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1. The most common cause of sudden death is: a. Ventricular tachycardia b. Cerebrovascular accident c. Ventricular asystole d.

Acute renal failure 2. In case of coma, a common cause of death is: a. The tongue falling back and obstructing the air ay b. Secretions obstructing the airway c. Cardiac arrest d. !"ile"sy #. $moking can cause: a. Lung cancer b. Thromboangiitis obliterans c. Chronic bronchitis d. Myocardial ischemia %. Thromboangiitis obliterans involves hich vessels: a. &emoral b. 'o"liteal c. Anterior and posterior tibial d. Aortoiliac (. )hich of these are included in the treatment of tobacco addiction* a. Nicotine b. Bupropion c. +o"amine d. Adenine ,. A female taking alcohol is more "rone to develo" to-icity and cirrhosis com"ared ith male hen the same amount of alcohol is taken due to: a. Decreased alcohol dehydrogenase in stomach b. +ecreased absor"tion c. .arge body si/e d. 0enetic factors 1. The characteristic feature of 2orsakoff3s syndrome is: a. +isorientation b. Coarse tremor c. +elirium d. Amnesia 4. )hich is seen in o"ioid "oisoning* a. 5y"erventilation b. 6aised blood "ressure c. Bradypnea d. +ys"nea

7. .o '82 levels are found in: a. Anemia b. C8 "oisoning c. 9ethemoglobinemia d. ypo!entilation

1:. 8-ygen content of the arterial blood is reduced in all e-ce"t: a. Methemoglobinemia b. &allot3s tetralogy c. C" poisoning d. &ibrosing alveolitis 11. A$.8 titres are used in the diagnosis of: a. Acute rheumatoid arthritis b. Acute rheumatic #e!er c. Scarlet #e!er d. $ost in#ectious glomerulonephritis 12. Increased levels of C'2 are seen in: a. Cirrhosis b. 5emoglobino"athies c. !-hausting e-ercise d. ypothyroidism 1#. 'ostural hy"otension is not seen in: a. +iabetes b. ypoglycemia c. Tabes dorsalis d. ;se of antihy"ertensive drugs 1%. 'eriorbital edema is not seen in: a. 5y"othyroidism b. Acute renal failure c. Cardiac failure d. %t is seen in all o# the abo!e 1(. All of the follo ing cause eight loss e-ce"t: a. +iabetes mellitus b. 'heochromocytoma c. 5y"erthyroidism d. %nsulinoma 1,. 'lasma"heresis is recommended in all of the follo ing e-ce"t: a. 5y"erviscosity syndrome b. 9acroglobulinemia c. Immune com"le- glomerulone"hritis d. Chronic acti!e hepatitis

11. $e"sis syndrome includes the follo ing: a. &!idence o# in#ecti!e #ocus b. <ormal "ulse c. Tachypnea d. "rgan #ailure 14. A massive s"lenomegaly is seen in: a. Chronic myelogenous leu'emia b. Visceral leishmaniasis c. (aucher)s disease d. 9yelodys"lasia 17. 5orner3s syndrome associated ith "ain shoulder and arm is suggestive of: a. Aortic aneurysm b. 9yocardial infarction c. Cervical s"ondylosis d. $ancoast tumor 2:. .+5 is increased in: a. Acute pancreatitis b. Myocardial in#arction c. 'neumothorad. Cystic fibrosis 21. 9acroglossia is seen in follo ing e-ce"t: a. Amyloidosis b. Acromegaly c. yperthyroidism d. +o n3s syndrome 22. Clubbing is seen in: a. 5e"atorenal syndrome b. .eft=to=right shunt c. Childhood asthma d. Suppurati!e pneumonia 2#. Carotid massage causes: a. %ncrease o# !agal tone b. +ecrease of sym"athetic discharge c. +ecrease of vagal tone d. Tachycardia 2%. 6habdomyolysis is characteri/ed by: a. *ea'ness o# the a##ected muscles b. Increased 9g>2 c. %ncreased +, d. Decreased Ca,-

2(. All of the follo ing metabolic diseases may cause chronic or recurrent abdominal "ain, e-ce"t: a. Acute intermittent "or"hyria b. Addison3s disease c. 5y"ercalcemia d. yper'alemia 2,. $udden death can occur in all of the follo ing cardiovascular conditions e-ce"t: a. Ventricular fibrillation b. 9assive myocardial infarction c. Atrial #ibrillation d. 6u"ture of the aorta from dissecting aneurysm 21. Cor "ulmonale may be seen in: a. C"$D b. Mar'ed obesity c. Mitral stenosis d. +yphoscoliosis 24. Cyanosis is classically described as occurring: a. If 1.( g?d. of deo-yhemoglobin is "resent b. If # g?d. of deo-ygenated hemoglobin is "resent c. %# . g/dL o# reduced hemoglobin is present d. All of the above 27. If a third heart sound is heard, it is: a. Al ays "athological b. Indicative of aortic stenosis c. Suggesti!e o# poor le#t !entricular #unction d. $uggestive of mitral stenosis #:. All of these "roduce a continuous murmur e-ce"t: a. Arteriovenous malformations b. 6u"tured aneurysm of sinus of Valsalva c. 'atent ductus arteriosus d. Mitral !al!e prolapse TT$ "g. 1 1 @est ay to treat street oundsA aB Immediate suturing b0 Cleaning with Saline 1 Debridement cB 8ral Ab- dB .eave it alone 2 !rythema <odosum can be caused byA aB Sarcoidosis bB $ost prim. Tbc cB Sulphonamide Therapy dB Streptococcal $haryngitis # 'ruritus is seen in all e-ce"tA aB 5odgkin .ym"homa bB 8bstructive Caundice cB 'rim. @iliary Cirrhosis dB Lead $oisoning % Acne Vulgaris is rare in?onA aB &ace bB @ack

cB Leg dB $cal" ( @asal Cell Carc. of the $kinA aB Accounts #or the ma2ority o# cancers on the e3posed s'in bB Is almost unkno n in blacks cB Is an im"ortant ha/ard of radiothera"y dB 9ay be caused by "rolonged e-"osure to arsenic , !cthyma is aA aB +ee" Viral Infect. bB Super#icial Bacterial %n#ect. cB +ee" @acterial Infect. dB <on=infect. Inflammation TT$ "g. 2 1 )hich of the follo ing methods is thee best for controlling an outbreak of 96$A of ounds in "ost=o"erative ard aB ;se of face masks by the "ersonal bB *ashing hands thoroughly be#ore 1 a#ter dressing the wounds cB Through fumigation of the room dB 're=o" Vancomycin to every "atient 4 D$tra berry TongueE follo ed by D6as"berry TongueE is characteristic forA aB 9um"s bB 9easles cB Scarlet 4e!er dB $mall 'oeB Chicken 'o7 !rysi"elas isA aB .ym"hangitis due to $ta"hylococcus bB Lymphangitis due to Streptococcus cB Subcut. %n#lam. due to Streptococcus dB Anaerobic Infection 1: !-tensive chr. Candidiasis should arouse sus"icion ofA aB %V bB Tbc cB 5isto"lasmosis dB .e"rosy 11 .anghans 0iant Cells are seen inA aB Sarcoid (ranuloma bB Tuberculous (ranuloma cB .e"rosy dB $y"hilis 12 )hich are not features of @otulismA aB +eranged "u"illary refle-es bB Spasticity cB Akinesia dB 5igidity TT$ "g. # 1# The follo ing is true about TetanusA aB Centrally "laced s"asm bB Contagious cB .ocal <ecrosis dB $re!ented by %mmunisation 1% &eatures of 2lebsiella 'neumonia is?areA aB 5igh mortality bB ;""er lobes are involved

cB $ystemic disturbances dB Chocolate coloured s"utum eB All o# the abo!e 1( $ta"hylococcus Aureus commonly inhabitsA aB <ose bB Throat cB !ar dB $kin 1, T@C is e-acerbated byA aB 0astrectomy bB Alcoholism cB +iabetes dB All o# the abo!e 11 .yme disease is caused byA aB Borrelia Burgdor#eri bB @orrelia +utoni cB @orrelia 6ecurrentis dB @orrelia Turicate 14 To-ic $hock syndrome is caused byA aB 'seudomonas bB Staphylococcus cB 0onococcus dB 'enumococcus TT$ "g. % 17 @ull neck in +i"htheria is due toA aB Cellulitis bB Lymphadenopathy cB 6etro"haryngeal Abscess dB .aryngeal !dema 2: All of the follo ing may be com"lications of 'ulmonary Tbc, e-ce"tA aB !m"yema bB @roncho"leural &istula cB @ronchiectasis dB 'ulmonary 5aemorrhage eB C"- 5etention 21 The best single laboratory aid in +- of Tbc aB $kin Test bB Chest F=6ay cB Sputum &3amination dB 5istology eB 'hysical !-amination 22 )hich of the follo ing is <8T associated ith $tre"tococcusA aB 6heumatic &ever bB $carlet &ever cB Acute 0lomerulone"hritis dB Scalded s'in syndrome 2# In "rim. $y"hilis the lesion seen isA aB %ndurated 6lcer bB 9ulti"licity of .esion cB 'ainful ;lcer dB @leeding ;lcer 2% &ollo ing can be used for +- of 5. 'ylori e-ce"tA aB 6a"id ;rease Test bB ;rea @reath Test cB 0astric @io"sy G staining ith 0iemsa dB SA4A Test TT$ "g. ( 2( )hich of the follo ing Ig is characteristically elevated in a "arasitic infection ith &ilariasis aB IgA bB %g& cB Ig0 dB Ig9 2, )hich of the follo ing is false about 5. 'yloriA aB !ndosco"y is best for +- bB 6rease acti!ity becomes negati!e in a chronic carrier cB ;nless treated it ill remain life long dB 0astric Carcinoma can develo" in chronic disease

21 A farmer rearing shee" "resented ith com"laints of&ever, )eakness and 5e"atomegaly. @io"sy of the liver sho ed non=caseating 0ranulomas. These are most likely due to an infection ithA aB @rucella 9elitensis bB @rucella Canis cB &rancisella Tularensis dB 7ersinia $estis 24 @otulinum To-in is used in the T- ofA aB 4acial Dystonia 1 Tics bB Tetanus cB 0uillain=@arre $yndrome dB @otulisms 27 9ethod of choice to confirm 5. 'ylori eradication isA aB 6rea Breath Test bB Culture cB $erology dB 9icrosco"y #: 9ost common F=6ay finding of 'ulmonary Tbc in AI+$ isA aB ;""er /one ha/iness bB Di##use %n#iltrates cB 9ulti"le cavities dB 'neumonic 'atch 1. 9ost common cause of s"ontaneous "neumothora- is: a. 5upture o# sub pleural bleb b. T@C c. Trauma d. Asthma 2. All of the follo ing cause transudation in "leural cavity e-ce"t: a. &mpyema b. Congestive heart failure c. <e"hritis d. Meigs syndrome #. 'leural fluid lo in glucose is seen in: a. 5A b. T@C c. Mesothelioma d. &mpyema %. Causes of hemorrhagic "leural effusions are: a. 'ulmonary infarction b. Mesothelioma c. @ronchial adenoma d. TBC (. @ilateral "leural effusion are seen in: a. <e"hrotic syndrome b. Constrictive "ericarditis c. Congestive heart failure d. All o# the abo!e ,. @ilateral malignant "leura effusion is most often seen in: a. @reast cancer b. Lung cancer c. 9esothelioma d. .ym"homa 1. @est "osition to see small "leura effusions on chest F=ray is: a. Anterior="ost vie b. 'osterior=ant vie c. .atero=lateral vie d. Lateral decubitus !iew

4. Increased amylase in "leural fluid is seen in: a. Malignancy b. 6A c. 'ulmonary infarction d. T@C 7. All are features of A6+$ e-ce"t: a. 'ulmonary hy"ertension b. <ormal "ulmonary artery edge "ressure c. 5y"o-emia d. Low protein pulmonary edema 1:. The thing that differentiate A6+$ from cardiogenic "ulmonary edema is: a. <ormal '82 b. Normal pulmonary artery wedge pressure c. <ormal arterial=alveolar gradient d. <ormal 'C82 11. A6+$ is associated ith: a. Acute pancreatitis b. Trauma c. Se!ere 4alciparum malaria 12. The follo ing about 2lebsiella "neumonia are true e-ce"t: a. 6ed Helly s"utum b. $een in alchoholics c. $een in older "eo"le d. $enicillin is the drug o# choice 1#. 'ost=influen/a bacterial infection of the lung is caused by: a. Staphylococcus b. $tre"tococcus c. $neumococcus d. emophilus 1%. 'rimary aty"ical "neumonia is caused by: a. Mycoplasma b. 9ycobacterium kansasli c. 'hotochromogens d. $neumocystis carinii 1(. A "erson ho has high fever, tachycardia, hemo"tysis and lobar consolidation on chest F=ray has: a. @roncho"neumonia b. Lobar pneumonia c. 'ulmonary edema d. 'ulmonary infarction 1,. <osocomial "neumonia is caused most often by: a. $tre"tococci b. 9yco"lasma c. (ram8neg. bacteria d. Virus 11. All of the follo ing organisms can cause interstitial "neumonia, e-ce"t: a. 'neumocystis carinii b. 9yco"lasma "neumonia c. .egionella "neumo"hilia

d. emophilus in#luen9a 14. Viruses causing "neumonia are all e-ce"t: a. C9V b. Mumps c. 5er"es d. 9easles 17. True about .egionella "neumonia include: a. "ccurs in epidemics b. Treated ith "enicillin c. Associated ith s"lenomegaly d. +iagnosed from s"utum e. Are more common in children 2:. Common "resenting sym"tom of "neumocystis carinii is: a. Cavity on chest F=ray b. 5emo"tysis c. Breathlessness d. 'urulent s"utum 21. Com"lications of lobar "neumonia does not include: a. .ung abscess b. Amyloidosis c. Suppurati!e arthritis d. Infective endocarditis 22. All are seen in em"hysema e-ce"t: a. +ecreased vital ca"acity b. 5y"erinflation c. 5onchi d. +amage to alveoli 2#. )hich "ulmonary function change is not seen in C8'+*: a. Decreased residual !olume b. +ecreased &!V c. .o mid e-"iratory flo rate d. +ecreased diffusion ca"acity 2%. .ung involvement in chronic bronchitis is: a. Bilateral b. $egmental c. .obar d. ;nilateral 2(. All are true in the definition of chronic bronchitis e-e"t: a. Cough for # months b. 'roductive cough c. $ym"toms more than 2 consecutive months d. emoptysis 2,. 'ulmonary hy"ertension in C8'+ are due to: a. Constriction o# pulmonary !essels b. ypo3ia c. Interstitial fibrosis d. @ronchoconstriction 21. .ung function tests in em"hysema reveals: a. Increased vital ca"acity

b. Decreased di##usion capacity #or carbon mono3ide c. Increased diffusion ca"acity for carbon mono-ide d. +ecreased total lung ca"acity e. +ecreased &!V1 24. True statements about em"hysema is: a. Breathlessness are always there b. Di##usion rate o# carbon mono3ide is reduced c. 6estrictive "attern of lung disease d. Long8term bronchodilators is not e##ecti!e 27. The earliest manifestation of "ulmonary embolism are: a. Cyanosis b. 5emo"tysis c. Dyspnea d. Chest "ain #:. 'ulmonary embolism causes: a. Bradycardia b. Decreased cardiac output c. Arterial hypo3emia d. Acute load on right !entricle #1. 'ulmonary embolism is most commonly caused by hich of the follo ing: a. Trauma b. Atherosclerosis c. Thrombosis o# the pel!is !essels d. <one of the above #2. I acute "ulmonary embolism the most freIuent !C0=finding is: a. Sinus tachycardia b. '="ulmonale c. 6ight a-is deviation

a0 Atherosclerosis is in!ersely proportional to: aB .+. level cB Chylomicron level bB V.+. level dB 5+. level

b0 $rin9metal angina has the #ollowing characteristics; e3cept: a0 'ain at rest b0 $T elevation during the attack c0 <ormal !C0 ithout "ain d0 6e"resents transmural ischemia e0 $T de"ression ith "ain

c0 *hat is called the widow)s artery: a0 $u"erior mesenteric artery b0 ;terine artery c0 Internal mammary artery d0 .eft anterior descending coronary artery

d0 &n9yme appearing early in myocardial in#arction:

aB C'2 cB $08T

bB .+5 dB $0'T

e0 The indication o# percutaneur transluminal coronary angioplasy is: aB Angina refractory to medical treatment bB $ingle vessel disease cB 'ro-imal non calcified stenosis dB 'atient ho had by "ass surgery eB All

#0 The drug contraindicated in prin9metal angina is: aB <ifedi"ine cB 'ro"ranolol bB Amyl nitrate dB Calcium channel blocker

g0 The critical narrowing o# coronary !essels to cause angina is: aB 9ore than (:J cB 9ore than 1:J bB 9ore than ,:J dB 9ore than 4:J

h0 Duration o# pain in angina is: aB 2=( min cB #:=,: min bB (=#: min dB K 1h

i0 Drug o# choice in prin9metal angina is: aB <itrates cB Vera"amil bB +iltia/em dB 'ro"ranolol

20 %ndication #or coronary bypass operation include all o# the #ollowing e3cept: aB $evere angina not res"onding to medical thera"y bB 8cclusive disease of the left main coronary artery cB Tri""le vessel disease dB 'revious infarction and congestive cardiac failure

'0 Critical narrowing o# coronary blood !essel is: aB 1:J cB 4:J bB ,:J dB 7:J

l0 5is'c #actors #or coronary arterial disease: aB 5igh 5+. bB .o .+. cB Increased homocystein levels dB +ecreased fibrinogen levels eB Increased li"o"roteins

m0 &3cersise testing is absolutely contraindicated in which o# the #ollowing: aB 8ne eek follo ing myocardial infarction bB ;nstable angina cB Aortic stenosis dB 'eri"heral vascular disease

n0

ypertriglyceridemia is not caused by: aB +iabetes mellitus cB Alcohol bB 8besity dB Cigarette smoking

o0 *hat is diagnostic o# #resh myocardial in#arction in &C(:

aB LT interval "rolongation bB ' mitrale cB $T segment elevation dB $T segment de"ression

p0 All o# the #ollowing are indications #or Treadmill testing; e3cept: aB To evaluate unstable angina bB To evaluate unstable myocardial infarction cB To asses outcome after coronary revasculari/ation dB To diagnose and evaluate the treatement of e-ercise arrhythmias. induced

<0 All o# the #ollowing are ris' #actors #or atherosclerosis e3cept: aB Increased aist=hi" ratio bB 5y"erhomocysteinemia cB +ecreased fibrinogen levels dB +ecreased 5.$ levels

r0 Acute coronary syndrome includes all e3cept: aB $T!9I cB $table angina bB <$T!9I dB ;nstable angina

s0 *hich o# the #ollowing is common risc #actor #or coronary heart disease e3cept: aB &amily 5?8 of I5+ bB +ecreased homocysteinemia cB 5+. M %: mg?d. dB Ty"e 1 +9

t0 Myocardial in#arction most o#ten results in: aB 9itral stenosis bB Aortic regurgitation cB Aortic stenosisB dB 9itral regurgitation

u0 Thrombolytic therapy in acute M% is contraindicated in all e3cept:

aB 5ealed "e"tic ulcer bB 6ecent invasive "rocedure cB 'ulmonary hy"ertension dB 'ulmonary thromb embolism

!0 5ight !entricular in#arction is associated with all e3cept: aB Cardiomegaly cB 5y"otension bB Arrythmia dB <ormal CV'

B Transient myocardial in#arction in &C( is characteri9ed by:

aB $T segment elevation cB 'athological L aves

bB 'rolonged L6$ dB T ave inversion

-B 4ibrous scar in myocardial in#arction is well established by:

aB , eeks cB , days

bB , months dB #: days

y0 The complication o# M% are all; e3cept:

aB 'ulmonary embolism bB $ystemic embolism cB +issection of aorta dB Ventricular fibrillation

90 Drugs o# choice to relie!e pain in myocardial in#arction: aB 9or"hine cB +ia/e"am bB &ort in dB <$AI+

aa0

Drugs use#ul in acute M% are all; e3cept: aB <ifedi"ine cB AC! inhibitors bB As"irin dB 9eto"rolol

ab0

All o# the #ollowing may cause ST segment ele!ation on &C(; e3cept: aB !arly re"olari/ation variant bB Constrictive "ericarditis cB Ventricular aneurysm dB 'rin/metal angina

ac0 The amino acit which is associated with atherosclerosis is: aB .ysine cB Cystein bB 5omocystein dB Alanine

ad0 A patient presents with intense chest pain o# - hrs duration. &C( shows ST depression in leads % and V=8V.. There is associated T in!ersion and the C$+8MB is ele!ated. *hich o# the #ollowing should be included in his management: aB <itroglycerine dri" cB Coronary angiogra"hy eB i.v meto"rolol Correct :1Bd 2Bc,e #Bd 12Bc,e %Ba (BAll ,Bc 1Bc 4Ba 7Ba 1:Bd 11Ba bB As"irin dB $tre"tokinase

1#Bc 1%Bd 1(Bc 1,Ba 11Bc 14Bc 17Bb 2:Bd 21Ba,c,d

22Bd 2#Bc 2%Ba 2(Bc 2,Ba 21Ba 24Bb 27Bb #:BAll

e. Hypertension
1 Luick reduction of blood "ressure is done in: aB Cerebral infarct b0 ypertensi!e encephalopathy cB 9yocardial infarction dB Any "atient ith hy"ertension aB bB c0 dB 2 5y"ertention can be caused by: 6enin Antigiotensin 1 Angiotension '0

# 5y"ertension ith increased renin levels is seen in: aB $egmental infarction b0 4ibromuscular hyperplasia o# renal artery cB Aortic stenosis dB 5y"eraldosteronism aB bB c0 dB eB a0 bB cB dB aB bB cB dB aB bB c0 dB % 6enin de"endent hy"ertension includes 'rimary hy"eraldosteronism !ssential hy"ertension 5eno!ascular hypertension 'heochromocytoma 5y"ertension ( @enign hy"ertension is characterised by : yaline arteriosclerosis &ibrinoid necrosis Calcified vessel all @erry aneurysm , )hich does not cause hy"ertension N +obutamine 5itodrine +o"amine 9etho-amine 1 9alignant hy"ertension is diagnosed hen= Associated malignancy is "resent +iastolic blood"ressure 12:mg5g $apilledema associated with ele!ated Bloodpressure All of the above

4 Treatment of hy"ertension emergency is= a0 ydrala9ine bB 0lukokinase cB 'ro"ranolol

aB bB cB d0 eB a0 bB c0 dB eB a0 bB cB dB a0 bB cB dB eB aB bB cB d0 aB bB cB d0

&urosemide 7 Calcium blocking agents of use in treatment of hy"ertension include= 'ra/osin Vera"amil Ca"to"ril Ni#edipine .idofla/ine 1: $everity of blood "ressure is graded mainly by N Systolic B.$. 'ulse "ressure Diastolic pressure 6es"onse to treatment 116enin "lays im"ortant role in N 5eno!ascular hypertension 9alignant hy"ertension Coronary artery disease !ssential hy"ertension 12 )hich of the follo ing antihy"ertensives ill you not "rescribe to a truck driver N Clonidine 5ydrala/ine Aldomet 'ro"ranolol 1# )hich one of the follo ing is of most serious "rognostic significance in a "atient of essential hy"ertension N +iastolic @.'. greater than 1#:mm5g Transient ischaemic attacks .eft ventricular hy"ertro"hy $apilloedema and progressi!e renal #ailure 1% In benign hy"ertension commonest vascular "athology is N Atherosclerosis &atty infiltration of intima &ibrinoid necrosis yaline arteriosclerosis

1% 'athological change in malignant 5T is N aB @enign ne"hrosclerosis b0 yperplastic arteriosclerosis cB Cystic medical necrosis dB 5yaline arteriosclerosis 1( All of the follo ing are feature of malignant hy"ertension !FC!'T N aB 0rade IV hy"ertensive retino"athy bB 5aemolytic blood "icture cB 6enal failure d0 5espiratoy #ailure

a0 bB cB dB eB

1, +rug of choise for hy"ertensive crisis associated ith acute ne"hritis is N Sodium nitroprusside 5ydrala/ine 6eser"ine Calcium channel blockers 'ro"ranolol 11 A young "atient "resented ith @.'. of 17:?12: mm5g ithout any clinical sym"tom and fundus e-amination is normal, treatment od choice 8ral <itroglycerine IV <itroglycerine "ral &nalapril IV !nala"ril $ublingual short acting <ifedine A %: years old male "atient, is suffering from ty"e II diabetes mellitus and hy"ertension. )hich of the follo ing antihy"ertensive drug should not be used in such "atients N .isino"ril ydrochlorthia9ide .osartan Trandol"ril A young hy"ertensive "atient has serum 2 2.4 meI?2 and increased aldesterone level ith decreased "lasma renin activity. The likely is?are N 6enal artery stenosis !cto"ic ACT5 syndrome +iuretic thera"y Conns syndrome .iddle3s syndrome

aB bB cB dB eB

aB b0 cB dB

aB bB cB d0 eB

HeartFailure

!-amination of a "atient in a su"ine "osition reveals Hugular veins from the base of the neck to the angle of the Ha . This finding indicates: aB b0 cB dB aB bB cB d0 decreased venous return. increased central !enous pressure. increased "ulmonary artery ca"illary "ressure. left=sided heart failure. )hat is not a "rimary cause of C5&* Cardiomyo"athy 5igh blood "ressure Coronary artery disease $oliomyelitis

Congestive heart failure is a condition hich is chronic and hich reIuires constant attention to diet, a reduction of stress, and daily medicines. )hich of the follo ing ould most increase the burden on an already= eakened heart* aB <arcole"sy bB 5aving a drink c0 "besity

a0 bB cB dB

9edicine is an im"ortant com"onent of treatment for congestive heart failure. )hich one of these is N"T "rescribed routinely for C5&* Ben9odia9epine +igitalis AC!=inhibitors +iuretics )hat is the technical term hich describes the coronary arteries as being narro ed by hardened "laIue, hich limits the free flo of o-ygen and over orks the heart* Aoritis Thrombosis Artherosclerosis Atherosclerosis $ometimes, "eo"le ith congestive heart failure develo" arrhythmias of the heart. These irregular rhythms can be conducive to develo"ing a blood clot. 'hysicians freIuently treat "eo"le ith Oblood thinningO medicines hich reIuire regulation of the density of the blood. )hich of these is the name for a blood=thinner* Tetracycline !rythromycin *ar#arin Amo-icillin There are t o kinds of C5&, de"ending on hich of the heartOs t o ventricles are affected. If the "roblem stems from the left ventricle, the "rime "um"ing mechanism in the heart, hich sym"toms tend to dominate* +iarrhea !ntero"hathy shortness o# breath and #atigue 5e"atic dysfunction )hat is the name for shortness of breath hen lying do n* A"nea "rthopnea 'laty"nea !"ista-is

aB bB cB d0

aB bB c0 dB

aB bB c0 dB aB b0 cB dB

a0 bB cB dB eB

)hat is the condition in hich the lungs retain e-tra fluid* This condition is a "art of left ventricular im"airment. pulmonary edema Asthma )hoo"ing cough 'neumonia

aB bB c0 dB

)hich of the follo ing is <8T a risk factor for cardiovascular disease* $moking !levated blood cholesterol $tress Consumption o# aspirin 8besity )hich of the follo ing decreases blood volume by increasing the e-cretion of sodium and fluids* As"irin Diuretics <itroglycerin +igitalis 6enin )hich of the follo ing is used to treat the sym"toms of heart failure by increasing the strength of heart contractions P"ositive inotro"yB* +iuretics Digitalis <itroglycerin 6enin eB

aB b0 cB dB eB

aB b0 cB dB

aB bB cB dB e0

The com"onents of fallots tetralogy are * V$+ 'ulmonary stenosis +e-tra "osition of aorta 6ight ventricular hy"ertro"hy All are correct fB Commonest ty"e of cong.heart disease seen in adults * A$+ V$+ T8& &+A Biscupid aortic !al!e

A continous murmur is heard in * $DA V$+ A$+ T8&

Congenital heart disease usually not associated ith synco"e is * aB !bsteins anomaly bB Tetralogy of fallot cB A$+ d0 $ulmonary stenosis eB 9ost common ty"e of A$+ is * aB 8stium "rimum b0 "stium secundum cB $inusvenosus ty"e dB !ndocardial cushion defect

Causes of death in untreated coarctation of aorta may include all of the follo ing e-ce"t * aB @acterial endocarditis and aortitis bB 6u"ture of aorta c0 Myocardial in#arction dB Congestive heart failure eB Cerebrovascular accidents )hich is incorrect about '+A * a0 5ight to le#t shunt bB !ndocarditis is common cB Can calcify

dB In untreated leads to "ulmonary hy"ertension Causes of cyanosis * a0 T"4 bB '+A c0 Tricuspid atresia d0 &isenmengers comple3 eB T0A aB bB c0 dB a0 bB cB dB .eft ventricular hy"ertro"hy is seen in * A$+ 9$ Aortic stenosis Carcinoid syndrome Clinical features of ostium secondum ty"e of atrial se"tal defect are all e-ce"t. * "ccurrence o# congesti!e #ailure in childhood Atrial arrhythmias )ide and fi-ed s"litting of the second heart sound 9id diastolic rumble along the left sterna border

aB bB c0 dB

$udden death is common in * 9itral stenosis Atrial V$+ Aortic stenosis '+A

In aortic regurgitation the left ventricle is * a0 ypertrophic b0 Dilated cB $mall dB Atro"hic a0 bB cB d0 In aortic regurgitation the murmur is * &arly diastolic .ate systolic !arly systolic Mid diastolic

5emo"tysis is seen in * aB Aortic stenosis

bB 'ulmonary stenosis c0 Mitral stenosis dB Tricus"id stenosis Angina "ectoris occurs most commonly in * aB b0 cB dB aB bB cB dB aB b0 cB dB aB bB cB d0 a0 bB cB dB aB bB cB d0 a0 bB cB dB 9$ AS 96 A6 9urmur of "ulmonary stenosis is best heard over * -nd le#t intercostals space %th left intercostals s"ace ,th intercostals s"ace on left side in midclavicular line <one of the above <ormal si/e of the mitral valve * 2=%cm >8?cm 1=2cm ,=1:cm Aortic regurgitation is seen in all e-ce"t * 6heumatic fever Infective endocarditis 9arfan syndrome Myocardial in#arction Angina G synco"e in same "atient is seen in * Aortic stenosis 9V' 9$ A6 )hich one of the follo ing is characteristic of mitral valve "rola"sed syndrome * 6ough mid diastolic murmur Colla"sing "ulse .oud first heart sound Mid systolic clic' !arliest sign of dee" vein thrombosis is * Cal# tenderness 6ise in tem"erature $ elling of calf muscle <one of the above

)hite leg is due to * aB &emoral vein thrombosis and lym"hatic obstruction b0 Deep #emoral !ein thrombosis

cB .ym"hatic obstruction only dB <one of the above All of the follo ing are seen in dee" vein thrombosis e-ce"t * 'ain +iscolouration $ elling Claudication Varicose veins are seen in * DVT su"erficial venous thrombosis AV #istula $rolonged standing "besity )hich of the follo ing is true about varicocele e-ce"t * Incom"etent valves of testicular vein are res"onsible for varicocele 7:J are on the left side Asymptomatic cases re<uire surgery <one of the above $mall vessel vasculitis are * Classical $AN *egeners granulomatosis 0iant cell arteritis S$ Churg8struass syndrome 2a asakis disease has the follo ing features e-ce"t * Coronary artery aneurysm ConHunctival suffusion Thrombocytopenia +esIuamation of the skin of fingers and toes

aB bB cB d0 a0 bB c0 d0 e0 aB bB c0 dB a0 b0 cB d0 e0 aB bB c0 dB

aB bB cB d0 a0 bB c0 dB

In takayasu arteritis there is * Intimal fibrosis 6enal hy"ertension Coronary aneurysm Alla o# the abo!e $kin manifestations of "olyarteritis include * Li!ido reticulosis 5y"er "igmentation Subcutaneous in#arct @ullous dermatitis

a0 bB cB d0 aB bB c0 dB aB bB c0 dB

Treatment of egners granulomatosis is * Steroids Cyclos"orine 6adiothera"y cyclophosphamide All o# #ollowing may be associated with peptic ulcer e3cept: Alcoholic cirrhosis Qollinger ellison syndrome $lummer !inson syndrome 'rimary 5y"er"arathyrodism The most common cause o# drug induced esophagitis is: &lagyl Indomethacin Do3ycycline $teroids *hich is true about achalasia cardia: 4ailure o# rel3ation o# lower oesophageal sphincter Associated ith Vit. A dificiency <ot a "remalignant condition It is a normal "henomenon

aB bB c0 dB eB

4ollowing is true about Barret@s esophagus: 8ccurs in #rd decade .ined by transitional e"ithelium Not re!ersible by medical therapy It is a "hysiological condition

Treatment o# drug induced gastritis: aB 9eso"rostol b0 -8 receptor bloc'ers cB Antacids d0 4amotidine aB bB cB d0 a0 bB cB dB 4ollowing are sites o# Cushing@s ulcer e3cept: 8eso"hagus $tomach 'ro-imal duodenum Distal duodenum $rogressi!e dysphagia is seen in: &sophagus Carcinoma 0lobus hystericus 'resbyeso"hagus Achalasia True regarding (&5D is all e3cept:

aB bB c0 dB

Avoid coffee G Tea Transient lo er eso"hageal rela-ation Lower esophageal sphincter length and its pressure is important 'roton "um" inhibitor is the treatment of choice

aB bB cB dB e0

All are complications o# ulcerati!e colitis e3ept: 5aemorrhage $tricture 9alignant change 'oly"osis "esophageal !arices

$ost diarrhoeal paralytic ileus occurs in: a0 ypo'alaemia bB ypomagnesemia cB 5u"ocalcemia dB All of the above eB Ae2unal lactase de#iciency lead to diarrhoea with the ingestion o#: a0 Mil' bB 0luten cB 9eat dB 6ice a0 bB cB dB eB aB bB c0 dB aB b0 cB dB Speci#ic test #or malabsorption: D83ylose test $chilling test &ecal fatestimation 5ydrogen breath test $atient with congenital lactose de#iciency will e3perience distention; #latulence and diarrhea on ingestion o#: 0lucose $ucarose Mil' !ggs 5are complication o# ulcerati!e colitis: 'seudo"oly"i Carcinoma To-ic dilatation 9assive hemorrhage

There are other diseases associated with celiac disease; which: aB About 1:J have an itchy rash on the e-tremities, buttocks, neck, trunk, and scal", called dermatitis her"etiformis. bB 6ecurrent "ainful mouth ulcers,

cB Insulin=de"endent diabetes dB Autoimmune thyroid disease e0 All o# the abo!e *ith celiac disease; malabsorption means: a0 $oor absorption o# #ood nutrients bB Absence of absor"tion of food nutrients cB $lo absor"tion of food nutrients dB &ast absor"tion of food nutrients a0 b0 c0 dB a0 b0 cB dB aB bB cB dB e0 aB bB c0 dB aB bB c0 dB aB bB c0 dB emoblia is characterised by: Aaundice Biliary colic Malena &ever *hene!er there is a stone in bile duct which o# the #ollowing: Bile salts Bilirubin Amylase $0'T Con2ugated hyperbillirubinemia is seen in: 0ilberts syndrom Criggler <aHHar Ty" 1 Criggler <aHHar Ty" 2 All of the above Dubin Aonsons syndrome The characteristic #eature o# chronic alcoholic li!er disease is: &atty liver Cirrhosis $eri!enular #ibrosis 5yaline $clerosis %n heapatic cirrhosis; which o# the #ollowing is increased: Al"ha 1 globulin Al"ha 2 globulin (ama globulin All of the above Antibiotics are us#ul in all o# the #ollowing condition e3cept: )hi""le disease Tro"ical syndrome Celiac disease @lind loo" syndrome

*hich o# the #ollowing is associated with acute pancreatitis: aB 5y"o"arathyroidism b0 Thia9ides

c0 $regnancy d0 Corticosteroids aB bB cB d0 aB bB cB dB e0 Acute pancreatitis can be caused by: Alcohol 5y"ertriglyceridemia A/athio"rine All o# the abo!e

*hat are contraindications #or the use o# oral antidiabetic drugs: 'regnancy breastfeeding severe infection 6enal dysfunction All %# a person is recei!ing an insulin drip; what is li'ely to happen to potassium le!elsB a0 Decrease bB Increase a0 bB cB dB aB b0 cB dB aB bB c0 dB Most common tumor o# pancreas is: %nsulinoma 0astrinoma A';+R$ omas VI'oma Complications o# chronic pancreatitis include the #ollowing e3cept: 'ortal hy"ertension "bstructi!e 2aundice +uodenal obstruction 6enal artery aneurysm Serum amylase le!els raised in all e3cept: +uodenal ulcer "erforation 'ancreatitis Appendicitis $mall bo el strangulation A CC8year8old man has ne!er been !accinated #or hepatitis B. Serologic tests re!eal negati!e hepatitis B sur#ace antigen D BsAg0 and positi!e antibody to sur#ace antigen. *hich o# the #ollowing conditions does this serologic pattern best #it withB pre!ious hepatitis B in#ection chronic active he"atitis acute he"atitis @ infection "oor "rognosis need for vaccine to he"atitis @

a0 bB cB dB eB

A CC8year8old woman de!elops mild epigastric abdominal pain with nausea and !omiting o# - days duration. er abdomen is tender on palpation in the epigastric region; and the remaining e3amination is normal. er white count is =C;EEE/mL; and amylase is CEE 6/L D-.F=-. 6/L0. *hich o# the #ollowing is the most common predisposing #actor #or this disorderB aB b0 cB dB aB bB cB d0 eB drugs gallstones malignancy alcohol *hich o# the #ollowing is a ris' #actor #or Helicobacter pylori in#ection: e-cess e-"osure to antibiotics female seal"ha1=antitry"sin deficiency low socioeconomic indicators "roton "um" inhibitor thera"y

1.Acromegaly is characterised by all e-ce"t:


aB +iabetes bB 9uscular hy"ertro"hy cB !nlarged nasal sinuses dB Increased heel "ad thickness 2 . 5y"er"rolactinemia is an adverse side effect of : aB Amantidine bB @romocri"tine cB .evodo"a dB 9etoclo"ramide # .+iabetes insi"idus is treated ith: aB Thia/ides bB 8-ytocin cB +esmo"ressin dB 0libenclamide %.A "atient sustained,head trauma leading to transection of "ituitary stalk,all,occur e-e"t aB +9 bB Adrenocortical insufficiency cB +ibetes insi"idus dB 5y"othyroidism ( .Causes of hy"o"ituitarism are all,e-ce"t aB Cancer breast bB Cancer bronchus cB Chromo"hillic adenoma dB Acido"hilic tumor ,.!m"ty sella syndrome is often characteri/ed by: aB 'ituitary tumour bB Cretinism cB Acromegaly dB <one of above 1. In a "atient "resenting ith "olyouria and "olydi"sia the diagnosis is likely be: aB +iabetes mellitus bB +iabetes Insi"idus cB 'sychological dB 5y"erthyroidism 4.Cardiac manifestations of 0raveOs disease ould include all of the follo ing e-ce"t: aB )ide "ulse "ressure bB Atrial fibrillation cB 'leuro"ricardial scratch dB Aortic insufficiency 7 .All are feauture of subacute thyroiditis e-ce"t: aB 'ain in the neck bB &ever cB 6aised !$6 dB 6aised readioactive 1#1 I u"take Correct:1.b ,2 .d, # a,c , %.a, (.d, ,.d, 1.a,bc, 4.d , 7 d

1:.All of the follo ing conditions are kno n to cause diabetes insi"idus e-ce"t: aB 9ulti"le sclerosis bB 5ead inHury cB 5istiocytosis dB Viral ence"halitis 11.The early feature of hy"othyroidism is : aB .o T# bB .o T% cB 6ise in T$5 dB +elayed dee" tendon refle-es 12.)hich is not a feauture of hy"othyroidism: aB 9y-edema bB Car"al tunnel syndrome cB 9enorrhagia dB Increased a""etite 1#.6adio iodine u"take in endemic goitre aB <ormal bB Increased cB +ecreased dB !rratic 1%.&eatures of hy"erthyroidism are: aB 'ericardial effusion bB 9enorrhagia cB +elayed ankle rela-ation dB +iarrhoea eB 5eat intolerance 1(.6egarding my-edema the follo ing are true e-ce"t: aB $ ollen,8edematous look of face bB Im"otency,amenorrhoea cB @,9.6 increaed by #:=%(J dB +ullness,.oss of 9emory 1,.Commonest sym"tom of endemic goitre aB Asym"tomatic bB 5y"othyroidism cB .um" in neck dB 5y"erthyroidism 11.6egarding 5ashimotos thyroiditis hich is false: aB Autoimmune thryoditis bB 'lasma cell and lym"hocytic infiltration cB 5y"othyroid state dB 5y"o"arathyroid state Correct:1:.a ,11.c, 12 .d, 1#.b 1%.d,e, 1(.c, 1,.a ,11.d

14.Treatment in 5ashimotoOs disease aB Carbima/ole bB Thyro-ine cB 6adio iodine dB $ubtotal thyroidectomy 17 .Cardio"ulmonary manifestations of hy"erthyroidism : aB Tachycardia bB $inus bradycardia cB Cardiomyo"athy dB .o out"ut cardiac failure 2: .The feautres of AddisonOs disease is?are: aB )eight loss bB $kin "igmentation cB 5y"onatremia dB 5y"erkalemia eB all Above 21 .A (:=year=old female is 11: cm tall and eighs 1( kg. There is a family history of diabetes mellitus. &asting blood glucose is 1(: mg?d. on t o occasions. $he is asym"tomatic, and "hysical e-am sho s no abnormalities. The treatment of choice is aB 8bservation bB 9edical nutrition thera"y cB Insulin dB 8ral hy"oglycemic agent 22 Insulin resistance syndrome includes aB +ysli"idemia bB 5y"ertension cB 5y"eruricemia dB 5igh 5+. 2# . A 1(=year=old is brought to the emergency de"artment in a coma. An alert ambulance attendant notes that the "atientOs breath smells like acetone. This observation is most consistent ith hich of the follo ing diagnoses* a) Alcohol into-ication b) +iabetic hy"erosmolar coma c) +iabetic ketoacidosis d) 5eroin overdose e) 'rofound hy"oglycemia 2% .)hich one of the follo ing investigations is most sensitive for early diagnosis of diabetic ne"hro"athy: aB $erum creatinine level bB Creatine clearance cB 0lucose Tolerance Test dB 9icroalbuminuria

2( .&ungal lung infection commonly seen in diabetics is: a) Actiomycosis b) 9urcomycosis c) As"ergillosis d) Coccidiodomycosis 2, .)hich of the follo ing statements is true regarding ty"e 1 diabetes mellitus: aB &amily history is "resent in 7: J cases bB +e"endent on insulin to "revent ketoacidosis cB Time of onset is usually "redictable dB Autoimmune destruction of beta cells occur eB 9ostly occurs in chlidren 21 .)hich is the feauture of +a n "henomenon: aB !arly morning hy"oglycemia bB !arly morning hy"erglycemia cB @reakfast hy"oglycemia dB 'ost "randial coma 24. $omogyi "henomenon is: aB 5y"oglycemia follo ed by hy"erglycemia bB 5y"eglycemia follo ed by hy"oglycemia cB 0lycosuria ith normal blood sugar dB 6eactive hy"oglycemia 27 .All of the follo ing are assosiated ith insulin resistance e-ce"t: aB Acantosis nigricans bB .i"odystro"hy cB 0out dB )erner $yndrome #:. Im"aired glucose tolerance can cause: aB <euro"athy bB <e"hro"athy cB 6etino"athy dB I5+Pischemic heart diseaseB Correct :14.b 17.a,c, 2:.e 21.b 22a,b, 2#.b 2%.d 2( b 2,.b,d,e 21.b 24.a 27.c #:.d

. ;9&=Tgm, 0eneral medicine ,th year Pto"ics ith Iuastions and ans ers for the final e-am in familymedicineB To"ics: !<T, 8"htalmology and <e"hrology. &NT and "phtalmology. eB +o nbeat nystagmus is characteri/ed by: a. post #ossa lessions b. vestibular lesions c. labyrinthin lesion d. cerebellar lesion fB Ata-ic nystagmus is seen in leisions of: a. medial longitudinal #asciculus b.Cerebellum c. .abyrinth d. Vestibular <c. gB At birth the follo ing structures are of adult si/e e-ce"t: a.Ty"anic cavity b. Mastoid antrum c. 9alleolus d. Tym"anic ring hB A "atient ith furuncle of ear is "resented. )hat is the commonest treatment* a. !ar "ack ith 1:J ichtamon in glycerine ick b. Antibiotic and rest c. antibiotic and drainage d. Analgesic iB In hich sinus is sinusitis in children most common* a. &rontal b. Ma3illary c. !thmoid d. $"henoidal HB 9ost common sinusitis in children is* a. &rontal b. Ma3illary c. !thmoi d. $"henoidal 1.The com"onents of 5ornerOs syndrome are all e-ce"t: a. Anhydrosis b. 9iosis c. $roptosis d. !no"htalmosis

4. The normal AV=ratio in fundosco"y is: a. C:> b. #:2 c. 1:2 d. 1:# 7. Commonest cause of "a"illoedema is: a. 5ise in intracranial tension b. 8"tic neuritis c. 8"tic atro"hy d. Chronic ne"hritis 1:. All are causes of Argyll=6obertson "u"il e-ce"t: a. $yringomyelia b. +isseminated sclerosis c. Chronic alcoholism d. Asyphy3ia and deep anaesthesia 11. 5ornerOs syndrome is characteri/ed by all e-ce"t: a. 9iosis b. &3ophtalmus c. Anhydrosis d. .oss of cillios"inal refle12. 0a/e nysrtagmus is seen in: a. 9iners b. Infants c. Myastena gra!is d. +iabetes mellitus 1#. Ata-ic nystagmus means a lesion in the: a. labyrinth b. Cerebellum c. Vestibule d. Medial longitudunal #asciculus 1%. $ee=$a nystagmus is usually seen ith: a. Craniopharyngomas b. 'ineal tumors c. 5ydroce"halus d. Viral ence"halitis 1(. 6etinitis "igmentosa is transmitted as: a. $"oradic b. Auto/onal recessive c. F=linked d. All o# these 1,. $uconHuctival hemorrage occurs in all conditions e-ce"t: a."assive venous conHesion

b.'ertusis c. Trauma d. high intraoccular tension 11. in "atients ith acute glaucoma the "ro"hylactic treatment for the other eye is: a. $eripheral iridectomy b. Anterior sclerotomy c. Irienclesis d. $cheieOs o"eration Nephrology 14. 9aHority of "rimary infection of the urinary tract are caused by: a. &.coli b. stre"tococcus fecalis c. 'seudomonas d. 'roteus 17. "olycystic kidneys kan be associated ith: a. Cysts in liver and .ungs b. Coarctation of aorta c. @erry aneurisms d. a and c are correct 2:. )orst "rognosis in renal cell carcinoma is associated ith: a. 5aematuria b. $i/e K (cm c. Invasion of renal vein d. $ulmonary secondary metastases 21.)hich of the follo ing findings in urnalysis is correct regarding acute glomerulone"hritis* a. 'roteinurea b. )hite blood cell casts c. 5edblood cell casts d.5yaline casts eB )hich of the follo ing treatments is adeIuate in slo ing do n the evolution of renal disease in a diabetic "atient ith "roteinurea on urinalysis* a. Calcium chanell blockers b. AC&8inhibitors c. @eta blockers d. .oo" diuretics fB )hich of the follo ing alternatives is most indicative in the screening of "rostate cancer* a. "rostate ultrasound b. +6! Pdigital rectal e-aminationB c. '$A P"rostate s"ecific antigenB d. $SA 1 D5& aeB )hich of the follo ing changes is seen in a "atient ith chronic kidney failure due to chronic

analgesic P<$AI+B ingestion* a.0lomerulosclerosis b. $apillary necrosis and tubulointerstitial in#lamation c.Cortical necrosis d. Tubular necrosis eB In a ,( years old male "atient ith reccurent severe artritis in his big toes and elevated creatinine levels. )hich the most likely cause to his symtoms* a.0lomerulone"hritis b.Vascular inHury c. 5enal parenchymal uric acid cristals d. ;ric acid kidney stones 2,.In hich "art of the normal kidney ne"hron is most of the ater reabsobed from* a. Ascending loo" of 5enle b. +escending loo" of 5enle c. $ro3imal con!ulted tubule d. Collecting duct eB In a young "atient ith renal colic, urinalysis sho ing he-agonal crystals and a cyanide= nitro"rusede test of urine is "ositive. )hich of the follo ing is the most likely diagnosis* a. Cystineuria b. Thalasemia c. $arcoidosis d. hereditary glycinuria

eB In "asient ith se"sis, hy"otension and oliguria follo ing a "neumonia infection. +es"ite antibiotic treatment and i.v fluids ith the evolutin of PA6&B acute renal failure. )hich of the follo ing is the most likely cause of A6&* a. Antibiotic treatment b. Acute infectiouse P0<B 0lomerulone"hritis c.Contrast ne"hro"athy d. DATN0 Acute tubular necrosis eB )hich of the follo ing findings is not com"atible ith diabetic ne"hro"athy* a. <e"hrotic range "roteinuria b. 9icroalbuminuria c. 5y"ertension d. 5ed blood cell D5BC0 casts in urine fB A 21=year=old oman ith ell=controlled bi"olar affective disorder, treated ith lithium, develo"s "olyuria and "olydi"sia. )hich of the follo ing statments is the correct cause of her symtoms* a. Central diabetes insipidus DD%0 b. <e"hrogenic +I c. 'rimary "olydi"sia d. 8smotic diuresis

O *hich o# the #ollowing is true o# iron de#iciency anemia 1. Iron binding ca"acity is decreased 2. Increased number of sideroblast C. Serum iron concentration is decreased %. All of above Anemia can mani#est as all e3cept 1. 5eadache 2. Vertigo C. Delirium %. Tinnitus Low serum iron is seen in8 =. %ron de#iciency anemia 2. $ideroblastic anemia #. Thalasemia traits %. $ickle cell anemia Microcytic hypochronic anemia is seen in8 =. Sideroblasti' anemia -. Thalasemia #. Vitamin C deficiency %. All of above Treatment o# choice #or aplastic anemia is8 1. @lood transfusions 2. 8-ymethalone C. Bone marrow transplantation %. A/athio"rime Aplastic anemia can be caused by all e3cept8 1. Cholram"henicol -. epatitis A #. Analgin >. +anamycin All are true #eatures o# sic'le cell anemia e3cept8 =. Leucopenia 2. 'ulmonary hy"ertension #. 5eart enlargement %. &ish mouth vertebra The total daily loss o# iron amounths to about8 1. :.1 mg 2. :.( mg C. = mg %. 1: mg Most iron is stored in combination with8

1. $ul"hate -. 4erritin #. Transferin %. Ascorbic acid Diagnostic o# iron de#iciency anemia is8 1. +ecreased serum iron -. Decreased #erritin #. +ecreased 5b A2 %. 9icrocytic hy"ochronic anemia Megaloblastic anemia in blindloop syndrome is due to8 =. Vitamin B=- de#iciency 2. Intrinsic factor deficiency #. Iron absorbtion defect %. &olate deficienc Bone marrow transplantation is not indicated in8 1. A"lastic anemia -. Congenital spherocytosis #. Thalasemia %. Acute myeloid leukemia in first remission A =? years old #emale presents with generali9ed wea'ness and plapitations. er b is Gg/dl and peripheral smear shows microcytic hypochromic anemia; reticulocyt count is E;H I serum bilirubin is = mgI. whats is the most li'ely diagnosisB =. %ron de#iciency 2. 5emolytic anemia #. A"lastic anemia %. &olic acid deficiency A child . years old presents with anemia. "n e3amination his MVC was GE and MC wa --. Blood erythrocyt protoporphyrin was high. *hats the probably diagnosisB 1. Thalasemia -. %ron de#iciency syndrome #. 'or"hyria %. $ickle cell anemia Viral in#ection in hemolysis is seen in8 epatitis B 5e"atitis C 'rolonged fever epatitis A CMV Anemia in chronic renal #ailure DC540 is due to8 Decreased erythropoietin production %ron de#iciency 5y"o"lastic bone marro +ecreased vitamin= @ 12 Decreased #olate le!et %ron absorbtion is increased in8 %ron de#iciency anemia $regnancy

All ty"es of anemia 9alignancy Macrolytic anemia

$olycythemia:
Causes o# secondary polycythemia may include8 1. Chronic cor "ulminale 2. 6enal carcinoma #. Cerebellar haemangioblastoma >. All o# abo!e True about polycycthemia !era is all e3ept8 @leeding Thrombosis +ecreased !$6 in#ection

Lymphoma:
lymphadenopathy is seen in all o# the #ollowing e3cept8 "rimary sy"hilis dono!anosis .0V Chancroid Treatment o# choice #or stage %%% a odg'in)s lymphoma8 Chemotherapy 6adiothera"y Combination of chemothera"y and radiothera"y e-cision stage B symptom o# odg'ins lymphoma include8 weight loss #e!er bone marro infiltration "ruritus anemia

Myeloma:
multiple myeloma is characteri9ed by all e3ept8 C6& Pchronic renal failureB (um hyperplasia .ytic bone lesions 6es"iratory infections %n multiple myeloma #ollowing are seen8 %ncreased calcium $clerotic bone lesion @one de"osition 5enal #ailure

Leu'emia:
5egarding leu'emia which o# the #ollowing is correct8 ALL is common in children A.. is seen in the fifth decade Bone marrow transplant is done in ALL

d0 Bleeding tendency in AML Leu'emoid reaction is seen in8 acute in#ection myelomatosis hemorrhage erythroleukemia blast crisis in CML is indicated by all e3cept8 lympadenopathy high fever sudden enlargement o# spleen bleeding tendencies a patient su##ering #rom chronic myeloid leu'emia; b #alls #rom == gI to >gI. in a short span o# time; and splenomegaly occurs. The cause could be8 accelerated CML CML in blast crisis Ineffective erythro"oiesis 9yelofibrosis Leu'emia is predisposed to by8 Blooms syndrome 4anconis anemic Ata3ia telangiectesia +line#elthers syndrome B cell prolymphocytic leu'emia patients di##er #rom those with B cell chronic lymphocytic leu'emia in8 'resenting at a younger age 5aving a lo er total leucocyte count 5aving "rominent lym"hadeno"athy a!ing a shorter sur!i!al

<euroN"sychiatric disorders
<eurologic 1. $"inal "uncture should be used to determine aB s"inal fluid "ressure bB heter a block e-ists cB ty"es and number of cells "resent dB "rotein and sugar levels eB all o# the abo!e 2. The condition here babinski sign is "ositive but dee" tendon Herks are absent is = aB cerebral hemorrhage bB cerebral "alsy cB cerebral tumor dB 4rederichJs ata3ia

#. 'rimary o"tic nerve atro"hy is a recogni/ed com"lication of: aB glaucoma bB disseminated sclerosis cB 'agetOs disease of the skull dB neurosyphilis eB ethambutol therapy %. 6ecogni/ed causes of motor neuro"athy include: aB diabetes mellitus bB porphyria cB (uillain8Barre syndrome dB &riedrichOs ata-ia eB diphtheria (. 'in "oint "u"ils, loss of consciousness and hy"er"yre-ia is seen in aB subarachnoid hemorrhage bB pontine hemorrhage cB cerebral infarction dB thalamic syndrome ,. )hich of the follo ing statements about hallucinations are correct* aB acoustic hallucinations are a common complication o# amphetamine bsychosis bB paranoid symptoms are characteristic o# Kcocaine psychosisK cB amphetamines can induce hallucinations dB hallucinations are inevitable sym"toms of schi/o"hrenia eB "urely visual hallucinations suggest a functional abnormality 1. <euro"sychiatric sym"toms of he"atic insufficiency include: aB a re!erse sleep pattern bB Argyll=6obertson "u"ils cB myelopathy with paraplegia dB perse!eration signs eB diagnostic !!0 abnormalities 4. A classic ty"e migraine is characteri/ed by hich of the follo ing* aB it cannot be diagnosed if there are no "rodromal sym"toms bB it shows a gradual progression cB a homonymous hemianopsia is present dB there is edema of the "a"illa eB freIuently occuring acoustic hallucinations 7. The most common com"lication of vagotomy is aB diarrhea bB dryness of the mouth cB tachycardia dB bleaching

1:. Intentional tremor in young "atients is commonly due to aB Cerebellar disease bB *ilsonJs disease cB'arkinsons dB 5ead inHuries 11. 9ask like faces is seen in aB $ar'insons bB +isseminated sclerosis cB after strokes dB 'seudo bulbar "alsy 12. @rain tumor has the follo ing sym"toms e-ce"t aB bitem"oral hemiano"ia bB loss o# consciousness cB headache dB vomiting 1#. @rain death means loss of aB cortical #unction bB brain stem #unction cB s"inal refle-es dB corneal re#le3 1%. Cerebral edema is characteristically seen in "oisoning by aB 9ethanol bB .ead cB Carbon mono-ide dB All o# the abo!e 1(. A %: year old female "resents ith a history of sudden onset of headache and nausea hich "assed off ith rest and analgesics. .ater she develo"ed blurring of vision for a fe days. 8n the day of admission she had develo"ed third nerve "alsy ith neck rigidity. The tem"erature as #1,1SC. The most likely diagnose is aB acute attack of migrane bB viral ence"halitis cB sub8arachnoid hemorrhage dB severe hy"ertension 1,. The follo ing are true in early onset Al/heimerOs disease aB Associated with chromosomal anomalies bB pro#ound retardation is seen cB necrosis i# brain neurons dB none 11. Cervical cord inHury does <8T cause aB 5ornerOs syndrome bB loss o# sensation o!er #ace cB s"asticity of foot

dB atrophy with #asciculations o# lower limb 14. +emyeliation is seen in aB Multiple Sclerosis bB A%DS cB $rogressi!e multi#ocal leu'oencephalopathy dB 'oliomyelitis eB .eukodystro"hy 17. True about Al/heimerOs disease aB mutation in the A$$ gene bB Autoantibodies cB Aluminium is aris' #actor dB !iral in#ections ha!e increased ris' eB ereditary 2:. In amyotro"hic lateral sclerosis true is aB "resent ith sei/ures bB lesion in anterior horn cells cB corticospinal tract dB hypore#le3ia 21. 'rogressive dementia is seen in aB Al/heimers disease bB Creut/feld=Cakob disease cB 5untingtons disease d0 All 22. )hich is a feature of classical migrane aB Symptoms are better with increasing age bB <o aura cB early treatment aborts attac' dB does not res"ond to ergotamine 2#. A#( year old male ith no history of +9 or hy"ertension "resents ith sudden onset bursting headache and altered sensorium. 9ost "rbable cause ould be aB 9eningitis bB !nce"halitis cB %ntracerebral hemorrhage dB Intracranial tumor 2%. Anterior cerebral arterial occlusion can cause aB controlateral lower leg wea'ness bB urinary incontinence cB 5emiano"ia dB 5emianesthesia of controlateral half of face 2(. &eatures of 'arkinsons disease aB decreased blin'ing

bB $"asticity cB on8o## phenomenon dB decreased muscular "o er eB Tremor 2,. A middle aged man "resents ith "rogressive atro"hy and eakness of hands and forearms. 8n e-amination he is found to have slight s"asticity of the legs, generali/ed hy"er=refle-ia and increased signal in the cortoco=s"inal tracts on 96I. The most likely diagnosis is aB 9ulti"le $clerosis bB Amyotrophic lateral sclerosis cB $ubacute combined degeneration dB 'rogressive s"inal muscular atro"hy 'sychiatric 21. )hich of the follo ing observations hel" to differentiate neurosis from "sychosis* aB neurotic "atients characteristically disclaim reality bB endogenous e3periences cause e3citation in neurosis cB real illusions can occur in neurosis dB associative function is not affected in neurosis eB the JegoJ is intact in neurotic patients 24. A 1(=year=old girl "resents to the emergency room ith severe eight loss. 8n e-amination she is cachectic, bradycardic, and hy"otensive. The first course of action should be to: aB determine the family dynamics bB administer a high="rotein and carbohydrate diet cB draw blood #or a serum electrolyte determination and then start intra!enous #eeding dB arrange to have the "atient admitted to the "sychiatric ard eB "re"are for electroconvulsive thera"y 27. Common com"lications of alcoholism include: aB cerebral damage bB gastritis cB suicide dB "olyneuro"athy eB all o# the abo!e #:. )hich of the follo ing has an etiologic role in anore-ia nervosa* aB cultural in#luences bB hypothalamic8pituitary abnormalities cB parental o!er8regulation dB schi/o"hrenia #1. Case $tudy:

A ,2=year=old man seeks evaluation for eakness, a loss of initiative, a loss of eight, and abdominal discomfort. 5e a""ears to be de"ressed. 'ossible diagnoses can include: aB dementia bB hy"erthyroidism cB pain 'iller abuse dB pancreatic carcinoma #2. Characteristic sym"toms of schi/o"hrenia include: aB com"ulsive thoughts bB progressi!e dementia cB de"ersonali/ation dB aking u" early in the morning eB thought withdrawal ##. Characteristic sym"toms of mor"hine ithdra al include: aB e3cessi!e yawning bB hy"otension cB muscle spasms dB dry conHunctiva eB diarrhea #%. Characteristic sym"toms of acute manic "sychosis include: aB lack of insight bB #light o# ideas cB confabulation dB distractibility eB depression in the #amily history #(. Characteristic sym"toms of de"ression include: aB diminished concentration bB hallucinations cB hypochondriasis dB delusions of "ersecution eB weight loss