KAUH residency exam 2021

1. Autosomal dominant: Neurofibromatosis type 1.

2. Patient with old and new creatinine values suggestive of AKI on top of
CKD, he is on multiple medications (one of them is atenolol), is now
in the ICU with bradycardia & hypotension ECG showing sinus brady
(case of beta blocker toxicity). What treatment to give?
- IV glucagon
- Furosemide
3. Bile acids are derived from:
- Heme
- Cholesterol
- Triglycerides
- Protein
4. Nerve affected in monteggia fracture:
- Median nerve
- Ulnar nerve
- Muscular branch of the radial nerve
- Posterior interosseous nerve
- Deep branch of the median nerve
5. All true about postmenopausal bleeding except:
- The most common cause of post menocausal bleeding is
endometrial cancer.
6. Not effect of hypokalemia:
- Constipation
- Metabolic acidosis
7. All are true regarding amylase, except:
- Amylase correlates well with severity of pancreatitis
- May be within normal in pancreatitis due to hypertriglyceridemia
- Begins to rise shortly after onset of pancreatitis
 - Amylase levels normalize within 24 hours of an episode of
acute pancreatitis.
8. All true about acute adrenal insufficiency, except:
- Hypertension.
9. The child develops Mature pincer grasp at age of:
- 12 months
10. Uremia is a risk factor for which of the following:
- Acute coronary syndrome
- PE
- Aortic dissection
- Pneumothorax
- Pericarditis
11. One of the following is of the criteria for spontaneous bacterial
peritonitis:
- WBCs> 150 cells/mm3
- WBCs> 250 cells/mm3
- Neutrophils> 100 cells/mm3
- WBCs> 100 cells/mm3
- Neutrophils> 250 cells/mm3
12. Which of the following form the marginal artery of drummond:
- Superior mesenteric artery and inferior mesenteric artery
- Inferior mesenteric and inferior rectal
- Superior mesenteric and middle rectal
- Splenic artery and superior mesenteric
13. Which of the following enteric pathogens is associated with
greatest risk for seizures:
- Salmonella typhi
- Shigella dysenteriae
- Campylobacter jejuni
- Rotavirus
14. In a population, the Median survival for colorectal cancer was 20
months. Median survival is best defined as:
- A midpoint value where an equal number of values are present
on its left and on its right.
15. Large gastric ulcers are:
- Prone to bleeding
- Prone to perforation
16. Which of the following is not a chromosomal breakage disease:
- Fanconi anemia
- Bloom syndrome
- Ataxia-telangiectasia
- McCune - Albright syndrome
- Nijmegen syndrome
17. Areolar and nipple lymphatic drainage:
- Apical
- Pectoral
- Parasternal
18. Female with hypothyroidism on levothyroxine, presents with
hypotension, bradycardia, confusion, hypothermia. Dx:
- Myxedema coma
- Adrenal insufficiency
19. Management of adrenal crisis:
- IV fluids and hydrocortisone
- IV Fluids only
20. Hematemesis in a liver cirrhosis with confusion, first step in
management:
- Secure airway and intubation
21. Burn question in closed area with black soot in nostrils first step:
- Intubation
22. High fever and barking cough:
 - Bacterial tracheitis
23. About OCP, all are true except:
- irregular menses
24. A question about infertility, all are true except :
- HSG is done at mid luteal phase for better visualization
25. A question about a female patient with seizure disorder on AEM,
she became pregnant, all are true except:
- Discontinue all AEM as all are teratogenic.
- Valproate is contraindicated in pregnancy because it is
teratogenic.
26. A patient presented with dark urine, fatigue (picture of
rhabdomyolysis), best investigation:
- Creatine kinase
27. All cause QT prolongation except:
- Levofloxacin
- Hypocalcemia
- Erythromycin
- Amiodarone
- Digitalis toxicity
28. A question about a patient with hypercalciuria and predisposition
to kidney stones what is the best to do:
- Decrease sodium intake
29. Persistent gastric outlet obstruction causes all of the following
except:
- Hypokalemia
- Hypercholermia
- Metabolic acidosis
- Aciduria
30. Case of a Postpartum female who has headache, vomiting and
first seizure, what is the most appropriate diagnostic test to do?
 - Ct scan with contrast
- Ct scan without contrast
- MRI
- MRA and MRV
31. A female patient with a history of resected breast cancer 2 years
ago, now she is complaining of back pain, nausea, vomiting and
polyurea. next step:
- Spine Xray
- Serum Ca level
- Serum Na level
32. All are seen in neurogenic shock except:
- Hypotention
- Bradycardia
- Warm skin
- Catanous vasodilation
- Narrow pulse pressure
33. A 35-year old female presented with a history of 1-week flu-like
symptoms and chest pain that is worse with lying flat and better with
leaning forward, she looks uncomfortable. ECG shows sinus
tachycardia, troponin is positive. What is the most likely diagnosis?
- Pericarditis
- Myocarditis
- ST elevation MI
- Pulmonary embolism
34. Angle of louis (Manubriosternal joint) is at the level of:
- T4
35. Patient presented after dog attack with multiple head and hand
lacerations. what to do next:
- Steri strip for all and give Augmentin
- Wound cleansing and bandaging
 - Repair the head laceration but not the hand
- Repair the hand laceration but not the head
- Repair both lacerations
36. Picture of osteomyelitis in a patient with sickle cell disease, Most
common causative organism:
- Staph aureus
37. One of the following indicates poor prognosis in pneumonia:
- Elevated serum urea
- Increased RR
- Consolidation on CXR
38. One of the following is not a red flag for back pain:
- Back pain in a 6 year old child
- Associated with saddle anesthesia
- Associated with fever
- Positive straight leg raising test on examination
39. Not a part of APGAR score:
- RR
40. A Child starts to become clumsy and wants to be carried, he has
unsteady gait, his facial expression is lost. Physical examination
showed lower limb weakness, areflexia and bilateral facial weakness.
What's the diagnosis?
- Botulism
- Miller Fisher syndrome
41. Wrong regarding Folate in pregnancy:
- It is water soluble
- Best to be taken in the first trimester
- Deficiency causes Macrocytic anemia
- Used with MTX to reduce its side effects
- It decreases risk of NTD development
42. A patient presented with fever, polyneuropathy, physical
examination showed Livedo reticularis. Dx:
- Polyarteritis nodosa
43. Which of the following is false:
- Cystic artery arises from the right hepatic artery.
- Cystic artery branches into anterior and posterior.
- Gallbladder is composed of columnar epithelium.
- Gallbladder has two muscular layers, muscularis mucosa
and muscularis propria.
44. About recurrent miscarriage, all are true except:
- Can be associated with severe pre-eclampsia.
- Early screening for bacteral vaginosis prevents first trimester
miscarriage.
- Septate uterus is a recognized cause.
- Increased risk in patients with oligomenorrhea.
45. All of the following are true, except:
- Obesity predisposes to early menarche.
- GnRH agonist is the drug of choice in constitutional precocious
puberty.
- Hypothyroidism causes precocious puberty with delayed bone
age.
46. A female is being evaluated for primary amenorrhea, and she has
short stature, you should screen for:
- Coarctation of aorta
- Pulmonary stenosis
47. A 6 week old child presented with an umbilical discharge, on
examination it is not smelly but there is a red spot at the umbilical
stump, what's the diagnosis?
- Umbilical granuloma
- Vitelline duct remnant
 - Patent urachus
48. A Child presented with low urine output and urine is dark, BP
170/100, peripheral edema, tachypnea and cardiomegaly. What's the
diagnosis?
- Chronic HTN
- Myocarditis
- Acute GN
49. RTA victim with Glasgow Coma scale of 5, dilated non reactive left
Pupil, right pupil is reactive to light. what to expect on exam:
- Right-sided hemiparesis
- Clonus
- Left foot weakness
50. Asian adult with microscopic hematuria, on urinalysis RBCs 10-15
with 50% dysmorphic, normal BP, urine albumin to Cr ratio is 39.
What's the diagnosis?
- IgA nephropathy
- Thin basement membrane disease
- Focal segmental glomerulosclerosis
- Minimal change disease
51. All of the following are true, except:
- Splenic artery gives inferior pancreaticoduodenal artery
- Inferior pancreaticoduodenal arises from the SMA
- Superior pancreaticoduodenal arises from the gastroduodenal
artery.
52. 16 kg child with 10% Isonatremic dehydration, the total fluid
requirement?
- 2900 ml over 24 hr
53. Elderly with a 60 pack/year smoking history who presents with
exertional dyspnea that limits his activity. his FEV1 60s FEV1/FVC
 60s, 3 months ago he had an ER visit with increased dyspnea and
sputum, what is the best next step in management?
- Inhaled tiotropium
- Inhaled corticosteroid
- As needed salbutamol
- As needed ipratropium
54. Patient presents with abscess for incision and drainage, which of
the following requires further evaluation:
- 4 cm mass in the left axilla
- 4 cm mass in the buttock
- 4 cm mass on the left knee
- 4 cm mass on the right forearm
- 4 cm mass on the neck
55. In which condition do you have to do surgical consultation in a
patient with GI bleeding:
- Esophageal varices
- Hx of abdominal aorta graft
- Liver disease
56. Regarding lab findings in acute hepatitis, one is true:
- LDH levels are almost always normal
- Direct and indirect bilirubin rise in equal quantities
- AST is higher than ALT
57. What contributes most to shock in anaphylaxis:
- Low preload
- Afterload reduction
- Histamine release
58. About blowout fractures, all are true except:
- Avoid nasal blowing to avoid emphysema
- Give Prophylactic antibiotics
- Give eye drops for inflammation
 - decongestants to decrease fluid accumulation
- Use Cold compressors
59. Female has cystinosis and she is planning to have children, which
of the following is true:
- All female will be affected
- All male will be affected
- 50% will be carriers
- 50% will be affected
60. Syncope due to serious condition can be most likely due to:
- Structural cardiac lesions
- Dysrhythmias and myocardial ischemia
61. Screening test for hemochromatosis:
- Transferrin saturation
- Serum Ferritin
62. A patient presented at day 8 post left hemicolectomy, developed
swinging pyrexia and ileus, what to do next:
- Abdominal CT with IV contrast
- Erect chest x-ray
- Abdominal ultrasound
63. All are indications for endocarditis prophylaxis except:
- Peripartum cardiomyopathy
- Congenital heart disease
- Hx of cardiac transplant
- cardiac valve replacement repair
64. All can be diagnosed with a third trimester anomaly scan except:
- Dilated renal pelvis
- Unilateral renal agenesis
- Facial cleft
- Down syndrome
- Placenta previa
65. In cases of chest pain, how to differentiate cardiac from
noncardiac causes:
- BNP
- S1Q3T3 on ECG
66. About endometriosis, all are true except:
- It is a disorder with no cure.
- May be asymptomatic
- Regresses after menopause
- Occurs more frequently in women with a history of multiple
births
67. A case of a 3 month history of epigastric pain that does not
improve with antacid. What is the next step?
- Give omeprazole
- Do upper endoscopy
- Stool antigen for H.pylori
- Do right upper quadrant ultrasound
68. About prenatal ultrasound, all are correct except?
- Fetal movement can be detected by ultrasound as early as 9
weeks.
- Bilateral renal agenesis can be seen on ultrasound by 12
weeks.
- Measurement of nuchal translucency is best between 11-13
weeks.
- Can accurately diagnose omphalocele
- Can detect most NTD.
69. The daily caloric requirement in a full term baby:
- 100-120 kcal/kg
70. 35 YO female patient with 6-month history of bloody loose stools,
no fever, no weight loss, no eye complaints. Colonoscopy showed
erythematous mucosa in the rectum, sigmoid and descending colon.
 Ascending and transverse colon are not affected. Biopsy showed
crypt abscesses, what's your diagnosis?
- Ulcerative colitis
- lymphoblastic colitis
71. Regarding the vagina, all are true except:
- Vaginal pH=4-5 in childbearing age
- Vagina is lined with nonkeratinized stratified squamous
epithelium
- Vagina is directed upward and backward
- Posterior vaginal fornix is deeper than the anterior
- Vagina has many glands
72. Regarding endometrial cancer, all are true except:
- Serous type has good prognosis
- Clear cell has worse prognosis than endometrioid
- Endometrioid is the most common type
- Depth of invasion is an important prognostic factor
73. All of the following can present with fundal height that is small for
date, except:
- Esophageal atresia
- IUGR
- Renal agenesis
- Transverse lie
- Mother with chronic HTN
74. About hydatid liver cyst, all are true except:
- Water-lily appearance suggests highly active disease
- It's most commonly seen in the right lobe of the liver
- ELISA is diagnostic in 85% of cases
- Small cyst can be managed with albendazole and observation
- If possible, complete resection of the cyst without rupture is
preferred.
75. Which of the following is not given in septic shock?
- Empiric antibiotics
- Starch-based colloids
- IV Fluids
- Norepinephrine
- Arginine vasopressin
76. Management of neonatal hypoglycemia:
- IV D10
77. Pregnant patient presented to the clinic at 24 weeks and she had a
blood sugar reading of 145 after 1-hr 50 g OGTT. what to do next?
- Measure blood sugar after 2-hr 75 g OGTT
- Measure blood sugar after 3-hr 100 g OGTT
- Reassure the patient as she does not have diabetes
- Start her on insulin
78. A preterm infant with a picture of respiratory distress syndrome
(has tachypnea, grunting), the cause of his condition:
- Decreased alveolar compliance
79. All the following risk factors for obstructive sleep apnea except:
- Smoking
- DM
- Obesity
- Sedating drugs
80. All will be low after treatment of DKA except:
- Glucose
- Potassium
- Acetoacetate
- Free fatty acid
- Beta-hydroxybutyrate
81. Patient with chest pain, on physical examination he is bradycardic
and hypotensive, what's your diagnosis?
 - Right ventricular MI
82. Factors that cause less scarring and better healing:
- Early closure, avoid infection & excessive tissue tension
- Lower local oxygen tension
- Zinc deficiency
- Wound infection
- Lower blood supply as it induces less bleeding
83. What is the physical finding that best suggests VP shunt
malfunction?
84. Q about the anatomy and function of the placenta.
85. Q about Dysgerminoma.
86. Q about Celiac disease.