MCCQE1

1.WhichofthefollowingiscorrectregardingWernikesEncephalopathy:
-OftendevelopsintoKorsakof'sevenwhentreated
-It has a mortality rate of 70 %to 80 % if untreated
-Thetreatmentisthiamine100mg.POdailyfor5days
-ThesymptomsincludeNistagmusataxiaandopisthotonos
-Noneoftheabove*

2.WhichisthemostseriouscomplicationofthesupracondilarfractureoftheHumerus?
-Acompartmentsyndromeofforearm
-Failuretoheal
-Healinginanonanatomicposition
-Injuryintothemediannerve.
-PermanentrestrictionoftheElbowmotion.

3.WhichoneofthefollowingdescriptorsofadiagnostictestisInfluencedbytheprevalenceofthediseasebeingtestedfo
r:
-Specificity
-Sensitivity
-Accuracy
-Positivepredictivevalue
-Reliability

4.A43yearsMadmittedforEmergencyGastrectomeypresentconfusiononthe3rdpost-
Opday.complainsoflackofsleepduetocockroachesontheceilingheisnotedtobeflashed&tremelusbythenurse
sduringtheday..themostlikelyproblemis:
-Post-OpElectrolitesInbalance
-ParanoidSchizophrenia
-DepressionPsychosis
-DeleriumTremons
-Anoxicbrainsystem

5.Pt.withknowntypeIIDM.treatedwithClorpropamidepresenttoEDincomma..bloodsugar=1mmol/
L...yougivethePt1ampuleofD50W&thePtwakesuppromptley.whatisthenextappropriatemanagement:
-Giveanotherampulethendischarge.
-Give2ampulesthendischarge.
-Giveanotherampulethenobservetheptfor6h.intheED.
-Giveonemoreampule,admitthePt.&startIV.GlucoseInfusionwithfrequentongoingglucosemeasurement

6.Pregnant36weekswithvaginalwaterydischarge,management:
-dosterilespeculumexam

7.Barbituratewithdrawal=convulsion

8.Retrovarteduteruscomplain=asymptomatic

9.G5P4post-delivery, postpartumhemorrhage, mostlikely causeis :

-Uterineatony

10. Analskintaginchildassociatedwith,
-chronicAnalFissure

11. Childwithabdominalpainattacks,drowninghislegsup,mucouidbloodystool.Diagnosis?
-Intussusception

12. 1stsignoffootgangreneis=restpain

13. Pt.Mpaininbothlowerlimbswithweekpopletialarterypulsation,management?
transvertebralangiogram

14. basketballplayeravertedhisanklejointduringjumpingatmatch,onExaminationPainwithIncrease
dVariousrange.Management?
-Repairligamentsurgery
-Belowkneecast

15. cleanwoundcutwithlaceration&incompletesectionofnerve,management?
-SutureofwoundImmediately
-Leavethewoundopen

16. painonwalkingincreasein2nd&3rdmetatarsalboneofforefoot.Diagnosis?
-Stressfracture
-Sesamoidbone

17. Pt.68yearsgoingtoelectivesurgery,hehas4mo.historyofchestpain&gotsameattackatnightbeforethed
ayofsurgery,whatdoudo?
-Lignocainebeforesurgery
-Trinatreateduringsurgery
-SendhimforICU
-Postponetheoperation&checkfunctionofthecoronaries

18. collagestudentF20yearspresentedwithlowerabdominalpain,PEbilaterallowerabdominaltenderness,febr
ileVaginalexam:tender withcervicalmobilization,pregnanttest(-).Diagnosis?
-Acutesalpengitis
-Ectopicpregnancy
-UTI

19. vaginalbleeding,stoopedatthedayofadmission,pregnancytestis(+)USshowsemptyuterus&leftadnexalmass.
Diagnosis?
-Ectopicpregnancy

20. youngPt withhistory ofnon productive coughbut clinicallywell ..C-X ray showsbilateral
basalInfiltration ..Diagnosis. ?
-MycoplasmaPneumonia

21. PtwithUlcerinsoleofthefoot,at2nd&3rdmetatarsaljointXRaynecrotic&destroyedpartof2nd&3rdmetatars
albone..whattodo?
-Radical debridment
-Abovekneeamputation
-Dailysteriledressing
-Oralantibiotic

22. Problemwhichcausemostworkdays=backpain

23. Nicotinicskinpatchyiscontraindicatedin:
-Pregnancy
-CVA
-IschemicHeartdisease
-Alcoholic

NB.(notsure)

24. Psychotherapyissuperiortomedicationin:
-Schizophrenia
-Bipolardisorder
-Alcoholic withdrawal
-Dysthimia

25. motherworriedaboutherchildbecauseofhistoryofmyopathyinfamily..whatInvestigationtobedone1st?
-CPK
-Musclebiopsy
-Nervebiopsy
-EMG

26. PtonLithiumtherapybecameweak,lethargic,Intoleranttoheat.whatInvestigationmustbedone?
-Lithiumlevel
-BP
-ThyroidFunctiontest

27. surgicalnurse25yearsoldisconcernedthatsheisloosinghermind,forthepast6monthssheisbeenpreo
ccupiedwithcontamination,onhiswardshehasbeennottouchinganypatient,doorknobs...etc.
Shewasalsowashingherhandexcessively,whichofthefollowingtreatmentswillhelpinreducingherpreoccupationan
dhand
washing?
-Fluxetine
-Lorazepam
-Perphenazine
-Insight-orientedpsychotherapy
-Nifedipine

28. M50yearswithProstaticCancerwithbonemetastasis.Tr
eatment?radicalprostatectomy
-Radiotherapy
-Hormonaltherapyintheformoftotalandrogenicblockage
-IVchemotherapy

29. Pt with familyhistory ofurticaria, presentedwith urticaria ...investigation revealedC1 esteraseinhibitor

deficiency... Diagnosis. ?
-HereditaryAngioedema

30. thickened upperLt. lipwith mildvesicles... Diagnosis?

-Urticaria
-Angioedema
-HSVinfection

31. ErithematousVulvawithwhitishlesionofCandidaofGroin&Satellitelesions..whatisthepredisposingdisease?
-DM
-CA.vulva
-Lichensclerosis

32. Ptwithsuddencough&painintheRt.sideofthechest..yoususpectaspirationofforeignbody..whatfindingoftheC-
Xray?
-HyperlucentRt.side

33. DefrentiaionbetweenMaxilary&Zigomaticfractures???????

34. calculationoftheeffectivenessofav

accineIncidenceNonVaccinate-

IncidenceVaccinated
x
100IncidenceNonVaccinate

35. childchalkingduringeating..hebecameCyanotic,agitated,withforcefulbreathing..1stactiontodois:
-Hithimfromhisbackwhileheaddownward
-Introduceyourfingerinhismouth

36. 17yearsF.atstage3Tannerstillnotmenses..management?
-Examinationofthepelvis
-Chromosomeanalysis
-Estrogen Progesteronelevel
-Reassurance

37. asthmaticPt.presentedintheERwithDyspnea,usedtoinhaledsalbutamolwithnoImprovement..PEshowsdys
pneaslitrhonchiattheupperchest&neck...management.?
-IV.fluid+Aminophine
-CoricosteroidsInhaled
-InhaledSalbutamol+IVhydrocortisone+IVFluid

38. AlfafetoproteinIncreasedin
-Menengomyelocele
-RenalAgenesis
-DownSyndrome

39. ptwithabnormalpapsmear..whatisthenextstep?
-Colposcopy

40. 60yearsF.presentedwith5x5cm.adnexalmass..management.?
-Surgery
-Chemotherapy
-Radiotherapy

41. Pt.foundunconsciousonthefloorbehindthebar,alcoholic,ERagitatedsemiconscious...PEshowslacerationon
thehead,allthelimbscanbemoved,alltheothersarenormal…whatisyouraction?
-CTofthehead
-IV.fluid+Observation
-Discharge

42. Pt.faildownfromthe2ndflooronhisback..thefollowingwillbepartoftheInitialmanagementEXCEPT :
-Cervicalcollar
-IV.fluid
-SpineXRay
-Urinarycatheter

43. tertiarypreventionis
-Rehabilitation.

44. in the ER. youngPt treated withProcainamide his BP.decreased to 80\60 youtried another timewith
Procainamide ..his BP. stilldecreasing..whattodo?
-Benztropine
-Salineperfusion
-Digitalis
-Defibrillation
-Intubation

NB.thePt.hadArrhythmiawithhypertension(that’swhywegavehimprocainamide)&becauseitsnotdecreasingwe
havetodefibrillate him...

45. F23yearspresentwithfibroadenomaoftheLt.breastinthelowermedialquadrantofthebreastallarepossibleEXCE
PT:
-GiveEstrogen
-GiveProgesterone
-Fineneedle aspirationwill bring clearliquid
-Mammographycanshowabnormality
-Thegrowthofthe Tumorfollowingcycles

46. F. febrilewithtumorinupper Rt.quadrantoftheanus..

themassispainful&red ..whattodo?hotbandages
-Coldsitzbaths
-Surgery
-SystemicAntibiotics
-TopicalAntibiotics

47. childwithjuvenilepoliposis..possiblecomplication:
-Diarrhea
-Painlessbleeding
-Painfulbleeding
-Malignancy(cancer)
-Non ofthe above

48. amotherbroughthear12yearsdaughterwhopresentrepetitiveUTItemp.38.5,IVP&cystographyarenormal.
.whatisthebesttestto do:
-Urineculture
-US&voidingcystography
-Bloodculture
-Cystoscopey
-Noneoftheabove

49. fibroadenomaofthebreastwhatisfalse:
-Themostcommonbenigntumor
-Fineneedle aspirationbring clearfluid
-Truesolidtumor
-

Tumoreasytofindbecauseencapsulat

edNB.checkitalone

50. Fpregnant28years..withnocturnalnumbnessinhands&forearmwhichwakeshearupfor3months..shealso
havedifficultygraspingobjects..whatisthemostlikelyetiology?
-Dermatomiosis
-Abruptioplacenta
-Multiplesclerosis
-CarpalTunnel Syndrome
-Hyperventilationsyndrome
51. 72yearsoldwithheartfailurewithhighbloodpressuretreatedforlongtime.HewasbroughttoERforhypotension80
\60HR110,
whattogive?
-Procaine
-Lidocaine
-Cardioversion
-Digitaline
-Furosemide

52. Post-op.ofPancreas..whatisthecauseofhypovolemicshock?
-Initialnecrosisofacutepancreatitishasproducedtripsine
-Septicshock
-Lossofliquids
-Side effect of

anesthesiaNB.notsu

re

53. 68yearsF.withhistoryofHysterectomy,cametoseeubecauseofmicturationtroubleateffort,nodigestivetr
ouble,shehasafeelingofapainlessmassintravaginaly,shehastotrytwiceinordertovoidherbladderwhatisthe
diagnosis?
-Rectocele
-Cystocele
-Prolapse(Prosedentia)
-Urethralsphincterspasm
-Post-surgicalstricture

54. youngM.feelssuddencrackinhiscalf,whatisthebestclinicalsigntodiagnoseAchillestendonrupture?
-Decreaseddorsalflexion
-Impossibilitytowalkonthetoes
-Increasedpassivedorsiflectionofthefoot
-Squeezingcalfdoesnotpassivelyplanterflexfoot

55. farmer74yearsM.presentwithbilateralsemetricalneaurosensorialdefenses,PEisnormal.diagnosis?
-Autosclerosis
-Professionaldefenses
-Acusticneuroma
-Presbiacusis
-Circulatorydeficit

NB.Mostcommoncauseofhearlosinginelderlyispresbiacusis

56. F. 45years withdecreasedvisual acuity,nopain ,no tears.whatdo uexamfirst ?

-Tonometry
-Refraction
-Angiography
-Neurologictest
-Rheumatoidfactorscreening

57. BurnedInfant2nddegreeintheupperlimb,whatdoudo?
-Debrid&skingraft.
-Debrid &bandage
-Debrid& topic cream
-Cleanthewound&systemicantibiotic
-Localcareonly

58. Cyclistattackedbybeecomestoemergencywithhypotension80\60,Heartrate115..whatdoudofirst?
-AntihistamineH1&H2
-Salineperfusion
-EpinephrineInjection
-Intubation
-IV.steroid

NB.wealsogiveitbysubcutaneousorIM.&inchildrenIVorEndotrachealtube

59. child5yearsbittenbytheneighborsdog..thedogreceivedallthevaccines.whatdoudo?
-Observethedog10days&antirabbiserum
-Observethedog&antirabbisserum&vaccine
-Killthedog
-Vaccinatethekid
-Observethe dog
60. F.28yearspresentwithchronicrhinorrhea,intheexamyoufoundmucousalnasalatrophy..diagnosis?
-Sinusitis
-Cocaineintake
-Nasalpoliposis
-Allergicrhinitis

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

62. whatisthemostcommoncauseoflungabscessinpost-Oppt.
-Bacterial discriminationfrom operativesite
-Atelectasia
-Pneumonia
-Aspiration

63. M.25yearswhenhegoestotoilet,hecomplainsofpainfuldefecationintheanalregion,attheexamyouwillfind
bluishmassattheanalmargin..whatistheDiagnosis?
-Hemorrhoidsinternalsclerosed
-Hemorrhoidsexternalstrangulated
-Hemorrhoidsexternalthrombosed
-Pyelonedlecyst
-Poliposis

64. allthefollowingtumorsfavorizedbyTOBACCOExcept...
-Bladder
-Esophagus
-Liver
-Cervix
-Lung

65. 5yearschildhavebeenbeatenbyadog..hehadadeepwound,thedogisinasafeplace..whatdoudo?
-Disinfect&cleanthewound&putbandage

66. breastfeedingwomenwithDVT.treatment.?
-Warferin
-IV.heparin
-Antistreptocinase
-Bandage

67. immediatepost-oppresentssuddenhallucination,agitation&pretendthatwasmisstreated..Diagnosis?
-Psychosis
-Depression
-Post-opdelirium
-Analgesicwithdrawalsyndrome

68. aptconsultuforpainlesstesticularswelling,transiluminationwas(-)afterminortrauma...Diagnosis?
-Spermatocele
-Epidedimitis
-Varicocele
-Hydrocele
-Germinoma

69. F.47yearspresentwithsuddenstrongpainoftheRt.upperquadrantwithfever38.5vomiting,nojaundice...Diagno
sis?
-Colidutalobstruction
-CAofpancreas
-Acutecholicystitis
-Acutehepatitis
-Biliarylithiasis

70. Ptrefaredtoubyhisdentistbecauseofwhitishlesionatthebaseofthetongue..whatisyourattitude?
-Biopsy
-Identificationofgerms
-Askforacorrectionofhisdentalprostheses
-Treathim byanti micoticoral bath

71. young boypresentwithfrequentepisodeofrhinitiswithpurulentdischarge&

fever,fromamaxillarysinus,whatisthemostlikelycomplicationifuntreated?
-Purulentmeningitis
-Ethmoidalsinusitis
-Orbitalcellulitis
-Frontalsinusitis

72. Fpt.PE.painlessmobilemassonRt.upperquadrantwithoutfeverorJaundice,whatisthemostlikelydiagnosis?
-TumorofLt.inferiorlobeoftheLiver
-Hydrocholecyst
-Tumorof superior pole of theRt. kidney
-Livermetastasis

73. child 13 years obese present with painful Rt. knee & pain of Rt. hip with difficulty walking & reduced
abduction & Internal rotation ,whatisyourdiagnosis?
-JuvenileArthritis
-Septicarthritisofthehip
-Avascularnecrosisoffemoralhead
-Cartilagedysplasia
-Slippedcapitalepiphysis

74. Pt.fellonhishand,EmergencyXRaywasnormal,butthept.complainfrompainfulwristatabduction.management.
?
-Cast
-Explainhimthatthepainwilldisappearafter2weeks,itsnormal.
-Bandage
-ShortcastplusX Rayin15days
-NSAID's

NB.diagnosisisScaphoidfracture&itsverydifficulttoseeitinXRay.

75. IndicationofelasticbandinHemorrhoidsis:
-ThrombosedHemorrhoids
-TypeIIbleedingInternalHemorrhoids
-ExternalHemorrhoids
-Angioma

76. 65yearsobesePt.complainsofstrong&suddenmidabdominalpainradiatingtoLt.flank,whatisyourdiagnosis?
-Acutepancreatitis
-Cholecystitis
-Ureteralstone
-MesentericInfarctus
-Ruptureofabdominalaorta

77. Pt.complainsofRt.upperquadrantpain&fever,PEshowsslightabdominaltenderness,whatinvestigationdo
udotocomfirmethediagnosis?
-Biopsy
-Bariummeal
-PeritonealAspiration
-Rectosigmoidoscopy
-Echography

78. mostcommoncomplicationofEpiduralAnesthesiainapregnantwoman:
-Fetalhypoxia
-Hypotension
-Decreaseincontraction
-Arrestoflabor

79. Childpulledbyhismotherfromhisarms..PEshowsthatonearmisadducted&theforearmisonpronation.wh
atisthemostlikely diagnosis?
-Humeralfracture
-LaxationoftheInferiorextremityoftheulna
-Subluxationofulnarhead
-Ruptureofrotatorcuff

80. defensemechanisminphobia=displacement,avoidance

81. defensemechanisminborderlinePD.=splitting

82. Pt.doingtheoppositeofwhathebelievesisgood=reactionformation.

83. Pt.onlithiumtherapycomplainoffatigue,increasedweight,heatintolerance,whattestwouldyouorder?
-Thyroidstimulatinghormone leveltest
84. Pt.presentedwithpulmonaryedema&BP.180\95,whatisthebesttreatment?
-Furesemide

85. 47years F. with jaundice & history of nausea& vomiting , anorexia & depression , she ison Rifampicine,
INH, Pyridoxine. PE
Hepatomegaly+tenderness,Investigationreveal:SGOT,SGPTincreasedx5,ALPslightlyincreased.themostlikelydia
gnosisis:
-Druginducedhepatitis
-Viralhepatitis
-Acutepancreatitis
-LiverCA.

86. Pt.complainfromvisualspatialdefect,whereisthelesion?
-Rt.cerebralhemisphere
-Lt.cerebralhemisphere

87. 4 yearsAfricanboy onseptrinefortonsillitis presentedwithJaundice, Investigations:Hb.9.8 gm%,

reticulocytescount8% ,Hb.electrophoresis:Hb.A.whatisthemostlikelydiagnosis?
-Sicklecellanemia
-Thalassemia
-Spherocytosis
-G6PDdeficiency

88. F.65yearspresentwithrecurrentpainlesslowerGIbleeding,colonoscopy,gastroscopy,bariumenema,en
doscopy&upperGIseriesallarenormal,whatisthedig.?
-Rt.colonangiodysplasia

89. F.50yearsoperatedforcholicistectomypresentedwithheavywoundbleeding,shegivesyouahistoryofmassi
vebleedingwhenshehadatoothextraction,whatwillyoufind?
-IncreasedPTT+IncreasedBT
-IncreasedPTT+decreasedBT
-NormalPTT+IncreasedBT

NB.diagnosisisVonWillebranddisease

90. pregnantwomanwithabruptioplacenta,developedechymosis&bleeding,yourdiagnosisisDIC.whatisthemo
stspecifictesttoconfirm it?
-IncreasedFDP(fibrinedegradationproduct)

91. RTA(roadtrafficaccident)Pt.withmultiplefracture&trauma,24hlaterhedeveloptachypnea,PCO2=32,PaO2=
50.XRayshowsbilateral infiltrateswhatisthenextsteptodo?
-Lungscan
-Ventilator

92. allthefollowingareprimarypreventionexcept:
-Immunization
-Healthrelatededucation
-Pap smear

93. pregnantladydevelopedpostpartumhemorrhageaftervacuumdelivery,whatisthemostlikelycause?
-Uterineatony
-DIC

94. primigravidaafterdeliveryofa4000gmbaby,afteraprolongedlaborcouldnoturinate.Whatisthemostlikelycause
?
-Bladderatony

95. ChildRTApresentwithurethralbleeding&urinaryretention.Management?
-Retrogradeurethrogram

96. M.25yearsRTA,4h.LaterdevelopedRt.Flankpainwithheamaturia.Whattodo?
-IVP.

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

98. WhatisthemostlikelycauseofnochanginginvariabilityinfetalheartonNST(nonstresstest)?
-Fetalsleep

99. NSTindicatedinallexcept:
-IUGR
-DM
-HT.
-40 weeksPregnancy

100. ThemostspecifictestinUTIininfantsis:
-Sampleobtainedbycatheter

101. Howdoucalculatethenaturalgrowthofacountry?
-Crudebirthrate-deathrate

102. Child4-5yearscandoallofthefollowingexcept:
-Imitation
-Groupplay
-Autonomy
-Abstractthinking

103. Allofthefollowingarenormalduringpregnancyexcept:
-Spidertelangiectasia
-Heartrateof90
-DecreasedBP.
-Palmar erythema
-Whitebloodcell3000

NB.TheWBCisincreasedinpregnantButwithimpairedfunction

104. Whatisthebesttreatmentofmildtoxemiaofpregnancy?
-Bedrest&Lt.Lateralposition

105. F.16yearsoldcomplainingoflossofweightof10Kg.Allofthefollowingsuggestnonorganiccauseexcept:
-Doesnotworryaboutweightloss
-Engagedinathleticactivity
-Familyhistoryofeatingdisorder
-Persistentcomplainoffatigue

NB.ItsacaseofAnorexiaNervosa

106. WhichofthefollowingsuggestaDMina20yearsM.?
-Lossofweightdespitegoodeating

107. Allofthefollowingsuggestthyrotoxicosisexcept:
-Lossof weight
-Meanorrghe
-Diarrhea
-Sweating

108..................Young lady present a feature of hypothyroidism (cold intolerance, fatigue, anorexia,

weight gain, meanorraghe, dry & rough skin,hairdry&coarse
)TSHisincreased&T4islow.Whatisyourtreatment?
-StartL-thyroxine

109. LadydevelopseverePPH(postpartumheamorrage),shepresentafter6wkswithfatigueaninabilityto
breastfeed(absenceofbreastmilk).Allwillbedecreasedexcept.
-Prolactin
-TSH
-LH
-T4

NB.Diagnosis.isSheehan’ssyndrome(postpartumpituitary
infarct)TheT4hasgotalong1\2t..

110. Lady15daysafterdeliverycomplainofepigastricpainradiatingtothebackwithnausea&vomiting,hi
storyofgroupBstrep.Infection.Thepainisrelievedbyleaningforward,PE.revealanepigastrictendernesswhati
sthediagnosis?
-Pancreatitis

NB.Thepainisrelievedbyleaningforward(Inglefinger’ssign)

111. Ladywhodeliveredafterprolongedlaborpresenttoyouafter2days.AllofthefollowingsuggestEndometriti
sExcept:
-Tenderuterus
-Foulsmelling
-Uterus 9cm.belowumbilicus
-Pyrexia
112. Lady afterdeliverydevelops fever.Shestillfebrile after5daysof antibiotictherapy.PVexam
isnormal.Diagnosis.?
-Pelvic-thrombo-phlebitis

113. YoungM.Complainsofpainafterdefecation.PErevealabluemass,tender.Diagnosis.?
-ExternalthrombosedHemorrhoid
-InternalthrombosedHemorrhoid

114. Recurrentperinealabscessassociatedcommonlywith:
-Perianalfistula

115. Allofthefollowingarecontraindicatedtoepiduralanesthesiaexcept:
-Decreaseplatelet
-Bleedingdiathesis
-Sepsisatsiteofinjection
-DecreasedBP.
-Laborat35wks.

116. M.cameafter24h.ofattackofrenalcolic.IVPdoneshowsstone0.5cm.atL4,thekidneyisslightlyenlarged.M
anagement?
-Observation
-Tranurethralremovalofthestoneaftercystoscopy

NB.Conservativetreatmentifthestoneislessthan5mm&nocomplication.

117. M.55yearswithpainlessmassinscrotum(2cm)transilluminationis(+ve).Diagnosis.?
-Hydrocele
-Spermatocele
-Hernia
-Varicocele
-TestiularCA.

118. M.25yearspresentedwithsolidscrotalmass,afterminortraumatothetestis.Diagnosis.?
-Seminoma

119. Experimentalstudydonewith2drugs,showsthattheresultissignificant,theepidemiologistwrotein
hisreportthat“p”islessthan0.5.Whatdoesthatmean?
-Theassociationislessthan1\20(5%)likelytobeduetochancealone

120. Ultrasoundwilldiagnoseallthefollowingat20wksEXCEPT :
-Twinpregnant
-Poyhydramnios
-Trisomy21

121. Alfafetoproteinisincreasedin:
-Edwardsyndrome
-Down’ssyndrome
-Myelomeningocele

122. Psoriasis...Allexcept:
-Decreased C3 , C4

123. Oldmancomplainoflowbackpain,XRayshowsdecreasedjointspace&osteophytesdiagnosis?
-Degenerativejointdisease(osteoarthritis)

124. Boy2years,complainofkneepain,PEtenderbutnotswollenknee,slightlywarmerthantheother
joint.Whatisthebestinvestigationto do?
-Xrayoftheknee
-Bonescan

125. Pt.presentwithfracture,youwanttomakeacaste.Youadvisehimaboutcompartmentsyndrome.Whatwilla
ppearfirst?
-Pallor
-Coldness
-Numbness
-Decreasedpulse
-Paralysis

126. ThemosteffectivetreatmentinOsteoporosisis:
-Exercise
-Analgesics
-Vitamins
-Estrogen
127. Pt.OnOCPcomplainofamenorrhea3monthsafterusingthepills.Whatistrueaboutamenorrhea?
-Duetohighprogesterone
-DuetoEstrogen

128. Definitionofpotentialyearsoflifelost(PYLL):.................................

129. Sexuallyactiveladypresentwithdysuria&vaginaldischarge.AllthefollowingcancausethisconditionEXCE
PT :
-Gonorrhea
-Chlamydia
-Trichomonasis
-CondylomaAccuminata

130. BacterialvaginosisEXCEPT:
-Cluecells
-FishyodourwithKOHtest
-Decreasedlactobacilli
-Vaginitis
-Frothyoffensivedischarge

131. Pt.complainofvertigo,howcanyoudiagnoselabyrinthitis?
-Nystagmus

132. Pt.Operatedforpituitary tumor,thenhe developedpolyuria,dehydration inspiteofreceiving 4LIV

fluid.Whatwillu give?
-GivemoreIVfluid
-Startoralrehydration
-Give vasopressin

(DDAVP)NB.Thisisacase

ofSIADH

133. AlcoholicPt.Complainofinstabilityingait,heusesacanetoavoidfrequentfall.Rombergtestis(+ve).whatis
yourdiagnosis?
-DT.
-Alcoholic withdrawal
-Alcoholiccerebellarsyndrome

134. Pt.complainof TinnitusinRt.ear,onExamufoundsensorineuraldeafness.Diagnosis.?

-Acusticneuroma

135. Newborn,allthefollowingareincreasingriskfactorsofdeafnessEXCEPT:
-Familyhistory
-Usedofgentamycin
-HistoryofCMVinfection
-Delayedspeaking

136. Whatwillbeyourmanagement.Fora3yearsboywithstuttering?
-Reassurance

137. AllthefollowingneonatesarepronetohypoglycemiaEXCEPT:
-IUGR
-Diabeticmother
-Normalinfantbornat36wks
-Hypothermia
-Non ofthe above

138. 32yearsF.consultuforinabilitytoconceivefor2years,sheismarriedwhohas3childrenfromanother
woman.Temperaturechartshowsovulation.Whattodofirst?
-B-HCG
-Hysterosalpingogram
-Progesterone at 21 day
-Semenanalysis

139. F.18yearsheight158cm,normalbreast,withprimaryamenorrhea,PEsmalluterus,allofthefollowingtobed
oneEXCEPT:
-TFT(Thyroid)&Prolactinlevel
-Progesteronetest
-FSH,LHlevel
-Laparoscopy
-SkullXRay

NB.MCCQ2001(GY11)wenormallydotheothersinthesameorderasitis..
140. F.21years,with2monthshistoryoffibroidmass,asymptomatic.Management?
-Reassessafteroneyear
-Myomectomy
-Hysterectomy
-Hormonaltherapy

141. WhatisthemostcommonsourceofmercurypoisoninginCanada?
&whoarethemostexposedgroupofpeopleinCanada?
-Fish-(nativeIndians)

142. Whichofthefollowingyoushouldnotnotifythepoliceabout?
-Childabuse
-Spouseabuse
-Childneglect
-Noneoftheabove

143. YoudoastresstestECGforaPt.AllaresignificantEXCEPT :
-STdecreasedbymorethan2mm
-Chestpain
-STincreased(upwardslopping)
-DecreasedinBPbymorethan50mmHg.

144. AllaretruewithpostinfectiousGN.Except:
-NormalC3,C4
-Hypoalbuminemia
-Increasedcholesterol
-Proteinuriais more than 2 gm.

145. M.65years,presentwithlowbackpainanemia&hypocalcemia.Whatwillyoudotoconfirmthediagnosis?
-WBC.Count
-Bonemarrowaspiration
-Plateletcount

146. HIVPt.Withfever&weightloss,hemayhaveallofthefollowingEXCEPT:
-Esophagealcandidosis
-MycobacteriumAvium
-Mycoplasmapneumonia
-CMVinfection
-Mycoplasmacellulari

147. F. 35years withataxia, weaknessofthe Lt.Side ofbody, dysphagia& visualtrouble. PEreveals

diplopia&nystagmus. WhatistheDiagnosis.?
-MultpleSclerosis.

148. WhatisthemostcommoncomplicationofJuvenileRheumatoidArthritis:
-Iridocyclitis
-Hepatitis
-Nephritis
-vasculitis

149. M. Broughttou bypolice,for assaultinga12years oldboy.When askedhisnameby thepolice,

hesaidthathe don’tknow, &whenuaskhimhowmanylegsdoesthehorsehave,hesaid5.Whatisthediagnosis?
-Malingering
-Factitiousdisorder
-Antisocialpersonality
-Fugue

150. Inwhichpathologyyouhavegloves&stockinganesthesia?
-DM.

151. M.Withbipolardisordercamewithagitation&aggressivebehavior.Besttreatment?
-IVHaloperidol
-Lithium&Antipsychotics

152. All are seenin DT.Except :

-HT.
-Fever
-Tachycardia
-Fixedhallucination
153. BestprophylaxisforaCanadiantravelingtoaMalariaareawithnoresistanttrainis:
-Chloroquine

154. Pt.Diagnosedwithdysthymiawhatisthebesttreatment:
-Psychotherapy
-Fluoxetine
-Imipramine

155. IncardiacarrestduetoVentricularFibrillation,whatistrue?
-NaHCO3shouldbegivenevery5-10minutesunlessbloodgasareknown
-Lignocaine mustbe given
-DCcardioversionfirst

156. Dyspepsia,allarehelpfulEXCEPT:
-Antacids
-Elevate bedhead
-Cimetidine
-Misoprostol

157. AsthmaticPt.Onsteroids,hastogoforoperationforperforatedduodenalulcer.Whatwilludo?
-100-200mgHydrocortisone IVbeforethe surgery
-Beta-agonistinhalorbeforethesurgery

158. Chineserestaurantfoodpoisoning.AllaretrueEXCEPT:
-Symptomswithin1\2h.
-Resolvesafter24h
-Symptomsofashma+ataxia+dyspnea

NB.Monosodiumglutamateisthecauseofthissyndrome(itsapharmacologicalbutnotallergicreaction.Doserelatedsy
mptomofburningsensationthroughoutthebody,facialpressure,anxiety&chestpain)

159. RA.Pt.Onaspirinpresentwithanormocyticnormochromicanemia.Allaretrueexcept:
-Respondto treatment with B.12
-Feritine maybeIncreased
-DecreasedserumIron
-Normal total Iron binding capacity

160. WhatisthemostcommoncauseofcongenitalheartfailureinNB.
-VSD
-ASD
-TGA
-TetralogyofFallot

161. Anursewithhypoglycemia&decreasedC-peptide.Whattodo?
-RefertoPsychiatrist

162. AllarefeatureofTSSExcept:
-Fever
-DecreasedBP.
-Pustularskinlesion
-Erythroderma

163. AllarefeatureofKAWASAKIdiseaseEXCEPT:
-Feverfor5days
-Purulentconjunctivitis
-Skinrash
-Fissureoflip
-Strawberrytongue

164. Variabledecelerationcommonlyseenin:
-UteroplacentalInsufficiency
-Cordcompression
-Sleepingfetus

165. AllincreasethelevelofcarbamazepinEXCEPT:
-Cimetidine
-Estrogen
-Phenobarbital

166. M.PresentwithRt.Sidehorner’ssyndrome&contralaterallossofsensationofthebody.Whereisthesiteofth
elesion?
-PICA
-ICA
-InternalCarotid

167. Pt.Withhypokalemia.AlltrueEXCEPT:
-Diarrhea
-Paralyticileus
-Hypotension
-Hypoventilation
-Muscularweakness
-Polyuria&polydepsia

168. Allareliveattenuatedvaccineexcept:
-BCG.
-Vaccineofyellowfever
-Polio
-Measles
-Diphtheria

169. Howoftendougiveaboosterinpeoplepreviouslyadequatelyimmunizedagainsttetanus:
-Every10years

170. AllareincludedintheroutineimmunizationEXCEPT:
-Measles
-Pneomococusvaccination
-Mumps
-Rubella

171. HeamophilusInfluenzacontact,prophylaxisis:
-Refampicine

172. Pregnant,8wks,cameintocontactwithaboysuspectedofhavingRubellainfection.Management?
-Rubellavaccination
-GiveRubellaIgG.
-Doantibodytitreinthepregnantlady
-Therapeuticabortion

173. Farmercamewithanailinhisfoot&temp.of38.2.Management:
-Antibiotics
-Tetanustoxoids + antititanusIg. + antibiotic
-AntitetanusIg.

174. F.YoungpresentwithMeanorrhagea.Commonestcauseis:
-Deficientlutealphase
-Short secretory phase
-Prolongedsecretoteyphase

NB.Anovulationisthebestanswerifthere.

175. PostmenopausalladywithMI.&sheisanactivesmoker.Shedoesnotwanttostopsmoking.SheisonHor
monalReplacementTherapy.Whatadvicedougive?
-Stop Estrogen & start exercise

176. Post-Opcontinuedtobleeddespite10unitsofpackedRBC. Transfusion.Whatisthecause?

-Hypercalcemia
-Hyperkalemia
-Dilutionalthrombocytopenia

177. RA.Pt.OnASA.DevelopedITP.Whatisthetreatment?
-Steroids

178. Pt.Developedexcessivemenstrualbleeding&purpura.Allthefollowinglab.FindingareexpectedEXCEPT:
-DecreasedHb.
-Decreasedplatelets
-Increasedplatelets
-Prolonged bleedingtime

179. Bartholinitisabscess.Whatisthetreatment?
-Antibiotics
-Marsupialization
NB.I&Disagoodansweraswell.

180. Pt.Withlymphadenopathy&splenomegaly&raisedWBC.Whatistheconfirmatoreytest?
-CBCdeferential
-Bone marrow

aspirationNB.Leuke

miacase

181. Pt.Withbilateralhilarlymphadenopathywithmicronodularinfiltrates.AllcangivethisfeatureEXCEPT?
-Sarcoidosis
-TB.
-Transbrbronchialbronchogeniccarcinoma

182. Pt.Withpainfulbluishmassprotrudingfromtheanus.Diagnosis.?
-Prolapsed anal piles
-Thrombosedexternalpiles
-Internalpiles

183. AllcanCausePruritisaniEXCEPT:
-Laxative
-Hemorrhoids
-Fecalincontinence
-Colorectal CA

184. F.24yearswith(+ve)pregtest,presentwith2daysvaginalbleeding,USshows3cmmassintheLt.Adn
exa&emptyuterus,pregnantSympt&signsofpreghasdisapeared&thecervixisclosed.Diagnosis.?
-Completeabortion+lutealcyst.

NB.uconsiderectopicpregnancyuntilotherwiseproven.

185. IndicationofC-sectioninbreechpresentationis:
-Footling
-Frontbreechpresentation

186. Prevalencedefinition:totalnumberofcasesinapopulationatagiventime.

lifebirth
187.------------------------------------------Crudebirthrate= 1000
Totalmedialpopulation

188. Thetreeofautosomaldominanttransmission

189. F.Consultyoubecauseofapossibilityofheroffsprings(kids)havingHuntington’sChorea.Herfatheris
affected.Herhusbandfamilydon’thavethisdiseaseWhatisthepossibilitythatherchildrenwilldevelopthedisea
se?
-50%
-0%
-25%
-100%

190. F.Withpregnancylikesymptoms,USshowsgrapelikemassesintheuteru
s.AlltrueEXCEPT:Multiplegestation
-Bilat.Ovariancyst
-Hyperthyroidism
-Hypothyroidism,coma,preorbital myxedema

191. Allhaveriskfactortodeveloppreeclampsia:
-Nulipara
-DM
-Historyofpreeclampsia
-Multiparity

192. PregnantPt.20weeks Theuterussizeis25cm.AlltrueEXCEPT:

-Normal pregnant
-Wrongestimationofgestationalage
-Twinpregnant
-Bilat.Renaldysgenesis
193. Oldladywithankleedemaattherightmedialmalleulus,withsuperficialulcer&surroundingscar.Diagnosis.
?
-Venusinsufficiency
-Venusvalvularinsufficiency

194. Preg.Ladywithknownfibroid,complainingfromabdominalpain
-Reddegeneration

195. M.16yearsoldcomplainfromlossofweight,heispassingbloodydiarrhea,Investigationshownor
malupperindoscopy&segmoidoscopy.Whattodonext?
-UpperGIseries

196. Child4yearsold,presentedwithpost.Mediastinaltumor.Whatisthecommonestgermcelltumor?
-Thymoma
-Neuroblastoma
-lymphoma

197. PT.Withfatmalabsorption,passingfloatingstools+lossofweight&easybruising.Diagnosis.?
-GIlymphoma
-GITB
-Glutaneantheropathy(celiacdisease)
-Repeatedepisodeofpancreatitis

198. Pt.WithDKA.AlloccurEXCEPT:
-IncreasedAmylase
-Abd.Pain
-IncreasedK.
-Increased osmolarity
-Leukocytosis

NB.Merck1999(p.178)inDKA.serumamylasetypicallyelevatedwhileKisIncreasedornormal

199. F.Pt.OnInsulintherapy,shehasababy.YouwillsuggestherthefollowingaboutInsulinExcept:
-Holdinsulinuntilthebabystarteating

NB.(alwaysInsulin&HeparinareSAFEduringpregnancy&lactation)

200. BestsitetoobtainsmearforGonorrheainawomanis:
-Vulva
-Vagina
-Cervix(mouthofthewound)

201. WhichstageofsexualexcitementaccordingtoTonomcriteriawhenthefemaleishavingclitoralerec
tion,increasedvaginalsecretion,nipple erection?
-Earlyexcitement
-Resolution
-Lateexcitement
-Latentphase

202. F.Withdifficultycaringshoppingbag,weakabductionofthethumb+minorwastingofthethumb(
minorthenaratrophy)Diagnosis.?
-Carpaltunnelsyndrome

203. RadialnerveinjuryattheleveloftheheadofRadius.Whatwillufind?
-Droppingwrist

NB.Merck1999(p.1493)TheSaturdaynightpalsyisanothernamefortheRadialnervepalsy.

204. Whichofthefollowingisasexualdesireabnormality

-Doesnotimaginesexualfantasies
-Nosexualactivityformorethan2wks
-Nervousaboutsexualact
-Try to avoid partner contact

205. Transvestitismdisorder,alltrueEXCEPT

-Dressingclothesofothersexforsexualexcitement
-Morecommoninmale
-They arefemale
206. AllareknowntocausedepressionEXCEPT:

-Clonidine
-Cimetidine
-Cyclosporine
NB.Thedrugswhichcausedepressionare:Anti-HT,Anti-Parkinsonian,Hormones,Steroids,Anti-TB,Anti-Neoplastic

207. Pt.Broughttoumute&inaccessibletoexamination.Diagnosis.

?-CatatoniaMCCQPS6(2001).

208. M.35yearsFoundinthestreetwandering,hedoesn'tknowhisname,talktohimself.AllarepossibleetiologyE
XCEPT:

-Schizophrenia
-Fugue
-Alzheimerdisease

209. Girlcamewithmidlineneckcyst,whichmoveswhileprotrudingthetongue(withswallowing).Diagnosis.

?-Dermoidcyst
-Brachialcyst
-Thyroglossalductcyst

210. AllareroutineinvestigationforanoldladywithurinaryincontinenceEXCEPT:

-Urineanalysis
-Cystogram
-Urinarydiary
-

DirectvisualizationofincontinencewhenPt.withfullbladderwhilecoughi

ngANSWERKEY

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.
A128
.
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.
A186
.
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