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1.30-year-oldladyhasdevelopedweaknessofbothlegs3daysaftereatingataseafoodrestaurant.Shehasbeenhavingloosewaterystoolsabout10timesperdayandhastakenORS.Onexaminationsheishavingflaccidparaplegia,areflexiawithabsentplantars.Armandtruncalexaminationisnormal.Cranialnervesandhighmentalfunctionarenormal.FirstdifferentialDiagnosisis?
a.Multiplesclerosisb.Malingeringc.Gullian barresyndromed.Dyselectrolytemia
2.Punchedoutulcersinoesophagusaresuggestiveof?a.Eosinophilicesophagitisb.Refluxesophagitisc.Herpesoesophagitisd.Chemicaloesophagitis
3.A50-year-oldtallthinsmokerwaspuffingonacigarettewhenhedevelopedasevereboutofcough.Subsequentlyhedevelopedrespiratorydistress,wasunabletotalk,developedcyanosisandwasrushedtothehospital.OnexaminationRR– 30/minwithretractionsandhyper-resonantpercussionnoteonrightmiddlelobe.Auscultationshowsabsentbreathsoundsinrightmiddlezone.Whatisthediagnosis?
a.Acuteexacerbationofchronicbronchitisb.Pneumothoraxc.Bronchopleuralfistulad.Acutecor pulmonale
4.75-year-oldhypertensivepatienthasdevelopedasuddenonsetleftsidedfacialasymmetryandinabilitytouseleftarm.HewasrushedtothehospitalwhereanurgentNCCTheadwasperformedafter3hoursofonsetofsymptoms.Commentondiagnosis?a.Rightsidedintraparenchymalhaemorrhageb.Rightsidedacuteischemicstrokec.Rightsidedintraventricularhaemorrhaged.Rightsidedcorticalvenousthrombosis
5.A40-year-oldmanishavingsevereepigastricpainepisodesrespondingtoPPIbutrecurswhenhedoesnottakePPI.Nowhehasalsodevelopeddiarrhoeawithpurgerateabout5-6timesperdayforlastonemonth.TheDiarrhea isnonresponsivetofasting.UGIEshowsagiantduodenalulcer.Whattestshouldbedonenexttodiagnosetheetiology?a.Breathureatestb.72-hourprolongedfastingtestc.Secretinstudyd.Smallintestinalmucosalbiopsy
6.30-year-oldladyishavingbutterflymalarrashwithanemia andjointpains.Whichisthebesttestfordiagnosisofthispatient?
a.Anti-smithantibodyb.DsDNAc.ANAd.Anti-histoneantibody
7.35-year-oldalcoholiccomestoyouwithreportofabnormalSchillingtest.Youhaveprescribedpancreaticsupplementstothepatientandschilling’testhasbecomenormal.Whatisthelikelyaetiologyofabnormalschillingtest?
a.TypeAgastritisb.Chronicpancreatitisc.Whipplediseased.Bacterialovergrowthsyndrome
9.Commentondiagnosisofthis40-year-oldmanwithhighgradefeverandbreathlessnessforlast3days.Onexaminationtracheaisshiftedtoleft,RR=30/minwithdullnessonpercussioninrightinframammaryandinfra-axillaryareas.Airentryisreducedonrightside.CXRwasperformedandIVazithromycinwasstarted.Diagnosis?
a.Pneumothoraxb.Hydropneumothoraxc.Pneumoniad.Parapneumonicpleuraleffusion
10.Whichofthefollowingconditionhasmuscleweaknesswithpreserveddeeptendonreflexes?a.Guillainbarresyndromeb.Polioc.MyastheniaGravisd.Leadpoisoning
11.Oedipuscomplexis?a.Expressivesexualfeelingofparentforoppositesexchildandrivalrywithsamesexparentb.Repressedsexualfeelingofparentforoppositesexchildandrivalrywithsamesexparentc.Repressedsexualfeelingofchildforoppositesexparentandrivalrywithsamesexparentd.Repressedsexualfeelingofchildforsamesexparentandrivalrywithoppositesexparent
12.25-year-oldyoungladyhasthecomplaintshownintheimageandherANAtestisstronglypositive.Whichdiseasewouldyoususpect?a.SLEb.Sclerodermac.Buerger diseased.Polyarteritisnodosa
13.A20-year-oldcollegestudentcomplainsofthunderclapheadacheandnuchalrigidity.Whatisbesttesttoconfirmthediagnosis?
a.GuardedLumbarpunctureb.NCCTHeadc.CECTheadd.MRA
14.40-year-oldrickshawpullerisadmittedduetomultipleepisodesoffocalseizuresoccurringonalmostdailybasisforlastfewweeks.Hismedicationstatusisnotknown.NCCTheadimageisshownbelow.Whatinvestigationwillbebesttoestablishetiology oflesions?a.CSFimmunoblotforneurocysticercosisantigenb.CSFELISAForcryptococcalantigenc.Beta1,3glucantestd.IgM/IgGtitrefortoxoplasmosis
15.20-year-oldladyishavingcomplaintsofbilateralptosisonwatchingtelevision,chewingmuscleandshouldergirdleweakness.Whichtestwouldbeusefulforherdiagnosis?a.Anti- Endomysial antibodiesb.Anti- P/Qvoltagegatedcalciumchannelantibodiesc.Anti- Ach- receptorantibodytiterd.Anti- synthetasesyndrome
16.Notseeninmassivepulmonaryembolismexcept?a.Inter-ventricularseptumdeviationb.FallofSBPc.Pulmonaryplethorad.ElevatedJVP
17.TypeofanaemiaisSLEis?a.Microcytichypochromicb.Normocyticnormochromicc.Macrocyticanemiad.Dimorphicanemia
21.NotusefulfordiagnosisofDiabetesmellitus?a.Fastingsugarof>126mg%b.RBSof>200mg%c.HbA1Cof>6.5%d.PPvalueof>250mg%
22.Mostcommoncauseofacutecor-pulmonaleis?a.PAHduetoPulmonaryembolismb.PAHduetoDeepVeinthrombosisc.PAHduetoLVpathologyd.PAHduetoidiopathicreason
24.Whichofthefollowingleadstomelena?a.Constipationb.Rectalpolypc.Angiodysplasiacolond.Dileufoys lesion
25.Whichofthefollowingdiseasesleadstometabolicalkalosis?a.Massivehematemesisb.Gastricoutletobstructionc.Dengueshocksyndromed.Acutetubularnecrosis
26.Mostcommontumor associatedwithsuperiorvenacavasyndrome?a.Lungcancerb.Lymphomac.Metastasisd.Thyroidcancer
27.FirstantibodytodetectrecentinfectiondevelopingwithDaneparticleis?a.HbsAgb.Anti-HbsAgc.Anti-HbcAg IgMd.Anti- HbeAg IgM
28.A50yearoldmanhaspresentedwithoneepisodeofhematemesis.OnvitalexaminationHR=110/minwithBPof110/80mmHg.Systemicexaminationshowsenlargedspleenwithdilatedtortous veinsaroundtheumbilicus.Firstdifferentialdiagnosisis?a.KalaAzarb.Decompensatedcirrhosisc.Fattyliverd.TenseAscites
29.Whichofthefollowingisnotincludedintriadofmeningitis?a.Feverb.Headachec.Nuchalrigidityd.Alteredsensorium
31.Whichisbestformanagementofbacterialmeningitis?a.Cefepime+Vancomycinb.Cefotaxime+Amikacinc.Ampicillin+Gentamycind.Cefepime+gentamycin
32.Caprgras syndromeisseenin?a.Severedepressionb.Paranoidschizophreniac.Delusionaldisorderd.Othellosyndrome
34.45yearoldmanhaslittleinterestinactivitiesheformerlyenjoyed.Hehaslost8kgweight;andhewakesup2hoursbeforealarmgoesoff.Hesaysmyfamilywillbebetterwithoutme.Hefeelsbetterineveningthaninmorning.Whatisthebesttreatmentforthisperson?a.Phototherapyb.SSRIc.Psychotherapyd.C.B.T
35.A3-year-oldboyshowsnointerestorconnectionwithhisparentsandneitherplayswithotherchildreninplayschool.Hedoesnotspeakvoluntarilyandisfascinatedwatchingrotatingobjects.Hescreamsfiercelywhenhisenvironmentischanged.Diagnosisis?
a.Autismb.ADHDc.Aspergersyndromed.Rettsyndrome
36.A7-year-oldchildfrequentlygetsintotroubleatschool.Heisfriendlywithotherchildrenbutgetsaggressivetowardstheteacherandprincipalincludingbitingtheschoolattendant.Diagnosisis?a.Autismb.ADHDc.Oppositionaldefiantdisorderd.SeparationAnxietydisorder
37.28-year-oldwomansaysshefrequentlyexperiencespalpitations,shortnessofbreathandchronicindigestion.Shesayssheaslongasshecanremembershefeelstenseandnervousformostpartofthedayforlast2years.Diagnosisis?
a.Generalisedanxietydisorderb.Depressionc.Schizophreniad.Panicdisorder
38.A50-year-oldwomanwith30yearhistoryofbeingunwellandsaysherfamilyphysicianhasnotbeenabletodiagnoseorhelpher.HersymptomsofunwellnessincreaseswithstressDiagnosisis?
a.Hypochondriasisb.Somatizationdisorderc.Post-traumaticstressdisorderd.Bodydysmorphicdisorder
39.Thefollowingclinicalfindingisfoundinallexcept?a.Lungabscessb.Bronchiectasisc.Chronicbronchitisd.Inflammatoryboweldisease
40.Metabolicacidosiswithhyperkalemia isseenin?a.Hyperaldosteronismb.Vomitingc.Acutekidneyinjuryd.Diarrhea withseveredehydration
41.A34-year-oldpathologistcomplainsoffeelingsleepyallthetimeandfallsasleepinlabeveryday.Hestoppeddrivinghisbikebecausehefellasleepdrivinghismotorcycle.Whatiscorrectaboutthecondition?
a.Morbidobesitywithsnoringb.HLADR2c.Malingeringd.Sleeptalking
43.A30yearoldmansaysthatmostnightsinlast1yearhelaysawakeinbedfor2-3hoursbeforehefallsasleep.Hissleepisofteninterrupted.Thenextdayhefeelstiredandforgetfulandmakesmultiplemistakesinhiswork.Alldrugswillbeusefulforhimexcept?a.Flunazepamb.Zolpidemc.Rameltond.Modafinil
44.Mostprevalentpsychiatricdisorderis?a.Anxietydisordersb.Bipolardisordersc.Stressdisodersd.Schizophrenia
45.Respiratoryacidosisisseenin?a.Highaltitudeb.Anxietyneurosisc.Inadequatepost-operativeanalgesiad.MyasthenicCrisis
46.AllaretrueaboutBuspironeexcept?a.Non-BZDanxiolyticagentnotproducingtoleranceb.Noabusepotentialc.Non-sedatingd.Preferredtoinitiatetreatmentingeneralisedanxietydisorder
48.Symptomsofalcoholwithdrawalappearmaximumbyhowmuchtimeaftercompletecessationofdrinkinginchronicalcoholic?a.0-1daysb.2-3daysc.3-4daysd.4-5days
50.Markersforheavyalcoholconsumption?a.GammaGlutamyltransferaseandCarbohydratedeficienttransferrinb.GammaGlutamyltransferaseandMeancorpusclevolumec.HighMCHandincreasedserumuricacidd.LowMCHandLowMCV
51.Alcoholwithdrawalisassociatedwithallexcept?a.Formicationb.Lilliputhallucinationsc.Mcewan signd.Auditoryhallucinations
52.Allarecorrectaboutlithiumusageexcept?a.Therapeuticlevelsforacutemaniaare0.6-0.8meq/dlb.Shouldbestopped24hoursbeforesurgeryc.Causesincreasedurineoutputandragingthirstd.Inhibitshydrolysisofinositol1phosphate
54.MasterandJohnsonsqueezetechniqueisusedfor?a.Frigidityb.Prematureejaculationc.Vaginismusd.Impotence
55.BestforAlcoholdeaddictionis?a.Chlordiazepoxideb.Diazepamc.Acamprosate– Naltrexoned.Antabuse(Disulfiram)
56.OCDdevelopsduetodefectinwhichphaseofpsychosexualdevelopment?a.Oralphaseb.Analphasec.Phallicphased.Genitalphase
58.Besttreatmentforphobia?a.Systemicdesensitizationb.Cognitivebehaviourtherapyc.Betablockerd.Alloftheabove
59.AllareincludedinBleuler’scardinalsymptomsofschizophrenia(4A)?a.Autismb.Ambivalencec.Affectdisturbancesd.Apraxia
68.Whichconditionhaswatermelonstomach?a.Linitis plasticab.Menetrier’s diseasec.TypeAgastritisd.Gastricantralvascularectasia
70.Drugpreferredfornegativesymptomsinschizophrenia?a.Clozapineb.Haloperidolc.Chlorpromazined.Insulincoma
71.A55-year-oldmanwithhypertensionistoldtogethisBPcheckedregularly.OneveryvisithisBPistoldtohimandheistaughtmentalrelaxationtechniquestolowerBPwithemphasisoncontinuingmedicationdaily.Thisisanexampleof?
a.Biofeedbackb.Cognitivebehaviourtherapyc.Aversiveconditioningd.Systemicdesensitization
72.MetabolicacidosiswithHypokalemia isseenin?a.Diarrheab.Acutetubularnecrosisc.Ethyleneglycolpoisoningd.Rhadbomyolysis