SLE Assessment Exam 2

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Quizzes Created: 4 | Total Attempts: 6,068

Questions: 100 | Attempts: 1,174 | Updated: Mar 22, 2023

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SLE Assessment exam 2

Questions and Answers

1.

Patient with recurrent vomiting for 2 days, Hematocrit 65 the doctor can report thisresult caused by:
- A.
  
  Glucagon
- B.
  
  Cytokine
- C.
  
  Apoprotein
- D.
  
  C R protein
Correct Answer
A. Glucagon

Explanation
Glucagon is a hormone produced by the pancreas that helps regulate blood sugar levels. It stimulates the liver to release stored glucose into the bloodstream. In the given scenario, the patient has recurrent vomiting and a high hematocrit level of 65, which indicates dehydration. Glucagon can cause nausea and vomiting as a side effect, and in this case, it is likely that the elevated glucagon levels are causing the patient's symptoms. Therefore, the correct answer is Glucagon.

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2.

The most common site of origin of the tumor associated with the Zollinger-Ellison syndrome is:
- A.
  
  Pancreas
- B.
  
  Stomach
- C.
  
  Spleen
- D.
  
  Lymph node
- E.
  
  Duodenum
Correct Answer
A. Pancreas

Explanation
The most common site of origin of the tumor associated with the Zollinger-Ellison syndrome is the pancreas. Zollinger-Ellison syndrome is a rare condition characterized by the presence of gastrin-secreting tumors called gastrinomas. These tumors are most commonly found in the pancreas, although they can also occur in other parts of the digestive system such as the duodenum. The excessive production of gastrin by these tumors leads to increased acid production in the stomach, causing symptoms such as peptic ulcers, abdominal pain, and diarrhea. Therefore, the pancreas is the correct answer as it is the primary site of origin for these tumors.

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3.

Which of the following associated with fetal congenital heart disease
- A.
  
  Rubella
- B.
  
  Toxoplasmosis
- C.
  
  HIV
- D.
  
  HSV
Correct Answer
A. Rubella

Explanation
Rubella is associated with fetal congenital heart disease. Rubella, also known as German measles, is caused by a viral infection. If a pregnant woman contracts rubella during the first trimester, it can lead to various birth defects, including congenital heart disease in the fetus. This occurs because the rubella virus can cross the placenta and affect the developing heart of the baby. Therefore, rubella is a known risk factor for fetal congenital heart disease.

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4.

Which subtype of bipolar disorder type 2 best responsive to lithium
- A.
  
  Classic mania
- B.
  
  Dysphoric
- C.
  
  Mixed
- D.
  
  Rapid cycling
Correct Answer
A. Classic mania

Explanation
Classic mania is the subtype of bipolar disorder type 2 that is best responsive to lithium. Lithium is a mood stabilizer commonly used to treat bipolar disorder, and it has been found to be particularly effective in managing classic mania symptoms. Classic mania is characterized by elevated mood, increased energy, and impulsivity. Lithium helps to stabilize mood and reduce the intensity of manic episodes, making it an appropriate treatment option for individuals with this subtype of bipolar disorder type 2.

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5.

An easy way to demonstrate rib fracture is by:
- A.
  
  Oblique chest x-ray
- B.
  
  Tomogram of chest
- C.
  
  AP chest x-ray
- D.
  
  PA chest x-ray
Correct Answer
A. Oblique chest x-ray

Explanation
An oblique chest x-ray is an easy way to demonstrate rib fractures because it allows for a better visualization of the ribs compared to other imaging techniques. The oblique view provides a different perspective of the ribs, making it easier to identify any fractures or abnormalities. This view can help pinpoint the exact location and extent of the rib fracture, aiding in accurate diagnosis and treatment planning.

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6.

Acne about 1cm with pus ,what is the stage?
- A.
  
  Inflammatory
- B.
  
  Obstructive
- C.
  
  Infected
Correct Answer
A. Inflammatory

Explanation
The given description of "Acne about 1cm with pus" indicates that there is inflammation present in the acne. Inflammatory acne is characterized by redness, swelling, and the presence of pus. This stage of acne occurs when the hair follicles become clogged with excess oil, dead skin cells, and bacteria, leading to an inflammatory response. Therefore, the correct stage in this case would be "Inflammatory."

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7.

Young healthy male has abdominal pain after basketball. Examination fine except for Left paraumbilicaltenderness, what to do?
- A.
  
  Send home & reassess within 48 hours
- B.
  
  Flat plate graph
- C.
  
  Abdominal US
- D.
  
  Abdominal X-ray
Correct Answer
A. Send home & reassess within 48 hours

Explanation
Based on the given information, the young healthy male has abdominal pain after playing basketball. The examination is fine except for left paraumbilical tenderness. In this scenario, the best course of action would be to send the patient home and reassess within 48 hours. This approach allows for observation and monitoring of the symptoms to see if they improve or worsen over time. It is a conservative approach that avoids unnecessary tests or interventions unless the symptoms worsen or new symptoms develop.

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8.

What is the mechanism of action of the drug that is used in treatment of Anxiety ?
- A.
  
  Decrease the availability of serotonin
- B.
  
  Decrease the availability of serotonin
- C.
  
  Blockage of serotonin production
Correct Answer
A. Decrease the availability of serotonin

Explanation
The correct answer is "Decrease the availability of serotonin." This mechanism of action suggests that the drug used in the treatment of anxiety works by reducing the levels of serotonin, a neurotransmitter in the brain that is associated with mood regulation. By decreasing the availability of serotonin, the drug may help to alleviate symptoms of anxiety and promote a sense of calmness.

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9.

3 days old baby his mother is HBV positive what is your action?
- A.
  
  Immunoglobulin and three doses of HBV vaccine
- B.
  
  Immunoglobulin
- C.
  
  Immunoglobulin and one dose of vaccination
Correct Answer
A. Immunoglobulin and three doses of HBV vaccine

Explanation
Given that the mother is HBV positive, there is a risk that the baby may have been exposed to the virus during childbirth. To prevent transmission of the virus to the baby, the recommended action is to administer immunoglobulin and three doses of HBV vaccine. This combination helps to provide immediate protection against the virus and also boosts the baby's immune response to prevent future infections.

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10.

Athletic female with 3 month history of amenorrhea O/E otherwise healthy , Workup of FSH , LH , Prolactine , were all normal what is most likely diagnosis?
- A.
  
  Hypothalamic amenorrhea
- B.
  
  Ovarian or adrenal failure
- C.
  
  Genetic syndrome
- D.
  
  Pituitary adenoma
Correct Answer
A. Hypothalamic amenorrhea

Explanation
The most likely diagnosis in this case is hypothalamic amenorrhea. This is supported by the fact that the patient is athletic and has a 3-month history of amenorrhea, which suggests a disruption in the hypothalamic-pituitary-ovarian axis. The normal levels of FSH, LH, and prolactin indicate that there is no ovarian or adrenal failure, genetic syndrome, or pituitary adenoma causing the amenorrhea. Hypothalamic amenorrhea is commonly seen in athletes due to the stress and energy imbalance associated with intense physical activity.

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11.

What is the treatment of leprosy according to WHO organization ?
- A.
  
  Dapsone
- B.
  
  Colchicines
- C.
  
  Rifampicine
Correct Answer
A. Dapsone

Explanation
Dapsone is a medication commonly used in the treatment of leprosy according to the World Health Organization (WHO). It is an antibiotic that helps to kill the bacteria that causes leprosy. Dapsone is often used in combination with other drugs to effectively treat and manage leprosy. It is an important component of multi-drug therapy (MDT), which is the recommended treatment regimen for leprosy by the WHO.

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12.

An 18 years old male who was involved in an RTA had fracture of the base of the skull. O/E he had loss ofsensation of the anterior 2/3 of the tongue & deviation of the angle of the mouth. Which of the followingnerves is affected?
- A.
  
  VII (Facial)
- B.
  
  IV (Abducens)
- C.
  
  V (Trigeminal)
- D.
  
  III (Occulomotor)
- E.
  
  I (Olfactory)
Correct Answer
A. VII (Facial)

Explanation
The facial nerve (VII) is responsible for innervating the muscles of facial expression, including those involved in tongue movement and controlling the angle of the mouth. In this case, the patient's loss of sensation in the anterior 2/3 of the tongue and deviation of the angle of the mouth indicate damage to the facial nerve. The other nerves listed do not control these specific functions and are therefore not likely to be affected in this scenario.

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13.

2 week baby born with hypotonia, areflexia, fasiculations of the tounge andrespiratory distress, he was born full term , pregnancy with this baby was normal noteventful , nerve conduction studies were done and were normal, he has Pneumonitison x-rays , the diagnosis is :
- A.
  
  Hypothyroidism
- B.
  
  Gillian Barre syndrome
- C.
  
  Myasthenia Gravis
- D.
  
  Cerebral Palsy
Correct Answer
A. Hypothyroidism

Explanation
The correct answer is Hypothyroidism. This is because the baby is presenting with hypotonia, areflexia, fasciculations of the tongue, and respiratory distress, which are all characteristic features of hypothyroidism in newborns. The normal nerve conduction studies indicate that there is no nerve damage or dysfunction, ruling out conditions like Guillain-Barre syndrome and myasthenia gravis. Cerebral palsy is also unlikely as the baby was born full term with a normal pregnancy. The presence of pneumonitis on x-rays may be a secondary finding in hypothyroidism.

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14.

A known case of treated Hodgkin lymphoma with radiotherapy not on regular follow up presented with gradual painless difficulty in swallowing and breathing on examination there is facial swelling and redness,what is the diagnosis?
- A.
  
  SVC obstruction
- B.
  
  Abdominal aortic aneurism
- C.
  
  Thoracic aortic aneurysm
- D.
  
  IVC obstruction
Correct Answer
A. SVC obstruction

Explanation
The correct answer is SVC obstruction. SVC obstruction occurs when there is a blockage or compression of the superior vena cava, a large vein that carries deoxygenated blood from the upper body to the heart. In this case, the patient's history of treated Hodgkin lymphoma and the symptoms of gradual painless difficulty in swallowing and breathing, along with facial swelling and redness, are indicative of SVC obstruction. This can occur as a late complication of radiotherapy for Hodgkin lymphoma, causing compression or narrowing of the SVC.

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15.

Which of the following found to reduce the risk of postherapeutic neuralgia?
- A.
  
  Acyclovir only
- B.
  
  Corticosteroids only
- C.
  
  Acyclovir and Corticosteroids
Correct Answer
A. Acyclovir only

Explanation
Acyclovir is a medication commonly used to treat viral infections, including herpes. Postherpetic neuralgia is a complication that can occur after a herpes infection, causing chronic pain in the affected area. Acyclovir has been found to reduce the risk of developing postherpetic neuralgia by effectively treating the underlying viral infection. Corticosteroids, on the other hand, are not specifically targeted towards viral infections and may not have the same effect in preventing postherpetic neuralgia. Therefore, the correct answer is acyclovir only.

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16.

Patient K/C of DM and obesity and he planed to reduce his weight what the best method?
- A.
  
  Decrease by 500 kcal/kg per week
- B.
  
  Decrease calori and increase fat
- C.
  
  Decrease calori intake in day time
- D.
  
  Decrease 800 per day
Correct Answer
A. Decrease by 500 kcal/kg per week

Explanation
One of the best methods for a patient with diabetes and obesity to reduce weight is by decreasing their calorie intake by 500 kcal per kilogram of body weight per week. This approach allows for a gradual and sustainable weight loss, which is important for individuals with these health conditions. It is crucial to create a calorie deficit while ensuring a balanced diet that includes all necessary nutrients. This method promotes healthy weight loss and can have a positive impact on the patient's overall health.

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17.

Patient develop neurological deficit O/E congested neck veins and tachycardia , heused to take a polish white rice as a meal what is the diagnosis ?
- A.
  
  Wet beriberi
- B.
  
  Dry beriberi
- C.
  
  Vitamin A deficiency
- D.
  
  Folic acid deficiency
Correct Answer
A. Wet beriberi

Explanation
The patient's symptoms of neurological deficit, congested neck veins, and tachycardia suggest a diagnosis of wet beriberi. Wet beriberi is a condition caused by thiamine (vitamin B1) deficiency, which can occur due to a diet lacking in essential nutrients like polish white rice. Thiamine is important for the proper functioning of the nervous system and cardiovascular system. Symptoms of wet beriberi include cardiovascular abnormalities such as high heart rate and congested neck veins, as well as neurological symptoms like muscle weakness and sensory disturbances.

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18.

Old man with a non tender cervical mass, what is the best diagnostic procedure?
- A.
  
  Fine needle aspiration
- B.
  
  CT scan
- C.
  
  Ultrasound
- D.
  
  TSH level
Correct Answer
A. Fine needle aspiration

Explanation
Fine needle aspiration is the best diagnostic procedure for an old man with a non-tender cervical mass. This procedure involves using a thin needle to extract cells from the mass for examination under a microscope. It is a minimally invasive and relatively safe procedure that can provide valuable information about the nature of the mass, such as whether it is cancerous or benign. CT scan and ultrasound can also provide helpful imaging information, but they may not be as effective in obtaining a definitive diagnosis. TSH level, on the other hand, is a blood test used to assess thyroid function and would not be relevant in this case.

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19.

Patient came to you asking about why should we take influenza vaccine annually what do you tell him?
- A.
  
  Changings in virus structure
- B.
  
  Change in mood of transmission
- C.
  
  Antibacterial prophylaxis
Correct Answer
A. Changings in virus structure

Explanation
The correct answer is "Changings in virus structure". The reason why influenza vaccine should be taken annually is because the virus undergoes frequent changes in its structure. This means that the strains of the virus that circulate each year may be different from the previous year. By getting vaccinated annually, individuals can protect themselves against the specific strains of the virus that are expected to be prevalent in a given flu season.

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20.

Patient diagnosed and treated from H.pylori .The doctor should screen him for what?
- A.
  
  Gastric cancer
- B.
  
  Gastric bleeding
- C.
  
  Gastric atrophy
- D.
  
  Gastritis
Correct Answer
A. Gastric cancer

Explanation
After a patient has been diagnosed and treated for H. pylori, it is important for the doctor to screen him for gastric cancer. H. pylori infection is a known risk factor for gastric cancer, and although the infection has been treated, there is still a possibility of developing cancer in the future. Therefore, regular screening is necessary to detect any early signs of gastric cancer and initiate appropriate treatment. Gastric bleeding, gastric atrophy, and gastritis may also be potential complications of H. pylori infection, but the most important concern is the possibility of gastric cancer.

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21.

what is the best management for a patient chronic pain ?
- A.
  
  Acetaminophen
- B.
  
  Naloxon
- C.
  
  Morphine
- D.
  
  Ibuprofen
Correct Answer
A. Acetaminophen

Explanation
Acetaminophen is often considered the best management for a patient with chronic pain. It is a commonly used over-the-counter pain reliever that can effectively reduce pain and fever. It is generally safe and well-tolerated when used as directed, making it a suitable option for long-term pain management. Acetaminophen is particularly recommended for individuals who cannot take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or opioids like morphine due to contraindications or side effects. Naloxone, on the other hand, is an opioid antagonist used to reverse opioid overdose, and morphine is a potent opioid analgesic typically reserved for severe pain. Therefore, acetaminophen is the best choice among the given options for managing chronic pain.

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22.

Most common cause of failure to thrive is ?
- A.
  
  Intolerance to failure to proteins and carbohydrates
- B.
  
  Asthma
- C.
  
  Cystic fibrosis
- D.
  
  GERD
- E.
  
  Low socioeconomic status
Correct Answer
A. Intolerance to failure to proteins and carbohydrates

Explanation
Intolerance to failure to proteins and carbohydrates can be a common cause of failure to thrive. This condition refers to the inability of the body to properly digest and absorb proteins and carbohydrates, leading to inadequate nutrition and poor growth. It can result from various factors such as enzyme deficiencies or gastrointestinal disorders. If a person is unable to break down and utilize these essential nutrients, it can lead to weight loss, developmental delays, and overall failure to thrive.

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23.

A 65-year-old man with a history of primary open-angle glaucoma presents with sudden painless loss of vision in his right eye. On examination of the right eye the optic disc is swollen with multiple flame-shaped and blot haemorrhages. What is the most likely diagnosis?
- A.
  
  Occlusion of the central retinal vein
- B.
  
  Occlusion of the central retinal artery
- C.
  
  Ischaemic optic neuropathy
- D.
  
  Vitreous hemorrhage
- E.
  
  Diabetic retinopathy
Correct Answer
A. Occlusion of the central retinal vein

Explanation
The most likely diagnosis in this case is occlusion of the central retinal vein. This is supported by the sudden painless loss of vision, swollen optic disc, and presence of multiple flame-shaped and blot haemorrhages. Occlusion of the central retinal vein can lead to impaired blood flow and subsequent damage to the optic nerve, resulting in vision loss.

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24.

The commonest symptom in the presentation of abruptio placenta is?
- A.
  
  Vaginal Bleeding
- B.
  
  Abdominal pain
- C.
  
  Hypogastric tenderness
- D.
  
  Irregular uterine contractions
- E.
  
  Abdominal mass
Correct Answer
A. Vaginal Bleeding

Explanation
The commonest symptom in the presentation of abruptio placenta is vaginal bleeding. This is because abruptio placenta refers to the premature separation of the placenta from the uterine wall, leading to bleeding. Vaginal bleeding is a significant sign of this condition and can range from mild to severe, depending on the extent of placental separation. Other symptoms such as abdominal pain, hypogastric tenderness, irregular uterine contractions, and abdominal mass may also be present but are not as common or specific to abruptio placenta.

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25.

Patient who had history of previous infective endocarditis, and now came with dental caries for dental procedure, what is the appropriate prophylaxis:
- A.
  
  Amoxycillin 2gm one hour before procedure
- B.
  
  Amoxycillin 1gm one hour before procedure
- C.
  
  Clindamycin 2gm one hour before procedure
- D.
  
  Clindamycin 1gm one hour before procedure
Correct Answer
A. Amoxycillin 2gm one hour before procedure

Explanation
Patients with a history of previous infective endocarditis are at an increased risk of developing further infections, including from dental procedures. Antibiotic prophylaxis is recommended to prevent bacterial endocarditis in these patients. The appropriate prophylaxis in this case is amoxycillin 2gm one hour before the dental procedure. This higher dose of amoxycillin is recommended for patients with a higher risk of developing infective endocarditis, such as those with a history of the condition.

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26.

Regarding breast malignancy which of the following is Bilateral ?
- A.
  
  Lobular carcinoma
- B.
  
  Ductal ectasia
- C.
  
  Pager's disease
- D.
  
  Infiltrating ductal carcinoma
Correct Answer
A. Lobular carcinoma

Explanation
Lobular carcinoma is a type of breast malignancy that can occur in both breasts simultaneously, making it bilateral. This type of cancer starts in the milk-producing glands of the breast and can spread to other parts of the body. Ductal ectasia, Paget's disease, and infiltrating ductal carcinoma are all types of breast malignancies that typically affect only one breast and are therefore not bilateral.

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27.

60 years female, c/o back pain, bone density=2.5, what will you do ?
- A.
  
  Calcium+ Vitamin D + phosphorus
- B.
  
  Exercise advise
- C.
  
  Calcium
- D.
  
  NSAID
Correct Answer
A. Calcium+ Vitamin D + phosphorus

Explanation
The correct answer is calcium+ Vitamin D + phosphorus. This is because the patient is a 60-year-old female complaining of back pain and has a bone density of 2.5. This bone density indicates osteoporosis, a condition characterized by low bone mass and deterioration of bone tissue. Calcium, Vitamin D, and phosphorus are essential nutrients for maintaining bone health and can help prevent further bone loss and fractures. Exercise advice is also important for strengthening the bones and muscles. NSAIDs may provide temporary relief for the pain, but they do not address the underlying issue of osteoporosis.

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28.

Cause of Polyhydramnios?
- A.
  
  Duodenal atresia
- B.
  
  Post mortem pregnancy
- C.
  
  Mother with diabetes insipidus
- D.
  
  Renal agenesis
Correct Answer
A. Duodenal atresia

Explanation
Duodenal atresia is a congenital condition where there is a blockage or narrowing of the duodenum, the first part of the small intestine. This blockage can lead to an accumulation of amniotic fluid in the womb, causing polyhydramnios. Polyhydramnios is a condition characterized by an excessive amount of amniotic fluid surrounding the fetus. Therefore, duodenal atresia can be a cause of polyhydramnios.

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29.

Baby in NICU has a heart rate of 300, good blood pressure level. What should u do:
- A.
  
  Digoxin
- B.
  
  DC shock
- C.
  
  Amiodarone
- D.
  
  Carotid massage
Correct Answer
A. Digoxin

Explanation
Digoxin is a medication commonly used to treat certain heart conditions, including abnormal heart rhythms. In this case, the baby in the NICU has a heart rate of 300, which is considered abnormally high. Digoxin helps to slow down the heart rate and can be administered to the baby to bring it back to a normal range. It is a suitable choice in this situation to help regulate the baby's heart rate.

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30.

Patient with muscle weakness, decreased reflexes. There is also history of diarrhea. What could be the cause?
- A.
  
  Hypokalemia
- B.
  
  Hyponatremia
- C.
  
  Hyperkalemia
- D.
  
  Hypercalcemia
Correct Answer
A. Hypokalemia

Explanation
The patient's symptoms of muscle weakness and decreased reflexes, along with a history of diarrhea, suggest a possible electrolyte imbalance. Hypokalemia, which is a low level of potassium in the blood, can cause muscle weakness and decreased reflexes. Additionally, diarrhea can lead to potassium loss, further supporting the possibility of hypokalemia as the cause of the symptoms.

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31.

Old female with recurrent fracture, Vitamin D insufficiency and smoker. Which exogenous factor has the greatest exogenous side effect on osteoporosis?
- A.
  
  Smoking
- B.
  
  Old age
- C.
  
  Vitamin D insufficiency
- D.
  
  Recurrent fracture
Correct Answer
A. Smoking

Explanation
Smoking has the greatest exogenous side effect on osteoporosis because it decreases the production of estrogen, which is important for maintaining bone density. Smoking also increases inflammation and oxidative stress, both of which can contribute to bone loss. Additionally, smoking impairs the absorption of calcium, an essential mineral for bone health. Therefore, smoking can accelerate bone loss and increase the risk of fractures in individuals with osteoporosis.

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32.

Female who does a lot of training and had amenorrhea for 5 months, this can increased her risk of:
- A.
  
  Infertility
- B.
  
  Osteoporosis
- C.
  
  Endometrial cancer
- D.
  
  Ovarian cancer
Correct Answer
A. Infertility

Explanation
Due to the prolonged absence of menstruation (amenorrhea) in a female who does a lot of training, her risk of infertility is increased. Amenorrhea can be caused by excessive exercise, which can disrupt the hormonal balance necessary for ovulation and fertility. This disruption can make it difficult for the woman to conceive.

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33.

Which of the following is TRUE regarding Anorexia Nervosa :
- A.
  
  Refuse to main body above normal is diagnostic criteria
- B.
  
  It occurs exclusively in adolescent and early adult female
- C.
  
  Absence of 2 menstrual cycles are diagnostic
- D.
  
  It is more common than Nervosa bulimia
Correct Answer
A. Refuse to main body above normal is diagnostic criteria
34.

Patient G3 P3 all her deliveries were normal except after the second one she did D&C , Labs all normal except: high FSH, high LH, low estrogen, what s the diagnosis?
- A.
  
  Asherman syndrome
- B.
  
  Turner syndrome
- C.
  
  Sheehan syndrome
- D.
  
  Ovarian failure
Correct Answer
A. Asherman syndrome

Explanation
The patient's history of normal deliveries and the presence of high FSH, high LH, and low estrogen levels suggest a diagnosis of Asherman syndrome. Asherman syndrome is characterized by the formation of scar tissue in the uterus, usually as a result of previous D&C procedures. This can lead to menstrual abnormalities, infertility, and hormonal imbalances. The high FSH and LH levels indicate ovarian dysfunction, which is commonly associated with Asherman syndrome. Turner syndrome is unlikely as it is a genetic condition that causes various physical and developmental abnormalities. Sheehan syndrome is also unlikely as it is characterized by postpartum pituitary gland necrosis, which would not explain the hormonal imbalances seen in this patient. Ovarian failure could be a possibility, but the specific history of D&C and normal deliveries points more towards Asherman syndrome.

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35.

Old female with pubic itching with bloody discharge, then she developed pea shaped swelling in herlabia, most likely:
- A.
  
  Bartholin gland carcinoma
- B.
  
  Bartholin cyst
- C.
  
  Bartholin abscess
Correct Answer
A. Bartholin gland carcinoma

Explanation
Based on the symptoms described, such as pubic itching with bloody discharge and the development of a pea-shaped swelling in the labia, the most likely diagnosis is Bartholin gland carcinoma. Bartholin gland carcinoma is a rare form of cancer that affects the Bartholin glands, which are located on either side of the vaginal opening. The symptoms mentioned are indicative of a malignant growth in the Bartholin gland. Bartholin cyst and abscess are more common benign conditions that typically present with different symptoms.

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36.

Regarding postpartum Psychosis:
- A.
  
  Recurrences are common in subsequent pregnancies
- B.
  
  It often progresses to frank schizophrenia
- C.
  
  It has good prognosis
- D.
  
  It has insidious onset
- E.
  
  It usually develops around the 3rd week postpartum
Correct Answer
A. Recurrences are common in subsequent pregnancies

Explanation
Recurrences are common in subsequent pregnancies because postpartum psychosis is often triggered by hormonal changes during pregnancy and childbirth. These hormonal fluctuations can disrupt brain chemistry and increase the risk of developing psychosis. Therefore, women who have previously experienced postpartum psychosis are more likely to experience it again in future pregnancies. This recurrence pattern highlights the importance of early detection and intervention to ensure the well-being of both the mother and the baby.

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37.

Young patient with peptic ulcer , wich one of the following doesnt cause it ?
- A.
  
  TCA
- B.
  
  Sepsis
- C.
  
  Delayed gastric emptying
- D.
  
  Pyloric sphincter stricture
Correct Answer
A. TCA

Explanation
Tricyclic antidepressants (TCAs) do not cause peptic ulcers. Peptic ulcers are commonly caused by factors such as infection with Helicobacter pylori bacteria, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), excessive alcohol consumption, and smoking. TCAs are a class of medications primarily used to treat depression, anxiety, and other mental health conditions. They do not directly irritate the stomach lining or contribute to the development of peptic ulcers.

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38.

Contraindication to use in Migraine :
- A.
  
  Buprobion
- B.
  
  Lithium
- C.
  
  Valium
- D.
  
  Propanol
Correct Answer
A. Buprobion

Explanation
Bupropion is contraindicated for use in migraine because it can lower the seizure threshold and increase the risk of seizures, which is already elevated in patients with migraine. Migraine is a neurological condition characterized by recurrent headaches, and individuals with this condition are already prone to seizures. Therefore, using bupropion in migraine patients can potentially exacerbate their condition and lead to serious complications. It is important to avoid bupropion in these patients and consider alternative treatment options.

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39.

Patient present with gross haematuria what best investigation
- A.
  
  Cystscopy
- B.
  
  Renal biopsy
- C.
  
  Urine culure
- D.
  
  U/S
Correct Answer
A. Cystscopy

Explanation
Cystoscopy is the best investigation for a patient presenting with gross hematuria. This procedure involves inserting a thin tube with a camera into the bladder to examine the urinary tract for any abnormalities or sources of bleeding. It allows direct visualization of the bladder and urethra, making it a valuable diagnostic tool in identifying the cause of hematuria. Renal biopsy is not necessary in this scenario as the focus is on the lower urinary tract. Urine culture may be useful to detect any urinary tract infections, but it does not provide direct visualization. Ultrasound (U/S) can be helpful in assessing the kidneys and urinary system, but cystoscopy provides more accurate information in this case.

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40.

Patient wake up with inability to speak .He went to a doctor and he still couldnt speak. He can cough whe he is asked to do then he gave you a picture of his larnyx by laryngoscope . Which grossly looks normal .
- A.
  
  Functional aphonia
- B.
  
  Paralysis of vocal cords
- C.
  
  Infection
- D.
  
  Referral to ENT
Correct Answer
A. Functional aphonia

Explanation
The patient's inability to speak despite normal appearance of the larynx suggests functional aphonia. Functional aphonia is a psychological disorder where there is a loss of voice without any structural or physical abnormalities. It is often triggered by emotional or psychological factors and can be treated through therapy or counseling.

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41.

Best drug for moderate to sever anxiety
- A.
  
  Aloprozolam
- B.
  
  Imipramine
- C.
  
  Phenilzine
- D.
  
  Haloperidol
Correct Answer
A. Aloprozolam

Explanation
Alprazolam is the best drug for moderate to severe anxiety because it is a benzodiazepine that works by enhancing the effects of a neurotransmitter called GABA in the brain, which helps to reduce anxiety and promote relaxation. It has a rapid onset of action and is effective in managing symptoms of anxiety disorders. Imipramine is a tricyclic antidepressant, Phenelzine is a monoamine oxidase inhibitor, and Haloperidol is an antipsychotic medication, none of which are specifically indicated or considered first-line treatments for anxiety disorders.

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42.

Child , 22kg he is dehydrated what is the rate of fluid given to this child per hour?
- A.
  
  65ml
- B.
  
  90ml
- C.
  
  130ml
- D.
  
  30ml
Correct Answer
A. 65ml

Explanation
The rate of fluid given to the child per hour is 65ml. This is determined based on the child's weight (22kg) and the fact that he is dehydrated. The appropriate fluid replacement for a dehydrated child is typically calculated as 100ml/kg/day. Therefore, for a 22kg child, the fluid requirement would be 2200ml/day. To find the rate per hour, we divide this by 24, resulting in 91.67ml/hour. However, it is important to start rehydration slowly, so the rate is typically reduced to 65ml/hour initially.

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43.

Primi at 35 weeks of gestation with pre-eclampsia, BP is high with ankle edema, what is the best to be done ?
- A.
  
  Maternal-fetal monitoring with continuous hospitalization.
- B.
  
  Immediate delivery.
- C.
  
  Labetolol
- D.
  
  Low salt diet.
- E.
  
  Diuretic
Correct Answer
A. Maternal-fetal monitoring with continuous hospitalization.

Explanation
Maternal-fetal monitoring with continuous hospitalization is the best course of action in this scenario. Pre-eclampsia is a condition characterized by high blood pressure and can be dangerous for both the mother and the baby. Monitoring the mother and the fetus in a hospital setting allows for close observation of blood pressure, fetal well-being, and any signs of worsening pre-eclampsia. This approach ensures that any necessary interventions can be promptly initiated to prevent complications and ensure the best possible outcome for both the mother and the baby. Immediate delivery may be considered in severe cases, but in this case, it is not the best option as the question does not mention severe pre-eclampsia. Labetolol, low salt diet, and diuretics may be used as adjunctive measures, but they do not address the need for continuous monitoring and hospitalization.

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44.

Patient presented with constipation , to confirm has hypothyrodism ?
- A.
  
  TSH
- B.
  
  T4
- C.
  
  Free T4
- D.
  
  T3
Correct Answer
A. TSH

Explanation
TSH (thyroid-stimulating hormone) is the most appropriate test to confirm hypothyroidism in a patient presenting with constipation. TSH is produced by the pituitary gland and stimulates the thyroid gland to produce T4 (thyroxine). In hypothyroidism, the thyroid gland is underactive and does not produce enough T4, leading to symptoms such as constipation. Therefore, measuring TSH levels can help determine if the patient has hypothyroidism, as elevated TSH levels indicate an underactive thyroid. T4, free T4, and T3 levels may also be measured to further evaluate thyroid function, but TSH is the primary test for confirming hypothyroidism.

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45.

A drug abuser is at risk of which of the following ?
- A.
  
  Hepatitis C
- B.
  
  Hepatitis A
- C.
  
  Hepatitis B
- D.
  
  Hepatitis D
Correct Answer
A. Hepatitis C

Explanation
Drug abusers are at risk of contracting Hepatitis C. Hepatitis C is a viral infection that affects the liver and is commonly transmitted through the sharing of needles or other drug paraphernalia. This puts drug abusers at a higher risk of exposure to the virus. Hepatitis C can cause chronic liver disease, liver cirrhosis, and even liver cancer if left untreated. It is important for drug abusers to be aware of this risk and take necessary precautions to prevent the transmission of Hepatitis C.

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46.

60 years admitted to the hospital as end stage COPD, what will you expect in lab. Work :
- A.
  
  Erythrocytosis
- B.
  
  Low ferritin level
- C.
  
  Hyponatremia
- D.
  
  Hypokalemia
Correct Answer
A. Erythrocytosis

Explanation
In end stage COPD, the body compensates for the low oxygen levels by producing more red blood cells, leading to erythrocytosis. This is because the body tries to increase the oxygen-carrying capacity of the blood. Low ferritin levels may also be expected as a result of chronic inflammation and poor nutrition in COPD patients. Hyponatremia and hypokalemia are not typically associated with end stage COPD.

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47.

23 years old female consulted her physician because of breast mass, the mass is mobile, firm and approximately 1 cm in diameter. It is located in the upper outer quadrant of the right breast. No axillary lymph nodes are present. What is the treatment of choice for this condition?
- A.
  
  Watchful waiting
- B.
  
  Radical mastectomy
- C.
  
  Biopsy
- D.
  
  Lumpectomy
- E.
  
  Modified radical mastectomy
Correct Answer
A. Watchful waiting

Explanation
Watchful waiting is the appropriate treatment choice in this case because the patient is young, the mass is small and mobile, and there are no axillary lymph nodes present. These characteristics suggest a low likelihood of malignancy. Watchful waiting involves closely monitoring the mass over time to assess for any changes or growth. If there are no significant changes, further intervention may not be necessary. This approach avoids unnecessary invasive procedures and potential complications associated with surgery.

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48.

A child of 7 years came with SOB, cough, he had history of different previous allergies,on examination he had wheezy chest, what is the most appropriate initial management:
- A.
  
  Nebulized albuterol
- B.
  
  Inhaled corticosteroid
- C.
  
  Theophylline
- D.
  
  Monteleukast
Correct Answer
A. Nebulized albuterol

Explanation
The most appropriate initial management for a child of 7 years with wheezy chest, SOB, and cough, who has a history of different previous allergies, would be nebulized albuterol. Albuterol is a short-acting bronchodilator that helps to relieve bronchospasm and improve airflow in the lungs. It is commonly used as a first-line treatment for acute asthma exacerbations. In this case, the child's symptoms suggest bronchospasm, and nebulized albuterol would provide immediate relief by opening up the airways and relieving the wheezing.

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49.

Patient came for eye examination , he didn’t complain Of anything and there is no history of medical illness , what is the frequency of eye examination?
- A.
  
  1-2 year
- B.
  
  6-9 month
- C.
  
  5-7 year
- D.
  
  4-5 year
- E.
  
  2-3 year
Correct Answer
A. 1-2 year

Explanation
The frequency of eye examination for a patient who does not complain of anything and has no history of medical illness is typically recommended to be every 1-2 years. Regular eye examinations are important for maintaining good eye health and detecting any potential issues early on.

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50.

All of the fallowing are criteria of subarachnoid hemorrhage EXCEPT:
- A.
  
  Paraplegia
- B.
  
  Confusion
- C.
  
  Nuchal Rigidity
- D.
  
  Due to berry aneurysm rupture
- E.
  
  Acute severe headache
Correct Answer
A. Paraplegia

Explanation
Subarachnoid hemorrhage is a condition characterized by bleeding in the space between the brain and the thin tissues that cover it. Symptoms of subarachnoid hemorrhage include confusion, nuchal rigidity (stiff neck), acute severe headache, and it is commonly caused by the rupture of a berry aneurysm. Paraplegia, which refers to the paralysis of the lower half of the body, is not typically associated with subarachnoid hemorrhage. Therefore, the correct answer is paraplegia.

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