1) In history taking you must include all the following except?

- Introduce Yourself 2) One of the best communications skills in history taking is? - Eye to eye contact 3) Which one of the following regard social history? - Occupation 4) In hidden agenda is? - Ask patient about something keep it inside 5) Which of the following disease forms 90% of cases in the PHC? - Upper respiratory tract infection (URTI) 6) All true about past medical history except? - Smoking and alcohol 7) Which one of the following cause unilateral clubbing? - Axillary artery aneurysm 8) On examine Trachea move to towards on side : - Upper lobe collapse 9) Murphys sign is positive in? - Acute Cholecystitis 10) In Saudi Arabia, most common cause of renal failure is? - DM (Diabetes mellitus) 11) In Saudi Arabia family medicine is known as? - Family physician for each family

12) Types of family are? - Nuclear and extended

A,B

13) Principles of primary health care? - All of the above 14) Most common cause of intestinal obstruction is? - Adhesive bands 15) Most important vital signs in chronic disease in PHC? - Blood Pressure 16) Most common site for peripheral cyanosis is? - Hands, feet Commonest cyanosis -----cold 17) Absolute deficiency of insulin secretion referred as? - DM1, B-Cell destruction A&D 18) Prevalence of diabetes in KSA is? - 30% 19) Which of the following symptoms for its definition is not correct? - Nocturnal, morning urination 20) Diagnosis diabetes mellitus, which of the following is most appropriate test on one reading? - None of the above Hb1c 21) The most important factor to do screening for diabetes mellitus? - Age

22) In gestational diabetes mellitus (ONE FALSE)? - Reading as fasting=95, 1h=less than 180, 2h less than 155, 3h= less than 145 23) Which of the following is not macrovascular complications? -erectile dysfunction Ectopic 24) which of the following is not included in goals of treatment? -No proteinuria 25) the absolute contraindication to use metformin is? - renal faular hepatic faiular

*) Regarding to insulin ( one false ) : - the main side effect is hypoglycemia and Wight loss.

26) ex of rapid acting insulin is? - lispra *) Pioglitazone ( Actose ) is : - increase glucose uptake by skeletal muscle 27) the first treatment in pregnant women with GDM is? -Diet ( carbohydrate ) 28)type one DM associates usually with? - Celiac disease (hashimotos disease)

29) which of the following has a peak action 2-4 h? -Regular *) Insulin stimulate all of the following EXCEPT : - Gluconeogenesis 30) Preventive health means? -prevent occurrence of the disease 31) Methods to diagnose and treat extent disease in early stages before it causes significant morbidity? -secondary prevention 32)we classify blood pressure as malignant hypertension when diastole blood pressure is more than? -130 mmHg 33) in pediatric gastroenteritis the first step in assessment in PHC is? -assessment of hydration status 34) which of the following is not emergency case in PHC? -Diabetes mellitus 35) laryngopharyngitis (croup) best treatment is? -Steam inhalation 36) one of the most common fracture attending PHC is ? -Supracondylar 37) the eitiology of graves disease is? -Autoimmune

38) best test to diagnose graves disease is? -Thyroid ABS(antibodies) 39) evalutating a 36 year old man in your office with chief complaint of abdominal pain which of the following characteristics of pain if present would lead toward and emergent evaluation? - the pain began suddenly

40)difference between Duodenal and Gastric Ulcer? -Duodenal Ulcer- pain increase by hunger, pain is relieved by eating -Gastric Ulcer- pain relieved by hunger, pain increase by eating 41) in history taking you must include all the following except? -Introduce Yourself 42) while performing an abdominal examination on a 42 year old female in your office, she suddenly stops? -choleycistitis 43) the best measure for obesity is? -Body Mass Index 44) Prevalence of obesity was more in? -Females 45) Metabolic syndrome has 4 components? a)diabetes b)hypertension c) hyperlepidema

d) waist circumference #######sah 46) Metabolic syndrome criteria is? - HDL less than 40 in males - HDL less than 50 in females -LDL less than 100 in males+++ -LDL less than 150 in females 47)which of the following is not a contributing factor to obesity? - excessive sleeping 48) the increase in obesity lead to increase the prevalence of all the following except ? -Right ventricular hypertrophy 49)The best treatment options regarding obesity is? -Diet, Exercise 50)All of the following are causes of secondary hypertension except? -crohons disease 51) what is the definition of prehypertensive? -120-139/80-89 52) systolic blood pressure in stage 2 hypertension is? ->160 mmHg 53)if patient attending to PHC setting with blood pressure 155/90 in 10 minutes after his arrival first step is? -recheck the blood pressure by yourself

54)the most one of the lifestyle modification after weight reduction cand reduce the SBP is? -Adopts DASH eating plan 55)the first initial drug in healthy person with hypertension according to JNC7 is? -Thiazides diuretics 56)Side effects of thiazides is? - Hypokalemia -Hypomagnesiumia -HypoNitrinea -Hyperglacemia 57)best treatmen for treatment hypertensive patients with DM is? -ACEI and ARB A,C

Lisinipril is ACEI contra in preg + renal failure 58) Absolute contraindication to use ACEI is? -Pregnancy 59) Atenolol is? - B-blocker 60)single most predictor of mortality and morality is? -left ventricular hypertrophy 61)drug of choice of acute otitis media in PHC? -amoxicillin

62)most common cause of Otitis Media? -Streptoccocus Pneumonia 63)the commonest complain of acute tonsillitis is? -sore throat 64) the best way to diagnose tonsillitis is? -clinical examination 65) complication of sinusitis include all except ? -Subdural hepatoma 66) risk of otitis media includes all of the following except? -Female sex 67) percent of people from ages 0-3 years old who have otitis media? -90% 68) Recurrent otitis media definition is? -more than 3 episodes of last 6 monts 69) most common fracture attending PHC is? -Supracondylar 70) Malignant hypertension is medical emergency where diastolic pressure is above? -130 71) the aim of manage malignant hypertension is? -110 mmHg over 24 hours

72) best treatment of abcess is? -Drainage 73) croup is (ONE TRUE)? -All of the above or dexa lo mafe all Intial steme 74) best initial treatment for laryngotrachitis is? -Steam inhalation 75) absolute contraindication to use metformin is? -Type 1 DM 76) example of rapid acting insulin is? -Lispro 77)Actose is? -Glitazons ((( pioglitazone this anas )) Ddp e.g. sitagliptine 78)best type of diet is? -high fiber diet 79)the recommended weight reduction is? - 7-10% 80)common cause of common cold is? -Rhinovirus 81)most effective preventive measure against the common cold is? -meticulous hand washing

82)which of the following physical signs associated with allergic rhinitis is found most commonly in children not adults? -salute sign 83)which of the following is most sensitive and specific means for diagnosis of appendicitis? -History & physical examinations

84)Diabetic should do follow-up check-up every? -3 months 85)Hypertensive should do follow up every? -1 month to 2 months

Ciprofloxacin contra in pedia less than 12 years Heparin cross placenta Artificial sound not with IBS Microcytic ----- chronic renal f Ulcerative colitis ---- cancer Influenza + nomococal vaccine for ----DM Increase risk influenza in ---- school age High risk hepatoma in-----hip B Chronic cough------- post nasal drop DM with lower limb -----rosiglitazone Topical decongestant lead to ----- rhinitis medica Lisinopril ---MOA ACE decrease vasopressor activity decrease aldosterone secretion - HDL increase not risk - Absolut contra Vaccine ----- no conrtra for vaccine - Type of dehydration

- : hypotonic or hyponatremic (primarily a loss of electrolytes, sodium in particular), hypertonic