Mock Exam 5
Q1. A man came with bruising and increase time of bleeding with factor 8 deficiency :
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Here are the answers with Explanation
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c) Type II hypersensitivity
Q1. A man came with bruising and increase time of bleeding with factor 8 deficiency :
a) Haemophilia
A
b) Von
Willebrand disease
Q2. An old man 65 years with
Hemoglobin= 9, you will:
a) Assess Iron
levels
b) Assess LDH
c) Arrange for
endoscopy
Q3. In aspirin overdose :
a) Liver
enzyme will peak within 3-4 hr
b) first signs
include peripheral neuropathy and loss of reflexes
c) 150 mg/kg
of aspirin will not result in aspirin toxicity
Q4. A man who is having severe
vomiting and diarrhea and now de
veloped leg cramps after receiving 3 liters of dextrose, he is having:
veloped leg cramps after receiving 3 liters of dextrose, he is having:
a) Hypokalemia
b)
hyponatremia
c)
hyperkalemia
d)
hypernatremia
Q5. Man who received blood
transfusion back in 1975 developed jaundice most likely has:
a) Hepatitis A
b) Hepatitis C
c) Hepatitis D
d) Hepatitis E
e) Autoimmune
hepatitis
Q6. Best method to prevent
plague is:
a) Hand wash
b) Kill rodent
c) spray
pesticide
d) give
prophylactic AB
Q7. Patient come to ER with
constricted pupil and respiratory compromise you will suspect:
a) Opiates
“like morphine”
b) Cocaine
c) Ectasy
Q8. Management of somatization
a) Multiple
phone call
b) Multiple
clinic appointments
c) Refer to
pain clinic
d)
Antidepressant
Q9. A lot of bacteria produce
toxins which are harmful. Which one of the following is useful?
a) Botulism
b) Tetanus
c) Diphtheria
d) Staph
aureus
Q10. Organophosphorus poisoning,
what is the antidote?
a) Atropine
b)
Physostigmine
c) Neostigmine
d) Pilocarpine
e)
Endrophonium
Q11. Patient using haloperidol,
developed rigidity (dystonia) treatment :
a) …………………………………..
Q12. High risk factor in CLL :
a) Age
b) Smoking
c) History of
breast ca
d) History of
radiation
Q13. A 60 years old male was
refer to you after stabilization, investigation show Hgb 8.5 g/l, hect. 64% ,
RBC 7.8 , WBC 15.3 & Platelet 570, Diagnosis :
a) Iron
deficency Anemia
b)
Hemoglobinopathy
c) CLL
d) 2ry
polycythemia
Q14. A 24 years old patient. Came
for check up after a promiscuous relation 1 month ago, he was clinically
unremarkable, VDRL: 1/128, he was allergic to penicillin other line of
management is:
a) Ampicillin
b) Amoxicillin
c)
Trimethoprim
d) Doxycyclin
Q15. Cellulitis in children most
common causes:
a) Group A
streptococcus
b) Staphylococcal
aureus
Q16. Patient with Hodgkin’s
lymphoma and red strunberg cell in pathology and there is eosinophil lymphocyte
in blood so pathological classification is:
a)
Mixed-cellularity subtype
b) Nodular
sclerosis subtype of Hodgkin's lymphoma
Q17. Therapeutic range of INR [In
presence of Anticoagulant]
a) 2.5-3.5
b) 2.0-3.0
Q18. Patient had arthritis in two
large joints & pansystolic murmur “carditis” Hx of URTI, the most important
next step:
a) ESR
b) ASO titre
c) Blood
culture
Q19. Patient with gunshot and
part of his bowel spillage out and you decide to give him antibiotic for Bacteroid fragilis, so what you will give?
a) Amoxicillin
b) Clindamycin
‘Sure’
c)
Erythromycin
d) Doxycycline
e) Gentamicin
Q20. Treatment of peritonitis the
organism is Bacteroid fragilis
a) Clindamycin
b)
Mitronidazole
c) Carbapenem
Q21. Patient with high output
fistula, for which TPN was ordered , after 2 hours of the central venous
catheterization, the patient become comatose and unresponsive , what is the
most likely cause ?
a) Septic
shock
b) Electrolytes
imbalance
c) Delayed
response of blood mismatch
d)
Hypoglycemia
e)
Hypernatremia
Q22. What is most sensitive
indicator for factitious fever?
a) Pulse rate
Q23. Healthy patient with family
history of DM type 2, the most factors that increase chance of DM are:
a) HTN and
Obesity
b) Smoking and
Obesity
c) Pregnancy
and HTN
d) Pregnancy
and Smoking
Q24. In diabetic retinopathy,
most related factors:
a) HTN and
obesity
b) HTN and
smoking
c) Smoking and
obesity
Q25. Patient with blood group A
had blood transfusion group B , the best statement that describe the result is
a) type IV
hypersensitivity
b)
inflammatory reaction
c) Type II
hypersensitivity
Q1. A man came with bruising &
increase time of bleeding with factor 8 deficiency :
a) Haemophilia A
b) Von
Willebrand disease
· Hemophilia A is clotting factor VIII deficiency & is the
most common form, Hemophilia B is factor IX deficiency. It is a Recessive
X-linked disorders
Q2. An old man 65 years with
Hemoglobin= 9, you will:
a) Assess Iron
levels
b) Assess LDH
c) Arrange for endoscopy
· Anemia is a common sign of colon cancer in elderly
Q3. In aspirin overdose :
a) Liver
enzyme will peak within 3-4 hr
b) first signs
include peripheral neuropathy and loss of reflexes
c) 150 mg/kg of aspirin will not result in aspirin toxicity
· The early signs and symptoms of aspirin overdose include impaired hearing and ringing in the ears.
Other early signs of aspirin poisoning include lightheadedness, breathing
rapidly, double vision, vomiting, fever and dehydration
· The acutely toxic dose of aspirin is generally considered
greater than 150 mg per kg of body mass. Moderate toxicity occurs at doses up
to 300 mg/kg, severe toxicity occurs between 300 - 500 mg/kg
Q4. Man who is having severe
vomiting and diarrhea and now developed leg cramps after receiving 3 liters of
dextrose, he is having:
a) Hypokalemia
b)
hyponatremia
c)
hyperkalemia
d)
hypernatremia
· K+ is secreted
in stool, as he is having a diarrhea he will lose a huge amount of K+, also muscle cramp is a symptom of
Hypokalemia
Q5. Man who received blood
transfusion back in 1975 developed jaundice most likely has:
a) Hepatitis A
b) Hepatitis C
c) Hepatitis D
d) Hepatitis E
e) Autoimmune
hepatitis
Q6. Best method to prevent
plague is:
a) Hand wash
b) Kill rodent
c) spray
pesticide
d) give
prophylactic AB
· Plague is a deadly infectious disease that is caused by the
enterobacteria Yersinia pestis. carried by rodents mostly rats
Q7. Patient come to ER with
constricted pupil and respiratory compromise you will suspect:
a) Opiates “like morphine”
b) Cocaine
c) Ectasy
· Certain drugs cause constriction of the pupils, such as alcohol and opioids
· Other drugs, such as atropine, mescaline, psilocybin mushrooms,
cocaine and amphetamines may cause pupil dilation
Q8. Management of somatization
a) Multiple
phone call
b) Multiple clinic appointments
c) Refer to
pain clinic
d)
Antidepressant
· Cognitive Behavioral Therapy is the best established treatment
for a variety of somatoform disorders including somatization disorder
Q9. A lot of bacteria produce
toxins which are harmful. Which one of the following is useful?
a) Botulism
b) Tetanus
c) Diphtheria
d) Staph
aureus
Q10. Organophosphorus poisoning,
what is the antidote?
a) Atropine
b)
Physostigmine
c) Neostigmine
d) Pilocarpine
e)
Endrophonium
Q11. Patient using haloperidol,
developed rigidity (dystonia) treatment :
a) Antihistamine and anticholinergic
· Haloperidol is a dopamine antagonist used in psychosis
· Side effects : Extrapyramidal side effects, Dystonia, Tremors,
Dry mouth, Depression
Q12. High risk factor in CLL :
a) Age
b) Smoking
c) History of
breast ca
d) History of
radiation
· Risk factors: 1) Age. Most people diagnosed with chronic
lymphocytic leukemia are over 60. 2) Sex. Men are more likely than are women to develop chronic
lymphocytic leukemia. 3) Race. Whites are more likely to develop chronic lymphocytic leukemia
than are people of other races. 4) Family history of blood and
bone marrow cancers. A family history of chronic
lymphocytic leukemia or other blood and bone marrow cancers may increase your
risk. 5) Exposure to chemicals. Certain herbicides and insecticides
Q13. A 60 years old male was
refer to you after stabilization, investigation show Hgb 8.5 g/l, hect. 64% ,
RBC 7.8 , WBC 15.3 & Platelet 570, Diagnosis :
a) Iron
deficency Anemia
b)
Hemoglobinopathy
c) CLL
d) 2ry
polycythemia
Q14. A 24 years old patient. Came
for check up after a promiscuous relation 1 month ago, he was clinically
unremarkable, VDRL: 1/128, he was allergic to penicillin other line of
management is:
a) Ampicillin
b) Amoxicillin
c)
Trimethoprim
d) Doxycyclin
· Venereal Disease Research Laboratory [ VDRL ] test is a
serological screening for syphilis that is also used to assess response to
therapy, to detect CNS involvement, and as an aid in the diagnosis of
congenital syphilis
· The first choice for uncomplicated syphilis is a single dose of intramuscular penicillin G or a single dose of oral azithromycin. Doxycycline and
tetracycline are alternative
Q15. Cellulitis in children most
common causes:
a) Group A
streptococcus
b) Staphylococcal aureus
Ø Staphylococcus aureus is the most common bacteria that cause
cellulitis. Ø Group A Streptococcus is the next
most common bacteria that cause cellulitis. A form of rather superficial
cellulitis caused by strep bacteria is called erysipelas; it is characterized
by spreading hot, bright red circumscribed area on the skin with a sharp raised
border. The so-called "flesh-eating bacteria" are, in fact, also a
strain of strep which can -- in severe cases -- destroy tissue almost as fast
as surgeons can cut it out.
Q16. Patient with Hodgkin’s
lymphoma and red strunberg cell in pathology and there is eosinophil lymphocyte
in blood so pathological classification is:
a)
Mixed-cellularity subtype
b) Nodular sclerosis subtype of Hodgkin's lymphoma
· Classical Hodgkin's lymphoma can be subclassified into 4 Pathologic subtypes based upon
Reed-Sternberg
cell morphology and the composition of the reactive cell infiltrate seen in the
lymph node biopsy specimen “the cell composition around the Reed-Sternberg
cells”
Name
Description Nodular sclerosing CHL Is the most common subtype and is composed of large tumor nodules showing scattered lacunar classical RS cells set in a background of reactive lymphocytes, eosinophils
and plasma cells with varying degrees of collagen fibrosis/sclerosis.
Mixed-cellularity subtype
Is a common
subtype and is composed of numerous classic RS cells admixed with numerous
inflammatory cells including lymphocytes, histiocytes,
eosinophils, and plasma cells, without
sclerosis. This type is most often associated with EBV infection and may be confused with
the early, so-called 'cellular' phase of nodular sclerosing CHL Lymphocyte-rich or Lymphocytic predominance Is a rare subtype, show many features which may cause diagnostic confusion with
nodular lymphocyte predominant B-cell Non-Hodgkin's Lymphoma (B-NHL). This form
also has the most favorable prognosis
Lymphocyte depleted
Is a rare subtype, composed of large numbers of
often pleomorphic RS cells with only few reactive lymphocytes which may easily be confused with diffuse large cell lymphoma
Q17. Therapeutic range of INR [In
presence of Anticoagulant]
a) 2.5-3.5
b) 2.0-3.0 “But normal range in absence if
Anticoagulant is 1.8-1.2”
Q18. Patient had arthritis in two
large joints & pansystolic murmur “carditis” Hx of URTI, the most important
next step:
a) ESR
b) ASO titre
c) Blood
culture
· The diagnosis of Rheumatic fever can be made when two of the
major Modified Jones criteria, or one major criterion plus two minor criteria,
are present along with evidence of streptococcal infection: elevated or rising
Antistreptolysin ‘ASO’ titre or DNAase
Q19. Patient with gunshot and
part of his bowel spillage out and you decide to give him antibiotic for Bacteroid fragilis, so what you will give?
a) Amoxicillin
b) Clindamycin ‘Sure’
c)
Erythromycin
d) Doxycycline
e) Gentamicin
Q20. Treatment of peritonitis the
organism is Bacteroid fragilis
a) Clindamycin
b)
Mitronidazole
c) Carbapenem
· B. fragilis is involved in 90% of anaerobic
peritoneal infections
· B. fragilis is susceptible to metronidazole,
carbapenems, tigecycline, beta-lactam/beta-lactamase inhibitor combinations
(e.g., Unasyn, Zosyn), and certain antimicrobials of the cephamycin class,
including cefoxitin
· Clindamycin is no longer recommended as the first-line agent for
B. fragilis due to
emerging high-level resistance
Q21. Patient with high output
fistula, for which TPN was ordered , after 2 hours of the central venous
catheterization, the patient become comatose and unresponsive , what is the
most likely cause ?
a) Septic
shock
b) Electrolytes imbalance
c) Delayed
response of blood mismatch
d)
Hypoglycemia
e)
Hypernatremia
· Enterocutaneous fistula is an abnormal communication between the
small or large bowel & the skin.
· It is a complication that is usually seen following surgery on
the small or large bowel
· Low-output fistula(< 200 mL/day), moderate-output fistula
(200-500), high-output fistula ( > 500 mL/day )
Q22. What is most sensitive
indicator for factitious fever?
a) Pulse rate
· Factitious fever: Fever produced artificially by a patient. This
is done by artificially heating the thermometer or by self-administered
pyrogenic substances. An artificial fever may be suspected if the pulse rate is
much less than expected for the degree of fever noted. This diagnosis should be
considered in all patients in whom there is no other plausible explanation for
the fever. Patients who pretend to have fevers may have serious psychiatric
problems.
Q23. Healthy patient with family
history of DM type 2, the most factors that increase chance of DM are:
a) HTN and Obesity
b) Smoking and
Obesity
c) Pregnancy
and HTN
d) Pregnancy
and Smoking
Q24. In diabetic retinopathy,
most related factors:
a) HTN and obesity
b) HTN and
smoking
c) Smoking and
obesity
· The risk factors that increase diabetic retinopathy background
are:
1) HTN
2) Poor
glucose control or long case D.M
3) Raised
level of fat ( cholesterol)
4) Renal
disease
5) Pregnancy
(but not in diabetes caused by pregnancy)
Q25. Patient with blood group A
had blood transfusion group B , the best statement that describe the result is
a) type IV
hypersensitivity
b)
inflammatory reaction
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