1. Earliest and often the only presentation of TB kidney is
A. Increased frequency
B. Colicky pain
C. Hematuria
D. Renal calculi
Answer: A
2. Most common cause of diarrhea in AIDS patients?
A. Salmonella typhimurium
B. Cryptosporidium
C. Candida
D. isophora
Answer: B
3. Not seen with uremic lung
A. alveolar injury
B. Pulmonary edema
C. Interstitial fibrosis
D. Fibrinous exudate in alveoli
Answer: C
4. Oliguric phase of ARF is characterized by A/E
A. Chest pain
B. Acidosis
C. Hypertension
D. Hypokalemia
Answer: D
5. In EEG type of wave seen in metabolic encephalophathy
A. Alpha
B. Beta
C. Gamma
D. Delta
Answer: D
6. Asbestosis causes all except
A. Shaggy heart borders
B. Honeycombing
C. Hilar lymphadenopathy
D. Basal peribronchial fibrosis
Answer: C
7. The most common cause of sudden death in sarcoidosis is
A. Pneumonia
B. Cor pulmonale
C. Arrythmias
D. Liver failure
Answer: C
8. Most common cause of unilateral Hilar lymphadenopathy
A. Histoplasmosis
B. Sarcoidosis
C. Aspergillosis
D. Tuberculosis
Answer: D
9. 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
10. 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
11. In LVH, SV1 +RV6 is more than mm
A. 25
B. 30
C. 35
D. 45
Answer: C
12. 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
13. Obesity is seen in all except
A. Cushing syndrome
B. Pickwinian syndrome
C. Prader willi syndrome
D. Sipple syndrome
Answer: D
14. Cause of death in diabetic ketoacidosis in children
A. Cerebral edema
B. Hypokalemia
C. Infection
D. Acidosis
Answer: A
15. Acute hyponatremia becomes symptomatic at
A. < 135 mEq
B. < 125 mEq
C. < 120 mEq
D. < 110 mEq
Answer: B
16. Hyponatremia is seen in
A. Hyperthyroidism
B. Hypothyroidism
C. Diabetes insipidus
D. Increased insensible losses
Answer: B
17. Chronic Non-Spherocytic hemolyticanemia is seen in which class of G6PD deficiency
A. Class I
B. Class II
C. Class III
D. Class IV
Answer: A
18. What is the Neutrophil count for moderate neutropenia
A. < 500/mm’
B. 500-1000/mm’
C. > 1000/mm3
D. 100/mm3
Answer: B
19. Gout can be precipitated by all of the following
A. Thiazides
B. Furosemide
C. Cyclosporine
D. High dose salicylates
Answer: D
20. 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
21. 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
22. 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
23. Diagnostic feature of CRF is
A. Broad casts in urine
B. Elevated blood urea
C. Proteinuria
D. Bleeding diathesis
Answer: A
24. Eosinophilic meningitis is seen with all except?
A. Coccidiomycosis
B. Cryptococcal meningitis
C. Lepto meningeal metastasis
D. Helminthic infections
Answer: B
25. Christmas tree appearance of urinary bladder is seen in
A. Neurogenic bladder
B. Stress incontinence
C. Autonomous bladder
D. Enuresis
Answer: A
26. 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
27. In Takayasu’s arteritis there is
A. Intimal fibrosis
B. Renal hypertension
C. Coronary aneurysm
D. All of the above
Answer: B
28. Which is not a high pitched heart sound
A. Mid systolic click
B. Pericardial shudder
C. Opening snap
D. Tumor plop sound
Answer: D
29. 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
30. Rupture of berry aneurysm most commonly results in
A. Subarachnoid hemorrhage
B. Subdural hemorrhage
C. Extradural hemorrhage
D. Intra-parenchymal hemorrhage
Answer: A
31. 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
32. 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
33. The drug used in the management of medullary carcinoma thyroid is
A. Cabozantinib
B. Rituximab
C. Tenofovir
D. Anakinra
Answer: A
34. Incorrect about cerebral salt wasting syndrome
A. Urine sodium > 20mEq/d1
B. Hyponatremia
C. Fludrocortisone is used
D. Expansion of plasma volume
Answer: D
35. 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
36. 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
37. The most important diagnositic feature for beta thalassemia trait
A. Raised HbF
B. Reduced MCH
C. Reduced MCV
D. Raised HbA2
Answer: D
38. Uricase used in the treatment of chronic gout is
A. Allopurinol
B. Benzbromarone
C. Pegloticase
D. Methotrexate
Answer: C
39. All are seen in acute HiV syndrome except
A. Diarrhoea
B. Pneumonia
C. Wight loss
D. Myelopathy
Answer: B
40. Nephrocalcinosis is seen in all except
A. Polycystic kidney
B. Hyperparathyroidism
C. Medullary sponge kidney
D. Renal tubular acidosis
Answer: A
41. Most common acute complication of dialysis is
A. Hypotension
B. Bleeding
C. Dementia
D. Muscle cramps
Answer: A
42. 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
43. Round pneumonia is seen with
A. Streptococcal pneumonia
B. Kerosene oil aspiration
C. Lung cancer
D. Mendelson syndrome
Answer: A
44. 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
45. Duration of apnea in obstructive sleep apnea is
A. <10 sec
B. <20 sec
C. <30 sec
D. <60 sec
Answer: A
46. Causes of haemorrhagic pleural effusion are all except
A. Pulmonary infarction
B. Mesothelioma
C. Bronchial adenoma
D. Tuberculosis
Answer: C
47. 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
48. Reactive arthritis is usually caused by
A. Shigella flexneri
B. Shigella boydii
C. Shigela shiga
D. Shigela dysentriae
Answer: A
49. 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
50. Treatment of asymptomatic bradycardia is
A. No treatment is required
B. Give atropine
C. Isoprenaline
D. Cardiac pacing
Answer: A
51. 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
52. Dose of rTPA in ischaemic stroke is
A. 60 mg
B. 90 mg
C. 100 mg
D. 120 mg
Answer: B
53. Cerebral angiography was performed by
A. Sir Walter Dandy
B. George Moore
C. Seldinger
D. Egas Moniz
Answer: D
54. Mauriac’s syndrome is characterized by all except
A. Diabetes
B. Obesity
C. Dwarfism
D. Cardiomegaly
Answer: D
55. Which of the following is associated with hyponatremia and low osmolality
A. Hyperlipidemia
B. SIADH
C. CHF
D. CKD
Answer: C
56. 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
57. 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
58. 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
59. Bence jones proteinuria is best detected by
A. Dipstick method
B. Sulfosalicylic acid
C. Heat test
D. Electrophoresis
Answer: D
60. 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
61 Most common cause of pleural effusion in AIDS patients
A. Kaposi sarcoma
B. TB
C. Pneumocystis Jiroveci
D. Mycoplasma
Answer: A
62. Biomarker not involved in acute kidney injury is
A. NGAL
B. KIM 1
C. Micro RNA 122
D. Cystatin C
Answer: C
63. 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
64. 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
65. 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
66. Canon ‘a’ wave is seen in
A. Junctional rhythm
B. Atrial fibrillation
C. Atrial flutter
D. Ventricular fibrillation
Answer: A
67. Most common cause of unilateral pedal edema
A. Pregnancy
B. Lymphedema
C. Venous insufficiency
D. Milroy disease
Answer: C
68. 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
69. 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
70. Most characteristic cardiovascular defect seen in Rubella
A. Pulmonary artery stenosis
B. Coarctation of aorta
C. Ankylosis spondylitis
D. Rheumatic fever
Answer: A
71. Osborn J waves is seen in
A. Hypothermia
B. Hyperkalemia
C. Hypocalemia
D. Hypokalemia
Answer: A
72. Which is not related to HIV
A. Primary CNS lymphoma
B. Tertiary syphilis
C. Oesophageal candidasis
D. None
Answer: B
73. 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
74. Respiratory centres are stimulated by
A. Oxygen
B. Lactic acid
C. Carbon dioxide
D. Calcium
Answer: C
75. Alcoholic shows which type of cardiomyopathy
A. Hyper cardiomyopathy
B. Dilated cardiomyopathy
C. Pericarditis
D. Myocarditis
Answer: B
76. Which murmur increases on standing?
A. HOCM
B. MR
C. MS
D. VSD
Answer: A
77. 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
78. 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
79. 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
80. Punched out ulcer in esophagus is seen in
A. herpes
B. cmv
C. Oesophagitis
D. candida
Answer: C
81. Type of sensation lost on same side of Brown Sequard syndrome
A. Pain
B. Touch
C. Proprioception
D. Temperature
Answer: C
82. Achondroplasia shows which type inheritance
A. XLR
B. XLD
C. Autosomal recessive
D. Autosomal dominant
Answer: D
83. MELD score includes
A. Serum creatinine
B. Transaminase
C. Albumin
D. Alkaline phosphatase
Answer: A
84. Infarcts involving which portion of the myocardium cause aneurysm as a postMI complication
a) Subendocardial
B. Anterior transmural
C. Posterior transmural
D. Inferior wall
Answer: D
85. Risk factors for alzheimer’s disease include
a) Klinefelter syndrome
B. Low BP
C. Down’s syndrome
D. None
Answer: C
86. 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
87. 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
88. 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
89. 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
90. pANCA positive vasculitis is
A. Wegener’s granulomatosis
B. Churg – Strauss syndrome
C. Polyarteritis nodosa
D. All of the above
Answer: B
91. Levine sign is seen in
A. Stable angina pectoris
B. Acute bronchial asthma
C. Hemolytic anemia
D. Gastroesophageal reflux disease
Answer: A
92. 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
93. HbA1c control for how much time
A. 2 -3 weeks
B. 3 – 6 weeks
C. 6 – 8 weeks
D. 14 – 18 weeks
Answer: C
94. 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
95. 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
96. Polyuria with low fixed specific gravity urine is seen in ?
A. Diabetes mellitus
B. Diabetes insipidus
C. Chronic glomerulonephritis
D. Potomania
Answer: C
97. DOC for treatment of SSPE
A. Abacavir
B. Inosine pranobex
C. Glatiramer
D. Interferon
Answer: B
98. Rademecker complex in EEG is seen in
A. SSPE
B. vCJD
C. cCJD
D. Kuru
Answer: A
99. Charcot’s joint in diabetes affects commonly
A. Shoulder joint
B. Knee joint
C. Hip joint
D. Tarsal joint
Answer: D
100. Shelf life of platelets to blood bank is
A. 5 days
B. 7 days
C. 10 days
D. 21 days
Answer: A
101. DOC for listeria meningitis
A. Ampicillin
B. Cefotaxime
C. Cefotriaxone
D. Ciprofloxacin
Answer: A
102. 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
103. 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
104. Best management after human bite
A. Ampicillin plus sulbactam
B. Clindamycin plus TMP-SMX
C. Fibroquinolone
D. Doxycycline
Answer: A
105. Duroziez’s sign is seen in
A. Aortic Regurgitation
B. Tricuspid RegurgitationMitral stenosis
C. Pericardial effusion
D. None
Answer: A
106. TTKG in hypokalemia is
A. < 3-4
B. > 6-7
C. > 9-10
D. > 10-15
Answer: A
107. Most common cause of death in diphtheria is due to
A. Airway compromise
B. Toxic cardiomyopathy
C. Sepsis
D. Descending polyneuropathy
Answer: B
108. Upper lobe bronchiectasis is seen in which disease?
A. Cystic fibrosis
B. Aspergilloma
C. HIV
D. Bronchogenic carcinoma
Answer: A
109. 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
110. 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
111. 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
112. 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
113. 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
114. Pure motor palsy seen in poisoning of
A. Lead poisoning
B. Arsenic poisoning
C. Cocaine poisoning
D. Cannabis poisoning
Answer: A