Saudi Licensing Exam Prep--Mock Exam Series

Here today we are going to start Mock Exam Series for preparation of SLE..
Questions will be posted and answers will be posted in the end of paper in a link...
Key to solve these questions are as follows:

Do questions before going through answers. Best of luck for your exam
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Mock Exam 1


Q1 - 502)  59 y/o presented with new onset supraventicular tachycardia with palpitation,no Hx of SO Or chest pain ,chest examination normal , oxygen sat in room air = 98% no peripheral edemaOthers normal, the best initial investigation:
  a.  ECG stress test                                                                                            
b. Pulmonary arteriography                                                                  
c. CT scan                                                                                                
d. Thyroid stimulating hormone          

Q2 -Lactating women presented with breast engorgment  and tendress  Your managements:
       a. Warm compressor and continoue breast feeding
       b. Dicloxacillin and continoue breast feeding
      c. Dicloxacillin and milk expression
      d. Discontinoue breast feeding  and cold compressor

Q3 -The Fastest route of antipsychotic is:
      a. IM
      b. IV
     c. Oral
     d. Sublingual
 
Q4 -While you are in the clinic you find that many patients presents with red follicular conjactivitis (Chlamydia ) your management is:
          a. Improve water supply and sanitation
         b. Improve sanitation and  destroying of the vector

         c. Eradication of the reservoir and destroying the vector
         d. Destroy the vector and improve the sanitation
       
Q5 - The most important exogenous risk factor for osteoporosis is:
a.  Alcohol intake
b. Age  
c. Smoking
d. Lack of exercise

Q6 -Patient with family history of coronary artery disease his BMI= 28 came to you asking for the advice:
a. Start 800 calorie intake daily
b. Decrease carbohydrate daytime
c. Increase fat and decrease protein
d. Start with decrease ……. K calorie per kg per week


Q7 -Lactating mother newly diagnosed with epilepsy , taking for it phenobarbital you advice is:
a. Discontinue breastfeeding immediately
b. Breastfeed baby after 8 hours of the medication
c . Continoue breastfeeding as tolerated

Q8 - Pregnant women has fibroid with of the following is True:
a. Presented with severe anemia                                                                                                  
b. Likely to regress after Pregnancy                                                                                        
c. Surgery immediately                                                                                                          
d. Presented with Antepartum He

Q9 - 510) A known case of chronic atrial fibrillation on the warfarin 5 mg came for follow up you find INR 7 but no signs of bleeding you advice is:
a. Decrease  dose to 2.5 mg                                                                                            
b. Stop the dose and repeat INR next day                                                                                
c. Stop warfarin                                                                                                                
d. Continoue same and repeat INR

Q10 - Patient is a known case of CAD the best exercise:
a. Isotonic exercise
b. Isometric exercise
c. Anerobic exe
d. Yogha

Q11 - The mechanism of action of Aspirin:
a. Inhibit cycloxgenase
b. Inhibit phospholipase A2
c. Inhibit phospholipid D

Q12 - 513) The absolute contraindication  of breastfeeding is :
a. Asymptomatic HIV patient
b. Active hepatitis C
c. Pulmonary TB on  treatment 3 months

Q13 - A boy felt down on his elbow , the lateral x-ray shows:
a. Anterior Pad sign
b. Posterior pad sign
c. Anterior line of humerous intersecting the cubilium
d. Radial line forming 90 degree with cubilium

Q14 - A known case of treated hodgkin lymphoma(mediastinal mass) with radiotherapy Not on regular follow up presented with gradual painless difficulty in swallowing and SOB , There is facial swelling and redness : DX
a. SVC obstruction
b. IVC obstruction
c. Thoracic aortic aneurysm
d. Abdominal aortic aneursm

Q15 - Patient is presented with hand cellulitis and red streaks in the hand and tender axillary lymphadenopathy. This condition is more likely to be associated with:
a. Malignancy
b. Pyoderma
c. Neuropathy
d. Lymphangitis                                                                                                                                                                                                                                                                                                                                                        
Q16 -Young aged male presented to ER after blunt trauma to Abdomen, CT scan shows intramural hematoma: your management is
   a. Lapratomy with evacuation of the hematoma
   b. Dissection of duodenum
   c. Observation

Q17 -Patient presented with sore throat, anorexia, loss of appetite , on throat exam showed enlarged tonsils with petechi on palate and uvula , mild tenderness of spleen and liver :DX
  a. Group A strep                                                                                                                                       b. EBV

Q18 -Patient with GERD has barret esophagus , this metaplasia increase risk of :
         a. Adenocarcinoma                                                                                                                                  b. Squmaou cell carcinoma

Q19 -Which of the following medication can be used as prophylaxis in appendectomy:
                   a.    Cephalexin
     b. Ceftriaxone
     c. Metronidazole
     d. Vancomycin
     e. Ampicillin

Q20 -Which of the following prognostic factor for SLE:
a. ANA levels
b. Sex
c. Age
d. Renal involvement
       
Q21 -The most common site for osteomyelitis is:
               a. Epiphysis
               b. Diaphysis
              c. Metaphysis
             d. Blood flow

Q22 - In “holding breath holding” which of the following True:
a. Mostly occurs between age of 5 and 10                                                                      
b. Increase Risk of epilepsy                                                                                                    
c. A known precipitant  cause of generalized convulsion                                                                     d. Diazepam may decrease the attack                                                                                                                                                                                                                        

Q23 -  Infant presented with hemangioma on the back . your management is:
a. Intralesional injection of corticosteroids
b. Topical corticosteroids
c. Excise of the lesion

Q24 -  Pregnant lady , 34 wk GA , presented with vaginal bleeding more than her menstruation. On examination , cervix is dilated 3 cm with bulging of the membrane, fetal heart rate = 170 bpm . The fetus lies transverse with back facing down . us done and shows that placenta is attached to posterior fundus and sonotranulence behind placenta. Your management is :
   a. C/S                                                                                                                                                         b. Oxytocin                                                                                                                                         c.Tocolytics                                                                                                                    
d.Amniotomy                                                                                                                                    

Q25 - Infant with congenital hip dislocation:
       a. +ve click in flexion ,abduction
      b. The only treatment is surgery

     c. Not reduced with flexion and abduction of the hip
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Here are answers with explanation

Q1 -   59 y/o presented with new onset supraventicular tachycardia with palpitation,no Hx of SO Or chest pain ,chest examination normal , oxygen sat in room air = 98% no peripheral edemaOthers normal, the best initial investigation:

  a.  ECG stress test                                                                                              b. Pulmonary arteriography                                                                    c. CT scan                                                                                                  d. Thyroid stimulating hormone            

the correct answer is d

Q2 - Lactating women presented with breast engorgment  and tendress  Your managements:

       a. Warm compressor and continoue breast feeding

       b. Dicloxacillin and continoue breast feeding

      c. Dicloxacillin and milk expression

      d. Discontinoue breast feeding  and cold compressor

      the correct answer is a . tis case is ( engorgement of breast ) . but if there are redness , swelling , fever  this case is ( mastitis ) and choose  b

Q3 - The Fastest route of antipsychotic is:

      a. IM

      b. IV

     c. Oral

     d. Sublingual

   the correct answer is b

Q4 - While you are in the clinic you find that many patients presents with red follicular conjactivitis (Chlamydia ) your management is:

          a. Improve water supply and sanitation

         b. Improve sanitation and  destroying of the vector

         c. Eradication of the reservoir and destroying the vector

         d. Destroy the vector and improve the sanitation

                    the correct answer is a

Q5 -  The most important exogenous risk factor for osteoporosis is:

a.  Alcohol intake

b. Age   

c. Smoking

d. Lack of exercise

the correct answer is c

Q6 - Patient with family history of coronary artery disease his BMI= 28 came to you asking for the advice:

a. Start 800 calorie intake daily

b. Decrease carbohydrate daytime

c. Increase fat and decrease protein

d. Start with decrease ……. K calorie per kg per week

the correct answer is d

Q7 -  Lactating mother newly diagnosed with epilepsy , taking for it phenobarbital you advice is:

a. Discontinue breastfeeding immediately

b. Breastfeed baby after 8 hours of the medication

c . Continoue breastfeeding as tolerated

the correct answer is c

-very vague question , some books avoid  Phenobarbital during breast feeding if possible. And in American academy of pediatric classified Phenobarbital as adrug that cause major advers effect in some nursing infant, and should be given to nursing  women with cation .

Q8 -  Pregnant women has fibroid with of the following is True:

         a. Presented with severe anemia                                                                                                     b. Likely to regress after Pregnancy                                                                                          c. Surgery immediately                                                                                                            d. Presented with Antepartum He

                the correct answer is b

               Fibroids may also be the result of hormones. Reproductive hormones like estrogen and progesterone can stimulate cell growth, causing fibroids to form. During pregnancy, your influx of hormones may cause your fibroids to grow in size. After pregnancy and during menopause most fibroids begin to shrink, due to a lack of hormones.

Q9 -  A known case of chronic atrial fibrillation on the warfarin 5 mg came for follow up you find INR 7 but no signs of bleeding you advice is:

a. Decrease  dose to 2.5 mg                                                                                              b. Stop the dose and repeat INR next day                                                                                   c. Stop warfarin                                                                                                                  d. Continoue same and repeat INR

the correct answer is b

INR	ACTION
>10	Stop warfarin. Contact patient for examination. MONITOR INR
7-10	Stop warfarin for 2 days; decrease weekly dosage by 25% or by 1 mg/d for next week (7 mg total); monitor INR
4.5-7	Decrease weekly dosage by 15% or by 1 mg/d for 5 days of next week (5 mg total); repeat monitor INR
3-4.5	Decrease weekly dosage by 10% or by 1 mg/d for 3 days of next week (3 mg total); repeat monitor INR.
2-3	No change.
1.5-2	Increase weekly dosage by 10% or by 1 mg/d for 3 days of next week (3 mg total);
<1.5	Increase weekly dose by 15% or by 1 mg/d for 5 days of next week (5 mg total);

Q10 -  Patient is a known case of CAD the best exercise:

a. Isotonic exercise

b. Isometric exercise

c. Anerobic exe

d. Yogha

the correct answer is c

1-anerobic exercise ( endurance ) : for improve cardiac function                                                                2- weight bearing excercise ( isometric ) : for build muscle strength , bone density                                                                                                              3- stretching excercise : for prevent cramp , stiffness and back pain

Q11 - The mechanism of action of Aspirin:

a. Inhibit cycloxgenase

b. Inhibit phospholipase A2

c. Inhibit phospholipid D

the correct answer is a

Q12 - The absolute contraindication  of breastfeeding is :

a.       Asymptomatic HIV patient

b.      Active hepatitis C

c.       Pulmonary TB on  treatment 3 months

The correct answer is a

Absolute contraindication of breastfeeding :

1-Infants with galactosemia.

2-Mothers who use illegal drugs.

3-Mothers infected with HIV, human T-cell lymphotropic virus type I or type II, or who have an active herpes lesion on the breast.

4-Mothers taking any of the following medications: radioactive isotopes, cancer chemotherapy agents, such as antimetabolites                                                                                                 .

Q13 -  A boy felt down on his elbow , the lateral x-ray shows:

a.       Anterior Pad sign

b.      Posterior pad sign

c.       Anterior line of humerous intersecting the cubilium

d.      Radial line forming 90 degree with cubilium

                                                                                                                                                    the correct answer is A

Q14 -  A known case of treated hodgkin lymphoma(mediastinal mass) with radiotherapy Not on regular follow up presented with gradual painless difficulty in swallowing and SOB , There is facial swelling and redness : DX

a.       SVC obstruction

b.      IVC obstruction

c.       Thoracic aortic aneurysm

d.      Abdominal aortic aneursm

The correct answer is a

________________________________________________________________________

Q15 -  Patient is presented with hand cellulitis and red streaks in the hand and tender axillary lymphadenopathy. This condition is more likely to be associated with:

a.       Malignancy

b.      Pyoderma

c.       Neuropathy

d.      Lymphangitis                                                                                                                                                                               the correct answer is b (I'm not sure )

                                                                                                                                                                          

Q16 - Young aged male presented to ER after blunt trauma to Abdomen, CT scan shows intramural hematoma: your management is

   a. Lapratomy with evacuation of the hematoma

   b. Dissection of duodenum

   c. Observation

     the correct answer is c

Q17 - Patient presented with sore throat, anorexia, loss of appetite , on throat exam showed enlarged tonsils with petechi on palate and uvula , mild tenderness of spleen and liver :DX

  a. Group A strep                                                                                                                                         .    b. EBV

The correct answer is b

Q18 -  Patient with GERD has barret esophagus , this metaplasia increase risk of :

         a. Adenocarcinoma                                                                                                                                  b. Squmaou cell carcinoma

              the correct answer is a

Q19 - Which of the following medication can be used as prophylaxis in appendectomy:

                   a.    Cephalexin

     b. Ceftriaxone

     c. Metronidazole

     d. Vancomycin

     e. Ampicillin

        The correct answer is c

        1^st line of antibiotic : 1- cefoxitin  2- cefotetan

        2^nd line of treatment : 1- metradinazole   2- ampicikkin-sulbactam

Q20 - Which of the following prognostic factor for SLE:

a.       ANA levels

b.      Sex

c.       Age

d.          Renal involvement

          The correct answer is d

Q21 -  The most common site for osteomyelitis is:

               a. Epiphysis

               b. Diaphysis

              c. Metaphysis

             d. Blood flow

              The correct answer is c

Q22 - In “holding breath holding” which of the following True:

a. Mostly occurs between age of 5 and 10                                                                    
b. Increase Risk of epilepsy                                                                                                  
c. A known precipitant  cause of generalized convulsion                                                                  
d. Diazepam may decrease the attack

Breath holding spells  are the occurrence of episodic apnea in children, possibly associated with loss of consciousness, and changes in postural tone. They are most common in children between 6 and 18 months and usually not present after 5 years of age. They are unusual before 6 months of age. A positive family history can be elicited in 25% of cases. It may be confused with a seizure disorder.

There are four types of breath holding spells.

1-The most common is termed simple breath holding spell, in which the manifestation is the holding of breath in end expiration. There is no major alteration of circulation or oxygenation and the recovery is spontaneous.

2-The second type are the Cyanotic breath-holding spells. They are usually precipitated by anger or frustration although they may occur after a painful experience. The child cries and has forced expiration sometimes leading to cyanosis (blue in color), loss of muscle tone, and loss of consciousness. The majority of children will regain consciousness. The child usually recovers within a minute or two, but some fall asleep for an hour or so. Physiologically, there is often hypocapnea (low levels of carbon dioxide) and usually hypoxia (low levels of oxygen. There is no "post ictal" phase (as is seen with seizures), no incontinence, and the child is fine in between spells. EEGs are normal in these children. There is no relationship to the subsequent development of seizures or cerebral injury as a consequence of breath holding spells.

3-In the third type, known as Pallid breath-holding spells, the most common stimulus is a painful event. The child turns pale (as opposed to blue) and loses consciousness with little if any crying. The EEG is also normal, and again there is no post ictal phase, nor incontinence. The child is usually alert within a minute or so. There may be some relationship with adulthood syncope in children with this type of spell.

4-  A fourth type, known as Complicated breath-holding spells, may simply be a more severe form of the two most common types. This type generally begins as either a cyanotic or pallid spell that then is associated with seizure like activity. An EEG taken while the child is not having a spell is still generally normal.

DX: clinical , good history include sequence of event , lack of incontinence and no post ictal phase.   Treatment : reassurance and iron.                                                                                                                                                                                                                             

Q23 -  Infant presented with hemangioma on the back . your management is:

a. Intralesional injection of corticosteroids

b. Topical corticosteroids

c. Excise of the lesion

Q24 - Pregnant lady , 34 wk GA , presented with vaginal bleeding more than her menstruation. On examination , cervix is dilated 3 cm with bulging of the membrane, fetal heart rate = 170 bpm . The fetus lies transverse with back facing down . us done and shows that placenta is attached to posterior fundus and sonotranulence behind placenta. Your management is :

         a. C/S                                                                                                                                      b.Oxytocin                                                                                                                                      c.Tocolytics                                 

 d.Amniotomy                                                                                                                                      a the correct answer is 

Q25 -  Infant with congenital hip dislocation:

       a. +ve click in flexion ,abduction

      b. The only treatment is surgery

     c. Not reduced with flexion and abduction of the hip

      the correct answer is a . this is ortolani test