
- Cases about hypercholerstolemia asking about medications , when to use
fibrate , statin , .....
- 2 cases about croup , easy
- Patient with vesicular rash in 1 dermatom ? Answer is shingle
- Another case about patient with favet and rash around mouth and inside it ,
diagnosis was herpes , and they ask about the type ? HSV1 , HSV2, hepes
zoster , herpes simplex
- Mother with HIV ? How it could be transmitted to baby ? Breast feeding ,
through placenta , through umbilical blood .... ?
-female was diagnosed with mastitis in right breast and she received antibiotic ,
now she came with mass in the same breast what is the cause ? Ductal ectasia ,
antibioma ? ......

-female with amenorrhea + history of D&C

Labs , high Lh,FSH and low estrogen , ehat is the cause ? Asherman syndrome ,
ovarian failure ,.......

-baby fall down , and he has bloody otorrhea , what is the cause ? Answer is
basal skull fracture

-accident , patient was initially fine but hen he has sever neck pain , what is the
cause ? Cervical sublaxation , or disck prolapse or cervical spondylosis

-patient with fracture in humerus and ulna and he can not extend his arm or
fingers ? Which nerve affected ? Radial , median or ulnar
-q about boutonniere deformity? Answer is PIP flexion and hyperextension in DIP

16 December
*Painless jaundice* =

either gilbert syndrome ( elevation of indirect bilirubin only without any other
changes )

*Or*
head of pancreas carcinoma ( elevation of direct bilirubin + ALP + GGT +
weigh loss + tumor marker CA19.9 + Courvoisier's sign )

# if ALP elevated *without* GGT elevation consider *bone disease* as paget

disease of bone

# if GGT elevated *without* ALP elevation consider *Alcoholic patient*

# Also if AST elevated more than ALT consider *Alcoholic patient*

*from these basic informations you can approach such cases*

Vaginal discharge
—————————————
*Purulent not pruritic*
*1-gonorrhea* (gram -ve intracellular diplococci)
-gram stain
-IM kanamycin, vibramycine
-PID

*2-chlamydia vaginosis* (chronic cervicitis)

-PID

*1- bacterial vaginosis*

-premature labour
Pprom, chirioamniositis
-clue cell
-whisp test is to add 10% potassium hydroxide to demonstrate the smell
-metronidazole

Offensive fishy odour

*Pruritic discharge*
*1- candidiasis*
-risk factors DM, ocp, pregnancy, antibiotics
2- whity creamy, cheesy plaques "stuck" all over the vaginal wall
- a smear of hyphae to confirm diagnosis
-miconaxole, keyoconaxole

*2-trichomona vaginalis*
-sexually active
-greenish copious discharge
-speculum examvaginal wall "strawberry appearance"
-metronidazole

December 14

-Which of the following blood group more with gastric ulcer:

1-A
2-AB
3-O
4-B
-patient heavy smoker with signs of cancer+ hypercalcemia which cell
responsible:
1- kulchitsky ✅(mostly small lung ca)
2-clara
3-...
4-...
-patient with watery diarrhea and high fever what is the treatment:
1-ceftriaxone
2-ciprofloxacin
3-metronidazole ✅ (giardiasis)
4-vancomycin
-patient with watery diarrhea with blood and mucus , high fever and develop
seizure what is the cause:
1-adenovirus
2-rotavirus
3-salmonella
4-shigella ✅
-what type of lipid that sphingosine from:
1-lectin
2-cephalin
3-....
4-ceramide of choline(not sure if it in choices) ✅
-methyerogometrin side effect:
1-DM
2-HTN

-what best treatment to female with DM and weight gain and heart disease:
1-metformin✅
2-pioglitizone

-MS with acute attack what to give:

1-oral steroid
2-IV steroid✅
3-IVIG
-MG with acute attack :
1-IVIG
2-Phyisostigmime
3-plasmoharesis ✅
-cervical pain +lower limb numbness +paresthesia+ no LOC and no hemiplegia:
1-cervical stenosis✅
2-CVA

-the highest risk factor for heart disease:

1-ethinic race
2-mumber of family member

-central lump back with discharge and some details what is management:
1-FNA
2-antibiotics and resection

-women do C/S abd after that came with discharge and when doctor separate
incision see the omentum what is this called:
1-wound dehiscence ✅(not sure)

-pateint with apnea for 10 min the resolve the recur the resolve and patient had
hearf failure and Dm what is this called:
1- kussumal breathing
2-cheyne stokes✅

-most common anorectal in elderly :

1-anal fussure
2-hemorrhoids ✅

-patient with hepatosplenomegaly and fever and give treatment then resolved
and after 6-8 weeks come back with generalized plaques and papules :
1-dermal leishmaniasis
2-leprematous leprosy
3-sarcoidosis
4-TB

-patient with colon cancer and after that give dextrose the develop lethargy and
weakness and the lab as following:
Low Serum Na +osmolality and normal urine osmolality what is the cause:
1-water overload✅
2-SIADH
3-addison disease

-patient with long standing fever and dx with Kawasaki fever which of the
folllowing strongly associated :
1-strawberry tongue✅

-MS was in recovery phase after after some period came with acute relapse and
associated with conduction block what is the cause:
1-focal inflammatory demyelination
2-viral immune response

-patient with fever and ear pain +tympanic membrane effusion+the ear moved
forward and downward what is the cause:
1-glue ear
2-mastoiditis ✅

-patient came with edematous mucosa and obstructed one nostril what to give:
1-steroids✅
2-antihistamine
3-antibiotics

-patient with skin manifestation and one of cousin had same condition and have
axillary flickering what is the inheritance :
1-autosomal linked✅
2-x linked recessive
3- multifactorial
4- environmental

-women with ductal papilloma what is associated:

1-blood stained discharge✅
2-hemorrhagic papules in areola

-which of the following theoretically cancer can be prevented by virus vaccine:

1- mycosis fungosis
2- T-cell leukemia

-newborn with eye hemangioma the occlude the eye completely and you concern
to not develop amblyopia when to do resection (surgery):
1- one day✅(not sure)
2- one week
3-one month
4-six month

Q1- case of MS pt came to ER with relapse , what will you give him?
1- IV cortisone
2- IVIG

-case of MG pt came to ER with relapse , she was diagnosed with MG 3 months

ago , started on neostigmine at that time , what will you give her?
1- stop neostigmine
2- start physostigmine
3- azothioprine
4- plasmapheresis

-patient came with nutritional def.,No fat and No edema, what’s the Dx?
1- marasmus ✅
2- kwashiorkor

-patient move to new though before expressing the first one

1. Case of incarcerated inguinal hernia what do u do, he was lifting weight and had pain, o/e u find
inguinal hernia that is nor reducible tender and worm
Refer to surgery
Call urologist
Do U/S
Another test I forgot

1. Patient married want to conceive, he has low mood recently diagnosed with diabetes 2 years ago. O/E
u find atrophied testes, scanty pubic hair, his muscles were not bulky.
Labs: testosterone: low. FSH: low and something else which was normal
What sur next step?
Brain MRI
Karyotype
?
1. Physician wants to start an antidepreesive medication for a patient.
Whats true about antidepressives? (something like this)
- Start Any antidepressive can be used as all have same efficacy
- Start with one drug for 2 weeks


- Stop the medication if there is no response

1. Pregnant in her 38 week and 2 weeks ago she was admitted and ECV was done for her. Currently the
fetus positin is in linear with amniotic fluid index 12.
 Whats the contraindication for ECV in her condition?
Amniotic fluid
Fetal position
Fetal age
Previous attempt failed

1. Pregnant and diabetic, her previous fetus died as IUFD due to her DM. Currently her fetus is in good
condition, her glucose is undercontrol what you well tell her?
Deliver the baby at 36 week
Deliver at 38 through CS
Observe for Spontaneous delivery

1. Patient who had left facial palsy, loss of taste in ant left side and Schimmer test on the left side is
positive. Wheres the injury site?
Distal to greater petrosal nerve
Proximal ……………..
Distal to Chordea tympani
1. Barretes esophagus case. Whats normal histology of esophagus? Stratified squamous

8- Q/ Patient complain of abdominal pain I think with diarrhea , also his wife noticed he had SOB and
tightness. Doctor order 5- hydroxyindoleacetic acid in urine Which cell responsible ?

A.chromaffin cell (the answer) [carcinoid syndrome ]

B.Enterocell C.Lympho cell

D.Goblet cell

https://emedicine.medscape.com/article/282515-overview

1. of Incretin?
2. Case of breast milk jaundice management? Observation, Transfusion, phototherapy
3. Q/ Dizygotic twines which is true?

1placenta 2 amointic fluid regardless sex

1placenta 1 amontic same sex

2placenta 1 amontic same sex

2placenta 1 amontic regardless sex

1. Patient with Staph Aureus resistant to Cefoxitin which antibiotic to give?

2. Q/ Patient take a lot of sleeping drugs unresponsive pulse rapid weak, show reflex gasping breathing,
give 2 breathing by mask, next step ?
 Wait for blue team

Perform CPR

Intubate

1. You are going to talk about hypertension in a conference and a pharmaceutical company is funding
this conference. What do you do?

Corporate participant?

Refuse

Talk as theres no ethical issue

14- Q/ Stone at L4 on xray:

-ureter
-minor calyx
Major Calyces

Renal pelvis

15- Steroid sensitive Minimal change disease occur mostly at which age? (Months)

15 months to 36

48-96 months

- 6m-15 months

16- Case of shingles whats the treatment? Gamcyclovir, Acyclovir, NSAID, antibiotic

17- Patient with bilateral hand nodules and he is sad that he has bone lost in his joints. Whats the
cause of bone loss?

Product produce from synovial cell

18- Patient with DIP nodules on the sidesbilaterally whats this?

Bouchards,
 Heberdens

Synovial

19- Patient with ascites, hepatosplenomegaly. What medication your giving him?

Acetazolamide

Antibiotic

20- Most common cause of benign bleeding in postmenopausal women?

Ectropion

Atrophic vaginitis

Endometrial hyperplasia

21- Patient found to have high Bhcg with fetus in good condition what does she have?

Choriocarcinoma

Hydatiform mole

Trophoblastic tumor in placenta site

22- Most common cause of tinnitus? SNHL, Chronic otitis media

23- Treatment of acute hepatitis? Lamivudine, interferons, observe,

24- ATP osteoporosis medication? Alendronate, Etidronate. And others

25- IV drug abuser whats the first thing u will test? HIV, HCV, Staph Viridns

26- Patient was found to have a mass in the urterovesical pouch what the approach?

Laparotomy, Laparoscopy,

27- lateral rotation of hip muscle? Gracilis,

 28- responsible for clearing the corneal from fluid? Epithelium, endothelium, stroma, tear film

29- Patient who fears from going outside zoo and other open place and it worsen to the degree she
stays in home and don’t go out. Whats her diagnosis?

-Agarophobia

- Social phobia

30- gram negative kidney bean shaped diplococci. N. Gonorrhea. Chlamydica. Trachomonas

31- Patient 23y/o with incidental hyperbilirubinemia asymptomatic I think it was Indirect

o Dubin Johnson

o Crigler Najar

o Gilberts syndrome

32- recurrent corneal ulcer photosensitivite what is the most likely precipitating factors?
-dusts and
pollen
-stress and UV light

33- 13. child came with his mother 1 week after his 18 months asks you for hepatitis A vaccine (As it
wasn’t available last week) when to give Hepatitis A?
- Today

- 1 week later - 1 month late

34- 4-month history of an elderly complains of tiredness, hepatospleenmegaly with high leukocytes
-
leukmoid reaction
- AML

- CML - CLL

35- 16 y/o SCD patient with picture showing edematous glans penis and foreskin and its tender whats the
diagnosis?
- Priapism
- Balanitis
- Alloplasia
- Paraphimosis
36- Hypothyroidism patient with pain in shoulder and decrease in ROM in the shoulder ?


• Impingement


• Rotater cuff tear

• Adhesive capsulitis

37- Picture of corneal ulcer

38- ER OCP mechanism.
39- Medications worsen primary dysmenorrhea
Copper IUD
Levonogestrel IUD

40- Pregnant in her 36 wk her fundal symphysis pubis height is 2 weeks larger what clinical assessment
shoulde be done within the following 2 weeks or something like that?
- Cardiotocography
- Fundal height
- Abdominal circumference
41- Diagnostic test of cholangitis? Ct, U/s, mri, xray
42- 76 y/o female who takes aspirin. What is the rate of protection from stroke to the risk of developing
ulcer? 4,8,9,10 %
43- Mitral stenosis what the patient will have

- Left atrium dilated with right ventricle hypertrophy

- Left atrium dilated with decrease pulmonary pressure

- Right ventricle hypertrophy and increase pulmonary pressure

- Right ventricle hypertrophy and something else

44- Research qs from 13: Congintal heart q
Oil lung q
Mers q

45- Purpose of randomization in clinical trial:

- To make sure that the intervention have a real effect

- To equalize the variables

46- Giradiasis treatment (Metronidazole)

47- Above 40 got pegnant before and had the child with Anencephaly she came for consultation what is
the posibility the other child will get neurotube defect. What to tell her?

- Do chronic villus sampling

- Tell her that her age increase her risk

- Tell her that she have the same risk as the population

48- Picture of Patient with multiple ulcers in the mouth, glans penis and has joint involvement and skin
manifestation.

- Behcets

49- Colon Cancer and smoking research question asking about RR

50- Women o/E found to have subareolar mass and nipple discharge. Next step?

- U/S

- Excision and biopsy

- FNA and mammogram

51- Patient who don’t want to do mammogram. How many years does the cancer detected in
mammogram before it appears in physical exam? 2,3,4,5 year

52- Sulfa drug allergy: violaceuous hue

53- Tonsillectomy indication. Sleep apnea syndrome, retropharyngeal abscess, asymptomatic large tonsils

54- At which age child start to learn few words 6,12,24, m

55- What is the specificity of a screening test:

- Without the disease test positive

- With the disease test negative

- Without the disease test negative

- With the disease test positive

56- Patient with palpitation, goiter, and weight loss with ECG showing SVT

57- Pediatric patient with type 1 DM found unconscious in the bathroom, his parents are calling you and
they tell you he missed his insulin dose what do you tell them?

- Give insulin

- Give Glucagon injection

- Give oral fluid mixed with sugar

58- A mother concerned about her 13 m old child that he’s development is not up to his sibling. What is
the delay?

- Walking alone

- Crawling

- Sit without support

- Walk holding furniture

59- 21 y/o female who never had sexual activity came to do check up. Which investigation u will do for
her as a screening.

- papanicolaou smear

- Mammogram

- HPV testing

60- Case of Bronchitis in pediatric

1-Foolded with C terminal

2-most common cause of death in ksa:DM
3-GTP in cytoplasm
4-at low dose: Midozolam
5-which med to remove: Spironolactone
6-dog bite: Polymicrobial
7-TOF: pulmonary stenosis
8-least in infective endo: ASD
9-post coital bleeding: cervix
10-vwb: bleeding time
11-melanocyte: corricotropes
12-decrease in hemorrhage: venous capacitance
13-lung ca 70% (stat)
14-dna sequance
15-retro something (lymph node drainge)
16-planter faschitiits
17-inferior epigastric
18-B. Vaginaosis
19-lady with dm and pregnant : candidiasis?
20-di di regardless sex
21-hepatitis A didnt tAke when to give? (Give now)
22-vericella in adults took one long time ago, what to do now? Give second
dose??
23-fragile X: macroorchadism
24-mickels: terminal ileum
25-atropine se: dry mouth
26-COCP: inhibit pvulation by
27-gout : purine
28-unlock the knee: popliteal
29-someone fell down cant extend knee? Quads
30-tongue soneory: trigeminal
31-female 21 yo with knee pain: patello mdri esh
32-preterm at 24 completed weeks
33-urge incon>anti muscarinic
34-MG > anticholenergic receptrors
35-endomysial abx positive> celiac
36-Asd heart murmur📌
37- salmonella > peyer patches 📌
38-puborectalis 📌
39-round ligament 📌
40-acute glaucoma: acetaxolamide
41-cerclAge : 14 weeks
42-hydrops fetalis: 4 alpha and 2 beta
43-hba1c >10%
44-epidermis from dermis> ten
45-acne > inflammatory
46-osmotic fragility test: spect ankyrin def
47-ptergiyum? Malignancy, vision,
48-otitis media resistant? Amox-cluvlanic
49-dosthicriasis
50-periairicular LN, what to give?
51-outward and down > 3rd
52-prenant , lost 2 kilo, debydrated why?
H.pylori?
53-derealization
54-streptomycin > tinnitus
55-constipaition and villous vomting : full thinkness biopssy
56- hisrprung leveling colostomy
57-pyloric stenosis - sonography
58-ureter stone at l3 and l3
59-entero virus
60-(mastoiditis??)pain at jaw and ear complications? hearing loss
61-upper resp+creps > myocarditis
62- fluids ca:L na:low k:Low
63-esophageal spasm? No motility, endpoint, dysphagia and regurg
64-hypothyroid lab
65-healthy with nodule? Lobe excision?
66-ph interperation of dm patient
67-dm what to fine? Acetoacetate
68- dm with ulcer? Debridment and culture
69-type of breathing? Cheyne stokes
70-fever vomiting and headache came back from sudan? Peripheral blood
71- flushing and sob, where the tumor? Superior mediastinum
72-htn retinopathy 3rd > henorrhages
73-2year ago pas smear ascus> colpo
74-fetal position
75-trabeculectomy > open glaucoma
76- tympanic membrane bulging> om
77-daycare developed bilateral watery discharge > isolate himself to avoid
78-upr hx and developed watery discharge> herpes
79- strawberry nevus > at elbow since birth
80-winging of scapule> thoracic n
81-no rubbed off> thrush
82-posterior bleeding? Nose pack?
83-bee sting what mechanism of hypersenstivity?
84-cell cycle lognger> interphase
85- vaginal itching and all cultures are negative and everything is negative, what
to do? Come back when symptomatic, std refer, empiric, go home no follow up
89- cancer lowering > vitamin D

December 12
Seizure at home then
arrythmia at ER, Patien is on digoxin and antidepressant “didnt mention the
type”, whats the cause?
Digixion, quinidine, SSRI, phenothiazide

Vasomotor rhinitis, tx?

Ortho: medial sole of foot pain, solider, whats the cause?

Strain, flexor, extensor, achilis tendon

What is a sign for primary polycythemia rubra vera that is not in secondary
polycythema (splenomegaly, hepatomegaly, HTN..)

4 months of generalized pain, chest pain, pale, history of use of new drug(didn’t
mention the drug), now patient is very anemic, whats the most likely cause?
antibodies directed to drugs on surface of RBCs (written exactly the same way)
Newly diagnosed RA
Anxiety
Pneumonia

35 week, painful contractions, passing clear fluid for 8 hours, now good
contraction, cervix 2 or 3 dilated, baby is fine, what to give?
Penicillin
Oxytucin
Naloxone
Morphine

25 y/o Unmarried, irregular period, severe lower abdominal pain, whats the most
likely? (Nothing more in the scenario)
Torsion
Appendicitis
Ectopic pregnancy
Gastroenteritis

Child with Otitis media + history of impetigo that was well treated with abx, how to
treat OM?
Amoxicillin
Ceftriaxone
Erythromycin
Cefalexin

Risk of Exposed: 3
Risk of Unexposed: 2
(These were the only numbers in the question and it was a case-control study
about insecticide use and skin cancer)

What can we calculate?

Number of patient to treat is 20
Number of patient to harm is 20
Relative risk is .7
Expected Patient something

*Type of bias in meta analysis

Attrition bias
Recall bias

* Graph used to describe pretest post test probability

Nomogram
Funnel
Curve

*Most cells seen in peripheral smear

Neutrophils
Basophils
Lymphocytes

* UC patient presented to the ER he has been on oral steroids for three days
(see labs below) his was ESR 4.5 and normal range given was less than 8.5.
what is the possible cause? * (literally that was all the information given in that
question)
Abscess
Obstruction
The behcets case

*Case of dilated cardiomyopathy ejection fraction of less than 25 percent with

sinus rhythm pvc and ocassional ventricular tachycardia
Heart transplant
Cardioversion and paceamaker
Avoid exercise
Anticoagulant

*Case of Meningicooccocemia with picture Brother close contact what to do.

Rifampin
Active immunization
Hospitalize and observe
Penicilin G

* Breast cancer which axillary lymph node is important to examine

Anteriar
posterior
Lateral
Medial

*Phrenic nerve crush, location to scalene muscle

Anterior to anterior scalene muscle
Lateral to anterior scalene muscle
*GFR 80 what are the changes ull see microscopically

which of the following is the association with single umbilical artery

African american race
Diabetes
Low fetal mortality
diarrhea arthritis and picture with oral ulcers and penile ulcers.
A) UC
B) SLe
C) behcets

Pregnant in her 36 week with UTI how will you treat her
Nitrofurantoin
Co-trimoxazole
Doxy
December 6, 2017
Which pneumoconiosis predispose or
risk for pulmonary tuberculosis??
Asbestosis
Silicosis ✅
Farmers lung
Which polyposis disease associated with
DNA mismatch repair ?
Familial polyposis disease
Hereditary nonpolyposis colorectal cancer✅
Syndrome start with b

Scenario about patient with gout and asking about the precursor of uric acid ?
Purine ✅
Fatty acids
Amino acids

Recommendation for decreasing colorectal cancer?

Decrease meat and dairy products
Decrease meat and bread
Increase fruits and vegetables
Increase fruits and dairy products

Kwashiorkor ?
Low protein high carbohydrates ✅
Low protein low carb
High protein with low carb
High protein with high carb

3 years can do?

Climbing the stairs ✅
Catch the ball with alternative foot
Viral conjunctivitis associated with:
Papilla
Follicles ✅

Treatment of secondary hemochromatosis ?

Phlebotomy
deferoxamine✅

What is the most common cause of delirium in eldary

-hypoxia
-substance abuse
-intoxication
-multiple medication✅

Posterior compartment of the leg supplied by?

Tibial nerve✅
Drugs and Urine Discoloration

1) Rifampicin - red/orange

2) Nitrofurantoin - brown

3) Iron supplements - black

4) Cimetidine - blue-ish

5) Metronidazole - brown

6) Heparin / warfarin - pink/red

7) Amitriptyline - blue/green
29/11/2017, 13:10:48: +966 53 882 2686: ‫ ﻧوﻓﻣﺑر‬٢٨ ‫اﺳﺋﻠﮫ اﻣﺗﺣﺎن‬
Q-Patient with cardic atherosclerosis most common risk is?
Ldl
HDL
Oxidised ldl
Oxidesed HDL

Q_Ocps cause hyperkalemia?

Levosregnorl
Nor estrgomin
Nor estrgominate

Not sure of spelling

Q_Pt with hiv refused to tell his wife?

1- convenice him about importantance to inform her
2-tell authoritie in country
3_take appointment with his wife to inform her
4 tell him not to come again

Q_Pt with back pain and rectum pain

high psa
Alp high
Diagnosis?
-Prostate cancer
2-Prostatis
3-Benign prostatic hyperplasia
4-Colon cancer

Q_Child with night fever decrease feeding

Ankle pain
Lab show low hgb low plat normal wbcs
Erythrocyte in urine
Next action?

1_Bone marrow aspiration

2-Renal biopsy
3-Double strand DNa

Q-clincal picture of Alzheimer's did want chromosome?

13
15
21
X

Q.cp of pigmentation and axillary frinckels mode of inheritance?

1-Dominant
2.Sex
3-Mitochondrial
4_Mulfacorial

Q_Pt with renal transplant sudden refuse of body and fauilre due to
1- cd4
2_ cd8
3-macrophages

Q_ pt with insect bite and tenderness over it with tender lymh node in area with
lab
Increase WBC and neutrophils? diagnosis?
1_cellulitis
2-urticria
3-lymhngitis
Q-post naupause with total hestrectomy-Develop vasomotor Complication?
1-Continues estrogen and progesterone
2_Cyclic estrogen and progesterone
3_Estrogen only
Q-Standard deviation measure
?
Variably
Data distribution

Q from Africa with Enlarged lymh nodes gene

?
C myc

Q sickle cell anemia gene mutations?

Cross mutation
One insertion
Two insertion
Three insertion

Q media for tuberculosis?

Low....Jensen
Gram stain
Chocolate agar

Q child with fever ring worm suspected to diagnosis sample need ?

Gram stain
Indian ink
Koh

Q_husband was in Bangkok came back with dizziness confused after heavy
drink ascitis hepatosplenomegaly juandice he was heavy drinker alcol for 30 ?

1_Acute hepatitis
2_Liver failure

Q-pt with fever night sweet with picture of blood film?

1-malaria
2_leshimana
Q_female G0p0 40 y
Complaint of sever bleeding with menses last six month and now you examine
here to found alot of blood clots in pelvis
With lab very low hgb
Your first action in treatment?
1- progestogen
2_ blood transfusion
3- hysterectomy

Q- male 30 y with pain in RT and Lt quadrant

With mass bilat?

Polycystic kidney
Renal cell carcinoma

Q-picture of female face with ance

asking about component in Ocps cause acne?

Q-case of sever lymphoma asking about type of treatment of chemotherapy ?

Can't remember names of drug

Q-injury in post traingle which nerve affected

Cause loss sensation of mandibule?

Q injury in back pt cannot elevate hand above head?

Facial
Axially
Long thoracic n

Q.female Complian of infertility for two years

She has regular cycle every 35 to 40 day
Stay five days otherwise she is normal
Semen analysis normal
But female monophasic body temperature
Cause of infertility?

Cervical cause
Penis cause
Anovulation
Q calculate date of ovulation in cycle 34 days?
20
10
14

December 5
- what is the most common cause of hypertension in aduloucence
A essential
B renal
C hyperthyroidism

- what is the bond between trna and mrna ( hydrogen )

- what is the best shape of hip for a woman to deliver her baby ?
- case of gout. What is the drug use for prevention for the attacks?
-what is the genome that cause colon cancer?
- case of PCOS. what type of cancer she might get?
- cases asking about incidince and prevalence
- what is the most common symptom of perforated dudenal ulcer
- what is the first symptom of left sided heart failure ?
Fanconi anemia mode of inhiritince ?
- case of neurofibromatosis. What is the mode of inhiritence?
- case of mysthania gravis. What is the pathology of the disease?
- case about patient was angry because the doctor was late for the appointment..
answer was ( aknowledge the patient anger )
- case abour de quervain tenosynovitis. How to treat ?
- case with picture . Ask about diagnosis ( lymphangitis)
- case about female with normal secondary charactristics but without uterus.
What is thr diagnosis?
- what is the chromosome affected in casr of neurofibromatosis