This document appears to be a student exam for an internal medicine course consisting of multiple choice and short answer questions. The multiple choice section covers topics in cardiology, hematology, infectious diseases, gastroenterology, syncope, hypertension, bleeding disorders, rheumatology, nosocomial infections, diabetes, and hepatitis. The short answer questions ask about intravenous cannulation, acute hyperglycemic emergencies, criteria for diagnosing heart failure, definitions and classification of jaundice, and the physical exam of the abdomen. The exam contains 30 multiple choice questions and 5 short answer questions.

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Al Azhar University-Gaza
Faculty of Dr. H .Abdulshafi Of Dentistry
Name:………………………… Date : 25 June, 2012
Time : 2 Hours
Student No : ………………...
Final Exam
Internal Medicine I (PRACTICAL) - 3rd
year
Second Semester 2011-2012
Answer Sheet
Question Answer Question Answer
1 16
2 17
3 18
4 19
5 20
6 21
7 22
8 23
9 24
10 25
11 26
12 27
13 28
14 29
15 30

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Part(I) Examination (MCQ’s)
Select the best answer (Only ONE Answer)
(1) All of the followings are symptoms and signs of cardiovascular diseases Except :
A) Hot and pale extremities
B) Chest pain
C) Lower limbs swelling
D) cough
E) Dyspnea
(2) All of the followings are presentation of ischemic heart disease Except
A) Unstable angina
B) Cardiac arrhythmia
C) Heart failure
D) Sudden death ( cardiac arrest, ventricular fibrillation )
E) Pulmonary embolism
(3) Which one of the followings is the cardinal symptom in cardiology
A) Dyspnea
B) Sputum production and haemoptysis
C) Chest pain
D) Cough
E) Cyanosis
(4) All of the followings are clinical and biochemical features of hemolytic anemia Except :
A) Rapid fall of hemoglobin
B) Splenomegaly
C) Jaundice due to increased direct ( Conjugated ) Bilirubin
D) Pigment Gall stones
E) Leg ulcers
(5) All of the followings are major Dukes criteria for diagnosing infective endocarditis Except :
A) Positive Blood cultures with appropriate organism
B) Immunologic phenomena ( Oslers nodse, Roth spots )
C) Evidence of Coxiella burnetii infection
D) New Valvular regurgitation
E) Positive Echocardiographic findings
(6) The cardinal manifestation of Gastroesophageal disease ( GERD ) is :
A) Heart burns ( Hyperacidity )
B) Epigastric pain
C) Dysphagia
D) Early Satiety
E) Nausea and vomiting

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(7) All of the followings are early signs of syncope Except :
A) Pallor
B) Bradycardia
C) Heavy perspiration
D) Blood pressure approximately baseline
E) Nausea
(8) Angina pectoris, which one of the following is false?
A) Mainly due to decrease coronary blood supply
B) Mainly due to increase myocardium demand for oxygen
C) It is a symptom not a disease
D) Chest pain relieved by rest
E) Chest pain relieved with sub lingual nitrate
(9) In hypertensive urgency , all of the followings are true Except :
A) Diastolic blood pressure > 120-130
B) Associated with end organ damage
C) Lower down the blood pressure within 24 hours
D) Can be treated with oral drugs
E) Not associated with end organ damage
(10)Which one of the following bleeding disorder is inherited?
A) Liver disease
B) Von Willebrands disease
C) Vitamin K deficiency
D) Warfarin overdose
E) DIC (Disseminated Intravascular Coagulation)
(11)Red flags (serious conditions ) in rheumatology practice include all of the followings Except
A) Fractures
B) Day pain
C) Septic arthritis
D) Acute Gout
E) Fever or unexplained weight loss
(12)In nosocomial infection, microbes come from all the following Except:
A) patient's own flora
B) cross infection from medical personnel
C) sterile gloves
D) cross infection from patient to patient
E) hospital environment- inanimate objects
(13)An important means of preventing hospital acquired infections is:
A) For health care workers to wash their hands between patient contacts
B) For all patients to be placed in single rooms
C) For all patients to receive a single dose of antibiotics at the time of admission
D) An infection control program with one nurse for every 100 patients in the hospital
(14)Dental management of Sjogrens syndrome , include all of the followings Except:
A) Prevention of caries
B) Enhance salivary output
C) Treatment of oral candidiasis
D) Pain control for enlarged salivary glands
E) All of the above

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(15)All of the followings are symptoms and signs of respiratory diseases Excep:
A) Cough
B) Chest pain
C) Clubbing
D) Small volume pulse
E) Dyspnea
(16)Concentration of HBV is the highest in the following body fluid
A) Urine
B) Saliva
C) Semen
D) Wound exudates
E) Tears
(17)Possible complication of IV cannulation include all the following Except
A) IV site infection
B) Pulmonary edema
C) Cellultis
D) Infiltration
E) Thrombophlebitis
(18) Which of the following diseases is characterized by arrhythmias, tremors, diarrhea and weight loss:
A) Cushing's syndrome.
B) hypothyroidism.
C) Addison's disease.
D) Hyperthyroidism
E) Hyperparathyroidism
(19)All of the followings are symptoms and signs of hyperglycemia Except
A) Vomiting
B) Hyperventilation
C) Acetone breath
D) Profuse sweating
E) Dry mouth and skin
(20)All of the followings are symptoms and signs of hypoglycaemia Except :
A) Dehydration and dry skin
B) Dilated (reacting) pupils
C) Anxiety, tremor, aggression
D) Confusion
E) Loss of consciousness
(21)During dental management if acute MI is suspected you should do the following
A) Reassure the victim and keep them warm
B) Sit them up if breathless
C) Give high flow oxygen by mask
D) Give 300 mg Aspirin, chewed if the patient is not allergic
E) All of the above
(22)Which would be the most appropriate to treat mild-to-moderate hypoglycaemia?
A) Cup of tea
B) Chocolate bar
C) Six crackers
D) Glass of fruit juice

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(23)Which of the following strategies should always be a part of the treatment plan for a person with DKA?
A) Insulin therapy and magnesium replacement
B) Oral antidiabetic therapy and re-hydration
C) Insulin therapy and re-hydration
D) Possible insulin therapy and sodium bicarbonate replacement
(24)Which electrolyte is critical to monitor during DKA as correction of the metabolic acidosis can
possibly result in cardiac arrythmias and muscle weakness?
A) Sodium
B) Potassium
C) Acetoacetate
D) Beta-hydroxybutyrate
(25)Common symptoms of hepatitis include:
A) Fever, nausea, diarrhea
B) Malaise, anorexia, jaundice
C) Nausea, vomiting, right upper quadrant abdominal pain
D) Clear urine, dark colored stools, anorexia
(26)A common type of nosocomial infection is:
A) Urinary tract infection
B) Meningitis
C) Cellulitis
D) Gastroenteritis
(27)A 60 years old male with history of Type 1 diabetes loses consciousness during the course of dental
treatment. What do you think is the most likely cause ?
A) Addosonian crisis
B) Anaphylaxis
C) Hyperglycemia
D) Hypoglycemia
E) Ketoacidosis
(28)Which one of the following is the least likely indication for antibiotic prophylaxis to prevent bacterial
endocarditis
A) Congenital heart disease
B) Diabetes mellitus
C) Previous history of endocarditis
D) Rheumatic fever
E) Valvular heart disease
(29)Siogren’s syndrome includes all of the following Except:
a) Xerostomia
b) Keratoconjunctivitis
c) Arthritis
d) Lymphoma
(30)A 10 year old child wanting dental treatment has a history of sore throat and migratory joint pain.
You should suspect:

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A) Rheumatoid arthritis
B) Rheumatic fever
C) Traumatic injury
D) Osteoarthritis
Part (II) Examination
(Short Answer Questions)
Question (1)
Mention the indications and advantages of Intravenous Cannulation
Question (2)
Discuss briefly Acute Hyperglycemic Emergencies
Question (3)
Mention major and minor clinical criteria for diagnosis of heart failure

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Question (4)
Definition and classification of Jaundice
Question(5)
(a)Mention steps of physical examination of the abdomen, and
(b)Anatomical areas of abdomen and organs present in each

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GoodLuck
Dr.Suhail Kishawi