و عليكم السلام
my dear, the MCCEE is mainly clinical exam, it is very similar to USMLE step 2 exam, you may have few MCQs about the basic sciences but generally you dont need to study biochemistry, physiology, pathology, pharmacology, etc..
Regarding the preparation, i think these are the best resources:
موجودة على الرابط التالي
http://www.mimg.org/vb/showthread.php?t=5615
افضل المراجع للمذاكرة
toronto notes تورنتنو نوت
هو المرجع الرسمي حسب الموقع و مهم تقراه كامل
لكن لو ما عندك وقت على الاقل اقرا الخمسة الاجزاء
introduction & ethics
family medicine
community medicine
population medicine
psychiatry
USMLE step 2 secrets
كتاب جدا رائع و مفيد لا بد من قراءته قبل الامتحان يعطيك معلومات هامة تجي في الامتحان و فيه كل التخصصات و ملخص ما ياخد وقت طويل
psychiatry pretest mcqs
اسئلة و حالات في الطب النفسي مشابهة للامتحان الكندي
behavioral sciences high-yield
مهم تقرأ منه بعض المواضيع مثل
sleep, human develpoment, sexual development, ethics, personality, defense mechanisms
Kaplan lectures for usmle step 2
محاضرات الكابلان تشرح جميع المواضيع بشكل مبسط و رائع لكن تاخد وقت طويل
لو ما عندك وقت على الاقل
psychiatry
NMS usmle step 2 mcqs
كتاب فيه اسئلة ممتازة لكن صعبة شوية، مفيد في اسئلة الباطنة
Kaplan usmle step 2 mcqs
ايضا كتاب فيه اسئلة رائعة و صعوبتها معقولة
old mcqs very important to read as many mcqs as u can
من اهم الاشياء انك تقرأ اسئلة الامتحانات السابقة
جدا مهمة
اسئلة كثير جدا تتكرر
طبعا المهم انك تعرف حل السؤال فقط لكن لو عندك وقت حاول تقرأ الموضوع كامل لانه بعض الاسئلة يكون فيها اختلاف بسيط
ملاحظة: اغلب الكتب و ايضا مجموعة كبيرة من الاسئلة موجودة في مكتبة فاطمة بجدة عند مدخل الجامعة بوابة رقم4
(المذاكرة للامتحان تحتاج على الاقل 4 شهور عشان تلحق تقرأ الكتب كلها)
و هنا مجموعة من الاسئلة موجودة في موضوع سابق على الرابط
http://www.mimg.org/vb/showthread.php?t=5615&page=2
و ايضا موقع ممتاز مليان اسئلة
MCCEE
http://devbro.com/mcc
MCCEE EXAM, SEPTEMBER 2006-09-08
1. the most common causative organism in a patient who had food poisoning after eating egg is:
salmonella=> the most common organism in egg
2. in a study for prevalence of colon cancer among differnt age groups the results were
10-20y= 20
20-30y= 55
30-40y= 68
40-50y= 100
50-60y= 154
60-70y= 209
>70y= 204
conclusion: cancer colon ancrease with age, this conclusion is:
-justified
-not justified, because when we use rate for prevalence...
-not justified, because.......
3. 40 y.o female had breast cancer and treated properly, found to have gallstone incidently, pt denied any hx of epigastric pain or discomfort, what u will do:
-observation
-lap chole => bc there is likelihood of future complications and deterioration
4. female pt came with recurrent angioedema and stridor with family history of angioedema, diagnosis:
-IgA syndrome
5. all of the following drugs may cause depression except:
-warfarin
-propranolol => may cause depression and bizarre dreams
6. regarding intravenous regional block anesthesia (Bier Block). which is true:
-can be used also for postoperative analgesia =>not sure of this and dont remember other answers, but Bier's block is a short-lived, wide-field ambulatory intravenous anesthesia used for hand surgery
7. case of asthma, one of the following is true regarding agents used in management of cases:
-hydration, beta agonist inhalation, IV corticosteroid
8. one of the following is not risk factor for lung CA:
-nickel miners =>nickel increase incidence of lung cancer
-coal miners
9. pt on ventilator has pCO2=50, which of the following is next step:
-increasse the respiratory rate
-increase tidal volume
10. regarding non-ionizing radiation:
-workers with {welderاللحام} light have high risk?? =>not sure about it but read about ionizing and non ionizing rad.
-????
11. 40 y.o female pt has depression but no neurological symptom, she has strong family history of Huntington's disease, which is true:
-this presentation can be early Sx of Huntington
-Criteria of Huntington include psychiatric and neurological Sx => neuropsychiatric Sx with depression and cognitive impair. typically occur after motor abnormalities, but may be the presenting manifestations. But classically the early symptoms are chorea, seizures or rigidity
12. regarding MMSE, which is true:
-score < 25 is abnormal => false, score equal or less than 24 means cognitive impairment
-it can be used for F/U of cognitive function = right
13. the best drug for ttt of OCD:
-sertraline (SSRI) => the effective ttt is SSRI + clomipramine + CBT
-???
14. pt has paresthesia and weakness of the hand, how u can confirm diagnosis: (carpal tunnel/ fracture?)
-nerve conduction study => neurophysiology confirm lesion site and severity, Phanel's and Tinel's not reliable
-X-ray
15. female pt came with Hx of fatigue, the rest of Hx and Ex is unremarkable, Dx:
-chronic fatigue syndrome => diagnosed by exclusion
16. female 14 y.o want OCP, mother called u concerned about this what u will do:
-prescribe OCP to the daghuter => OCD & STD in teen, treat without informing parents
17. pt with mitral valve disease want to do dental work, came for concelling for prophylaxis:
-depend on type of dental work => only dental procedures involving extractions, scaling, polishing or gingival surgery need prophylaxis (oxford handbook)
18. 50 yo hypertensive came with epistaxis u will do all of the following except:
-anterior packing
-posterior packing => only done if bleeding continues despite anterior pack
19. case of child with enuresis, the most appropriate management is:
- alarm => first line ttt is behavioral therapy (alarm,chart,biofeedback), 2nd line is imipramine
20. which one of the following can use thiazide therapy:
-middle age hypertensive man with headache??? => read the classical candidate for thiazide therapy and contraindications
-???
21. the best treatment for decompression illness is:
-recompression
22. the drug therapy for BPH is:
- 5alpha reductase inhibitor (Finasteride)
23. child has missed his second dose of H.influenza vaccine, and came late what will u do:
-give him the missed dose and give the other dose after 2 month
24. 18 yo male with yellow nail (onychomycosis) what is the ttt:
-oral griseofulvin 2 month => toenail mycoses are resistant to ttt and need 1-3 month of systemic itraconazole or griseofulvin
-oral ketoconazole 12 month
-topical......
25. how can u prepare the wet preparation of gynecologic infection for clue cells:
-drop of cervical secretions with KOH covered with slide
-drop of vaginal secretion with KOH " " " "
-drop of cervical secretion with normal saline " " " "
-drop of vaginal secretion with normal saline " " " " => bacteria coating WBC seen in bacterial vaginosis under microscope
26. pt had gynecologic infection with greenish thick discharge treated with metronidazole the most likely cause is:
-trichomonas (protozoa) => frothy yellow discharg + strawberry cervix
-bacterial vaginosis (anaerobes) => greyish white adherent discharge, this is the right answer because discharge is thick and this is the most common gynecologic infection in adult women
27. pt had cervical cancer treated with chemo. came with hematuria the most likely cause is:
-infective cytitis
-hemorrhagic cystitis
-extension of disease or recurrence
28. ttt of DKA include all of the following except:
-NaHCO3 ampules
-check K and glucose every 2 hours
29. intravenous immunoglobulins can be used in ttt of:
-Kawasaki
30. pt with Sx of meningitis, CSF analysis showed slightly raised protiens, normal glucose, cells mostly lymphocytes, most likely:
-aseptic meningitis
31. 80 yo male with back pain, X-ray show sclerosis of pelvic bone, most likely diagnosis:
-metastatic prostate CA
32. 70 yo male with back pain, high serum calcium and protiens, what is the Dx:
-multiple myeloma
33. child came with ambigiuous genitalia, most likely Dx:
-CAH
34. 3 weeks infant came with persistent non-bilious vomiting since birth, Dx:
-pyloric stenosis
35. infant 4 weeks with vomiting and metabolic alkalosis, how u confirm the diagnosis (pyloric stenosis):
-ultrasound (show pyloric muscle) => right answer!
-x-ray (GI series meal show enlarged stomach and elongated pylorus)
36. child came with severe pain in knee, there is tenderness, x-ray show subperiosteal lesion, diagnosis:
-osteomyelitis => local tenderness goes more with OM + subperiosteal lesion
-bone tumor
37. abdominal mass in newborn is most likely due to:
-kidney and renal abnormalities => most of abdominal masses in babies are hydronephrosis and polycystic kidneys
38. 17 yo female came with primary amenorrhea, how u will confirm the Dx:
-karyotype => Turner's syndrome is most common
39. mother brought her 9 y.o daughter c/o bilateral tender breast enlargement, what will u do:
-nothing, reassure that this is normal => due to puberty
40. 20 yo female need councelling to get pregnant, what will u do:
-start folic acid 0.4mg/day
41. the most common cause of amenorrhea in pt on regular OCP:
-pregnancy
-???
42. at what time uterine perforation may occur with IUCD:
-first insertion
-before insertion with sound
-during manipulation to find a lost IUCD
-with abdominal trauma
43. pt had laparoscopic tubal ligation and discharged 4 hours later, called u at night c/o shoulder tip pain, what u will do:
-reassure that pain most likely due to diaphragmatic irritation
-ask her to come to ER
-ask her not to take analgesics and if pain become more severe present to ER
44. female pt had tubal ligation then came with severe abdominal pain, the most likely cause is:
-salpingitis
-bowel injury
-bladder injury
45. the best time to do amniocentesis:
-between 15 and 18 weeks
-between 19 and 21 weeks
46. pregnant pt came @ 40 weeks with IUGR, what is ur management:
- C-section
47. all of the following are relative contraindications for tocolytics except:
-twin pregnancy
48. female pt diagnosed with bicornuate septal uterus, what u will tell her:
- she may have recurrent abortions => "may have" so this is the most correct
- she is infertile
- she can never get pregnant
49. male pt came with fasciculation, weakness, hyperreflexia (combined UMN & LMN Sx), Dx:
- motor neuron disease => this is the most common disease with both UMN & LMN lesions
50. an infant came with dehydration and Na = 170, which of the following may occur during management:
-seizure => the stem was more complicated but this was the most correct answer as seizure may occur during rapid correction of hypernatremia
51. pt had 2 episodes of sudden blindness, what is the Dx:
-amaurosis fogax => a sudden transient loss of vision in one eye
52. the most common cause of hearing loss in older age is:
-presbycuosis
53. pt came with Hx of edema around eye with PROPTOSIS and ophthalmoplegia, Dx:
-orbital cellulitis => since there is proptosis, then it is orbital
-periorbital cellulitis
54. one of the following neurological diseases has no effective ttt:
- Creutzfeldt-Jakob disease
55. alcoholic pt has hypomagnesemia, which is true:
- may have hypocalcemia => most commonly associated with hypomagnesemia
- may have hypokalaemia
56. young healthy girl came for annual check up, asymptomatic and PE was unremarkable, urinalysis show protien +++, what is next step:
-do 24 hour urine for creatine clearance? => wrong because it should be 24-hour urine for protein!
-repeat urinalysis 2 times => right, always confirm protienuria on repeated tests
-observe only
57. male pt with urinary retention, u passed a catheter and pt relieved but durnig the following hour pt had severe diuresis what will u do:
-correct fluid loss partially with IV fluids
-encourage oral overhydration => if pt is conscious and well, this route is preferable
58. pt came to u in the ER...a woman sustained a human bite..u orderd for HBV screen for ur patient..u didn't order HCV or HIV...the second day, the biter's doctor told u that his patient "the biter" got some blood in the mouth from the bite..and he wants to know f ur patient has HCV or HIV, u asked ur patient to do the test and she strongly refused..what u will do:
-tell public health commitee to order ur patient to do the test for the other patients best interest
-ask the lab to do HIV test from the sample they have without even a verbal consent from the patient
-ask the lab to do HCV
-tell the physician to treat his patient as if there is HCV or HIV contamination => you should respect the pt desire
-let the biter seek the permission himself from the bitten woman
59. pt came to u after biten by animal, with open wound, he told u he has taken tetanus vaccine during the last 2 years, what is ur management:
-local antibiotic
-suture
-give tetanus toxoid
the pt already had the vaccine within the last 5-10 years so no need to give toxoid, post exposure, wound should be cleaned with water and soap, debrided and left open, so most reasonable answer is to give local antibiotic although it should be more appropriately systemic antibiotics
60. newborn has tested +ve for HIV ELISA & western blot @ 6 month, which is true:
-baby is infected and mother is infected
-baby is not infected and mother is infected
-baby is infected and mother is not infected
if the mother was infected and the baby was not, then Western blot (Ag) will be -ve and ELISA (IgG) will be washed out from baby @ 18 month, so only ELISA will be +ve but not Western
if baby was infected but not the mother then only Western blot will be +ve and IgG will need time to develop so ELISA may not be +ve, unless passed through placenta
61. all can cause lung abscess except:
-mycobacterium tuberculosis
-pneumocystis carnii => RIGHT
According to Kumar Medicine: definition of lung abcess is a severe localized suppuration in the lung associated with cavity formation on CXR, with fluid level and NOT DUE TO TUBERCULOSIS!
62. death rate from diphteria has decereased, due to:
-decrease incidence rate (after vaccination)
63. pt was biten by animal, which of the following true:
-give rabies immunoglobulin => must be given immediately
-give rabies vaccine
-kill the animal and take brain biopsy to confirm
According to Kumar: post exposure prophylaxis of Rabies (1)give 5 doses of human diploid cell vaccine on days 0,3,7,14,28 (2)clean wound with soap and water (3)debride adequately (4)left wound open (5)give rabies Ig immediately, 20 IU/kg, half @ site of lesion and half IM
64. pt came with IDA all of the following may be abnormal except:
-FEP (Free Erythrocyte Protoporphyrin) => FEP and transferrin are both high in IDA
-serum iron
the most important in IDA is low serum ferritin (but its also acute phase reactant so may raise with inflammation), low ferritin + low serum iron confirm Dx, TIBC may be high but can be normal!
can be abnormal= FEP, transferrin, ferritin, TIBC, serum iron
65. a nurse patinet with hypoglycemia, how to confirm the diagnosis (factitious):
- c-peptide
66. newborn pt came with bleeding:
- hemophilia
- hemorrhagic disease of newborn => the most common cause of neonatal bleeding due to vitamin K deficiency
67. pt has history of palpitation, hypertension, there is family history of thyroid cancer:
-Multiple Endocrine Neoplasia => MEN type 2a (Pheochromocytoma,Thyroid medullary carcinoma,Parathyroid hyperplasia)
68. an African Canadian adult male came with history of anemia and pain, what is the most likely diagnosis:
-Sickle Cell Anemia
69. a middle aged Greek female came with anemia, how to confirm the diagnosis:
-hemoglobin electrophoresis => Thalassemia, the normal HbA 98% contains 2alpha+2beta, HbA2 2% 2alpha+2delta, HbF 1% 2alpha+2gamma, HbBart occurs in hydrops fetalis in case of 4 abnormal genes in alpha thalassemia 4gamma, HbH occur in HbH disease in case of 3 abnormal genes of alpha thalassemia when they are adults 4beta, HbS in SCA 2alpha + 2 abnormal Beta, in Beta thalassemia major there is no beta globins so only HbF and HbA2, while in Beta thalassemia minor there will be some beta globins so HbA is there but reduces and HbF and HbS2 are elevated
70. elderly male came with recurrent lower GI bleeding (100ml), all investigations are normal, what is the most likely Dx:
-angiodysplasia => typically present with fresh bleeding in the elderly
-telangiectasia
71. pt came with upper GI bleeding, endoscopy show longitudinal mucosal wound in lower esophagus, pt is not bleeding now, what will u do:
-suture the wound => right, there no bleeding right now but pt may rebleed later, and since the scope is already there suture the open wound
-observation
72. elderly male came with postprandial abdominal pain, Hx of IHD, what is the Dx:
-bowel ischemia
73. treatment of acute dystonia is:
-benzotropine => acute dystonia occur in young men starting neuroleptics (antidopaminergic agents e.g. phenothiazines like chlorpromazine), ttt with anticholinergic i.e benzatropine
74. the lesion of primary syphilis (Chancre=painless raised skin lesion) should appear within:
-3 month => usually appear 21 days after exposure, but ranges between 10 - 90 days max.
-6 month
75. pt has mass in mandibular area, examination revealed enlarged parotid gland, how u confirm the diagnosis:
-CT head and neck => right, 80% of salivary gland tumors are in parotid, 80% of these are pleomorphic adenomas
-sialogram => indicated in case of stones which present with unilateral pain with swelling
76. pt came with chest pain and supraventricular tachycardia, ttt is:
-digoxin orally
-digoxin IV
-lidocaine IV => ADENOSINE is drug of choice for Dx and ttt of SVT, LIDOCAINE is especially effective in VT/VF with ischemic myocardium if pt is hemodynamically stable, AMIODARONE used in ventricular arrythmia with CHF and low EF, if pt is hemodynamically unstable DEFIBRILLATION is the ttt.
SVT=ADENOSINE
VT=AMIODARONE+LIDOCAINE
VF=DEFIBRILLATION
AF=slow rate DIGOXIN + cardiovert with AMIODARONE or DC
77. ur patient has gonorrhea..and his wife works in the lab and he doesn't want her to know...what u will do when u send the sample:
- send the label with another patient's name
- put a label with a symbol i think..almohem enno shi ma yedol 3aleeh
- u call his wife immediately and tell her to visit u and force him to tell her infront of u
- send the result to another lab
- encourage him to tell his wife => ethically his wife should know about that but you should try to convince him not to force him
78. 7 years girl..with history of vomiting since birth came with mild hematemesis, what will be the cause:
-hiatis hernia
-GERD => may cause esophagitis which may cause mild bleeding
-esophageal diverticulae
79. case of recurrent UTI due to posterior urethral valve..what will be the most appropriate measure to decrease the UTI till operation can be performed:
-continuous antibiotic
-acidification of urine => an easy and safe method to decrease UTI
-antibiotic for a short period
-good nutrition
-suprapubic cath
80. u will treat asymptomatic UTI in all of the following except:
-pregnant woman
-diabetic
-immunocompromised
-pt with indewlling cath => no need for treatment coz pt will have it no matter what we do and there is no danger
81. a case of newborn with billous vomiting u will confirm the diagnosis of biliary atresia with:
-CT abd
-barium meal
-upper GI series
-US => diagnostic
-Abd X-ray
82. which of the following is a complication of dystocia in the second stage of labor:
-bleeding => one of the complications of dystocia
-ruptured uterus
-Uterine atony
83. G5 P4 normal medical..previous C/S in the middle of the labor she had perfuse vaginal bleeding..and hypoteniosn what will be ur Dx:
-uterine rupture => most likely Dx
-lacertaed cervix
-vaginal trauma
-blood dyscariasis
-DIC
84. primeigravida, normal medical and surgical in the labour..6 hours in stage 2 the baby started to have severe brady cardia and she's tired what u will do:
-oxytocin
-analgesia
-immediate C.S => save baby and mother
85. G2.P1 the previous delivery was C/S and she wants to deliver vaginally..which of the following sentences is correct:
-absolutely she never can deliver normally
-She can deliver normally
-absolutely she can't deliver normally if the previous C.S was classic => previous classic CS is absolute CI
86. ECG: DIAGNOSIS IS LEFT AXIS DEVIATION WITH RIGHT BUNDLE BRANCH BLOCK (there is RSR pattern)
Q: a case of an old male with long history of cardiac disease came with Sx of CHF, ECG is provided, what is the
diagnosis?
87. ECG: DIAGNOSIS IS ATRIAL FLUTTER==sawtooth
Q: a case of young male with history of RHD in the past, what is the diagnosis?
88. PICTURE OF ULCER LESION IN THE LOWER LIP, DIAGNOSIS?==SQUAMOUS CELL CANCER
89. PICTURE OF INFANT WITH BURN IN THE BUTTOCK, WHAT WILL U THINK OF?==INFLICTED BY FAMILY OR CHILD ABUSE
90. PICTURE OF BLACKISH AXILLA, 40 Y.O FEMLAE CAME C/O DISCOLOURATION OF AXILLA, WHICH ONE MAY BE THE CAUSE?==DRUG SHE IS TAKNIG
91. PICTURE OF A CHILD WITH RAISED ERYTHEMATOUS LESION IN TRUNK AND FACE, WHAT OTHER ABNORMALITIES U MAY FIND?==MOUTH LESIONS AND LYMPHADENOPTHY(KAWASAKI DISEASE)
92. PICTURE OF AN INFANT WITH RECTAL PROLAPSE HOW U CAN DIAGNOSE?==CYSTIC FIBROSIS, SWEAT CHLORIDE TEST
93. PICTURE OF YOUNG MAN WITH PRESSURE LESIONS IN TRUNK AND LEFT ARM
the patinet brought unconscious after phenobarbitone overdose, what is the cause of pressure ulcer==skin necrosis
94. PICTURE OF TOE WITHOUT NAIL AND BLOOD WITH GRANULATION TISSUE
35 YO female presented with such a toe, she noticed a red lesion under the nail of the big toe and she was treated with antifungals (she thought it was athlete's foot) but no improvement, it became bigger with destruction of the whole toenail, no past medical or surgical Hx, what will u do:
-culture for mycosis
-give antibiotic
-take a Biopsy
95. PICTURE OF CHROMOSOMAL ANALYSIS (KARYOTYPE) SHOWING XO (TURNER SYNDROME)
what can we find in this pt clinically?==(findings of Turner's syndrome!)
96. PICTURE OF BLUE SWELLING IN THE FLOOR OF THE MOUTH UNDER THE TONGUE
what is the diagnosis?==Ranula
97. when a patient does action reverse to what he was doing in the past, this defense mechanism is called:
-undoing
================================================== =======================
TAREG
77. HIV +patint with history of heart disease died with pneumonia and sepsis
which of the following is considered age specific death rate:
-AIDS
-HIV + virus
-cardiovascular disease
-pneumonia
78. waht is agoraphobia
79. teenage boy complainig of not having agirl friend yet and from sexual
fantasies about his male friend:
-reassurance that homosexual attraction is common among teenagers
80. all of the following are established relations except:
-chweing betel nuts and oral cancer
-nickel and liver cancer
81. cleft palate the cause of frequent visits would be:
-recurrent ottitis media
-feeding diffeculties
82. female complaining of RIF pain radiate to her leg PE RT adnexal mass 4cm
next step:
-U/S
-B-hcg
83. patint on antidepressent had 2 manic episodes:
-bipolar I
84. teenage boy on antidepressant medications for 4 months wants to
discontinue:
-continue for 1 year
85. good prognostic factor for autism:
-engage in group play????
86. all of the following are symptoms of "chinease resturant syndrome"
except:
87. ct head finding in schizophrenic patint:
-increase ventricular size
88. amniocentesis is recomended in all except?????
89. primegravida in labor PE cervix 4cm and foot felt:
-cissarian section
90. you treat asymptomaic bacteuria in all of the following except:
-patient with endwelling cathteter
91. infant with vesicouretric reflux:
-continous Abx
92. eye trauma with apaper:
-corneal abrasion
93. raising cut off point of adisease well:
-increase sensitivity and decrease specificity
94. gender identity disorder???
-cross dressing in childhood
95. revearse action of a past action the diffense mechanism is:
-undoing
96. iron overdose first symptom:
-abdominal pain and vomiting
-jundice
97. personality disorder:
-antisocial personality
98. 20 year old girl diagnosed with depression and currently not in agood
relation with her mother or her boy friend the best psychotherapy:
-interpersonal psychotherapy????
99. group of people had aparty and presnted with food poisining after 24 h
what is the organism:
-E.coli
100. selective mutism????
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SMILO
77. Male patient presented to ER with agitation, mania and grandiosity .The best ttt:
1)- Haloperidol
2)- Imipramine
3)- Sartaline
4)- Lithium
78. The old patient with depression. You want to prescribe MAOI for him. The one with less sedating and anticholenergic effect is:
1)- Imipramine
2)- Sartaline
79. 40 Y/O female had bilateral laproscopic oopherectomy on the morning and discharged after 4 hours. On evening she called the on call who was you and complaint of shoulder tip pain. What you will tell her?:
1)- To come immediately to ER
2)- to stop the analgesia and watch for the pain if it continued to come immediately
3)- to visit her physician tomorrow
4)- Reassure her that this is due to diaphragmatic irritation and not to worry
5)-
80. 16 y/o girl was sexually assaulted. What you will give her as prophylaxis against syphilis and gonorrhea:
1)- Penicillin
2)- doxycyclin
3)- gentamicin (am not sure from this option)
81. 14 y/o girl came to you as the family physician telling you she’s sexually active and asked for contraception. What you will do?:
1)- Tell her to stop this activity
2)- tell her to bring her parents for a consent
3)- phone her mother to tell her as she’s one of ur known patients
4)- provide contraception and counselling in regard to STDs
5)-
82. male patient in 60s or 50s (I don’t remember) has recurrent apical pneumonia and dysphagia. Which one of the following tests will help in the diagnosis:
1)- Barium meal
2)- Chest X ray
3)- tonometry of the gastric inlet
4)- ..
83. Couple came to you as they didn’t have any marital activity for the last 9 months. The husband is 45 male diabetic and HTN on medic. His waife secretly told you that he has spontaneous morning erection also when he sees adult magazines. You action will be:
1)- send them to psychiatric without further evaluation
2)- send the husband to urologist
3)- change the HTN medication.. (not sure from this option too)
4)-
5)-
84. Parent phoned you and told you that their 8 years son caught stealing cards from (I don’t remember where)..and they are so angry and they don’t want him to be grown like (someone in the family..?)..what you will tell them:
1)- that you are sorry but you have to inform (something like police!?)
2)- that he needs psychiatric consultation
3)- that they have not to worry as this is a totally normal for his age
4)- that he needs regular visits with the school counsellor (I hope it was counsellor)
5)- ..
85. a mother phoned you telling her 3 y/o girl is aggressive used to spill her milk then to cry vigorously kicking the ground with her limbs. Your advice:
1)- to ignore her daughter and see
2)- to distract her daughter and redirect her from ( I think something like violent behaviour) to positive play
3)- that he daughter needs psychiatrist
4)-
5)-
86. Alen 4 years old boy(or 3!) has a confirmed diagnosis of autism. The mother phoned you and wants to know the prognosis. You will tell her that the prognosis will be good:
1)- of he showed some interest in group play with his peers
2)- if he talked
3)- ..
4)-..
5)-..
87. Female patient with breast cancer on radio therapy (and I think on chemo).. Incidentally on chest X ray 2 stones were found in the gall bladder. She denies any post-prandial pain or discomfort or any upper right quadrant pain. Your action
1)- elective laproscopic cholecystectomy
2)- ERCP
3)- Leave her without treatment and reassure later (or F/U)
4)- Do liver enzymes test
5)- ..
88. 48 years old African-Candian male patient presents to ER with sever abdominal pain and bone pain. He had many episodes before of abdominal and bone pain but this is the worst. Dx:
1)- Haemochromatosis
2)- SCA
3)- Familial Mediterranean Fever
4)- Cholecystitis (am not sure from this option)
5)-
89. female patient in 40s had elective cholecystectomy. After the operation by 5 days she presented with Lt leg pain. O/E there was a red swelling on the upper medical side of the Lt thigh. Dx?am not sure if the scenario is complete)
1)- Superficial thrombophlebitis
2)- Deep thrombophlebitis
3)- (A VERY WEIRD NAME I think of bug or bacteria!)
4)- DVT
5)- Lymphadema
*am sure from all options
90. 13 Y/O old obese boy presented with limping and leg , calf and thigh pain . Dx:
1)- Congenital hip dislocation
2)- Slipped…epiphysis
3)- Leg-Calve.. S
4)-
91. 5 y/o boy presented to ER after being pulled strongly from his RT arm. O/E the arm was adducted , on pronation position and hanged simply at the body side. (am not sure if this MCQ had the scenario of dropped shoulder or not)
1)- Median nerve injury
2)- Radial nerve injury
3)- Injury of the brachial plexus
4)- Ulnar nerve injury
5)- Rotator Cuff injury
92. ACLS question: arrested patient has ventricular arrhythmia. You opened the airways, chest compression to reassure the blood circulation into vital organs. You D.C shocked him on 200,300 and 360 J.. and he still on arrhythmia.. Your next action:
1)- D.C shock again on 360 J
2)- Continue chest compression
3)- atropine every 3-5 min
4)- (I think there was lidocine
5)- ..
93. Female patient presented with palpitation and found to have supraventricular tachy cardia (I don’t remember if they mentioned any numbersor any very critical sympotoms like CVA, arrest or anything).. Your Management:
1)- Adinosine
2)- Lidocine
3)- D.C shock
4)-
5)-
94. a VERY obese male has a severe morning headache and quit his job sue to this & fatigue all over the day. His wife told you that he snores very loudly in the night not like his usual and awakes her many times in the night with his snoring and he was just like suffocating .
He’s not known to have any other chronic medical or surgical illness. Your immediate action:
1)- Send him to sleep lab looking for sleep apnea and if he needs a resp. support on sleep
2)- Aggressive reduction of his weight
3)- referr him to ENT (am not sure from this option)
4)-
5)-
95. Amniocentesis detects all of the following except:
1)- Dawn $
2)- X fragile $
3)- Anencephaly
4)- ..
5)- ..
96. 18 years old college student came to you telling that she never has menses. Not known to have any chronic medical or surgical illness. O/E she was totally normal but the chest was slightly broad. Her pre-pubertal pelvic examination was normal too. Your next action (am sure they didn’t mention anything abt if she has breast or not):
1)- Ask for chromosome analysis (or karyotyping I don’t remember)
2)- Head CT
3)- Prolactin
4)- Abdomin X ray
5)- U/S (am not sure if this was there or not)
97. the famous MCQ of the nurse with hypoglycaemia and low C-peptide
98. male patient with post prandial mid-abdominal pain. (I don’t remember the rest of the Q)
1)- mesenteric ischemia
2)- uretral stone
3)-
4)-
5)-
99. Caucasian male immigrant in his 20s or 30s (am not sure) presented to you with left lower abdominal pain and diarrhea with floating stool. He lost I think 7-10 Kg in the last 6 months and he suffers fatigue and malaise, And there was mild tenderness too (am not sure from the rest of the scenario but I think they mentioned something about WBC). Dx:
1)- chronic appendicitis
2)- acute appendicitis
3)- Giardiasis
4)- Inflammatory bowel disease ( I don’t remember if they specified one of them )
5)- Mesentric lymphadenitis
100. Male patient with gastric ulcer. Endoscopy done showing irregular shaggy ulcer in the stomach. Biopsies were negative. He has ahydrochlorria (mostly tis word was in this MCQ ;p). What you will do:
1)- Repeat the endoscopy with new biopsies
2)- measure gastrin level
3)- Abdomen CT
4)- Barium meal
5)- ….
101. patients with dementia. There brain CT will show (am not sure if this was the only info in this MCQ)
1)- atrophy of the frontal lobe
2)- Widened lateral ventricles (most probably they specified which ventricle )
3)- ..
4)- ..
5)- ..
102. Old male patient with lower back pain and hypercalcemia. (as I remember they braught a lab but I don’t remember what exactly). Dx:
1)- Myeloblastic leukemia
2)- RA
3)- Hyperparatheyroidism (am not sure from this option)
103. 10 Y/O boy from Urban presented with a bite from his pet dog. What you will do:
1)- clean the wound, debride and bandage
2)- kill the dog
3)- take blood sample from the dog to test for rabies (am sure form this option lol but not sure if in this MCQ or the next one)
4)- ..
5)- ..
104. A 13 or 15 boy had a bite from his own dog. The dog has received all of his vaccinations and it’s in a safe place. What you will do:
1)- vaccinate the boy against rabies
2)- give Ig
3)- Give tetanus vaccine as the boy didn’t have one for more than 5 years
4)-
5)-
105. A bruit in the lower limbs is most probably due to:
1)- A-V fistula
2)- ..
3)- ..
4)- ..
5)- ..
106. diagnosis of renal artery stenosis causing renovascular hypertension can be approached by:
1)- arteriogram
2)- U/S
3)- ..
4)- ..
5)- ..
107. Male patient with renal colic discovered to have 0.5 mm stone at the level of L4 on the Lt ureter with mild enlargement of Lt. kidney. Management:
1)- stone removal by cystoscope
2)- ..
3)- ..
4)- ..
5)- ..
108. one of your patients in the post-op period complains of severe pain. He’s on Narcotics (PRN I think. I don’t remember what but I think they mentioned one that can cause dependence). The nurse told you she believes that he’s faking his pain and asked you to give him placebo. What you will do?
1)- call his relatives for a consent for placebo
2)- give placebo
3)- NOT give placebo
4)- ..
5)- ..
* as I remember they didn’t mention anything abt any other abnormalities or somplains. And they didn’t mention an option for examining and assessing.
109. 36 weeks pregnant female presented with abdominal pain and beelding. Not known to have any chronic medical or surgical illness. Next action:
1)- oxytocin
2)- U/S
3)- abdomin X ray
4)- (I think they mentioned NST)
5)-
110. Pregnant female I think she’s in her 25 weeks and the examination showed 20 weeks aged uterus. What you will order for:
1)- X ray
2)- NST
3)- Biophysical profile
4)- U/S
5)- ..
*am sure they mentioned both the U/S and the biophysical profile.. I got confused bs when I read “you will order for” of course I will order not only for U/S but U/S FOR biophysical prfile!.
111. Primi in term in labour. Not known to have any chronic medical o surgical illness. O/E you felt a foot. No rupture of membranes yet or blood. She’s on NST with a good uterine contraction and baby reaction.Your next action:
1)- Urgent U/S
2)- Immediate C/S
3)- try to correct the position of the baby
4)-
5)-
112. You are talking to a mother just delivered and got a baby with cleft palate. You are telling her what’s the situation and the prognosis. You want to tell her what will be the most reason that the baby will visit your office for in the coming years. You will say it’s:
1)- Feeding problems
2)- Otitis media
3)- Speech problems
4)- Mental problem (I think)
113. old patient with hoarseness of the voice and dysphagia to all solids. (I don’t remember the rest of the scenario or the options :S)
114. a mother asking you abt safety in the home for her baby you will tell her all except:
1)- home plants could be dangerous
2)- be carefull with toys or pieces less than (3 cm I think)
3)- stairs bar MUST be more than 15 cm wide (am sue from this option)
4)- never leave the baby alone in the bath
5)- bathing water should not be more than 40 (or 45 C)
115. All can cause liver Ca except:
1)- Vinyl chloride
2)- cirrhosis
3)- Nickel earrings
4)- ..
5)- ..
116. Regarding non-ionized radiation:
1)- Microwave radiation usually harmful (am sue from this option enno usually)
2)- ..
3)- ..
4)- ..
5)- ..
117. Tabes dorsalis neuorosensoy deficit will be found in:
1)- Syphilis
2)- ..
3)- ..
4)- ..
5)- ..
118. another MCQ abt tabes dorsalis: male patient can’t stand or walk in a dark room, He has to look where he puts his foot and produce a loud sound with his foot hitting the floor with a wide based gait. Dx:
1)- tabes dorsalis
2)- ..
3)- ..
4)- ..
5)- ..
119. Bacteria found in raw egg:
1) Salmonella
2) ..
3) ..
4) ..
5) ..
120. eye lesions (I think the case that he can’t look latterly)
121. am not sure if this MCQ was there: Alcholic male with unilateral parotic enlargement : parotiditis
122. female with bilateral spontaneous galactorrhea. Normal examination aside from the spont mild in both. No headache and Normal Sella turcica in radiograph. What you will do next( I think they didn’t mention amenoeehea..they mentioned either irregular menses or oligomenorrhea):
1)- prolactin level
2)- BHCG
3)- mammography
4)- ..
5)- ..
123. Multiple sclerosis CSF analysis will show:
1)- high glucose
2)- High protein (am not sure form this option)
3)- Bloody CF
4)-..
5)- ..
124. Female patient presented after appendectomy with heavy bleeding and gave a history of heavy bleeding after a tooth extraction before. (I don’t remember if they asked abt the Dx or what you will find in PTT and BT)
125. knee injury MCQ after skating.She can bear wait on the injured limb with mild pain. The medial crushiate ligament was stable but there was a tenderness along the medical side of the patella. Dx:
1)- Patella fracture (am not sure if in this MCQ or not)
2)- Medical meniscus ligament injury
3)-
4)-
5)-
126. Basket ball player after he averted his ankle in the match. He can’t walk on it. O/E there was swelling of the lateral side of the dorsum of the foot I think and diffuse tenderness (am not sure from this MCQ scenario plz check)
127. Male after RTA has bleeding through urethra what you will do:
1)- folley cath
2)- suprapubic cath
3)- retrograde pyelogram
4)- IVP
5)- ..
128. diffuse swelling of lips and eyes with no specific allergen with family Hx. Dx: angiodema
129. Stuttering in 3 y/o boy: reassurance
130. 6 Y/O female can’t pronounce the words clearly. IQ is normal and examination of ears and other things were normal.No history of any abnormalities. What you will do:
1)- refer her to speech therapist
2)- refer her to psychiatrist
3)- ..
4)- ..
5)- ..
131. carpal Tunnel syndrome Dx:
1)- EMG
2)- CT
3)- EEG
4)- ..
5)- ..
132. Best treatment for Tourette $:
1)- Halloperidol
2)- Lithium
3)- ..
4)- ..
5)- ..
133. ADHD have all of the following except:
1)- short attention span
2)- hyperactivity
3)- antisocial behaviour
4)- ..
5)- ..
134. best ttt for OCD
135. frostbite injury in ER. Ttt:
1)- warming with 40 C water for half an hour
2)- rubbing with patient’s clothes
3)- blanket warming
4)-
5)-
136. APGAR score case
137. Old lady with a disease ( I don’t remember it much) needs a surgery. The Formal consent should include all of the following except:
1)- Exact diagnosis
2)- Surgery description
3)- prognosis with and without surgery
4)- positives and negatives of all modality of treatments (surgery and others)
5)- other options as a modality of treatment
138. Most causative agents of UTI in a pregnant lady:
1)- E.Coli
2)- staph. Aureus
3)- strept. Epidermis
4)- Chlamydia
5)-..
139. All of the following can be a side effect of estrogen except:
1)- weight loss (we definitely know it’s WEIGHT GAIN :-S )
2)-..
3)-..
4)- ..
5)- ..
140. All can enhance sexual function except:
1)- vaginal lubrication
2)- oral testosterone
3)- GnRH agonist
4)- (a compound I don’t remember but if am not wring it’s was vaigara in it’s chemical name)
5)- Oral progesterone (I don’t remember if they mention it alone or with estrogen as HRT)
141. Adults with gender identity problem usually have a childhood history of :
1)- trans-dressing (or cross-dressing am not sure)
2)- ..
3)- ..
4)- ..
5)- ..
142. Child sexual abuse. All commonly found except:
1)- the abused child is a female
2)- the abuser is known to the abused
3)- family Hx of sexual abuse
4)- the abuser threatened the child for not disclosing what happened
5)- …
143. Sexual excitation achieved with inanimate objects (like shoes or dresses) called:
144. A mother brought her 17 y/o son saying he’s alcoholic. All of the following questions can be of help to know if he’s alcohol dependant except: (remember CAGE questions)
1)- Do u feel like to cut-off alchol
2)- Are you annoyed with others commenting on ur drinking habits
3)- have u ever felt guilty for drinking too muvh
4)- how often do u drink per week (or the option was do u drink in occasions only)
5)- …
145. Most common cause of newborn meningitis (or pneumonia I don’t remember):
1)- Haemophilus Influenza
2)- Strep Group B
3)- ..
4)- ..
5)- ..
146. 6 months old infant brought to you for vaccination. 4 months old vaccine was missed but 2 months old was given. What you will do?
1)- start the vaccination schedule all over again from the beginning
2)- give him ‘4 months vaccine and set an appointment after 2 weeks for 6 months vaccine
3)- give him ‘4 months vaccine and set the appointment after 2 months for 6 months vaccine
4)- ignore the ‘4 months vaccine and give him 6 months vaccine
5)- ( I think the option was to give him ‘ 4 month vaccine now and the 6 months vaccine on 12 months)
147. Dehydrated child with Hyponatremia . In the process of correction he might develop:
1)- seizure
2)-
3)-
4)-
5)-
148. hypomagnesemia (many questions :S but I don’t remember)
149. male patient thinks that some of his body parts is not his. Also he has (I don’t remember the exact words but the idea of merging with others). And he Believes someone is following him. Dx:
1)- schizophrenia
2)-
3)-
4)-
5)-
150. 11 y/O with night bed wetting happened after moving to a new neighbourhood after her parents separation. What will be best ttt:
1)- antidepressants
2)- antidiuretics
3)- decrease water intake before sleeping
4)- cognitive therapy
5)- (that thing in night gives sound when wetting happens)
And regarding the best time for taking the exam, YES
I think your internship year is the best time, because your clinical knowledge will be fresh and updated, and as you may know, the exam will be done three times per year, in JANUARY, MAY, and SEPTEMBER, and the internship starts in AUGUST, so the appropriate time I think is either in MAY or SEPTEMBER
In MAY, it will help you earlier for your residency applications which you will apply for during your internship, and keep in your mind that the MCCEE result may take up to 2 month to be announced officially and sent to you, so before end of your internship you will have the result paper ready and can apply for competitive jobs e.g. demonstrators in universities.
In SEPTEMBER, you will be able to study after end of your internship i.e. your internship will end by end of July, so you will have AUGUST and about 15 days in SEPTEMBER as vacation and you can free yourself for studying for the exam, but in this way your result will be sent to you by NOVEMBER or DECEMBER, and competitive jobs applications will need you to have MCCEE results in your file, so you may not get accepted in some jobs.
In summary either take the exam in MAY during internship, or in SEPTEMBER after internship, but never later than this and preferably not earlier as you may not have enough time to study.
Hope you all the best and if you have any question dont hesitate to ask here
Regards
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