81) Paracetamol overdose- 60 hr prognostic value.
a) Serum prothrombin time.
b) .
c) .
d) .
e) .
82) 48 hrs after first MI attack, patient has second attack, serum marker which is of value
a) trponin I,
b) troponin T,
c) serum LDH,
d) CK-MB levels.
e) .
83) Patient has aortic valve disease, signs of blood loss, previous scar on abdomen
a) aortoenteric fistula
b) .
c) .
d) .
e) .
84) Signs of blood loss, upper GI endoscopy -normal, Faecal Occult blood test -negative, next appropriate investigation
a) Mesenteric angiography.
b) .
c) .
d) .
e) .
85) Longstanding hypertension, Investigation to find cause
a) isotope scan,
b) USG abdomen ,
c) Renal angiography.
d)
e) .
86) Patient on renal transplant for six months develops ARF likely cause
a) acute rejection,
b) due to nephrotoxicity of Cyclosporin,
c) Acute urinary tract obstructi
d) .
e) .
87) Patient asthmatic on salmeterol, presents with titubation and postural tremor, cause
a) Parkinsonism,
b) salmeterol induced tremor,
c) essential tremor,
d) Thyrotoxicosis.
e) .
88) H/o sudden unsteadiness in gait, headache, vomiting and raised BP, cause
a) acute cerebellar haemorrhage,
b) Subarachnoid haemorrha
c) .
d) .
e) .
89) Patient presents with intermittent tetanic spasms, serum corrected calcium-1.8 mmol/l next appropriate investigation to find cause
a) serum V it D levels,
b) serum PTH levels,
c) CT br
d)
e) .
) Patient presents with solitary cervical lymph node, on biopsy -papillary Ca thyroid, thyroid gland-normal. Treatment?
a) radioiodine,
b) external irradiation,
c) radical cervical node dissection,
d) Total thyroidectomy.
e) .
91) Patient presents with mal-absorption, small bowel biopsy-PAS laden macrophages in lamina propria, diagnosis
a) whipple disease,
b) Celiac disease.
c) .
d) .
e) .
92) A 16 yr female brought with thyrotoxic featu(d), mother on long term thyroxin replacement therapy diagnosis
a) factitious hyperthyroidism,
b) graves disease,
c) Sub acute thyroiditis.
d) .
e) .
93) Patient presents with generalised erythema and pustules, past h/o of psoriasis and patient put on corticosteroids for past 2 weeks. Appropriate management
a) hospital admission ,
b) PUVA,
c) oral erythromycin on outpatient basis
d)
e) .
94) In Ankylosing spondylitis which is true-
a) positive trendelenberg test,
b) global restriction of LS movement,
c) increased lumbar lordo
d) Decreased angle of stretch test.
e) .
95) In enteropathic arthritis which is most likely
a) Inflammation of sacroiliac joint.
b) .
c) .
d) .
e) .
96) Patient with RA for 20 yrs, renal function-protein-++++, haematuria-++ presents with CRF, most likely due to
a) secondary amyloidosis
b) .
c) .
d) .
e) .
97) patient presents with deteriorating vision, confusion and headache, serum IgM-+++,ESR-^^^ ,cause
a) myeloma,
b) monoclonal gammopathy of undetermined origin ,
c) Waldenstorm macroglobulinem
d)
e) .
98) Which of the following test is of prognostic value in Leukaemia?
a) cytogenic karyotyping,
b) cytochemistry,
c) immunophenotyping,
d) Bone marrow trephine biopsy.
e) .
99) Patient presents with 5 day H/o of generalised rash anterior and posterior cervical lymphadenopathy and 1 day h/o of fleeting polyarthritis of large joints. Diagnosis
a) measles ,
b) rubella,
c) lyme disease,
d) gonococcal arthritis
e) .
100) patient develops generalised rash after taking antibiotic for mild sore throat -most likely
a) Infectious mononucleosis.
b) .
c) .
d) .
e) .
101) patient presents with exudates over pharynx, and cervical lymphadenopathy and weakness of leg muscles, H/o of sore throat.
a) Diphtheria,
b) streptococcus,
c) Infectious mononucleosis
d)
e) .
102) patient changed from naproxen to rofecoxib due to GI side effects, which statement is true?
a) Rofecoxib acts on different enzyme than naproxen.
b) .
c) .
d) .
e) .
103) patient is put on Carbamazepine 200mg and asked to stop taking alcohol, after 4 days ,his requirement goes to 400mg .cause
a) auto induction of carba,
b) autoinhibiton by carba,
c) decreased bioavailablil
d) Increased first pass effect.
e) .
104) which of following are likely in delayed blood transfusion reaction?
a) conjugated hyperbilirubinemia,
b) hemoglobinuria,
c) hemosiderinuria,
d) Positive coomb’s test.
e) .
105) patient presents with muscle ache and ARF, haematuria+++ cause
a) Rhabdomyolysis.
b) .
c) .
d) .
e) .
106) patient presents with headache, dizziness, O/E plethoric, Hb-18.9, PCV-0.56 platelet count-500+, next appropriate investigation
a) red cell mass ,
b) LAP score,
c) USG abdo
d) Bone marrow biopsy
e) .
107) patient presents with decreased vibration sense in foot and muscle weakness of leg, H/o of pernicious anaemia, likely due to
a) Vitamin B12 deficiency
b) .
c) .
d) .
e) .
108) patient presents with fatigue-blood-spherocytes appropriate investigation-
a) Red Cell osmotic fragility test,
b) HB electrophoresis,
c) USG abdomen,
d) bone marrow biopsy
e) .
109) patient with sickle cell disease presents with Blood- reticulocytes-decreased, Hb-decreased, which is likely
a) parvovirus infection
b) .
c) .
d) .
e) .
110) patient presents with changing mole, on skin biopsy it is malignant melanoma with Breslow thickness
c) HIV viral 100,000copies/ml etc
d) .
e) .
124) which of following karyotype presents with short stature
a) 45XO,
b) 47XXY
c)
d) .
e) .
125) patient with RA presents with pain and reddening of right eye ,visual acuity and retinal fundoscopy normal, which is likely
a) Conjunctivitis,
b) Scleritis,
c) Acute closed angle glaucoma,
d) Uvei
e) .
126) patient presents with cough and breathlessness chest X-ray-dense shadow in right upper lobe. Likely cause
a) Aspergilloma,
b) Tb,
c) Invasive bronchopulmonary aspergillosis
d) .
e) .
127) patient after extensive burns with breathlessness no fever, neutrophil count normal cause for deteriorating Pao2
a) ARDS,
b) Pneumonia
c)
d) .
e) .
128) patient presents with infection and bruising blood counts low which drug results in this picture
a) Azathiprine,
b) Cyclophosphamide,
c) Prednisolone
d) .
e) .
129) isolated B cell deficiency
a) Prednisone,
b) Cyclophosphamide,
c) Azathioprine,
d) Methotre
e) .
130) An MI patient prescribed with Aspirin, mechanism of action
a) Inhibits cyclooxygenase activity
b) .
c) .
d) .
e) .
131) patient on valproate becomes pregnant what is likely effect
a) Neural tube defect in foetus
b) .
c) .
d) .
e) .
132) opening snap in MS is indicative of
a) That the valve is mobile
b) .
c) .
d) .
e) .
133) patient presents with ankle swelling bilateral, elevated JVP, clear lung fields,
a) RVF infarction,
b) Cardiogenic shock,
c) Pericardial tampon
d) Pulmonary artery hypertens
e) .
134) patient complains of intermittent chest pain which increases on breathing and ECG-diffuse St segment elevation.
a) Myopericarditis
b) .
c) .
d) .
e) .
135) patient on long term NSAID presents with renal failure -which is likely
a) Interstitial nephritis
b) Nephrocalcinosis
c) .
d) .
e) .
136) drug of choice for L pneumophila-
a) Doxycycline,
b) Erythromycin
c)
d) .
e) .
137) nurse has needle stick injury what is immediate step?
a) Wash hands thoroughly under running water,
b) Antiretroviral treatm
c) Test for hepatitis a, hepatitis c, HIV, etc...
d)
e) .
138) patient with dysuria, urethral swab-neutrophils, no organism drug of choice
a) Metronidazole,
b) Ciprofloxacin,
c) Nitrofurantoin
d) .
e) .
139) patient presents with multiple lustreless nails and no other skin lesions. Investigation
a) Nail clippings for mycology,
b) Examine nail under wood light.
c)
d) .
e) .
140) which is suggestive of glomerular nephritis
a) Presence of red cell casts in urine.
b) .
c) .
d) .
e) .
141) patient presents with breathlessness, chest x-ray-bilateral hilar adenopathy, next appropriate investigation
a) Serum ACE activity
b) .
c) .
d) .
e) .
142) H/o suggestive of Benign intracranial hypertension
a) .
b) .
c)
d) .
e) .
143) patient develops extensive facial and tongue oedema after taking food, also develops rash to contact with cosmetics serum C3 C4 levels are normal.
a) C1 esterase deficiency,
b) Idiopathic angioedema,
c) Food allergy,
d) Mastocytosis
e) .
144) patient with unilateral knee swelling is tapped, the joint fluid is sterile .One week later he develops painful knee swelling, next appropriate step
a) Start IV antibiotics,
b) Arthroscopic wash
c) .
d) .
e) .
145) patient presents with ulcer above the medial malleolus, appropriate investigation
a) Venous duplex scan,
b) Ankle-brachial artery pressure index etc
c)
d)
e) .
146) patient with prepatellar bursitis is confirmed by
a) Joint line tenderness,
b) Quadriceps muscle wasting
c) .
d) .
e) .
147) treatment of monoarticular joint pain in gout
a) Ibuprofen
b) .
c) .
d) .
e) .
148) dry cough in ACE inhibitor therapy is due to accumulation of
a) Bradykinin
b) .
c) .
d) .
e) .
149) During drug trial, injection causes elevation of BP .which of following is the likely drug?
a) angitensin1,
b) angiotensin2,
c) .
d)
e) .
150) which of following statement is true?
a) The direct nephrotoxic potential of diclofenac is increased by Lithium
b) .
c) .
d) .
e) .
151) ward outbreak of MRSA which is appropriate
a) Antibiotic treatment culture positive patients
b) .
c) .
d) .
e) .
152) question on control of pain even after NSAID and opioid
a) .
b) .
c) .
d) .
e) .
153) change from hydrocortisone to prednisone; calculate dose based on hydrocortisone value.
a) .
b) .
c) .
d)
e) .
154) frank diabetes and BMI - 35 which is appropriate drug?
a) Metformin,
b) Acarbose,
c) Glibenclam
d) Weight reduction
e) .
155) Drug which reduces tremor in Parkinsonism
a) amantidine,
b) selegiline
c) .
d) .
e) .
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