AMC-MCQs

Discussion in 'Australian Medical Council (AMC) EXAM' started by Joseph., Oct 20, 2007.

  1. Joseph.

    Joseph. Guest

    A man 56 yrs old, had a swollen knee. The aspiration shows cloudy fluid, neutrophils and no bacteria on microscopy and culture. What is the most likely diagnosis?
    a- Septic arthritis
    b- Reiter’s
    c- Gout
    d- Rheumatoid arthritis
    e- Osteoarthritis

    Osteoarthritis is:
    a- ESR is increased or decreased
    b- Night stiffness
    c- Calcium pyrophosphate crystals are found in synovial fluid
    d- Sodium aurothiomalate can be used in treatment
    e- Serum calcium is increased

    Brain stem aneurysm:
    a- Papilloedema

    Which of following would least likely be associated with primary hypothyroidism?
    a- 72 yrs old woman with a large multinodular goitre
    b- 9 yrs old boy, short and retarted
    c- 28 yrs old woman with 3 yrs of menorrhagia
    d- 16 yrs old girl anovulatory cycles
    e- 2 yrs old boy with jaundice and constipation

    Photo of penis (held with no gloves!). Little round lesions for six weeks itching. What is the diagnosis?
    a- Fleas
    b- Scabies
    c- Mosquito bites
    d- Syphilis
    e- Lympho Granuloma venereum

    (J Type)
    With regards to colorectal carcinoma which is correct?
    a- Over 50% of cancers detected with screening are Dukes A
    b- Flexible sigmoidoscopy picks up more than 40%
    c- Faucal occult blood testing is good screening for the population
    d- 20% will be missed by faucal occult blood because the cancer is not bleeding at the time
    e- Most of the cancers do not arise from villous adenomata

    A patient with years of being unwell presents with a creatinine of 1.2mmol/l and high urea. He is vomiting and is anaemic. All the following are true, except:
    a- Minimal change clomerulonephritis
    b- Membranous glomerulonephritis
    c- Diffuse proliferative glomerulonephritis
    d- Focal glomerulonephritis
    e- Hypertensive nephropathy

    Cerebral infarction:
    a- Homeis syndrome with increased sweating
    b- Papilloedema with optic neuritis
    c- Pain and sensation loss on the same side of the body
    d- Quadriplegia with anterior or middle cerebral artery infarct
    e- Unilateral blindness with anterior circulation

    A 52 yrs old male patient has ischaemic type chest pain for three hours and has a normal ECG:
    a- If the ECG is normal, he does not have a cardiac problem
    b- He should have an exercise stress test immediately
    c- Thrombolyties are usually not indicated
    d- Heparin and IV nitrates are indicated
    e- Wait for any treatment until cardiac enzymes are back

    (J Type)
    Regarding a serum lipid profile and diet, what is true?
    a- Red wine improves LDL/HDL ratio
    b- Olive oil will increase the LDL/HDL ratio
    c- Positive energy balances increase LDL
    d- 100-300g of fish per week will have no effect on plasma or membranes
    e- An increase in dietary saturated fatty acids will increase VLDL

    (J Type)
    Regarding the treatment of pager’s disease, the following is/are true:
    a- Patient should be given calcitonin
    b- Diphosphonates are indicated
    c- Cortisol
    d- May need chemotherapy
    e- 1000mg calcium everyday
  2. Joseph.

    Joseph. Guest

    Treatment of chronic renal failure:
    a- Antacid syrups can helps
    b- Oral phosphate binding agents halt progress of bone disease
    c- All patients will have symptomatic bone disease
    d- Uraemic patients need to be dialysis
    e- Hyperkalaemia can only be treated with dialysis

    In regards to polycythemia rubra Vera which is correct:
    a- Can be caused by obstructive sleep apnoea
    b- Erythropoietin levels are high
    c- Iron deficiency is common, so iron supplement should be given
    d- ESR is increased
    e- Clinical cyanosis may be difficult to detect

    (J Type)
    In a patient with known aortic stenosis god left ventricular function and clinical presentation with CCF. Which of the following drugs are contraindicated?
    a- Quinidine
    b- Verapamil
    c- Beta blocker
    d- Diuretics
    e- Digoxin

    (J Type)
    In which of the following conditions you be likely to see cannon a-waves?
    a- Atrial fibrillation
    b- Ventricular extra-systoles
    c- Complete heart block
    d- Incupid incompetence
    e- Aortic stenosis

    (J Type)
    A patient with mitral stenosis due to rheumatic fever is congestive cardiac failure; the following is/are true:
    a- Surgical mitral valve plasty might improve the situation
    b- ACE inhibitors may be indicated
    c- Right heart failure is rare
    d- Angiography should be done before operation
    e- Ejection fraction 30. Patient needs treatment

    Pulmonary hypertension and cor-pulmonate are frequency secondary to:
    a- Emphysema
    b- Bronchiectasis
    c- Pneumothorax
    d- Cadiomyopathy
    e- Sarciodosis

    A 60 years old woman with long history of smoking presented with dyspnoea. On examination there were basal crepitations. FEVI and FVC were both severely reduced but the ratio (not given but calculated) was 80%. Fibro sing alveolitis
    b- Interstitial lung disease
    c- Bronchogenic carcinoma
    d- Decreased lung compliance
    e- Asthma

    A 30 years old man with visual disturbance can hear properly but has diplopia when looking down out and laterally
    a- Carotid artery aneurysm
    b- Cerebelo pontive angle tumor
    c- Acoustic neuroma
    d- Horner’s syndrome

    How do you differentiate between obstructive and restrictive lung disease?
    a- Prolonged expiratory flow rate
    b- Use of intercostals muscles
    c- Movement of the upper part of the thorax
    d- Inspiratory crepitations
    e- Increased residual volume
  3. Joseph.

    Joseph. Guest

    Ptosis may be found in each of the following conditions except:
    a- Cluster headache (Horton’s syndrome)
    b- Following cervical sympathectomy
    c- Posterior artery communication aneurysm
    d- Myasthenia gravis
    e- Bell’s (facial nerve) palsy

    The defect in visual fields most commonly associated with a pituitary tumour is:
    a- Crossed homonymous henianopia
    b- Central scotoma
    c- Bitemporal hemianopia
    d- Total blindness in one field
    e- Peripheral concentric constriction and enlargement of the blind spot

    Cardiac diseases known to be associated with sudden death include all of the following except:
    a- Coronary artery disease
    b- Prolonged QT syndrome
    c- Hypertrophic obstructive cadiomyopathy
    d- Mitral stenosis
    e- Aortic stenosis

    The commonest arrhythmia associated with thyrotoxicosis is:
    a- Sinus tachycardia
    b- Atrial Fibrillation
    c- Atral flutter
    d- Atrial ectopics
    e- Ventricular ectopics

    A 35 years old housewife presents with headache, extreme muscular weakness, polyuria and polydypsia and two episodes of carpopedal spasm. On examination she has a blood pressure of 190/115mmHg and proteinuria. Initial screening blood tests show random glucose 7.2mmol/L, sodium 158mmol/L, potassium 30.mmol/L. The most likely diagnosis is:
    a- Pancreatic insufficiency
    b- Diacates insipidus
    c- Adrenocortical adenoma
    d- Renal failure
    e- Hypoparathyroidism


    The diagnosis for the patient in Question 40 is likely to be confirmed by measuring:
    a- Dexamethasona suppression test
    b- Urinary vanilly mandic acid
    c- Plasma renia
    d- Plasma cortisc
    e- Glucose tolerance

    The most common cause of secondary hypertension is:
    a- Drugs
    b- Coarctation of the aorta
    c- Primary aldosteronism
    d- Renal abnormalities
    e- Elevated catecholamines

    The most common cause of normocytic anemia is:
    a- acute hemorrhage
    b- Chronic inflammation
    c- Malignancy
    d- Hemolysis
    e- Liver disease

    The most cause of chronic bacterial orchitis is:
    a- Tuberculosis
    b- Syphilis
    c- Leptospirosis
    d- Staphylococcus aureus
    e- Pseudomonas sp

    A 35 years old woman whose pre-pregnancy body mass index was 35.0 kg/m2, is found to have glucosuria (3+) and a random capillary blood glucose level of 12.0mmol/L in the second trimester of her pregnancy. An oral glucose tolerance test confirms diabetes mellitus. Her first pregnancy results in intra-uterine fetal death at 37 weeks gestation. The most likely treatment will be:
    a- A diet in which total energy intake in restricted severely
    b- Insulin
    c- No long term follow up, since the risk of non insulin dependent diabetes is negligible
    d- Appetite suppressants
    e- Oral hypoglycemic agents
  4. Joseph.

    Joseph. Guest

    A 46 years old woman with a body mass index of 38 presents with a 2 weeks history of sever headache, blurring of vision and nausea which followed a course of tetracyclines for a lower respiratory infection. The significant abnormality on examinations is papilledema. The probability diagnosis is:
    a- Cerebral glioma
    b- Temporal arteritis
    c- Gravitational headache
    d- Benign intracranial hypertension
    e- Cerebral abocess

    Diverticular disease of the colon is:
    a- Associated with hypertrophy of circular smooth muscle
    b- Most prominent in the right half of colon
    c- Often complicated by carcinoma
    d- Usually congenital in origin
    e- Not associated with any of the above

    In a cerebrovascular accident, hemorrhage and thrombosis may be clearly distinguished on which of the following points?
    a- Sequence of the clinical features
    b- Degree of loss of consciousness
    c- Description of onset
    d- Presence of headache
    e- None of the above

    In which of the following is ascites usually present on clinical examination?
    a- Left ventricular failure
    b- Cirrhosis of the liver
    c- Intra-abdominal Hodgkin’s disease
    d- Nephrotic syndrome
    e- Carcinoma of the uterus

    The ‘opening snap’ of mitral stenosis:
    a- Denotes valve mobility
    b- Disappears if atrial fibrillation occurs
    c- Is usually best head at the apex?
    d- Replaces the third heart sound
    e- Is really a closing snap?

    The notifiable communicable disease that is most commonly reported in Australia is:
    a- Hepatitis A
    b- Salmonella infections
    c- Gonorrhoeae
    d- Rubella
    e- Syphilis

    Which of the following organisms is highly resistant to amoxicillin?
    a- Haemophilus influenzae
    b- Streptococcus pyogenes
    c- Escherichia coli
    d- Klebsiella
    e- Staphylococcus aureus
  5. Joseph.

    Joseph. Guest

    Which commonly arises in a solar keratoses?
    a- Malignant melanoma
    b- Squamous carcinoma
    c- Basel cell carcinoma
    d- Kerato-acanthoma
    e- Sarcoma

    A 30 years old woman has a history of one week of sweats and fevers. Yesterday she had right sided pleuritic chest pain. Questioning reveals a long history of recurrent mouth ulcers episodic joint pains in he hands, photosensitive skin eruptions on the face and Raynaud’s phenomenon.
    A most likely diagnosis:
    a- Systemic Lupus Erythematosis (SLE)
    b- Atypical pneumonia
    c- Dermatomyositis
    d- Hepatitis C
    e- Rheumatoid arthritis

    Where there is immunodeficiency, bacterial infections characteristically involve of the following except?
    a- Skin
    b- Respiratory system
    c- Sinuses
    d- Joints
    e- Gastrointestinal system

    A 65 yrs old woman presents with recent onset of severe right sided headaches associated with soreness of the scalp. Three days prior to admission she developed blurring of vision in the right eye. On examination she has a visual acuity of less than 6/60 in the right eye and early swelling of the right optic disk. Which of the following is the most appropriate next step?
    a- Bed rest and analgesics
    b- Pilocarpine 2% eyes drops hourly
    c- Prednisolone 60mg daily
    d- Cerebral CT scan
    e- Urgent craniotomy

    All but one of the following are recognised features of hypertrophic
    obstructive cadiomyopathy. The exception is:
    a- Sudden death
    b- A large pressure gradient between sub aortic and lower ventricular chambers in ventricular systole
    c- Sometimes autosomal dominant inheritance
    d- Q waves in anterior ECG leads
    e- Eosinophilla

    A patient presents with worsening early morning headache and early papilledema and is considered to have raised intracranial pressure. Which
    Of the listed features, if presents, would also be characteristic of this diagnosis?
    a- Nuchal rigidity
    b- Tachycardia
    c- Marked loss of visual acuity
    d- Third cranial nerve palsy
    e- Hemiation of the cerebellar tonsils through the tentorium serebelli

    Lower than normal renin levels may occur in association with:
    a- Accison’s disease
    b- Pregnancy
    c- Beta block ace
    d- Diuretic therapy
    e- Malignant hypertension
  6. Joseph.

    Joseph. Guest

    A 55 yrs old housewife complains of persistent widespread pains in the bones getting worse over the course of 6 months. The differential diagnosis includes all except one of the following. The one exception is:
    a- Osteomalacia
    b- Multiple myeloma
    c- Osteoporosis
    d- Hyperparathyroidism
    e- Paget’s disease

    A moderately obese man, aged 65 years, presents with a history of pain and mild swelling of the left knee for the past four months. The only relevant past history is of transient cerebral ischemic attacks being managed by aspirin, 300mg daily. Full blood count and renal function are normal but the serum urate is 0.51mmol/L. He suffered from a single episode of podagra four years previously. Which of the following statements is correct?
    a- The current attacks of arthritis is probably osteoarthritis
    b- His 24 hour urinary uric excretion is probably elevated
    c- Allupurinol should be used to reduce his serum uric acid level to normal
    d- A reduction of aspirin dosage to 100mg daily will lead to a fall in the serum urate level
    e- If uric acid reduction were required, it would be better to prescribe sulphinpyrazone that allupurinol to a patient already receiving aspirin

    Characteristically, type A viral hepatitis:
    a- Is a DNA virus infection often associated with seafood poisoning
    b- Has an incubation period of three months
    c- Carries a greater risk of fulminant hepatic failure in young compared with old patients
    d- Often presents with headache plus right hypochoncrial pain and tenderness
    e- Can progress to chronic active hepatitis if cholestasis is prolonged

    Which of the listed drugs has the potential to induce life threatening cardiac arrhythmias when taken in overdose?
    a- thioricazine
    b- Haloperidol
    c- Lithium
    d- Fluphenazine
    e- Levodopa

    Which of the following adverse effects is best associated with use of flucloxacillin?
    a- Phototoxicity
    b- Interstitial nephritis
    c- Cholestatio hepatitis
    d- Agranulocytosis
    e- Acute hemolytic anemia

    Hirsutism is recognized side-effect of treatment with all excepts one of the following agents. Which is the exception?
    a- Progestogens
    b- Psoralens
    c- Minoxidil
    d- Trimethoprim
    e- Diazoxide

    During the first 4 hours after an overdose of paracetamol, a patient will develop:
    a- Hypoglycemia
    b- Hyperventilation
    c- Increased serum ALT and AST
    d- Pin-point pupils
    e- None of the above

    The ECG changes in left ventricular hypertrophy typically include all of the following but one. The exception is:
    a- ST elevation in lead
    b- Tall R waves in leads V5 and V6
    c- Deep S waves in leads V1 and V2
    d- Left axis deviation
    e- T waves inversion in lead a VL

    A 55 years old man with a 30 pack/year smoking history presents with a history of angina of effort. With respect to potential drug therapy, which one of the following statements is covered?
    a- verapamil and nifedipine would each reduce myocardial rate and contractility
    b- Glyceryl trinitrate transdermal patches should be worn for 24 hours and then replaced
    c- The predominant mechanism of action of glyceryl trinitrate is peripheral arterial vasodilatation and a reduction in cardiac after-load
    d- Beta blockers are indicated as prophylactic therapy for exercise induced but not vasspastic angina
    e- Beta blockers and calcium channel blockers could each precipitate asthma

    Which of the listed anti arrhythmic drugs is the drug of choice in most cases of Supraventricular tachycardia (including nodal tachycardia)?
    a- Digoxin
    b- Quinidine
    c- Flecanide
    d- Verapamil
    e- Propranolol

    In a patient with severe asthma, which of the features listed would be the most ominous?
    a- Arterial PO2 50mmHg
    b- Arterial PCO2 50mmHg
    c- FEV10.8 litres
    d- Very loud wheezes
    e- Respiratory rate of 20 per minutes

    An elderly man has been hospitalized for one week because of severe and worsening Parkinson’s disease. He is found in bed tachypnoeic, tachycardic and responsive only to painful stimuli. Pulmonary examination reveals diffuse wheezes and crackles in the right lung field posteriorly and absent breath sounds in the left lung field. Which of the following conditions is most likely to be responsible for this patient’s deterioration?
    a- Massive pulmonary embolism
    b- Pulmonary oedema after acute myocardial infarction
    c- Aspiration pneumonia with unilateral bronchial obstruction
    d- Spontaneous pneumathorax
    e- Tracheosophageal fistula
  7. Joseph.

    Joseph. Guest

    All except one of the following statements are characteristic of ventricular septal defect of the heart. The o exception is:
    a- It produces a left to RIGHT SUNT
    b- It can be diagnosed by cardiac ultrasound
    c- It is associated with a continuous murmur throughout systole and diastole
    d- It is one of commonest congenital hear lesions
    e- It is associated with a step up in oxygen saturation in the right ventricle

    All of the following except one typically produce keratin scales.
    The one exception is:
    a- Squamous cell carcinoma
    b- Solar keratoses
    c- Psoriasis
    d- Pityriasis versicolor
    e- Basal cell carcinoma

    A 75 yrs old woman, previously in good health, presents with a history of painless jaundice of 2 weeks duration. There is a distended gall bladder revealed by ultrasound examination. What is the most likely cause?
    a- Chronic Pancreatitis
    b- Alcoholic cirrhosis
    c- Gall stones
    d- Carcinoma of the pancreas
    e- Acute Cholecystitis

    In diabetic neuropathy you can find each of the following except:
    a- Bradycardia
    b- Urine retention
    c- Impotence
    d- Diarrhoea at night
    e- Foot ulcer

    In suspected acute MI what is the criteria for thrombolytic therapy?
    a- T inversion
    b- ST depression/elevation???
    c- New LBBB
    d- New RBBB
    e- Q waves

    A 55 yrs old woman was found unconscious in her house. She has a dilated pupil. What is the cause?
    a- overdose
    b- Brain infarct
    c- Subdural hematoma
    d- Subarachnoid hemorrhage
    e- Coma

    Antidote for heparin is:
    a- Protamine sulphate
    b- Vitamin K
    c- Fresh frozen plasma

    In heparin induced thrombocytopenia which of the following is typically seen?
    a- Petechial purpura on the skin
    b- Thrombosis
    c- Joint bleeding
    d- Hematuria
    e- Ecchymosis

    All of the following can cause renal papillary necrosis except:
    a- Liver disease
    b- Medullary sponge disease
    c- Sickle cell disease
    d- Diabetes mellitus
    e- Analgesic nephropathy

    Opening snap indicates:
    a- Mitral Valve mobility
    b- Atrial fibrillation cause disappearance of the opening snap
    c- Replaces S3
    d- Best heard at 2nd right intercostals space
    e- Remains unaltered despite progression of disease

    In a man from overseas, his chest x-ray reveals silent tuberculosis. PPD skin test is 10 in. treatment of choice is:
    a- Sputum culture
    b- Observation
    c- Triple therapy
    d- Isoniazid
    e- Isoniazide and ethambutal

    In infectious mononucleosis:
    a- Incubation period is 4-5 days
    b- Is seen more in patients with AIDS
    c- Incubation period is 14-21 days

    In asthma, which is the most important factor in diagnosing its severity?
    a- Decreased PEY
    b- Increased diumal variability
    c- Decreased diumal variability
  8. Joseph.

    Joseph. Guest

    A man returning from an overseas trip has Diarrhoea and vomiting for 2 weeks, salmonella was isolated. What is the next step in management?
    a- Ampicillin
    b- Repeat stool culture
    c- Trimethoprim-sulphamethoxazole
    d- Only observation
    e- Metronidazole

    All of the following are side effects of Prednisolone except:
    a- Hirsutism
    b- Lymphopenia
    c- Leucocytosis
    d- Osteoporosis
    e- Weight gain

    Polycythemia rubra vera:
    a- Contraction of plasma
    b- Expansion of plasma volume

    Which of the following is correct regarding the overdose of TCA?
    a- In a mixed overdose with TCA’s and benzodiazepines flumazenil is contraindicated

    All of the following are features of Parkinson’s disease except:
    a- Postural reflexes lost
    b- Can begin unilaterally
    c- Tremor gets worse during sleep
    d- Cogwheel rigidity
    e- Able to stop while walking

    A patient presents with impaired sensation on the medical aspect of the hand, 4th and 5th fingers of the hand are flexed. Where is the lesion?
    a- Ulnar nerve at the elbow
    b- Ulnar nerve at the wrist
    c- Redial nerve damage at the wrist
    d- Medial nerve damage at the wrist
    e- Redial nerve damage at the elbow

    A patient presents with moderate hemiparesis of legs and arms, no dysphasia, face appears normal. Where is the lesion most likely to be?
    a- Cerebral cortex
    b- Internal capsule

    All of the following are features of thyrotoxicosis except:
    a- Wasting of small muscles of the hand
    b- Fine tremor of hands
    c- Irritability
    d- Weight loss
    e- Wide pulse pressure

    Which of the following is the most common cause of ketoacidosis?
    a- Cessation of insulin in IDDM
    b- Undiagnosed IDDM
    c- Undiagnosed NIDDM
    d- Adrenal failure
    e- Infection

    In paracetamol poisoning the involvement of which organ is most important?
    a- Renal injury
    b- Hepatic injury
    c- Brain injury
    d- Stomach injury
  9. Joseph.

    Joseph. Guest

    A 70 yrs old woman complains of fatigue Blood picture:
    a- Autoimmune haemolytic anemia
    b- Pernicious anemia
    c- Anemia of chronic disease
    d- Anemia due to silent gastrointestinal bleeding
    e- Leukaemia (CML)

    A patient has massive ascitis and in the fluid malignant cells are found. Which of the following is a possible finding?
    a- Splenomegaly
    b- Hepatomegaly
    c- Supraclavicular
    d- On digital rectal examination, nodules can be palpated

    In bronchial asthma, which is the best indicatory of good treatment?
    a- FEVI
    b- ABG
    c- Decreased RV
    d- PEFR

    Which category of woman will benefit the most from a mammography?
    a- Age 35-50 years
    b- Age 50-65 years
    c- Age>65 years
    d- Woman with first degree relative with breast cancer
    e- Woman with breast cancer

    Regarding unilateral undescended testis, which of the following is most commonly associated?
    a- Malignancy
    b- Varicocele
    c- Inguinal hernia
    d- Hydrocele
    e- Torsion of the testis

    All of the following would be excepted after splenectomy for spherocytosis, except?
    a- Transient Leucocytosis
    b- Persistence of anemia
    c- Same osmotic fragility
    d- Persistence of spherocytosis
    e- Normal life span of the erythrocytes

    A 50yrs old man came to the emergency room, presenting with 3 days vomiting followed by periumbilical pain. On examination, his abdomen is distended and bowel sounds are absent. Abdominal x-ray shows multiple air-fluid levels. Hb 180 g/L, Which of the following is the best fluid management for this man?
    a- 2000 ml of 4% dextrose in 405% NaCL preoperatively
    b- 2000 ml of 4% dextrose in 4.5% NaCL during the operation
    c- 2000 ml of Hartmann’s solution preoperatively
    d- 2000 ml f Hartmann’s solution during the operation
    e- 2000 ml of 5% dextrose

    All of the following are risk factors for breast cancer, except:
    a- Early artificial menopause
    b- First pregnancy after 35 yrs of age
    c- Early menarche
    d- No breast feeding
    e- Cancer of the other breast

    A diabetic patient with an ulcer at the head of the 2nd metatarsal on the sole of the foot. Which of the following would be the most likely cause?
    a- Microvascular
    b- Diabetic neuropathy
    c- Infection
    d- Varicose veins
    e- Hyperglycaemia

    Hutchinson’s melanotic freckle. Which of the following is not correct? (Scborrhic ketatosis)
    a- Mostly occurs in the elderly
    b- Mainly occurs in covered parts of the body
    c- Malignant
    d- Irregular
    e- Irregular colour (from back to brown)

    A female had mastalgia for the last 1 year. Conservative treatment has not worked. How would you manage this patient?
    a- Bromocriptine
    b- Danazole
    c- Clomiphene
    d- OCP
    e- NSAID’s

    A middle aged female complains of morning Diarrhoea and cramps. On examination there are no remarkable findings. The most likely diagnosis:
    a- Irritable bowel disease
    b- Ca colon
    c- Crohn’s disease
    d- Ulcerative colitis
  10. Joseph.

    Joseph. Guest

    A diabetic person presents with a red & swollen leg, from the ankle to the knee. What is most likely responsible for this?
    a- Clostridium welchii
    b- Group A streptococcus
    c- Group B streptococcus
    d- Staphylococcus
    e- Thrombophlebitis

    All are true about gallstones, excepts:
    a- Usually asymptomatic
    b- Stone in the bile duct presents with clinical sepsis
    c- Usually radiolucent

    A 35 yrs old woman having severe sudden abdominal pain throughout the night wakes up and passes dark urine in the bathroom. She immediately goes to se the doctor. Investigation shows:
    - Bilirubin – 5 times normal
    - Alkaline phosphates – 3 times normal
    - AST & ALT – 4 times normal
    - S. amylase – 2 times normal
    What is the most likely diagnosis?
    a- Acute cholelithiasis
    b- Acute Cholecystitis
    c- Ca gallbladder
    d- Acute choledocholithiasis


    All are true in regards to scaphoid fracture, except?
    a- There is pain/tenderness in the anatomical snuff box
    b- Necrosis of the distal fragment can occur
    c- Treat even if initial x-ray are normal
    d- X-ray changes may be seen after 2 weeks

    Photography 5: X-ray showing colleens fracture. An elderly person sustained a fall on an outstretched hand. What is true?
    a- Median nerve function should be assessed
    b- The plaster cast is not suitable to correct the fracture in the elderly
    c- Immediate internal fixation
    d- Plaster case from below elbow to MCP joint, for at least 10 weeks

    The most appropriate OCP for a 24 yrs old woman taking phenytoin is:
    a- Microgynon 30
    b- Microgynon 50
    c- Clomiphene
    d- Oestrogen 85 micrograms

    Depo provera can cause all the following, except:
    a- Mild hypertension
    b- Amenorrhoea after the 3rd injection
    c- Fertility problems for 6-12 months after stopping the treatment
    d- Menstrual irregularities
    e- Weight gain

    All of the following are true about neural tube defect, except:
    a- Decrease the alpha fetoprotein
    b- Polyhydraminos
    c- Folic acid prophylaxis can decrease the risk of neural tube defects
    d- There is a 4% chance of neural tube defect in the 2nd pregnancy

    D % C is indicating in which of the following?
    a- Postmenopausal bleeding

    A 9 day old baby with projectile vomiting and dehydration with k 7.1, Na 125, Cl 80, & HCO3 20. What is your diagnosis?
    a- Pyloric stenosis
    b- Galactosemia
    c- Sepsis
    d- Hypoglycaemia
    e- Congenital adrenal hypertrophy

    An 8 week old baby presents with unilateral sticky eye. Similar episode before, was treated with antibiotics for 3 days and resolved. What is the most likely diagnosis?
    a- Gonococcal conjunctivitis
    b- Allergic conjunctivitis
    c- Inadequate antibiotic treatment
    d- Decrease IgA A in the tears
    e- Blocked tear duct
  11. Joseph.

    Joseph. Guest

    An 8 year old boy presents with photophobia, irritability & stiffness. Lumbar puncture findings show 50 neutrophils, 100 lymphocytes, proteins normal, and glucose normal. Which is the most likely diagnosis?
    a- Tuberculosis meningitis
    b- H. Influenza
    c- Echo virus
    d- E. coil
    e- HSV encephalitis

    A 4 year old child presents with sudden onset of cough, unilateral wheeze and decreased respiratory movement on one side. There is no family history of atopy. What is the most appropriate management?
    a- Chest x-ray
    b- Full blood examination
    c- CT of chest
    d- Ultrasound
    e- Inspiratory & expiratory chest x- ray

    A 5 months old baby unwell for a week is noticed by his parents to have episodes of leaning forward and shaking his arms. His parents are concerned, because he is not responding as he used to. What is the likely cause?
    a- Infantile spasm
    b- Febrile seizures
    c- Breath holding spells
    d- Infantile myoclonic seizures
    e- Petit mal epilepsy

    A 2 years old child presents with cough for 2 months. On examination you find clubbing, wheezing and crackles. What is your management?
    a- Prescribe antibiotics
    b- Perform a chloride sweat test
    c- Prescribe oral corticosteroids

    A mother notices a lump in the right groin of her 2 years old son, which disappeared after a few hours. Despite a thorough examination you are unable to discover anything. The most appropriate management would be?
    a- Reassurance &send home
    b- Admission into hospital for surgery
    c- Request the mother to bring the child to you immediately when the lump reappears again
    d- Review after 1 week

    A full term infant girl is transferred to the postnatal ward when aged 1 hour. On arrival she is notice to have cyanosed hand & feet. On examination you find the responsive and cries lustily on handling. The respiratory rate is 40/min and the lungs & heart are clinically normal. Which of the following is correct?
    a- The infant has probably had a convulsion
    b- The infant’s rectal temperature should be checked
    c- The infant has early sings of respiratory distress
    d- Oxygen should be given
    e- An immediate chest x-ray should be arranged

    An 8 years old boy was stung by a bee. He had difficulty breathing and facial oedema. What is the best treatment?
    a- Adrenaline 1:1000IM
    b- Adrenaline S.C.
    c- Antihistamine iv
    d- Hydrocortisone
    e- Intravenous fluids

    All of the following can cause short stature, except:
    a- Psychosocial deprivation
    b- Obesity
    c- Congenital adrenal hyperplasia
    d- Hypothyroidism
    e- Turner syndrome

    A 2 week old baby gained 200 grams/week since birth. The mother complains that the child vomits mild soon after feeding, otherwise okey. What will you do?
    a- Reduce the time between feeds
    b- Shorten the duration of feedings
    c- Give Water before feeding with milk
    d- Endoscopy
    e- Urine microscopy

    A 10 year old child, 139 cm tall, is brought to the doctor by his parents. His parents are concerned and say, “He had been a fatso forever”. What could be associated with this?
    a- Height for age is always more
    b- Elevated TSH
    c- Insulin resistance
  12. Joseph.

    Joseph. Guest

    70 yrs old man, smoking 90-pack/year now with sign of respiratory alkalosis. PH=7.38 (N 7.35-7.45) PO2=48, PCO2 68. What will confirm that he has compensatory respiratory alkalosis?
    a- Low PO2
    b-
    c- Low Po2, high PCO2 and normal PH
    d- High CO2
    e- Heavy smoker

    What is immature defence mechanism?
    a- Suppression mature
    b- Denial neurotic
    c- Intro-fection
    d- Projection
    e- Sublimation

    Woman pregnant, with oedema of the ankle and the hand, hypertension, ascites, baby born with jaundice and bilateral cataract. Previous baby has similar condition:
    a- ABO- incompatibility
    b- Acute glomerulonephritis
    c- Rubella embryopathy
    d- Galactosemia
    e- Retrolental fibroplasia

    Regarding mammography what is most correct:
    a- Has higher detection rate of breast lump than self-examination
    b- Can differentiate between cyst and solid mass USG
    c- Has more benefit in pre-menopausal than post-menopausal woman


    Which of the following drugs is least likely teratogenic?
    a- Phenytoin
    b- Danazol
    c- Stilloestrobeol
    d-
    e- Corticosteroids

    What will least likely produce intrauterine deafness?
    a- Phenytoin
    b- Birth weight less than 1500gms
    c- Kernicterus
    d- Microcephaly


    X-ray wrist with Cole’s fracture. What is correct treatment?
    a- Immobilisation for 10 weeks
    b- Reductio and immobilisation is correct treatment
    c- Check medianus
    d- Internal fixation

    Regarding cluster headache all of the following is correct except:
    a- Every day and/or day and night same time
    b- More in man than woman
    c- Pain
    d- Awake patient 4 – 6 hrs after sleep
    e- Vomiting

    Woman 35 yrs old has sharp jaw pain, loss of sensation in trigeminal area:
    a- Trigeminal neuralgia
    b- Multiple sclerosis


    Regarding Seminoma what is correct:
    a- Occurs in childhood, locally metastasis, radiosensitive
    b- Occurs in childhood, distant metastasis, radiosensitive
    c- Occurs in young male, locally metastasis, and radioresistant
    d- Occurs in young male, distant metastasis, radiosensitive
    e- Occurs in old man, distant metastasis, radioresistant

    A baby with a 4 months history of unilateral discharge, few polymorphonuclear cells……………
    a- Gonococcal infection
    b- Chlamydia infection
    c- Blocked tear duct
    d- Antibiotics prescribed for short period

    All of the following is true in pulmonary embolism except:
    a- Increased second heart sound
    b- Syncope
    c- Dyspnea
    d- Pleural rub
    e- Bronchial breath sound

    Man has polyuria. What is most common finding in diabetes mellitus?
    a- Weight loss regardless of increased appetite
    b- Dysuria
    c-
    d-
    e- Sugar craving

    70 yrs old lady, on Digoxin 0.25, Hydrochlorothiazide. She fell dizzy, now presents with arrhythmia 220/min pulse 110/min? K 3.1, urea ^ (high)………….
    a-
    b- Continue Digoxin + hydrochlorothiazide and add Furosemide
    c- Stop Digoxin
    d- Stop Digoxin + KCI
    e- Do Cardioversion
  13. Joseph.

    Joseph. Guest

    9 yrs old girl, occasionally headache. Vomiting before breakfast. Child is otherwise well:
    a- Migraine
    b- Hydrocephalus
    c- Medulloblastoma

    Implantation of fertilized egg will most likely occur at:
    a- 8 days
    b- 5 days
    c- 10 days
    d- 20 days
    e- 5 weeks

    Patient with ileocolostomy, what is lost in highest concentration before and after operation?
    a- Bicarbonate
    b- Calcium
    c- Kalium
    d- Sodium
    e- Potassium

    3 and ½ years old boy came on teacher and parent request. Teacher complained that child is aggressive toward other kinds in childcare, poorly concentrate: parents said that they could not cope with child. When child is left alone in your room he is quietly playing with toys, without any above-mentioned problem.
    What is most likely?
    a- Attention Deficit Disorder
    b- Opponent defiance
    c- Poor parenting
    d- Normal variant

    9 yrs old girl truanting from the school, playing arcade games. When interviewed she is tearful, and she has insomnia……….
    a- Anorexia nervosa
    b- Attention deficit disorder
    c- Anxiety separation disorder
    d- Conduct disorder

    Mother of 15 year old girl phoned you to discuss her daughter behaviour. She refuses to eat meal with a family, exercise more than before, refuse to take Benzodiazepines prescribed by her GP. What will be your advice?
    a- Tell her that girl has anorexia nervosa and needs hospitalization
    b- Familiar meeting as part of initial assessment
    c- She has exercised dependency, which has excellent prognosis

    Man with Supraventricular tachycardia. Ventricular beat? Atrial beat?
    a- Verapamil
    b-
    c- Cardioversion

    What is best day-to-day estimation of Digoxin therapy?
    a- Apex beat
    b- Redial pulse


    Polycythemia rubra Vera. All of there following is true except:
    a- Elevated erythropoietin
    b- Sleep apnoea can cause it
    c- Plasma contracted
    d- Clinically hard to recognise


    Estimation of suicidal attempt:
    a-
    b- Privacy Act forbid giving information to family members regarding suicide
    c- Removing fire arms from house doesn’t mean much because of inevitability……

    30 yrs old woman with 3 yrs old child, regular cycles she can’t be pregnant although coitus usually in the middle of the cycle. Most likely cause is:
    a- Hyperprolactinemia
    b- Inefficient luteal phase
    c- Tube disruption – PID
    d- Seminal vesicle anomalies


    Woman with C I N 3
    a- Cervical biopsy preceded by colposcopy


    Photo. Picture of small ulcer surrounding by black deposit patient had colostomy:
    a- Squamocellular carcinoma
    b- Metastatic deposit
    c- Pyoderma gangrenosum
    d- Diathermic burn
  14. Joseph.

    Joseph. Guest

    Malignant cells in gross ascites. What is least likely to find?
    a- Palpable left supraclavicular node
    b- Palpable liver
    c- Palpable spleen
    d- Perirectal lymph node

    Diabetic woman, on therapy with ACE, asking you for advice regarding her possible pregnancy:
    a- Stop ACE change for Aldomet
    b- Continue ACE

    Child, 4 yrs old, only breast feed, most likely cause of anemia is:
    a- Iron deficiency anemia

    Pancreatitis can be caused by all of the following except:
    a- Mumps
    b- Smoking
    c- Alcohol
    d- Islet cell tumour
    e- Gall stone

    What matching pair is correct?
    a- Anticardiolipin antibodies – intrauterine growth retardation
    b- Lupus anticoagulant – pulmonary embolism thrombosis
    c- Anti Ro antibody – heart block
    d- Platelet count <100.000 – foetal intracerebral Haemorrhage

    Newborn, cyanotic, cyanosis completely disappeared after giving him 100% O2.
    a- Lung disease
    b- Methemoglobinemia
    c- Tetralogy Fallot

    70 yrs old woman losing weight, pain in hands. She has hypercalcemia in blood. Most important to distinguish between malignancy or hyperparathyroidism is:
    a- Elevated serum Ca
    b- Elevated alkaline phosphates
    c- Elevated hyper parathyroid hormone

    Man with acute respiratory distress involved in car accident, trachea shifted to the right no breathing on the left:
    a- Pneumothorax
    b- Haemato pneumothorax
    c- Tension pneumothorax
    d- Flail chest


    Man involved in car accident subcutaneous emphysema on the neck
    a- Rupture of diaphragm
    b- Rupture of trachea

    Newborn, couple hours after delivery, resp. distress. ? Abdomen empty, no breathing on the left
    a- Left pneumothorax
    b- Diaphragmal hernia

    Man had craniotomy. Lab:…………………………….Urine osmolarity 805
    a- Water intoxication
    b- S I A D S- may be
    c- Diabetes insipidus

    Old man with a recurrent hemoptysis and cough…….
    a- Recurrent pulmonary emboli
    b- Chronic bronchitis
    c- Teleangiectasis
    d- Bronchiactasis /TB /pneumonia / Neoplasm

    Sucking pneumothorax, what is management?
    a- Tight air dressing


    Man three attack of gout in left knee. Now present with a pain and swollen right knee, what is Rx?
    a- Indomethacin in the first 24 hours
    b- Allopurinol in the first 24 hours
    c- Hydrocortisone 100mg in the knee
    d- Colchicine in the first 24 hours

    What will decrease uptake to iodine on scintigraphy?
    a- Hashimoto’s thyroiditis
    b- Subacute thyroiditis
  15. Joseph.

    Joseph. Guest

    . Small boy 2yrs, with wheezing, cough, symptoms stared after his older brother birthday party:
    a- Spiral CT of thorax
    b- Indirect laryngoscopy
    c- Bronchoscopy + direct laryngoscopy

    Woman normal pregnancy, normal delivery, stillbom baby. The most likely explanation is:
    a- Unexplained intra-uterine hypoxia
    b- Cord accident during delivery

    Old lady sudden sharp abdominal pain with abdominal distension, long history of constipation, no stool or flatus passed today:
    a- Superior mesenteric embolus
    b- Sigmoid carcinoma
    c- Diverticulosis

    Prodromal symptom of SCH:
    a- Ideas of reference
    b- Dysfunctional parenting
    c- Unemployment

    Diabetic woman depressed. What will be most ominous sign in prognosis?
    a- Alcohol abuse
    b- Decreased level of HbAlc

    A man with a long standing rheumatic arthritis, Hb reduced MCV – normal ferritin increased 3x……….
    a- Anemia of chronic disease
    b- Iron deficiency anemia

    Woman second pregnancy, first child has spina bifida, and she wants advice regarding her next pregnancy. All of the following is true except:
    a- Preconceptual intake of folate and thiamine will not increase risk
    b- Amniocentesis at 11 weeks
    c- Ultrasound at 11 weeks to check Nuchal thickness

    Young couple, advice regarding sterility. Your advice them IVF all of the following except:
    a- Regular anovulatory cycles
    b- < 1.000.000 spermatozoid in ejaculate in 6 times


    Young girl monospot test +-ve, clinical picture of infectious monocleosis. What is your next step?
    a-
    b- Antibiotics
    c- Paracetamol and bed rest


    Mother HBsAg +-ve, newborn, what is correct Rx?
    a- Normal immunoglobulin
    b- Hepatitis B immunoglobulin + hepatitis B vaccine

    50yrs old woman with enlarged spleen, moderate generalized lymphadenopathy. Most likely is:
    a- Chronic lymph. Leukaemia
    b- Hodgkin disease

    Best method to visualize biliary tract is:
    a- Ultrasound
    b- E R C P
    c- X-ray

    What is not feature of subdural haematoma?
    a- Bradycardia
    b- Hypotension
    c- Lucid intervals

    Characteristic of genitor-urethral tract in pregnancy is:
    a- Dilatation of ureter
    b- Dilatation of ureter and calyces due to progesterone
    c- Reduced incidence of infection

    Regarding post operative management of pain:
    a- Pethidine is better than morphine
    b- Older people require lower dose because they are more sensitive
    c- Pethidine should not be repeated more than every 4 hours
    d- Pethidine is given by calculating mg/kg of body weight
    e- Pethidine has longer duration than morphine

    Woman had baby with neural tube defect/spina bifida. She wants advice regarding her next pregnancy. All is correct except:
    a-
    b- Preconceptual intake of thiamine is important in prevention of NTD/SB
    c- She will have low amniotic alpha – fetoprotein
    d- Environmental and social factors are important
  16. Joseph.

    Joseph. Guest

    Patient with Helicobacter pylorus infection. He had 1 week treatment. What is simple test to check eradication?
    a- Complement test
    b- Serologic test
    c- Urea breath test
    d- Endoscopy
    e- Histological test

    Patient with Wernicke’s encephalopathy. What is appropriate Rx?
    a- 50 ml 50% dextrose
    b- Immediate glucagon injection
    c- Immediate glucose injection
    d- Thiamine injection followed by glucose infusion


    Erythema nodosum is associated with all of the following except:
    a- Rheumatic fever
    b- Tuberculosis
    c- B-haemolytic streptococcus infection
    d- Streptococcus viridans infection
    e- Rheumatic arthritis

    Amyloidosis can occur in all of the following except:
    a- Chronic active hepatitis
    b- Leprosy
    c- Multiple myeloma
    d- Tuberculosis
    e- Renal failure

    Short stature in adulthood is associated with all of the following except:
    a- Congenital adrenal hyperplasia
    b- Turner’s syndrome
    c- Premature puberty
    d- Obesity
    e- Psycho-social deprivation

    Uncomplicated haemorrhoids are associated with all of the following except:
    a- Discharge with mucus
    b- Blood
    c- Pain
    d- Protruding limp (bulging mass)
    e- Pruritus ani

    Young woman primigravida, 17 weeks pregnant, lower & sharp abdominal pain. Could be all of the following except?
    a- Red degeneration of fibroid
    b- Ectopic pregnancy
    c- Ruptured ovarian cyst
    d- Acute appendicitis

    Man was exposed to bank robbery 3 weeks ago…………..
    a- Denial
    b- Insight and hallucination
    c- Self- defence
    d- Irritability, outburst of anger


    The risk of colonic cancer will be highly increased with:
    a- Diverticulosis
    b- Crohn’s disease
    c- Post irradiation colitis
    d- Familiar Melanosis coli
    e- Ulcerative colitis

    70 yrs old man present with fatigue. On psychical exam, slight pallor.
    Blood: Hb 96, MCV 118, WBC decreased, Platelet low
    Peripheral blood picture show few hyper-segmented polymorphonuclear cells.
    a- Autoimmune haemolytic anemia
    b- Pernicious anemia
    c- Anemia of chronic disease
    d- Fe deficiency anemia
  17. Joseph.

    Joseph. Guest

    Regarding Rosacea what is correct:
    a- Acneiform pustules
    b- Topical corticosteroids will help
    c- Diet has role in aetiology
    d- Rhinophyma is not associated with the disease
    e- Sunlight exposure helps in the treatment

    Woman are scheduled for laparoscopy. She is concerned about that so you should tell her all of the following except:
    a- It is life threaten particularly if vena cava is damaged although risk is very small – may be
    b- Small amount of CO2 will be residual after procedure so she can experience abdominal tenderness and shoulder tip pain
    c- Although it is not standard procedure polycystic ovarium sy, can be easily diagnosed by laparoscopy
    d- Rupture of intestine
    e-
    I thing B, because first part of statement is true, small amount of CO2 will be residual in abd. After laparoscopy but second part: abd. tenderness and shoulder tip charac, of ruptured ectopic pregnancy

    Regarding oral contraception all of the following is true except:
    a- Reduced incidence of Fe anemia
    b- Decreased triglycerides
    c- Reduced pelvic inflammatory disease
    d- Incidence of endometrial carcinoma

    A man had injury sharp pain and knee effusion playing soccer a month ago. He pause for month and start to play again. Now presented with pain in the knee that is often locked, give away and he can’t extend his leg:
    a- Displaced fracture of Patel
    b- Rupture of anterior cruciate ligament
    c- Rupture of medical collateral ligament
    d- Medial meniscus


    Woman on hormone replacement therapy have hot flushes, headache, she can’t sleep. She has been now prescribed Progesterone for the first 12 days (or 15) of each month. All her symptoms will improve except:
    a- Hot flushes
    b- Dry vagina
    c- Sleep
    d- Increased incidence of endometrial carcinoma
    e- Osteoporosis

    All of the following are features of pulmonary embolism except:
    a- Pleuritic rub
    b- Dyspnoea
    c- Bronchial breathing

    Patient punctured his finger in first digital crease level. Patient has on passive stretching:
    a- Midpalmar abscess
    b- Tendosynovitis

    Patient from car accident came in ER. he has been treated for his injuries but soon later, he start bleeding from multiple puncture siestas a part of investigation for his bleeding, you will do all of the following except:
    a- Platelet count
    b- Fibrinogen
    c- Platelet aggregate study
    d- Prothrombin time and A P T T?
    e- Degradation fibrin
  18. Joseph.

    Joseph. Guest

    Which of the following statements is/are true concerning metastatic cancer in the liver?
    a- Squamous cell cancer in the head and neck region commonly metastatic to liver
    b- In Australia gastrointestinal cancer more commonly metastatic to liver than does any other malignancy.
    c- Once metastatic disease has been diagnosed in the liver the condition cannot be cured by surgical operation.
    d- Average life-expectancy for a patient with diagnosed metastases in the liver without treatment is in the order of 2-3 years.
    e- Carcinoma embryonic antigen titre is a useful diagnostic test for all metastatic liver cancer.

    Indicators of a poor prognosis in acute pancreatitis include -
    a- Marked initial elevation of serum amylase
    b- Arterial pO less than 60 mmHg
    c- Serum calcium concentration less than 1.8 mmol/L
    d- Haematocrit increase greater than 10%
    e- Urea greater than 10mmol/L

    Pancreatic cancer is associated with a poor prognosis because -
    a- It is a rapidly growing tumour
    b- It has usually spread beyond the pancreas at the time of presentation.
    c- It seldom arises before the age of 70 years
    d- It is associated with anorexia and weight loss tendering the patient unfit for surgery
    e- the presence of jaundice indicates that the cancer is incurable

    Of the following malignant tumours indicate which two are most likely to respond favourably to treatment with chemotherapeutic agents.
    a- Squamous carcinoma of lung
    b- Chondrosarcoma
    c- Wilm’s tumour
    d- Teratoma of testis
    e- Glioblastoma

    Which of the following statements is/are correct about cancer?
    a- The most common site for gastric cancer is the fundus of the stomach.
    b- Previous hepatitis B infection is recognised as a predisposing factor Hepatoma.
    c- Cancer of the bile duct is most common in Southeast Asia.
    d- There is a causal relationship between Diverticular disease and colon cancer.
    e- Pipe smoking is a risk factor in cancer of the floor of the mouth.
    aippg.com
    Sympathectomy may be expected to improve-
    a- Intermittent claudication
    b- Rest pain
    c- Ischemic ulceration
    d- Varicose ulceration
    e- Deep vein thrombosis

    A 72 years old non-diabetic man presents with a three year history of intermittent claudication and a four week history of severe rest pain in his left lung. On examination there are no pulses below the common femoral pulse, the big toe demonstrates superficial ulceration and gangrene. He should -
    a- Have an angiogram to assess suitability for bypass grafting
    b- Have an amputation to the toe with primary wound closure
    c- Have an amputation of the toe with secondary wound closure
    d- Have a lumber sympathectomy
    e- Be placed on bed rest and given beta blockers

    Which of the following is/are true of varicose veins?
    a- They are usually related to saphenofemoral incompetence
    b- They can often be effectively treated by Sclerotherapy
    c- The long saphenous vein should always be stripped
    d- There is often an inherited predisposition
    e- They often commence during pregnancy

    Which of the following is/are correct for peripheral vascular disease?
    a- Patients with claudication usually progress to threatened limb
    b- An absent dorsalis pedis pulse is invariably indicative of vascular disease
    c- An upper abdominal bruits is usually associated with renal artery stenosis
    d- 50% or more of patients presenting with lower limb claudication have ischemic heart disease
    e- Is more common in patients with analgesic nephropathy

    Raynaud’s disease is a condition in which -
    a- Small arterioles go into spasm when exposed to cold conditions
    b- Capillaries tend to dilate in the extremities
    c- Young women are affected more commonly
    d- Fingers are affected more commonly than toes
    e- Sympathectomy may be expected to give permanent relief
  19. Joseph.

    Joseph. Guest

    Typical features of a large arterio-venous fistula are -
    a- Decreased pulse pressure
    b- Bradycardia
    c- Dilated local veins
    d- A bruit over the fistula
    e- Left ventricular hypertrophy

    A 50 years old male smoker presents with a history of right calf claudication at 100 meters. He has a god right femora pulse but no pulses distally. Which of following would you advice as initial management?
    a- Stop smoking
    b- Regular walking
    c- Check fasting glucose and lipids
    d- Femoro-popliteal bypass
    e- Laser angioplasty

    Which of the following blood tests is/are indicators of nutritional status?
    a- Albumin
    b- Transferrin
    c- Retinol binding globulin
    d- C-reactive protein
    e- Pre-albumin

    Which of the following is/are true of total parenteral nutrition?
    a- It is best delivered via a jugular vein catheter
    b- It requires phosphate replacement to avoid hypophosphataemia
    c- It is superior to enteral feeding, even if the gastrointestinal tract is available
    d- May cause hyperglycaemia
    e- Requires biochemical monitoring

    Which of the following is/are true of enteral feeding?
    a- can be delivered via a Percutaneous gastrostomy tube
    b- Can cause aspiration pneumonia
    c- May cause osmotic diarrhoea
    d- Is cost-effective nutritional support
    e- Should never be used post-operatively

    http://www.aippg.net/forum/posting.php?mode=reply&t=69347

    A 25 year old male is delivered to the A & E department by ambulance after a high speed motor vehicle accident in which he has sustained blunt trauma to the head, face and chest. He is unconscious and cyanosed with pulse 120 and BP 90 systolic gurgling sounds accompany his shallow, laboured and rapid respiratory efforts. There is much blood around the nose and mouth. Which of the following do you require first to initial resuscitation?
    a- Intercostal tube, underwater seal drainage apparatus, minor surgical instrument pack
    b- Large calibre intravenous cannulae, IV fluid administration set and colloid solution
    c- Oropharyngeal airway, light, suction, oxygen mask
    d- Tracheostomy tube, suction, minor surgical instruments pack
    e- Endotracheal tube, laryngoscope, suction, ventilator

    Which of the following are the common modes of presentation of blunt abdominal trauma?
    a- A shocked patient with involuntary guarding on abdominal examination
    b- The patient presents with hypovolaemic shock and no source of blood loss can be found in the chest, the extremities or the soft tissue of the trunk.
    c- The patient has a rising blood and a falling pulse rate, and signs of altered consciousness.
    d- The patient has board-like rigidity of the abdomen from the time of the accident and a chest x-ray taken in the upright posture shows free gas under the diaphragm.
    e- A shocked patient has fractures of the lower ribs

    A 30 year old man arrives at hospital 40 minutes after being involved in a motor vehicle accident. He has already received 1000 mls of plasma substitute during transport. He is unconsciousness and responds only to pain. There are no focal neurological signs. There is stridor, intercostal retraction and no evidence of pneumothorax pulse rate is 140/min. blood pressure is 70 mmHg. Systolic and the abdomen is rapidly distending. There is a right femoral shaft fracture and there is ischaemia of the lower right leg. Before proceeding to operating theatre for laparotomy. This patient needs -
    a- CT scan
    b- Peritoneal lavage
    c- Rapid transfusion
    d- Adequate airway
    e- Right femoral angiography
  20. Joseph.

    Joseph. Guest

    A young man presents after a motor vehicle accident with clinical evidence of head injury, unconsciousness, tension pneumothorax, hypotension and expanding abdomen, select the three highest priorities from the following options -
    a- Blood volume replacement
    b- CT scan of the head
    c- Chest x-ray
    d- Application of MAST suit
    e- Decompression of pneumothorax


    http://www.aippg.net/forum/posting.php?mode=reply&t=69347
    After total thyroidectomy -
    a- Bilateral vocal cord paralysis is common
    b- Acute haemorrhage in the neck wound is life-threatening because of resulting hypovolaemia
    c- Transient hypocalcaemia may occur
    d- Tracheostomy is often required because of trachemalacia
    e- Long-term maintenance thyroxine therapy should begin six months after operation

    www.aippg.com
    Ulcerative colitis e-recurrent episodes of attack jaundice e- high alkaline phosphates- What is your diagnosis?
    a- Cholelithiasis
    b- Sclerosing cholangitis
    c- Primary biliary cirrhosis

    Snake bite no bleeding -
    a- Close observation for 24 hours
    b- Hospitalization and antivenom
    c- Tourniquet apply
    d- Cut & free bleeding from puncture site

    Rest pain Awake from sleep sweet 377 -
    a- Ischaemic pain
    b- Claudication distance (for muscle pain)

    Sudden serve backache pain -
    a- Leaking aneurysm

    40 yrs old two days sever pain in his scrotum -
    a- Acute Epididymitis
    b- Torsion
    c- Tumour
    d- Hydrocele

    A young adolescent present with sudden sever pain -
    a- Needs surgery


    Most appropriate for shape size & function of the urinary system -
    a- Ultrasound
    b- IVU
    c- Renal scan

    After pelvic injury blood in the urethral ureatus -
    a- Urethro-graphy

    Pneumathorax-
    a- Inter costal tube
    b- Intubation
    c- 20 cc bore needle drainage
  21. Joseph.

    Joseph. Guest

    Sueking chest injury, surgical emphysema, noneckvein enlarged, heart sound ok, breathing problem - What is your management?
    a- Monogestric intubation
    b- Oral intubation
    c- Thoracotomy tube drainage


    http://www.aippg.net/forum/posting.php?mode=reply&t=69347
    Complication of colitis -
    a- Malunion
    b- Non union
    c- Carpal tunnel syndrome

    Gout e- knee arthritis confirmatory test -
    a- Bifringement crystals

    Thyroid tissue present on the aspirated dup cervical lymph node -
    a- Lateral aberrant thyroid
    b- Thyroid Ca

    Familial associated Ca-
    a- Medullary Ca
    b- Follicular Ca
    c- Mucinous Ca
    d- Anaplastic Ca

    Picture- Red spot on the Rt. side of the face -
    a- Port wine lesion
    b- Capillary Humour glioma
    c- Melanotic freckle
    d- Basal cell ca

    Picture - Breast lump of a 45 yrs old woman & mammography scan -
    a- Ca breast
    b- Cyst
    c- Fibro adenoma

    Picture- Pyloric stenosis Rt. e- vomiting which fluid is used -
    a- Urosomal saline
    b- Hartmann’s solution


    After intusion his urine out put is 50 ml/hr. How much Rt. is used for the next 24 hrs?
    a- No rt. supplement
    b- 20 mmol Rt
    c- 55 mmol Rt.
    d- Above 55 mmol Rt.
    e- none of the above

    Picture of thigh, look like black spot around & above the medial maleolus -
    a- venous hypertension
    b- Arterial hyper/ischaemia

    40 yrs old man e- left textis enlarged on recumbent position -
    a- Varicocele
    b- Seminoma
    c- Teratoma
    d- Hydrocele
    e- Epididymitis
  22. Joseph.

    Joseph. Guest

    Picture of the hand bone (scaphoid) montegia -
    a- Plaster up to the proximal interphalangeal joint of the thumbs

    Patient comes e- renal colic and wants pathedimic, doctor examines him but no pain associated e- complains he has came e- bloody urinary sample. On examination physically he is alight. What is your initial management?
    a- Fresh urinary sample examination
    b- Morphine & buscopan injury and follow up after 24 hrs
    c- Immediate hospitalization


    www.aippg.com
    Young man coming back after Bali visit, he has lost r kg weight & diarrhoea 3 wks visit otherwise physical examination ok. What is your appropriate management?
    a- Stool culture
    b- Flexible sigmoidoscopy & rectal biopsy
    c- Do colonoscopy

    After severe vomiting of complain heart burn distress, surgical emphysema -
    a- Rupture oesophagus
    b- Rupture trachea
    c- Rupture diaphragms

    Myonecrosis Rx -
    a- Cleaning & excision of the devitalized tissue & apposition the lays appropriately
    b- Hyper baric O2
    c- Hyper immune globulin

    Hashimotor thyroiditis except -
    a- Hypothyroidism
    b- Hyperthyroidism
    c- Auto immune antibody

    Appends sectomy after 5 days on the medial end of the opsation side- where is a fluctuating swelling present, what is your management?
    a- take in the operation room
    b- Remove the under lying suture
    c- Incision & drainage

    Paraplegia patient e- over hoe incontinence what is your management?
    a- Suprapubic catheterization
    b- Persistant penile catheterization
    c- Inter mi hewed

    A woman comes e- bladder come to the xiphoid process -
    a- Acute retention
    b- Cl retention
    c- Neuro genic bladder

    Patient presents e- 1st degree haemorrhoids what is your management?
    a- Roughage diet
    b- Opsalion
    c- Sclerosis throsy

    http://www.aippg.net/forum/posting.php?mode=reply&t=69347
  23. R.dass

    R.dass Guest

    Regarding CRF all of the following can be used to reduced hyperkalemia except -
    a- Calcium
    b- Glucose and insulin
    c- Magnesium
    d- Sodium bicarbonate
    e- Resonium

    A newborn was peripherally cyanosed and crying lustily. The axillary temp was 37.8C. What would be the next management?
    a- Take an x-ray
    b- Reassure
    c- Oxygen
    d- Urine culture

    10/52 old child with persistent unilateral eye discharge responding to antibiotics but recurring -
    a- Nasolacrimal duct obstruction
    b- Gonococcus infection
    c- Chlamydia infection

    All of the following are features of hypercalcemia except -
    a- Depression
    b- Diarrhoea
    c- Polyuria
    d- Polydipsia

    18/12 old girl breast tanner stage 3, no pubic or axillary hair -
    a- Idiopathic thelarche
    b- Premature puberty
    c- Normal variant
    d- Turners syndrome

    19yr old lady presented with frequent syncopal attack of 6 wks duration. PR 44/min, BP 180/110 and ejection systolic murmur in the aortic region. Probable DX -
    a- Cardiac arrhythmia
    b- Vasovagal attack
    c- Complete heart block
    d- Aortic stenosis

    2yr old presented with recurrent chest infection and FTT found to have continuous murmur below left clavicle and upper if sternal border. Probable diagnosis -
    a- PDA b- ASD
    c- VSD d- AS

    19yr old primi is not followed the an clinic for last 8 wks came in her 39/40 POA, found to have transverse lie, what will you do next?
    a- Immediate CS
    b- U/scan
    c- External cephalic version
    d- Vaginal examination
    e- Trial of labour

    O2 saturation in SVC - 70%, IVC - 80%, RA - 90%. What could be the examination finding?
    a- Fixed split in sternal border
    b- Continuous murmur in the upper if sternal
    c- PSM in lower sternal border

    Vitamin B complex deficiency will cause which of the following eye complication -
    a- Optic neuropathy
    b- Retinal pigmentation
    c- Papilloedema
    d- Cataract
  24. R.dass

    R.dass Guest

    One yr old child, with If testes in the scrotum and Rt/testes couldn’t be found in the inguinal region. WOF statement is true -
    a- More chance to get torsion of If testes
    b- If you do orchidopexy at 3 yr child’s spermatogenesis will be normal
    c- Chance to get malignancy of his If/testes is more common than other children

    Erythema nodosum is presented in -
    a- Sarcoidosis
    b- Rheumatoid arthritis
    c- Leprosy
    d- Rheumatic fever
    e- Tuberculosis aippg.com

    A lady presented with insomnia (mainly early morning), weight loss and loss of appetite. She doesn’t like to get up from bed feeling not worth. Possible diagnosis -
    a- Somatization
    b- Generalized anxiety disorder
    c- Major depression
    d- Hyperthyroidism
    e- Obsessive compulsive disorder

    Common side effect of atypical anti psychotics -
    a- Neutropenia
    b- Sexual dysfunction
    c- Weight gain
    d- Parkinson

    A patient presented with hemiplegia and recovered in few hrs. his CT scan was normal. What will you do next?
    a- Treat with anti-thrombolytic agent
    b- Treat with anti-coagulant
    c- Do nothing
    d- Give aspirin

    A patient presented with transient amnesia and blurred vision bilaterally. Where is the possible side of lesion?
    a- Middle cerebral artery
    b- Internal cerebral artery
    c- Vertebral basilar artery
    d- Anterior cerebral artery

    Which one of the following is cause for post coital bleeding?
    a- Fibroid b- Cervical polyp
    c- Candidiasis

    Cause of acute retention of urine, except -
    a- Spinal cord lesion
    b- Genital warts
    c- Retroverted simplex
    d- Herpes simplex

    Which condition will not associated with Raynaud’s phenomenon
    a- Rheumatoid arthritis
    b- Scleroderma
    c- Ankylosis spondylitis
    d- PAN e- SLE

    13yr old girl presented few months after attained menarche, with heavy periods each lasting about 10 days. All of the following are correct
    a- She may need iron supplement
    b- Her periods can be get regular after sometimes
    c- If she wants to become pregnant she will need Clomiphene
    d- Can be treated with NSAID
  25. R.dass

    R.dass Guest

    26 yr old lady presented with hematemesis about 1L of blood few hrs ago with 2 episodes of melena. After IV cannulation, what is the next step in the management/
    a- Immediate surgery
    b- Give Omeprazole IV
    c- Immediate Gastroscopy
    d- Sucralfate
    http://www.aippg.net/forum
    Newborn male child with normal genitalia -
    a- XXY
    b- Testosterone ineffective in the end organ
    c- Female child with 17 OH deficiency
    d- Mother received cyproterone from 8 wks of POA

    During transition from fetal circulation to neonatal, except -
    a- Increased RV out put
    b- Closer of ductus arteriosus
    c- Closer of ductus venous
    d- Cessation of blood flow through F.ovale
    e- Increased blood flow to pulmonary region

    70 yr old lady with pneumaturia, what is the underlying cause
    a- CA colon
    b- Pelvic inflammatory disease
    c- Diverticular disease
    d- Tuberculous caecum
    e- Ulcerative colitis

    A lady traveled from UK in a plane 1/52 back, presented with acute chest pain. What could be the cause (ECG given)?
    a- Inferior infarction
    b- Ventricular fibrillation
    c- Pulmonary embolism
    d- Atrial flutter

    Deep vein thrombosis can be reliably diagnosed by -
    a- Calf Tenderness
    b- Hoffman sign
    c- Swelling of calf

    Regarding mycoplasma pneumonia
    a- Caused by mycoplasma hominis
    b- Common presentation is pharyngitis
    c- Common in immune compromised person
    d- Common cause of labour pneumonia

    Which of the following statement is incorrect -
    a- Strept pneumonia is the commonest organism causing lung abscess
    b- Psittacosis infection is commonly presented with splenomegaly

    50 yr old lady presented with intermittent sudden severe facial pain on one side associated with sensory loss on that side. Possible diagnosis -
    a- Trigeminal neuralgia
    b- Post herpetic neuralgia
    c- Multiple sclerosis
    d- Migraine
    e- Facial nerve palsy

    Hypertension is the important risk factor for which of the following
    a- Coronary artery disease
    b- Renal failure
    c- Ischemic stroke
  26. R.dass

    R.dass Guest

    A diabetic patient takes 20 unit of short acting insulin and 10 unit of intermediate acting insulin in the afternoon. Wakes up around 4am with sweating. Which of the following treatment is best for prevention of this attack?
    a- Reduce the short acting insulin
    b- Increase the short acting insulin
    c- Reduce the intermediate acting insulin
    d- Increase the intermediate acting insulin
    e- Reduce both short and intermediate acting insulin
    aippg.com
    An old lady presented with extended bladder up to umbilical without pain. Possible Dx
    a- Chronic urinary retention
    b- Neuropathic bladder
    c- Herpes infection around Vulval area

    Elderly abuse is common in Australia. Which of the following is true?
    a- Elderly female are more commonly affected than elderly male
    b- More often by unknown person
    c- The abusers are more likely mentally retarded
    d- Mentally ill is least abused
    e- Physically ill is least likely affected

    A lady presented with frequent hot flushing and dry vagina. Which of the following management will be more efficient and won’t cause spotting?
    a- Oestrogen and progesterone both daily
    b- Oestrogen daily with progesterone for last 12 days
    c- Oestrogen patch
    d- Oestrogen pessary

    An 18 yr old dressed as a female came to you his boyfriend for problem in sexual relationship. He always felt uncomfortable with his sex since childhood. He has been dressing several times in past. What is this phenomenon?
    a- Homosexual
    b- Transsexualism
    c- Transvestism
    d- Masochism
    e- Gender identify disorder

    A lady has dog phobia but her boyfriend have a germen shepherd dog. WOF would most appropriate initial management?
    a- To tell her to ask her boyfriend to have a small dog
    b- To tell her to ask her boyfriend to have a cat instead of dog
    c- Ask to leave her boyfriend
    d- Ask her to read books regarding dog with some shepherd picture

    A lady 150cm, in labour, Cx effaced and 4cm dilated and head at 0 station. With intact membrane, what is the next management?
    a- Trial of labour
    b- LSCS
    c- U/scan detect fetal abnormality
    d- X-ray pelvimetry
    e- Oxytocin

    A patient has a history and suggestive of hemochromatosis. What is the investigation you will do to screen the relative?
    a- Liver biopsy
    b- Ferritin level
    c- Transferin level
    d- CT abdomen

    A baby born to HbsAg +ve mother, what is your management?
    a- vaccinate the mother
    b- Reassure
    c- Separate the child from mother
    d- Give immunoglobulin to mother
    e- Give hyper-immunoglobulin and Hep B vaccine to baby

    Postmenopausal woman with decreased libido. All of the following are the cause except
    a- Lack of ability of orgasm
    b- Loss of pelvic muscle strength
    c- Atrophy of vagina
    d- Dryness of vagina
  27. R.dass

    R.dass Guest

    A pregnant prime G1P0 with 31 weeks came with breech presentation what will you do
    a- Urgent U/scan
    b- Do Vx examination
    c- Do x-ray pelvimetry
    d- Do cephalic version
    e- Review in 2 week time

    WOF association is correct -
    a- Mother with platelet count 100 thousand (150-250 thousand) - neonatal intracerebral haemorrhage
    b- Mother with Antiphospholipid ab - IUGR
    c- Mother with anti RO ab - neonatal heart block
    d- Mother with proteinuria of 4g/I in the 1st trimester - material renal impairment in 3rd trimester
    e- Mother with lupus antibody - she has more risk of pul thromboembolism
    aippg.com
    Regarding carpal tunnel syndrome -
    a- Most common presentation is regular awakening in the night with pain
    b- Tingling pain along the course of median nerve
    c- Paresthesia over little finger

    A patient with chronic ulcer on the lower limb, and pain become worse when elevated. The likely cause is
    a- Perforator incompetence
    b- Ischemic ulcer
    c- Venous ulcer
    d- Streptococcal infection
    e- Diabetic ulcer

    Ascities with malignant cells what is true -
    a- Palpable nodules on rectal examination
    b- Supraclavicular LN
    c- Liver enlargement
    d- Splenomegaly
    e- Generalized lymphadenopathy

    Regarding CTG patterns which is correct -
    a- Small (<10bsm) deceleration later and almost at the end of uterine contraction, but it takes time to reach the base line - foetal hypoxia
    b- Loss of beat to beat variation over a period of 5min - need urgent delivery

    A patient developed motor weakness of R/face, arm and leg, sensation intact. The site of lesion -
    a- L/middle cerebral artery
    b- L/anterior cerebral artery
    c- L/internal capsule
    d- Vertebro - bascilar artery

    In colorectal ca, what percentage of stage duke A is diagnosed by faecal occult blood -
    a- Less than 5% b- 15%
    c- 25% d- 50
    e- More than 75%

    Common cause of bloody discharge from nipple -
    a- Duct ectasis
    b- Intra ductal papiloma
    c- Pagget disease
    d- Ca breast

    Point prevalence in schizophrenia means that -
    a- Cases in one year
    b- Current cases at that time
    c- The total number of cases

    13yr old child with 9yr old height, WOF indicate good prognosis for his final height?
    a- His bone age is 16yr
    b- His bone age is 13yr
    c- His bone age is 9yr
  28. R.dass

    R.dass Guest

    After recovery from fever a child developed a neck swelling which is translucent and is located in the poster triangle of the neck. What is the possible diagnosis?
    a- Cystic hygroma
    b- Tuberculous adenitis
    c- Branchial cyst
    d- Bacterial adenitis
    e- Metastatic LN

    A patient was treated with anti-H.pyloric regimen for recurrent peptic ulcer. WOF is safest and least inconvenient Ix to evaluate the effectiveness of treatment
    a- Serology
    b- Biopsy
    c- Serum Gastrin level
    d- Ba meal x-ray
    e- Urea breath test aippg.com

    A patient presented with sweating and agitation, probably opioid toxicity. What is your treatment?
    a- Naltreaxone
    b- Naloxone
    c- Diazepam
    d- Diuretic
    e- Anticholinergic

    Postoperative patient, his pt chart shows 2 L i. V infusion, 2L loss from nasogastric tube, urine out put 700 ml (N = 1500ml or > 50ml/h, oliguria < 400ml/h). His potassium level is 3.4 (3.5 - 5mmol/l). What will you order for next 24 hrs?
    a- 3L normal saline + 1L 5% dextrose + 100mmol KCL
    b- 2L Hartman + 1L normal saline + 100mmol KCL
    c- 4L normal saline + 50mmol/l
    d- 3L Hartman + 1L 5% dextrose

    Which of the following suggestive pulmonary embolism?
    a- CXR- normal, ventilation scan - normal, perfusion scan - reduced
    b- CXR- normal, ventilation scan - normal, perfusion scan - normal
    c- CXR- abnormal, ventilation scan - reduced, perfusion scan - reduced
    d- CXR- normal, ventilation scan - reduced, perfusion scan - reduced

    Which fining is more common in pleural effusion due to TB chest?
    a- Low or absent glucose
    b- Mononuclear cells
    c- Blood stained effusion
    d- Protein < than 3g/dl

    A patient was prescribed sertraline for depression he was scared that he might develop dependency and impotence. What should you advise?
    a- Yes he is correct
    b- He may develop impotence but it is unlikely to cause dependency
    c- Both these side effect are not related to sertraline

    A man underwent anterior resection for ca rectum, on the 5th day of operation there was a copious serosanguineous fluid coming through surgical wound. What is the expected complication?
    a- Failure in anastomosis
    b- Concealed haematoma
    c- Wound infection
    d- Wound dehiscence

    What are the complication excepted inmonochorionic di-amniotic twins than dichorionic di-amniotic twins, except -
    a- Acute poly-hydramniosis
    b- Cerebral palsy in second twin
    c- Feto-fetal blood transfusion

    It is important to assess mental state of adolescence, all of the following finding are normal except -
    a- Fighting with their siblings
    b- Disregarding their physical well being
    c- Most of the time accompanying with peers
    d- Conflict with their parents regarding the religion and cultural believes

    A patient who had a reflux esophagitis came with progressive dyspepsia of 2-mo duration. He is otherwise normal. Possible cause -
    a- Oesophageal CA
    b- Oesophageal stricture
    c- Plummer Wilson disease
    d- Psychogenic

    A child has abnormal blinking movement of eyes, which was more on watching TV and when he was tired and stressed. They are present even during examination -
    a- Habitual tic
    b- Partial complex seizure
    c- Myoclonic epilepsy

    Picture of U/scan and mammography of breast lump given lump seems to be cystic in u/scan and homogenous round mass in the mammography, what is the next management?
    a- excision biopsy
    b- Incision biopsy
    c- Fine needle aspiration
    d- Mastectomy
    e- Radiotherapy
  29. R.dass

    R.dass Guest

    35 yr old lady came to you with a h/o mild menorrhagia and anxiety, recently she feels her husband is detected from her and she is closed to her husband as she used to be, she has two children living in rented house and bought all household things in higher purchase, they can’t afford to go out together for dinner. Examination was normal. What is the next step of management?
    a- Refer her to a psychiatrist aippg.com
    b- Send her for marriage counselling
    c- Interview her husband
    d- Advise them to take a holiday
    e- Refer her to the gynecologist

    Which of the following is correct regarding ca nasopharynx?
    a- Arises from lymphatics
    b- Not sensitive to radiotherapy
    c- Respond well to chemotherapy
    d- Associated with EB virus infection
    e- Locally destructive lesion

    All of the following can cause serotonin syndrome except -
    a- Haloperidol
    b- L - tryptophan
    c- Moclobemide
    d- Citalopram
    e- Imipramine

    Nullipara came with menorrhagia, what is the cause except?
    a- Adenomyosis
    b- Ux myoma
    c- Sub mucus myoma
    d- Inadequate luteal phase of progesterone
    e- Subserosa

    A lady held up during an armed bank robbery 3 wks back, she was extremely distressed and came to you, what would be her likely reaction?
    a- Irritability and angry
    b- Hypersomnia
    c- Amnesia

    Regarding Parkinson disease, which is true?
    a- Ataxia
    b- Hyper reflexia
    c- Impaired postural reflex
    d- Inability to look downward

    50Yr old woman complain her husband will die of ca though he is perfectly healthy, she also belief that she is the member of secret service. On examination she appeared to be normal and her premorbid personality was normal, when you asked about her belief she became withdrawn and gave wake answers what is the diagnosis/
    a- Delusional disorder
    b- Paronia
    c- Schizophrenia
    d- Organic mental disorder
    e- Dementia

    In Australia the most common cause of jaundice in pregnancy in 3rd trimester is -
    a- Hepatitis A
    b- Hepatitis B
    c- Hepatitis C
    d- Cholestasis
    d- Choledolithiasis

    Which of the drug will reverse the effect of heparin?
    a- Vitamin K
    b- Protamine sulphate
    c- APPT

    28 yr old female came with a soft swelling in upper 1/3 of anterior triangle, partially covered by anterior border of sternomastoid muscle. What is the diagnosis?
    a- Branchial cyst
    b- Thyroglossal cyst
    c- Tuberculous abscess
    d- Lymph node
  30. R.dass

    R.dass Guest

    A lady came with POA of 41 wks, which of the following will be excepted -
    a- IUGR
    b- CPD
    c- Meconium aspiration
    d- Fetal death rate will increase by 0.12% if pregnancy continues for another wk
    e- If fetal well being is good, con allow the pregnancy to continue for next 3-7 days

    Pregnant female in her 24/40 POA complaining of calf pain, Doppler done and DVT confirmed. Before commencing anti coagulant therapy, what are the lx can help to exclude congenital defect, except?
    a- INR
    b- Anti thrombin 111
    c- Protein S
    d- Factor V modulline
    aippg.com
    Intermittent - claudication, which one of the artery is more commonly affected -
    a-lliac artery
    b- Superficial femoral artery
    c- Profundus artery

    A female patient with a h/o self harm, which is the important bad prognostic finding?
    a- Past h/o similar attempt
    b- F/H of schizophrenia
    c- Poverty
    d- Depression
    e- Alcoholism

    Psychodynamic psychotherapy is useful in -
    a- Schizophrenia
    b- Specific phobia
    c- OCD

    Primary ovarian failure, what is the important lx?
    a- Reduced progesterone
    b- Increased LH
    c- Reduced oestrogen
    d- Increased FSH

    Regarding Mullerian agenesis, except -
    a- Normal breast development
    b- Short Vx
    c- X linked recessive

    All can be beneficial in treatment of chronic venous ulcer except -
    a- Elevation of limb
    b- Compression stocking
    c- Topical antibiotics
    d- Ligation of superficial veins
    e- Stripping of veins

    Regarding ca Cx, which will improve the early detection of CIN lesion?
    a- Make available of Pap smear to more people
    b- Improving screening method to detect CIN early

    X-ray abdomen showing multiple fluid levels, most probable diagnosis?
    a- Early small bowel obstruction
    b- Late small bowel obstruction
    c- Large intestine obstruction
    d- Rectal ca

    Child came with earache, on examination red tympanic membrane, which is bilging. WOF is true -
    a- Local antibiotic
    b- Cleaning the ear
    c- With the rupture of membrane pain will be immediately relieved
  31. R.dass

    R.dass Guest

    Football player while turning got knee pain and swelling in ½ hr, possible Dx -
    a- Rupture of cruciate number
    b- Rupture of cruciate ligament
    c- Medial ligament
    d- Patellar tendon

    Dorsal aspect of the hand ulcer and nodule, red and black in colour -
    a- Basal cell ca
    b- Squamous cell ca
    c- Angioma
    d- Melanoma

    7 mo old child presented with funny flexion movement and during that time he is not responding, as he is used to. What is the likely cause?
    a- Febrile seizure
    b- Infantile spasm
    c- Breath holding attack
    d- Infantile myoclonic seizure
    e- Petit mal epilepsy

    Thalassemia WOF is incorrect -
    a- Detective globulin chin production
    b- If both parents are T. minor, 25% of their children have T. major
    c- If lady with T. minor become pregnant she needs frequent blood transfusion

    8 yr old child presented with fever and jaundice and found to have 4cm splenomegaly. She had a p/h of neonatal jaundice needed phototherapy for several days. After that frequent h/o upper Rt/abd pain and jaundice. Possible diagnosis -
    a- Pyruvate kinase deficiency
    b- G6PD deficiency
    c- Spherocytosis
    d- Viral hepatitis

    18 mo old child brought by grandmother who says that baby babbles but not hearing well. The hearing test done at 10 mo of age was normal. What is the next step?
    a- Reassure that this is normal
    b- Repeat the hearing test now
    c- Audiological assessment aippg.com

    Elderly female came with confusion; she is on digoxin 0.125 mg and Diltiazem. ECG was given - ? A. fibrillation or couple beats (digoxin toxicity). What is the next management?
    a- Increase the digoxin dose to 0.25mg
    b- Increase the dose of Diltiazem
    c- Stop all treatment and review in 12 hrs time

    Regarding MVP which is true -
    a- Prone to endocarditis
    b- Diastolic murmur


    2CT scan of a pt one with contrast and other without contrast was given. A lady presented with sever headache on vertex and vomiting. Possible cause -
    a- Closed head injury
    b- SAH

    In the limbic system area of affect -
    a- Cingulate gyrus
    b- Amygdala
    c- Thalamus
    d- Carpus callosum

    3 yr old girl presented with periorbital oedema, proteinuria 3+, all are true except -
    a- 90% of cases will improve with Prednisolone
    b- Most of the cases are doe to focal glomerulonephritis
    c- Penicillin prophylaxis should be given
    d- Prognosis is good

    Accessory nerve supply to which muscle -
    a- Pterygoid muscle
    b- Temporalis
    c- Masseter
    d- Sternomastoid

    Which hematogenous organism is commonly causing septic arthritis?
    a- H. influenza
    b- Strept. Pneumonia
    c- Staph aureus
    d- Strept. Pyogen

    2 yr old with intermittent bile stain vomiting in between normal, otherwise clinically normal, possible diagnosis -
    a- Volvulus
    b- Pyloric stenosis
    c- Duodenal atresia
    d- GOR
    e- UTI

    ECG with short history -
    a- Wolf Parkinson syndrome

    ECG with short history -
    a- Inf MI
    b- Anterio-lateral MI
    c- Anterio-septal MI

    ECG with short history -
    a- LVH + RBBB
    b- RVH + LBBB

    ECG short history except -
    a- Atrial block with variable block
  32. R.dass

    R.dass Guest

    A patient with years of being unwell presents with a creatinine of 1.2mmol/l and high urea. He is vomiting and is anaemic. All the following are true, except:
    a- Minimal change clomerulonephritis
    b- Membranous glomerulonephritis
    c- Diffuse proliferative glomerulonephritis
    d- Focal glomerulonephritis
    e- Hypertensive nephropathy


    aippg.com
    Cerebral infarction:
    a- Homeis syndrome with increased sweating
    b- Papilloedema with optic neuritis
    c- Pain and sensation loss on the same side of the body
    d- Quadriplegia with anterior or middle cerebral artery infarct
    e- Unilateral blindness with anterior circulation

    A 52 yrs old male patient has ischaemic type chest pain for three hours and has a normal ECG:
    a- If the ECG is normal, he does not have a cardiac problem
    b- He should have an exercise stress test immediately
    c- Thrombolyties are usually not indicated
    d- Heparin and IV nitrates are indicated
    e- Wait for any treatment until cardiac enzymes are back

    Regarding a serum lipid profile and diet, what is true?
    a- Red wine improves LDL/HDL ratio
    b- Olive oil will increase the LDL/HDL ratio
    c- Positive energy balances increase LDL
    d- 100-300g of fish per week will have no effect on plasma or membranes
    e- An increase in dietary saturated fatty acids will increase VLDL


    Regarding the treatment of pager’s disease, the following is/are true:
    a- Patient should be given calcitonin
    b- Diphosphonates are indicated
    c- Cortisol
    d- May need chemotherapy
    e- 1000mg calcium everyday

    Treatment of chronic renal failure:
    a- Antacid syrups can helps
    b- Oral phosphate binding agents halt progress of bone disease
    c- All patients will have symptomatic bone disease
    d- Uraemic patients need to be dialysis
    e- Hyperkalaemia can only be treated with dialysis

    In regards to polycythemia rubra Vera which is correct:
    a- Can be caused by obstructive sleep apnoea
    b- Erythropoietin levels are high
    c- Iron deficiency is common, so iron supplement should be given
    d- ESR is increased
    e- Clinical cyanosis may be difficult to detect


    In a patient with known aortic stenosis god left ventricular function and clinical presentation with CCF. Which of the following drugs are contraindicated?
    a- Quinidine
    b- Verapamil
    c- Beta blocker
    d- Diuretics
    e- Digoxin


    In which of the following conditions you be likely to see cannon a-waves?
    a- Atrial fibrillation
    b- Ventricular extra-systoles
    c- Complete heart block
    d- Incupid incompetence
    e- Aortic stenosis


    A patient with mitral stenosis due to rheumatic fever is congestive cardiac failure; the following is/are true:
    a- Surgical mitral valve plasty might improve the situation
    b- ACE inhibitors may be indicated
    c- Right heart failure is rare
    d- Angiography should be done before operation
    e- Ejection fraction 30. Patient needs treatment

    Pulmonary hypertension and cor-pulmonate are frequency secondary to:
    a- Emphysema
    b- Bronchiectasis
    c- Pneumothorax
    d- Cadiomyopathy
    e- Sarciodosis
  33. R.dass

    R.dass Guest

    Ptosis may be found in each of the following conditions except:
    a- Cluster headache (Horton’s syndrome)
    b- Following cervical sympathectomy
    c- Posterior artery communication aneurysm
    d- Myasthenia gravis
    e- Bell’s (facial nerve) palsy

    The defect in visual fields most commonly associated with a pituitary tumour is:
    a- Crossed homonymous henianopia
    b- Central scotoma
    c- Bitemporal hemianopia
    d- Total blindness in one field
    e- Peripheral concentric constriction and enlargement of the blind spot

    Cardiac diseases known to be associated with sudden death include all of the following except:
    a- Coronary artery disease aippg.com
    b- Prolonged QT syndrome
    c- Hypertrophic obstructive cadiomyopathy
    d- Mitral stenosis
    e- Aortic stenosis

    The commonest arrhythmia associated with thyrotoxicosis is:
    a- Sinus tachycardia
    b- Atrial Fibrillation
    c- Atral flutter
    d- Atrial ectopics
    e- Ventricular ectopics

    A 35 years old housewife presents with headache, extreme muscular weakness, polyuria and polydypsia and two episodes of carpopedal spasm. On examination she has a blood pressure of 190/115mmHg and proteinuria. Initial screening blood tests show random glucose 7.2mmol/L, sodium 158mmol/L, potassium 30.mmol/L. The most likely diagnosis is:
    a- Pancreatic insufficiency
    b- Diacates insipidus
    c- Adrenocortical adenoma
    d- Renal failure
    e- Hypoparathyroidism


    The diagnosis for the patient in Question 40 is likely to be confirmed by measuring:
    a- Dexamethasona suppression test
    b- Urinary vanilly mandic acid
    c- Plasma renia
    d- Plasma cortisc
    e- Glucose tolerance

    The most common cause of secondary hypertension is:
    a- Drugs
    b- Coarctation of the aorta
    c- Primary aldosteronism
    d- Renal abnormalities
    e- Elevated catecholamines

    The most common cause of normocytic anemia is:
    a- acute hemorrhage
    b- Chronic inflammation
    c- Malignancy
    d- Hemolysis
    e- Liver disease

    The most cause of chronic bacterial orchitis is:
    a- Tuberculosis
    b- Syphilis
    c- Leptospirosis
    d- Staphylococcus aureus
    e- Pseudomonas sp

    A 35 years old woman whose pre-pregnancy body mass index was 35.0 kg/m2, is found to have glucosuria (3+) and a random capillary blood glucose level of 12.0mmol/L in the second trimester of her pregnancy. An oral glucose tolerance test confirms diabetes mellitus. Her first pregnancy results in intra-uterine fetal death at 37 weeks gestation. The most likely treatment will be:
    a- A diet in which total energy intake in restricted severely
    b- Insulin
    c- No long term follow up, since the risk of non insulin dependent diabetes is negligible
    d- Appetite suppressants
    e- Oral hypoglycemic agents

    A 46 years old woman with a body mass index of 38 presents with a 2 weeks history of sever headache, blurring of vision and nausea which followed a course of tetracyclines for a lower respiratory infection. The significant abnormality on examinations is papilledema. The probability diagnosis is:
    a- Cerebral glioma
    b- Temporal arteritis
    c- Gravitational headache
    d- Benign intracranial hypertension
    e- Cerebral abocess

    Diverticular disease of the colon is:
    a- Associated with hypertrophy of circular smooth muscle
    b- Most prominent in the right half of colon
    c- Often complicated by carcinoma
    d- Usually congenital in origin
    e- Not associated with any of the above

    In a cerebrovascular accident, hemorrhage and thrombosis may be clearly distinguished on which of the following points?
    a- Sequence of the clinical features
    b- Degree of loss of consciousness
    c- Description of onset
    d- Presence of headache
    e- None of the above

    In which of the following is ascites usually present on clinical examination?
    a- Left ventricular failure
    b- Cirrhosis of the liver
    c- Intra-abdominal Hodgkin’s disease
    d- Nephrotic syndrome
    e- Carcinoma of the uterus

    The ‘opening snap’ of mitral stenosis:
    a- Denotes valve mobility
    b- Disappears if atrial fibrillation occurs
    c- Is usually best head at the apex?
    d- Replaces the third heart sound
    e- Is really a closing snap?
  34. R.dass

    R.dass Guest

    The notifiable communicable disease that is most commonly reported in Australia is:
    a- Hepatitis A
    b- Salmonella infections
    c- Gonorrhoeae
    d- Rubella
    e- Syphilis

    Which of the following organisms is highly resistant to amoxicillin?
    a- Haemophilus influenzae
    b- Streptococcus pyogenes
    c- Escherichia coli
    d- Klebsiella
    e- Staphylococcus aureus

    Which commonly arises in a solar keratoses?
    a- Malignant melanoma
    b- Squamous carcinoma
    c- Basel cell carcinoma
    d- Kerato-acanthoma aippg.com
    e- Sarcoma

    A 30 years old woman has a history of one week of sweats and fevers. Yesterday she had right sided pleuritic chest pain. Questioning reveals a long history of recurrent mouth ulcers episodic joint pains in he hands, photosensitive skin eruptions on the face and Raynaud’s phenomenon.
    A most likely diagnosis:
    a- Systemic Lupus Erythematosis (SLE)
    b- Atypical pneumonia
    c- Dermatomyositis
    d- Hepatitis C
    e- Rheumatoid arthritis

    Where there is immunodeficiency, bacterial infections characteristically involve of the following except?
    a- Skin
    b- Respiratory system
    c- Sinuses
    d- Joints
    e- Gastrointestinal system

    A 65 yrs old woman presents with recent onset of severe right sided headaches associated with soreness of the scalp. Three days prior to admission she developed blurring of vision in the right eye. On examination she has a visual acuity of less than 6/60 in the right eye and early swelling of the right optic disk. Which of the following is the most appropriate next step?
    a- Bed rest and analgesics
    b- Pilocarpine 2% eyes drops hourly
    c- Prednisolone 60mg daily
    d- Cerebral CT scan
    e- Urgent craniotomy

    All but one of the following are recognised features of hypertrophic
    obstructive cadiomyopathy. The exception is:
    a- Sudden death
    b- A large pressure gradient between sub aortic and lower ventricular chambers in ventricular systole
    c- Sometimes autosomal dominant inheritance
    d- Q waves in anterior ECG leads
    e- Eosinophilla


    A patient presents with worsening early morning headache and early papilledema and is considered to have raised intracranial pressure. Which
    Of the listed features, if presents, would also be characteristic of this diagnosis?
    a- Nuchal rigidity
    b- Tachycardia
    c- Marked loss of visual acuity
    d- Third cranial nerve palsy
    e- Hemiation of the cerebellar tonsils through the tentorium serebelli

    Lower than normal renin levels may occur in association with:
    a- Accison’s disease
    b- Pregnancy
    c- Beta block ace
    d- Diuretic therapy
    e- Malignant hypertension

    A 55 yrs old housewife complains of persistent widespread pains in the bones getting worse over the course of 6 months. The differential diagnosis includes all except one of the following. The one exception is:
    a- Osteomalacia
    b- Multiple myeloma
    c- Osteoporosis
    d- Hyperparathyroidism
    e- Paget’s disease

    A moderately obese man, aged 65 years, presents with a history of pain and mild swelling of the left knee for the past four months. The only relevant past history is of transient cerebral ischemic attacks being managed by aspirin, 300mg daily. Full blood count and renal function are normal but the serum urate is 0.51mmol/L. He suffered from a single episode of podagra four years previously. Which of the following statements is correct?
    a- The current attacks of arthritis is probably osteoarthritis
    b- His 24 hour urinary uric excretion is probably elevated
    c- Allupurinol should be used to reduce his serum uric acid level to normal
    d- A reduction of aspirin dosage to 100mg daily will lead to a fall in the serum urate level
    e- If uric acid reduction were required, it would be better to prescribe sulphinpyrazone that allupurinol to a patient already receiving aspirin
  35. R.dass

    R.dass Guest

    Characteristically, type A viral hepatitis: aippg.com
    a- Is a DNA virus infection often associated with seafood poisoning
    b- Has an incubation period of three months
    c- Carries a greater risk of fulminant hepatic failure in young compared with old patients
    d- Often presents with headache plus right hypochoncrial pain and tenderness
    e- Can progress to chronic active hepatitis if cholestasis is prolonged

    Which of the listed drugs has the potential to induce life threatening cardiac arrhythmias when taken in overdose?
    a- thioricazine
    b- Haloperidol
    c- Lithium
    d- Fluphenazine
    e- Levodopa

    Which of the following adverse effects is best associated with use of flucloxacillin?
    a- Phototoxicity
    b- Interstitial nephritis
    c- Cholestatio hepatitis
    d- Agranulocytosis
    e- Acute hemolytic anemia

    Hirsutism is recognized side-effect of treatment with all excepts one of the following agents. Which is the exception?
    a- Progestogens
    b- Psoralens
    c- Minoxidil
    d- Trimethoprim
    e- Diazoxide

    During the first 4 hours after an overdose of paracetamol, a patient will develop:
    a- Hypoglycemia
    b- Hyperventilation
    c- Increased serum ALT and AST
    d- Pin-point pupils
    e- None of the above

    The ECG changes in left ventricular hypertrophy typically include all of the following but one. The exception is:
    a- ST elevation in lead
    b- Tall R waves in leads V5 and V6
    c- Deep S waves in leads V1 and V2
    d- Left axis deviation
    e- T waves inversion in lead a VL

    A 55 years old man with a 30 pack/year smoking history presents with a history of angina of effort. With respect to potential drug therapy, which one of the following statements is covered?
    a- verapamil and nifedipine would each reduce myocardial rate and contractility
    b- Glyceryl trinitrate transdermal patches should be worn for 24 hours and then replaced
    c- The predominant mechanism of action of glyceryl trinitrate is peripheral arterial vasodilatation and a reduction in cardiac after-load
    d- Beta blockers are indicated as prophylactic therapy for exercise induced but not vasspastic angina
    e- Beta blockers and calcium channel blockers could each precipitate asthma

    Which of the listed anti arrhythmic drugs is the drug of choice in most cases of Supraventricular tachycardia (including nodal tachycardia)?
    a- Digoxin
    b- Quinidine
    c- Flecanide
    d- Verapamil
    e- Propranolol

    In a patient with severe asthma, which of the features listed would be the most ominous?
    a- Arterial PO2 50mmHg
    b- Arterial PCO2 50mmHg
    c- FEV10.8 litres
    d- Very loud wheezes
    e- Respiratory rate of 20 per minutes

    An elderly man has been hospitalized for one week because of severe and worsening Parkinson’s disease. He is found in bed tachypnoeic, tachycardic and responsive only to painful stimuli. Pulmonary examination reveals diffuse wheezes and crackles in the right lung field posteriorly and absent breath sounds in the left lung field. Which of the following conditions is most likely to be responsible for this patient’s deterioration?
    a- Massive pulmonary embolism
    b- Pulmonary oedema after acute myocardial infarction
    c- Aspiration pneumonia with unilateral bronchial obstruction
    d- Spontaneous pneumathorax
    e- Tracheosophageal fistula
  36. R.dass

    R.dass Guest

    All except one of the following statements are characteristic of ventricular septal defect of the heart. The o exception is:
    a- It produces a left to RIGHT SUNT
    b- It can be diagnosed by cardiac ultrasound
    c- It is associated with a continuous murmur throughout systole and diastole
    d- It is one of commonest congenital hear lesions
    e- It is associated with a step up in oxygen saturation in the right ventricle

    All of the following except one typically produce keratin scales. aippg.com
    The one exception is:
    a- Squamous cell carcinoma
    b- Solar keratoses
    c- Psoriasis
    d- Pityriasis versicolor
    e- Basal cell carcinoma

    A 75 yrs old woman, previously in good health, presents with a history of painless jaundice of 2 weeks duration. There is a distended gall bladder revealed by ultrasound examination. What is the most likely cause?
    a- Chronic Pancreatitis
    b- Alcoholic cirrhosis
    c- Gall stones
    d- Carcinoma of the pancreas
    e- Acute Cholecystitis

    In diabetic neuropathy you can find each of the following except:
    a- Bradycardia
    b- Urine retention
    c- Impotence
    d- Diarrhoea at night
    e- Foot ulcer

    In suspected acute MI what is the criteria for thrombolytic therapy?
    a- T inversion
    b- ST depression/elevation???
    c- New LBBB
    d- New RBBB
    e- Q waves

    A 55 yrs old woman was found unconscious in her house. She has a dilated pupil. What is the cause?
    a- overdose
    b- Brain infarct
    c- Subdural hematoma
    d- Subarachnoid hemorrhage
    e- Coma

    Antidote for heparin is:
    a- Protamine sulphate
    b- Vitamin K
    c- Fresh frozen plasma


    In heparin induced thrombocytopenia which of the following is typically seen?
    a- Petechial purpura on the skin
    b- Thrombosis
    c- Joint bleeding
    d- Hematuria
    e- Ecchymosis

    All of the following can cause renal papillary necrosis except:
    a- Liver disease
    b- Medullary sponge disease
    c- Sickle cell disease
    d- Diabetes mellitus
    e- Analgesic nephropathy

    Opening snap indicates:
    a- Mitral Valve mobility
    b- Atrial fibrillation cause disappearance of the opening snap
    c- Replaces S3
    d- Best heard at 2nd right intercostals space
    e- Remains unaltered despite progression of disease

    In a man from overseas, his chest x-ray reveals silent tuberculosis. PPD skin test is 10 in. treatment of choice is:
    a- Sputum culture
    b- Observation
    c- Triple therapy
    d- Isoniazid
    e- Isoniazide and ethambutal
  37. R.dass

    R.dass Guest

    In infectious mononucleosis:
    a- Incubation period is 4-5 days
    b- Is seen more in patients with AIDS
    c- Incubation period is 14-21 days

    In asthma, which is the most important factor in diagnosing its severity?
    a- Decreased PEY
    b- Increased diumal variability
    c- Decreased diumal variability aippg.com


    A man returning from an overseas trip has Diarrhoea and vomiting for 2 weeks, salmonella was isolated. What is the next step in management?
    a- Ampicillin
    b- Repeat stool culture
    c- Trimethoprim-sulphamethoxazole
    d- Only observation
    e- Metronidazole

    All of the following are side effects of Prednisolone except:
    a- Hirsutism
    b- Lymphopenia
    c- Leucocytosis
    d- Osteoporosis
    e- Weight gain

    Polycythemia rubra vera:
    a- Contraction of plasma
    b- Expansion of plasma volume

    Which of the following is correct regarding the overdose of TCA?
    a- In a mixed overdose with TCA’s and benzodiazepines flumazenil is contraindicated

    All of the following are features of Parkinson’s disease except:
    a- Postural reflexes lost
    b- Can begin unilaterally
    c- Tremor gets worse during sleep
    d- Cogwheel rigidity
    e- Able to stop while walking

    A patient presents with impaired sensation on the medical aspect of the hand, 4th and 5th fingers of the hand are flexed. Where is the lesion?
    a- Ulnar nerve at the elbow
    b- Ulnar nerve at the wrist
    c- Redial nerve damage at the wrist
    d- Medial nerve damage at the wrist
    e- Redial nerve damage at the elbow

    A patient presents with moderate hemiparesis of legs and arms, no dysphasia, face appears normal. Where is the lesion most likely to be?
    a- Cerebral cortex
    b- Internal capsule


    All of the following are features of thyrotoxicosis except:
    a- Wasting of small muscles of the hand
    b- Fine tremor of hands
    c- Irritability
    d- Weight loss
    e- Wide pulse pressure

    Which of the following is the most common cause of ketoacidosis?
    a- Cessation of insulin in IDDM
    b- Undiagnosed IDDM
    c- Undiagnosed NIDDM
    d- Adrenal failure
    e- Infection

    In paracetamol poisoning the involvement of which organ is most important?
    a- Renal injury
    b- Hepatic injury
    c- Brain injury
    d- Stomach injury
  38. R.dass

    R.dass Guest

    Which of the following is the most common pathology involved in endocarditis?
    a- Rheumatic fever
    b- Staphylococcus
    aippg.com
    A 60yrs old male patient has difficulty climbing upstairs. O/E he had wasting of right biceps, diminished biceps jerk, lower limb spasticity, lower limbs reflexes exaggerated and Babinski’s sign present, hip flexion weak. What is the most probable diagnosis?
    a- Cervical disc lesion
    b- Lumbar canal stenosis
    c- Motor neuron disease
    d- Multiple sclerosis
    e- WPW syndrome

    A man on anti-hypertension therapy goes for surgery. Discontinuation of which of the following drugs causes serve rebound hypertension during operation?
    a- Enalapril
    b- Clonidine
    c- Methyldopa
    d- Hydralazine
    e- Verapamil

    After splenectomy for spherocytosis, each of the following is correct except:
    a- Erythrocyte osmotic fragility will not change
    b- Erythrocyte life span will be normal
    c- Anemia will be found


    Normocytic, normochromic anemia can be found in which of the following diseases?
    a- Sickle cell anemia
    b- Vitamin B12 deficiency
    c- Renal failure
    d- Liver failure
    e- Hemolysis

    A woman complaining of episodes of intense pain over the lower jaw and zygomatic bone lasting for about 2-5 min which has been going for 2 weeks.
    There are no trigger zones and on examination there is sensory loss on the same side. Which of the following is the most likely diagnosis?
    a- Multiple sclerosis
    b- Trigeminal neuralgia
    c- Migraine
    d- Facial palsy
    e- Herpetic neuralgia

    What is the best way to diagnose giardiasis?
    a- Duodenal aspirate showing trophozoites
    b- Fecal microscopy showing ova
    c- Fecal culture
    d- Serum immunology
    e- Villous atrophy

    A man with multiple episodes of sore throat developed periorbital edema, BP of 160/120, oliguria, which of the following is correct?
    a- Giving water corrects oliguria
    b- Hematuria is a prognostic indicator

    Which of the following is correctly matched?
    a- Decreased transferrin: in iron deficiency anemia
    b- Increased transferrin: in hemosiderosis
    c- Normal transferrin: in Hemachromatosis

    Which of the following is most implicated in causing pseudo membranous colitis?
    a- Metronidazole
    b- Ampicillin
    c- Vancomycin
    d- Sulphonamides
    e- Tetracyclines
  39. R.dass

    R.dass Guest

    A result of 120mmol/l sodium is consistent with:
    a- Decreased sodium osmolality
    b- Decreased total extracellular body Na
    c- Water intoxication
    d- Inappropriate ADH secretion
    e- Diabetes insipidus

    Which of the following is correct regarding myasthenia gravis?
    a- Some patients do not have anti-cholinergic antibodies
    b- Anti cholinergic drugs are used for treatment
    c- Thymectomy is only indicated for thymoma
    d- Reduced tendon reflexes are characteristic
    e- Repeated stimulation of peripheral nerve always shows pathological fatigue

    Eradication of helicobacter pylori is important because: aippg.com
    a- It influences relapse
    b- It reduces complication (incidence of gastric lymphoma)
    c- It heals quickly
    d- It decreases local gastritis
    e- It decreases the cimetidine dosage

    Which of the following anti-hypertensive drug causes reflex tacycardia?
    a- Methyldopa
    b- Hydralazine
    c- Prazosin
    d- Verapamil
    e- Diltiazem

    Which of the following is true regarding NIDDM?
    a- The genetic factors are more important that in IDDM
    b- Abdominal fat is a risk factor
    c- Oral hypoglycemic agents can cause insulin resistance
    d- Patients with NIDDM will never?? Insulin
    e- Patients with gestational diabetes don’t go into NIDDM

    Regarding significant aortic stenosis, which of the following is true?
    a- If the gradient is>50mmHg, patients needs surgery
    b- Poor LV function is a contraindication for surgery
    c- Can cause death
    d- Chest pain indicates angina pectoris
    e- Palpable thrill

    A child is presents with long history of unexplained productive cough and wheeze. He is failing to thrive (signs of malobsorbtion). What is your initial investigation?
    a- Stool exam
    b- Chest x-ray
    c- Sweat test
    d- Blood exam

    What is true about febrile convulsion?
    a- It occurs between 6-8 years of age
    b- Prognosis is not good
    c- Risk of developing epilepsy is 10%
    d- Lasts about 15 min.

    Which of following conditions usually resolves spontaneously?
    a- Congenital heart block
    b- Patient ductus in 15 yrs boy
    c- Atrial septal defect
    d- Small ventricular septal defect

    In a child with Kernicterus which abnormality is found in the blood?
    a- High Unconjugated bilirubin concentration


    A child is who was well before developed malaise and now he has fever 40°c. 3 days ago he falls from tree. Mother noticed that he limped. His thigh is swollen there is an area of pain and tenderness. What is the likely cause?
    a- Fracture
    b- Thrombophlebitis
    c- Ca of bone
    d- Osteomyelitis

    A child is presents with sudden onset of high fever. He is unable to drink or swallow. He is stridor. Sever epiglottitis has been diagnosed. What is your management?
    a- Antibiotics
    b- Intubations may be required
    c- Throat should be examined


    A 76 yrs old man is investigated for a complaint of weakness. The hematological report shows:
    Hb 5.6g/100ml, MCV 72u, MCHC 23%, WBC 12*10, Platelets 382*10,
    ESR 46mm/1 hour.
    The film shows a marked hypochromia, a moderate, marked polkilocytosis, slight Polychromasia, mature neutrophils, reticulocytes 3%

    The most likely diagnosis is:
    a- Megaloblastic anemia
    b- Iron deficiency anemia caused by chronic blood loss
    c- Chronic renal failure
    d- Anemia due to folate deficiency
    e- Thalassaemia minor

    The mortality from the initial blood of a ruptured intracranial aneurysm is about:
    a- 3-5%
    b- 5-10%
    c- 20-35%
    d- 70-90%
    e- 95%
  40. R.dass

    R.dass Guest

    A 27 yrs old woman in her tenth week of pregnancy was found on a mid-steam urine culture to have Ecoil 10 colonles/ml. She was asymptomatic. Which of the following should be considered next?
    a- Intravenous pyelogram
    b- Repeat of urine culture and antibiotic therapy if the same organisms are present
    c- No further investigation
    d- Investigation after delivery
    e- Immediate antibiotic therapy aippg.com

    Creatinine clearance:
    a- Is an accurate measure of renal tubular function
    b- Requires measurement of only the urine creatinine concentration
    c- Cannot be measured in the nephrotic syndrome
    d- Approximatles to the glomerular filtration rate
    e- Measures the total body pool of creatinine

    A 27 yrs old woman presents with increased frequency of nucturition including nocturia over the recent three weeks. Over this time she has been thirsty and lethargic. Which one of the metabolic derangements is least likely to present in this way?
    a- Hypokalemia
    b- Diabetes mellitus
    c- Antidluretic hormone deficiency
    d- Hypercalcemia
    e- Dilantin toxicity

    Which of the following rules out radical mastectomy for breast cancer?
    a- Satellite nodules over breast skin
    b- Parastemal tumor nodules
    c- Proven supraclavicular metastasis
    d- Oedema of the arm
    e- All of the above

    Polymyalgia rheumatics is usually
    a- Seen in teenagers
    b- Associated with a high erythrocyte sedimentation rate
    c- Treated initially with penlcillamine
    d- Associated with night blindness
    e- Is associated with a high white cell count

    The luteal phase of the following menstrual cycle is associated with:
    a- High luteinizing hormone (LH) levels
    b- High progresterone levels
    c- High prolactin levels
    d- Low basal body temperature
    e- Proliferative changes in the endometrium

    A 48 yrs old woman has lost all desire for sexual intercourse since hysterectomy 9 months previously. The sexual problem is most likely to reflect:
    a- Removal of the cervix
    b- The onset of menopause
    c- The expectation of sexual alteration by operation
    d- A loss of desire due to ageing
    e- Loss of any further chance of pregnancy

    due to: (Obstruct Bowel)
    a- Meckel’s diverticulum
    b- Benign tumour
    c- Carcinoma

    A 38 yrs old woman came with repeated H/O Diarrhoea, since 3-4 months. She had lost 4 kg. in weight and used to get lower abdominal pains at irregular intervals. O/E a ill defined mass was found in the Rt sliac fosses. What is the most probable diagnosis?
    a- Ulcerative colitis
    b- Chron’s disease
    c- Cacinoma of sigmoid colon
    d- Appendicular absuss
    e- Effusion

    A 38 yrs old man came to you saying that his father and brother both had died from. (Carcinoma of the bowel) He wanted the same disease to the excluded in him which investigation would you advice:
    a- Occult blood in stools
    b- Sigmoidoscopy
    c- Sigmoidoscopy +3 stool specirmes for occult bid
    d- Colonoscopy

    Which are the whom you will part for M.T. emergency surgery in intestinal obstruction? (ABD – Emergency)
    a- strangulation
    b- Severely dehydrated RT
    c- Pulse>100
    d- Inguinal hernia in the newborn

    Which of the following conditions will you be able to flicit the history of passing bid per sectum after the act of bifurcation? (bleeding/Rectum)
    a- Carcinoma colon
    b- Fissure in ano
    c- Internal hemorrhoids
    d- External hemorrhoids

    In epigastric hernia, (of linea alba) which is true:
    a- Situated below the umbilicus
    b- Contains intestine
    c- Is vary large
    d- Contains extra-peritoneal fat
    e- Required treatment
  41. R.dass

    R.dass Guest

    Patient with chronic WPW syndrome presents with AF.
    WOF are management:
    a- Digoxin
    b- Verapamil
    c- Cardioversion
    d- Sotolol
    e- Disepynamide

    Metabolism of Digoxin is decreased by:
    a- Quinidine
    b- Warfarin
    c- Verapamil
    d- Amiodarone
    e- Ametidine

    Digoxin intoxication presents with W.O.F. except:
    a- Hypokalemia
    b- Patient has yellowish vision
    c- A.F. can occur

    Patient nerve is affected. W.O.F. may be the symptoms:
    a- Absence of knee reflex
    b- Ankle jerk is affected
    c- Sensory loss of the medium aspect below knee
    d- Difficulty in dorsiflaxion
    e- Sensory loss in the sole aippg.com

    Peracetamol poisoning- In the management. W.O.F. is appropriate to prevent:
    a- IV acetyl cysteine
    b- Oral acetyl cysteine
    c- Gestric lavage with charcoal
    d- Ipecac syrup
    e- Peritoneal dialysis

    Patient with severe hypertrophic cardio-myopathy. W.O.F. drugs are suitable for this patient?
    a- Digoxin
    b- Amiodarone
    c- Verapamil
    d- Furasemide

    Patient had acute Pancreatitis 4 days later he presents with pseudo cyst. What is your management?
    a- Pseudocyst has connection with pancreatic ducts
    b- Cyst has epithelial wall
    c- Cyst resolve spontaneously leave it

    Blood picture of anemia in chronic disease:
    a- Serum Fe increases
    b- Macrocytic anemia
    c- Microcytic anemia
    d- Normocytic anemia

    Guillian-barre syndrome after viral infection:
    a- Increasing protein with normal cell in CSF
    b- Antibodies against myelin shed
    c- Nerve conduction can be used
    d- Low glucose in CSF

    Osteosclerosis:
    a- Normal tympanic membrane
    b- Bulging blunt tympanic membrane

    Congenital spherocytosis except:
    a- Transient Leukocytosis
    b- Decreasing erythrocyte life span
    c- Thrombocytosis
    d- Splenectomy

    TLA unilateral eyesight lost
    a- Atheroma of internal carotid
    b- Vertebral basilar
    c- Posterior communicating cerebral

    Investigation of hypoadrenalism:
    a- Low renin
    b- Genitalia pigmentation
    c- Autoimmune in
    d- ACTH stimulation test
  42. R.dass

    R.dass Guest

    In diabetic neuropathy you can find each of the following except?
    a- Bradycardia
    b- Urine retention
    c- Impotence
    d- Diarrhoea at night
    e- Foot ulcer

    A young man presents with pleuritic chest pain and cough. On examination there is dullness on percussion and bronchial breathing over the right lower zone, posteriorly. Which of the following is the most likely diagnosis?
    a- Right lower lobe consolidation
    b- Right lower lobe collapse
    c- Asthma
    d- TB cavity

    A 37 yrs old woman has unilateral exophthalmos. Which of the following is the most likely cause?
    a- Glaucoma aippg.com
    b- Nasopharyngeal tumour invading the orbit
    c- A neoplastic lesion in the lamina cribrosa
    d- Thyrotoxicosis
    e- Infection of the frontal sinus
    f- Maxillary arterial truma

    A middle aged man is brought to your surgery with a history of being bitten by a snake. On examination there are scratch marks on the lower leg and on other symptoms. What is you management?
    a- Reassure and send him home
    b- Excise wound
    c- Administer antivenin immediately
    d- Apply Tourniquet
    e- Observation and admission, given antivenom if necessary

    In a patient presenting with lacunar infarction, which of the following are true?
    a- Sensory loss only
    b- Dysphasia
    c- Due to an aneurysm
    d- Haemorrhage from the middle cerebral artery
    e- ? Thrombo embolism may cause

    Helicobacteopylori causes all of the following excepts?
    a- Duodenal ulcer
    b- Gastritis
    c- Gastro-oesophageal reflux
    d- Gastric carcinoma
    e- Gastric lymphoma

    A 28 years old male presents with distal weakness and atrophy of the small muscles of both hands (interossei, lumbricals, thenar and hypothenar). What is the most likely diagnosis?
    a- Multiple sclerosis
    b- Bilateral median nerve palsy
    c- Syringomyelia
    d- Bilateral ulnar nerve palsy
    e- Brainstem infarction

    The single most reliable test for hemochromatosis is?
    a- RE cell mass
    b- Serum iron
    c- Serum Ferritin
    d- Serum tranferrin
    e- Transferrin saturation

    A female age 23 yrs, presents with proteinuria. There is a previous history of enuresis till 13 years of age. Her sister also had enuresis as a child. The history is suggestive of which of the following?
    a- Chromic glomerulonephritis
    b- Reflux nephropathy
    c- Congenital nephritis
    d- Polycystic kidney disease
    e- Analgesic nephropathy

    In which of the following, is administration of immunologic as prophylaxis not useful?
    a- Hepatitis A
    b- Hepatitis B
    c- Rubella
    d- Mumps
    e- Varicella

    A 68 years old female presents with a 2 week history of unilateral headache and an ESR 8omm/hr. The most appropriate treatment is:
    a- NSAID’s
    b- Aspirin
    c- Carbamazepine
    d- Prednisolone
    e- Ergotamine

    Which of the following is least likely to facial nerve palsy?
    a- Skull fracture
    b- Mastoiditis
    c- Chronic parotitis
    d- Parotid tumour
    e- Acoustic neuroma
  43. R.dass

    R.dass Guest

    All of the following drugs are nephrotoxic except:
    a- Cyclosporine
    b- Gentomicin
    c- Digoxin
    d- Phenacitine
    e- Gold

    Common clinical findings in gross sever ascites. Except
    a- Shifting dullness
    b- Bilateral dullness in the base of the lungs
    c- Palpable hepatomegaly
    d- Eversion of the umbilicus

    In a patient with Emphysema all of the following clinical findings are present, except;
    a- Increased TLC
    b- Clubbing
    c- Hyperinflation

    A 50 yrs old woman is suffering from spastic paraplegia with pain at the T8 level. What is the most likely cause?
    a- Syringomyelia
    b- Caudal equine claudication
    c- Spinal cord compression
    d- Multiple sclerosis
    e- Guillain-barre syndrome

    Patient had two attacks of left side transient blindness during last month. He has weakness of the right hand. When he speaks, he uses wrong words. What is the most likely cause?
    a- Posterior cerebral artery thrombosis
    b- Vertebral artery thrombosis
    c- Right carotid thrombosis
    d- Left middle cerebral artery thrombosis
    e- Right middle cerebral artery thrombosis

    An old lady presented with the extended bladder up to Xiphoid process. What is the most likely diagnosis?
    a- Acute urinary retention
    b- Chronic urinary retention
    c- Neuropathic bladder

    All of the following are common clinical features of duodenal ulcer except
    a- Loss of appetite
    b- Hunger pain
    c- Periodicity
    d- Nocturnal pain
    e- Pain immediately before meal

    Hypoglycaemia can be found in all of the following conditions except
    a- hyperprolactineamia
    b- Anorexia nervosa
    c- Primary hyper aldostronizm
    d- Addisons disease

    A lady is on phenytoin. Her blood level of phenytoin is less than half of the therapeutic dose. Which of the following is correct?
    a- Double the dose
    b- Phenytoin interferes with warferine action

    Mycoplasm pneumonia is characterized by all of the following features except
    a- ESR may be very high
    b- WBC normal
    c- Lower lob pneumonia
    d- Cough is unusual
    e- Tetracycline is the treatment

    What is the common clinical feature of the acute pulmonary embolism?
    a- tachypnia
    b- Plural pain
    c- Haemoptesis
    d- Cyanosis
    e- Hypertension

    A 7 month’s pregnant lady wide second hart sound, which does not change with respiration. Chest x-ray shows pulmonary plethora. What is the most likely diagnosis?
    a- ASD
    b- VSD
    c- Mitral regurgitation

    A patient is suffering from infective endocarditis, develops a new diastolic murmur in the lower sternal border. What is the most likely cause?
    a- Rapture of chordae tendenia
    b- Aortic stenosis
    c- Pulmonary regurgitation
    d- Tricuspid stenosis
    e- Mitral stenosis
  44. R.dass

    R.dass Guest

    A patient who suffers from chronic arthritis looks pale. He takes NSAID, Hb low, Fe low, Ferities high, MCV normal. What is the most likely cause?
    a- Iron deficiency anemia
    b- Anemia of chronic disease

    Patient with more than 12 cm splenomegaly, blood film shows tear drops polkilocytosis. What is the most likely cause?
    a- Myelofibrosis
    b- CLL
    c- CML
    d- Multiple myeloma

    A 27 yrs old male diagnosed with anaemia. Blood exam shows microcytic hypochromic anaemia. What is your initial investigation?
    a- Stool exam
    b- Colonoscopy
    c- Segmoidoscopy
    d- HB electrophoreses

    A patient presented with anaemia. On investigation it was found that Hb-low, A2-high. What is the most likely cause?
    a- Thalassaemia minor
    b- Hereditary spherocytosis

    What is the common cause of death in a patient with Thalassaemia?
    a- Heart failure
    b- Renal failure
    c- Infection and septicaemia
    d- Anaemia

    A young lady is suffering from minorragia. She has bruises on her limbs. Her brother and family have bleeding disorder:
    a- Haemophilia A
    b- Von Willebrand’s disease
    c- Congenital Hypofebrinogenemia
    d- Haemophilia B

    A woman who have history of Von Willebrand’s disease, has cholecystectomy. What is your initial management?
    a- Cryoprecipitate
    b- Vitamin K
    c- Blood transfusion
    d- Factor VIII concentrates

    Which of the following is least likely to cause transmission of HIV and Hip B virus?
    a- Albumin
    b- Factor VIII
    c- Fresh frozen plasma
    d- Platelet concentrates
    e- Cryoprecipitate

    A young man suffers from fever, mild generalized lymphadenopathy, macula-popular rash on the upper part of the body and palm and soles. He also had erosion on pharynx. Gray tonsilar exudate, perianal lesion. What is your diagnosis?
    a- Yaws
    b- Secondary syphilis
    c- Infectious mononucleosis

    Granuloma annularis:
    a- Pruritis
    b- Ulceration
    c- Griseofulvine should be given
    d- Premalignant
    e- Raised irregular border
  45. R.dass

    R.dass Guest

    Australian woman live longer. What is the cause?
    a- genetic determination
    b- Visit doctor frequently

    Which of the following findings suggests that the patient has gout?
    a- High serum uric acid
    b- Birefringence crystals in Synovial fluid
    c- High level of uric acid in urine

    Rheumatic fever’s clinical feature:
    a- Involves only large joints
    b- Usually affects small joints
    c- Does not cause permanent deformity

    Hypertension is the most preventable factor in which if the following conditions:
    a- Stroke
    b- Coronary artery disease
    c- Renal disease

    A patient came to the emergency department claiming that he has got snakebite. Clinical exams revealed that there was no sign of bite, but there was an area of erosion on the left foot. What is your management?
    a- Administration of anti-venom
    b- Observation
    c- Apply tourniquet
    d- Sent him home

    A patient was diagnosed with trigeminal neuralgia. Which of the following clinical finding is true?
    a- Patient has sensory loss
    b-
    c-
    d- Jaw is deviated to the affected side
    e- Jaw is deviated to the unaffected side, when asked to open it

    Regarding emphysema, all of the following clinical findings are true except:
    a- Clubbing
    b- CO
    c- Fixed expiratory capacity
    d- Decreased ventilator capacity

    An alcoholic patient is complaining from oily stool and weight loss. What is your next?
    a- Stoll fat estimation
    b- Pancreatic function test
    c- ERCP/CT
    d- Sweet teat
    e- X-ray of abdomen

    Hypertensive patient on ACEI and diuretics. Which of the following changes will occur in the blood?
    a- Decreased K
    b- Decreased Na
    c- Reduced bicarbonate
    d- Hyperlipidaemia
    e- Reduced GFR

    Treatment of hyperphosphataemia in chronic renal failure
    a- Aluminium hydroxide
    b- Calcium carbonate
    c- CaCO3 with phosphate binder
    d- Mg hydroxide
  46. R.dass

    R.dass Guest

    Regarding treatment of asthma in adults. All are true except:
    a- Hydrocortisone tablet before each attack
    b- Aminophylline injection
    c-
    d- Patient can decide to change the treatment
    e- Steroid inhaler

    Which type of bon loss is common in chronic renal failure?
    a- Ostoid fibrosis with osteomalisia
    b- Osteoporosis

    46. A woman presented with bald patches on the scalp. The area is shiny and oily.
    Which of the following investigation would you implement to confirm the diagnosis?
    a-
    b-
    c- Tell her that it is not causing total hair loss
    d- Potassium hydroxide (KOH) testing of the sample aippg.com

    Cause of cellulites:
    a- Group B streptococcus
    b- Group A streptococcus
    c- Staphylococcus

    A patient came with red eye. No proptosis or chemosis, upper left eye lid oedematous.
    What is your management?
    a- Urgent CT of the eye
    b- I/V flucloxacillin
    c- Local chloramphenicol

    Thrombolytic therapy is indicated in which of the following cases:
    a- Q= wave
    b- ST depression
    c- New RBBB
    d- LBBB
    e- New LBBB

    Pt. With chest pain, which is true:
    a- Thrombolytic therapy is not indicated if ECG is normal
    b- Heparin I/V
    c- Immediate ETT

    Pt. was antihypertensives, Stopping of which of the drugs may produce intraoperative hypertensive crisis:
    a- Clonidine
    b- Methyldopa
    c- Enalepril
    d- Propranolol

    Regarding infective endocarditis which is true:
    a- Vasculitis can be associated
    b- Staph. Aureas is the most common cause
    c- More common in the atrial wall
    d- More common in the ventricular wall

    Infectious mononucleosis:
    a- Resembles acute HIV infection
    b- Liver function is usually impaired
    c- Incubation period is -5 days
    d- Diagnosed by antibody

    Hep- CV infection in Australia most commonly occurs in-
    a- I/V drug abuse
    b- Homosexuals

    A 60 yrs old man alcoholic for 30 yrs. Now lethargic, weak, platelet count low, ESR high, which of the following is true?
    a- Multiple myeloma
    b- Aleukaemic leukaemia
    c- Primary thrombocytopenia
  47. R.dass

    R.dass Guest

    Regarding Parkinsons disease, which are true except:
    a- Involuntary Stopping while walking
    b- Tremor during sleep
    c- Postural hypotonia

    Pt. with hemiplegia right side, with sensory loss in face and facial palsy atrial WOF is true:
    a- Hypertensive hemorrhage in the internal capsule
    b- Middle cerebral artery hemorrhage
    c- Left middle cerebral artery
    d- ICA occlusion
    e- TCA occlusion

    Female Pt. 32 yrs old with H/O server sudden attacks of pain, well in-between, one sided sensory loss in the face. The possible diagnosis is:
    a- Multiple sclerosis
    b- Trigeminal neuralgia
    c- Post herpetic neuralgia

    Pt. with wasting of biceps, lost biceps reflex, increased lower limb reflexes. The most likely cause is:
    a- Cervical cord compression
    b- Motor neurone disease
    c- Lumbar canal stenosis

    Pt. with ptosis, dilated pupil, loss of corneal reflex and all movement of eye. The most possible lesion is:
    a- Internal carotid artery aneurism in the cavernous sinus
    b- Brain stem inearction

    Sensory loss of the medial aspect of the hand, inability to flexion and abduction of the little and ring finger. The lesion is:
    a- Ulner N. lesion in the wrist
    b- U.N. lesion in the elbow
    c- Median N. lesion at the wrist

    Compartment syndrome in the leg. Which is true?
    a- Weakness in the dorsiflaxion of the toe
    b- Weakness in the plantar flexion
    c- Weakness in eversion
    d- Weakness in inversion
    e- Weakness in flexion of the knee

    You were called to see an old lady who was found unconscious in her bedroom, pupil dilated, hypertensive, QT interval prolonged, ventricular tachycardia and atrial fibrillation. The possible cause is:
    a- Narcotic overdose
    b- Subarachnoid haemorrhage
    c- Dissecting aneurism

    Thrombolytic therapy is indicated in which of the following conditions
    a- Q wave in ECG
    b- Development of recent RBBB
    c- Development of LBBB
    d- ST depression

    WOF is true for polycythemia rubravera
    a- Erythropoietin is decreased
    b- It is difficult to diagnose cyanosis
    c- Plasma volume is contracted
    d- ESR is raised
    e- Splenomegaly aippg.com

    Regarding papillary necrosis of the kidney, all of the following are true except:
    a- Alcohol
    b- Medullary sponge kidney
    c- Analgesic nephropathy
    d- Diabetic nephropathy
    e- Sickle cell nephropathy
  48. R.dass

    R.dass Guest

    A pt. with hyperkalemia and increased S. creatinine WOF is the best method to diagnose whether his renal failure is due to acute or chronic renal failure:
    a- Creatinine clearance test
    b- Serum urea level
    c- Ultrasonography
    d- IVP

    Pt. developed puffiness in the face following upper respiratory tract infection. His BP is 180/120mmHg. WOF things can happen: aippg.com
    a- If haematuria is present it is dangerous
    b- There is immediate danger of development of LVF

    Blood Na level is 120 meq/L. What does it mean?
    a- Extracellular fluid osmolarity is decreased
    b- Total body Na is decreased
    c- SIADH
    d- Decreased ADH secretion
    e- Renal exchange of Na is decreased

    Pt. was hypertensive, developed heart failure and has gout and was having Allopurinol ACE inhibitor, Hydrochlorothiazide and indomethacin. What is the cause?
    a- Deplesion of Na in the extracellular fluid
    b- Indomethacin toxicity
    c- ACE inhibitor toxicity

    Hypercalcaemia may occur in all the causes except:
    a- Pancreatitis
    b- Hyperparathyroidism
    c- Renal tubular acidosis

    Diabetic autonomic neuropathy- all are true except
    a- Bradycardia
    b- Nocturnal diarrhoea
    c- Urinary retention
    d- Impotency
    e- Pupil size

    Regarding Diabetes mellitus- NIDDM is more related to the following than IDDM
    a- Abdominal fat is a risk factor
    b- IDDM is more genetically related than NIDDM
    c- Oral hypoglycaemic agents reduce insulin resistance

    Diabetic ketoacidosis most commonly occurs in
    a- Undiagnosed IDDM
    b- Known IDDM pt. forgot to take insulin
    c- Diabetic pt. with infection
    d- Known IDDM c infection

    Regarding positive balance diet, WOF is true
    a- Olive oil increases LDL
    b- Olive oil reduces LDL
    c- Taking fish 300gm per day does not decrease LDL
    d- Alcohol does not change triglyceride level

    An 18 yrs old girl with history of jaundice came with palmer fever and palmer erythema. Which of the following is true for liver biopsy findings?
    a- Periportal lymphocytes and bridging necrosis
    b- Fatty change in the liver

    A picture of a 23 yrs old girl with infected cystic acne with hirsuitism. Which of the following is the most appropriate initial treatment?
    a- Antiandrogen
    b- Isotretinoin for 20wks
    c- Isotretinoin with tetracycline
    d- Broad spectrum antibiotic
  49. R.dass

    R.dass Guest

    In a pt. with aortic cardiac catheterization shows pressure gradient of 55mmHg. Which of the following will help you to take decision for operation?
    a- Decreased Lt. ventricular ejection fraction
    b- Increased LV end diastolic volume

    Mitral Stenosis:
    a- Loud SI
    b- M.D. M
    c- Tapping apex beat
    d- Opening snap
    e- Graham’s Steel murmur aippg.com

    A pregnant lady presents with mild dyspnoea. O/E splitting of the 2nd Ht. Sound and no change with respiration. What is the possible cause?
    a- ASD
    b- VSD

    Regarding keratoacanthoma which is true
    a- rapidly growing and spontaneous resolution
    b- 2-3 week to grow
    c- 2-3 months to grow

    Regarding stent in coronary angioplasty which is true
    a- Reduce complication and increase stenosis
    b- Reduce complication and reduce stenosis
    c- Reduce immediate stenosis least no change in complication

    A lady came with dyspnoea. Blood gas analysis shows- HCO3-23 Pa CO2 29, Pa O2 60, PH 7.4. Which of the following is true for her condition?
    a- Respiratory alkalosis with reduced gas exchange
    b- Respiratory alkalosis with normal gas exchange

    A 65 yrs old man with profuse bleeding per rectum. The cause is-
    a- Diverticulosis
    b- Ca. rectum
    c- Ischemic colitis

    A pt. came from Indonesia. Has diarrhoea treated with Metronidazol for 3 days was not responding. Stool culture 4 days before shows salmonella typhae. Regarding further management WOF is true-
    a- Amoxycillin
    b- No Rx repeat culture after 10 days
    c- Add Trimethoprim + Sulfonamide
    d- Give Metronidazol

    Most common cause of pseudomembranous colitis is-
    a- Ampicillin
    b- Vancomycin
    c- Metronidazol

    A man suffering from diarrhoea for 3 months. WOF is not true
    a- Camylobactor jejuni
    b- Giardia

    Regarding Giardia infection, diagnosis is confirmed by which of the following
    a- Tropozoide finding from duodenum aspiration
    b- Cyst in the stool
    c- Histopathology of duodenum shows Giardiasis

    A young male pt. came with fever and cough. On x-ray it was diagnosed as an inactive T.B. M.T. was possible. What is your next step of your management?
    a- Triple drug Rx
    b- Consecutive 6 sputum culture and wait for the result
    c- INH prophylaxis for 12 months
    d- Repeat X-ray after 3 months

    Anaerobe non-spore bearing bacteria could be isolated from which of the following
    a- Brain abscess
    b- Hip prosthesis

    Pt. is in shock. If you ask for blood bank which of the following would be most appropriate blood group to be transfused?
    a- O Negative
    b- Same group uncrossed blood

    All of the following are characteristic features of Mycoplasma Pneumonae except
    a- Pleuritic chest pain
    b- Severe cough
    c- Fever
    d- Lober pneumonia
  50. R.dass

    R.dass Guest

    Regarding Lt. Renal artery stenosis all of the following are true except
    a- Rx with ACE inhibitor will deteriorate the function of the same kidney
    b- Hyperkalemia

    (Test for Giardia
    1. Stool examination - 3 separate Specimen - Cyst or Tropozoid
    2. Duodenal or Jejunal fluid piration for Tropozoid
    3. Biopsy for Giardia on the surface of epithelium

    Rifampicin should not be given to any it vasculitis occur -
    Complication of PTCA (Per cutaneous core angipled)
    Occlusion of the vessel by thrombosis -
    Loose flap of intima
    Restenosis is due to combination of elastic recoil + smooth muscle proliferation which tends to occur in months
    - Recurrent angina - 6 months 32%)

    Patient with tonsilar membrane (or sore throat) generalized lymphadenopathy, liver and spleen enlarged, (Dg: infective Mononucleosis) how you will confirm Dg:
    a- Atypical lymphocytes
    b- AB+ CHV?

    Hutchison melanotic freckle is characterized with all of the following except:
    a- Irregular edge
    b- Irregular pigmentation
    c- Become malignant
    d- Areas under the cloth
    e- Associated with old age

    Uncomplicated haemorrhoids except
    a- Pruritus ani
    b- Discharge mucus
    c- Bulging mass
    d- Perianal pain
    e- Blood in stool

    Fistula is:
    a- Abnormal tract between two epithelial surfaces

    Woman 17 week pregnant, least likely
    a- Ectopic pregnancy

    Proverb explanation, assessment of concrete thinking?
    a- Dysthymia
    b- SCH

    Deja - vu:
    a- Temporal lobe
    b- Parietal lobe

    Grandiose character doesn’t care about others, feels unique:
    a- Narcissistic personality disorder
    b- Delusional disorder
    c- Histrionic
    d- Borderline disorder
    e- Schizoid personality

    A newborn baby during the first 24 hours can’t move his midarm forceps delivery was used. Mostly injured is:
    a- Branchial plexus
    b- Fractured humerus


    Patient in ER with overdoses of unknown substance, miosis resp. O2
    a- Naloxone
    b- Acetylcholine
    c- Prostigmine
    d- Atropine

    Wheat divided by 5 equal good, good is left and right?
    a- Clang mixing
    b- Association disorder
    c- Delusion included

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