Selection Examination for General Medicine & Geriatrics

Paper one –Bio Medical Science

October 2017

1. Regarding volu me of distribution (vd) of a drug,

A. if a drug is highly protein bou nd vd is small.
B .if a vd of a drug is very large it can be easily dialyzable.
C .it determines the peak concentration of a drug after IV bolus .

2. Adre naline
A. acts on alpha 1 receptor causes reduce s ecretions
B. acts on beta 1 receptor causes bronchoconstriction
C. acts on be ta 2 receptor causes
D. causes mast cell stabilization
E. acts on a lpha 1rec eptor causes

3. Regarding water s oluble beta blockers

A. la betalol is an example.
B. ha ve less he patic first pass metabolism
C. reduce rate of nightmares
D. reduce rate of bradyca rdia

4. Drugs known to cause hypertens ion

A. naproxen
B. lefluna mide
C. azathioprine
D. cyclosporine
E. erythropoietin
5. Regarding Anti TB drugs
A. pyrazinamide –hepatitis
B. Rifa mpic in – hepatic enzyme inducer
C. streptomycin – nephrotoxicity
D. Ethambutol – cont raindicated in pregnancy
E. INAH – use as prophylaxsis

6. Regarding Antifungals
A. cotrimoxazole – vaginal candidias is
B. ketoconazole – induce liver enzymes
C. flucanazole – poorly absorbed by gut
D. nystatin – systemic infections
E. amphoteric in B – neprotoxicity

7. Compare to he parin, in low molecular weight heparin

A. causes HIT
B. can re verse with protamine sulphate
C. have short half life
D. more clotting factors are inhibited
E. nee d to moniter with PT INR

8. Regarding Va ncomycin
A. inh ibit cell wall s ynthesis
B. need to monitor drug levels
C. uses for penic illin resistant viridians streptococci
D. causes pseudomembranous colitis
E. well a bsorbed from the gut
9. Trinucleotide repeating disorders are,
A. cystic fibros is
B. hunt ington disease
C. phenylketonuria
D. fredrich ’s ataxia
E. frag ile x syndrome

10. Regarding prevalence

A. is increased by inc reased inc idence
B. is incre ased by hig hly spec ific screening test
C. is increased by inc reasing survival from a disease
D. is increased by inc reasing populat ion sample size

11. Regarding significance tests

A. student t test use to compare two paired nu merical grou ps
B.chi square test use to compare two categorical groups
C. one wa y ANOVA is used to assess significance of two c ategorical groups

12. By increasing size of a random sample

A. incre ases standard deviation
B. re duces varia nce
C. increases degree of freedom
D. increases standard error of mean
E. increases mean

13. Regarding bradyk inins

A. causes vasoconstriction
B. re duce inflammation
C. in excess causes angioedema
D.subcutaneous injection causes pain

14. Regarding hypers ensitivity

A. lu pus ne phritis – type 2
B. goodpasture’s s yndrome – type 3
C. atopy –type 1
D. arthus reaction – t ype 2
E. contact dermatit is – type 4

15. Regarding adrenal hormones

A.aldosterone
B. cortisol
C. adre naline
D. ADH
E. re nnin

16. Regarding glucocoricoids

A. incre ases blood glucose level
B. re duce lymphoc yte count
C. increases basal metabolic rate
D. flu id retention
E. da mage gastric mu co sal barrier

17. Incre ased thyrox in secretion causes

A. we ight loss
B. re duction of appetite
C. reduction of sweating
D. tachycardia
E. tremors
18. Inflammatio n is c aused by;
A. prostaglandin
B. prostacyclin
C. lipoxin
D. leukotrienes
E. thromboxa ne

19. Atherosclerotic plaque cons ist of;

A. macrophages
B. foa m cells
C. neutroph ils
D. smooth muscles
E. RBC

20. Hormones secreted by pitu itary are;

A. ADH
B. GnRH
C. ACTH
D. TSH
E. Prolactin

21. Regarding coronary c irculation;

A. posterior part of t he heart mainly supplied by left coronary artery
B. interventricular septum is supplied by both right and left coronary arteries
C. significant a nastomosis between right and left coronary arteries occur in the
apex
D. thrombos is of anterior descending artery result s anteroseptal MI
E. duratio n of cardiac systole is more than diastole
22. Second degree heart block results;
A. incre ase cardiac output
B. increase stroke volume
C. prolo nged QRS duration
D. atrial rate is more than pulse rate
E. will progress in to ventricular tachycardia

23. Regarding cardiovascular changes in a athlete;

A. eccentric LVH
B. cause resting bradycardia
C. increase a rterial number in skeletal mu scles
D. increase DBP
E. causes enla rgement of coronary arteries

24. Coronary blood flow in creased in;

A. exerc ise
B. early systole
C. sympathetic activation
D. productio n of nitric oxide

25. Regarding cardiac output;

A. incre ased by high peripheral res istance
B. increased by paras ympathetic stimulation
C. increased by exerc ise
D. equals to hea rt rate * peripheral resistance
E. reduce in standing from supine position
26. Regarding V/Q ratio;
A. in pulmo nary embolism its reduced
B .there is no cha nge in ph ysiolog ical shunt
C. in lung a pex is more than lu ng base
D. increased in lobar collapse
E. reduced in foreign body obstruction

27. Regarding compliance of the lung;

A. it’s the change of volume in lu ng per u nit change of airway pressure
B. increased in pulmonary fibrosis
C. reduced in e mph ysema
D. beco me half after removal of one lung

28. G as exchange in respiratory system;

A. incre ased in lo bar pneumonia
B. co2 diffuse 20 times faster than o2
C. it’s not affected by molecular weight
D. its inversely proportionate to thickness of membrane

29. Regarding control of respiration;

A. automatical ly controlled by medullary respiratory centre
B. hypoxia control medullary respiratory centre
C. medu llary respiratory centre is directly inh ibited by opioids
D. hype rcapnia stimu late respiratory centre than hypoxia
30. Regarding GFR;
A. is 90 ml/min in normal healthy man
B. re duced in preg nancy
C. reduced when onc otic pressure is low
D. ANP increases GFR
E. metformin worsen the renal failure

31. Regarding CSF;

A.normal pressure is 20 -30 cm H2O
B. 3 r d & 4 t h ve ntricles connected via cerebral aqueduct
C.4 t h ventricle is communicate with subarachnoid space
D.CSF vo lume is 500ml
E. CSF produced by arachnoid villi

32. Regarding hypothalamus;

A. need for lo ng term memory
B. secrete TSH
C. control sympathetic system
D. release oxytocin

33. Features of cer ebellar lesion;

A. steriognos is
B. graph isthesia
C. two po int discrimination
D. vibration
E. pro pioce ption
34. Common pe roneal nerve lesion at fibiu la head causes;
A. affect e versio n of the foot
B.affect pla ntar flex ion
C. affect dorsiflexion
D. sensory impa irment over dorsum of the foot
E. abse nt ankle reflex

35. Gamma neuron is different from alpha neuron because gamma neuron;
A. always stimulated
B. stimulation causes contraction of muscle
C. supply to propioceptory fibers of the muscle
D. prese nt i n spinal c ord

36. Sensatio n of smell is different from sensation of taste by:

A. to sens itize nerves it should be dissolve
B. being visceral sens ation
C. having rapid adapt ation
D. having free nerve ending as receptors

37. Regarding cranial nerve leison s;

A. loss of anterior 2/3 of tongue taste – glossopharyngeal nerve
B. nasal vo ice – vagus nerve
C.upward gaze palsy – trochlear nerve
D. small pu pils – optic nerve
E. ptosis – fac ial nerve
38. Regarding sleep;
A. REM sleep associates with nightmares
B. stage 3 NREM sleep cons ist of sinusoidal waves in EEG
C. reduction of duration of REM sleep clos ure to morning
D. in narcole psy sudden onset of REM sleep is a feature
E. REM sleep accounts for 50% of sleep

39. Regarding spinal tract;

A. corticospina l tra ct decussate at pons
B. spina l cord end at L 3 level
C. substantia nigra is at midbrain
D. optic nerve is s ituated close to anterior commu nicating artery
E.s mell sensation is related to limbic system

40. 40 . Regarding CNS drugs,

A. I V Ceftriaxone is contr aindicated in ch ildren
B. S ide e ffects of dru gs acting on CNS will increase in elderly

41. Regarding SIRS ,

A. Affect gap junctions of endothelium
B. Caused by defective antithrombotic factors

42. Falciparum malaria,

A. I n u ncomplicated malaria first line treatment is Coartem.
B. No h ypnozoites
C. Resistance to artemether is common in vivax malaria
D. No re ported cases of indigenous malaria after eradication
43. Regarding H Pylori induced gastritis
A. Antral regio n can be affected Commented [h1]:

B. Da mage gastric mu cosal barrier

C. Increase gastric ac id secretion
D. Cause pe ptic ulcer
E. Cause megaloblastic ana emia

44. Hepatitis C
A. 80% leads to chronic infection
B. Tra nsmitted by sexually
C. cause hepatocellular CA
D. Diagnosed by immun oblot
E. Is a DNA virus

45. Regarding TB
A. IGRA assay detect latent TB
B. PCR can’t use for diagnos is of extrapulmonary TB
C. Cu lture done only for res istant cases in srilanka
D. Sputum fo r ZN test is highly sens itive
E. Mantoux detect immunoglobin for TB Bacilli

46. Cutaneous le ishmanias is ,

A. Caused by L . Donavani
B. Caused following ioxodo tick bite
C. Cause pa inful u lcer
D. Cause Ulcer is with raised edges and mid krater
E. Treated by sodiu m stibogluconate
47. Following test can be used for HIV infection monitoring ,
A. P24 a ntigen
B. HI V antibodies
C. RNA viral load
D. CD 8 cell cou nt
E. CD 4 cell count

48. Leprosy,
A. Type 1 reactio n oc cur in borderline leprosy
B. Nerve palsy can oc cur without skin lesions
C. Can culture organism in special culture mediu m
D. 1 month after treatment patient in noninfectious

49. Ja panese Encephalitis ,

A. Tra nsmitted by Culex mosqu ito
B. I n majority cause s evere disability
C. Treatment is ac iclovir
D. Can be diagnosed by CSF examination

50. In metabolic acidosis,

A. I ncreased H+ secretion
B. I ncreased pCO2
C. Reduced HCO3 excretion
D. Reduced K + excretion in DCT
E. Reduced ammonia production in renal tubules

51. Regarding hormones of GIT ,

A. Chole ysistokinin and prancreos ymin – relax sphincter oddi
B. Acetylcholine - reduce peristalsis
C. Secretin – release of pancreatic secretions
D. Progesterone – relax lower oesophageal sphincter

52. Regarding pa ncreatic hormone s secretion ,

A. Alpha cells - glucagon
B. Beta cells – insulin
C. Gamma cells – gastrin
D. Eps ilon cells – somatostatin

53. Regarding iron deficiency ana emia ,

A. Re duced TIBC
B. Re duced Ferritin
C. Reduced RDW
D. Soluble transferrin transporters reduced
E. Reduced M CHC

54. Regarding hormones,

A. TSH reduce T 4 release
B. ADH increase during sleep
C. TRH inhibit prolac tin secretion
D. Progesterone causes relaxation of lower oesophageal sph incter

55. Regarding GIT,

A. Ile al resection cau ses folic acid deficiency
B. Alcohol induces gastric acid secretion
C. Tramado l wil worse the hepatic ence phalopathy
D. Defecation is a spinal reflex

56. True o r False ,

A. M ycoplasma pneu monia can diag nosed by presence of cold agglutinins
B. Oculomotor nerve lies clos e to anterior cerebral artery