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434

148.
Tinea capitis RX.
a)
start Nystatin b)

wood lamp149.
12 year old female , non pruritic annular eruption in the right foot for 8
months , looks pale and notscaling , no response to 6 weeks of miconazole
a)
discoid lupus erythramotosis
b)
erythema nodosum
c)
tinea corporis
d)
granulomatous annulare
e)
choricum marginatum

150.
Patient when examined you noticed absence of eye lashes and thin hair what
is the diagnosis ..
a)
Trichotillomania

151.

Picture of a patient with psoriases how to decrease keratinization


a)

Frequent bath
b)
Avoid sun
c)
Antibiotic

152.

Patient with scaly lesions around moth and ear


a)
Clue cells on urine analysis indicate
b)
Bacterial vaginosis

Note: Clue cells are epithelia cells covered with bacteria seen in urine analysis

153.

Side effect of Retin-A Gel in treatment of Acne?


a)
Increase breast tissues.
b)

Sensitivity to Sunlight.
c)
Increase oil in the skin.

154.
All the following are treatment of scabies except :
a)
Crotamitonb)
Lindane
c)
Permethrin
d)

Albendazole155.

Hx of alopecia started from temporal then occipital reached to frontal Dx:


a)
Androgenic alopecai
b)

Alopecia arreata

435

436

1.
In cachectic patient, the body utilize the proteins of the muscles:
a)

To provide Amino acid and protein synthesis.

During the first few days of starvation, glucose utilization by the brain and erythrocytes
necessitatesdepletion of liver and muscle glycogen and an increased glucose production by the
liver, usinggluconeogenic amino acids derived from catabolism of muscle.

2.
Which of the following describes the end of the early inflammatory phase :
a)
Formation of scar.b)
Formation of ground base of collagen.c)

The end of angiogenesis

The entire wound healing process is a complex series of events, that classified as:I.

Inflammatory Phase:
1)
Immediate to 2-5 days2)
Homeostasis: Vasoconstriction, Platelet aggregation, Thromboplastin makes clot.3)
Inflammation: Vasodilatation, Phagocytosis.II.

Proliferative Phase:
1)
2 days to 3 weeks.2)
Granulation.3)
Contraction.4)
Epithelialization.III.

Remodelling Phase
1)
3 weeks to 2 years.2)
New collagen forms which increases tensile strength to wounds.3)
Scar tissue is only 80 percent as strong as original tissue.

3.
Anatomy of facial artery after leave mastoid
a)

Superficial to mandular vein and external carotid


b)
Deep to external carotidc)
Superficial to external

4.

the separation of chromatid occur in:


a)

Anaphase
b)
Metaphase
c)
Telophase

Sister chromatid separation occurs in the

Anaphase stage
.

During

Metaphase
the chromosomes line up in the center of the cell, their centromeres becomeattachment to the
spindle fibers.

In

Telophase
nuclear membrane is begin to reform at both ends of the cell and spindle fibers disappear.

5.

Adult Polycystic kidney mode of inheritance :


a)

Autosomal dominant.

Adult polycystic kidney disease (polycystic kidney disease type I) has an autosomal dominant
mode ofinheritance. Most common potentially lethal disorder of the kidney caused by mutations
in a single gene.The vast majority of cases are due to a cases (85%) result from mutations in the
PKD1 gene. End-stagerenal failure with hypertension and uremia develops in half the patients
and eventually renal dialysis orrenal transplantation becomes necessary.

7.

Which of the following organs is likely to receive a proportionately greater


increase in blood flow?
a)

kidneys
b)
liver
c)
Heart
d)
skin

437

8.
Scenario of trauma , on face examination there is shifted mouth angle, loss of
sensation of anterior thirdof tongue, which CN is affected:
a)

Facial nerve
b)
Trigeminal nerve

Distal to stylomastoid foramen, the following nerves branch of the facial nerve:

Posterior auricular nerve - controls movements of some of the scalp muscles around the ear.

Branch to Posterior belly of Digastric and Stylohyoid muscle.

Five major facial branches (in parotid gland) - from top to bottom:
o

Temporal branch of the facial nerve


o

Zygomatic branch of the facial nerve


o

Buccal branch of the facial nerve


o

Marginal mandibular branch of the facial nerve


o

Cervical branch of the facial nerve

9.

Link the suitable treatment with organism:


a)
Shegella
3

rd

generation of cephalosporin or trimethoprim-sulfamethoxazoleb)


Salmonella
ciprofloxacin , 3

rd

generation
Cefotaxim

c)
Campylobacter
erythromycin

d)

Giardia The most common treatment for giardiasis is metronidazole (Flagyl) fo


r 5-10

notes for all these organisms :

The most appropriate treatment is fluid and electrolyte replacement

The use of antibiotics to treat


these organisms

is controversial usually self


limiting

10.

The most unwanted side effect of anti-cholinergic drugs is :


a)

Constipation& dry mouth.

More than 50% of patients taking anticholinergic have side effects: dry mouth, blurry vision,
constipationand urinary retention. A lot of side effects can result from anticholinergic drug but the
commonest isconstipation.

11.
The best way to prevent infection in Medical practice :
a)
Wear gloves b)

Wash hands
c)
Wear mask d)
Wear groan

12.

A patient on IV line developed fever due to infection. The most common


source of bacterialcontamination of IV cannula:
a)
Contamination of fluid during manufacturing process
b)
Contamination of fluid during cannula insertion
c)

Contamination at site of skin entry


d)
Contamination during injection of medicatione)

Seeding from remote site during intermittent bacteremia

13.
A lot of bacteria produce toxins which are harmful. Which one of the following
is used in amiddirs:
a)

Botulism
b)
Tetanusc)
Diphtheria d)
Staph aureus

The botulinum toxin (botulism) is the main virulence factor. It is extremely potent neurotoxin
thatprevents acetylcholine release from nerve endings resulting in flaccid paralysis.

438

14.
Blood culture show gram negative rod shape that grow only on charcoal free
fungal organism is:
a)
Staph. Aureusb)
Chlamydiac)

Klebsiella
d)
Mycoplasma

If there is legionella

choose it
grame negative rod growth on charcoal agar.

Buffered charcoal yeast extract (BCYE) agar at pH 6.9 in 4-5 days, is a selective growth medium
used toculture or grow certain bacteria, particularly the Gram-negative species francisella
tularensis, Legionellapneumophila and Haemophilus influenza.

Other Important and common agar & medium;

Thayer-Martin agar

(TM)
Neisseria gonorrhoeae.

Hektoen enteric agar


(HEA)
Salmonella and Shigella.

The Lowenstein-Jensen medium

Mycobacterium tuberculosis

Some drug interaction:

fentanyl + heroin or cocaine (irregular heartbeats, inability to breath & death)

warfarin + aspirin (increased risk of bleeding)

lisinopril + K (abnormal heart beats)

15.
Most common side effect of atropine is :
a)
urinary incontinenceb)

Dryness
c)
Bradycardia.

General side effects have included hyperpyrexia, chest pain, excessive thirst, weakness, syncope,
tonguechewing, dehydration, dry mucus membrane (78% of patients) and feeling hot, other
general side effectsinclude "atropine toxicity" which often present as fever, agitation, and dry
skin/mucous membranes.

16.
In the neck, esophagus is:
a)

Posterior to the trachea


b)
Anterior to the tracheac)
Posterior to vertebral column

17.

Which of the following shift the O2 dissociation curve to the right:

a)
Respiratory alkalosisb)

Hypoxia
c)
Hypothermia

A left shift will increase oxygen's affinity for hemoglobin.

In a left shift condition (alkalosis, hypothermia, etc.) oxygen will have a higher affinity for
hemoglobin.

SaO2 will increase at a given PaO2, but more of it will stay on the hemoglobin and ride back
through thelungs without being used. This can result in tissue hypoxia even when there
is sufficient oxygen in theblood.

A right shift decreases oxygen's affinity for hemoglobin.

In a right shift (acidosis, fever, etc.) oxygen has a lower affinity for hemoglobin. Blood will
releaseoxygen more readily.

This means more O2 will be released to the cells, but it also means less oxygen will be carried
from thelungs in the first place.

In Summary :

PH
increase results in shift to the left, decrease results in shift to the right.

Temperature
increase results in shift to the right, decrease results in shift to the left.

PCO2
increase results in shift to the right, decrease results in shift to the left.

2,3-DPG
increase results in shift to the right, decrease results in shift to the left.

439

18.

Which of the following is a treatment for giardiasis:


a)
Prazequantil
b)
Mebendazole
c)

Metronidazole
d)
Albendazole

Standard treatment for giardiasis consists of antibiotic therapy.

Metronidazole is the most commonly prescribed antibiotic for this condition. Appropriate fluid
andelectrolyte management is critical, particularly in patients with large-volume diarrheal losses.

19.

Tyramine cause hypertension crises with :


a)
TCAb)

MAOI
c)
SSRI

Tyramine acts as a catecholamine releasing agent, tyramine is physiologically metabolized


byMAOA. In humans, if monoamine metabolism is compromised by the use of monoamine
oxidaseinhibitors (MAOIs) and foods high in tyramine are ingested, a hypertensive crisis can
result.

20.
Methergine contraindicated :
a)
Asthmab)

HTN and pregnancy


c)
Gastric disease

Methergine is semi-synthetic ergot alkaloid used for the prevention and control of
postpartumhemorrhage. Contraindicated in Hypertension; toxemia; pregnancy; and
hypersensitivity.

21.

In IDA , which of the following iron studies is most specific:


a)
Iron levelb)
TIBCc)

Ferritin level

Ferritin is a high molecular weight protein that consists of approximately 20% iron. It is found in
all cells,but especially in hepatocytes and reticuloendothelial cells, where it serves as an iron
reserve.While a lowserum ferritin is widely viewed as the best single laboratory indicator of
iron depletion.

As ferritin is an acute phase reactant, and is increased when an acute or chronic inflammatory
process ispresent.

22.

Treatment of chlamydia:
a)

Doxycycline

A single dose of azithromycin or a week of doxycycline (twice daily) is the most commonly
usedtreatments.

All sex partners should be evaluated, tested, and treated.

23.
Family went to a dinner party after 6 hours they all had symptoms of
abdominal pain, nausea, vomitingand dehydration. Some of them recovered
while others
needed hospitalization. Whats the most likely
organism?
a)
Guardia
b)

Staph aureus
c)
Salmonella

d)
c.perfiringis
e)
c.boyulism

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