MCCQE

1 message

NCLEXATT Pearson <[email protected]> Wed, May 22, 2024 at 1:44 PM

To: Daddy <[email protected]>

MCCQE

1. Which of the following is correct regarding Wernikes Encephalopathy :

-Often develops into Korsakof's even when treated
-It has a mortality rate of 70 % to 80 % if untreated
-The treatment is thiamine 100 mg. PO daily for 5 days
-The symptoms include Nistagmus ataxia and opisthotonos
-None of the above *

2. Which is the most serious complication of the supra condilar fracture of the Humerus ?
-A compartment syndrome of forearm
-Failure to heal
-Healing in a non anatomic position
-Injury into the median nerve.
-Permanent restriction of the Elbow motion.

3. Which one of the following descriptors of a diagnostic test is Influenced by the prevalence of the disease being tested for :
-Specificity
-Sensitivity
-Accuracy
-Positive predictive value
-Reliability

4. A 43 years M admitted for Emergency Gastrectomey present confusion on the 3rd post-Op day. complains of lack of sleep due to
cockroaches on the ceiling he is noted to be flashed & tremelus by the nurses during the day .. the most likely problem is :
-Post-Op Electrolites Inbalance
-Paranoid Schizophrenia
-Depression Psychosis
-Delerium Tremons
-Anoxic brain system

5. Pt. with known type II DM. treated with Clorpropamide present to ED in comma .. blood sugar = 1 mmol / L. .. you give the Pt 1
ampule of D50W & the Pt wakes up promptley . what is the next appropriate management :
-Give another ampule then discharge.
-Give 2 ampules then discharge.
-Give another ampule then observe the pt for 6 h. in the ED.
-Give one more ampule , admit the Pt. & start IV. Glucose Infusion with frequent ongoing glucose measurement

6. Pregnant 36 weeks with vaginal watery discharge , management :

-do sterile speculum exam

7. Barbiturate withdrawal = convulsion

8. Retrovarted uterus complain = asymptomatic

9. G5 P4 post-delivery, postpartum hemorrhage, most likely cause is :

-Uterine atony

10. Anal skin tag in child associated with ,

-chronic Anal Fissure

11. Child with abdominal pain attacks , drowning his legs up , mucouid bloody stool. Diagnosis ?
-Intussusception

12. 1st sign of foot gangrene is = rest pain

13. Pt. M pain in both lower limbs with week popletial artery pulsation , management ?
transvertebral angiogram

14. basket ball player averted his ankle joint during jumping at match , on Examination Pain with Increased Various range.
Management ?
-Repair ligament surgery
-Below knee cast

15. clean wound cut with laceration & incomplete section of nerve , management ?
-Suture of wound Immediately
-Leave the wound open

16. pain on walking increase in 2nd & 3rd metatarsal bone of forefoot. Diagnosis ?
-Stress fracture
-Sesamoid bone

17. Pt. 68 years going to elective surgery , he has 4 mo. history of chest pain & got same attack at night before the day of surgery ,
what do u do ?
-Lignocaine before surgery
-Trinatreate during surgery
-Send him for ICU
-Postpone the operation & check function of the coronaries

18. collage student F 20 years presented with lower abdominal pain , PE bilateral lower abdominal tenderness , febrile Vaginal exam :
tender with cervical mobilization , pregnant test (-). Diagnosis ?
-Acute salpengitis
-Ectopic pregnancy
-UTI

19. vaginal bleeding , stooped at the day of admission , pregnancy test is (+) US shows empty uterus & left adnexal mass. Diagnosis ?
-Ectopic pregnancy

20. young Pt with history of non productive cough but clinically well .. C-X ray shows bilateral basal Infiltration .. Diagnosis. ?
-Mycoplasma Pneumonia

21. Pt with Ulcer in sole of the foot , at 2nd & 3rd metatarsal joint X Ray necrotic & destroyed part of 2nd & 3rd metatarsal bone .. what
to do ?
-Radical debridment
-Above knee amputation
-Daily sterile dressing
-Oral antibiotic

22. Problem which cause most work days = back pain

23. Nicotinic skin patchy is contraindicated in:

-Pregnancy
-CVA
-Ischemic Heart disease
-Alcoholic

NB. (not sure)

24. Psychotherapy is superior to medication in:

-Schizophrenia
-Bipolar disorder
-Alcoholic withdrawal
-Dysthimia

25. mother worried about her child because of history of myopathy in family .. what Investigation to be done 1st ?
-CPK
-Muscle biopsy
-Nerve biopsy
-EMG

26. Pt on Lithium therapy became weak, lethargic, Intolerant to heat. what Investigation must be done ?
-Lithium level
-BP
-Thyroid Function test

27. surgical nurse 25 years old is concerned that she is loosing her mind, for the past 6 months she is been preoccupied with
contamination, on his ward she has been not touching any patient ,door knobs ...etc.
She was also washing her hand excessively, which of the following treatments will help in reducing her preoccupation and hand
washing ?
-Fluxetine
-Lorazepam
-Perphenazine
-Insight-oriented psychotherapy
-Nifedipine

28. M 50 years with Prostatic Cancer with bone metastasis. Treatment ?

radical prostatectomy
-Radiotherapy
-Hormonal therapy in the form of total androgenic blockage
-IV chemotherapy

29. Pt with family history of urticaria, presented with urticaria ... investigation revealed C1 esterase inhibitor deficiency ... Diagnosis. ?
-Hereditary Angioedema

30. thickened upper Lt. lip with mild vesicles ... Diagnosis ?
-Urticaria
-Angioedema
-HSV infection

31. Erithematous Vulva with whitish lesion of Candida of Groin & Satellite lesions .. what is the predisposing disease ?
-DM
-CA. vulva
-Lichen sclerosis

32. Pt with sudden cough & pain in the Rt. side of the chest .. you suspect aspiration of foreign body .. what finding of the C-X ray ?
-Hyperlucent Rt. side

33. Defrentiaion between Maxilary & Zigomatic fractures ???????

34. calculation of the effectiveness of a vaccine

Incidence Non Vaccinate - Incidence Vaccinated

--------------------------------------------------------------- x 100
Incidence Non Vaccinate

35. child chalking during eating .. he became Cyanotic, agitated, with forceful breathing .. 1st action to do is :
-Hit him from his back while head downward
-Introduce your finger in his mouth

36. 17 years F. at stage 3 Tanner still not menses .. management ?

-Examination of the pelvis
-Chromosome analysis
-Estrogen Progesterone level
-Reassurance

37. asthmatic Pt. presented in the ER with Dyspnea , used to inhaled salbutamol with no Improvement.. PE shows dyspnea slit rhonchi
at the upper chest & neck ... management. ?
-IV. fluid + Aminophine
-Coricosteroids Inhaled
-Inhaled Salbutamol + IV hydrocortisone + IV Fluid

38. Alfa fetoprotein Increased in

-Menengomyelocele
-Renal Agenesis
-Down Syndrome

39. pt with abnormal pap smear .. what is the next step ?

-Colposcopy

40. 60 years F. presented with 5 x 5 cm. adnexal mass .. management. ?

-Surgery
-Chemotherapy
-Radiotherapy

41. Pt. found unconscious on the floor behind the bar, alcoholic, ER agitated semiconscious ... PE shows laceration on the head, all the
limbs can be moved, all the others are normal… what is your action?
-CT of the head
-IV. fluid + Observation
-Discharge

42. Pt. fail down from the 2nd floor on his back .. the following will be part of the Initial management EXCEPT :
-Cervical collar
-IV. fluid
-Spine X Ray
-Urinary catheter

43. tertiary prevention is

-Rehabilitation.

44. in the ER. young Pt treated with Procainamide his BP. decreased to 80\60 you tried another time with Procainamide .. his BP. still
decreasing .. what to do ?
-Benztropine
-Saline perfusion
-Digitalis
-Defibrillation
-Intubation

NB. the Pt. had Arrhythmia with hypertension (that’s why we gave him procainamide) & because its not decreasing we have to
defibrillate him ...

45. F 23 years present with fibroadenoma of the Lt. breast in the lower medial quadrant of the breast all are possible EXCEPT :
-Give Estrogen
-Give Progesterone
-Fine needle aspiration will bring clear liquid
-Mammography can show abnormality
-The growth of the Tumor following cycles

46. F. febrile with tumor in upper Rt. quadrant of the anus .. the mass is painful & red .. what to do ?
hot bandages
-Cold sitz baths
-Surgery
-Systemic Antibiotics
-Topical Antibiotics

47. child with juvenile poliposis .. possible complication :

-Diarrhea
-Painless bleeding
-Painful bleeding
-Malignancy (cancer)
-Non of the above

48. a mother brought hear 12 years daughter who present repetitive UTI temp. 38.5 , IVP & cystography are normal .. what is the best
test to do :
-Urine culture
-US & voiding cystography
-Blood culture
-Cystoscopey
-None of the above

49. fibroadenoma of the breast what is false :

-The most common benign tumor
-Fine needle aspiration bring clear fluid
-True solid tumor
-Tumor easy to find because encapsulated

NB. check it alone

50. F pregnant 28 years .. with nocturnal numbness in hands & forearm which wakes hear up for 3 months .. she also have difficulty
grasping objects .. what is the most likely etiology ?
-Dermatomiosis
-Abruptio placenta
-Multiple sclerosis
-Carpal Tunnel Syndrome
-Hyperventilation syndrome

51. 72 years old with heart failure with high blood pressure treated for long time. He was brought to E R for hypotension 80\60 HR 110,
what to give ?
-Procaine
-Lidocaine
-Cardioversion
-Digitaline
-Furosemide

52. Post-op. of Pancreas .. what is the cause of hypovolemic shock ?

-Initial necrosis of acute pancreatitis has produced tripsine
-Septic shock
-Loss of liquids
-Side effect of anesthesia

NB. not sure

53. 68 years F. with history of Hysterectomy, came to see u because of micturation trouble at effort, no digestive trouble, she has a
feeling of a painless mass intravaginaly, she has to try twice in order to void her bladder what is the diagnosis ?
-Rectocele
-Cystocele
-Prolapse (Prosedentia)
-Urethral sphincter spasm
-Post-surgical stricture

54. young M. feels sudden crack in his calf, what is the best clinical sign to diagnose Achilles tendon rupture ?
-Decreased dorsal flexion
-Impossibility to walk on the toes
-Increased passive dorsiflection of the foot
-Squeezing calf does not passively planter flex foot

55. farmer 74 years M. present with bilateral semetrical neaurosensorial defenses , PE is normal . diagnosis ?
-Autosclerosis
-Professional defenses
-Acustic neuroma
-Presbiacusis
-Circulatory deficit

NB. Most common cause of hear losing in elderly is presbiacusis

56. F. 45 years with decreased visual acuity, no pain , no tears. what do u exam first ?
-Tonometry
-Refraction
-Angiography
-Neurologic test
-Rheumatoid factor screening

57. Burned Infant 2nd degree in the upper limb, what do u do ?

-Debrid & skin graft.
-Debrid & bandage
-Debrid & topic cream
-Clean the wound & systemic antibiotic
-Local care only

58. Cyclist attacked by bee comes to emergency with hypotension 80\60 , Heart rate 115 .. what do u do first ?
-Antihistamine H1 & H2
-Saline perfusion
-Epinephrine Injection
-Intubation
-IV. steroid

NB. we also give it by subcutaneous or IM. & in children IV or Endotracheal tube

59. child 5 years bitten by the neighbors dog .. the dog received all the vaccines. what do u do ?
-Observe the dog 10 days & anti rabbi serum
-Observe the dog & anti rabbis serum & vaccine
-Kill the dog
-Vaccinate the kid
-Observe the dog

60. F. 28 years present with chronic rhinorrhea , in the exam you found mucousal nasal atrophy .. diagnosis ?
-Sinusitis
-Cocaine intake
-Nasal poliposis
-Allergic rhinitis

61. F. 45 years back from a plane travel , complains vertigo, tenitus, moderate hearing loss, BP is 160\110 .. Diagnosis ?
-Hypertensive crise
-Miners disease
-Migraine
-Acustic neuroma
-Barotaruma

62. what is the most common cause of lung abscess in post-Op pt.
-Bacterial discrimination from operative site
-Atelectasia
-Pneumonia
-Aspiration

63. M. 25 years when he goes to toilet, he complains of painful defecation in the anal region, at the exam you will find bluish mass at
the anal margin.. what is the Diagnosis ?
-Hemorrhoids internal sclerosed
-Hemorrhoids external strangulated
-Hemorrhoids external thrombosed
-Pyelonedle cyst
-Poliposis

64. all the following tumors favorized by TOBACCO Except...

-Bladder
-Esophagus
-Liver
-Cervix
-Lung

65. 5 years child have been beaten by a dog .. he had a deep wound, the dog is in a safe place .. what do u do ?
-Disinfect & clean the wound & put bandage

66. breast feeding women with DVT. treatment. ?

-Warferin
-IV. heparin
-Antistreptocinase
-Bandage

67. immediate post-op presents sudden hallucination , agitation & pretend that was miss treated .. Diagnosis ?
-Psychosis
-Depression
-Post-op delirium
-Analgesic withdrawal syndrome

68. a pt consult u for painless testicular swelling , transilumination was (-) after minor trauma ... Diagnosis ?
-Spermatocele
-Epidedimitis
-Varicocele
-Hydrocele
-Germinoma

69. F. 47 years present with sudden strong pain of the Rt. upper quadrant with fever 38.5 vomiting, no jaundice ... Diagnosis ?
-Colidutal obstruction
-CA of pancreas
-Acute cholicystitis
-Acute hepatitis
-Biliary lithiasis

70. Pt refared to u by his dentist because of whitish lesion at the base of the tongue .. what is your attitude ?
-Biopsy
-Identification of germs
-Ask for a correction of his dental prostheses
-Treat him by anti micotic oral bath

71. young boy present with frequent episode of rhinitis with purulent discharge & fever, from a maxillary sinus, what is the most likely
complication if untreated ?
-Purulent meningitis
-Ethmoidal sinusitis
-Orbital cellulitis
-Frontal sinusitis

72. F pt. PE. painless mobile mass on Rt. upper quadrant without fever or Jaundice, what is the most likely diagnosis ?
-Tumor of Lt. inferior lobe of the Liver
-Hydrocholecyst
-Tumor of superior pole of the Rt. kidney
-Liver metastasis

73. child 13 years obese present with painful Rt. knee & pain of Rt. hip with difficulty walking & reduced abduction & Internal rotation ,
what is your diagnosis ?
-Juvenile Arthritis
-Septic arthritis of the hip
-Avascular necrosis of femoral head
-Cartilage dysplasia
-Slipped capital epiphysis

74. Pt. fell on his hand , Emergency X Ray was normal , but the pt. complain from painful wrist at abduction. management. ?
-Cast
-Explain him that the pain will disappear after 2 weeks, its normal.
-Bandage
-Short cast plus X Ray in 15 days
-NSAID's

NB. diagnosis is Scaphoid fracture & its very difficult to see it in X Ray.

75. Indication of elastic band in Hemorrhoids is :

-Thrombosed Hemorrhoids
-Type II bleeding Internal Hemorrhoids
-External Hemorrhoids
-Angioma

76. 65 years obese Pt. complains of strong & sudden mid abdominal pain radiating to Lt. flank, what is your diagnosis ?
-Acute pancreatitis
-Cholecystitis
-Ureteral stone
-Mesenteric Infarctus
-Rupture of abdominal aorta

77. Pt. complains of Rt. upper quadrant pain & fever , PE shows slight abdominal tenderness, what investigation do u do to comfirme
the diagnosis ?
-Biopsy
-Barium meal
-Peritoneal Aspiration
-Rectosigmoidoscopy
-Echography

78. most common complication of Epidural Anesthesia in a pregnant woman:

-Fetal hypoxia
-Hypotension
-Decrease in contraction
-Arrest of labor

79. Child pulled by his mother from his arms .. PE shows that one arm is adducted & the forearm is on pronation. what is the most
likely diagnosis ?
-Humeral fracture
-Laxation of the Inferior extremity of the ulna
-Subluxation of ulnar head
-Rupture of rotator cuff

80. defense mechanism in phobia = displacement, avoidance

81. defense mechanism in borderline PD. = splitting

82. Pt. doing the opposite of what he believes is good = reaction formation.

83. Pt. on lithium therapy complain of fatigue , increased weight , heat intolerance , what test would you order ?
-Thyroid stimulating hormone level test
84. Pt. presented with pulmonary edema & BP. 180\95 , what is the best treatment ?
-Furesemide

85. 47 years F. with jaundice & history of nausea & vomiting , anorexia & depression , she is on Rifampicine, INH, Pyridoxine. PE
Hepatomegaly + tenderness, Investigation reveal :SGOT, SGPT increased x 5, ALP slightly increased . the most likely diagnosis is :
-Drug induced hepatitis
-Viral hepatitis
-Acute pancreatitis
-Liver CA.

86. Pt. complain from visual spatial defect , where is the lesion ?
-Rt. cerebral hemisphere
-Lt. cerebral hemisphere

87. 4 years African boy on septrine for tonsillitis presented with Jaundice , Investigations : Hb. 9.8 gm % , reticulocytes count 8 % , Hb.
electrophoresis : Hb.A . what is the most likely diagnosis ?
-Sickle cell anemia
-Thalassemia
-Spherocytosis
-G6PD deficiency

88. F. 65 years present with recurrent painless lower GI bleeding, colonoscopy, gastroscopy, barium enema, endoscopy & upper GI
series all are normal, what is the dig. ?
-Rt. colon angiodysplasia

89. F. 50 years operated for cholicistectomy presented with heavy wound bleeding , she gives you a history of massive bleeding when
she had a tooth extraction , what will you find ?
-Increased PTT + Increased BT
-Increased PTT + decreased BT
-Normal PTT + Increased BT

NB. diagnosis is Von Willebrand disease

90. pregnant woman with abruptio placenta, developed echymosis & bleeding , your diagnosis is DIC. what is the most specific test to
confirm it ?
-Increased FDP (fibrine degradation product)

91. RTA (road traffic accident) Pt. with multiple fracture & trauma, 24 h later he develop tachypnea, PCO2 = 32, PaO2 = 50. X Ray shows
bilateral infiltrates what is the next step to do ?
-Lung scan
-Ventilator

92. all the following are primary prevention except :

-Immunization
-Health related education
-Pap smear

93. pregnant lady developed postpartum hemorrhage after vacuum delivery , what is the most likely cause ?
-Uterine atony
-DIC

94. primigravida after delivery of a 4000 gm baby, after a prolonged labor could not urinate. What is the most likely cause ?
-Bladder atony

95. Child RTA present with urethral bleeding & urinary retention. Management ?
-Retrograde urethrogram

96. M. 25 years RTA, 4 h. Later developed Rt. Flank pain with heamaturia. What to do ?
-IVP.

97. F. 65 years complains heamaturia with clotting, frequency, nocturia & no dysuria. Diagnosis. ?
-Bladder CA.

98. What is the most likely cause of no changing in variability in fetal heart on NST (non stress test) ?
-Fetal sleep

99. NST indicated in all except :

-IUGR
-DM
-HT.
-40 weeks Pregnancy

100. The most specific test in UTI in infants is :

-Sample obtained by catheter

101. How do u calculate the natural growth of a country ?

-Crude birth rate - death rate

102. Child 4-5 years can do all of the following except :

-Imitation
-Group play
-Autonomy
-Abstract thinking

103. All of the following are normal during pregnancy except :

-Spider telangiectasia
-Heart rate of 90
-Decreased BP.
-Palmar erythema
-White blood cell 3000

NB. The WBC is increased in pregnant But with impaired function

104. What is the best treatment of mild toxemia of pregnancy ?

-Bed rest & Lt. Lateral position

105. F. 16 years old complaining of loss of weight of 10 Kg. All of the following suggest non organic cause except :
-Does not worry about weight loss
-Engaged in athletic activity
-Family history of eating disorder
-Persistent complain of fatigue

NB. Its a case of Anorexia Nervosa

106. Which of the following suggest a DM in a 20 years M. ?

-Loss of weight despite good eating

107. All of the following suggest thyrotoxicosis except :

-Loss of weight
-Meanorrghe
-Diarrhea
-Sweating

108. Young lady present a feature of hypothyroidism (cold intolerance, fatigue, anorexia, weight gain, meanorraghe, dry & rough skin,
hair dry & coarse .... ) TSH is increased & T4 is low. What is your treatment ?
-Start L-thyroxine

109. Lady develop severe PPH (post partum heamorrage), she present after 6 wks with fatigue an inability to breast feed (absence of
breast milk). All will be decreased except .
-Prolactin
-TSH
-LH
-T4

NB. Diagnosis. is Sheehan’s syndrome (postpartum pituitary infarct)

The T4 has got a long 1\2t ..

110. Lady 15 days after delivery complain of epigastric pain radiating to the back with nausea & vomiting , history of group B strep.
Infection. The pain is relieved by leaning forward, PE. reveal an epigastric tenderness what is the diagnosis ?
-Pancreatitis

NB. The pain is relieved by leaning forward (Inglefinger’s sign)

111. Lady who delivered after prolonged labor present to you after 2 days. All of the following suggest Endometritis Except :
-Tender uterus
-Foul smelling
-Uterus 9 cm. below umbilicus
-Pyrexia
112. Lady after delivery develops fever. She still febrile after 5 days of antibiotic therapy. PV exam is normal. Diagnosis. ?
-Pelvic-thrombo-phlebitis

113. Young M. Complains of pain after defecation. PE reveal a blue mass , tender . Diagnosis. ?
-External thrombosed Hemorrhoid
-Internal thrombosed Hemorrhoid

114. Recurrent perineal abscess associated commonly with :

-Perianal fistula

115. All of the following are contraindicated to epidural anesthesia except :

-Decrease platelet
-Bleeding diathesis
-Sepsis at site of injection
-Decreased BP.
-Labor at 35 wks.

116. M. came after 24 h. of attack of renal colic. IVP done shows stone 0.5 cm. at L4, the kidney is slightly enlarged. Management ?
-Observation
-Tranurethral removal of the stone after cystoscopy

NB. Conservative treatment if the stone is less than 5 mm & no complication.

117. M. 55 years with painless mass in scrotum (2 cm) transillumination is (+ve) . Diagnosis. ?
-Hydrocele
-Spermatocele
-Hernia
-Varicocele
-Testiular CA.

118. M. 25 years presented with solid scrotal mass, after minor trauma to the testis. Diagnosis. ?
-Seminoma

119. Experimental study done with 2 drugs, shows that the result is significant, the epidemiologist wrote in his report that “p” is less
than 0.5. What does that mean ?
-The association is less than 1\20 (5%) likely to be due to chance alone

120. Ultrasound will diagnose all the following at 20 wks EXCEPT :

-Twin pregnant
-Poyhydramnios
-Trisomy 21

121. Alfa feto protein is increased in :

-Edward syndrome
-Down’s syndrome
-Myelomeningocele

122. Psoriasis ... All except :

-Decreased C3 , C4

123. Old man complain of low back pain, X Ray shows decreased joint space & osteophytes diagnosis ?
-Degenerative joint disease (osteoarthritis)

124. Boy 2 years, complain of knee pain, PE tender but not swollen knee, slightly warmer than the other joint. What is the best
investigation to do ?
-Xray of the knee
-Bone scan

125. Pt. present with fracture, you want to make a caste. You advise him about compartment syndrome. What will appear first ?
-Pallor
-Coldness
-Numbness
-Decreased pulse
-Paralysis

126. The most effective treatment in Osteoporosis is :

-Exercise
-Analgesics
-Vitamins
-Estrogen
127. Pt. On OCP complain of amenorrhea 3 months after using the pills. What is true about amenorrhea?
-Due to high progesterone
-Due to Estrogen

128. Definition of potential years of life lost (PYLL) : .................................

129. Sexually active lady present with dysuria & vaginal discharge. All the following can cause this condition EXCEPT :
-Gonorrhea
-Chlamydia
-Trichomonasis
-Condyloma Accuminata

130. Bacterial vaginosis EXCEPT :

-Clue cells
-Fishy odour with KOH test
-Decreased lactobacilli
-Vaginitis
-Frothy offensive discharge

131. Pt. complain of vertigo, how can you diagnose labyrinthitis ?

-Nystagmus

132. Pt. Operated for pituitary tumor, then he developed polyuria, dehydration inspite of receiving 4 L IV fluid. What will u give ?
-Give more IV fluid
-Start oral rehydration
-Give vasopressin (DDAVP)

NB. This is a case of SIADH

133. Alcoholic Pt. Complain of instability in gait, he uses a cane to avoid frequent fall. Romberg test is (+ve). what is your diagnosis ?
-DT.
-Alcoholic withdrawal
-Alcoholic cerebellar syndrome

134. Pt. complain of Tinnitus in Rt. ear, on Exam u found sensorineural deafness. Diagnosis. ?
-Acustic neuroma

135. New born, all the following are increasing risk factors of deafness EXCEPT:
-Family history
-Used of gentamycin
-History of CMV infection
-Delayed speaking

136. What will be your management. For a 3 years boy with stuttering ?
-Reassurance

137. All the following neonates are prone to hypoglycemia EXCEPT:

-IUGR
-Diabetic mother
-Normal infant born at 36 wks
-Hypothermia
-Non of the above

138. 32 years F. consult u for inability to conceive for 2 years, she is married who has 3 children from another woman. Temperature
chart shows ovulation. What to do first ?
-B-HCG
-Hysterosalpingogram
-Progesterone at 21 day
-Semen analysis

139. F. 18 years height 158 cm , normal breast, with primary amenorrhea , PE small uterus, all of the following to be done EXCEPT :
-TFT (Thyroid) & Prolactin level
-Progesterone test
-FSH, LH level
-Laparoscopy
-Skull X Ray

NB. MCCQ 2001 (GY 11) we normally do the others in the same order as it is ..
140. F. 21 years , with 2 months history of fibroid mass, asymptomatic. Management ?
-Reassess after one year
-Myomectomy
-Hysterectomy
-Hormonal therapy

141. What is the most common source of mercury poisoning in Canada ? & who are the most exposed group of people in Canada ?
-Fish - (native Indians)

142. Which of the following you should not notify the police about ?
-Child abuse
-Spouse abuse
-Child neglect
-None of the above

143. You do a stress test ECG for a Pt. All are significant EXCEPT :
-ST decreased by more than 2 mm
-Chest pain
-ST increased (upward slopping)
-Decreased in BP by more than 50 mmHg.

144. All are true with post infectious GN. Except :

-Normal C3 , C4
-Hypoalbuminemia
-Increased cholesterol
-Proteinuria is more than 2 gm.

145. M. 65 years , present with low back pain anemia & hypocalcemia. What will you do to confirm the diagnosis ?
-WBC. Count
-Bone marrow aspiration
-Platelet count

146. HIV Pt. With fever & weight loss , he may have all of the following EXCEPT :
-Esophageal candidosis
-Mycobacterium Avium
-Mycoplasma pneumonia
-CMV infection
-Mycoplasma cellulari

147. F. 35 years with ataxia, weakness of the Lt. Side of body , dysphagia & visual trouble . PE reveals diplopia & nystagmus. What is
the Diagnosis. ?
-Multple Sclerosis.

148. What is the most common complication of Juvenile Rheumatoid Arthritis:

-Iridocyclitis
-Hepatitis
-Nephritis
-vasculitis

149. M. Brought to u by police, for assaulting a 12 years old boy. When asked his name by the police , he said that he don’t know , &
when u ask him how many legs does the horse have , he said 5 . What is the diagnosis ?
-Malingering
-Factitious disorder
-Antisocial personality
-Fugue

150. In which pathology you have gloves & stocking anesthesia ?

-DM.

151. M. With bipolar disorder came with agitation & aggressive behavior. Best treatment ?
-IV Haloperidol
-Lithium & Antipsychotics

152. All are seen in DT. Except :

-HT.
-Fever
-Tachycardia
-Fixed hallucination

153. Best prophylaxis for a Canadian traveling to a Malaria area with no resistant train is :
-Chloroquine

154. Pt. Diagnosed with dysthymia what is the best treatment :

-Psychotherapy
-Fluoxetine
-Imipramine

155. In cardiac arrest due to Ventricular Fibrillation , what is true ?

-NaHCO3 should be given every 5-10 minutes unless blood gas are known
-Lignocaine must be given
-DC cardioversion first

156. Dyspepsia, all are helpful EXCEPT:

-Antacids
-Elevate bed head
-Cimetidine
-Misoprostol

157. Asthmatic Pt. On steroids , has to go for operation for perforated duodenal ulcer . What will u do ?
-100-200 mg Hydrocortisone IV before the surgery
-Beta-agonist inhalor before the surgery

158. Chinese restaurant food poisoning. All are true EXCEPT :

-Symptoms within 1\2 h.
-Resolves after 24 h
-Symptoms of ashma + ataxia + dyspnea

NB. Monosodium glutamate is the cause of this syndrome (its a pharmacological but not allergic reaction. Dose related symptom of
burning sensation throughout the body, facial pressure, anxiety & chest pain)

159. RA. Pt. On aspirin present with a normocytic normochromic anemia . All are true except:
-Respond to treatment with B.12
-Feritine maybe Increased
-Decreased serum Iron
-Normal total Iron binding capacity

160. What is the most common cause of congenital heart failure in NB.
-VSD
-ASD
-TGA
-Tetralogy of Fallot

161. A nurse with hypoglycemia & decreased C-peptide. What to do ?

-Refer to Psychiatrist

162. All are feature of TSS Except :

-Fever
-Decreased BP.
-Pustular skin lesion
-Erythroderma

163. All are feature of KAWASAKI disease EXCEPT:

-Fever for 5 days
-Purulent conjunctivitis
-Skin rash
-Fissure of lip
-Strawberry tongue

164. Variable deceleration commonly seen in :

-Uteroplacental Insufficiency
-Cord compression
-Sleeping fetus

165. All increase the level of carbamazepin EXCEPT :

-Cimetidine
-Estrogen
-Phenobarbital

166. M. Present with Rt. Side horner’s syndrome & contralateral loss of sensation of the body. Where is the site of the lesion ?
-PICA
-ICA
-Internal Carotid

167. Pt. With hypokalemia . All true EXCEPT :

-Diarrhea
-Paralytic ileus
-Hypotension
-Hypoventilation
-Muscular weakness
-Polyuria & polydepsia

168. All are live attenuated vaccine except :

-BCG.
-Vaccine of yellow fever
-Polio
-Measles
-Diphtheria

169. How often do u give a booster in people previously adequately immunized against tetanus :
-Every 10 years

170. All are included in the routine immunization EXCEPT:

-Measles
-Pneomococus vaccination
-Mumps
-Rubella

171. Heamophilus Influenza contact, prophylaxis is :

-Refampicine

172. Pregnant , 8 wks, came into contact with a boy suspected of having Rubella infection . Management ?
-Rubella vaccination
-Give Rubella IgG.
-Do antibody titre in the pregnant lady
-Therapeutic abortion

173. Farmer came with a nail in his foot & temp. of 38.2 . Management :
-Antibiotics
-Tetanus toxoids + antititanus Ig. + antibiotic
-Antitetanus Ig.

174. F. Young present with Meanorrhagea. Commonest cause is :

-Deficient luteal phase
-Short secretory phase
-Prolonged secretotey phase

NB. Anovulation is the best answer if there.

175. Postmenopausal lady with MI. & she is an active smoker. She does not want to stop smoking. She is on Hormonal Replacement
Therapy. What advice do u give ?
-Stop Estrogen & start exercise

176. Post-Op continued to bleed despite 10 units of packed RBC. Transfusion. What is the cause ?
-Hypercalcemia
-Hyperkalemia
-Dilutional thrombocytopenia

177. RA. Pt. On ASA. Developed ITP . What is the treatment ?

-Steroids

178. Pt. Developed excessive menstrual bleeding & purpura . All the following lab. Finding are expected EXCEPT:
-Decreased Hb.
-Decreased platelets
-Increased platelets
-Prolonged bleeding time

179. Bartholinitis abscess. What is the treatment ?

-Antibiotics
-Marsupialization
NB. I & D is a good answer as well.

180. Pt. With lymphadenopathy & splenomegaly & raised WBC . What is the confirmatorey test ?
-CBC deferential
-Bone marrow aspiration

NB. Leukemia case

181. Pt. With bilateral hilar lymphadenopathy with micronodular infiltrates. All can give this feature EXCEPT ?
-Sarcoidosis
-TB.
-Transbrbronchial bronchogenic carcinoma

182. Pt. With painful bluish mass protruding from the anus. Diagnosis. ?
-Prolapsed anal piles
-Thrombosed external piles
-Internal piles

183. All can Cause Pruritis ani EXCEPT:

-Laxative
-Hemorrhoids
-Fecal incontinence
-Colorectal CA

184. F. 24 years with (+ve) preg test , present with 2 days vaginal bleeding, US shows 3 cm mass in the Lt. Adnexa & empty uterus,
pregnant Sympt & signs of preg has disapeared & the cervix is closed. Diagnosis. ?
-Complete abortion + luteal cyst.

NB. u consider ectopic pregnancy until otherwise proven.

185. Indication of C-section in breech presentation is:

-Footling
-Frontbreech presentation

186. Prevalence definition: total number of cases in a population at a given time.

life birth
187. Crude birth rate = ------------------------------- x 1000
Total medial population

188. The tree of autosomal dominant transmission

189. F. Consult you because of a possibility of her offsprings (kids) having Huntington’s Chorea. Her father is affected. Her husband
family don’t have this disease What is the possibility that her children will develop the disease ?
-50 %
-0 %
-25 %
-100 %

190. F. With pregnancy like symptoms, US shows grape like masses in the uterus. All true EXCEPT:
Multiple gestation
-Bilat. Ovarian cyst
-Hyperthyroidism
-Hypothyroidism, coma, preorbital myxedema

191. All have risk factor to develop preeclampsia:

-Nulipara
-DM
-History of preeclampsia
-Multiparity

192. Pregnant Pt. 20 weeks The uterus size is 25 cm. All true EXCEPT:
-Normal pregnant
-Wrong estimation of gestational age
-Twin pregnant
-Bilat. Renal dysgenesis
193. Old lady with ankle edema at the right medial malleulus, with superficial ulcer & surrounding scar. Diagnosis. ?
-Venus insufficiency
-Venus valvular insufficiency

194. Preg. Lady with known fibroid, complaining from abdominal pain
-Red degeneration

195. M. 16 years old complain from loss of weight, he is passing bloody diarrhea, Investigation show normal upper indoscopy &
segmoidoscopy. What to do next ?
-Upper GI series

196. Child 4 years old, presented with post. Mediastinal tumor. What is the commonest germ cell tumor ?
-Thymoma
-Neuroblastoma
-lymphoma

197. PT. With fat malabsorption, passing floating stools + loss of weight & easy bruising. Diagnosis. ?
-GI lymphoma
-GI TB
-Glutane antheropathy (celiac disease)
-Repeated episode of pancreatitis

198. Pt. With DKA. All occur EXCEPT:

-Increased Amylase
-Abd. Pain
-Increased K.
-Increased osmolarity
-Leukocytosis

NB. Merck 1999 (p.178) in DKA. serum amylase typically elevated while K is Increased or normal

199. F. Pt. On Insulin therapy, she has a baby. You will suggest her the following about Insulin Except:
-Hold insulin until the baby start eating

NB. (always Insulin & Heparin are SAFE during pregnancy & lactation)

200. Best site to obtain smear for Gonorrhea in a woman is:

-Vulva
-Vagina
-Cervix (mouth of the wound)

201. Which stage of sexual excitement according to Tonom criteria when the female is having clitoral erection, increased vaginal
secretion, nipple erection ?
-Early excitement
-Resolution
-Late excitement
-Latent phase

202. F. With difficulty caring shopping bag, weak abduction of the thumb + minor wasting of the thumb (minor thenar atrophy)
Diagnosis. ?
-Carpal tunnel syndrome

203. Radial nerve injury at the level of the head of Radius. What will u find ?
-Dropping wrist

NB. Merck 1999 (p.1493) The Saturday night palsy is another name for the Radial nerve palsy.

204. Which of the following is a sexual desire abnormality

-Does not imagine sexual fantasies

-No sexual activity for more than 2 wks
-Nervous about sexual act
-Try to avoid partner contact

205. Transvestitism disorder, all true EXCEPT

-Dressing clothes of other sex for sexual excitement

-More common in male
-They are female
206. All are known to cause depression EXCEPT:

-Clonidine
-Cimetidine
-Cyclosporine
NB. The drugs which cause depression are : Anti-HT, Anti-Parkinsonian, Hormones, Steroids, Anti-TB, Anti-Neoplastic

207. Pt. Brought to u mute & inaccessible to examination. Diagnosis.

?-Catatonia MCCQ PS6 (2001).

208. M. 35 years Found in the street wandering, he doesn't know his name, talk to him self. All are possible etiology EXCEPT:

-Schizophrenia
-Fugue
-Alzheimer disease

209. Girl came with midline neck cyst, which moves while protruding the tongue (with swallowing). Diagnosis.

?-Dermoid cyst
-Brachial cyst
-Thyroglossal duct cyst

210. All are routine investigation for an old lady with urinary incontinence EXCEPT:

-Urine analysis
-Cystogram
-Urinary diary
-Direct visualization of incontinence when Pt. with full bladder while coughing

ANSWER KEY

1. D
2. A
3. D
4. D
5. D
6. A
7. A
8. A
9. A
10. A
11. A
12. A
13. A
14. B
15. A
16. A
17. D
18. A
19. A
20. A
21. A
22. A
23. A
24. D
25. A
26. C
27. A
28. B
29. A
30. C
31. A
32. A
33.
34.
35. A
36. D
37. C
38. A
39. A
40. A
41. B
42. D
43. A
44. D
45.
46. B
47. C
48. B
49. B
50. D
51. D
52.
53. B
54. D
55. D
56. A
57. C
58. C
59. E
60. D
61. B
62. D
63. C
64. C
65. A
66. B
67. C
68. C
69. C
70. A
71. B
72. B
73. E
74. D
75. B
76. D
77. E
78. B
79. C
80. A
81. A
82. A
83. A
84. A
85. A
86. A
87. D
88. A
89. A
90. A
91. B
92. C
93. A
94. A
95. A
96. A
97. A
98. A
99. D
100. A
101. A
102. D
103. E
104. A
105. D
106. A
107. B
108. A
109. D
110. A
111. C
112. A
113. A
114. A
115. E
116. B
117. A
118. A
119. A
120. C
121. C
122. A
123. A
124. B
125. C
126. D
127. A
128.
129. D
130. D
131. A
132. C
133. C
134. A
135. D
136. A
137. E
138. B
139. E
140. A
141. A
142. B
143. C
144. A
145. B
146. C
147. A
148. A
149. A
150. A

151. B
152. D
153. A
154. B
155. C
156. D
157. A
158. C
159. A
160. A
161. A
162. C
163. B
164. B
165. C
166. A
167. A
168. E
169. A
170. B
171. A
172. C
173. B
174. A
175. A
176. C
177. A
178. C
179. B
180. B
181. C
182. B
183. D
184. A
185. A
186.
187.
188.
189.
190. D
191. D
192. D
193. B
194. A
195. A
196. B
197. C
198. D
199. A
200. C
201. A
202. A
203. A
204. A
205. C
206. C
207. A
208. C
209. C
210. D