Chose the Best Single Answer

1-Each of the following conditions is known to cause fatty liver EXCEPT: A- Obesity.

B –Corticosteroids therapy. C – Diabetes mellitus

D– Hypercholesterolaemia. E – Alcoholic liver disease

2-Which one of the following is MOST suggestive of essential tremor? A –Often associated with cogwheel rigidity.B – Improve with intentional movement.C – Made worse with alcohol.D – Strong familial tendency.E – Made worse with beta blockers.

3– All the following are characteristic of tumour lysis syndrome EXCEPT: A –Hyperkalemia.B –Hypercalcemia.C –Lactic acidosis.D –Hyperphosphatemia.E -Hyperuricemia

4 - Which one of the following pathological changes favours ulcerative colitis over Crohns disease ?

A –Ileal involvement. B –Crypt abscesses.

C – Transmural involvement. D – Granulomas.

E – Skip lesions5-woman presents with a mark ed right sided ptosis and failure of upgaze Which is the

most likely diagnosis A- Horners syndrome.

B –Third cranial nerve palsy. C –Dystophia myotonica.

D –Myasthenia gravis. E –Dysthyroid eye disease.

6-In a patient who has mitral valve insufficiency , which procedure does not require prophylactic antibiotic therapy ?

A-Cardaic catheterization. B –Prostatectomy.

C – Cystoscopy. D – Tonsillectomy.

E – Periodontal surgery. 7-Phenothiazine may cause the following except:

A- Orthostatic hypotension.B-Increase lacrimation.C- Cholestatic jaundice.D-Photosensitivity.E-Agranulocytosis.

8–Upper gastrointestinal bleeding refers to bleeding that occurs proximal to the: A- Hepatic flexure.B- Splenic flexure.C – Ligament of Treitz.D- Gastro-oesophageal junction.E – Ileocaecal valve.

9-Left bundle branch block is associated with one of the following conditions? A –Ischaemic heart disease.B – Mitral stenosis. C –Pericarditis.D – Pulmonary embolism.E –Tricuspid stenosis.

10-Each of the following diseases has an AUTOSOMAL DOMINANT INHERITANCE except?

A –Huntingtons chorea. B – Adult polycystic kidney disease.

C – Marfans syndrome. D – Haemochromatosis.

E – Neurofibromatosis.11-Bloody diarrhea can be induced by the following, EXCEPT

A-E.histolyticaB-Shingella shigaeC-Giardia lambliaD-Ulcerative colitisE.Cancer rectum

12 –A 60 year – old man is diagnosed with hypertension. Which one of the following drug combination is potentially hazardous and should be AVOIDED?

A – Thiazide and lisinopril.B –Bisoprolol and lisinopril.

C – Diltiazem and atenolol.D- Nifedipine and enalapril.E – Verapamil and enalapril.

13 –In a patient with liver cirrhosis which one of the listed features is characteristic of portal hypertension?

A – Jaundice.B – Gynaecomastia.C- Spider telangiectasia.D – Hepatomegaly.E – Oesophageal varices.

14 -Which one of the following is not a recognized complication of diabetes? A – Radiculopathy.B – Cranial neuropathy.C –Myopathy.D –Peripheral neuropathy.E –Mono neuritis multiplex'

15 -Chondrocalcinosis is associated with each of the following EXCEPT: A- HyperparathyoidismB – Addisons disease.C- Haemochromatosis.D – Hypothyroidism.E – Gout.

16 -The most common inherited prothrombotic disorder is : A – Activated protein C resistant ((Factor V Leiden ).

B- Prothrombine gene mutation. C – Protein C deficiency.

D –Protein S deficiency. E –Antithrombin deficiency.

17-A 67 year –old male presents to the Emergency Room with epigastric pain associated with nausea and vomiting,found to be hypotensive .What is the FIRST investigation to be

done? A – Random blood sugar.

B –Abdominal X ray. C –Electrocardiogram(ECG )

D –Serum amylase. E – Abdominal Ultrasound.

18 -Which of the following are risk factors for the development of pneumothorax ?

A – Smoking B – History of prior pneumothorax.

C – Menstrual cycle. D – Tuberculosis.

E – All of the above 19 –Which one of the following hepatobiliary disorders is LEAST associated with jaundice

during the course of the disease ? A –Liver abscess.

B – Acute viral hepatitis. C – Carcinoma of the head of the pancreas.

D – Primary biliary cirrhosis. E – Alcoholic cirrhosis.

20-Major causes of metabolic acidosis include each of the following EXCEPT? A –Chronic renal failure.B – Diabetic – Keto –Acidosis.C- Steroid therapy.D –Metformine therapy.E- Methanol ingestion.

21 -Hypocomplementaemia is seen in the following ,EXCEPTA-Ventriculo-atrial shunt nephritis.B- Membrano-proliferative glomerulonephritis.C-Acute post –streptococcal nephritis.D-Henoch – Schonlein nephritis.E-Systemic lupus nephritis.

22--Avascular necrosis of the bone is a recognized complication of the following EXCEPT:

A-Cushing,s syndrome.B-Congestive cardiac failure.C- Sickle cell disease.D- Systemic lupus erythematosis.E- Renal transplantation.

23 -In massive pulmonary embolism , the following are incorrect EXCEPT: A-Clinical evidence of deep venous thrombosis is characteristically present.B- Arterial pco2 is low.C-Pulmonary embolectomy is the treatment of choice.D-Chest X-ray shows oligemia in lung fields in majority of cases.E- Subctaneous Heparine Should be started after the diagnosis is confirmed.

24–Which one of the following disorders is MOST commonly associated with Steven –Johnson syndrome?

A .Herpes simplex infection.B .Sarcoidosis.C . Systemic lupus erythematosis.D. Herpes zoster infection.E .Coeliac disease.

25-H.pylori is best diagnosed by a non – invasive test , which one you will do: A. Rapid urease test.B. Urea breath test.C. Ig G antibodies.D. Ig M antibodies.E. Biopsy and pathology

26. The most common major medication used to treat androgen excess is ? A. Prednisone B. Dexamethazone C. Progestin D. Estrogen E. Spironolactone .

27.Major eriteria for the diagnosis of acute rheumatic fever include all of the following except?

a. increased anti- stroptolysin ( ASO ) titer b. carditis c. chorea d. polyarthritis e. subcutaneous nodules

28 –Causes of acute pancreatitis include each of the following EXCEPT ?A – Alcoholism.B – polyarteritis nodosa.C – Hyperlipaedemia.D – Hypoparathyroidism.E – Mumps.

29– Regarding acute aortic regurgitation which one of the following is TRUE ?A –Rheumatic fever is the most frequent cause.B –The pulse pressure is wider than in chronic aortic regurgitation.C –The fourth heart sound sound S4 is often present.D –Left ventricular dilatation is a helpful early echocardiographic finding.E – It is often regarded as a medical emergency

30-Increse in thyroxine binding globuline (TBG ) level occurs in the following ,EXCEPT :A-Pregnancy.B- Acute hepatitis.C-Nephrotic syndrome.D-Estrogen therapy.E-Adminstration of clofibrate.

31- Signs of upper motor neuron dysfunction include all of the following EXCEPT ?A- Hypertonia.B –Increased reflexes.C- Babinski sign.D – Weakness.E –Tremors

32- In massive pulmonary embolism , the following are incorrect EXCEPT :A-Clinical evidence of deep venous thrombosis is characteristically present.B- Arterial pco2 is low.C-Pulmonary embolectomy is the treatment of choice.D-Chest X-ray shows oligemia in lung fields in majority of cases.E- Subctaneous Heparine Should be started after the diagnosis is confirmed

33- A 24 year old in her second trimester of pregnancy develop symptomatic thyrotoxicosis.What initial management would you recommend ?A –No treatment till delivery.B –Radioactive iodine.C- Subtotal thyroidectomy.D – Beta blockers.E – Propylthiouracil.

34-Pleural effusion can be associated with the following , EXCEPT :A-Pulmonary tuberculosis.B- Streptococcus pneumonia.C- Congestive cardiac failure.D-PericarditisE-Mycoplasma pneumonia..

35- The following viral hepatitis are RNA virus EXCEPT :A –Hepatitis A virus.B – Hepatitis B virus .

C – Hepatitis C virus.D – Hepatitis D virus .E – Hepatitis E virus.

36-The following are known causes of clubbing EXCEPT ?A- Atrial septic defect with left to right shunt.B –Liver cirrhosis .C –Asbestosis.D-Fallots tetralogy.E – Fibrosing alveolitis.

37-Treatment of peptic ulcer disease in H. pylori positive patient isA-Proton pump inhibitor,c Clarithromycine and AmoxicillinB-Misoprotol 200ug /x4.C-Dual therapy is effective as triple therapy.D-Proton pump inhibitor alone can eradicate H.pylori.E-Metronidazole is better than Amoxicillin.

38-ECG changes of hyperkalaemia include the following, EXCEPTA-Wide QRS complexB-Prolonged P-R intervalC-Depressed S-T segmentD-Absent P-waves.E-Ventricular tachycardia

39-In Thalassemia major , the following are true , EXCEPT:A-Fetal haemoglobin may be increasesd up to 90 % of total haemoglobinB-SplenomegalyC-HBA2 is increased.D- HBA2 is decreased.E- Microscopic hypochromic haemolytic anaemia

40-In neuroleptic malignant syndrome , the following are correct ,EXCEPT :A-It complicates phenothiazine therapy..B-Is frequently complicated by rhabdomyolysis.C-Dantrolene is helpful in the treatment.D- Can complicate bromocriptine therapy.E- Hyperthermia and rigidity are classic features.

41-A 40 year – old patient , on investigation serum potassium 7.4Meq/l and electrocardiogram shows high tented T wave .What is the first line of treatment ?A – Insulin with dextrose infusion ..B – Sodium bicarbonate.C – Calcium gluconate.D –Ventolin.E –Lasix.

42-The following drug combinations are usually undesirable , EXCEPT:A-Levodopa and Nifedipine.B-Rantidine and Metronidazole.D-Digoxin and amiodarone.Bezafibrate and warfarine.E- Cholestyramine and prednisone.

43-Atropine poisoning causes :A- Hallucination. B-Bradycardia.C-Profuse sweating.D- Pin –point pupils.E- Hypothermia.

44-In Wilsons disease , the following are true EXCEPT:A-Increased urinary copper excretion.B-OsteopoerosisC-Reduced plasma caeruloplasmin.D-Chronic active hepatitis.E- Kayser – Fleiscer ring

45-The leading cause of cancer death in females is :A- Breast cancer.B – Colon cancer .C- Lung cancer.D – Malignant melanoma.E –Pancreatic cancer.

46-In Carpal tunnel syndrome, the following are correct, EXCEPTA-Often bilateral in amyloidosisB-Diagnosed by finding delayed ulnar nerve conduction

C-Wasting of abductor pollicis brevisD-Causes pain in foreamE-Associated with acromegaly

47- Arthropod- born disease include each of the following EXCEPT :A- Malaria.B – Hydatid disease.C –Ttrypanosomiasis.D –Leishmaniasis.E –Lyme disease.

48-Which one of the following statements BEST describes a person with irritable bowel syndrome (I.B.S ) ? A - Characterised by nocturnal diarrhea . B –If there is nausea and vomiting the diagnosis should be reconsidered. C – Weight loss becomes more evident as the disease runs a chronic course. D - Sigmoidoscopy findings are often diagnostic. E – High fibre diet is often prescribed for the treatment of the syndrome.

49-The common migraine (without aura) presents withA. NauseaB. Photo- and phonophobiaC. Throbbing qualityD. Unilateral site

E. All of the above

50-First-line therapy for myasthenia gravis isA. Corticosteroids (eg. Prednisone)B. Anticholinesterases (eg. Pyridostigmine)C. ThymectomyD. Plasmapheresis

E. Azatioprine