1.

Which one of the following disorders can cause decreasing

vocal resonance by auscultation of the lung:
a. pleural effusion
b. consolidation.
c. Large superficial cavity.
d. Lung Collapse with patent bronchus

2. Hemoptysis can be mostly caused by which one of the

following lung disorders?
a. pleural effusion.
b. Bronchial carcinoma
c. Bronchial asthma
d. COPD
e. Idiopathic pulmonary fibrosis

3. Dullness on the Traubs' area is caused by which one of the

following:
a. Splenomegaly
b. Pelvic mass
c. Lt sided consolidation
d. Rt sided pleural effusion
e. COPD

4. Which one of the following is true regarding the Light's

criteria for diagnosis of exudative pleural effusion:
a. pleural fluid LDH /serum LDH 0.5
b. pleural fluid protien /serum protien ≥ 0.5
c. pleural fluid glucose /serum glucose > 0.5 X
d. Pleural fluid LDH is less than two thirds upper limit of serum LDH
BY: MDM ENTITY 1
5. All of the following are major treatment lines in acute severe
asthma EXCEPT:
a. Salbutamol inhalation
b. Magnesium sulfate infusion
c. Montelukast
d. O2 therapy
e. Systemic steroids

6. A female patient 25 yrs old, had an epileptic attack, two days

after she had a high- grade fever, cough, and expectation of
fetid odor sputum (increased on lying on the It side) and Rt
side pleuritic chest pain. What is the most probable diagnosis:
a. Massive pleural effusion
b. COPD
c. Aspiration lung abscess
d. Interstitial lung fibrosis
e. Bilateral bronchiectasis

7. Which of the following pulmonary disorders are causes of

clubbing:
a. Transudative pleural effusion
b. Fibroid pulmonary tuberculosis
c. Pulmonary embolism
d. Bronchial asthma.
e. Acute lung abscess:

BY: MDM ENTITY 2

8. All of the following are the first-line treatment in pulmonary
tuberculosis EXCEPT:
a. Ethambutol
b. Isoniazid
c. Cyclophosphamide
d. Pyrazinamide
e. Rifampicin

9. All the following physical examination findings are seen in

aortic regurgitation EXCEPT:
a. A booming "pistol shot" sound heard over the femoral artery
b. A rapidly rising "water-hammer " pulse
c. A systolic crescendo-decrescendo murmur radiation to the
carotids
d. A to-and-fro murmur audible over a lightly compressed femoral
artery
e. Alternate flushing and paling of the skin at the root. of the nails

10. In case of the mitral stenosis which of the following

parameters is typically increased:
a. Cardiac output
b. Left atrial pressure
c. Left ventricular diameter
d. Left ventricular end-diastolic pressure
e. Pulmonary vascular compliance

BY: MDM ENTITY 3

11. Major criteria for infective endocarditis include which of the
following
a. Fever
b. Osler's nodule
c. Single positive blood culture of typical microorganism
d. Positive echocardiogram with evidence of endocardial
involvement
e. Positive rheumatoid factor

12. First line of drug of choice for the management of

hypertension in patients with angina
a. Beta-blockers
b. ACE inhibitors
c. Calcium channel blockers
d. Hydralazine
e. Diuretics

13. C wave in JVP indicates:

a. Atrial contraction
b. Bulging of the tricuspid valve
c. Ventricle systole
d. Rapid ventricular filling
e. Return of venous blood

BY: MDM ENTITY 4

14. Which of the following statements is accurate about physical
examination findings in patients with pulmonary emboli?
a. A temperature above 103° F is common in patients with
pulmonary emboli
b. Tachypnea is among the most common physical signs of
pulmonary emboli
c. Chest wall tenderness as the sole physical finding indicates a
cause other than pulmonary embolism
d. Patients with massive pulmonary embolism display signs of
systemic hypertension
e. Non-tender Abdominal enlargement

15. What underlying pathophysiological changes are chronic

heart failure associated with:
a. Activation of the renin-angiotensin-aldosterone system (RAAS)
b. Inhibition of RAAS
c. Inhibition of the sympathetic nervous system
d. Reduced production of brain natriuretic peptide (BNP)
e. Systemic vasodilatation

16. A 40-year-old male chronic smoker comes with acute epigastric

discomfort for the past hour. ECG shows ST segment elevation
in inferior leads what is the immediate intervention
a. Aspirin
b. Thrombolytic therapy
c. IV pantoprazole
d. Beta blockers
e. Diuretics

BY: MDM ENTITY 5

17. Which of the following approaches is currently NOT
accepted for the management of spontaneous pneumothorax:
a. Chest tube insertion for patients with a primary episode.
b. Thoracotomy for any patient with a primary episode.
c. Video-assisted thoracoscopic surgery (VATS), bleb excision,
and pleurodesis in recurrent pneumothorax on the same side.
d. Thoracotomy, bleb excision, and pleurodesis in recurrent
pneumothorax on the same side.
e. Operation after the first episode in an airline pilot.

18. All the following are indications of thoracotomy and surgical

exploration of 30 yrs. male 70 kg with a stab wound in the
chest EXCEPT:
a. Drainage of 2000 cc on chest tube insertion
b. Multiple fracture ribs with surgical emphysema.
c. Hemodynamically unstable patient with blood pressure 70/40
unresponsive to IV fluids.
d. Drainage of 200 ccs of blood in three successive hours.
e. Associated heart injury and cardiac tamponade.

19. For a patient with a stab wound to the anterior surface of the
chest, cardiac injury is suspected if there is which of the following:
a. High blood pressure.
b. High audible heart sounds.
c. Paradoxical breathing
d. Slow heart rate.
e. Congested neck veins.

BY: MDM ENTITY 6

20. Three days after the post-motor vehicle crash, a patient was
started on a regular diet. The nurse noticed the patient's chest
tube drainage changed from serosanguinous to milky white.
The fluid was sent for triglyceride and chylomicron levels. The
most probable diagnosis is :
a. Thoracic duct injury with chylothorax.
b. Pulmonary contusion with empyema.
c. Pneumatocele rapture with persistent air leak
d. Retained hemothorax with interstitial bleeding
e. Diaphragmatic hernia

21. 6 months old boy presented to the pediatrician with bluish

discoloration of the lips. An ejection systolic murmur was
heard over the 2nd left intercostal space. Echo: VSD with the
overriding aorta and pulmonary stenosis. 2 days later he was.
rushed to the ER with deepening cyanosis. Treatment of this
attack includes all of the following EXCEPT:
a. Sedation
b. Propranolol
c. Digitalis
d. Oxygenation
e. Squatting position

22. Rheumatic fever is caused by:

a. Group A streptococcus
b. Pseudomonas
c. Hemophilus influenza
d. Group B Streptococcus Klebsiella

BY: MDM ENTITY 7

23. A 3-year-old unvaccinated girl presents to the ER with high-
grade fever, soft inspiratory sound, severe respiratory distress,
and drooling of saliva. She is leaning forwards with her hands
on her knees and chin turned upwards. She is extremely
anxious and avoids talking. Which of the following is the most
appropriate diagnosis:
a. Pneumonia
b. Bronchial asthma
c. Bronchiolitis
d. Bronchitis
e. Epiglottitis

24. A 4-year-old boy presents to the outpatient clinic. On

auscultation: a pan systolic murmur is heard over the left
parasternal area and radiating to all pericordium. The
diagnosis is:
a. Atrial septal defect
b. ventricular septal defect
c. patent ductus arteriosus
d. Mitral regurge
e. Coarctation of aorta
25. A 7-month-old boy presents to the ER with an RR of 60/min
and chest indrawing. He had a common cold and runny nose 1
week ago. His X-ray shows hypertranslucent lung fields. The
temperature is normal. The diagnosis is:
a. Acute bronchiolitis
b. Acute bronchitis
c. Bronchopneumonia.
d. Foreign body aspiration
e. Lobar pneumonia
BY: MDM ENTITY 8
26. A 4-year-old boy presents to the ER with RR 60/min,
nonproductive cough, and subcostal and intercostal
retractions. The ER physician mentions to the pediatric
consultant that there are wheezes all over the chest with
prolonged expiration and that the child is using his accessory
muscles for respiration. The boy has a history of previous
similar episodes and is on regular inhaler medications. The 1st
drug of choice for this attack is:
a. Beta 2 agonist
b. Inhaled steroid
c. Oral steroid
d. Adrenaline nebulization
e. Intravenous steroid

27. A 60-year-old male comes in for routine follow-up visits. He

suffered from no disease and take no medications. He is not a
smoker. No family history of premature deaths. He walks two
hours daily as exercise. His blood pressure was 145 /95 mmHg
for two consecutive visits two weeks apart. All his
investigations are normal. Which of the following is best the
management plan for this patient?
a. Lifestyle modification for 6 months
b. Lifestyle modification for 12 months
c. Lifestyle modification+ Immediate drug therapy
d. Immediate drug therapy
e. No need to change lifestyle or receive therapy

BY: MDM ENTITY 9

28. A 50-year-old male patient, diabetic for three years, had one
attack of Ischemic heart disease one year ago. On examination,
his blood pressure is 150/90 mm Hg. The results are total
cholesterol (TC), 288 mg/dL; triglycerides, 262 mg/dL; (HDL),
35mg/dL; and (LDL), 200 mg/dl. Which of the following is the
LDL goal for this patient?
a. < 100 mg/dl
b. < 130 mg/dl
c. < 160 mg/dl
d. < 190 mg/dl
e. 190-240 mg/dl

BY: MDM ENTITY 10