Tutorial

MCQs for 6th year Students

How to answer the MCQs
Always calculate the time available for each question before the exam and stick to that time strictly.
Do not allow yourself to become delayed by any single question. Instead, answer the question using your first impression and mark the question with a star so you can return to it.
After finishing your first run through the all questions, you should then start a second run returning to those questions which you have starred giving them further consideration.
You should aim to answer at least 90% (ideally 100%) of MCQs in every paper.
There are extremely few MCQs for which an educated guess will not increase your chance of a correct answer to greater than 50%.

Only use the information given to you and don’t assume anything else.

The root, stem and the options contain everything you need to answer each question. Perhaps an important fact is missing and you will need to identify what that is.
Pay close attention to the facts. If you change your understanding of a topic based on the question, include that adjustment in your analysis and selection of an answer.
Try to approach the questions simply and avoid introducing further complications.
The exam is there to test your knowledge, not to trick you, so avoid unique interpretations of the facts.

A process of elimination

You should start by eliminating answers that you are sure are incorrect, and narrow the options down until you have the most likely answer.
Always remember:
Read the alternatives very closely.
Look quickly at the modifier, then analyse the reasoning and then the result.
The response will not be correct if the reasoning is not correct.
Of the limited options possible, only one of them will identify and resolve the central issue.


‘Best’ answer questions
Not every question will have several “wrong” answers.
Often you will be asked to choose the “best” answer because there may be more than one answer to solve the problem.
When approaching a question like this, remember:
If you can prove an answer more easily, it is likely to be the correct one.
More precise answers are usually better, because they will address the factual situation better than less precise answers.

Making educated guesses

When faced with an MCQ that you are unsure about, a number of points can help you make an educated guess.
An understanding and familiarity with the key words and phrases that commonly feature in MCQs is vital to maximising your score .
Questions which include absolute and sweeping statements such as never, always, or exclusively are generally false (because exceptions can be found to virtually any rule).
Questions which include the keywords :could, possible, or may are more often true than not (after all, anything is possible).
A 45 - year-old patient on hemodialysis has noted that his blood pressure is difficult to control. He is on regular erythropoietin, ferrous sulfate, vancomycin, and vitamin D. His blood pressure is 180/99 mm Hg. Which of the following is the most likely cause for the worsening control of his blood pressure?
A. ErythropoietinB. Ferrous sulfateC. VancomycinD. Vitamin DE. Uremia

The correct answer is (A) Erythropoietin
The patient most likely has a worsening of his blood pressure due to erythropoietin.
This is seen in about 33% of dialysis patients.

In pure acute paroxysmal nocturnal dyspnea ,all the following can occurs except.

A-Acute dyspnea
B-Cough
C-Purulent sputum
D- The sputum may be streaked with blood
E- Tachycardia with inspiratory crackles


The Answer is (C)
Which of the following cause central Cyanosis
Exposure to cold.
heart failure.
Shock.
Right to left Cardiac shunt.
Raynaud's phenomenon.

The Answer is (D)

A twenty year old girl is taking anti tuberculosis treatment. Shepresents in eye clinic with out door visual complaints. The most likely cause of her symptoms is side effect of:
A-Isoniazid.
B- Rifampicin.
C- Ethambutol.
D- Pyrazinamide.
E- Streptomycin

The Answer is (C)

Adverse Reaction of First Line Anti Tuberculosis Drugs
A patient presents with mild fever and haemoptysis from Sinjar. Which of the following tests would be diagnostic of active tuberculosis disease?

The Answer is (D)

skin sensitivity tests (Heaf, Mantoux) and the newer T-cell based assays are only useful to determine latent tuberculosis infection and tell you nothing about disease activity. 21 year old man presented with history of fever( stepladder to intermittent fever), headache and abdominal pain. Abdominal examination shows tender spleen with palpable liver. Blood count no abnormality. According the most possible Diagnosis which antibiotic is more suitable.
A-Ciprofloxacin.
B-Gentamycin.
C-Metrinidazol.
D-Tetracycline.
E-Vancomycin.


The Answer is (A)
A forty year old lady gives history of weight gain and hoarseness of voice. On examination her pulse is 60 per minute and skin is pale, coarse and dry. The most important investigation to find diagnosis in this case is:
A-Adrenocorticotrophin hormone (ACTH).
B-Cortisol level.
C-Gonadotrophin levels.
D-Insulin like growth factor (IGF).
E-T4 and TSH level.

The Answer is (E)

An 70 year woman has a history of dry cough for 2 months. She has lost 5 kg of weight over the 2 months. Her chest X ray shows a left apical shadowing. Blood tests reveal a raised white cell count of 16. She has not managed to cough up any sputum. Which of following tests should be performed?
A. CT scan of the chest
B. Serum ANCA
C. Ultrasound of the chest
D. Kveim test
E. Bronchoscopy
A 26-year-old woman with a history of a tingling sensation in her fingers and toes for 2 days and rapidly progressive weakness of her legs. Deep tendon reflexes are absent. She had an upper respiratory tract infection 2 weeks ago. The most likely diagnosis is?
A -Myasthenia gravis
B-Multiple sclerosis
C-Guillain-Barré syndrome
D-Poliomyelitis
E-Tick paralysis


The Answer is (C)
A 66-year-old woman presented with sudden retrosternal chest pain with nausea and diaphoresis. She has hypotension, jugular venous distention, and a murmur of tricuspid regurgitation. An ECG shows ST-segment elevation in the right precordial leads. Which of the following is the most likely diagnosis?

The Answer is (E)

A 30-year-old man has had severe colicky right flank pain radiating into the thigh for 4 hours. He is afebrile. Urinalysis shows RBCs too numerous to count and no bacteria. Which of the following is the most likely diagnosis?
A-Acute glomerulonephritis.
B-Bacterial cystitis
C-Benign prostatic hyperplasia
D- Urolithiasis
E-Bladder carcinoma

The Answer is (D)
A 40 year old lady was admitted to hospital with fevers and cough productive of sputum. Chest X-ray shows diffuse patchy consolidation around the left lung. She has had a flu like illnes 4 weeks ago, and has a past medical history of asthma. She also smokes. Which organism is likely to be responsible?
The Answer is (D) staphylococcus.
Following a viral infection, patients are predisposed to staphylococcal infection.
The chest XR changes suggest staphlococcus rather than streptococcus (which would cause lobar consolidation)
A 71 year old man who is a heavy smoker has been brought into hospital, with a history of cough and breathlessness. He has a history of COPD which has been managed with home nebulisers but not oxygen. He was given 60% oxygen by the ambulance crew. He appears confused . What should be done?
A. Stop oxygen
B. Give 24% oxygen
C. Continue 60% oxygen
D. Non invasive ventilation
E. Intubation and ventilation.
The Answer is (B)
The best answers here are either give 24% oxygen or non invasive ventilation.
If the patient is not too unwell and is alert, it is safe to turn down the oxygen to 24% (1 L) and assess the degree of hypoxia and CO2 retention. With steroids and salbutamol nebulisers, the patient may improve and not require NIV.
A O2 of 18 is too high for a patient with COPD, and when patients are admitted oxygen therapy should be delivered to achieve a O2 of about 8-10 on the blood gas.
A young girl complains of nocturnal cough and shortness of breath which disturbs her sleep. With bilateral high pitch expiratory rhonchi.The most important investigation to confirm the diagnosis you made is:
A-Chest X-ray.
B-Eosinophil count.
C-Lung function tests.
D-Serum IgG levels.
E-Sputum examination


The Answer is (C)
A forty year old woman gives history of fever for last threeweeks accompanied by dry cough, night sweats and weightloss. Chest examination is normal. Abdominal examinationreveals hepatosplenomegaly. Chest X-ray shows symmetricallydistributed fine nodules. The most likely diagnosis is:

Typhoid.

B- Chronic liver disease. C- Malaria. D- Pneumonia. E- Military tuberculosis

The Answer is (E) A patient with history of fever, headache and neck stiffness,normal funduscopy, the most important investigation is:
A-Magnetic resonance imaging brain.
B-Complete blood counts.
C-Computerized tomography scan brain.
D-Cerebrospinal fluid examination.
E-X-ray skull.

The Answer is (D)

An old patient presented in emergency ward with history ofweakness of right side of body of rapid onset. The most helpfulfirst line investigation for management of this patient is:
A-Cerebral angiography.
B-Cerebro spinal fluid examination.
C-Computerized tomography scan brain.
D-Fasting lipid profile.
E-Nerve conduction study


The Answer is (C)
The anti diabetic agent of choice for a fifty year old obese lady with mild hyperglycemia is:
A-Chlorpropamide.
B-Glibenclamide.
C-Insulin.
D-Metformin.
E-Repaglinide.

The Answer is (D)

In a patient with history of haematemesis, the clinical feature which suggests that peptic ulcer is the underlying cause is:
A-Ascites.
B-Drowsiness.
C-History of jaundice.
D-Splenomegaly.
E-Tender epigastrium.

The Answer is (E)
A patient presents with episodes of loss of consciousness. The GP's letter includes a list of their medications. Which could likely be responsible for the patient's blackouts?
A- Aspirin
B Simvastatin
C- Metformin
D- Ramipril
E- Persantin


The Answer is (D)
A 17-year-old boy has had two episodes of severe anaphylactic shock following bee stings. Which of the following is the most appropriate intervention?
A. Administration of corticosteroids during
the summer
B. Long-term prophylactic antihistamine therapy
C. Protective clothing
D. Desensitization with bee venom extract
E. Restrict him to the house during the summer months

The Answer is (D)

In Vivax malaria all the following are true exceptA. May be complicated by anaemiaB. May be complicated by jaundiceC. In a traveller may present more than six months after exposureD. Is sensitive to chloroquineE. Cannot co-exist with falciparum malaria in the same patient

The Answer is (E)
55 year old patient had myocardial infarction 6 days ago. He suddenly develops dyspnoea, cough and frothy sputum.
For the first time a harsh systolic murmur is heard over the praecordium. This sequence of events might be caused by:
A. Pulmonary embolism
B. Aortic dissection
C. Tricuspid regurgitation
D. Ruptured papillary muscle
E. Ruptured aortic cusp
Answer( D)
Ruptured papillary muscle
Following an MI, ruptured papillary muscle or interventricular septum is most likely to cause the combination of pulmonary oedema and new murmur (either mitral regurgitation or due to VSD).

مع تحيات

مكتب زياد للاستنساخ والطباعة الليزرية
موصل- مقابل كلية طب الموصل