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

  1. Joseph.

    Joseph. Guest

    A lady delivered a still born baby. WOF you will not do to confirm Dx?
    a- Post mortem of the baby
    b- Coomb’s test
    c- Anti cardiolipid Ab
    d- Anti lupus ab

    A woman who has previously delivered a 4 kg baby with troublesome delivery. She is para-2 and gravida 3. You should do all of the following except -
    a- Induction of labour in 37-38 wks
    b- Do caesarean section at term
    c- Check blood glucose level regularly from 30wks

    A patient come with 16 weeks pregnancy, she has high blood pressure 180/120 with proteinuria, what is the most likely cause?
    a- She has existing disease
    b- She may have multiple pregnancy

    A 19 yrs old primi 38 wks gestation with hyper reflexia, hypertension and oedema might be excepted to have the elevated blood levels except -
    a- Uric acid
    b- Creatinine
    c- Platelate decreased
    d- SGOT
    e- BUN

    A lady came with vaginal bleeding after 2yrs of menopause. WOF is diagnosis?
    a- Atrophic vaginitis

    Short stature pregnant lady with 38 wks what is next step -
    a- X-ray
    b- Caesarean

    A girl with abdominal pain. US examination showed 3 cysts in the right ovary with 2, 3 and 4 cm?
    a- Observe and 2-3 months repeat US
    b- Reassuring
    c- Laproscopy
    d- Aspiration

    NO bleeding after withdrawing contraceptive pills would be due to -
    a- Ovary b- Uterus
    c- Pituitary d- Hypothalamus

    A patient forms a solid tumour which was solid, uterine curettage shows endometrium hyperplasia. What is the cause?
    a- Cyst b- Teratoma
    c- Dysgerminoma d- Granulosa cell tumor

    Effect of progesterone on kidney in pregnancy -
    a- Relax only ureter
    b- Relax both pelvis and ureter

    All f the following could be cause of greenish foul smell discharge except -
    a- Trichomoniasis b- Gardenella
    c- FB d- Cervical cancer
    e- ? Chlamydia

    A Primigravida 38 wks in labour. On P/V pelvis was reduced. Station 0 cervix 4 cm dilated, membrane intact -
    a- X-ray pelvimetry b- C/S
    c- Oxytocin d- Continuous trial labour
  2. Joseph.

    Joseph. Guest

    A mother of 3 children has mastalgia. She is not responding usual treatment. Next appropriate treatment -
    a- OCP b- Danazole
    c- Bromocriptine

    A 37 weeks pregnant painful vaginal bleeding (1000ml blood loss). WOF is not consistent with abruption placentae?
    a- Foetal death b- BP 110/80
    c- Uterus firm and contract d- Fetal head high in presentation

    A patient who has difficulties with pregnancy. She lost her 3 pregnancy in 6, 8, 10 wks. Before that she had terminate 2 babies at 10 and 12 wks. What could be the cause?
    a- Cervical in competence
    b- Deficient luteal phase
    c- Chromosomal abnormality

    Find out in correct association with pregnant lady which cause foetal effect on pregnancy
    a- IUGR - Anticardiolipin antibody
    b- Platelate count 100,000 - intracranial haemorrhage
    c- Heart block - antibody

    25 yrs old woman galactorrhea and amenorrhoea. CT scan shows 3mm on optic chaisma. Prolactin > 1500. Best Rx-
    a- Transfrontal
    b- Transphenoidal
    c- Bromocriptine
    d- OCP
    e- Clomiphene

    A lady 3 days after giving birth becomes irritable and tearful. WOF is correct?
    a- Seen in at least 50%
    b- not occur in C/S patient

    A woman came to you 2 yrs after menopause asking for treatment to reduce the postmenopausal symptom. HRT oestrogen 1st 28 days and progestrogen 12. You are explaining all except -
    a- She will have premenstrual like symptom
    b- Will have withdrawal bleeding in every month
    c- Progesterone will increase HDL more than oestrogen
    d- Will reverse the action of progesterone
    e- Progesterone will augment the action of oestrogen for prevention of osteoporosis

    Primary dysmenorrhoea all true except -
    a- Bromocriptine
    b- Indomethacine
    c- Mefenamic acid
    d- OCP

    Pregnancy with group B streptococcus. Which is not true?
    a- Infection in 32 wk is absolute indication for C/S
    b- Can lead to neonatal meningitis
    c- Can lead o neonatal infection

    Pregnancy with carpal tunnel syndrome -
    a- Become better as pregnancy
    b- Treatment with siling and arm elevation
    c- Required surgery

    Pregnant woman wake up at night due to pain tingling and numbness in Rt hand. WOF the cause -
    a- carpal tunnel syndrome
    b- Ulnar palsy
    c- Branchial palsy

    26 yrs old Nulliparous married wants baby complaining of severe menorrhagia. O/E swelling in the abdomen up to umbilicus -
    a- Total hysterectomy
    b- Open myomectomy after correcting her anaemia with BT

    Cleft lip in 2nd child what is the chance?
    a- 2% b- 3 - 5%
    c- 25% d- 9%
  3. Joseph.

    Joseph. Guest

    A 2 yrs old boy with minimal contaminated cut injury he didn’t immunized before what is the most likely treatment?
    a- T.T. (Tetanus toxoid)
    b- DPT
    c- TIG
    d- Antibiotics

    A 2 yrs old boy came with unilateral wheeze-
    a- Foreign body

    A boy can roll over, can prone to supine and hold his head. He bounches in supported standing. He laughs and babbles what is the age -
    a- 3 month b- 7 month
    c- 10 month

    What is normal in a new born baby?
    a- Hypertrophy of clitoris
    b- Engorgement of breast

    A chest x-ray of pneumonia -
    a- Mycoplasma
    b- Streptococcus A

    A baby with jitteriness which will be the immediate management?
    a- Serum glucose level

    A 3 yrs old boy with hip pain. WOF is the most likely cause?
    a- Perth’s disease
    b- Tenosynovitis

    A 8 wks baby with intermittent vomiting WOF most likely cause -
    a- Urinary tract infection
    b- Pyloric stenosis

    A 9 wks old baby with force full vomiting his serum k 7.7 -
    a- Pyloric stenosis
    b- Congenital adrenal hyperplasia

    All of the following could be the cause of anaemia in infancy except -
    a- Prematurity
    b- Multiple pregnancies
    c- Thalassemia

    a boy with weakness of both leg he has a history of viral fever without reflex WOF DX-
    a- Gillian Barrie syndrome

    A boy was bitten by a 1 meter long black snake WOF management -
    a- Observation
    b- Anti snake venom and apply tourniquet

    Baby multiple healthy -
    a- Parents deletion (non-accidental injury)
    b- Environment
  4. Joseph.

    Joseph. Guest

    Convulsion -
    a- Hyper Na b- Hypo Na
    c- Hyper K d- Hypo K

    A child with multiple subperiostial hematoma and calcification -
    a- Scurvy b- Accidental injury
    c- Unaccidental injury d- Osteomyelitis

    A boy cannot see blackboard L 8/20, R 10/20. He can see the letters on the screen of PC. After wearing hole glasses sight improves -
    a- Myopia b- Amblyopia
    c- Astigmatism

    A child was born normally WT 3.2 kg. Apgar score was 5 in 1 min and 8 in 5 min. He has delay development. WOF condition is associated with his developmental delay?
    a- Paternal uncle has intellectual deficit
    b- Father is an alcoholic
    c- Sister has febrile seizure
    d- Mother has 2 café’s lait spots
    e- Paternal grandmother has hypothyroidism
    About mental health act WOF is correct-
    a- Identical in every state
    b- May be life saving

    What is the prodormal feature of schizophrenia?
    a- Idea of reference
    b- Unemployment
    c- Dysfunctional parenting

    Hypnagogic hallucination WOF correct -
    a- It can happen in normal sleep

    About diagnosis of Tourette disorder all of the following are essential except -
    a- Tic’s bou 3-4 times a day
    b- Pt does not distress by tics
    c- Always start before the age of 18

    WOF is the distinguishing feature of schizophrenia and acute organic brain syndrome -
    a- Difficulty in sustaining attention
    b- Fluctuation disturbances of consciousness
    c- Visual hallucination
    d- Auditory hallucination

    What is the best prognostic feature of schizophrenia?
    a- Presence of affective disorder

    All of the following cause of serotonine syndrome -
    a- Haloperidol b- Clonazepam
    c- Moclobomide d- Dextrometherphan

    A bank manager was robbed 3 wks ago WOF most likely -
    a- Out burst of anger b- Depression
    c- Panic attack

    A man is saying, “Wheat is good for health.” Wheat 5 types what is the do -
    a- Clang
    b- Confabulation

    Déjà vu can be seen commonly in WOF lobe -
    a- Tempo
    b- Front
  5. R.dass

    R.dass Guest

    The parents of an adopted girl, who has schizophrenic coming to ask about the chance of their genetic daughter getting schizophrenia. WOF answer you would give?
    a- Nil b- Less than 2%
    c- 10% d- 30-40%

    35 yrs old female comes to you with history of menorrhagia and anxiety. Recently she feels her husband is detached from her and she is not close to him as she used to be. She has 2 children living in a rented house and brought all household things on higher purchases and they have to pay it off regularly. They can’t afford to go out together for a dinner. Exam normal. What is your next step management?
    a- Refer her to a psychiatrist
    b- Send her to marriage consoling
    c- Have an interview with her husband
    d- Advice to have a holiday
    e- Refer to a gynecologist

    WOF is right -
    a- Postpartum blues predispose to postpartum psychosis
    b- More than 50 of women suffer from postpartum blues
    c- She requires anti-psychotic medication
    d- Requires ECT

    Narcissistic personality -
    a- Does not from any body

    36 yrs old bus driver complain he can’t sleep at night apart from he driving stress. You notice that the driver drinks 6 can bear and 10 cups of coffee weekly. What is next step?
    a- Tell him to go on sickness break
    b- Treat for sleep apnea
    c- Prescribe diazepam
    d- Tell him to cut down on alcohol and change to different coffee
    e- Tell him nothing needs to be changed

    The most common cause of blood fluid from nipple of breast is -
    a- Intraductal papiloma
    b- Breast Ca
    c- Trauma

    The most likely for a male 22yrs ingurino-scrocal swelling with swelling disappeared on lying down -
    a- Direct inguinal hernia
    b- Varicocele
    c- Saphaena varix
    d- Lymphoma

    Contacted dermatitis except -
    a- Avoiding antigen
    b- Steroid IV
    c- Don’t use steroids

    WOF not related with breast Ca -
    a- Contras breast Ca b- Family history
    c- Uterine Ca d- Artificial menopause
  6. R.dass

    R.dass Guest

    The most likely for a breast with toothpaste and nipple retracted -
    a- Breast Ca b- Page’s disease
    c- Mammary duct dysphasia d- Papillary

    Picture a lesion on the back of hand -
    a- malignant skin cancer b- Infected solar keratosis
    c- Keratoacanthoma

    The goals of surgery for mobility of obesity are all the following except -
    a- Reduce energy
    b- Increased metabolic

    50 yrs old female abdominal pain for half day, the most likely diagnosis is -
    a- Omentum arterial vessel blocking

    Hutchinson melanoma freckle except -
    a- Covered area
    b- Irregular edges

    Picture a big neck swelling -
    a- Goiter
    b- Graves

    X-ray tibia and fibula opening fracture -
    a- Debridama internal fix- type I
    b- If no contaminations, debridma is unnecessary
    c- External fix- type II, III
    d- Close cut

    Picture - Colles fracture. What is the most likely complication?
    a- Malunion b- Wrist stiffness

    13. Picture - Figures deformation -
    a- Rheumatoid arthritis
    b- Contracted tendon

    ECG preoperative exam -
    a- LBBB b- RBBB
    c- WPW

    A spinal L4.5 slipped disc produces -
    a- Absent ankle jerk
    b- Lost of dorsiflaxion
    c- Loss of sensation on the medial calf

    After falling injury, x-ray showed pelvic injury and blood clots at external urinary meatus. WOF are appropriate -
    a- Flory catheter b- IVP
    c- Tap d- Urethrography

    Undescended testis in children is most commonly associated with -
    a- Infertility b- Indirect inguinal hernia
    c- Malignancy d- Torsion

    The most common tumor to metatarsals to bone is -
    a- Stomach b- Ovarian
    c- Breast d- Rectum
    e- Colon
  7. R.dass

    R.dass Guest

    . A diabetic with heel ulcer. The cause is -
    a- Blood vessel b- Infection
    c- Peripheral never

    Management of Wernicke’s syndrome with low plasma sugar should be -
    a- IV 5% glucose
    b- Vita B1 and then 5% glucose

    The advantage of mammography is -
    a- Painless
    b- Early detection than self examination

    Fistula -
    a- Two opening between

    A patient with acidic urine WOF most common stone can be seen -
    a- Uric acid b- Cystine
    c- Oxalates

    A boy 2 yrs with subclave strawberry naevus -
    a- Observe b- Surgery
    c- Laser d- Nitigen
    A 65 yrs old man with profuse bleeding per rectum the cause is -
    a- Diverticulosis
    b- Ca rectum
    c- Ischemic colitis

    Most correct about Otosclerosis -
    a- A reddish tinge on the tympanic membrane
    b- Normal tympanic membrane

    VII nerve least occurs in WOF-
    a- Chronic parotids
    b- Acoustic neuroma
    c- Mastoiditis
    d- Base of the skull fracture

    Uncomplicated mucosal haemorrhoids WOF is not true -
    a- Lowering of a lump
    b- Bleeding
    c- Server pain
    d- Mucous discharge

    Immediate management of Rt tension pneumothorax -
    a- Intercostals tube
    b- Wide bore needle at 2nd intercostals space
    c- Endotrachial tube

    After splenectomy which one of the following will not occur?
    a- Giardia

    A middle aged man presents with BP 80/60, HR 120, back pain and slight abdominal guarding, WOF is most likely diagnosis?
    a- Acute pancreatitis
    b- Acute myocardial infarction
    c- Leaking aortic aneurysm
    d- Perforated peptic ulcer

    34 yrs old man presents with acute abdomen for 3 days and he has H/O vomiting following by perinial pain. O/E abdomen distended but non tender, bowel sound absent. Abdominal x-ray shows multiple air fluid levels. What is the best management before surgery?
    a- 2000ml 4% in 0.45% NaCL
  8. R.dass

    R.dass Guest

    The common treatment for severe obstructive hypertrophic cardiomyopathy is:
    a- Digoxin
    b- Captopril
    c- Atenolol
    d- Verapamil
    e- Lasix

    A 12 yrs old girl, while watching TV at night time, becomes distressed and short of breath. On examination she was breathing rapidly. This disorder is due to:
    a- Epilepsy
    b- Asthma
    c- Panic attack
    d- Depression

    Digoxin gives all of these arrhythmias except:
    a- Atrial fibrillation
    b- Ventricular tachycardia
    c- Ventricular ectopics
    d- Nodal rhythm
    e- Paroxismal atrial tacycardia

    Prolong PR caused by:
    a- Digoxin
    b- Amiodaron
    c- Verapamil
    d- Atenolol
    A 45 yrs old lady is very depressed and she wants to commit suicide. She feels guilty and refuses any medical treatment and admission to hospital. Her relatives also disagree to hospital admission but want to give her medication at home. What is the right management?
    a- Advice antidepressant
    b- Close monitoring by family members
    c- Admit her to hospital for urgent ECT regardless of their consent
    d- Start antidepressant by injection for monitoring action

    A young man has been suffering pain in his left eye for the past two days. He complains of a headache and on examination his temperature is 38.5 c and he also swelling in his left upper eye lid. What is the right management?
    a- Analgesics
    b- Intravenous antibiotics
    c- Topical chloramphenicol
    d- Eye trauma

    A 50 yrs old hypertensive man has come to your surgery and complains of failure of erection in the last couple of weeks. What is your initial management?
    a- Reassure the patient that this is normal and can happen in this age bracket
    b- Viagra
    c- Review his medication
    d- Ask about his sexual activity and sexual technique
    e- Assess cardiovascular status

    Combined HRT have all the advantages except:
    a- Prevent hyperplasia of endometrium
    b- The production of some perimenopausal symptoms
    c- Production of period bleeding at the end of cycle progestrone
    d- Augmentation of bone protection by progesterone

    A 23 yrs old woman with secondary amenorrhea is found to have high level of prolactine and on CT scan is found small adenoma in the pituitary which was over 1mm in chaisma optic. She is planning a pregnancy in 12 months time. What is the best treatment for this patient?
    a- Transfrontal resection
    b- Transphenoidal resection
    c- Bromocriptine
    d- Chemotherapy

    What would be seen in a one-sided lesion of the trigeminal nerve?
    a- One-sided facial paresis
    b- Inability to poke the tongue out from the mouth
    c- Inability to raise the palate
    d- Displacement of the jaw when the mouth is open

    What is inappropriate in the treatment of an acute asthma attack?
    a- Prescribing oral steroids
    b- Prescribing inhaled steroids earlier to reduce an inflammation
    c- Prescribing combination of inhaled Salbutamol and oral theophyline
    d- Educate the patient to be more active to decide about his/her medication
    e- FEV measure at home
  9. R.dass

    R.dass Guest

    A 65 yrs old man presents with blurred vision and moderate pain in the left eye. On examination the eye is red, sclerae is misty, pupil dilated and fixed. What is your diagnosis?
    a- Retinal vein occlusion
    b- Glaucoma
    c- Cataract
    d- Iritis
    e- Conjunctivitis

    The acute anterior uveitis is most commonly associated with:
    a- Rheumatoid arthritis
    b- Ankylosing spondylitis
    c- Sjorgenis syndrome
    d- Reiteris syndrome
    e- SLE

    Middle age man suffering hypertrophic obstructive carditis has an outflow obstruction of the left ventricle on ECHO examination. Which drug can help to reduce this gradient?
    a- Verapamil
    b- Captopril
    c- Frusemide
    d- Digoxine
    e- Prazosines

    A 67 yrs old woman is suffering from tremors in her right hand especially when she is watching TV or answering a phone. On examination a coarse tremor appears in the right hand while she talking but it disappears when she looks at her hand. There is a slight spasticity in the right hand without “cogwheel”. What medication is most likely to help?
    a- Propranolol
    b- Carbidopa/levodopa
    s- Segmental
    d- Benztropin
    e- Observe

    What is the characteristic for Granuloma Anullare?
    a- Raised irregular border
    b- Itchy
    c- Usually ulcerate
    d- Premalignant
    e- Respond to griseofulvin

    Bronchogenic adenoma is:
    a- Always benign
    b- Premalignant
    c- Malignant
    d- Never obstract bronchus
    e- Never diagnosed on Endoscopy

    A 24 yrs old man comes to see you because of sharp abdominal and lower back pain. The sample of urine which he has brought with him is obviously blood-stained. He is asking you to give him a penitidine injection for pain relief. On examination the abdomen is intact without quarding or tenderness. What is the next most appropriate step?
    a- Send him home
    b- Do penitidine and reassess him 1 hour later
    c- Do penitidine + buscopan, send him home, review next day
    d- Examine the fresh urine sample
    e- Send him to the hospital for surgical assessment

    Why do Australian women have a longer life span than Australian men?
    a- Women more often use the medicare system and look after their health
    b- Women are more biologically and genetically safe
    c- Men are more prone to accidents
    d- Men use the gym more
    e- Men are more stressed at work

    What is the most important thing about screening programs for some disease?
    a- Interference with the natural history of the disease
    b- New techniques are available
    c- Treatment is available
    d- The importance to pick up earlier stages of the disease

    A student presents to your surgery with fever, malaise and sore throat for the last 12 days. On examination you find whitish exudate on the tonsils, maculo-papular rash on moderate lympho-adenopathy. What is your diagnosis?
    a- Syphilis
    b- Yaws
    c- Ep. Barr virus infection
    d- Pemphygouse
    e- Steven-Johnson’s syndrome

    What is not true about eczema?
    a- Usually on the flectural surfaces
    b- Moisturising agents are helpful
    c- Soap and water are helpful
    d- Dryness of the skin
    e- Family history of asthma and hay fever
  10. R.dass

    R.dass Guest

    Lesion of the spinal cord at S1 level produces which symptoms?
    a- Absent ankle jerk
    b- Absent knee jerk
    c- Loss of dorsiflaxion of the foot
    d- Loss of sensation on the medial aspect of the cal

    A 35 yrs old policeman comes to you for jaundice. He is taking sulfasalazine, Prednisolone for ulcerative colitis. He drinks 60gm alcohol/day. His lab investigations are:
    Serum bilirubin 18 (N 17)
    Alkaline phosphate increase
    GGT increase
    SGOT 30 (N.26)
    SGPT normal
    What is your diagnosis?
    a- Fatty liver
    b- Alcoholic cirrhosis
    c- Bilary stone
    d- Sclerosing cholangitis
    e- Cholestatis

    Causes of hypercalcemia:
    a- Vitamin D toxicity
    b- Hyperparathyroidism
    c- Bony metastasis

    Patient with Parkinson’s disease can have all of the following except:
    a- Tremor during sleep
    b- Mask like face
    c- Depression
    d- Bradykinesia
    e- Waddling gait

    Right sided hemiplegia involving right side of face is most likely a result of:
    a- Middle cerebral artery embolism
    b- Carotid artery embolism
    c- Subclavian artery
    d- Basilar artery
    e- Posterior cerebral artery

    A young man presents with a sore throat for the past 24 hours and he develops proteinuria++, and hematuria. What is this?
    a- IgA nephropathy
    b- Post streptococcal glomerulonephritis
    c- Membranous glomerulonephritis
    d- Interstitial nephritis

    A 60 yrs old patient presents with CCF and Captopril is commenced with history of hypertension. He is already long term Chlorothiazide, it will result in:
    a- Serum creatinine is increased
    b- K is increased
    c- K is decreased
    d- Na is decreased
    e- Increase in cholesterol

    Which drug can rapidly cross blood brain barrier?
    a- Water-soluble
    b- Lipid soluble

    What is the specific feature of Parkinson’s disease?
    a- Abdominal postural reflex
    b- Broad based gait
    c- Hyperreflexia
    d- Hypertonia
    e- Loss of downward gaze

    What is the commonest way of transmission of Hepatitis C in Australia?
    a- Blood transmission
    b- IV drug abuse
    c- Body fluids
    d- Homosexuality

    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 12cm splenomegaly blood film shows tear drops polkilocytosis. What is the most likely cause?
    a- Myelofibrosis
    b- CLL
    c- CML
    d- Multiple myeloma
  11. R.dass

    R.dass Guest

    A 27 yrs old male diagnosed with anemia, blood exam shows microcytic hypochromic anemia. What is your initial investigation?
    a- Stool exam
    b- Colonoscopy
    c- Sigmoidoscopy
    d- HB electrophoreses

    A patient presented with anemia. On examination 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 septicemia
    d- Anemia

    A young lady is suffering from menorrhagia. She has bruises on her limbs. Her brother and father have bleeding disorder:
    a- Haemophilia A
    b- Von Willebrand’s disease
    c- Congenital Hypofebrinogenemia
    d- Haemophilia B
    A woman who has history of Von Willebrand’s disease has cholecystectomy. What is your initial management?
    a- Cryoprecipitate
    b- Vita. K
    c- Blood transfusion
    d- Factor VIII

    Which of the following is least likely to cause transmission of HIV and Hep. 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, and macula-popular rash on the upper part of the body and palm and soles. He also had erosion in pharynx, Grey tonsilar exudate, perianal lesion. What is your diagnosis?
    a- Yaws
    b- Secondary syphilis
    c- Infectious mononucleosis

    Granuloma annular is:
    a- Pruritis
    b- Ulceration
    c- Griseofulvine should be given
    d- Premalignant
    e- Raised irregular border

    43. 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 acid
    b- Birefringence crystals in Synovial fluid
    c- High level of uric acid in urine

    Rheumatic fever’s clinical feature:
    a- Involved 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

    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- Jaw is deviated to the unaffected side, when asked to open it

    Regarding emphysema, all of the following clinical findings are true except:
    a- Fixed expended
    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
  12. R.dass

    R.dass Guest

    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

    In infective endocarditis, WOF is true
    a- Vasculitis

    WOF true for polycythemia rubravera:
    a- Erytropoetin is decreased
    b- It is difficult to diagnose cyanosis
    c- Plasma volume is contracted
    d- ESR is raised

    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

    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 180/120 mmHg, WOF things can happen:
    a- If haematuria is present it is dangerous
    b- There is immediate danger of development of LVF

    Blood Na level is 120meq/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
  13. R.dass

    R.dass Guest

    A photo showing circular raised margined lesions on the face. What is the possible diagnosis?
    a- Microsporum canis

    In paracetamol poisoning, the cause of morbidity is-
    a- Hepatic injury
    b- Metabolic acidosis
    c- Metabolic alkalosis
    d- Hypoglycemia (cause of mortality)

    In tricyclic anti depressant poisoning WOF are true except:
    a- HCO3 to prevent arrhythmia
    b- Flumazenil should not be given if is due to TCA + Diazepam
    c- Bile acid
    d- Magnesium
    e- Diazepam to

    Regarding bronchial asthma all are true except:
    a- Total lung volume is decreased
    b- Increase in residual volume
    c- Decreased tidal volume
    d- Decreased vital capacity
    WOF are true regarding Asthma except:
    a- It increases Br. Sensitivity
    b- It does not occur after 50 yrs of age
    c- Inspiratory crackles

    A pt. with one sided dullness with shifting of trachea on the same side, Diminished breath sound and respiratory movement. Which of the following is true?
    a- Pleural effusion with collapse

    A 23 yrs old lady with distended abdomen, glositis, muscle wasting, anaemia, macrocytosis, diarrhoea no history of surgery. WOF is true:
    a- Gluten sensitive enterocolitis
    b- Duodenal biopsy is reqd. for confirm the diagnosis
    c- Crohn’s disease
    d- Ulcerative colitis
    e- Pernicious anaemia

    A photo of raised irregular border lesion in the leg
    a- Granuloma Anullare

    An abattoir worker came with H/O fever, myalgia and dark urine. The most likely cause is
    a- Leptospirosis
    b- Brucellosis

    Regarding eradication of H. Pylori which is true
    a- it helps in healing of the ulcer
    b- Prevents relapse rate
    c- Need for long time therapy

    Which of the following is not true regarding transferrin?
    a- Increased in iron deficiency anaemia
    b- Increase in chronic infection
    c- Decrease in nephritic syndrome
    d- Increased in pregnancy

    Pt. with severe chest pain, absent carotid pulse, pain radiating to the back. What would you find in chest X-ray?
    a- Widening of the mediastinum

    In thyrotoxicosis all of the following are present except
    a- Limb girdle muscle weakness
    b- Small muscle wasting
    c- Atrial fibrillation

    Regarding Myasthenia gravis which is true
    a- Some people does not have antibody
    b- Thymectomy is only done when thymoma is present
    c- Reflexes are diminished after repeated stimulation
    d- EMG always slow
    e- Electomyograph

    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
  14. R.dass

    R.dass Guest

    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

    Regarding Prednisolone, which are true except
    a- Osteomalacia

    Regarding stent in coronary angioplasty which is true
    a- Reduce complication and increase stenosis
    b- Reduce complication and reduce stenosis

    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- Lobber pneumonia

    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
  15. R.dass

    R.dass Guest

    A 35 yrs old lady nullipara wishes to conclave, but has fibroid uterus, bleeding 60ml, Hb level is 90g/l, O/E ut is boggy to the level of the umbilicus. What is your management?
    a- Correct the anaemia the myomectomy
    b- Suppression of the fibroid by GnRH analogue for 3 months the myomectomy
    c- Hysterectomy
    d- Hysterectomy & oophorectomy
    e- Observe 6 months the myomectomy

    Infective endocarditis: what is the most common organism?
    a- Staphylococcus aureus
    b- Streptococci viridans
    c- Streptococci faecalis
    d- Coxiella
    e- Viruses

    A pt. came to you with severe chest pain ECG done but it is normal, what is your management?
    a- Thrombolytic therapy should not be given if ECG is normal
    b- Discharge the patient for going home
    c- I/V heparin and nitrates are contraindicated
    d- Exercise test is to be done immediately
    e- ECG should not be repeated unless pain once again
    A 22 months old child came to you with respiratory distress, unilateral wheeze. Previously he was well. What is your management?
    a- Measure O2 level
    b- Do an X-ray chest inspiratory and expiratory
    c- Give antibiotic
    d- Give bronchodilator

    A 22 yrs old man came to you complaining of snake bite 2 hours before. O/E there is abrasion in the leg otherwise normal. What is your management?
    a- Give antivenom
    b- Observe for 24 hours
    c- Give an inclusion and let bleed for 5 minutes
    d- Clean the wound and give bandage and let him go
    e- Do nothing

    A bisexual man diarrhoea for one month, has mouth ulcers, artharalgia, one joint of hand is painful: 2nd pain, ulcers on palms and soles. What is the diagnosis?
    a- Reiter’s disease
    b- Behcet’s disease
    c- AIDS
    d- Syphilis
    e- Reactive arthritis

    Retinal neovascularisation:
    a- Glaucoma
    b- Retinal V thrombosis
    c- Hypertension
    d- Malignant melanoma
    e- Diabetes mellitus

    A 23 yrs old girl has abdominal colic; 2 weeks back she had viral infection, perpural rash. Most probable diagnosis is:
    a- ITP
    b- Ischaemic colitis
    c- Henoch-Schonlein purpura
    d- Glandular fever

    What differentiate between haemolytic and iron deficiency anaemia?
    a- Polycythaemia
    b- Polychromasia
    c- Normal platelet count

    a- Is secreted from ant pituitary
    b- Acts by enzyme oxynase
    c- Causes contraction of various involuntary muscles like ut & threat
    d- Causes contraction of ut only

    Progesterone can cause AOF except:
    a- Mild hypertension
    b- Amenorrhoea after 3rd injection
    c- Infertility may occur up to 6 months after stopping
    d- Breakthrough bleeding

    In a 35 yrs old woman having ovarian tumour and endometrial hyperplasia WOF is correct?
    a- Fibroma
    b- Granulosa cell tumour
    c- Teratoma

    A 50 yrs old woman came to you with complaint of slight vaginal bleeding. She also complains that she has amenorrhoea for 11 months. What is your diagnosis?
    a- Endometrial carcinoma
    b- Ca. cervix
    c- Oestrogenic stimulation of the ovary
    d- Vaginal atrophy
    e- Cervical polyp

    A woman 16 weeks pregnant having hypertension 110/95 mm of Hg. proteinurea +++ mild oedema. What is your diagnosis?
    a- Preclampsia
    b- Renal hypertension
    c- Glomerulonephritis

    30 yrs cystic fibrosis with chest pain treated with nebulised tobramycin th/DM, recent weight loss, steathhorrea. Correct management?
    a- Decreased carbohydrates diet and stabilising glycaemic control
    b- Pancreatic enzyme
    c- Continue nebulised tobramycin for another 3 weeks
    d- Chest physiotherapy
  16. R.dass

    R.dass Guest

    Difficult breathing after penicillin for U.R.T.I. has generalized urticaria and blood pressure 90mm Mg. Correct management?
    a- IV I.M adrenalin 1:10,000
    b- S.C. adrenalin 1:1000
    c- I.V. pneumothorax
    d- Airway assessment
    e- 500ml IV colloid

    Each is important host defence against bacterial meningitis:
    a- IgA
    b- Ciliary activity
    c- Mucosal epithelium
    d- Complement
    e- IgM

    factor least likely to affect prognosis of breast ca:
    a- Tumour size
    b- Oestrogen receptor status
    c- Menopause
    d- Involvement of axillary lymph node
    e- Percent 8 cell in s-phase

    Nephrotic Syndrome commonly caused by except?
    a- Post glomerulonephritis
    b- Result decrease in plasma volume
    c- Plasma cholesterol normal but HDL
    d- Result in renal salt wasting
    37 yrs old man with depression presents to emergency drowsy and aggressive. He has taken a bottle of doxepin and scotch together. Important management includes:
    a- Admin for ECG monitoring for 4 hours
    b- Serial doses of charcoal orally
    c- Do serum paracetamol as the only drug screen
    d- As the patient is conscious significant T.C.A. overdose can be ruled out
    e- Alkalisation of urine will aid excretion of doxepin, and will protect against arrhythmia

    A 15 yrs old girl presents with fever and painful left forearm two days after her cat had clawed the arm. There is regional lymph adenopathy present and temperature is 39.C. Which of the following statement is true:
    a- The implicated bacterium E. coli
    b- Most suffer of cat fever are >60
    c- Complication may includes involvement live, spleen, central nervous system, bowel and skin
    d- Ampicillin and cephalosporin are inadequate therapy
    e- Lymphadenopathy in the field of drainage is invariable

    A 71 yrs old woman presents with crushing chest pain, a ECG shown. She is pale and diaphoretic, peripheral vein. The most likely cause of the hypotension is?
    a- Chordae rupture causing acute mitral regurgitation
    b- S.B.E.
    c- Right ventricular myocardial infarction
    d- Second degree AV Block
    e- Pericardial tamponade

    Insulin resistance is a complication of on-going therapy requiring increasing doses. Which of the following is the most common cause?
    a- Anti-insulin antibody
    b- Switching from procine to human insulin
    c- Obesity
    d- The somoguy effect
    e- Non-compliance

    Condition that are associated with Lichen planus includes all of the following with the exception of?
    a- Primary biliary chirrhosis
    b- Graft versus host disease
    c- Chronic active hepatitis
    d- Amalgam in dental fillings
    e- Chronic myeloid leukemia

    Lipid lowering drugs are a complex group of drugs with a spectrum of side effects. Which of the following indication is correct?
    a- Gemfibrozol is indicated for hypercholesterolaemia
    b- Simvastatin is effective for hypertrigliceridemia
    c- Fish oils are suite for treating hypercholesterolaemia
    d- Fluvastatin is effective for combined hypercholesterolaemia and hypertrigliceridaemia
    e- Individual without coronary heart disease with LDL cholesterol level > 4.5 mmol/l should not receive such drugs because of side effect profiles

    Which of the statement concerns infantile spasm is correct?
    a- Age of onset is usually 18 months
    b- They occur less frequent with physically activity
    c- ECG is usually normal
    d- Developmental milestone are unaffected
    e- Aetiology is frequently idiopathic

    A girl infant is brought to your rooms for investigations of abdominal pain manifested by colic and progressive constipation. Other siblings are well. Which of the following is least likely to b implicated?
    a- Lead poisoning
    b- Hypo thyroidism
    c- Hirsprung disease
    d- Hypocalcaemia
    e- Infantile botulism

    Louis a 5 year-old-by is brought to you for testing his free lead level, which is significantly elevated. His physical and loco motor examination is completely normal. On questioning, the parents state that they have recently moved to an old terrace. The initial most appropriate management would be to?
    a- Commence decontamination of the house
    b- Commence a chelating agent
    c- Commence d-penlcillamine for 2-6 months
    d- Check the free erythrocyte protoporphyrin
    e- Check the urinary excretion of the lead after administration of calcium EDTA

    Alf. a 74 yrs old man recently admitted for management of respiratory failure asks about home-oxygen. The following are criteria for long-term continuous oxygen therapy except:
    a- PaO2 < 55mmHg
    b- O2 saturation < 88%
    c- Treating the hypoxia associated with the sleep apnoea
    d- If the patient has mental impairment oxygen should be withheld for safety reasons
    e- Congestive heart failure with intractable angina

    All of the following statements about inflammatory bowel disease are true except:
    a- Pseudopolyps developing in ulcerative colitis do not become malignant
    b- Development of fistula between bowel and skin or bladder suggests granulomatous bowel disease, such as a regional enteritis
    c- Severe hypotension with fever, leucocytocis and abdominal distention suggests development of toxic megacolon which usually requires immediately surgery
    d- Occult bleeding occurs in both ulcerative colitis and regional enteritis but gross bleeding is more characteristic of ulcerative colitis
    e- Metronidazole may be to control acute diarrhoea in Crohn’s disease
  17. R.dass

    R.dass Guest

    Graves disease:
    a- Is the major cause of thyrotoxicosis in the elderly
    b- Is more common in men than women
    c- Is associated with delectable thyroid stimulating antibodies in 50% of cases
    d- Usually remains in remission after a course of anti-thyroid drug therapy
    e- Ophthalmopathy frequently does not parallel the clinical course of thyrotoxicosis

    The pain associated with uterine contractions may be relieved by:
    a- Diazepam
    b- Intramuscular Pethidine
    c- Pudendal block
    d- Inhalation of nitrous oxide
    e- Caudal block

    Causes of non-unlon of fracture include-
    a- Very slight banding movements during the healing phase
    b- Infection of the fracture haematoma
    c- Anoxia
    c- Uraemia
    e- Paget’s disease

    Clouding of consciousness:
    a- Is a hallmark of dementia
    b- Occurs frequently in Schizophrenic disorder
    c- When diagnosed should prompt research for organic aetiology
    d- Refers primarily to disorientation in time
    e- Is frequently not noticed when it occurs in hospitalized patients

    Which of the following are true statements regarding psoriatic arthritis?
    a- The commonest type is an oligcarticular, asymmetric arthritis
    b- An association with HLA B27 is seen in those patients with sacro-iliitis
    c- Pure distal interphalangeal joint change is uncommon
    d- Gold therapy is effective in the polyarticular types
    e- Periarticular osteoporosis is a radiological feature
    In a patient with fibroadenosis of the breast:
    a- Duct papillomatosis may be present
    b- Pregnancy usually produces relief
    c- The breasts should be replaced by prosthetic implants
    d- Radiotherapy is a useful palliative treatment
    e- The breasts should be replaced by prosthetic implants

    Regarding therapy of thyrotoxicosis:
    a- Carbimazole acts mainly to inhibit the endocytosis of thyroglobulin
    b- Propanolol is particularly useful in the presence of cardiac failure
    c- Post-surgical recurrence is best managed by antithyroid drugs and/or radio-iodine
    d- Therapeutic radioactive Iodine has been shown to be associated with an increased incidence of leukemia
    e- Electroversion of atrial fibrillation is performed prior to commencement of antithyroid drugs

    Gastro oesophageal reflux:
    a- May present with heartburn
    b- It always associated with a hiatus hernia
    c- If untreated usually leads to stricture formation

    Years old patient presents with headache and sudden monocular visual loss. What test should immediately order?
    a- Complete blood count
    b- Sedimentation rate
    c- Skull x-ray
    d- Chest x-ray
    e- Urinalysis

    A patient presents with a painful arc of abduction at the shoulder joint in the range from 60-120 degree. Which of the following conditions would cause this?
    a- Osteoarthritis of the shoulder joint
    b- Partial tear of the rotator cuff muscle
    c- Fractured neck of humerus
    d- Arthritis of the acromio-clavicular joint
    e- Subcaspination calcification

    A 37 yrs old man requests a check up. He says he is quite well and has no particular worries. There is no significant past or family history. The only positive finding on examination is a BP reading of 160/110. Urinalysis is normal. The doctor should:
    a- Arrange for an IVP
    b- Commence a trial of Thiazide diuretic
    c- Advise patient to return for review in one week for another examination
    d- Prescribe a B blocker drug and review in two weeks
    e- Arrange chest x-ray and ECG

    The most serious side effect of tri-cyclic drugs involves:
    a- The genitor-urinary tract
    b- The salivary glands
    c- The elementary tract
    d- The cardiovascular system
    e- The respiratory system

    A patient aged 60 yrs presents with bleeding per vaginam. Two years previously she had the same complaint and at that time uterine curettage revealed no abnormality. The best management would be:
    a- Hysterectomy
    b- Colposcopy
    c- Haemoglobin estimation
    d- Culdoscopy
    e- Hysteroscopy

    Arthritis is common in which of the following conditions
    a- Rubella
    b- Mumps
    c- Measles
    d- Infection mononucleosis
    e- Varicella
  18. R.dass

    R.dass Guest

    In which of the following conditions of the colon is malignant change most likely to occur?
    a- Adenomatous polyp
    b- Melanosis coli
    c- Diverticulitis
    d- Familial intestinal polyposis
    e- Ulcerative colitis

    Bone pain is recognised as an important feature in which of the following conditions?
    a- Paget’s disease
    b- Multiple myeloma
    c- Osteomalacia
    d- Primary hyperparathyroidism
    e- Sarcoidosis

    Features of primary herpetic stomatitis include-
    a- vesicles and ulcers on the buccal mucosa as well as tongue and palate
    b- Inflamed gums
    c- Pain
    d- Recent contact with chicken pox
    e- Cervical lymph node enlargement

    Causes of aseptic necrosis of the hip includes
    a- Femoral neck fracture
    b- Alcoholism
    c- Corticosteroid therapy
    d- Sickle cell disease
    e- Dysbaric disorders
    Patients with major depression often have:
    a- Inversion of diurnal rhythm
    b- Early morning wakening
    c- Diurnal mood variation
    d- Abnormal cranial CT scans
    e- Diarrhoea

    A patient with serous otitis media:
    a- Is usually a young man or man
    b- May have an allergy which blocks the Eustachian tube
    c- Is said to have glue ear
    d- Has a bulging red eardrum
    e- May require the insertion of a grommet

    Raynaud’s Phenomenon may be secondary to-
    a- Atherosclerosis obliterans
    b- Scleroderma
    c- Cold hemaglutination
    d- Ergotism
    e- Rheumatoid arthritis

    Formal thought disorder often occurs in-
    a- Agoraphobia
    b- Schizophrenic disorder
    c- Delirium
    d- Histrionic personality disorder
    e- Conversion disorder

    A patient undergoing an overnight Dexamethasone suppression test (1 mg orally at midnight) fails to show suppression of her plasma cortisol measured at 8 am. This could be due to:
    a- Endogenous depression
    b- Alcoholism
    c- Obesity

    A 56 yrs old man presents with peritonitis due to ruptured colonic diverticulum. After successful surgery he is found to be ollguric hypotensive (BP 90/60) and febrile (38.5 C.) Serum creatinine is 460 mmol/l, urea 32 mmol/l, Na 134 mmol/L, K 3.0 mmol/L and HCO3 16 mmol/L, Haemoglobin is 16.4 G/100ml. Urine Na concentration is 5 mmol/L. Which of the following statements is/are true?
    a- He has established acute tubular necrosis
    b- Dialysis must be instituted immediately
    c- He is saline and may recover his renal function simply with intravascular volume repletion
    d- Blood cultures should be taken followed by antibiotic therapy
    e- Serum K is reduced because he has a metabolic acidosis
  19. R.dass

    R.dass Guest

    Regarding gas shadows and fluid levels seen on an x-ray incases of intestinal obstruction-
    a- A fluid level seen at the duodenal cap is physiological
    b- The distended jejunum is flat and characterless
    c- The ileum is characterized by the concertina effect of the valvulae conniventes
    d- Obstruction of the ascending colon often causes fluid levels in the small intestine despite the lieocaecal value
    e- The presence of fluid levels in the large intestine is indication an urgent barium meal and follows through

    The following are likely to be normal in a five year old child:
    a- A blood pressure of 135/90
    b- A palpable systolic thrill
    c- A third heart sound
    d- A pulse rate of 100/minutes
    e- A spit second heart sound

    In the management of ingrowing toenail-
    a- The success of conservative measures depends a great deal on the patient’s co-operation
    b- The toenail should be cut across convexly
    c- The corners of the nail should be cut back
    d- Avulsion of the whole nail is the most effective method of treatment
    e- Removal of the germinal matrix on the affected side is the surest means of cure
    Regarding subarachnoid haemorrhage-
    a- Berry aneurysms are responsible for at least half of the cases
    b- The aneurysms are due to atherosclerosis
    c- The aneurysms are due to syphilis in 20% of cases
    d- No age is exempt
    e- 20% patients have more than one aneurysm

    Congenital lymphoedema-
    a- Is also called Milroy’s disease
    b- May be familial
    c- Is usually complicated by cellulitis or ulceration
    d- Is associated with increased length as well as girth of the involved limb
    e- Is usually secondary to lymphatic obstruction due to tumour

    Management of the lymphodemalous limb may antall-
    a- Bed rest and elevation
    b- Use of support stocking
    c- Use of intermitted compression therapy
    d- Intermittent antibiotics
    e- Lympho venous

    Which of the following is most likely to increase kidney damage?
    a- Heart Failure with hypertension
    b- Dehydratation and electrolyte imbalance
    c- Systemic infection
    d- Urinary tract infection
    e- Drug toxicity

    An alcoholic presents with disorientation, diploma and ataxia of 6 days duration. On examination is disorientated and presents Nistagmus and bilateral gaze palsy, there is also symmetrical polyneuropathy. This patient probably has:
    a- Hepatic encephalopathy
    b- Delirium tremens
    c- Alcoholic hypoglycaemia
    d- Wernicke’s encephalopathy
    e- Korsakoff’s psychosis

    The normal daily requirements of potassium in adult is:
    a- 5 meq
    b- 25 meq.
    c- 55 meq.
    d- 1 meq.
    e- 155 meq

    Rapid shallow breathing is found in:
    a- Metabolic Acidosis
    b- Metabolic Alkalosis
    c- Emphysema
    d- Restrictive Lung Disease
    e- Scoliosis
  20. R.dass

    R.dass Guest

    Which of the following is not true for third heart sound?
    a- Is not heard in Atrial Fibrillation
    b- Is present in left heart failure
    c- Is diastolic
    d- Is normal in children
    e- Can be heard in Mitral Insufficiency

    Which of the following is the true Best investigation for Bleeding disorders?
    a- Bleeding time
    b- P.T.
    c- PTT
    d- Platelets
    e- Clinical history

    A patient has urinary incontinence, upper motor neurone in the legs, extensor planter response bilateral, propiception and pain sensation is altered and also has lack of sensation from the inguinal region below. What is the diagnosis?
    a- Spine lesion at T10
    b- Spine lesion at L1-L2
    c- Cervical compression
    d- Syringomyelia
    e- B12 deficiency

    A 67 yrs old male ha urinary problems, wasting and weakness of biceps in both arms, spastic presents in both legs and bilateral planter response. What is your diagnosis?
    a- Multiple sclerosis
    b- Cervical compression with myelopathy
    c- Motor neurone disease
    d- Subacute combined degeneration
    A 60 yrs old man suffered of in and needles in the legs, ataxia and glove and stocking sensation. What is the diagnosis?
    a- Diabetic neuropathy
    b- Marie Charcott Thooth
    c- Vitamin B 12 deficiency
    d- Gillian Barre
    e- Diabetic Amyotrophy

    A 65 yrs old male complains of pulsatile temporal headache anorexia, loss of weight and muscle pain, his E.S.R. is 107. He probable has:
    a- Dermatomyositis
    b- P.A.N.
    c- Giant Cell Arteritis
    d- Cerebral tumour
    e- Ver tebro-basilar insufficiency

    Which of the following is not protein anabolic?
    a- Growth hormone
    b- Thyroxine
    c- Insulin
    d- Androgens
    e- Cortisol

    Electrical impulse can cause ventricular fibrillation if it falls on:
    a- P wave
    b- P-R interval
    c- QRS
    d- ST interval
    e- T wave

    Increased jugular venous pressure without displacement of Apex beat can be found in all of the following except:
    a- Mitral Insufficiency
    b- Cor- pulmonale
    c- Mitral stenosis
    d- Myocardial infarction
    e- Costrictive pericarditis

    Regarding hepatic encephalopathy, which of the following is not true?
    a- Improves with Porto-caval shunt
    b- Carbohydrate in diet are helpful
    c- Protein in the diet is helpful
    d- Thiazide diuretics are not indicated
  21. R.dass

    R.dass Guest

    A homosexual male refers fatigue for 3 months, anorexia and vomiting. Lab results are as follows:
    BIL 15 Albumin 35 ALT: 80
    AST 100 HBsAg (+) Liver biopsy: Chronic Active Hepatitis
    Regarding this patient which of the following is correct
    a- Absence of jaundice is unusual in CAH - 352 D
    b- The biopsy result is unexpected with respected to the raised AST and ALT
    c- His sexual contacts must be given immunoglobulin
    d- There are less than 2% chances that he will develop cirrhosis
    e- He may develop Hepatoma
    Regarding Q fever - which of the following is not true?
    a- Is caused by coxiella Burnett
    b- Is spread by tick
    c- Infected persons may transmit the condition to others
    d- Affect may organs
    e- There are abnormal liver function tests

    Regarding Echinoccocous in Australia, man os usually:
    a- A primary host
    b- An intermediate host
    c- Only accidentally infested
    d- Infested by the parasite entering via unbroken skin
    e- Infested by eating infested liver and sheep meat

    Treatment of Trycophyton is:
    a- Topical Griseofulvin
    b- Topical Miconazole
    c- Oral Metronidazol
    d- Topical Nistatin
    e- Oral Thiaoprine

    A patient is on treatment or Parkinson’s and develops dyskinesia:
    The best management should be:
    a- Decrease Levo-dopa
    b- Increase Levo-dopa
    c- Give anticholinergics
    d- Add Adamantine
    e- Add Bromocriptine

    Which of the following statements about the clinical interview is correct?
    a- It is important to question the patient at length on the whole medical history even though the patient is very ill to ensure at no detail is over looked
    b- If the patient is very ill, even though he is conscious, what he says is usually inaccurate and it is wise not to put too much weight on it
    c- The key feature to be established for each symptom is whether or not it is psychogenic
    d- There has been a complete failure of patient to doctor communicate diagnosis at the conclusion of the interview
    e- Emotionally charged detail is often better assessed at a second or third interview

    A rough estimate of the extent of the field of vision can be obtained by comparing the visual fields of the subject under test with those of the examiner. In performing the test, the examiner sits face to face with the subject.
    If you were judging the performance of a clinician, which of the following points of technique would you consider to be incorrect?
    a- The light source is located behind the patient
    b- The subject is asked to cover the eye not under test and to look the examiner in the eye with the other
    c- The subject’s right eye is compared with the examiners right eye and left with left
    d- The examiner prevents the patient from moving his head by fixing the patient’s chin centrally with his free hand
    e- The examiner’s hand moves in a plane midway between the subject’s face and his own

    In which of the following situations is a turning fork of no value?
    a- Testing high tone hearing loss
    b- Testing limb vibration sense
    c- Testing middle ear conduction function
    d- Comparing right and left acoustic nerve function
    e- Distinguishing between middle and inner ear deafness

    A lump in the neck can be identified as a goitre because:
    a- It moves upwards when the tongue is protruded
    b- It moves upwards in swallowing
    c- It displaces the trachea to one or other side
    d- It is tender and fluctuant on palpation
    e- There often is fixation of the overlying skin to the lump

    Which of the following sets of signs most appropriately describes - Isolated sever chronic (Mitral) regurgitation
    a- Slow rising pulse, apical impulse displaced and sustained, basal ejection systolic murmur
    b- Jerky pulse, apical impulse displaced active and ill sustained apical pan systolic murmur and third heart sound
    c- Large volume collapsing pulse, apical impulse displaced and sustained, early peaking ejection systolic murmur and early diastolic murmur down the left sternal margin
    d- Small volume pulse, apical impulse undisplaced, loud first heart sound at the apex with opening sound and diastolic murmur
    e- Jerky pulse, apical impulse slightly displaced active
  22. R.dass

    R.dass Guest

    Which question would you judge to be incorrect?
    a- She percusses from resonant to less resonant areas of the chest when defining the upper border of the liver
    b- She percusses along a line at right angles to the border of the heart whose size & position she is attending to define
    c- She delivers only 2 or 3 blows in any one position of the pleximeter finger before moving to the next position
    d- She percusses over the distal phalanx of the pleximeter finger & maintains a slight air gap between the remainder of the finger & the chest wall
    e- She compares corresponding areas of the chest on each side rather than percussing out one side at a time

    Which of the following most accurately describes the third heart sound?
    a- A high frequency systolic sound related to left ventricular ejection
    b- A low frequency early diastolic sound related to rapid early ventricular filling, heard in some fit young people & also in heart failure
    c- A low frequency late diastolic sound related to atrial contraction & a noncompliant ventricle
    d- A high frequency early diastolic sound coincident with mitral valve opening
    e- A low frequency early diastolic sound heard only in heart failure

    Which of the following statements about examination of the abdomen is correct?
    a- Abdominal enlargement most marked in the flanks suggests small bowel obstruction
    b- The presence of enlarged superficial veins over the abdomen suggests portal hypertension
    c- A midline pulsatile mass suggests an abdominal aneurysm
    d- The triangle formed by the 12th rib, the erector spine muscles & the quadratus lumborum is important in kidney examination
    e- An easily seen mass above the inguinal ligament suggests a direct inguinal hernia

    Isolated cerebrallar lesions may produce each of the followings except:
    a- Truncal ataxia
    b- Limb ataxia
    c- Nystagmus
    d- Hypertonia
    e- Intention tremor

    In a patient who has had a stroke as a result of a cerebral embolus: Which of the following areas of clinical examination is least likely to be helpful in determining the basis of the patients problems?
    a- Pulse rate, rhythm & character
    b- Auscultation for a mid diastolic murmur at the apex
    c- Examination of the retina for haemorrhages closely associated with retinal infarcts
    d- Palpation of the calves for thrombosed deep veins
    e- An ECG & auscultation of the heart for an atrial gallop & pericardial friction rub, if there has been a history of prolonged chest pain

    Which of the following groupings of clinical features carries the gravest prognosis for a patient presenting with hypertension regardless of the apparent efficacy of treatment?
    a- Arm BP of 200/170, blood pressure known to have been normal 6 months previously, strong family history of essential hypertension
    b- Arm BP 150/120, papilloedema present with pulmonary oedema and ankle oedema, serum creatinine 0.3 mmol/L. (upper limit of normal 0.09mmol/L)
    c- Arm BP 150/120, papilloedema present with pulmonary oedema, serum creatinine 0.28 mmol/L if diabetes also present
    d- Arm BP 210/135, rib-notching on x-ray, leg BP 90/40 male patient age 12 years and systolic murmur audible over precordium
    e- Arm BP 160/125, retinal haemorrhages soft and hard exudates L ventricular hypertrophy present clinically with loud aortic component to the second sound, late onset mild diabetes present

    If you suspect a patient has suddenly developed an embolic blockage of a Femoral artery -
    a- You should warm the leg to induce maximal vasodilatation of skin and collateral vessels
    b- You should withhold pain relief (morphine and omnopon) until a consultant has seen the patient
    c- You should call for surgical help immediately
    d- You should elevate the leg to increase venous return
    e- The patient and his relations should be informed that amputation is a likely outcome

    Patients with peripheral (lower limb) atherosclerosis associated with intermittent claudication-
    a- Should keep their legs and feet as warm as possible at all times of the year
    b- Should have an initial angiographic study to establish a base line and subsequently repeats angiograph because symptoms and signs can be so misleading
    c- Should be encouraged to walk within the limits of their claudication pain and encourage trying to increase their range of daily activities over a period of weeks or months
    d- Should be encouraged to use footwear which is as light as possible in order to reduce work loads on their calf muscles
    e- Should always be given a 6-12 trial of vasodilator drugs because these have been demonstrated to open up capillary-channels with the majority of patients

    A 45-year-old non-smoking lean man experiences the sudden onset of severe anterior chest pain which radiates to his neck and down both arms. The pain is described as heavy and lasts 2 hours before being partially relieved by an injection. Which of the following statement is correct?
    a- This man has no identifiable risk factors so that the diagnosis of myocardial infarction is unlikely
    b- The pain is fairly typical of muscular skeletal pain and if it recurs would best be treated by giving 15mg of morphine by deep IM injection
    c- If the pulses in the upper limbs are unequal and on early diastolic murmur is present a diagnosis of aortic dissection is possible
    d- You find that the ECG on admission is within normal limits: this together with the history strongly suggests that the pain is due to something other than acute myocardial infarction
    e- The ECG on admission shows ST elevation in leads II III and AVF with 1st degree Av block. Temporary cardiac pacing is indicated because of the risk of complete heart block.

    A 19 years old Polynesian girl with the history of the rheumatic fever at the age of 10 years is admitted late one night with a 4 days history of arthralgia and dysponea on exertion. She has been taking oral ampicillin prescribed by her GP for the past 2 days. On examination she is febrile with signs of moderate cardiac enlargement but no evidence of heart failure. A loud apical pansystolic murmur is present. Other examination reveals no other abnormality. The most appropriate action for you to undertake as the house surgeon on the evening of admission would be:
    a- Continue her ampicillin I/V after taking a series of blood cultures
    b- Take a throat swab and blood for serology and after liasion with the laboratory take a series of blood cultures withhold antibiotic treatment
    c- Accept that blood cultures are not likely to be useful and treat her overnight with penicillin, cloxacillin and Gentamicin to cover the possibility of infective endocarditis
    d- Take a throat swab and blood for serology, continue ampicillin and start high dose aspirin to relieve the arthralgia and reduce her temperature
    e- Take a throat swab and blood for serology, withhold antibiotics and commence on high dose steroid treatment because of the possibility of rheumatic carditis
  23. R.dass

    R.dass Guest

    Which of the following statements concerning heart failure is most correct?
    a- AS cardiac output drops progressive peripheral vasodilatation occurs in an attempt to maintain peripheral circulation
    b- Ventricular filling pressure is usually reduced
    c- Digoxin through its inotrophic action produces an increase in cardiac output and a rise in ventricular filling pressure and myocardial oxygen requirement
    d- Diuretics relieve congestive symptoms by reducing filling pressure without altering cardiac output
    e- Dopamine is the drug of choice for treating severe heart failure complicating acute myocardial infraction

    Which of the following sets of clinical findings would be most consistent with isolated severe mitral stenosis?
    a- Normal pulse, displaced overactive L ventricular apical impulse, apical pansystolic murmur and S3
    b- Collapsing pulse, displaced overactive left ventricular apical impulse, early diastolic murmur down the L sternal edge and apical mid-diastolic murmur
    c- Normal pulse, systolic waves in the JVP and a systolic murmur down the L sternal edge which increases with inspiration
    d- Small volume pulse, tapping L ventricular apical impulse, loud S1, opening snap and long mid-diastolic murmur, pre-systolic accentuation at the apex
    e- Slow rising pulse, sustained L ventricular apical impulse, basal ejection systolic murmur apical S4

    A 73 yrs old woman with a long h/o heart failure presents with nausea, vomiting and abdominal pain increasing over the previous month. On examination she has signs of moderate congestive heart failure with basal crepitations, JVP 4cm elevated, liver enlargement 4cm below the costal margin and slightly tender on palpation and moderate pitting ankle oedema. She sys she has been taking digoxin 0.25mg 1 tablet mane and slow K 2 tablets mane.
    Which of the following statements is most correct?
    a- If the serum electrolytes are normal digoxin toxicity is unlikely and the patients GIT symptoms are most probably related to hepatic congestion
    b- The patient should be given Propranolol 40mg tds as prophylactic antiarrthmic treatment while digoxin toxicity is ruled out
    c- Because of the patient’s vomiting the heart failure would be best treated by extra digoxin and Lasix parenterally
    d- The symptoms of Digoxin toxicity and hepatic congestion resulting from heart failure may be similar
    e- The patient may be hypokalemic and the heart failure would be best treated by substituting aldactone for Lasix and giving extra potassium supplement

    A 41 year old businessman, father of three children, presents to the GP on a Sunday afternoon with a h/o dull retrosternal pain for the first time.
    The first episode occurred during a round of golf, but was relieved with rest in about 10 minutes. There after episodes occurred with intermitted frequency and severely in relation to exertion, but on the morning before he came to the surgery, he had an episode of pain lasting 20 minutes while shaving.
    He was a heavy smoker and had a long h/o wheezy bronchitis. When examined he was quite undistressed in normal sinus rhythm BP 150/95, no evidence of hear failure. ECG normal,
    Which of the following would you consider most appropriate?
    a- Request admission to the local hospital for further management
    b- Prescribe anginine tablets to be taken sublingually if the pain recurred
    c- Reassure him that there is no sign of coronary problem and ask him to call back if there is any recurrence
    d- Commence him on Propranolol 80mg tds, together with anginine as required for recurrence of pain
    e- Have him exercised by running up and down the 2 flights of steps adjacent to your office and then repeat ECG

    Which of the following is true of JVP?
    a- It has diffuse character and A&V waves relating to atrial contraction and venous are often visible
    b- Systolic pulsation is characteristic of tricuspid stenosis
    c- Regular cannon “a” waves occur with junctional rhythm
    d- Irregular cannon a waves occur in complete heart block
    e- Normally the venous pressure

    A young man aged 19 with a previous h/o rheumatic fever is found to have an enlarged heart on a routine CXR. His pulse is regular and BP 140/10. The JVP is normal and the liver is not enlarged. With this information although there may well be more than one murmur present, which on of the following murmurs would you except to be present?

    The level of the diastolic Bp is most likely a reflection of
    a- The degree of arterio sclerosis
    b- Intravascular volume
    c- The resistance offered by pericapillary arterioles
    d- Cardiac output
    e- Cigarette smoking

    Which of the following on its own consider the least important in relation to risk from coronary artery disease?
    a- Alcohol abuse
    b- Hypercholesterolaemia
    c- Hypertension
    d- Family history of coronary artery disease
    e- Cigarette smoking

    A 34 year old Polynesian woman comes to A&E department with a 2 hour h/o acute dyspnoea of sudden onset associated with irregular palpitations. No other definite history can be obtained.
    A friend says she thinks the patient may have had rheumatic fever in childhood. On examination she is very distressed and dyspnoeic, pulse is irregularly irregular: the apical rate being approximately 120 beats/minute.
    The JVP is slightly elevated, liver is not enlarged and there is no oedema. Widespread fine crepitations are present throughout the lung fields. The apical impulse is undisplaced and tapping in quality.
    On auscultation at the apex, the first heart sound is loud and a diastolic murmur is audible. Which of the following statements related to the case is least likely to be true?
    a- Digitalization and diuretic therapy are appropriate in treatment of this lady
    b- Cardioversion is unlikely to be successful
    c- When the heart rate is low the diastolic murmur should be more prominent
    d- The chest x-ray will show moderate L ventricular dilatation, pulmonary venous hypertension and interstitial oedema
    e- Echocardiogram done when heart rate is slowed will show a reduced (flattened) E-F diastolic filling slope of the anterior mitral valve leaflet

    By which of the following methods may bacteria transfer anti-crobial resistance or virulence factors
    a- Conjunction
    b- Transduction
    c- Transformation
    d- None of the above
    e- All of the above
  24. R.dass

    R.dass Guest

    Bacterial plasmids
    a- Consists of RNA
    b- Are the factors responsible for bacterial virulence?
    c- May be transmissible to other bacteria
    d- Are never responsible for resistance to antibiotics
    e- Are only found in germ negative bacteria

    In which of the following clinical situations has antagonism between antibiotics in combination been shown to occur?
    a- Tobramycin and carbenecillin in pseudomonas aerogenosa septicemia
    b- Gentamicin and cephalosporin in Klebsiella pneumonia
    c- Tetracycline and penicillin in pneumococcal meningitis
    d- Streptomycin and penicillin in enterococcal endocarditis
    e- Gentamicin and mefacillin in staph sepsis

    Aminoglycoside antibiotics activity
    a- Inhibiting cell wall synthesis
    b- Damages cytoplasmic membrane
    c- Prevents nucleic acid replication or transcription
    d- Impairing protein synthesis at ribosomes
    e- Impending essential metabolic pathways

    Grading of tumours is based on
    a- Fine structural appearance
    b- Histological appearance
    c- Clinical examination
    d- Gross examination
    e- All of the above
    Which of the following gram positive organisms will not respond to penicillin?
    a- Bacillus anthracis
    c- Corynbacterium diptheriae
    d- Staph aurius
    e- Clostridium welchii

    Infection with a toxin producing strains of corinybacterium diptheriae is usually associated with -
    a- Temperature of 40 c. and follicular tonsillitis
    b- Temperature of 38 c. and grey membranes at the site of infection
    c- Positive paul-bunnel test
    e- Inhibition of synaptic input to spinal motorneurone

    Listeria monocytogenes may cause
    a- Infections in immunosuppressed patient
    b- A malignant fistulae
    c- Following anterior
    d- Gastroenteritis
    e- Encephalitis lehtrogication

    In trichophyton fungal infection of the scalp taenia capitia
    Which is correct?
    a- Exam of the affected scalp under woods light
    b- Exam of the affected hair under woods light
    c- Exam of the affected hair under fluorescent microscope
    d- Exam of the affected skin by fluoroscopy
    e- All of the above

    A 60 years old female complaining of tremors in her hands while doing her house work. These tremors disappear on resting her hands on her knees, but when her hands are grasped the tremors reappear again. What would you give her?
    a- Amentadine
    b- L-dopa
    c- Benzodiazepine
    d- Beta blocker (Propranolol)
    e- Bromocriptine

    Which of the following is the best parameter in the pre-operative assessment of a patient with bleeding diathesis?
    a- Bleeding time
    b- C.T.
    c- P.T.
    d- P.P.T.
    e- The clinical history
  25. R.dass

    R.dass Guest

    A 18 year old girl complaining of menorrhagia, bruising and purpuric rash. The blood count was found to be normal except for the platelet count which was 20x 109L. On exam the spleen was 5cm below the costal margin. What is your diagnosis?
    a- I.T.P.
    b- Henoch-Schonlein purpura
    c- S.L.E.
    d- QLL
    e- Hypersplenism

    A 55 years old female Rt. handed, came to the casualty with sudden onset of Rt. hemiparesis of the face and body but preserved sensation. What is the most likely diagnosis?
    a- Rt. middle cerebral artery thrombosis
    b- Lt. middle cerebral artery thrombosis
    c- Atherosclerosis of the arteries of the internal capsule
    d- Inferior cerebral artery occlusion
    A 55 years old man was brought to the casualty by his wife unconscious. His wife said that her husband is alcoholic and has been drinking a binge of alcohol for 3 days. TWO week ago he was brought to his home with bruises and unconscious. She said that her husband’s appetite after that was good and nothing wrong with him. Than he started to be confused. O/E he found to have palmar erythema and spider nevi and extensor plantar reflex. What is your diagnosis?
    a- Subarachnoid Hge
    b- Subdural hematoma
    c- Hepatic encephalopathy
    d- Wernicke’s encephalopathy
    e- Brain tumor

    A 27 years old male came with arthritis, urethritis and skin lesions over the palms and soles also the penia after an attack of gastroenteritis a week before. What is the most likely diagnosis?
    a- Behcet’s disease
    b- Reiter’s disease
    c- Gonorrhoea
    d- Felty’s syndrome
    e- He probably has seropositive disease

    What is closely related to GFR?
    a- Serum bilirubin
    b- Serum Uric acid
    c- Serum Creatinine & creatinine clearance
    d- Serum urea

    A young man 24 yrs old on routine exam. He was found to be normal except for having a Blood pressure 160/100. There is no history of hypertension. What would you do?
    a- Start with Thiazide diuretic
    b- Repeat the exam. One week later
    c- Order an ECG
    d- Order an X-ray
    e- Order IVP and Catecholamines in urine

    Aortic regurge occur with the following except:
    a- Marphan’s syndrome
    b- Ankylosing syndrome
    c- Aortic medial leaflet necrosis
    d- Rheumatic fever
    e- Prolonged steroid therapy

    In cystic fibrosis all are correct except:
    a- Sterility and oligospermia
    b- Complete villous atrophy
    c- Increase NaO1 in the sweat
    d- Steatorrhea

    Which of the following sets of physical signs if elicited in a patient would specifically alert you to the possibility of thyrotoxicosis?
    a- Warm moist hands and a bruit over a palpable thyroid gland
    b- A palpably enlarged thyroid gland with mild stridor on inspiration
    c- Atrial fibrillation and mild hypertension
    d- Weight loss with a record of persistent slight pyrexia
    e- Abnormally brisk tendon reflexes and a coarse muscle tremor

    What is the most reliable clinical method of determining whether a thyroid gland is diffusely enlarged?
    a- Careful inspection of the front of the neck in the thyroid area from both sides and frontal position
    b- Palpation of the gland with the fingers of both hands during a swallowing movement, the examiner standing behind the patient
    c- Measurement of the neck circumference 5cm above the supra-sternal notch and comparing the result with standard values for age and ex sex
    d- Palpating the gland with the right hand and during a swallowing movement from a position in front of and slightly to the left of the patient (assuming a right handed examiner)
    e- Measuring the length and breath of the gland with thyro-calipers and comparing the results with the standard record
  26. R.dass

    R.dass Guest

    A rugby player comes to you with a moderately painful swollen left knee joint, injured during a game the previous day. Which of the following signs would most clearly suggest the possibility of his having torn the medial meniscus (semi-liner cartilage)?
    a- Limitation of the last few degrees of extension by a springy resistance
    b- Inability to fully flex the knee because of pain
    c- Noticeable wasting of the left quadriceps
    d- Audible clicking from within the joint on passive flexion/extension
    e- Abnormal anterior posterior range of movement of the tibia on the femur with the joint flexed at 90c.

    An effusion into the pericardium range of demonstrated by -
    a- Scintigraphy (radio-nucleotide scanning)
    b- Computerized tomography
    c- Ultrasound
    d- Intracardiac injection of opaque medium (Angiocardiography)
    e- All of the above

    Osteomyelitis (infection of bone) -
    a- Usually involves mid-shaft near the nutrient artery
    b- may show no radiological abnormality in the early stages
    c- Typically shows an area of low uptake on scintigraphy
    d- Should first be examined by ultrasound
    e- Can be distinguished from tumour by presence of periosteal new-bone formation

    The rate of elimination of alcohol from the body depends largely on -
    a- Essentially by the kidney
    b- Essentially by respiration
    c- Rate of conversion of alcohol to acetaldehyde
    d- Rate of conversion of acetic acid to CO2 & H2O
    e- Rate of conversion of acetaldehyde to acetic acid
    A child who is in good health but his parents c/o of that the child has attack of complete loss of movement especially by night when he watches the TV. The attack last few seconds and during which his eyes are opened and he can hear voices. The parents say that one of their relatives has the same problem. The diagnosis is:
    a- Sleep paralysis
    b- Grand epilepsy
    c- Myoclonic epilepsy
    d- Temporal lobe epilepsy
    e- Familial periodic paralysis

    A 15 year-old-boy is complaining of headache, bluring of vision, absence of public hair, polyuria and polydypsia. His parent noticed that he has not progressed in growth. What is the diagnosis?
    a- Pituitary adenoma
    b- Diabetes insipidus
    c- Diabetes mellitus
    d- Craniopharyngioma
    e- Medulloblastoma

    What is associated with heparin induced thrombocytopenia?
    a- Neutropenia
    b- Tachycardia
    c- Anaemia
    d- Eosinophilia
    e- Thrombosis

    Thrombocytopenia due to salicylate therapy may commonly associated with -
    a- Splenomegaly
    b- Anaemia
    c- Leucopenia
    d- Eosinophilia
    e- G.I.T. bleeding

    A 66 yrs old man with weakness and wasting of the upper limbs, decrease biceps jerky spasticity increase deflexed of legs and no sensory symptoms.
    a- motor neurone disease
    b- B12 deficiency
    c- Cervical Spondylosis
    d- Syringomyelia
    e- Alcolic neuropathy

    A 45 years old man C/O of urinary urgency and 10/E he was found to have flaccid paralysis of the lower limbs, increased reflexes and extensor planter reflex. This is sensory loss below the inguinal ligament. No abnormality in the upper limbs, the diagnosis is:
    a- MS
    b- S.C.D.C.
    c- Vord compression at T 10
    d- Disc prolapse at L 1-2
    e- Disc prolapse at L 4-5
  27. R.dass

    R.dass Guest

    What is common in autoimmune haemolytic thrombocytopenia purpura and ITP?
    a- Splenomegaly
    b- Petechiae on buttocks
    c- Haemorrhage in the optic fundi
    d- Erythema nodosum
    e- Purpura rash on the lower bodyparts (extremities)

    In hepatitis A
    a- IgM means immunity
    b- Bilirubinuria occurs before jaundice
    c- Will get protection if globulin is given within 24 hours after exposure to infection
    d- Presence of transfer agent ………………. is diagnostic and means it will become fulminant hepatitis
    e- There is no chronic stage

    Captopril is complicated by hypotension if given with:
    a- Low salt diet
    b- Give with Thiazide diuretic
    c- Beta blocker
    d- Give to 73 yrs old man

    Dissecting aortic aneurysm of the descending aorta -
    a- Atherosclerosis
    b- May produce aortic incompetence
    c- Can be diagnosed by ultra sound
    d- Will need surgery if causes low C.O. symptoms

    Short term treatment with high dose of corticosteroids can cause-
    a- Cushing’s disease
    b- Psychosis
    c- Osteoporosis
    d- Hypertension

    Which drug of the following need to be reduced or even contraindicated in renal failure?
    a- Nitrofuratoin
    b- Gentamycin
    c- Tetracyclines
    d- Erythromycin

    A child came to the casualty with hypertension, respiratory distress and oedema of the lower limb. He had a bee sting in his leg, what would you give him?
    a- IV fluids
    b- Intravascular adrenaline
    c- IV hydrocortisone
    d- Antihistamines

    The second heart sound is increasingly split in:
    a- RBBB
    b- ASD
    c- PS
    d- Constrictive pericarditis

    Parathyroid adenoma can cause;
    a- Renal stones
    b- Hypercalcaemia
    c- Hyperphosphaturia
    d- Hypercalciuria

    48 yrs old mother with two children who had common cold recently two weeks ago. She became irritable, she has been complaining of difficulty during swallowing and sweating. Investigations showed increased T4, increased T3 resin uptake, TSH normal, Radioiodine nil (she had tender enlarge thyroid)
    What is/are correct?
    a- She does not have Grave’s disease
    b- She is thyrotoxic
    c- If you do radio active iodine uptake you will find it normal or low
    d- She has including antithyroid antibodies
  28. R.dass

    R.dass Guest

    Myxedema is usually associated with:
    a- carpal tunnel syndrome
    c- Cerebrallar type ataxia

    25 yrs old woman with Raynauld’s phenomena and dysphagia, She smokes 20 cigarettes a day and She’s got cough. Which of the following is/are likely to be found?
    a- Subcutaneous calcification
    b- She probably will develop arthritis if she is HLA 29
    c- X-ray shows immobile oesophagus
    d- Treat for chronic bronchitis

    A female patient 30 yrs old with recurrent attacks of palpitation came to the casualty. Her pulse was 170/min. The ECG showed normal QRS but P waves were absent. What is/are the possible treatment?
    a- IV verapamil
    b- IV digitalis
    c- Carotid sinus massage
    d- Isoprenaline
    Which of the following drug/disease combination is/are true?
    a- tetracycline/Pyelonephritis
    b- Caphalexin/Meningitis
    c- Gentamycin/Lower lobe pneumonia
    d- Chloramphenicol/Typhoid fever

    A young patient presents with jaundice and his liver function test was abnormal. He also has arthritis. What is the most likely cause?
    a- hepatitis A
    b- Hepatitis B
    c- Hepatitis C
    d- Hepatitis E
    e- Infectious mononucleosis

    Which of the following viral infection most likely become chronic?
    a- Hepatitis A
    b- Hepatitis B
    c- Hepatitis C
    d- Hepatitis E

    What is cause for increased life expecting at birth of females than males in Australia?
    a- Males exercise more than females
    b- Genetic and biological differences
    c- Females seek health care facilities more than males
    d- Males die more in accidents and violence than the females
    e- Employment stress is more for males

    A 36 yrs old man who is a known ischeamic heart disease patient, complaints of recently increased frequency of chest pain. This episode is prolonged chest pain. Which is true regarding this patient?
    a- Thrombolytic therapy is not indicated if ECG is normal
    b- Heparin is not indicated if ECG and enzyme are normal
    c- Repeat ECG is not indicated if not associated with pain
    d- Stress test has to be done urgently
    e- Serial enzyme assay has to be done even with chest pain

    A 40 yrs old man, who is known hypertensive presents with severe chest pain radiating to the back. His BP was 180/120. Chest x-ray showed mild cardiomegaly with widening of mediastinum. He also had soft diastolic murmur along the left sternal border. ECG showed acute inferior infarction. What is the appropriate management?
    a- CTBG.
    b- Thrombolys the patient
    c- Give morphine, beta blocker and arrange for Trans oesophageal echocardiography
    d- Give intravenous heparin

    Commonest organism causing spreading cellulitis-
    a- Group A streptococcus
    b- Group B streptococcus
    c- Gram negative bacilli
    d- Staphylococcus
  29. R.dass

    R.dass Guest

    A 22 yrs old man comes with jaundice; on examination he also has cervical lymphadenopathy. His liver unction test was:
    a- SGOT 450.
    b- SGPT 400.
    c- LKP 200.
    d- CCT 250.
    e- Bilirubin 80.

    Peripheral blood showed atypical lymphocytes. What is the most likely diagnosis?
    a- Hepatitis A
    b- Hepatitis B
    c- Infectious mononucleosis
    d- Cytomegalo virus
    e- Hepatitis C

    What is the causative of herpes zoster?
    a- HSV 1.
    b- Varcola
    b- HSV 2.
    d- Varicella
    e- EBW

    A patient with WPW syndrome has broad complex tachycardia with fibrillation. What is the management?
    a- Digoxin
    b- Verapamil
    c- DC Cardioversion
    d- Beta blocker
    e- ACE inhibitors

    A 69 yrs old man presents with temporary memory loss and blurring of vision for 10 minutes duration. Where is the lesion?
    a- Vertebrobasillar insufficiency
    b- Transient global amnesia
    c- Carotid artery stenosis
    d- Dementia
    e- Middle cerebral artery thrombosis
    A 65 yrs old man presents with confusion. His plasma sodium was 168-mmol and urine osmolality 205 (50-200), what is the cause for his results?
    a- Addison’s disease
    b- Compulsive water drinking
    c- Diabetes insipitus
    d- SIADH
    e- Congestive cardiac failure

    Which of the following is not usually a presentation of Mycoplasma pneumonia?
    a- Pleuritic chest pain
    b- Fever
    c- Headache
    d- Severe cough
    e- Cold

    A 60 yr old lady, lost ten kg weight over the past 6 months, what is the least likely cause?
    a- Depression
    b- Carcinoma of pancreas
    c- Non-insulin dependant diabetes
    d- Hypothyroidism

    On examination of a 70 yr old lady there was generalized lymphadenopathy and splenomegaly. Her only compliant was abdominal discomfort. What is the most likely diagnosis?
    a- Acute lymphoblastic leukemia
    b- Acute myeloid leukemia
    c- Hodgkin’s lymphoma
    d- Infectious mononucleosis

    All are side effect of corticosteroid except:
    a- Hirsuitism
    b- Lymphopenia
    c- Osteomalacia
    d- Leucocytosis
    e- Cushing’s syndrome
  30. R.dass

    R.dass Guest

    Regarding HIV which of the following is correct?
    a- Usually develops after two years of infection
    b- Most of the opportunistic infection occurs with generalized lymphadenopathy
    c- Monthly pentamidine nebulisation reduces the incidence of opportunistic lung infection
    d- Antibodies will develop within a mean period of nine year after infection

    In a suspected HIV patient, what is the advise you will give?
    a- Usually seroconverts within 3 months
    b- Should avoid sexual contact
    c- chance of transplacental infection is 75%
    d- 25% transplacental
    e- 17% breast feeding

    12 yr old school girl suddenly collapsed at school. She was brought by ambulance with dextrose drip 60/ml min. On examination of her dolls eye reflex were present but she was not responding to painful stimulus. Her vital signs as follows:
    Resp. rate 14/min.
    Pulse rate 50/min.
    SaO2 100%
    B/P 180/110(?)

    If you are working in a tertiary hospital, what is the next step of management?
    a- Arrange for urgent CT scan
    b- Give dextrose infusion and start on saline
    c- Give steroids
    d- Intubate the patient
    e- Neurosurgical reference

    A hypertensive patient present with haematuria (Glomurular nephritis picture). On investigation of urine, which of the following will confirm the diagnosis?
    a- Erythrocyte cast
    b- Granular cast
    c- Hyaline cast

    The diagnosis of chronic renal failure is confirmed by presence of
    a- Haematuria
    b- Small size kidney
    c- hypertension
    d- Proteinuria
    e- Anaemia

    A 48 yr old female, who is smoker complaints of dysponea. She has a past history of exposure to asbestosis ten years ago. On investigation her total lung capacity was 145% of normal expectancy. Diffusion capacity was 25%. On examination, she had widespread wheeze over lung field. What is the diagnosis?
    a- Chronic bronchitis
    b- Emphysema
    c- Asbestosis
    d- Asthma
    e- Carcinoma of bronchus

    A patient present with dyspnoea. On examination, percussion note was dull on the right lower lobe, and bronchial breath sound on the mid zone. What is the most likely cause?
    a- Rt. lower lobe consolidation
    b- Rt. pleural effusion
    c- Rt. lower lobe collapse
    d- Lt. side pneumothorax

    Pulmonary embolism is associated with all of the following except-
    a- Opening snap
    b- Pre systolic crescendo murmur
    c- Presence of S3
    d- Loud S1
    e- Atrial fibrillation

    Which of the following statement is correct regarding his management?
    a- No antibiotic prophylaxis before tooth extraction
    b- Warferin is only indicated if patient has TIA and atrial fibrillation
    c- Mitral valvulolasty has to be done
    d- Captopril should be given

    About keratoacanthoma, which is correct?
    a- Slow growing tumour with spontaneous resolution
    b- Fast growing tumour with spontaneous resolution
    c- Never undergo spontaneous resolution
  31. R.dass

    R.dass Guest

    Which of the correct combination of antibodies with disease?
    a- Anti smooth muscle antibody - primary biliary cirrhosis
    b- Anti mitochondrial antibody - Chronic active hepatitis
    c- Anti ribonuclear protein - Sjogren’s syndrome
    d- Anti acetylcholine receptor antibody - Myasthenia gravis
    e- Anti nuclear antibody - Thyroiditis

    A chronic inflammatory arthritis patient presents with anemia, and investigation showed;
    Hb 10gms%
    Sr.Fe 6 (12-15)
    TIBC less than normal
    MCV 80 (80-90)
    Ferritin 820 (very high)
    Transferrin - Low normal range

    What is the most likely cause for this patient’s anemia?
    a- Anemia of chronic disease
    b- He is probably iron deficient
    c- Megaloblastic anemia
    d- Hemochromatosis

    A man presents with pain on the right knee for the past two days duration. On aspiration of the knee the fluid was cloudy. Microscopic examination showed polymorphs 500/mm cube, No organism seen. What s the probable diagnosis?
    a- Rheumatoid arthritis
    b- Septic arthritis
    c- Reiter’s disease
    d- Ankylosing spondylitis

    Anterior uveitis is commonly found in:
    a- Reiter’s syndrome
    b- Sjogren’s syndrome
    c- Ankylosing spondylitis
    d- Rheumatoid arthritis

    Which of the following is not typical of duodenal ulcer?
    a- Nocturnal pain
    b- Pain relived with antacids
    c- Hunger pain
    d- Loss of appetite
    e- Epigastric pain

    A female patient has reflex oesophagitis, not responding to H2 receptor antagonist. She also complaints that her fingers are changing color when immersed in cold water, what is your next step of management?
    a- Ranitidine
    b- Fundoplication
    c- Omeprazole
    d- Pneumatic dilatation of esophagus
    e- Octreotide

    Regarding Paget’s disease what is true?
    a- hypercalciuria is always present
    b- Alkaline phosphatase is usually elevated
    c- Osteosarcoma is a common complication

    Which of the least appropriate statement about chronic asthma?
    a- Will not usually present after fifty years of age
    b- Hypersensitivity to bronchial stimulus
  32. R.dass

    R.dass Guest

    A 46 yrs old female present with pain and proptosis of her left eye. What is the probable diagnosis?
    a- Cluster headache
    b- Sinusitis
    c- Retroorbital tunnel
    d- Temporal

    A.T. scan result from:
    a- Post streptococcal
    b- Morphine’s syndrome
    c- Ankylosing spondylitis
    d- Prolonged steroid therapy

    In hepatic encephalopathy which are not correct?
    a- Portocaval anastomosis improves the condition
    b- We give CHO liberally
    c- High protein diet is recommended
    d- Constipation does not aggravate the condition

    The forth heart sound is heard in;
    a- myocardial infarction
    b- M.S. severe
    c- Severe A.S.
    d- T.S.

    Coronary insufficiency;
    a- aortitis can be a cause
    b- Dissecting aneurysm can be a cause
    c- Aortic regurge
    d- M.S.

    Analgesic nephropathy;
    a- Haematuria and renal colic
    b- The main pathology is peritubular necrosis
    c- Papillary necrosis can occur and leads to abstruction
    d- Can present with sterile pyuria
    A lady presents with headache that occurs premenstrual, and the pain starts from the occipital spreads forwards the left frontal region. The pain is aggravated on walking and she is irritable, (photophobia) is present. What is the most likely cause?
    a- Tension headache
    b- Premenstrual tension
    c- Migraine without aura
    d- Cluster headache
    e- Temporal arteritis

    A patient presents with fourth attack of gout with pain in the knee joint. What is the management of this patient?
    a- Paracetamol
    b- Probenecid
    c- Indomethacin
    d- Allopurinol

    What is the true about heparin-induced thrombocytopenia?
    a- bleeding
    b- Thrombosis
    c- Neutropenia
    d- Eosophilin

    All are true regarding hemolytic anemia except;
    a- Increased iron absorption
    b- Reduced MCV
    c- Increased urobilinogen
  33. R.dass

    R.dass Guest

    Which of the following drug will not increase the pressure gradient in hypertrophy obstructive cardiomyopathy?
    a- Digoxin
    b- ACE inhibitors
    c- Diuretics
    d- Verapamil
    e- Vasodilators

    Reducing of hypertension is most important in which of the following?
    a- Coronary heart disease
    b- Ischemic stroke

    A 65 yrs old man presents with sudden weakness of Lt. Upper limb. He almost recovered completely from it. On examination you find only mild weakness of the limb. Which of the following would be cause for his symptoms?
    a- Rt. sided lacunar infarct
    b- Lt. sided lacunar infarct
    c- Middle cerebral artery infarct

    In polycythemia, which is not commonly found?
    a- Reduced amount of Leucocytes
    b- Bleeding
    c- Thrombosis
    d- Increased platelet
    e- Splenomegaly

    Which of the following is more suggestive of tuberculous pleural effusion?
    a- Increase lymphocytes
    b- Decreased glucose
    c- Increased protein
    d- Severely blood stained
    The features of lower motor neurone lesion are;
    a- Muscle weakness, wasting, fasciculation, hyper reflexia
    b- Muscle weakness, wasting, hypotonia, fasciculation and decreased reflex
    c- Hypotonia, increased muscle mass, fasciculation and decreased reflex
    d- Muscle weakness, rigidity and increased reflex and absent abdominal reflex

    A 58 yrs old man accompanied by his wife to the hospital with bruises seen on his ---. She complains that her husband was binge drinking for one week. On examination he was confused and had extensor planter reflex. What is the probably diagnosis?
    a- Hepatic encephalopathy
    b- Korsakov’s psychosis
    c- Central pontine myelinosis
    d- Subdural hematoma
    e- Dementia

    IgA nephropathy - what is the usual presentation?
    a- Hematuria, rashes over the buttocks and legs
  34. R.dass

    R.dass Guest

    During normal inspiration -
    a- Right atrial pressure increases
    b- Pulmonary venous flow increases
    c- Systemic arterial pressure increases
    d- Heart rate decreases
    e- Splitting of the second heart sound is increased

    The following statements are true -
    a- The normal pulmonary artery systolic pressure is 40-60mm Hg
    b- A pulmonary capillary wedge pressure greater than 25 mm Hg is usually associated with pulmonary oedema
    c- The hypotension associated with isolated right ventricular infarction is due to a low left atrial pressure and usually responds to fluid challenge
    d- in constrictive pericarditis the left and right ventricular diastolic pressures equalize
    e- Following an anterior myocardial infarction cardiogenic shock (BP 80/50) associated with a pulmonary wedge pressure of 20mm Hg is best treated with inotropic support

    The following statements are correct for cardiac muscle -
    a- Cardiac muscle differs from smooth and striated muscle because of its inherent rhythmicity
    b- Depolarisation of cardiac muscle is the result of an initial calcium influx
    c- Repolarisation of cardiac muscle is the result of potassium efflux
    d- Calcium ions are required for electromechanical coupling of the cardiac myosite
    e- The energy for contraction of the cardiac, myosite is provided as adenosine diphosphate

    On examination of the jugular venous pressure -
    a- With the patient at 45 degree the jugular venous pressure usually lies up to 3 cm above the sternal angle
    b- The Y descent of the venous pressure s associated with right ventricular filling
    c- In tricuspid regurgitating the V wave is more prominent but similar in timing to that in the normal subject
    d- Cannon waves may be present with VVI pacing
    e- Inspiration causes a rise in the venous pressure in the presence of cardiac tamponade

    Endothelial derived relaxation factor (nitric oxide) -
    a- Reduces platelet adhesion and aggregation
    b- is released during forearm ischaemia and is responsible for flow dependent vasodilatation
    c- is responsible for coronary vasodilatation in response to acetylcholine
    d- Acts as a potent vasoconstrictor at high concentrations
    e- Promotes mitogenesis and proliferation of smooth muscle cells

    A significant reduction in systemic arterial pressure is characteristically observed during inspiration in the following conditions -
    a- Severe asthma attack
    b- Positive pressure ventilation
    c- Aortic dissection causing aortic regurgitation and cardiac tamponade
    d- Massive pulmonary embolism
    e- Massive haemorrhage

    The following statements are correct for mitral stenosis -
    a- The later the opening snap the more severe the stenosis
    b- It is approximately equally common in men and women
    c- A loud first heart sound suggests a rigid or calcified valve
    d- Presystolic accentuation of the diastolic murmur occurs if the patient is in atrial fibrillation
    e- The Graham Steell murmur is due to associated aortic incompetence

    The following conditions are associated with disturbances of lipid metabolism that give rise to an increased risk of coronary artery disease -
    a- Familial hyperalphalipoproteinaemia
    b- Familial mixed Hyperlipidaemia
    c- Hormone replacement therapy in post-menopausal women
    d- Heterozygous familial hypercholesterolaemia
    e- Hypothyroidism

    During the normal cardiac cycle -
    a- The aortic and pulmonary valves close synchronously
    b- The period of left ventricular isovolumic contraction occurs between the first heart sound and the onset of the carotid upstroke
    c- The V wave of the jugular venous pulse coincides with the carotid pulse
    d- The interventricular septum depolarizes from right to left
    e- Right ventricular systole is prolonged during expiration

    The following agents have been shown to reduce mortality significantly after myocardial infarction -
    a- Captopril
    b- Nifedipine
    c- Oral nitrates
    d- Timolol
    e- Simvastatin
  35. R.dass

    R.dass Guest

    In Fallot’s tetralogy -
    a- Right to left shunting is present, but cyanosis may not be detected at birth
    b- The second heart sound is widely split
    c- The chest x-ray shows plethoric lung fields
    d- Paradoxical emboli occur because of right to left shunting of blood in the heart
    e- Pulmonary hypertension develops in early life

    The following conditions are associated with false positive responses in exercise tolerance testing -
    a- Hypertension
    b- Aortic valve disease
    c- Left bundle branch block
    d- Hypertrophic cardiomyopathy
    e- Digoxin therapy

    Coarctation of the aorta is
    a- Usually congenital but may be acquired
    b- Recognised by absent or delayed femoral artery pulses
    c- A common cause of heart failure in infancy but an uncommon cause of hypertension in adults
    d- Associated with an increased incidence of bicuspid aortic valve
    e- A cause of left to right shunting of blood

    In non-rheumatic atrial fibrillation -
    a- The risk of embolic stroke is increased 5-fold
    b- The risk of stroke is less than in atrial fibrillation due to rheumatic valve disease
    c- Excess alcohol intake is an unlikely cause
    d- Cardioversion may be performed without anticoagulation if a transthoracic echocardiogram is normal
    e- Paroxysmal atrial fibrillation is associated with a lower risk of stroke

    The following statements are correct for Starling’s law -
    a- The force of contraction is inversely proportional to the initial length of the cardiac muscle fibre
    b- The law is only true for isolated heart preparations
    c- The law means that stroke volume is proportional to left ventricular end diastolic volume unless the inotropic state of the myocardium or vascular resistance change
    d- As a consequence of the law, factors which reduce cardiac filling will increase contractility
    e- The law is dependent on the integrity of the cardiac stretch receptors

    A broad complex tachycardia is more likely to be Supraventricular tachycardia with aberrant conduction than ventricular tachycardia if -
    a- Cannon waves are seen in the neck veins
    b- Fusion beats are seen on the electrocardiogram
    c- Atrioventricular dissociation is seen on the electrocardiogram
    d- The QRS complexes are morphologically identical to a bundle branch block pattern seen when the patient is in sinus rhythm
    e- The tachycardia is abolished by carotid sinus massage

    During pregnancy -
    a- Cardiac output increases
    b- A cardiomyopathy may occur
    c- New cardiac murmurs are usually innocent
    d- Use of anticoagulants is a more difficult problem than in non-pregnant women
    e- Pulmonary oedema due to mitral stenosis is characteristically treated by valvotomy

    On standing from the supine position -
    a- Compensatory changes in the circulation are the result of the stimulation of the carotid sinus and aortic baroreceptors by a reduced blood pressure
    b- Reduced cerebral blood flow causes an increase in cerebral PCO2 and a decrease in cerebral PO2
    c- Total peripheral vascular resistance decreases
    d- Cardiac output increases
    e- Circulating Angiotensin II decreases

    Amiodarone -
    a- Causes nausea in about 50% of patients with congestive cardiac failure
    b- Causes hypothyroidism or hyperthyroidism in 3-5% of patients
    c- Prolongs the action potential duration
    d- is preferable to flecainide in the treatment of ventricular tachycardia in patients with ischaemic heart disease and impaired left ventricular function
    e- has a half life of about 10 days

    The following statements about the Valsalva manoeuvre are correct -
    a- The manoeuvre is performed by straining to inhale against a closed glottis
    b- Initially blood pressure increases transiently, then falls because venous return is impaired
    c- A tachycardia is present whilst straining but a Bradycardia occurs after release of the manoeuvre
    d- The heart rate and blood pressure responses are abolished by sympathectomy
    e- The cardiovascular responses to the manoeuvre may be impaired in diabetes
  36. R.dass

    R.dass Guest

    In congestive cardiac failure -
    a- ACE inhibitors reduce mortality by up to 40%
    b- Digoxin may result in symptomatic improvement in patients in sinus rhythm with a dilated left ventricle and third heart sound
    c- Beta blockade may result in symptomatic improvement in cases of dilated cardiomyopathy
    d- A third sound is associated with ventricular filling
    e- Treatment with a combination of nitrates and hydralazine may prolong survival

    In the new born infant the following circulatory changes occur -
    a- Peripheral vascular resistance rises
    b- Pulmonary vascular resistance rises
    c- Blood flow across the forearm ovale reverses
    d- Blood flow across the ductus arteriosus is initially reduced and reversed immediately after birth before ceasing entirely in a further day or two
    e- Superior vena caval blood flow exceeds inferior vena caval blood flow for the first time

    Atrial myxomas -
    a- are more common in the right atrium than in the left atrium
    b- do not recur after resection
    c- may mimic infective endocarditis
    d- are poorly visualized on echocardiography
    e- usually arise from a pedicle near to the fossa ovalis
    Prinzmetal’s or variant angina is characterized by -
    a- Evidence of proximal coronary artery disease in over 50% of cases
    b- Marked ST elevation with increased R wave amplitude during anginal attacks
    c- Ventricular dysrhythmias during pain
    d- Pain at rest or at night
    e- A good response to sublingual nitrates

    The following metabolic and neurohumoral effects are observed in patients with congestive cardiac failure -
    a- Compensatory reduction on basal metabolic rate
    b- Inhibition of aldosterone secretion because of sodium retention
    c- Polycythaemia
    d- Increased circulating renin concentrations
    e- Increased responsiveness of the heart to circulating catecholamines

    After splenectomy -
    a- Howell-jolly bodies are found in the red cells
    b- There is an exaggerated neutrophil and platelet response to inflammation
    c- Penicillin prophylaxis against staphylococcal infection should be continued for life
    d- Lymphopenia is found
    e- Meningococcal vaccine should be administered to patients visiting equatorial Africa

    The following are features of myelodysplastic syndrome -
    a- Increased numbers of blasts in the bone marrow
    b- Atypical monocytes in the peripheral blood
    c- Transfusion-dependent anaemia
    d- Transformation into treatment-resistant acute myeloid leukaemia (AML)
    e- Treatment with busulphan may be effective

    In acute leukaemia -
    a- The presence of Auer rods confirms the diagnosis of acute lymphoblastic leukaemia (ALL)
    b- The presence of the Philadelphia chromosome confers a good prognosis
    c- Disseminated intravascular coagulation (DIC) is common in acute promyelocytic leukaemia (AML-M3)
    d- CNS involvement is common in acute lymphoblastic leukaemia
    e- Hypokalaemia in acute monocytic leukaemia is due to renal tubular damage by lysozyme

    Fragmented red cells on the blood film -
    a- are found in disseminated intravascular coagulation
    b- in thrombotic thrombocytopenic purpura are due to damage to red cells by intravascular fibrin
    c- are found in march haemoglobinuria
    d- are usually associated with Polychromasia
    e- are associated with increased serum haptoglobins

    The following are features of iron-deficiency anaemia -
    a- Reduced bone marrow stainable iron
    b- reduced serum iron and iron binding capacity (TIBC)
    c- a low MCV, MCH and MCHC
    d- Target cells and pencil cells in the peripheral blood
    e- Correction can almost always be achieved with simple oral iron preparations
  37. R.dass

    R.dass Guest

    Beta-thalassaemia major -
    a- May present with severe anaemia between the ages of 5 and 10 yrs
    b- commonly presents with neonatal jaundice
    c- can be diagnosed antenatally by Hb electrophoresis on fetal red cells
    d- is associated with atrophy of the spleen
    e- should be treated with regular oral desferrioxamine to reduce iron overload

    Fresh frozen plasma (FFP) -
    a- is available in the UK in 300 ml aliquots
    b- Is the optional replacement fluid after major burns
    c- two units should be given for every four units of SAG-M blood transfused in an operative situation
    d- Contains blood group antibodies
    e- is approved for the urgent correction of over-anticoagulation with warferin

    A prolonged thrombin clotting time may occur in -
    a- warferin therapy
    b- prothrombin deficiency
    c- disseminated intravascular coagulation (DIC)
    d- dysfibrinogenaemia
    e- liver disease

    The following are recognised to be associated with an inherited tendency to venous thrombo-embolism -
    a- the lupus anticoagulant
    b- abnormal structure of factor V causing resistance to degradation by activated protein C
    c- factor IX deficiency
    d- anti-thrombin deficiency
    e- protein S deficiency

    Heparin treatment for pulmonary embolus -
    a- should be commenced as a constant intravenous infusion os 40,000 u/24 hours
    b- prolongs the prothrombin time (PT)
    c- may cause a fall in platelet count
    d- may give rise to Osteomalacia
    e- if ‘overload’, may be reversed by quinine suphate

    Cold agglutinins -
    a- cause abnormal red cell indices when blood is processed at room temperature
    b- cause rouleaux on the blood film
    c- most commonly have anti-Rhesus specificity
    d- are associated with lympho-proliferative disorders
    e- when associated with haemolysis transfusion of packed red cells are the mainstay of treatment

    Lymphocytosis -
    a- in chronic lymphocytic leukaemia (CLL) may be due to T-cell proliferation
    b- in pertussis morphologically resembles CLL
    c- Presenting in association with skin rashes is frequently of T-cell origin
    d- in glandular fever resembles that of CLL
    e- Is a racial variant occurring not uncommonly in people of African origin

    In a patient with macrocytosis -
    a- the presence of target cells is in keeping with a diagnosis of liver disease
    b- the finding of Polychromasia should prompt a reticulocyte count
    c- the finding of neutrophil hypersegmentation should prompt measurement of serum vitamin B12
    d- the finding is normal if the patient is a neonate
    e- the presence of a monocytosis is in keeping with a diagnosis of myeloproliferative disorder

    In blood coagulation -
    a- the intrinsic pathway proceeds more rapidly than the extrinsic one
    b- the intrinsic system is activated by blood coming into contact with a non-endothelialised surface e.g. subendothelium
    c- calcium ions are required for the intrinsic, but not the extrinsic pathway to proceed
    d- platelets play a part in the normal coagulation cascade
    e- when the coagulation mechanisms are working normally, blood may take more than an hour to clot in a dry, plastic tube

    The following statements are true about factor VIII -
    a- it consists of two parts of approximately equal size
    b- synthesis of factor VIIIc and VIII von Willebrand factor (VWF) is controlled by sex-linked (X chromosomes) genes
    c- synthesis of VIIIc and VWF takes place chiefly in the liver
    d- in von Willebrand’s disease, there is a reduction in both VIIIc and VIII VWF
    e- a factor VIIIc level of 10% (normal range 50-150%) is associated with severe bleeding diathesis
  38. R.dass

    R.dass Guest

    In transmitted cytomegalovirus (CMV) infection -
    a- the risk of cytomegalovirus transmission can be reduced by leucocyte-depleting blood filters
    b- more than a third of blood donors in the UK are CMV antibody positive
    c- premature neonates should receive blood from CMV-negative donors
    d- acyclovir is an effective treatment for CMV pneumonitis after bone marrow transplant
    e- measurement of IgM CMV antibodies is the earliest method of diagnosing infection

    In a patient with paroxysmal nocturnal haemoglobinuria (PNH) -
    a- iron may precipitate acute hemolysis
    b- aplastic anaemia is a recognised complication
    c- chronic granulocytic leukaemia may supervene
    d- the Hess test is commonly abnormal
    e- Splenomegaly is commonly present

    Cryoprecipitate -
    a- is prepared by thawing fresh frozen plasma
    b- is free of risk of hepatitis infection
    c- is rich in fibrinogen
    d- may reverse the platelet defect in Uraemic patients
    e- is of therapeutic valve in haemophilia B
    Granulocyte colony stimulating factor (G-CSF) -
    a- achieves its best physiological effect by intravenous bolus administration rather then subcutaneous injection
    b- administration during chemotherapy improves the effectiveness of cytotoxics against carcinoma cells
    c- can stimulate the proliferation of myeloblasts in acute myeloid leukaemia
    d- bone pain as a recognised side-effect
    e- increases the number of CD34 positive stem cells in the blood in normal people

    In aplastic anaemia -
    a- a history of preceding hepatitis A is associated with a relatively benign course
    b- immunosuppressive therapy may be effective
    c- a leuko-erythroblastic blood picture may be present at diagnosis
    d- ferrokinetic studies show predominant accumulation of isotope in the liver
    e- a positive Ham’s test may be present

    A patient with a first pulmonary embolus has been on continuous i.v. heparin for five days and has received one dose of 10mg warferin 12 hours before blood is drawn for coagulation tests: these show an activated partial thromboplastin time (APTT) ratio of 1.7, and an international normalized prothrombin ratio (INR) of 1.8 -
    a- the heparin should be increased
    b- the INR result shows the effect of over-heparinisation
    c- the patient is unusually sensitive to the effect of warferin
    d- the aimed for INR range in this patient is 3-4.5
    e- the INR is the patient’s prothrombin time in seconds divided by the normal control time in seconds

    Dietary iron -
    a- in a normal diet amounts to about 3 mg/day
    b- absorption is reduced by vitamin C
    c- absorption is reduced by phosphates
    d- is about 90% excreted in health
    e- is absorbed in the ferric (Fe 3+)

    Increased plasma erythropoietin occurs in -
    a- Aplastic anaemia
    b- polycythaemia rubra vera (PRV)
    c- renal failure
    d- massive obesity
    e- Hepatoma

    A 54 yrs old man has WBC 5.4X 109/l, HB 10.4 g/dl, platelets 135 X 109/l. Differential count shows: neutrophils 87%, lymphocytes 6%, monocytes 3%, metamyelocytes 3%, promyelocytes 1%, and nucleated red cells 3/100 white cells. The following are appropriate investigations to elucidate the cause of the abnormal blood picture -
    a- Chest x-ray
    b- haemoglobin electrophoresis
    c- fasting cholesterol
    d- bone marrow aspirate
    e- HLA typing

    Regarding human blood groups -
    a- naturally occurring anti-A and anti B antibodies can be IgM and IgG
    b- most people secrete their A or B blood group antigens in saliva
    c- The ABO type of an individual can ‘change’ during some illness e.g. acute leukaemia
    d- Group O is the commonest blood in all racial groups
    e- Lack of certain blood group antigens protects against Plasmodium vivax

    A healthy blood donor with a haemoglobin of 14 g/dl is found to have a positive direct antiglobulin (Coombs’) test. The following are appropriate investigations -
    a- reticulocyte count
    b- anti-nuclear factor
    c- physical examination for enlarged lymph nodes
    d- Drug history
    e- Barium enema
  39. R.dass

    R.dass Guest

    Usually the first sign of salicylate poisoning in children is -
    a- Delirium
    b- Coma
    c- Hyperventilation
    d- Hyperpyrexia
    e- Convulsion

    Which of the following is not associated with neonatal hyperbilirubinaemia?
    a- Fetal rubella infection
    b- ABO incompatibility
    c- Malaena
    d- Hereditary spherocytosis
    e- Bruising

    The commonest of anemia in an infant aged 12 months is -
    a- Bleeding from Meckel’s diverticulum
    b- Recurrent bleeding from the nose
    c- Fibrocystic disease of the pancreas
    d- Diet only of milk
    e- Folate deficiency

    A 5 yrs child presents with an acute painful leg left and temperature of 39.5 C. WOF is the most likely cause?
    a- Scurvy
    b- Rickets
    c- Synovitis of the hip
    d- Osteomyelitis
    e- Perthe’s disease

    A boy aged 8 yrs presents with an acute attack of wheezing. He has a past history of recurrent episodes of wheezing since the age of 5 yrs and has been well in between attacks. O/E he has minimal thoracic movement with hyperinflation. Breath sounds and sibilant rhonchi are barely audible on auscultation. He is cyanosed even on 40% O2.
    Which is the most likely diagnosis?
    a- Bronchlolitis
    b- Inhaled foreign body
    c- Cystic fibrosis
    d- Asthma
    e- Bronchlectasis

    Each of the following statements is correct except-
    a- Malabsorption in cystic fibrosis is predominantly due to impaired pancreatic exocrine function
    b- Malabsorption of fat predispose to rickets
    c- Disaccharides deficiency is a complication of gastroenteritis
    d- Steatorrhoea may occur with heavy infestation of Giardia lamblia
    e- Patients with coeliac disease usually have fat globules in the stool

    A child aged two years whose brother has just recovered from gastro-enteritis has complained of abdominal pain for 18 hours and has been feverish and irritable. He has vomited twice since the pain commenced but has not had a bowel action. O/E his temperature is 38 C. He resists examination of the abdomen and has tenderness and guarding of the lower abdomen without associated distension. His management should be -
    a- Erect x-ray examination of the abdomen
    b- Oral antipyretic
    c- Laparotomy
    d- White cell count and review
    e- Oral Metronidazol

    A 7 yr boy complaining of one sided faeculant nasal discharge. The most common cause is -
    a- Foreign body
    b- Sinusitis
    c- Cold

    The commonest cause of Anorectal bleeding in children is -
    a- Ulcerative colitis
    b- Rectal polyps
    c- Intussusception
    d- Fissure in ano
    e- Peptic ulcer

    Which of the following are helpful in the treatment of Atopic eczema, except?
    a- Avoidance of wool garments
    b- Antibiotics
    c- Moisturizing cream
    d- Sea-water bath
    e- Oral corticosteroids
  40. R.dass

    R.dass Guest

    What is the most common presentation of chronic renal failure in childhood?
    a- Polyuria
    b- Increased creatinine clearance
    c- Decreased uric acid level in serum
    d- Hyperglycaemia

    3 yr child was brought to you by his mother with bow legs. O/E there is tibial torsion, distance between knees is 3 inches. Your action is-
    a- Popliteal splints
    b- Osteotomy bilateral
    c- Vitamin D
    d- Reassure the mother
    e- Weighing of the outer soles of the shoes

    Which newborn is more prone to develop kernicterus, Except?
    a- High titre conjugated bilirubin
    b- Diabetic mother
    c- Premature
    d- Hypothyroid
    e- Small for dates

    In patient with asthma severe? The best method of assessing the severity of the disease would be-
    a- Arterial blood gases analysis
    b- FEVI
    c- The severity of cyanosis
    d- The severity of the dyspnoea
    e- Tachycardia

    Teratoma of the testis characteristically metastasis to-
    a- Para-aortic nodes
    b- Inguinal nodes
    c- Kidneys
    d- Vertebral
    e- All of the above

    A patient diagnosed as craniopharyngioma and tumour mass is 10mm in CT scan. The best treatment should be -
    a- Tamoxifen
    b- Bromocryptine
    c- Surgery trans-spnoncidal approach
    d- Surgery Transfrontal approach

    A young man with a history f frequent sore throat with a puffy face, oliguria, blood pressure reading of 160/120 and pulmonary crepitations. WOF is correct?
    a- Haematuria is a grave prognostic sign
    b- His main immediate risk is of death from left ventricular failure
    c- Increase in oral fluids will result in a diuresis
    d- If there is renal tenderness a renal biopsy should be undertaken
    e- Dialysis is contra-indicated during the acute phase of the illness

    All of the following are lesions in basal ganglions except?
    a- Tremor
    b- Dystonia
    c- Ataxia
    d- Chorea
    e- Rigidity

    WOF statements concerning. Parkinson’s disease is not true -
    a- It frequently commences on one side
    b- It flexed pasture is characteristic
    c- It causes falls without loss of consciousness
    d- It causes involuntary stopping whist walking
    e- The tremor persists during sleep

    Regarding immunology, WOF statement is correct?
    a- Killer cells are T-subsets and kill tumour cells
    b- B cells produce first IgM and later IgG
    c- IgM need the help of complement
    d- IgG increases with infectious mononucleosis
    e- Staphylococcus aureus needs opsonization
  41. R.dass

    R.dass Guest

    The valve of giving anti D gamma globulin to an Rh -ve mother is -
    a- Elimination of the fetal RBC from the maternal stream
    b- Coating the fetal red blood cells thus preventing to maternal
    c- Immunological reaction
    d- Stimulate the immune response of the mother to produce antibodies against the fetal blood cells
    e- Inhibiting the immune response of the mother to the fetal red blood cells

    A 6 yr old boy thought always to be healthy is found to have a loud parsystolic murmur at the lower left sternal edge. He is not cyanosed. The apex occurs left ventricular and pulmonary second sound is normal. The ECG shows left ventricular hypertrophy and the chest x-ray shows mild cardiomegaly and pulmonary plethoric. The most likely diagnosis is-
    a- ASD
    b- VSD
    c- MI
    d- Co-arotaxia of aora
    e- Cardiomyopathy

    WOF statements is true of cerebral palsy?
    a- It is present before birth
    b- It is a static instead of progressive lesion
    c- It is a psychomotor disorder of obscure cause
    d- It is an inherited disease
    e- it is synonymous with rhethosis

    Which of the following will indicate developmental delay?
    a- Smiles for the first time at 8 weeks
    b- Sits up unsupported at 8 weeks
    c- Walks for the first time at 16 months
    d- Says about 3 words at 16 months
    e- Has day and night urinary control at 5 years

    Purulent vaginal discharge Except-
    a- Pyometra
    b- Monilial vaginitis
    c- CIN III
    d- Decubitus ulcer

    In patients with pernicious anaemia, optimal therapy with vitamin B12 will correct-
    a- Gastric acidity to normal levels
    b- Thrombocytopenia
    c- Malabsorption of vitamin B12 measured by the Schilling test
    d- Hyper segmentation of the neutrophils
    e- Early and mild peripheral neuropathy

    Deficiency in boys significantly associated with -
    a- Parental criminality
    b- Low average IQ
    c- Large family size
    d- Inconsistent harsh paternal discipline
    e- Lower socio-economic class

    In regard to chronic venous disease which of the following comments is/are true?
    a- In primary varicose veins, the prevalence of sapheno femoral incompetence is higher than that of sapheno-popliteal incompetence
    b- When sapheno-femoral and sapheno-papliteal incompetence occurs in the patient it is most likely to be an acquired problem
    c- Chronic venous disease due to the post-phlebitis (post-thrombolic) syndrome is often cured by venous ligation and excisional surgery
    d- Venous ulceration is only associated with the post phlebitis (post thrombotic) syndrome
    e- Graduated compression stocking produce an equivalent effect to surgery for both the symptoms and complications of chronic venous disease

    Deep sea fish -
    a- Protect against coronary heart disease whet, consumed in quantities at 30g or more twice per week
    b- Contain high levels at n-3 fatty acids
    c- When consumed in amounts greater than 400g per week does not affect the skin bleeding time
    d- Is a poor source of protein compared to meat
    e- Is useful for treating high plasma cholesterol levels

    A 32 yr old woman presents with severe menorrhagia. She wishes to have pregnancies in the future. Her uterus is enlarged to a size which is equivalent to a ten week pregnancy. Ultrasonography confirms that this is due to fibromyomata. Which of the following therapies may be appropriate in her management?
    a- Gonadotrophin releasing hormone analogue therapy
    b- Vaginal hysterectomy
    c- Hysteroscopic endometrial resection
    d- Myomectomy
    e- Oral oestrogen supplementation
  42. R.dass

    R.dass Guest

    A 3 yr old child was brought with a history of unilateral nasal discharge and halitosis of 3 days duration. What is your most probable diagnosis?
    a- Sinusitis
    b- Insilitis
    c- FB in the nose
    d- Otitis media
    e- Gingivostematitis

    A mother brought her 6 yr old child to you saying that it was not doing very well in school. IQ was 80. No other abnormal find. What is your advice to the mother?
    a- Send the child to a school for the severely disabled and mental retardet
    b- Ask the teacher to give extra lesion to the child after school hours
    c- Refer to a psychiatrist
    d- Reassure the mother that he may

    A six year old child developed oedema of feet and periorbital oedema. The next day he had vomiting and diarrhoea and developed joint pains. The next day he got a purpuric rash on the past aspect of him thigh and calf and Gluteal regular. What is he most appropriate investigation would perform in this child?
    a- Urine microscopy and culture
    b- Xray the joints
    c- Stool examination
    d- Estimation of immunoglobulins in the serum

    A 4 yr old child was brought to you with a smooth round Huctuant swelling at the junction of the middle and the lower third of the Rt. sternomastoid muscle. It was a subcutaneous swelling. What is your approach?
    a- Hodgkin’s lymphoma
    b- Take a chest x-ray
    c- Lymph node enlargement
    d- Do aspiration of the controls and send for pathology
    e- Excision physiotherapy

    An elderly woman can read the newspaper, but has halos in bright sunlight?
    a- Glaucoma
    b- Cataract
    c- Presbyopia
    d- Macular degeneration

    Which of the following drugs decreases renin?
    a- Beta blockers
    b- ACE inhibitors
    c- Spironolactone
    d- Hydralazine
    e- Centrally acting antihypertensives

    Newborn with respiratory distress, faint breath sounds on the left and with a scaphoid abdomen -
    a- Meconium aspiration syndrome
    b- Situs inversus
    c- Diaphragmatic hernia

    Which nerve gives the sensation of taste to the anterior 2/3rd of tongue?
    a- Trigeminal nerve
    b- Facial nerve
    c- Hypoglossal nerve
    d- Glossopharyngeal nerve

    A patient who underwent a cholecystectomy now comes with jaundice. What is the investigation of choice?
    a- Oral cholecystogram
    b- CT scan
    c- Ultrasound
    d- Sr. creatinine
    e- Upper GI studies
  43. R.dass

    R.dass Guest

    All of the following are true regarding a pseudobulbar palsy except -
    a- Wasting and fasciculation of tongue
    b- Jaw jerk decreased
    c- Loss of sphincter control
    d- Gag reflux present

    Regarding ACE inhibitors which is not true?
    a- Used in the treatment of heart failure
    b- Used as first line in the treatment of Hypertension
    c- Used in Diabetics
    d- Cannot be used in the treatment of Aortic stenosis

    Regarding CRF and Calcium metabolism -
    a- Ca is increased
    b- Ca is decreased
    c- There is no relation between CRF and Ca
    d- Causes Osteomalacia

    Most significant complication of massive blood transfusion?
    a- Pulmonary oedema
    b- Change in acid base balance
    c- DIC and coagulation defect
    d- Increased IVP
    e- No such complications

    Regarding CRF and potassium all of the following reduce potassium except (treatment of hyperkalemia)-
    a- Calcium carbonate
    b- Glucose and insulin
    c- Dialysis
    d- Resonium
    e- Sodium Bicarbonates

    55 yr old patient with dysphagia for solids with a previous history of reflux-
    a- carcinoma oesophagus
    b- Stricture
    c- Scleroderma
    d- Achalasia
    e- Raynaud’s

    An infant came with pneumonia, X-ray showed consolidation of a lobe with round translucencies and a small pleural effusion. What is the treatment of choice?
    a- Crystalline penicillin
    b- Flucloxicillin
    c- Amoxicillin / clavulanic acid
    d- Tetracycline

    A new born was peripherally cyanosed and crying lusting. The axillary temperature recorded was 37.2 degrees what would be the next step?
    a- Take an xray
    b- Reassure
    c- Oxygen
    d- Urine culture

    34 yrs old lady on phenytoin wants to take OCP’S what can be prescribed-
    a- Microgynon 30
    b- Microgynon 50
    c- Triphasic
    d- Oetradiol patches
    e- Progesterone only oil

    6 months old boy brought by his mother with a temperature of 38.9degrees with bilateral wheezing his resp. rate was 36/min. other members in the family had a h/o similar illness. There is family h/o asthma. What is the diagnosis?
    a- Asthma
    b- Foreign body
    c- Bronchiolitis
    d- Pneumonia
  44. R.dass

    R.dass Guest

    16 weeks pregnant lady came for a check up, for the diagnosis of foetal anencephaly all are true except -
    a- Increased alpha feto protein
    b- Increased beta HCG
    c- Nuchal thickness
    d- Decreased alpha feto protein

    Regarding tubal pregnancy most suggestive is -
    a- Ultrasound showing empty uterus
    b- Ultrasound showing tubal mass
    c- Negative beta HCG
    d- CT scan

    10 weeks old child with persistent unilateral eye discharge not responding to antibiotics but recurring -
    a- Nasolacrimal duct obstruction
    b- Gonococcus
    c- Chlamydia

    Unilateral foul smelling, bloodstained discharge from nose -
    a- Foreign body
    b- Nasal polyps
    c- Atopy
    d- Rhinitis

    10 yrs old came to your surgery with scrotal pain. On examination both testis are in the scrotum, next management -
    a- Do an ultrasound
    b- Arrange surgery
    c- Write some analgesic and send him home
    d- Do nothing it will go away
    e- Tell his mother to review back again when the pain recurs

    19 yrs old girl had a binge of drinking the previous night with lower abdominal tenderness and all investigations and tests are normal -
    a- Treat as gastroenteritis
    b- Tell her it is due to alcohol
    c- Not sure of diagnosis come back for review
    d- Give analgesic and ant-emetic and send her home

    Reversal of non depolarizing skeletal muscle blockage -
    a- Pyridostigmine
    b- Neostigmine
    c- Atropine
    d- Benzhexol

    Differentiation between schizophrenia and schizophreniform disorders in by -
    a- Affective symptoms
    b- Duration of symptoms
    c- Lack of insight
    d- Female and male ratio

    A lady with a previous divorce now comes to you with a seductive behaviour -
    a- Narcistic
    b- Histrionic
    c- Borderline

    In Australia bush fires are common either accidentally or due to some people lighting fire deliberately. Which is true regarding pyromaniacs?
    a- Done for notoriety and publicity
    b- To hide their acts
    c- As they like to play with fire
    d- Set fire and get panic attacks
    e- For satisfaction
  45. R.dass

    R.dass Guest

    People living near airport have -
    a- Explosive personality
    b- Insomnia

    Regarding panic attacks all are true except-
    a- 20% have had at least one attack in their lifetime
    b- With out agoraphobia it is equal in mal and female
    c- Always avoid precipitating factors
    d- Usually occurs in the twenties

    Regarding treatment of chronic duodenal ulcer -
    a- Eradication of H pylori
    b- H2 blockers
    c- PPI
    d- Selective vagotomy

    4 year old boy with fever and malaise, lymphocyte count - normal, platelets decreased, Hb decreased -
    a- ALL
    b- Infectious mononucleosis
    c- Hodgkin’s disease
    d- Read Stenberg cells
    Pregnant lady with Group B strep infection. What is true?
    a- Penicillin to be given as prophylaxis
    b- Bolus dose of penicillin before labour
    c- Take a swab and if B strep present then treat

    Regarding MI, maximum deaths occur in -
    a- With in 1st 2 hours
    b- 2 to 12 hrs
    c- 12 to 24 hrs
    d- 2 to 7 days
    e- After discharge

    A case of stable angina with chest pain on examination enzymes and ECG are normal but as you were examining him he belches and says he feels better, what would you do?
    a- Admit to coronary care and do ECG monitoring
    b- Send him home with appointment to cardiologist
    c- Refer to gastroenterologist
    d- If enzymes normal then probably no cardiac

    With regard to primary health care all are true except -
    a- 1/3rd population come to a GP with psychiatric symptoms
    b- Most patients are psychotic
    c- Only few are referred to psychiatrists
    d- Alcoholics and drug abuse frequently overlooked by GP’s

    A patient with known Parkinson’s disease for 2 yrs on long term treatment now comes with tongue protruding out. What would you do?
    a- Decrease levodopa + Carbidopa
    b- Increase levodopa + Carbidopa
    c- Stop levodopa + Carbidopa
    d- Treat with chlorpromazine

    In a case of twin pregnancy all are true except -
    a- Asymmetrical growth retardation
    b- Anaemia in pregnancy
    c- Premature labour
    d- 2nd twin foetal malformation
  46. R.dass

    R.dass Guest

    60 yrs old female diarrhoea and profuse mucous discharge, what could be the cause -
    a- Chron’s disease
    b- Ulcerative colitis
    c- Villous adenoma
    d- Rectal Ca
    e- Acute mesenteric ischaemia

    How do you differential between Anorectal and colorectal cause of bleeding -
    a- Blood mixed with stools
    b- Fresh bright bleeding
    c- Mucoid discharged
    d- Pain during defecation

    Most common cause of severe chest pain in pericarditis-
    a- Viral pericarditis
    b- Tuberculosis
    c- Mycoplasma
    d- Uraemia
    e- MI

    All of the following are causes of supraclavicular mass except -
    a- Stomach Ca
    b- Cervical rib
    c- Breast Ca
    d- Subclavian thrombosis
    e- Subclavian artery aneurysm

    Which of the following has worst prognosis?
    a- Advanced breast Ca
    b- Choriocarcinoma
    c- Hodgkin’s lymphoma
    d- Non-Hodgkin’s lymphoma
    e- Prostate carcinoma

    Which of the following does not metastasize to brain?
    a- Malignant melanoma
    b- Prostate Ca
    c- Lung Ca
    d- Breast Ca

    40yr old lady with a 2 cm palpable breast lump on the right side. What is the next step?
    a- FNAC
    b- Ultrasound
    c- Lumpectomy
    d- Mammography
    e- Radical mastectomy

    A lady with palpable breast lump, FNAC showed few malignant cells. regarding conservative surgery what is true?
    a- Assess for oestrogen receptors
    b- Bone marrow biopsy
    c- Axillary lymph node sampling
    d- Mammography

    A lady with a breast cancer on left side operated 2 yrs ago now detects a small lump on the right side. How do you explain the lump?
    a- Cancer arising de novo
    b- Fibroadenoma
    c- Metastasis from the previous one

    Facial nerve palsy can be associated with all of the following except?
    a- Chronic parotitis
    b- Ca parotid
    c- Acoustic neuroma
    d- # base of the skull
  47. R.dass

    R.dass Guest

    A middle aged woman the deafness and loss of corneal reflex but with no tinnitus -
    a- Vestibular neuronitis
    b- Meniere’s disease
    c- Acoustic neuroma
    d- Multiple sclerosis

    Ptosis, dysphagia, ataxia, on the same side and spinothalamic loss on the opposite side -
    a- Vertebral artery occlusion
    b- Basilar artery occlusion
    c- MS-midbrain
    d- Lateral medullary syndrome

    22yrs old lady with diplopia. On examination the right eye, the medial side of the image is lost (i.e. diplopia on looking laterally). What is the diagnosis?
    a- Left 6th nerve palsy
    b- Left 3rd nerve palsy
    c- Right 6th nerve palsy
    d- Posterior cranial fossa tumour

    Reading a patient with hepatoma, which of the following is least likely?
    a- Hepatitis B
    b- Hepatitis C
    c- Hemochromatosis
    d- CMV
    e- Alcoholic cirrhosis

    In which of the following cell mediated immunity is lost first followed by loss of humoral immunity?
    a- CLL
    b- HIV
    c- RA

    Which of the following is not a carcinogen?
    a- EBV
    b- CMV
    c- Hep C
    d- HIV

    A picture of a lesion at the lateral angle of the eye. What is the treatment(It’s a BCC)?
    a- Surgical removal
    b- Excision and radiation
    c- Cryotherapy
    d- Chemotherapy
    e- Local steroids

    Picture of swelling at the outer angle of the eye. t is described as being hard and present since birth -
    a- Osteoma
    b- Sebaceous cyst

    Picture of a large swelling on the back near the left scapula -
    a- Lipoma
    b- Sebaceous cyst

    Picture of the face with a non itchy rash like lesion on the cheeks, forehead -
    a- SLE
    b- Seborrhoeic dermatitis
    c- Acne rosacea
    d- Dermatomyositis
  48. R.dass

    R.dass Guest

    Post operative specimen (testicle with epididymis)
    a- TB
    b- Epididymoorchitis
    c- Teratoma
    d- Torsion of testis
    e- Seminoma

    A chest x-ray of a child showing consolidation, neutrophils increased. What could be the cause?
    a- Klebsiella pneumonia
    b- Group A streptococcus
    c- Staphylococcus
    d- Mycoplasma pneumonia

    A lesion (looks like an ulcer) diagnosis -
    a- Amelanotic melanoma
    b- Implantation Dermoid
    c- Basal cell carcinoma

    ECG- patient is a diabetic and he is dyspnoeic diagnosis-
    a Inferior wall MI
    b- Anterior wall MI
    c- Pericarditis
    d- WPW syndrome
    e- Pulmonary embolism

    ECG patient has palpations, otherwise normal -
    a- Atrial fibrillation
    b- Atrial flutter with variable block
    c- WPW syndrome with accelerated beats

    ECG patient comes with sweating, palpitations -
    a- Ventricular Ectopic
    b- Ventricular tachycardia
    c- Atrial fibrillation
    d- RBBB

    How do you treat WPW in a patient with a previous history of collapse?
    a- Beta blockers
    b- Cardioversion
    c- Radiofrequency ablation abnormal tract
    d- Surgical ablation
    e- Long term verapamil

    40y old man with SVT 160/min. Patient not arousable, treatment is -
    a- Cardioversion
    b- Adenosine
    c- Procainamide
    d- Verapamil
    e- Take an ECG

    Child with heart rate 220/min otherwise normal. How do you manage?
    a- Cold stimulus
    b- Valsalva
    c- Verapamil

    All of the following are side effects of depot medroxyprogesterone, except -
    a- Amenorrhoea
    b- Weight gain
    c- Depression
    d- Used with oestrogen causes stratification and cornification of vagina
    e- Hypotension
    f- Hypertension
  49. R.dass

    R.dass Guest

    20yr old man came with pain referring from groin to trip of penis brought a sample of urine mixed with blood and asks for a shot if Pethidine to relieve his pain. What is the next step -
    a- Give him an injection of Pethidine to relieve his pain
    b- KUB
    c- Ultrasound abdomen
    d- Examine fresh urine sample

    12 yr old boy bee sting with wheeze, with swollen lips, tachycardia, restless, immediate treatment -
    a- Adrenaline IM
    b- Hydrocortisone IV
    c- Oxygen
    d- Antihistamine
    e- Give NSAID and send him home

    Young man with RTA, Bp 90/70, pulse 140 difficulty in breathing -
    a- Start two IV line to Hartmann
    b- Wide bore needle
    c- Tube drainage
    RTA respiratory distress mediastinal shift to opposite side with emphysema in the neck. What is the diagnosis?
    a- Tension pneumothorax
    b- Hemothorax
    c- Cardiac tamponade
    d- Bronchial tear

    Newborn male with normal genitalia- which is true-
    a- 47xxy
    b- 46xy with androgen sensitivity
    c- Mother treatment with cyptoterone from 8 weeks

    16 yr old girl came with her mother with no menstrual breast development is normal (testicular feminisation)-
    a- 45xo
    b- 46xy

    After MVA a patient is dyspnoiec Bp 100/70, HR 110/min, Breath sounds decreased on left side, heart sounds normal, JVP raised, next step in management -
    a- IV fluids
    b- Wide bore thoracotomy
    c- Tube thoracotomy

    A patient with excruciating chest pain and a diastolic murmur. What does therapy show?
    a- Widening of mediastinum
    b- Increased left ventricular size
    c- Trachea shifted to left

    A child with fever malaise, sore throat………white papillae on the tongue and later a sandpapery rash……what is true diagnosis?
    a- Measles
    b- Rubella
    c- Scarlet fever

    A child with fever of 3 days duration and a rash develops when fever subsides -
    a- Rubella
    b- Roseola (Measles)
    c- Erythema multiforme
    d- Steven Johnson syndrome
  50. R.dass

    R.dass Guest

    An unconscious man (a known COPD case) was brought to the emergency, on examination there was a bruise on the parietal area and needle mark in the cubital fossa. His ABG was as follows (PH: 7.26, PCO2: 60, PO2: 50) His previous ABG showed (PH: 7.35, PCO2: 30, PO2: 60). What is the diagnosis?
    a- Narcotic
    b- Subdural haemorrhage

    16 weeks pregnancy woman with proteinuria 3+, hematuria and hypertension -
    a- PIH
    b- Pre-existing renal disease
    c- Essential hypertension
    d- Pregnancy will continue until term

    Which of the following is familial -
    a- Papillary carcinoma
    b- Medullary carcinoma
    c- Follicular Ca
    d- Anaplastic
    e- Secondary Ca of thyroid

    A patient with HIV and cough (respiratory symptoms) has a Mantoux 5mm -ve, what is the next step?
    a- INH prophylaxis
    b- Zidovudine
    c- Interferon

    Patient with HIV +ve status, what is true -
    a- Life long infectivity
    b- He has AIDS
    c- Can transmit through saliva
    d- He should avoid sexual intercourse

    Tremor can be present in all of the following except -
    a- Hyperthyroidism
    b- Hypothyroidism
    c- Benign essential tremor
    d- Parkinsonism
    e- Chronic liver disease

    A lady with tremor on lifting the phone and disappears when she looks at her hand with mild rigidity of the hand but no cog wheel rigidity. What is the treatment?
    a- Propranolol
    b- Benzhexol
    c- Levodopa

    Complication of # of Epiphyseal plate -
    a- Retardations of longitudinal growth
    b- Joint stiffness
    c- Malunion
    d- Non - union
    e- Levodopa

    Which of the following does not have any interaction?
    a- Warferin & isosorbitrate
    b- Verapamil & metoprolol
    c- Erythromycin & terfenadine
    d- Digoxin & Amiodarone

    12yr old weight 90th percentile with a limp -
    a- Perthes’s disease
    b- Slipped capital femoral epiphyses
    c- Tibial synovitis

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