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
260. Bechterews disease also known as
A. Rheumatoid arthritis
B. Ankylosing spondylitis
C. Osteoarthritis
D. Syphilitic arthritis
Answer: B
261. Comprehension in intact with aphasia in
A. Wernicke’s
B. Broca’s
C. Global aphasia
D. Transcortical sensory
Answer: B
262. Following statements about sarcoidosis is false
A. The first manifestation of the disease is an accumulation of mononuclear inflammatory cells, mostly CD8 + THI lymphocytes in affected organs
B. The Heerfordt- Waldenstrom syndrome describes individuals with fever, parotid enlargement, anterior uveitis, and facial nerve palsy
C. Elevated level of angiotensin converting enzyme (ACE) are a feature
D. Bilateral parotid involment is the rule
Answer: A
263. The treatment options for patients with RRMS (relapsing-remitting multiple sclerosis) are all except
A. IFN – 1 b
B. IFN – 1 a
C. Glatiramer acetate
D. TNF – a
Answer: D
264. DOC for Tourette syndrome
A. Haloperidol
B. Valproate
C. B complex
D. Clonidine
Answer: D
265. SSPE is not diagnosed by
A. EEG
B. Antibodies to measles in CSF
C. Antibodies to measles in blood
D. Antigen in brain biopsy
Answer: C
266. Bronchiectasis Sicca is seen with
A. Tuberculosis
B. Pertussis
C. Cystic fibrosis
D. Kartagener syndrome
Answer: A
267. Brock’s Syndrome is
A. Bronchiectasis Sicca
B. Middle Labe Bronchiectasis
C. Kartagener’s Syndrome
D. Sarcoidosis
Answer: B
268. Central bronchiectasis is seen with
A. Cystic Adenomatoid Malformation
B. Cystic fibrosis
C. Broncho carcinoma
D. Tuberculosis
Answer: B
269. Type 3 respiratory failure occurs due to ?
A. Post-operative atelectasis
B. Kyphoscoliosis
C. Flail chest
D. Pulmonary fibrosis
Answer: A
270. Bilateral Painless parotid enlargement is seen in all except
A. Mumps
B. Alcoholics
C. Sarcoidosis
D. Diabetes mellitus
Answer: A
271. All of the following are features of Scleroderma are following except
A. Diffuse periosteal reaction
B. Esophageal dysmotility
C. Erosion of tip of phalanges
D. Lung Nodular infiltrates
Answer: A
272. LBBB is seen with all except
A. Acute MI
B. Ashmann syndrome
C. Hypokalemia
D. Hyperkalemia
Answer: C
273. Therapeutic hypothermia is of benefit in preventing neurological complications in
A. Sepsis
B. Poly-trauma
C. Cardiac arrest
D. lschemic stroke
Answer: C
274. Distribution of weakness in Pyrimidal tract lesions?
A. Extensors more than flexors in lower limb
B. Flexors more than extensors in upper limb
C. Antigravity muscles are affected
D. Antigravity muscles are spared
Answer: D
275. Aldose reductase inhibitor drugs are useful in
A. Cataract
B. Diabetes mellitus
C. Hereditary fructose intolerance
D. Essential fructosuria
Answer: B
276. Not a cause of hypernatremia
A. Adipsic diabetes insipidus
B. Decreased insensible losses
C. Nephrogenic diabetes insipidus
D. Carcinoid syndrome
Answer: B
277. Backwash ileitis is seen in
A. Ulcerative colitis
B. Crohn’s disease
C. Colonic carcinoma
D. heal polyp
Answer: A
278. Which of the following is not seen in Hereditary Spherocytosis
A. Direct Coomb’s Positive
B. Increased Osmotic Fragility
C. Splenomegaly
D. Gall stones
Answer: A
279. Usually associated with parvovirus B19 infection in those with hereditary spherocytosis
A. Mild to moderate splenomegaly
B. Aplastic crisis
C. Gallstones
D. Hemolytic crisis
Answer: B
280. Which of the following is given to treat thrombocytopenia secondary to anticancer therapy and is known to stimulate
progenitor megakaryocytes
A. Filgrastim
B. Oprelvekin
C. Erythropoietin
D. Anagrelide
Answer: B
281. Lambda – Panda sign is typically seen in
A. Sarcoidosis
B. Tuberculosis
C. Histoplasmosis
D. Leishmaniasis
Answer: A
282. All are indications for stopping effending ATT drug permanently except
A. Gout
B. Autoimmune thrombocytopenia
C. Optic neuritis
D. Hepatitis
Answer: D
283. Interferon gamma release assay measures IFN release against which M. TB antigen
A. ESAT-6
B. E SAT-7
C. CF-11
D. CF-12
Answer: A
284. The term end-stage renal disease (ESRD) is considered appropriate when GFR falls to
A. 50% of normal
B. 25% of normal
C. 10-25% of normal
D. 5-10% of normal
Answer: D
285. Muehrcke lines in nails are seen in
A. Nephrotic syndrome
B. Barrter syndrome
C. Nail patella syndrome
D. Acute tubular necrosis
Answer: A
286. Not true obstructive sleep appoea
A. Nocturnal asphyxia
B. Alcoholism is a cofactor
C. Prone to hypertension
D. Overnight oximetry is diagnostic to replace polysomnography
Answer: D
287. Obstructive sleep apnoea may result in all of the following except
A. Systemic hypertension
B. Pulmonary hypertension
C. Cardiac arrhythmia
D. Impotence
Answer: C
288. Tophi in gout found in all regions except
A. Prepatellar bursae
B. Muscle
C. Helix of ear
D. Synovial membrane
Answer: B
289. All drugs used in treatment of acute gout except
A. Allopurinol
B. Aspirin
C. Colchicine
D. Naproxen
Answer: A
290. Wrong abour continuous murmur
A. Seen with coarctation of aorta
B. Peaks at S2
C. Heard both in systole and diastole
D. Increase on squatting
Answer: D
291. Banana shaped left ventricle is seen in
A. HOCM
B. DCM
C. RCM
D. Takotsubo cardiomyopathy
Answer: A
292. Wide QRS complex 0.12 seconds may be seen in all of the following, except
A. Hyperkalemia
B. Wolf Parkinson White Syndrome
C. Ventricular Tachycaridia
D. Left Anterior Fascicular Block
Answer: D
293. Subacture combined degeneration of cord is caused due to deficiency of
A. Vitamin B1
B. Vitamin B5
C. Vitamin B6
D. Vitamin B12
Answer: D
294. Foot ulcers in diabetes are due to all except
A. Decreased immunity
B. Neuropathy
C. Microangiopathy
D. Macroangiopathy
Answer: A
295. Not a cause of Gynaecomastia
A. Hypothyroidism
B. Kallman
C. obesity
D. Klinefelter syndrome
Answer: A
296. Brain tumor causing hypernatremia in children
A. Medulloblastoma
B. Cerebellar astrocytoma
C. Craniophyrangioma
D. Brain stem glioma
Answer: C
297. Poorly controlled diabetes with blood sugar of 450 mg% is associated with:
A. Hyponatremia
B. Hypernatremia
C. Hypokalemia
D. Hypomagnesemia
Answer: A
298. 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
299. With regards to hereditary spherocytosis, which of the following is false
A. Usually has autosomal dominant inheritance
B. Caused by mutations in genes for proteins such as spectrin, ankrin or band 3
C. Red blood cells are destroyed in the spleen
D. Aplastic crises are common
Answer: D
300. All of the following are true regarding splenectomy in patients with hereditary spherocytosis, except ?
A. Avoid in mild cases
B. Delay splenectomy until at least 4 years old age
C. Anti-pneumococcal vaccination must be given before splenectomy
D. Prolonged anti-pneumococcal antibiotic prophylaxis must be
given after splenectomy
Answer: D
301. Most common heavy chain disease is
A. Franklin disease
B. Seligmann disease
C. Mu heavy chain disease
D. Waldenstrom cryoglobulinemia
Answer: B
302. Treatment of choice in acute sarcoidosis is
A. Prednisolone
B. Cyclosporin
C. Infliximab
D. IV immunoglobulins
Answer: A
303. MDR TB must be treated for at least ?
A. 12 months
B. 18 months
C. 20 months
D. 36 months
Answer: C
304. The following are the complication of haemodialysis except
A. Hypotension
B. Peritonitis
C. Hypertension
D. bleeding tendency
Answer: B
305. The most likely diagnosis in the case of a patient with multiple pulmonary cavities, hematuria and red cell casts is
A. Anti-GBM disease
B. Churg-Strauss
C. Systemic lupus erythematousus
D. Wegner’s granulomatosis
Answer: D
306. Hung-up reflexes are seen in
A. Chorea
B. Atheotosis
C. Cerebral palsy
D. Cerebellar palsy
Answer: A
307. Arsenic poisoning causes
A. Polyneuritis
B. Mononeuritis multiplex
C. Radiculopathy
D. Myelopathy
Answer: A
308. Tropical pulmonary eosinophilia is caused because of
A. Occult filariasis
B. Cerebral melaria
C. Penumonic plague
D. Asthmatic bronchitis
Answer: A
309. Characteristic ECG finding of pulmonary embolism
A. Sinus tachycardia
B. S Q3T3
C. T wave inversion
D. Epsilon waves
Answer: B
310. Pleural effusion in rheumatoid arthritis is typically associated with the following features except
A. Glucose > 60 mg/dl
B. Protein > 3 gm/di
C. Pleural fluid protien to serum protein ratio of >0 .5
D. Pleural fluid LDH to serum LDH ratio of >0.6
Answer: A
311. In anklyosing spondylitis joint involvement is least in?
A. Wrist and hand
B. Sacroiliac joint
C. Acromio-clavicular joint
D. Costochondral junction
Answer: A
312. Least common site involved in osteoarthritis is
A. Hip joint
B. Knee joint
C. Carpometacarpal joint of thumb
D. Distal carpophalangeal joint
Answer: C
313. Inverted T waves are seen in
A. Hyperkalemia
B. Hyperthermia
C. Wellen syndrome
D. Coronary syndrome
Answer: C
314. Wide QRS complex is typically seen in
A. Bundle Branch block
B. Sick sinus syndrome
C. Mobitz type I block
D. Mobithz type II block
Answer: A
315. Low QRS voltage on ECG indicates ?
A. Pulmonary embolism
B. Pericardial effusion
C. Cor pulmonale
D. Infective endocarditis
Answer: B
316. 65-year-old man presents with anemia, posterior columan dysfunction, and planter extensor. Which of the following
is the likely cause
A. Tabes dorsalis
B. Frederich’s ataxia
C. Vitamin B1 deficiency
D. Vitamin B 12 deficiency
Answer: D
317. Proptosis is not seen in
A. Grave’s disease
B. Sarcoidosis
C. Pituitary adenoma
D. Myxoedema
Answer: D
318. True about obesity
A. Seen mostly in females
B. Prevalence decrease upto 40 years of age
C. No genetic predisposition
D. Smoking is a risk factor
Answer: D
319. What is the of correction of sodium deficit
A. 0.5 mmol/hour
B. 1 mmol/hour
C. 1.5 mmol/hour
D. 2.0 mmol/hour
Answer: A
320. Maximum loss of sodium in a child occurs in
A. Gastric juice
B. Ileal fluid
C. Non cholera Diarrhoea
D. Cholera
Answer: B
321. With regards to G6PD deficiency, which of the following in false
A. Affects the pentose phosphate pathway
B. Associated with neonatal jaundice
C. Acute haemolysis can be precipitated by broad beans
D. X-linked recessive disorder that does not affect heterozygous
famales
Answer: D
322. All of the following statements about genetics of G6PD deficiency are true, except
A. X-linked inheritance
B. More severe in Men
C. Contradicts Lyon Hypothesis
D. May affect Heterozygous females
Answer: C
323. Platelets in stored blood do not live after
A. 24 hours
B. 48 hours
C. 72 hours
D. 96 hours
Answer: C
324. Earliest and often the only presentation of TB kidney is
A. Increased frequency
B. Colicky pain
C. Hematuria
D. Renal calculi
Answer: A
325. Most common cause of diarrhea in AIDS patients?
A. Salmonella typhimurium
B. Cryptosporidium
C. Candida
D. isophora
Answer: B
326. Not seen with uremic lung
A. alveolar injury
B. Pulmonary edema
C. Interstitial fibrosis
D. Fibrinous exudate in alveoli
Answer: C
327. Oliguric phase of ARF is characterized by A/E
A. Chest pain
B. Acidosis
C. Hypertension
D. Hypokalemia
Answer: D
328. In EEG type of wave seen in metabolic encephalopathy
A. Alpha
B. Beta
C. Gamma
D. Delta
Answer: D
329. Asbestosis causes all except
A. Shaggy heart borders
B. Honeycombing
C. Hilar lymphadenopathy
D. Basal peribronchial fibrosis
Answer: C
330. The most common cause of sudden death in sarcoidosis is
A. Pneumonia
B. Cor pulmonale
C. Arrythmias
D. Liver failure
Answer: C
331. Most common cause of unilateral Hilar lymphadenopathy
A. Histoplasmosis
B. Sarcoidosis
C. Aspergillosis
D. Tuberculosis
Answer: D
332. Which of the following is cause of RBBB
A. It can occur in a normal person
B. Pulmonary embolism
C. Corpulmonale
D. All of the above
Answer: D
333. Alternating RBBB with Left anterior hemiblock is seen in
A. 1′ degree heart block
B. Complete heart block
C. Mobitz type II block
D. Bi-fascicular block
Answer: D
334. In LVH, SV1 +RV6 is more than mm
A. 25
B. 30
C. 35
D. 45
Answer: C
335. Most common site for berry aneurysm rupture
A. Anterior circulation of brai
B. Posterior circulation of brain
C. Ascending aorta
D. Descending aorta
Answer: A
336. Obesity is seen in all except
A. Cushing syndrome
B. Pickwinian syndrome
C. Prader willi syndrome
D. Sipple syndrome
Answer: D
337. Cause of death in diabetic ketoacidosis in children
A. Cerebral edema
B. Hypokalemia
C. Infection
D. Acidosis
Answer: A
338. Acute hyponatremia becomes symptomatic at
A. < 135 mEq
B. < 125 mEq
C. < 120 mEq
D. < 110 mEq
Answer: B
339. Hyponatremia is seen in
A. Hyperthyroidism
B. Hypothyroidism
C. Diabetes insipidus
D. Increased insensible losses
Answer: B
340. Chronic Non-Spherocytic hemolytic anemia is seen in which class of G6PD deficiency
A. Class I
B. Class II
C. Class III
D. Class IV
Answer: A
341. What is the Neutrophil count for moderate neutropenia
A. < 500/mm’
B. 500-1000/mm’
C. > 1000/mm3
D. 100/mm3
Answer: B
342. Gout can be precipitated by all of the following
A. Thiazides
B. Furosemide
C. Cyclosporine
D. High dose salicylates
Answer: D
343. Relative risk of developing TB in patients already infected with TB bacilus is highest in
A. Diabetes
B. Recent infection
C. Post transplantation
D. Malnutrition
Answer: C
344. I.R.I.S. is
A. Immune reconstitution idiopathic syndrome
B. Immune reconstitution immunological syndrome
C. Immune reconstitution inflammatory syndrome
D. Inflammatory reconstitution immune syndrome
Answer: C
345. In renal failure, metabolic acidosis is due to
A. Increased fr production
B. Loss of HCO,
C. Decreased ammonia synthesis
D. Use of diuretics
Answer: C
346. Diagnostic feature of CRF is
A. Broad casts in urine
B. Elevated blood urea
C. Proteinuria
D. Bleeding diathesis
Answer: A
347. Eosinophilic meningitis is seen with all except?
A. Coccidiomycosis
B. Cryptococcal meningitis
C. Lepto meningeal metastasis
D. Helminthic infections
Answer: B
348. Christmas tree appearance of urinary bladder is seen in
A. Neurogenic bladder
B. Stress incontinence
C. Autonomous bladder
D. Enuresis
Answer: A
349. the diffusion capacity of lung (DL) is decreased in all of the following conditions except
A. Inerstitial lung diseas
B. Goodpasture’s syndrome
C. Pneumocystis Jiroveci
D. Primary pulmonary hypertension
Answer: B
350. Keratoderma-Blenorrhagicum is pathogno-monic of
A. Behcet’s disease
B. Reiter’s disease
C. Lyme’s disease
D. Glucagonoma
Answer: B
351. In Takayasu’s arteritis there is
A. Intimal fibrosis
B. Renal hypertension
C. Coronary aneurysm
D. All of the above
Answer: B
352. Which is not a high pitched heart sound
A. Mid systolic click
B. Pericardial shudder
C. Opening snap
D. Tumor plop sound
Answer: D
353. Broad complex tachycardia, due to ventricular tachycardia is suggested by all except
A. Fusion beats
B. AV dissociation
C. Capture beats
D. Termination of tachycardia by carotid sinus massage
Answer: D
354. Rupture of berry aneurysm most commonly results in
A. Subarachnoid hemorrhage
B. Subdural hemorrhage
C. Extradural hemorrhage
D. Intra-parenchymal hemorrhage
Answer: A
355. Target BP before thrombolysis in ischemic stroke is below
A. 185/110 mmHg
B. 165/100 mm Hg
C. 145/100 Hg
D. 120/80 mm Hg
Answer: A
356. The most common cause of malignant adrenal mass is
A. Adrenocortical carcinoma
B. Malignant phaeochromocytoma
C. Lymphoma
D. Metastasis from another solid tissue tumor
Answer: D
357. The drug used in the management of medullary carcinoma thyroid is
A. Cabozantinib
B. Rituximab
C. Tenofovir
D. Anakinra
Answer: A
358. Incorrect about cerebral salt wasting syndrome
A. Urine sodium > 20mEq/d1
B. Hyponatremia
C. Fludrocortisone is used
D. Expansion of plasma volume
Answer: D
359. A 70 kg adult male presents with serum sodium of 110 meq/dl. Calculate correction required in 24 hours
A. 100 mEq
B. 200 mEq
C. 300 mEq
D. 400 mEq
Answer: D
360. Which of the following is a quantitative defect in globin synthesis
A. Thalassemia
B. Sickle cell hemoglobinopathy
C. G6PD deficiency
D. Diamond-Black fan syndrome
Answer: A
361. The most important diagnositic feature for beta thalassemia trait
A. Raised HbF
B. Reduced MCH
C. Reduced MCV
D. Raised HbA2
Answer: D
362. Uricase used in the treatment of chronic gout is
A. Allopurinol
B. Benzbromarone
C. Pegloticase
D. Methotrexate
Answer: C
363. All are seen in acute HiV syndrome except
A. Diarrhoea
B. Pneumonia
C. Wight loss
D. Myelopathy
Answer: B
364. Nephrocalcinosis is seen in all except
A. Polycystic kidney
B. Hyperparathyroidism
C. Medullary sponge kidney
D. Renal tubular acidosis
Answer: A
365. Most common acute complication of dialysis is
A. Hypotension
B. Bleeding
C. Dementia
D. Muscle cramps
Answer: A
366. Characteristic features of a lesion in the lateral part of the medulla include all except
A. Ipsilateral Homer’s syndrome
B. Contralateral loss of proprioception to the body and limbs
C. Nystagmus
D. Dysphagia
Answer: B
367. Round pneumonia is seen with
A. Streptococcal pneumonia
B. Kerosene oil aspiration
C. Lung cancer
D. Mendelson syndrome
Answer: A
368. An elderly male admitted for Pneumonia presents with diarrhea and gripping abdominal pain five days after discharge from the hospital. Drug which is likely to benefit is
A. Imodium
B. Metranidozole
C. Diphenoxylate
D. Levofloxacin
Answer: D
369. Duration of apnea in obstructive sleep apnea is
A. <10 sec
B. <20 sec
C. <30 sec
D. <60 sec
Answer: A
370. Causes of haemorrhagic pleural effusion are all except
A. Pulmonary infarction
B. Mesothelioma
C. Bronchial adenoma
D. Tuberculosis
Answer: C
371. Following is characteristic neurologic finding in primary amyloidosis
A. Peripheral motor and sensory neuropathy
B. Peripheral neuropathy associated with cerebral manifestation
C. Guillain – Barre type of syndrome
D. Spinal cord compression in thoracic region
Answer: A
372. Reactive arthritis is usually caused by
A. Shigella flexneri
B. Shigella boydii
C. Shigela shiga
D. Shigela dysentriae
Answer: A
373. Which of the following arrhythmia is most commonly associated with alcohol binge in the alcoholics
A. Ventricular fibrillations
B. Ventricular premature contractions
C. Atrial flutter
D. Atrial fibrilation
Answer: D
374. Treatment of asymptomatic bradycardia is
A. No treatment is required
B. Give atropine
C. Isoprenaline
D. Cardiac pacing
Answer: A
375. WPW syndrome is caused by
A. Bundle Branch Block
B. Right sided accessory pathway
C. Ectopic pacemaker in atrium
D. Left budle Branch block
Answer: B
376. Dose of rTPA in ischaemic stroke is
A. 60 mg
B. 90 mg
C. 100 mg
D. 120 mg
Answer: B
377. Cerebral angiography was performed by
A. Sir Walter Dandy
B. George Moore
C. Seldinger
D. Egas Moniz
Answer: D
378. Mauriac’s syndrome is characterized by all except
A. Diabetes
B. Obesity
C. Dwarfism
D. Cardiomegaly
Answer: D
379. Which of the following is associated with hyponatremia and low osmolality
A. Hyperlipidemia
B. SIADH
C. CHF
D. CKD
Answer: C
380. Deletion of one alpha globin gene on one chromosome is best defined as
A. Hb Barts hydrops fetails
B. Alpha thalassemia major
C. Alpha thalassemia trait
D. Alpha thalassemia silent carrier
Answer: D
381. Which of the following is caused by deletion of all four alpha globin genes
A. Beta thalassemia major
B. Hb Barts
C. HbH
D. a° thalassemia trait
Answer: B
382. In Beta thalassemia, the most common gene mutation is
A. Intron 1 inversion
B. Intron 22
C. 619 bp deletion
D. 3.7 bp deletion
Answer: A
383. Bence jones proteinuria is best detected by
A. Dipstick method
B. Sulfosalicylic acid
C. Heat test
D. Electrophoresis
Answer: D
384. HIV RNA by PCR can detect as low as
A. 30 copies viral RNA/ml of blood
B. 40 copies viral RNA/ml of blood
C. 50 copies of viral RNA/ml of blood
D. 60 copies of viral RNA/ml of blood
Answer: B
385. Most common cause of pleural effusion in AIDS patients
A. Kaposi sarcoma
B. TB
C. Pneumocystis Jiroveci
D. Mycoplasma
Answer: A
386. Biomarker not involved in acute kidney injury is
A. NGAL
B. KIM 1
C. Micro RNA 122
D. Cystatin C
Answer: C
387. Most common site of cerebral infarction is in the territory of
A. Anterior cerebral artery
B. Middle cerebral artery
C. Posterior cerebral artery
D. Posterior inferior cerebellar artery
Answer: B
388. Hemiplegia is most often caused by thrombosis of ?
A. Anteiror cerebral artery
B. Middle cerebral artery
C. Posterior cerebral artery
D. Basiliar artery
Answer: B
389. Indication for prophylaxis in pneumocystis carini pneumonia include
A. CD4 count < 200
B. Tuberculosis
C. Viral load > 25,000 copies/ml
D. Oral candidiasis
Answer: A
390. Canon ‘a’ wave is seen in
A. Junctional rhythm
B. Atrial fibrillation
C. Atrial flutter
D. Ventricular fibrillation
Answer: A
391. Most common cause of unilateral pedal edema
A. Pregnancy
B. Lymphedema
C. Venous insufficiency
D. Milroy disease
Answer: C
392. Grisel syndrome all are true except
A. Post-adenoidectomy
B. Conservation treatment
C. Inflammation of cervical spine ligaments
D. No need for neurosurgeon
Answer: D
393. A female patient of 26 years, presents with oral ulcers, photosensitivity and skin malar rash in face sparing the nasolabial folds of both side.
A. Sturge weber syndrome
B. SLE
C. Dermatitis
D. Psoriasis
Answer: B
394. Most characteristic cardiovascular defect seen in Rubella
A. Pulmonary artery stenosis
B. Coarctation of aorta
C. Ankylosis spondylitis
D. Rheumatic fever
Answer: A
395. Osborn J waves is seen in
A. Hypothermia
B. Hyperkalemia
C. Hypocalemia
D. Hypokalemia
Answer: A
396. Which is not related to HIV
A. Primary CNS lymphoma
B. Tertiary syphilis
C. Oesophageal candidasis
D. None
Answer: B
397. Essential major blood culture criteria for infective endocarditis.
A. Single positive culture of hacek
B. Single positive culture of coxiella
C. Single positive culture of cornybacterium
D. Both a & b
Answer: A
398. Respiratory centres are stimulated by
A. Oxygen
B. Lactic acid
C. Carbon dioxide
D. Calcium
Answer: C
399. Alcoholic shows which type of cardiomyopathy
A. Hyper cardiomyopathy
B. Dilated cardiomyopathy
C. Pericarditis
D. Myocarditis
Answer: B
400. Which murmur increases on standing?
A. HOCM
B. MR
C. MS
D. VSD
Answer: A
401. Which wall of heart enlargement can be seen on barium swallow in patient with mitral stenosis
A. Left atrium
B. Right atrium
C. Left ventricle
D. Right ventricle
Answer: D
402. Which of the following statements is true about the bundle of kent?
A. Abnormal pathway between two atria
B. It is muscular or nodal pathway between the atria and ventricle
in WPW syndrome
C. It is slower than the AV nodal pathway
D. None
Answer: B
403. Deep venous thrombosis which is incorrect –
A. Clinical assessment highly reliable
B. Mostly bilateral
C. Most common clinically presents as pain and tenderness in calf
D. Some cases may directly present as pulmonary
thromboembolism
Answer: B
404. Punched out ulcer in esophagus is seen in
A. herpes
B. cmv
C. Oesophagitis
D. candida
Answer: C
405. Type of sensation lost on same side of Brown Sequard syndrome
A. Pain
B. Touch
C. Proprioception
D. Temperature
Answer: C
406. Achondroplasia shows which type inheritance
A. XLR
B. XLD
C. Autosomal recessive
D. Autosomal dominant
Answer: D
407. MELD score includes
A. Serum creatinine
B. Transaminase
C. Albumin
D. Alkaline phosphatase
Answer: A
408. Infarcts involving which portion of the myocardium cause aneurysm as a post MI complication
A. Subendocardial
B. Anterior transmural
C. Posterior transmural
D. Inferior wall
Answer: D
409. Risk factors for alzheimer’s disease include
A. Klinefelter syndrome
B. Low BP
C. Down’s syndrome
D. None
Answer: C
410. A patient with native aortic valve disease came with right hemiparesis. What will you do to prevent further stroke?
A. Antiplatelet only
B. Anticoagulant only
C. Both antiplatelet and anticoagulant
D. One dose of low molecular weight heparin sub-cutaneously followed by dual antiplatelet therapy
Answer: A
411. The most common subtype of NonHodgkin’s lymphoma in India is:
A. Diffuse small cell lymphocytic lymphoma
B. Diffuse large B cell lymphoma
C. Follicular lymphoma
D. Burkitt’s lymphoma
Answer: B
412. Which of the following drug can be given in patients of primary pulmonary hypertension?
A. Icatibant
B. Bosentan
C. Labetolol
D. Sodium nitroprusside
Answer: B
413. An 86 years old lady presented with severe constipation. She was a known hypertensive on medications for 10 years. In clinic, her BP was 157/98 mm Hg with a heart rate of 58/min. On taking here BP in the supine position it was found to be 90/60 mm Hg. She had the recent history of depression. She is taking atenolol, thiazide, imipramine, haloperidol and docusate. What will be the next best step in the management?
A. Change atenolol and thiazide to calcium channel blocker and ACE inhibitor and add bisacodyl for constipation
B. Change imipramine and haloperidol to fluoxetine and risperidone and add bisacodyl for constipation
C. Only add bisacodyl for constipation and continue rest of the medications
D. Discontinue all her medications and start her on steroids
Answer: B
414. pANCA positive vasculitis is
A. Wegener’s granulomatosis
B. Churg – Strauss syndrome
C. Polyarteritis nodosa
D. All of the above
Answer: B
415. Levine sign is seen in
A. Stable angina pectoris
B. Acute bronchial asthma
C. Hemolytic anemia
D. Gastroesophageal reflux disease
Answer: A
416. Which of the following complications is not seen in mitral valve prolapse?
A. Stroke
B. Infective endocarditis
C. Mitral stenosis
D. Ventricular arrhythmia
Answer: C
417. HbA1c control for how much time
A. 2 -3 weeks
B. 3 – 6 weeks
C. 6 – 8 weeks
D. 14 – 18 weeks
Answer: C
418. All are seen in MEN IIA syndrome except
A. Medullary carcinoma of thyroid is seen in 100% of the patients
B. 40 – 30% patients have phaeochromocytoms
C. Caused by loss of function mutation in IIRT protooncogene
D. Primary hyperparathyroidism is the most variable feature of MEN II A syndrome
Answer: C
419. Hypoxic pulmonary vasoconstriction due to
A. Irreversible pulmonary vasocontriction hypoxia
B. Reversible pulmonary vasoconstriction due to hypoxia
C. Direct blood to poorly ventilated areas
D. Occurs hours after pulmonary vasoconstriction
Answer: B
420. Polyuria with low fixed specific gravity urine is seen in ?
A. Diabetes mellitus
B. Diabetes insipidus
C. Chronic glomerulonephritis
D. Potomania
Answer: C
421. DOC for treatment of SSPE
A. Abacavir
B. Inosine pranobex
C. Glatiramer
D. Interferon
Answer: B
422. Rademecker complex in EEG is seen in
A. SSPE
B. vCJD
C. cCJD
D. Kuru
Answer: A
423. Charcot’s joint in diabetes affects commonly
A. Shoulder joint
B. Knee joint
C. Hip joint
D. Tarsal joint
Answer: D
424. Shelf life of platelets to blood bank is
A. 5 days
B. 7 days
C. 10 days
D. 21 days
Answer: A
425. DOC for listeria meningitis
A. Ampicillin
B. Cefotaxime
C. Cefotriaxone
D. Ciprofloxacin
Answer: A
426. Dent’s disease is characterized by all except
A. Chloride channel defect
B. Males are affected
C. Nephrolithiasis
D. Defect in limb of Loop of Henle
Answer: D
427. All are true for transplanted kidney except
A. Humoral antibody responsible for rejection
B. CMI is responsible for rejection
C. Previous blood transfusion
D. HLA identity similarity seen in 1:100 people
Answer: D
428. Best management after human bite
A. Ampicillin plus sulbactam
B. Clindamycin plus TMP-SMX
C. Fibroquinolone
D. Doxycycline
Answer: A
429. Duroziez’s sign is seen in
A. Aortic Regurgitation
B. Tricuspid RegurgitationMitral stenosis
C. Pericardial effusion
D. None
Answer: A
430. TTKG in hypokalemia is
A. < 3-4
B. > 6-7
C. > 9-10
D. > 10-15
Answer: A
431. Most common cause of death in diphtheria is due to
A. Airway compromise
B. Toxic cardiomyopathy
C. Sepsis
D. Descending polyneuropathy
Answer: B
432. Upper lobe bronchiectasis is seen in which disease?
A. Cystic fibrosis
B. Aspergilloma
C. HIV
D. Bronchogenic carcinoma
Answer: A
433. On medical check up of a Punjabi student following findings were seen Hb of 9.9gm/d1, RBC count of 5.1 million, MCV of 62.5 fl and RDW of 13.51%. What is the most probable diagnosis ?
A. HbD
B. Thalassemia trait
C. Iron deficiency anemia
D. Anemia of chronic disease
Answer: B
434. Risk factors associated with health care associated pneumonia (HCAP)
A. Acute care hospitalization for at least 2 days in the preceding 90 days
B. Home infusion therapy
C. Immunosuppressive disease or immunosuppressive therapy
D. Antibiotic therapy in the preceding 90 days
E. Hospitalization for > 48 h
Answer: A:B:C:D:E
435. Malignancy associated with hypercalcemia:
A. Breast cancer
B. Small cell lung cancer
C. Non-small lung cancer
D. Prostate cancer
E. Multiple myeloma
Answer: A:C:D:E
436. Capnography helps to know the following
A. Correct intubation
B. Pulmonary embolism
C. Adequate ventilation
D. Lung perfusion
E. Significant metabolic change
Answer: A:B:C:D:E
437. The severity of mitral stenosis can be judged by
A. Intensity of murmur
B. Duration of murmur
C. Left ventricular S3
D. Loud S1
Answer: B
438. Pure motor palsy seen in poisoning of
A. Lead poisoning
B. Arsenic poisoning
C. Cocaine poisoning
D. Cannabis poisoning
Answer: A
439. Smokers are prone to which lung infection
A. Mycobacterium tuberculosis
B. Pneumonia
C. Influenza
D. All the above
Answer: D
440. Some patients with severe form of Idiopathic infantile hypercalcemia, presnt with phenotypic features similar to which of the following?
A. Williams syndrome
B. Potters syndrome
C. Angelman syndrome
D. VHL syndrome
Answer: A
441. Which liver disease/s is/are associated with ductopenia?
A. Chronic graft rejection
B. Hepatic sarcoidosis
C. Paraneoplastic syndrome related to hodgkins lymphoma
D. All the above
Answer: D
442. Which of the following is not true about metabolic syndrome?
A. It is also called Syndrome X
B. Acanthosis and signs of hyperandrogenism may be seen
C. Type A has autoantibodies against the insulin receptor
D. Insulin resistance increases the risk of type 2 DM in patients
with PCOS
Answer: C
443. Metabolic syndrome diagnosis in men based on NCEP ATP III criteria includes the following except
A. Abdominal obesity > 40 inches
B. HDL < 50 mg / dL
C. BP >/= 130/85 mm Hg
D. Fasting glucoe > 110 mg/ dL
Answer: B
444. Ejection click of pulmonary stenosis is better heard in
A. Inspiration
B. Expiration
C. Patient bending forward
D. Patient lying in left lateral position
Answer: B
445. Reciprocal changes in ECG in patients with inferior wall myocardial infarction are seen in which leads
A. I
B. II
C. III
D. aVF
Answer: A
446. All are features of aortic stenosis except
A. Congestive heart failure due to systolic or diastolic dysfunction
B. Presence of ejection systolic murmur
C. Presence of pulsus tardus
D. Pressure in the aorta is the same as in left ventricle
Answer: D
447. Which of the following is not true about bicuspid aortic valve?
A. Usually undetected in early life
B. It is more common in females than in males
C. Post-stenotic dilatation of ascending aorta can be seen
D. Diagnosis is made by echocardiography
Answer: B
448. Which of the following hemodynamic changes is not evident in cardiac tamponade during diastole?
A. Right atrial and ventricular collapse
B. Absent y wave on JVP
C. Biphasic venous return
D. Elevated pericardial pressure
Answer: C
449. Major criteria for infective endocarditis include which of the following
A. Injection drug user
B. Fever
C. Oslers nodes
D. Typical organism of infective endocarditis isolated from two
separate blood cultures
Answer: D
450. Which of the following ECG features are not seen in patients with ventricular tachycardias?
A. Bizzare QRS complexes
B. Presence of AV dissociation [fusion beats]
C. Prolonged duration of QRS complexes
D. P pulmonale
Answer: D
451. Cerebro-occulo-genital syndrome has the following features except
A. Microcephaly
B. Short stature
C. Agenesis of corpus callosum
D. Flaccid quadriplegia
Answer: D
452. Pulsus biseferians, which of the following is not true
A. It is seen in aortic regurgitation
B. It is better felt in peripheral arteries
C. It has one peak in systole and one in diastole
D. It has two peaks
Answer: C
453. Square wave seen in ECG recording denote
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Standardization of ECG
Answer: D
454. Which of the following is not true about Torsades de pointes?
A. Presence of prolonged QT interval on ECG
B. Presence of polymorphic QRS complexes
C. It is a type of supraventricular tachycardia
D. QRS complexes appear to rotate around the isoelectric
baseline of ECG
Answer: C
455. Prolonged QT interval is seen in all of the following except
A. Hypokalemia
B. Hypocalcemia
C. Use of macrolide antibiotitcs
D. Hypernatremia
Answer: D
456. Following are the clinical signs of widened pulse pressure seen in patients of aortic regurgitation except
A. Corrigans sign
B. De Mussets sign
C. Water Hammer pulse
D. Diastolic murmur
Answer: D
457. Episode of stable angina pectoris typically lasts for
A. Less than 1 min
B. 2 – 5 mins
C. 5 – 10 mins
D. > 10 mins
Answer: B
458. Not True about Prinzmetal’s angina:
A. May present at rest
B. Occurs due atherosclerotic obstruction of coronary arteries
C. Smoking is a risk factor
D. Nitrates are used for treatment
Answer: B
459. Obstructive shock can be seen in
A. Pulmonary embolism
B. Tension pneumothorax
C. Pericardial tamponade
D. All the above
Answer: D
460. Pharmacological stress during stress myocardial radionucleotide perfusion imaging can be induced using
A. Dipyridamole
B. Adenosine
C. Dobutamine
D. All the above
Answer: D
461. While treating patients with malignant hypertention the maximum allowed decrease in blood pressure in the first 2 6 hours should not exceed %
A. 15
B. 20
C. 25
D. 30
Answer: C
462. Contraindication for percutaneous ballon mitral valvotomy include the following except
A. Presence of pulmonary hypertension
B. Left atrial thrombus
C. Severe mitral regurgitation
D. Commissural calcification
Answer: A
463. Mitral valve replacement is recommended in patients with
A. Moderate MS in NYHA class II
B. Moderate MS in NYHA class III
C. Severe MS in NYHA class II
D. Severe MS in NYHA class III
Answer: D
464. HOCM is common in which age group?
A. 10 – 30 years
B. 20 – 40 years
C. 30 – 50 years
D. 40 – 60 years
Answer: B
465. Preferred vein for central venous catheter insertion is
A. Right internal jugular vein
B. Left internal jugular vein
C. Right subclavian vein
D. Right antecubital vein
Answer: A
466. Kerley B lines seen in mitral stenosis when the resting left atrial pressure exceeds
A. 10 mm Hg
B. 20 mm Hg
C. 30 mm Hg
D. 40 mm Hg
Answer: B
467. Which of the following is the most common anamoly in patients with fanconi’s anemia?
A. Hyperpigmentation of the trunk, neck and intertriginous areas
B. Absent radii and thumb
C. Weak radial pulse
D. Presence of horse shoe kidneys
Answer: A
468. Patients with which of the following conditions are at greatest risk of pernio
A. Raynaud’s phenomenon
B. Kawasaki disease
C. Henoch Schonlen purpura
D. Hepatitis C infection
Answer: A
469. What is Tiffeneau – Pinelli index?
A. FEV1/FVC ratio
B. Body mass index
C. Quetlet index
D. Ventilation/Perfusion ratio
Answer: A
470. Lights criteria is used for
A. Pleural effusions
B. Pericardial effusions
C. Ascites
D. Increased intracranial tension
Answer: A
471. Common cause of death in a patient with chronic bronchieactasis is
A. Right sided heart fail
B. Infection
C. Hemoptysis
D. Carcinoma
Answer: A
472. Leutriene inhibitors are used in asthma for
A. Monotherapy for acute attack
B. Add-on therapy in patients not controlled by low dose inhaled
glucocorticoids
C. Status asthmaticus
D. None of the above
Answer: B
473. Apnea hypoapnea index indicating obstructive sleep apnea is
A. <1
B. 2 – 5
C. 5 – 8
D. >8
Answer: A
474. Multiple episodes of acute chest syndrome are associated with
A. Asthma
B. Bronchieactasis
C. SLE
D. Sjogrens syndrome
Answer: A
475. Triad of skin lesions, mononeuritis multiplex, eosinophils seen in
A. Alports syndrome
B. Churg – Strauss syndrome
C. Cryoglobulinemia
D. Wegeners granulomatosus
Answer: C
476. Chronic bronchitis is said to be present when patient has chronic cough
A. 3 consecutive months in at least two consecutive years
B. 2 consecutive months for 3 consecutive years
C. 3 consecutive months in one year
D. 1 month in a year for 2 consecutive years
Answer: A
477. Brocks syndrome is due to which lobe of lung?
A. Right middle lobe
B. Right lower lobe
C. Left upper lobe
D. Left lower lobe
Answer: A
478. Presence of Velcro crackles at the lung base on auscultation is a sign of
A. Scleroderma
B. Systemic Lupus
C. Wegeners Granulomatosus
D. Polyarteritisnodosa
Answer: A
479. Type IV respiratory failure occurs due to
A. Alveolar flooding
B. Inability to eliminate CO2
C. Lung atelactasis
D. Hypoperfusion of respiratory muscles
Answer: D
480. Tool/s which objectively asses the risk of adverse outcomes in a patient with pneumonia is/are
A. Pneumonia severity index [PSI]
B. CURB – 65 criteria
C. Apachee Score
D. Glasgow scale
Answer: A:B
481. In ICU setting patients suffering from which respiratory pathology are at risk of CO2 narcosis?
A. Pneumonia
B. Asthma
C. Emphysema
D. Bronchieactasis
Answer: C
482. Inspiratory squeaks are the physical examination finding of
A. Bronchiolitis
B. Pulmonary hypertension
C. Pneumonia
D. Pulmonary edema
Answer: A
483. Which of the following are the clinical abnormalities of uremia?
A. Hyperphosphatemia
B. Uremic frost
C. Peptic ulcer
D. All the above
Answer: D
484. Which type of Bartter’s syndrome is associated with mutations in barttin?
A. Type 1
B. Type 2
C. Type 3
D. Type 4
Answer: D
485. Test used for screening for urinary tract infection is
A. Nitrite test
B. Na nitropruss ide test
C. Paul Bunnel test
D. Fentons test
Answer: A
486. Patient with nephrotic syndrome has decreased amount of which antibody
A. IgG
B. IgE
C. IgM
D. IgA
Answer: A
487. RIFLE criteria is used for diagnosis of
A. Acute kidney injury
B. Acute splenic injury
C. Acute liver injury
D. Acute bowel injury
Answer: A
488. Hemodynamically important lesions of renal artery stenosis are predicted by renal artery velocities more than on
Doppler ultrasound.
A. 100 cm/s
B. 125 cm/s
C. 150 cm/s
D. 200 cm/s
Answer: D
489. Gitelman’s syndrome resembles the effects of which of the following drugs?
A. Thiazide
B. Furosemide
C. Spironolactone
D. Amiloride
Answer: A
490. Definition of complicated urinary tract infection is, the infection which fail to resolve or recur within week/s of standard therapy.
A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks
Answer: B
491. A patient presents with blunt trauma to abdomen. On investigations patient is found to have hepatic injury which has a ruptured subcapsular hematoma with active bleeding. What is the grade of liver injury?
A. Grade I
B. Grade II
C. Grade III
D. Grade IV
Answer: C
492. Excellent predictor of mortality and morbidity in patients after hepatectomy is
A. Serum lactate levels
B. Serum magnesium level
C. Serum iron level
D. Serum copper level
Answer: A
493. Ascitic fluid SAAG < 1.1 what is the disease associated with
A. Hepatic failure
B. Idiopathic portal fibrosis
C. Constrictive pericarditis
D. Peritoneal carcinomatosis
Answer: D
494. Gene associated with the development of Peutz-Jeghers syndrome is
A. STK 11
B. PTEN
C. KRAS
D. BRCA 1
Answer: A
495. Right hand dominant patient presents with normal comprehension but speaks with short utterances of a few words at a time, comprised mostly of nouns. What is the most probable location of the lesion
A. Left inferior frontal gyrus
B. Right inferior frontal gyrus
C. Left superior temporal gyrus
D. Right superior temporal gyrus
Answer: A
496. Pure word deafness is associated with
A. Middle cerebral artery stroke
B. Posterior cerebral artery stroke
C. Vertebral artery aneurysm
D. Basilar artery aneurysm
Answer: A
497. Global aphasia is seen due to
A. Strokes involving entire middle cerebral artery distribution in left hemisphere
B. Strokes involving entire middle cerebral artery distribution in right hemisphere
C. Strokes involving entire posterior cerebral artery distribution in left hemisphere
D. Strokes involving entire posterior cerebral artery distribution in right hemisphere
Answer: A
498. Lambert Eaton syndrome true is
A. It is a paraneoplastic syndrome associated with squamous cell carcinoma of lung
B. IgM antibodies against ligand gated calcium channels
C. There is increase in release of presynaptic acetylcholine
D. With continuous stimulation there is marked increase in amplitude of action potentials.
Answer: D
499. Which is not seen in Alzheimers disease
A. Gradual development of forgetfulness
B. Defective visuospatial orientation
C. Depression
D. Sequence of neurological abnormalities follows a described order
Answer: D
500. Which lobe is affected in the early course of alzheimers disease
A. Frontal lobe
B. Parietal lobe
C. Medial temporal lobe
D. Lateral temporal lobe
Answer: C
501. Which is/are the usual first deformity/ies to be seen in CMT disease?
A. Pes cavus
B. Club hand
C. Mannus valgus
D. Flexion deformity of knee
Answer: A
502. Huntingtons disease is commonly seen in age group between
A. 15 – 35 years
B. 25 – 45 years
C. 35 – 55 years
D. 45 – 65 years
Answer: B
503. Which cranial nerve is involved in Weber syndrome?
A. II
B. III
C. IV
D. V
Answer: B
504. Violent abnormal flinging movements which are irregular and affecting one side are called as A. Chorea
B. Athetosis
C. Dystonia
D. Hemiballismus
Answer: D
505. Wernickes encephalopathy develops secondary to accumulation of which substrate?
A. Glutamate
B. Aspartate
C. Lactate
D. Acetate
Answer: A
