‫بسم اهلل الرحمن الرحيم‬

‫ محلول‬٢٠٢٤ ‫امتحان لوكال باطنيه‬

‫اصفر‬: ‫االجابه‬
Q1

Management of multi drug resistance typhoid ?

A. Ceftriaxone
B. Azithromycin
C. Ciprofloxacin
D. Levofloxacin

Q2

45 year old, obese man had high HbA1C with anti GAD antibodies what is your
diagnosis?

A. type 1diabetes
B. type 2 diabetes
C. Moody
D. LADA

Q3

What increases the risk and prevalence of HTN in diabetics patients ?

A. obstructive sleep apnoea Obesity

B. parasomnia
C. hyperaldosteronism
D. Coarctation of the aorta

Q4

55 year old Patient with DEXA scan of -2,55 what is the likely cause of this finding ?

A. multiple myeloma Normal range >-1 /osteopenia=-1–2.5/

B. obesity osteoporosis<_2.5
C. hypothyroidism
D. acromegaly

Q5

Regarding Dengue fever which of the following is true:

A. Primary infection cause DHF Viral infection

 B. Infection give life long immunity
C. Antiviral therapy is effective
D. Management is mainly supportive

Q6

An elderly man ex alcoholic developed pancreatitis with un clear cause

But treated for UTI several times what is the cause of pancreatitis is ?

Nitrofinotoin cause pancreatitis

A. Septrin

B. Ciprofloxacin

C. Chlorpromazine

D. Nitrofurantoin

Q7

What is the type of hypersensitivity reaction in the acute stage of extrinsic allergic
alveolitits ?
Immune
complex
A. Type 1
B. Type 2
C. Type 3
D. Type 4

Q8

Regarding HIV 1 and HIV 2 which is true ?

A. Kaposi sarcoma is associated with HIV2

B. HIV1 has a longer incubation period
C. HIV 1 and HIV 2 have a similar geographical distribution
D. Can coexist in the same person
Q9

A patient developed weakness in his lower limb , spasticity, hypertonin, fasciculations ,

but normal sensation where is the lesion?

A. Anterior horn cell

B. Posterior column
C. Corticospinal tract
D. Lateral spinothalamic tract

Q10

35 year old female with Focal seizures and migraine and has family history of the same
condition . She has a past history of osteoporosis what is the best medication for her ?

A. Carbamezbin
B. Na Valproate
C. Topiramate
D. Lamotrigine

Q11

A farmer with fever and murmur with a negative culture and deranged liver enzymes and
echo shows vegetation what is the organism:

A. Staphylococcus infection
B. Fungal infections
C. Coxiella
D. Streptococcus infection

Q12

Patient with a history of bowel resection due to crohn’s disease what is the type of renal
stones he is expected to develop?

A. Cystine
B. Oxalate
C. Urate
D. phosphate
Q13

25 year old female complains of back pain ,she has high hb and high erythropoietin
,what is the investigation to do?

A. BM aspirate for myeloproliferative disorder

B. CXR
C. US
D. ABG

Q14

Patient with unilateral headache neck pain during weight lifting developed partial ptosis
what is the cause of his presentation?

A. Sympathetic over activity

B. Parasympathetic underactivity
C. Sympathetic underactivity
D. Oculomotor nerve lesion

Q15

Patient with rash in elbows and knees that’s very itchy what immunoglobulins are found
in the dermo-epidermal junction

A. IgM
B. IgG
C. IgA
D. IgD

Q16

A patient with neuropsychiatric Wilson was given chelator therapy after which she
developed rash in her upper back, neck and upper arms what antibodies are likely to be
present?

A. anti centromere antibodies

B. anti histone antibodies
C. anti nuclear antibodies
 D. Anti scl 70

Q17

17 years old boy with nephrotic syndrome due to minimal change disease what is
suspected outcome

A. persistent proteinuria
B. complete recovery
C. ESRD
D. recurrent relapses

Q18

Measurement of cholesterol level 100 patient while smoking and after smoking
cessation what is the best statistical test:

A. Simple T test pooled variance

B. Simple T test un pooled variance
C. Chi Square
D. Paired T test

Q19

Patient complain of polyuria and polydipsia after water deprivation test urine osmolality
was found to be < 700 mosm , and it did not increase after desmopressin administration

A. nephrogenic DI
B. cranial DI
C. psychogenic polydepsia
D. diabetes mellitus

Q 20

Normal anatomical location of the azygous lobe

A. upper left lobe

B. upper right lobe
C. lower right lobe
D. middle right lobe
Q21

Patient had gastrectomy done 10 years ago and now presenting with low haemoglobin,
MCV 105 how to treat ?

A. Iron supplements
B. IM vitamin B 12
C. Folate supplements
D. Erythropoietin

Q22

About pathology of Parkinson

A. B Amyloid Alzahimer
B. Tauopathies Fronto temporal
C. Alpha syncholinopathy
D. ubiquitouapathy

Q23

About meningitis

A. streptococcus have high risk of complications

B. Neisseria meningitis may be sporadic
C. H influenza in adult
D. all of them are managed by the same dose of penicillin

Q24

Presentation of asthma like symptoms+ eosinophilia

A. Loffler syndrome
B. churg struss
C. Eosinophilic pneumonitis
D. allergic bronchopulmonary aspergillosis

Q25

A patient has pain due to a stretched liver capsule. How to treat his pain
A. Codeine
B. Naproxen
C. Dexamethasone
D. Paracetamol

Q26
A patient was started on Total parenteral nutrition then develop muscle weakness,
parathesia and numbness with electrolyte imbalance is causing his symptoms
A. Hyperkalaemia
B. Hypocalcaemia
C. Hypomagnesaemia
D. Hypophosphatemia

Q27
A patient developed hemoptysis with complete eggs found what is the likely cause:
A. Ascariasis
B. Fascioloasis
C. Pargominus
D. Strongyloides

Q28
A patient overdosed on alcohol brought by his friends examination showed a bitten
tongue and soiled underwear. On examination he had small pupils that react to light
What is the cause of his presentation:

A. Epileptic seizure
B. Hypoglycaemia
C. Alcohol toxicity
D. Opioid overdose

Q29
19 years old male with unproductive cough and nasal bleeding abd signs
(Abnormal LFT and RFT )
Diagnosis?
A. Cholangitis
B. Wiel syndrome
C. Hepatitis A
D. Dengue fever
Q30
In Neuromyelitis optica spectrum disorder the autoantibodies are directed against :
A. Astrocytes
B. Ependymal cells
C. Oligodendrocytes Multiple s
D. Microglial cells

Q31
Lymphocytes proliferation test is used in :
A. Flariasis
B. Leishmaniasis
C. Malaria
D. Trypanosoma

Q32
Antigenic variation occur in which organism
A. P.vivax
B. P. Falciparum
C. Trypansoma
D. Gardia lamibla

Q33
Patient with Barret oesophagus develop low grade dysplasia, what is the
management
A. A trial of PPI
B. oesophageal ablation
C. oesophageal resection
D. oesophagoctomy

Q34
Function of fish oil and free fatty acid
A. increase HDL
B. increase LDL
C. decrease total cholesterol
D. decrease apolipoprotein a

Q35
D dimer in pulmonary embolism:
A. Has high negative predictive value in low probability patients
B. High positive predictive value
C. Low false positive
D. Low false negative

Q36
which soil worm have auto infection
A. Trichuris
B. Strogyloid
C. Necator
D. Ancylostoma

Q37
A patient with Lepromatous leprosy has developed severe erythemata nodosum
leprosum what is the treatment
A. High dose steroid
B. Thalidomide
C. NSAIDs
D. Stop anti leprosy treatment

Q38

Female presented with bloody diarrhea, tenesmus, she has a hx of heavy smoking,
the disease is sparing the terminal ileum, and has crypt abscess, then diagnosed as
Crohn’s disease. She is very worried about her condition and want to know more.
What is the investigation of choice to confirm her diseae?

A. Anti endomesyal Ab
B. ANA profile
C. Dilated distal colon in X ray
D. ASCA (Anti- Saccharomyces cerevisiae)

Q39
45 year-old, female with losses, upper abdominal pain, have oral ulcers, diagnosed
as IDA. O/E: Abdomen with minimal ascites, and different parts itching skin lesions.
Which of the following best to reach diagnosis?
A. Endomesyal Ab
B. Abdo U/S
C. Upper GI endoscopy
D. Small bowel enema

Q40
Vessel responsible for haemoptysis in Tb patient ?
A. Bronchial artery
B. Bronchial vein
C. Pulmonary artery
D. Pulmonary vein

Q41
Calculate the anion gap S.na 139, S.k 5, S.cl 109, S. Hco 20
A. 8
B. 12
C. 14
D. 16

Q42
A patient has history of recurrent bloody diarrhoea he was found to have anal tags.
In biopsy there is crypt abscess and lymphocytic infiltration in the lamina propria
what is the most likely diagnosis?

A. UC
B. Crohn’s
C. Microscopic colitis
D. Tuberculous colitis

Q43
A patient developed weakness in lower limb and tingling sensation and areflexia
precipitated by viral infection 2 weeks ago + albumin cellular dissociation

A. Viral Transverse myelitis

B. Diabetic neuropathy
C. GBS

Q44
Pt presented to ER one examination his Upper limbs are flexed over the chest and
lower limbs was rigid (decorticate position) hand s are held in fists where is the
lesion in regards to the red nucleus
A. Below it
B. above it
C. within it
D. adjacent to it

Q45
In Premature ovarian failure
 A. High FSH, Low oestrogen
B. High FSH/LH ratio
C. High FSH, high LH ,Low oestrogen
D. Low FSH high oestrogen

Q46
Drug that cause Non alcoholic steatohepatitis (NASH) :
A. Amiodarone
B. Azathioprine
C. Erythromycin
D. Chlorpromazine

Q47
Patient have MI after 2 days develop chest pain an pleural friction rub
What is the treatment:
A. High dose aspirin
B. Indomethacin
C. Steroid
D. Heparin

Q48
Patient presented with chest pain and there was 3 mm ST elevation in the anterior
leads. The patient underwent PCI and became pain free however he developed
tachycardia , on examination he was hemodynamically stable and ECG shows ST
segment elevation of 0.5
A. Amiodarone
B. Urgent pci
C. Flecanide
D. Beta blocker

Q49
A. Blunt Y decent in JVB :
B. Cardiac tamponad
C. Restrictive pericarditis
D. Obstructive cardiomyopathy

Q50

Female pt delivered 9 month ago presented with fatigue HB normal pulse=92

‫تقريبا‬BP 80/50 mchc 35mg/dl, Tsh=0.2 ng, T4= Low. What is Your intervention ?
A. Thyroxin

B. Carbimazol

C. ferrous sulphate

D. Prednisolone

Q51

Which antituberculous drug is least to cause hepatotoxicity

A. Streptomycin
B. Rifampicin
C. Pyrazinamide
D. Ethambutol

Q52

Which haemoglobinathy is Least likely to have sever malaria

A. Sickle cell disease

B. Sickle cell trait
C. G6P
D. Thalassemia

Q53

Patient came to ER with severe headache and described it as the worst headache he
has ever had. on examination there is neck stiffness what is the best initial test?

A. Non contract CT
B. CT angiography
C. Lumber puncture
D. Brain MRI

Q54

What is the hallmark of carcinoid syndrome

A. Cutaneous flushing
B. Diarrhoea
C. Bronchospasm
 D. Cardiac valve involvement

Q55

A patient was brought by his friends from a party his regular medications include a
salbutamol inhaler. He has symptoms of anaphylaxis (stridor and peri oral swelling )
what to give?

A. IV hydrocortisone
B. IM adrenaline
C. Salbutamol inhaler
D. Ipratropium (not sure)

Q56

The Commonest bacteria in exacerbating chronic bronchitis

A. H .influenzae

B. S. pneumoniae

C. Maroxella

D. K.pneumoniae

Q57

A patient with history of previous exacerbations of copd fev1 43 what to add :

A. Falmetrol
B. Salbutamol
C. Ipratropium
D. Tiotropium

Q58

Which of the following supports Diagnosis of asthma:

A. Eosinophilia
B. PEFR less than 85
C. Diurnal variation more than 10٪
 D. FEV1improved with more than 15 ٪after bronchodilator

Q59
SLE patient with positive anticardolipin antibodies presented with chest pain and SOB ,
ST depression V1,V2 slightly high troponin what to do

A. CT coronary angiography

B. CT chest non contrast

C. CT pulmonary angiography
D. HRCT

Q60

What is the mechanism of action of Clopidogril

A. p2y12 inhibitior

Q61

Which of the following describes the mechanism of action of Beta agonists

A. increase cAMP

Q62

lung mass more likely to be

A. Metaplesia
B. Dysplasia
C. Neoplasia
D. Hyperplasia

Q63

A patient presented with haemoptysis, haematuria, an proteinuria. What test should be

done to reach a diagnosis :

A. CXR
B. Renal biopsy
 C. ANCA
D. Renal ultrasound

Q64

A patient presented with SVT and he has history of what is the treatment of choice

A. I.v adenosine

B. I.v amidarone

C. I.v verapamil

D. I.v esmlol

Q65

A patient diagnosed as severe Aortic stenosis and underwent Echocardiography (EF

65%). One month later, he developed severe pulmonary oedema, and the EF 35%. What
do you expect this patient to have?

A. First heart sound decreased

B. Early new diastolic murmur
C. decreased murmur intensity
D. Increased S2

Q66

Rheumatoid arthritis pathophysiology

A. B cells

B. T cytotoxic cells

C. T helper cells

D. Natural killer cells

Q67
What is the site of conversion of T4 to T3

A. adipose tissue
B. skeletal and cardiac muscle
C. thyroid
D. blood

Q68
Ejection systolic murmur in pulmonary area is heard in
A. Periaortic membrane
B. ASD
C. Severe tricuspid stenosis
D. Aortic Regurgitation

Q69
28 year old female with peripartaum cardiomyopathy delivered 2ws ago
presented now with progressive dyspnea, angina. Echocardiography EF 25% She
is on Frusemide, Spironolactone, carviadalol. What is the next best management
for this patient?
A. Cardiac resynchronization therapy (CRT)
B. Add enalipril
C. Add Digoxin
D. Increase dose of beta blocker

Q70
A Lady was brought by her husband to the hospital because She became
forgetful, she has urine incontinence, walking in an unusual way and
experienced multiple falls

A. Normal pressure Hydrocephalus

B. Picks disease
C. Alzheimer’s disease
D. Lewey body dementia

Q71
A 49 year old patient was found to be hypertensive on ambulatory blood
pressure. What medication to prescribe?

A. Amlodipine
B. Ramipril
C. Duretics
D. B blocker

Q72
Increase in the cardiac output during exercise due to :
A. Decreased venous return
B. decreased stroke volume
C. sympathetic activation
D. parasympathetic activiation

Q73
Regarding Pyrexia of unknown origin for more than 2 week which of the following
is correct
A. 50 %will recover spontaneously
B. most likely due to malignancy in developing countries
C. Malaria treatment is useful
D. TB treatment is useful

Q74
Most of the carbon dioxide produced in the tissue, transported to lung as :
A. attached to Hb
B. Dissolved in blood
C. converted to HCO3 by carbonic anhydrase
D. carbon monoxide

Q75
HIV visceral leishmaniasis co-infection, what is the treatment of choice:
A. Na stibogluconate
B. Paromamycin
C. Amphotericin B
D. Long course of pentamidine

Q76
Patient with ESDR , come to ER complain of chest pain that increases with
inspiration , ECG shows diffuse ST segment elevation what will benefit him more:
A. Hemodialysis
B. Ergent PCI
C. Clopidogril
D. LMWH

Q77
Regarding Calcium metabolism
A. Most of the Ca in the body found in free ions
B. 98% of the Ca reabsorp by the Kidney
C. Calcitonin decrese exrection of Ca in the kidney
D. The kidneys are the main organ that regulates calcium metabolism

Q78
Patient with pheochromocytoma, for pre operative preparation which drug cause
vascular expansion:
A. Doxazosin
B. Parzosin
C. Atenolol
D. phenoxybenzamine

Q79
Patient with Chronic lymphocytic leukemia after receiving chemotherapy Ca high
i think also high k what you should do to prevent these condition
A. pre chemotherapy hydration
B. pre chemotherapy hydration+allopurinol
C. Pre chemotherapy allopurinol
D. frusemide +allopurinol

Q80
A Patient presented with eye irritation and back pain/stiffness in the
morning what is the most likely cause of his symptoms/diagnosis :
A. Still’disease
B. Ankylosing spondylitis
C. Rheumatoid arthritis
D. SLE

Q81
Cytokines synergy
A. Act on the same cell
B. cytokines work sequentially
C. Act in concert in same cell
D. Act against other cytokine

Q82
Regarding sensitivity which of the following statements is true :
A. High sensitivity implies high false negatives
B. High sensitivity implies low false positives
C. Identifies those who don’t have the disease
 D. Identifies those who truely have the disease

Q83
Quantiferon Test used to differentiate between
A. primary and postprimary TB
B. Latent TB and Active TB
C. Latent TB and BCG vaccination
D. Pulmonary and extra pulmonary TB

Q84

A young female presented to her GP with tonsillitis. She was diagnosed with VSD when
she was 6 years old and was on regular follow up. Her examination was normal and the
GP noted a decrease in her murmur. The tonsillitis was successfully treated. What is the
next step in her management?

A. Penicillin Prophylaxis for life

B. Follow up and monitoring
C. Refer for cardiac catheterization
D. refer for surgical closure

Q85

Hormone secreted by adipose tissue increases insulin sensitisation and has anti-
inflammatory and antith4ombotic effect

A. Leptin
B. Adiponectine
C. Resistin
D. TNF

Q86

The mean arterial pressure is

A. Heart rate times the stroke volume

B. Systolic blood pressure minus diastolic blood pressure
C. systolyic pressure-pulse pressure
 D. Diastolic pressure+1/3 puls pressure

Q87

Rheumatoid patient present with SOB , FEV1= 2.3 FVC =3.8 what is the cause

A. fibrosing alveolitis
B. obliterating bronchiolitis
C. Rheumatoid nodule

Q88

Lady with mechanical heart valve taking warfarin, have amenorrhea for 6ws then
discovered that she is Pregnant what is correct about her anticoagulation

A. warfarin should be continue till 16 wks

B. give heparin at first , warfarin at second and return to heparin
C. stop warfarin and start heparin till labour
D. Rivaroxiban instead of warfarin

Q89

Young patient have history infective diarrhoea one week ago, came with hypertension,
haematuria and proteinuria, Hb 8g think, creatinine 2.9, what is the Diagnosis:

A. Post infectious glomerulonephritis

B. HUS
C. TTP

Q90

In Severe malaria what is the complication with highest mortality:

A. Cerebral Malaria
If asked about serious and
B. ARDS
common cerebral m
C. Severe anaemia
D. AKI
Most common presentation
hypoglicemia

Q91
A patient present with recurrent nasal bleed was found to have pulmonary AV
malformation what is your diagnosis

A. Heridatery Hemorrhagic Telengectasia

B. wegner granulomatosis
C. Good pasture syndrome

Q92

A Patient presented with abnormal jerky movements in her hands. On examination she
has chorea and there’s a family history of the same condition. What is the genetic
problem ?

A. ATP1A 3 mutation
B. CAG repetitions
C. ATP7B
D. LINGO1

Q93

About a 70 year old female presented with bradykinesia and retropulsion. Her condition
showed poor response to levodopa. She presented again with vertical nystagmus what
is the diagnosis?

A. Progressive supranuclear gase palsy

B. LevoDopa resistant Parkinson’s
C. normal pressure hydrocephalus

Q94

35 y old female complaining of fatigable weakness and dysphagia more towards end of
day also co double vision and on exam has bilateral ptosis which improved temporarily
with ice pack test What is the diagnosis:

A. Myasthenia gravis
B. Lambert Eaton
C. MS
Q95

Cerebral malaria pathogenesis

A. cerebral ischemia
B. cerebral oedema
C. cytoadherence of organism to cerebral vessels
D. Hypoglycemia

Q96

55 year old Known Rheumatoid arthritis come to hospital complaining of Vertigo ,

occipital pain and dysphasia what is the cause?

A. Atlantoaxial subluxation
B. CVA
C. acoustic neuroma
D. Vestibular neuritis

Q97

55yrs old female known rheumatoid arthritis has not tolerated methotrexate and
sulfasalazine on naproxen for 2 years now Which drug can be given to her as
monotherapy to control her symptoms ?

A. Cyclosporine
B. Increase dose of naproxen
C. Lefulonamide
D. Oral steroid

Q98

Physiological Response to hypovolemia what is the main response to preserve volume

A. activation of Renin aldosterone system

B. Inhibition of Renin
C. Inhibition of ADH
D. Increase in ANP
Q99

A 30 year old patient form White Nile state complaining of bloody diarrhoea for 3 weeks
what is the likely cause ?

A. Intestinal Shistosomiasis
B. Gardiasis
C. Lactose intolerance
D. microscopic colitis

Q100

Regarding the diagnosis of brucellosis:

A. Widal test is diagnostic

B. Blood culture high yield
C. Bone marrow culture remains positive after antibiotic
D. stool culture will be positive in first week

Q101

A know case of asthma on SABA presented with acute attack of SOB which of the
following most likely indicates that its life threatening asthma:

A. Patient can’t complete sentences

B. Normal pCO2
C. FEV 1sec 1.5L
D. Decrease PO2

Q102

Young patients come to hospital complaining of Painful skin nodules in shins and lateral
thigh associated with joint pain a swelling (ankle joint ) Preceded by coryzal symptoms
which investigation should be done:

A. ANA
B. CXR
C. Skin biopsy

Q103
Acute rejection after organ transplantation is due to :

A. Cellular immunity
B. Humeral immunity
C. Type 4 hypersensitivity reaction

Q104

A 40 year old male complains of a unilateral headache that is associated with tearing
and nasal congestion. The episodes last 45 minutes and have been recurrent in the past
2 weeks. Free between attacks , What is the diagnosis?

A. Migraine
B. Cluster headache
C. Tension headache

Q105

a patient have DM on examination was jaundiced and has hepatomegaly and lower
limb oedema elevated liver enzymes total bilirubin=4, Creatinine 1.9

What is most cause of his heart failure

A. Ischemic heart disease

B-Hemochromatosis

C.amyloidosis Kidney involve

E-wilson

Q106

60 yrs old patient come to ER compliaing of upper and lowre limb weakness, imaging
was done there is no Hemorrhage his BP 180/110 , NIHHS =11 , what is the next best

Step

-carotid andarectomy

-thrombolysis

- asprin 300 mg

- Clopidogril
Q107

25yr old nurse complaining of fatigue and nusea after returning from holiday diagnosed
as Addison disease ، develop recurrent vaginal candidiasis after start treatment with
steroid , her brother have DM and vitiligo . Her Bp =80/50 ,PR =92

A. autoimmune polyendocriopathy type1

B. Autoimmune polyendocriopathy type 2
C. steroid induced
D. adrenoleukodystrophy

Q108

Reitter syndrome, benefit from prolonged antibiotic use if it caused by:

A. Chlamydia

B. C.jejeni

C. E. coli

D. Shigella

Q109

26 years old male come complaining of cough What is in favour of a diagnosis of

sarcoidosis

A. Bilateral infilteration without hilar lymphadenopathy

B. unilateral hilar lymphadenopathy
C. Pleural effusion
D. Uvitis

Q110

Young patient complaining of facial muscles weakness involving the forehead ,

preceded by viral infection what is most appropriate management

A. Acyclovir
B. IV immunoglobulin
C. Prednisolone
D. brain imaging
Q111
Increase Respiratory effort during exercise is due to
A. increased CO2 decrease O2
B. Low pH
C. buffering system

Q112
A patient with a history of MI had an episode of fast palpitations followed by syncope.
This recurred while he was driving and his car went off the street. He doesn't remember
what happened during the event. What is your diagnosis?

A. Epileptic seizure

B. Ventricular tachycardia
C. Heart block
D. Neurocardiogenic Shock
No

Q113
Which of the following hormones is responsible from increasing blood glucose following
fasting in normal metabolic status

A. Insulin
B. Glucagon
C. Epinephrine
D. Cortisol

Q114
50 year old female presented with memory problems. She is neglecting her personal
hygiene and shows signs of dementia and eating more than usual and gain weight
Presence of Primitive reflex :Grasp + palmomental reflex MMS 20/30

A. Frontotemporal dementia
B. vascular dementia
C. Alzheimer disease
Q115

Young patients Known case of Rh arthritis developed pleurisy. Which of the following
indicates that the pleural effusion is caused by Rheumatoid arthritis?

A. Presence of active arthritis at same time with pleural effusion

B. Protein more than 6mg/dl in pleural fluid

C. Glucose less than 10 mg/dl in pleural fluid

D. Resolve with systemic steroid therapy

Q116 ‫معاد‬
A patient developed unilateral headache neck pain after weight lifting and there is
partial ptosis. What is the cause of his symptoms?

A. Sympathatic overactivity
B. Parasympathatic underactivitiy
C. Sympathetic underactivity
D. Occulmotor nerve lesion

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