1.

A 19-Year-old girl newly diagnosed with type 1 DM, taking aspart and glargine
complaining of both fasting and postprandial hypoglycemia, hbA1c and fasting
glucose are within normal range?
A) Stop both

B) Decrease the dose of both

C) Continue the same

D) Stop glargine and change aspart to sliding scale

2.A patient with a known case of cirrhosis came with increasing ascites without pain
or fever, he is on spironolactone 90mg and furosemide 40mg. What is the next step
in management?
A) Increase the dose of furosemide

B) TIPS

C) Therapeutic paracentesis

D) Albumin replacement

3.A case of ectopic pregnancy on day 1 B-HCG was 1000, day 4>1200, day 7>700
what to do next?
A) reassure

B) consider a second dose of methotrexate

C) follow up with oncology

D) metastasis screening
4) What is the antidote for organophosphate toxicity?
A) Atropine

B) naloxone

C) succinylcholine

5) Child came in the early morning complaining if barking cough and inspiratory
stridor. What is the investigation of choice?
A) bronchoscopy

B) chest radiograph

C) MRI

D) CT

6) Type of isolation for meningitis?

A) droplet

B) contact

C) mixed

D) airborne

7) Patient coming from hajj with signs of meningitis what's the tx?
A) Vancomycin and ceftriaxone
B) Vancomycin & cefotaxime

C) Ceftriaxone and azithromycin

8) Old Female patient with an incisional hernia came to ER with a discharge and
ulcer over a long-standing incarcerated hernia all vitals are normal, what will you
do?
A) dressing

B) laparoscopy

C) MRI

D) Laparotomy of abdomen

9) A child presented with ear pain, on examination: perforated membrane with

purulent discharge: what is the most likely diagnosis?
A) Acute OM

B) Chronic OM

C) OM with effusion

D) Otitis externa

10) A 21-year-old pregnant woman, 8 weeks GA came with bleeding but stable, US
done showed a non-viable fetus and age 5 weeks, appropriate mx?
A) Misoprostol

B) Hysterotomy
C) Hypertonic saline infusion

11) A 7-year-old girl having nausea and vomiting whenever on an airplane flight for
more than 1 hour what to give for prevention?
A) nothing

B) ondansetron

C) granisetron

D) diphenhydramine

12) Child with muscular dystrophy. He is in RDS the parents refuse intubation
because they had a child with the same condition and he died. What to do?
A) Intubate

B) Call ethics

C) Call child rights

D) Do nothing

13) A 38-week gestation with high pressure, low platelet, and protein in the urine
what to do?
A) Emergency delivery

B) Observation

14) A 13-year-old boy medically free presented with neck swelling. One of the
relatives was recently diagnosed with lymphoma and the family is worried about
their child. Which of the following is an indication for lymph node biopsy?
A) Absence of fever

B) Presence of Hepatosplenomegaly

C) Lymph node size > 1cm

15) Child who is 18 months with left Undescended testes not palpable in the
inguinal region, the left one is there what’s the most appropriate to do?
A) Left orchidopexy

B) Diagnostic laparoscopy

C) Wait till 3 years

16) Newborn baby has yellowish discoloration that is not fading for five days.
Previously was diagnosed to have physiological jaundice and so phototherapy was
started, which of the following is the most likely cause?
A) ABO incompatibility

B) Rh incompatibility

C) G6PD deficiency

D) Biliary atresia

17) Which of the following is the most common congenital heart disease presented
with cyanosis in neonates?
A) Coarctation of the aorta

B) PDA
C) TOF

D) TGA

E) ASD

18) An old male patient was admitted with a case of large intestinal obstruction. He
underwent rigid sigmoidoscopy that showed a mass in the sigmoid region. A biopsy
was taken and came back as Adenocarcinoma. What is the best next step?
A ) Colonoscopy

B ) CT abdomen

C) MRI of the pelvis

D) Sigmoidectomy

19) Primigravid comes with labor for 4h Dilated 5 cm, effaced 80%, station +1 after
5h there is no change in the cervix, and contraction occurs every 3 min. and stays
for 60 sec. What to do?
A) Instrument use

B) C/S

C) IV oxytocin

D) Wait for 2h

20) A woman was bathing her child and noticed a mass in his flank, which of the
following investigation is most appropriate?
A) Abdominal radiography (XRAY)
B) Abdominal CT

C) Abdominal MRI

D) Abdominal radiography and ultrasonography

I'll be happy to help you with these questions. Here are the answers:
1. Hypoglycemia in a Type 1 DM Patient
The correct answer is B) Decrease the dose of both. Since the patient is
experiencing both fasting and postprandial hypoglycemia, and her HbA1c and
fasting glucose are within normal range, decreasing the dose of both aspart and
glargine is the most appropriate step.
2. Management of Ascites in Cirrhosis
The correct answer is C) Therapeutic paracentesis. The patient has increasing
ascites without pain or fever, and is already on maximum doses of spironolactone
and furosemide. Therapeutic paracentesis is the next step in management.
3. Ectopic Pregnancy Management
The correct answer is B) Consider a second dose of methotrexate. The patient's β-
hCG levels are not decreasing as expected, indicating that the ectopic pregnancy
may not be responding to the initial dose of methotrexate.
4. Antidote for Organophosphate Toxicity
The correct answer is A) Atropine. Atropine is the antidote for organophosphate
toxicity.
5. Investigation of Choice for Croup
The correct answer is A) Bronchoscopy. The child's symptoms of barking cough and
inspiratory stridor are consistent with croup. Bronchoscopy is the investigation of
choice to confirm the diagnosis.
6. Type of Isolation for Meningitis
The correct answer is A) Droplet. Droplet isolation is recommended for patients with
meningitis.
7. Treatment for Meningitis in a Patient from Hajj
The correct answer is A) Vancomycin and ceftriaxone. This combination of
antibiotics is recommended for the treatment of meningitis, particularly in patients
who have recently traveled to high-risk areas such as Hajj.
8. Management of an Incarcerated Hernia
The correct answer is D) Laparotomy of abdomen. The patient has a long-standing
incarcerated hernia with discharge and ulceration, indicating a high risk of
complications. Laparotomy is the most appropriate management option.
9. Diagnosis of Ear Pain and Discharge
The correct answer is A) Acute OM. The patient's symptoms of ear pain, perforated
membrane, and purulent discharge are consistent with acute otitis media (OM).
10. Management of a Non-Viable Fetus
The correct answer is A) Misoprostol. Misoprostol is a medication that can be used to
manage a non-viable fetus.
11. Prevention of Motion Sickness
The correct answer is B) Ondansetron. Ondansetron is an antiemetic medication
that can be used to prevent motion sickness.
12. Management of a Child with Muscular Dystrophy in RDS
The correct answer is B) Call ethics. The parents' refusal of intubation for their child
with muscular dystrophy in respiratory distress syndrome (RDS) raises ethical
concerns. Calling the ethics committee is the most appropriate step.
13. Management of Preeclampsia
The correct answer is A) Emergency delivery. The patient has high blood pressure,
low platelet count, and protein in the urine, indicating severe preeclampsia.
Emergency delivery is the most appropriate management option.
14. Indication for Lymph Node Biopsy
The correct answer is C) Lymph node size > 1cm. A lymph node size greater than
1cm is an indication for lymph node biopsy.
15. Management of an Undescended Testis
The correct answer is B) Diagnostic laparoscopy. The child has a non-palpable
undescended testis, and diagnostic laparoscopy is the most appropriate next step to
determine the location and viability of the testis.
16. Cause of Persistent Jaundice in a Newborn
The correct answer is D) Biliary atresia. The newborn's jaundice has not faded for
five days, and phototherapy has been started. Biliary atresia is a possible cause of
persistent jaundice in newborns.
17. Most Common Congenital Heart Disease with Cyanosis
The correct answer is C) TOF (Tetralogy of Fallot). TOF is the most common
congenital heart disease that presents with cyanosis in neonates.
18. Next Step in Management of Colorectal Cancer
The correct answer is B) CT abdomen. After a diagnosis of adenocarcinoma of the
sigmoid colon, a CT scan of the abdomen is necessary to stage the cancer and plan
further management.
19. Management of Labor Arrest
The correct answer is C) IV oxytocin. The patient has been in labor for 9 hours
Meta AI has reached its word limit for this prompt. To continue, try a more specific
prompt.
1. Which antibiotic is most effective against Staphylococcus aureus infections?

Ciprofloxacin
Penicillin
Vancomycin
Tetracycline
2. What is the first-line treatment for hypertension?

Beta-blockers
Calcium channel blockers
Angiotensin-converting enzyme (ACE) inhibitors
Diuretics
3. A patient presents with symptoms of fever, cough, and shortness of breath. The
chest X-ray reveals consolidation in multiple lung lobes. What is the most likely
diagnosis?

a) Pneumonia caused by Streptococcus pneumoniae

1 IAshmatic patient he take inhaler beclometasone..present symptoms in night once

a weekwhat do u add for treatment:
A salmeterol
B salbutamol
C budesonide...
Old patient with left hemiplgia in ct there is high intake by T 2 in the right
hemisphere. .
what ofthese conditions worsen this situation:
A blood fasting g < 6.5B
temperature body < 37C
blood pressure < 140...

Q Pregnant 10 weeks with hypertension and diabetis mellitus . she is on insulin but
notcontrolled
.O/E Bp : 150/95 FBS: 190 Urine +3Managment:
1. ACEi
2. 2.hemodialysis
3. 3.Pregnancy termination
4. IV Mg sulphates Answer:
Pregnancy terminationExplanation: This lady may go into eclampsia if pregnancy
not terminated on time. We coulduse Mg sulphates but if the patient was in
eclampsia
Q
1
.
Pregnant 10 we
e
ks with hypertension and diabetis mellitus
. she is
on insulin but notcontrolled
.O/E
Bp
: 150/95
F
BS: 190
Urine +3Managment:
1.
ACEi
2.
hemodialysis
3.
Pregnancy termination
4. IV Mg sulphates Answer: Pregnancy terminationExplanation: This lady may go
into eclampsia if pregnancy not terminated on time. We coulduse Mg sulphates but
if the patient was in eclampsia.
Q
2
-

Most accurate test to diagnose diabetic nephropathy:

1.
US
2.
urine microalbuminemia
3.
Urine dipstick albumin
4. Urea-creatinine

Q
3
- A thin patient complaining of cough, wheezes and has upper chest patchy
opacities ,helives in over crowded town.whatshould be done for prophylaxsis to
he contacts:1.Himopalus influenza b (Hib)2.Meningococcal vaccine3.Brucella4.Bacill
us calmate-guerin

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Q
5
- Drug used in rapid relief of anxiety (panic anixiety):1.Benodiazibine2.SSRI3.
Barbiturate4. Busbiron
Q
4
-

years old

Child
with
leukemia and she is on chemotherapy ,came with fever
,
apathyand sever
ely
dehydrated
. Labs showed:
Na
: 140
K
: 3.6
Plaltlet count 47,000Managment:
1.
Lumbar puncture
2.
Refer to oncology
3.
I
V
ceftriaxone
4
.
Platlet transfusion
Answer: IV ceftriaxone
Explanation:
This child probably has gone into septicemia (DIC),that is comm withAML3,
Promyelocytic leukemia so must be treated with IV Antibiotics. Platelets tr
ansfusion is notwarranted
as patient is not bleeding actively.So mere platelets transfusion will not re
lieve her fever
andsepticemia.At this amount of platelets as bleeding and subdural spinal
hematoma is a chanceSo i would not prefer Lumbar Puncture(LP).
Answer: Benodiazibine
Q
6
-Female patient wear glass since 10 years ,she diagnosed recently type 2DM,shesho
uld screen for examination of her eyes :a) 6 monthsb) 12 monthsc) 2 yearsd) 5
years
Answer: Every year

Q
7
-patient w
ith
cough and h
e
moptysis and ha
s some joints
arthritis
.
 Renal function(urea -creatinine)
are
increased
.
This condition is due to:
1.
Allergy.
2.
Inflammatory
3.
Auto immune
Answer: Auto immuneExplanation: This is a case of Good
Pasture syndrome

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Q
9
-Anti TB drug causing hearing loss and
tennitis:1.Ethambutol2.Pyrizanamide3.Streptomycin4.ISoniazide
Q
10
-
What is the initial management for a middle age patient newly diagnosed knee
Q1
2
-picture of hand.Asking what is the appropiate procedure(warts)1.Tobical ab 2.Oral
ab3.Steroid4.Cryosurgery
Q
8
-DVT most cause is:1.Recent Knee surgery2.Airplaine fly 4 hours3.Maternal history
of DVT4.Previous history of DVT
Answer: Recent Knee surgery

Answer: Streptomycin
osteoarthritis.a) Intra-articular corticosteroid.b) Reduce weightc) Exercise.d)
Strengthening of quadriceps muscle.
Answer: Reduce weight

Q
11
-Newborn came with red-lump on left shoulder, increase in size:
1.
Cavernous

Hemangioma
2.
Milia
3.
Port wine
Answer: Cavernous Hemangioma
Answer: Cryosrgery
Q
13
- 8 year old boy weight and hight above 95th centile.His BMI is 30what to
do:1.surgery2.medication3.observation for 12 month4.life style modification
Answer: life style modificationExplanation: This child is obese and it will
improve with life style modification.
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Q
14-
A
nti TB D
rug
caus
ing
vertigo
:
Sterptomycin is the answer.

Q
1
5
-diabetic patient c
o
mplain
ing
of leg ulcer
,
he started antibiotic but no improvment
.T
hepulse
s are present.Treatment:1.
Surgical de
b
ridment
2.
Ambutation
3.
Hyper baric
O2
Answer: Surgical debridment
Explanation: Necrotic debris should be removed to augment the healing
and controlinfection along with better glycemic control.

Q
1
6
-T
reatment
of anxiety disorder
:1.
Alprazolam
2.
Flufenazine
3.
Haloperidol
Answer: AlprazolamTip: Alprazolam is a short acting benzodiazepine
used in Anxiety disorder.
Q
17
-45 years old patient complaining of pain related to meals with some relieve of pain
after taking antiacids.O/E there is gastric mass 3 cm palpable in the epigastrium.H-
Pylori is -ve.All otherexamination normal.What is your diagnosis:1.Gastric
ulcer2.Gastric cancer3.Lymphoma
Answer: Gastric cancer Explanation: When there is mass palpable its
always Ca stomach untill unless proven otherwise.Tip: I have seen another
question like this but they wanted investigation.The answerfor that is
Endoscop
Q18-patient treated for bipolardisorder, he is on LITHIUM what is not
important:1.Thyroid function2.Liver function3.Pregnancy test4.Renal function
Answer: Liver function

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Q
19
-old patient w
ith
left tender iliac fossa
,
abdominal rigidity
.Diagnosis:

1.
Acute diverticulitis
2.
Appendicitis
3.UC4.Ca colon
Answer: Acute diverticulitisTip: Acute diverticulitis is very common in old
age and it is usually presented inleft illiac fossa. UC would rather present
in middle or young age.

Q2
0
-common cold
.
what

is the common organism:

1.
Rhinovirus
2.
C
or
navirus
3.
Respiratory syncityal virus
Answer: Rhinovirus
Q2
1
-why should influnza vac
cine be
taken
annually:

1.
Because of virus resistance
2.
Due to antigenic drift
Answer: Due to antigenic drift
Q2
2
-pregnant multiprous 41weeks and 2 days of gestation.the cervicx dilated 2cm,the
fetusis mid anterio posterio.Station-2,effacement 50%.How to manage: 1.Oxytocin
2.Rupture ofthe membranes 3.Cervical ripinig agent 4.Insert a catheter
Answer: Oxytocin
Q2
3
-patient complain
ing
of sensory neural hearing loss , vertigo, tinnitus and vomiting
Diagnosis:1.Menier's disease2.Otosclerosis3.Otitis media4.Bengin postional vertigo
Answer: Menier's disease
Q2
4
-A case of painful vesicles. Treatment :1.Antibiotic2.Antiviral agent3.Immunoglobulin
Answer: Antiviral agen
t
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Q2
5
-female patient BMI 16 ha
s
fine hair a
l
l

over the body

and has
amenorrea and refuse toeat
:Diagnosis:

1.
 Anor
e
xia nervousa
2.
Bul
li
mia
3.
Body dismorphic disorder
Answer: Anorexia nervousa

Q
26
-HBA1c in diabetic should be:1.82.63.74.4
Answer: 6Explanation: The goal is to keep HBA1c less than 6.5
Q
2
7-Asymptomatic patient and said he is an IVdrug abuser.what is important
to investigate:1.Staph Aureus2.HIV3.Viral HB4.HCV
Answer: HIVExplanation: Most of the people here too make mistake of
clicking HCV but HIV is more important than HCV as HIV will spread like
that and there is no treatment.HCV has a treatment. IV drug abusers are
mostly HIV postive.Tip: It is a Public hazard.
Q
28
- A patient complaining of red eye,photophopia,cilliary injection Cloudy anterior
chamber:Diangosis:1.Uveitis2.Corneal ulcer 3.Viral conjunctivitis4.Glaucoma
Answer: UveitisTip: Dont be confuse here with Glaucoma. Cilliary
injection is the clue to diagnosis ofUveitis

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Q
29
-pt complain
ing
of epilepsy and facial twitches on taping the facial areaParathormone level

8 (high)Calcium :low
Creatinine: High
Diagnosis:
1.
Digeorge syndrome
2.
Pseudohypoparathyrodism
3.CRF4.Osteoporosis
Answer: PseudohypoparathyrodismExplanation: Most people are confused
that it is CRF but in CRF seum calcium isusually normal.although initially
serum calcium is low. Secondly Epilepsy is theclue to diagnosis as
Pseudohypoparathyroidism is associated with certaindisorders involving
the brain and there is resistance to TSH and patients areusually
Hypothyroid not responding to Thyroxine. Creatinine may be high.
Thereare many types and the most common is Type1,also called Albright
renalOsteodystrophy. Probably this is this one.This is the most repeated
Question in DHA. I was having the same question in mypaper which i will
upload soon.
Q
30
-Pt Known BPH stable on medications(prazocin). on examination prostate was
smooth with no nodularity, He asked for PSA screening.what will you till him:a.No
need for PSA.b. order other advanced Investigations (biopsy)
Answer: No need for PSA.Explanation: Soomth surface and no nodularity
clinically excludes Ca prostate sono need for PSA as false postive reports
are there and it will cost and then willmake patient anxiety.
Q3
1
-54 years old patient ,farmer,coming complaining of dry eye,he is smoker for 20
yearsand smokes 2 packs/ day.your recommendation advise him:a-exerciseb-stop
smokingc-wear sunscreen
Answer: stop smoking

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Q
35
-
pt has a

problem in delivering speech in the work,but other wise he is good

in
working

Q3
2
-clinical picture of fever
,
sore throat and enlarged spleen &

liver EBV +ve:

Diagnosis:
Answer: It is Infectious Mononucleosis

Q
33
-pt hypertensive and diabetic he is on hydrochlorothizize ,but not controlled
Treatment:1.
Double the dose of hydrochlorothizide
2.
Add BB
3.Add
ACE
i
Answer: Add ACEiExplanation: Best drug in DM type 1. RENAAL
studies.Tip: For type 2 DM the best drug is ARB
Q
34
-pregnant came with fever and gum bleeding, O/E spleen is palpable 5 cm below
leftcostal margin, uterus is palpable at the symphsis pubis, platelets count
50,000. Diagnosis:a- Gestational thrombocytopeniab- HEELP syndromec- Idiopathic
thrombocytopenic purpura
Answer: ITPExplanation: Another culprit for making mistake in this Q. I
have seen mostly they think that splenomegaly is not the feature of ITP.
But remember splenomegaly also doesntexclude ITP.HEELP syndrome is
characterized by Hemolytic anemia,Elevated liverenzymes and Low
platelets. Here no such things available to establish a
diagnosis.Gestational Thrombocytopenia is a possibilty but that does not
present with fever andsplenomegaly.Tip: ITP is aggravated by
infection like in this case Fever is a clue to infection. ITP isalso fales upin
Pregnancy.
in his job: Diagnosis:1.Specific Phobia2.GAD3.Depression4.Social
Phobia5.Performance anxiety
Answer: Performance anxiety

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Q
36
-
P
t with HTN presented with edema, azotemia,GFR: 44,what is the cause of her Kidney
diseae:a) bilateral renal artery stenosisb) diabetic nephropathyc) Reflux
Uropathy
d) Renal tubular acidosis
Answer: bilateral renal artery stenosis

Q37
-female patient complain
ing

of
frequency and urgency
.
Investigation
s
show few WBS
on urinalysis
and no bacteria diagnosis:
1.
Interstitial cystitis
2.
Symptomatic bacturia
3.
Pylonephritis
Answer: Interstitial cystitis
Q
38
-pt complaining of double vision.Which nerve is invloved:1.3rd nerve2.4th
nerve3.6th nerve4.2nd nerve
Answer: 3rd nerveExplanation: Dipopia is caused by 3rd nerve damage

Q
39
-
A
sthmatic patient .FEV
1
:85%What you expect after add short acting B
eta Agonists:1.
FEV
1
decrease
s

2.
FEV
1
increase
s
to 95%
3.
No change
Answer: FEV1 increases to 95%Tip: It may not increase up to 95 % but it
will increase so.

Q
40
-picture of lesion (red margin) w
ith
central clearing
and
flu like symptoms
.Diagnosis:1.
Teania corporis
2.
Lyme disease
3. Urticaria4. HSP
Answer: Lyme disease

Explanation: It is typical of Erythema migran of Lyme disease caused by

tick ofIxodes.Organism is Borrelia burgdorferi .Usually in camping
and hiking.

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Q4
1
-What is the most true statement about the benefit of excersice
;1.
continuous steady excersice increase Basal metabolic rate
2.
Excersice decrease HDL
3.
Truncal obesity resistant to excersice
Answer: continuous steady excersice increase Basal metabolic
rateExplanation: Exercise does not decrease HDL rather it increases
HDL.Tip: HDL is a good Cholesterole. Always respect HDL.
Q4
2
-
A
man with 2nd and 1st degree burn over his face and neck
Treatment:1.
wash
,
cover all burns with Silver sulfadiazine
,
cover with sterile gauze
2.
give IV

fluid, antibiotic and tetanus toxoid and discharge home with daily dressing
3.
cover burn with Silver sulfadiazine, sterile gauze, oral fluid, and discharge home
4.
Silver sulfadiazine, sterile gauze, IV fluid and admit to hospital
Answer: cover burn with Silver sulfadiazine, sterile gauze, oral fluid, and
dischargehome
Q4
3
-Celiac disease which
does not cause it:
a) Rice & cornb) Oatc) whee
t
d) Gluten
Answer: Rice & corn
Q
44
: sub dermal implantable contraception: a- It has low compliance compared to
OCP b- More side effect c- No local reactiond-it is associated with thrombotic
tendency more than OCP
Answer: it is associated with thrombotic tendency more than OCP

Q
45
-hypertensive pt using sildenafil , in his case it is contraindication to take :a.CCBb.B
blockerc.Nitrated.Diuretics
Answer: Nitrate
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