M2015A-1-50-20-40.pdf Past Paper PDF

## Pregnancy - **Overpassing term pregnancy is defined as:** - term + one month - term + 10 days - term + 15 days - term + 21 days ## Chest Pain - **A 40-year-old man presents with severe substernal chest pain radiating to the neck; made worse by breathing, coughing and lying...

## Pregnancy - **Overpassing term pregnancy is defined as:** - term + one month - term + 10 days - term + 15 days - term + 21 days ## Chest Pain - **A 40-year-old man presents with severe substernal chest pain radiating to the neck; made worse by breathing, coughing and lying on his back, ten days following a flu-like illness. Arterial blood gases are normal. His uncle had a heart attack at age 58. What is the most likely diagnosis?** - Acute myocardial infarction - Dissection of the aorta - Acute pericarditis - Pulmonary thromboembolism - Esophageal spasm ## Hepatitis B - **A 25 year old medical student is stuck with a hollow needle during a procedure performed on a patient know to have hepatitis B and C viral infection, but who is HIV Negative. The patient's baseline laboratory studies include serology :HBsAg negative, anti-HbsAb Positive, anti-HBcIgG Negative. Which of the following regarding this medical student's hepatitis status is true?** - Prior vaccination with Hepatitis B vaccine - Acute infection with hepatitis B - Prior infection with hepatitis B - The student was vaccinated for hepatitis B but is not immune ## Back Pain - **A 30-year-old man complained of severe back pain after moving a heavy object in his home. On physical examination he had urinary incontinence, grade III power in both lower limbs and loss of ankle and knee jerks. What is the most likely diagnosis?** - Spinal cord contusion - Spinal cord tumour - Central lumbar disc prolapse - Muscle strain of erector spinae muscles - Subarachnoid haemorrhage ## Chest Pain in Renal Disease - **A 68 year old man with a history of end stage renal disease is admitted for chest pain. On Examination a pericardial friction rub is noted. His ECG shows diffuse ST segment elevation. Which of the following is the best treatment?** - NSAIDs - Percutaneous Coronary intervention - Pericardiocentesis - Dialysis ## Vaginal Discharge - **A 26-year-old woman goes to her GP with an offensive vaginal discharge and vaginal irritation. A vaginal swab is sent to the lab for culture and a heavy growth of Trichomonasvaginalis is reported. A pregnancy test is negative. What is the most appropriate treatment?** - Acyclovir - Ampicillin - Fluconazole - Metronidazole - Nystatin ## Dizziness - **A 40 year old gentleman presents the Emergency after he wakes up this morning feeling dizzy with nausea and vomiting. The symptoms are aggravated with change of head position especially to the right. He denies any hearing loss or tinnitus. On examination no neurological deficit was noted. Which of the following is the most likely diagnosis?** - Meniere's disease - Transient ischemic attack - Benign positional vertigo - Labyrinthitis - Acoustic neuroma ## Necrotic Spot - **A diabetic patient presented with a black necrotic spot in the nose and complaining of headache, what is the most likely diagnosis ?** - Ecthymagangrenosum - Anthrax - Tuberculosis - Rhinocerebral mucormycosis ## Secondary Hypertension - **What is the most common cause of secondary hypertension?** - Primary hyperaldosteronism - Renal artery stenosis - Renal parenchymal disease - Pheochromocytoma - Renal calculi ## Proximal Muscle Weakness - **A 34 year old woman presented with 6 week history of progressive weakness in the proximal muscles of upper and lower extremities. During the workup for this problem, a centrally located pulmonary nodule was found and turned out to be malignant. Which of the following problems is NOT commonly associated with this cancer?** - SIADH - Hypercalcemia - Very aggressive - Ectopic ACTH production - Most treatments is palliative only ## Midsystolic Murmur - **A 25 year old woman is found to have a midsystolic murmur on routine evaluation. The murmur does not radiate but it does increase with standing. She otherwise feels well and the rest of the examination is normal. What is the most likely diagnosis ?** - Aortic stenosis - Heypertrophic obstructive cardiomyopathy - Mitral regurgitation - Tricuspid regurgitation - Mitral valve prolapse ## Painful Eye - **A 50-year-old patient presents with acute onset of a painful, red eye with impairment of vision and photophobia. What is the most likely diagnosis?** - Keratitis - Episcleritis - Viral conjunctivitis - Subconjunctival haemorrhage - Blepharitis ## Basketball Death - **A 14 year old male collapses and dies while playing basketball at school tournament. He has no known past medical history. Which of the following is the most likely underlying disease in this patient ?** - Hypertrophic cardiomyopathy - Coronary atherosclerosis - Aortic aneurysm rupture - Ventricular septal defect - Bicuspid aorta ## Hirsutism - **For the following explanation for hirsutism, select the most likely cause that is often associated with elevated 17-hydroxyprogesterone levels** - Drugs - Adrenal tumor - Polycystic ovarian disease - Adrenal hyperplasia - Ovarian tumor ## Child With Purpura - **A 10 year old child has recurrent signs and symptoms of palpable purpura on the buttocks, arthralgias,colicky abdominal pain and microscopic hematuria, which of the following is the most likely diagnosis?** - SLE - Juvenile rheumatoid arthritis - Wegener granulomatosis - Immune complex vasculitis - Influenza ## Breast Mass - **During routine physical examination of a 42-yearold woman, a physician notes the presence of a 12mm breast mass. Mammography is negative. Which of the following statements is true?** - The mammography should be repeated in 4 to 6 months. - The patient should be referred for biopsy of the mass. - The patient should be followed-up after 6 months. - An ultrasound of the breast should be ordered. - The woman should be tested for the presence of BRCA1 gene. ## Cough With Hemoptysis - **An otherwise healthy 34-year-old patient develops acute onset of cough with episodes of hemoptysis. What is the most likely etiology?** - Bronchogenic neoplasm - Wegener's granulomatosis - Congestive heart failure - Acute bronchitis - Tuberculosis ## Post-Cholecystectomy Fever - **A 57 year old woman who underwent emergent cholecystectomy for a perforated gall bladder 3 days prior now has a fever of 39.5 c and is complaining of chills. The patient has not been ambulating and says she is in great deal of pain at her incision. What is the most likely cause of her fever?** - Atelactasis - UTI (urinary tract infection) - Wound infection - DVT (Deep vein thrombosis) - Abscess ## Acute Abdominal Pain - **A patient is admitted to the emergency room because of acute abdominal pain. All of the following indicate acute intestinal ischemia except?** - History of atrial fibrillation - Acute abdominal pain - Diarrhea and/or vomiting - History of an arterial emboli of the lower extremities - Abdominal rigidity two hours after the onset of pain ## Fat Embolism - **Fat embolism is best diagnosed by:** - Myoglobinuria - Presence of fat in urine and sputum - Elevation in serum lipase - Results of arterial blood gaz - Clinical factors ## Subarachnoid Hemorrhage - **Which is not true about subarachnoid hemorrhage?** - Usually occurs at a relatively young age - Rebleeding is uncommon - Most commonly due to an aneurysm - Mortality is about 50% - The onset of coma is a poor prognostic sign ## Subacute Bacterial Endocarditis - **Which of the following pathogens is the most common cause of subacute bacterial endocarditis (SBE)?** - Staphylococcus epidermidis - Viridans streptococci - Enterococcus faecalis - Candida albicans - Proteus mirabilis ## Ulcerative Colitis - **A 54-year-old man with ulcerative colitis is scheduled for total colectomy and ileoproctostomy. His past medical history is significant for chronic smoking, diabetes, and a prior myocardial infarction. He leads a sedentary lifestyle and denies any history of angina. What would be the next step in this patient's management?** - Cardiac catheterization - Exercise stress testing - Left ventricular ejection fraction determination - No further evaluation - Surgery under epidural anesthesia ## Sexually Transmitted Infection - **What is the most frequent sexually transmitted infection in women?** - AIDS (HIV) - Herpes - Hepatitis B - Gonococcie - Chlamydiae ## Retroplacental Hematoma - **Most important cause of retroplacental hematoma is** - age of women - parity - twins pregnancy - arterial hypertension ## Amniotic Fluid - **All of the followings are true concerning the amniotic fluid except:** - It is mainly derived from the fetal urine - It protects against the compression of the umbilical cord - It contains pulmonary surfactant - It is mainly derived from the gastrointestinal secretions - It provides a space for fetalmovements ## Abnormal Involution of the Placenta - **What is the mos tfrequent complication of an abnormal involution of the placenta** - Development of fibromes - Delayed hemorrhage - Infection - Infertility - Adenomyosis ## Post-Partum Hemorrhage - **What is the most frequent cause post partum hemorrhage?** - Uterineatony - Retention of placentary debris - Perineal lacerations - Uterine rupture - CIVD