اسئلة الباطنية 2017 (3)
1) Which of the following is true about Cushing syndrome ?
A. It's due to deficiency of cortisol hormone .
B . Enlarged extremities are commonly seen .
C . Osteoporosis is not a feature .
D . Iatrogenic cause is uncommon .
E . A moon face and buffalo hump are characteristic .
2) In hypercapnia are all true except ?
A . Bounding pulse
B . Headache
C . Peripheral vasoconstriction
D . Confusion
E . Flapping tremor
3 ) To assist in the decision whether to hospitalize a patient with community acquired pneumonia , each of the following may be a factor in favor of hospitalization except which one ?
A. The patient is confused
B . Serum creatinine > 2.0 mg / dl
C . Respiratory rate > 30
D . Blood pressure < 90 mg hg
E . Age > 64 years
4) All of the following can be used in hypertensive crisis except ?
A. Sodium nitroprusside
B . Furosemide
C . Labetalol
D . Clevidipine
E . Hydralazine
5 ) Diarrhea may occur with all of the following except ?
A . Food poisoning
B . Viral gastroenteritis
C . Inflammatory bowel disease
D . Colonic Neoplasia
E . Hypothyroidism
6 ) A 7 years old has severe microcytic anemia due to B Thalassemia major ( homozygous ) . He requires frequent blood transfusion( once every sex week's ) To prevent the skeletal and developmental complications of thalassemia . Which of the following medication is also indicated in the treatment of patients requiring frequent blood transfusion ?
A . Oral calcium supplement
B . Fresh frozen plasma
C . Desferrioxamine
D . Pencillamine
E . Cryoprecipitate
7) One of the following vaccines is a killed vaccine ?
A . Measles vaccine
B . Mumps vaccine
C . Rubella vaccine
D . Pertussis vaccine
E . Oral polio vaccine
8 ) All of the following are found in patient with bronchial asthma ?
A . Hyperinflated chest
B . Wheezing
C . Dyspnea
D .Clubbing
E . Cough
9 ) Regarding Sarcoidosis which is true ?
A . It is a caseating Granuloma
B . It has no extrapulmonary manifestation .
C .Spontaneous resolution may occur in 2 year .
D .Steroids is always indicated .
E . Increase in serum ACE level is diagnostic .
10) All of the following causes exudative pleural effusion except ?
A .Constrictive pericarditis
B .Mesothelioma
C .Rheumatoid arthritis
D .Pneumonia
E .Tuberculosis
11) Atrial fibrillation can be caused by all the following except ?
A . Mitral valve disease
B . HTN
C . Hypothyroidism
D . Pneumonia
E . Atrial myxoma
12 ) A 73 years old man presents with several episodes of hematemesis . Examination shows signs of orthostatic hypotension and melena . What is the first priority in caring for this patient ?
A .NG tube placement and gastric lavage .
B . Resuscitation with adequate IV access and appropriate fluid and blood product fusion .
C .IV infusion of H2 receptor antagonist to stop bleeding .
D .Urgent upper endoscopy .
E . Urgent surgical consultation .
13) Regurgitation AC syndrome one of the following is true ?
A . Cardiac enzymes is always elevated .
B . ECG changes is mandatory for the diagnosis .
C . Obesity and HTN are non modifiable risk factor .
D . Creatinine kinase can be raised due to other non cardiac cause .
E . Cardiac troponin remains elevated for 24 hour only .
14) All of the following can cause Hemoptysis except ?
A . Pneumonia
B . Idiopathic pulmonary fibrosis
C . Tuberculosis
D . Pulmonary embolism
E . Goodpasture syndrome
15) Regarding HTN which is true ?
A . The patient should be screened for secondary HTN .
B . Secondary HTN account for 90% of cases .
C . Addison disease is one of the causes of secondary HTN .
D . 24 hr urinary collection for metanephrin level may be diagnostic .
E . In isolated systolic HTN no treatment is required .
16) A 35 year old is evaluated for symptoms of S.O .B . Her reports no other lung or heart disease . He smokes half pack a day for the past 10 years . On examination his JVP is 2 cm , heart sound normal . Lung clear . CXR shows hyperinflation and Emphysematous changes , while pulmonary function tests shows an FEV1 / FVC ratio < 70% . Evaluation of his family reveals other affected individuals .
Which of the following is most likely diagnosis ?
A . Alpha one antitrypsin deficiency
B . B glucosidase deficiency
C .G6PD
D .Glucocerebrosidase deficiency
E . Growth hormone deficiency
17) Sacroilietis commonly occurs in all of the following diseases except ?
A . Ulcerative colitis
B . Crohn disease
C . Gout
D . Ankylosing spondylitis
E . Psoriatic arthritis
18) The following are more in favor of type one DM than type two except ?
A . Association with ketoacidosis .
B . Association with HLA_DR3 or HLA_DR4 .
C . Strong family history of diabetes .
D . Present of islet cell antibodies .
E . Abrupt onset of signs and symptoms .
19) Regarding bronchial asthma all are true except ?
A . It is chronic airway inflammation .
B . Treatment with long acting B2 agonist is the cornerstone .
C . PFT increase in FEV1 more than 200 ml and 12 % indicates reversibility .
D . It's characterized by dyspnea , chest tightness , cough and wheezes .
E . Attack can be induced by exercise
20) Signs and symptoms of hypothyroidism include all the following except ?
A . Thick dry skin
B . Depression
C . Constipation
D . Tachycardia
E . Weight gain
21) A 65 years old man develops palpitations and dizziness . His blood pressure is 80/50 mm hg and his pulse is regular at 150 / min . His ECG shows a saw toothed pattern of P waves . Which of the following procedure is most appropriate in converting him back to sinus rhythm ?
A . Carotid sinus pressure
B . Gagging procedure
C . Valsalva maneuver
D . Eyeball compression
E . Electrical cardioversion
22) A 23 years old woman experienced watery diarrhea , nausea, vomiting and abdominal cramps 6 hours after eating a salad and a hamburger in a local restaurant . The most likely organism causing her disease is ?
A . Vibrio vulnificus
B . Listeria monocytogenes
C . Yersinia enterocolitica
D . Clostridium difficile
E . Staphylococcus aureus
23) Air conditioner repair worker is more likely to be at risk of contracting ?
A . Hepatitis
B . Brucellosis
C . Legionnaires disease
D . Histoplasmosis
E . Tuberculosis
24) A 19 year old woman present with daily acid reflux symptoms and intermittent dysphagia to solid . Since onest of symptoms 3 months ago , she has lost 2 kg , she has sporadic rectal bleeding . Her past medical history is negative . Her father had stomach cancer at age 42 . What would you recommend ?
A . EGD
B . Reassurance
C . Barium esophagrame
D . PPI therapy for 6_8 week's
E . Abdominal CT
25) Causes of pancytopenia includes all the following except ?
A . Megaloblastic anemia
B . Aplastic anemia
C . Myelofibrosis
D . IDA
E . Acute leukemia
26) Which of the following is true of psoriatic arthropathy ?
A . Nail pitting may give a clue to the diagnosis .
B . Absence of plaques of psoriasis excludes the diagnosis .
C . The diagnosis can be confirmed by a blood marker .
D . Typhi can some times be seen over the affected joints .
E . Severity is related to skin changes severity .
27) Regarding Nephrotic syndrome all are true except ?
A . Renal vein thrombosis is a complication .
B . Increase bleeding tendency
C . Increase susceptibility to infection .
D . DM is a recognized cause .
E . Hypoalbuminemia and Proteinuria is present
28 ) 60 years old male presented with massive hematemesis , examination revealed Splenomegaly , clubbing and Palmar Erythema . The cause of his hematemesis ?
A . Mallory Weiss syndrome
B . Gastric ulcer
C . Angiodysplasia
D . Esophageal varices
E . Gastritis
29) A 63 years old man is involved in a motor vehicle accident and is brought to the hospital . On examination, his blood pressure is 90/60 mm hg , pulse 110 / min , and his abdomen is distendes and rigid , he has internal injuries and bleeding on an abdominal CT scan , and requires emergent blood transfusion on his way to the operating room . His blood group is AB , which of the following statement is not correct ?
A . He is a universal recipient .
B . He has anti A and anti B in his serum .
C . If a cross match is not available, group O RBCs are universal .
D . If insufficient AB blood is available , type A can be used .
E . If insufficient AB blood is available , type B can be used .
30) The study of the distribution of a disease or condition in a population is referred to as ?
A . Descriptive
B . Analytical
C . Experimental
D . Prospective
E . Retrospective
31) All about irritable bowel syndrome are true except ?
A . Abdominal pain relieved by defecation .
B . Symptoms can be increased by stress .
C . Waking at night with pain or diarrhea support the diagnosis .
D . Altered bowel habit is common .
E . Examination is often normal .
32) Regarding diabetic ketoacidosis which is true ?
A . Dehydration is less life threatening than hyperglycemia .
B . Potassium level initially is high and falls down with treatment .
C . Is a late complication of type one DM .
D . Can be managed as outpatient in most of the cases .
E . Elevated WBC count always indicates infection .
33) All of the following are side effects of steroids except ?
A . Elevated blood pressure
B . Acne
C . Skin bruises
D . Hypoglycemia
E . Cataract
34) Blood gas analysis in type one respiratory failure shows ?
A . High PCO2 and normal PO2 .
B . Low PCO2 and normal PO2 .
C . Normal PCO2 and high PO2 .
D . High PCO2 and low PO2 .
E . Normal PCO2 and low PO2 .
35) In salmonellosis which is true ?
A . Positive blood culture occur in the second week .
B . Positive stool culture occur in the first week .
C . Splenomegaly doesn't occur .
D . Can be complicated by Osteomyelitis .
E . The route of transmission is air borne .
36 ) One of the following is true about COPD ?
It is one of the cause restrictive PFT .
Steroids are the cornerstone treatment .
It is a curable disease .
PFT reversibility always present .
Can cause right sided heart failure .
37) All of the following are cause of chronic cough except ?
A . GERD
B . Sodium valproate
C . ACE_i
D . Long term smoking
E . Postnasal drip
38) Which of the following antiarrhythmic drug mediates it's effect by interfering with movement of calcium through the slow channel ?
A . Phenytoin
B . Verapamil
C . Lidocaine
D . Amiodarone
E . Bretylium
39) 63 years old woman is seen in the emergency room with acute shortness of breath . There is no history of heart or lung problems in the past . She was recently diagnosed with breast cancer and is under going active treatment . On examination her blood pressure is 120/80 mm hg , pulse 100 / min , and heart and lungs are normal . There are no clinical sings of DVT . Which of the following investigation is most likely to rule out a PE ?
A . Normal CXR
B . Normal ECG
C . Normal ventilation _ perfusion lung scan .
D . Normal high resolution CT
E . Normal MRI
40) A 66 year old man has progressive shortness of breath due to COPD . He is currently able to do his activities of daily living , but has trouble walking more than 50 m . His physical examination reveals hyperinflation , increased resonance to percussion , and bilateral expiratory wheezes . He is in appropriate medical therapy for his stage of COPD . Which of the following is also indicated in the management of this condition ?
A . Meningococcal vaccine
B . Yearly influenza vaccine
C . Weight reduction obese
D . Haemophilus influenza B vaccination
E . Pneumococcal vaccination
41) A 39 year old woman with HTN , is taking hydrochlorothiazide ,enalapril and diltiazem . She desires to become pregnant . The most important step would be to ?
A . Switch HCTZ to Furosemide
B . Switch diltiazem to amlodipine
C . Discontinue diltiazem
D . Discontinue enalapril
E . Discontinue HCTZ
42) Regarding Acromegaly all are true except ?
A . Caused by tumor in adrenal gland in more than 90 % .
B . Excessive sweating .
C . Large hand and feet .
D . Increased growth hormone .
E . Proganthism .
43) All are features of LVF except ?
A . Orthopnea
B . Hepatomegaly
C . Pulsus alternance
D . Bilateral basal crepitation
E . Kerly B line on CXR
44) All of the following statement are correct about routine urine examination except ?
A . Specific gravity of 1015 is normal .
B . RBCs is a normal finding .
C . One RBC is a normal finding.
D . One WBC is a normal finding.
E . Negative sugar is a normal finding
45) Which oxygen delivery device should be used in COPD patient ?
A . Trauma mask
B . Nasal cannulae
C . Simple face mask
D . Venturi mask
E . Nonrebreather mask
46) One of the following can cause Hypokalemia ?
A . Spironolactone
B . Hyperaldosteronism
C . ACE_i
D . Addison disease
E . Renal tubular acidosis type 4
47) Which of the following most likely to cause deviation of trachea ?
A .Previous TB of the right upper lobe
B .Small right pleural effusion
C .A Left basal pneumonia
D . Idiopathic pulmonary fibrosis
E . Blunted right costophrenic angle
48) Optimal medical therapy in patient with carotid artery stenosis ?
A . Smoking cessation
B . Antiplatelet agent
C . Control HTN
D . Statin drugs
E . All are true
49) Skin cancer result from exposure to one of the following ?
A . Infrared rays
B . X rays
C . Solar ultraviolet
D . Ionizing radiation
E . Microwave
50) Regarding immunoglobulins all are true except ?
A . Rhesus antibodies are of IgG class .
B . IgG is the first response to invading organism .
C . IgA has the highest concentration in human secretion .
D . IgM is the best complement activator .
E . IgE mediates allergy by binding antigen on the membrane of the cell .
51) Social class can be measured by all of the following except ?
A . Sex
B . Income
C . Education
D . Occupation
E . Residency
52) One of the following disease is considered eradication worldwide since more than 30 years ?
A . Smallpox
B . Chickenpox
C . Plague
D . Typhus
E . Mumps
53) All of the following sentences are true about the assessment of bleeding except ?
A . Taking blood sample at the time of bleeding give an accurate level of HB .
B . Hypovolemia increases the risk of tissue hypoxia and multiorgan failure .
C. Blood loss could be estimated from the size of blood clot and the weight of swabs use .
D . Any thirsty patient should be considered Hypovolemic .
E . Arterial blood gas is a quick method to measure Hb level .
54) Epidemiology mean ?
A . Study of population ( study of the distribution and determination health related states or even .
B . Study of disease only .
C . Study population growth .
D . Study of mortality .
E . Study of chronic disease .
55) Patient with cystic fibrosis expected to have deficiency in all of the following except ?
A . Vitamin A
B . Vitamin B12
C . Vitamin K
D . Vitamin D
E . Vitamin E
56) Regarding Mycoplasma pneumonia all are true except ?
A . It is one of atypical pneumonia .
B . Can cause autoimmune Hemolytic anemia .
C . Can cause meningioencephalitis .
D . Cephalosporin antibiotic is a drug of choice .
E . Bilateral patchy consolidation .
57) One of the following is most suited for detection of diabetic ?
A . Renal ultrasound
B . Urine analysis for cast
C . Urine albumin
D . IVP
E . Serum creatinine
A. It's due to deficiency of cortisol hormone .
B . Enlarged extremities are commonly seen .
C . Osteoporosis is not a feature .
D . Iatrogenic cause is uncommon .
E . A moon face and buffalo hump are characteristic .
2) In hypercapnia are all true except ?
A . Bounding pulse
B . Headache
C . Peripheral vasoconstriction
D . Confusion
E . Flapping tremor
3 ) To assist in the decision whether to hospitalize a patient with community acquired pneumonia , each of the following may be a factor in favor of hospitalization except which one ?
A. The patient is confused
B . Serum creatinine > 2.0 mg / dl
C . Respiratory rate > 30
D . Blood pressure < 90 mg hg
E . Age > 64 years
4) All of the following can be used in hypertensive crisis except ?
A. Sodium nitroprusside
B . Furosemide
C . Labetalol
D . Clevidipine
E . Hydralazine
5 ) Diarrhea may occur with all of the following except ?
A . Food poisoning
B . Viral gastroenteritis
C . Inflammatory bowel disease
D . Colonic Neoplasia
E . Hypothyroidism
6 ) A 7 years old has severe microcytic anemia due to B Thalassemia major ( homozygous ) . He requires frequent blood transfusion( once every sex week's ) To prevent the skeletal and developmental complications of thalassemia . Which of the following medication is also indicated in the treatment of patients requiring frequent blood transfusion ?
A . Oral calcium supplement
B . Fresh frozen plasma
C . Desferrioxamine
D . Pencillamine
E . Cryoprecipitate
7) One of the following vaccines is a killed vaccine ?
A . Measles vaccine
B . Mumps vaccine
C . Rubella vaccine
D . Pertussis vaccine
E . Oral polio vaccine
8 ) All of the following are found in patient with bronchial asthma ?
A . Hyperinflated chest
B . Wheezing
C . Dyspnea
D .Clubbing
E . Cough
9 ) Regarding Sarcoidosis which is true ?
A . It is a caseating Granuloma
B . It has no extrapulmonary manifestation .
C .Spontaneous resolution may occur in 2 year .
D .Steroids is always indicated .
E . Increase in serum ACE level is diagnostic .
10) All of the following causes exudative pleural effusion except ?
A .Constrictive pericarditis
B .Mesothelioma
C .Rheumatoid arthritis
D .Pneumonia
E .Tuberculosis
11) Atrial fibrillation can be caused by all the following except ?
A . Mitral valve disease
B . HTN
C . Hypothyroidism
D . Pneumonia
E . Atrial myxoma
12 ) A 73 years old man presents with several episodes of hematemesis . Examination shows signs of orthostatic hypotension and melena . What is the first priority in caring for this patient ?
A .NG tube placement and gastric lavage .
B . Resuscitation with adequate IV access and appropriate fluid and blood product fusion .
C .IV infusion of H2 receptor antagonist to stop bleeding .
D .Urgent upper endoscopy .
E . Urgent surgical consultation .
13) Regurgitation AC syndrome one of the following is true ?
A . Cardiac enzymes is always elevated .
B . ECG changes is mandatory for the diagnosis .
C . Obesity and HTN are non modifiable risk factor .
D . Creatinine kinase can be raised due to other non cardiac cause .
E . Cardiac troponin remains elevated for 24 hour only .
14) All of the following can cause Hemoptysis except ?
A . Pneumonia
B . Idiopathic pulmonary fibrosis
C . Tuberculosis
D . Pulmonary embolism
E . Goodpasture syndrome
15) Regarding HTN which is true ?
A . The patient should be screened for secondary HTN .
B . Secondary HTN account for 90% of cases .
C . Addison disease is one of the causes of secondary HTN .
D . 24 hr urinary collection for metanephrin level may be diagnostic .
E . In isolated systolic HTN no treatment is required .
16) A 35 year old is evaluated for symptoms of S.O .B . Her reports no other lung or heart disease . He smokes half pack a day for the past 10 years . On examination his JVP is 2 cm , heart sound normal . Lung clear . CXR shows hyperinflation and Emphysematous changes , while pulmonary function tests shows an FEV1 / FVC ratio < 70% . Evaluation of his family reveals other affected individuals .
Which of the following is most likely diagnosis ?
A . Alpha one antitrypsin deficiency
B . B glucosidase deficiency
C .G6PD
D .Glucocerebrosidase deficiency
E . Growth hormone deficiency
17) Sacroilietis commonly occurs in all of the following diseases except ?
A . Ulcerative colitis
B . Crohn disease
C . Gout
D . Ankylosing spondylitis
E . Psoriatic arthritis
18) The following are more in favor of type one DM than type two except ?
A . Association with ketoacidosis .
B . Association with HLA_DR3 or HLA_DR4 .
C . Strong family history of diabetes .
D . Present of islet cell antibodies .
E . Abrupt onset of signs and symptoms .
19) Regarding bronchial asthma all are true except ?
A . It is chronic airway inflammation .
B . Treatment with long acting B2 agonist is the cornerstone .
C . PFT increase in FEV1 more than 200 ml and 12 % indicates reversibility .
D . It's characterized by dyspnea , chest tightness , cough and wheezes .
E . Attack can be induced by exercise
20) Signs and symptoms of hypothyroidism include all the following except ?
A . Thick dry skin
B . Depression
C . Constipation
D . Tachycardia
E . Weight gain
21) A 65 years old man develops palpitations and dizziness . His blood pressure is 80/50 mm hg and his pulse is regular at 150 / min . His ECG shows a saw toothed pattern of P waves . Which of the following procedure is most appropriate in converting him back to sinus rhythm ?
A . Carotid sinus pressure
B . Gagging procedure
C . Valsalva maneuver
D . Eyeball compression
E . Electrical cardioversion
22) A 23 years old woman experienced watery diarrhea , nausea, vomiting and abdominal cramps 6 hours after eating a salad and a hamburger in a local restaurant . The most likely organism causing her disease is ?
A . Vibrio vulnificus
B . Listeria monocytogenes
C . Yersinia enterocolitica
D . Clostridium difficile
E . Staphylococcus aureus
23) Air conditioner repair worker is more likely to be at risk of contracting ?
A . Hepatitis
B . Brucellosis
C . Legionnaires disease
D . Histoplasmosis
E . Tuberculosis
24) A 19 year old woman present with daily acid reflux symptoms and intermittent dysphagia to solid . Since onest of symptoms 3 months ago , she has lost 2 kg , she has sporadic rectal bleeding . Her past medical history is negative . Her father had stomach cancer at age 42 . What would you recommend ?
A . EGD
B . Reassurance
C . Barium esophagrame
D . PPI therapy for 6_8 week's
E . Abdominal CT
25) Causes of pancytopenia includes all the following except ?
A . Megaloblastic anemia
B . Aplastic anemia
C . Myelofibrosis
D . IDA
E . Acute leukemia
26) Which of the following is true of psoriatic arthropathy ?
A . Nail pitting may give a clue to the diagnosis .
B . Absence of plaques of psoriasis excludes the diagnosis .
C . The diagnosis can be confirmed by a blood marker .
D . Typhi can some times be seen over the affected joints .
E . Severity is related to skin changes severity .
27) Regarding Nephrotic syndrome all are true except ?
A . Renal vein thrombosis is a complication .
B . Increase bleeding tendency
C . Increase susceptibility to infection .
D . DM is a recognized cause .
E . Hypoalbuminemia and Proteinuria is present
28 ) 60 years old male presented with massive hematemesis , examination revealed Splenomegaly , clubbing and Palmar Erythema . The cause of his hematemesis ?
A . Mallory Weiss syndrome
B . Gastric ulcer
C . Angiodysplasia
D . Esophageal varices
E . Gastritis
29) A 63 years old man is involved in a motor vehicle accident and is brought to the hospital . On examination, his blood pressure is 90/60 mm hg , pulse 110 / min , and his abdomen is distendes and rigid , he has internal injuries and bleeding on an abdominal CT scan , and requires emergent blood transfusion on his way to the operating room . His blood group is AB , which of the following statement is not correct ?
A . He is a universal recipient .
B . He has anti A and anti B in his serum .
C . If a cross match is not available, group O RBCs are universal .
D . If insufficient AB blood is available , type A can be used .
E . If insufficient AB blood is available , type B can be used .
30) The study of the distribution of a disease or condition in a population is referred to as ?
A . Descriptive
B . Analytical
C . Experimental
D . Prospective
E . Retrospective
31) All about irritable bowel syndrome are true except ?
A . Abdominal pain relieved by defecation .
B . Symptoms can be increased by stress .
C . Waking at night with pain or diarrhea support the diagnosis .
D . Altered bowel habit is common .
E . Examination is often normal .
32) Regarding diabetic ketoacidosis which is true ?
A . Dehydration is less life threatening than hyperglycemia .
B . Potassium level initially is high and falls down with treatment .
C . Is a late complication of type one DM .
D . Can be managed as outpatient in most of the cases .
E . Elevated WBC count always indicates infection .
33) All of the following are side effects of steroids except ?
A . Elevated blood pressure
B . Acne
C . Skin bruises
D . Hypoglycemia
E . Cataract
34) Blood gas analysis in type one respiratory failure shows ?
A . High PCO2 and normal PO2 .
B . Low PCO2 and normal PO2 .
C . Normal PCO2 and high PO2 .
D . High PCO2 and low PO2 .
E . Normal PCO2 and low PO2 .
35) In salmonellosis which is true ?
A . Positive blood culture occur in the second week .
B . Positive stool culture occur in the first week .
C . Splenomegaly doesn't occur .
D . Can be complicated by Osteomyelitis .
E . The route of transmission is air borne .
36 ) One of the following is true about COPD ?
It is one of the cause restrictive PFT .
Steroids are the cornerstone treatment .
It is a curable disease .
PFT reversibility always present .
Can cause right sided heart failure .
37) All of the following are cause of chronic cough except ?
A . GERD
B . Sodium valproate
C . ACE_i
D . Long term smoking
E . Postnasal drip
38) Which of the following antiarrhythmic drug mediates it's effect by interfering with movement of calcium through the slow channel ?
A . Phenytoin
B . Verapamil
C . Lidocaine
D . Amiodarone
E . Bretylium
39) 63 years old woman is seen in the emergency room with acute shortness of breath . There is no history of heart or lung problems in the past . She was recently diagnosed with breast cancer and is under going active treatment . On examination her blood pressure is 120/80 mm hg , pulse 100 / min , and heart and lungs are normal . There are no clinical sings of DVT . Which of the following investigation is most likely to rule out a PE ?
A . Normal CXR
B . Normal ECG
C . Normal ventilation _ perfusion lung scan .
D . Normal high resolution CT
E . Normal MRI
40) A 66 year old man has progressive shortness of breath due to COPD . He is currently able to do his activities of daily living , but has trouble walking more than 50 m . His physical examination reveals hyperinflation , increased resonance to percussion , and bilateral expiratory wheezes . He is in appropriate medical therapy for his stage of COPD . Which of the following is also indicated in the management of this condition ?
A . Meningococcal vaccine
B . Yearly influenza vaccine
C . Weight reduction obese
D . Haemophilus influenza B vaccination
E . Pneumococcal vaccination
41) A 39 year old woman with HTN , is taking hydrochlorothiazide ,enalapril and diltiazem . She desires to become pregnant . The most important step would be to ?
A . Switch HCTZ to Furosemide
B . Switch diltiazem to amlodipine
C . Discontinue diltiazem
D . Discontinue enalapril
E . Discontinue HCTZ
42) Regarding Acromegaly all are true except ?
A . Caused by tumor in adrenal gland in more than 90 % .
B . Excessive sweating .
C . Large hand and feet .
D . Increased growth hormone .
E . Proganthism .
43) All are features of LVF except ?
A . Orthopnea
B . Hepatomegaly
C . Pulsus alternance
D . Bilateral basal crepitation
E . Kerly B line on CXR
44) All of the following statement are correct about routine urine examination except ?
A . Specific gravity of 1015 is normal .
B . RBCs is a normal finding .
C . One RBC is a normal finding.
D . One WBC is a normal finding.
E . Negative sugar is a normal finding
45) Which oxygen delivery device should be used in COPD patient ?
A . Trauma mask
B . Nasal cannulae
C . Simple face mask
D . Venturi mask
E . Nonrebreather mask
46) One of the following can cause Hypokalemia ?
A . Spironolactone
B . Hyperaldosteronism
C . ACE_i
D . Addison disease
E . Renal tubular acidosis type 4
47) Which of the following most likely to cause deviation of trachea ?
A .Previous TB of the right upper lobe
B .Small right pleural effusion
C .A Left basal pneumonia
D . Idiopathic pulmonary fibrosis
E . Blunted right costophrenic angle
48) Optimal medical therapy in patient with carotid artery stenosis ?
A . Smoking cessation
B . Antiplatelet agent
C . Control HTN
D . Statin drugs
E . All are true
49) Skin cancer result from exposure to one of the following ?
A . Infrared rays
B . X rays
C . Solar ultraviolet
D . Ionizing radiation
E . Microwave
50) Regarding immunoglobulins all are true except ?
A . Rhesus antibodies are of IgG class .
B . IgG is the first response to invading organism .
C . IgA has the highest concentration in human secretion .
D . IgM is the best complement activator .
E . IgE mediates allergy by binding antigen on the membrane of the cell .
51) Social class can be measured by all of the following except ?
A . Sex
B . Income
C . Education
D . Occupation
E . Residency
52) One of the following disease is considered eradication worldwide since more than 30 years ?
A . Smallpox
B . Chickenpox
C . Plague
D . Typhus
E . Mumps
53) All of the following sentences are true about the assessment of bleeding except ?
A . Taking blood sample at the time of bleeding give an accurate level of HB .
B . Hypovolemia increases the risk of tissue hypoxia and multiorgan failure .
C. Blood loss could be estimated from the size of blood clot and the weight of swabs use .
D . Any thirsty patient should be considered Hypovolemic .
E . Arterial blood gas is a quick method to measure Hb level .
54) Epidemiology mean ?
A . Study of population ( study of the distribution and determination health related states or even .
B . Study of disease only .
C . Study population growth .
D . Study of mortality .
E . Study of chronic disease .
55) Patient with cystic fibrosis expected to have deficiency in all of the following except ?
A . Vitamin A
B . Vitamin B12
C . Vitamin K
D . Vitamin D
E . Vitamin E
56) Regarding Mycoplasma pneumonia all are true except ?
A . It is one of atypical pneumonia .
B . Can cause autoimmune Hemolytic anemia .
C . Can cause meningioencephalitis .
D . Cephalosporin antibiotic is a drug of choice .
E . Bilateral patchy consolidation .
57) One of the following is most suited for detection of diabetic ?
A . Renal ultrasound
B . Urine analysis for cast
C . Urine albumin
D . IVP
E . Serum creatinine
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