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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 airway
b. Secretions obstructing the airway
c. Cardiac arrest
d. Epilepsy

3. Smoking can cause:


a. Lung cancer
b. Thromboangiitis obliterans
c. Chronic bronchitis
d. Myocardial ischemia

4. Thromboangiitis obliterans involves which vessels:


a. Femoral
b. Popliteal
c. Anterior and posterior tibial
d. Aortoiliac

5. Which of these are included in the treatment of tobacco addiction?


a. Nicotine
b. Bupropion
c. Dopamine
d. Adenine

6. A female taking alcohol is more prone to develop toxicity and cirrhosis compared with male
when the same amount of alcohol is taken due to:
a. Decreased alcohol dehydrogenase in stomach
b. Decreased absorption
c. Large body size
d. Genetic factors

7. The characteristic feature of Korsakoff’s syndrome is:


a. Disorientation
b. Coarse tremor
c. Delirium
d. Amnesia

8. Which is seen in opioid poisoning?


a. Hyperventilation
b. Raised blood pressure
c. Bradypnea
d. Dyspnea
9. Low PO2 levels are found in:
a. Anemia
b. CO poisoning
c. Methemoglobinemia
d. Hypoventilation

10. Oxygen content of the arterial blood is reduced in all except:


a. Methemoglobinemia
b. Fallot’s tetralogy
c. CO poisoning
d. Fibrosing alveolitis

11. ASLO titres are used in the diagnosis of:


a. Acute rheumatoid arthritis
b. Acute rheumatic fever
c. Scarlet fever
d. Post infectious glomerulonephritis

12. Increased levels of CPK are seen in:


a. Cirrhosis
b. Hemoglobinopathies
c. Exhausting exercise
d. Hypothyroidism

13. Postural hypotension is not seen in:


a. Diabetes
b. Hypoglycemia
c. Tabes dorsalis
d. Use of antihypertensive drugs

14. Periorbital edema is not seen in:


a. Hypothyroidism
b. Acute renal failure
c. Cardiac failure
d. It is seen in all of the above

15. All of the following cause weight loss except:


a. Diabetes mellitus
b. Pheochromocytoma
c. Hyperthyroidism
d. Insulinoma

16. Plasmapheresis is recommended in all of the following except:


a. Hyperviscosity syndrome
b. Macroglobulinemia
c. Immune complex glomerulonephritis
d. Chronic active hepatitis
17. Sepsis syndrome includes the following:
a. Evidence of infective focus
b. Normal pulse
c. Tachypnea
d. Organ failure

18. A massive splenomegaly is seen in:


a. Chronic myelogenous leukemia
b. Visceral leishmaniasis
c. Gaucher’s disease
d. Myelodysplasia

19. Horner’s syndrome associated with pain shoulder and arm is suggestive of:
a. Aortic aneurysm
b. Myocardial infarction
c. Cervical spondylosis
d. Pancoast tumor

20. LDH is increased in:


a. Acute pancreatitis
b. Myocardial infarction
c. Pneumothorax
d. Cystic fibrosis

21. Macroglossia is seen in following except:


a. Amyloidosis
b. Acromegaly
c. Hyperthyroidism
d. Down’s syndrome

22. Clubbing is seen in:


a. Hepatorenal syndrome
b. Left-to-right shunt
c. Childhood asthma
d. Suppurative pneumonia

23. Carotid massage causes:


a. Increase of vagal tone
b. Decrease of sympathetic discharge
c. Decrease of vagal tone
d. Tachycardia

24. Rhabdomyolysis is characterized by:


a. Weakness of the affected muscles
b. Increased Mg+2
c. Increased K+
d. Decreased Ca+2
25. All of the following metabolic diseases may cause chronic or recurrent abdominal pain, except:
a. Acute intermittent porphyria
b. Addison’s disease
c. Hypercalcemia
d. Hyperkalemia

26. Sudden death can occur in all of the following cardiovascular conditions except:
a. Ventricular fibrillation
b. Massive myocardial infarction
c. Atrial fibrillation
d. Rupture of the aorta from dissecting aneurysm

27. Cor pulmonale may be seen in:


a. COPD
b. Marked obesity
c. Mitral stenosis
d. Kyphoscoliosis

28. Cyanosis is classically described as occurring:


a. If 1.5 g/dL of deoxyhemoglobin is present
b. If 3 g/dL of deoxygenated hemoglobin is present
c. If 5 g/dL of reduced hemoglobin is present
d. All of the above

29. If a third heart sound is heard, it is:


a. Always pathological
b. Indicative of aortic stenosis
c. Suggestive of poor left ventricular function
d. Suggestive of mitral stenosis

30. All of these produce a continuous murmur except:


a. Arteriovenous malformations
b. Ruptured aneurysm of sinus of Valsalva
c. Patent ductus arteriosus
d. Mitral valve prolapse

TTS pg. 1
1 Best way to treat street wounds…
a) Immediate suturing b) Cleaning with Saline & Debridement
c) Oral Abx d) Leave it alone
2 Erythema Nodosum can be caused by…
a) Sarcoidosis b) Post prim. Tbc
c) Sulphonamide Therapy d) Streptococcal Pharyngitis
3 Pruritus is seen in all except…
a) Hodgkin Lymphoma b) Obstructive Jaundice
c) Prim. Biliary Cirrhosis d) Lead Poisoning
4 Acne Vulgaris is rare in/on…
a) Face b) Back
c) Leg d) Scalp
5 Basal Cell Carc. of the Skin…
a) Accounts for the majority of
cancers on the exposed skin
b) Is almost unknown in blacks
c) Is an important hazard of
radiotherapy
d) May be caused by prolonged exposure
to arsenic
6 Ecthyma is a…
a) Deep Viral Infect. b) Superficial Bacterial Infect.
c) Deep Bacterial Infect. d) Non-infect. Inflammation
TTS pg. 2
7 Which of the following methods is thee best for controlling an outbreak of
MRSA of wounds in post-operative ward
a) Use of face masks by the
personal
b) Washing hands thoroughly before &
after dressing the wounds
c) Through fumigation of the
room
d) Pre-op Vancomycin to every patient
8 “Strawberry Tongue” followed by “Raspberry Tongue” is characteristic for…
a) Mumps b) Measles
c) Scarlet Fever d) Small Pox
e) Chicken Pox
9 Erysipelas is…
a) Lymphangitis due to
Staphylococcus
b) Lymphangitis due to
Streptococcus
c) Subcut. Inflam. due to
Streptococcus
d) Anaerobic Infection
10 Extensive chr. Candidiasis should arouse suspicion of…
a) HIV b) Tbc
c) Histoplasmosis d) Leprosy
11 Langhans Giant Cells are seen in…
a) Sarcoid Granuloma b) Tuberculous Granuloma
c) Leprosy d) Syphilis
12 Which are not features of Botulism…
a) Deranged pupillary reflexes b) Spasticity
c) Akinesia d) Rigidity
TTS pg. 3
13 The following is true about Tetanus…
a) Centrally placed spasm b) Contagious
c) Local Necrosis d) Prevented by Immunisation
14 Features of Klebsiella Pneumonia is/are…
a) High mortality b) Upper lobes are involved
c) Systemic disturbances d) Chocolate coloured sputum
e) All of the above
15 Staphylococcus Aureus commonly inhabits…
a) Nose b) Throat
c) Ear d) Skin
16 TBC is exacerbated by…
a) Gastrectomy b) Alcoholism
c) Diabetes d) All of the above
17 Lyme disease is caused by…
a) Borrelia Burgdorferi b) Borrelia Dutoni
c) Borrelia Recurrentis d) Borrelia Turicate
18 Toxic Shock syndrome is caused by…
a) Pseudomonas b) Staphylococcus
c) Gonococcus d) Penumococcus
TTS pg. 4
19 Bull neck in Diphtheria is due to…
a) Cellulitis b) Lymphadenopathy
c) Retropharyngeal Abscess d) Laryngeal Edema
20 All of the following may be complications of Pulmonary Tbc, except…
a) Empyema b) Bronchopleural Fistula
c) Bronchiectasis d) Pulmonary Haemorrhage
e) CO2 Retention
21 The best single laboratory aid in Dx of Tbc
a) Skin Test b) Chest X-Ray
c) Sputum Examination d) Histology
e) Physical Examination
22 Which of the following is NOT associated with Streptococcus…
a) Rheumatic Fever b) Scarlet Fever
c) Acute Glomerulonephritis d) Scalded skin syndrome
23 In prim. Syphilis the lesion seen is…
a) Indurated Ulcer b) Multiplicity of Lesion
c) Painful Ulcer d) Bleeding Ulcer
24 Following can be used for Dx of H. Pylori except…
a) Rapid Urease Test b) Urea Breath Test
c) Gastric Biopsy & staining
with Giemsa
d) SAFA Test
TTS pg. 5
25 Which of the following Ig is characteristically elevated in a parasitic infection
with Filariasis
a) IgA b) IgE
c) IgG d) IgM
26 Which of the following is false about H. Pylori…
a) Endoscopy is best for Dx b) Urease activity becomes negative in a
chronic carrier
c) Unless treated it will remain
life long
d) Gastric Carcinoma can develop in
chronic disease
27 A farmer rearing sheep presented with complaints ofFever, Weakness and
Hepatomegaly. Biopsy of the liver showed non-caseating Granulomas. These
are most likely due to an infection with…
a) Brucella Melitensis b) Brucella Canis
c) Francisella Tularensis d) Yersinia Pestis
28 Botulinum Toxin is used in the Tx of…
a) Facial Dystonia & Tics b) Tetanus
c) Guillain-Barre Syndrome d) Botulisms
29 Method of choice to confirm H. Pylori eradication is…
a) Urea Breath Test b) Culture
c) Serology d) Microscopy
30 Most common X-Ray finding of Pulmonary Tbc in AIDS is…
a) Upper zone haziness b) Diffuse Infiltrates
c) Multiple cavities d) Pneumonic Patch
1. Most common cause of spontaneous pneumothorax is:
a. Rupture of sub pleural bleb
b. TBC
c. Trauma
d. Asthma
2. All of the following cause transudation in pleural cavity except:
a. Empyema
b. Congestive heart failure
c. Nephritis
d. Meigs syndrome
3. Pleural fluid low in glucose is seen in:
a. RA
b. TBC
c. Mesothelioma
d. Empyema
4. Causes of hemorrhagic pleural effusions are:
a. Pulmonary infarction
b. Mesothelioma
c. Bronchial adenoma
d. TBC
5. Bilateral pleural effusion are seen in:
a. Nephrotic syndrome
b. Constrictive pericarditis
c. Congestive heart failure
d. All of the above
6. Bilateral malignant pleura effusion is most often seen in:
a. Breast cancer
b. Lung cancer
c. Mesothelioma
d. Lymphoma
7. Best position to see small pleura effusions on chest X-ray is:
a. Anterior-post view
b. Posterior-ant view
c. Latero-lateral view
d. Lateral decubitus view
8. Increased amylase in pleural fluid is seen in:
a. Malignancy
b. RA
c. Pulmonary infarction
d. TBC
9. All are features of ARDS except:
a. Pulmonary hypertension
b. Normal pulmonary artery wedge pressure
c. Hypoxemia
d. Low protein pulmonary edema
10. The thing that differentiate ARDS from cardiogenic pulmonary edema is:
a. Normal PO2
b. Normal pulmonary artery wedge pressure
c. Normal arterial-alveolar gradient
d. Normal PCO2
11. ARDS is associated with:
a. Acute pancreatitis
b. Trauma
c. Severe Falciparum malaria
12. The following about Klebsiella pneumonia are true except:
a. Red jelly sputum
b. Seen in alchoholics
c. Seen in older people
d. Penicillin is the drug of choice
13. Post-influenza bacterial infection of the lung is caused by:
a. Staphylococcus
b. Streptococcus
c. Pneumococcus
d. Hemophilus
14. Primary atypical pneumonia is caused by:
a. Mycoplasma
b. Mycobacterium kansasli
c. Photochromogens
d. Pneumocystis carinii
15. A person who has high fever, tachycardia, hemoptysis and lobar consolidation on chest
X-ray has:
a. Bronchopneumonia
b. Lobar pneumonia
c. Pulmonary edema
d. Pulmonary infarction
16. Nosocomial pneumonia is caused most often by:
a. Streptococci
b. Mycoplasma
c. Gram-neg. bacteria
d. Virus
17. All of the following organisms can cause interstitial pneumonia, except:
a. Pneumocystis carinii
b. Mycoplasma pneumonia
c. Legionella pneumophilia
d. Hemophilus influenza
18. Viruses causing pneumonia are all except:
a. CMV
b. Mumps
c. Herpes
d. Measles
19. True about Legionella pneumonia include:
a. Occurs in epidemics
b. Treated with penicillin
c. Associated with splenomegaly
d. Diagnosed from sputum
e. Are more common in children
20. Common presenting symptom of pneumocystis carinii is:
a. Cavity on chest X-ray
b. Hemoptysis
c. Breathlessness
d. Purulent sputum
21. Complications of lobar pneumonia does not include:
a. Lung abscess
b. Amyloidosis
c. Suppurative arthritis
d. Infective endocarditis
22. All are seen in emphysema except:
a. Decreased vital capacity
b. Hyperinflation
c. Ronchi
d. Damage to alveoli
23. Which pulmonary function change is not seen in COPD?:
a. Decreased residual volume
b. Decreased FEV
c. Low mid expiratory flow rate
d. Decreased diffusion capacity
24. Lung involvement in chronic bronchitis is:
a. Bilateral
b. Segmental
c. Lobar
d. Unilateral
25. All are true in the definition of chronic bronchitis exept:
a. Cough for 3 months
b. Productive cough
c. Symptoms more than 2 consecutive months
d. Hemoptysis
26. Pulmonary hypertension in COPD are due to:
a. Constriction of pulmonary vessels
b. Hypoxia
c. Interstitial fibrosis
d. Bronchoconstriction
27. Lung function tests in emphysema reveals:
a. Increased vital capacity
b. Decreased diffusion capacity for carbon monoxide
c. Increased diffusion capacity for carbon monoxide
d. Decreased total lung capacity
e. Decreased FEV1
28. True statements about emphysema is:
a. Breathlessness are always there
b. Diffusion rate of carbon monoxide is reduced
c. Restrictive pattern of lung disease
d. Long-term bronchodilators is not effective
29. The earliest manifestation of pulmonary embolism are:
a. Cyanosis
b. Hemoptysis
c. Dyspnea
d. Chest pain
30. Pulmonary embolism causes:
a. Bradycardia
b. Decreased cardiac output
c. Arterial hypoxemia
d. Acute load on right ventricle
31. Pulmonary embolism is most commonly caused by which of the following:
a. Trauma
b. Atherosclerosis
c. Thrombosis of the pelvis vessels
d. None of the above
32. I acute pulmonary embolism the most frequent ECG-finding is:
a. Sinus tachycardia
b. P-pulmonale
c. Right axis deviation
a) Atherosclerosis is inversely proportional to:

a) LDL level b) VLDL level

c) Chylomicron level d) HDL level

b) Prinzmetal angina has the following characteristics, except:

a) Pain at rest

b) ST elevation during the attack

c) Normal ECG without pain

d) Represents transmural ischemia

e) ST depression with pain

c) What is called the widow’s artery:

a) Superior mesenteric artery

b) Uterine artery

c) Internal mammary artery

d) Left anterior descending coronary artery

d) Enzyme appearing early in myocardial infarction:


a) CPK b) LDH

c) SGOT d) SGPT

e) The indication of percutaneur transluminal coronary angioplasy is:

a) Angina refractory to medical treatment

b) Single vessel disease

c) Proximal non calcified stenosis

d) Patient who had by pass surgery

e) All

f) The drug contraindicated in prinzmetal angina is:

a) Nifedipine b) Amyl nitrate

c) Propranolol d) Calcium channel blocker

g) The critical narrowing of coronary vessels to cause angina is:

a) More than 50% b) More than 60%

c) More than 70% d) More than 80%


h) Duration of pain in angina is:

a) 2-5 min b) 5-30 min

c) 30-60 min d) > 1h

i) Drug of choice in prinzmetal angina is:

a) Nitrates b) Diltiazem

c) Verapamil d) Propranolol

j) Indication for coronary bypass operation include all of the following except:

a) Severe angina not responding to medical therapy

b) Occlusive disease of the left main coronary artery

c) Tripple vessel disease

d) Previous infarction and congestive cardiac failure

k) Critical narrowing of coronary blood vessel is:

a) 70% b) 60%

c) 80% d) 90%
l) Riskc factors for coronary arterial disease:

a) High HDL

b) Low LDL

c) Increased homocystein levels

d) Decreased fibrinogen levels

e) Increased lipoproteins

m) Excersise testing is absolutely contraindicated in which of the following:

a) One week following myocardial infarction

b) Unstable angina

c) Aortic stenosis

d) Peripheral vascular disease

n) Hypertriglyceridemia is not caused by:

a) Diabetes mellitus b) Obesity

c) Alcohol d) Cigarette smoking

o) What is diagnostic of fresh myocardial infarction in ECG:


a) QT interval prolongation

b) P mitrale

c) ST segment elevation

d) ST segment depression

p) All of the following are indications for Treadmill testing, except:

a) To evaluate unstable angina

b) To evaluate unstable myocardial infarction

c) To asses outcome after coronary revascularization

d) To diagnose and evaluate the treatement of exercise induced


arrhythmias.

q) All of the following are risk factors for atherosclerosis except:

a) Increased waist-hip ratio

b) Hyperhomocysteinemia

c) Decreased fibrinogen levels

d) Decreased HLS levels


r) Acute coronary syndrome includes all except:

a) STEMI b) NSTEMI

c) Stable angina d) Unstable angina

s) Which of the following is common risc factor for coronary heart disease
except:

a) Family H/O of IHD

b) Decreased homocysteinemia

c) HDL < 40 mg/dL

d) Type 1 DM

t) Myocardial infarction most often results in:

a) Mitral stenosis

b) Aortic regurgitation

c) Aortic stenosis)

d) Mitral regurgitation

u) Thrombolytic therapy in acute MI is contraindicated in all except:


a) Healed peptic ulcer

b) Recent invasive procedure

c) Pulmonary hypertension

d) Pulmonary thromb embolism

v) Right ventricular infarction is associated with all except:

a) Cardiomegaly b) Arrythmia

c) Hypotension d) Normal JVP

w) Transient myocardial infarction in ECG is characterized by:

a) ST segment elevation b) Prolonged QRS

c) Pathological Q waves d) T wave inversion

x) Fibrous scar in myocardial infarction is well established by:

a) 6 weeks b) 6 months

c) 6 days d) 30 days

y) The complication of MI are all, except:


a) Pulmonary embolism

b) Systemic embolism

c) Dissection of aorta

d) Ventricular fibrillation

z) Drugs of choice to relieve pain in myocardial infarction:

a) Morphine b) Fortwin

c) Diazepam d) NSAID

aa) Drugs useful in acute MI are all, except:

a) Nifedipine b) Aspirin

c) ACE inhibitors d) Metoprolol

ab) All of the following may cause ST segment elevation on ECG, except:

a) Early repolarization variant

b) Constrictive pericarditis

c) Ventricular aneurysm

d) Prinzmetal angina
ac) The amino acit which is associated with atherosclerosis is:

a) Lysine b) Homocystein

c) Cystein d) Alanine

ad) A patient presents with intense chest pain of 2 hrs duration. ECG
shows ST depression in leads I and V1-V5. There is associated T inversion
and the CPK-MB is elevated. Which of the following should be included in
his management:

a) Nitroglycerine drip b) Aspirin

c) Coronary angiography d) Streptokinase

e) i.v metoprolol

Correct :1)d 2)c,e 3)d 4)a 5)All 6)c 7)c 8)a 9)a 10)d 11)a

12)c,e 13)c 14)d 15)c 16)a 17)c 18)c 19)b 20)d 21)a,c,d

22)d 23)c 24)a 25)c 26)a 27)a 28)b 29)b 30)All


e. Hypertension
1 Quick reduction of blood pressure is done in:
a) Cerebral infarct
b) Hypertensive encephalopathy
c) Myocardial infarction
d) Any patient with hypertension

2 Hypertention can be caused by:


a) Renin
b) Antigiotensin 1
c) Angiotension 2
d) PG

3 Hypertension with increased renin levels is seen in:


a) Segmental infarction
b) Fibromuscular hyperplasia of renal artery
c) Aortic stenosis
d) Hyperaldosteronism

4 Renin dependent hypertension includes


a) Primary hyperaldosteronism
b) Essential hypertension
c) Renovascular hypertension
d) Pheochromocytoma Hypertension
e)
5 Benign hypertension is characterised by :
a) Hyaline arteriosclerosis
b) Fibrinoid necrosis
c) Calcified vessel wall
d) Berry aneurysm

6 Which does not cause hypertension –


a) Dobutamine
b) Ritodrine
c) Dopamine
d) Methoxamine

7 Malignant hypertension is diagnosed when-


a) Associated malignancy is present
b) Diastolic bloodpressure 120mgHg
c) Papilledema associated with elevated Bloodpressure
d) All of the above

8 Treatment of hypertension emergency is-


a) Hydralazine
b) Glukokinase
c) Propranolol
Furosemide
9 Calcium blocking agents of use in treatment of hypertension include-
a) Prazosin
b) Verapamil
c) Captopril
d) Nifedipine
e) Lidoflazine

10 Severity of blood pressure is graded mainly by –


a) Systolic B.P.
b) Pulse pressure
c) Diastolic pressure
d) Response to treatment
e)
11Renin plays important role in –
a) Renovascular hypertension
b) Malignant hypertension
c) Coronary artery disease
d) Essential hypertension

12 Which of the following antihypertensives will you not prescribe to a truck driver –
a) Clonidine
b) Hydralazine
c) Aldomet
d) Propranolol
e)
13 Which one of the following is of most serious prognostic significance in a patient of
essential hypertension –
a) Diastolic B.P. greater than 130mmHg
b) Transient ischaemic attacks
c) Left ventricular hypertrophy
d) Papilloedema and progressive renal failure

14 In benign hypertension commonest vascular pathology is –


a) Atherosclerosis
b) Fatty infiltration of intima
c) Fibrinoid necrosis
d) Hyaline arteriosclerosis

14 Pathological change in malignant HT is –


a) Benign nephrosclerosis
b) Hyperplastic arteriosclerosis
c) Cystic medical necrosis
d) Hyaline arteriosclerosis
15 All of the following are feature of malignant hypertension EXCEPT –
a) Grade IV hypertensive retinopathy
b) Haemolytic blood picture
c) Renal failure
d) Respiratoy failure
16 Drug of choise for hypertensive crisis associated with acute nephritis is –
a) Sodium nitroprusside
b) Hydralazine
c) Reserpine
d) Calcium channel blockers
e) Propranolol

17 A young patient presented with B.P. of 190/120 mmHg without any clinical symptom
and fundus examination is normal, treatment od choice
a) Oral Nitroglycerine
b) IV Nitroglycerine
c) Oral Enalapril
d) IV Enalapril
e) Sublingual short acting Nifedine

A 40 years old male patient, is suffering from type II diabetes mellitus and hypertension.
Which of the following antihypertensive drug should not be used in such patients –
a) Lisinopril
b) Hydrochlorthiazide
c) Losartan
d) Trandolpril

A young hypertensive patient has serum K 2.8 meq/2 and increased aldesterone level with
decreased plasma renin activity. The likely is/are –
a) Renal artery stenosis
b) Ectopic ACTH syndrome
c) Diuretic therapy
d) Conns syndrome
e) Liddle’s syndrome

HeartFailure

Examination of a patient in a supine position reveals jugular veins from the base of the neck
to the angle of the jaw. This finding indicates:

a) decreased venous return.


b) increased central venous pressure.
c) increased pulmonary artery capillary pressure.
d) left-sided heart failure.

What is not a primary cause of CHF?


a) Cardiomyopathy
b) High blood pressure
c) Coronary artery disease
d) Poliomyelitis
Congestive heart failure is a condition which is chronic and which requires constant
attention to diet, a reduction of stress, and daily medicines. Which of the following would most
increase the burden on an already-weakened heart?
a) Narcolepsy
b) Having a drink
c) Obesity

Medicine is an important component of treatment for congestive heart failure. Which one of
these is NOT prescribed routinely for CHF?
a) Benzodiazepine
b) Digitalis
c) ACE-inhibitors
d) Diuretics

What is the technical term which describes the coronary arteries as being narrowed by
hardened plaque, which limits the free flow of oxygen and overworks the heart?
a) Aoritis
b) Thrombosis
c) Artherosclerosis
d) Atherosclerosis

Sometimes, people with congestive heart failure develop arrhythmias of the heart. These
irregular rhythms can be conducive to developing a blood clot. Physicians frequently treat
people with 'blood thinning' medicines which require regulation of the density of the blood.
Which of these is the name for a blood-thinner?
a) Tetracycline
b) Erythromycin
c) Warfarin
d) Amoxicillin

There are two kinds of CHF, depending on which of the heart's two ventricles are affected.
If the problem stems from the left ventricle, the prime pumping mechanism in the heart, which
symptoms tend to dominate?
a) Diarrhea
b) Enterophathy
c) shortness of breath and fatigue
d) Hepatic dysfunction

What is the name for shortness of breath when lying down?


a) Apnea
b) Orthopnea
c) Platypnea
d) Epistaxis
What is the condition in which the lungs retain extra fluid? This condition is a part of left
ventricular impairment.
a) pulmonary edema
b) Asthma
c) Whooping cough
d) Pneumonia
e)

Which of the following is NOT a risk factor for cardiovascular disease?


Smoking
a) Elevated blood cholesterol
b) Stress
c) Consumption of aspirin
d) Obesity

Which of the following decreases blood volume by increasing the excretion of sodium and
fluids?
a) Aspirin
b) Diuretics
c) Nitroglycerin
d) Digitalis
e) Renin

Which of the following is used to treat the symptoms of heart failure by increasing the
strength of heart contractions (positive inotropy)?
a) Diuretics
b) Digitalis
c) Nitroglycerin
d) Renin
e)

The components of fallots tetralogy are ?


a) VSD
b) Pulmonary stenosis
c) Dextra position of aorta
d) Right ventricular hypertrophy
e) All are correct
f)

Commonest type of cong.heart disease seen in adults ?


ASD
VSD
TOF
FDA
Biscupid aortic valve
A continous murmur is heard in ?
PDA
VSD
ASD
TOF

Congenital heart disease usually not associated with syncope is ?


a) Ebsteins anomaly
b) Tetralogy of fallot
c) ASD
d) Pulmonary stenosis
e)

Most common type of ASD is ?


a) Ostium primum
b) Ostium secundum
c) Sinusvenosus type
d) Endocardial cushion defect

Causes of death in untreated coarctation of aorta may include all of the following except ?
a) Bacterial endocarditis and aortitis
b) Rupture of aorta
c) Myocardial infarction
d) Congestive heart failure
e) Cerebrovascular accidents

Which is incorrect about PDA ?


a) Right to left shunt
b) Endocarditis is common
c) Can calcify
d) In untreated leads to pulmonary hypertension

Causes of cyanosis ?
a) TOF
b) PDA
c) Tricuspid atresia
d) Eisenmengers complex
e) TGA

Left ventricular hypertrophy is seen in ?


a) ASD
b) MS
c) Aortic stenosis
d) Carcinoid syndrome

Clinical features of ostium secondum type of atrial septal defect are all except. ?
a) Occurrence of congestive failure in childhood
b) Atrial arrhythmias
c) Wide and fixed splitting of the second heart sound
d) Mid diastolic rumble along the left sterna border

Sudden death is common in ?


a) Mitral stenosis
b) Atrial VSD
c) Aortic stenosis
d) PDA

In aortic regurgitation the left ventricle is ?


a) Hypertrophic
b) Dilated
c) Small
d) Atrophic

In aortic regurgitation the murmur is ?


a) Early diastolic
b) Late systolic
c) Early systolic
d) Mid diastolic

Hemoptysis is seen in ?
a) Aortic stenosis
b) Pulmonary stenosis
c) Mitral stenosis
d) Tricuspid stenosis

Angina pectoris occurs most commonly in ?


a) MS
b) AS
c) MR
d) AR

Murmur of pulmonary stenosis is best heard over ?


a) 2nd left intercostals space
b) 4th left intercostals space
c) 6th intercostals space on left side in midclavicular line
d) None of the above

Normal size of the mitral valve ?


a) 2-4cm
b) 4-6cm
c) 1-2cm
d) 6-10cm

Aortic regurgitation is seen in all except ?


a) Rheumatic fever
b) Infective endocarditis
c) Marfan syndrome
d) Myocardial infarction

Angina & syncope in same patient is seen in ?


a) Aortic stenosis
b) MVP
c) MS
d) AR

Which one of the following is characteristic of mitral valve prolapsed syndrome ?


a) Rough mid diastolic murmur
b) Collapsing pulse
c) Loud first heart sound
d) Mid systolic click

Earliest sign of deep vein thrombosis is ?


a) Calf tenderness
b) Rise in temperature
c) Swelling of calf muscle
d) None of the above

White leg is due to ?


a) Femoral vein thrombosis and lymphatic obstruction
b) Deep femoral vein thrombosis
c) Lymphatic obstruction only
d) None of the above

All of the following are seen in deep vein thrombosis except ?


a) Pain
b) Discolouration
c) Swelling
d) Claudication

Varicose veins are seen in ?


a) DVT
b) superficial venous thrombosis
c) AV fistula
d) Prolonged standing
e) Obesity

Which of the following is true about varicocele except ?


a) Incompetent valves of testicular vein are responsible for varicocele
b) 90% are on the left side
c) Asymptomatic cases require surgery
d) None of the above

Small vessel vasculitis are ?


a) Classical PAN
b) Wegeners granulomatosis
c) Giant cell arteritis
d) HSP
e) Churg-struass syndrome

Kawasakis disease has the following features except ?


a) Coronary artery aneurysm
b) Conjunctival suffusion
c) Thrombocytopenia
d) Desquamation of the skin of fingers and toes

In takayasu arteritis there is ?


a) Intimal fibrosis
b) Renal hypertension
c) Coronary aneurysm
d) Alla of the above

Skin manifestations of polyarteritis include ?


a) Livido reticulosis
b) Hyper pigmentation
c) Subcutaneous infarct
d) Bullous dermatitis
Treatment of wegners granulomatosis is ?
a) Steroids
b) Cyclosporine
c) Radiotherapy
d) cyclophosphamide
All of following may be associated with peptic ulcer except:
a) Alcoholic cirrhosis
b) Zollinger ellison syndrome
c) Plummer vinson syndrome
d) Primary Hyperparathyrodism

The most common cause of drug induced esophagitis is:


a) Flagyl
b) Indomethacin
c) Doxycycline
d) Steroids

Which is true about achalasia cardia:


Failure of relxation of lower oesophageal sphincter
Associated with Vit. A dificiency
Not a premalignant condition
It is a normal phenomenon

Following is true about Barret`s esophagus:


a) Occurs in 3rd decade
b) Lined by transitional epithelium
c) Not reversible by medical therapy
d) It is a physiological condition
e)
Treatment of drug induced gastritis:
a) Mesoprostol
b) H2- receptor blockers
c) Antacids
d) Famotidine

Following are sites of Cushing`s ulcer except:


a) Oesophagus
b) Stomach
c) Proximal duodenum
d) Distal duodenum

Progressive dysphagia is seen in:


a) Esophagus Carcinoma
b) Globus hystericus
c) Presbyesophagus
d) Achalasia

True regarding GERD is all except:


a) Avoid coffee & Tea
b) Transient lower esophageal relaxation
c) Lower esophageal sphincter length and its pressure is important
d) Proton pump inhibitor is the treatment of choice

All are complications of ulcerative colitis exept:


a) Haemorrhage
b) Stricture
c) Malignant change
d) Polyposis
e) Oesophageal varices

Post diarrhoeal paralytic ileus occurs in:


a) Hypokalaemia
b) Hypomagnesemia
c) Hupocalcemia
d) All of the above
e)
Jejunal lactase deficiency lead to diarrhoea with the ingestion of:
a) Milk
b) Gluten
c) Meat
d) Rice

Specific test for malabsorption:


a) D-xylose test
b) Schilling test
c) Fecal fatestimation
d) Hydrogen breath test
e)
Patient with congenital lactose deficiency will experience distention, flatulence and
diarrhea on ingestion of:
a) Glucose
b) Sucarose
c) Milk
d) Eggs

Rare complication of ulcerative colitis:


a) Pseudopolypi
b) Carcinoma
c) Toxic dilatation
d) Massive hemorrhage

There are other diseases associated with celiac disease, which:


a) About 10% have an itchy rash on the extremities, buttocks, neck, trunk, and scalp, called
dermatitis herpetiformis.
b) Recurrent painful mouth ulcers,
c) Insulin-dependent diabetes
d) Autoimmune thyroid disease
e) All of the above
With celiac disease, malabsorption means:
a) Poor absorption of food nutrients
b) Absence of absorption of food nutrients
c) Slow absorption of food nutrients
d) Fast absorption of food nutrients

Hemoblia is characterised by:


a) Jaundice
b) Biliary colic
c) Malena
d) Fever

Whenever there is a stone in bile duct which of the following:


a) Bile salts
b) Bilirubin
c) Amylase
d) SGPT

Conjugated hyperbillirubinemia is seen in:


a) Gilberts syndrom
b) Criggler Najjar Typ 1
c) Criggler Najjar Typ 2
d) All of the above
e) Dubin Jonsons syndrome

The characteristic feature of chronic alcoholic liver disease is:


a) Fatty liver
b) Cirrhosis
c) Perivenular fibrosis
d) Hyaline Sclerosis

In heapatic cirrhosis, which of the following is increased:


a) Alpha 1 globulin
b) Alpha 2 globulin
c) Gama globulin
d) All of the above

Antibiotics are usful in all of the following condition except:


a) Whipple disease
b) Tropical syndrome
c) Celiac disease
d) Blind loop syndrome

Which of the following is associated with acute pancreatitis:


a) Hypoparathyroidism
b) Thiazides
c) Pregnancy
d) Corticosteroids

Acute pancreatitis can be caused by:


a) Alcohol
b) Hypertriglyceridemia
c) Azathioprine
d) All of the above

What are contraindications for the use of oral antidiabetic drugs:


a) Pregnancy
b) breastfeeding
c) severe infection
d) Renal dysfunction
e) All
If a person is receiving an insulin drip, what is likely to happen to potassium levels?
a) Decrease
b) Increase

Most common tumor of pancreas is:


a) Insulinoma
b) Gastrinoma
c) APUD`S omas
d) VIPoma

Complications of chronic pancreatitis include the following except:


a) Portal hypertension
b) Obstructive jaundice
c) Duodenal obstruction
d) Renal artery aneurysm

Serum amylase levels raised in all except:


a) Duodenal ulcer perforation
b) Pancreatitis
c) Appendicitis
d) Small bowel strangulation

A 33-year-old man has never been vaccinated for hepatitis B. Serologic tests reveal
negative hepatitis B surface antigen (HBsAg) and positive antibody to surface antigen.
Which of the following conditions does this serologic pattern best fit with?
a) previous hepatitis B infection
b) chronic active hepatitis
c) acute hepatitis B infection
d) poor prognosis
e) need for vaccine to hepatitis B
A 33-year-old woman develops mild epigastric abdominal pain with nausea and
vomiting of 2 days duration. Her abdomen is tender on palpation in the epigastric region,
and the remaining examination is normal. Her white count is 13,000/mL, and amylase is
300 U/L (25–125 U/L). Which of the following is the most common predisposing factor for
this disorder?

a) drugs
b) gallstones
c) malignancy
d) alcohol

Which of the following is a risk factor for Helicobacter pylori infection:


a) excess exposure to antibiotics
b) female sex
c) alpha1-antitrypsin deficiency
d) low socioeconomic indicators
e) proton pump inhibitor therapy
1.Acromegaly is characterised by all except:
a) Diabetes
b) Muscular hypertrophy
c) Enlarged nasal sinuses
d) Increased heel pad thickness
2 . Hyperprolactinemia is an adverse side effect of :
a) Amantidine
b) Bromocriptine
c) Levodopa
d) Metoclopramide
3 .Diabetes insipidus is treated with:
a) Thiazides
b) Oxytocin
c) Desmopressin
d) Glibenclamide
4.A patient sustained,head trauma leading to transection of pituitary stalk,all,occur exept
a) DM
b) Adrenocortical insufficiency
c) Dibetes insipidus
d) Hypothyroidism
5 .Causes of hypopituitarism are all,except
a) Cancer breast
b) Cancer bronchus
c) Chromophillic adenoma
d) Acidophilic tumor
6.Empty sella syndrome is often characterized by:
a) Pituitary tumour
b) Cretinism
c) Acromegaly
d) None of above
7. In a patient presenting with polyouria and polydipsia the diagnosis is likely be:
a) Diabetes mellitus
b) Diabetes Insipidus
c) Psychological
d) Hyperthyroidism
8.Cardiac manifestations of Grave's disease would include all of the following except:
a) Wide pulse pressure
b) Atrial fibrillation
c) Pleuropricardial scratch
d) Aortic insufficiency
9 .All are feauture of subacute thyroiditis except:
a) Pain in the neck
b) Fever
c) Raised ESR
d) Raised readioactive 131 I uptake

Correct:1.b ,2 .d, 3 a,c , 4.a, 5.d, 6.d, 7.a,bc, 8.d , 9 d


10.All of the following conditions are known to cause diabetes insipidus except:
a) Multiple sclerosis
b) Head injury
c) Histiocytosis
d) Viral encephalitis
11.The early feature of hypothyroidism is :
a) Low T3
b) Low T4
c) Rise in TSH
d) Delayed deep tendon reflexes
12.Which is not a feauture of hypothyroidism:
a) Myxedema
b) Carpal tunnel syndrome
c) Menorrhagia
d) Increased appetite
13.Radio iodine uptake in endemic goitre
a) Normal
b) Increased
c) Decreased
d) Erratic
14.Features of hyperthyroidism are:
a) Pericardial effusion
b) Menorrhagia
c) Delayed ankle relaxation
d) Diarrhoea
e) Heat intolerance
15.Regarding myxedema the following are true except:
a) Swollen,Oedematous look of face
b) Impotency,amenorrhoea
c) B,M.R increaed by 30-45%
d) Dullness,Loss of Memory
16.Commonest symptom of endemic goitre
a) Asymptomatic
b) Hypothyroidism
c) Lump in neck
d) Hyperthyroidism
17.Regarding Hashimotos thyroiditis which is false:
a) Autoimmune thryoditis
b) Plasma cell and lymphocytic infiltration
c) Hypothyroid state
d) Hypoparathyroid state

Correct:10.a ,11.c, 12 .d, 13.b 14.d,e, 15.c, 16.a ,17.d


18.Treatment in Hashimoto's disease
a) Carbimazole
b) Thyroxine
c) Radio iodine
d) Subtotal thyroidectomy
19 .Cardiopulmonary manifestations of hyperthyroidism :
a) Tachycardia
b) Sinus bradycardia
c) Cardiomyopathy
d) Low output cardiac failure

20 .The feautres of Addison's disease is/are:


a) Weight loss
b) Skin pigmentation
c) Hyponatremia
d) Hyperkalemia
e) all Above

21 .A 50-year-old female is 170 cm tall and weighs 75 kg. There is a family history of diabetes
mellitus. Fasting blood glucose is 150 mg/dL on two occasions. She is asymptomatic, and physical
exam shows no abnormalities. The treatment of choice is
a) Observation
b) Medical nutrition therapy
c) Insulin
d) Oral hypoglycemic agent

22 Insulin resistance syndrome includes


a) Dyslipidemia
b) Hypertension
c) Hyperuricemia
d) High HDL

23 . A 15-year-old is brought to the emergency department in a coma. An alert ambulance attendant


notes that the patient's breath smells like acetone. This observation is most consistent with which of the
following diagnoses?
a) Alcohol intoxication
b) Diabetic hyperosmolar coma
c) Diabetic ketoacidosis
d) Heroin overdose
e) Profound hypoglycemia

24 .Which one of the following investigations is most sensitive for early diagnosis of diabetic
nephropathy:
a) Serum creatinine level
b) Creatine clearance
c) Glucose Tolerance Test
d) Microalbuminuria
25 .Fungal lung infection commonly seen in diabetics is:
a) Actiomycosis
b) Murcomycosis
c) Aspergillosis
d) Coccidiodomycosis
26 .Which of the following statements is true regarding type 1 diabetes mellitus:
a) Family history is present in 90 % cases
b) Dependent on insulin to prevent ketoacidosis
c) Time of onset is usually predictable
d) Autoimmune destruction of beta cells occur
e) Mostly occurs in chlidren
27 .Which is the feauture of Dawn phenomenon:
a) Early morning hypoglycemia
b) Early morning hyperglycemia
c) Breakfast hypoglycemia
d) Post prandial coma
28. Somogyi phenomenon is:
a) Hypoglycemia followed by hyperglycemia
b) Hypeglycemia followed by hypoglycemia
c) Glycosuria with normal blood sugar
d) Reactive hypoglycemia
29 .All of the following are assosiated with insulin resistance except:
a) Acantosis nigricans
b) Lipodystrophy
c) Gout
d) Werner Syndrome
30. Impaired glucose tolerance can cause:
a) Neuropathy
b) Nephropathy
c) Retinopathy
d) IHD(ischemic heart disease)

Correct :18.b 19.a,c, 20.e 21.b 22a,b, 23.b 24.d 25 b 26.b,d,e 27.b 28.a 29.c 30.d
. UMF-Tgm, General medicine 6th year (topics with quastions and answers for the final exam in
familymedicine)
Topics: ENT, Ophtalmology and Nephrology.

ENT and Ophtalmology.

e) Downbeat nystagmus is characterized by:


a. post fossa lessions
b. vestibular lesions
c. labyrinthin lesion
d. cerebellar lesion

f) Ataxic nystagmus is seen in leisions of:


a. medial longitudinal fasciculus
b.Cerebellum
c. Labyrinth
d. Vestibular Nc.

g) At birth the following structures are of adult size except:


a.Typanic cavity
b. Mastoid antrum
c. Malleolus
d. Tympanic ring

h) A patient with furuncle of ear is presented. What is the commonest treatment?


a. Ear pack with 10% ichtamon in glycerine wick
b. Antibiotic and rest
c. antibiotic and drainage
d. Analgesic

i) In which sinus is sinusitis in children most common?


a. Frontal
b. Maxillary
c. Ethmoid
d. Sphenoidal

j) Most common sinusitis in children is?


a. Frontal
b. Maxillary
c. Ethmoi
d. Sphenoidal

7.The components of Horner's syndrome are all except:


a. Anhydrosis
b. Miosis
c. Proptosis
d. Enophtalmosis
8. The normal AV-ratio in fundoscopy is:
a. 3:4
b. 3:2
c. 1:2
d. 1:3

9. Commonest cause of papilloedema is:


a. Rise in intracranial tension
b. Optic neuritis
c. Optic atrophy
d. Chronic nephritis

10. All are causes of Argyll-Robertson pupil except:


a. Syringomyelia
b. Disseminated sclerosis
c. Chronic alcoholism
d. Asyphyxia and deep anaesthesia

11. Horner's syndrome is characterized by all except:


a. Miosis
b. Exophtalmus
c. Anhydrosis
d. Loss of cilliospinal reflex
12. Gaze nysrtagmus is seen in:
a. Miners
b. Infants
c. Myastena gravis
d. Diabetes mellitus

13. Ataxic nystagmus means a lesion in the:


a. labyrinth
b. Cerebellum
c. Vestibule
d. Medial longitudunal fasciculus

14. See-Saw nystagmus is usually seen with:


a. Craniopharyngomas
b. Pineal tumors
c. Hydrocephalus
d. Viral encephalitis

15. Retinitis pigmentosa is transmitted as:


a. Sporadic
b. Autozonal recessive
c. X-linked
d. All of these

16. Suconjuctival hemorrage occurs in all conditions except:


a.passive venous conjesion
b.Pertusis
c. Trauma
d. high intraoccular tension

17. in patients with acute glaucoma the prophylactic treatment for the other eye is:
a. Peripheral iridectomy
b. Anterior sclerotomy
c. Irienclesis
d. Scheie's operation

Nephrology

18. Majority of primary infection of the urinary tract are caused by:
a. E.coli
b. streptococcus fecalis
c. Pseudomonas
d. Proteus
19. polycystic kidneys kan be associated with:
a. Cysts in liver and Lungs
b. Coarctation of aorta
c. Berry aneurisms
d. a and c are correct

20. Worst prognosis in renal cell carcinoma is associated with:


a. Haematuria
b. Size > 5cm
c. Invasion of renal vein
d. Pulmonary secondary metastases

21.Which of the following findings in urnalysis is correct regarding acute glomerulonephritis?


a. Proteinurea
b. White blood cell casts
c. Redblood cell casts
d.Hyaline casts

e) Which of the following treatments is adequate in slowing down the evolution of renal disease in
a diabetic patient with proteinurea on urinalysis?
a. Calcium chanell blockers
b. ACE-inhibitors
c. Beta blockers
d. Loop diuretics

f) Which of the following alternatives is most indicative in the screening of prostate cancer?
a. prostate ultrasound
b. DRE (digital rectal examination)
c. PSA (prostate specific antigen)
d. PSA & DRE

ae) Which of the following changes is seen in a patient with chronic kidney failure due to chronic
analgesic (NSAID) ingestion?
a.Glomerulosclerosis
b. Papillary necrosis and tubulointerstitial inflamation
c.Cortical necrosis
d. Tubular necrosis

e) In a 65 years old male patient with reccurent severe artritis in his big toes and elevated
creatinine levels. Which the most likely cause to his symtoms?
a.Glomerulonephritis
b.Vascular injury
c. Renal parenchymal uric acid cristals
d. Uric acid kidney stones

26.In which part of the normal kidney nephron is most of the water reabsobed from?
a. Ascending loop of Henle
b. Descending loop of Henle
c. Proximal convulted tubule
d. Collecting duct

e) In a young patient with renal colic, urinalysis showing hexagonal crystals and a cyanide-
nitroprusede test of urine is positive. Which of the following is the most likely diagnosis?
a. Cystineuria
b. Thalasemia
c. Sarcoidosis
d. hereditary glycinuria

e) In pasient with sepsis, hypotension and oliguria following a pneumonia infection. Despite
antibiotic treatment and i.v fluids with the evolutin of (ARF) acute renal failure. Which of the
following is the most likely cause of ARF?
a. Antibiotic treatment
b. Acute infectiouse (GN) Glomerulonephritis
c.Contrast nephropathy
d. (ATN) Acute tubular necrosis

e) Which of the following findings is not compatible with diabetic nephropathy?


a. Nephrotic range proteinuria
b. Microalbuminuria
c. Hypertension
d. Red blood cell (RBC) casts in urine

f) A 27-year-old woman with well-controlled bipolar affective disorder, treated with lithium,
develops polyuria and polydipsia.
Which of the following statments is the correct cause of her symtoms?
a. Central diabetes insipidus (DI)
b. Nephrogenic DI
c. Primary polydipsia
d. Osmotic diuresis
'
Which of the following is true of iron deficiency anemia
1. Iron binding capacity is decreased
2. Increased number of sideroblast
3. Serum iron concentration is decreased
4. All of above

Anemia can manifest as all except


1. Headache
2. Vertigo
3. Delirium
4. Tinnitus
Low serum iron is seen in-
1. Iron deficiency anemia
2. Sideroblastic anemia
3. Thalasemia traits
4. Sickle cell anemia

Microcytic hypochronic anemia is seen in-


1. Sideroblastik anemia
2. Thalasemia
3. Vitamin C deficiency
4. All of above
Treatment of choice for aplastic anemia is-
1. Blood transfusions
2. Oxymethalone
3. Bone marrow transplantation
4. Azathioprime

Aplastic anemia can be caused by all except-


1. Cholramphenicol
2. Hepatitis A
3. Analgin
4. Kanamycin
All are true features of sickle cell anemia except-
1. Leucopenia
2. Pulmonary hypertension
3. Heart enlargement
4. Fish mouth vertebra

The total daily loss of iron amounths to about-


1. 0.1 mg
2. 0.5 mg
3. 1 mg
4. 10 mg
Most iron is stored in combination with-
1. Sulphate
2. Ferritin
3. Transferin
4. Ascorbic acid
Diagnostic of iron deficiency anemia is-
1. Decreased serum iron
2. Decreased ferritin
3. Decreased Hb A2
4. Microcytic hypochronic anemia

Megaloblastic anemia in blindloop syndrome is due to-


1. Vitamin B12 deficiency
2. Intrinsic factor deficiency
3. Iron absorbtion defect
4. Folate deficienc
Bone marrow transplantation is not indicated in-
1. Aplastic anemia
2. Congenital spherocytosis
3. Thalasemia
4. Acute myeloid leukemia in first remission

A 16 years old female presents with generalized weakness and plapitations. Her Hb is
7g/dl and peripheral smear shows microcytic hypochromic anemia, reticulocyt count is 0,8
% serum bilirubin is 1 mg%. whats is the most likely diagnosis?
1. Iron deficiency
2. Hemolytic anemia
3. Aplastic anemia
4. Folic acid deficiency
A child 5 years old presents with anemia. On examination his MVC was 70 and MCH
wa 22. Blood erythrocyt protoporphyrin was high. Whats the probably diagnosis?
1. Thalasemia
2. Iron deficiency syndrome
3. Porphyria
4. Sickle cell anemia
Viral infection in hemolysis is seen in-
Hepatitis B
Hepatitis C
Prolonged fever
Hepatitis A
CMV
Anemia in chronic renal failure (CRF) is due to-
Decreased erythropoietin production
Iron deficiency
Hypoplastic bone marrow
Decreased vitamin- B 12
Decreased folate levet
Iron absorbtion is increased in-
Iron deficiency anemia
Pregnancy
All types of anemia
Malignancy
Macrolytic anemia

Polycythemia:
Causes of secondary polycythemia may include-
1. Chronic cor pulminale
2. Renal carcinoma
3. Cerebellar haemangioblastoma
4. All of above
True about polycycthemia vera is all exept-
Bleeding
Thrombosis
Decreased ESR
infection
Lymphoma:
lymphadenopathy is seen in all of the following except-
primary syphilis
donovanosis
LGV
Chancroid
Treatment of choice for stage III a Hodgkin’s lymphoma-
Chemotherapy
Radiotherapy
Combination of chemotherapy and radiotherapy
excision
stage B symptom of Hodgkins lymphoma include-
weight loss
fever
bone marrow infiltration
pruritus
anemia
Myeloma:
multiple myeloma is characterized by all exept-
CRF (chronic renal failure)
Gum hyperplasia
Lytic bone lesions
Respiratory infections
In multiple myeloma following are seen-
Increased calcium
Sclerotic bone lesion
Bone deposition
Renal failure
Leukemia:
Regarding leukemia which of the following is correct-
ALL is common in children
ALL is seen in the fifth decade
Bone marrow transplant is done in ALL
d) Bleeding tendency in AML

Leukemoid reaction is seen in-


acute infection
myelomatosis
hemorrhage
erythroleukemia
blast crisis in CML is indicated by all except-
lympadenopathy
high fever
sudden enlargement of spleen
bleeding tendencies
a patient suffering from chronic myeloid leukemia, Hb falls from 11 g% to 4g%. in a
short span of time, and splenomegaly occurs. The cause could be-
accelerated CML
CML in blast crisis
Ineffective erythropoiesis
Myelofibrosis
Leukemia is predisposed to by-
Blooms syndrome
Fanconis anemic
Ataxia telangiectesia
Klinefelthers syndrome
B cell prolymphocytic leukemia patients differ from those with B cell chronic
lymphocytic leukemia in-
Presenting at a younger age
Having a lower total leucocyte count
Having prominent lymphadenopathy
Having a shorter survival

Neuro–psychiatric disorders

Neurologic

1. Spinal puncture should be used to determine


a) spinal fluid pressure
b) wheter a block exists
c) types and number of cells present
d) protein and sugar levels
e) all of the above

2. The condition where babinski sign is positive but deep tendon jerks are absent is -
a) cerebral hemorrhage
b) cerebral palsy
c) cerebral tumor
d) Frederich's ataxia
3. Primary optic nerve atrophy is a recognized complication of:
a) glaucoma
b) disseminated sclerosis
c) Paget's disease of the skull
d) neurosyphilis
e) ethambutol therapy

4. Recognized causes of motor neuropathy include:


a) diabetes mellitus
b) porphyria
c) Guillain-Barre syndrome
d) Friedrich's ataxia
e) diphtheria

5. Pin point pupils, loss of consciousness and hyperpyrexia is seen in


a) subarachnoid hemorrhage
b) pontine hemorrhage
c) cerebral infarction
d) thalamic syndrome

6. Which of the following statements about hallucinations are correct?


a) acoustic hallucinations are a common complication of amphetamine
bsychosis
b) paranoid symptoms are characteristic of "cocaine psychosis"
c) amphetamines can induce hallucinations
d) hallucinations are inevitable symptoms of schizophrenia
e) purely visual hallucinations suggest a functional abnormality

7. Neuropsychiatric symptoms of hepatic insufficiency include:


a) a reverse sleep pattern
b) Argyll-Robertson pupils
c) myelopathy with paraplegia
d) perseveration signs
e) diagnostic EEG abnormalities

8. A classic type migraine is characterized by which of the following?


a) it cannot be diagnosed if there are no prodromal symptoms
b) it shows a gradual progression
c) a homonymous hemianopsia is present
d) there is edema of the papilla
e) frequently occuring acoustic hallucinations

9. The most common complication of vagotomy is


a) diarrhea
b) dryness of the mouth
c) tachycardia
d) bleaching
10. Intentional tremor in young patients is commonly due to
a) Cerebellar disease
b) Wilson's disease
c)Parkinsons
d) Head injuries

11. Mask like faces is seen in


a) Parkinsons
b) Disseminated sclerosis
c) after strokes
d) Pseudo bulbar palsy

12. Brain tumor has the following symptoms except


a) bitemporal hemianopia
b) loss of consciousness
c) headache
d) vomiting

13. Brain death means loss of


a) cortical function
b) brain stem function
c) spinal reflexes
d) corneal reflex

14. Cerebral edema is characteristically seen in poisoning by


a) Methanol
b) Lead
c) Carbon monoxide
d) All of the above

15. A 40 year old female presents with a history of sudden onset of headache and nausea which passed
off with rest and analgesics. Later she developed blurring of vision for a few days. On the day of
admission she had developed third nerve palsy with neck rigidity. The temperature was 37,7°C. The
most likely diagnose is
a) acute attack of migrane
b) viral encephalitis
c) sub-arachnoid hemorrhage
d) severe hypertension

16. The following are true in early onset Alzheimer's disease


a) Associated with chromosomal anomalies
b) profound retardation is seen
c) necrosis if brain neurons
d) none

17. Cervical cord injury does NOT cause


a) Horner's syndrome
b) loss of sensation over face
c) spasticity of foot
d) atrophy with fasciculations of lower limb

18. Demyeliation is seen in


a) Multiple Sclerosis
b) AIDS
c) Progressive multifocal leukoencephalopathy
d) Poliomyelitis
e) Leukodystrophy

19. True about Alzheimer's disease


a) mutation in the APP gene
b) Autoantibodies
c) Aluminium is arisk factor
d) viral infections have increased risk
e) Hereditary

20. In amyotrophic lateral sclerosis true is


a) present with seizures
b) lesion in anterior horn cells
c) corticospinal tract
d) hyporeflexia

21. Progressive dementia is seen in


a) Alzheimers disease
b) Creutzfeld-Jakob disease
c) Huntingtons disease
d) All

22. Which is a feature of classical migrane


a) Symptoms are better with increasing age
b) No aura
c) early treatment aborts attack
d) does not respond to ergotamine

23. A35 year old male with no history of DM or hypertension presents with sudden onset bursting
headache and altered sensorium. Most prbable cause would be
a) Meningitis
b) Encephalitis
c) Intracerebral hemorrhage
d) Intracranial tumor

24. Anterior cerebral arterial occlusion can cause


a) controlateral lower leg weakness
b) urinary incontinence
c) Hemianopia
d) Hemianesthesia of controlateral half of face

25. Features of Parkinsons disease


a) decreased blinking
b) Spasticity
c) on-off phenomenon
d) decreased muscular power
e) Tremor

26. A middle aged man presents with progressive atrophy and weakness of hands and forearms. On
examination he is found to have slight spasticity of the legs, generalized hyper-reflexia and increased
signal in the cortoco-spinal tracts on MRI. The most likely diagnosis is
a) Multiple Sclerosis
b) Amyotrophic lateral sclerosis
c) Subacute combined degeneration
d) Progressive spinal muscular atrophy

Psychiatric

27. Which of the following observations help to differentiate neurosis


from psychosis?
a) neurotic patients characteristically disclaim reality
b) endogenous experiences cause excitation in neurosis
c) real illusions can occur in neurosis
d) associative function is not affected in neurosis
e) the 'ego' is intact in neurotic patients

28. A 15-year-old girl presents to the emergency room with severe


weight loss. On examination she is cachectic, bradycardic, and
hypotensive. The first course of action should be to:
a) determine the family dynamics
b) administer a high-protein and carbohydrate diet
c) draw blood for a serum electrolyte determination and then
start intravenous feeding
d) arrange to have the patient admitted to the psychiatric ward
e) prepare for electroconvulsive therapy

29. Common complications of alcoholism include:


a) cerebral damage
b) gastritis
c) suicide
d) polyneuropathy
e) all of the above

30. Which of the following has an etiologic role in anorexia nervosa?


a) cultural influences
b) hypothalamic-pituitary abnormalities
c) parental over-regulation
d) schizophrenia

31. Case Study:


A 62-year-old man seeks evaluation for weakness, a loss of initiative,
a loss of weight, and abdominal discomfort. He appears to be
depressed. Possible diagnoses can include:
a) dementia
b) hyperthyroidism
c) pain killer abuse
d) pancreatic carcinoma

32. Characteristic symptoms of schizophrenia include:


a) compulsive thoughts
b) progressive dementia
c) depersonalization
d) waking up early in the morning
e) thought withdrawal

33. Characteristic symptoms of morphine withdrawal include:


a) excessive yawning
b) hypotension
c) muscle spasms
d) dry conjunctiva
e) diarrhea

34. Characteristic symptoms of acute manic psychosis include:


a) lack of insight
b) flight of ideas
c) confabulation
d) distractibility
e) depression in the family history

35. Characteristic symptoms of depression include:


a) diminished concentration
b) hallucinations
c) hypochondriasis
d) delusions of persecution
e) weight loss