1. A patient with flail chest was intubated and sent to the ICU.

What is the most accurate

investigation to assess his pulmonary function after intubation?

A. ABG

B. Pulse oximetry

C. Estimated end-tidal CO2

D. Chest x-ray

2. A random group of Bedouins were randomly selected to study the effect of sun
exposure on skin diseases. They were given a questionnaire asking about sun exposure,
diet, and skin health. Type of study?

A. Cohort

B. Cross-sectional

C. Prospective

D. Case control
3. I forgot the stem of the question, but it was about a study done on 2 groups one diseased
and on controls and asking about the study design
4. Calculate the cumulative incidence rate: the group was 2000 people, 200 were diseased
at the begging of the 10 years, by the end 900 more were diseased, what is the
cumulative risk of the 10 years?
5. Al Ain Municipality was astonished by the increasing number of children mortality
because of RTAs. What preventive measure can you do?

A. Enforce seat belts

B. Traffic lights

C. Air bags only for licensed cars

D. Install additional humps in the roads

6. A 50 y/o female had a breast mammogram that showed microcalcifications suspicious

of cancer. O/E she has no palpable masses. What is your next step?

A. Repeat mammography after 3 months

B. Excisional biopsy

C. Repeat mammography after 12 months

D. Give her tamoxifen for 6 months

7. A woman presented with fever (39C) & bilateral breast fullness and pain 3 weeks post-
delivery. She has also been feeling unwell and tired most of the time. On examination,
there was no rash or erythema, but her breasts were tender. What is your diagnosis?

A. Breast engorgement

B. Mastitis

C. Breast abscess

8. A patient has an ECG showing monomorphic PVCs.

A. Atrial fibrillation

B. Extrasystole

C. AV block

D. Left ventricular hypertrophy

9. A hypertensive & diabetic patient (with no signs of target organ damage) also has
severe osteoarthritis, presents with shortness of breath. She presented complaining of
chest pain. He started taking his son’s diclofenac 50mg TID for 2 weeks. Now she has
increased BP with pedal edema & crackles over the lungs. Auscultation of the heart
reveals S3 heart sound. Next best step?

A. Start fosinopril

B. Stop diclofenac

C. Change labetalol as this is a side effect

D. Change her oral hypoglycemic

10. Evolving MI after the usage of cocaine what to give?

A. PCI

B. Beta blockers

C. Alpha blockers

D. Amlodipine

11. A patient undergoes an artificial valve replacement. For how long should he take
warfarin?

A. 6 months

B. 1 year
 C. Lifelong

12. Lady with a clear history of contact dermatitis at the site of belt what medication to
give?

A. Steroid cream

B. Antihistamine

C. Emollient cream

13. A 21-year-old university student presented with 1 cm honey-crusted lesion on his lower
lip. Best treatment option?

A. Flucloxacillin

B. Penicillin + flucloxacillin

C. Augmentin

D. Topical fusidic acid

E. Penicillin only

14. A lady pregnant with twins has hyperemesis gravidarum. Which electrolyte
abnormality do you expect to find?

A. Hypokalemia

B. Hyperkalemia

C. Hyponatremia

D. Hypernatremia

15. A lady presented with nipple discharge and amenorrhea. Her TSH is 7. Prolactin level
is 90. What do you do?

A. T3 and T4

B. TSH

C. Imaging of sella turcica

D. Give bromocriptine

16. A 35-year-old patient was diagnosed with papillary thyroid cancer (2x2.5 cm).
Management?

A. Lobectomy & isthmectomy

 B. Near total thyroidectomy with radioactive iodine

17. A patient was diagnosed with hepatitis C. He does not want you to inform his wife as
he fears that she will divorce him, and he believes that he probably has had it for a long
time so she would already be infected. The doctor agreed and did what the patient
wanted. What ethical rule was followed?

A. Respecting the patient’s autonomy

B. Non-maleficence

C. Beneficence

D. Justice

18. A nurse coming to you to stop her OCPS, what you will do according to her occupation
and health?

A. Check her Rubella and give vaccine if low

B. Give her hepatitis B vaccination prior to conceiving

19. A pregnant lady did not visit ANC until 12 weeks of gestation when she was found to
have a rubella IgG titer of 2. Next step?

A. Rubella IgG IM stat

B. Vaccinate her directly post-pregnancy

C. Check antibodies at 28 weeks

D. Vaccinate her after weaning

20. A 70-year-old man was admitted for a surgical procedure. 10-days post-op, when he
tried to mobilize for the first time, he developed sudden unilateral pleuritic chest pain
associated with dyspnea and diaphoresis. It subsided on its own. He was afebrile. What
is the most likely diagnosis?

A. Pulmonary embolism

B. Bronchiectasis

C. Atelectasis

D. Pulmonary infarct

E. ARDS

F. Lobar pneumonia
21. A patient presents with fever & diarrhea 10 days post-appendectomy for suppurative
appendicitis. Cause?

A. Pelvic abscess

B. Enterocolitis

C. Ruptured appendiceal stump abscess

D. Enteric fistula

22. A patient underwent a cholecystectomy 3 days back for acute cholecystitis. Her liver
enzymes were normal initially, but she developed post-operative painless jaundice.
O/E, there was wound tenderness. No ileus. Likely cause?

A. Ascending cholangitis

B. Acute pancreatitis

C. Clipping of CBD

D. Anesthesia induced liver injury

23. A burn patient presents with a suppurative lesion. On examination you notice blue-
green pus with a fruity odor. What is the most likely cause?

A. Pseudomonas

B. Staphylococcus aureus

24. 60-year-old male presents with an ulcer over the medial malleolus, varicose veins, and
hyperpigmentation. His left calf muscle was mildly swollen but not tender. Next step?

A. Bed rest

B. Compression bandage

C. Topical antibiotics

D. Heparin

E. 80 mg Enoxaparin

25. Which of the following is unlikely to present as a lateral superficial neck mass?

A. Cystic hygroma

B. Carotid body tumor

C. TB adenitis
 D. Branchial cyst

26. A tall lady presented complaining of headaches and numbness in her hands. On
examination, her BP is 210/160 mmHg. Her heart is in the 5th intercostal space
midclavicular line and you hear S4. Opthalmoscope showed av nicking (and multiple
findings that goes with htn) She had an abdominal bruit, what is the underlying disease?

A. Coarctation of the aorta

B. Abdominal aortic aneurysm

C. Renal artery stenosis

27. A 60 y/o man was diagnosed with cancer in the mid-third of the esophagus. What sign
makes the patient most likely untreatable?

A. Hiccups

B. Hoarseness

C. Regurgitation

D. Weight loss

28. A patient has esophageal cancer. What makes the diagnosis of cancer untreatable?

A. Hoarseness of voice

B. Increased RR (50 rpm)

C. SPO2 < 90 %

D. pCO2 > 45

29. What predicts a poor prognosis of pancreatitis in the first 48 hours?

A. LDH >600

B. ↑ amylase

C. ↑ triglycerides

30. A patient comes with upper GI bleeding. He is managed with fluids and the bleeding
stopped. Endoscopy was done and showed a 1 cm ulcer with non-bleeding vessel at the
base of the ulcer. What do you do?

A. Endoscopic clipping of the vessel

B. Angio-embolization of the vessel

C. IV vasopressin
 D. H. pylori eradication

31. Which factor do NOT decrease bioavailability?

A. Protein binding

B. Gastric emptying

C. Hepatic impairment

D. Drug formulation

32. A lady pregnant with a girl wants to know the chances of the child having cystic fibrosis
as she has 2 kids with CF already.

A. 100 %

B. 75 %

C. 50 %

D. 25 %
33. A patient has oozing from the venipuncture site 4-hours after a gastrectomy. She also
has purpuric lesions on her LLs & the dressing over the surgical wound was soaked.
Cause?

A. ↓ vitamin K

B. Ineffective electrocautery

C. ↓ platelets

D. ↓ anti-fibrinolytics

34. A female working as a domestic worker presents with fever and sweating. She reports
having lost 4 kgs of weight. No sore throat. On examination, she has enlarged matted
cervical lymph nodes. Chest is clear. What is the most likely diagnosis?

A. TB lymphadenitis

B. Infectious mononucleosis

35. Example of direct transmission?

A. Sexual transmission of chlamydia

B. Hepatitis B infection from needle sharing

C. TB infection through inhalation of air

D. Cholera infection from water

36. What drug will not cause dyslipidemia?

A. OCPs

B. Betablocker

C. ACE inhibitor

D. Thiazide diuretic
37. Patient with minimal change disease, what drug showed lowering of proteinuria?
A. Nothing
B. Steroids
C. ACE inhibitors

38. A 28 y/o man presented with xanthomas all over his hands and body. His father died at
the age of 51 due to a myocardial infarction. Investigations showed an abnormal lipid
profile (LDL = 400; TGs = 200; HDL = 45). His father has CAD. Diagnosis?

A. Familial hypercholesterolemia

B. Familial combined hyperlipidemia

C. Type IV dyslipidemia

39. A patient presents with upper & lower limb weakness and incoherent speech for 2
hours. How can you prevent future episodes?

A. Aspirin

B. Clopidogrel

40. I really can’t remember the stem but it has multiple issues but mainly it was muscle
weakness and tiredness over the day. A patient had weakness with inability to move
above her head, she also had SOB and some pulmonary sxs, O/E chest is clear muscle
wasting, diagnosis?
A. MG
B. HF

41. A female presents complaining of bitemporal headache for the past 2 years. The
headache was controlled for the first year with paracetamol 600mg & ibuprofen 400mg
a day. For 1 year, the medications stopped helping and the headache is worsening. No
associated nausea or vomiting, and no red flags. Headaches becomes better with
exercise. What is the most likely cause?

A. Drug-induced headache
 B. Tension headache

C. Migraine without aura

42. A patient was found to have mets to brain. What cancer is most likely to metastasize to
the brain?

A. Lung

B. Renal

43. A 70-year-old alcoholic patient is complaining of generalized vague pain. He reports

that he started drinking since the age of 10. His last episode of drinking happened in
the past 24 hours. He denies any mood changes or medical illnesses. There were no
findings on examination. What is the cause?

A. Alcoholic dependence

B. Factitious disorder

C. Malingering disorder

D. Pain related to substance abuse

E. Pathological pain (pain related to a medical condition)

F. Pain due to mood disorder

44. What is the 50g-GTT cut-off value for diagnosing gestational DM?

A. 7.8 mmol/L

B. 6.6 mmol/L

C. 4.6 mmol/L

D. 8.8 mmol/L

45. What ECG changes are seen in pregnancy?

A. Left atrial hypertrophy

B. Left axis deviation

C. Left strain

D. Left ventricular hypertrophy

46. Which cardiac problem carries the highest mortality risk in pregnancy?

A. Mitral stenosis
 B. Coarctation of the aorta

C. Aortic stenosis

47. A pregnant lady at 8 weeks is complaining of frequency & urgency. Best treatment?
(Nitrofurantoin was not an option)

A. Ampicillin

B. Penicillin

C. Ciprofloxacin (CI in pregnancy)

D. Gentamicin

48. A G6P3+A2 lady at 28 weeks of gestation came for a follow up. USS showed that the
baby’s head circumference corresponds with 27 weeks & his body with 24 weeks. AFI
= 9. What is the cause of the discrepancy?

A. Wrong date of 1st US (could be if symmetrical)

B. Tracheoesophageal fistula

C. Placental insufficiency

D. Chromosomal defect

E. TORCH

49. A G4P3 woman came at 32 weeks of gestation complaining of brownish vaginal

bleeding. She has no abdominal pain. On examination, she was stable and her uterus
was soft & not tender. Fetus was breech. Her cervix was long and closed with no visible
bleeding. USS showed a viable fetus. What is the most likely cause?

A. Excessive show

B. Placenta previa

C. Abruptio placenta

50. A G6P5 woman at 32 weeks of gestation presented with a blood pressure of 149/99
mmHg. On examination, there were fundoscopic hypertensive changes (AV nipping &
exudates). She had ++ proteinuria & had creatinine (1.6). No previous records of her
BP. Diagnosis?

A. Chronic hypertension with renal complications

B. Preeclampsia
 C. Pregnancy-induced hypertension

D. Gestational hypertension

51. Definition of labor

52. A 35-year-old G4P3 came at 35 weeks of gestation with ruptured membranes. Her
previous 3 pregnancies were delivered at 37, 38, and 36 weeks respectively. She is a
known case of diabetes. What is a risk factor for her premature rupture of membranes?

A. > 35 years

B. DM

C. Previous history of PROM

D. Multiparity

53. Which of the following meds taken by mother don’t alter the baby’s heart rate
variability?

A. Magnesium sulfate

B. Indomethacin

C. Pethidine IM

D. Diazepam

54. A primigravida came in labor. She had 1 contraction every 3 minutes lasting 45 seconds
each. Her cervix was 4 cm dilated and the baby was at station -2. After 4 hours, her
contractions had increased to 2 in 5 minutes lasting 45 seconds each. The cervix was
7cm dilated and the baby was at station -1. There was caput formation & grade 3
molding. Fetal CTG is reassuring. Urinary catheter could not be inserted. Next
appropriate step?

A. IV oxytocin

B. Paravaginal prostaglandin

C. LSCS due to obstructed labor

D. Wait for normal delivery

55. A woman at 39 weeks of gestation has a complete breech baby. The membrane is intact,
and her cervix is 2 cm (or 4 cm) dilated. CTG is reactive, showing good fetal heartbeat.
The baby weighs 3.8 kg and the placenta is anterior. What will you do?

A. ECV then CS
 B. ECV then wait for spontaneous labor

C. Elective C/S

D. Wait for NVD

56. A pregnant patient presents with PV bleeding at 8-10 weeks. She is febrile and has an
open cervical OS. WBCs were high. What is the least harmful management for an
inevitable / incomplete abortion?

A. Suction evacuation

B. Prostaglandin suppository

C. Oxytocin

D. Hysterectomy

E. Dilatation & curettage

57. A middle-aged female had ovarian cancer that was removed. Her menarche was at 17
y/o & she has been taking COCPs in between pregnancies (for a total of 5 years). What
increases her chances of getting endometrial cancer?

A. Medroxyprogesterone

B. COCPs

C. Theca cell tumor (unopposed estrogen)

D. Menarche at 17

E. Multiparity

58. A pregnant female at 16 weeks of gestation presents with mild dragging pain in the left
iliac fossa. O/E there is an adnexal mass. US showed a 10 x 15 cm, multiseptated,
hyperechoic cyst with calcifications in the left ovary (complex cyst). The right ovary is
normal. Management?

A. Laparoscopic / open cystectomy as soon as possible

B. Laparoscopic / open cystectomy at 28 weeks

C. Open cystectomy + C/S at 38 weeks

D. Open/ laparoscopic cystectomy 2-weeks post-partum

59. What investigations do you order for a woman with symptoms of PCOS (hirsutism &
acne)?
 A. Total testosterone + DHEA + 17 hydroxyprogesterone

B. Total testosterone + estradiol + 17 hydroxyprogesterone

C. Free testosterone + DHEA + estradiol

D. Androstenedione + DHEA + 17 hydroxyprogesterone

60. A woman has deep dyspareunia and flushing following a total hysterectomy & bilateral
salpingo-oopherectomy for endometriosis. What do you give her?

A. Estrogen only pills

B. Estrogen & progesterone

C. DepotProvera

61. A healthy 49-year-old woman, not on any medications, is complaining of hot flashes &
a labile mood that are affecting her life. She had regular cycles that lasted for 23-25
days previously, but for the past 9 months she has missed 3 cycles. She denies any post-
coital bleeding or stopping. She is asking for medications to help with her symptoms.
What would you give her?

A. SSRI

B. Low-dose combined OCPs

C. Continuous progesterone

D. Cyclic progesterone

62. A post-menopausal lady is complaining of PV bleeding. Her endometrial thickness is

2mm. Examination shows vaginal atrophy. Next step?

A. Vaginal estrogen cream

B. Endometrial biopsy

C. USS

63. A 55 y/o lady – menopausal for 5 years — is complaining of bleeding with brownish
spotting. Examination shows an easily bruising vagina & cervical stenosis. Her last pap
smear 3 months ago was normal. Next step?

A. Do US scan

B. Vaginal estrogen cream

C. Cyclic progestin
 D. Endometrial biopsy

64. A woman with PCOS features (hirsutism, obesity, amenorrhea for 4 months) was
worried that she did not get pregnant after 18 months of her marriage. She also recalls
that her last periods were very heavy. What is the initial management?

A. Metformin

B. Clomiphene citrate

C. Exercise & 10% weight loss

65. A young lady G3P3L3. Her eldest is 2.5 years and the youngest is 1 month old. She is
trying to loose weight and taking fruits and vegs only, she is breastfeeding and taking
the same vitamins she was taking in her pregnancy, she presented with SOB and
tiredness when climbing the stares or lifting weight, diagnosis?

A. IDA

B. HF

66. A multiparous lady presents 8 weeks post-delivery with nocturia & incontinence on
coughing. She wakes up at night 2 times to micturate. Her symptoms have increased
recently. She has normal urine volume. Diagnosis?

A. Stress incontinence

B. Detrusor hyperactivity

C. Total incontinence

67. A 70 y/o multiparous lady came to the clinic. Her cervix is visible at the introitus on
stressing (coughing / straining). She also has visible cystocele & rectocele. What is the
type of prolapse?

A. Procidentia

B. Vault prolapse

C. 2nd degree prolapse

D. 3rd degree prolapse

68. Multiple workers exposed to the same chemical present with a cough. What is the best
method to reduce exposure?

A. Check if the workplace environment is well-ventilated

B. Make them wear a mask

 C. Automated cabinet

69. A lady working an office-job developed neck pain. It was treated but the pain recurred
when she goes back to work. What will tell her?

A. Adjust the positioning of the computer

B. Use arm & neck splints

C. Neck strengthening exercises

70. What is the most common mode of spread of occupational diseases among workers in
the chemical industry?

A. Inhalation

B. Skin

C. Mucus

D. Ingestion

71. A patient with known history of DM & hypertension presents complaining of painless
transient loss of vision. He describes it as a “curtain falling down” that resolved within
15 minutes. Diagnosis?

A. Amaurosis fugax

B. Retinal artery embolism

C. Retinal detachment

72. Which changes are not seen in hypertensive retinopathy?

A. Arteriovenous nipping

B. Microaneurysm

C. Exudates

D. Papilledema

73. Which of the following is an indication for surgical intervention of disc prolapse?

A. Loss of anal tone

B. Pain radiation to the thigh

C. Loss of sensation over the lateral side of the foot

74. A 9 m/o baby weighing 9kgs is 10% dehydrated. He has low BP and is tachycardic.
 What is the deficit requirement?

A. 900 mL

B. 180 mL

C. 90 mL

D. 240 mL

75. A 4-week-old baby was brought by his mother for dehydration. He had been vomiting
for 3 days. He had a high-pitch cry, and O/E his skin was doughy & velvet-colored.
Serum Na = 155 mmol/L & K = 2.3 mmol/L. What is the cause of his minimal clinical
dehydration?

A. Total body sodium

B. Extracellular fluid accumulation

C. Plasma protein

D. Intracellular potassium

76. The question about how to monitor the resuscitation in 80 kg lady? Urine output above
40

77. A female child was born with congenital adrenal hyperplasia. She presented with severe
masculinization of the genitalia. What will you tell the mother?

A. Child may be infertile

B. Child may require a clitorectomy

C. She has an increased risk of ovarian cancer

D. Laparoscopy will be needed to visualize her pelvic organs

78. A 6-year-old girl with breast tanner stage 3 has underwent thelarche and pubarche. Her
FSH + LH and estradiol are 60. What is the diagnosis?

A. Hypothalamic

B. Dysplasia

C. McCune Albright Syndrome

D. Constitutional precocious puberty

79. A child had decreased breath sounds over the right infra-scapular region. His
presentation started 5 days ago.
 A. Foreign body aspiration

B. Viral pneumonia

80. When will a baby start laughing out loud?

A. 2 months

B. 4 months

C. 6 months

D. 9 months

81. A child was diagnosed iron deficiency anemia & was prescribed iron supplements 1.5
months ago. His hemoglobin is now normal. What advice do you give him?

A. Stop iron intake and repeat hemoglobin after 2 weeks

B. Continue iron intake for 12 months

C. Continue iron intake till 3 months

D. Measure TIBC and base further management on the value

E. Continue iron till MCV is normal

82. A child was brought by his mother to the ER for fever, rigors, and diarrhea. In the ER,
he becomes restless and develops a generalized purpuric petechial rash. His pulse rate
was 160 bpm, respiratory rate 25-30 rpm, and his BP was 110/60 mmHg. The nurse
gave him oxygen. What is your next step in management?

A. Dopamine

B. IV fluid

C. Antibiotics (meningococcal picture)

D. 2 units of platelets

83. A child was brought by his mother with 3-day history of poor feeding. He also had a
sore throat. O/E, he was febrile and there was a maculopapular rash with circumoral
pallor. His tongue was coated with red papillae. Management? (scarlet fever)

A. IV antibiotics

B. Oral antibiotics + IV dextrose drip

C. Oral antibiotics
 D. IV fluids

E. Oral antibiotics + antiseptic mouthwash

84. A child has a cast placed after a supracondylar fracture. The father notices pallor of the
limb. The limb remained pale after the cast removal. Next step?

A. Fasciotomy

B. Thrombolytic therapy

C. Heparin

D. Brachial artery exploration

85. Macrosomic baby born to a diabetic mother had a glucose level of 2.2 mmol.
Management?

A. Glucose D5%

B. Glucose D10%

C. Tell the mother to wait till blood glucose

D. Allow the mother to start feeding & check it again (wasn’t an option in the exam,
instead it was to wait until it goes back to normal alone or sth)

86. A 10 years old boy had motor movements in his shoulder & neck for the past year,
started developing along with grunting. His teacher complains that he does not pay
attention in class. Diagnosis?

A. Tourette syndrome

B. Attention deficit disorder

C. Schizophrenia

D. Conduct disorder

E. OCD

87. A child was brought by his mother to the ER for a cough. He seemed sick and had a
low BP. He was coughing but not in paroxysms. He also had paradoxical breathing and
supraclavicular recessions. What is the first step of management?

A. IV fluids

B. Oxygen

C. Antibiotics
 D. ICU

88. A child has the clinical picture of HSP. What additional findings? Stool occult blood

89. A 45 y/o female has known history of diabetes, hypertension. She is on meds, Her blood
pressure & sugar levels were still not controlled but she does not wish to add any more
medications. she stopped smoking for 4 months and started daily exercise for 2 months,
what stage on her life style changes?

A. Pre-contemplation

B. Contemplation

C. Action

D. Maintenance

E. Re-evaluation

90. A 72-year-old man is brought in by his son for decreased appetite and lack of interest
in previous activities. He says that his father no longer responds when his grandchildren
greet him, and he is unable to do basic tasks. His short-term memory is intact, but they
noticed that he calls his grandchild by his son’s name. The son has recently moved his
father to live closer to him 2 months ago. Diagnosis?

A. Age-related senile dementia

B. Alzheimer’s disease

C. Major depressive disorder

D. Multi-infarct dementia

91. A male with MDD has cardiac problems (angina). Most appropriate drug to use?

A. Imipramine

B. Fluoxetine

C. Amitriptyline

92. A lady presented with nightmares following the death of her husband. She says that she
has been avoiding things that remind her of him, and she is having flashbacks of him.
She has also been contemplating suicide. You notice that she has a grandiose attitude
towards him. What is the most likely diagnosis (duration of symptoms not mentioned)?

A. PTSD

B. Morbid grief
 C. Brief grief

D. Adjustment disorder with depressed mood

E. Major depressive disorder

93. You were called to the ER to see a 50 y/o female with history of depression. She says
that she has an empty belly & chest, and that she does not have a jaw, so she won’t eat.
Which delusion does she have?

A. Nihilistic

B. Perception

C. Paranoid

94. A man got a new job as a representative but is anxious to present seminars. He has
managed to avoid 3 seminars so far and is thinking of quitting his job. Diagnosis?

A. Simple anxiety

B. Social phobia

C. Agoraphobia

D. Panic disorder

95. A lady is unable to talk & can only express herself by writing. This problem started
after she lost her job. Diagnosis?

A. Hysterical aphonia (type of conversion disorder)

B. MDD

C. Adjustment disorder

D. Stress disorder

96. A 70 y/o man was brought to the clinic by his son due to memory loss. He had 1 episode
of losing his way home after prayer. The son also noticed that his father was calling
him by his grandson’s name. He mentions that his father is happy and doing well.
Diagnosis?

A. Alzheimer’s disease

B. Age-related (senile) dementia

C. Major depressive disorder

97. A 58-year-old recently retired man presents with shortness of breath. He has been
 smoking 20 cigarettes / day since he was 20 years old and has been working in building
construction sites. He also gave history of working in an insulation piping company.
On examination, he had lower limb edema. CXR was done and showed left lateral
calcified pleural plaques (thickened lung wall) and basal fibrosis. What is the most
likely diagnosis?

A. Asbestosis (mesothelioma)

B. Silicosis

98. A man presenting with a cough had a CXR done that showed bilateral opacities. It’s
due to strep, best treatment?

A. Amoxicillin

B. Amoxiclav

C. Azithromycin

D. There was another option I think cefotaxime

99. A diabetic patient with stage 3 CKD presents with acute pain in the 1st
metatarsophalangeal joint. On examination, the joint is red & swollen, and he is unable
to fully flex the big toe. An acute attack of gout. What is the best treatment option for
his acute attack?

A. Allopurinol (not started during acute flares as it may worsen the symptoms)

B. Colchicine (not contraindicated but dose adjustment and close monitoring is

important – signs of toxicity are leukopenia / elevation of AST / neuropathy)

C. NSAIDs (diclofenacsodium) (nephrotoxic)

D. Steroids (may be the best option)

E. Indomethacin

100. Picture of butterfly rash. Patient has symptoms of malar rash & photosensitivity.
Diagnosis? She also has joint pains and decreased night vision. What is your most likely
diagnosis?

A. Rheumatoid arthritis

B. SLE

C. Vitamin A deficiency

101. A pregnant lady with SLE gave birth. Her child was bradycardic. Which auto-antibody
 is associated with high risk of heart block in the fetus?

A. Anti-Ro (neonates) – also true for SSA & SSB

B. Anti-Jo (polymyositis)

C. ANA (sensitive for SLE)

D. Anti-double stranded DNA (specific to SLE)

E. Anti-histone (drug-induced SLE)

102. A man has chronic sinusitis, high creatinine, and +++ blood on urine dipstick.
Diagnosis?

A. Wegener granulomatosis

B. Churg Strauss

C. Mixed cryoglobulinemia

D. Hemolytic uremic syndrome

103. What sign would be present in a patient coming with alcohol withdrawal?

A. Apathy

B. Tachycardia

C. Hypersomnia

D. Insomnia

E. Muscle rigidity

104. An 18-year-old boy came back home after spending a night at his friend’s house. His
mother noticed that he was anxious, restless, sweating, and had increased lacrimation.
She brought him to the ER where he was complaining of fatigue and a headache. No
appetite changes. He was mildly hypertensive, and his pupils were dilated. His speech
was intact, and he denied taking any drugs. What drug did he take?

A. Alcohol (withdrawal)

B. Glue inhalation

C. Amphetamine

D. Cocaine

E. Opioids
105. A 30-year-old male presented with flu-like symptoms, rhinorrhea, irritability, and
sweating. These symptoms are most likely due to withdrawal of which drug?

A. Amphetamine

B. Opioids

C. Cannabis

106. A man was brought to the emergency after an RTA. He had severe hypotension (80/50
mmHg) and was given IV fluids. Afterwards his BP increased to 90/70 mmHg and his
pulse decreased to 125 bpm. Liver US attached. What is your next step?

A. Urgent laparotomy

B. Diagnostic laparoscopy

C. Peritoneal lavage

107. A female involved in an RTA (while wearing a seatbelt) is complaining of diffuse

abdominal pain. Bowel sounds are absent. X-ray shows fluid in the peritoneal cavity.
Which organ is most likely injured?

A. Liver

B. Spleen

C. Kidney

D. Bowel

108. A 65-year-old man came complaining of dribbling and other urinary symptoms. On
DRE, he had a moderately enlarged firm prostate. PSA was 7.8 initially and 7.9 after 4
weeks. Curious to know why PSA is high, what is the next step?

A. Alpha-blocker & follow up PSA

B. 5-alpha-reductase & follow up PSA

C. TURP

D. Transrectal biopsy with antibiotic coverage

E. Transurethral biopsy with antibiotic coverage

109. A patient passed a stone and got it, what to do?

A. Chemistry of the stone

B. 24 hours urine calcium

110. What is the mechanism of action of labetalol?

A. Selective for post-synaptic

B. Alpha and beta receptor blocker

111. An old man on dialysis underwent angioplasty for an AV graft that was unsuccessful
due to thrombosis (and thrombectomy failed). Another graft is currently being prepared.
How could you have prevented its failure?

A. Monitor flow thrill by physical examination

B. Streptokinase

C. Aspirin

D. Use another way for dialysis

E. Catheter