TAS FEB. 2022
16/02/2022
TAS Feb. 2022
EMQs:
1.
Lung function tests(No 100%Respiratory)
a. Bronchial asthma
b. Neuromascular disease
c. Cystic fibrosis
d. FB
e. Laryngomalacia
f. ILD
h. PHTN
i. PCD
1- 14 years old girl presented with SOB
FEV1 1.7 (Z -3.5) FVC 2 (Z -3.4) TF 2.3 (Z +1.1)
2- 14 years old presented with SOB
FEV1 1.8 (Z -3.3) FVC 2.8 (Z -0.4) TF 1.9 (Z -0.6)
3- 14 years old presented with SOB
FEV1
2.
1.4 (-3.5)
FVC 1.5 (z -3.6)
TF 0.7 (Z -5.3)
Blood gas
a- Acute Metabolic acidosis
b- Acute Respiratory acidosis
c- Chronic Respiratory alkalosis
d- Chronic Metabolic alkalosis
e- Compensated Chronic Metabolic acidosis
f- Compensated Chronic Respiratory acidosis
g- Mixed Metabolic & Respiratory acidosis
h- Mixed Metabolic & Respiratory alkalosis
1- Ph 7.10 PCO2 8
HCO3 18 (14-28)
2- Ph 7.35 PCO2 9.2 HCO3 36 (19-28)
3- Ph 7.21 PCO2 9.2 HCO3 21 (14-28)
1
BE -7.5
BE +8.2
BE -2
TAS Feb. 2022
3.
Endocrine
a- Vit. D deficiency
b- Vit. D resistant
c- XL hypophosphatemic reckits
d- Hypoparathyroidism
e- Pseudohypoparathyroidism
f- Hyperparathyroidism
g- Vit. D intoxication
h- Renal osteodystrophy
i- Malignancy
1- 3 ys old girl with bow legs, delayed walking
Ca 1.8 (2.2-2.7) Ph 1(0.9-1.8)
ALP 1500 (75-308) PTH 70 (11-35)
2- 1 week old seizures abnormal pancystolic murmer
Ca 1.2 (2-2.7)
Ph 2(0.9-1.8)
ALP 230 (75-308)
3- Child with Short stature , brachydactly,
Ca 1.6 (2-2.7)
4.
Ph
2.3(0.9-1.8) PTH 70(11-35)
GIT
a- Pepsinogen
b- Cholycystokinin
c- Histamine
d- Lipase
e- Bicarbonate
f- Somatostatin
g- Intrinsic factor
h- Gastrin
i- Trypsinogen
1- Secreted from enterochromaffin cells & stimulate acid secretions by parietal
cells of stomach
2- Needs activation by brush border kinase
3- present in parietal cells inhibit gastrin & histamine release
2
TAS Feb. 2022
5. Immunology
a- IgE
b- TNF alfa
c- CD20
d- IL1
e- IL6
f- inositol inhibitor
1- Omalizumab
2- Etanercept
3- Rituximab
6.Oncology
a- Dexamethazone
b- Cisplatin
c- Doxirubucin
d- 5-flurouracil
e- 6-mercaptopurin
f- Vincrestin
g- Ifosphamid
1- Case of ALL presented with numpness in hands & feet
2- Case of Ewings sarcoma presented with dyspnea at night
3- Case of lymphoma presented with glycosuria
3
TAS Feb. 2022
7. Anatomy
a- Abducent nerve
b- Hypoglossal
c- Ophthalmic
d- Mandibular
e- Maxillary
f- Hypoglossal
g- Vagus
h-Glossopharyngeal
i- Facial
1- Responsible for sensation of anterior 2/3 of the tongue
2- Its injury leads to post surgical stridor
3- 1st nerve affected due to IIH
8. Statistics
a- Sensitivity
b- Specificity
c- Negative predictive value
d- Positive predictive value
f- Pretest propability
g- False positive
h-False negative
i-Likelihood ratio
What these represent?
1- d/d+b
2- b
3- a+c/a+b+c+d
a
c
Total a+c
b
d
Total b+d
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TAS Feb. 2022
9. CVS
a- Defect in the atrial septum at fossa ovalis
b- Narrowing in the descending aorta
c- Disalighnement in ventricular septum, overriding aorta, Rt ventricular outflow
obstruction
d- Failure of pulmonary veins to drain in the left side & drain in the right side
e- Connection between pulmonary artery & aorta
f- Aorta arise from rt ventricle & pulmonary arise from left ventricle
g- Narrowing of ascending aorta at the sinus of Valsalva
h-Hypoplastic left heart
1. 10 days old NB his SPO2 88% in air plethoric lung, 1/6 soft systolic
murmers on the LUSE, antenatal, ECHO normal
2. 1 week old boy poor feeding& cyanosis SPO2 82% oligemic lung, systolic
murmer on the LUSE, RVH, right axis deviation
3. 6 ys old, HTN,150/90 Headache, systolic murmer radiated to back, LVH
10. Pharmacology
a- Amikacin
b- Trimethoprim
c- Carbapenam
d- Fluconazole
f- Ceftriaxone
g- Clindamycin
1. Antimicrobial that potentiat sulfa
2. Antimicrobial same group as gentamycin
3. Antimicrobial Inhibit synthysis of tetrahydrofolate
5
TAS Feb. 2022
BOF:
1. Mechanism of action of IGF1: 100% pharma,Endocrine
(increase insulin secretion, stimulate chondrocytes proliferation, stimulate
growth hormone, stimulate GH secretion)
2. Morphine mode of metabolism : 100% pharma&Palliative
(conjugation, glucuronidation, methylation, CYP2D6, cytochrome p450)
3. Cyclopentolate mode of action: 100% pharma&Ophthalmology
(competitive inhibitor on iris sphincter muscle, inhibit ACh at presynaptic,
prevent ACh secretion at synaptic cleft, Competitive agonist on iris sphincter,
Agonist at presynaptic,)
4. Pedigree: 100% Genetics
(AD, XLD, XLR, AR, imprinting disorder)
5. Visual field defect: Left upper quadrantopia 100% Ophthalmology
(right lower optic tract, left lower optic tract, left lower optic radiation, right
lower optic radiation, geniculate nucleus)
6. WHO definition of obesity in below 5 years?
(BMI more than 3 SD, BMI more than 2 SD, obesity is weight-for-height
greater than 3 standard deviations above the WHO Child Growth Standards
median.)
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TAS Feb. 2022
7. Chronic granulomatous disease (CGD) due to:
(Defect in neutrophil oxidative burst, defect in neutrophil count, LAD, defect
in phagocytosis)
8. 6 ys old with hx of URTI & fever 3 days ago presented with limping,
restricted movement, with this X-Ray diagnosed as Perthes disease asking
about pathophysiology in the x ray ?
(avascular necrosis of femoral head, dysplasia of femoral head, transient
symovitis, hip dislocation)
9. Which is the correct combination between antiepileptics & mechanism of
action (select one answer) : 100%pharma&Neurology
(Carbamazipine block voltage gated Na channels)
(Lamotrigin is a T channel blocker)
(Gapapentin act on GABA receptor )
(Na valproate act on GABA transaminase)
10.
A 3 ys old boy diagnosed as Dravet syndrome due to mutation in
SCN1A gene that affect: 100%pharma&neurology
(Na channelopathy, K channelopathy, Ca channelopathy)
11.
In Non REM sleep what is the appropriate?
(increased air way resistance, increase muscle tone, increase HR, increase
RR)
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TAS Feb. 2022
12.
A child with fever, vomiting and diarrhea, for 5 days, dry MM, came to
ER, dehydrated, given 20ml NS bolus, HR was188 and RR 45 then after
therapy became HR 200 & RR 55, CRT 3 sec before and after, asking about
the explanation : 100% Cardio&Emergency
(poor myocardial function, decrease in intravascular fluid volume, )
13.
PT baby 29 weeks blood gas at 36 hours with lab results show high
Na 148, normal K 4.3, normal Cl 106, high urea 10, Cr. in the upper normal
70 asking about the cause of lab results : 100% Neonat.&Emergency&Renal
(maternal electrolyte reflection, dehydration due to water loss, heamolysed
sample, transepidermal water loss).
14.
PT 26 weeker on on enteral feeding 90ml/kg/day with hyponatremia
Na 128 K 4.5 Cl 103 asking what is the cause: 100% Renal&Neonatology
(immature renal tubules, excess fluids volume, hypotonic fluids,
inappropriate ADH )
15.
The father known SCD, mother is a carrier, they got monozygotic
female twin asking about carrier rate for each child :
(50%, 25%, 100%, 33%)
16.
A child with picture of homocystinuria blond hair, blue eyes, dislocated
lense, presented with hemiparesis asking what is the investigation :
(serum AA level, brain MRI, blood film,)
17.
A child with hypotonia, developmental delay, metabolic acidosis with
normal anion gap, generalized weakness, aminoaciduria asking about
vitamin defiency :
( B12, Vit D ,vit. E, Niacin, Pyridoxin vit. A, niacin)
18.
A child with rickets, Na 130, K. 3.2, Cl 112, urine Ph 5, Ph 7.12
HCO3 11 asking about pathophysiology :
(defect in HCO3 reabsorption in PCT, defect in H ion secretions in PCT)
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TAS Feb. 2022
19.
A question about iron metabolism:
(absorebed in the ferric state F3, absorbed in proximal part of SI, not
affected by acute phase reactants, hepcidin affect its excretions)
20.
A group of 100 patient with neurodegerative disease the researcher
want to study the effect of new drug melatonin on their sleep pattern before
& after treatment, which will represent null hypothesis:
(paired T test, Qui square test, pearson, ANOVA, correlation coeffient)
21.
Scaenrio asking about the type of study :
Retrospective study on MRSA increasing case in the last year to know the
cause of the out come
(cohort, cross section, case report, case control)
22.
The researcher recruited a group of 250 adolescent from the same
region to study the effect of new drug?
(blind blacebo RCT, case control, cohort, case series)
23.
In mid gut rotation which is true?
(duodenum lies behind the ceacum in front of the mesenteric vessels,
duodenum lies on the rt hypochondrium beside the ceacum, 1st part of
duodem retroperitoneal, ampula of Vater opens in the 4th part of duodenum,
ceacum & the intestine lie in the upper quadrant, )
24.
A child with syncopal attacks cardiac catheter result:
Saturation:
SVC 79
RA 78 RV 78 PA 80 LV 97% Femoral artery 98%
Pressure :
SVC -- RA 3 RV 40/3 PA 40/10 LV 130/60 Femoral artery 80/60 :
(AS, PS, MS, AR, VSD)
25.
Site of maturation of T cell in the lymph node? Both Right
(cortex, capsule, germinal matrix, paracortex, medulla)
26.
Uk law for discrimination depends on ? 100%Ethics, 100% P.Safety
(Refugee, Relegion, Kinship, Political, social status)
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TAS Feb. 2022
27.
A 3 ys old girl with spinal cord injury presented in neurogenic shock
with bradycardia & hypotension, CNS examination normal what is the
pathophysiology of her shock: 100%Cardio, Emergency&Neuro
(Affected autonomic nervus system of cardiac ms leading to
bradyarrhythmias, affected autonomic nervus system of coronary arteries,
affected autonomic nervus system of blood vessels causing VD, increasing
capillary permeability)
28.
Which of the following can suggest sexual abuse?
100%Infention,Safety&Adolscent
a. Positive culture of chlamydia in urine sample of 8 years old female
b. Painfull anogenital warts in 18 months old
c. Conjunctival swap of nisseria
d. Positive oral swab of herpes simplex type2
29.
Which is responsible for risk talking behaviour in adolescent :
100%Neuro
(maturation of the prefrontal area, sleep deprivation, pressure in the
school, substance abuse)
30.
A child non immunized, with drolling of saliva, high fever, C/S show
gram -ve bacilli what is the organism: 100%Infection
(HI, chlamidia , listeria, chlostredium deficille, nesseria)
31.
A girl 6 ys old with pubic hair normal genitalia bone age 7.5 adult
oudor wt 90 centile hight 75 centile cause:
(exaggerated maturation of the hypothalamic pituitary axis,
exaggerated maturation of the hypothalamic gonadotrophin axis
estrogen secreting tumour, premature adrenarche, CAH, )
32.
Commonest enzyme deficiency in CAH : 100%Endocrine
(21hydroxylase, 17 hydroxylase, 3 hydroxylase, 11 hydroxylase)
33.
A15 years old obese child BMI 30 polyurea, glycosurea, Anti GAD
antibodies positive cause:
(DM1, DM2, monogenic diabetis,)
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TAS Feb. 2022
34.
Association with type1 DM : 100%Endocrine,DM&Immunology
(AIHA, Vetiligo, Addison, thyroid disease, pernitious aneamia)
35.
Mechanism of hypokalemia in DKA:
(osmotic diuresis, intracellular shift of K, fluid overload, dehydration)
36.
Side effect of salbutamol:
(increase glucose & increase lactate)
(decrease glucose & increase lactate)
(decrease glucose & decrease lactate)
(increase glucose & normal lactate)
37.
A child with bloody diarrhea, CBC show aneamia, thrombocytopenia ,
high KFTs, what is the causative organism :
(E choli, Campylobacter, pseudomonas)
38.
Baby pesented with generalized oedema, scrotal oedema
hypoalbumeneamia & proteinurea ++++ ,no heamaturea, normal BP cause:
(increased glumerular permeability to albumin,
(increased tubular permeability to albumin)
(IgA nephropathy)
39.
What is the layer affected in epidermolysis bullosa simplex :
(basement membrane without scar, intraepidermal without scar ,
intraepidermal with scar ,basal cell layer with scar, basal cell layer with scar,)
40.
What added to PCV after conjugation :
(covers more serotypes, boast immunity against diphteria, less ingection site
reaction, improved immue response)
41.
Anthypertensive with antiproteinuric effect:
(Prazocin, Enalapril, Amlodepine, Atenolol)
42.
A child 5 days old with seizures, conotruncal defect, what isassociated:
(thyroid aplasia, parathyroid hypoplasia, adrenal hypoplasia, William $)
43.
Baby with velocardifacial features how to confirm diagnosis:
(FISH, microarray, karyotype,)
44.
Pathophysiology in ITP :
(Destruction of antibody coated platelets by splenic macrophages,
destruction of platelets by autoantibodies, Destruction of platelets by
NK cells)
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TAS Feb. 2022
45.
Postnatal screening of MCAD in UK what it detect :
(acylecarnitine, MCAD enzyme assay, )
46.
DMD positive Gower sign, hypertrophy in calf muscles delayed walking
CPK, very high13000, how to confirm?
(Muscle biopsy, nerve conduction, DNA study, EMG)
47.
Microarray what it test :
( missing or extra DNA sequence across over chromosome, specific
nucleotide repeat sequence,)
48.
Mechanism of action of Doxycyclin in chlamydia treated patient:
(protein synthesis, cell wall, nuclic acid, antimetabolite,)
49.
In Peanut allergy what is the cell responsible for presenting Antigen in
the epithelium :
(dendritic cell, mast cell, b cell , t cell)
50.
Cause of periventricular calcification in CT :
(CMV, toxoplasma, HSV, rubella)
51.
A child with HIE & diagnosed as spastic diplegia, tip toe what can be
seen in brain MRI :
(periventricular leukomalacia, hydrocephalous, calcification in basal ganglia)
52.
TOF develop at what what stage:
-Embryonic(3-6 wks),
-Pseudoglandular(7-16wk)
-Canalicular stage(17-24wk)
53.
How to improve quality of work for the staff in the night shift:
(nap less than 45 min. taking melatonin, doing exercise for 10 at work,
working throught the night)
54.
Pathophysiology of parvovirus B19 in aneamia:
(cytotoxic against erythrocyte progenirator cell, bone marrow suppression)
55.
Lissencephaly is due to defect in :
(organization, methylation, migration, prosencephaly development)
56.
Baby boy 8 weeks old presented with vomiting blood gas: ph 7.54
HCO3 34 Cl 89 K. 2.5 Na 135 what of the pathophysiology:
(defect in the loob of Henle, loss of HCL from the stomach, loss of chloride
from the colon, )
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TAS Feb. 2022
57.
You are a volunteer in an area of earthquake checking a 6 months old
girl with dehydration, severe watery diarrhea 20 times per day, what is the
mechanism :
(activation of of cl channel, increase VIP, lactose intolerance,)
58.
Preterm with diaghragmatic hernia preductal saturation 95%
postductal 74% what is the cause:
(pulmonary vascular problem with lung immaturity, ventilation perfusion
mismatch due to left lung atelectasis, lung hypoplasia)
59.
Neonate with brain death, temp. 36C how to diagnose:
(failure of respiratory drive after disconnection from MV&increase PCO2 to
8KPS, EEG, corneal reflex, motor reflex, painfull stimulation, cerebral duplex
u/s)
60.
Gentamycin level predose high , post dose normal
(lengthen the interval with the same dose, decrease dose same interval, )
61.
What are the arteries forming circle of wills :
(anterior cerebral, basilar, vertebral)
62.
CT brain with mild dilatation in the lateral & severe dilatation in the 4th
ventricle :
(aqueduct of Sylvius, foramen of Monro, luscka & magendi)
63.
Component in breast milk responsible for BM jaundice:
(lactalbumin, betaglucoronidase, lactglubulin,)
64.
Mechanism of action amikacin :
(protein synthesis, cell wall, cell membrane)
65.
Nerve responsible for gastric emptying :
(vagus nerve, celiac trunc, superior mesenteric, )
66.
A child with hx of chicken box few weeks ago, then developed painful
erythematous rash, microbiology suggest to add clindamycin, what it can
add to ceftriaxone?
(inhibit the toxin, antagonize the superantigen, act against anearobes)
67.
What is the deapest
layer affected in the first degree burn?
(papilary dermis,? reticular dermis, hypodermis, basal layer,? cornium layer)
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TAS Feb. 2022
68.
What is the main component of surfactant?
(protein surfactant A, protein surfactant B , phosphatydil choline,
phosphatidyl glycerol)
69.
What is the main action of adrenaline in anaphylaxsis?
(stabilize mast cells, increase PVR, decrease angioedema, Bronchodilation by
action on B2 receptors)
70.
What is the mechanism of action of Atomoxetin in ADHD :
(inhibit the euptake noreadrenaline)
(inhibit the reuptake of dopamine)
(inhibit both dopamine& noreadrenaline reuptake)
‫احلمد لل والصالة والسالم علي رسول الل‬
‫الشكر كل الشكر جلروبنا املميز‬
‫وجعله صدقة و علم ينتفع به‬
‫نسأل الل لنا و لكم التوفيق والسداد‬
‫كما نسألكم خالص الدعاء‬
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