1. Adirection, 25 year old female presents with generalized restriction of eye movement in all intermittent ptosis, proximal muscle weakness and fatigability.Which is the MOST useful test in making the diagnosis?
A. CPK
B. Edrophonium test
C. EMG
D. Muscle biopsy
Answer: B
2. Kayser- Fleischer rings (KF rings) are seen in:
A. Pterygium
B. Hematochromatosis
C. Wilson’s disease
D. Menke’s kinked hair syndrome
Answer: C
3. All are features of Abetalipoproteinemia, EXCEPT:
A. Plasma levels of cholesterol and triglyceride are extremely low
B. Manifest in early childhood with diarrhea
C. Progressive pigmented retinopathy seen
D. Neurological manifestation as ataxia in first decade
Answer: D
4. Which of the following findings is diagnostic of iron deficiency anemia?
A. Increased TIBC, decreased serum ferritin
B. Decreased TIBC, decreased serum ferritin
C. Increased TIBC, increased serum ferritin
D. Decreased TIBC, increased serum ferritin
Answer: A
5. Which of the following endocrine tumors is most commonly seen in MEN I?
A. Insulinoma
B. Gastrinoma
C. Glucagonoma
D. Somatostatmoma
Answer: B
6. All of the following statements regarding Sickle Cell Anemia is true, EXCEPT:
A. Patients require frequent blood transfusions
B. Patients usually presents before the age of 6 months
C. There is a positive correlation between HBS and polymerization
of HBS
D. Reccurent infections is the most common cause of death
Answer: B
7. Leucoerythroblastic picture may be seen in all of the following conditions, except:
A. Myelofibrosis
B. Metastatic carcinoma
C. Gaucher’s disease
D. Thalassemia
Answer: D
8. All of the following are major complications of massive transfusion, except:
A. Hypokalemia
B. Hypothermia
C. Hypomagnesemia
D. Hypocalcemia
Answer: A
9. Richter’s syndrome refers to which of the following malignant transformation?
A. CLL evolving into aggressive lymphoma
B. Hairy cell leukemia evolving to AML
C. Blast crisis in CML
D. Splenic infiltration in NHL
Answer: A
10. Sickle cell anemia leads to resistance towards?
A. P. falciparum
B. P. ovale
C. P. malariae
D. P. vivax
Answer: A
11. Romiplostim acts on which of the following receptors:
A. Thrombopoeitin
B. IL 6
C. IL 8
D. PGE 1
Answer: A
12. Oncogene associated with burkitt’s lymphoma is:
A. BCL-1, IgH
B. BCL-2, IgH
C. C-MYC
D. ALK
Answer: C
13. FALSE statement regarding the ECG in acute pericarditis is:
A. T wave inversion develop before ST elevations return to baseline
B. Global ST segment elevation is seen in early pericarditis
C. Sinus tachycardia is a common finding
D. PR segment depression is present in majority of patients
Answer: A
14. Omalizumab is used in treatment of:
A. Breast carcinoma
B. Asthma
C. Rheumatoid arthritis
D. None of the above
Answer: B
15. The pathognomonic finding in miliary TB is which of the following?
A. Bone marrow infiltrations
B. Choroid tubercles
C. Miliary mottling in chest X-Ray
D. Histological finding in liver biopsy
Answer: B
16. All are important pathogens causing pneumonia in COPD patients, EXCEPT:
A. Haemophilus influenzae
B. Pseudomonas aeruginosa
C. Legionella spp
D. Klebsiella pneumoniae
Answer: D
17. PNH patients will be having deficient surface proteins that normally protect the red cells from activated compliments. What are the two deficient surface proteins?
A. CD 45 and CD 59
B. CD 51 and CD 59
C. CD 55 and CD 59
D. CD58 and CD 59
Answer: C
18. Which of the following biochemical test is used to diagnose Dubin Johnson syndrome?
A. Serum transaminases
B. Bromsulphalein test (BSP)
C. Hippurate test
D. Gamma glutamyl transferase level
Answer: B
19. Cholecystokinin is produced from:
A. Hepatocyte
B. Gastric mucosa
C. Duodenal mucosa
D. Epithelial cells of distal common bile duct
Answer: C
20. Esophageal manometry is useful all this conditions EXCEPT:
A. Achalasia
B. Diffuse esophageal spasm
C. To assess the peristaltic integrity prior to the surgery for GERD
D. Malignancy
Answer: D
21. Which of the following drugs is useful in the prophylaxis of migraine?
A. Propranolol
B. Sumatriptan
C. Domperidone
D. Ergotamine
Answer: A
22. All of the following are true about treatment of migraine, EXCEPT:
A. Naratriptan acts longer than sumatryptan
B. Sumatryptan is used in acute attack of migraine
C. Sumatryptan acts on 5HT 1B/1D receptors in great vessels
D. Sumatryptan is used for chronic migraine
Answer: D
23. Lateral medullary syndrome is due to the occlusion of which of the following vessels?
A. Posterior superior cerebellar artery
B. Anterior inferior cerebellar artery
C. Basilar artery
D. Vertebral artery
Answer: D
24. POEMS Syndrome includes all, EXCEPT:
A. Polyneuropathy
B. Organomegaly
C. Endocrinopathy
D. Multiple sclerosis
Answer: D
25. Barr body is found in the following phase of the cell cycle:
A. Interphase
B. Metaphase
C. GI phase
D. Telophase
Answer: A
26. All of the following statements about Pulsus Bigeminus are true, except:
A. Must be distinguished from Pulsus Alternans
B. Is a sign of digitalis toxicity
C. Compensatory pause is absent
D. Rhythm is Irregular
Answer: C
27. Pulsus Bigeminus is seen in therapy with:
A. Digitalis
B. Beta Blockers
C. ACE Inhibitors
D. Calcium Channel Blockers
Answer: A
28. Wide pulse pressure is seen in all except:
A. PDA
B. Aortic stenosis
C. Aortic Regurgitation
D. A.V. malformation
Answer: B
29. Erb’s Point in cardiology refers to:
A. Right 2nd intercostal space
B. Left 2nd intercostal space
C. Right 3rd intercostal space
D. Left 2nd intercostal space
Answer: C
30. S2 is best appreciated in:
A. 3rd left intercostal space
B. 2nd right intercostal space
C. 4th left intercostal space
D. 5 left intercostal space
Answer: A
31. Paradoxical splitting of second heart sound is seen in?
A. RBBB
B. ASD
C. LBBB
D. VSD
Answer: C
32. All of the following statements about third Heart sound (S3) are true, except:
A. Occurs due to rapid filling of the ventricles during atrial systole
B. Seen in in Constrictive Pericarditis
C. Seen in Atrial Septal Defect (ASD)
D. Seen in Ventricular Septal Defect (VSD)
Answer: A
33. Left Axis Deviation is seen as
A. Positive in Lead I and Positive in Lead II
B. Positive in Lead I and Negative in Lead II
C. Negative in Lead I and Negative in Lead II
D. Negative in Lead I and positive in Lead II
Answer: B
34. P wave is due to:
A. Atrial depolarization
B. Atrial repolarization
C. Ventricular depolarization
D. Ventricular repolarization
Answer: A
35. Absent P Wave is seen in:
A. Atrial Fibrillation
B. Cor-pulmonale
C. Mitral Stenosis
D. COPD
Answer: A
36. A patient in regular rhythm presents with absent P waves on ECG. Leads II, III and AVF reveal a Saw-Tooth Pattern. Which of the following is the most likely diagnosis:
A. Atrial Fibrillation
B. Atrial Flutter with Variable Block
C. Atrial Flutter with Fixed Block
D. Multifocal Atrial Tachcardia
Answer: C
37. A wide and notched P wave is typically seen in:
A. Mitral Stenosis
B. Cor-Pulmonale
C. COPD
D. Pulmonary embolism
Answer: A
38. A QRS duration between 100 and 120 milliseconds suggests all of the following, Except:
A. Normal
B. Left anterior Fascicular Block
C. Left posterior Fascicular Block
D. Left Bundle Branch Block
Answer: D
39. Low QRS voltage on ECG with left ventricular hypertrophy on Echocardiography suggests a diagnosis of:
A. Pericardial effusion
B. Cardiac Amyloidosis
C. Corpulmonale
D. Infective endocarditis
Answer: B
40. Tall T waves on ECG are seen in:
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypocalcemia
Answer: A
41. ST elevation is seen in all of the following conditions except :
A. Myocardial infarction
B. Coronary artery spasm
C. Constrictive pericarditis
D. Ventricular aneurysm
Answer: C
42. The most common reentrant tachycardia associated with WPW syndrome is
A. Orthodromic AV reentry
B. Antidromic AV reentry
C. Rapidly conducting AF
D. None
Answer: A
43. Athletic syndrome is characterized by:
A. Increased amplitude of QRS
B. Tachycardia
C. Decreased QT interval
D. U-waves
Answer: A
44. Predisposing factors for coronary artery disease include, all Except:
A. Homocysteinemia
B. ? Lipoprotein B
C. ? Fibrinogen
D. ? plasminogen activator inhibitors 1
Answer: B
45. 40 year old male patient presents to the Emergency department with central chest pain for 2 hours. The ECG shows ST segment depression and cardiac troponins are elevated. Patient has a positive history of previous PCI 3 months back. He is administered Aspirin, Clopidogrel, Nitrates and LMWH, in the Emergency Department and shifted to the coronary are unit. The best recommended course of further action should include.
A. Immediate Revascularization with Thrombolytics
B. Early Revascularization with PCI
C. Continue conservative management and monitoring of cardiac
enzymes and ECG
D. Continue conservation management and plan for delayed
Revascularization procedure after patient is discharged
Answer: B
46. The most common toxin causing Dilated Cardiomyopathy is:
A. Alcohol
B. Chemotherapeutic agents
C. Heavy metal
D. Occupational exposure
Answer: A
47. The 9 month old child of a diabetic mother presents with tachypnea and hepatomegaly. Echocardiography of the heart showed normal cardiac morphology with asymmetric septal hypertrophy. Which of the following you will give to treat this child :
A. Digoxin
B. Frusemide
C. Propranolol
D. Isoptin
Answer: C
48. Kussmaul’s sign is classically described in:
A. Restrictive Cardiomyopathy
B. Pericardial Tamponade
C. Constrictive pericarditis
D. Right Ventricular Infarct
Answer: C
49. Hypertension with Hypokalemia is seen in:
A. Bartter Syndrome
B. Liddle’s Syndrome
C. Gitelman’s Syndrome
D. All of the above
Answer: B
50. Which of the following statements about atrial myxomas is true
A. Most common in Left Atrium
B. More common in Males
C. Distant metastasis are seen
D. Most myxomas are familial
Answer: A
51. Which condition is most commonly associated with coarctation of aorta?
A. PDA
B. Bicuspid aortic valve
C. Aortic stenosis
D. VSD
Answer: B
‘
52. Acute Infective Endocarditis with abscess formation is most commonly associated with
A. Listeria
B. Staphylococcus
C. Streptococcus
D. Enterococcus
Answer: B
53. In Marfan’s syndrome, Aortic aneurysm occurs most commonly in:
A. Ascending aorta
B. Descending aorta
C. Abdominal aorta
D. Arch of aorta
Answer: A
54. Which of the following is not expected in a case of Microcytic Hypochromic Anemia:
A. Reduced serum Iron
B. Reduced Total RBC distribution Width
C. Normal Ferritin levels
D. Increased TIBC
Answer: B
l
55. Megaloblastic anemia should be treated with both folic acid vitamin B12 because :
A. Folic acid alone causes improvement of hematologic symptoms but worsening of neurological symptoms
B. It is a Co factor
C. It is enzyme
D. None of the above
Answer: A
56. Indirect Coomb’s test detects:
A. Antibodies attached to RBC Surface
B. Antibodies in the serum
C. Antigens attached to RBC Surface
D. Antigens in the serum
Answer: B
57. Direct Coomb’s test detects:
A. Antibodies attached to RBC Surface
B. Antibodies in the serum
C. Antigens attached to RBC Surface
D. Antigens in the serum
Answer: A
58. Haemoglobin F is raised in:
A. Juvenile chronic myeloid leukemia
B. Hereditary spherocytosis
C. Congenital red cell aplasia
D. Mysthania gravis
Answer: A
59. HAM test is based upon :
A. GPI Anchor Proteins
B. Complement
C. Spectrin protein
D. Mannose binding proteins
Answer: B
60. Which is the most common cytogenetic abnormality in adult myelodysplastic syndrome (MDS)
A. Trisomy 8
B. 20q?
C. 5q?
D. Monosmy 7
Answer: C
61. Gaisbock syndrome is known as
A. Primary Familial Polycythemia
B. High Altitude Erythrocytosis
C. Spurious Polycythemia
D. Polycythemia Vera
Answer: C
62. All of the following statements about Burkitt’s lymphoma are true, Except:
A. B cell lymphoma
B. 8, 14 translocation
C. Can present as an abdominal mass
D. Radiotherapy is the treatment of choice
Answer: D
63. ‘Hairy cell leukemia’ is a Neoplastic proliferation of :
A. T. cells
B. B. cells
C. Myeloid cells
D. Macrophages
Answer: B
64. Chemotherapeutic Agent of Choice for the treatment of CML is:
A. Imatinib
B. Vincristine
C. Cyclophosphamide
D. Methotrexate
Answer: A
65. The immunoglobulin most commonly involved in Multiple Myeloma is :
A. IgG
B. IgM
C. IgA
D. IgD
Answer: A
66. The most common translocation seen in patients with Multiple Myeloma is
A. t(11;14)
B. t(4;14)
C. t(14;16)
D. t(14;20)
Answer: A
67. All the following are true about multiple myeloma except:
A. Osteolytic bone disease
B. t(8-14) translocation
C. Light chain proliferation
D. Bence-Jones proteins in urine
Answer: B
68. Converging point of both pathway in coagulation is at:
A. Factor VIII
B. Stuart factor X
C. Factor IX
D. Factor VII
Answer: B
69. Which of the following statements about coagulation factor VII is not true
A. Deficiency is inherited as an Autosomal Recessive trait
B. Deficiency is associated with prolonged APTT
C. Deficiency can be managed by Fresh Frozen plasma
D. Has a shorter half life in comparison to Hageman factor (XII)
Answer: B
70. Thrombotic thrombocytopenic purpura is a syndrome characterized by:
A. Thrombocytosis, anemia, neurologic abnormalities, progressive renal failure and fever.
B. Thrombocytopenia, anemia, neurologic abnormalities, progressive hepatic failure and fever
C. Thrombocytosis, anemia neurologic abnormalities, progressive renal failure and fever
D. Thrombocytopenia, anemia, neurological abnormalities, progressive renal failure and fever
Answer: D
71. Hypercoagulability due to defective factor V gene is called :
A. Lisbon mutation
B. Leiden mutation
C. Antiphospholipid syndrome
D. Inducible thrombocytopenia syndrome
Answer: B
72. The preferred test for confirming H. pylori eradication is:
A. Urease breath test
B. Culture
C. Serological test
D. Biopsy urease test
Answer: A
73. All of the following are used for treatment of H.Pylori, except:
A. Gentamycin
B. Clarithromycin
C. Metronidazole
D. Amoxicillin
Answer: A
74. Commonest site of peptic ulcer is :
A. 1st part of Duodenum
B. IInd part of duodenum
C. Distal 1/3 of stomach
D. Pylorus of the stomach
Answer: A
75. Dumping syndrome is due to:
A. Diarrhoea
B. Presence of hypertonic content in small intestine
C. Vagotomy
D. Reduced gastric capacity
Answer: B
76. Schilling test is Abnormal in:
A. Intrinsic factor deficiency
B. Amylase deficiency
C. Lipase deficiency
D. Pancreatic endocrine insufficiency
Answer: A
77. Which of the following statements regarding the schilling test for vitamin B12 malabsorption is most accurate?
A. The schilling test results are abnormal in patients with dietary vitamin B12 deficiency.
B. In patients with pernicious anemia, the results of the schilling test normalize after oral administration of intrinsic factor,
C. In patients with ileal disease, the results of the schilling test normalize after oral administration of intrinsic factor
D. Pancreatic exocrine insufficiency does not cause schilling test results to be abnormal.
Answer: B
78. All of the following drugs may be used in the treatment of ulcerative colitis Except:
A. Corticosteroids
B. Azathioprine
C. Sulfasalazine
D. Methotrexate
Answer: D
79. Extraintestinal manifestations of Inflammatory bowel disease include all of the following, Except:
A. Uveitis
B. Sclerosing cholangitis
C. Osteoarthritis
D. Skin nodules
Answer: C
80. Secretory diarrhea is not seen in:
A. Phenolphthalein
B. Celiac disease
C. Cholera
D. Addison’s Disease
Answer: B
81. Which of the following is not a prognostic factor for Acute Pancreatitis
A. Serum Amylase
B. Serum Calcium
C. Serum Glucose
D. Serum AST
Answer: A
82. Best provocative test for diagnosis of Gastrinoma is:
A. Ca++ infusion test
B. Secretin injection test
C. ACTH stimulation test
D. Steroid assay
Answer: B
83. The most classical symptom of VIPOMA is:
A. Gall stones
B. Secretory diarrhea
C. Steatorrhea
D. Flushing
Answer: B
84. All following are at-risk group adults meriting Hepatitis B vaccination in low endemic areas except:
A. Patients on chronic hemodialysis
B. Diabetics on insulin
C. Medical/nursing personnel
D. Patients with chronic liver disease
Answer: B
85. Extrahepatic Manifestations of Hepatitis C include all of the following Except:
A. Lichen Planus
B. Celiac Disease
C. Glomerulonephritis
D. Cryoglobulinemia
Answer: B
86. Which is not true about alcoholic hepatitis :
A. Gamma glutamyl transferase is raised
B. SGPT is raised > SGOT
C. SGOT is raised > SGPT
D. Alkaline phosphatase is raised
Answer: B
87. Hepatic Encephalopathy is predisposed
by all, Except:
A. Hyperkalemia
B. Dehydration
C. Constipation
D. GI Bleeding
Answer: A
88. Features of Hepatorenal syndrome are
A. Urine sodium < 10 meq/1
B. Normal renal histology
C. Renal function abnormal even after liver become normal
D. a and b
Answer: D
89. All of the following statements about.
Wilson’s disease are true, EXCEPTa) It is an autosomal recessive disorder
B. Serum ceruloplasmin level is < 20 mg/dl
C. Urinary copper excretion is
D. Zinc acetate is effective as maintenance therapy
Answer: C
90. A 14 year old boy presents wit recurrent episodes of hepatitis Ophthalmoscopic evaluation reveals KF rings and serum ceruloplasmin levels are < 20 mg/dl. The treatment of choice for initial therapy is
A. Zinc
B. Penicillamine
C. Tetrathromolybdate
D. None of the above
Answer: A
91. What is the uppermost intercostal space used for hepatic biopsy :
A. 5th
B. 7th
C. 9th
D. 11th
Answer: B
92. Significant weight loss is defined as:
A. 5% weight loss in 1-2 months
B. 5% weight loss in 2-3 months
C. 10% weight loss in 1-2 months
D. 10% weight loss in 2-3 months
Answer: A
93. CRF with anemia best treatment:
A. Oral Iron Therapy
B. Erythropoietin Stimulating Agents
C. Blood transfusion
D. Androgenic Steroids
Answer: B
94. The initial treatment of choice for secondary hyperparathyroidism in renal osteodystrophy is:
A. Cinacalcet
B. Bisphosphonates
C. Calcium restriction
D. Phosphate binders
Answer: D
95. The most common presentation for IgA nephropathy is:
A. Nephritic syndrome
B. Nephritic syndrome
C. Microscopic hematuria
D. Repeated gross hematuria
Answer: D
96. Disease, does not recur in the kidney after renal transplant is :
A. Alport syndrome
B. Amyloidosis
C. Good Pasteur’s syndrome
D. Diabetic nephropathy
Answer: A
97. True about light microscopy in minimal change disease is:
A. Loss of foot process seen
B. Anti GBM Abs seen
C. IgA deposits seen
D. No change seen
Answer: D
98. HIV renal specific nephropathy is:
A. Focal Segmental Glomerulosclerosis
B. Membranoproliferative Glomerulonephritis
C. Mesangioproliferative Glomerulonephritis
D. Membranous Glomerulonephritis
Answer: A
99. Distal renal tubular acidosis is associated with:
A. Oxalate stones
B. Citrate
C. Calcium stones
D. Uric acid stones
Answer: C
100. Which of the following statement about Renal Cell Carcinoma (Hypemephroma) is false:
A. Originate in the cortex
B. Histologically are usually Adenocarcinomas
C. May present with varicocele
D. Radiosensitive
Answer: D
101. Classic triad inRenal cell carcinoma includes all of the following, Except:
A. Hematuria
B. Hypertension
C. Flank mass
D. Abdominal Pain
Answer: B
102. FEVI/FVC is decrease in:
A. Asthma
B. Kyphosis
C. Scoliosis
D. Fibrosis
Answer: A
103. Aspirin-sensitive asthma is associated with:
A. Obesity
B. Urticaria
C. Nasal polyp
D. Extrinsic asthma
Answer: C
104. Feature of Acute severe Asthma include all of the following, Except:
A. Tachycardia > 120/min
B. Pulsus paradoxus
C. Respiratory acidosis
D. Drowsy
Answer: A
105. An Adult with asthma presents with asthma symptoms every day and wakes up in the night approximately 2 to 3 days in a week. He can be classified as having :
A. Intermittent Asthma
B. Mild Persistent Asthma
C. Moderate Persistent Asthma
D. Severe Persistent Asthma
Answer: C
106. In a Patient with clinical signs of Asthma which of the following tests will confirm the diagnosis:
A. Increase in FEV1/FVC
B. > 200 ml increase in FEVI after Methacholine
C. Diurnal variation in PEF > 20 Percent
D. Reduction of FEV I > 20 % after bronchodilators
Answer: C
107. Antibody used in the treatment of Bronchial Asthma is:
A. Omalizumab
B. Rituximab
C. Daclizumab
D. Transtusuzumab
Answer: A
108. Which of the following is the least common bacteria responsible for Acute Exacerbation of Chronic Bronchitis
A. Streptococcus pneumoniae
B. Moraxella catarrhalis
C. Haemophilus influenza
D. Staphylocccus aureus
Answer: D
109. Occupational Lung Disease commonly seen in Textile Industry Workers is:
A. Byssinosis
B. Bagassosis
C. Farmer’s Lung
D. Asbestosis
Answer: A
110. All the following are features of Tropical pulmonary Eosinophilia except
A. Eosinophilia > 3000/mm3
B. Microfilaria in blood
C. Paroxysmal cough and wheeze
D. Bilateral chest mottling and increased bronchovascular
markings
Answer: B
111. Most common pattern of Pneumonia seen in Klebsiella infection is:
A. Lobar Pneumonia
B. Bronchopneumonia
C. Interstitial Pneumonia
D. Miliary Pneumonia
Answer: A
112. All of the following are more commonly seen in Klebsiella Pneumonia than in Pneumococcal Pneumonia, Except:
A. Lower lobe involvement
B. Abscess Formation
C. Pleural Effusion
D. Cavitation
Answer: A
113. Friedlander Pneumonia refers to Pneumonia caused by:
A. Klebsiella
B. Pneumococcus
C. H. lnfluenzae
D. Staphylococcus
Answer: A
114. Atypical pneumonia can be caused by the following microbial agents except?
A. Mycoplasma pneumoniae.
B. Legionella pemmophila
C. Human Corona virus
D. Klebsiella pneumoniae
Answer: D
115. The most definitive method of diagnosing pulmonary embolism is :
A. Pulmonary arteriography
B. Radioisotope perfusion pulmonary scintigraphy
C. EKG
D. Venography
Answer: A
116. All of the following show low glucose in pleural fluid, EXCEPT
A. Empyema
B. Malignant pleural effusion
C. Rheumatoid arthritis
D. Dressler’s syndrome
Answer: D
117. Which of the following statements about Branchial cysts is true:
A. 50-70% are seen in lungs
B. Most common site is mediastinum
C. They are premalignant lesions
D. Infection is uncommon in Pulmonary bronchogenic cysts
Answer: B
118. Which of the following drugs, is used for Smoking Cessation?
A. Naltrexone
B. Bupropion
C. Buprenorphine
D. Methadone
Answer: B
119. ANCA is NOT associated with which of the following diseases :
A. Wegener’s granulomatosis
B. Henoch schonlein purpura
C. Microscopic PAN
D. Churg Strauss syndrome
Answer: B
120. Feature of microscopic polyangitis is:
A. IgG deposits in kidney
B. Bronchospasm
C. Renal involvement in 80% of cases
D. All of the above
Answer: C
121. Jaw tightness is typically seen in:
A. PAN
B. Coarctation of aorta
C. Giant cell arteritis
D. Wegner’s Granulomatosis
Answer: C
122. Reversed Coarctation is seen in:
A. Giant cell Arteritis
B. Polyarteritis Nodosa
C. Takayasu Arteritis
D. Kawasaki Disease
Answer: C
123. Takayasu arteritis mainly affects?
A. Pulmonary artery
B. Celiac artery
C. Subclavian artery
D. SMA
Answer: C
124. Most common variant of Takayasu Disease in India is:
A. Type-1
B. Type-2
C. Type-3
D. Type-4
Answer: C
125. Kawasaki disease is associated with all of the following clinical features except
A. Truncal rash
B. Posterior cervical lymphadenopathy
C. Thrombocytopenia
D. Pericarditis
Answer: C
126. Treatment of choice for Kawasaki Disease is:
A. IV Immunoglobulins
B. Steroids
C. Dapsone
D. Methotrexate
Answer: A
127. Features of SLE include all of the following except:
A. Recurent abortion
B. Sterility
C. Coomb’s positive hemolytic anemia
D. Psychosis
Answer: B
128. Shrinking Lung Syndrome is seen in:
A. SLE
B. Rheumatoid Arthritis
C. Scleroderma
D. Sarcoidosis
Answer: A
129. Antibodies most commonly seen in drug induced lupus are:
A. Anti ds DNA Antibodies
B. Anti Sm Antibodies
C. Anti-Ro Antibodies
D. Antihistone Antibodies
Answer: D
130. Bilateral parotid enlargement occurs in all, Except:
A. Sjogren’s syndrome
B. SLE
C. HIV
D. Chronic pancreatitis
Answer: B
131. Lupus Pernio is seen in:
A. Tuberculosis
B. SLE
C. PAN
D. Sarcoidosis
Answer: D
132. Keratoderma Blenorrhagica is typically seen in
A. Rheumatoid Arthritis
B. Psoriatic Arthritis
C. Reactive Arthritis
D. Ankylosing spondylitis
Answer: C
133. Which of the following statements about Hemochromatosis is not true
A. Hypogonadism may be seen
B. Arthropathy may occur
C. Diabetes Mellitus may develop
D. Desferrioxamine is treatment of choice
Answer: D
134. Renal artery stenosis may occur in all of the following, except :
A. Atherosclerosis
B. Fibromuscular dysplasia
C. Takayasu’s arteritis
D. Polyarteritis nodosa
Answer: D
135. The most common cause of Cushing’s syndrome is:
A. Pituitary adenoma
B. Adrenal adenoma
C. Ectopic ACTH
D. Iatrogenic steroids
Answer: D
136. Intake of exogenous steroid causes:
A. Addison’s disease
B. Cushing’s syndrome
C. Pheochromocytoma
D. Conn’s syndrome
Answer: B
137. Most common cause of Addison’s Disease in India is:
A. Autoimmune
B. Postpartum
C. HIV
D. Tuberculosis
Answer: D
138. Initial Drug of choice for suspected case of acute adrenal insufficiency is:
A. Norepinephrine
B. Hydrocortisone
C. Dexamethasone
D. Fludrocortisones
Answer: C
139. Nelson’s syndrome is most likely seen after:
A. Hypophysectomy
B. Adrenalectomy
C. Thyroidectomy
D. Orchidectomy
Answer: B
140. Primary Hyperaldosteronism can be diagnosed by all of the following criteria, except:
A. Diastolic Hypertension without edema
B. Hyperaldosteronism which is not supressed by volume expansion
C. Low Plasma Renin Activity
D. Metabolic Acidosis
Answer: D
141. Primary hyperparathyroidism is suggested by all of the following, except:
A. Increased serum calcium
B. Low urinary calcium
C. Increased PTH
D. Increased C-AMP
Answer: B
142. Hypophosphatemia is seen in:
A. Pseudohypoparathyroidism
B. Hyperparathyroidism
C. Hyperthyroidism
D. Hypoparathyroidism
Answer: B
143. Granulomatous condition causing hypercalcemia include all of the following, except:
A. TB
B. Sarciodosis
C. Berylliosis
D. SLE
Answer: D
144. Osteoporosis is seen in all the following except
A. Thyrotoxicosis
B. Rheumatoid arthritis
C. Hypoparathyroidism
D. Steroid therapy
Answer: C
145. Features of tumor lysis syndrome are:
A. Hypocalcemia
B. Hypophosphatemia
C. Alkalosis
D. Hypokalemia
Answer: A
146. A pregnancy woman is diagnosed to suffering from Graves’ disease. The most appropriate therapy for her would be:
A. Radioiodine therapy
B. Total thyroidectomy
C. Carbimazole parenteral
D. Propylthiouracil oral
Answer: D
147. Investigation of choice in pheochromocytoma is:
A. CT scan
B. Urinary catecholamines
C. MIBG scan
D. MRI Scan
Answer: B
148. The predominant symptom/sign of pheochromocytoma is:
A. Sweating
B. Weight loss
C. Orthostatic hypotension
D. Episodic hypertension
Answer: D
149. The gold standard test for diagnosis of Insulinoma is:
A. ’72 hour’ fast test
B. Plasma Glucose levels < 3 mmol/l C. Plasma Insulin levels > 6µU/ml
D. C- peptide levels < 50 p mol/e
Answer: A
150. Diagnosis of carcinoid tumour is done Urinary estimation of:
A. VMA
B. Metanephrines
C. Catecholamines
D. 5HIAA
Answer: D
151. Carcinoid syndrome produces valvular disease primarily of the
A. Venous valves
B. Tricuspid valve
C. Mitral valve
D. Aortic valve
Answer: B
152. Most common cause of chronic granulomatous disease in children is:
A. Myeloperoxidase deficiency
B. Defective phagocytosis
C. Defective H2O2 production
D. Job’s disease
Answer: C
153. In Turner’s syndrome which of the following is NOT seen :
A. Short stature
B. Widely spaced nipple
C. Webbed neck
D. Mental retardation
Answer: D
154. Broca’s aphasia is?
A. Fluent aphasia
B. Non fluent aphasia
C. Sensory aphasia
D. Conduction aphasia
Answer: B
155. All of the following are Fluent Aphasia’s Except:
A. Anomie Aphasia
B. Wernicke’s Aphasia
C. Conduction Aphasia
D. Broca’s Aphasia
Answer: D
156. Fluent Aphasia with preserved comprehension and impaired repetition is:
A. Broca’s
B. Wernicke’s
C. Anomie
D. Conduction
Answer: D
157. Involvement of pyramidal tract leads to all of the following except
A. Spasticity
B. Fasciculation
C. Hyper-reflexia
D. Positive Babinski sign
orrect Answer – B
158. The following are components of Brown Sequard syndrome except :
A. Ipsilateral extensor plantar response
B. Ipsilateral pyramidal tract involvement
C. Contralateral spinothalamic tract involvement
D. Contralateral posterior column involvement
Answer: D
159. Early loss of bladder control is seen in
A. Conus Medullaris
B. Cauda Equina
C. Gullain Barre Syndrome
D. Amyotrophic Lateral Sclerosis
Answer: A
160. Most common cause of embolic stroke is?
A. Intra-Cardiac Thrombi
B. Particulate Matter From IV Drug Injections
C. Protein C deficiency
D. Antiphospholipid syndrome
Answer: A
161. The common cause of subarachnoid haemorrhage is:
A. Arterio-venous malformation
B. Cavernous angioma
C. Aneurysm
D. Hypertension
Answer: C
162. Lateral medullary syndrome is caused by thrombosis of:
A. Anterior inferior cerebral artery
B. Posterior inferior cerebellar artery
C. Vertebral artery
D. b and c
Answer: D
163. Which of the following statements about the pathology in Alzheimer’s disease is not true:
A. Neuritic Plaques are formed of amyloid protein
B. Neurofibrillary tangles (NFT) are made of tau protein
C. NFTs appear extracellularly before intracellular appearance
D. Number of NFTs correlates with dementia
Answer: C
164. Which of the following metal ions is associated with secondary Parkinsonism:
A. Mangnese (Mn)
B. Magnesium (Mg)
C. Selenium (Se)
D. Molybednum (Me)
Answer: A
165. Which of the following sites is responsible for the amnestic defect in Wernicke’s Korsakoff syndrome:
A. Mamillary body
B. Thalamus
C. Periventricular Grey matter
D. Hippocampus
Answer: B
166. In children most common posterior fossa tumour is:
A. Meningiomas
B. Astrocytoma
C. Medulloblastoma
D. Glioblastoma multiforme
Answer: B
167. All the following are true of Craniopharyngioma except
A. Derived from Rathke’s pouch
B. Contains epithelial cells
C. Present in sella or infra-sellar location
D. Causes visual disturbances
Answer: C
168. Predominantly sensory neuropathy is/are caused by:
A. Cisplatin
B. Pyridoxine excess
C. Suramin
D. a and b
Answer: D
169. Which one of the following is correct regarding Eaton-Lambert syndrome
A. It commonly affects the ocular muscle
B. Neostigmine is the drug of choice for this syndrome
C. Repeated electrical stimulation enhances muscle power in it.
D. It is commonly associated with adenocarcinoma of lung
Answer: C
170. All of the following are feature of dermatomyositis, Except:
A. Salmon Patch
B. Gottron’s patch
C. Mechanic finger
D. Periungual telengiectasias
Answer: A
171. Best prognostic factor for head injury is :
A. Glasgow coma scale
B. Age
C. Mode of injury
D. CT
Answer: A
172. Impotence is a feature of which of the following :
A. Multiple sclerosis
B. Poliomyelitis
C. Amyotropic lateral sclerosis
D. Meningitis
Answer: A
173. Which of the following is the most common initial presenting feature of multiple sclerosis:
A. Optic Neuritis
B. Cerebellar Ataxia
C. Internuclear ophthalmoplegia
D. Diplopia
Answer: A
174. “Prosopagnosia” is characterized by :
A. Inability to read
B. Inability to identify faces
C. Inability to write
D. Inability to speak
Answer: B
175. Criteria for Brainstem death includes:
A. Positive Doll’s eye Reflex
B. Absent pupillary light reflex and delated pupils
C. Pinpoint pupils
D. Positive vestibulo-ocular reflex
Answer: B
176. Renal papillary necrosis is almost always associated with one of the following conditions: March 2004
A. Diabetes mellitus
B. Analgesic nephropathy
C. Chronic pyelonephritis
D. Post streptococcal glomerulonephritis
Answer: A
177. Renal vein thrombosis is associated with all of the following except: September 2011
A. Trauma
B. Sickle cell anemia
C. Nephrotic syndrome
D. Dehydration
Answer: B
178. Best marker to assess prognosis after Surgery for colon carcinoma: March 2005
A. CA 19-9
B. CA-125
C. Alpha fetoprotein
D. CEA
Answer: D
179. All of the following are features of Obstructive jaundice except: September 2007
A. Normal alkaline phosphatase
B. Mildly elevated serum aminotransferases level
C. Clay colour stools
D. Pruritis
Answer: A
180. Chvostek sign is seen in: March 2013
A. Hypercalcemia
B. Hypoparathyroidism
C. Insulinoma
D. Diabetes mellitus
Answer: B
181. ECG pattern seen in pulmonary embolism is: September 2009, March 2013
A. S3Q3T1
B. S1Q1T3
C. S1Q3T3
D. S3Q3T3.
Answer: C
182. Specific antibody associated with primary biliary cirrhosis is:
A. Anti-myosin
B. Anti-nuclear
C. Anti-mitochondrial
D. Anti-endomysial
Answer: C
183. ‘v’ Wave in JVP is due to ?
A. Right atrial contraction
B. Left atrial contraction
C. Right atrial relaxation
D. Closure of tricuspid valve
Answer: A
184. Gene for Rh antigen is located on chromosome ?
A. 1
B. 4
C. 9
D. 19
Answer: A
185. Mannitol infusion causes increase in
A. Blood viscosity
B. Osmolarity
C. Intra-ocular tension
D. Intercranial tension
Answer: B
186. Normal QRS axis ?
A. +30 to 110°
B. -30 to +110°
C. +110° to +150°
D. -110° to -150°
Answer: B
187. Acrodermatitis hemorrhagica is due to deficiency of
A. Zinc
B. Manganese
C. Copper
D. Selenium
Answer: A
188. Which of the following is not seen in Secondary Adrenal insufficiency
A. Pigmentation
B. Postural hypotension
C. Hypoglycemia
D. Lassitude
Answer: A
189. Typhoid is treated by all except
A. Erythromycin
B. Ceftriaxone
C. Amikacin
D. Ciprofloxacin
Answer: A
190. Drug treatment is given for how many days in pneumococcal meningitis
A. 5 days
B. 7 days
C. 14 days
D. 21 days
Answer: C
191. Marker of acute kidney injury all except
A. Clusterin
B. Osteopontin
C. Alanine aminopeptidase
D. Acid phosphatase
Answer: D
192. The treatment of choice in acute hyperkalemia of life threatening to cardiac myocytes is
A. Infusion of calcium gluconate
B. Oral resins
C. Intravenous infusion of insulin
D. ß blocker
Answer: A
193. Vitamin E causes
A. Hemorrhagic stroke
B. Cardiac failure
C. Ataxia
D. Megalablastic anemia
Answer: C
194. Which of the following circulating antibodies has the best sensitivity and sepcificity for the diagnosis of celiac disease ?
A. Anti Saccharomyces antibody
B. Anti-tissue transglutaminase antibody
C. Anti-gliadin antibody
D. Anti-gliadin antibody antibody
Answer: A
195. Aseptic meningitis caused by
A. Indomethacin
B. Ibuprofen
C. Aspirin
D. Icatibant
Answer: B
196. High Steppage Gait is seen in
A. Foot drop
B. Frontal lobe stroke
C. Tabes dorsalis
D. Leprosy
Answer: C
197. In a patient with bronchial asthma silent chest signifies
A. Good Prognosis
B. Bad Prognosis
C. Grave Prognosis
D. Not a Prognostic sign
Answer: C
198. Which is correct about pneumonia
A. Bronchophonia
B. Decreased vocal fremitus
C. Shifting of trachea
D. Amphoric breathing
Answer: A
199. Systemic Millary TB spreads via
A. Artery
B. Vein
C. Bronchus
D. Lymphatic
Answer: A
200. DOC for acute attack of Hereditary angioneurotic edema
A. Danazol
B. Cl, inhibitor concentrate
C. Icatibant
D. Methylprednisolone
Answer: B
201. Type 5 Hypersensitivity mimics
A. Type 1
B. Type 2
C. Type 3
D. Type 4
Answer: B
202. Which is best for plaque morphology
A. CCTA
B. MRI
C. CMR
D. IVUS
Answer: A
203. Most common cause of heart block in infants is
A. SLE
B. Surgery for congentital heart disease
C. Viral myocarditis
D. Rheumatic fever
Answer: B
204. Aphasia which affects the arcuate fibres is called
A. Global aphasia
B. Anomie aphasia
C. Conduction aphasia
D. Broca’s aphasia
Answer: C
205. Drug for management of hypertension in Phaeochromocytoma
A. Phenoxybenzamine
B. Phentolamine
C. Labetalol
D. Esmolol
Answer: A
206. Causes of hyperparathyroidism are all except
A. Solitary adenoma
B. Malignant
C. Thyroid malignancy
D. Parathyroid hyperplasia
Answer: C
207. Mentzer index more than 13 suggests a diagnosis of
A. Iron deficiency anemia
B. Thalassemia
C. Hereditary Spherocytosis
D. Autoimmune Hemolytic Anemia
Answer: A
208. Which of the following statements about iron deficiency anemia is correct
A. Decreased TIBC
B. Increased ferritin levels
C. Bone marrow iron is decreased after serum iron is decreased
D. Bone marrow iron is decreased earlier than serum iron
Answer: D
209. Persistent priapism is due to
A. Sickle cell anaemia
B. Hairy cell leukaemia
C. Paraphimosis
D. Urethral stenosis
Answer: A
210. The type of arteritis which may lead to myocardial infarction in children is
A. Kawasaki disease
B. Takayasu arteritis
C. Polyarteritis nodosa
D. Microscopic polyangitis
Answer: A
211. Onion skin spleen is seen in
A. ITP
B. Thalassemia
C. SLE
D. Scleroderma
Answer: C
212. Most common pulmonary manifestation in AIDS
A. TB
B. Pneumonia
C. Bronchiectasis
D. Mycobacterial avium intracellular
Answer: B
213. Chronic hemodialysis in ESRD patient is done
A. Once per week
B. Twice per week
C. Thrice per week
D. Daily
Answer: C
214. Interstitial nephritis is common with
A. NSAID
B. Black water fever
C. Rhabdomyolysis
D. Tumor lysis syndrome
Answer: A
215. Best test for lung fibrosis
A. Chest x-ray
B. MRI
C. HRCT
D. Biopsy
Answer: C
216. Which of the following is a Channelopathy
A. Ataxia Telangiectasia
B. Frederich Ataxia
C. Spinocerebellar ataxia
D. Anderson Tawil Syndrome
Answer: D
217. Good syndrome is
A. Thymoma with immunodeficiency
B. Thymoma with M. Gravis
C. Thymoma with serum sickness
D. Thymoma with pure red cell aplasia
Answer: A
218. Patient diagnosed with HIV and Tuberculosis. How to start ATT and cA.R.T
A. Start ATT first
B. Start cART first
C. Start both simultaneously
D. Start cART only
Answer: A
219. Most common cause of lung abscess
A. Staph aureus
B. Oral anaerobes
C. Klebsiella
D. Tuberculosis
Answer: B
220. Normal CRP with elevated ESR seen in
A. RA
B. SLE
C. Scleroderma
D. Polymyalgia rheumatica
Answer: B
221. Restrictive and constrictive pericarditis occurs together in
A. Radiation
B. Adriamycin
C. Amyloidosis
D. Post cardiotomy syndrome
Answer: A
222. All form boundaries of triangle of auscultation except
A. Trapezius
B. Latissmusdorsi
C. Scapula
D. Rhomboid major
Answer: D
223. Rytand’s murmur is seen in
A. A-V Block
B. Mitral stenosis
C. Aortic stenosis
D. Aortic regurgitation
Answer: A
224. Not associated with diabetes mellitus
A. Cushing syndrome
B. Acromegaly
C. Hypothyroidism
D. Pheochromocytoma
Answer: C
225. Fever increase water losses by mUday per degree Celsius
A. 100
B. 200
C. 400
D. 800
Answer: B
226. Most common cause of hypernatremia
A. Adipsic diabetes insipidus
B. Carcinoid syndrome
C. Renal losses
D. Sweating
Answer: C
227. Rarest type of Von Willebrand disease :
A. vWD type 1
B. vWD type 2A
C. vWD type 2N
D. vWD type 3
Answer: D
228. A patient has ecchymosis and petechiae all over the body with no hepatosplenomegaly. All are true except
A. Increased megakaryocytes in bone narrow
B. Bleeding into the joints
C. Decreased platelet in blood
D. Disease resolves itself in 80% of Patients in 2-6
Answer: B
229. All of the following are true about Rheumatoid arthritis, except
A. PIP and DIP joints involved equally
B. Pathology limited to articular cartilage
C. Women are affected 3 times more commonly than men
D. 20% of patients have extra articular manifestations
Answer: D
230. Development of Lymphoma in Sjogren’s syndrome is suggested by all of the following except
A. Persistent parotid gland enlargement
B. Cyoglobilinemia
C. Leukopenia
D. High C4 compement levels
Answer: D
231. Hemodialysis can be performed for long periods from the same site due to
A. Arteriovenous fistula reduces bacterial contamination of site
B. Arteriovenous fistula results in arterialization of vein
C. Arteriovenous fistula reduces chances of graft failure
D. Aretiovenous fistula facilitates small bore needles for high flow
rates
Answer: B
232. In AIDS patient presenting with fever, cough a diagnosis of pneumocystin pneumonia is best established by
A. CT scan chest
B. Bronchoalveolar lavage
C. Staining of intra-nuclear inclusion with silver staining
D. Aspiration and culture
Answer: B
233. The most common neurological disorder seen in CRF patients
A. Dementia
B. Peripheral neuropathy
C. Bakes intestinal dilator.
D. Restless leg syndrome
Answer: B
234. ECG image,U wave seen, patient is on furosemide & beta blocker. Diagnosis
A. Hypocalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hypercalcemia
Answer: B
235. In Zollinger Ellison syndrome what is raised?
A. Insulin
B. VIP
C. Gastrin
D. Glucagon
Answer: C
236. Menke’s disease” is a disease of
A. Impaired zinc transport
B. Impaired copper transport
C. Impaired magnesium transport
D. Impaired molybdenum transport
Answer: B
237. Anosmia is early clinical feature of
A. Alzheimer
B. Parkinson’s disease
C. Huntington’s chorea
D. All of the above
Answer: D
238. DOC of GTCS in pregnancy
A. Lamotrigine
B. CBZ
C. Levetiracetam
D. Valproate
Answer: A
239. A Patient with history of shortness of breath has Decreased FEV1/FVC Ratio, Normal DLCO. A 200 ml increase in baseline FEVI is observed 15 minutes after administration of bronchodilators. The likely diagnosis is
A. Asthma
B. Chronic Bronchitis
C. Emphysema
D. Interstitial Lung Disease
Answer: A
240. Pseudo-hemoptysis is seen mostly with
A. Streptococcus
B. E. coli
C. Serratia marcescens
D. R.S.V
Answer: C
241. Finger is glove sign is seen in
A. Pulmonary alveolar Proteinosis
B. Pneumocystis Carinii
C. Tuberculosis
D. Bronchocele
Answer: D
242. Which of the following disorders is least likely associated with progression to lymphoma
A. Sjogren’s syndrome
B. Araxia telangiectasia
C. Severe combined immunodeficiency
D. Lynch II syndrome
Answer: C
243. Woman of 30-years with Raynaud’s phenomenon, polyarthritis, dysphagia of 5-years and mild Sclerodactyl, blood showing Anti-centromere antibody positive, the likely cause is
A. CREST
B. Mixed connective tissue disorder
C. SLE
D. Rheumatoid arthritis
Answer: A
244. Most common mechanism of arrhythmia
A. Re-entry
B. Early after depolarization
C. Late after depolarization
D. Automaticity
Answer: A
245. -30 to -90 degree axis deviation indicates
A. Left Axis Deviation
B. Right Axis Deviation
C. Extrene Right Axis Deviation
D. Normal Cardiac Axis
Answer: A
246. Which of the following is not a sign of upper motor neuron paralysis
A. Babinski sign
B. Spastic paralysis
C. Denervation potential in EMG
D. Exaggeration of tendon reflexes
Answer: C
247. Most common oral infection in diabetes mellitus
A. Candida
B. Aspergillus
C. Streptococcus
D. Stphylococcus
Answer: A
248. All are features of hypernatremia except
A. Convulsions
B. Elevated intracranial tension
C. Periodic paralysis
D. Doughy skin
Answer: C
249. Doughy skin and woody induration of tongue is seen in
A. Hypernatremia
B. Hyponatremia
C. Hypokalemia
D. Hyperkalemia
Answer: A
250. Which of the following is MOST commonly affected by Crohn’s Disease
A. Cecum
B. Rectum
C. Sigmoid colon
D. Terminal Ileum
Answer: D
251. All of following cause intravascular hemolysis, except
A. Mismatched blood transfusion
B. Paroxysmal cold hemoglobinuria
C. Thermal burns
D. Hereditary spherocytosis
Answer: D
252. Blood transfusion should be completed within hours of initiation
A. 1- 4 hours
B. 3- 6 hours
C. 4- 8 hours
D. 8- 12 hours
Answer: A
253. Vitamin B level in chronic myeloid leukemia is
A. Elevated’
B. Decreased
C. Normal
D. Markedly
Answer: A
254. Which is the most common organ involved in sarcoidosis
A. Lung
B. Liver
C. CNS
D. Eye
Answer: A
255. Following statements about sarcoidosis is false
A. Elevated level of angiotensin converting enzyme (ACE)
B. Bilateral parotid enlargement is the rule
C. Pleural effusion is common
D. Facial nerve palsy may be seen
Answer: C
256. The most common cause of seizures in a patient of AIDS is
A. Toxoplasmosis
B. Cryptococcal meningitis
C. Progressive multifocal leucoencephalopathy
D. CNS lymphoma
Answer: A
257. Gene responsible for resistance to rifampicin
A. Rpo B gene
B. Kat G gene
C. Rpm B gene
D. Emb B gene
258. Lepsroy causes ?
A. Membranous GN
B. Focal glomerulosclerosis
C. Membranoproliferative GN
D. Mesangioproliferative GN
Answer: A
259. Nephrotic syndrome is the hall mark of the following primary kidney diseases except
A. Membranous Glomerulopathy
B. IgA nephropathy
C. Minimal change disease
D. Focal segmental Glomerulosclerosis
Answer: B
