Medicine Exam 6th year 2012 GI :(10) 1.45 year old male patient . with pruritis and jaundice< elevated liver cnzymesk and alkaline phosphatase. +ve pANCA and -ve ANA -ve AMA < the dx is : 5. patien has h. pylori gastric ulcer, after eradication of the organism ,one of the following still detectable: a. urease test b. fecal antigen a. cholangiocarcinorna c. h.pylori serology** b. GBS c. primary sclerosing cholangitis*** d- primary biliary cirrhosis 6. patient founfd to have multiple liver cysts seen by U/s . next step is : a. ERCP 2.Patient with aortic stenosis and lowe Gl bleeding( or melena)>> the most likely diagnosis: c. Hydatiform serology*** a. Angiodysplasia** d- laproscopy b.CT b.doudenal ulcer c-gastric ulcer d- ulcerative colitis. 3. Patient complaining of regurgitation of food that was eaten several day before < and have fouly smelling breath. he has : a. zincker diverticulum 7.female patient, BMl =35, non alcoholic, no family hx of liver diseases, Lab show elevation of liver enzymes. mos likely dx is: a. NASH*** 8. pt \\ith recent hx ofHBV infection ,where he was +ve HBsAg and anti HBc igm ... now he has non detectable level of HBsAg and there is no anti HBsAg ... one of the following is the least likely : a. he is in the window period 4. patient present with one day history of bloody diarrhea, the most likely organism is b. he has -ve HBV DNA c. he may have +ve anti HBCag a. Campylobacter jejuni** b. giardia d. he has -ve HBsAg Medicine Exam 6th year 2012 e. he may have chronic infection**** c.RTA3 d.RTA4 9. wrong about entcrobius vermicularis: c. diarrhea a. eosinophilia** b. treated by mebendazole c. worm =I em in adult d. easily person to person 3. pregnant patient with seizure attack, high Bp,edema , dx is : ecclampsia d- school aged children are mostly infected 4. not associated with renal stone : I 0. case describing acute exacerbation of ulcerative cholitis with bleeding per rectum : a. hyperparathyroidism b. polycystic kidney disease a. give IV hydrocortisone*** c. medullary cyclic kidney*** b. give metronidazole e recurrent UTI c. give iv 5 salsalate Nephrology:(IO) 5. diabetic nephropathy (?0) : I. Case cenario describing patient with normal every thing but +2 protinuria , a. protinuria*** b. duration of the disease a. reassurance** b. give ACE inhibitor 6. hypercoagulability in MCD is due to all of the following except: 2. Patient with Sjogren's syndrome a. chronic DIC*** , who have hypokalemia . hyperchloremia . urine pH=6, the most likely dx is : b. tibronigenemia c. low c protein a. RTA I** d. low antithrombin 3 b.RTA2 Medicine Exam 6th year 2012 a. macm 7. patint with serum Na= 160, weight =70, severe dehydration .. the amount of water defecit is : c.statin a. I. 9.6 d. IV insulin *** b.6.9 2. 28 year old patient with Hx of infertility, gynecomastia, small testis , high LH and FSH. low testosterone, most appropriate next step is : c.7 b.Gemfebrozil d.6*** a. testicular bx 8. patient in the ICU 30** d. HLA DB I 8. Fe jawab : LDL-c decrease with thyroxin 9. Question about diagnosis of diabetes: 2. In chronic tophacious gout the goal is : a. FBS >94 . 2 times a. dec uric acid in the serum to <4 b. pregnant woman with OGTT. FBS> 210 .. I 0. Patient with polydipsia and polyuria. urine osmolality is low. and siay low after water deprivation test. but after giving desmopressin, the urine osmolality increase, OX: b. dec uric acid in the serum to <7* * c. dec uric acid in the serum to <8 d. disappearance of tophus 3. Not bad prognosis in sarcoidosis a. SIADH a. sinus disease b. psychogenic polydipsia b. lung fibrosis c.nephrogenic OJ c. lupus pernio d. idiopathic central 01** d. bone marrow involvement e LOfgren syndrome** !!.patient with hypertension, elevated Na, decreased K . next step is : 4. Adult still"s onset disease, all true except a. plasma aldosteron concentration and plasma rennin activity*** a. high ferritin b. metaniphrin b. high ANA. RF** c. urine cortizol Medicine Exam 6th year 2012 c. high spiking fever 9. Case of suspected fibromyalgia, in order to exclude other causes the least important test to do is : 5. Not associated with ankylosing spondylitis: a. CBC. ESR b. ANA** a. aortic regurgeb. enthesitis c. CK d. CPK c.pulmonary fibrosis d. hip arthritis e.RPGN*** I 0.\\Tong association is : a. churg straus _atopy 6. Not present in dermatomyositis: b. PAN- HBV a. calcinosis*** c. WG-cANCA b. rash on the neck d.hypersensivity- vasculitis*** c.nephritis *** e. mixed cryogloulinemia- HCV ld.ANA 7. Patient with pulmonary fibrosis .he may have all of the following except: II. Patient with Amaurosis fugax, temporal muscle wasting, high esr , next step is : a. prednisolone 60 mg a.RA b.anti centromere respiratory:(ll) c. Raynaud's d.HLA** I. plethysmograph: central apnea 8. Wrong about autoantibodies: 2. Flow volume loop: tracheal stenosis A. very high ANA titer indicate severe disease 3. Normal in severe asthma: a. FRC Medicine Exam 6th year 2012 b. RV c.TLC ** 7. Not associated with increase in troponin: d. DLCo** a. PE b. Pulmonary edema** c. HTN 4. one is not different between emphysyma and chronic bronchitis: 8. Mechanism of hypoxia in COPD: a. young age in emphysyma a. Mixed hypoventilation v/q mismatch** b. family Hx b. hypoventilation c. challenge test** c. shunt d. low DLCo in emphysyma 5. female patient with daytime sleepiness. has 5-6 apnea!hypopnea!hour. 9.female patient presented with dry cough. and suspected to have asthma . what of the folioing is the most usefull : a. variability next step is : a. CPAP b. loos weight I 0. Young patient with DVT, normal pt, elevated ptt what is the next step: c. Multiple Sleep Latency Test (MSLT) a. mixing test b. factor level 6.HIV patint on HAART. treated for TB, he started to have visual sx and loss of colour vision, the most likely drug is : c.D-dimer a. ethambutol** II. One is correspond with the most severe asthma: b.rifambin a. P02 55/ PC02 35 c.pyrodixamine b. P02 55/ PC02 43*** Medicine Exam 6th year 2012 c. P02 60/ PC02 38 5. Wrong match: a. hyperkalemia- inverted T wave** b. Acute pericarditis- ST elevation Cardiology:(l3) 6. Major criteria in Duke's for infective endocarditis: I. Not bad prognostic sign in M I: a. new mitral valve regurge** a. heart fai Iure b. Osier b. HTN** c. roth spot c.DM 2. One that does not cause elevation in troponin: C.Jfo Jiy.) a. PE b. pulmonary edema** 3. Case of inferior MI. and hypotension. the immediate management: 7. One cause stabilization of atheromatous plaque: a. ASA b.statin* * c. ACE inhibitor 8. Wrong match: a. ACE inhibitor- hyperkalemia b. CCB-Iower limb edema c. B-blocker-impotence d. a-blocker- urine retension*** a. give 500cc saline** b. pacemaker c. iv morphine 9. Case of acute pulmonary edema in patient vvith heart failure, one is not given : a. furosemide 4. Pateient with mitral stenosis, present with pulmonary infiltrate. and bilateral crackle, all of the following may cause this except : b. b. blocker ( besoprolol)** a. Pneumonia 10. Case of arrhythmia ( b. B. blocker*** a. D/C cardiversion c. A fib b.iv adenosine** c. iv amiodarone §::o.. .?) Medicine Exam 6th year 2012 II. Patient with valvular \egetation, one is wrong: 2. Patient with MDS del ch 7. del(5q), del(20q), blast 20%, what would you tell the family: she is unlikely to live more than I year a. do not coagulate 3. In All , good prognosis: b. take 3 ex , 30 minute apart , before treatment t( 12.21) c. give bacteriosratic Ab in the beginning then bactericidal d. surgery consult for removal of the vigitation ansA or D 4. Wrong about glanzman thrombasthenia: a. normal platelet count b. There· s a defect in platelet plug formation. c. abnormal clot retraction test 12. in heart failure, you suspect to found all of the following exccprt : d. del ch (17) a. increase TN F e. abnormal flowcytometry. CD19. CD38 b. increase B. naturetic peptide c. increase aldosteone d. increase b. adrenergic receptor density 13. Patient with heart failure and edema: a. 1-2 liter of extracellular tluid is enough to cause edema b.edema may cause skin rupture 5. Not acute complication of blood transfusion : a. iron overload** b. TRALI c. WBC reaction d. ABO incombitability hemolysis c. in patient with hemiplesia. edema is more in the affected side. 6.patient with recurrent viraL tungal , protozoal infection. the most likely defect in Hematology :(13) a. B. lcell I. AML and M3: t( 15.17) b. T.cell** Medicine Exam 6th year 2012 1(922) c.macrophagc d. neutrophil 13. In hemophilia: e. immunoglobulin inversion 22 7. MM patient. one is not of the routinely tests : neurology :(6) a. b2.macroglobulin I. Although the definition ofT IA is neurological detecit that last less than 24 h. it is usually less than : b. Albumin c. MRI for lytic bone lesion d. renal biobsy to rio amyloidosis** a. 12 h b.8 8. Tear drop ceiL increase relics ....

Medicine Exam 6th

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