cardiac disease with highest mortalityin pregnant women?

Discussion in 'MRCP Forum' started by Pragati, Jun 15, 2006.

  1. Pragati

    Pragati Guest

    which cardiac disease among the following results in highest mortality in pregnant women?
    mitral stenosis
    aortic stenosis
    coarctation of aorta
    TAPVC
    EISSENMENGERS
    PULMONARY STENOSIS
    Sexual differentiation:
    A.The H-Y antigen is a plasma membrane protein.
    B.46XX may rarely have a male phenotype.
    C.Mullerian Inhibitor appears to have a local action on the side
    of the testis producing it.
    D.Androgens prevent development of the paramesonephric duct.
    E.Wolffian tissues respond only to dihydrotestosterone

    Kaposi’s sarcoma often manifests as

    (A) multiple blue dermal plaques

    (B) melanotic nodules

    (C) eczema

    (D) maculopapular rash
    (
    E) serum-filled bullae
    (A) Kaposi’s sarcoma often manifests as multiple blue dermal plaques. Lesion have two prominent features: accumulation of spindle cells and presence of vascular elements. Classical Kaposi’s sarcoma is an indolent disease of later life, and is much more common in men than women. Kaposi’s sarcoma in association with HIV infection is a much more aggressive disorder.
    For skin disease to considered occupational, the history should reveal all of the following EXCEPT


    (A) other workmen affected

    (B) no dermatitis

    (C) worsening eruption during weekend

    (D) list of chemicals contacted

    (E) reappearance on return to work

    C) The history should not reveal worsening eruption during the weekend. Allergy, diabetes, psoriasis, xeroderma, or seborrheic dermatitis may all be mistaken for occupational disorder. The list of possible occupational skin hazards is long. At times, a site visit to the work place is required to confirm the diagnosis.
    Skin manifestations associated with chronic ulcerative colitis include all of the following EXCEPT

    (A) maculopapular eruptions
    (B) erythema nodosum
    (C) pyoderma gangrenosum
    (D) erythema multiforme
    (E) necrobiosis lipoidica

    (E) Skin manifestations do not include necrobiosis lipoidica. Unlike the arthritis of ulcerative colitis, the dermatologic lesions respond to therapy to control the bowel disease. Necrobiosis lipoidica is associated with diabetes and the lesion is found on the anterior aspect of the leg
    Mycosis fungoides is best described as a

    (A) fungal infection of the epidermis
    (B) benign skin lesion
    (C) cutaneous lymphoma
    (D) dermatitis
    (E) form of eczema
    C) Mycosis fungoides is best described as a cutaneous lymphoma. Lesions may remain confined to the skin for years, and internal organ involvement occurs when the disease advances in to late stages. It is a disorder involving T lymphocytes. Treatment is usually palliative rather than curative.
    Following the appearance of the primary chancre, the serologic test for syphilis (STS) may remain negative for a period not longer than

    (A) one week
    (B) two weeks
    (C) one month
    (D) three months
    (E) six months
    The STS may remain negative for a period not longer than one month after the appearance of the primary chancre. The STS usually becomes positive about one week after the chancre appears. With therapy the chancre heals in a week.

    Characteristic of ringworm fungi as compared with other fungi is their

    (A) ability to digest and hydrolyze keratin

    (B) high degree of contagiousness

    (C) ability to invade the dermis

    (D) sensitivity to penicillin

    (E) ability to spread to other organs
    (A) The ability to digest and hydrolyze keratin as characteristic of ringworm fungi. As dermatophytes fluoresce, an ultraviolet light with a Wood’s filter may be used to identify infected hair. The spectrum of infection depends on the exact species, and can range from a few dull gray, broken-off hairs to a severely painful inflammatory mass. Host response is also an important factor.

    125. Verrucae (warts)

    (A) are viral in etiology

    (B) may be premalignant lesions

    (C) are found mainly in patients with a lymphoma

    (D) are contagious in children only

    (E) may be treated with griseofulvin

    A) Verrucae are viral in etiology. The human papillomavirus is a DNA-containing virus of the papovavirus group that includes animal tumor viruses. Although most warts are not felt to be premalignant, there is evidence to show that genital warts are correlated with malignancy.The cutaneous manifestations of protoporphyria are best treated with

    (
    A) phenobarbital
    (
    B) corticosteroids
    (
    C) high carbohydrate
    (
    D) beta-carotene
    (
    E) chloromazine
    t
    D) Beta-carotene increased the patient’s tolerance for sunlight, apparently by quenching active intermediates. Beta-carotene is an effective scavenger of free radicals. While many affected individuals can tolerate sun exposure while taking beta-carotene, it has no defect in porphyrin-heme synthesis
    The receptors for these hormones are intracellular


    (A) protein kinases

    (B) growth hormone/prolactin

    C) steroid hormones

    (D) acetylholine/GABA

    (E) LH/TSH/parathyroid
    C) Receptors for steroid hormones, thyroid hormones, and vitamin A are intracellular. Disease states due to abnormal intracellular receptors include testicular feminization, cortisol resistance, vitamin D-dependent rickets, type II thyroid hormone resistance, and pseudohypoaldosteronism. There are several different types of cell membrane receptors

    All of the following are characteristics of panhypopituitarism EXCEPT


    (A) occurrence of myxedema

    (B) decreased melanin pigmentation

    (C) emaciation and cachexia

    (D) loss of axillary and pubic hairs

    (E) moderate norocytic and normochromic anemia

    C) Patients with panhypopituitarism are found to have a normal distribution of body weight and are rarely cachectic or even undernourished. Patients with pituitary tumors present with symptoms of a mass, or either hyperfunction or hypofuction or both.





    Signs of cerebral compression are all except –

    (a) Bradycardia

    (b) Hypotension

    (c) Papilloedema

    (d) Vomiting
    raised intracranial pressure headache


    The characteristic features of the headache in raised intracranial pressure are:

    generalised ache over cranium
    worst on awakening - the brain is relatively poorly supplied by oxygen as a result of hypoventilation during the sleeping hours
    may awaken patient from sleep
    aggravated by bending, stooping
    severity gradually progresses
    The headache is associated with:

    nausea and vomiting
    obscurations - transient loss of vision - with sudden change in posture; indicates markedly elevated intracranial pressure
    eventually, impaired conscious level
    Investigation should be with a CT scan.
    type 1 diabetic on insulin therapy taking both regular insulin and PHI
    8am 16:30pm
    Regular 4U 8U
    PHI 24U 10 U
    Hypoglycemia at 15:30pm. What to do?
    -decrease PHI at 8 am
    -Substitute PHI with ultra lente
    -Reduce the dosage of regular insulin

    A WOMEN WITH UNTREATED DM HAS GFR=120ml/min;PLASMA GLUCOSE=600mg/dl;URINE GLUCOSE=3000mg/dl;URINE FLOW RATE=4ml/min;REAABSORPTION RATE OF GLUCOSE IS -

    A. 720mg/min
    B.600mg/min 8O
    C.120mg/min
    D.180mg/min :
    Thrombophlebitis is seen in –

    (a) Carcinoma ovary

    (b) Carcinoma breast

    (c) Carcinoma testes

    (d) Carcinoma stomach


    Q1. Depression is associated with which of the following sleep patterns
    -decreased REM latency
    -decreased REM normal NREM
    -decreased stage 2 NREM
    -decreased stage 4 NREM
    - decreased latency REM and decreased 4 stage sleep

    Q2.What is the defense mechanism of bipolar personality disorder -Splitting

    Q3.Which one of these constitute a part of mature ego defence mechanism -Humour

    Q4. What is the drug interaction of St-John`s wort with SSRI
    -serotonin syndrome
    -

    Q5. An aged female with history of depression for two months comes to psychiatrist. She admits using St John’s Wort 300 mg for last 1 week in consultation with a naturopath. What should be done?
    -Stop using St John’s Wort and add Sertraline
    -Increase dosage of St John’s Wort to 1800 mg
    -Coadminister St John’s wort at reduced dosage of 50% with Sertraline for its safe
    -give paxel

    Q6. Pt is on Lithium therapy becomes hypothyroid. What is the treatment?
    -Reduce dose of lithium to 50%
    -Start levothyroxine
    -Stop lithium

    Q7. Pt on Lithium therapy became weak, lethargic, and Intolerant to heat. What Investigation must be done?
    -Lithium level
    -Monitor TSH level

    Q8. In Autistic disorder choose the best option
    -More common in girls
    -Autosomal recessive
    -
    Q9. Handwashing ritual in 11 years old. Mother is very worried and does not treatment with any medication. Which one is the best option? which psychotherapy?
    -Cognitive behavioral therapy /behavioural therapy
    -Family therapy.
    -biofeed-back
    -psychodynamic psychotherapy
    -relaxation therapy

    Q10. Which of the drugs cause amnesia the most?
    -Triazolam
    -Diazepam
    -phenytoin
    -Imipramine

    Q11. A person is brought into the police station found wandering aimlessly and he is unable to tell his name or any other personal information regarding time and place. Which of the following would not be part of your d/d?
    -Malingering
    -temporal lobe epilepsy
    -dissociative fugue
    -dissociative amnesia (amnestic disorder)
    -factitious disorder

    Q12. Which is not a part of normal grief reaction?
    -physical symptoms
    -preoccupation with suicide
    -hearing voices
    -consider himself responsible

    Q13. Anti-depressant treatment should be carried on for how many months?
    -2weeks
    -6weeks
    -2years
    -indefinite time

    Q14. Paranoia is not seen in
    -pernicious anemia
    -hypothyroidism
    -mania

    Q15. Which is true regarding suicide in adolescent?
    -More common in summer
    -Attempt to suicide is more common in F than in M.
    -More common in M, ratio 4:1
    -Suicide M:F=10:1 (checked)

    Q16. question on Ego dystonic and Ego syntonic
    (NB. Dystonic = OC Disorder D is for D, Syntonic = OC Personality)

    Q17. 8 weeks pregnant patient with depression on Sertraline wants to stop medication. What will you do?
    -do a detailed physical and mental examination
    -continue antidepressant
    -substitute another
    -lower the dosage

    Q18. CBT -goal of therapy should be directed

    Q19. BPD -Valproic acid

    Q20. clozapine -CBC

    Q21. Symptoms of depression improved but mild -continue and inc. the dose of flu.

    Q22. A patient with schizophrenia & is on treatment. He can not sit still (akathisia symptoms). What is the best treatment?
    -Lorazepam

    Q23. Dystonia
    -More common in young male (checked)
    -more common in female

    Q24. 6 yr old child with seizure then followed by paralysis of arm along with confusion
    -post ictal Todd’s paralysis

    Q25. Characteristics of panic attacks-
    -episodic and symptoms increase in intensity
    -trigger

    Q26. TCA side effect -hypotension

    Q27. Differentiation b/w Alz. N pseudodementia -MMSE

    Q28. Loosening of association A/W
    -schizophrenia
    -mania

    Q29 Somatoform disorder- multiple somatic symptoms

    Q30. Psycho stimulants are used in which of the following disorders?
    - Attention deficit hyperactivity disorder
    -Tic disorder
    -childhood schizophrenia

    Q31. Child adopted. Does not show stranger anxiety and goes off with strangers

    Q32. F, 37 years has problems at work for several months, she also has episodes of hyperactivity & euphoria. These were preceded by episodes of sadness & inability to cooperate with her colleagues in spite trying hard to do her best. What is the diagnosis?
    -Bipolar disorder
    -Dysthymia
    -Cyclothimia
    -Masked depression
    -Factitious disorder

    Q33. Anorexia Nervosa A/E
    -Bradycardia
    -hypertension
    -mediastinal air
    -atrophic breast
    -dental crown

    Q34. What is Delusion?
    -a persistent belief contradicting
    -a fixed thought

    Q35. Among antipsychotics what is correct?
    -Haloperidol-
    -Olanzapine properties
    -Risperidone causes prolactinemia and increases sexual activity
    -clozapine properties

    Q36. 17yr old girl comes with depression. She is treated with Sertraline. Then she admits abusing amphetamine. What should be done-
    -Stop Setrtraline and give paxel
    -Give written instructions about amphetamine abuse
    -Inform family

    Q37. Pt on carbamazepine with new onset seizures, 3 attacks in last 2 weeks. Serum level of Carbamazepine is normal. What to do?
    -CT scan and EEG
    -Give another agent- phenytoin

    Q38. 32 yrs old pt presented with decreased concentration, slowness of thinking apathy, socially withdrawn, short term memory loss with difficulty in learning new information then developed seizure. What is the diagnosis?
    -AIDS-dementia complex
    -Alzheimer’s disease

    Q39. Tardive diskinesia features on haloperidol DOC- clozapin

    Q40. Schizophrenia is most commonly associated to
    -monozygotic twins
    -dizygotic twins
    -siblings
    -family history

    Q41. A man admitted for operation present with confusion on the 5th post-Op day. Which one is a feature of delirium?
    -Depressed mood, preoccupation with suicide.
    -thinks himself the best person and should be shifted to the best ward
    -Is upset with shadows and constantly asks what time it is
    -Thinks of buying everybody a jacket

    Q42. Case of drug addiction with rhinorrhea, tearing, tachycardia, dilated pupils & high BP. Most likely cause is:
    -Cocaine
    -LSD
    -Heroin
    -opiod withdrawl
    -Barbiturates

    Q43. Child 9 years old studying in kindergarten is unable to read, write or even to color a picture. He becomes happy when he answers simple questions. What is your diagnosis?
    -Autism
    -Mental retardation
    -Specific learning disability
    -ADHD

    Q44. Paranoid ideations in substance abuse, what is the drug- choices I dnt remember

    Q45. A child having problem with words, cannot distinguish between turn and over. Also causes frequent grammer errors. What is the diagnosis?
    -Language disorder

    Q46. A 9yr old child eats glue, pencils etc. teacher controlled his behaviour by placing vegetables on his table he started eating that, this is an example of?
    -ODD
    -conduct disorder
    -autism
    -ADHD


    POPULATION HEALTH & ETHICS


    Q47. Drug compliance can be increased by
    -alcoholism
    -more no of drugs for t/t
    -fear of doctor
    -social problem

    Q 48. 59 year old female for PHE. What will you advice
    -self examination of breast
    -Bone scan

    Q 49. Which of the following has extra human host- pinworm

    Q 50. Question on higher socio-economic condition and effect on health care system

    Q51. A patient with history of occupational exposure 20 years back now presents for 6 months with cough and weight loss. CXR shows fibrosis of upper lobes. What is the diagnosis?
    -Tuberculosis
    -mesothelioma
    -rapidly progressive silicosis

    Q52. Which of the following CA is caused by vinyl chloride?
    -Lung CA
    -Esophagus CA
    -pharyngeal CA
    -Liver CA
    -Bladder CA

    Q53. What is the best way to appreciate health care quality during pregnancy and delivery in Canada?
    -Neonatal mortality rate
    -Perinatal mortality rate
    -Infant mortality rate
    -Maternal mortality rate

    Q54. Maximum radiation exposure takes from?
    -Nuclear fallout
    -natural background
    -nuclear reactor
    -X-ray
    -uranium mine

    Q55. In surveillance in worker for radiation hazard best will be
    -Annual PE.
    -Total body radiation count
    -CBC every 6 months
    -Chest X ray yearly
    -eye examination for cataract yearly

    Q56. All of the following foods can cause cancer except
    -Monosodium glutamate
    -fat
    -alcohol
    -smoking

    Q57. Ethics question- a man suspects to be having probable gonorrhea. His wife works in lab. He doesn’t want her to know his specimen. What to do.
    -ask him to tell his wife
    -put a code no. on the sample, not his name.
    -Don’t listen to him and straight inform his wife
    -send him to another clinic

    Q58. Rehabilitation after a car MVA means:
    - primary prevention
    - secondary prevention
    - tertiary prevention

    Q59. Occupational hearing loss is characterized by
    - worst at high frequencies
    -worst at low frequencies
    -progressive even if exposure stopped

    Q60. ONE of the following statements is wrong
    -A layer of ozone develops near a photocopying machine in closed area
    -Ice skating rink contains higher concentration of NO2 ??? was this choice here? Or was that a separate question?

    Q61. Proper disposal of waste- what is the best and most efficient way to reduce lead poisoning?
    -wash the hands thoroughly every time they eat.
    -use disposable outfit
    -wear masks

    Q62.Greatest affect on mortality -accidents

    Q63. MC cause of peri-natal mortality - prematurity (checked)

    Q64.Regarding Pancreatic cancer, which of the following is not a risk factor
    -caffeine
    -pancreatitis
    -alcohol

    Q65. Clinical scenario on silicosis. Progression of symptoms for the last 6 months to 1 year. X Ray shows upper lobe fibrosis. Past history of silica exposure 20 years back.
    -mesothelioma
    -pulmonary tuberculosis
    -rapid progression of silicosis of lung

    Q66. Old man with CVA requires CPR. Terminally ill. No written will. Family wants full support. What to do in case of withdrawing support?
    -apply rules and laws regarding euthanasia

    Q67. In periodic health checkup, a 55 yr old has come for a yearly checkup and has no complaints. What should you advice?
    -check urine glucose
    -check occult blood test

    Q68. The most important cause of increased complications of measles in developing countries
    -Inadequate immunization
    -Inadequate nutrition

    Q69. Young patient with vegetative state, no relatives, and patient is suffering from a terminal illness no chance of recovery. According to what you decide not to pull off the ventilator? Age, coma

    Q70. Death certificate, alcoholic, pleural effusion and died of acute respiratory failure, what is the cause of death
    -respiratory failure
    -pleural effusion
    -alcohol
    -cardiac arrest

    Q71. Mother goes for checkup. She mentions she is against her adolescent daughter’s wishes and sternly told her not to use OCP when her daughter wanted to use them. She thinks that will help her grow promiscuous. Hearing this what should the physician do?
    -Inform the mother that sexual activity in this age group is normal
    -privately give OCPs to the girl without the mother’s knowledge
    -

    Q72. Which is the least cause of HIV infection?
    -Homosexuality
    -heterosexuality
    -Prostitution
    -Drug abuse (1999)
    -Blood transfusion (1988)

    Q73. You gave a new drug to your patients with dementia. A new effect was noted. Those suffering from multi infarct dementia improved while that with Alzheimer’s not. What should you do before prescribing this-
    -inform pharmaceutical company about possible indication of use
    -can use it in this new indication and it shows advantages
    -

    Q74. In which of the following food does botulism more common?
    -freeze packaging
    -vacuum packaging

    Q75. All are transmitted feco-orally EXCEPT:
    -HAV
    -EBV
    -Norwalk virus
    -Polio virus

    Q76. All are true regarding criteria for organ transplantation except
    -Absence of all spinal reflexes
    -Absent corneal reflex
    -Absent pharyngeal reflex

    Q77. Risk assessment can be done by
    -cohort study
    -case control study
    -none of the above

    Q78. Diabetic patient with gangrene foot refused amputate. What should the doctor do?
    -Force the patient undergo amputation
    -use other means to prevent sepsis

    Q79. Question on case control study
    Q80. Prophylaxis of contacts of meningococcus- Rifampicin

    Q81..Define health promotion -control over health

    Q82. 45 year old male on beta blocker therapy works with wood cutting machines. Hand cyanosis occurs with working tools
    -give information about occupational hazard

    Q83. Competency of patient. Incompetent when?
    -if don’t know the nature of assets
    -spends more than he earns
    -suffers from a mental disease

    Q84. Doctors note to employer regarding illness of employee. What should physician not write?
    -the diagnosis
    -make recommendations at work place
    -make a note on restriction of activity
    -give an idea of probable duration of illness

    Q86. What about smoking prevention? Question incomplete

    Q87.What measures have greatly reduced the complications of caustic ingestion in children?
    -Cartons are made tamper proof
    -esophagoscopy and early management of scars


    MEDICINE

    Q88. Elderly female on Tamoxifen therapy for advanced CA breast with bone mets. Became thirsty and increased urination, disoriented, nausea and vomiting, confused and agitated
    -Hypercalcemia
    -brain metastasis

    Q89. Mother notices her 11 year old girls walks drooping on right side. What is the diagnosis?
    -idiopathic scoliosis

    Q90. Case of Peanut anaphylaxis. Child with urticaria and severe attack of dyspnea with facial edema. What is your management?
    -Cortisol I.V
    -Epinephrine SC or IM
    -Intubation
    -Antihistamine H1 & H2

    Q91. What happens in Organophosphate poisoning -cholinestrase inhibition

    Q92.question incomplete Vitamin b12 ---- cbc GIVEN SHOWING PANCYTOPENIA

    Q93. M. 42 years with dark skin, palpable liver. Father died of cirrhosis. Diagnosis ?
    -Wilson disease -Hemochromatsis

    Q94. 50 F years with recent operation presented with heavy wound bleeding, she gives you history of massive bleeding when she had a tooth extraction, what will you find?
    -Increased PTT + Increased BT
    -Increased PTT + decreased BT
    -Normal PTT + Increased BT (Vwd------ increase BT)

    Q95. vWD management-DDAVP

    Q96. Female 60 years old with constipation for many months, she has not passed stools for the last 3 days. On examination the abdomen is distended but non tender. What is your management ?
    -Laxative
    -High fiber diet
    -Mineral oil
    -Enema

    Q97. Huntington disease inheritance. Paternal grandmother died of it. Paternal uncle all had. Father died of accident at 35 yrs of age. What are the chances the person will have the disease (Symptoms arising from a typical presentation of HD usually do not develop until a person is aged 35 years or older!)
    -50%
    -100%
    -0%
    -25%

    Q98. A couple comes for counseling. Brother of the lady has the disease- Achondroplasia. What are the chances the offspring will have the disease
    -25%
    -50%
    -100%

    Q99. Which has the best prognosis among skin cancers?
    -Basal cell carcinoma
    -malignant melanoma
    -junctional naevus

    Q100. Question on old age risk factor on living alone, regular tx visits osteoporosis, which factor is the most risk for fractures? question incomplete

    Q101. Clinical scenario with BP low, CVP low, and PCWP=4. What is the management?
    -give ringers lactate
    -give inotrope

    Q 102. Multiple black warty lesions on the back with stuck on appearance
    -Seb keratosis
    -melanoma

    Q103. Clinical scene with H/O syncope, B.P=110/90. Systolic murmur to carotid
    -Aortic stenosis
    -Aortic sclerosis
    -AR
    -MR

    Q104. Management of DVT
    -give heparin
    -give warfarin
    -IVC filter

    Q105. Diabetic with sudden heaviness of left arm and face(jaw). What needs to be done immediately?
    -ECG
    -CT scan

    Q106. question on chronic stable angina- heparin

    Q107. Case of occipital headache- no loss of consciousness and dilatation of right pupil. What is the diagnosis?
    -basillar migraine
    -atlanto occipital joint affection

    Q108. Portal hypertension with variceal bleeding and hypotension. What to do? -vasopressin

    Q109. Desensitisation is useful in which of the following?
    -Isolated allergy to cats
    -food allergy
    -asthma

    Q 110. Acute asthma not given
    -antibiotic
    -sodium cromolyn
    -theophylline
    -salmeterol
    -steroid

    Q 111 Pica,constip, cramps -lead poisoning

    Q112. Pyelonephritis causative organism -E.coli

    Q113. Lung abcess t/t - cloxacillin

    Q114. Features of mycoplasma 20y old with fever with history of non productive cough but clinically well .. C-X ray shows bilateral basal Infiltration. Drug of Choice?
    -Erythromycin

    Q115. Cerebellar signs- nystagmus

    Q116. Signs of lacunar infarct-
    UM signs- clonus and Babinski
    LM signs- fasciculations

    Q117. Non obese patient feels drowsy in the morning. Wife complains of snoring at night and waking up many times (features consistent with Sleep apnea syndrome)
    -sleep study and pulse oximetry 9polysomnography)
    -ENT consultation

    Q118. Rheumatoid arthritis patient develops sudden pain and swelling left calf and ankle. Thigh is normal. Cause?
    -DVT
    -Rupture of popliteal cyst

    Q119. Which of following is the most important for preventing CVA?
    -Hypertension control
    -smoking cessation
    -lipid lowering agent
    -aspirin

    Q120. A group of people returning from Rocky Mountains developed diarrhea. Cause
    -Rocky Mountain spotted fever
    -giardiasis

    Q121. Dull on percussion -Pleural effusion
    Q122. An alcoholic man presented to ER poor controlled diabetes. Urine ketone negative. Blood values- HCO3 very low. serum osmolaity 307.
    -Lactic acidosis
    -Methanol poisoning
    -ketoacidosis
    -nonketotic hyperosmolar

    Q123. Drug of choice for obese diabetic type 2
    -Acarbose
    -metformin
    -troglitazone
    -Glyburide

    Q124. A type 1 diabetic on insulin therapy taking both regular insulin and PHI
    8am 16:30pm
    Regular 4U 8U
    PHI 24U 10 U
    Hypoglycemia at 15:30pm. What to do?
    -decrease PHI at 8 am
    -Substitute PHI with ultra lente
    -Reduce the dosage of regular insulin

    Q125. Which of the following is true regarding Chromoglycate ?
    -Contraindicated with steroids
    -Necessary in acute attack of asthma
    -Prevent binding of IgE with cells
    -Prevents histamin from synthesized cells

    Q126. What are the beneficial effects with cromolyn
    -helps in reducing the dosage of steroids

    Q127. Definitive test for chronic pancreatitis is
    -CT
    -ERCP
    -MRI

    Q128. A 74 yr old male with platelet count of 350,000 to 400,000. What to do?
    -ASA
    -Warfarin

    Q129. After airplane travel complains vertigo, tinnitus, moderate hearing loss snhl, is hypertensive, Diagnosis?
    -Miners disease
    -Acoustic neuroma
    -Barotaruma
    -Meniere’s ds

    Q130. Nomocytic anemia -not seen improvement wit vit.b12

    Q131. Clinical scenario of pseudogout –NSAID

    Q132. Osteoarthritis
    -Acetaminophen
    -ASA
    -celecoxib

    Q133. Facial edema, increase JVP, plethora inv (consistent with SVC syndrome) -CXR(not sure)

    Q134. Not seen with Solvents -Pulmonary fibrosis(checked)

    Q135. M. 72 years present with one year history of Cough n pulmonary infiltrate X Ray shows middle lobe infiltration of the lung. Diagnosis?
    -abscess
    -aspiration
    -Bronchiectasis
    -chronic bronchitis

    Q136. question on anion gap. Values of sodium, bicarbonate and chloride given. Na – (HCO3+Cl)= AG
    -20
    -25

    Q137. Old man with chronic bronchitis, known smoker, stays alone. Recent aggravation of cough. Having asterixis
    -CO2 narcosis
    -hepatic encephalopathy
    -uremia


    PEDIATRICS

    Q138. Child 6 years old brought by his mother with otitis media then hepatosplenomegaly and lymphadenopathy at all sites along with fever. His blood investigation showed Hb=85g/l, and low platelets. The family history is noncontributory. Diagnosis
    -Acute leukemia
    -Infectious mononucleosis
    -Kawasaki disease

    Q139. which of the following is not used in JRA?
    -methotrexate
    -steroids
    -physiotherapy
    -multivitamins
    -analgesics

    Q140. Mother worried about her child because of history of myopathy in family. What Investigation to be done 1st ?
    -CPK
    -Muscle biopsy
    -Nerve biopsy
    -EMG

    Q141. 3 yr old child presents with stridor and drooling features of Epiglottitis. Management?
    -intubation
    -antibiotics
    -tracheostomy
    -xray

    Q142. Newborn with small head, small palpebral fissure, small philtrium & small eyes & flattened meat facial area. Diagnosis?
    -Fetal alcohol synd.
    -coccaine
    -intrauterine infection

    Q143.child born with petechiae, hearing loss and intracranial calcification-
    -congenital viral infection CMV

    Q144. A child 3 years has BP 138/95. He has a systolic murmur right 2nd space, femoral pulse not palpable. Born premature. Diagnosis?
    -coarctation
    -PDA

    Q145. 4 years African boy on trimethoprim/sulfamethoxazole for tonsillitis presented with Jaundice , Investigations : Hb. 9.8 gm % , reticulocytes count 8 %. what is the most likely diagnosis ?
    -Sickle cell anemia
    -Thalassemia
    -Spherocytosis
    -G6PD deficiency

    Q146. I am not sure this was there!!!!
    A 9-year-old boy has been referred to you for evaluation of bedwetting. He is dry during the day but wets every night. His physical examination and urinalysis are normal. Which one of the following is the most appropriate method for managing this child?
    -An alarm system that rings when the bed gets wet and teaches the child to respond to
    bladder sensations at night.
    -desmopressin (DDAVP)
    -psychiatric counseling before all

    Q147. Child 8-11yrs old with bitemporal hemianopia. Diagnosis
    -Craniopharyngoma

    Q148. Asymptomatic girl, 2/6 systolic murmur on pulmonary, fixed splitting of S2
    -ASD

    Q149. Growth delay. Which one is of less importance?
    -H/O parents growth
    -

    Q150. Baby 2 or 4 months of age. Microcytic hypochromic anemia. What is the cause?
    -Breast feed only
    -mother did not take adequate iron supplementation during pregnancy.
    -Prematurity

    Q151. What is true regarding congenital pyloric stenosis?
    -Commonly present at 3 months
    -Associated with metabolic acidosis due to vomiting
    -Visible peristalsis is seen in abdomen

    Q152. A child presented with fever & small white lesion on the mucous membrane of the mouth followed by generalized macul0-papular rash. What is the management?
    -Give ASA to decrease fever
    -Give gamma Immunoglobulin.
    -Notify the public health unit
    -Isolation of the family member
    -acyclovir

    Q153.1 week passing hard stool every 2-3 day
    - tell the way to relieve colic.
    -rectal biopsy
    -sweat chloride test
    Q154. 4month old-------- check weight and height charts

    Q155. A baby with birth wt.3.5kg now 4 weeks weighs 3.6 kg. Mother worried not drinking enough milk. What will you advise?
    -Tell her that nothing to worry, as some kids don’t gain much weight in the first month
    -start formula feeding
    -investigate the kid

    Q156. Homeless mother with one month child ------ assess the wt change in one month

    Q157. Baby`s development milestone not correct
    -4 month not rolling
    -no social smile at 2 months

    Q158. Baby normal after birth. When feeding started, immediate choking and aspiration
    -Esophageal atresia

    Q159. Symptoms of meningitis------ Streptococcus pneumonae

    Q160. Baby cyanosed after birth no improvement with oxygen. PaO2=27mmHg. What is the diagnosis?
    -TOGV
    -VSD

    Q161. Which one of the following is not indicative of sexual abuse in a child?
    -Gonorrhea culture
    -HSV
    -HPV
    -vaginal hematoma
    -vulvar laceration

    Q162. Impetigo in child
    -oral TMP
    -oral penicillin
    -cefuroxime

    Q163. Baby with PDA
    -continuous murmur

    Q164. Case of infectious mono

    Q165. Celiac disease ideal diet - rice and corn flour

    Q166. All the following neonates are prone to hypoglycemia EXCEPT:
    -IUGR
    -Diabetic mother
    -Normal infant born at 36 wks
    -Hypothermia
    -Non of the above

    Q167. What is true about 11 y.o weight>120% of ideal?
    -Hypotension
    -Exercise, increase physical activity (checked from T.N.)
    -High density lipoproteins is increased
    -endocrinologist referral
    -diet reduced to 30% less calories

    Q168. A child with acute otitis media. Treated with antibiotics. 2 episodes in last 3 months. What to do?
    -another course of antibiotics broad spectrum
    -myringostomy with insertion of vent
    -myringoplasty

    Q169. A child with pyloric stenosis. What is correct regarding his condition?
    - it peaks at 3 months of age
    -visible peristalsis
    -x-ray should be done
    -develop metabolic acidosis

    Q170. 3month infant anemia cause - Prematurity

    Q171. Hearing deficit in newborn not associated with -delayed speech in sibling

    Q172. In bleeding from vitamin K deficiency in newborn which investigation is helpful?
    -P TIME / INR,
    -APTT
    -Bleeding Time


    OBS & GYN

    Q173. A 19 yr old at 10 week of gestation comes with complaint of intractable vomiting for one week.most appropriate investigation will be?
    -beta-hcg
    -serum electrolytes
    -Blood Glucose
    -NST

    Q174. Which one of these is a/w human papilloma virus?
    -Condyloma acuminate
    -Condyloma lata
    -umbilicated lesion

    Q175. Labour pain in 36 weeks primi. P/V reveals long cervix. Appropriate management will be
    -give diazepam
    -give morphine
    -give epidural
    -observe and reassure

    Q176. Lady after a prolonged labor she delivered a 4 kg baby. She is not able to urinate. Diagnosis?
    -Urethral trauma
    -Maternal dehydration
    -Uterine atony
    -Bladder atony

    Q177. varicella-----immunise and advice contraception for 3 mnths

    Q178. 19 week gestation delivery, cervix open. Product extruded is of weight 300gms with normal features. -incomptent cervix

    Q179. Pap smear showing atypia. Patient asymptomatic. No clearcut lesion visible. What will be the next step?
    -repeat pap smear in 3-6 months
    -colposcopy directed biopsy

    Q180. When to give antibiotics in CS
    -1 hr before
    -after delivery of baby
    -after separation of cord

    Q181. Pap smear collection method -Rotate spatula 360 degrees

    Q182. NO flow with estrogen n prog. Challenge -Asherman syndrome

    Q183. TSS -cervico vaginal secretion and cloxacillin

    Q184. Oligohydrmnios is seen in -RENAL agensis

    Q185. What is not recommended screening test in pregnancy?
    - routine urine culture is not necessary during 2nd trimester (?)

    Q186. Foul smelling vaginal discharge
    -Candida
    -Bacterial vaginosis

    Q187. What`s the most worrisome in 42w gestation?
    -Non reactive NST (?)
    -decreased fetal movement
    -polyhydramnios

    Q188. Type1 DM-Gestational DM, drug contraindicated - Clorpropamide

    Q189. HRT in 60 year old. Regular menses for 10 years. Then for 3 months amenorrhea.
    -reassure
    -Do endometrial biopsy
    -increase the progesterone component

    Q190. On HRT. Does not know whether menopausal. What to do?
    -Stop HRT and measure FSH and LH
    -give estrogen and progestrerone challenge

    Q191. Cervix at the level of vaginal introitus in a 60 year ols. Rectocele+cystocele. Treatment?
    -Abdominal hysterectomy
    -Vaginal hysterectomy
    -pelvic sling

    Q192. With copper T increased chances of infection in which of the following
    -Nullipara
    -promiscuous
    -PID

    Q193. Post op pt of hysterectomy. POD 7. CXR showing multiple cavities- Aspiration. Treatment
    -metronidazole
    -clindamycin

    Q194. Brow presentation, management?
    -Caesarian section
    -vaginal delivery if anterior brow

    Q195. 8cm ,Simple ovary cyst in a 58 y.o women. Management?

    Q196. Mg sulfate to mother, what not checked
    -serum creatinine
    -knee jerk
    -liver enzymes
    -respiratory rate

    Q197. Pregnancy of 12 weeks. Uterus at level of umbilicus. Beta HCG 68000. No gestyational sac in uterus. What is the management
    -suction curettage
    -hysterectomy
    -hysterotomy
    -extraamniotic instillation
    -methotrexate

    Q198. H/O anencephaly folic acid dose
    - 4mg -1mg

    Q199. G2P0 Rh immunization, previous abortion
    -serial monthly Ab titres and serial amniocentesis
    -give Rhogam

    Q200. Vaginal lubrication on sexual stimulation occurs due to increased secretion from
    -Skenes gland
    -Bartholins gland
    -Vaginal gland
    -vaginal transduate

    Q201. 18yr F posted for surgery. She was given 8 ml of lidocaine 1% and diazepam for the procedure. After surgery collapses, HR=45/min, BP=80/60mmHg. What is the diagnosis?
    -Vasovagal shock due to hypovolemia
    -diazepam allergy
    -lidocaine toxicity

    Q202.Which of the following is normally seen in pregnancy- fetal heart sound auscultation at 22 weeks

    Q203. Endometrosis diagnosed by
    -Laparoscopy
    -US

    Q204. Female with incontinence with hissing sound of tap water and during straining while laughing or sneezing
    -Stress incontinence
    -detrusor instability

    Q205. Ovarian cyst in pregnancy of 8 weeks of 6 cm in size. What to do?
    -laparotomy
    -observation

    Q206. Pruritus and erythematous lesion on vulva with satellite lesions over the medial aspect of thigh and inguinal fold. what is the predisposing disease ?
    -DM
    -CA. vulva (vulvar intraepithelial neoplasia)
    -Lichen sclerosis
    -pubic lice

    Q207. PID A/E
    -pain adenexa
    - no mass? (not sure bcz everysymp.was there)

    Q208. what about 4 degree perineal tear? Question incomplete

    Q209. After vaginal delivery episiotomy wound gaping. How will you manage
    -resuture with absorbable suture
    -parenteral antibiotic and sitz bath and topical application with repair at later date
    -topical antibiotic only with sitz bath

    Q210. .A lady whose mother had osteoporosis wants prophylaxis for osteoporosis what to give?
    -Vitamin D and calcium
    -Exercise
    -Analgesics
    -Vitamins
    -Estrogen

    SURGERY

    Q211. A pt. with multiple rib fracture is agitated and not allowing doing any examination in ER. What is the immediate management?
    -Diazepam
    -analgesic to ribs
    -haloperidol
    -morphine
    -oxygen

    Q212. RTA # pelvis, prostate not palpable on DRE. Diagnosis?
    -extraperitoneal urethera rupture
    -bladder rupture
    -pelvic haematoma

    Q213. Pelvis #. Blood in meatus, cannot pass urine, what to do
    -pass foley catheter
    -suprapubic cystostomy

    Q214. Nasal intonation in voice of a 5yr old child due to
    -nasal turbinate hypertrophy
    -Hard palate defect
    -a/w Cervical LN swelling
    -thyroid enlargement

    Q215. Man suffered electrocution due to electric pole contact. Patient is unconscious and clinging to the electric wire. What to do?
    -Start CPR
    -use special insulating protective gloves and extricate the patient
    -switch off the power supply and then resuscitate

    Q216. A patient sustained electrical burn and comes to your clinic. O/E a burn area 2cm by 6 cm is noted in the forearm with fingers affected. What should be the next appropriate step?
    -Do ECG and if found normal then discharge and advise pt for followup
    -Do cardiac enzyme test
    -Admit the patient and monitor ECG for 24 hrs
    -Admit the patient and do ECG 3 times
    -ECG must be monitored for three days

    Q217. Pt. With frost bit, best treatment is:
    -Put hands in warm water 38-40 degrees for 30 min.
    -IV antibiotics
    -Escharectomy
    -Debridment
    -fasciatomy

    Q218. Post operative case of CA breast with modified mastectomy done and pt presently on Tamoxifen therapy. Which screening will be ideal for screening recurrence?
    -mammography
    -Chest X-ray
    -Bone scan

    Q219. Effects of Vasectomy (question incomplete)
    - Impossible to reverse fertility after 2 years
    -No affect on BP

    Q220. Fitula-in –ano due to
    -Ischi-rectal Abcess
    -anal fissure

    Q221. Pt. bleeding during defecation painful not allow exam
    -Thrombosed external piles
    -anal fissure

    Q222. After # in forearm manipulation and plaster cast done. Patient develops pain on passive extension. Diagnosis
    -Compartment syndrome

    Q223. What is the most appropriate measure in clostridial prevention in wounds?
    -Radical debridement of wound
    -antibiotic
    -give anti serum
    -oxygen

    Q224. Ankle joint injury with laceration, no distal pulsations on Examination Pain Management?
    -Debride
    -Manipulate and feel for pulse
    -apply splint and immobilize

    Q225. A case of large cervical LN 3cm3cm of rubbery consistency in the lateral aspect of neck. What will be your next step?
    -Abdominal US
    -Excisional biopsy
    -FNAC

    Q226. 50y haematuria,mass in kidney with inc. blood supply-RCC

    Q227. What is the condition most commonly mistaken for Appendicitis in children
    -mesenteric lymphadenitis
    -Meckels diverticulum

    Q228. most common indication for surgery in stone---- severe ureter colic (not sure) urosepsis?

    Q229. Flank pain. In IVU, calyses are seen blunted. Dye excretion is delayed in the affected kidney. 2-3cm stone is seen in the pelvis in the lower 1/3rd of the ureter. What to do?
    -analgesics and hydration
    -lithotripsy
    -percutaneous stone removal
    -Remove the stone by retrograde cystoscopy

    Q230. 65 years obese Pt. complains of repeated attacks of strong & sudden mid abdominal pain radiating to Lt. flank with pallor and diaphoresis with asymptomatic perios inbetween. what is your diagnosis ?
    -Acute pancreatitis
    -Cholecystitis
    -Ureteral stone
    -Mesenteric Ischemia
    -Rupture of AAA

    Q231. 74y old underwent TURP. Specimen shows low grade carcinoma in 5% of the specimen
    -observation
    -Radical protratectomy
    -hormone therapy
    -radiation
    (checked T.N. old age if T1- then observe)

    Q232. Prostate a1 adenocar.------ RT+PROSTECTOMY

    Q233. H/O prostate cancer showing nodule----- USG guided biopsy

    Q234. Man 56 years. Father died of prostate ca. o/e a small nodule right lobe. PSA= 2.2. What advice
    -follow up in 6 months DRE and PSA
    -follow up in 3 months PSA
    -us guided Biopsy now

    Q235. Old lady with ankle edema at the right medial malleulus, with superficial ulcer & surrounding scar. Diagnosis. ?
    -Arterial insufficiency
    -perforator incompetence

    Q236. Stasis ulcer causing pigmentary changes. What is the treatment?
    -pnuematic stocking
    - stripping saphenous vein

    Q237. Pneumothrax-------------Chest tube

    Q238. In Femoral hernia what is common?
    -gut obstruction
    -medial and above the inguinal ligament

    Q239. Welding burn management 2nd degree in the upper limb, what do u do ?
    -Debrid & skin graft.
    -Debrid puncture blisters & bandage with topic cream
    -Leave the wound open & systemic antibiotic

    Q240. Breast ca operated, used ASA, bleeding, what to do
    -platelet transfusion
    -give desmopressin

    Q241. A 70-yr. old man complaining of pain in his mouth. You examine him and he has a flat ulcer on the gum of the lower jaw, near the molar teeth area. He tills you that his denture has recently become loose and ill fitting. What is the diagnosis?
    -traumatic ulcer
    -ulcerating carcinoma of the buccal mucosa

    Q242. Post-op pt continued to bleed despite 10 units of stored blood transfusion.
    What is the cause of the continued bleeding?
    -Dilutional thrombocytopenia
    -Hypercalcemia
    -Hyperkalemia

    Q243. Young man came with history of automobile accident, multiple anterior chest FRACTURE and hoarseness, chest x-ray shows widened mediastinum, what’s your immediate management?
    -Pericardiocentesis
    -Support the anterior chest fracture
    -Intubation
    -Aortic angiogram

    Q244. 35yr old female suffering from LLQ pain with non bloody stool. Tenderness present over the area. No fever. Normal rectal examination. Diverticulum seen in a barium enema. What to do?
    -give antibiotic prophylaxis for 2 weeks
    -try high fiber diet
    -do colonoscopy

    Q245. Hearing loss in old age. O/E AC>BC more in left. Weber lateralizes to right. What is the most appropriate?
    -diagnosis of sensorineural deafness
    -conduction deafness
    -recommend using hearing aid
    -recommend audiometry test to be done

    Q246. Irregular and constricted pupil with reduced reaction to light in
    -acute glaucoma
    -acute iritis

    Q247. 70yrs M with total hip replacement complains of distention and obstipation in the post operative period. Caecal diameter found 10cm in x ray. What is your diagnosis?
    -Oglive syndrome
    -Caecal volvulus
    -sigmoid volvulus

    Q248. Man with numbness in the back of the leg and unable to dorsiflex the foot along with severe backache and stiffness & no history of urine incontinence.
    -OSTEOMYELITIS T12- L1
    -peroneal nerve injury
    -cauda equina syndrome.

    Q249. Thyroid swelling in a hypothyroid patient. What is to be done?
    -give L-thyroxine
    -Thyroid scan
    -FNAC

    Q250. Swelling of rt upper extremity of a female with no previous history due to
    -venous embolism
    -lymphedema
    Q251. Lesion on lip - Biopsy

    Q252. Renal injury bleeding- pyelogram

    Q253. Pre op most worrying -H/o MI -age over 70

    Q254. A case showing symptom and signs of complicated appendicitis

    Pictures

    Q255. Basal Body temperature chart of a woman (anovulatory cycle) -short luteal phase

    Q256. Vaginal lesions- diagnosis
    -vaginal herpetic lesion
    -moniliasis

    Q257. Picture of slide showing T. vaginalis. What is the treatment
    -oral Metronidazole
    -ceftriaxone
    -doxicycline
    -topical application.

    Q258. Picture of a child suffering from constipation showing large protruding tongue. Diagnosis?
    -hypothyroidism.
    -Downs syndrome

    Q256. Picture of SKIN lesions involving nails and hand which are suggestive of PSORIASIS . What is common?
    -DIP involvement
    -Sacroilitis

    Q260. Picture of a child having scaling yellowish over scalp and dry face.
    -Seborrhic Dermatitis
    -Atopic dermatitis
    -PSORIASIS

    Q261. ECG strip showing variability of R-R interval and RsR’ pattern in lateral leads and lead I
    -Atrial fibrillation with LBBB

    Q262. Picture of a short stature girl with no sexual development, no pubic hair, no breast development (Turner syndrome). What should be done?
    -karyotype
    -FSH and LH
    -TSH & GH

    Q263. Fetal heart rate monitoring strip (showing late decelerations?) 32 weeks with uterine contraction. What should be done?
    -Do caesarian section
    -wait and augment
    -give tocolytics
    -give steroids.

    Q264. A girl with a SKIN lesion with irregular border and variegated appearance. Recently been bitten by dog in that area. Diagnosis
    -naevi
    -malignant melanoma
  2. Seeker

    Seeker Guest

    Thanks for this collection but I couldn't find the answers.
  3. jan2010

    jan2010 Guest

    Any answers please ??????

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