"Prof/ Rgaee Foda "MCQs" " 62Qs

:Best single answer

All of the following suture materials are non absorbable except-1

A-Silk
B- Chromic
C- Nylon
C- Prolene
E- Mersilene
what is the most common cause or cardiac arrest in infants and -2
: children
A- Congenenital heart disease
.B- Trauma
.C- Acquired heart disease
.D- Intoxication
.E- Hypoxia
: causes of abdominal pain include all of the following except-3
A- Pneumonia
.B- Diabetic ketoacidosis
.C- Acute salpingitis
D- Head trauma
.E- Myocardial infarction
factors that may be associated with the development of acute -4
: pancreatitis include all of the following except
.A- Alcohol
.B- Gallstones
. C- Celiac sprue
.D- Hyperlipidemia
.E- Trauma
:which are of the following plans is the best hospital disaster plan-5
.A- One plan for internal, one plan for external disaster
.B- Plan for physician, plan for administration, plan for nursing…etc
C- Plan that can expand as needed to fit the size of the event simple and
.flexible
.D- Permanent plan than will not be revised

1
E- A detailed complex plan that accounts for every possible emergency
.situation on paper leaving nothing to chance
A 70 years old woman presents to ED with 2 hours of substantial -6
chest pain. She is agitated and has a systolic pressure of 80 m.m Hg
her lung fields are clear . an ECG reveals an acute infero lateral
: myocardial infarction all of the following statements are true except
.A- Intravenous crystalloid be given
.B- Thombolytic may be indicated
.C- The patient is in cardiogenic shock
.D- Primary angioplasty may be performed
.E- Epinephrine should be usd initially to stabilize the B.P
-:Serum amylase is usually raised in the following except -7
.A- Acute pancreatitis , obstruction of pancreatic duct
.B- Perforated peptic ulcer
.C- Mumps
.D- Liver disease
.E- Following morphine or codeine medication
Which of the following conditions is matched with an -8
-: inappropriate therapy
.A- Arterial claudication elevation
.B- Superfical thromboflbitis NSAID s & warn compresses
.C- Deep venous thrombosis Inferior vena cava interruption
.D- Varicose veins Vein sclerotherepy
.E- Arterial embolus Embolectony
With absent distal pulse
-: All of the following are associated with atrial fibrillation except -9
.A- 5-7 times increased risk stroke
.B- thyrtoxicosis
.C- Pulmonary
.D- Aortic stenosis
.E- Rheumatic mitral valve disease
The treatment of an oesophageal burn with a gent may luclude all -10
: of the following EXCEPT
.A- Expeditious administration of antidote
.B- Induction of vomiting
. C- Steroids and antibiotics
.D- Bougienage (oesophoseal)

2
.E- Gastrostmy tube
: The blood supply of the "hind-gut" is derived from -11
.A- Celiac axis
.B- Superior mesenteric artery
.C- Inferior mesenteric artery
.D- Common femoral artery
.E- None of the above
: treatment of paralytic ileus includes all the following EXCEPT -12
.A- Intravenous fluids
.B- Nasogastric suction
.C- Correction of electrolyte imbalance
.D- Cessation of oral intake
.E- Early operation
In patient with gross hematuria, a radiolucent filling defect in the -13
:renal pelvis on intravenous pyelogram may be due to
.A- Nonopaque calculous
.B- Blood clot
.C- Tumor
.D- Extrinsic compression
.E- All of the above
In acute simple small intestinal obstruction which of the -14
:following is not usually present
.A- Pain
.B- Fever
.C- Vomiting
.D- Distension
.E- Constipation
A patient with severe hypovolemic shock will have all of the -15
: following EXCEPT
.A- Loss of more than 40% of blood volume
.B- Base excess
.C- Low urinary output
.D- Low blood pressure
.E- Cool, pale extremities

Acceptable methods of managing haemorrhage in the pre -16

: hospital setting include except

3
.A- Administration of I. V. isotonic crystalloids
B- Removal of penetrating foreign body and immediate application of
.direct pressure
.C- Splinting long bone injuries
.D- Applying direct pressure over the bleeding area
."E- "Scoop and run
Signs and symptoms associated with thyroid storm includes all of -17
: the following except
.A- Fever
.B- Tachycardia
.C- A trial fibrillation
.D- Anxiety
.E- Loss of reflexes
The fully developed picture of traumatic (hypovolmic) shock is -18
: not characterized by which of the following
.A- Oliguria
.B- Peripheal vaso constriction
.C- Increased blood viscosity
.D- Mental dullness
.E- Bradvcardia

: Leading cause of death after multiple blunt trauma is -19

.A- Transaction of cervial spine cord
.B- Haemorrhage from hepato-splenic injury
.C- Thoracic aortic aneurysm
.D- Major intra cranial injury
.E- Hemorrhage from multiple long bones fracture
which of the following findings suggests that shock in an injured -20
?patient may have a cause other than hypovolemia
.A- Hypotension
.B- Distended neck veins
.C- Decreased skin temperature
.D- Diminished pulse pressure
.E- Falling central venous pressure
All of the following statement are true concerning the evaluation -21
: of renal colic except
.A- Costo vertebral angle tendemess may be present

4
 .B- Microscopic haematuria is often
.C- Pain starts in the lion radiates to the groin
.D- Plain x-ray abdomen may be negative
.E- The defentive diagnosis must be made before giving analgesic
In epistaxis, what percentage of the cases will respond to ten -22
?minutes of direct pressure
.A- 10%
.B- 30%
.C- 70%
.D- 90%
.E- 0%
In comatosed diabetic patient, one of the following items suggest -23
: hypoglycaemia rather than keto acidosis
.A- Systemic hypertension
.B- Diminished tendon reflexes
.C- Air hunger
.E- Moist skin and tongue
In the management of diabetic ketoacidosis , one item of the -24
-: following is true
.A- Intracellular water deficit is best restored using half strength saline
B- Potassium should be given before checking the serum potassium
.cencetration
.C- Bicarbonate infusion is not necessary even in severe acidosis
D- 5% dextrose solution should be avoided unless hypoglycemia
.supervenes
E- Peripheral circulatory failure requires rapid volume replacement
.initially
which one of the following statements regarding thoracic aortic -25
?dissection is true
.A-The patient most likely be hypotensive on initial presentation
B- ST segment elevation in the anterior leads is a typical
.electrocardiogram (E.C.G)
C- Patients are likely to describe server chest pain , worsens with
.inspiration and radiates to right Shoulder
D- Radiographic findings include a widened mediastinum with possible
.obliteration of aortic knob
.E- Nitroprusside and dopmine are the therapeutic agents of choice

5
Central venous pressure is usually elevated in the following -26
-:except
.A- Heart failure
.B- Positive end expiratory pressure ventilation
.C- Valsalva manoeuvre
.D- Expansion of blood volume
.E- Non cordiogenic shock
A25 year old man attend E.D complaining of rectal) bleeding he -27
noticed blood in the toilet ofter defecation . on pain on defecation
? what is the most likely diagnosis
.A- Anal fusure
.B- Trombosed external haemorrhoid
.C- Internal haemorrhoid
.D- Bleeding dverticulitis
.E- Rectal prolopse
-: The most common cause of mediastinal haemorrhage -28
.A- Bleeding from tumor
.B- "spontaneous" following server coughing
.C- Dissecting thoracic aneurysm
.D- Anticoagulation therapy
.E- Trauma
:Brain injury alone -29
.A- Frequently causes shock
.B- Causes shock that reversed by very simple measures
.C- Causes shock only if the skull is intact
D- Causes shock in the terminal stages when medullary failure
.supervenes
The level of consciouseness for a head injury patient is BEST -30
: evaluated by
.A- Glasgow coma scale
.B- Response to pain
.C- CT scan
.D- Pupillary responses
.E- Visual evoked potentials
A22-year-old man is admitted after an automobile accident. His -31
respiratory. 25/min with complaint of left chest pain. Blood pressure

6
is 120/95; pulse, 110. Chest x-ray shows left haemmediate treatment
:is
.A- Tube thoracostomy, left
.B- Intercostal block and strapping
.C- Bilateral tube thoracostomy
.D- Pericardiocentesis
.E- Endotracheal intubation, mechanical ventilation, and pleural aspiration
In which of the following situation should the joint be reduced -32
:immediately prior to obtaining radiographic confirmation
.A- Recurrent anterior dislocation of the shoulder
.B- Lateral dislocation of the patella
.C- Posterior dislocation of the hip
.D- Elbow dislocation associated with supracondylar fracture
.E- Ankle dislocation with a cool foot and no palpable foot pulse
which of the following statement regarding fracture reduction is -33
?true
.E- Reduction is required for all displaced fractures
B- Reduction is usually performed using brisk , rapid force applied
.perpendicular to the extremity
C- Reduction should always be preceded and followed by neuro vascular
.examination
D- Reduction does not need to be followed by a post reduction rediograph
if the physician examination demonstrates that the reduction was
. successful
.E - Reduction does not usually require administration of pain medication
which one of the following statements about compartment -34
? syndrome is true
A- Compartment syndromes are serious compilation of orthopedic
.injuries that usually lead to death
B- Diagnosed definitively by measuring the tissue pressure in the
.compartment
C- Frequently occur between elbow and shoulder following supra
.condylar fracture
.D- Can be detected by absence of distal pulse
.E- Treatment is mainly mrdical
-: Abdominal aortic aneurysm is most common misdiagnosed as -35
A- Pancreatitis

7
B- Nephrolithiasis
C- Myocardial infarction
D- Lower back strain
E- Diverticulitis
: All of the following are true statements regarding chest except -36
A- It represents an unstable segment of the normally rigid chest wall that
.moves independenty paradoxically
.B- It is usually caused by major blunt trauma
.C- It is usually associated with pulmonary contusion
D- It can be effectively managed with systemic analgesics, epidural
.anaesthesia and mechanical ventilation
.E- It often requires surgical stabilization
A 82 year old male is brought into . ED ofter being ejected from -37
his motor cycle . on primary survey the patient was profoundly
agitated and has sustained significant mid face injuries the best initial
-: approach to managing this patient is
.E- Placing a naso gastric tube to evaluate the abdominal injury
.B- Protecting air way by blind nasotracheal intubation
.C- Obtaining cervical spine , chest and pelvis films
D- obtaining air way contral through strict in the line immobilization of
.cerical spine and orotracheal intubation
.E- Give low flow oxgen
A 40years old patient has a systolic B.p of 50 mm Hg following a -40
bee sting which one of the following is the best choice for fist
-:treatment of this patient
A- Epinephrine 1:1000 0.5 m1 I.m
B- Diphenhydramine 50mg I.V
C- Methylprednisolone 125mg I.V
.D- Epinephrine 1 : 10000 ml I.V slowy
E- Glucagon 2mg I.V
which of the following is the most common cause of air way -41
-:obstruction
.A- Tracheal – laryngeal fracture
.B- Foreign body
.C- Pooled secretions
.D- Prolanse of the tongue
-:A bout triage all are true except -42

8
A- Defined as sorting of patients based on the for treatment andavailable
.resources to provide that treatment
.B- Is a dynamic process requiring reevaluation & reassessment
.C- Can be colour coded
.E- Two types of triage situations usually exist
Accurate assessement of an isolated penetrating neck wound -43
-:includes evaluation of the following except
.A- Violation of the platysma
.B- Zone of anterior entrance and exit wounds
.C- Anterior & posterior location
. D- Cranial nerves III ,IV , VI
.E- Presence of subcutaneous emphysema
-:Sign and symptoms of airway injury include -44
.A- Stridor
.B- Hoarseness or muffled voice
.C- Dyspnea
.D- Subcutanous emphysema
.E- All of the above
which of the following is an appropriate procedure in the initil -45
management of severe haemorrhage from a penetrating neck
-:wound
.A- clamping bleeding vessels
.B- infusing IV fluids in ipsilateral arm in zone I injuries
.C- Direct pressure
D- Reverse trendlenburg

All of the following are common site for avulsion fractures -46
-:except
.A- Anterior superior iliac spine
B- Coccyx
.C- Anterior iliac spine
.D- Ischial tuberosity
.E- Iliac crest
The clinical presentation of tension pneumothorax include all of -47
-:the following except
A- Servere dyspnea.
B- Hypotension.

9
C- Tachycardia.
D- Unilateral chest pain.
E- Unilateral dullness on percussion.
48- Adverse effects to sublingual nitroglycerine include all of the
following the except :-
.A- Sinus bradycardia
.B- Coronary artery steel
.C- Hypotension
.D- Sinus tachycardia
.E- Headache
-:The first intervention in a patient with a withessed VF arrest is -49
.A- Airway management
.B- CPR
.C- Defibrillation
.D- administration of epinephrine
.E- none of the above
Patient who present with of the following are at increased risk of -50
-:pulmonary embolism except for these
.A- With recent trans / atlantic air plane travel
.B- With malignancies
.C- With recent extremity injury
.D- Using NSAIDS
.E- With protein-s deficiency
Factors that may precipitate a sudden asthma attack include all of -51
-:the following except
.A- Sinus infections
.B- Exposure to cold air
.C- Exercise
.D- Exposure to dust pollen
.E- Over use of inhaled steroids
which type of not an acceptable therapeutic modality for patient -52
-: with pulmonary embolism
.A- Heparin 10.000 u bolus with infusion to follow
.B- Vena cava filter
.C- Ultra sonic clot disruption
.D- Surgery
.E- Thrombolysis

10
? which type of fracture is rarely overlooked on radiograph -53
.A-Tibial plateau fracture
.B- Scaphoid (navicular) fracture
.C- Fifth metatarsal fracture
.D- Non displaced supra condylar fracture
.E- Colle's fracture
?what is the most common cause of urinary retention in men -54
.A- prostate cancer
.B- urethral
.C- Nephrolithiasis
.D- Neurogenic bladder
.E- Benign prostatic hypertrophy
A 2 years old boy presents to E.D . after ingestion of a calculator -55
battery . A chest radiograph demonestrotes that the battery is in the
oesothagus . what would be the most appropriate next course of
? action
.A- Observation
.B- Having the patient drink a glass of milk
.C- I. V. administration of glucagons
.D- Sublingnal administration of nifedipine
.E- Endoscopy (upper GI)
-:All of the following are common of acute appendicitis except -56
.A- Vomiting
.B- Anorexia
.C- Fever
.D- Abdominal pain
.E- Nausea
The typical clinical features of diabetic ketoacidosis include the -57
-:following EXCEPT
.A- A bdominal pain and air hunger
.B- Rapid , weak pulse and hypotension
.C- Skin is dry
.D- Vomiting and constipation
.E- Coma with extensor planter responses
All of the following require urgent neuro-surgical evalution and -58
-: treatment except
.A- Cerebellar infarction

11
.B- Subdural haematoma
.C- Subarachnoid haemorrhage
.D- Embolic strok
.E- Epidural haematoma
: Regarding injuries which of the following is true -59
.A- Injuries result from acute exposure to physical energy
.B- Most injuries are preventable
.C- Injuries may result from exposure to heat caustics and electricity
.D- Injuries present in predictable patterns in the body
.E- All of the above
:All of the following findinges suggest urethral injury EXCEPT -60
.A- Blood at the external urethal meatus
.B- Absence of a palpable prostate on rectal examination
.C- High-riding prostate on rectal examination
.E- Blood in the rectal lumen
specific risk factors predisposing persons to injury include all -61
: except
.A- Old age
.B- Durg and alcohol use
.C- Fatigue
.D- Proper seat blet use
.E- Tendency for violent behaviour
which is the MOST commonly injured intra-abdominal organ in -62
?blunt trauma
.A- Liver
.B- Kidney
.C- Spleen
.D- Stomach
.E- Colon

12
 " Prof. Murad Hassanin: Obstetric emergencies " 16 Qs
Best SINGLE Answer

63.The most common cause of primary post partum haemorrhage is:

a) Cervical lacerations.
b) Vaginal lacerations.
c) Atony of the uterus.
d) Retained placenta.
e) Haemorrhagic blood disease.
64.Complication of the third stage of labor include.
a) Post partum haemorrhage.
b) Retention of the placenta.
c) Inversion of the uterus.
d) Post partum shock.
e) All of the above.
65.Maternal prognosis in abruption placenta becomes more grave
with.
a) Early delivery.
b) Profuse vaginal bleeding.
c) Concealed haemorrhage.
d) Non of the above.
66.Placenta praevia is associated with a higher incidence of post
partum haemorrhage due to.
a) Weak contraction and retraction of the lower uterine segment.
b) Increased liability of the cervix and lower uterine segment to
lacerate.
c) Anaemia resulting from the ante partum haemorrhage.
d) Retained placental fragment.
e) All of the above.
67.Maternal mortality in placenta praevia is due to.
a) Haemorrhage.
b) Infection.
c) Air embolism.
d) Laceration of cervix and lower uterine segment.
e) All of the above.
68.Cause less painless recurrent vaginal bleeding during last
trimester of pregnancy may be due to.

13
 a) Rupture of uterus.
b) Abruption placenta.
c) Placenta praevia.
d) Vasa praevia.
69.The treatment of choice for complete placenta praevia is.
a) Vaginal delivery.
b) Caesarean section.
c) Internal version.
d) Non of the above.
70.The most common cause of ruptured uterus is.
a) Obstructed labor.
b) Obstetric trauma.
c) Previous caesarean section.
d) Occipto posterior.
e) Non of the above.
71.The early symptom of uterine rupture during labor is.
a) Vaginal bleeding.
b) Pain.
c) Cessation of uterine contraction.
d) Shock.
e) Haematuria.
72. A high retraction ring "Bandl's ring" in the uterus is.
a) Not seen or felt abdominally.
b) Not usually pathologic.
c) Associated with rupture uterus.
d) All of the above.
e) Non of the above.
73. Amniotic fluid embolism is often associated with.
a) Shock.
b) Hypofibrinogenaemic.
c) Oxytocic stimulation.
d) All of the above.
74. The commonest cause of hypofibrinogenaemia in pregnancy is.
a) Intra uterine fetal death.
b) Concealed accidental haemorrahge.
c) Amniotic fluid embolism.
d) Septic abortion.

14
 e) Excessive infusion of dextran.
75. Amniotic fluid embolism occurs more often.
a) In multiparous women.
b) In oxitocin stimulation labors.
c) Near end of the first stage of labor.
d) All of the above.
e) Non of the above.
76. The 1st step in the management of eclamsio is.
a) Termination of pregnancy.
b) Correction of haemoconcentration.
c) Sedation.
d) Blood transfusion.
77. The single most effective drug in eclampsia is.
a) Phenobarbital.
b) Magnesium sulphate.
c) Diuretics.
d) Hypotensives.
78. With severe hyper emesis graviderum the following may occur.
a) Sever dehydration.
b) Pulse increase to 110.
c) Temperature rise to 39˚C.
d) All of the above.
e) Non of the above.

)Dr/ Azza Zohdy(

15
Pediatrics Emergencies 13 Qs

79.In resuscitating a collapsed child, which one of the following is

correct?
a) 30 ml/kg of fluid should be given if hypovolaemia is suspected.
b) Treatment of metabolic acidosis would be with 10 mmol/kg of
sodium bicarbonate.
c) Naloxon may be used to stimulate respiration in a child born by
caesarian section under general anesthesia.
d) In a systole, the first dose of adrenaline should be 10 ug/kg.
e) Atropine is frequently used for tachycardia.
80.In kerosene poisoning.
a) The stomach should be emptied by ipecacuana.
b) More common in urban areas.
c) Anaemia is a late complication.
d) Pulmonary complications respond rapidly to antibiotics.
e) Occurs in poor families.
81.A 2 year-old girl is found with an empty aspirin bottle, and few of
the tablets in her mouth. Her mother does not know how many
tablets were in the bottle and brings her to the ER. Action to be taken
is.
a) Reassure and send her home.
b) Admit to ICU.
c) Give liquid paraffin oil.
d) Measure serum salicylate level.
e) Inform the police officer.
82.A 2 year-old boy is seen in the casualty 30 minutes after ingesting
150 ml of amitiryptline syrup. He is fully conscious.
a) An urgent plasma amitriptline estimation is essential.
b) Vomiting should be induced.
c) Cardiac arrhythmias should be anticipated.
d) The pupils are likely to be constricted.
e) He can go home after 2 hours of observation.
82.The following apply to poisoning in children.
a) Lead poisoning is associated with abdominal pain.
b) Steroids may prevent stricture in caustic soda ingestion.
c) Alcohol poisoning needs no specific treatment in children.

16
 d) Tricyclic antidepressants should be treated by forced alkaline
diuresis.
e) Salicylate poisoning present with bradycardia as an early sign.
83.A child is admitted following paraffin oil ingestion.
a) Should be given an emetic.
b) Should have gastric lavage.
c) Is liable to develop pneumonitis.
d) Is liable to develop sever diarrhea.
e) Should be fasted for 24 hours.
84.An infant with high fever in the ER may be treated with.
a) Rectal diazepam.
b) Rectal paracetamol.
c) Oral aspirin.
d) Oral epicac.
e) Hot spong.
85.Treatment of salicylate poisoning include all of the following
except.
a) Encourage high fluid intake.
b) Forced acid diuresis.
c) Vitamin K administration.
d) Gastric lavage.
e) Sodium bicarbonate.
86.A 3 year-old presented to the ER in coma after history of 2days
with abdominal pain.
Hb 14 g/dl.
WCC 17000/mm.
Blood glucose 25 mmol/l.
Sodium 150 mmol/l.
Potassium 3.7 mmol/l.
a) The surgeon must consulted to role out acute abdominal
condition.
b) Bedside urine analysis alone should make the diagnosis.
c) D 5 + 0.2 normal saline should be infused immediately.
d) Injecting the proper drug subcutaneously will immediately
reverse the coma.
e) Subcutaneous injection following the sliding scale method should
be started immediately.

17
87.In a 7 year-old girl with diabetic ketoacidosis.
a) Boluses of sodium bicarbonate are frequently necessary to correct
metabolic acidosis.
b) Nasogastric tube insertion should be avoided.
c) A bolus of 4 units/kg actrapid should be given iv.
d) The estimated fluid replacement should be replaced over 24
hours.
e) Hypokalemia may occur in the acute phase.
88.In paediatric resuscitation.
a) The first shock from defibrillator should be set at 5 joules/kg.
b) A cardiac arrest in children is precipitated by respiratory problem.
c) The correct dose of atropine is 0.1 mg/kg.
d) In an 8 kg infant the first dose of adrenalin is 0.8 mg.
e) 1 mmol/kg sodium bicarbonate is routinely administered during
arrest.
89.A one year-old boy presented to ER with severe diarrhea and
shock. His weight is 10 kg. His estimated deficit fluid is.
a) 1000 ml.
b) 800 ml.
c) 1200 ml.
d) 2000 ml.
e) 500 ml.
90.A child with a serum K of 8 mmol/l and ECG changes may be with
all of the following except.
a) Glucose insulin infusion.
b) Sodium bicarbonate infusion.
c) Calcium gluconate.
d) Kayexalate.
e) Lidocain.

"Dr. Nivien Khattab "15 Qs

18
 Cardio Pulmonary resuscitation
)CPR(

:Choose the best answer

91.To open the airway of a victim with suspected neck fracture,
the rescuer should.
a. Perform the jaw thrust maneuver.
b. Perform a tracheostomy.
c. Not do anything until a physician arrives.
d. Tilt the neck backwards.
92.In the victim of Cardiac Arrest, the most reliable indicator of
effective rescue breathing is.
a. The patient color changes.
b. The victim's chest rises and falls.
c. When the rescuer ventilates, air enters easily.
d. The victim's pupils constrict.
93.When establishing unresponsiveness in an infant the rescuer
should.
a. Gently blow into the infant's ear.
b. Pick up the infant by the ankles and gently shake.
c. Gently tap or shake the infant.
d. Deliver a chest thrust.
94.Why is it dangerous to leave an unconscious victim lying on
his/her back with a pillow under the head?
a. It may be difficult for blood to get to the brain.
b. It may be difficult to tell when the victim regains consciousness.
c. It may cause the tongue to obstruct the airway.
d. It may cause serious neck damage.
95.In order to determine if an obstructed airway situation exists
in a conscious victim, the rescuer should.
a. Ask the victim "can you speak?".
b. Shake the victim.
c. Deliver back blows.
d. Perform manual thrusts.
96.If breathing does not seem to be present after you have
opened the airway.
a. Measure the blood pressure.

19
 b. Give blow to back.
c. Check pupils.
d. Attempt mouth –to- mouth ventilation.
97.CPR may be discontinued.
a. When the rescuer suspects that ribs are fractured.
b. When the victim has a neck fracture.
c. When another non-physician rescuer agrees that the patient is
dead.
d. When the victim's pulse and respiration are restored.
98.When a cardiac arrest occurs CPR should be initiated by.
a. Any trained individual present.
b. Physicians only.
c. Paramedics and physicians only.
d. Paramedics, nurses and physicians only.
99. To determine whether or not an adult victim has a pulse, the
rescuer should palpate the pulse.
a. At the carotid artery in the neck.
b. At the femoral artery in the groin.
c. At the brachial artery in the arm.
d. At the radial artery in the wrist.
100. To perform chest compressions on an adult, one hand is
placed on the top of the other with the heel of lower hand
pressing.
a. On the centre of the chest.
b. On the back.
c. On the left ribs.
d. On the xiphoid process.
101. The principal method used for opening the airway in most
cases is.
a. Head tilt, with chin lift.
b. Turning the head to one side.
c. Striking the victim on the back.
d. Wiping out the mouth and throat.
102. The rescuer should palpate the infant's pulse by.
a. Feeling for the carotid pulse in the neck.
b. Feeling for the brachial pulse in the arm.
c. Feeling for the radial pulse in the wrist.

20
 d. Feeling for the femoral pulse in the groin.

103.According to the new guidelines, the decision to start CPR is

made if the adult victim is unresponsiveness and not breathing
normally.

(a) True. (b) False.

104. Do not delay defibrillation for in-hospital adult cardiac

arrest.

(a) True. (b) False.

105. A child with a witnessed, sudden collapse and the rescuer is

alone.

== The cardiac arrest is likely to be arrhythmogenic in

origin.

(a) True. (b) False.

== Perform 2 min. CPR before calling for help.

(a) True. (b) False.

Prof. Mamdouh Zaki

"Orthopedic 2006 "14 Qs

21
Best Single Answer MCQ
106.The serum calcium concentration is carefully controlled to:
A. Preserve membrane potentials
B. Prevent concentration of calcium and phosphorus from
exceeding the solubility product
C. Prevent renal stone formation
D. Both B and C
E. Both A and B
107.The most active form of vitamin D is:
F. 25-hydroxy-vitamin D
G. 1, 25-hydroxy-vitamin D
H. 24, 25-hydroxy-vitamin D
I. 1, 25-hydroxy-vitamin D
108.The relatively safe, maximum normothermic (20-25c) ischemia
time for a completely amputated extremity is:
a. 2 hours
b. 4 hours
c. 6 hours
d. 12 hours
e. 18 hours
109.A lesion of the posterior cord of the brachial plexus affects the
muscles supplied by:
A. Musculocutaneous and long thoracic nerve
B. Sub-scapular, thorocodorsal, axillary and radial nerves
C. Anterior thoracic and ulnar nerve
D. Median, brachial cutaneous and anterior thoracic nerves
E. Median and ulnar nerve
110.All of the following are important factors influencing the success
of the surgical repair of peripheral nerves except:
A. Type of nerve
B. Level of injury
C. Length of defect
D. Sex of patient
E. Age of patient
111.The most appropriate early treatment of frostbite of the hand is:

22
 A. Slow re-warming at room temperature
B. Hyperbaric oxygen
C. Low molecular weight dextran and re-warming at room temp.
D. Rapid re-warming at 40-42 degrees C
E. Rapid re-warming at 35 degrees C
112.The typical fracture resulting from indirect force applied to the
patella is:
A. Transverse
B. Vertical
C. Un-displaced
D. Oblique
113.Stress fracture in the fore foot most commonly involves:
A. First metatarsal
B. Second metatarsal
C. Base of the fifth metatarsal
D. Proximal phalanx of second toe
114.The basic musculoskeletal concern in the maintenance of
function following stroke is:
A. To prevent loss of joint mobility
B. To limit activity until muscular control is regained
C. To begin electrical stimulation of muscles early
D. To prevent pathological fractures
115. The type of peripheral nerve injury that is characterized by a
physiological interruption of nerve conduction causing a transient
incomplete or complete paralysis is referred to as:
A. Neurapraxia
B. Axonal degeneration
C. Neurotmesis
D. Axonotemesis
E. Wallerian degeneration
116. Intertrochanteric fractures of the femur in elderly patients are
best managed by:
A. Skeletal traction with balanced suspension
B. Transcutaneouspin fixation
C. Prosthetic femoral head replacement
D. Closed or open reduction and internal fixation’
E. Total hip replacement

23
 117.The earliest sign of acute Volkmann’s ischemic contracture
after supracondylar fracture lower end humerus is:
A. Absence of the radial pulse
B. Pain on passive extension of the fingers
C. The loss of voluntary finger motion
D. Absent sensation in the median nerve distribution
E. Pallor of the nail beds
118.A 17-year-old boy sustained an injury while tackling during
football game, Swelling and tenderness, as well as palpable step,
were noted over the right acromoclavicular joint and x-ray revealed
a subluxation of the joint the needed treatment consist of:
A. A figure of eight bandage
B. A sling supporting the affected arm
C. Supine bed rest and small sandbag
D. Open reduction and fixation
E. Excision of the distal end of the clavicle
119.A patient presented to the emergency department with a near
complete amputation of his left lower extremity. The initial
intervention for him is:
A. Apply a tourniquet to stop bleeding
B. Apply direct pressure to control the bleeding
C. Clamp off any obvious bleeding vessels
D. Assess the distal extremity for any pulses
E. Assess the patient’s airway and breathing

Prof/ Mamdouh Zaki

"Qs 28" 2005

24
For the following question, choose only one “the best correct”
:answer

120.Which of the following considered the 1ry cause of pathological

fracture:
A. Indirect trauma
B. Direct trauma
C. Bone softening
D. Muscle pull
E. Activity with stress
121.Which is correct as regarding fracture reduction:
F. Required for any degree of displacement in fracture shaft
humerus.
G. Done using a brisk, rapid force applied perpendicular to the
extremity.
H. Always proceeded and followed by neurovascular
examination.
I. Does not need to be followed by post reduction radiography.
J. Does not usually require the administration of pain
medication.
:The most important step in local examination of fracture is.122
A. Inspection.
B. Palpation.
C. Movement.
D. Neurovascular exam.
E. Radiological exam.
The least radiographic views needed for diagnosis of fracture.123
:leg bones is
A. AP.
B. Stress.
C. Lateral.
D. AP + lateral.
E. Oblique.
Which of the following tools can be needed for diagnosis of .124
?fracture and joint injuries
A. CTS.
B. MRI.

25
 C. Isotopic bone scan.
D. Ultra sonopaphy.
E. Any of the previous.
A child 10 years old developed fracture both bones left leg .125
was treated by successful closed reduction and fixed in
above knee POP cast. The proper time of removing the cast is
:after
.A. Three weeks
.B. One month
.C. Two months
.D. Fracture union
.E. Three months
:In open fracture, the offending wound can be .126
A. Overlaying the fracture.
B. In the same segment of the limb.
C. In another segment of the limb.
D. A, B, or C.
E. In the other limb.
Open fracture with extensive stripping of bone, soft tissue .127
laceration and devitalization requiring plastic reconstruction,
:and without major vascular injury is considered
A. Type I.
B. Type II.
C. Type III A.
D. Type III B.
E. Type III C.
In the E.D. management of open fracture, which of the .128
?following is contraindicated
A. Taking swab for C/S.
B. Gentle flushing of the wound with sterile saline.
C. Wound exploration for clamping bleeders.
D. Compression dressing.
E. Splinting.
The most important steps in treatment of open fracture in .129
:the theater is
A. Copious irrigation.
B. Proper debridement.

26
 C. Fracture reduction.
D. Fracture fixation.
E. Wound closure.
For wound closure of open fracture, the following is correct .130
:except
A. Minimal deeps suture material.
B. Never apply suture under tension.
C. Primary suture for type I and definitely clean type II.
D. Early cover for bone.
E. Delayed cover for nerves and tendons.
During follow up for fracture heeling, at which stage safety .131
:against possible deformity can be predicted
A. Stage of hematoma.
B. Stage of inflammation.
C. Stage of soft callus.
D. Stage of hard callus.
E. Stage of remodeling.
The initial antibiotics for treatment of farm related .132
:contaminated open fracture is
A. Cephalosporin + aminoglygosides + penicillin G.
B. Cephalosporin + aminoglygosides
C. Cephalosporin
D. Any antibiotics
E. According to C/S.
:The gold standard tool for fixation of any open fracture .133
A. Closed POP cast.
B. POP cast with window over the wound.
C. Skin on skeletal traction.
D. External fixator.
E. Internal fixation.
In the management of open fracture tibia, what factor is .134
?considered most important in preventing deep infection
A. Size of skin lesion.
B. Amount of contamination.
C. Culture from the wound.
D. Method of fixation.
E. Degree of debridement.

27
At the scene of trauma, which of the following causes of .135
?death after injury can be possibly controlled by trained paramed
A. Respiratory arrest.
B. Laceration of brain.
C. High cord laceration.
D. Injury of the heart.
E. Injury of major vessels.
:BLS training program include the following except .136
A. Fracture splinting.
B. Wound care.
C. I.V. fluid and drug therapy.
D. Air way clearance.
E. External bleeding control.
:ISS of 30 as a score for injured person is considered .137
A. Minor
B. Mild
C. Moderate.
D. Severe.
E. Fatal.
An 18 years-old man has acute respiratory distress after .138
sustaining injuries in a motorcycle accident. He has a blood
pressure of 80/60 mm Hg and a pulse rate of 110/m.
Examination reveals chest tempany to percussion, distended
neck veins, and deviation of the trachea awayfrom his right
hemithorax where the breath sounds are diminished. Heart
sounds are regular and normal on auscultation. Initial
:management should consist of

A. Administration of 2 L of saline solution.

B. Subxiphoid pericardial aspiration.
C. Rapid infusion of 500 ml of colloid solution.
D. Insertion of a large bore needle in the Rt 3rd intercostal space.
E. Intubation followed by mechanical ventilation.
A 22 year-old man sustained multiple injuries in motorcycle .139
accident including ipsilateral open right femur and
comminuted tibia fractures. He has acute abdominal
distention and tenderness to palpation. The pelvis is stable to

28
examination. He has a blood pressure of 70/40 mm Hg
despite appropriate fluid resuscitation and a pulse rate of
120/m; the pulse is thready. Which of the following
procedures is considered the highest priority in
?management of the patient

A. Emergent CT of the abdomen and pelvis.

B. Insertion of a swan-Ganz catheter to monitor cardiac index.
C. Administration of albumin solution.
D. Emergent laparotomy in the operating room.
E. Application of a pneumatic antishock garment.
Concerning GCS what numeric value is given as regards .140
?”the verbal response when it is “inappropriate
A. 1.
B. 2.
C. 3.
D. 4.
E. 5.
In cases of hypovolaemic shock; fluid shift to the .141
:intravascular bed occur during
A. Initial stage.
B. Compensated stage.
C. Progressive stage.
D. Refractory stage.
In cases of hypovolaemic shock, reversal of electrolyte shift .142
:across cell membrane occurs during
.A. Initial stage
.B. Compensated stage
.C. Progressive stage
.D. Refractory stage
:In hypovolaemic shock, C.V.P. is low with .143
.A. Myocardial infarction
.B. Heart failure
C- Pulmonary embolism.
D-Cardiac tamponade
E-Tension pneumothorax

29
During the compensated stage of hypovolaemic shock the .144
?following is true in urine except which
.A. Oliguria
.B. Increased sodium
.C. Increased urea
.D. Increased osmolarity

Which of the following is considered the best measure of the .145

?adequacy of resuscitation in the first 6 hours after injury
A. Blood pressure
.B. Urine output
C-Central venous pressure.
D-Heart rate.
E-Basic deficit (metabolic acidosis).
?Which statement in the following is not correct .146
.A. Full standard blood matching need 20 m
.B. Abbreviated blood matching need 15 m
C-Emergency blood matching need 10 m.
D-Universal donor is used only in special critical situations
E-Emergency major group blood matching is safe 99%
?Stored bank blood has which of the following risks .147
.A. Coagulation deficit
.B. Deficient O2 carrying capacity
C-Increased acid load.
D-Introduction of cellular aggregate and debris.
E-All the previous.

General medicine

30
Prof/ Awadalla "30 Qs"

:Choose the best single answer

148.Which one of the following is NOT commonly a precipitant of

nonketotic hyperosmolar coma?
(A) Hydrochlorothiazide
(B) Cimetidine
(C) Heat stroke
(D) Aspirin
149. All of the following can cause an anion gap acidosis EXCEPT:
(A) Cyanide poisoning
(B) Paraldehyde ingestion
(C) Salicylate toxicity
(D) Renal failure
(E) Dichloroacetate therapy
150. What is the correct sequence of agents in the treatment of
thyroid storm?
(A) Propranolol, propylthiouracil (PTU), lodine.
(B) Iodine, PTU propranolol.
(C) PTU, lodine, propranolol.
(D) PTU, propranolol. iodine.
151. How should insulin be administered to patients with
nonketotic hyperosmolar coma?
(A) Bouls.
(B) Bouls plus infusion.
(C) continuous infusion
(D) No insulin should be administered.
152. A 60 –year-old woman is brought to the emergency
department (ED) on account of altered mental status ,
polyuria ,and poldipsia.Her bedside glucoce level is 735 mg/dl. All
of the following could have precipitated this patient's diabetic
ketoacidosis EXCEPT:
(A) The death of loved one.
(B) An infected toe .
(C) A motor vehicle accident.

31
 (D) The administration of an ampule of dextrose to the. patient by
paramedics
(E) Having a "few too many " whiskey sours at the office party .

Diabetes and Diabetic Ketosis

153. Secondary diabetes mellitus is associated with the following
except :
(A) Thiazide diuretic therapy.
(B) Hemochromatosis.
(C) Primary hyperaldosteronism.
(D) Pancreatic carcinoma.
(E) Hypo-throidism.
154. The physiogical effects of insulin include the following:
(A) Deceased glycolysis.
(B) Deceased glycogenolysis.
(C) Increased lipolysis.
(D) Increased gluconeogenesis.
(E) Increased protein catabolism.
155. In decompensated diabetes mellitus :
(A) Thirst results from the in creased osmalarity of glomerular filtrate.
(B) Hyperpnea is the result of acidosis due to increased lactic and
ketoacid production.
(C) Negative nitrogen balance results from the increased protein
catabolism .
(D) Lipolysis increases as a result of relative insulin deficiency.
(E) Insulin deficiency inhibits the peripheral utilisation of ketacidosis.
156. Typical presentations of diabetes include of the following except :
(A) Weight loss and nocturia.
(B) Balanitis on pruritis vulval.
(C) Epigastric pain and vomiting.
(D) Limb pains with exaggerated ankle reflexes.
(E) Asymptomatic glycosurea in the elederly.
157. As regards biguanide drug therapy in diabetes mellitus, one of
the following is true:
(A) Is more likely to cause weight gain than weight loss.

32
 (B) Increases plasma immunoreactive insulin concentration .
(C) Decreases pancreatic glucagons release .
(D) Inhibits hepatic glyogenolysis.
(E) Cause trouble some constipation.
158.Typical symptoms of hypoglycemia in diabetic patients include
the following except.
(A) Feeling of faintness and hunger .
(B) Tremor ,palpitations and dizziness .
(C) Headache,diplopia and confusion
(D) Abnormal behaviour despite plasma glucose consistenly>5
mmol/l
(E) Nocturnal sweating ,nightmares and convulsions
159. Factors predisposing to frequent hypoglycemie episodes in a
diabetic patient include the following axcept
(A) Delayed meals
(B) Unusual exercise
(C) Excessive alcohol intake .
(D) Development of hyperadrenalism .
(E) Errors in drug adminstration.
160. In a comatose diabetic patient,clinical features suggesting
hypoglycemia rather ketoacidosis include the following exept.
(A) Systemic hypotension
(B) Diminished tendon reflexes
(C) Air hunger
(D) Moist skin and tongue
(E) Abdominal pain
161.The typical clinical features of diabetic ketoacidosis include the
following except.
(A) Abdominal pain and hunger.
(B) Rabid, weak pulse and hypoteusias
(C) Dry skin
(D) Vomiting and constipation
(E) Coma with extensor planter responeses.
162. Expected findings in severe diabetic ketoacidosis include the
following except :
(A) Water deficit of 5-10 litres
(B) Both sedium and potassium deficits of >400 mmol.

33
 (C) Arterial blood gas analysis ; Paco2 7 kpa and pH =7.20
(D) Normal or high serum potassium.
(E) Peripheral blood leucocytosis.
163. Dysphonia would be an expected finding in a patient with the
following diseases except:
(A) Myasthenia gravis
(B) Supranuclear bulbar palsy
(C) Parkinson's disease
(D) Cerebellar disease
(E) Bilateral recurrent laryngeal nerve palsy
164. Dysphonic would be an expected finding in a patient with
following diseases except:
(A) Parkinson's
(B) Supranuclear bulbar palsy
(C) Cerebellar disease
(D) Myasthenia gravis
(E) Lesion of wernicke's area.
165. Loss of tendon reflexes is characteristic of the following diseases
except:
(A) Proximal myopatly.
(B) Peripheral neuropathy.
(C) Syringomyelia
(D) Quoda equina lesion
(E) Tabes dossales
167. The following statements about bladder innervations are correct
except:
(A) Sacral cord lesions usually produce urinary retension.
(B) Thoracic cord lesions produce urinary urge incontinence.
(C) Pelvic nerve parasympathetic stimulation causes bladders
demptying
(D) Pudendal nerve lesions produce automatic bladder emptying
(E) L1-L2 segment sympathetic outflow mediates bladder relaxation
168. Right homonymous hemianopea usually results from damage to
one the following :
(A) left read nucleus
(B) left optic radiation
(C) optic chiasma

34
 (D) right lateral geniculate body
(E) left optic nerve.
169.Absence of papillary constriction in either eye on shining a light
into the right pupil suggests a lesion in the following except:
(A) Bilateral Argyll Roberson pupils
(B) Bilateral Homes-Aclie pupils.
(C) Right optic nerve.
(D) Right oculomotor nerve.
(E) Bilateral Horner's syndrome.
170. Typical causes of transient cerebral ischemic attacks include the
following except:
(A) Carotid artery stenosis
(B) Atrial fiberillation
(C) Hypotension
(D) Irtra-cerebellar hemorrhage
(E) Sick sinus syndrome
171.Clinical features suggesting intracerebral hemorrhage include the
following except:
(A) Abrupt onset of servere headache followed by coma.
(B) Third cranial nerve palsy
(C) Retinal hemorrhages and or papilledema
(D) Onset of stroke on wakeng from sleep
(E) Tinnitus, deafere and vertigo are absent
172.Typical manifestations of brain stem infarction include the
following except:
(A) Pin-point pupils
(B) Vertigo and deplopia
(C) Sensory dysphasia
(D) Severe headache
(E) Bidirectional jerking nystagmus
173.Functional recovery following store is more likely to be poor in
the following corebitior EXCEPT:
(A) Coma is prolonged to more than 3 days
(B) The stoke is hemorrhagic rather than embolic in origin
(C) Asso ciated hypertension is severe
(D) There is conjugate gaze palsy
(E) Hemiplegic right sided rather than left sided.

35
174.A patient presents to the emergency department (ED) in a
comatose state .All of the following are potential causes for the
comatose state Except .
(A) Glyburide ingesion
(B) Hyperammponmia
(C) Lacunar infarct
(D) Hyponatremia
(E) Hypothermia
175. All of the following can induce pinpoint pupils (miosis) Except
(A)Potine hemorrhage
(B) thorazine
(C) clonidine
(D) diphenhydramine
(E)fentany
176.Treatment of a hemiplegic migraine may include all of the
following measures Except
(A) ergotamines
(B) prochloperazine
(C) acetaminophen
(D) seclusion in dark ,quiet room
(E) morphine
177. All of the following require urgent neurosurgical evaluation and
treatment Except
(A) cerebellar infarction
(B) subarachnoid hemorrhage (SAH)
(D) embolic stroke
(E) epidural hematoma
178. All of the following characteristics are typical of peripheral
vertigo Except
(A) acute onset
(C) absence of neurological signs
(D) nausea and vomiting
(E) positive Nylen-Barany maneuver

36
 Dr/ Hanan Fathy; Toxicology "14 Qs"

Choose the correct answer: " only one answer "

179.Bulemia is :

a – polyhagia .
b – Increased appetite to sweats.
c – Characteristic sign in drug dependence.
d – Seen mainly in opiate addiction.
180.In hashish poisoning all of the following is true except .
a – Pupil is bilaterally constricted .
b – Hallucination and euphoria are present in almost all
cases .
c – The patient cant determine distances .
d – withdrwal many occur at home ( no need for
hospitalization ) .
181.Match between column ( a ) and ( b ) :
The pupil is:
a – Constricted ( miosis ) in 1- Morphine.
b – Dilated ( mydriasis ) in 2- Phenothiazines .
c – Not characteristic in 3- Barbiturates .
4-Methanol .
182.Forced alkaline diuresis is an effective line of treatment of
poisoning by :
a – opiate .
b – Benzodiazepines .
c – Barbiturates .
d – Ethanol .
183. All about phenothiazines are true except :
a – Pupils are bilaterally constricted in all types of
phenothiazines .
b – The patient suffer from agitation .

37
 c – The patient may suffer from hallucinations .
d – Gastric lavage is not contraindicated .
184.All about anexate ( flumazenil ) is true except :
a – It is an antidote for benzodiazepines.
b – It is completely safe.
c –Not needed in all cases .
d – It acts by blocking GABA receptors .
185. In methanol poisoning :
a – Gastric lavage should be done immediately .
b – Activated charcoal is effective .
c – Forced alkaline diuresis is not indicated .
d – Hemodialysis is not needed .
186. The differences between ethyl and methyl poisoning are
all of the following except :
a – Methyl alcohol is more dangerous .
b – The patient starts complaining 2 hours after poisoning
in both of them .
c – optic atrophy occurs in methyl not ethyl poisoning .
d – Alcohol dehydrogenase is the enzme responsible for
metabolism of both of them .
187. Match group ( a ) with group ( b ) :

a – Line of treatment . b – Type of poisoning .

1- Naloxone. - Barbiturates .
2- NaHco3 I . V . - Opiate .
3- Forced alkaline diuresis . - Methyl alcohol .
4- oxygen and reassurance . - Hashish .
188. Cause of death in methyl alcohol poisoning is mainly :
a – CNS depression .
b – Severe respiratory acidosis .
c – Severe metabolic acidosis .
d – Acute renal failure .
189. Rhabdomyolysis and acute renal failure many occur in

38
 poisoning by :

a – Opiate
b – Barbiturates .
c – Phenothiazines .
d – Ethyl alcohol .
190.25 years old patient presented to the ER by disturbed
consciousness level , blood pressure 90/ 60 pulse 115 beat /
minute ,history of spontaneous vomiting all over the day .
Pupils were bilaterally dilated .
a – What is your D.D? (differential diagnosis .)
b –What are the investigations you need to prove or to exclude
your possibilities.
c – Explain your management of the most likely diagnosis .
191.20 years old female presented to the ER by her family .
They said that they found an empty strip of tablets used for
sedation beside her. The patient was in coma grade I
Blood pressure 100/60 pulse 100 beats / minute .
temperature 37 c˚ .

a – What is the most likely diagnosis ?

b – Explain your management of this case .
192.12 Years old child was brought to the ER by his family . his
mother said he returned to home pale with cold extremities
and his consciousness level started to deteriorate . O/E : he
was pale, drowzy and confused , blood pressure 100/60 puls
105 beat / minute . during management you noticed that lips
became cyanosed , blood pressure decreased to 80/50 and
pulse increased to 120 beat / minute . the patient became
coma grade I . Pupils became bilaterally constricted .
a – What is most likely diagnosis?
b – What is the most important investigation?
c – Explain your management?

39
 Dr. Wagih Makram Ebeid
Airway "10 Qs"

193.To open the airway in an unconscious non traumatized victim

is by:
A. Head telt chin lift.
B. Head telt neck lift.
C. Jaw thrust.
D. All of the above.
194.Tidal volume (VT) means:
A. Maximal volume that can be expired below VT.
B. Each normal breath.
C. Volume remaining after maximal exhalation.
D. Maximal additional volume that can be inspired above VT.
195.Correct position for Intuhation is:
A. Flexion of the neck and extension of the head at the atlanto-
occiptal joint.
B. Flexion of the neck and flexion of the head.
C. Extension of the neck and extension of the head.
D. Non of the above.
196.Correct size of oropharyngeal airway is:
A. Vertical distance between the chin and tip of the nose.
B. Vertical distance between the angle of the jaw and incisor teeth.
C. Distance between the ear and the chin.
D. Any size.
197.Indotracheal tube size 8 means:
A. Internal diameter is 8 mm.
B. Outer diameter is 8 mm.
C. Length of tube is 8 cm.
D. Diameter of the cuff is 8 mm.
198.To confirm correct Indotracheal tube placement:
A. Visualize insertion of tube through the vocal cords.
B. Auscaltate the epigastrin and chest.
C. Use of oesophageal detector device.

40
 D. All of the above.
199.Using a bag valve musk (B.V.M) (Ambo Bag) without oxygen
and a reservoir bag. Can deliver oxygen up to:
A. 14%.
B. 16%.
C. 21%.
D. 4%.
200.Drugs that can be introduced in the Indotracheal tube are:
A. Atropine – Epinephrine – Sod Bicarbonate.
B. Calcium chloride – Atropine – Narcan.
C. Hydrocortisone – Atropine – Morphine.
D. Lidocaine – Atropine – Narcan – Epinephrine.
201.Laryngeal mask airway (L.M.A) size 4 the cuff should be
inflated by:
A. 30 ml of air.
B. 20 ml of air.
C. 40 ml of air.
D. 10 ml of air.
202.The Combitube (double lumen tube).
A. Can be used in infants.
B. Is inserted blindly into the mouth.
C. Is inserted using a laryngoscope.
D. Is incorrect if introduced in the oesophagus.

41
"Prof/Mahmoud Abdulrahman "8 Qs "MCQ
; Critical Care
: Best single Answer

Prolonged application of cold fomentation over the burned are is .203

.not recommended because this
A. May increase pain.
B. Increase bulle.
C. May cause arrhythmia.
D. Waste time.
204.The first to do when you see a burned patient.
A. Analgesia.
B. Fluid resuscitation.
C. Dress the wound.
D. Ensure airway potency.
205.The following burns can be managed in out clinic except.
A. Adult with 10% second degree burn.
B. Diabetic patient with only burn of the hand.
C. Child with deep burn in dorsum of foot.
D. Scalding burn 10% in 45 years old patient.
206.When the student in the lab, conc. Sulphuric acid fell on his hand,
the immediate management is.
A. To apply some alkali to neutralize the acid.
B. Put the hand under tap water.
C. Apply antibiotic cream and dress the wound.
D. All of the above.
207.The amount of water needed for burn resuscitation is affected by.
A. Depth of burn.
B. Surface burned area.
C. Weight of the patient.
D. B and C.
E. A, B& C.
208.Glucose 5% infusion is better to be avoided in resuscitation of
burn in the 1st 24 hours because.

42
A. May lead to brain oedema.
B. Can not expand the circulations.
C. It may affect the veins.
D. None of the above.
209.The simplest method to reduce pain from burn in the home is.
A. Cold fomentation.
B. Application of tooth paste.
C. Morphia injection.
D. Dress the wound.
210.The most common cause of acute renal failure complicating burn
is.
A. Burn of the flannels.
B. Insufficient fluid therapy.
C. Absorption of burned necrotic tissue.
D. Complication of the given drugs.

43
Prof/Ahmd Magdy MCQS Single Answer
Cardiology

Five life-threatening causes of Chest Pain (the big five) include all -211
:except
A-Acute coronary syndrome
B-Aortic dissection
CPulmonary embolism
C-Tension peumothorax
E-Esophageal spasm
:For acute chest pain the immediate goals include all except -212
,A-IV line, supplemental O2
B-monitor, pulse oximeter
C-ECG
D-Echocardiography
E-Rule out the “The Big Five
:Radiation of the chest pain, all true except-213
A-Cardiac pain may radiate to the neck, throat, mandible, teeth, upper
.extremity, or shoulder
.B-Wide extension decreases the probability of MI
C-Radiation to the Rt or both arms is a more powerful predictor than Lt
.arm alone
.D-GB pain can present with rt shoulder pain
E-Chest pain that radiates between the scapulae may be due to aortic
.dissection
:Features Decreasing Likelihood of AMI, all true except-214
A-Pleuritic chest pain
B-Chest pain sharp or stabbing
C-Positional chest pain
D-Absence of associated symptoms as sweating
E-Chest pain reproduced with palpation
:Onset of chest pain, all true except-215

44
A-Pneumothorax, aortic dissection or acute PE typically has an
abrupt onset
B-Onset of ischemic pain is often acute with an increasing
.intensity over time
C-Pericarditis pain is commonly sudden
D-Early morning onset with ischemic pain
E-"Functional" or non-traumatic musculoskeletal chest pain
might have more vague onset
:Causes of abrupt onset chest pain, all true except-216
,A-Pneumothorax
B-aortic dissection
C-Pulmonary embolism
D-Acute pericarditis
E-Coronary dissection
:Provocation of the chest pain, all true except-217
A-Post-prandial suggests GI and excludes cardiac
B-Exertion: classic of angina
.C-Swallowing: esophageal
D-Body position, movement, deep breathing: suggests musculoskeletal or
.pericardial
E-Pleuritic suggests PE, pneumothorax, pleurisy, pleuropericarditis
:Unstable angina, all true except-218
A-Has the qualities of typical angina
,B-The episodes are more severe and prolonged
C-May occur at rest
D-May be precipitated by less exertion than previously
E-Always on the left precordial area
:Types of unstable angina, all true except-219
A-New onset angina, Rest angina
B-Progressive crescendo angina
C-Micro-vascular angina
D-Post infarction angina
E-Variant spastic angina
Chest pain problems in history taking include all these -220
:subsets except
A-Women more atypical presentation than men

45
B-Patients with diabetes do not always have typical symptoms -
autonomic neuropathy
C-Elderly patients – atypical presentation
D-Panic disorder patient
E-Smoker patients
Chest pain patients, exam findings that might help -221
:distinguish cardiac from non cardiac chest pain
A-marked difference in blood pressure between arms suggests aortic
dissection
B-Hyperesthesia on palpate the chest wall may be due to herpes zoster
C-Absence of pericardial rub excludes pericarditis
D-Heart murmur suggests cardiac pain
E-Cardiac gallop suggests infarction or myocarditis
ECG features of acute myocardial infarction include all -222
:except
A-ST elevation
B-New Bundle branch block
C-ST depression
D-New T wave inversion
E-Prolonged QT interval
Tests that might help to diagnose chest pain due to MI, -223
:all true except
.A-CK-MB Sensitivity > 90% for MI 5-6hours after symptom onset
B-Troponin-I: similar sensitivity and specificity to CK-MB for AMI
C-Troponin-T: less sensitive for myocardial injury
D-Myoglobin test becomes positive 6-8 hours after the onset
:Aortic Dissection, all true except-224
A-Occurs due to Intimal tear with entry of blood into the vascular media
B-Stanford Classification: type A involves Ascending aorta (w/ or w/o
descending)
C-Stanford Classification type B: descending aorta only
D-Increased risk includes hypertension and Marfan’s
E-Absence of aortic regurgitation excludes proximal aortic involvement
:Aortic Dissection, all true except-225
A-Pain is abrupt and severe
B-Pain in chest or between the scapulae

46
C-Pain is tearing or crushing
D-Nausea, vomiting, diaphoresis common
E-Unequal pulse is the only diagnostic sign
:Pulmonary Embolus-226
:Clinical Presentation, all true except
A-Pleuritic chest pain occurs in 74%
B-Dyspnea in 84%
C-Respiratory rate > 16 in 92%
D-Sinus tachycardia is the commonest ryhthm disturbance
E-Absence of hymoptsis excludes pulmonary embolism
Investigation for pulmonary Embolism-227
:all true except ,
A-The commonest ECG change is sinus tachycardia
B-D-Dimers is highly senetive in diagnosis
C-X-ray chest is normal in only 10%
D-Ventilation perfusion lung scan is 95% sensetive
E-Multi-slice CT is highly diagnostic
:Investigations for aortic dissection, all true except-228
A-Trans-thorathic echo
B-MR angiography
C-CT chest
D-Trans-esophageal echocardiography
E-Cardiac catheterization is a must before surgery

47
"Prof/Ragaee Foda ( Qs of the 1st part " 58 Qs

For the following questions,please choose “the best correct”

:answer
:veins are called capacitance vessels because they contain -229
A-84%of blood volume
B-64%of blood volume
C-74% of blood volume
D-54% of blood volume
E-44% f blood volume
:pulse pressure is-230
A-systolic pressure-diastolic pressure
B-1/3 systolicpressure+diastolic pressure
C-1/2 systolic pressure +1/2 diastolic pressure
D-1/2 systolic pressure +diastolic pressure
E-none of the above
:mean capillary pressure is arround-231
A-10 mmHg
B-15 mmHg
C-25 mmHg
D-39 mmHg
E-none of the above
:plasma colloid osmotic pressure is due to-232
A-sodium
B-chloride
C-protein
D-clotting factors
E-none of the above
:the thoracic duct empties into-233
A-right atrium
B-superior vena cava
C-left innominate vein
D-inferior vena cava

48
E-left internal jugular vein
:the lymphatic flow is aided by-234

A-contraction by smooth muscles in vessel wall

B-contraction of surrounding muscles
C-arterial pulsations
D-movement of body parts
E-all of the above
:the common cause of coronary occlusion is-235
A-spasm
B-embolus
C-thrombus
D-combination of the above
E-none of the above
:in haemorrhagic shock which occurs first-236
A-reduced cardiac output
B-low blood pressure
C-reduced renal perfusion
D-reduced cerebral perfusion
E- a + b occur simultaneously
:special features of septic shock include-237
A-warm skin
B-high cardiac output
C-bounding pulse
D-none of the above
E-all of the above
:hormones secreted by the kindney include-238
A-renin
B-erythropioetin
C-vitamine D
D-all of the above
E-none of the above
:the normal ph of the arterial blood is-239
A- 7.35
B- 7.4
C- 7.45
D- 7.5

49
E-none of the above

:which of the following causes metabolic acidosis-240

A-renal tubular acidosis
B-severe diarrhea
C-chronic renal failure
D-all of the above
E-none of the above
:death is imminent when pH falls below-241
A- 7.4
B- 7.2
C- 7.0
D- 6.8
E- 6.5
:the vascular spasm following injury is due to-242
A-anoxia
B-thromboxane A2
C-endothelin
D-prostaglandine
E-none of the above
:normal prothrombin time is-243
A-10 econds
B-12 seconds
C-14 seconds
D-16 seconds
E-18 seconds
:steroid hormones are secreted by all except-244
A-ovary
B-testes
C-adrenal medulla
D-placenta
E-none of the above
:the usual number of para thyroid glands are-245
A-two
B-four

50
C-six
D-eight
E-none of the above
:the normal blood cell survival in healthy adult is about-246
A-10 days
B-30 days
C-60 days
D-120 days
E-180 days
after haemorrhage the deficiency of lost plasma protein is rectified -247
:by
A-small intestine
B-liver
C-spleen
D-muscles
E-bone marrow
the branches of the external carrotid artery include all of the -248
:following except
A-superior thyroid artery
B-inferior thyroid artery
C-ascending pharyngeal artery
D-lingual artery
E-facial artery
:pulse oximetry in management of seriously ijured pstients-249
A-measure ventilation or partial pressure of oxygen
B-can be placed distal to the blood pressure cuff
C-it can replace arterial blood gas analysis
D-none of the above
E-all of the above
complications of central venous puncture include all of the following -250
:except
A-pneumo or haemothorax
B-chylothorax
C-air embolism
D-arteriovenous fistula
E-haemoptysis
:the level of conciousness for head injury patients is best evaluated by-251

51
A-Glasgow coma score
B-response to pain
C-C.T scan
D-pupillry response
E-visual evoked potential
:regarding injuries whlasgow coma scoreich of the following is true -252
A-injuries result from acute exposure to physical energy
B-most injuries are preventable
C-injuries may result from exposure to heat,severe cold
D-injuries present in predictable palterus in the body
E-all of the above
in managing the head injured patients, the most important initial -253
:step is to
A-secure the airway
B-obtain –C –spine film
C-support the circulation
D-control scalp haemorrhage
E-determine the Glasgow coma scale(GCS)
:the first maneuver to improve oxygenation after chest injury is-254
A-intubate the patient
B-assess arterial blood gases
C-administer supplemental oxygen
D-ascertain the need for chest tube
E-obtain a lateral cervical spine view
the most important, immediate step in management of an open -255
:pneumothorax
A-endotracheal intubation
B-operation to close the wound
C-placing a chest tube through the chest wound
D-placement of an occlusive dressing over the wound
E-initiation of 2 large caliber Ivs with crystalloid solution
which of the following injuries is most likely to be missed by -256
:diagnostic peritoneal lavage (D.P.L)
A-hepatic lacerations
B-perforated jejunum
C-ruptured duodenum
D-mesenteric laceration

52
E-capsular splenic laceration
among the following, the finding signifies that shock in an injured -257
:patient have a cause other than hypovolaemia is
A-hypothermia
B-distended neck veins
C-diminished puse pressure
D-decreased skin temperature
E-decreasing central venous pressure
which one of the following finding in an adult should prompt -258
:immediate management during the primary survey
A-distended abdomen
B-Glasgow coma scale score of 11
C-temperature of 36.5 c
D-heart rate of of 120 beats per minute
E-respiratory rate of 40 breaths per minute
important screening X-ray to obtain in primary survey of multiple -259
:system trauma patient are
A-skull, chest and abdomen
B-chest,abdomen and pelvis
C-skull, cervical spine, and chest
D-cervical spine,chest and pelvis
E-cervical spine, chest and abdomen
A 30 year old man attended ED with history of falling of a ladder -260
and hitting his head, he was unconcious briefly but soon awoke and
returned to his normal mental state. Over the course of the next hour
he became confused and then lapsed into unconciousness again ,
:which of the following injury pattern does this patient probably have
A-epidural haematoma
B-intracerebral haemorrhage
C-subarachnoid haemorrhage
D-subdural haematoma
E-none of the above
which of the following most reliably exludes carotid or vertebral -261
:artery injury in blunt trauma
A-no external signs of neck trauma
B-absence of neurologic deficits
C-absence of neck haematoma

53
D-angiography
E-none of the above
A 20 year old man presents with flaccid paralysis, hypothermia -262
following car crash. Which of the following is an important feature in
:differentiating spinal shock from other causes of shock
A-absence of tachycardia
B-apnea
C-poor capillary refill
D-responsive to initial fluid bolus
E-all of the above
:the leading cause of death after multiple blunt trauma is-263
A-thoracic aortic injury
B-transection of the cervical cord
C-major intracranial injury
D-haemorrhage from splenic artery
E-severe sepsis
complications of transfusion with multiple units of blood include all -264
:of the following except
A-fluid overload
B-thrombocytopenia
C-hypothermia
D-haematemesis
E-dysrrythmia
acute emergency situation when blood has to be given immediately -265
without full laboratory cross matching, it is best to give blood which
:is
A-group O Rh -ve
B- group O Rh +ve
C-group AB Rh-ve
D-group AB Rh +ve
E-unmatched type-specific
:the normal adult blood volume is approximately-266
A-7% of the body weight
B-8% of the body weight
C-9% of the body weight
D-about 7 liters
E-non of the above

54
:the early measurable circulatory sign in hypovolaemic shock is -267

A-tachycardia
B-hypotension
C-decreased pulse pressure
D-arterial blood gases changes
E-non of the above
:contra indications to placement of Foley's catheter include all except -268
A-scrotal haematoma
B-blood at the penile meatus
C-perineal eccymosis
D-high riding or non palpable prostate
E-painless haematuria
:the classic E's of injury prevention include all except-269
A-education
B-eradication
C-enforcement
D-engneering
E-enviroment
:signs and symptoms of air way injury include-270
A-stridor
B-horseness or muffled voice
C-dyspnea
D-subcutaneous emphysema
E-all of the above
which of the following is an appropriate procedure in the initial -271
:management of severe haemorrhage from penetrating neck wound
A-clamping bleeding vessels
B-infusing I.V fluids in ipsilateral arm in zone I injuries
C-direct pressure
D-reverse Trendlenberg position
E-bradycardia
the fully developed picture of traumatic (hypovolaemic) shock is not -272
: characterised by which of the following
A-oliguria
B-peripheral vasoconstriction
C-increased blood viscosity

55
D-mental dullness
E-bradycardia
in hypotensive patients where is the least likely source of potentially -273
:significant blood loss that could account for the hypotension
A-chest
B-abdomen
C-pelvic girdle, soft tissue compartements
D-external bleeding
E-intracranial bleeding
:the best predictor of survival in the setting of cardiac arrest-274
A-elapsed time prior to initiation of resuscitation
B-initial rhythm
C-age
D-pre-morbid disease
E-blood gases results
acceptable methods of managing haemorrhage in the pre-hospital -275
:setting incude all of the following except
A-administration of I.V isotonic crystalloids
B-application of pressure bandage for upper limb bleeding
C-removal of penetrating foreign body and immediate application of direct
pressure
D-splinting long bone injuries
E-escape & run
a 19 year old male patient is brought to ED after being struck by a -276
car, the patient is only complaining of right lower leg pain over the
site of an obvious deformity, the following management descisions are
:acceptable except
A-only a leg film is ordered as the patient has no other complaints
B-routine labs& full clinical assessment
C-the patient is placed on a cardiac monitor
D-urine is sent for analysis
E-splintage of the affected limb
:the following are signs of fracture of the base of the skull except-277
A-racoon eyes(bilateral periorbital haematoma)
B-sceleral haemorrhage with a definite posterior margin
C-cerebrospinal rhinorrhoea
D-cerebrospinal otorrhoea

56
E-battles sign (bruising over the mastoid process)

pre-hospital cervical spine immobilization, which of the following -278

:statements is true
A-uses a soft cervical collar and hard board for comfort and immobilization
B-ideally maintains cervical lordosis and alignment without rotation and
distraction or compression
C-is adequate when cervical level is limited to 25 degrees of motion
D-can not protect spinal canal tissue from further damage
E-non of the above
the clinical presentation of tension pneumothorax includes all of the -279
:following except
A-severe dyspnea
B-tachycardia
C-hypotension
D-unilateral dullness on percussion
E-unilateral chest pain
:central venous pressure is usually elevated in the following except -280
A-heart failure
B-positive end expiratory pressure
C-valsalva manoeuver
D-expansion of blood volume
E-hypovolaemic shock
:all of the following are associated with atrial fibrillation except -281
A-a 5-7 increased risk of stroke
B-thyrotoxicosis
C-pulmonary embolism
D-aortic stenosis
E-rheumatic mitral valve disease
a 20 year old male presents to ED after sustaining a blow the left side-282
of his face with a peice of wood , he is complaining of diffuse cervical
spine pain and inability to straighten his neck and has no neurological
:deficit. Your management should next consists of
A-sending the patient home with muscle relaxant
B-forcing the patient neck in a rigid collar
C-obtaining cervical spine films and oblique films
D-loading the patient with methyl prendisolone

57
E-non of the above

external extremity haemorrhage can be controlled most safely using -283

:which of the following techniques
A-tourniquets proximal to the bleeding site
B-tourniquets distal to the bleeding site
C-direct pressure over the over the bleeding site
D-elevation of the bleeding extremity
E-clamping or ligation of any arterial injuries
:all of the following suture materials are non absorbable except-284
A-silk
B-nylon
C-prolene
D-chromic
E-mersilene
the scope of responsibility for emergency physicians, includes all -285
:except
A-providing acute care to patients to decrease morbidity and mortality
B-performing injury risk factor assessment
C-providing injury prevention counsling
D-understanding the bio mechanics and etiology of an injury
E-enforcing mandated legal interventions
which of the following concerning the mechanics of flow through IV -286
:catheter is true
A-the larger the catheter diameter the faster the flow
B-the larger the catheter the slower the flow
C-the higher the viscosity of the infused fluid , the lower the flow
D-the catheter diameter is the critical dimension concerning the flow
E-all of the above
Prof/ Zainab Sonbul : Anesthesia " 13 Qs "

287-general anaethesia alters the mechanical properties of the chest

wall leading to:
A-increased FRC
B-increased lung volumrs
C-decreased elastic recoil of the lung
D=decreased copliance

58
E-no change in lung physiology

288-A 35-year old man enters the hospital with a diagnosis of

restrictive pulmonary disease. The pulmonary function test result
compatible with this diagnosis is:

FVC FEV1 FEV1/FVC

A- normal decreased decreased
B- decreased decreased normal
C- decreased decreased increased
D- increased increased normal
E- normal decreased normal

Where : FVC=forced vital capacity

FEV1=forced expiratory volume in one second
Questions 289 and 290: pulmonary function test results of a 25-year-
old, 70kg man(at sea level,breathing room air):Vital capacity: 3600ml
Inspiratory capacity:2500ml Dead space :300ml Oxygen saturation:
93%,O2 tension: 82mmHg,CO2 tension : 48mmHg-these values
shows that the patient has:
A-a normal dead space
B-an abnormal inspiratory capacity
C-a low PCO2
D-a decreased vital capacity
E-an abnormal O2 saturation

290-treatment of this patient should be directed toward:

A-decreasing dead space
B-improving tidal volume
C-maintaining the status quo
D-decreasing atelectasis
E-slowing ventilation
291-the work of breathing is:
A-increased in the anaethetized patient breathing spontaneously
B-solely due to airway resistance
C-solely due to elastic forces
D-at its lowest at a respiratory rate of 25 breathes per minute

59
E-increased in patients with restrictive disease if the respiratory rate is
increased
292-anatomic dead space:
A-is independent of lung size
B-is about 1 mL/kg boy weight
C-is not affected by airway appliances
D-combined with alveolar dead space conistitutes physiologic dead space
E-is of less importance in the newborn than the adult
293-recognition of hypoxaemia in the recovery room:
A-depends on the detection of cyanosis
B-detection of apnea
C-depends on the detection of circulatory responses
D-is best monitored with pulse oximetry
E-is done better with a transcutaneous oxygen monitor than with a pulse
oximetry
294-The functional residual capacity(FRC) is defined as the
combination of:
A- tidal volme and residual volume
B-tidal volume and expiratory reserve volume
C-tidal volume and inspiratory reserve volme
D-residual volume and expiratory reserve volumr
E-vital cpacity less the closing volume
295-the maximum volume of air inhaled from the end of normal
inspiration is referred as:
A-tidal volume
B-inspiratory capacity
C-inspiratory reserve volume
D-vital capacity
E-FRC
296-factors contributing to increased air way pressure under
anaesthesia include all of the following EXCEPT:
A-muscle paralysis of the chest wall
B-a decrease in functional residual capacity
C- the supine position
D-the presence of an endotracheal tube
E-controlled ventiliation
297-in the normal adult lung:

60
A-small airways cause the majority of airway resistance
B-gas exchange occurs only terminal bronchioles
C-tracheal cartilage is incompleate anteriorly
D-terminal bronchioles have no cartilage in their walls
E-the pores of Kohn connect the right and left sides
298-tracheal mucus flow is:
A-impeded by deviation from room air oxygen tension
B-decreased in patients with chronic obstructive lung disease
C-not important as a cleaning mechanism
D-unrelated to ciliary activity
E-more active after a patient smokes a cigarette
299-the peripheral chemoreceptors are:
A-located in the medulla oblongata
B-poorly perfused,therefore, respond slowly to changes in the oxygeg
content of the blood
C-responsible for the hypoxic derive to respiration
D-influenced by oxygen content rather than oxygen tension

" Dr/Aza Zohdy 1st part " 7 Qs

300-Epinephrine is useful in cardiopulmonary resuscitation in all of

the following
EXCEPT:
A-Bradycardia.
B-Asystole.
C-Apnea.

61
D-Hypotension.
E-Anaphylaxis.
301-Pupillary responses and AVPU are alternatives to what test
during a trauma code?
A-Head CT.
B-Funduscopic examination.
C-Cold calorics.
D-Apneic testing.
E-Glasgow coma score.
302-A previously healthy 7- month old infant with a temperature of
41 C, pulse of 190,
respiratory rate of 70, blood pressure of 65/20. one day history of
diarrhea.
He is un responsive to verbal commands and painful stimuli. The
most appropriate
Initial therapy is :
A-Cooling blankets.
B-Asprin 100 mg/kg.
C-Ceftriaxone 150 mg/kg.
D-Normal saline 20 ml/kg.
E-Epinephrine 10 ug/kg.
303- A5 year old came to the ER with a non tender red-blue
discoloration on both cheeks.
The mother gives a history of fall the day before, the most likely
diagnosis is :
A-Child abuse.
B-Facial cellulites.
C-Thrombocytopenic purpura.
D-Henoch—Sconlien purpura.
E-Panniculitis.
304-In resuscitation of a 5 year-old boy, after establishing the
unresponsivness you have to
A-Shout for help and open the airway.
B-Give 5 rescue breaths and call for help.
C-Give 2 rescue breaths and call for help.
D-Call for help and give 15 chest compressions.
E-Give 15 chest compressions and 2 ventilations .

62
 305-Hypernatremic dehydration is defind as serum sodium above:
A-120 mmol/L.
B-130 mmL/l
C- 145 mmol/L.
D-125 mmol/L.
E-135mmol/
306- Cardiopulmonary arrest is diagnosed by:
A-Unresponsiveness.
B-Apnea or gasping brearhing.
C-Absent circulation.
D-Pallor or deep cyanosis.
E-All of the abov

63