Jordan University Hospital

Residency entrance exam 2016

April 4, 2016.

Pediatrics:
1.
2.
3.
4.

Not a component of ToF > ASD

Correct about Milestones > draw circle at 3 years
All are manifestations of acute kidney injury except > Anemia
All are correct x-ray findings of CHD except:
- Transposition of great arteries >> wide mediastinum**
- TOF >> boot shape heart
- Large VSD >> cardiomegaly
5. Most specific urine analysis finding of Glomerular disease RBC casts
6. Hypotnoia + decreased reflexes + tongue fasciculation > spinal
muscular dystrophy
7. Incorrect about Migraine EEG usually used for diagnosis
8. Correct about Rota virus live attenuated vaccine
9. Incorrect about Kawasaki criteria subcutaneous nodule
10.
Must be present in HSP Rash
11.
In premature babies, at what age you stop correction of
milestones 24 months
12.
Not a symptom of DKA >> Diarrhea
13.
Vit A deff causes Night blindness
14.
Not in Organophosphate poisoning Dry mouth
15.
Not a cause for prolonged physiological Jaundice
- Formula milk**
- Prematurity
- Polycythemia
- Low calories intake
16.
Wrong about Human Milk vs Formula milk>> lesser amount of
Carbs.
17.
Solid tumor, most common cause of mets to bone, bone morrow
Neuroblastoma
18.
Needs further evaluation white pupillary reflex
19.
Typical case of asthma asking for diagnosis
20.
C/I to do Gastric lavage >
- sharp object ingestion
- obtunded patient
21.
Not a cause for Life long Hypothyroid>
- thyroid dysgenesis
-TSH receptor deficiency

22.
23.
24.
25.

Maternal antithyroid drug

maternal antibodies
Reflex that persist through the whole life > parachute reflex
common variable immunodeficiency :
early childhood
low IgG
low B cells**
low C3,C4
IVIG is rarely useful
..
..

OBGYN:
1. Pregnant woman 37 GA, C/O abdominal pain, suspected appendicitis,
after opening her abdomen appendix not inflamed, what to do >
- Appendectomy + CS
- appendectomy alone
2. 58 postmenopausal woman diagnosed with ovarian cyst, what's you
management >
-Tumor marker then manage accordingly
3. woman with ovarian cyst, salpingo-oopherectomy done, found to be
poorly-differantiated teratoma, what's your management >
4. Antibiotic absolutely contraindicated during pregnancy>
- Doxycycline
- Trimethoprim_sulfamethaxazole
5. Valvular CA, What to pay attention before removal?
- Size of primary tumor
- Type of primary tumor
- site of primary tumor
- the condition of the surrounding area
- marital status
6. Incorrect about Semen Analysis results>
- 20 million motile sperm
7. Pt with soft cervix, anterior, 75% effacement, -1 station. Whats the
next step
- IOL
- ARM then observe
- ARM+IOL
- C/S
- Amniotomy + oxytocin in saline
8. Not true about OCP mechanism of action
- sterile inflammatory reaction in the uterus

9. Signs and symptoms of Pulmonary Embolism in pregnant lady, what is

the most important thing to do before going to surgery?
- pulmonary angiography
- ABGs
- multiple X ray's
- Doppler u/s
- V/Q scan
10.
Most common cause of Jaundice in pregnancy
-Malignancy
-Acute viral hepatitis**
-Cholestasis of pregnancy
11.
frothy greyish vaginal discharge with bad odor , is caused by
which organism :
-candida albicans
-candida tropicals
-gardenella vaginalis
- Trichomonas vaginalis
-chlamydia
12.
Most common presentation of uterine polyp
- Intermenstrual bleeding
- Irregular menses
- Heavy menses
13.
Non-reactive CTG, what to do next?
- Reassure, repeat CTG later in the day
- Walk for 1 hour
- Give orange juice then repeat
- Give her IV dextrose
- Do contraction stress test
14.
Major risk of external cephalic version When done in the
appropriate time is >
- Abruptio placenta
- cord compression
- change the type of breach
15.
not in the criteria for class 2 Abruptio placenta >
- fetal distress
16.
when to start investigating 1ry Amenorrhea with +ve 2ry sexual
char. >
- 16 y/o**
- 12 y/o
- 18 y/o
- 20 y/o
17.
period of organogenesis from LMP >
- day 30-60
- day 21-60

18.
22 y/o female came with midcyclic dull lower abdominal pain
found to have 5X5 bilocular ovarian cyst, what to do >
- give analgesics and follow-up
- laprascopy and aspirate the cyst
19.
Which of the following factors is most preventable/ modifiable
risk factor to decrease still birth
1-multiple gestation
2- old age
3- Pregnancy-induced HTN
4- post term> 42 weeks
5- Maternal overweight and obesity
20.
Correct about ELISA for HIV >
- detects antibodies for HIV **
- detects capsule component of the virus
21.
What dont ensure lung maturity of fetus
- L:s ratio of 2:1
- Phosphatidyl glycerol
- Fetal heart activity by us at age of 30 wk
22.
Do not increase at time of delivery?
- Prostaglandin dehyrogenase
- Estrogen
- Interlukins
- Basal cortisol
23.
1 or 2 Questions about ethics

Internal Medicine
1. Female Individual with A-Antigen and B-Antibody, Blood Group is > A
2. Which coagulation factor is deficient in stored blood >
- factor 8
- factor 11
3. fever for 3 weeks, blood culture showed MRSA, what's your INITIAL
management>
- echocardiogram
4. most specific test to differentiate AKI from CKD >
- large kidney on u/s
5. One of the PFT measures is higher in asthma than COPD >
- DLCO
6. Metabolic syndrome not in the critiria >
- LDL>160

7. 1 hour hx of retrosternal chest pain, ST elevation in 2,3, avf leads.

depressed ST in V1-4, PR 55, BP 90/60, what is the diagnosis >
- inferior MI with right side infarction
8. Adult with dry cough, crackles on examination, middle lobe
consolidation, whats not in your empirical treatment >
- Ciprofloxacin**
- Levofloxacine
- cefriaxone
9. Wrong about Ulcerative colitis >
- rarely affects rectum
10.
Diabetic BP goal >
- 130/80 (according to JNC 8)
- 140/90 (according to JNC 9)
11.
All are causes of polyuria except
- AKI
- CKD
- Hypokalemia
- Hypercalcemia
12.
Hypertensive, BP was 160/100 on atenolol 100 once daily,
lisinopril once daily. Amlodipine once daily, HCT 25mg. all are probable
causes of resistant HTN except >
- Nephrotic syndrome
- herbals
- OCPs
13.
Patient with Hemoglobin = 8.2 , MCV = 112 , WBC= 3950 ,
plt=142,000, Blood Film will show > hyper segmented neutrophils
14.
About stroke prevention methods, according to multiple
randomized trials what is the most accurate one:
- aspirin > thrombotic ischemic stroke
- clopidogril > thrombotic ischemic stroke
- carotid endartectomy > stenosis of 80%
- warfarin > A.fib
- warfarin > .....
15.
known case of AFib ....on warferin 3mg/day and digoxin ...came
to ER with nausea , vomiting , anorexia ,pulse=55 next step :
- troponin
- digoxin level
- ECG
- echo
16.
One of the following is associated with increased risk of contrastinduced nephropathy>
- pyelonephritis
- Nephrolithiasis

- hyperparathyroidism
- multiple myeloma

17.
most common cause of death in kidney transplantation :
- operation complication
-atherosclerosis **
-infection
-cancer
-graft rejection
18.
The least to compare between asthma and COPD:
- effect of exercise **
- Cough character
- Symptoms variability
- smoking
- eczema
19.
The most important to differentiate types of acquired community
pneumonia >
- Patient history
- microbiology
20.
wrong about blood transfusion >>
- to decrease complications , blood unit is transfused over 12 hrs
21.
Specific for schizophrenia >
- Auditory Hallucinations
22.
Female with Vocal cord dysfunction how to diagnose?
- Flexible laryngoscopy
23.
DM patient on insulin for 10 years , with retinopathy and
neuropathy and need screening for nephropathy ...all may be found
except :
-nephrotic rang proteinuria
-Microalbuminuria
-hypertension
-RTA type 4
-RBC casts**
24.
One of these conditions is associated with the highest risk of
VTE?
- anti phosphilipid syndrome
- OCP use
- Heterozygous of protein c deficiency
- Heterozygous carrier of factor 5 leiden
25.
All are causes of positive troponin except>
- pulmonary embolism
- pulmonary edema

- septic shock
- chronic renal failure
- uncotrrolled HTN**

General Surgery
1. In examining patients one is false:
- Gowns should be for ALL patients considered blood infected
- hand wash is recommended after each patient
- needles and syringes should be discharged into the sharp container**?
- gloves should be worn during the examination regardless of anything
2. Which is not an indicator for acute pancreatitis severity?
- serum ca
- age
- serum amylase**
- LDH
- WBC
3. Not an indication for thyroid surgery :
-Toxic nodule
-Multinodular goiter
-exophthalmos**?
-Recurrent hyperthyroidism
-Large diffuse goiter
4. About Tumor of head of pancreas, which is wrong:
- Pale stool
- Palpable gall bladder
- Diabetes insipidus**
- back pain
- Weight loss
5. Young male with enlarged lymph node in post. triangle of neck what is the
management :
- antibiotics with observation (right answer)
- FNA
- excisional biopsy
- neck CT scan
6. Multiple fractures + Hypovolemic shock, Whats your initial fluid therapy
>
- Ringers lactate**
- normal saline

- dextrose water
- albumin
7. The most common organism in acute cholecystitis >
- E.Coli**
- enterobacter
- enterococcus
- klebsella
- proteus
8. One of the following is not a clean contaminated surgery>
- thyroid surgery**
-billiary surgery
-cholecystectomy
-gastric surgery
-appendectomy
9. The major cell type in wound healing >
- Fibroblast ?
- Macrophage ?
-lymphocyte
-endothelial
-neutrophill
10. Basal Cell Ca the least commonest site
-Around Eyes
-Around Nose
-Lower lip**
-Cheeks
-scalp
11. Wrong about Anal fissure>
- Rarely posterior
12. About Small intestine malignancy all true except :
- carcinoid of appendex is usually asymptomatic
- Most tumors are malignant
- Carcinoid is always associated with hepatic mets
13. 70 y/o female + painless fresh bleeding per rectum + hypotension
after resuscitation.. Upper endoscopy is normal.. most likely diagnosis:
- Colon Cancer
- Diverticular bleeding **
- Hemorrhoid
- PUD
- Cancer
14. Most important factor in formation of cholestrol stones in gallbladde >
- supersaturation
- nucleation

15. Relative indication for mechanical vs tissue valve >

- Age less than 30**
- women of childbearing age
- patient with bleeding tendency
- elderly patient
16. Regarding acute abdomen, which is wrong?
- intestinal obstruction pain increase with movement**
- elevated B-hcg level of less than 4000 can be associated with ectopic
pregnancy
- midgut pain is periumbilical and vague
- parietal pain favors a surgical treatment
17. which is incorrect for acute abdomen >
- Amylase twice normal indicates pancreatitis
18. one of the following is not associated with Tension Pneumothorax
- hypotension
- deviated trachea
- tachycardia
- tachypnea
- collapsed neck veins**

Finito

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