M. A.

UNRWA 2019
1. A 12-year-old boy develops severe scrotal pain and swelling of the left
side of his scrotum shortly after returning from a game of football. What
is the most likely diagnosis?
A) Epididymo-orchitis
B) Torsion of the testis
C) Incarcerated inguinal hernia
D) Torsion of the Hydatid of Morgagni

2. A 3-week-old, well-developed, breast-fed infant is still jaundiced.

Which of the following therapy is indicated?
A) The administration of barbiturates
B) Exposure to blue light
C) A blood exchange
D) No treatment is necessary at this time

3. Vaginal discharge in a woman can be caused by any of the following,

EXCEPT:
A) Chlamydial infection
B) HIV
C) Gonorrhea
D) Bacterial vaginosis
E) Trichomonas vaginalis

M. A.
M. A.
*4. A 2-week-old infant is brought to your office. Two days ago the baby
vomited. The baby also has diarrhea. The mother tells you that the
infant's appetite is good, and he voids large amounts of urine (the nappy
is always wet).
On observation the infant is alert. What is the most likely diagnosis?
A) Sepsis
B) Gastroenteritis *
C) Intestinal malrotation
D) Volvulus of the small intestine
E) Overfeeding *
،‫( ھﻮ اﻟﺼﺤﯿﺢ‬E) ‫ اﻹﺧﺘﯿﺎر‬:‫* ﺣﺴﺐ اﻟﻤﺮﺟﻊ‬
!‫ اﺧﺘﯿﺎرات ﻓﻘﻂ‬٤ ‫ﻟﻜﻦ ﻓﻲ اﻻﻣﺘﺤﺎن ﻛﺎن ﻣﻮﺟﻮد أول‬
‫( اﻧﮫ ھﻮ اﻟﺼﺤﯿﺢ؟‬B) ‫ و ﺗﻢ اﻋﺘﻤﺎد اﻹﺧﺘﯿﺎر‬،‫ ﻓﮭﻞ اﻟﺘﻌﺪﯾﻞ ﻣﻘﺼﻮد‬-
‫ و ﻟﻜﻦ ﺳﻘﻂ ﻣﻨﮭﻢ ﺳﮭﻮا ً ﻛﺘﺎﺑﺘﮫ ﺑﻮرﻗﺔ‬،‫( ھﻮ اﻟﺼﺤﯿﺢ‬E) ‫ ان اﻹﺧﺘﯿﺎر‬answer sheet ‫ أو اﻧﮭﻢ اﻋﺘﻤﺪوا ﺑﺎﻟـ‬-
!‫ و ﺑﺎﻟﺘﺎﻟﻲ ﺳﯿﺘﻢ ﻋﺘﺒﺎر ﺟﻤﯿﻊ اﻹﺧﺘﯿﺎرات اﻷرﺑﻌﺔ اﻷﺧﺮى ﺧﻄﺄ ؟‬،‫اﻷﺳﺌﻠﺔ‬

5. All of the following statements concerning acute epiglottitis are correct,

EXCEPT:
A) It progresses slowly
B) Fever and excitement are observed
C) Dyspnea, cyanosis and retroflection of the head are observed
D) Suffocation might develop

6. All of the following are major complications of mumps, EXCEPT:

A) Pancreatitis and meningoencephalitis
B) Pneumonia
C) Orchitis
D) Oophoritis

M. A.
M. A.
7. Possible complications of tonsillitis include all of the following,
EXCEPT:
A) Cervical lymphadenitis
B) Acute rheumatic fever
C) Sepsis
D) Chronic rheumatoid arthritis
E) Acute diffuse glomerulonephritis

8. All of the following are side effects of steroids, EXCEPT:

A) Cataract
B) Retardation of growth in children
C) Increased incidence of vascular thrombosis
D) Hyperglycemia
E) Osteoporosis

*9. Thiazides cause all of the following, EXCEPT:

A) Hyperglycemia
B) Increased calcium excretion
C) Increased uric acid excretion
D) Useful in congestive heart failure
!! ‫*ﺳﺆال ﺧﻼﻓﻲ آﺧﺮ‬
!! ‫ ﺻﺤﯿﺤﺘﺎن‬C ‫ و‬B ‫ﻛﻠﺘﺎ اﻹﺟﺎﺑﺘﯿﻦ‬
C ‫ أو‬B ‫ ﻣﺜﻼً ؟ وھﻞ ﺗﻢ اﻋﺘﺒﺎر أي ﻣﻦ اﻹﺧﺘﯿﺎرﯾﻦ‬E) both (b)&(c) ‫ﻓﮭﻞ ﺳﻘﻂ ﺳﮭﻮا ً ﻛﺘﺎﺑﺔ اﻹﺧﺘﯿﺎر اﻷﺧﯿﺮ‬
!!‫إﺟﺎﺑﺎت ﺧﺎطﺌﺔ ؟؟‬

10. Regarding brucella all of the following are true, EXCEPT:

A) Man to man transmission
B) It is a zoonosis
C) Blood culture is used for diagnosis
D) Brucella miletensis is the commonest cause
E) Transmitted through animal products

M. A.
M. A.
11.An old lady presents with history of fever and left sided chest
pain for one month. Examination of respiratory system shows decreased
chest movements, stony dull percussion noted and absent breath sounds
on left side. Her chest X-ray is likely to reveal:
A) Collapse
B) Consolidation
C) Fibrosis
D) Pleural effusion
E) Pneumothorax

12. Mycobacterium tuberculosis is characteristically transmitted from

one individual to another by:
A) Airborne transmission
B) Contact with blood products
C) Food contamination
D) Contaminated water supply
E) Insect victor

13. Diltiazem is a drug from which group:

A) B- blockers
B) Ca-channel blockers
C) ACE-inhibitors
D) Diuretics
E) Centrally acting

14. Which of the following is the live attenuated vaccine?

A) Diphteria
B) Oral polio
C) Tetanus toxoid
D) Pertussis

M. A.
M. A.
15. Which of the following is a rare symptom of acute appendicitis?
A) Epigastric pain radiating to the right lower quadrant
B) Nausea, vomiting and moderate fever
C) Diarrhea
D) Leukocytosis
E) Tenderness at McBurney's point

16. Diabetes Mellitus type 2 is characterized by:

A) Acute onset
B) Ketonuria
C) Weight loss and sweating
D) (b) and (c) only
E) None of the above

17. Concerning undescended testicle, all of the following are correct,

EXCEPT:
A) The testis may be in an ectopic site or incompletely descended
B) Orchiopexy has to be done just after school entry
C) The affected testis is more liable to trauma, torsion and malignancy
D) In neglected bilateral cases, sterility usually occurs
E) The condition may be unilateral or bilateral

18. A case about 5 year-old child with DM type 1, c/o abdominal pain and
vomiting,
>> DKA

19. Which vaccine should not be given to a child suffering from

convulsions:
A) Measles
B) BCG
C) DPT
D) OPV

M. A.
M. A.
20. Which of the following is an absolute contraindication for use of
combined contraceptive pills (OCP) ?
A) Diabetes
B) Hypertension
C) Obesity
D) Impaired liver function

21. A recently married 24-year-old nulliparus would like to become

pregnant, which of the following supplementations and vitamins would
she begin taking:
A) Iron
B) B 12
C) Calcium
D) Folic acid
E) Iodine

22. The earliest manifestation of colorectal carcinoma is usually:

A) Loss of weight and anorexia
B) Change in bowel habit and rectal bleeding in the elderly
C) Permanent fever
D) Intestinal obstruction
E) Abdominal mass

23. All of the following drugs can be used in the treatment of epilepsy,
EXCEPT:
A) Chlorpromazine
B) Phenobarbital
C) Carbamazepine
D) Valproic acid
E) Phenytoin

M. A.
M. A.
24. The advantages of breast feeding include all of the following,
EXCEPT:
A) Reduced cost
B) An improved mother-child relationship
C) Delays the uterine involution
D) Reduces allergic disoreders in the child
E) Rapid loss of maternal fat

25. An acute illness presenting with jaundice, dark urine, anorexia,

malaise, acute fatigue and right upper quadrant tenderness in a 6-year-
old child is:
A) Acute chloecystitis .
B) Tumor of the head of the pancreas.
C) Viral hepatitis
D) Rh incompatibility
E) G6PD deficiency

26. Sulfonylureas therapy work by:

A) An extra pancreatic effect (i.e., at the insulin receiving sites)
B) Stimulating insulin release from the beta-cells
C) Reducing the absorption rate of glucose from the intestinal tract
D)Release of enzymes from the beta-cells for potentiating insulin action at the
insulin receiving sites

27. The most common organism causing UTI during pregnancy is:
A) Kliebsiela
B) Proteus
C) E-coli
D) Pseudomonas aeruginosa
E) Streptocoocus

M. A.
M. A.
28. A 16-year-old girl has a right lower quadrant pain at her mid-cycle
with fever (38 C), mild diarrhea and two episodes of vomiting, WBCs is
12,500. The diagnosis could be:
A) Acute appendicitis
B) Rupture of an ovarian cyst
C) Acute gastroenteritis
D) Complicated Crohns disease
E) All of the above

29. A 33-year-old woman experiences visions of flashing lights followed

by throbbing left-sided temporal pain and nausea. Which of the following
is the most likely diagnosis ?
A) Tension headache
B) Transient ischemic attack (TIA)
C) Temporal arteritis
D) Migraine headache
E) Cluster headache

30. Painless hematuria is the leading presentation of:

A) Renal cell carcinoma
B) Transitional cell carcinoma of the bladder
C) Ureteric stone
D) Pelvi-ureteric obstruction
E) Ureterocele

31. Which of the following is the commonest blood disorder during

pregnancy?
A) Iron deficiency anemia
B) Thalassemia minor
C) Sickle cell disease
D) Vitamin B12 deficiency anemia
E) Folic acid deficiency anemia

M. A.
M. A.
32. All of the following are symptoms or signs of impending eclampsia,
EXCEPT:
A) Severe headache
B) Polyuria
C) Epigastric pain
D) Exaggerated reflexes
E) Visual disturbances

33. Rigors are typical features of all of the following, EXCEPT:

A) Brucellosis
B) Primary pulmonary tuberculosis
C) Malaria
D) Acute pyelonephritis
E) Acute cholangitis

34. Monilial vaginitis:

A) Is treated with metronidazole
B) Is associated with a green, frothy discharge
C) Less common during pregnancy
D) Characteristically has white plaques on the vaginal wall
E) Usually presents with pain

35. Meningitis is suspected when a patient presents with:

A) Sudden onset of fever
B) Stiff neck
C) Bulging fontanels in an infant
D) All of the above
E) (a) and (c) only

M. A.
M. A.
36. Indications of anti-D administration to RH negative mothers married
to RH positive husbands include all of the following, EXCEPT:
A) Following abortion
B) Following delivery of RH negative baby
C) At 28 week gestation
D) Following ectopic pregnancy
E) Following amniocentesis

37. The maternal mortality rate can be estimated as following:

A) The number of maternal deaths per 1000 live births
B) The number of maternal deaths per 100,000 live births
C) The number of maternal deaths per 100,000 live birth + still birth
D) The number of maternal deaths per 100 live births

38. Which of the following statements regarding placenta previa is true:

A) The incidence of this condition decreases with advancing maternal age
B) The incidence of this condition is not influenced by previous deliveries or
abortions
C) The initial bleeding is painless and seldom causes death
D) Vaginal surgery is the therapy of choice
E) Immediate vaginal examination is mandatory when placenta previa is
suspected

39. The following medications are safe in the treatment of hypertension

during pregnancy, EXCEPT:
A) Methyl dopa
B) B blocker (Labetalol)
C) ACEi (Enalpril)
D) Calcium channel blocker (Nifidipine)

M. A.
M. A.
40. Which of the following is the drug of choice for giardiasis?
A) Thiabendazole
B) Metronidazole
C) Mebendazole
D) Albendazole

41. A 24 years old sexually active woman presents with lower abdominal
pain, seven weeks of amenorrhea and vaginal bleeding. A palpable mass
is noted in the adnexal area of the uterus. She is tachycardic and
hypotensive. The most likely diagnosis is:
A) Adnexal torsion
B) Middle cyclic syndrome
C) Ectopic pregnancy
D) A tubo-ovarian abscess
E) Fibroid

42.A patient with anemia and a low mean corpuscular volume (MCV)
that does not respond to an adequate iron treatment will most likely have:
A) Malabsorption of vitamin B12 from the gastro-intestinal tract
B) Sickle cell anemia
C) Aplastic anemia
D) Thalassemia

43. In hepatitis A all the following are correct, EXCEPT:

A) Is an enterovirus
B) Has no chronic carrier state
C) Incubation period of up to 4 weeks
D) Can be prevented by active immunization
E) Is spread by aerosol droplets

M. A.
M. A.
44. Which of the following statements regarding the detection of breast
masses is the most correct?
A) Breast masses are usually detected by women themselves through BSE
B) Breast masses are usually detected by physicians and nurses
C) Breast masses are usually detected by mammography
D) Breast masses are usually detected by biopsy

45. Common indicators of morbidity include:

A) Incidence rate
B) Prevalence rate
C) Crude death rate
D) All of the above
E) (a) and (b) only

46. Diabetic neuropathy can lead to all the following conditions,

EXCEPT:
A) Orthostatic hypotension
B) Impotence
C) Hemiplegia
D) Lower extremities pain
E) Poor bladder function

47. Prolonged jaundice in newborn is due to all of the following,

EXCEPT:
A) Breast feeding
B) Cystic fibrosis
C) Neonatal hepatitis
D) Urinary tract infection
E) Hyperthyroidism

M. A.
M. A.
48. All of the following are associated with streptococcal infection group
A, EXCEPT:
A) Acute pharyngitis
B) Impetigo
C) Erysipelas
D) Erythema nodosum
E) Acute glomerulonephritis

49. All the following are major criteria in acute rheumatic fever.
EXCEPT:
A) Carditis
B) Hepatosplenomegaly
C) Erythema marginatum
D) Chorea
E) Arthritis

50. A 3-month-old infant girl is brought to your office with the symptoms of
a long-standing rhinitis and difficulties in feeding. Her birth weight was
4,000 g and her physiologic jaundice ceased on the 28th day. The infant
also has constipation and she cannot elevate or hold her head. The mother
says that she has never seen her smile. On examination: the rectal
temperature is 36°C, her skin is dry, her mouth is open and an umbilical
hernia is detected. Tracheal rales are audible. Auscultation of the lungs
and the heart is unrevealing. The size of the liver and the spleen is normal. The
movements of the infant are sluggish and her mood is indifferent.
What is the most likely cause of her symptoms?
A) Bilirubin encephalopathy
B) Hypothyroidism
C) Hurler's syndrome (gargoylism)
D) Congenital cytomegalovirus infection
E) Crigler-Najjar syndrome

M. A.