5th stage Question & Instruction By Habil Qabil.pdf

2018 - 2019 5th Stage Examination Questions & Instruction Prepared by Habil Qabil University of sulaymaniyah College of Medicine 5th stage 5th Stage _ Examination Questions & Instruction 2018 – 201...

2018 - 2019 5th Stage Examination Questions & Instruction Prepared by Habil Qabil University of sulaymaniyah College of Medicine 5th stage 5th Stage _ Examination Questions & Instruction 2018 – 2019 Prepared by: Habil Qabil  Index Chapter one / Theoretical examination 5 - 110 Essay 6  Medicine 6  Surgery 12  Pediatrics 16  Gynecology 28  Orthopedics 36  Urology 41  Ophthalmology 47  Radiology 50 MCQ 52  Medicine 52  Pediatrics 60  Gynecology 64  Urology 65  Orthopedics 74  Ophthalmology 80  Dermatology 84  E.N.T 94  Radiology 96  Psychiatry 106 Chapter Two / Practice course 111 - 175  Dermatology 112  E.N.T 117  Gynecology 124  Medicine 134  Ophthalmology 139  Orthopedics 141  Pediatrics 148  Psychiatry 156  Radiology 161  Surgery 164  Urology 170 ｜1 Chapter 3 / Instruction 176 - 217 Part 1 Instruction 177 Part 2 Unit & Hour of Lectures 181 Part 3 Theory 185 Part 4 Practice Course 189 Part 5 Maps 201 Part 6 Link 203 Part 7 Index Lec of 5th stage 207 ｜2 Preface Dear students, Welcome to the fifth stage of medical college ! Hopefully, From this year on, you will be dealing with the clinical aspects of multiple branches of medicine { Dermatology , E.N.T , Psychiatry , Urology , Orthopedics......etc } which you familial to most of the disease regarding etiology , cause , investigation & managment. The clinical years (fourth, fifth and sixth) also have a higher percentage of your total score dedicated to them. What is presented to you herein is a booklet guide for your fifth year of academic life. Hopefully, this is going to come in handy for you from time to time. Feel free to come back to this booklet when you feel you like it. This booklet is divided into three chapters: * Chapter one: includes the theoretical examination questions that were collected from the year 2012 all the way to 2019. * Chapter two: includes the practical examination questions that were collected during the academic year of 2018 - 2019. It is a good idea to have a look at these questions prior to your practical course exams as you will be quite familiar with the types of questions that you might get asked. * Chapter three: is a general guide to the fifth stage. It helps to make you familiar with the things that you should keep in mind about this year of your academic life. In this chapter you will find information about each subject, distribution of your scores (theoretical exam, practical exam, quiz and attendance), method of performing practical exams, requirements for each practical course. I hope this booklet will be of utmost benefit to the reader. I have special thanks to all my friends who helped in making this booklet possible. If you have any questions, comments, Suggestions, problems about this booklet & fifth stage you can contact me by using the Email below or through social media My Email : [email protected] My FB : https://www.facebook.com/habil.qabil.501 ｜3  Theory Question 2012 – 2013, 2013 – 2014, 2014 – 2015 by Shanyar , Rawa Mohsin , Shwan Sabah  Theory Question 2015 – 2016 by Akar Jamal  Theory Question 2016 – 2017 by Sima Ibrahim , Taban Ahmad  Theory Question 2017 – 2018 Essay by Dosty Osman , Rahel Omer , Rasyan Dara MCQ by Rasyan Dara  Theory Question 2018 – 2019 Essay Mid & Final , MCQ Ophthalmology final By Habil Qabil Pediatrics case final By Hevar Taha , Aynda Ali MCQ Mid year By Avin Sdiq Mohammed Second round Question by Adnan Ali , Sarbast xatib , Sharo xasraw , Shania Ali , Atta Ameen , Levan Latif  Practical question 2018 – 2019 By 5th stage medical student through Google form, Idea & Preparation by Habil Qabil  Part 1 Instruction by Habil Qabil , Kashma Ali , Mohammed Jabar  Map by Muhemmed Salam ｜4 Chapter one / Theoretical examination Essay Medicine , Surgery , Pediatrics , Gynecology, Orthopedics , Urology , Ophthalmology , Radiology MCQ Medicine , Pediatrics , Gynecology , Urology , Orthopedics , Ophthalmology , Dermatology , E.N.T , Radiology , Psychiatry ｜5 Essay Medicine - Theoretical - Examination 2012 – 2013 - Medicine Mid-Year Essay: 70 marks, Single-choice: 30 marks 1. A. Write about investigations for Graves’ disease. B. Write about adrenal crisis and the advice given to a patient with Addison disease. 2. What are the criteria for the diagnosis of pre-diabetes and diabetes in adult non-pregnant patients? 3. A. What are the causes of thunderclap headache? B. What are the indications, contraindications, and complications of lumbar puncture? 4. Write about the management protocol for status epilepticus. 5. What are the types of deformity in osteoarthritis of knee and why do they occur? 6. Write about rheumatoid serum factor and its role in diagnosing hematological diseases. 7. A. What are the risk factors for UTI? B. What are measures to reduce hyperkalemia in chronic kidney disease? Final-Year Essay: 80 marks Single-choice: 20 marks 1. Enumerate risk factors for multiple sclerosis and write short notes on them. 2. Enumerate types of lower motor neuron disease and give examples for each and write short notes on each type. 3. Write short notes on myxedema coma. 4. Write briefly about the diagnosis and treatment of von Will brand disease. 5. A married 25-year old woman with SLE wants to get pregnant. How do you advise her and how do you follow her up? 6. List the cardio toxic drugs, their mechanisms of action, and lines of management. 7. A 52-year old man presents with blood pressure ~ 157/98 mmHg persistently on 3 occasions in 2 months duration, smokes 10 cigarettes a day, no alcohol, and no past medical history. His younger brother was recently admitted for MI. Total cholesterol is 6.2, HDL is 1.3, and glucose is normal. A. What is the 10-year cardiovascular disease risk for this patient? (Chart provided) B. Do you start treatment? If yes with which one? C. What are the indications for ambulatory blood pressure monitoring? D. If blood pressure remains high what other medication do you add? 8. Discuss briefly the treatment of glomerulonephritis. ｜6 2013 - 2014 - Medicine Mid-Year (Essay: 70, MCQ: 30) 1. What is synovial membrane & what happens to it in RA? 2. What are the nodes in OA; their location, pathophysiology & significance? 3. Short notes on: A. Tetany B. Malignant hypercalcemia 4. Discuss: A. Differential diagnosis of short stature B. Approach to a patient with gynecomastia 5. Advice & workup of 25 yr. lady with epilepsy who wants to get pregnant? 6. Causes of acute coma in 20 yr. Adult? 7. Management of DKA. Final-Year (Essay: 80, MCQ: 20) 1. Treatment of Chronic Inflammatory Demyelinating Polyradiculopathy (CIDP) in a flowchart 2. Short notes on: a. Inclusion and exclusion criteria for thrombolytic therapy b. Cardinal features of Parkinson’s disease 3. Short notes on: a. Drugs not bound by activated charcoal during acute poisoning b. Principles of GIT decontamination in acute poisoning 4. International criteria for diagnosing Behçet's disease with their scores 5. How do you manage a patient with lymphadenomegaly involving cervical and inguinal lymph nodes, mostly walnut sized? She had no response to a good course of antibiotics. 6. Short notes on: a. Contraindications of renal biopsy b. Nephritic syndrome 7. Write the etiologies and clinical features of Syndrome of Inappropriate ADH (SIADH) 8. A case on falls in elderly with a fracture a. What are the risk factors for fall in this patient? b. What is your next step to decrease risk of fall in this patient? c. What are the causes of fragility fracture in this patient? d. What investigation do you do next to know the cause of the fracture? ｜7 2014 – 2015 - Medicine Mid-Year Essays: 60 marks, 20 MCQs: 40 marks 1. Write a short essay about the investigation and management of herpes simplex encephalitis 2. Classify the etiology of focal/unilateral cerebellar lesions 3. Write briefly about the clinical features and investigation of pheochromocytoma 4. Enumerate the causes of hypoglycemia in non-diabetic patients 5. what are the radiological findings of OA in the knee joint? 6. Enumerate the causes of death in rheumatoid arthritis Final-Year Essays: 80 marks, 20 MCQs: 20 marks 1. The characteristics of presenting problems in geriatrics and discuss one of them 2. Discuss the investigations used to assess renal function 3. Enumerate and write briefly about the skin and gastrointestinal manifestations of systemic sclerosis 4. What are the neurological manifestations of RA? 5. How do you differentiate acute from chronic kidney disease? 6. Management of paracetamol poisoning 7. Causes of anemia and thrombocytopenia in chronic lymphocytic leukemia "CLL" 8. Write about the investigations of hyperparathyroidism 9. Edrophonium (Tensilon) test A. Indication B. Method C. Risks 10. discuss the management of a 26 year old female presenting with repeated attacks of tonic clonic seizure for the first time 2015 – 2016 - Medicine Mid-Year 1. Types of disability & brief notes on them 2. Behçet's disease, Criteria of diagnosis 3. Classification & Clinical feature of Cushing syndrome 4. Management of DKA 5. 6. Guideline criteria of brain death ｜8 Final-Year 1. Definition of chronic renal failure 2. Write about brown squared syndrome? 3. Management of DKA 4. Classification & Clinical feature of Cushing syndrome 5. Write about nephritic syndrome 6. A case presentation of dementia, how do you manage it? 7. A case presentation of Stroke, How do you manage it? 8. Polymyalgia Rheumatica diagnostic criteria 2016 – 2017 - Medicine Mid-Year Essay questions; (5, 10 for each, 50 marks), MCQ (25, 2 for each, 50 Marks) 1. Enumerate causes & classification of Acute Kidney Injury. 2. Management of sever Hypocalcaemia. 3. How to differentiate Toxic- metabolic coma from structural coma. 4. Mention classification of hypogonadism. 5. Low (poor) prognostic markers (sign) in Rheumatoid arthritis (RA). Final-Year Essays; (70 Marks), MCQs; (30 Marks) 1. Enumerate the clinical (systemic) manifestations of diffuse systemic sclerosis. 2. Approach of 25 year old man presented with progressive cervical lymph-node enlargement for few months. 3. Enumerate 6 hallmarks of cancer. 4. Talk in detail about the clinical importance of general urine examination (GUE). 5. Shortly talk about investigation and management of pneumococcal meningitis. 6. Enumerate clinical features of acromegaly. 7. Management of patient with dementia (75 yrs. old lady fall on ground with swollen wrist and high fever with urine retention). 2017 – 2018 - Medicine Mid-Year 1. Discuss investigation of a patient with Cushing syndrome. 2. What is thyroid storm? Discuss {clinical feature} briefly signs and symptoms and treatment {How you managed}. 3. Discuss lines of treatment of hypopituitarism and follow up 4. What are the types of complicated migraine headache and how is it managed? 5. Discuss diagnostic criteria of polymyalgia rheumatic. ｜9 Final-Year Essay, 10 marks each: 1. Briefly discuss the cardinal features of Parkinson disease 2. Write short notes on adrenal crisis, what's your advice to a patient with Addison's disease {adrenal insufficiency} 3. List the drugs that are used for treatment of SLE 4. A 62 year old male presented with microscopic hematuria how do you approach this patient? 5. How do you approach a female patient presented with breast lump? 6. How do you manage a patient with paracetamol poisoning? 7. List characteristic {type} of geriatric presenting problems and talk about one of them (Note that the question asks about the characteristics of the problems NOT the problems themselves.) 2018 – 2019 - Medicine Mid-Year 40 essay 60 MSQ 1. Write causes of SIAD Dr. Sirwan 2. Write cause & clinical manifestation of addicion disease Dr. Taha mahwi 3. Write clinical manifestation of rheumatoid arthritis Dr. Rauf 4. Write investigation & management of TB meningitis Dr. Hawar Final-Year 1. Clinical variant of motor neuron disease, briefly describe one of them? 2. Skin & articular manifestation of SLE 3. Shortly discuss about intermediate neurological syndrome of organophosphate poisoning 4. Approach to patient with bleeding tendency 5. Criteria for diagnosis polymyalgia rheumatica 6. Difference between benign & malignant tumor 7. Criteria for diagnosis Diabetic & Prediabetic patient ｜ 10 Second round 1. Pathogenesis of OA 2. Criteria for DX Behjet syndrome 3. Approach to anemia 4. Management DKA 5. Types of biopsy in CA 6. Steps in Management of ischemic stroke 7. Poor prognosis of drowning ｜ 11  Surgery - Theoretical - Examination 2012 – 2013 - Surgery Mid-Year Essay: 50 marks Single-choice: 50 marks 1. A case on empyema thoraces A. What is the most likely diagnosis? B. What is your diagnostic workup for this patient? C. What is your management? 2. A. Write about the treatment of rib fractures. B. Write about bronchoscopy. C. What are the thoracic surgical approaches? 3. What are the points in history about previous adverse responses to anesthesia? 4. What are the primary aims of pharmacological premedication? Final-Year Essay: 50 marks Single-choice: 50 marks 1. An elderly man presents with a 2-year history of urinary incontinence and wide- based shuffling gait which were attributed to prostatism and old age. In the last three months features of dementia have appeared (problems with memory, etc.). He had a head trauma 30 years ago. A. What is the most likely diagnosis? B. How would you confirm it? C. How would you treat it? 2. Discuss the factors important in choosing the type of heart valve (mechanical or tissue) for replacement 3. What are the immediate and late complications of extubation of endotracheal tube? 4. A. What are the differences between skin graft and skin flap. B. Define scar and how do you obtain fine scar? C. Enumerate the diagnostic modalities for lung cancer. 2013 – 2014 - Surgery Mid-Year (Case: 15, Short: 35, MCQ: 50) Q1// A 24 yr. male (185cm, 78 kg) cabin crew worker presented to the emergency department with sudden onset of right sided chest pain, dyspnea and dry cough. On examination there was absent breath sounds on the right side but normal breath sounds on the left, the tracheal position was central. The condition started 3 days ago and has gotten worse since. There was no history of trauma and the medical history was insignificant. ｜ 12 A. What is the most likely provisional diagnosis? B. What is the best line of management? C. Is there any indication for surgery? Q2// Short notes on the followings: A. ASA Physical Status classification B. Clinical Predictors of Increased Perioperative Cardiovascular Risk C. Total Circulatory Arrest D. Indications for surgery in VSD E. What is the Q10 rule and what is its benefit? Final-Year (Short: 45, Matching: 15, MCQ: 40) 1. Clinical features of brain tumors 2. Short notes on subdural hematoma 3. Define scar and how do you obtain fine scar? 4. What are the differences between skin grafts and skin flaps? 5. Factors that increase postoperative nausea and vomiting 6. Short notes on postoperative airway obstruction & laryngeal spasm 2014 – 2015 - Surgery Mid-Year (6 essays: each 12 marks) (28 MCQs: 28 marks) 1. How you evaluate a patient with head injury? 2. What is diffuse axonal injury and how do you manage it? 3. Enumerate the indications of flexible bronchoscopy 4. Enumerate the most common thoracic incisions 5. Discuss short notes about the preoperative evaluation and preparation of a patient for general anesthesia 6. Enumerate the adverse effects of opioids and morphine Final-Year (50 MCQs: (50 marks) (10 surgery MCQs, 40 anesthesiology MCQs)) Long essay 1. Discuss pediatric brain tumors (10 marks) 2. Define flaps, different classifications with examples for each (10 marks) Short essays (30 marks) 1. Classification of cutaneous vascular anomalies 2. Pulmonary hydatid cyst 3. Enumerate five congenital CNS anomalies and define each 4. Surgical indications of ventricular septal defect closure 5. Total circulatory arrest 6. Indications of video-assisted thoracoscopic surgery (VATS) ｜ 13 2016 – 2017 - Surgery Mid-Year 1. Clinical feature of Epidural hematoma (both semester) 2. Factor that determine Severity of brain injury (cerebral fracture) 3. Write about chest tube (Tube thoracotomy) 4. Pre-operative evaluation (assessment) of patient with lung CA 5. Talk about Triple maneuver 6. Complication & management of local anesthesia toxicity Final-Year Write shortly on the following: (Each 5 Marks) 1. Factors that determine the final appearance of a scar. Or {How to obtain linear scar} 2. Types & Classifications of flap. 3. Advantages & disadvantages of pulse oximetry. 4. Enumerate only (5) complications of Mechanical Ventilation. 5. Indications of CABG (Coronary artery bypass graft). {Surgical indication IHD} 6. List stages of empyema (empyema thoracic) 7. Define Tension Pneumothorax & mention its causes. 8. Metastatic Intracranial (brain) Tumors. Or {Secondary CNS metastasis} 9. Mention (5) CNS developmental anomalies and their definition. 10. Clinical features of epidural hematoma. MCQ >>> 50 MCQ (Each 1 Mark) 15 MCQs >>> Plastic Surgery (Mostly Dr Suzan) 10 MCQs >>> Cardiothoracic Surgery (Dr Ahmad & Dr Shkar) 25 MCQs >>> Anesthesia (Mostly Dr ‘Amr, plus 3 MCQs from First Semester) 2017 – 2018 - Surgery Mid-Year Essay questions, 10 marks each Write short notes about the following 1. What are the risk factors for lung cancer? 2. What is Glasgow coma scale and what is the clinical significance? {Use} 3. Talk about depressed skull fracture 4. Is blood pressure important in head injury {Role}? Why? ｜ 14 Final-Year 1. Write the differences between partial thickness and full thickness graft. 2. What are the reasons you depend on when deciding the right valve type for a patient needing valve replacement? 3. Vertebral column tumor 4. What are indications for brain imaging after trauma {head injury} 5. What are the indication for surgery in a patient with coronary artery disease? {IHD} 6. Write the definition and clinical features of bronchiectasis. 7. Write five congenital abnormalities of CNS and define each. 8. What are the indications for endotracheal intubation? 9. What are the drawbacks of laryngeal mask airway? 2018 – 2019 - Surgery Mid-Year 50 Essay 50 MSQ, 50 MSQ 1 mark for each one Dr. Aram baram 1. Enumerate 5 indication of chest tube 12mark 2. Write diagnostic approach for chest mass lesion that suspect malignancy 13mark Dr. Ali 3. Clinical features of congenital hydrocephalus 12mark 4. Complication of ventriculoperitoneal shunt 13 mark Final-Year Essay 60 mark, MSQ 40 Mark 1. Define lung abscess & write investigation use to diagnosis 2. Surgical indication of aortic insufficiency 3. Enumerate clinical feature intracranial tumor 4. Surgical management pain 5. Cause skin graft failure 6. Clinical feature unilateral cleft palate Second Round 1. Embryology Cleft lip & Palate 2. Difference betwean Partial thickness & Full thickness gragt 3. Traumatic & Non Traumatic Cause Empyma 4. Management Pitutary adenoma 5. Surgicalmanagment epilepsy 6. Whats total circulatory arrest ｜ 15  Pediatrics - Theoretical - Examination 2012 – 2013 - Pediatrics Mid-Year -True-false: 40 marks (with cancelling) -Single-choice: 30 marks -Case questions: 30 marks (three cases each with three short-answer questions) 1. A case on VSD 2. A case on dehydration from diarrhea 3. A case on HSV encephalitis Final-Year Single-choice: 40 marks 1. A case on hypertrophic pyloric stenosis A. What is the most likely diagnosis? B. What is the best diagnostic investigation? 2. A case on bloody diarrhea A. What is the most likely organism? B. Mention two complications. 3. A case on Guillain-Barre syndrome A. Mention two more investigations to reach the diagnosis. B. What is the most likely diagnosis? C. Mention the single best drug therapy. 4. A case on post-infectious glomerulonephritis A. What is the most likely diagnosis? B. Mention two more investigations to confirm the diagnosis C. Outline the management of this case. 5. Examine this pedigree A. What is the most probable pattern of inheritance? B. What is the most likely diagnosis in this case? 6. Enumerate the points of advice to a patient with diabetes ｜ 16 2013 – 2014 - Pediatrics Mid-Year (Essay: 40, MCQ: 40) 1. A case on rolandic epilepsy a. What is the diagnosis? b. What is the best treatment? c. What is the prognosis? 2. A case on Duchene Muscular dystrophy a. What is the diagnosis? b. What other test do you need to confirm the diagnosis? c. What is the prognosis? 3. A case on HUS a. What is the diagnosis? b. Write two other tests to help in the diagnosis? c. What was wrong with the initial management? 4. A case on leukemia a. What is the diagnosis? b. What test confirms the diagnosis? 5. Examine this pedigree (: affected ♂, □: healthy ♂,: affected ♀, ○: healthy ♀, == : consanguinity) a. What is the most likely mode of inheritance? b. Write three diseases with this mode of inheritance. ｜ 17 2014 – 2015 - Pediatrics Mid-Year 4 essays: 40 marks 40 MCQs: 40 marks Q1: A case: “I think it is acute post streptococcal glomerulonephritis” a) What is the diagnosis? b) Write two other important investigations to help you confirm your diagnosis. c) Outline the treatment. Q2: A case: “I think it is meningococcal meningitis’ a) What is the most likely organism? b) What other clinical sign suggests the bacterial cause? c) What is the antibiotic of choice? d) What prophylaxis should be done? e) What complication had occurred? (The patient has died) Q3: A case: “I think it is tuberous scleroses a) What is the most likely diagnosis? b) What other clinical signs are important? c) What important investigation is available here for diagnosis? d) What type of epilepsy is common with this disease? Q4: A case: “I think it is galactosemia” a) What is the most likely diagnosis? b) How would you confirm your diagnosis? Final-Year 8 cases: 50 marks , 37 MCQs: 37 marks , 4 extended matching questions 13 marks 1. A case about: "I think it is some (moderate) dehydration" 2. "I think it is nephrotic syndrome" A. What is the diagnosis? B. Three common complications of this condition C. Outline the management 3. "I think it is congenital adrenal hyperplasia" A. What other investigation would you send? B. What is the most likely diagnosis? C. Urgent measure to manage this patient 4. "I think it's hemophilia A" A. What is the most likely diagnosis? B. Treatment ｜ 18 5. "I think it is hemolytic anemia" A. What does this indicate? B. Write five diseases that cause this condition 6. "I think it is transposition of great arteries” A. What is the most likely diagnosis? B. What investigation do you need to confirm it? C. Immediate measure to treat this patient 7. "I think it is organophosphate poisoning" A. What other question would you like to ask his father? B. What is the most likely diagnosis? C. Management 8. Febrile convulsion A. What advice would you give to his parents to prevent further attacks? B. What are the other two pathological processes possible in a child with fever and convulsion? C. What do you expect the prognosis will be? 2015 – 2016 - Pediatrics Mid-Year Case 40 mark : MSQ 40 mark 1. A case of meningitis, died after LP A. Cause of death B. How to present such death? C. If alive, Treatment 2. Spinal muscular atrophy type 1 A. Diagnosis B. List of investigation C. Which character feature in muscle D. Treatment 3. HUS A. Diagnosis B. 2 other test C.? 4. Pyelonephritis 5. VSD A. Diagnosis A. Diagnosis B. Other investigation B. 2 finding on CXR C. Treatment C. Cause of loud S2 ｜ 19 Final-Year 1. PDA A. Diagnosis B. 2 ECG finding C. 2 treatment 2. Duchene muscular atrophy A. Why duhine pleg in B. Why cardiac C. Rest treatment to disease D. Best treatment E. Prognosis 3. Preconscious puberty A. Diagnosis B. Best treatment 4. Shigella dysentery A. Most causative organism B. 2 Possible complication 5. Complication of nephrotic syndrome 6. Morphological classification of anemia & common causes 2016 – 2017 - Pediatrics Mid-Year Case 1 Dr Ibrahim Meningitis Empirical Abx?! What you give with or before Abx?! After 4 days pt. develops seizure, why?! Further Mx. Of meningitis Case 2 Dr Bakir Pyelonephritis Other Ix? TX? Advice? Case 3 Dr Bakr Nephrotic syndrome What is steroid dependent? What is steroid resistance? Relapse in nephrotic syndrome? ｜ 20 Case 4 Dr Aso Coarctation of aorta Case with differential cyanosis + weak pulse in LL.? Dx? Confirm of Dx. by? First line of Tx? Definitive Tx. Dr Hersh A. Steps of hematopoiesis and Hb chain associated with each step? B. Write short notes about lab. Findings and Tx. Of PNH (paroxysmal nocturnal hemoglobinuria)? Final-Year 1. Dr Adnan A case with S&S of severe dehydration in an infant: ⁃ Assess state of dehydration? ⁃ What is the preferred type of fluid to be given? ⁃ How do you manage this case. ⁃ The same patient after improvement and discharge, presented with S&S of lactose intolerance. ⁃ How do you manage? 2. Dr Tara A case of a girl uses long acting steroid for alopecia, the girl becomes obese & develops striae headache...... ⁃ What is the cause of her symptoms? ⁃ Enumerate 3 investigations to be sanded? ⁃ If she stops the drug what do you expect to occur and why? 3. Dr Ibrahim A case of a boy one day after he woke up found difficulty in washing his hand and combing his hair and during breakfast dropped the cup and broke it, his brother has Duchene muscular dystrophy and his parents are first degree relative. ⁃ What do you think he is suffering from? ⁃ What investigations you send? ⁃ The best treatment and its duration? 4. Dr Hersh A case of a child presented with splenomegaly, lymphadenopathy easy bruise bleeding from gum during brushing no nausea & vomiting 2 wks. (Or 1 month) before got URTI Hb =7 WBC = 18 Platelet =7000 Atypical lymphocytosis ⁃ Two (2) differential diagnosis? ⁃ Important investigation that help you reach the final diagnosis. ｜ 21 5. Dr Baker ⁃ Risk factors and important investigations for recurrent UTI ⁃ Management of post streptococcal GN? 6. Dr Aso A case presented with loss of consciousness, SVT, loud S2 cardiomegaly, pulmonary, plethora weak radial pulse before 2 wks. (or 1 month) got infection of URT......? ⁃ Initial treatment. ⁃ Provisional diagnosis. ⁃ How you confirm. ⁃ Line of management. Second round 1. Risk factor for recurrent UTI, Mx of postsreptococcal pyelonephritis 2. Case about infectious mononucleosis 3. Case about juvenile epilepsy 4. Case about Cushing syndrome 5. Case about sever dehydration 6. Case about SVT and aortic stenosis (not sure) 2017 – 2018 - Pediatrics Mid-Year Q-1) answer the following cases, 10 marks each: (note: the cases were long and detailed and many findings were given, I couldn’t remember them all so the following are as much as I remembered...) 1. An infant, 6 weeks age, presenting with vomiting for 3 weeks, and mother says that her son is having constipation in the past 10 days and growth has stopped, on examination, PH of blood is raised, there is dehydration, no adverse events during intrauterine and intrapartum time, only had neonatal jaundice after birth A. What is the diagnosis? --hypertrophic pyloric stenosis B. Mention one single specific diagnostic test: --Ultrasound 2. A small girl presenting with diarrhea and visible blood was seen in her last diarrhea and she developed convulsion, temperature is higher than 38.3 C and WBC is high… A. What is the most likely causative microorganism? --shiegella B. Write 2 possible complications... ｜ 22 3. A child (boy) suddenly presented with seizure, he was fine the previous day, only 2 weeks ago he had an oral rash and was treated with nystatin antifungal, but it was useless and he recovered spontaneously A. What is the most likely diagnosis? --herpes simplex encephalitis B. What caused the oral rush? --herpes virus C. What investigation will prove the diagnosis? D. Give one specific treatment --IV acyclovir 4. An 5 month infant presenting with prolonged attacks of excessively crying to pediatric hospital, they diagnosed the child with infantile colic and has been given antispasmodic drops for it , but didn´t get better , later on neurological examination they found that the child has delay in development and microcephaly A. What's the diagnosis? Infantile spasm B. What is the single investigation to detect it? EEG C. What is seen in the investigation? D. What is the treatment for it? 5. An infant 2 week presenting to hospital with vomiting, dehydration, hyperkalemia, hypernatremia and had ambiguous genitalia A. What's the diagnosis? Congenital adrenal hyperplasia (should you write adrenal crisis too???!!) B. Mention two investigations to prove the diagnosis. High ACTH, low cortisol C. What's the maintenance therapy...? 6. A boy 3.5 years of age, mother bring him to outpatient Clinique complaining he gets dyspnea on exertion, and also slow growth, on auscultation there is a grade 4 murmur on the lower left sternal border and heaving, the second heart sound is very loud A. How you reach diagnosis? B. Write 2 findings on x-ray C. Why the second heart sound is loud? D. Will ECG help in diagnosis? p.s. the diagnosis was VSD ( Or A case of VSD (3.7 year old child presented with failure to thrive, harsh pan systolic murmur at lower sternal end, loud S2 at pulmonary area...) A. How to approach the diagnosis? B. Mention two X-ray findings. C. What is the cause of loud S2? D. Does ECG help in diagnosis? ｜ 23  Dr. X – Lec X Final-Year 1. A case about DKA (a mother brought her child complaining of abdominal pain for the last 3 days. She has vomited three times in the last 3 hours. his mother says that he has been tired for the last 2 days and not acting like himself , on further questioning ,asked for more glasses of water and had nocturnal enuresis , you understand that she is losing wait despite of increased appetite. On investigation BP 80/50, HR 155, RR 40. T 37.5 You see that she is gasping for respiration {breath deeply} and her capillary refill time prolonged to 4 seconds.) A. What is your diagnosis? B. What is the best treatment? C. What are possible complications? 2. {Case on hemolytic anemia} Short notes on congenital spherocytosis 3. {Case on Henoch-Shonlein purpura} A. What is provisional diagnosis? B. What are two serious complications? 4. Case on sub acute viral encephalitis post measles. 5. Case on TGA 6. Case on ASD 7. Case on febrile seizure 2018 – 2019 - Pediatrics Mid-Year 70 Essay 30 MSQ Dr. Ibrahim Q1 bacterial meningitis, recessive fluid & antibiotic, after 2 day, get 2 attack of convulsion Na = 118 Ans / SIAD Q2 Case of Gillian bare syndrome: weakness lower limb, develop lose tendon reflex in lower limb after 2 day, has history pneumococcal infection 2 week ago A. provision DX Single investigation to confirm C. Write line treatment Surgery ｜ 24 Dr. ASO Q3 VSD or HF Q4 PDA Q5 TGA or COA Dr. Rozhan Q6 Congenital spherocytosis Write 2 investigation to confirm Dr. Hersh Q7 Enumerate consequence of gastroenteritis Final-Year 1. 5yr male present with recurrent chest infection & multiple hospital admission , on examination show Congestive HF due to muscle dysfunction that is not due to Congenital , on examination there is enlargement of both posterior legs , sphincter is normal , knee jerk is diminished but ankle jerk is normal. A. Dx B. Best investigation for Dx C. 2 line of treatment D. Prognosis 2. 2 month old male present with feeding difficulty , sweating , increase HR & Respiration , has family history same condition in his cousin , on examination , there is grade 2 murmur in aortic area radiate to the neck , loud 1st heart sound , pulse was weak A. Provisional Dx B. CXR finding C. ECG finding 3. 2 week old premature delivery in 32 week gestation in emergency stayed on ventilator after giving surfactant for ARDS , on auscultation was active precordium with machinery murmur in left upper edge of sternum , pulses was easily feeled { palpable } , on CXR pulmonary plethora , inc pulmonary marking A. Provisional Dx B. how you confirm Dx C. Does it has any medical management ｜ 25 4. 5 day old child present with bruises & melena , pregnancy & delivery was unremarkable , mother said that he was vigorously beast feeding , on examination there is only bruises , investigation , HB 8.5 , WBC 8600 , PLT 200000 , Fibrinogen was normal , PT 28 , PTT increase A. Dx B. Tx 5. 5yr old girl known case adrenal insufficiency, present with fever, chest infection, very ill, with BP 60/30, mother gave history of giving same morning dose of hydrocortisone as usual A. Dx B. Tx 6. 10 yr. old male present with generalized edema , condition start one week ago with puffiness of face that progress into generalized edema & anasarca , received medication 3wk ago for respiratory infection , examination showed bilateral leg edema & ascites , Investigation : Blood urea 245 GUE: +++RBC, + albumin, granular cast, BP 170/110 A. Dx B. 3 investigation C. Management 7. Enumerate investigation for Dx of H.pylori 8. Discuss vaccination for nephrotic syndrome Second round Q1 Diagnostic steps in neonatal cholestasis dr.hersh Q2 Nutritional treatment in chronic renal failaure dr.bakr Q3 Dr Aso : Child present with upper respiratory tract infection present with wheeze during auscultaion he has loud first heart sound and and 2nd heart soud was wid and splited & has ejectoin systolic murmer grade 1and 2 in pulmonary area A. DDx B. How conifirm it?? C. 2 x_ray finding?? ｜ 26 Q4 Dr.Aso Child 4.5 kg dileverid by c_section in poorly controled daibitic mother on ascultation has pan systolic murmer with loud 1st heart sound and ecg show biventricular hypertrophy (VSD) A. DDx?? B. 2 confirmation tests C. Treatment ?? Q5 Dr. Tara 10 years obise child present with straya and puffing face (Cushing syndrome) A. What is tha cause of this condition?? B. 5 investigation to conifirm it?? C. Deffrent of the condition from simple obesty ?? D. Growth hormone have rule?? Q6 Dr. Bakr 3 month child has fever for 3 day with crying and irretable cbc show increse WBC and ESR , CRP increse with 3 nutrophile and toxic granulation (Actue pylenephritis) A. DDx?? B. 2 investigation?? C. Treatment?? Q7. Dr. Ibarhim Chilad has cheeck rash diagnosis as acne volgaris and have rash on lumber area (Tuberous sclerosis) A. DDx?? B. Epilpsy asoiated with this condition?? Or What is the type of seizure initially >> focal seizure Q8 Dr. Rozhan Von willenbrand disease A. Dx 2 investigation needed to confirm B. Mangement ｜ 27  Gynecology - Theoretical - Examination 2012 – 2013 - Gynecology Mid-Year - Essay: 60 marks -True-false: 30 marks (no cancelling) - Single-choice: 10 marks 1. Write about the mode of action, side effects, and contraindications of IUCD. 2. Discuss the details of changes during puberty in females. 3. A case on ectopic pregnancy A. What is the diagnosis? B. What are the criteria for medical management? C. What are types of medical management? D. What are the risk factors for this condition? 4. A case on missed miscarriage A. What is the diagnosis? B. What are the ways of management? 5. A case on PID A. What is the diagnosis? B. What are the indications for in-patient management? 6. Write about the diagnosis of gonorrhea and Chlamydia infections. Final-Year 1. A 62-year old woman presents with heaviness in vagina and something protruding from the introitus. A. What is the most likely diagnosis? B. What are the risk factors for this condition? C. Mention three important investigations. 2. A. Define chronic pelvic pain syndrome and what are its causes? B. Enumerate complications of laparoscopy. 3. Discuss the classifications of urinary incontinence and define each type. 4. A woman presents with thick, white, curdy discharge and vulvar erythema. A. What is the most likely diagnosis? B. What are the risk factors for it? C. How would you confirm it? D. How would you treat it? ｜ 28 5. A. Write about the treatment of ovulatory factor of infertility. B. Define premenstrual syndrome and mention its treatment. 6. A. Define dysplasia, dyskariosis, CIN III, and squamo-columnar junction. B. What are the risk factors for ovarian cancer? 2013 – 2014 - Gynecology Mid-Year (Essay: 60, T&F: 30, MCQ: 10) 1. What are the causes of infertility, discuss ovulatory causes of infertility in details & how to treat them. 2. What is emergency contraception? Discuss its types 3. Discuss vulvovaginitis in children. 4. A 32 yr. woman G2P1 presented to the gynecological department with a history of 2 missed periods, mild brown vaginal discharge, nausea and vomiting in the morning. On ultrasound there was a uterine mass with a snowstorm pattern. a. What is the most likely diagnosis? b. What other investigation will help you to reach the diagnosis c. How do you manage this case? 5. Discuss the followings: a. Signs & Symptoms, Diagnosis and Management of Hepatitis B. b. Signs & Symptoms, Diagnosis and Management of Chlamydia. 6. Define ovarian reserve, which group of women need this test Final-Year (Essay: 60, T&F: 30, MCQ: 10) 1. 26 yr. lady presented with irregular vaginal bleeding after a period of amenorrhea. She has a history of primary infertility for 6 years and used treatment to conceive. US showed adnexal mass with empty uterus. ΒhCG test was positive. A. What is the diagnosis? B. What are the criteria for medical treatment? C. What is the medical treatment? D. What are the risk factors for this condition? 2. Discuss briefly germ cell tumors. 3. Define colposcopy, what are the tests that can be done during a colposcopy examination? ｜ 29 4. 45 yr. lady (G6P5A1) with involuntary loss of urine during physical exercises affecting her quality of life. A. What is the diagnosis? B. How do you investigate her? C. What are the surgical options for this condition? 5. Discuss the followings: A. Indications for endometrial sampling in menorrhagia B. Treatment of endometriosis 6. Discuss the followings: A. Contraindications of HRT B. Make a comparison between cupper IUD & marina 2014 – 2015 - Gynecology Mid-Year Essays: 60 marks True & false questions: 30 marks MCQs: 10 marks Q1: a case about ectopic pregnancy A: what is the diagnosis? B: what are the criteria for medical management? C: what are the drugs used in medical management? D: risk factors for this condition Q2: how do you differentiate clinically and laboratory between bacterial vaginosis and Trichomonas vaginalis? Q3: A: what are the phases of ovarian cycle, and discuss follicular cycle in detail. B: what are the signs and symptoms of pelvic inflammatory disease and how do you treat it? Q4: A: what are the causes and management of delayed puberty? B: write on female sterilization. ｜ 30 Final-Year Sorry essays: 60 marks True and false questions: 30 marks Single Best answer questions: 10 marks Q1: a case: "I think it is postmenopausal bleeding" Management Q2: A- Lifestyle modifications and medications used in urinary incontinence B- Causes of heavy menstrual bleeding and medications used for treatment Q3: Diagnostic and therapeutic indications of laparoscopy, complications Q4: A- Risk factors and diagnosis of endometrial cancer B- Symptoms and signs of uterine fibroids Q5: a case: a 20 year old female with multiple sexual partners presented with lower abdominal pain, fever, and smelly vaginal discharge. Pregnancy test was negative, uterine test was clear A- What is your most likely diagnosis? B- How do you manage it? Q6: A- Write in details about dermoid cyst B- Stages of breast development in female 2015 – 2016 - Gynecology Mid-Year 1. Case {early pregnancy disease DDX & investigation} 2. Case {Imperforated hymen} 3. A. Delay puberty definition & causes B. Contraceptive for a breast feeding woman 4. A. Complication of PID & define perihepatitis (fitz hugh curtis syndrome) B. AMH role in ovarian reserve C. Tubal factor of infertility & investigation ｜ 31 Final-Year T/F 30 mark, MSQ 10 mark 1. A case on uterine prolapse & sign & symptom 2. Indication of chemo in GTD 3. Treatment regimen for low risk patient 4. Approach to case of urinary incontinence by history & examination 5. A case on Endometritis A. Diagnosis B. Cause of infertility C. Management 6. Management of benign ovarian tumor by age 2016 - 2017 - Gynecology Mid-Year 1. 25 yr. Female with fever, abdominal pain, foully vaginal discharge present to you, recently she had charged her partner, there is no abdominal & urinary symptoms. {15 marks} A. What's the most likely diagnosis? B. What physical examination you perform & why C. What investigation you send & why D. What are the treatment option? 2. Talk about the theories of endometriosis etiology, then outline the prognosis & how will you prevent it? 3. 20 mark A. What's premenstrual syndrome? What are treatment that are available? B. 25 yr. old female G2P2, the condom had busted during intercourse & she don't want to be pregnant.. What's your management or your advice? 4. A. What's puberty & what are the factors that affect its timing B. By table list the difference between partial & complete molar pregnancy C. Female with 6 week amenorrhea & lower abdominal pain & vaginal discharge. - Give list of DDX - Mention 2 test to distinguish between them ｜ 32 Final-Year Essay Questions; BOF (Best of Five); (40 BOF >>> 40 Marks) 1. How do you approach to a lady who presented with a 6 month history of amenorrhea, and previously her cycles were abnormal. (15 Marks) 2. Write about the etiologies and pathophysiology of genital prolapse. (15 Marks) 3. A 30 year old lady presented to the emergency department with pain and abnormalities in menstrual cycle, by doing further investigation they found an endometrial fibroid; so describe the management of fibroid in detail. (15 Marks) 4. A/ Write about germ cell tumors. B/ Enumerate the endocrinological abnormalities in PCOS. 2017 – 2018 - Gynecology Mid-Year 1. A 36 years old female with husband comes to clinic complaining from inability to conceive after 4 years of unprotected intercourse, she had only one child 6 years ago delivered by c/s (15 mark) A. What type of infertility are they suffering from? (Ans: secondary infertility) B. Mention possible causes of that type of infertility. C. What investigations will you send the couple for? 2. What are the causes of delayed puberty and its management? (15 marks) 3. A 33 years old teacher, took 3 days permission due to headache, anxiety and mastalgia for 10 days duration prior to her menstruation (15 mark) A. what's the most likely diagnosis? B. what are the lines of management 4. A. How will you manage a suspected case of miscarriage by ultrasound results? {Discuss the diagnosis of missed miscarriage by ultrasound. } (5 marks) B. What are the absolute contraindications of combined oral contraceptive pills? (5 marks) C. What are the complications of pelvic inflammatory disease {PID}? (5 marks) Final-Year 1. A 35 years old female visited clinic , who got married 3 years ago presented with primary infertility, facial hirsutism ,BMI>30 and some years of oligomenorrhea : A. what's the most likely diagnosis? B. How do you confirm the diagnosis? C. How do u counsel the female about the future consequences of her condition {long term sequelae?} ｜ 33 2. Write down in detail lines of management of a 40 year old patient being diagnosed for uterine fibroid by ultrasound. 3. Write down clinical uses and complications of laparoscopic operation. {What are indications for operative laparoscopy in gynecology, what are the complications that may arise from the use of the technique?} 4. What are the grading and role of medical treatment {conservative management} in uterine prolapse? 5. A. When do you refer a patient with molar pregnancy to chemotherapy? {Indications for using chemotherapy after molar pregnancy} B. Write shortly about the clinical presentation of cervical cancer? 2018 – 2019 - Gynecology Mid-Year 60 Essay 40 MSQ Dr. Maryam Q1 Indication chemotherapy for persistent trophoblastic disease, regimen for low risk group 15mark Dr. Huda Q2 A/ Diagram for hypothalamic pituitary ovarian axis 10 mark B/ Investigation for abnormality sex development 5 mark Dr. Chro Q3 A/ anatomical cause of miscarriage & management 7mark B/ Ultrasound investigation for management miscarriage 8 mark Dr. Salama Q4 A/ Define puberty & factor that affect time 5 mark B/ Cause of delay puberty 10 mark ｜ 34 Final-Year Q1 A. woman has 3 previous miscarriage, cervix length 22mm, how do you mange this case 5mark B. Criteria for ant phospholipid syndrome & relation to miscarriage 5 mark Q2 A Define menopause & pathophysiology 4mark B Effect menopause on woman 6 mark Q3.28 years old women presented with 7 weeks amenorrhea and vaginal bleeding previously had normal regular cycles and pregnancy test is positive. Ultrasound showed empty uterus with and a right adnexal mass with fetal heart noted. What is the management of this case? 15 mark Q4 Surgical management for pelvic organ prolapse. 10 mark Q5.Women with history of one cesarean section delivery 6 years ago now presented with infertility for 3 years without contraception she has irregular cycles and intermeustral bleeding. A - Enumerate cause of secondary amenorrhea B - Briefly manage according cause Second round Q1 A case of secondary amenorrhea Q2 A case of PID Q3 A case of Urinary incontinence Q4 Q5 Q6 ｜ 35  Orthopedics - Theoretical - Examination 2012 – 2013 - Orthopedics Mid-Year -Essay: 70 marks , -Single-choice: 30 marks 1. Enumerate the indications of internal fixation. 2. Enumerate the late local complications of fractures. 3. Discuss the treatment and complications of anterior dislocation of shoulder. 4. Discuss the management of fracture shaft of humerus. 5. Write shortly on patello-femoral pain. 6. Write shortly on shoulder impingement syndrome. 7. Define felon, and discuss its management and its complications. 8. A. What are the predisposing factors and causes of avascular necrosis? B. What are the causes and cardinal pathological changes of osteoarthritis? 9. A. Write about the classification of cerebral palsy. B. Discuss the three kinds of spina bifida. 10. Enumerate the complications of amputation. Final-Year -Essay: 70 marks , -Single-choice: 30 marks 1. Enumerate benign bone lesions and discuss one of them 2. Discuss the diagnosis and treatment of C6-C7 intervertebral disc prolapse. 3. Discuss the clinical features of talipes equinovarus in a 3-day old neonate. 4. Discuss the clinical features of Perthes’ disease in a 6-year old boy. 5. Discuss the treatment of scaphoid fractures. 6. Enumerate the risk factors and causes of avascular necrosis of bone. 7. Write shortly about shoulder instability. 8. Discuss the treatment and complications of fracture shaft of femur. 9. Discuss the mechanism of injury, clinical features, and treatment of patellar fractures. 10. Discuss the classification and management of malleolar fractures. 2013 – 2014 - Orthopedics Mid-Year (Essay: 85, MCQ: 15) 1. Diagnosis & treatment of club foot in 3 day old neonate. 2. Enumerate the causes of LLD (anisomelia) & discuss one of them. 3. Indications & complications of external fixation. 4. Write short notes on traction types. 5. Short notes on frozen shoulder (adhesive capsulitis). 6. Short notes on ITBS (iliotibial band friction syndrome) ｜ 36 7. Classification & management of proximal humeral fractures 8. Management of supracondylar fracture in a 9 yr. Child. 9. Classification & management of olecranon fractures. 10. Diagram to compare Colle’s & Smith’s fractures Final-Year (Essay: 80, MCQ: 20) 1. Diagnosis & treatment of hallux valgus in a 35 yr woman 2. Discuss the classification of acetabular fractures 3. Write shortly on open (compound) fractures 4. Enumerate operative managements of osteoarthritis 5. What are the causes of acute knee swelling? 6. Discuss the management of a Galleass fracture 7. Write about De Quervain’s disease 8. What is the reason behind classifying hip fractures into intracapsular & extra capsular? 9. Write the clinical features of DDH in a 4 month old child 10. What is Irritable hip (transient synovitis)? 2014 – 2015 - Orthopedics Mid-Year 7 essays: 70 marks, 15 MCQs: 30 marks 1. Late manifestations of DDH 2. Complications of amputation 3. Clinical features of ulnar nerve palsy 4. Diagnosis and treatment of club-foot in a 7 day old infant 5. Types of fracture displacement 6. Classification and surgical management of ankle fracture in adults 7. Surgical options and complications of fracture of tibia and fibula Final-Year Short essays: 75 marks 1. Diagnosis and treatment of hallux valgus 2. Discuss Sheuermann's disease 3. Cubitus valgus 4. Trigger finger 5. Treatment of fracture of shaft of femur 6. Irritable hip 7. Causes of bow leg in a 3 year old child 8. Clinical features of developmental dysplasia of hip (DDH) in a 2 year old baby 9. Galeazzi fracture dislocation of forearm bone 10. Treatment of acute osteomyelitis ｜ 37 2016 – 2017 – Orthopedics Mid-Year Essay, 80 Marks, 20 MCQs >>> 20 Marks 1. Clinical features of radial nerve cut at the Axilla. 2. Discuss clinical features of irritable hip (Nonspecific transient sinusitis). 3. Indications for surgery in humeral shaft fracture. 4. Management of supracondylar fracture in a child. 5. Enumerate the differences between Monteggia & Galeazzi dislocation. 6. Define Colle’s fracture & its complications. 7. Enumerate the stages of indirect healing process. 8. Describe briefly the indications of open reduction and internal fixation. Final-Year Essay Questions; (70 marks); 1. Enumerate complication of septic arthritis. 2. List line of treatment of tuberculosis osteomyelitis. 3. Enumerate conservative management (steps of reduction) of supracondylar fracture of humerus in children. 4. Discuss clinical features of structural scoliosis. 5. Discuss pott's paraplegia. 6. Club foot management according to Ponseti method. 7. Clinical features of ulnar nerve cutting above wrist. 8. Discuss shortly union & consolidation. 9. Discuss classification & management & complications of intracapsular fracture of femur. 10. Discuss important radiological findings to look for in ankle fracture. 2017 – 2018 - Orthopedics Mid-Year Essay, 10 marks each: 1. Discuss classification, management and complication of tibia plateau fracture. 2. What are the reasons behind classifying fractures of neck of femur into intracapsular and extra capsular and what is the surgical management of each type? 3. Discuss Gustillo's classification of open fracture. 4. Discuss the indications of open reduction. 5. Discuss the early and late complications of amputated limb. 6. Discuss the difference between Colle's and Smith's fracture. ｜ 38 Final-Year 1. Discuss the clinical features of complete radial nerve injury at site of axilla. 2. Discuss the management of 1 year old girl infant with Left hip DDH 3. Discuss lines of treatment of septic arthritis in general 4. Enumerate causes of acute knee swelling and discuss one of them briefly 5. Briefly discuss the clinical features and management of torticollis 6. Enumerate the imaging modalities used to diagnose infection of the spine. 7. Discuss cast splintage in detail 2018 – 2019 – Orthopedics Mid-Year Dr. Ali tamimi Q1 Write short briefly about compartment syndrome Q2 Indication & types of reduction Dr. Areewan Q3 Management & complication of intracapsular fracture Q4 Write shortly about acetabular column fracture Q5 Write about management & complication tibiafibular shaft fracture Dr. Ahmad khuza3i Q6 Write Complication of clavicle fracture Dr. Omer barawi Q7 Complication of Amputation limb Final-Year Essay 70 mark, MSQ 30 Mark Q 1 / Discuss briefly treatment of cervical spondylosis Q2 / Complication scoliosis in general Q3 / Investigation & Complication septic arthritis in child Q4 / Clinical characteristic feature of spastic CP Q5 / Enumerate risk factor & Clinical feature for hallux valgus Q6 / Discuss shortly open fracture Q7 / Indication for surgical operation of humeral shaft fracture ｜ 39 Second round 1-Classification and imaging of cervical disc prolapse 2- Diagnosis of spinal infection 3- Clinical feature of radial cut at axilla 4- Line of Mx of fracture 5- Mx acute infection of hand 6- Types and Surgical Mx of patellar fracture 7- Cause of genu valgus between ｜ 40  Urology - Theoretical - Examination 2012 – 2013 - Urology Mid-Year Long essay: 30 marks 1. Discuss pyelonephritis. 2. What are the causes of urine retention? Short essay: 30 marks 1. Discuss hydronephrosis. 2. What are the clinical features of intra-peritoneal rupture of urinary bladder? Single-choice: 40 marks Final-Year Essay: 40 marks, Single-choice: 60 marks Long essay: 1. Discuss the treatment of metastatic CA prostate. 2. Discuss management of a man with a large abdominal mass and a palpable testicular mass. Short essay: 1. Write about the treatment of recurrent 1.2 cm upper ureter stone. 2. Write about the 4-cup test for localization of UTI. 3. Write about the clinical presentation and treatment of acute cystitis. 4. How do you evaluate a 3-year old baby with palpable lower abdominal mass and passing urine every 5-10 minutes? 2013 – 2014 - Urology Mid-Year (Long: 15, Short: 30, MCQ: 45) Long essay 1. Staging of bladder cancer 2. Management of acute pyelonephritis ｜ 41 Short essay 1. Predisposing factors for lower UTI 2. Resuscitation of a comatose patient with loin bruise after a road traffic accident 3. CT grading of renal trauma 4. Causes of hydronephrosis 5. Clinical features of vesical stones 6. Causes of bladder fistulas Final-Year (Case: 10, Long: 20, Short: 20, MCQ: 50) 1. Case: A 21 yr. young man was admitted to the hospital after a motorcycle accident. He underwent surgery. On the next day his urine output was 150 mL/24 hr., the results of his investigations were Na: 132 mmol/L, K: 5.5 mmol/L, Urea: 75 mg/dL, Creatinine: 2.2 mg/dL a. What is the clinical condition? b. How do you treat the patient? 2. Long essay: a. Write about renal cell carcinoma b. Discuss VesicoUreteric Reflux 3. Short essay: a. Ureteric stone b. Management of prostatic abscess c. Management of muscle invasive bladder cancer d. Enumerate the causes of hematuria by anatomic location 2014 – 2015 - Urology Mid-Year Long essays (30 marks) 1) Discuss hydronephrosis 2) Discuss the evaluation and management of a patient with azoospermia Short notes: (30 marks) 1) List the causes of erectile dysfunction with few examples 2) what are the imaging tests used to diagnose renal stones? 3) What are the mechanisms of renal injury? 4) Tumor staging in bladder cancer 40 MCQs: 40 marks ｜ 42 Final-Year Clinical problem questions: 20 marks 1. A case "I think it is renal stone" A- What is the most likely diagnosis? B- what other investigation you wish to do and explain why C- Management 2. A case about nocturnal enuresis Long essays: 30 marks 1. Undescended testis 2. Classification of UTI and duration of treatment for each one Short essays: 25 marks 1. Incontinence 2. Erectile dysfunction 3. Discuss imaging in renal malignancy 4. Indications of surgical intervention in BPH 5. Causes of urinary retention MCQs: 25 marks 2016 – 2017 - Urology Mid-Year Case 40 Marks; 1. A child comes to the ED (Emergency Department) who had an abdominal injury in the last 24 hours; with nausea and one time vomiting, on abdominal examination there is a tense abdomen with abdominal rigidity, and she is pale, her vitals (Tachycardia, hypotension), lab investigations as follow (High urea & creatinine & other tests for Na, K). A. What is the most likely diagnosis? B. Mention only one investigation you would like to do and why? C. Mention your management. 2. A 64 year old man, who smoked for 30 years; presented with terminal painless hematuria. A. What is the most likely diagnosis? B. Mention other differential diagnosis. C. Outline your management. ｜ 43 Long essays 20 marks 1. Classification of hydronephrosis. 2. What are the risk factors for Renal Cancer? Short essays 10 marks 1. What are the diagnostic cystoscopy finding in interstitial cystitis? 2. Discuss the clinical finding in cancer of testis. 30 MCQ >>> 30 Marks Final-Year Long Essay; (30 Marks) 1. Discuss the investigation of a patient with bladder cancer. 2. Define impotence and how you approach to the patient. Short Essay; (20 Marks) 1. Enumerate types of Hypospadias. 2. Indications for Varicocelectomy. 3. Short notes on Chronic Pelvic Pain Syndrome. 4. When it is appropriate to do surgery for these conditions and why? - Infantile hydrocele - Infant with inguinal hernia - Non palpable testis in a 3 month old baby - Hypospadias in 6 month old MCQ >>> 50 >>> 50 Marks 2017 – 2018 - Urology Mid-Year Q-1) case (20 marks) There is 34 year old female presenting to emergency department complaining of a moderate loin {flank} pain that she had been having for 6 months with a family history of renal disorders. The pain is dull in nature, it started few weeks ago, On examination there is bilateral nodular palpable mass in the loin. In these past months she has lost about 6-7 kg, she is loss of appetite and had nausea, anorexia, hypertension, and intermittent hematuria in the past few months. Laboratory tests: (hemoglobin is 8.2, RBC in urine is 30 cells, proteinuria is 10, K=5.5, Creatine = 3.3 {this is and case of polycyclic kidney disease} (It might look like chronic pyelonephritis, but remember pyelonephritis is not HEREDITARY). A. What is the diagnosis? B. How you confirm it? C. What is the treatment? An: polycystic kidney disease ｜ 44 Q-2) long essay (each 20 marks) 1. What are the causes of renal stone formation {renal calculi}? 2. Discuss and compare the Clinical features of ectopic vesica in males and females Q-3) short essay (each 10 marks) 1. What are the radiological features {finding} of renal injury? 2. By a diagram, write the types, causes and treatment of urinary incontinence Final-Year 1. A 37 years old female presents with severe suprapubic pain that she has had for several years, particularly when bladder is full, associated with dysuria , urgency ,nocturia , frequency Aggravated by drinking tea and coffee: (10 marks) A. What is the most likely diagnosis? (Interstitial cystitis?) B. Mention 3 differential dx C. What investigation you do to prove your diagnosis? 2. Long essay (each 15 marks) A. Talk about prostate abscess, definition, etiology, clinical features, and management B. Hypospadias: definition, types, indications for surgical correction 3. Short essay (each 5 marks) A. Talk about non-palpable testis {definition} and approach to it B. Write about PSA (prostatic specific antigen) C. Define erectile dysfunction and mention the causes D. Differential diagnosis of acute scrotum 2018 – 2019 - Urology Mid-Year 50 Essay 50 MSQ Dr. Aso Q1 / 27yr old pregnant lady , second trimester , admitted to emergency department at 3am , complain right loin pain , increase severity , constant in nature , radiate to suprapubic area , associate with dysuria , nausea , one time vomiting , with rigidity right muscle , costovertebral tenderness , vital sign normal , wbc 4000 , RBC 30, pus cell 3 A/ what's most likely diagnosis B/ Write 2 DDX C/ Write complication if this condition resolve 4 mark ｜ 45 Dr. Ali Q2 / Staging of Transitional cell bladder cancer 4mark Q3 / What are the clinical features of intra- peritoneal rupture of urinary bladder 2mark 20 MSQ Final-Year Long essay 40 mark 1. Condition that stimulate urological condition 2. Chronic pelvic pain syndrome, etiology, clinical feature management Short essay 30 mark 1. How to evaluate patient with bladder diverticum, diagnostic modality 2. Enumerate minimal invasive procedure for BPH, discus one of them 3. Complication suprapubic cystoscopy, percutaneous nephrostomy MSQ 30 mark Second round Long essay 40 marks 1- Acute prostatitis , etiology , clinical frature , diagnosis , treat 2- Varicocele Short essay 1- Cause bladder fistula 2- TURB syndrome 3- History of BPH ｜ 46  Ophthalmology - Theoretical - Examination 2012 – 2013 - Ophthalmology Mid-Year Essay: 40 marks , Single-choice: 60 marks 1. Write about the immediate and subsequent management of alkali burns. 2. Enumerate 5 therapeutic indications for contact lens wear. 3. Discuss briefly the causes of blepharitis. 4. Mention three types of proptosis and their causes. Final-Year Essay: 40 marks , Single-choice: 60 marks 1. Talk briefly about classification of glaucoma. 2. What are the clinical features of perforating injury to the eyeball? 3. How do you manage a 1-year old child presenting with red, sticky, watery eye? 4. Write about the management of 3rd nerve palsy. 2013 – 2014 - Ophthalmology Mid-Year (Essay: 60, MCQ: 40) 1. Write about 6 extra ocular muscles; origin, insertion, nerve supply, primary action. 2. Write about lens-associated cataract. 3. Complications of hyper mature cataract. 4. Complications of uveitis. Final-Year (Essay: 40, MCQ: 60) 1. Discuss 3 types of lasers with their main uses 2. Discuss briefly types of trauma to the globe 3. What are the risk factors for Central Retinal Vein Occlusion? 4. What are the clinical features of optic nerve diseases? 2014 – 2015 - Ophthalmology Mid-Year 5 definitions: 5 marks, 50 MCQs: 15 marks Amblyopia, visual axis, manifest squint, proptosis, keratoconus ｜ 47 Final-Year 40 marks: short essays , 60 MCQs: 60 marks Q1: Discuss briefly the types of laser used in ophthalmology Q2: Shaken baby syndrome, definition, presentation, systemic and ocular manifestations Q3: Enumerate five of the ocular manifestations of diabetes mellitus Q4: Definitions: 1. Light 2. Refractive errors 3. Chalazion 4. Arcus senilis 5. Keratoplasty 2016 – 2017 - Ophthalmology Mid-Year Q1/ Essay Questions (10 Marks), Q2/ MCQs, 40 MCQs >>> (10 Marks) 1. Briefly talk about classification of squint. 2. Enumerate different types of discharge, and how they will help you in differentiating different types of conjunctivitis. 3. Enumerate signs & Symptoms of panophthalmitis. 4. Enumerate clinical picture of orbital cellulitis & its complications. 5. Enumerate symptoms of cataract. Final-Year Part One (25 Marks) Q1/ Definition: (5 Marks) 1. Keratoconjunctivitis sicca 2. Aqueous humor 3. Direct light reflex 4. Photophobia 5. Hyphema Q2/ Short Essays: (20 Marks) 1. Signs and symptoms of optic nerve dysfunction. 2. Signs symptoms of acute angle closure glaucoma. 3. Enumerate 10 ophthalmological emergencies that need to be treated urgently and referred to an ophthalmologist. 4. Enumerate (5) risk factors for diabetic retinopathy. Part Two; MCQs >>> 25 (25 Marks) ｜ 48 2017 – 2018 - Ophthalmology Mid-Year Q-1) essay, 2 marks each: 1. Classify the types of ocular malalignment (squint) 2. Enumerate 4 complications of hyper mature cataract 3. What are tarsal glands (meibomian glands)? What are their functions? 4. Discuss lens associated glaucoma 5. Shortly discuss gross anatomy of cornea and its characteristic features Final-Year Essay questions % 50, MCQ %50 1. Briefly discuss the 3 types of laser therapy used in ophthalmology 2. What are signs and symptoms of optic nerve dysfunction? 3. Clinical features of acute angle closure glaucoma 4. What are the Causes and risk factors for corneal ulceration? 5. Briefly discuss types of cataract according to anatomy 2018 – 2019 - Ophthalmology Mid-Year 50 Essay , 50 MSQ Dr. Ali Q1 Briefly discuss anatomy human eye ball 10 mark Dr. Bakhyar Q2 A/ Enumerate structures pass through supra orbital fissure 5mark B/ Enumerate cause of unilateral proptosis 5mark Dr. Khalid Q3 Enumerate predisposing factor to dry eye 10mark Dr. Tara Q4 Enumerate nerve affected & muscle involved in paralytic squint 10mark Dr. Dere Q5 Enumerate complication hyper mature cataract 10 Final-Year %100 MCQ ｜ 49  Radiology - Theoretical - Examination 2016 – 2017 - Radiology Final-Year Q1/ Answer the following questions precisely; (10 Marks) A/ Give two radiological finding for the following; 1. Liver Cirrhosis. 2. Acute Pancreatitis. 3. How to differentiate small & large bowel obstruction. 4. Polycystic Ovarian Syndrome. 5. Endometriosis. B/ Write two CXR finding for five of the following; 1. Malignant Intrathoracic Lymphoma. 2. Tension Pneumothorax. 3. Pulmonary Embolism. 4. Meconium Aspiration. 5. Primary TB. 6. Cause of Vertebral Collapse & its appearance. 7. Differential Diagnosis of Opaque Sinus. Q2/ 60 MCQ (each 1.5 Mark) >>> 90 Mark ｜ 50 ｜ 51 MCQ Medicine – Theoretical – Examination – MCQ 2017 – 2018 Mid-Year 1. Which of the following drugs aren’t used in OA? ( osteoarthritis ) A) azathioprine B) topical caspacan C) topical diclofinac D) steroid injection E) ? Ans: A ? 2. Heberden nodes are: A) Osteophytes B) Located in PIP joints C) Located in MCP joints D) Always painful E) Occur in RA and OA Ans: A 3. Which one is not a property of hyaline cartilage? A) Aneural B) Avascular C) Alymphatic D) Shock absorbant E) Irregular and rough surface Ans: E 4. Which one is not an X-RAY change in OA? A) Marginal bony outgrowths ( osteophyte ) B) Eburnation C) Bone cyst formation D) Osteoporosis.. E) Presence of loose bodies Ans: D 5. Amount of synovial fluid is: A) 10-20 ml B) 0.1 – 4 C) 5-10 D) 10-15 Ans: B ｜ 52  6. All are true about absence seizure, except: A) Attacks last 60 seconds B) Attack is of sudden onset and offset C) Patient suddenly stop what they’re doing, eyes remain open, distant and staring D) The patient is of young age E) May occur several times per day Ans: A 7. The most important step in reaching a diagnosis of epilepsy is: A) Listening to a patient and a witness about the attack B) Wonder why the patient has epilepsy C) Try to establish a cause D) Investigate by EEG and MRI.. E) Assess patient reaction and the consequences of diagnosis in his life Ans: A ? 8. Which of the following is a type of cortical dementia? A) Parkinson B) Huntington C) AIDS dementia D) Frontotemporal dementia ( pick’s disease ) E) Progressive supranuclear palsy Ans: D 9. A patient presenting with acute coma, which of the following is not included in management? A) LP is mandatory to exclude meningoencephalitis B) If pin-point pupil give naloxone C) Acyclovir given D) Exclude hyperthermia before deciding its brain death Ans: D ? 10. Patient with headache and neck stiffness, which one is not true? A. Kerning sign is always positive B. If there is no fever meningitis is excluded Ans: ? 11. U/S in kidney disease is used for all the followings, except: A) Estimate completeness of emptying in suspected neurogenic bladder B) Detect signs of chronicity of renal disease C) Doppler U/S not used for detecting of renal transplant rejection D) Doppler U/S used for detecting severe renal artery stenosis E) Normal sized kidney in diabetic patient doesn’t exclude kidney disease Ans : C 12. Regarding urinalysis which one is not true? A) Isomorphic RBC occur in glomerulonephritis B) Presence of pus may indicate pyelonephritis C) Alkaline urine maybe due to renal tubular acidosis D) Dipstick test can detect proteinuria Ans: A ｜ 53  13. Regarding kidney function, all are true except: A) Creatinine clearance measurement indicates GFR B) Kidney is main source of erythropoietin , levels reduce in chronic renal failure C) Renin is produced in response to reduced afferent arteriolar pressure D) Renin generates angiotensin 2, which causes aldosterone release E) Serum creatinine is a reliable test for renal function Ans: E 14. Regarding renal imaging techniques, all are true except: A) IVU is superior to U/S for renal papillae, stones, and malignancy B) In IVU, you don’t need to do renal tests ( urinalysis ?) before doing the IVU C) Renal arteriography is mainly used for renal artery stenosis and hemorrhage D) In a patient with renal impairment, instead of CT, MRI can be done E) There is risk of contrast nephropathy in a patient with pre-existing renal impairment? Ans: B 15. Regarding parathyroid hormone diseases, which one wrong ?! A) Osteomalacia occur in hypocalcaemia, hyperphosphatemia, hypoparathyroidism Ans: A ? 16. All are features of hypothyroidism, except: A) Weight gain B) Cold intolerance C) Dry skin D) Alopecia E) Menorrhagia Ans: D 17. All are contraindications to metformin, except: A) Hypertension B) Severe renal impairment C) Severe hepatic failure D) Hypoxia E) Shock Ans: A 18. The lowest possible fasting blood glucose level in a diabetic patient is: A) 100 mg/dl B) 126 C) 140 D) 180 E) 200 Ans: B 19. Risk of monozygotic twin to get type 1 DM is: A) 100 % D) 20% B) 80 % E) 60 % C) 30-50% Ans: C ｜ 54  Dr. X – Lec X 20. All are risk factors for type 2 diabetes, except: A. Advanced age B. Smoking C. Gestation D. Obesity E. Inactivity Ans: B ?? 21. A patient presenting with features of DKA, what do you need to confirm it? A. Hyperglycemia and decreased serum bicarbonate B. Raised blood PH C. Hyper-reflexia D. Hypertension E. Decreased anion gap Ans: A 22. One of the following is true regarding endocrine system investigations : A) One test is enough for confirming diagnosis B) If you suspect hormone excess you should do stimulation test C) Don’t scan unless biochemistry confirms endocrine dysfunction Ans: C 23. All are false regarding acromegaly treatment, except: A. First line treatment is surgery, transCRANIAL tumor resection B. Somatostatin analogs alone are very effective C. Octreotide reduces GH secretion in the first hour in 50% of patients D. Surgical resection results in rapid and substantial reduction of serum GH immediately post operative Ans : D 24. Which of the following hormones act as an intracellular signal? A. Growth h B. TSH C. Thyroid h D. Catecholamines E. Insulin Ans: C 25. Which of these is the least beneficial treatment for hirsutism caused by PCOS? A) Eflornithine B) Cyproterone C) Spironolactone D) Metformin Ans: ? Surgery ｜ 55 Final-Year 1. All are true about acute kidney injury, except: A. AKI is usually irreversible B. ‘injury’ stage is when s. cr. Rise by >3 folds C. Elderly is a risk factor for AKI D. Acute tubular necrosis is the most common parenchymal cause Ans: B 2. All are true about chronic kidney injury, except: A. Kidney damage for ≥ 3 months B. Hypertension is the most common cause C. Analgesic nephropathy is a cause D. Evidence of renal osteodystrophy is in favor of CKD E. Proteinuria is a marker of CKD Ans: B 3. Which one is wrong about UTI? A. Reiter syndrome is a differential diagnosis B. Loin pain may indicate cystitis Ans: B 4. Which one is false about sloughed renal papillae? A. Can present as renal colic B. Fragments of renal papillary tissue are passed per urethra and can be identified histologically C. Can cause ureteric obstruction D. Analgesic nephropathy is a predisposing factor E. Occur mostly in acute pyelonephritis Ans: E? 5. Which of the following is false about dementia? A. Hallucination is common in dementia while rare in delirium Ans: A ? 6. On treatment of multiple sclerosis, which one of the following does not match? A. Depression  amitriptyline B. Ataxia  diazepam C. Paroxysmal phenomena  carbamazepine D. Sexual dysfunction  sildenafil E. Urinary dysfunction  baclofen Ans: E 7. All are acquired metabolic causes of polyneuropathy, except: A. DM B. Hypothyroidism C. B 12 deficiency D. Copper deficiency E. Apo lipoprotein A … Ans: E ｜ 56  8. 60 year old man presenting with proximal muscle weakness usually after the noon, erectile dysfunction, hyporeflexia, smoker, diagnosis is: A. Lambert-Eaton myasthenic syndrome B. Botulism C. Emery-dreifuss muscular dystrophy D. Oculopharyngeal muscular dystrophy E. Facioscapulohumeral muscular dystrophy Ans: A 9. Antibiotics used in empirical therapy for preterm infant with bacterial meningitis is: A. Ceftriaxone + vancomycin B. Ampicillin + cefotaxime C. Ampicillin + vancomycin Ans: B 10. Which one is true regarding brain abscess? A. Most common cause is hematogenous spread B. Cerebral abscess arising from otitic infections tends to go to frontal lobe C. Fever is almost always present D. Infective endocarditis forms multiple abscesses Ans: D ? 11. An MCQ about transient ischemic attack… 12. All are measures of treating postural hypotension in elderly, except: A. NSAID’s B. Fludrocortisone C. Midodrine D. Dehydration correction E. Head-down tilt of the bed Ans: E 13. Which one is false about cryoglobinemia? A. There are 3 types B. Occur after age 50 Ans: B? 14. A case of hyponatremia and low ADH. The cause? A. Central diabetes insipidus B. Psychogenic polydipsia C. Heart failure D. Cirrhosis Ans: A? 15. Polymyalgia rheumatica include all except: A. High ESR ≥ 40 B. Age ≥ 50 C. Muscle tenderness the most prominent feature D. Morning stiffness ≥ 30 mins E. GCA occur in 10-20 % Ans: C ｜ 57  16. Which of the following drugs cause ophthalmoplegia? A. Methotrexate B. Hydroxychloroquine C. Sulfasalazine D. Leflunomide E. Azathioprine Ans: B 17. All are true about metformin, except: A. Increase insulin release B. Reduce insulin resistance C. Reduce hepatic glucose formation D. Reduce weight E. Improve liquid profile Ans: A 18. Which of the following occur in DKA? A. Blood PH rise B. HCO3 increase C. SpO2 decrease D. HCO3 decrease Ans: D 19. Which of the following you shouldn’t do in the acute management of coma? A. CSF analysis without precaution Ans: A 20. Ankylosing spondylitis begin from: A. Cervical spine B. Upper part of sacroiliac joint C. Lower part of sacroiliac joint D. Lower half of sacroiliac j Ans: C ? 21. A man presented with poisoning, he is red, flushing, dry, hot, has hypertension, he was most likely poisoned by: A. Cholinergic drugs B. Anti-cholinergic d Ans: B 22. Antidote of paracetamol is: A. Atropine B. Oxygen C. Methionine D. … Ans: C ｜ 58  23. Which one is true about β-thalassemia major? A. 80000 people in Sulaymaniyah have thalassemia B. A2 chains are usually normal C. Dependent on transfusion D. Fetal hemoglobin is ≥ 80 % Ans: A ? 24. All the following have enthesopathy, except: A. Ankylosing spondylitis B. Psoriatic arthritis C. SLE Ans: C 25. Cause of hypercalcemia with low PTH include all, except: A. Malignancy B. Thyrotoxicosis C. Thiazide diuretics D. Glucocorticoids deficiency E. Familial hypocalciuric hypercalcemia Ans: E 26. Get up and go test is for: A. Power B. Balance C. Mental state D. Memory E. Strength Ans: B 27. All used in treatment of multiple myeloma, except: A. Revlimid B. Velcodcz C. Glevac D. Dexamethasone Ans: C? 28. Prolactin increase in all, except: A. Trauma to chest wall B. Pregnancy C. Thyrotoxicosis Ans: ? ｜ 59  Pediatrics – Theoretical – Examination – MCQ 2017 - 2018 Final-Year 1. Child having symptoms of moderate dehydration, how you manage: A. ORS 75ml/kg in 4 hours B. IV, 30 ml/kg in 30 mins C. Antibiotics D. Treatment at home Ans: A 2. 9 month old with diarrhea and baborgymi and abdominal distention and excoriated diaper rash, whats the best test to do? A. Intestinal biopsy B. Serology C. Hydrogen breath test Ans: C 3. 6 months old with symptoms of severe dehydration, how you manage? A. ORS 75 ml/kg in 4 h B. Treat at home C. 30 ml/kg ringers lactate in 1 h D. Antibiotics E. Zinc Ans: C 4. 2 years old presenting with 3 months diarrhea and wt loss and pallor, you suspect celiac disease. What you do next? A. Send for duodenal biopsy B. Send for anti-tissue transglutaminase ab C. Put on gluten free diet for 6 months and see result D. Gluten free diet for life Ans: B 5. Few weeks old child presenting with jaundice and moderate hepatomegaly but result of ultrasound was normal, what you do next? A. Pre-operative cholangiography B. Liver biopsy C. Surgery D. Hepatobiliary scan E. ERCP Ans: B ｜ 60  6. In constitutional delay of growth failure, all true except: A. Family history of growth delay is important B. 2-3 years of delay in growth, later normal growth C. Skeletal growth is normal D. Short stature is the outcome Ans: C ?? 7. Which of the following cases indicate an abnormal puberty? A. A 14 year old girl increasing 5 cm after menarche B. 14 year old with stage 1 of tanners breast development C. 14 year old with tanner breast 2 stage in one breast and stage 3 in the other breast D. A 12 year old boy, with testis mass 4 ml (I guess it was 4) Ans: B 8. Most common CNS lesion causing GDPP is: A. Hamartoma B. Hydrocephalus C. Midline defect? D. Post?? Scar Ans: A 9. Earliest manifestations of a child with Cushing's syndrome besides obesity is: A. Short stature B. Striae C. Hypertension D. Osteoporosis And: A ?? 10. All are features of congenital hypothyroidism, except: A. Indirect hyperbilirubinemia B. Large fontanelle C. Umbilical hernia D. Diarrhea Ans: D 11. Most common cause of congenital hypothyroidism is: A. Thyroid dysgenesis B. Incomplete development of the gland due to prematurity C. Absence of the gland D. Maternal antithyroid antibodies Ans: A 12. Grave’s disease is associated with all the following other autoimmune diseases, except: A. Type 1 DM B. Myasthenia gravis C. Iron deficiency anemia D. Addison’s disease E. Vitiligo Ans: C ｜ 61  13. Which one is wrong regarding Hashimoto’s thyroiditis? A. Its mostly asymptomatic B. It’s a constant disease 14. Which of the following types of CP occur due to birth asphyxia? A. Spastic hemiplegic CP B. Spastic diplegic CP C. Spastic quadriplegic CP D. Dyskinetic CP E. Atonic/hypotonic CP Ans: E 15. For the diagnosis of CP, which of the following is true: A. EEG is always abnormal even when there is no attack of seizure B. Family history is important as some cases have genetic background C. Its hard to differentiate CP clinically from werdnig-hoffmann syndrome D. Imaging is always mandatory Ans: B 16. All the following are false regarding febrile seizure, except: A. Recurrent attacks may affect mentality in the future B. The focal type is better controlled than the generalized type C. CSF analysis is always required for first attack of febrile s D. There is no drug that can prevent it from happening again? Ans: A ? 17. All are false regarding epilepsy, except: A. Majority have no organic disease B. 90% can be controlled with drugs C. Symptomatic epilepsy means an epilepsy with symptoms Ans: A ? 18. Regarding cardiovascular diseases in children, all match except: A. Males more commonly have right side heart lesions B. Females and VSD C. TGA with white infants D. Supracristal VSD with Asian children Ans: A 19. Which of the following adverse maternal conditions don’t cause CVS disease in their children? A. DM B. Phenylketonuria C. Congenital rubella D. SLE E. Hypertension Ans: E ｜ 62  20. Regarding osteum secondum, which of the following is false? A. The hole is in the region of fossa ovalis B. Its mostly symptomatic C. More common in females Ans: B 21. All the following are false about VSD except: A. Restrictive means large defect B. Small VSD causes pulmonary hypertension C. Pulmonary systemic vascular resistance has no role D. A large defect causes pulmonary hypertension Ans: D ? 22. Regarding PDA, all are false except: A. It’s associated with maternal rubella infection Ans: A ｜ 63  Gynecology – Theoretical – Examination – MCQ 2017- 2018 Mid-Year 1. Fishy odor due to production of amines, I think right one is NACL 2. Curdy white vaginal discharge —> candidiasis 3. Which one true about H-mole pregnancy —> ultrasound is of value in diagnosis 4. Woman with complete molar pregnancy after treatment shouldn’t get pregnant until —> 1 year 5. Choriocarcinoma occur following ( molar pregnancy, full term pregnancy, abortion, ectopic ? ) all of the above 6. Which semen parameter is wrong —> volume should be cervical stenosis 8. A cause of primary amenorrhea —> imperforate hymen 9. HCG levels double —> each 2 days 10. Maximal growth velocity —> thelarche —> menarche 11. Which one false about injectable progesterone —> contraindicated in lactating women 12. Most common cause of central precocious puberty —> idiopathic 13. Rokitansky syndrome —> 46 XX 14. Cause of primary dysmenorrhea —> uterine over contractility 15. The one where you take biopsy —> mid secretory phase 16. Which one true about fertilization?? 17. Contraindication of medical therapy in ectopic pregnancy —> hemoperotonium? 18. Which one true about PID —> cervicitis is included in the disease course 19. Which one false —> continues secretion of LH and FSH from pituitary 20. Corpus luteum —> corpus Albicans ? 21. Turner syndrome characterized by —> primary amenorrhea 22. Ovulating agents —> cause multiple follicle 23. Which one wrong about TB —> TB bovis is most common 24. First trimester abortion cause —> chromosomal anomaly 25. cause y painless abortion bu in 2 nd trimester —> cervical os incompetence 26. True hermaphroditism —> both ovary and testes are present 27. Best test for ovarian reserve —> antimullerian hormone 28. If bicornuate uterus found, search for anomaly in —> urinary system 29. Gonorrhea commonly affect —> all the above locations 30. Which one not secreted from ant pituitary —> HCG 31. Which one is a sign of ovulation? 32. Normal menstrual blood loss —> none 33. Which one true about ectopic pregnancy —> 90% in Fallopian tube 34. In IUCD which one is right —> if pregnancy occur it’s more likely to be ectopic 35. Which one not used for PMS —> diuretics ｜ 64  Urology – Theoretical – Examination – MCQ 2017- 2018 Mid-Year 1. Transitional call carcinoma of bladder comprises how much of all types of bladder CA? A. 90 % B. 70% C. 30% D. 10% E. 5% Ans: A 2. Adenocarcinoma of urinary bladder usually arise from which part of bladder? A. Lateral wall B. Medial wall C. The neck D. Trigon E. Fundus Ans: E 3. Which one wrong regarding anterior urethral valve? A. Most common form of obstructive urethral lesion in infants B. Urethroscopy or VCUG demonstrate the lesion C. Endoscopic electrofulmegeration will effectively correct the obstruction D. Enuresis may be present E. It’s a congenital anomaly of urethra Ans: A 4. Which of the following drugs is not used as first line tx for uncomplicated cystitis? A. Trimethoprim B. Quinolones C. Nitrofurantoin D. Cephalosporis E. Streptomycin Ans: E? 5. Which type of bladder CA is common in areas were S. Hematobium is endemic? A. Transitional cell CA B. Adenocarcinoma C. Squamous cell CA D. …. E. … Ans: C ｜ 65  6. Ectopia vesica incidence is: A. 1 in 50 B. 1 in 500 C. 1 in 5000 D. 1 in 50000 E. 1 in 500000 Ans: D 7. Which of the following is true regarding urethral stricture? A. More common in women but rare in men B. The urinary stream is normal C. Acute urinary retention frequently occur D. Strel? Injuries can produce bulbar strictures Ans: D 8. Which of the following is wrong regarding posterior urethral valve? A. It’s the least common type of obstructive urethral lesion B. Occur only in males C. Found in distal prostatic urethra D. Urinary infection and sepsis occur frequently E. Failure to thrive maybe the only significant symptom Ans: A 9. Regarding tx of interstitial cystitis, all following are surgical options except: A. Denervation B. Urinary diversion C. Augmentation cecocystoplasty D. Ileocystoplasty E. Bilateral reimplantation of ureter Ans: E 10. All are complications of urethral stricture except: A. Chronic UTI B. Decompensation of uretrovesical junction with reflux hydronephrosis C. hypertrophy of bladder muscles D. urethral fistula E. erectile dysfunction Ans: E 11. which one wrong about epispadias? A. Occur in 1 in 120000 males B. Incontinence very common C. Ventral chordae D. In severe cases extrophy and epispadias co-exist E. Tx is always by surgery Ans: C ｜ 66  12. Which of the following is true? A. Apenia is a very common condition B. Micropenia occur due to excessive testosterone C. Megalopenia occur due to deficiency of testosterone D. Tx of megalopenia is surgery E. In micropenia pituitary gonadal axis appears to be intact Ans: E 13. Which of the following drugs is not used in the tx of interstitial cystitis? A. Dimethyl sulfoxide B. Sodium pentosanpolysulfate C. Cortisone acetate D. Oxychlorosine sodium E. Methotrexate Ans: E 14. Which of the following is true regarding ureteric colic? A. In its mild form it can be treated by conservative tx B. It’s a constant persistent pain C. The pain radiates to the suprapubic region D. Its due to the passage of a stone through the ureters E. Patient usually stays very still and avoids movement Ans: D? 15. In which of the following there is indication for conservative tx of renal stone? A. 6 mm stone B. Moderate hydronephrosis C. Hypertension D. Staghorn stone 16. Oliguria is: A. Passing 500 ml/24 h urine B. 300 ml/24 h C. 2 L /24 h D. 100 ml/24 h E. 900ml/24 h Ans: B 17. All are indications for open surgery in ureteric stone, except: A. Complex stone burden B. Failure of other lines of tx C. Non-functioning kidneys D. Congenital anomalies E. Bilateral silent stone in elderly Ans: E ｜ 67  18. Incidence of asymptomatic bacteriuria in women: A. 5-10 % B. 10-20 % C. 30-40% D. 50-60 % E. >80% 19. Which one wrong about hypospadias? A. Sexual differentiation and urethral development begin in utero at 15 weeks B. 1 in 300 male child's C. Urethral meatus opens in the ventral side of penis Ans: A 20. Which one is an indication for ESWL? A. Previous ESWL B. Pelvo-ureteric junction obstruction C. Lower ureteric stone in pregnancy D. Non-functioning kidney ｜ 68  Final-Year 1. Regarding the risk factors for carcinoma of the prostate, all are risk factors except: A. Increased rate with increasing age B. More common in the African-Americans C. There is familial and genetic influence D. Inflammation and infection are risk E. Benign prostatic hyperplasia Ans: E 2. Regarding the risk factors for carcinoma of the prostate, all are true except: A. A link is found between sexual activity or sexually transmitted diseases and prostate cancer B. A diet high in fat increases the risk by 2 folds C. Obesity is associated with lower risk of low grade and higher risk of high grade D. Exposure to cadmium increases the risk E. There is a definite link between alcohol consu