1- A patient was diagnosed to have locally invasive prostate cancer.

Which one of the

following symptoms
is expected to be seen in this patient?
a- Bone pain
b- Peripheral edema
c- Weight loss
d-Urinary frequency and hesitancy
e- The patient will be asymptomatic

2-A patient was diagnosed to have T-cell ALL. His case was shown to be refractory to
first line treatment.Which one of the following therapies is suitable for treating this
patient?
a- Inotuzumab ozogamicin
b-Nelarabine
c- Tisagenlecleucel
d-Asparaginase
e- High dose cytarabine

3- A 17-vear-old boy who is now 4 years off treatment for ALL presents with anemia,
thrombocytopenia, and fatigue. On bone marrow biopsy, he is found to have secondary
AML. His treatment for ALL included methotrexate, cyclophosphamide, vincristine,
daunorubicin, etoposide, dexamethasone, and asparaginase. Which one of the following
agents is most likely to have contributed to his secondary AML?
a- Dexamethasone
b- Daunorubicin
c- Asparaginase
d-Etoposide
e-Vincristine and daunorubicin

4- A Patient presented with generalized anxiety disorder, all these medications can be
used in the treatment of anxiety EXCEPT:
a- Pregabalin
b- Corticosteroids
c- Buspirone
d- Hydroxyzine
e- Antidepressants

5- Mucositis in patients receiving high-dose chemotherapy. FDA-approved drug used for

the prevention and treatment of mucositis
a- Palifermin
b- Amifostine
c- Gelclair
d- Caphasol
e- Biotene

6- A 63 years old man with narcolepsy type 1, he has a history of disc prolapse on
tramadol and benign prostatic hyperplasia (BPH) on tamsulosin. What is the safest
treatment for cataplexy for this patient?
a- Diphenhydramine
b-Amitriptyline
c- Fluoxetine
d- Selegiline
e- Impramine

7- Smoking can cause many types of cancer. Smoking cessation is associated with a
gradual decrease in the risk of all of the following cancer types except
a- Lung
b-Brain
c-Pharynx
d- Mouth
e- Esophagus

8- A patient was diagnosed to have colorectal cancer. All of the followings are common
sites for metastases by colorectal cancer except
a- Brain
b-Lung
c- Bone
d- Liver
e-Breast

9- Surgery is useful for curative treatment of which one of the following cases
a-A patient with stage 1 esophageal cancer
b-A patient with stage 4 pancreatic cancer
c-A patient with acute lymphoblastic leukemia
d-A patient with metastatic bladder cancer
e-A patient with chronic myelogenous leukemia

10- Most chemotherapeutic agents induce nausea and vomting. Which one of the
following patien? considered to have the lowest risk for development of CINV?
a- A 49 vears old female patient with poor emetic control in previous chemotherapy cycle
b- A 55 years old female with a history of motion sickness and poor emetic control in
previous chemotherapy cycles
c-A pregnant woman
d-A 53 years old woman with history of motion sickness and uncontrolled diabetes
e-A 41 years old male with a history of motion sickness and poor emetic control in
previous chemotherapy cycles

11- A 62 vears old man with cancer (Body surface area 1.7 m2) is treated by
cyclophosphamide containing regimen. Which one of the followings can be used as a
suitable prevention method?
a- Mercaptopurine sulfonate
b- Normal saline 3 L/day with furosemide
C- Glucose water 5.1 L with furosemide
d- Normal saline 5.1 L/day with furosemide
e- a & b

12- A patient 62 years old man with advanced stage solid tumor was treated with
chemotherapy with palliative intent. His current lab data shows: Hb 11.5 g/dl; Urea 44
(20-45mg/dl); creatinine 1.3 mg/dI (up to 1.4mg/di).
Which one of the followings is a factor that increases the risk of febrile neutropenia for
this patient?
a- His age
b- His current hemoglobin level
c- His current renal function
d- Treatment intent
e- His gender

13- An elderly patient with FLT3 positive AML. What is the best treatment in case of
relapse for this patient?
a- Ivosidenib
b- Enasidenib
c- Gilteritinib
d- Cytarabine and etoposide
e- Cytarabine and mitoxantrone

14- A 60 years old patient was diagnosed to have IgH mutated CLL. What is the
preferred treatment for this patient?
a- Ibrutinib
b- Acalabrutinib+obinutuzumab
c- Fludarabine, cyclophosphamide, and rituximab
d-Venetoclax plus obinutuzumab
e- Duvelisin
15- According to the depression monoamine hypothesis, there is a decrease in the brain
level of
a- Serotonin, acetylcholine, and dopamine
b- Serotonin, norepinephrine, and dopamine
c- Serotonin, norepinephrine, and epinephrine
d- Serotonin, GABA, and dopamine
e- Serotonin, GABA, and acetylcholine

16-Some medications are associated with depressive symptoms. Which one of the
following drugs is not implicated in depressive symptoms?
a- Bisoprolol
b- Isotretinoin
c- Oral contraceptive
d-Interferon-B1a
e-Metformin

17-A 16 years old man with depression. Which antidepressant drug is FDA-approved for
treatment of this patient?
a- Escitalopram
b- Desipramine
c- Sertraline
d- Citalopram
e- Fluvoxamine

18- A patient with depression was only partially responding to treatment by imipramine.
All of the Followings can be used to augment antidepressant effect EXCEPT:
a- Lithium
b- Haloperidol
c- Aripiprazole
d-Quetiapine
e- Brexpiprazole

19- M.K is 56 years old man diagnosed to have major depression. Which one of the
following drugs when given to this patient require regular monitoring of blood pressure?
a- Fluoxetine
b- Maprotiline
c- Venlafaxine
d- Phenelzine
e- vilazodane
20 cloanent. vth a history of obsessive compulsive disorde and resistant schizophrenia
that was treated by clozapine. Which one of the following medications can be reststan
inprove obsessive compulsive disorder symptoms that worsen by clozapine?
a- Lithium
b- Carbamazepine
c- Valproic acid
d- Citalopram
e- None of the above

21- A 32 years old lactating mother with schizophrenia. Which one of the following
drugs has the least risk on the infant?
a- Risperidone
6-Aripiprazole
c- Olanzapine
d- Clozapine
e- Chlorpromazine

22- Regarding Cushing syndrome. Mifepristone is one of the pharmacological therapies

for Cushing syndrome, for which all of the following are false EXCEPT:
a- It is glucocorticoid-receptor agonist
b-it increases endogenous cortisol and ACTH levels in Cushing patients
c-It is effective in reversing the manifestations of hypocortisolism
d-It can be used for endogenous Cushing syndrome in patients who have type 2 diabetes
e-May result in endometrial hyperplasia and hyperkalemia

23- Regarding chemotherapy-related complications, it includes all the followings except

a- chemotherapy-induced nausea and vomiting
b- myelosuppression
c- febrile neutropenia
d-Interstitial cystitis
e- mucositis

24- Regarding the treatment of adrenal insufficiency, the corticosteroid agent of choice is
a- deoxycorticosterone trimethylacetate
b- fludrocortisone acetate
c- prednisolone
d- prednisone
e-hydrocortisone

25- Regarding the vasomotor symptoms of perimenopause and menopause, all of the
following symptoms are false EXCEPT:
a- depression
b- sleep disturbances
c-anxiety
d- night sweats
e- vaginal dryness

26- For newly diagnosed patients with chronic myeloid leukemia. The standard of care is
a- chlorambucil
b- cyclophosphamide
c- l-asparaginase
d-imatinib
e- daunorubicin

27-All of the following are considered cognitive symptoms of Alzheimer's disease, with
the exception of:
a- Agnosia
b-Wandering
c- Disorientation
d- Impaired executive function
e- Aphasia

28- The cholinesterase inhibitor drug that can be taken when an Alzheimer patient's
condition is classified as severe is.
a-Donepezil
b-Rivastigmine
c- Galantamine
d- Memantine
e- Atropine

29- Jane is a 48-year-old woman who is experiencing severe hot flashes and night sweats.
She has a family history of breast cancer, but has no personal history of breast cancer or
cardiovascular disease. Which medication may be a potential option for relieving Jane's
hot flashes and night sweats, given her family history of breast cancer?
a- Calcium and Vitamin D3 supplementation
b- Hormone replacement therapy
c-gabapentin
d-corticosteroids
e- none of the above

30- Regarding general anxiety disorders, which symptoms of GAD are benzodiazepines
more effective for?
a- Psychic symptoms
b- Emotional symptems
c- Somatic and autonomic symptoms
d- Behavioral symptoms
e- none of the above

31- Regarding general anxiety disorders, what is the recommended approach for
benzodiazepine dosing in older patients?
a-Use high doses of short-elimination half-life agents
b-Use high doses of long half-life agents
c-Use low doses of short-elimination half life agents
d-Use low doses of long half-life agents
e-None of the above

32- A 35-year-old female with stage I breast cancer. Which one of the following effective
initial adjuvant chemotherapy regimens should be offered to her following mastectomy?
a-Doxorubicin alone
b-Doxorubicin and epirubicin
c-Doxorubicin and epirubicin with the addition of paclitaxel
d-Doxorubicin and epirubicin with the addition of trastuzumab
e-No chemotherapy is recommended at this stage.

33- A 41-year-old male with ALL. All of the following chemotherapeutic agents should
be given in the induction phase of this patient EXCEPT
a- L-asparaginase
b- doxorubicin
c- vincristine
d-methotrexate
e-dexamethasone

34- A 53-year-old man notes fatigue and poor sleep for the past 6 weeks, starting around
the time of his father's death. What is the type of insomnia this patient have?
a- Transient insomnia
b-Short-term insomnia
c- Chronic insomnia
d- Acute insomnia
e- Severe insomnia

35- Regarding dysmenorrhea. All of the following are appropriate recommendations for
the initial management of primary dysmenorrhea EXCEPT:
a- NSAIDs
b- Copper intrauterine device
c- Application of heat (topically)
d- Regular brisk exercise
e- A low-fat vegetarian diet

36- Regarding Addison disease. All of the following are true EXCEPT:
a-Skin hyperpigmentation is a characteristic feature
b-The short cosyntropin stimulation test is used to confirm the diagnosis
c-Hydrocortisone + fludrocortisone acetate is the treatment of choice
d- Hyperkalemia + hyponatremia are common
e-Laparoscopic adrenalectomy is the non-pharmacological treatment of choice

37- Regarding Grave's disease. All of the following are true EXCEPT:
a- is a curable condition
b- Nervousness, anxiety, and palpitations are common symptoms
c-Exophthalmos, pretibial myxedema, and thyroid acropachy are extrathyroidal findings
d-It is characterized by high levels of T3, T4 and TSH
e-It is the most common cause of hyperthyroidism

38- Regarding levothyroxine. All of the following are true EXCEPT:

a-It t is chemically stable, relatively inexpensive, active when given orally, and free of
antigenicity
b-It is a main source of thyroxine that is readily converted to triiodothyronine
c-It is the drug of choice for hypothyroid pregnant women
d-Higher than normal dose is usually indicated for the treatment of thyroid storm
e-Excessive doses may lead to heart failure, angina péctoris, and myocardial infarction

39. What is the primary goal of adjuvant chemotherapy?

a- To remove all macroscopic malignant cells
b- To decrease recurrence and prolong survival by eliminating microscopic malignant
cells
c- To decrease the tumor burden to make the surgery easier to perform
d- To control symptoms of cancer
e- None or the above

40- Concerning pharmacological therapy of non-cognitive symptoms of Alzheimer

disease, all of the treatments are correct EXCEPT:
a- Serotonin selective receptor inhibitors sartroline and citalopram given to depressed
patient with Alzheimer disease
b-Tricyclic antidepressant is highly recommended
c- Antipsychotics Aripiprazole, Risperidone and Olanzapine used to treat neuro psychotic
symptoms
d-Antipsychotic restricted to patients with severe symptoms
e- Treatment with antipsychotic should be tapered early not beyond three months

41- Regarding Epidemiology and Etiology of Anovulatory uterine bleeding. The

followings are most common causes of non-physiologic ovulatory dysfunction EXCEPT:
a- PCOS
b- Hypothalamic amenorrhea
c- Hypoprolactinemia.
d- Premature ovarian failure
e- Hyperprolactinemia.

42- There are different types of leukemias which can occur at different periods of human
life. The most common leukemia among elderly (above 65 years old) is
a-Chronic lymphocytic leukemia (CLL).
b- Acute myelogenous leukemia (AML)
c- Acute lymphocytic leukemia (ALL)
d- Chronic myelogenous leukemia (CML)
e- Acute non-lymphocytic leukemia (ANLL)

43- Major depressive disorders have several symptoms. All the followings are physical
symptoms of major depressive disorders EXCEPT:
a- Crying
b- Loss of sexual interest
c- Fatigue
e- Sleep disturbance
d-Pain

44- Spironolactone has several adverse reactions. All the followings are adverse reactions
of spironolactone except
a- Stomach discomfort
b- Hypernatremia
c- Impotence
d- Menstrual irregularities
e- Hyperkalemia

45- Sabria is an overweight 30-year white woman needs to use a contraceptive. All the
following factors should be considered before selecting the contraceptive method/therapy
except:
a. Woman weight
b- Woman ade
c- Woman ethnicity
d- Risk for sexual transmitted disease
e- Planning for future pregnancies

46- Regarding emergency contraception. All the following treatment are true, EXCEPT
a- ulipristal
b- levonorgestrel
c- a copper IUD mifepristone
d- higher doses of combined oral contraceptives
e- mifepristone

47- A blood test can be used as a diagnostic tool to help determine if a woman is entering
the menopausal stage. Which of the following test should be measured
a-follicle-stimulating hormone
b- testosterone
c- progesterone
d- thyroid function test
e- prolactin test

48- Which of the following statements about dysmenorrhea is false

a-is a pelvic pain occurs during or just prior to menstruation
b-smoking is a risk factor
c- regular exercise is considered a nonpharmacological intervention
d- NSAIDS are first-line therapy
e- combined hormonal contraceptives are contraindicated

49-Adnan received some prostate cancer medications. All the followings medication can
cause castration to him EXCEPT:
a- Degarelix
b- Leuprolide
c- Zoledronic acid
d-Triptorelin
e- Goserelin

50- ALL of the following drugs consider first-line antidepressants EXCEPT

a- Duloxetine
b- Fluoxetine
c- Paroxetine
d- Sertraline
e- Citalopram
51-ALL of the following drugs causing significant sexual dysfunction EXCEPT:
a- Citalopram
b- Mirtazapine
c- Duloxetine
d- Sertraline
e- Impramine

52- Which one of the following drugs commonly cause seizure, metabolic syndrome and
agranulocytosis.
a-Olanzapine
b-Clozapine
c- Aripiprazole
d-Ziprasidone
e- Haloperidol

53- Diaphragms and cervical cap are effective barriers and are used as tools for
contraception. All of the following statements are true EXCEPT:
a- They should be inserted up to 6 hours before intercourse.
b-They must be left in place for at least 6 hours after.
c-Diaphragms & Cervical caps can protect against STIs including HIV.
d-Diaphragm should not be left for >24 hours because of risk of toxic shock syndrome.
e-Cervical cap should not remain in place for > 48 hours to reduce the risk of TSS.

54- A 65yr old female patient with stage I, hormone receptor negative - breast carcinoma
The best management is
a- fluorouracil, doxorubicin, cyclophosphamide without surgical removal
b-fluorouracil, doxorubicin, cyclophosphamide before surgical removal
c-fluorouracil, doxorubicin, cyclophosphamide after surgical removal and radiation
d-only surgical removal and radiation
e-fluorouracil, doxorubicin, cyclophosphamide after radiation

55- B.C is 33 years old female who is presented to the emergency department with acute
symptoms of excessive anxiety, and irritability her sister reported that she recently has
worries that are difficult to control, and she had trouble concentrating, her physical
symptoms include restlessness, fatigue, muscle tension, sleep disturbance, and irritability.
What is the best treatment option for this case?
a- Amitriptyline
b- Diazepam
c- Sertraline
d- Doluxetine
e- Imipramine

56- M.R is 31 years old patient with the following symptoms: Hallucinations; delusions;
illogical conversation; Autistic thinking; uncooperativeness, physical aggression;
impaired self-care skills; and disturbed sleep and appetite, her parents are concerned
about her suicidal attempts.Which antiosvchotic medication is best used to address
suicidal behavior?
a- Haloperidol
b- Quetiapine
c- Risperidone
d-Aripiprazole
e- Clozapine

57-58-year-old male presented with a PSA of 179 ng/ml, T3 and Glesson 7 (3 + 4) and
diagnosed with prostate adenocarcinoma as castration-resistant prostate cancer. Which of
the following antiandrogens is FDA approved for castration-resistant prostate cancer and
can be used as the first-line setting to delay the initiation of chemotherapy in both
nonmetastatic and metastatic disease?
a- Bicalutamide
b-Enzalutamide
c- Nilutamide
d-Flutamide
e. Abiraterone

58-Malignant growths of muscle or connective tissue are called:

a- Carcinomas
b- Adenocarcinomas
c- Sarcomas
d-Osteoma
e-Papilloma

59- Eldery female patient with a history of graves disease, treated with radioactive lodine
previously, presented with symptoms of heat intolerance and Weight loss. Her laboratory
values show a reduction in TSH and an abnormally high T4. What is the best treatment
recommendation right now?
a- Start methimazole
b-Start Lugol's solution
c-Start propylthiouracil.
d- Start metoprolol
e- Start thyroxin
60- 56 years old menopause female suffering from urogenital symptoms, such as vaginal
dryness and dyspareunia. What is the recommended therapy for her symptoms?
a- Oral menopausal hormonal therapy
b-CHCs
c-intravaginal estrogen
d-Ospemifene
e- Bazedoxifene

61- Which of the following is an effective method to decrease the tumor flare syndrome
of prostate cancer associated with the first few weeks of LHRH agonist therapy?
a- Start the LHRH agonist with a loading dose to rapidly achieve steady-state levels
b- Start an antiandrogen before the LHRH agonist and continue for the first 3 to 4 weeks
of therapy
c-Start the LHRH agonist with a 50% dose decrease, slowly titrating to a full dose over 3
to 4 weeks
d-Alternate LHRH agonists during the first 3 to 4 months of therapy
e-Maintain testosterone levels above castration levels

62-T.R is 32 years old patient with history oh Hashimoto's disease, she is maintained on
thyroxin 75 mcg daily, she was presented to the emergency department with
hypothermia, reduced level of consciousness, bradycardia and periorbital puffiness.
What is the best management plan?
a-Propyl thiouracil IV followed by iodide and Corticosteroid and other conservative
measures
b-Thyroxin IV followed oy hydrocortisone and other conservative measures
c-High dose of oral Methimazole
d-Oral thyroxin
e-warm the patient and administer IV fluids and corticosteroid

63- Which one of the following therapies associated with greater reduction in blood loss
in women with heavy menstrual bleeding?
a- The levonorgestrel IUD
b- NSAIDs
d- Cyclic progestin theraoy as oral norethindrone acetate
c- Combination Hormonal Contraceptives
e- Medroxyprogesterone acetate

64- Regarding the treatment of acute myeloblastic leukemia (AMU, which of the
following induction regimens is most appropriate for a 73-year-old man with newly
diagnosed AML?
a-Cytarabine 6 doses with idarubicin for 3 days
b-Cytarabine continuous infusion for 7 days with mitoxantrone for 3 days and 6-
thioguanine for 7 days
c-Cytarabine for 7 days with daunorubicin for 3 days
d-Cytarabine for 7 days with idarubicin for 3 days and etoposide for 7 days
e- High-dose idarubicin for 3 days

65- Some women experience amenorrhea while taking combined oral contraceptives, ir
amentoricais unacceptable, the following is important
a- Combined oral contraceptives should be discontinued at all
b- Use a formula with more estrogen or less progestin
c- Use a formula with less estrogen and less progestin
d-Use a formula with more progestin and less estrogen
e- Use a progesterone-only method

66- Many factors may trigger or induce obstructive sleep apnea (OSA) all listed below,
EXCEPT:
a- Obesity
b- Heart failure
c- Hyperthyroidism
d- Increasing upper airways edema by smoking
e-Enlarged tonsils

67- Hyperpigmentation of the skin is a catachrestic feature of

a- primary acute adrenal insufficiency
b- primary chronic adrenal insufficiency
c- Cushing syndrome
d-Conn's syndrome
e- Hyperthyroidism

68- In the Cushing disease, the lab data that may confirm its diagnosis are
a-Probably normal or High ACTH
b- Low or normal ACTH
c- Low serum cortisol
d- Serum cortisol normal
e-CRH test no resconse

69- All the following treatments for thyrotoxicosis are non-safe in pregnancy EXCEPT:
A- methimazole
b- 5-flurouracil
c- carbamazepine
d- carbimazol
e- Propyl-thiouracil

70- All the following drugs are associated with development GAD except
a- Venlafaxine
b- caroamazenine
c- propranolol
d-indomethacin
e- INH

71- S.U is 45 years old man with Alzheimer disease who is stable on galantamine, he is
hypertensive with alcoholic liver cirrhosis and has positive family history for Alzheimer
disease. One of the following is not a risk factor for Alzheimer's disease:
a-Age
b- Hepatic encephalopathy
c- Head injury
d- Down syndrome
e- Depression

72- R.P is 45 years old female with History of Hypertension and Arrhythmia and she is
now maintained on Valsartan and Amiodarone with bisoprolol, she is now experiencing
new symptoms like cold intolerance, weight gain, fatigue and hair loss. Her doctor told
her that she may have thyroid issue due to amiodarone.What is the most likely effect of
amiodarone on thyroid gland?
a- Hypothyroidism
b- hyperthyroidism
c- TSH stimulation
d- TRH stimulation
e- TSH inhibition

73- F.A is 71 years old Female with, Agnosia, depression, psychotic symptoms,
aggression, motor hyperactivity, Memory loss, Aphasia, Apraxia, her MMSE was 6. She
was started on her treatment and followed up by her doctor. While monitoring F. A
during the course of the disease, Successful treatment would show a decline in MMSE
score of:
a- Less than 2 points per year
b- More than 2 points per year
c- Less than 3 points per year
d- More than 3 points per year
e- More than 5 points per year
74- Women with anovulatory bleeding from pros who are oursuing pregnancy. Women
may be treated with
a- letrozole
b- 35 mcg ethinyl estradiol
c- Norgestimate
d- Desogestrel
e- Drospirenone

75- Which TKI was used to overcome the T315l mutation?

a- Dasatinib
b- nilotinib
c- bosutinib
d-ponatinib
e- Imatinib

76- Cardiomyopathy are mostly happened with

a- Clozapine
b- Quetiapine
c- Olanzapine
d- Risperidone
e- Paliperidone

77-47-year-old woman with a new diagnosis of infiltrating intraducal adenocarcinorna

involving the left breast with no regional lymph node involvement, HER2 is negative.
Stage: I1B (73, NO, MO). Which of the following item is the most appropriate with this
case?
a- Good prognosis
b- Poor prognosis
c- Late stage
d-sensitive to Trastuzumab
e- Sensitive to Lapatinib

78-36 years old woman with a left breast mass, an excisional biopsy revealed malignant
changes, and as a part of her treatment for the cancer, adjuvant endocrine therapy has
been prescribed. Which of the following drug can be used as an adjuvant endocrine
therapy:
a- Trastuzumab
b- Lapatinib
c- Pacitaxen
d- Bevacizumab
e- Tamoxifen
79- A young female with newly diagnosed schizophrenia. What is the best treatment right
now?
a- Long Acting Injectable (risperidone)
b- Long Acting Injectable (Fluphenazine)
c-OraCiozanine
d- Oral risperidone
e- Oral Fluoxetine

80- Certain conventional treatments for insomnia should be avoided in patients with a
history of substance misuse. Which of the following drugs can be best choice for
treatment of insomnia in patient with substance abuse?
a- Quazeoam.
b- Triazolam.
c- Flurazepam.
d-Bupropion.
e- None of the above

81- Mrs. Right is a lactating mother with a one-year-old baby, she is seeking a safe
contraceptive during lactation, which one of the following you recommend her to avoid?
a- Mini-Dill
b- Norplant
c- DMPA
e- Low estrogen combined oral contraceptive pill
d- Combined oral contraceptive pill

82- A 45 years old man suffering from Cushing syndrome due to unilateral adrenal
adenoma. Treatment of choice for this patient Is
a- Transsonenoida resection of adrenal adenoma
b- Radiotherapy of adrenal adenoma
c- Laparoscopic adrenalectomy
d- Chronic drug therapy
e- Open surgery of adrenals

83- How long should a young woman use a backup contraception, if she has missed one
of her progestin-only pills for more than 3 hours?
a- No need to use backup methods
b- Take her missed pill immediately and use condom for the next 24 hours.
c- Take her missed pill immediately and use Condom for the next 48 hours
d- Take her missed pill immediately and use Condom for the 72 hours
e- Take her missed pill immediately and use Condom until the next period starts
84- Many drugs can interact with CHCs pills. Which one of the following drugs may
interact with CHCs pills
and most clearly decreases its efficacy?
a- Rifampicin
b- Amoxicillin
c- ceftriaxone
d- cefalexin
e- carbamazole

85- Hyperaldosteronism causes a variety of clinical manifestations. Adult manifestations

of hyperaldosteronism include the followings EXCEPT:
a- Tetany
b- Polydipsia
c- edema
d- Hypokalemia
e- Hypertension

86- Related to the antithyroid pharmacotherapy. The only conditions for which B-
blockers are the primary therapy for thyrotoxicosis are those associated with:
a- Thyroiditis
b- Graves' disease
c- Thyroid storm
d- Toxic nodules
e-Hashimoto's disease

87- For the evaluation of the therapeutic outcomes in a patient treated for breast cancer,
which of the following is the therapeutic endpoint in the treatment of metastatic breast
cancer?
a- Cure
b- Prevention
c- Early detection
d- Palliation
e- Targeted therapy

88- What is the most common pathologic cell type of prostate cancer?
a- Sarcoma
b-Carcinoid tumor
c- Lymphoma
d- Melanoma
e-Adenocarcinoma
89- The followings are negative symptoms of schizophrenia, except:
a- illusions
b- alogia
c- anhedonia
d- social isolation
e- avolition

90- Treatment of adrenal crisis should include a suitable IV fluid. The initial first line IV
fluid for patients with adrenal crisis is
a- Normal saline
d- Mannitol 20%
b- Dextrose 5% in normal saline
e- Dextrose 25% in water
c- Lactated ringer

91- Regarding the treatment of depression. A 5-week break after fluoxetine

discontinuation is critical before starting
a- MAOIs
b- BZDs
c- Ketamine
d- Citalopram
e- None of the above

92- In menstrual cycle pathophysiology, the most useful predictor of approaching

ovulation is
a- Androgen
b- LH surge
c- Aldosterone
d- Hydrocortisone
e-All of the above

93- A 47-year-old woman with chronic lymphocytic leukemia (CLL) presents to clinic
with night sweats and shortness of breath. Fluorescence in sit hybridization (FISH)
testing demonstrates a deletion 17p. She has not been previously treated for her CLL.
Which of the following would be the most appropriate frontline therapy option?
a- Fludarabine, cyclophosphamide and rituximab
b- doxorubicin, vincristine and prednisone
c- Ibrutinib
d- Bendamustine and rituximab
e-Obinutuzumab
94-Chemotherapy for breast cancer is chosen based on the following EXCEPT:
a- performance status
b- the risk of toxicity
c- aggressiveness of disease
d- patient preferences related to chemotherapy cost
e- presence of comorbidities in the patient

95- A 62-year-old worman was recently given a diagnosis of advanced non-small cell
lung cancer. She wit begin treatment with cisplatin 100 mg/m2 plus vinorelbine 30
mg/m2. Which is the most appropriate antiemetic regimen for preventing acute emesis?
a- Aprepitant plus palonosetron plus dexamethasone
b- Aprepitant plus prochlorperazine plus dexamethasone
c- Aprepitant plus granisetron plus ondansetron
d- Lorazepam plus ondansetron plus metoclopramide
e- None of the above

96- The principles of using combination anticancer chemotherapy include all the
following except
a- Agents with different organ toxicities
b- Agents with different pharmacologic action
c- Agents with different costs
d- Agents those do not result in significant drug interactions
e- Agents those are ideally synergistic when used together

97- Evaluation of therapeutic outcomes is necessary for all women treated by menopausal
hormonal therapy. Women receiving menopausal hormonal therapy should be evaluated
every
a- Week
b- Six months
c- Year
d- Five years
e- Ten years

98-Zainab is a 21 years old student female presented with amenorrhea due to

hyperprolactinemia. The preferred pharmacologic treatment for Zainab is.
a Cabergoline
b- Estradiol patch
c- Progestins
d- Insulin sensitizing agents
e- CHC
99- Rahaf is a 16-years old adolescent with primary amenorrhea who recently reaches
puberty. The recommended treatment for Rahaf after puberty is.
a-CHC
b- Oral progesterone
c- Oral estradiol
d- Oral bromocriptine
e- Oral ibuprofen

100- Amal is a 33-years old woman suffering from anovulatory bleeding and experienced
severe side effects on treatment with estrogen. The second line treatment would be.
a- CHC
b- Progestins
c- Metformin
d- Aspirin
e. Paracetamol

101- hormonal therapy is part from pharmacological management of cancer as curative

treatment and prevention benefit versus risk need to be weighted when making
recommendation for prevention of breast cancer with which of the following drugs.
a- tamoxifen
b- rolaxifen
c- exemestane
d- letrozole
e- anastrozole

102- Which one of the following antipsychotics is less likely associated with the risk of
development of
new-onset diabetes?
a- Risperidone.
b-Olanzapine.
c- Quetiapine.
d- Clozapine.
e- Aripiprazole.

103-ACTH-independent Cushing syndrome is usually caused by:

a- Adrenal adenomas & carcinomas.
b- Thyroid ectopic ACTH secretion
c- Pituitary adenoma
d- Endocrine ectopic ACTH syndrome
e- Non-Endocrine ectopic ACTH syndrome
104- In hyperaldosteronism, the ARR Is positive, confirmatory tests to exclude false
positives are the following, Except:
a- oral sodium-loading test
b- saline infusion test
c- Glucose tolerance test
d- fludrocortisone suppression test (FST)
e- captopril challenge test

105- 38 years old patient presented with excessive daytime sleepiness (EDS), fatigue,
impaired performance, and disturbed nighttime sleep. He was diagnosed with
Narcolepsy.Which one of the following is the standard of treatment for EDS?
a- Sodium oxybate.
b- Atomoxetine.
c- Modafinil.
d- Amphetamine.
e- Methylphenidate.