Saudi Licensing Exam- Mock Exam 4 & answers with explanation

Mock Exam 4

Q1. Which of the following is treatment for Giardiasis:

a) Prazequantil

b) Mebendazole

c) Metronidazole

d) Albendazole

Q2. Patient with epilepsy came with left shoulder pain, on examination flattened contour of the shoulder, and fixed adduction with internal rotation, what is the diagnosis?

a) Inferior dislocation

b) subacromal posterior dislocation

c) subglenoid anterior dislocation

d) subclavicle anterior dislocation

e) subclavicle anterior dislocation

Q3. Drugs used for Leishmania

· There are two common therapies containing antimony (known as pentavalent antimonials): meglumine antimoniate (Glucantime) and sodium stibogluconate (Pentostam)

Q4. A 12 years old female brought by her mother to ER after
ingestion of unknown number of paracetamol tablets. Clinically she is stable. Blood paracetamol level suggests toxicity. The most appropriate treatment

a) …………………………

Q5. All of the following are side effects of furasomide except:

a) Hyperkalemia

b) Hypoglycemia

c) Bronchospasm

d) Haemolytic anemia

e) Pre-renal azotemia

Q6. Patient with right arm tenderness with red streak line, the axillary lymph node is palpable :

a) Cellulitis

b) Carcinoma

c) Lymphangitis

Q7. Patient with central line became sepsis what organisms

a) GBS

b) Neisseria

c) Pseudmomnus

d) E. coli

Q8. Best way to prevent Entameba histolytica is

a) …………………………

Q9. Prevention of Lyme disease, what is best advice to parents?

a) …………………………

Q10. Prevention of Lyme disease :

a) …………………………

Q11. Parents asking about Lyme disease for there children. practitioner is mos correct to tell them (for prevention)

a) Kill vector

b) Clothes of natural fibers

c) Antibacterial soap

Q12. Drug of choice for a schistosomiasis is:

a) Praziquantel “Single oral dose annually”

b) Oxaminiquine

c) artemether

Q13. In flame burn , the most common cause of immediate death :

a) hypovolemic shock

b) septic shock

c) anemia and hypoalbumin

d) Smoke inhalation

Q14. Patient present with submandibular swelling with eating, relieved after eating , Dx :

a) …………………………

Q15. Long scenario of restless leg syndrome (he didn’t mention Dx in scenario), 85 old male many times awake from his sleep because leg pain, this pain relieved by just if he move his foot, but it recur, etsetra, best management:

a) Colazpin

b) haloperidol

c) lorazepam

d) One drug from dopamine agonist group forgot its name, it’s the right answer.

Q16. Best drug for von willebrand disease is:

a) Fresh frozen plasma

b) Cryoprecipitate

c) Steroids

Q17. Which of the following is a feature of iron defeicincy anemia?

a) …………………………

Q18. Patient just received organ transplantation what is the sign of acute rejection?

a) Fever

b) Hypotension

Q19. Sodium amount in Normal Saline [ 0.9% NaCl ] :

a) 75 mmol

b) 90 mmol

c) 154 mmol

d) 200 mmol

Q20. Group A Hemolytic streptococcus, causes rheumatic fever when:

a) Invade blood stream

b) Invade myocardium

c) After tonsillitis and pharyngitis

d) Skin infection

Q21. Man came with bruising and increase time of bleeding with factor 8 deficiency :

a) Haemophilia A

b) Von Willebrand disease

Q22. Anemia of chronic disease :

a) Decrease iron and increase TIBC “in Iron Deficiency Anemia”

b) Increase iron and increase TIBC

c) Increase iron and decrease TIBC

Q23. Man with polycythemia vera came with bruising what causes decrease blood flow?

a) Hypervescosity

b) Hypoxia

c) Hypovesicosity

Q24. Patient with polycythemia vera the cause of bleeding in this patient is

a) Increase viscosity

b) Low platelets

Q25. What is the major thing that can tell you that patient have polycythemia vera rather than secondary polycythemia:

a) Hepatomegaly

b) Splenomegaly

c) Venous engorgement

d) Hypertension

==============================================================================

Here are the answers with explanation

==============================================================================

Q1. Which of the following is treatment for Giardiasis:

a) Prazequantil

b) Mebendazole

c) Metronidazole

d) Albendazole

· Giardiasis “Beaver fever” is a diarrheal infection of the small intestine by a parasite : Giardia lamblia

· Fecal-Oral transmission

Q2. Patient with epilepsy came with left shoulder pain, on examination flattened contour of the shoulder, and fixed adduction with internal rotation, what is the diagnosis?

a) Inferior dislocation

b) subacromal posterior dislocation

c) subglenoid anterior dislocation

d) subclavicle anterior dislocation

e) subclavicle anterior dislocation

Q3. Drugs used for Leishmania

· There are two common therapies containing antimony (known as pentavalent antimonials): meglumine antimoniate (Glucantime) and sodium stibogluconate (Pentostam)

Q4. 12 years old female brought by her mother to ER after ingestion of unknown number of paracetamol tablets. Clinically she is stable. Blood paracetamol level suggests toxicity. The most appropriate treatment

a) N-acetylcestine

· IV infusion: 150mg/kg in 200ml D5% over 15mins then 50mg/kg in 500ml D5% over 4hrs then finally 200mg/kg in 1L D5% over 16hrs

Q5. All of the following are side effects of furasomide except:

a) Hyperkalemia

b) Hypoglycemia

c) Bronchospasm

d) Haemolytic anemia

e) Pre-renal azotemia

· Side effects of furasomide are hypotension, Hypokalemia, hyperglycemia, hemolytic anemia

Q6. Patient with right arm tenderness with red streak line, the axillary lymph node is palpable :

a) Cellulitis

b) Carcinoma

c) Lymphangitis

· Lymphangitis is an inflammation of the lymphatic channels. Most common cause is S. pyogenes

Q7. Patient with central line became sepsis what organisms

a) GBS

b) Neisseria

c) Pseudmomnus

d) E. coli

· All catheters can introduce bacteria into the bloodstream, but CVCs are known for occasionally causing Staphylococcus aureus and Staphylococcus epidermidis sepsis

· Also can be caused by gram-negative rods, Candida spp., and Enterococcus spp

Q8. Best way to prevent Entameba histolytica is

a) Boiling

· Fecal-Oral transmitted parasite, most important complication is Liver abscess.

· Treatment è Metronidazole

Q9. Prevention of Lyme disease, what is best advice to parents?

a) Insect “Tick” removal

· Lyme disease “Lyme borreliosis” is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia

· Transmitted to humans by the bite of infected ticks genus called Ixodes ( hard ticks )

· Symptoms. : fever, headache, fatigue, depression and a characteristic circular skin rash called erythema migrans

· Complication : symptoms may involve the joints, heart and CNS

· Treatment. : doxycycline (in adults), amoxicillin (in children), erythromycin (for pregnant women)

Q10. Prevention of Lyme disease :

a) Treat early disease with doxycycline , Prevent with tick bite avoidance

· Explanation: Light-colored clothing makes the tick more easily visible before it attaches itself. People should use special care in handling and allowing outdoor pets inside homes because they can bring ticks into the house.

· A more effective, communitywide method of preventing Lyme disease is to reduce the numbers of primary hosts on which the deer tick depends, such as rodents, other small mammals, and deer. Reduction of the deer population may over time help break the reproductive cycle of the deer ticks and their ability to flourish in suburban and rural areas.

· Backyard patios, decks, and grassy areas that are mowed regularly are unlikely to have ticks present. This may be because of the lack of cover for mice from owls and other raptors that prey on mice. The ticks also need moisture, which these areas do not provide. The areas around ornamental plantings and gardens are more hospitable for mice and ticks. The highest concentration of ticks is found in wooded areas. Individuals should try to prevent ticks from getting onto skin and crawling to preferred areas.

· Long hair should be worn under a hat. Wearing long-sleeved shirts and tucking long pants into socks is recommended

Q11. Parents asking about Lyme disease for there children. practitioner is mos correct to tell them (for prevention)

a) Kill vector

b) Clothes of natural fibers

c) Antibacterial soap

Q12. Drug of choice for a schistosomiasis is:

a) Praziquantel “Single oral dose annually”

b) Oxaminiquine

c) artemether

Q13. In flame burn , the most common cause of immediate death :

a) hypovolemic shock

b) septic shock

c) anemia and hypoalbumin

d) Smoke inhalation

Q14. Patient present with submandibular swelling with eating, relieved after eating , Dx :

a) Submandibular gland stone

2 UQU 2012 nd Edition

119

Q15. Long scenario of restless leg syndrome (he didn’t mention Dx in scenario), 85 old male many times awake from his sleep because leg pain, this pain relieved by just if he move his foot, but it recur, etsetra, best management:

a) Colazpin

b) haloperidol

c) lorazepam

d) One drug from dopamine agonist group forgot its name, it’s the right answer.

· RLS is a neurological disorder characterized by an irresistible urge to move one's body to stop uncomfortable or odd sensations. It most commonly affects the legs, but can affect the arms & torso

· Symptoms: urge to move - worsening of symptoms by relaxation - worse in the evening and early in the night

· Treatment. : dopamine agonists “Ropinirole, Pramipexole or gabapentin enacarbil” as first line drugs for daily restless legs syndrome; and opioids for treatment of resistant cases

Q16. Best drug for von willebrand disease is:

a) Fresh frozen plasma

b) Cryoprecipitate

c) Steroids

· Desmopressin is not mentioned here, some doctors consider it as 1st line of treatment

Q17. Which of the following is a feature of iron defeicincy anemia?

a) Low MCH “Mean Corpuscular Hemoglobin”

Q18. Patient just received organ transplantation what is the sign of acute rejection?

a) Fever

b) Hypotension

Q19. Sodium amount in Normal Saline [ 0.9% NaCl ] :

a) 75 mmol

b) 90 mmol

c) 154 mmol

d) 200 mmol

· Half NS [ 0.45% NaCl ] has 77 mmol , Quarter NS [ 0.22% NaCl ] has 39 mmol

Q20. Group A Hemolytic streptococcus, causes rheumatic fever when:

a) Invade blood stream

b) Invade myocardium

c) After tonsillitis and pharyngitis

d) Skin infection

· Acute rheumatic fever is a complication of respiratory infections

· Post-streptococcal glomerulonephritis is a complication of either strep throat or streptococcal skin infection

Q21. Man came with bruising and 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

Q22. Anemia of chronic disease :

a) Decrease iron and increase TIBC “in Iron Deficiency Anemia”

b) Increase iron and increase TIBC

c) Increase iron and decrease TIBC

Q23. Man with polycythemia vera came with bruising what causes decrease blood flow?

a) Hypervescosity

b) Hypoxia

c) Hypovesicosity

Q24. Patient with polycythemia vera the cause of bleeding in this patient is

a) Increase viscosity

b) Low platelets

· Polycythemia vera:

· Clonal proliferation of erythrocytes, leukocytes, and platelets

· Elevated erythrocyte mass is the most prominent feature

· Increased blood viscosity leads to symptoms such as headache, dizziness, pruritus, vertigo, or occlusive vascular lesions (eg, stroke and intermittent claudication)

· Platelet and erythrocyte abnormalities may cause symptoms such as gum bleeding, epistaxis, gastrointestinal bleeding, and thromboembolism

· Treatment is mainly by regular phlebotomy to reduce packed cell volume

· Early diagnosis and treatment strongly influence prognosis

Q25. What is the major thing that can tell you that patient have polycythemia vera rather than secondary polycythemia:

a) Hepatomegaly

b) Splenomegaly

c) Venous engorgement

d) Hypertension