AMC-MCQs

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

  1. R.dass

    R.dass Guest

    13 yr old child which would be the appropriate bone age for a normal adult height -
    a- 9yr old
    b- 13yr old

    Regarding mammography, all except -
    a- It is painless
    b- Can diagnose breast Ca earlier than self examination
    c- More diagnostic for 70yr old
    d- Definitive diagnosis of Ca breast

    A young boy has fever and limp. There is tenderness at one point in the tibia, all movements are full except flexion which is restricted to 30 degree. What is the diagnosis?
    a- Septic arthritis
    b- Osteomyelitis
    c- Perthes disease

    10 days old boy with vomiting, Sr potassium is 7.7, Sr Na is 118.What is the diagnosis?
    a- Pyloric stenosis
    b- Congenital adrenal hypoplasia
    c- SIADH
    d- Posterior cranial fossa tumour

    6 hours after difficult catheterization, a patient developed fever with chills-
    a- Suppurative urethritis
    b- Gram negative septicaemia
    c- Haemorrhage aippg.com

    Regarding hemochromatosis, diagnostic investigation is -
    a- Sr. ferritin
    b- Transferrin
    c- Sr. iron
    d- Liver biopsy

    In Australia the common cause of iron deficiency is -
    a- Nutritional deficiency

    Most common cause of bleeding P/R in children -
    a- Fistula in ano
    b- Fissure in ano

    Patient with depression is treated with antidepressants, following a course of treatment she now wants to stop the drug. What do you advice?
    a- Follow up every week
    b- Follow up every month
    c- Admission to hospital

    Child with abdominal mass and with metastasis to skull -
    a- Neuroblastoma
    b- Wilm’s tumour

    A child babbles sits for sometime unsupported, stands with support and holds an object by the palm. What is the age?
    a- 5 months
    b- 7 months
    c- 1 year

    A patient with Dysthymia for 2 years treatment is -
    a- SSRI +cognitive +behaviour therapy
    b- SSRI +benzodiazepine
    c- SSRI
    d- Antipsychotic +SSRI

    A young patient vomits 1 litre of blood and has 2 times malaena, what is next appropriate step?
    a- Gastroscopy
    b- Immediate surgery
    c- Barium meal

    Old lady with knee swelling and has weekly positive birefringent crystals the crystals contain -
    a- Calcium pyrophosphate dehydrate
    b- Calcium hydroxyapatite
    c- Urate

    A patient is worried about the (sexual dysfunction and depression) side effects of sertraline, what would be the advice regarding the same to the patient?
    a- it is only side effect of antidepressant
    b- Both these side effects are not related to sertraline
    c- it causes sexual dysfunction but not depressant
  2. R.dass

    R.dass Guest

    Young man after a RTA was found unconscious, only responds to painful stimuli and eye cold stimuli what is the GCS score-
    a- GCS>3
    b- 3 to 6

    Child with fever and blisters in the palm and sole and mouth, there is lymphadenopathy -
    a- Coxsackie’s
    b- Kawasaki
    c- Herpes

    All of the following are scaly lesions except -
    a- keratoacanthoma
    b- Squamous cell Ca
    c- Pityriasis rosea
    d- Psoriasis

    Rash similar to syphilis except -
    a- infectious mononucleosis
    b- Atopic eczema
    c- Discoid eczema
    d- Tinea corporis

    Pregnant lady with carpal tunnel syndrome. What is true?
    a- surgical intervention is rarely needed
    b- Splinting in hyperextension

    What is typical feature of carpal tunnel syndrome (CTS) repeat?
    a- severe pain awakening the patient at night
    b- Pain in the ring and little finger
    c- Paresthesia restricted to median nerve
    d- History of myxedema

    3rd day blues what is correct -
    a- occurs at least in 50% after delivery
    b- More common following “C” section
    c- Always lead to psychosis
    d- Results in more premature malformed children

    Regarding child abuse - aippg.com
    a- more common in deformed premature and LBW children
    b- Toddlers are more commonly affected
    c- Majority patients would have a psychiatric disorder
    d- Other children in the family won’t get affected

    Confidentially can be broken in which of following situations -
    a- child abuse
    b- When the police comes to ask
    c- Insurance matters

    All are hepatotoxic except -
    a- paracetamol
    b- OCP’S
    c- Halothane
    d- INH
  3. R.dass

    R.dass Guest

    Carcinomatous change can occur in all except -
    a- Sjogren’s syndrome
    b- Thyrotoxicosis
    c- Coeliac disease

    2yr old child with chronic respiratory infection, what would you do?
    a- sweat chloride test
    b- X ray chest
    c- Barium meal

    Child with chronic cough and rectal prolapse diagnosis?
    a- congenital megacolon
    b- Cystic fibrosis
    c- Whooping cough

    6 weeks old child on breast feeding with 4 days constipation and thriving well, diagnosis-
    a- Hirschsprung’s disease
    b- Normal variant
    c- Hypothyroidism
    d- Acquired constipation

    Which of the following is not associated with brain metastasis?
    a- small cell Ca
    b- Breast Ca
    c- Renal Ca
    d- Lung Ca

    An elderly patient, known case of Ca rectum, on morphine has chronic constipation and was treated with Lactulose but was not responding what is the next step?
    a- arrange a surgical consultation
    b- Enema
    c- P/R examination
    d- Modify diet

    All of the following are associated with Raynaud’s except -
    a- RA
    b- SLE
    c- Scleroderma
    d- Dermatomyositis
    e- Ankylosing spondylitis

    Cause of diarrhoea in an old bed ridden patient -
    a- faecal impaction
    b- Carcinoma aippg.com

    Haemolytic anaemia all are true except -
    a- increased urobilinogen
    b- lcterus and clear urine
    c- MCV decreased

    A child ingested washing powder half an hour ago next management -
    a- Admit to hospital and possible Endoscopy
    b- Charcoal
    c- Sent him home
    d- Syrup of ipecacuanha
    e- Observe
  4. R.dass

    R.dass Guest

    Mother of an 18 month child was concerned as it was not babbling; audio logical assessment was done when he was 10 months old. What is the next step?
    a- Arrange audiometry
    b- Repeat hearing test
    c- Reassure the mother

    7 ½ yr old girl attained menarche, her mother noticed the breast growth and axillary hair growth 6 months ago-
    a- Premature aneurysms
    b- Undiagnosed congenital adrenal hyperplasia

    In a young female patient what is the most common cause of subarachnoid haemorrhage
    a- Ruptured aneurysms
    b- AV malformations
    c- Mycotic aneurysm

    A neonate few hours after birth developed cyanosis which was not responding to oxygen diagnosis -
    a- Transposition of great vessels
    b- Tetralogy of fallot’s
    c- VSD

    Lung carcinoma seen in non smokers-
    a- Adenocarcinoma
    b- Squamous cell carcinoma

    A child has facial movements and it is increased on watching TV (question on tics). They are present even during examination -
    a- Myoclonic epilepsy
    b- Tics
    c- Partial complex epilepsy

    In TNM staging which has a better prognosis-
    a- T1 N0 M0
    b- T1 N1 M0

    60 yr old female patient had repeated bilateral Thrombophlebitis and DVT -
    a- pancreatic cancer aippg.com
    b- Ovarian cancer
    c- Protein deficiency

    Most common cause of central cyanosis -
    a- left to right shunt
    b- right to left shunt
    c- CO poisoning

    Regarding immunology what is correct -
    a- IgG associated with Atopic eczema
    b- Delayed hypersensitivity is t cell mediated
  5. R.dass

    R.dass Guest

    Why is it difficult to differentiate beta HCG and LH?
    a- FSH high
    b- LH high
    c- Prolactin high
    d- Progresterone

    Young hypertensive male with proteinuria, hematuria and upper respiratory infection for 2 days, diagnosis?
    a- IgA nephropathy
    b- Glomerulonephritis
    c- Nephrotic Syndrome
    d- Acute Pyelonephritis
    e- Membrane Nephropathy

    All of these can cause gynecomastia except -
    a- Spironolactone
    b- Cimetidine
    c- Digoxin aippg.com
    d- Labetolol/Frusemide
    e- Methyldopa

    Which of the following is least likely associated with primary hypothyroidism?
    a- 72 y/o with multinodular goitre
    b- 28 y/o with menorrhagia
    c- 9 y/o with retarded bone age
    d- 16 y/o with anovulatory cycles

    Which of the following is correct?
    a- Alcohol reduces triglycerides
    b- Olive oil decrease HDL
    c- Increased LDL/HDL ratio is good
    d- Taking 300gms of fish daily does not reduce cholesterol

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

    Regarding Diabetes mellitus what is true?
    a- At least take 100gms of carbohydrate everyday to prevent ketonuria
    b- If one parent has diabetes there is 1.8 chance of getting affected
    c- You can’t give insulin until level comes to normal

    Regarding diabetic foot, all are true except-
    a- 50% mortally following amputation
    b- If the pulse is present patient is unlikely to have it
    c- To have diabetic foot controlling glucose level can help

    Regarding 80% carotid artery stenosis, what is true?
    a- The incidence of stroke will be halved
    b- 40% stroke with out treatment
    c- 50% incidence of stroke after endarterectomy
    d- 40% death will occur within 30 days

    Spiral # of humerus, which nerve damaged?
    a- Radial
    b- Ulnar
    c- Median
    d- Volkmann’s ischaemia contracture
  6. R.dass

    R.dass Guest

    50yr old wakes up at night due to pain in the calf which is relieved by walking, what is the cause?
    a- Ischaemic pain
    b- Raynaud’s phenomenon
    c- Muscular cramps
    d- DVT
    e- Intermittent claudication

    A patient with pain in the calf worsened by elevation of feet -
    a- Ischaemia
    b- Noctumal cramps
    c- DVT

    Which of the following features to be due to arterial ischaemia?
    a- Pain along the buttock and thigh after exertion
    b- Weakness of the buttock and thigh
    c- Shooting pain from buttock and thigh
    d- Leg paralysis

    Most common feature of rectal carcinoma -
    a- Tenesmus
    b- Bleeding
    c- Incomplete defecation
    aippg.com
    A patient after MVA sustained a pelvic # and has blood in the external meatus initial investigation of choice is -
    a- Urethrogram
    b- CT scan
    c- Cystoscopy
    d- Catherisation
    e- IVU

    Regarding uncomplicated haemorrhoids all are true except -
    a- Pain
    b- Pruritis
    c- Bleeding
    d- Prolapse
    e- Mucus discharge

    Regarding PMS what is true?
    a- 5% have very severe symptoms
    b- 40% have PMS
    c- all patients with PMS always have Dysmenrrhoea

    A mechanic with penetrating hand injury what is true?
    a- Drainage should be done from extensor surface
    b- It indicates that there is extension of the palmar abscess into extensor aspect
    c- The swelling is due to oedema
    d- It indicates the involvement of extensor tendons

    Apathetic and dull are the negative symptoms of schizophrenia, which is the negative symptom?
    a- catatonia
    b- Blunted affect

    A patient who is aware about his own problems during treatment, what is it?
    a- Instinct
    b- Insight
    c- Pseudo altruism
    d- Intellectualization
  7. zar

    zar Guest

    answers

    hi

    the questions are very helpfull . Thanks

    can you plz post answers .

    both joseph n R.dass good work .
    can you plz post the 30th october amc mcqs questions . it will be great.

    thanks n regards
  8. Joseph.

    Joseph. Guest

    The change of the severe hypo-glycemia in the infant of a diabetic mother can be lessened by all the following except -
    a- Careful control of the maternal blood glucose levels during pregnancy
    b- Maternal intravenous loading with 10% glucose beginning 2 to 4 hr period to the expected time of delivery
    c- Careful glucose monitoring of the infant
    d- Early feeding of the infant
    e- Maintenance of the infant in a neutral thermal environment

    A term, 4200 g female infant is delivered via cesarean section because of cephalopelvic disproportion. The amniotic fluid was clear and the infant cried almost immediately after birth. Within the first 15 min. of life, however the infant’s respiratory increased to 80 breaths per minute and she began to have intermittent grunting respirations. The infant was transferred to the level two nursery and was noted to have an oxygen saturation of 94%. The chest radiograph showed fluid in the fissure, over-aeration, and prominent pulmonary vascular markings. The most likely diagnosis in this infant is -
    a- diaphragmatic hernia
    b- Meconium aspiration
    c- Pneumonia
    d- Idiopathic respiratory distress syndrome
    e- Transient tachypnea of the newborn

    The infant pictured below presented with syphilis. Clinical features of congenital syphilis during the first 3 months of life include all of the following except -
    a- Maculopapular rash
    b- Persistent rhinitis
    c- Anemia
    d- Interstitial keratitis
    e- Hepatosplenomegaly aippg.com

    A newborn infant is ready for discharge from the term nursery. In providing instructions to the parents, you include advice concerning infant automobiles restraints. Each of the following is true except:
    a- Children are safest restrained in the back seat of the car
    b- The risk of death is tenfold greater in unrestrained children
    c- Many children restrained are used improperly
    d- Most children between 1 and 4 yrs of age are not restrained
    e- An adult wearing a seat belt can safely hold an infant in his/her arms

    Correct statements regarding neural tube defects (anencephaly, meningomyelocele) include each of the following except –
    a- The hereditary pattern is considered multifactorial
    b- The prenatal diagnosis can be made by detection of very low levels of alpha-fetoprotein in the amniotic fluid
    c- There is an increased risk in the next pregnancy
    d- The risk of a third affected child is approximately 10%
    e- Environmental and social factors influence the incidence

    An infant born to a heroin addict is likely to exhibit all the following except –
    a- Prematurity and low birth weight
    b- Onset of withdrawal symptoms within the first 2 days of life
    c- Hyperirritability and coarse tremors
    d- Vomiting and diarrhea
    e- An increased incidence of hyaline membrane disease

    A previously healthy full-term infant has several episodes of duskiness and apnea during the second day of life. Diagnostic considerations should include each of the following except –
    a- Bacterial meningitis
    b- Congenital heart disease
    c- Seizure disorder
    d- Harlequin syndrome
    e- Hypoglycemia

    In the newborn period, which of the following is the least common sign of meningitis?
    a- Lethargy
    b- Jaundice
    c- Vomiting
    d- Nuchal rigidity
    e- Hypothermia
  9. Joseph.

    Joseph. Guest

    A 72 year old man complains of limiting exertional chest tightness. He has clinical evidence of significant aortic stenosis. Transthoracic echocardiography demonstrates a peak aortic valve gradient of 80 mmHg with moderate left ventricular function and probable aortic incompetence Cardiac catheterization is performed. What would be the most helpful information to obtain from this investigation?
    a- Aortic valve gradient
    b- Left ventricular function
    c- Presence of co-existing coronary artery disease
    d- Right heart pressure
    e- Severity of co-existing aortic incompetence

    A patient with dilated cardiomyopathy and permanent atrial fibrillation (AF) has a resting heart rate of 110 bpm. 24 hours taped recording show even higher uncontrolled rates, particularly associated with exercise. He is already taking 187.5 mg of digoxin and has a normal creatinine. Which one of the following would be the most beneficial treatment?
    a- Addition of beta blocker
    b- Addition of verapmil
    c- AV node ablation and permanent pacemaker insertion
    d- DC cardioversion
    e- Increase digoxin to 250 mg.

    A 30 year old window cleaner has a one year history of frequent, rapid, irregular palpitations associated with dizziness, but no actual syncope. He drinks approximately 35 units per week but is on no regular medications. His resting ECG confirms a diagnosis of Wolff-Parkinson-white syndrome (WPW). Which one of the following is the most appropriate treatment?
    a- Aminodarone
    b- Flecainide
    c- Radiofrequency ablation of accessory pathway
    d- Radiofrequency modification of AV node
    e- Sotalol

    A 60 year old presents with increasing swelling of ankles, abdominal distension, and dyspnoea. She has a past medical history of pulmonary, tuberculosis as a child and a left mastectomy and subsequent radiotherapy 5 years previously. On examination she is apyrexial, with a sinus tachycardia of 100bpm and blood pressure of 110/160 (paradox 8 mmHg.). She has significant peripheral oedema and ascites. Her jvp is elevated at 8 cm above the sternal angle and demonstrates a rapid y descent. What is the most likely diagnosis?
    a- Cardiac tamponade
    b- Constrictive pericaditis
    c- Intra- abdominal neoplasm
    d- Severe tricuspid incompetence
    e- Superior vena cava obstruction

    The following findings are obtained during right and left heart catheterization in a 50 yr old woman:
    Pressures: right atrial = mean 9, right ventricle = 35/2, pulmonary artery = 36/14, pulmonary capillary wedge = 10, aorta = 120/65.
    Saturations (%): superior vena cava = 65, right atrial = 76,
    Right ventricle = 77, pulmonary artery = 75, aorta = 97.
    She has no significant past medical history, except recent onset of paroxysmal atrial flutter. What is the most likely diagnosis?
    a- ASD – ostium primum aippg.com
    b- ASD – ostium secundun
    c- Sinus venous defect
    d- Tricuspid incompetence
    e- VSD

    An asymptomatic 5 yr old man is noted to have a systolic murmur. He is in sinus rhythm. Transthoracic echocardiography demonstrates normal left ventricular function and dimensions, together with moderate mitral regurgitation secondary to posterior mitral valve leaflet prolapse. The left atrium is enlarged at 4.5 cm. Which one of the following is the most appropriate course of action?
    a- Amiodarone to maintain sinus rhythm
    b- Recommend SBE prophylaxis and discharge
    c- Regular clinical follow-up with repeat echocardiography
    d- Regular clinical follow-up with repeat echocardiography and anticoagulation with warferin
    e- Transoesophageal echo and early referral for mitral valve replacement

    A 45 yr old HGV licence holder is seen in outpatients 6 weeks post uncomplicated inferior myocardial infarction (MI), for which he received streptokinase. His resting ECG shows inferior T wave inversion. What would be the next investigations/procedure?
    a- Angiography with percutaneous intervention to the right coronary artery
    b- Bruce protocol exercise test
    c- Echocardiogram
    d- Modified Bruce exercise test
    e- Thallium scan

    a patient presents with severe interscapular pain. A CT scan confirms a diagnosis of Type B aortic dissection. Clinical examination reveals sinus tachycardia of 100 bpm and blood pressure of 150/84 mmhg (similar in both arms.) Which one of the following is the most desired intervention?
    a- Intravenous beta blocker
    b- Intravenous GTN
    c- Oral ACE inhibitor
    d- Referral for urgent surgery
    e- Transoesophageal
  10. Joseph.

    Joseph. Guest

    Post anterior MI, a 60 yr old man develops cardiogenic shock with blood pressure of 80/50 mmhg and diminished urine output. A Swan-Ganz catheter is inserted and reveals a pulmonary capillary wedge pressure (PCWP) of 20 mmhg; systemic vascular resistance (SVR) 1580 (normal: 900-1200 dyne.s/cm5) and cardiac index (CI) of 1.8 (cardiac output /body surface area, normal; 2.8 -3.5 l/min/m2). Which one of the following should be the optimal initial treatment?
    a- Dobutamine
    b- Dopamine
    c- Intravenous GTN
    d- Intravenous fluids (gentle)
    e- Noradrenaline

    A patient has pulmonary embolus proven by spiral CT scanning. 24 hours after initiation of low molecular weight heparin (LMWH) therapy he becomes hypotensive, tachycardic and hypoxic without evidence of acute bleeding. His JVP is elevated at 8 cm above the sternal notch. Which one of the following would be the desired intervention?
    a- Charge LMWH to intravenous unfractionated heparin
    b- Inotropic support
    c- Insertion of inferior vena cava filter
    d- Thrombolysis with streptokinase
    e- Thrombolysis with tissue plasminogen activator

    Six months after prosthetic mitral valve replacement a patient presents with a 2 month history of rigors, anorexia, fatigue and weight loss. The CRP is elevated at 110. Transthoracic echo confirms moderate paravalvular regurgitation with vegetation. Which one of the most likely infecting organism?
    a- E.coli
    b- Staphylococcus aureus
    c- Staphylococcus epidermidis
    d- Streptococcus viridans
    e- Candida albicans aippg.com

    A 40-yr-old smoker is found to have fasting cholesterol of 8.0 mmol/l and triglycerides of 1.8 mmol/l. He is hypertensive with a strong family history of premature coronary artery disease. Which one of the following would be the recommended intervention?
    a- Atorvastatin
    b- Bezafibrate
    c- Cholestyramine
    d- Diet
    e- Pravastatin

    A patient with a previous history of myocardial infarction presents with a broad complex tachycardia. Blood pressure is 110/60 mmhg. Lung fields are clear. What is the most appropriate initial management therapy?
    a- Intravenous digoxin
    b- Intravenous lignocaine
    c- Oral aminodarone
    d- Overdrive pacing
    e- Transoesophageal echo and dc cardioversion if no thrombus

    Which one of the following physiological variables has the greatest influence toward increasing cardiac output during the later stages of strenuous exertion in a healthy adult?
    a- Coronary vasodilatation
    b- Decrease in systemic vascular resistance
    c- Increased alveolar ventilation
    d- Increased stroke volume
    e- Increased ventricular rate

    A patient undergoes assessment for suitability of percutaneous trans-septal mitral valvuloplasty for the treatment of rheumatic mitral stenosis. The presence of which one of the following features would most likely preclude this form of intervention?
    a- Atrial fibrillation
    b- Coronary artery disease
    c- Heavily calcified mitral valve
    d- Pulmonary hypertension
    e- Spontaneous contrast in the left atrium, seen on TOE

    An asymptomatic 30-yrs-old gym instructor is seen as part of a routine medical examination. An ECG demonstrates LBBB. Which one of the following clinical signs is most likely to be present?
    a- Displaced apex beat
    b- Fourth heart sound
    c- Left ventricular heave
    d- Reverse splitting of the second heart sound
    e- Third heart sound
  11. Joseph.

    Joseph. Guest

    A 15-yrs-old girl presents with a short history of fever, malaise and a flitting polyarthritis. Clinical examination reveals a oft apical systolic murmur and pericardial rub. Investigations demonstrate elevated inflammatory markers (CRP and ESR). Which one of the following is the most likely diagnosis?
    a- Acute rheumatic fever
    b- Atrial myxoma
    c- Kawasaki disease
    d- Subacute bacterial endocarditis
    e- Systemic lupus erythematosus

    A patient undergoes successful elective DC cardioversion for lone AF. Prior to the cardioversion he is taking warferin, digoxin and verapamil. Which one of the following drugs is the most important for the patient to be discharged on until outpatient review in six weeks?
    a- Amiodarone
    b- Aspirin
    c- Clopidogrel
    d- Digoxin
    e- Warferin

    A 40-yrs-old man is investigated having undergone successful communicate resuscitation following an episode of ventricular fibrillation.
    Echocardiogram demonstrates no structural abnormalities and coronary arteries are normal at angiography. Which one of the following would be the most appropriate long-term management?
    a- Amiodarone
    b- Automated implantable cardiac defibrillator
    c- Procainamide
    d- Sotalot aippg.com
    e- VT stimulation study and ablation

    When contemplating coronary bypass grafting, which one of the following is the preferred option for revascularising the left anterior descending artery (LAD)?
    a- Direct endarterectomy
    b- Left internal mammary artery
    c- Radial artery
    d- Right internal mammary artery
    e- Saphenous vein graft

    A 30-yrs-old man presents with recurrent episodes of chest pain and exertional pre-syncope. There is a family history of sudden death. Resting ECG demonstrates features of left ventricular hypertrophy and precordial T wave inversion. Which one of the following is the most likely diagnosis?
    a- Dilated cardiomyopathy
    b- Hypertrophic cardiomyopathy
    c- Ischaemic heart disease
    d- Pulmonary embolic disease
    e- Supravalvular aortic stenosis

    An infant with trisomy 21 (Down’s syndrome) presents with failure to gain weight and clinical evidence of heart failure. Which one of the following congenital cardiac abnormalities is most likely to account for this?
    a- Aortic incompetence
    b- Endocardial cushion defect
    c- Mitral valve prolapse
    d- Pulmonary hypertension
    e- Secundum ASD

    A 70-yrs-old man is found to be hypertensive with repeated blood pressure recording of > 160/95 mmHg. He is already taking a thiazide diuretic. There are no apparent secondary causes of hypertension. He has previously undergone coronary artery bypass grafting. Which one of the following is the most appropriate initial anti-hypertensive treatment?
    a- Alpha blocker
    b- Aniotensin-converting-enzyme inhibitor
    c- Angiotensin II receptor blocker
    d- Beta blocker
    e- Calcium channel antagonist

    A 45-yrs-old man presents with a protracted episode of central chest pain. He is a current smoker with a strong family history of premature coronary artery disease. His resting ECG is normal. Which one of these investigations would be the most helpful in assisting with planning initial management?
    a- Angiogram
    b- Echocardiogram
    c- Exercise test
    d- Troponin I
    e- Ventilation/perfusion scan
  12. Joseph.

    Joseph. Guest

    In chronic liver failure (obstructive jaundice) what is true -
    a- Vitamin K absorption is reduced
    b- Prothrombin cannot be converted to thrombin

    In hemochromatosis after venesection all are true except -
    a- Skin pigmentation becomes normal
    b- Cardiac siderosis is reversible
    c- Hepatoma can be cured

    153. In hemochromatosis -
    a- Size of the liver is decreased following treatment

    A patient with perforated peptic ulcer all are correct except -
    a- Patient remembers exactly the moment of rupture
    b- Back pain
    c- Vomiting
    d- Board like rigidity
    e- Guarding

    Concerning cluster headache all are correct except -
    a- Vomiting
    b- Treat with Methysergide
    c- Occurs after 3-4 hrs of failing asleep
    d- Occurs at the same time of the day

    A young man with needle marks and pin point pupils, gas reflexes are normal, no extensor planter reflexes -
    a- Opiate ingestion
    b- Temporoparietal #

    A young man with throat infection in child hood and was treated with penicillin. He now comes with a fear of developing a rash due to penicillin as he was influenced by his friend’s words. What does he have?
    a- Induced delusion
    b- Hypochondriasis

    A young man with left sucking wound in the chest. After initial airway resuscitation and circulation management what is the next step?
    a- Debridement and closure
    b- Pressure bandage
    c- IV fluids

    Which infection is least likely during childhood?
    a- Syphilis
    b- Gonorrhoea
    c- Streptococcal
    d- HIV
    e- Herpes

    Appropriate estimation of the foetal gestation age is by -
    a- Transvaginal ultrasound at 8 weeks
    b- Bimanual examination at 8 weeks
    c- Ultrasound at 18 weeks
  13. Joseph.

    Joseph. Guest

    Regarding OCP what is the absolute contraindication?
    a- Focal migrainous hemiplegia
    b- Hypertension
    c- Diabetes

    Regarding OCP what is correct?
    a- All the progesterone’s except cryproterone have derived from testosterone

    Young man with severe joint pain and profuse bleeding from venipuncture site. Diagnosis?
    a- DIC
    b- Thrombophlebitis

    All are true regarding DIC except -
    a- Fibrin Decreased
    b- FDP decreased
    c- PTT increased

    Intermittent claudication commonest site -
    a- Profunda Femoris
    b- Superficial femoral artery
    c- Posterior tibial artery
    d- Bifurcation of abdominal aorta
    e- External iliac artery

    Which defence mechanism is mature?
    a- Denial
    b- Projection
    c- Introjection
    d- Humour aippg.com

    Undescended testis is most commonly associated with -
    a- Torsion of testis
    b- Spermatogenesis will be perfect if the operation is done before 3 years
    c- Development delay of the child
    d- Acute Epididymitis
    e- Hernia

    G3P0 pregnant lady came to you at 16 weeks pregnancy. She had two spontaneous abortions at 17 and 18 weeks in the previous pregnancies. How do you treat?
    a- Chromosomal analysis
    b- Cervical stitch
    c- X linked recessive

    Regarding Mullerian agencies all of the following is true except -
    a- Short vagina
    b- Normal breast development
    c- Complete recessive

    What would be the most likely cause for bloody discharge from the nipple in a 50 year old lady?
    a- Intraductal papiloma
    b- Intraductal carcinoma
    c- Paget’s disease
    d- Fibrocystic disease

    The relative marker in Hepatocellular carcinoma is -
    a- PSA- Prostate, BHP
    b- CA 125 - Ovaru/Breast
    c- CEA - Colorectal Ca
    d- CA 153 - Breast Ben. Bre. Disease
    e- AFP - Fetoprotein Increase 90%

    Treatment of Seminoma stage 2 with metastasis to the Para-aortic lymph nodes -
    a- Radio therapy to testis and nodes
    b- Surgery and radiation to Para aortic nodes
    c- Chemotherapy
    d- Surgery

    70 year old woman with vaginal prolapse with pessary what is the complication?
    a- Atrophic vaginitis
    b- Cervical carcinoma
    c- Decubitus ulcer
    d- Carcinoma of vagina
  14. Joseph.

    Joseph. Guest

    After splenectomy you except all of the following except -
    a- Life long increased risk of infection
    b- Transient increased platelets to predispose to thrombosis
    c- Persistent decrease of RBC life span
    d- Decrease in anaemia

    Diabetic mother after prolonged labour delivered a jittery baby which responds to oxygen. What is the diagnosis?
    a- Hyperglycaemia
    b- Hypoglycaemia
    c- Meconium aspiration
    d- Hyperbilirubinemia

    Splenectomy is most beneficial in which of the following?
    a- Haemophilia
    b- Chronic ITP
    c- Myelofibrosis

    A middle aged man unable to fall asleep has night mares and remembers his daily activities, diagnosis?
    a- Anxiety disorder
    b- Depression aippg.com
    c- OCD

    Tourette syndrome; all are correct except -
    a- Motor and vocal tics are seen
    b- 2 or more bouts per day
    c- The person is not distressed with vocal tics
    d- Coprolalia is less than 10%
    e- Onset always less than 18 years of age

    Alcoholism is associated with all of the following except -
    a- Substance abuse (benzodiazepine)
    b- Depression
    c- OCD

    Proteinuria is seen in all of the following except -
    a- Congenital nephritis
    b- RPGN
    c- UTI
    d- RA
    e- Horseshoe Kidney

    A 35 yr old lady has a grey greenish vaginal discharge, microscopy shows clue cells, and she responded well to Metronidazole, diagnosis?
    a- Chlamydia
    b- Bacterial vaginosis
    c- Trichomoniasis
    d- Moniliasis

    Regarding stammering which is correct?
    a- Spontaneous resolution at 16 years

    Still birth after a normal delivery, all of the following tests are done except -
    a- Kleihaur test
    b- Chromosomal analysis
    c- Foetal parts
    d- Maternal antibodies
    e- Foetal post-mortem

    Polyhydramnios all are true except -
    a- Rh incompatibility
    b- Oesophageal atresia
    c- Bladder neck obstruction

    Polyhydramnios see in all except -
    a- Diabetes
    b- Multiple pregnancy
    c- Cardiac anomalies
    d- Hydrops fetalis
  15. Joseph.

    Joseph. Guest

    Child with grayish tonsilar exudates and atypical lymphocytes -
    a- Infectious mononucleosis
    b- CMV

    Urge incontinence all are true except -
    a- Colposuspension
    b- Taping the vagina
    c- Pelvic exercise
    d- Weighted vaginal cones

    Regarding Rubella and pregnancy a kindergarten teacher 6 weeks pregnant had one of her student with rubella. All are true except -
    a- Immunoglobulins
    b- IgG is increased initially then IgM
    c- Repeat SRH after 10 Days
    d- If mother infected early than child can have microcephaly, seizures and cataracts

    A patient with pyloric stenosis vomiting a lot and vomitus contains undigested food material taken 2 days back. What is the initial management?
    a- Normal saline
    b- Hartmann’s
    c- Ringer lactate

    Daily requirement of potassium -
    a- 50mmol
    b- 1gm
    c- 30mmol

    In pyloric stenosis vomiting is -
    a- Intermittent
    b- Occurs 1hour after food
    c- 2 days after food

    A man with abdominal pain xray showed multiple fluid levels. What is the management?
    a- 2 litres RL aippg.com
    b- 2 litres Hartmann’s before surgery
    c- 2 litres Hartmann’s after surgery
    d- 2 litres Hartmann’s After surgery

    Regarding antibiotic prophylaxis what is true -
    a- Single does is sufficient when compared to multidose
    b- Urologic surgery needs a culture for the specific antibiotic

    A 4 yr child constipated, rectum empty and sphincter tone lax, mass at the apex of rectum -
    a- Hirschsprung’s
    b- Acquired megacolon
    c- Hypothyroidism

    Hypercalcaemia seen in all except -
    a- Hyperparathyroidism
    b- Pancreatitis
    c- RTA

    3 yr old girl with periorbital oedema, protein 3+, all are true except -
    a- Prednisolone will improve in 90% cases
    b- Most of the cases are caused by focal segmental glomerulosclerosis
    c- Penicillin prophylaxis should be given
    d- Prognosis is good

    A young man with scrotal mass which disappeared on lying down -
    a- Hernia
    b- Varicocele

    A young girl with fever and oedema of the eye lid but there was no chemosis or proptosis, what is the treatment?
    a- IV flu cloxacillin
    b- Topical chloramphenicol
    c- Antibiotics

    Pooled immunoglobulin is given in all of the following except -
    a- Hepatitis A
    b- Mumps
    c- Rabies
    d- Tetanus

    A girl with neck stiffness, fever, lumbar puncture showed few neutrophils 200 lymphocytes, protein 2.1. What is the management?
    a- Bed rest and paracetamol
    b- Ceftriaxone
    c- Prednisolone
  16. Joseph.

    Joseph. Guest

    Adult patient ……………LP shows 85% neutrophils, 200 RBC’S, 2.1 glucose. What is the diagnosis?
    a- Bacterial meningitis
    b- Subarachnoid haemorrhage

    A child with high fever, how do you assess the severity?
    a- Increased WBC count
    b- Pallor, irritability
    c- Neck stiffness always present with in 6 hours

    Grand mother with BPD, which is true?
    a- There is less than 10% incidence in grandchild

    Postoperative pain management -
    a- Morphine is better than Pethidine

    Regarding HSP -
    a- Do microscopy of urine
    b- Abdominal x rays

    MS most erroneously diagnosed as -
    a- Conversion disorder
    b- Ataxia
    c- Neuropathy aippg.com

    Regarding CTG which is the most ominous sign?
    a- Early deceleration
    b- Late deceleration
    c- There is loss of variability during uterine contractions
    d- Beat to beat variation more than 5

    A young patient with abdominal pain, back pain and also has impotence. He was investigated on several occasions. What is the likely diagnosis?
    a- Hypochondriasis
    b- Munchausen’s syndrome
    c- Somatisation
    d- Factitious disorder

    Regarding perforated peptic ulcer all are true except -
    a- Guarding and rigidity present
    b- Patient with shock at the onset
    c- On percussion the liver is dull

    Question on Prader willi syndrome -
    a- Genetic syndrome
    b- Associated with obesity and Mental retardation
    c- Hypotonia
    d- Hypogonadism

    Fragile X- mental retardation -
    a- X-linked condition
    b- 1 in 2000 males
    c- 2nd to Down’s syndrome in males
    d- The first marker of the condition was a small gap, or fragile site, evident near the tip of the long arm of X chromosome
    e- Anticipation

    Affected (Heterozygous) woman:
    a- Early menopause
    b- May have learning difficulties
    c- Fank mental retardation

    Affected males -
    a- Macroorchidism (enlarged tests)
    b- Large ears
    c- Prominent fans
    c- A high-pitched vice
    d- Mental retardation
  17. Joseph.

    Joseph. Guest

    A 35 yr old school teacher came to you with a H/O. difficulty to asleep, irritability and anxiety. When he goes to bed all minor mistakes he made in the day came to his mind & argues with those in himself. These thoughts are intrusive & give him much distress though. He knows these thoughts are irrational. He tries to get rid of them but unable to do that. He is perfectionist and wants things to be done in the ways he likes. Which of the following drugs would be most beneficial to Him?
    a- Benzodiazepines
    b- Non benzodiazepine hypnotic
    c- SSRI
    d- Atypical anti psychotic
    e- Anti psychotic/ anti depressant

    Which of the following is a mature defense mechanism?
    a- Pseudo altruism
    b- Projection
    c- Repression
    d- Humour
    e- Reaction formation

    Primary Psychiatric health care is important for all of the following reasons except -
    a- One third of all patients present with mental illness to Psychiatrist
    b- It needs referral to Psychiatrist for a small number of patients
    c- Most of the patients present with psychotic symptoms
    d- Psychiatric patients commonly have medical problems
    e- Drugs & Alcoholics are commonly overlooked by primary health care providers

    18 yrs old boy dressed as female came to you with his boyfriend for problems in sexual relationship. He felt uncomfortable with his sex since childhood. He had been cross dressing in several occasions. What is the phenomenon called in Psychiatry?
    a- gender identity disorder
    b- Transsexuality
    c- Transvestism aippg.com
    d- Masochism
    e- Homosexualism

    A lady came to you for counseling after her 2nd marriage break-up. She was severdy depressed and anxious but looked very seductive during the interview. She was very suggestive when she was talking about her previous sexual relationship. Her behaviour is most probably due to -
    a- Borderline personality
    b- Histrionic personality
    c- Antisocial personality
    d- Dependent personality
    e- Substance abuse

    Panic disorder agora phobia all are correct except -
    a- More frequent in men
    b- Equally frequent in male and female
    c- Starts in the 20s
    d- Should avoid trigger factors

    Effects of noise in airport cause in the near by -
    a- Depression
    b- Schizophrenia
    c- Sleeplessness
    d- Aggressive psychosis

    Middle aged lady presented with nausea, dyspepsia and abdominal distension. She has a past history going to many doctors & treated for disorders. She has been treated by a rheumatologist for aches and pains by cardiologists for Palpitation and gave her Propranolol, neurologist for epilepsy. You find her tense and anxious. Examinations show normal findings. There are scars from appendectomy operation. What’s the appropriate diagnosis in this case?
    a- Conversion disorder
    b- Hypochondriasis
    c- Sumatisation disorder
    d- Munchausen’s syndrome
    e- Neurotic anxiety
  18. Joseph.

    Joseph. Guest

    A logia is a negative symptom of Schizophrenia. Which of the following symptoms is another negative symptom of schizophrenia?
    a- Auditory hallucination
    b- Delusion of reference
    c- Affective flattering
    d- Bizarre behaviour
    e- Tangentiality aippg.com

    Which is not correct about Tourette’s disorder?
    a- Onset is before 18 yrs
    b- Patient is not distressed by Tic
    c- Tics occur many times a day, usually every day
    d- More common in males than females
    e- Both motor and vocal Tics are present

    A high school teacher aged around 40, complains that he finds difficulty in falling asleep as he goes over the events of the day repeatedly in his head. He is known to be a perfectionist. Although he knows this ritual is intrusive he can’t resist it. Which of the following condition he is suffering from?
    a- Hypochondriasis
    b- OCD
    c- Schizophrenia
    d- Delusional disorder
    e- Personality disorder

    Two weeks before a patient was discharged from hospital after she recovered from a major depression. But now she develops a relapse but doesn’t to take medicine. What’s the next stage of management?
    a- Involuntary hospital admission
    b- Transfer to a community based care
    c- Tell her that recurrence rate is high & keep her under obstruction
    d- Weekly visit for follow-up
    e- Refer her to a psychiatrist

    What’s the difference between schizophrenia and schizophreniform disorder?
    a- Duration

    A 12 yr old boy frequently protrudes his tongues while watching TV WOF is correct?
    a- Habitual tics
    b- Sydenham’s Chorea aippg.com
    c- Hunting ton’s Chorea

    In ectopic pregnancy earliest rupture occurs at -
    a- Ampulla
    b- Isthmus
    c- Interstitium

    Non contraceptive benefits of OCP are all except -
    a- Reduce incidence of benign breast disease
    b- Reduce incidence of ovarian carcinoma
    c- Reduce incidence of endometrial carcinoma
    d- Reduce incidence of cervical carcinoma
    e- Reduce incidence of PCO

    Ectopic pregnancy can be confidently diagnosed by -
    a- Serum Beta HCG study
    b- USG of pelvis
    c- Laparoscopy
    d- Finding of empty uterus

    Earliest diagnosis of gestational age can be done by -
    a- 8 weeks intra vaginal USG
    b- 8 weeks abdominal/pelvic USG
    c- Bimanual examination at 8 wks
    d- B-HCG measurement at 16 wks
  19. Joseph.

    Joseph. Guest

    A 35 yrs old lady had a greenish grey vaginal discharge. Microscopic exam of vaginal smear showed due cells. What could be her condition?
    a- Moniliasis
    b- Gardnerella vaginitis
    c- Trichomoniasis aippg.com
    d- Chlamydial infections
    e- Staphylococcal vaginitis

    Bronchial asthma in pregnancy -
    a- Should not be treated with steroids
    b- Should not be treated with bronchodilators
    c- Usually not increased in incidence of bronchospasm
    d- Needs caesarean section
    e- Increased risk of premature labour

    A female patient married for 2 yrs. Came to you for consultation for infertility. She has regular periods. She has regular intercourse for past 6 months. On exam she has retroyarted uterus and no other abnormality. What may be the management?
    a- Do corrective surgery
    b- Manipulation and ring pessary
    c- Reassurance /give her a temp. chart/explain about ovulation time, fertile period and review after 4 weeks
    d- Do hysterosalphingography

    Carpal tunnel syndrome in pregnancy. Which of the following is the correct response?
    a- Diuretic treatment
    b- Surgical intervention
    c- Splinting of the hand in mid extension position
    d- Immediate termination of pregnancy
    e- ACE inhibitor therapy

    A pregnant lady with 16th wks pregnancy developed proteinuria+++, BP 104/95mm of Hg, serum creatinine 1.5. Which of the following may be the diagnosis?
    a- Pre eclampsia
    b- Pre existing renal disease
    c- Glomerulonephritis

    Which of the following is caused by anti cardiolipin antibody?
    a- Repeated abortion

    A 26 yrs old lady with irregular cycles, every cycle in 4-10 wks intervals, her LMP at that time way 6/52. On examination for her amenorrhoea FSH 3iu(N13), LH- 850 (N4-10, follicular phase, 20-100mid cycle), prolactin - 450(N-50-500). Which of the following is the most probable diagnosis of her amenorrhoea?
    a- Premature ovarian failure
    b- Poly cystic ovarian disease aippg.com
    c- Stress due to recent disease
    d- Early pregnancy
    e- LH secreting pituitary

    Risk of breast cancer, all are true except -
    a- Artificial early menopause
    b- Cancer in the other breast
    c- Cancer in the body of uterus
    d- First pregnancy after 35
    e- Family H/O breast cancer

    Which of the following is the absolute Contra indication of the one of OCP?
    a- Migraines aura
    b- Smoking
    c- Hypertension (severe)
    d- Diabetics mellitus
    e- Gallbladder disease
  20. Joseph.

    Joseph. Guest

    The time of ovulation is accurately diagnosed by which of the following?
    a- Serial measurement of oestrogen in the proliferating phase
    b- Urinary LH
    c- Regular basal body temp
    d- Serial LH measurement
    e- Estimation of progresterone in the mid luteal phase

    Repeated second mid trimester miscarriage. Patient is 3rd time pregnant what is the best management?
    a- Bed rest aippg.com
    b- Cercelage

    The most common cause of jaundice in pregnancy -
    a- Hepatitis B
    b- Cholestasis
    c- Obstruction

    Pregnant lady developed heart failure; she had fixed and wide splitting 2nd heart sound. What may be the cause?
    a- ASD
    b- VSD
    c- Pulmonary stenosis
    d- Coarctation of aorta
    e- PDA

    All are correct regarding Mullerian agencies except -
    a- Patient have a short vagina
    b- X-inked recessive
    c- Normal breast development

    A lady with 39 wks gestation, cervix 8 cm dilated, CTG shows foetal distress. What is the management?
    a- Induction by oxytocin
    b- Foetal scalp PH measurement
    c- Repeat CTG
    d- Immediate C/S

    After long term use of OCP there is increased risk of -
    a- Endometrial Ca
    b- Breast Ca
    c- Cervical Ca
    d- Ovarian Ca

    A pregnant lady of 30 wks gestation was found to be positive for Group B streptococcus. WOF is true?
    a- Treat the patient with immediately with penicillin
    b- Treatment with IV penicillin during labour will significantly reduce the risk of Neonatal infection aippg.com
    c- Treat with doxycycline
    d- Do not treat because 20% of women are carriers
    e- They are normal vaginal flora

    A man developed inguinoscrotal swelling which disappear on lying down, what could be probable cause?
    a- Direct inguinal hernia
    b- Varicocele
    c- Hydrocele
    d- Sapheno varix
    e- Tumour of the testis

    A 40 yrs old man presents with acute severe excruciating abdominal pain. Which is least likely?
    a- Acute MI
    b- Ruptured aortic aneurysm
    c- Renal colic
    d- Acute appendicitis
    e- Biliary colic
    f- Perforated peptic ulcer

    Patient with an accident has decreased breath sound on the left side, trachea deviated to the right side, surgical emphysema of neck and left side of chest. Which of the following is the correct diagnosis?
    a- Haemothorax
    b- Tension pneumothorax
    c- Cardiac tamponade
    d- Rupture bronchus
    e- Laceration of bronchus
  21. Joseph.

    Joseph. Guest

    What is the most common cause of blindness world wide?
    a- Trachoma
    b- Cataract
    c- Glaucoma
    d- Xerophthalmia
    e- Onchocercosis

    Antibiotic prophylaxis in surgery, which is not true?
    a- Multiple drugs are preferred than single drug

    Picture of specimen of swollen testis -
    a- TB testis
    b- Semonima
    c- Terratoma of testis
    d- Torsion of testis
    e- Infection

    Picture of a large lump on back of a man below the inferior border of left scapula -
    a- Lipoma
    b- Dermoid
    c- Sebaceous cyst
    d- Buffalo hump
    e- Hemangioma

    Picture, tumour on the lateral side of Rt. eye brow since 30 yrs which does not move on palpation. WOF is the most probable?
    a- Osteoma
    b- Lipoma
    c- Sebaceous cyst

    Which of the following nerve is damaged after # of lower part of humerus?
    a- Radial nerve
    b- Median nerve
    c- Ulner nerve
    d- Brachial nerve

    Undescended testis, which of the following has the most likely association?
    a- Infection
    b- Inguinal hernia
    c- Malignancy
    d- Torsion of testis
    e- Varicocele

    Patient developed intestinal obstruction with vomiting and dehydration X-ray showed multiple levels. Which of the following is the best option?
    a- 2000 cc Hartmann soln. starting preoperatively
    b- 2000 cc Hartmann soln. during operation
    c- 2000 cc 5% dextrose in water starting preoperatively and continued through

    Which of the following is not a feature of uncomplicated haemorrhoids?aippg.com
    a- Mucoid discharge
    b- Pain
    c- Pruritis
    d- Blood in stool

    Old bed ridden lady with occasional Diarrhoea, O/E faecal mass is felt in rectum -
    a- Ca rectum
    b- Stool impaction aippg.com
    c- Laxative use
    d- Chronic diarrhoea

    68 yrs old man,(picture given) developed this condition for 6 week (keratoacanthoma /BCC). What is the best management?
    a- Obstruction
    b- Local excision
    c- Wide excision
    d- Medial treatment

    WOF does not cause a supraclavicular palpable mass?
    a- Breast cancer
    b- Sub clavian arterial aneurism
    c- Sub clavian venous thrombosis
    d- Cervical rib
    e- Stomach cancer

    On 7th post operative day patient developed chest pain and breathing difficulty. What may be the cause?
    a- Atelectasis
    b- Pneumonia
    c- Pulmonary embolism
    d- Sepsis

    WOF needs immediate intervention?
    a- Surgical emphysema
    b- Tension pneumothorax
    c- Haemothorax
    d- Fractured ribs/ flail chest
    e- Open pneumothorax
  22. Joseph.

    Joseph. Guest

    Most common cause of bloody discharge from the nipple is -
    a- Intraductal papiloma
    b- Paget’s disease of the ectasia
    c- Mammary duct ectasia
    d- Intraductal carcinoma aippg.com
    e- Fat necrosis

    Facial nerve palsy occurs with all of the following except -
    a- Chr. Parotitis
    b- Mastoiditis
    c- Ca parotid gland
    d- Acoustic neuroma

    A man develops dysphagia o solids and liquids. WOF is the most likely?
    a- Achalasia
    b- Tumour of oesophagus
    c- Oesophageal spasm
    d- Stristure

    A 45 yrs old man states that his father and younger brother died of bowel cancer. He is worried about himself and wants to exclude the possibility of the disease. Which screening tests will you conduct?
    a- Occult blood in stool for 3 specimens
    b- Sigmoidoscopy
    c- Sigmoidoscopy + 3 stool specimen for occult blood
    d- Barium enema
    e- Colonoscopy

    Single thyroid nodule is most commonly seen in -
    a- Part of a multi nodular goiter
    b- Ca thyroid
    c- Thyroid cyst
    d- Thyroid adenoma
    e- Hashimoto’s disease

    A patient with BP 90/60, pulse 100/min. JVP 0.5 cm above the sternum & tachycardia. WOF is correct?
    a- Cardiac failure
    b- Tension pneumothorax
    c- Hypovolumic shock
    d- Cardiac tamponade
    e- Vasovagal syncope

    A lady presented with a 2 cm malignant breast lump. WOF suggests that conservative breast surgery can be contemplated?
    a- Hormone receptor status
    b- Peau de orange of the breast
    c- Palpation of axillary lymph node
    d- Mammography
    e- Metastasis of bone

    WOF does not metastasize to brain?
    a- Ca breast
    b- Ca lung
    c- Ca prostate
    d- Ca kidney

    A big inguinal mass present for 3 months (with superficial ulceration). WOF is a possible?
    a- Venous thrombosis
    b- Metastatic lymph node aippg.com
    c- strangulated inguinal hernia
    d- Aneurysm of epigastric artery

    50 yrs old smoker waken up at night due to pain in calf and relieved by walking around. most likely cause is -
    a- Ischaemic pain
    b- Raynaud’s phenomenon
    c- Muscle cramp
    d- DVT
    e- Intermittent claudication

    A elderly man feels pain in his leg after lifting it for some time above the bed. WOF is correct?
    a- Arterial ischaemia
    b- Venous stasis
    c- Muscle spasm
    d- Disc prolapse

    Commonest site of occlusion in patient with intermittent claudication?
    a- Abdominal aortic bifurcation
    b- External iliac artery
    c- Superficial femoral artery
    d- Profunda Femoris artery
    e- Posterior tibial artery

    WOF cause the most metastasis to bone?
    a- Ca breast
    b- Ca stomach
    c- Ca lung
    d- Melanoma
    e- Ca colon
  23. Joseph.

    Joseph. Guest

    When prophylactic antibiotic is given?
    a- 1 hour before operation
    b- Per operative antibiotic
    c- After 24 hours

    Picture of an ulcer with 6 months duration -
    a- Basal cell ca aippg.com
    b- Amelanotic melanoma
    c- Tubercular ulcer

    A patient developed pyloric stenosis. He vomited undigested food taken in the previous meal. He was dehydrated. WOF will be his best replacement fluid?
    a- Normal saline
    b- Dextrose 5% in water
    c- Dextrose 4% in N/5 (1/5 normal) saline
    d- Hartmann soln.
    e- Hypertonic saline

    A carpenter injured the palm of his hand with a screw driver and then developed an abscess, which cause a swelling on the dorsum of his hand. Which of the following statement is correct?
    a- It’s an extension of the abscess to the extensor tendons
    b- Incise the swelling on the dorsum of the hand
    c- Swelling is due to oedema
    d- It indicates involvement of the extensor tendons

    Carpal tunnel syndrome. WOF is true?
    a- Tingling sensation along the median nerve
    b- Pain at night
    c- Pain of the whole hand
    d- Pain during carrying weight

    Cholecystitis is commonly associated with -
    a- Stone in the gall bladder
    b- Stone in the bile duct
    c- Stone in the outflow tract
    d- Stone in the hepatic duct

    Patient developed a mass in the upper abdomen with a H/O trauma few days back. WOF is the best investigation?
    a- US of the abdomen
    b- CT scan
    c- Oral cholecystography
    d- ERCP

    A young man presents with a full thickness burn on his thigh, the size of a 20c coin, you should -
    a- Excise and do pedicle graft
    b- Excise and do a primary suture
    c- Excise and do a split skin graft
    d- Excise and do dressings
    e- Excise and do full thickness graft with micro vascular surgery

    All of the following are true regarding arterial ischaemia except -
    a- Pain in thigh, buttock and legs
    b- Sudden shooting pain along the back of thigh to the leg
    c- Cramping pain in the calf muscle
    d- Sensation of paralysis aippg.com
    e- Pain with exercise

    Patient developed RT. hypochondriac pain and jaundice. He had a history of cholecystectomy few yrs back. WOF is the best investigation to do?
    a- USG
    b- CT
    c- ERCP
    d- Oral examination
    e- Plain xray of abdomen

    The most likely early symptoms of acute pancreatitis?
    a- Vomiting
    b- Sweating
    c- Faintness
    d- Pain
    e- Constipation

    A discrete mobile rubbery mass in the left breast of a 22 yr old woman is most likely to be -
    a- Carcinoma
    b- Fibro adenoma
    c- Intra Ductal papiloma
    d- Fibro adenosis
    e- Fat necrosis
  24. Joseph.

    Joseph. Guest

    Metastatic spread of testicular tumour mainly occurs to -
    a- Lung
    b- Kidney
    c- Para aortic lymph nodes
    d- Inguinal lymph nodes
    e- Liver

    WOF is the cause of hypoprothrombinaemia in obstructive jaundice?
    a- Vitamin K Malabsorption
    b- Calcium absorption aippg.com
    c- Decreased fibrinogen
    d- Liver failing to convert prothrombin to thrombin

    A patient presented with tension pneumothorax, what is the immediate management?
    a- Intercostal tube
    b- Xray followed by intercostals tube
    c- Large bore needle at 2nd intercostals space
    d- Thoracotomy

    Child cam bounch back, can roll over, sit with arched back, can stand with support, no pincer grasp developed. What may be his probable age?
    a- 5 months
    b- 7 months
    c- 9 months
    d- 11 months
    e- 15 months

    Child was delivered normality with wt. 3.2 kg. Apgar score was 5 in 1 minute, 8 in 5 minutes. Now he has delayed development. Which one of the following can be associated with his delayed development?
    a- maternal uncle has intellectual deficit
    b- father is alcoholic
    c- Sister had febrile seizures
    d- Mother has 2 café au late spots aippg.com
    e- Paternal grandma has hypothyroidism

    X-ray of the baby shows opacities /consolidation. What may be the cause?
    a- Mycoplasma pneumoniae
    b- Beta streptococcus
    c- Streptococcus pneumoniae
    d- Staphylococcus aureus
    e- Klebseilla pneumoniae

    A full term baby is transferred to postnatal ward one hour after delivery. On arrival she is noticed to have ctanosed hands and feet. On examination you see that the child is responsive and cries lustily on handling. Resp. rate is 40/min. rectal temperature is 37.5 degree Celsius. Heart, lungs are clinically normal. WOF statements is appropriate?
    a- Oxygen should be given
    b- An immediate -ray chest should be arranged
    c- Reassure the mother that the baby is OK
    d- Infant has early signs of resp. distress
    e- The infant has most probably had a convulsion

    13yrs old boy with height of 9 yrs old. Which one of the following will support a good prognosis for further growth of the child?
    a- Bone of the child is 13 years
    b- Bone age of the child is 9 years

    After recovery from fever a child developed a neck swelling which is translucent and is located in the posterior triangle of the neck. What’s the possible Dx?
    a- Cystic hygroma
    b- Tubercular lymadenitis
    c- Branchial cyst
    d- Bacterial lymphadenitis aippg.com
    e- Metastatic lymph nodes

    Child came with fever & neck stiffness O/E CSF protein was 1.1gm/L, glucose - normal, Lymphocyte - 100/L, Neutrophil - 50/L. No organism was found. Most likely diagnosis was -
    a- Bacterial meningitis
    b- Herpes simplex meningitis
    c- Echo virus
    d- TB meningitis
    e- Typhoid

    A 9 month old child has been irritable and febrile for 48hrs. Now he has generalized erythematous rash and his temp. is 37.2 degree centigrade. What’s the most likely Dx?
    a- Herpes simplex 1 infection
    b- Rubella
    c- Scarlet fever
    d- Roseola infantum
    e- Erythema infectiosum
  25. Joseph.

    Joseph. Guest

    A 4 yr old boy was brought to you with fever of 2 days. He was limping and had tenderness and swelling over the upper end of tibia. What may be the possible cause?
    a- Septic arthritis
    b- Irritable hi
    c- Osteomyelitis
    d- Cellulitis
    e- Thrombophlebitis

    The most common cause of blood stained stool in an otherwise normal infant is -
    a- Anal fissure
    b- Fistula in ano aippg.com
    c- Haemorrhoids
    d- Meckel diverticulitis
    e- Intussusception

    What would mostly be associated with undescended testis?
    a- Inguinal hernia
    b- Testicular tumour
    c- Infertility
    d- Torsion of testis
    e- Infection

    18 months old child was brought by her mother she doesn’t babble. Hearing test was done at 10 months and was normal. What’s the next step of management?
    a- Reassure that the baby is normal
    b- Audiogram
    c- Check development

    A 9 day baby with projectile vomiting and dehydration. Lab tests show:
    K+ 7.5, Na+ 125, CI-80, Hco3-20. What could be the diagnosis?
    a- Pyloric stenosis
    b- Congenital adrenal hyperplasia
    c- Galactosemia
    d- Sepsis
    e- Gastro esophageal reflux

    8 yrs old child with headache, morning vomiting, ataxia & nystagmus for 6 wks. His school had episode of Chicken Pox 2 wks ago. He has a family H/O migraine. What could be the possible diagnosis/
    a- Migraine
    b- Post. Fossa tumour/Medulloblastoma
    c- Encephalitis aippg.com
    d- Varicella cerebellitis

    2 yrs old child with 1 month history of unilateral foul smelling sero-sanginous nasal discharge. Most probable cause is -
    a- Foreign body
    b- Nasal polyp
    c- Sinusitis
    d- Tonsillitis

    Mother brought her 12yrs. old child with hip pain and limping. He is in the 19th centile of height and also he is not growing in height. What may be the probable cause?
    a- Hip arthrosis
    b- Perthe’s disease
    c- Transient Synovitis
    d- Slipped upper femoral epiphysis
    e- Tuberculosis

    8 wks old baby with unilateral eye discharge, subsides with antibiotics, but recurs. Pathology shows polymorph but no organism. What may be the cause?
    a- Gonococcal conjunctivitis
    b- Blocked naso lacrymal duct
    c- Allergic conjunctivitis
    d- Chlamydial infection
    e- Syphilis

    A 4 months old baby with repeated chest infection, systolic murmur over the left sternal border, not putting on weight and breathlessness while feeding. Apex beat in the mind axillary line. What may be the diagnosis?
    a- VSD
    b- ASD
    c- Coarctation of Aorta
    d- Fallot’s Tetralogy
    e- Severe aortic stenosis

    3 hours, after birth a new born was found to have respiratory distress and reduced breath sound over the left side of chest. Abdomen was scaphoid, what may be the diagnosis?
    a- Congenital diaphragmatic hernia
    b- Tension pneumothorax aippg.com
    c- Staphylococcal pneumonia
    d- Sliding hernia

    A child was referred by Kindergarten teacher & the parent with the complaint of over activity, not cooperative enough with other children and destructive behaviour. But when kept alone, was found to be playing happily with toys and other children. Which of the following is true?
    a- It is a normal variant
    b- Poor parenting
    c- ADHD
    d- Autism
    e- Borderline disorder
  26. Joseph.

    Joseph. Guest

    A child had accidentally ingested dish washing powder. He developed ulcers in mouth drooling of saliva. What would be the next management?
    a- Reassure the parents that nothing will happen & send them home
    b- Admission to hospital with possible Endoscopy
    c- Ask them to bring the baby back if any problem arises

    New born with cataract and jaundice. 2 of his brothers/sisters had the same problem. What may be the DX?
    a- Rubella embryopathy
    b- Galactosemia
    c- Toxoplasmosis aippg.com
    d- Glaucoma (congenital)
    e- CMV infection

    A 2yrs old boy is seen by his mother to have a swelling in his right groin for a few hours. He has no other symptoms. Exam. Shows no swelling, both testes are in the scrotum but right spermatic cord is thicker. What is the management?
    a- Arrange for a surgical consultation for inguinal herniotomy
    b- Reassure the patient that the baby is OK
    c- Reexamine him at weekly intervals
    d- Arrange to review the child after some months
    e- Rt. Orchidopexy

    An 8 yrs old obese boy was brought to doctor. O/E his wt. was 48kg. which is more than 98th percentile and height was 140 cm. which is more than 90th percentile. He is otherwise normal. Which of the following is the correct statement?
    a- Advanced bone age
    b- Increased blood sugar level
    c- Primary hyperaldosteronism
    d- Thyrotoxicosis
    e- Hypothyroidism

    A 9 month old baby with fever was brought to doctor. O/E their was temp. 37.5 degree cent. He had cough, runny nose and resp. distress. There was wide spread bilateral wheeze on auscaultation. 2 other siblings in the house have H/O cold. Which of the following may be cause in this baby?
    a- Acute bronchiolitis
    b- Croup
    c- Asthma
    d- Pneumonia
    e- Inhaled foreign body

    A 2 yrs old girl is noted by her father having palpitation (about 160/min.) she is otherwise normal. She developed same symptoms twice before. Which of the following is the initial management?
    a- Administration of beta blocker
    b- Verapamil
    c- ACE inhibitor
    d- Cardioversion
    e- Cold water applied to face

    All of the following are features of cluster headache except -
    a- More in males
    b- Starts 3 to 4 hrs. after falling asleep aippg.com
    c- Headache present for several days in each episode
    d- Vomiting

    Which one of the following is used to overcome the muscle relaxant effects of anaesthesia?
    a- Neostigmine
    b- Physostigmine
    c- Atropine
    d- Fluphrenthixole
    e- Succinylchline

    Patient with Parkinson’s disease getting levodopa+ Carbidopa developed twitching movement of face. What’s the management?
    a- Benzhexol hydrochloric
    b- Reduce the existing dose
    c- Add anticholinergic
    d- Add antipsychotic
    e- Increase the dose of existing drug

    Antiphospholipid antibody is associated with -
    a- Recurrent abortion
    b- Increased complement
  27. Joseph.

    Joseph. Guest

    Which nerve carries taste sensation of anterior 2/3rd of tongue?
    a- Facial nerve
    b- Trigeminal nerve
    c- Glossopharyngeal nerve
    d- Hypoglossal nerve aippg.com

    Patient developed pain after elevating the leg above the bed. What may be the cause?
    a- Venous insufficiency
    b- Arterial insufficiency
    c- Thrombosis
    d- Varicosities of veins

    A person wakes up at night with calf pain. When he gets out of bed and walks about he is relived of the pain. WOF is correct?
    a- Ischaemic pain
    b- Rest pain
    c- Muscle cramp
    d- Schiatic pain
    e- Disc prolapse

    Patient developed joint swelling, Microscopic exam. of joint fluid showed positive birefringent crystals. WOF is true?
    a- Calcium pyrophosphate dehydrate crystal
    b- Calcium diphosphate urate crystal
    c- Monosodium urate crystal
    d- Gout

    WOF joints are not involved in Rheumatoid arthritis?
    a- Cervical spine
    b- First carpo metacarpal joint
    c- Distal inter phalangeal joint
    d- Metacarpo phalangeal joint

    WOF drugs are not hepatotoxic?
    a- Halothen
    b- Digoxine
    c- Warferin
    d- Tetracycline aippg.com
    e- CC4

    WOF does not cause facial nerve palsy?
    a- Ca parotid gland
    b- Chronic parotitis
    c- Mastoiditis
    d- Acoustic neuroma

    WOF can be associated with massive blood transfusion?
    a- Volume overload
    b- Coagulation defect

    When a man was asked to look at his left side he developed double vision in doing go.
    a- Left 3rd nerve
    b- Left 6th nerve
    c- Optic nerve
    d- Lesion at optic chaisma
    e- Right 6th nerve

    WOF is true of end arterectomy in a patient with more than 80% stenosis of internal carotid artery?
    a- Death rate will reduce by more than 50%
    b- If no surgery is done more than 70 % will die in one month
    c- Death 24 hours is more than 30%
    d- There is 10% reduction in mortality

    What is the most common cause of painful pericarditis?
    a- Uraemia
    b- Viral infection aippg.com
    c- Rheumatic arthritis
    d- SLE
    e- Tuberculosis
  28. Joseph.

    Joseph. Guest

    Death rate is highest in acute MI -
    a- In first 24 hours
    b- In first 3 hours
    c- In 1-7 days
    d- In the first month

    A patient presented with ptosis of left eye, left side sensory loss of face. Left side gag reflex was absent, right sided hemi paresis and incoordation of right upper and lower limb. Where is the lesion?
    a- Internal carotid artery
    b- Vertebral artery
    c- Middle cerebral artery
    d- Post. cerebral artery aippg.com
    e- Multiple sclerosis

    Regarding acute Hepatitis B infection WOF is true?
    a- Hepatitis B surface antigen
    b- hepatitis C antigen

    Patient developed cardiac arrhythmia. Ventricular rate was 110/min., BP was 90/40 with irregular ventricular contraction on ECG. Patient had impaired consciousness. What is the immediate management?
    a- Adenosine
    b- Cardioversion
    c- IV lignocaine
    d- Valsalva maneuver
    e- Cardiac massage

    ECG strip given -
    a- Lateral MI b- Inferior MI
    c- RVH d- LVH

    ECG strip given -
    a- Sick sinus syndrome
    b- WPW syndrome
    c- Atrial fibrillation
    d- Atrial flutter with variable block

    ECG strip of a diabetic patient given -
    a- Multiple U waves

    A 53 yrs old patient came with chest pain. P/H of taking Nitroglycerine for recurrent chest pain with improvement. This time ECG was done and was normal & cardiac enzymes/ troponin was negative. Pain decreased with belching. WOF will be his best treatment?
    a- Refer to gastroenterologist
    b- Immediate angioplasty
    c- Admit to ICU (?2 hrs.) for continuous monitoring
    d- Send home with cardiologist out patient appointment
    e- No heart pain & ECG being normal reassure & send him home

    Picture of face of a lady with wide spread non pruritic rash, diagnosis?
    a- Rosacea b- SLE
    b- Dermatitis d- Psoriasis

    What does it mean regarding sero conversion to HIV?
    a- Life long infectivity
    b- Prohibition of sex
    c- Treatment with Zudovudin
    d- He has AIDS

    WOF does not mimic secondary syphilis?
    a- Eczema
    b- Psoriasis
    c- Pityriasis rosea
    d- Dermatophytoid

    HIV patient had Mantoux positive. WOF is the correct response?
    a- INH prophylaxis
    b- INH should not be given due to hepatotoxicity
    c- Mantoux test is positive due to immuno suppression
    d- Treatment with anti TB drug aippg.com

    WOF is not pre malignant?
    a- Aphthus ulcer
    b- Leucoplakia
    c- Solar keratosis
    d- Sinus tract in chr. Osteomyelitis
    e- Skin irradiation in infancy/Thyroid irradiation in infancy

    Infectious mononucleosis -
    a- Resembles acute HIV
    b- Liver function tests usually impaired
    c- Diagnosed by anti body test
  29. Joseph.

    Joseph. Guest

    COR pulmonary secondary to Emphysema. Best management -
    a- O2 inhalation b- Digoxine
    c- Frusemide d- Bronchodilator

    Patient developed tinnitus, vertigo, diminished corneal reflex. What’s the possible diagnosis?
    a- Mennier’s disease aippg.com
    b- Acoustic neuroma

    55 yrs old lady can’t see properly while in out door. Every thing looks hazy, but she can read news paper. WOF is the correct response?
    a- Cataract b- Glaucoma
    c- Myopia d- Macular degeneration
    e- Diabetic retinopathy

    WOF is true of Paget’s disease?
    a- High output heart failure b- Bone pain usually
    c- Hypercalcemia d- Hyperphosphataemia

    A patient with rheumatoid arthritis developed anaemia which is normocytic normochromic. Ferritin level was high. What’s the diagnosis?
    a- Iron deficiency anaemia
    b- Anaemia of chronic disease
    c- Haemolytic anaemia

    Renin is developed by -
    a- Beta blocker b- Alpha blocker
    c- ACE inhibitor

    A 55 yrs old hypertensive patient developed severe chest pain radiating to back and dyspnoea of 3 hrs duration. O/E BP was 230/140, absent right carotid pulse, diastolic murmur along the left sternal border. ECG & cardiac enzymes were normal. What can be the chest x-ray finding?
    a- Widening of superior mediastinum
    b- Calcification of aorta
    c- Pulmonary oedema
    d- Pericardial effusion
    e- Cardiomegaly

    What is the cause of increased life expectancy of woman in Australia?
    a- Males exercise more than females
    b- Genetic make up
    c- Females seek healthcare facilities more than males
    d- Males die more in accidents & violence than females
    e- Employment stress is more for males

    In WOF conditions hypoxia can be corrected by giving 100% oxygen?
    a- lung disease
    b- Cyanotic heart disease
    c- Methemoglobinemia
    d- Carbon monoxide poisoning

    A 58 yrs old man was brought to hospital accompanied by his wife with bruise on his head. She complained that he was binge drinking for past one week. O/E he was confused & had extensor planter reflexes. WOF may be the probable dx?
    a- Hepatic encephalopathy
    b- Korsokov’s psychosis aippg.com
    c- Central pontine myelinosis
    d- Subdural haematoma
    e- Dementia
  30. Joseph.

    Joseph. Guest

    A man has lost ankle jerk and loss of sensation on the lateral aspect of leg and sole of foot. WOF nerve is affected?
    a- L-2 b- L-3
    c- L-4 d- S-1
    e- S-2

    WOF does not mimic secondary syphilis?
    a- Eczema b- Psoriasis
    c- Pityriasis d- Scarlet fever
    e- Dermatofitoid skin condition aippg.com

    Regarding haemolytic anaemia -
    a- MCV- decreased b- Bilirubin in urine
    c- Iron absorption - increased
    d- Heptoglobin - increased
    e- Haemoglobinurea

    WOF is not present after splenectomy for hereditary spherocytosis?
    a- Normal life span of RBC.
    b- Transient leucocytes
    c- Anaemia resolved
    d- Persistence of Osmotic fragility
    e- Persistence of Spherocytosis

    A patient was treated with anti H. pyloric regimen for recurrent duodenal ulcer. WOF is the proper and quick test to evaluate the effectiveness of therapy?
    a- Serology b- Urea breath test
    c- Biopsy d- Serum Gastrin level
    e- Ba-meal X-ray

    A patient developed sudden dyspnoea. Physical exam showed decreased left upper chest movement. There was hyper resonance to percussion & decreased breath sound on the left side. What may be the diagnosis?
    a- Atelectasis b- Left lung consolidation
    c- Left pneumothorax d- Left pleural effusion
    e- Right sided emphysema

    A young patient presented with haematuria, proteinurea (more than 3.5 gm) 3 days after a sore throat. WOF is the most likely diagnosis?
    a- Nephrotic syndrome
    b- Streptococcal glomerulonephritis aippg.com
    c- IgA nephropathy
    d- Acute pyelonephritis
    e- Membranous nephropathy

    A young patient presented with uncomplicated chronic duodenal ulcer. WOF is the best management?
    a- Eradication of H. pylori

    WOF does not cause carcinoma?
    a- Hepatitis C b- EB virus
    c- Cytomegalovirus

    Right side of chest is swollen and moves less than the left side. Right side is more resonant but breath sound is louder in the left side. The most likely disorder is -
    a- Consolidation on left side
    b- Pneumothorax on the right side
    c- Collapse on the right side
    d- Consolidation on the right side
    e- Pleural effusion on the left side

    A young man presented with dyspnoea, tachypnoea, hyperinflated left hemithorax with evidence of mediastinal shift to the right. Breath sound is less on the left. BP is 109/60. What’s your immediate management?
    a- Immediate fluid resuscitation to maintain BP
    b- Intubate and secure the air way
    c- Insert a wide bore needle in the 2nd intercostal space in the mid clavicular line aippg.com
    d- Insert a needle in the 4th space in the m8id axillary line

    A patient with Parkinson’s disease getting levodopa + Carbidopa developed twitching movement of face. What’s the management?
    a- Reduce dose of levodopa
    b- Give Benzhexol hydrochloride
    c- Increase the dose of levodopa
  31. Joseph.

    Joseph. Guest

    Renal calculi is associated with all of the following except -
    a- Depression b- Hypercalcuria
    c- Diarrhoea d- Lytic bone lesion
    e- Hyper calcinosis aippg.com

    On diagnostic evaluation a patient was found to have normal T3 and T4 but had decreased TSH. Which of the following drugs can not be give?
    a- Propranolol
    b- Iodine containing contrast medium

    Smoking increased malignancy, all of the following are associated with except -
    a- Ca pancreas b- Ca oesophagus
    c- Endometrial Ca d- Ca bladder
    e- Lung cancer

    Patient of chronic renal failure developed osteopenia. WOF is the treatment of choice?
    a- Phosphate binder
    b- CaCo3

    A patient with aortic stenosis had a gradient of 50 mm of Hg. What’s the most important factor to assess the severity of the disease?
    a- End diastolic pressure
    b- Left ventricular ejection fraction
    c- Presence of coronary disease
    d- Cardiac output

    WOF combination does not cause drug interaction?
    a- Warferin + Nitroglycerine
    b- Erythromycin + Terfenadin
    c- Warferin + Cimetidine
    d- ACE inhibitor + Amerloride

    Two days after a moderate MI a 65 yrs old man developed abdominal pain and diarrhoea with passage of blood. Abdomen is slightly tender. Plain X-ray shows distended intestine but no fluids level. Serum amylase is slightly elevated. Temp. is 38 degree C. The most likely diagnosis is -
    a- Ischaemic colitis b- Ca of sigmoid colon
    c- Diverticulitis d- Acute pancreatitis aa
    e- Heparin induced bleeding

    A 30 yrs old woman comes to you for a general check up. WOF you will do as the first thing?
    a- Complete body scan]
    b- Complete blood examination
    c- X-ray chest aippg.com
    d- Detailed history and physical examination
    e- Ask about her general health concern

    Which of the following condition is most benefited from splenectomy?
    a- Henoch Schonlein purpura
    b- Myelofibrosis
    c- Chronic ITP
    d- Sickle cell anaemia

    Hepatitis B -
    a- Epidemiologically similar to hepatitis E
    b- Immunization should be given to Gluteal region
    c- If it infects in infancy most probably leads to chronic course
    d- Both Hep S Ag and Hep E Ag are necessary for the diagnosis

    Picture of perianal haematoma was given. A netball player developed sudden onset of perianal pain came after 24 hrs. What’s the appropriate management?
    a- Incision and drainage under local anaesthesia
    b- Hot saline bath at 2 hrs intervals
    c- Rectal sphincterectomy under GA
    d- Antibiotics

    Which of the following organism can not be transmitted by blood transfusion except?
    a- Hep B b- Hep A
    c- Treponema palladium
    d- Malaria e- Hep C

    CT scan of the brain a space-occupying lesion asked for the diagnosis-
    a- Infarction b- Haemorrhage
    6. CT scan of the abdomen was given showed a large cyst in the hypochondrium -
    a- Pancreatic cyst b- Ascities
    b- Ovarian cyst d- Splenic cyst
    aippg.com
    In which situation you will give TPA with in 4 hrs -
    a- All anterior MI
    b- All inferior cyst
  32. R.dass

    R.dass Guest

    With respect to combined the oral contraceptive pill. Which of the following is not true?
    a- It reduces the incidence of benign breast disease
    b- It reduce the incidence of endometrial cancer
    c- It reduce the incidence of ovarian cancer aippg.com
    d- It reduce the plasma concentration of triglycerides
    e- It reduce the incidence of iron deficiency anemia

    Which of the following is associated with a reduced risk of breast cancer?
    a- Nulliparous
    b- Early menarche
    c- late menopause
    d- First child under 20 years of age
    e- If you breasts feed your children

    You discover that a pregnant woman of 30 weeks gestation is positive for streptococcus B. Which of the following is true?
    a- Treat the patient with penicillin immediately
    b- Treatment with IV penicillin during labour will significantly reduce the risk of severe neonatal disease
    c- Treat with doxycycline
    d- Do not treat because 25% of women are carriers
    e- They are part of normal vaginal flora 10-30%

    A woman that in a previous pregnancy had a child affected by anencephaly is pregnant again. With respect to managements of this pregnancy which of the following is not correct?
    a- Amniocentesis at 18 weeks
    b- CVB at 11 weeks
    c- Ultrasound at 11 weeks to look for malformations
    d- Ultrasound at 11 weeks looking for Nuchal thickness
    e- Maternal screening at 16 weeks

    36 years old primigravida is worried about Down’s syndrome. Which of the following investigations is the most specific and at the same time has the lowest risk for the foerus?
    a- Maternal screening at 16 weeks gestation
    b- Amniocentesis at 18 weeks
    c- CVB at 12 weeks
    d- Ultrasound at 11 weeks to look for Nuchal thickening
    e- Cordiocentesis at 24 weeks

    In which part of the body is the majority of the sperm blocked?
    a- Cervix
    b- Vagina
    c- Uterus
    d- Fallopian tubes aippg.com
    e- Isthmus

    A woman of 48 years that had a CIN lesion removed, 10 years ago and has recently had a hysterectomy but has her ovaries left. Which of the following is not true?
    a- Woman that have had this type of operation have less chances of getting cancer of the ovaries than woman that have not had this operation
    b- She will need to have vaginal vault smears every 2 years
    c- She will enter menopause at the normal age perhaps just a little earlier
    d- Oestrogen therapy will be beneficial to her when she enters menopause
    e- She will not need progesterone in HRT

    A 52 yrs old woman that has had a hysterectomy and post operative DVT comes to see you complaining of severe hot flushes. Which of the following would you recommend?
    a- The combined oral contraceptive pill b- Oestrogen transdermal patches 50 microgram
    c- Low dose oestrogen therapy per os
    d- Oestrogen and progesterone transdermal patch
    e- Progesterone therapy only

    A 26 yrs old Nulliparous woman who was recently married and wants to have children comes to see you complaining of severe menorrhagia. On examination you find that uterus was completely deformed by uterine fibroids and that her uterus can be felt just under her umbilicus, and haemoglobin is decreased (4 gram %). Which of the following would you recommend?
    a- Total hysterectomy
    b- Open myomectomy after controlling her anemia with blood transfusion
    c- Give 3 months therapy with gonadotropin agonists then do an open myomectomy
    d- Do a transcervical myomectomy
    e- Prescribe her the oral contraceptive pill

    A young woman with infertility, recommended to do laparoscopy. She comes to her GP looking for information about laparoscopy. All the following are true except:
    a- A minimum risk for laparoscopy due to damage to the internal organ
    b- Risk for damage to aorta or vena cava which can lead to death
    c- You can find diagnosis polycystic ovarian syndrome aippg.com
    d- Better for diagnosis of endometriosis
    e- Pain in the shoulder is common past operatively
  33. R.dass

    R.dass Guest

    A 50 yrs old woman whose last period was 2 years ago comes with 3 days vaginal bleeding without abdominal pain. What is the most likely cause?
    a- Early stage of cervical cancer
    b- Endometrial cancer
    c- Occasional follicular hypertrophy
    d- Vaginal atrophy aippg.com
    e- Anovulatory cycles

    Regarding endometrial ablation all is true except:
    a- Difficult to operate if the uterus is bigger than 10cms
    b- Cause amenorrhoea in 60-80% of the patient
    c- Postop you can use just oestrogen without progesterone
    d- Is more safe to use roller blade
    e- Required long hospital stay

    An 18 yrs old female who has multiple partners during the last year comes to you because of a vaginal discharge. All of the following are true except:
    a- Take HIV test
    b- Take lower endocervical swab for gonorrhoea
    c- Take a swab from the posterior fornix for Chlamydia
    d- Treat sexual partner
    e- Cervical smear cytology

    A 28 yrs old woman G2 PI with a normal vaginal delivery in the past. Now pregnant at 37 weeks and comes to the delivery ward for induction due to pre-eclampsia. The baby lies longitudinal, cephalic, not engaged. At this time you rupture the membrane and give the patient a syntocynon-infusion. In related to the start of first uterine contraction the foetus has Bradycardia of 60. What do you do next?
    a- Caesarean section
    b- Do abdominal CTG
    c- Do vaginal examination
    d- Just observe
    e- Oxytocin

    A woman after 10 hours of obstructive labour delivers by caesarean section. Three days later she develops fever 37.9c. What is the least likely?
    a- UTI
    B- Wound haematoma
    c- DVT
    d- Endometrial infection
    e- Engorgement of the breast

    A mother brings her 4 year old girl with intermittent yellow vaginal discharge. In the examination you find that the vulva is normal structurally except little red and the girl trends to put her hand o the area, with sign of scratching. What is the most likely diagnosis?
    a- Foreign body
    b- Monilial infection
    c- Gardenella vaginalis
    d- Syphilis
    e- Sexual abuse

    The most benefit from mammogram screening for breast cancer is:
    a- Earlier confirmation lump then self palpitation
    b- Woman with family history of breast cancer and first degree relatives
    c- 50-54 year are group
    d- 35-50 year are group aippg.com
    e- Woman over 65 yrs of age

    A 50 yrs old woman, bleeding after menopause, is taking Warfarin drugs. This is least likely with:
    a- CIN 3
    b- Cervical carcinoma
    c- Endometrial carcinoma
    d- Vaginal atrophy
    e- Anovulatory cycles

    In an Rh negative mother, al of the following are true except:
    a- Immunoglobin during the second trimester can be helpful
    b- In ABO incompatibility, Anti-Rh immunoglobin is not necessary
    c- Immunoglobin should be given during the first 72 hours after delivery

    All of the following treatment regimes regarding candidiasis can be used except:
    a- Imidazole
    b- Metronidazole
    c- Ketocanazole
    d- Nystatin
    e- Ictracondazole
  34. R.dass

    R.dass Guest

    A young couple wants to have a child. The husband’s mother had bipolar disorder. You tell them:
    a- The risk is less than 10% in offspring
    b- They should adopt a child as the risk is too high
    c- They should seek expert genetic counselling prior to having a child
    d- Should undergo amniocentesis to decide whether termination of pregnancy

    About progestogen in HRT, does all except:
    a- decrease the risk of endometrial cancer
    b- Decrease risk of cervical cancer
    c- Causes premenstrual cancer aippg.com
    d- Decreases HDL
    e- Augments effect of oestrogen in bone protection

    Combine HRT has all the advantages except:
    a- Prevent hyperplasia of endometrium
    b- The production f some perimenopausal symptoms
    c- Production of period bleeding at the end of cyclical progesterone
    d- Augmentation of bone protection by progesterone

    In post/menopausal woman, what is the least likely cause of greenish foul smelling vaginal discharge?
    a- Trichomonads vaginalis
    b- Gardnerella vaginalis
    c- Chlamydia
    d- Cervical carcinoma
    e- Foreign body

    A 19 yrs old primi, 38 weeks gestation with dryper reflexia, hypertension and oedema might be excepted to have elevated blood levels of all of the following except:
    a- Uric acid
    b- Creatinine
    c- Platelets
    d- SGOT
    e- BUN

    A 45 yrs old female who has been into post menopausal period for 6 months duration started complaining about intermittent bouts of flushes, insomnia, anger, depression and emotional outbursts. Your treatment for her would be:
    a- Reassurance
    b- Progesterogen only pills
    c- Oestrogen only pills
    d- Combination pills
    e- Non of the above

    Progesterone challenge test includes a 5 days course of medroxyprogesterone acetate (MPA) 10mg daily. If there is no withdrawl bleeding after stopping MPA, this will indicate:
    a- Hypothalamic incompetence
    b- Pituitary failure
    c- Ovarian failure
    d- Uterine pathology
    e- Thyroid disorder

    Cardiotocography involves a continuous recording of the fetal heart rate. Abnormal result may mean the presence of:
    a- Spontaneous acceleration of the fetal heart rate with uterine contraction
    b- Beat to beat variation during sleep
    c- Fetal heart rate 140 per minute aippg.com
    d- Slowing of the fetal heart rate in relation to movements
    e- Short-term variation of greater than 5 beats

    Regarding with Asthma in pregnancy. Following statements are true:
    a- There is no significant aggravation during pregnancy
    b- It affects 0.4% to 1.3% of all gestations
    c- Medical treatment includes Terbutaline and Cromolyn sodium
    d- Aminophylline is safe in pregnancy
    e- No evidence for teratogenicity by using corticosteroids

    The highest failure rate of method of contraception is:
    a- Condom
    b- IUCD
    c- OC pills
    d- Diaphragm and spermicides
    e- Injection depot medroxyprogesterone acetate
  35. R.dass

    R.dass Guest

    Carcinoma in situ of the cervix:
    a- may have extended into endocervical glands
    b- Is visible to the naked eye aippg.com
    c- Is a malignant invasive lesion
    d- Can be visualized colposcapically
    e- Can be treated by local destruction

    C.I.N. III:
    a- Includes cases of severe dysplasia
    b- Includes cases of carcinoma in situ
    c- Is premalignant
    d- Could be treated by superficial cervical cautorisation
    e- Often returns to normal spontaneously

    Signs of a ruptured octopic pregnancy are:
    a- rebound tenderness in the abdomen
    b- Heavy vaginal bleeding
    c- Cervical excitation
    d- Localized tenderness in the pelvic
    e- Tachycardia

    A patient with an ectopic pregnancy:
    a- Always has amenorrhoea
    b- Has a positive pregnancy test in 95 percentage of cases
    c- May complain of fainting attacks
    d- May complain of shoulder tip pain
    e- Usually presents with cardiovascular collapse

    Aetiological factors in ectopic pregnancy include:
    a- Gonococcal salpingitis
    b- Tubal surgery
    c- Intra-uterine contraceptive devices
    d- Tuberculous salpingitis
    e- Progestogen only oral contraceptives

    Useful procedures in making diagnosis of ectopic pregnancy:
    a- Examination under anesthesia
    b- Ultrasound scans of the pelvic
    c- A pregnancy test
    d- Laparoscopy
    e- Abdominal X-ray

    A pregnant lady with HTN her initial BP was 170/110 and now increases to 170/125, you will give her treatment all of the following except:
    a- ACE inhibitors
    b- Frusemide aippg.com
    c- Intravenous hydralazine

    A lady at 16th week of gestation with in her 2nd pregnancy she has history of birth of a baby was 4.7kgs and was born by midforcep delivery with fracture or her Clavicle, what will you do for better management?
    a- 3 hour glucose tolerance test
    b- Estimation of blood glucose, Ketone and Sugar

    Pregnant diabetic patient with IDDM, WOF is correct except-
    a- Strict control of blood glucose from 10th week onward

    A patient at 17th week gestation present with pain at right iliac fossa, likely-
    a- Ectopic pregnancies
    b- Appendicitis
    c- Red degeneration of myoma
    d- Ovarian tension
  36. R.dass

    R.dass Guest

    Which is the earliest site of rupture of ectopic pregnancy?
    a- Midportion (isthmus)
    b- Fibriated ampulla

    Regarding endometrial Ablation: WOF is not true
    a- Amenorrhoea occur in only 60-80% of cases
    b- Danazole given prior to ablation therapy aippg.com
    c- Ablation will be difficult if length of the uterus is more than 10cm
    d- Roller ball scooping is better than Electro-dissection
    e- After ablation only estrogen can be given without progesterone

    A 68 years old boy lady was taking Warfarin due to MI came with single episode of mild vaginal bleedings, WOF is the diagnosis-
    a- Cervical Ca
    b- Endometrial polyp
    c- Warfarin side effect
    d- Endometrial Ca

    A lady around 20 years of age, she was having Prolactin level 2200 IU/L. FSH normal, TSH normal, Adenoma - 1.8 and it extends up to 3mm from optic chiasma, your initial treatment will be:
    a- Transphenoidal surgery
    b- Transfrontal surgery
    c- Bromocriptin therapy

    A pregnant lady with a well balanced diet, WOF she will be deficient-
    a- Vitamin C
    b- Vitamin D
    c- Vitamin A
    d- Phospher
    e- None of the above

    A lady of 22 years old, she has hirsutism, oligomenorrhea, endometrial, shows - Atypia and hyperplasia, of endometrium, she was married and sexually active, WOF is correct except:
    a- Clomiphen citrate on 5-9 days/28
    b- Medroxyprogesterone 5mgs daily for 25 days
    c- Medroxyprogesterone 10mgs daily for 14 days

    A pregnant lady at 38 weeks of gestation present with vaginal bleeding 1000mls and abdominal pain. WOF is least likely:
    a- Fetal demise
    b- Uterus tense and contracts
    c- Head up with longitudinal lie

    A primi gravida with ruptured membrane for 6 weeks. Oxytocin drip was given: Cervical dilation - 4cms, position - mento anterior, no progress of labor. Regarding obstructed labor which is least likely:
    a- Anterior lip of cervix dilated
    b- Head 1 cm above ischial spine
    c- Per abdominal examination head 4cm above per vaginal examination 5cm below the ischial spine
    d- Presentation mento posterior

    To reduce the cervical Ca dramatically in Australia WOF is appropriate:
    a- More availability of Papsmear
    b- More availability of cervical screenings
    c- Colposcopy aippg.com
    d- Early treatment of CIN
    e- To invent vaccine to Human papiloma virus

    A man 25 years old married a woman of 22 years old for 3 years FSH, LH level of the body is normal, but she is not conceiving, All of the following condition are appropriate for IVF except:
    a- Mild endometriosis treated
    b- Sperm count<1,000,000/mm
    c- IVF with microinjection
  37. R.dass

    R.dass Guest

    Mammography is-
    a- Painless
    b- Can detect Ca earlier than self breast examination
    c- It is more beneficial in 30-40 years age group
    d- Difficult in defection after 60years aippg.com

    For induction of ovulation you can do all except:
    a- HMG
    b- Oral Clomiphene citrate
    c- GnRh + HMG
    d- BHCG

    What is the purpose of screening in general population?
    a- To detect the disease in early stage and protection
    b- Natural history of the disease of the disease can be changed in early detection

    A woman came after delivery of a child. What contraceptive she will take for the next one year, which failing rate that is <2% except:
    a- She will breast feed the baby and she will be Amenorrhea
    b- OCP

    A primigravida is in labour for 10 hours. Bishop’s pre-induction cervical scoring indicates cervix as 2cm dilatation, 40% effacement, posterior position, consistency firm and head station as + 1. Fetal is in longitudinal lie and cephalic presentation. Which of the following is the most appropriate method?
    a- Surgical rupture of membranes followed by intravenous Syntocinon
    b- Intravenous Syntocinon until cervix is 3cm and then surgical rupture of membranes
    c- Intravenous prostaglandin E2 gel 1-2 mg
    d- Intracervical Foley’s catheter
    e- Intravaginal prostaglandin F2 alpha

    The following are the conditions causing Polyhydramnios except:
    a- Anencephaly
    b- Spin bifida
    c- Hydrops fetalis
    d- Duodenal atresia
    e- Maternal heart disease

    The diagnosis of pre-invasive lesion is confirmed in a 50 years old lady. You would perform which of the following: (TYPE-J)
    a- Cone biopsy
    b- Cautery
    c- Large-loop excision of transformation zone (LIETZ)
    d- Colposcopy and punch biopsy
    e- Curettage

    A 23 years old patient is diagnosed as cervical erosion. She also has troublesome mucus discharge per vagina and is causing distress to the patient. The most appropriate management is:
    a- Reassurance
    b- Vagina pessary
    c- Cervical cauterization by diathermy
    d- Hysterectomy aippg.com
    e- Broad spectrum antibiotics

    Clinical management of abnormal uterine bleeding in a middle aged patient who has no apparent pelvic pathology includes the followings except:
    a- Non-steroidal anti-inflammatory drugs (NSAIDs)
    b- Endometrial abalation by laser
    c- Monophasic contraceptive pills
    d- Dilatation and currttage (D&C)
    e- Danazol

    On third day after birth, a 2 kg baby had bilirubin level of 250 mmol (<200). Which of the following is correct?
    a- Most likely cause is immaturity liver enzymes
    b- Usually exacerbate by breast feeding
    c- Kernicterus is common if untreated
    d- Is an indication for urgent exchange transfusion
  38. R.dass

    R.dass Guest

    32 weeks pregnant mother comes for the first time with B/P of 180/125, proteinuria>8g, with no oedema. All of the following are true except:
    a- MgSo4 infusion should be started prophylacticaly
    b- Methyldopa 500mg tds should be given
    c- She should be delivered within 48 hrs
    d- Betamethesone should be given Aippg.com
    e- Continuous CTG monitoring has to be done

    On examination of a pregnant woman, the foetus was term, with vertex presentation, longitudinal lie and head at 3 station. ARM done, clear liquor, and she was also started on Oxytocin drips, five minutes after commencing oxytocin, on auscultation with pinards fetoscope FSH was <60/min corresponding with uterine contraction. What is your next step of action?
    a- Do a carditocography
    b- Do a fetal scalp blood sampling
    c- Do another PV examination
    d- Do an ultrasound examination

    A 26 years lady comes with lower abdominal pain, and she had her last menstrual period (regular cycle) two weeks ago. Ultrasound scan was done and reported as, Uterus- normal, No fibroid seen. Both ovaries- normal size and texture, Lt. Ovaries has 3 cyst measuring 0.7cm, 2.2cm, and 3.0cm. “No neovascularisation seen”
    What is your next step of management in this patient?
    a- Reassurance her that nothing is wrong
    b- Laparoscopy and aspiration of the 2.2cm cyst
    c- Rescan the patient in two wks time

    The most common site for endometriosis is:
    a- Broad ligament
    b- Round ligament
    c- Utero sacral ligament
    d- Recto vaginal pouch
    e- Infundebulo pelvic ligament

    The most accurate method of assessing excepted due date is:
    a- Vaginal ultrasound at (8) weeks
    b- Bimanual vaginal exam (8) weeks
    c- Bimanual exam (18) weeks
    d- Abdominal ultrasound at (18) weeks
    e- X-ray

    Within the last ten years the most modern advancement in management and treatment of diabetic pregnancy is:
    a- Ultrasound examination of malformed fetus
    b- Home blood glucose monitoring
    c- Examination of glycosalated haemoglobin in RBC
    d- Paediatrician can correct congenital heart disease during neonatal period

    Relative contraindication to contraceptives includes of AOF except:
    a- Previous pulmonary thrombosis
    b- DVT
    c- Migraine headache
    d- Previous pregnancy with eclampsia
    e- Hypertension

    Increase breast milk production could be result from:
    a- Increase water intake
    b- A strong sucking infant
    c- Message breast during and (n between) after the feed
    d- Let down reflex aippg.com
    e- Stilbestrol

    The most common association with lumbar epidural:
    a- Hypotension d- Dural tap
    b- Hypertension e- Faetal Bradycardia
    c- Headache

    Ashmann’s Syn. The most diagnostic procedure:
    a- Uterine sound
    b- colposcopy
    c- Laptscopy
    d- Hystrosalpingography
    e- d and c
  39. R.dass

    R.dass Guest

    A female taken contraceptive is also on warferin was given amoxyllin for mild UTI suddenly develop slight vaginal bleeding most likely explaination is:
    a- Amoxyllin interfere with contraceptive absorption
    b- Amoxyllin interfere with warferin through bacteria in the gut which affect absorption of warferin
    c- Amoxyllin inhibit bacteria flora which stop vitamin K absorption
    d- Used extra method of contraception aippg.com
    e- Stop warferin

    A 26 yrs old female with 20wks pregnancy comes to you with concern. She had 2 previous abortions for which there is no pain and she didn’t notice any bleeding. What is the best management?
    a- Salbutamol
    b- Bed rest
    c- Stitch the cervix
    d- NT androgens
    e- Progesterone

    The most significant cause of infertility in a male with the following semen analysis is:
    a- Abnormal from more than 70%
    b- Volume 1.8ml
    c- Mobility 10%
    d- Sperm count 10 million
    e- Fructose low in the serum

    WOF is in correct concerning endometrium abalation:
    a- Progesterone
    b- High estrogen could be given as replacement after abalation
    c- Oral contraceptive

    Concerning Hydriomios WOF is incorrect:
    a- Acute hydriomios is more common than chromic hydriomios
    b- Associated commonly with multiple pregnancy
    c- Associated more commonly with diabetes
    d- Associated with Rh incompatibility

    AOF can cause secondary amenorrhoea at the level of hypothalamus except:
    a- Excessive weight loss
    b- Heavy exercise
    c- Prolactinemia
    d- Sheehan’s Syn.
    e- Stress

    Concerning oxytoxin drip WOF is not correct:
    a- Uterine rupture
    b- Water intoxication
    c- Faetal distress hypoxia
    d- Hypotension? Hypertension
    e- Tonic uterine contraction

    When does the fertilized ovun nidus, itself in to the endometrium?
    a- 2 to 5 days after ovulation
    b- 5 to 7 days after ovulation
    c- 6 hrs after fertilization
    d- 10 days after ovulation
    e- 5 to 7 days after fertilization

    WOF site is the location where most of reduction of the sperm count occurs:
    a- Vagina
    b- Cervix aippg.com
    c- Endometrium
    d- Follopian tube
    e- Comu

    Concerning uterine abalation most effective method is:
    a- Progestrone
    b- High estrogen could be given as replacement after abalation
    c- Oral contraceptive
  40. R.dass

    R.dass Guest

    Concerning Bulimia Nervosa common persistant (presentation)? Association is:
    a- Mark obesity
    b- Constipation
    c- Depression aippg.com
    d- Very good psychotherapy and behavioural therapy
    e- Good training and well control diet

    Childhood Autism commonly associated with AOF except:
    a- Sign develop early in childhood
    b- Look people as mechanical objects

    Dequaviean’s tenosynovitis WOF is true:
    a- NV is compressed median
    b- Pain on movement of the thumb
    c- Cause pain in the wrist
    d- Swelling at the wrist

    After mastectomy and radiation treatment of breast cancer oedema of the hand is due to:
    a- Obstruction of lymphatic system
    b- Excision of lymph nodes in the axilla

    Soon after splenectomy in a patient with congenital spherocytosis peripheral blood film will show:
    a- Leucocytosis
    b- Decreases survival of RBC
    c- Increase platelets count
    d- Spherocytes can be seen

    AOF are contraindication in pregnancy except:
    a- Lithium
    b- Thalidomide
    c- Nitrofuratoin
    d- Sulfurxazole
    e- Dalatin

    35 yrs old female with PPH of fresh blood per vagina BP 95/50mmHg, pulse 129/min, uterus small and well contracted, placenta membrane seems to be intact the most likely cause is:
    a- Ruptured uterus
    b- Laceration of vagina and cervix
    c- retained pieces of placenta

    Management of primary Dysmenorrhoea include all except:
    a- Mefanamic acid
    b- Indomethacin
    c- Bromocryptine aippg.com
    d- Oestrogen and progestrone

    Which of the most appropriate method to detect gestational age
    a- Bimanual examination at 8weeks
    b- Transvaginal examination ultrasound at 6 wks
    c- Abdominal ultrasound at 18 wks

    Which of the following drugs in high dose in late pregnancy causes neonatal neurological problem?
    a- Benzodiazepam
    b- Antipsychotic drug
    c- Anticonvulsant
    d- Narcotic analgesic
    e- TOA
  41. R.dass

    R.dass Guest

    Risk of breast cancer AOF are true except:
    a- Artificial early menopause
    b- Cancer in the other breast
    c- Cancer in the body of uterus
    d- First pregnancy after 35 yrs aippg.com
    e- First H/O breast cancer

    Regarding pulmonary embolism AOF true except:
    a- Massive pulmonary embolism usually is consistent with clinically proved DVT
    b- Symptoms depends on site, size and number of embolism
    c- Emboli in pulmonary artery may cause

    The following are of use in treating essential hypertension:
    a- Frusemide
    b- Hethyl dops
    c- Labetalol
    d- Propranolol
    e- Bed rest

    An unstable lie is associated with:
    a- Prematurity
    b- Placenta pracvia
    c- Uterus didelhys
    d- A fundal fibroid
    e- Grand multiparity

    Patients with rheumatic heart disease who become pregnant:
    a- Should always be given iron and folate supplements
    b- Commonly develop pre-eclampsia
    c- Commonly develop atrial fibrillation
    d- Should have operative procedures covered by prophylactic antibiotics
    e- Usually remain asymptomatic

    Pregnant patients diagnosed as having mitral sterosis:
    a- Have usually been diagnosed before the pregnancy began
    b- should usually have a termination of pregnancy
    c- should be considered for mitral valvotomy during pregnancy
    d- should have an elective C. S. performed at 37 wks
    e- should not routinely be given ergometrine in the 3rd stage of labour

    A high head at term could be true to:
    a- Wrong dates
    b- Placenta praevia
    c- Cephato-pelvic disproportion
    d- Placental abruption
    e- An occipito-posterior position

    The following drugs are effective in stopping premature labour:
    a- Pethidine
    b- Ritodnine
    c- Ethyl alcohol
    d- Diazepam
    e- Aspirin

    A 17 yrs old girl with soft fluctuant mass 4cm inside the introitus which is laterally located:
    a- Mullerian
    b- Wolffian aippg.com
    c- Bartholin’s
    d- Squamocolumnar
    e- Hymenal

    Treatment of endometriosis:
    a- Bromcergocryptine
    b- GnRh agonist
    c- Danazol
    d- Oral contraception
    e- Pregnancy
  42. R.dass

    R.dass Guest

    Distinguish ascities from ovarian cyst:
    a- Shifting dullness
    b- Tympony laterally and dullness anteriorly
    c- Tympony anteriorly and dullness laterally
    d- Fluid wave aippg.com
    e- Diminish intestinal peristalsis

    Sequence of event pubertal girl:
    a- Breast budding, accelerated growth, public hair, axillary hair
    b- Accelerated growth, breast budding, public hair, axillary hair
    c- Breast budding, public hair, accelerated growth, axillary hair
    d- Breast budding, axillary hair, public hair, accelerated growth
    e- Breast budding, public hair, axillary hair, accelerated growth

    A 65 yrs old woman has decreased interest in sexual activity. The most explanation is:
    a- Decreased lubrication
    b- Prone to vaginitis
    c- Vaginal atrophy
    d- Relaxation of pelvic muscular support
    e- Sexual orgasm is lost

    Perinatal death:
    a- No. of stillbirth /1000
    b- No. of neonatal death /1000
    c- No. of stillbirth and neonatal death /1000
    d- No. of stillbirth
    e- No. of neonatal death

    Cervical Ca is more common in:
    a- Nulliparous
    b- late menopause
    c- Divorced woman
    d- Sex first time at 27 years
    e- Early sex expenence

    Which is the commonest site from anaerobes?
    a- Brain abscess
    b- Endocarditis
    c- Infected prostheses

    What is the most common mode of transmission of Hep C in Australia?
    a- vertical transmission
    b- IV drug users
    c- Food
    d- Sexual contact
    e- Droplet

    A farmer suddenly had undulant fever for 2-3 days associated with abrupt onset of headache, severe myalgia, jaundice, and Petechial rash on the skin. Hepatosplenomegaly is present. Which of the following is the most appropriate diagnosis?
    a- Brucellosis
    b- Yellow fever
    c- Leptospirosis
    d- Malaria aippg.com
    e- Anthrax

    Advantages of coronary angioplasty stent are:
    a- Decreases the risk of acute complications
    b- Decreases risk of restenosis
    c- Both a + b
    d- Increases the risk of acute complications
    e- Increases risk of restenosis
  43. R.dass

    R.dass Guest

    Concerning renal artery stenosis all are true except:
    a- Commonly associated with atherosclerosis
    b- Hypekalemia
    c- Hypokalemia

    A patient comes to the ER severely shocked; pulse is 120. What is the next step in management?
    a- Wait for blood cross matching
    b- Give O-ve blood immediately
    c- Give iv fluids

    Which of the following is the unlikely sign of Mycoplasma pneumonia?
    a- Pleuritic chest pain
    b- fever
    c- Cough
    d- Headache

    All are true about lactose intolerance except:
    a- Increased glucose<1mmol after 50gm of glucose
    b- Steatorrhea
    c- Seen more in Asian people aippg.com
    d- Normal small bowel histology

    In a patient with cardiac arrest which of the following should be given first?
    a- Adrenaline
    b- Lignocaine
    c- Atropine
    d- Sodium bicarbonate
    e- Isoprenaline

    A male patient with COPD has an infective exacerbation and received 28% oxygen. He then became drowsy and ABG analysis showed PaCO2 61, PaO2 68. What is the first step in management?
    a- Immediate intubation and ventilation
    b- Decrease O2 and Repeat assessment and ABG analysis 30mins later
    c- Give immediate antibiotic cover against gram negatives
    d- Give higher O2 concentration
    e- Start aminotryptillin I/V infusion

    A patient with COPD was confused and was given 10ml/min O2 in the ambulance. He is now unresponsive. Which is the most likely result of an ABG taken now?
    a- PO2=40, PCO2=100, Ph=7.35
    b- PO2=100, PCO2=10, Ph=7.40
    c- PO2=60, PCO2=45, Ph=7.50
    d-v PO2=40, PCO2=100, Ph=7.15
    e- PO2=100, PCO2=60, Ph=7.25

    13 yrs old girl with irregular bleeding came after 1year of menarche. which persist for 10 days, you will do all of the following except:
    a- Clomiphen citrate given for ovulation if she desire for pregnancy
    b- estrogen
    c- Progesterone
    d- OCP
  44. R.dass

    R.dass Guest

    A 16 yrs old girl present with scanty pubic and axillary hair, her pubic hair develops at 13 yrs of ago, she has no breast enlargement, she is shy and do not allow to her perineum examination. You will do all of the followings investigations except:
    a- CT scan of sela tersica
    b- Pelvic USG through abdomen
    c- Prolactin level
    d- FSH level
    e- LH level aippg.com

    Effect of progesterone. All of the following except:
    a- Increase HDL
    b- Increase LDL
    c- Fluid retention
    d- Change of voice

    Postmenopausal woman came to you, gave him her prophylactic HRT, estrogen 0.625mgs and Progesterone for 14 days. You will tell her all of the following are effect of progesterone except:
    a- It will prevent her change of endometrial carcinoma
    b- Cardio-profile effect of estrogen will be corrected
    c- It will augment ostioporetic effect of estrogen

    18 yrs old lady with HTN and taking ACE inhibitors and well controlled; he wants to be pregnant. You will give her all of the following except:
    a- Change the ACE inhibitors and use other anti-hypertensive drugs

    A lady with cystic fibrosis, she wants to be pregnant. You will advice her-
    a- She should not be pregnant
    b- She should adopt a child
    c- Through it is risky for her she can be pregnant with modern therapy if she strongly desire

    A woman at 18 wks of twin gestation, during counseling you will tell her all except:
    a- Frequent visit
    b- Review during third trimester, she may develop
    c- if any pain develops, she will come to the hospital
    d- B-methasone to 30th week

    Mullerian agenesis, which is not true:
    a- karyatype 46XX
    b- Normal pubic hair
    c- Normal breast form
    d- X-linked recessive

    A 21 yrs old 12wks gestation, on examine uterus is 14 wks size. Something appeared on the introitus, suction D&C was done & removed a tissue which is hydrophic, WOF is true:
    a- HCG level determination weekly till it becomes normal
    b- Telling the patient not to get pregnant and give OCP

    Danazol effect:
    a- Cleft lip aippg.com
    b- Cardiac anomalies
    c- Female psuedohermaphroditism
    d- Limb malformation

    WOF can procedure retention of urine except:
    a- Fibroids
    b- Haematocolpus
    c- Retroverted uterus
    d- Wart obstructing the genital tract
    e- Spinal cord lesion
  45. R.dass

    R.dass Guest

    A 25 yrs old male present for infertility on examine is tall, small testis gypaecomastia, Dx?
    a- Hlinefelter syndrome
    b- Testicular syndrome
    c- Down syndrome aippg.com
    d- Turner syndrome
    e- Marfan syndrome

    HCG is a glycoprotein with Alpha & beta subunit, which is true:
    a- ACTH like effect
    b- Is principally produced by syncitiotrophoblast
    c- Peaks at 28-32 wks
    d- It will continue to be high at 16wks

    Asymptomatic bacteriuria, which is true
    a- WBC at 100,000
    b- 30% will be symptomatic
    c- Presents in 5-6% of female population
    d- Needs short course antibiotics
    e- Streptococcus faecalis is the predominant organism

    You are addressing a class of nurses about a pregnant woman who had a previous caesarean section for fetal distress. What would be your response when you are asked about the chances of this pregnancy being a normal delivery?
    a- 90%
    b- 75%
    c- 50%
    d- 20%
    e- 10%

    A primigravid patient was in the first stage of labour for 14 hours duration. After third days of delivery, the patient developed pyrexia of 38°c. Which of the following is the commonest cause for this rise of temperature?
    a- Engorged breast
    b- Upper genital tract injuries leading to endometritis
    c- Breast abscess
    d- Episiotomy with haematoma formation
    e- Pulmonary embolism

    A woman who has primary postpartum haemorrhage is examined and noted that her uterus is small and well controlled. Her blood pressure is 85/50mmHg and there was no missing cotyledons or fragmented membranes detected during post delivery check. The reason for her bleeding would be:
    a- Related placental tissue
    b- Ruptured uterus
    c- Vagino-cervical tears
    d- Clotting disorder aippg.com
    e- Uterine atony

    Painless jaundice in pregnancy is manifested by:
    a- Intrahepatic cholestasis of pregnancy
    b- Acute fatty degeneration of pregnancy
    c- Hepatitis B
    d- Severe hyperemesis gravidarum
    e- Elevated progresterone level during pregnancy

    Commonest organism causing bartholinitis is:
    a- Staphylococcus
    b- Streptococcus
    c- Associated with Neisseria gonorrhoeae
    d- Clostridium welchii
    e- Coliform organisms

    Primary dysmenorrhoea can be effectively treated by:
    a- Paracetamol
    b- Prostaglandin inhibitors
    c- Cervical dilatation
    d- Oral contraceptive pills
    e- Hysterectomy

    A woman who had a child with previous marriage married to another man for 1 year. Her husband had left sided orchidectomy last 8 years ago. They have normal sex life but they do not have children yet. What would be the cause of male infertility in this situation?
    a- Spermatocoele
    b- Diabetes mellitus aippg.com
    c- Varicocoele
    d- Past history of testicular torsion
    e- Encysted hydrocoele of the cord
  46. R.dass

    R.dass Guest

    After delivery, an infant develops prominent neurological depression for a prolong period. Which of the following medications used in the late pregnancy will produce this condition?
    a- Phenytoin
    b- Carbamazepine
    c- Sodium valproate aippg.com
    d- Phenobarbitone
    e- Benzodiazepine

    Antepartum hemorrhage (APH) in primigravida can be best diagnosed by:
    a- vaginal examination
    b- Localization of placenta by ultrasound
    c- Inspection of cervix with Sims speculum
    d- Cross-match blood
    e- Amniocentesis

    A primigravida is in labour for 10 hours. Bishop’s pre-induction cervical scoring indicates cervix as 2cm dilatation, 40% effacement, posterior position, consistency firm and head stations as+1. Fetus is in longitudinal lie and cephalic presentation. Which of the following is the most appropriate method?
    a- Surgical rupture of membranes followed by intravenous Syntocinon
    b- Intravenous Syntocinon until cervix is 3cm and then surgical rupture of membranes
    c- Intravaginal prostaglandin E2 gel 1-2mg
    d- Intracervical Foley’s catheter
    e- Intravaginal prostaglandin F2 alpha

    The followings are the conditions causing polyhydramnios except:
    a- Anencephaly
    b- Spina bifida
    c- Hydrops fetalis
    d- Duodenal atresia
    e- Maternal heart disease

    The diagnosis of pre-invasive lesion is confirms in a 50 years old lady:
    You would perform which of the following : (TYPE J)
    a- Cone biopsy
    b- Cautery
    c- Large-loop excision of transformation zone (LIETZ)
    d- Colposcopy and punch biopsy
    e- Curettage

    A 23 yrs old patient is diagnosed as cervical erosion. She also has troublesome mucus discharge per vagina and is causing distress to the patient. The most appropriate management is:
    a- Reassurance
    b- vaginal pessary
    c- Cervical cauterization by diathermy
    d- Hysterectomy aippg.com
    e- Broad Spectrum antibiotics

    Clinical management of abnormal uterine bleeding in a middle aged patient, who has no apparent pelvic pathology includes the followings except:
    a- Non-steroidal anti-inflammatory drugs(NSAIDs)
    b- Endometrial abalation by laser
    c- Monophasic contraceptive pills
    d- Dilatation and currttage (D & C)
    e- Danazol

    Many women with cystic fibrosis are now reaching child bearing age. Gynaecologists should advice them that:
    a- Contraception is not necessary because fertility rates are low
    b- They should never reproduce as their child has a very great chance of having the disease
    c- They should not conceive as the antibiotics usually used to treat their respiratory infections are contraindicated in pregnancy
    d- Pregnancy may in fact, be lift-threatening but successful delivery may usually be accomplished if strongly desired
    e- When they deliver, general anaesthesia should be employed to minimize stress of delivery

    A 32 yrs old ready to discharge from hospital after having a baby. She is breast feeding and asks for contraception method with less than 2% failure. She wants to have another baby after breastfeeding this one for 12 months. What would you advice her?
    a- Full breastfeeding is a safe contraceptive method provided no periods happen and the baby is not given additional food apart from breast milk
    b- IUD
    c- Mini pill (progesterone only)
    d- Depot provera
    e- Dianne 35- if she gets periods and fails to breastfeed the baby

    In twin delivery, after the first one is born, cord is tighted. You do all except:
    a- Check there is no bleeding from the uterus
    b- Check if the second twin’s lie aippg.com.
    c- Commence external diversion if second twin is in breech position
    d- Commence oxytocin if second twin is vertex and contractions have not resumed spontaneously
    e- CTG to be performed to monitor the heart rate if second twin
  47. R.dass

    R.dass Guest

    All of the following CTG changes are considered to the normal except:
    a- Acceleration with control
    b- Acceleration with sound stimulation aippg.com
    c- Very regular rhythm, with beat to beat variation <5-min
    d- Decrease variability during sleep
    e- Acceleration with foetal movements

    A 16 yrs old girl had height spurt at the age of 13 when in grade 5. with breast and pubic hair development during puberty but does not have a period. She is too shy for the most sensitive investigation except:
    a- pelvic ultrasound
    b- Chromosomal studies
    c- Intra vaginal ultrasound
    d- Progesterone, FSH/LH level
    e- CT pituitary gland

    A 13 yrs girl had first period a year ago. She has used the Monophasic CP since then and has had only 2 periods at irregular intervals. Your advice would be:
    a- Continue OCP and review in six months
    b- Change to triphasic OCP
    c- Surge of oral contraceptive pill
    d- She will need stimulation of ovulation in her fertility years if she wants to become pregnant

    A 23 yrs old woman with 2 years old child is found to have a very high level of prolactin and on CT scan is found adenoma in the anterior pituitary of 1.6mm in diameter about 3mm away from chiasma in optic and she doesn’t have visual disturbance. What is the best treatment?
    a- Transphenoidal surgery
    b- Transnasal surgery
    c- Bromocriptine
    d- Radiotherapy
    e- Chemotherapy

    OCP with phenytonin what is correct:
    a- Microgyunone 50 plus progesterone
    b- Oestrogen 35 plus progesterone
    c- Progesterone
    d- Oestrogen 125-75-50 progesterone
    e- Oestrogen 15 plus progesterone

    When labour becomes obstructed after 24 hours duration, the following may be excepted?
    a- Maternal Bradycardia
    b- Foetal Bradycardia aippg.com
    c- Transverse arrest of the foetal head
    d- Maternal hypotension
    e- Pronounced moulding of the foetal head

    Ectopic pregnancy commonly present as:
    a- The patient may be faint with a tender abdomen
    b- Shoulder tip pain
    c- Mass inn LIE or RIE
    d- Sudden severe pain, peritonism and shock
    e- Hyperpyrexia, hypotension and tachycardia

    Pulmonary disease commonly seen after the delivery is:
    a- Asthma
    b- Amniotic fluid embolism
    c- Bronchitis
    d- Atelectasis
    e- Bronchopneumonia

    Rate of the Caesarean section is decreased in all of the following diseases except:
    a- Dystocia
    b- fetal distress
    c- Breech
    d- Other unstable lie
    e- Fetal abnormalities

    Which of the following is most common cause of low milk production?
    a- Low intake of water
    b- Mother is very tired
    c- Infant is put to breast very frequency
    d- Infant is put to breast for less time and there is no proper let down reflex aippg.com
  48. R.dass

    R.dass Guest

    On third day after birth, a 2kg baby had bilirubin level of 250 mmol(<260). Which of the following is correct?
    a- Most likely cause is immaturity of liver enzymes
    b- Usually exacerbated by breast feeding
    c- Kernicterus is common if untreated
    d- Is an indication for urgent exchange transfusion

    32 wks pregnant mother comes for the first time with B/P of 180/125, proteinuria>8g, with no oedema. All of the following are true except:
    a- MgSo4 infusion should be started prophylacticaly
    b- Methyldopa 500mg tds should be given
    c- She should be delivered within 48 hrs
    d- Betamethesone should be given
    e- Continuous CTG monitoring has to be done aippg.com

    A 22 yrs old married for one year has come to consult you because of infertility. She is been having regular intercourse for the last six months. What is your management regarding this patient?
    a- Gamete intra fallopian transfer (GIFT)
    b- Give her a temperature chart and explain her about ovulation time, fertile period, and review her after 4 wks
    c- Do a hysterosalphingography

    All of the following can cause Hyperprolactinemia except:
    a- pituitary adenoma
    b- Phenothiazines
    c- Breast engorgement
    d- Oestrogen
    e- Renal failure

    A 26 yrs old lady with irregular cycles for a longtime had cycles once in 4-10 wks intervals. Her LMP at that time was 6/52 before. On routine examination for her amenorrhea:
    FSH 3IU (13)
    LH 850 IU (4-10 follicular phase, 20-100 midcycle)
    Prolactin 450 (50-100)
    What is the most likely cause for amenorrhea?
    a- Premature ovarian failure
    b- Polycystic ovarian disease
    c- Stress due to recent marriage
    d- Early pregnancy
    e- LH secreting pituitary aippg.com

    A 42 yrs old lady had menorrhagia and was anaemic, for which she under went a D&C three wks ago and no abnormality was seen. She has never had hormonal treatment before. All of the following can be given to her except:
    a- Tranexamic acid
    b- Prostaglandin synthetase inhibitors
    c- Norethesterone
    d- LHRH
    e- GnRH

    All of the following are side effect of progesterone except:
    a- Weight gain
    b- Menstrual irregularities
    c- Amenorrhea after 2-3 injections
    d- Reduced chance of fertility for 6-12 months after last injection
  49. R.dass

    R.dass Guest

    In the drug treatment in Psychiatry enzyme Cytochrome P450 is important especially for the antidepressant drugs. Which of the following statement is true regarding enzyme P450 -?
    a- it explains the interaction between the antidepressant and the other drugs
    b- Causes rush symptoms in the brain
    c- They are elevated by the neuroleptic drugs aippg.com
    d- They make the neuroleptic drugs lipid soluble

    The use of which of the following widely used antipsychotic drug has recently been suspended in Australia for its effect on heart causing prolongation of the QT interval:
    a- Clozapine
    b- Thioridazine
    c- Fluphenazine
    d- Chlorpromazine
    e- Risperidone

    Elderly abuse is becoming increasing in Australia and is a great concern. Which of the following statement regarding elderly abuse is true?
    a- Elderly female are more likely to be abused than elderly male
    b- More often by unknown person
    c- The abusers are more to be mentally ill
    d- Mentally ill are less likely to be abused
    e- Physical illness of the elderly reduce the risk of abuse

    A 35 yrs schoolteacher came to you with the history of difficulty in sleep, irritability and anxiety. When he goes to bed all minor mistakes he did in the day comes in to his mind and he argues with them himself. These thoughts come intrusively in to his mind and give him too much distress though he realizes that these thoughts are irrational. He tries to get rid of the thought but is unable to do that. He has to resolve the arguments before he can get in to sleep. He is perfectionist and wants things to be done in a way he likes. Which of the following drug would be most beneficial for him?
    a- Benzodiazepine
    b- Non Benzodiazepine hypnotic
    c- SSRI
    d- Atypical antipsychotic
    e- Antipsychotic/Antidepressant

    A 45 yrs old man was hospitalized after cycle accident where he hit a lamp-post. He has fracture of the femur and bruises over the chest. There is no apparent injury in the head. On 3rd day he became suddenly confused and disoriented. What is the most probable cause?
    a- Subdural Haematoma
    b- Alcohol withdrawal aippg.com
    c- Acute anxiety state
    d- Schizophrenic psychosis
    e- Hypersensitivity to drugs

    60 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 acromlo-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 aippg.com
    c- Haemoglobin estimation
    d- Culdoscopy
    e- Hysteroscopy
  50. R.dass

    R.dass Guest

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

    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

    In the diagnosis of hypogonadism the following are true -
    a- Low testosterone with high FSH more than LH levels indicate a primary seminiferous tubule dysfunction
    b- Low testosterone with raised FSH & LH indicate a pituitary or hypothalamic lesion
    c- Low testosterone with low normal FSH & LH indicate a primary testicular lesion
    d- Low FSH levels with a decreased sperm count indicate isolated FSH deficiency
    e- High serum testosterone and FSH & LH indicate a disorder of androgen action

    In the diagnosis of hypogonadism the following are true -
    a- An extra X chromosome is diagnosed by finding a Bar body in a buccal sinear
    b- The karyatype may be obtained by examining the peripheral blood lymphocyte
    c- In Klinefelter’s (KF) syndrome the testicles are small but firm
    d- In KF, unlike other hypogonads aggression may be a feature
    e- A normal XY karyatype is compatible with a diagnosis of KF

    The following statements are true -
    a- Orchitis in pre-pubertal boys due to mumps resolves completely, usually without sequelae
    b- Spironolactone decreases testosterone synthesis and blocks action of testosterone on the receptor aippg.com
    c- Ketoconazole blocks steroid but not testosterone synthesis
    d- Androgen deficiency in cirrhosis treated by testosterone may result in worsening of gynaecomastia
    e- Androgen therapy in chronic renal failure improves sexual performance if there is hypogonadism

    The following are true in crypto rchidism -
    a- Unilateral cryptorchidism may be associated with bilateral seminiferous tubule dysfunction
    b- Bilateral cryptorchidism may result in a low serum count with normal testosterone levels
    c- Bilateral cryptorchidism when associated with low testosterone levels is associated with other syndromes like KF
    d- Ultra sound abdominal scan may be helpful in localsing a non palpable testis
    e- The risk of malignancy in undescended testis is greater than the normal population, even after orchiopexy

    The first heart sound intensity is likely to be variable in -
    a- Atrial fibrillation
    b- Atrial flutter
    c- Multiple ectopic beats
    d- Complete heart block
    e- Left bundle branch block

    A giant A wave in the jugular venous pulse are commonly seen in -
    a- Fallot’s tetralogy
    b- Tricuspid stenosis
    c- Constrictive pericarditis
    d- Systemic hypertension
    e- Pulmonary hypertension

    Pulmonary hypertension is a recognized complication of -
    a- Thrombo-embolic disease
    b- Polycythemia rubra vera
    c- Life at high altitude
    d- Chronic alveolar hypoventilation
    e- Patent ductus arteriosus

    Following might be a clue to the etiology of hypertension -
    a- His mother had eclampsia
    b- His father had gout
    c- A systolic murmur in the abdomen
    d- A history of haemoglobinuria aippg.com
    e- History of attack of muscular weakness

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