1.

Which type diabetes is HLA associated -

a) Type I diabetes

b) Type II diabetes

c) Malnutritionrelatedtypedisease

d) Pregnancyrelatedtypediabetes

2. In a patient with NIDDM which of the following condition is seen -

a) Ketosis commonly occurs on stopping treatment.

b) Hypertriglyceridmianever occurs

c) Pancreatic beta cells stop producing insulin

d) There are increased levels of insulin in blood

3. Diabetes mellitis diagnosed when -

a) Fasting blood glucose is 100 and post prandial 140

b) Fasting blood sugar 125 and 2 hour postprandial blood sugar is 199

c) Insulinlevel

d) HbAlc>6.5%

4. Which is not a test for diabetes mellitus -

a) Fasting blood sampling

b) Randombloodsampling

c) D-xylose

d) Oralglucosetolerancetest

5. HbA, AC level in blood explains-

a) Acuteriseofsugar

b) Long terms status of blood sugar

c) Hepatorenalsyndrome

d) Chronicpancreatitis

6. Diabetes control is best monitored by –

a) Serum glucose b) Post prandial blood glucose

c) HbAlAC d) HbA2AC

7. An obese patient presented in casualty in an unconscious state. His blood sugar measured 400mg% urine

tested positive for sugar and ketones Drug most useful in management is -

a) Glibenclamide b) Troglitazone

c) Insulin d) Chlorpropamide

8. Which one of the following investigations is most sensitive for early diagnosis of diabetic nephropathy-

a) Serumcreatininelevel
b) Creatinineclearance

c) GlucoseToleranceTest

d) Microalbuminuria

9. Glycatedhaemoglobin reflects blood glucose of preceding -

a) 01-week b) 2-3 weeks

c) 4-5 weeks d) 6-8 weeks

10.A 65-year-old woman with history of Type 2 Diabetes mellitus for the last eight years dies in a hospital. She-

had no other significant medical history. Which of the following is the most likely cause of her death?

a) Diabeticketoacidosis

b) Myocardialinfarction

c) Renalfailure

d) Stroke

11. For diagnosis of diabetes mellitus, Fasting blood glucose level should be more than- a) 126 mg/dl b) 140

mg/dl 2012-13)

c) 100 mg/dl d) 200 mg/dl

12.Glycemic control indiabetes is best assessed by-

a) HbAIC b) Urinary glucose

c)Fasting glucose d) Post prandial glucose

13.A 40 yrs old female who is known case of ischemic heart disease (IHD) is diagnosed having hypothyroidism.

Which of the following would be most appropriate line of management for her -

a) Start levothyroxine at low dose

b) Donotstartlevothyroxine

c) Uselevothyroxine

d) Thyroid extract is a better option

14.Cardiac manifestations of Grave’s disease would include all of the folloing except -

a) Widepulsepressure

b) Atrialfibrillation

c) Pleuropericardialscratch

d) Aorticinsufficiency

15.The laboratory test of choice to confirm myxoedema coma is -

a) Thyroidstimulatinghormone (TSH)

b) Thyrotropinereleasinghormone (TRH)

c) Tri-iodothyronine (T3)

d) Tetraiodothyronine (T4)
16.Which of the following is found in primary hypothyroidism-

a) T3 decrease, T4 decrease, TSH increase

b) T3 decrease, T4 increase, TSH decrease

c) T3 normal, T4 normal, TSH increase

d) T3 decrease, T4 decrease, TSH normal

17.A large toxic retrosternal goiter is best treated by-

a) Antithyroid drugs b) Radio iodine

c) Surgicalresection d) Lugol’siodine

18.The drug of choice for treatment of hyperthyroidism during lactation period is - a) Carbimazole

b) Propylthiouracil

c) Methimizole d) Radioactiveiodine

19.The occurrence of hyperthyroidism following administration of supplemental iodine to subjects with endemic

iodine deficiency goiter is known as -

a) Jod-Basedoweffect

b) Wolff-Chaikoffeffect

c) Thyrotoxicosisfactitia

d) DeQuervain'sthyroiditis

20. Which of the following is NOT a feature of hypothyroidism ?

a) Mental retardation b) Large head

c) Calfmusclehypertrophy d) Microcephaly

21.Which of the following statements regarding treatment of hypothyroidism in a patient with ischemic heart

disease is true

a) Lowdoseoflevothyroxine

b) NormaldoseofLevothyroxine

c) DonotuseLevothyroxine

d) Usethyroidextract

22.In a patient of primary hypothyroidism, the hormonal profile will read -

a) Low T 3, lowT4, lowTSH

b) Low T3> low T4, high TSH

c) High T3, high T4, high TSH

d) Low T„ low T4, normal TSH

23.Most common cause of hyperthyroidism-

a) Thyroidhyperplasia

b) Thyroidadenoma
c) Thyroidcarcinoma

d) Gravedisease

24.All are true regarding Plummer Vinson syndrome, except -

a) Oesophagealweb

b) Predisposestomalignancy

c) Koilongchia

d) Commoninelderlymales

25. The patient has chronic posthemorrhagic anemia, accompanied by lower concentrations serum

iron, hypochromia of erythrocytes, poikilocytosis and anisocytosis. What is the value of color index at

this anemia?

A. 0,7

B. 1,1

C. 0,9

D. 1,0

26. A B-12 -deficiency anaemia developed in a patient following the stomach resection. What colour

index of blood is typical for this pathology?

A. 1.4

B. 1.0

C. 0.8

D. 0.5

27. Female, 55 years old, complaints of prolonged cyclical uterine bleeding during the year, weakness,

dizziness. Objective: pale skin. In the blood: Hb - 70 g/l, er.-3,2x10 12/l, CI - 0,6, leuk.-6,0x109 /l, reticulocytes -

1%; hypochromia of erythrocytes. What is anemia in patients?

A. Chronic posthemorrhagic

B. Hemolytic

C. Iron-deficiency

D. B12-deficiency

28.The earliest sign of iron deficiency anaemia-

a) Increase in iron binding capacity

b) Decreaseinserumferritinlevel

c) Decreaseinserumironlevel

d) Alltheabove

29.Most sensitive and specific test for diagnosis of iron deficiency is -

a) Serumironlevels

b) Serumferritinlevels

c) Serumtransferrinreceptorpopulation

d) Transferrin saturation

30.Best test for assessment of iron status is-

a) Transferrin b) Ferritin

c) Serumiron d) Hemoglobin

31.Which of the following findings is diagnostic of iron deficiency anemia -

a) Increased TIBC, decreased serum ferritin

b) Decreased TIBC, decreasedserumferritin

c) Increased TIBC, increasedserumferritin

d) Decreased TIBC, increasedsermferritin

32.True about iron deficiency anemia -

a) Microcytic hypochromic anemia

b) Decreased TIBC

c) Increasedferritin

d) Bone marrow iron decreased earlier than serum iron

33. “Protective” factors in pathogenesis of ulcer disease are:

a. mucous stomach cells regeneration; chloric acid, pepsin;

b. pepsin; mucus secretion; chloric acid.

c. prostaglandins; mucous stomach cells regeneration; mucus secretion;

d. mucus secretion; chloric acid, bile acid regurgitation;

34. Drug depended ulcer is induced:

a. aspirin; metoprolol;

b. metoprolol; prednisolon;

c. prednisolon; aspirin;

d. salmeterol; streptokinase.

35. Pain in epigastrium after meal is symptom ulcer disease of :

a. stomach;

b. distal part of esophagus;

c. duodenum.

36.Which drug is considered first-generation sulfonylureas?

A. Chlorpropamide

B. Glyburide

C. Glipizide

D. Glimepiride

E. Gliquidone

37. Gastric Ulcer is caused due to:

a. Bile acid reflux

b. Recurrent herb

c. Hyperacidity

d. Decreased mucosal resistance

38. Treatment of drug-induced gastritis:

a. Mesoprostol

b. H2 receptor blockers

c. Antacids

d. Aspirin

39.Duration of long-acting insulin is

A. 18-30 hours

B. 6-18 hours

C. 24-30 hours

D. 36-72 hours

40.Mechanism of sulphonylureas’ action includes

A. Stimulation beta cells to secrete insulin

B. Stimulating beta cells to synthesise insulin

C. Inhibiting beta cell to secrete insulin

D. Beyond pancreatic activity

E. Inhibiting insulin resistance

41.Duration of intermediate-acting insulin is

A. 12-18 hours

B. 6-18 hours

C. 12-24 hours

D. 24-36 hours

42.The pancreatic cells that secrete insulin are the: 

a) F-cells 
b) principal cells 

c) alpha cells 

d) beta cells 

e) delta cells

43. Which of the following is not a symptom of hyperthyroidism?

loss of weight

increased heart rate

increased mental awareness

increased ability to sleep

44. Indications of colonscopy:

a. rectal bleeding, anemia, suspected inflammatory bowel disease

b. suspected inflammatory bowel disease, severe shock.

c. severe respiratory disease

d. cardiac arrhythmia.

43. Contraindications of colonoscopy:

a. rectal bleeding, anemia, suspected inflammatory bowel disease

b. suspected inflammatory bowel disease,

c. severe respiratory disease, severe shock.

d. suspected inflammatory bowel disease

43. Normal serum bilirubin level is:

a. less than 1mg\dl,

b. less than 2mg\dl,

c. less than 3mg\dl,

d. less than 4mg\dl,

44.Hypothyroidism in infants can result in

a) Grave's disease

b) cretinism

c) Hashimoto's disease

d) myxedema

45. What can possibly cause the development of iatrogenic thyrotoxicosis?

a) overdose of thyroid hormones during treatment of hypothyroidism;

b) hypersensitivity of receptors to endogenous thyroid hormones;

c) all of the mentioned above

46. What are the complications of treatment with thyreostatics of imidazole group?

a) thrombocythosis;

b) lymphocytosis;;

c) leukopenia;

47. A 22-year-old pregnant is diagnosed with Graves' disease. Appropriate therapy includes:

A. Propylthiouracil therapy with the goal of maintaining her thyroid function tests in the highnormal

B. Radioactive iodine to ablate her thyroid gland or slightly high range

C. Methimazole therapy

D. A beta blocker

48. Which statement regarding diabetes mellitus is true?

a. Diabetes increases the risk for development of epilepsy.

b. The cure for diabetes is the administration of insulin only

c. Diabetes increases the risk for development of cardiovascular disease.

d. Carbohydrate metabolism is disturbed in diabetes, protein and lipid metabolism are normal.

49. Ascites in liver cirrhosis is formed as a result of:

a. secondary hyperaldosteronism, hypoalbuminemia, Portal Hypertension

b. hypoaldosteronism, potassium loss, salt retention

c. hypertension, salt retention

d. all the above

50. Decrease acid-secretory function occurs more frequently:

a. in chronic superficial gastritis

b. in chronic gastritis, antrum

c. in chronic atrophic gastritis

d. with hypertrophic gastritis

51. The ranitidine is:

a. blocker of H2-histamine receptors

b. total anticholinergic action

c. anticholinergic topical

d. antacid

52. With which therapy for diabetes mellitus is the patient not at risk for hypoglycemia?

a. Regular insulin

b. Lente insulin

c. Biguanides

d. Sulfonylureas
53. The method of diagnosing the cause and localization of bleeding from the upper gastrointestinal tract is:

a. Radiography

b. Portomanometriya

c. Laparoscopy

d. gastroduodenoscopy

54. The incubation period of hepatitis B:

a. 60-180 days

b. 120-160 days

c. 60-80 days

d. 30-90 days

55. The incubation period for hepatitis A is:

a. 3-8 days

b. 1-2 weeks

c. 8-10 weeks

56. Impaired glucose tolerance is corresponds to the concentration of glucose in capillary blood (mmol / l)

1) fasting<6.7 through 2 hours ≥ 7,8 and <11.1

2) fasting<6.0 through 2 hours ≥ 6,1 and <7.8

3) fasting<6.1 through 2 hours ≥ 7,2 and <11.1

4) fasting<6.1 through 2 hours≥ 7,8 and <11.1

57. Clinical manifestations of pyloric stenosis following:

a. vomiting, dehydration, tetany

b. bleeding , tetany

c. nausea,

d. diarrhea

58. The risk factors for type 1 diabetes include all of the following except:

a. Diet

b. Genetic

c. Autoimmune

59. Characteristic signs of alcoholic cirrhosis are:

a. The early development of jaundice and later - portal hypertension

b. Early CNS involvement

c. The early development of portal hypertension later - jaundice and liver insufficient accuracy

d. The presence of mitochondrial antibodies and an increase in the activity of alkaline phosphatase-basins

60. Which of the following drugs should appoint patients with chronic gastritis type B?
a. betatsid

b. panzinorm

c. ranitidine

d. prednisolone

61. Type 2 diabetes accounts for approximately what percentage of all cases of diabetes in adults?

a. 55%-60%

b. 35%-40%

c. 90-95%

d. 25-30%

62.To exclude the malignancy of gastric ulcer should be used:

a. X-ray examination

b. endoscopy

c. stool for occult blood

d. endoscopy with biopsy

63. Chronic atrophic gastritis is caused by:

a. Antibody response to the G cells of the stomach, which reduces the production of gastrin leads to

achlorhydria;

  b. mucosal atrophy in patients with atherosclerosis;

  c. long-term use of glucocorticoids;

  d. NSAIDs.

64. Complications of duodenal ulcer;

a. Bleeding;

b. portal hypertension;

c. jaundice;

d. ascites;

65. Risk factors for type 2 diabetes include all of the following except:

a. Advanced age

b. Obesity

c. Smoking

d. Physical inactivity

66. What are the etiological factors of autoimmune hepatitis:

a. The defeat of the endothelium of the liver vessels;

b. Hepatitis B;

c. Hepatitis C virus;
d. Non known;

67. DRUG-INDUCED CHRONIC HEPATITIS may be caused by:

a. Paracetamol

b. Isoniazid

c. Antibiotics

d. All of above

68. Chronic hepatitis is characterized by next clinical syndromes

a. Cholestatic, Hepatomegaly

b. Dispeptic

c. Portal hypertension

d. None of above

69. Blood sugar is well controlled when Hemoglobin A1C is:

a. Below 7%

b. Between 12%-15%

c. Less than 8%

d. Between 7%and 8%

70. Characteristic of pain in chronic gastritis:

a. localisation in mesogastriumbeginnig in night ;

b. localisation in right hypochandrium with irradiation in right shoulder;

c. localisation in epigastrium which is began after meal;

d. localisation in epigastrium which is redused after meal;

e. localisation in epigastrium, which is indused fat meal.

71. Localisaton of process in chronic gastritis В is:

a. antral part of the stomach;

b. gastroesophageal part of the stomach;

c. cardia;

d. body of the stomach

72. Ussually H. pylory is localisated:

a. antrum,bulbus of the duodenum;

b. cardia of the stomach;

c. body of the stomach.

d. esophagus; antrum.

73. For the clinic of chronic gastritis is characterized by:

a.subfebrile temperature;
b. moderate leukocytosis;

c. dyspeptic syndrome;

d. diarrhea;

74. Gastric secretion decreases:

a. famotidine;

b.solkoseril;

c.Cytotec;

d. Venter;

75. Omeprazole belongs to the group of drugs:

a. blockers;

b. M-holinoblokatory;

c. blockers of histamine H1-receptor antagonists;

d.proton pump blockers.

77. The drug of choice for treatment of hepatic encephalopathy

a. reaferon

b. Duspatalin

c. essentiale

d. Hepa-Merz

78. The drug of choice for primary biliary cirrhosis

a. thistle

b. Heptral

c. gepabene

d. ursofalk

e. Essentiale

79. Etiological treatment with interferon in chronic viral hepatitis are beginning to phase:

a. Replication

b. integration

c. proliferation

d. fibrosis

80.Which is characteristic of cytolytic syndrome?

a. increase: ALT, AST, LDG5

b. increase: direct bilirubin, alkaline phosphatase, uGTP, cholesterol

c. The increase in indirect bilirubin, ALT decrease, uGTP

81. Which is typical for mesenchimal inflammatory syndrome?

a. reduction: albumin, prothrombin, transferrin, cholesterol

b. increase: gammaglobulin, ESR, thymol, CRP

c. increase: ALT, AST, LDG5

82. The clinical manifestations of anemia:

a. bleeding

b. anemic syndrome

c. signs funicular myelosis

d. infectious complications

83. Intrinsic factor is produced in

a. fundus area of the stomach

b. duodenum

c. Serum

d. the wall of the small intestine

84.Untreated hyperglycemia may lead to all of the following complications except:

a. Hyperosmolar syndrome

b Vitiligo

c. Diabetic ketoacidosis

d. Coma

85. The indication for the purpose of glucocorticoids in chronic glomerulonephritis is:

a. nephrotic syndrome

b. hypertension

c. renal failure

d. hematuria

86. All of the symptoms characteristic of glomerulonephritis

a. Hypertension, the urine changes, edema

b. Pain in the lumbar region, edema, dysuria

c. dysuria, bleeding, pain

d. itching, dysuria, hypertension

87. Тhe treatment of chronic pyelonephritis is used:

a. antibiotics

b. antiplatelet agents

c. kortikosterovdov

d. methylxanthines

88. What does "uremia" mean?

a. The increase in blood urea level

b. The increase in urea and creatinine

c. The clinical manifestations of toxicity associated with renal failure

d. violation of the acid-base status

89. In glomerulonephritis affected:

a. tubules

b. glomerulus

c. renal pelvis

d. vessels

90.Patients with Diabetes Mellitus are at risk for developing complications.

Which of the following complications is NOT associated with Diabetes Mellitus?

a. Apathy

b. Neuropathy

c. Retinopathy

91. All are anti – thyroid drugs excepts

a) Carbimazole

b) Chlorpropamide

c) Propylthiouracil

92. Enlargement of the thyroid gland is called

a) Thyroidectomy

b) Thyrotoxicosis

c) Goitre

d) None

93. Individuals with hypothyroidism would mostly likely have which one of the following conditions?

A. Growth retardation if occurs during the perinatal period

B. Increased cardiac output

C. Weight loss

D. Excessive production of TSH if the defect is in the hypothalamus

E. Less than normal levels of cholesterol in the circulation

94.A 55-year old woman recently diagnosed with hyperthyroidism started an appropriate treatment. One month

later the following laboratory values were obtained: RBC 4.6 x 10 /mcl, WBC 0.9 x 10 /mcl, platelets 45 6 3 x

103/mcl. Which of the following drugs most likely causes these results?

A. L-thyroxine

B. Potassium iodide
C. Methimazole

D. Propranolol

95. A 59-year-old woman was admitted to the hospital with restlessness, insomnia, tremor and a pronounced

exophthalmos. The woman, who had been suffering from hyperthyroidism for two months, had been treated with

propylthiouracil but the drug was discontinued because of the appearance of agranulocytosis. Which of the

following agents would be most appropriate for the patient at this time?

A. Methimazole

B. Radioactive iodine

C. Potassium iodide

D. Propranol

96. Which of the following is the most common cause of goiter?

A) Iodine deficiency

B) Iodine excess

C) Acute thyroiditis

97. Which of the following is the best therapy for hypothyroidism?

A) Dessicated thyroid

B) Levothyroxine

C) Liothyronine

D) Methimazole

98. What is the recommended dosage of levothyroxine in elderly adults with stable primary hypothyroidism?

A) Initial dose of 25 µg daily, titrated every 4 to 6 weeks to achieve a normal serum TSH level

B) Initial dose of 50 µg daily, titrated every 2 weeks to achieve a normal serum TSH level

C) Initial dose of 75 µg daily, titrated every 2 weeks until the TSH level is suppressed below 0.1 mU/L

D) Initial dose of 100 µg daily, titrated every 2 months to achieve a normal T4 level E) Initial dose of 100 µg daily,

titrated every 4 weeks to achieve a normal T4 level

99. Which of the following is NOT a clinical symptom of hypothyroidism?

A) Cold intolerance

B) Depression

C) Diarrhea

D) Muscle cramps

E) Weight gain

100.       A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat.  In

addition, the patient voices concern about how her appearance has changed over the past year. The patient
presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely

cause of the patient’s signs and symptoms?

A.      Thyroiditis

B.      Deficiency of iodine consumption

C.      Grave’s Disease

D.      Hypothyroidism

101. A patient who is in her first trimester of pregnancy is diagnosed with hyperthyroidism. Which medication do

you suspect the patient will be started on?

A.      Propylthiouracil (PTU)

B.      Radioactive Iodine

C.      Tapazole

D.      Synthroid

102.   Which of the following side effects are possible for a patient taking an anti-thyroid medication?

A.      Agranulocytosis and aplastic anemia

B.      Tachycardia

C.      Skin discoloration

D.      Joint pain and eczema

103. Which of the following is not a sulphonurea:

A. Chlorpropamide

B. Metformin

C. Gilbenclamide

D. Glipizide

104. What is the target total cholesterol level recommended in people with Type 2 diabetes:

A. 5.0mmol

B. 6.0mmol

C. 4.5 mmol

D. 3.5mmol

105. Which of the following is not a microvascular diabetes complication:

A. Nephropathy

B. Retinopathy

C. Peripheral neuropathy

D. Myocardial Infarction
105. Damage to the small blood vessels in the kidney is termed:

A. Nephropathy

B. Neuropathy

C. Nephropexy

D. Nephrostomy

106. What measure is important for the prevention of diabetes at presence of family history?

a) prevention of acute infections

b) prevention of obesity

c) the exclusion of emotional stress

d) warning of marriage with diabetics

107.The main factors of the pathogenesis of diabetes mellitus type1:

a) insulin resistance and degradation in cells

b) the destruction of B-cells and insulin deficiency

c) 3 insulin deficiency and increasing contrinsulyarny hormones

d) increase in contrinsulyarnyhormones and insulin resistance

108. Diabetes of the type 1 should be treated in

a) diet therapy only;

b) 2.sulfanilamidnymi drugs;

c) only insulin therapy

d) biguanides;

109. Type 2 diabetes is characterized by:

a) 1.ketosis;

b) 2.weight loss;

c) 3 .an acute onset;

d) 4 .the slow onset of the disease;

110. Which indicator is the most reliable criteria for the degree of compensation of diabetes in dynamic survey

a) C-peptide;

b) the average daily blood glucose;

c) glycosylated hemoglobin;

d) the mean amplitude of glycemic fluctuations

111.An absolute contraindications for the oral sugar-reducing drugs is:

a) prostate adenoma;
b) psoriasis;

c) 3microbial eczema;

d) pregnancy;

112.The woman, 45 years old, with obesity 1st Class was found fasting glucose of 10 mmol \ l, after meal 14.8

mmol \ l, glucosuria 3% acetone in the urine is not. The brother of the patient suffers for diabetes. What type of

diabetes in a patient?

a) Diabetes mellitus type 1;

b) Diabetes mellitus type 2;

c) Diabetes is associated with a disease of the exocrine pancreas;

d) Diabetes is associated with endocrinepathies

113.The basic principle in the treatment of type 1 diabetes ?

a) diet therapy and lifestyle modification

b) oral hypoglycemic agents

c) insulintherapy

d) physical activity0.

114.Daily insulin requirements in the first year of diabetes?

a) 1 units on 1kg body weight

b) 0.5-0.6 units on 1kg body weight

c) 0.8-0.9 units on 1kg body weight

d) 1-2ed on 1kg of body weight

115.Symptoms of early stage nephropathy

a) microalbuminuria

b) leucocyturia;

c) hematuria;

d) oliguria;

116. Specify the initial symptom of diabetic retinopathy:

a) decreased vision

b) proliferative retinal changes

c) formation of aneurysms of the retina

d) retinal vascular neoplasm

117. The most frequent cause of death in type 2 diabetes is

a) hyperosmolar coma

b) gangrene of the lower limbs

c) myocardial infarction
d) diabetic nephropathy

118. Diabetes diagnosis is confirmed by:

the level of fasting plasma glucose> 6,7mmol / l

capillary blood glucose level fasting> 6.7 mmol / l

the level of fasting plasma glucose> 7.0 mmol / l

the capillary level of fasting blood glucose> 6.1 mmol / l

119.Complications of insulin therapy include the following:

hypoglycemic condition

ketoacidosis

the decrease in body weight

120.What is characteristic of insulin deficiency?

reduction of view;

the excessive weight gain;

the sweating;

thirst;

121.Which of the following tests are used to establish the diagnosis of diabetes mellitus?

oral glucose tolerance test

Intravenous glucose tolerance test

determining the level of glycated hemoglobin

test with dexamethasone

122.Which of the following statements regarding treatment of hypothyroidism in a patient with ischemic heart

disease is true -

a) Low dose of levothyroxine

b) Normal dose of Levothyroxine

c) Do not use Levothyroxine

d) Use thyroid extract

123.In a patient of primary hypothyroidism, the hormonal profile will read -

a) Low T 3, lowT4, lowTSH

b) Low T3> low T4, high TSH

c) High T3, high T4, high TSH

d) Low T„ low T4, normal TSH

124. None invasive diagnostic methods for H.pylori verification are:

 a. histologycal;

b. ureas test;

c. microbiological blood test on H. Pylori;

d. microbiological stool test on H. Pylori;

125. Acidity in gastritis B is:

a. normal;

b. high;

c. lower than the normal.

126. A characteristic of hemochromatosis:

a. The early development of jaundice and later - portal hypertension

b. Early CNS involvement

c. The early development of portal hypertension and later - jaundice and liver, insufficient accuracy

d. skin pigmentation and increased iron levels in the blood.

127. Main clinical symptom in duodenum ulcer disease is:

a. pain on empty stomach;

b. diarrhoea;

c. eructation;

d. early pain after meal;

128. First line drugs for H. Pylori eradication are:

a. amoxicillin, clarithromicin;

c. metronidazole; furazolidone.

d. sumamed;

129. What drugs are used to eradicate Helicobacter pylori?

a. amoxicilline, de-nol, metronidasole

b. omeprasole, metronidasole, amoxicilline, de-nol,

c. almagel, metronidasole,

d. sucralfate, metoclopramide

130. Parietal cells of stomach mucous produse:

a. gastrin;

b. natriahydrocarbonat;

c. pepsinigen;

d. chloric acid.

131. Gastrin is prodused by:

a. H-cells;
b. М-cells;

c. G-cells;

d. Р-cells;

132. Typical localization of chronic gastritis type A is:

a. antral part of the stomach;

b. gastroesophageal part of the stomach;

c. cardia;

d. body of the stomach;

133. Factors mucosal protection are:

a) mukoproteids and bicarbonates;

b) hydrochloric acid;

c) H. pylori;

d) an antibody to parietal cells of the stomach

134. Clinical manifestations of chronic gastritis:

a) cytolytic syndrome;

b) cholestatic syndrome;

c) syndrome of portal hypertension;

d) syndrome of gastric dyspepsia.

135. Proton pomp ingibitor (PPI) are:

a. atenolol;

b. lantoprasol;

c. methoprolol;

d. phamotidin.

136. Indications for surgery in peptic ulcer:

a) perforation, hemorrhage

b) vomiting, pain, penetration,

c. severe pain

d. untreatable case

137.Complication of PEPTIC ulcer;

a) Bleeding;

b) portal hypertension;

c) jaundice;

D) ascites;

138. Normal level AST:

a)Less than 35U/L

b)Less than 25U/L

c)Less than 45U/L

d)Less than 40U/L/

139. Proton pomp inhibitors are:

a)ranitidine(Zantak), cimitidine, famotidine, nizatidine;

b) omeprazole, lancoprazole, pentoprozole.

c.lancoprazole, pentoprozole.famotidine, nizatidine;

d. famotidine, nizatidine; pentoprozole.

140. Which of the interferons has mainly antiviral activity?

1) γ-IFN

2) α-IFN

3) β-IFN

141. A42-year-old previously well woman presentswith pruritus. She is not taking any medications,

and only drinks alcohol on a social basis.Her physical examination is entirely normalwith no signs of chronic liver

disease or jaundice.

Laboratory evaluation reveals an alkalinephosphatase level of three times normal, and

an ultrasound of the liver and gallbladder isnormal. Which of the following is the most

appropriate next step in diagnosis?

(A) antimitochondrial antibodies

(B) antinuclear antibodies

(C) protein immunoelectrophoresis

(D) abdominal ultrasound

142. A 73-year-old woman presents to the emergencyroom with black tarry stools and symptoms

of presyncope when standing up. Digitalrectal examination confirms the presence ofmelena. She recently started

using ibuprofenfor hip discomfort. Upper endoscopy confirmsthe diagnosis of a gastric ulcer. Which of the

followingis the most likely explanation for thegastric ulcer?

(A) increasing acid production

(B) causing direct epithelial cell death

(C) promoting replication of Helicobacter pylori

(D) inhibiting mucosal repair

143. Which of the following is a risk factor forHelicobacter pylori infection?

(A) excess exposure to antibiotics

(B) female sex

(C) alpha1-antitrypsin deficiency

(D) low socioeconomic indicators

(E) proton pump inhibitor therapy

144. A26-year-old woman develops a red rash overher cheeks and pain, and swelling in both wrists

as well as several small joints in her hands. Therash gets worse on sun exposure and involves

her cheeks, nose, ears, and chin. Medical evaluationreveals oral ulceration and 3+ proteinuria.

Which of the following is the most specifictest for diagnosis of this condition?

(A) lupus erythematosus (LE) cells

(B) antinuclear antibody (ANA)

(C) anti-Sm antibody

(D) anti-Ro antibody

(E) antiphospholipid antibody

145. A young woman presents with a facial rash,arthralgias, and fatigue. The rash on her face is

erythematous and raised, her heart and lungsare normal, and wrists are swollen and tender

on palpation. She has mild thrombocytopenia(90,000/mL). Which of the following is the

most appropriate initial autoantibody test?

(A) anti-double-stranded (ds)

deoxyribonucleic acid (DNA)

(B) anti-Sm

(C) anti-Ro or La

(D) ANA

(E) antiphospholipid antibodies (lupus anticoagulant)

146. A74-year-old woman has pain in her left handand right knee, which started months ago, and

is now interfering with her activities. The paingets worse as the day progresses. There is no

history of any trauma, and she is otherwisewell. Taking over-the-counter acetaminophen

usually relieves the pain. On examination, thereis bony soft tissue swelling of her second and

third DIP joints in the left hand and crepitusover the right knee with flexion. There is noerythema or joint effusion.

Which of the followingis the most likely explanation for thejoint pain of osteoarthritis?

(A) synovial inflammation is not the cause

(B) ligament inflammation is a common

cause

(C) clinically visible (via plain x-ray)

fractures are a common cause of pain

(D) osteophytes can cause pain

(E) muscles are not involved

147. A29-year-old woman develops painful swellingof both hands. She is also very stiff in the morning.

Physical examination reveals involvementof the proximal interphalangeal joints and

metacarpophalangeal (MCP) joints. Her RF ispositive and ANA is negative. Which of thefollowing medications is

most likely toimprove her joint pain symptoms?

(A) D-penicillamine

(B) an antimalarial

(C) methotrexate

(D) NSAID or aspirin

(E) gold

148. A72-year-old man injures his right knee in a caraccident, and now it is swollen and extremely

painful to bend the knee. X-rays of the knee ruleout a fracture, and joint fluid aspiration reveals

an opaque-colored fluid containing rhomboidcrystals with weak-positive birefringence. Which

of the following is the most appropriate nextstep in management?

(A) oral prednisone

(B) intravenous antibiotics

(C) oral NSAIDs

(D) acetaminophen

(E) allopurinol

149. Which of the following statements concerningthe articular manifestations of RA is correct?

(A) wrists are rarely involved

(B) involvement of hands is characteristicallyasymmetric

(C) fever up to 104°F is common with jointinvolvement

(D) ulnar deviation at the wrist is common

(E) absence of morning stiffness makes RA an unlikely cause of articular symptoms

150. A 25-year-old woman develops painfulswelling of both hands and wrists. She is also

very stiff in the morning. Physical examinationreveals erythema, swelling and joint line tenderness

of the proximal interphalangeal, MCP,and wrists joints. Her RF is positive, ANA isnegative, and x-rays of the

hands show earlyerosive joint changes. Which of the followingmedications is most likely to prevent progressionof

disease?

(A) D-penicillamine

(B) antimalarial

(C) methotrexate

(D) NSAID or aspirin

(E) gold

151. A 65-year-old man has pain in his left handand right knee, which is interfering with his

work. The pain came on gradually, first in hishand 6 months ago and now in his knee. It is

usually fine when he wakes up, but gets worseas the day progresses. There is no history of

any trauma, and he is otherwise well. Takingover-the-counter NSAIDs usually relieves the

pain. On examination, there is bony soft tissueswelling of his second and third DIP joints in

the left hand and crepitus over the right kneewith flexion. There is no erythema or joint effusion.

Which of the following characteristics is arisk factor for this condition?

(A) being Chinese

(B) being African

(C) being male

(D) being overweight

(E) hyperthyroidism

152. A 26-year-old man presents with dyspepsia. No alarm symptoms are present. This is his first episode and he

has no significant medical history of note. A test-and-treat strategy is agreed upon. What is the most appropriate

investigation to test for Helicobacter pylori?

a) Upper gastrointestinal endoscopy

b) Esophageal pH monitoring

c) Stool culture

d) Urea breath testing

153. A 27-year-old man complains of episodic abdominal pain. The pain is concentrated in the epigastrium and is

gnawing in quality. It wakes him up during the night and is promptly relieved by a glass of water and a piece

ofbread. He denies vomiting or diarrhea, but has experienced an occasional "dark stool." His vital signs are with

in normal limits. Physical examination shows mildepigastric discomfort on deep palpation. What is the most likely

diagnosis?

a) chronic gastritis В

b) chronic gastritis А

c) gastric ulcerdisease

d) duodenal ulcer disease

154. A 60-year-old woman comes to the physician with a 4-week history of abdominal symptoms. She complains

of upper abdominal discomfort and occasional dull epigastric pain accompanied by nausea. Her symptomsare

often worse after eating, especially with large meals. Which of the following is the most appropriate next step in

management of this patient?

A.Abdominal ultrasound
B. Antacids and metoclopramide

C. Helicobacter pylorystool antigen testing

D. Esophagogastroduodenoscopy

155. A 42-year-old Caucasian female presents to clinic complaining of severe fatigue and dark yellow urine,

anorexia, nausea, and malaise. She admits to having unprotected intercourse with six different partners within

the past year. Laboratory testing reveals the following:

Liver studies:Total bilirubin4.5 mg/dl, Alkaline phosphatase142 U/l, Aspartate aminotransferase (AST)184 U/l,

Alanine aminotransferase (AL T)345 U/l

Which of the following is the best means of screening for hepatitis B infection in this patient?

A. HBsAg and lgM anti-HBc

B. Complete Blood Count

C. liver function test

D. HBeAg

156. A 44-year-old white male comes to the office and says, "I have had this persistent, upper abdominal pain

forthe past 2 months. Physical examination reveals mild tenderness in the epigastric region.

Esophagogastroduodenoscopy reveals peptic ulcer

What is the best next step in the management of this patient?

A. Radical gastrectomy with en bloc resection of spleen and regional nodes

B. Give a combination of omeprazole, clarithromycin, and amoxicillin.

C. Give combination chemotherapy.

D. Radiotherapy

E. Observation and strict surveillance

157.A young man presents with HBsAg positive anti HBcIgM positive, HBeAg negative and normal levels of AST

and ALT. He is asymptomatic. What is the next line of management.

a) Wait and Watch b) Lamivudin

c) Immunoglobulin d) Liver Transplant

158.All the following hepatitis viruses is transmitted by parenteral route except-

a) Hepatitis В virus b) Hepatitis С virus

c) Hepatitis D virus d) Hepatitis E virus

159.In the treatment of Hepatitis - С inferferon is combined with which drug?

a) Acyclovir b) Ribavarin

c) Lamivudine d) Indinavir

160. A 52-year-old man presents to your office after passing a black stool. He also describes occasional

abdominal discomfort and nausea but denies hematemesis. He says that food seems to help his abdominal pain,
so he eats frequently during the day and keeps some snacks on his night stand. As a consequence he has

gained 5 pounds over the last year. The fecal occult blood test is positive. Which of the following is the most likely

cause of his condition?

A. Gastritis

B.Peptic ulcer disease

C. Inflammatory bowel disease

D. Hepatitis B

161. A 56-year-old man is brought to the emergency department with lethargy and confusion. He has a history

ofcirrhosis secondary to chronic alcoholism. He is taking spironolactone and furosemide.

Onphysical examination, he has a flapping tremor of his hands when they are held out. Abdominal examination

shows distension with shifting dullness anddiffuse tenderness to palpation. There is bilateral pitting edema of his

lower extremities.

Which of the following is the most appropriate next step in management?

A. Esophageal pH monitoring

B. Upper gastrointestinal endoscopy

C. Diagnostic paracentesis

D. He/icobacter pylori stool antigen testing

162. A 54-year-old man complaining of bitter taste and substernal burning 30-40 minutes after

meals. The burning is relieved with antacids and worsened by lying supine.He has had an unintentional weight

loss of 4.5 kg (1 0 lb}over the past 3 months. . Chest x-ray andelectrocardiogram show no abnormalities.

Which of the following is themost appropriate next step in management of this patient?

A.Upper gastrointestinal endoscopy

B. Esophageal pH monitoring

C. He/icobacter pylori stool antigen testing

D. Trial of famotidine

163. A 42-year-old dentist presents to his GP complaining of persistent lethargy. Routine bloods show abnormal

liver function tests so a hepatitis screen is sent. The results are shown below:

a) Anti-HAV IgG negative

b) HBsAg negative

c) Anti-HBs positive

d) Anti-HBc negative

e) Anti-HCV positive

What do these results most likely demonstrate?

A. Hepatitis B infection
B. Hepatitis C infection

C. Previous vaccination to hepatitis B and C

D. Hepatitis C infection with previous hepatitis B vaccination

164. You wish to screen a patient for hepatitis B infection. Which one of the following is the most suitable test to

perform?

A. HBcAg

B. HBsAg

C. Hepatitis B viral load

D. anti-HBs

165. A 59-year-old female presents to her GP with a two month history of indigestion. She is otherwise well, has

not had a similar episode before and takes no regular medication. Of note there is no recent weight loss or

vomiting and abdominal examination is unremarkable. What is the most appropriate initial management?

A. Long-term course of a H2 receptor antagonist

B. Urgent referral for endoscopy

C. One month course of a full-dose proton pump inhibitor

D. Urea breath testing and treat for H pylori if positive

166. Which one of the following statements regarding hepatitis C is correct?

a) Cannot be transmitted vertically from mother to child

b) Interferon-alpha and ribavirin are the treatments of choice

c) It is more infectious than hepatitis B following a needle stick injury

d) Breast feeding is contraindicated in mothers with hepatitis C

167.A 45-year-old man with a long history of alcohol intake comes into the emergency room with

upper gastrointestinal (UGI) bleeding. Urgentendoscopy reveals - the following findings the esophageal folds are

thick and tortuous, giving rise to a wormy or worm-eaten appearance.

Which of the following is the most likely diagnosis?

(A) esophageal varices

(B) esophageal carcinoma

(C) foreign body

(D) tertiary waves

(E) Barrett’sesophagus

168. Which of the following is an established risk factor for nonsteroidal anti-inflammatory disease

(NSAID)-induced gastric or duodenal ulceration?

(A) Helicobacter pylori infection

(B) cigarette smoking

(C) alcoholconsumption

(D) glucocorticoids

169. A24-year-old woman is pregnant with her first baby at 14 weeks. She feels well and the pregnancy is

noncomplicated. Routine screening is positive for chronic viral hepatitis for which

perinatal transmission is of major epidemiologic significance.

(A) hepatitis A virus

(B) hepatitis B virus

(C) hepatitis C virus

(D) hepatitis D virus

(E) hepatitis E virus

170.A 41 year old pregnant woman presents to A&E with right upper quadrant pain that started in thelast 12 hours

and is gradually worsening. She has dark urine and pale stools for the last 2 days.

She is noted to have a yellow sclera on examination. Her blood pressure is 145/95 mmHg. What is

the SINGLE most appropriate investigation?

A. Ultrasound of abdomen

B. Urine protein: creatinine ratio

C. Urinary bilirubin

D. Urinary urobilinogen

E. Alkaline phosphatase

171. A young patient presenting with massive hematemesis was found to have splenomegaly. In this case the

most likely source of bleeding is -

a) Duodenal ulcer b) Esophageal varices,

c)Erosive mucosal disease d) Gastric ulcer

172. Which one of the following serum levels would help in distinguishing an acute liver disease from chronic

liver disease - a) Aminotransaminase b) Alkaline phosphatase,

c)Bilirubin d) Albumin

173. In hepatic cirrhosis, which of the following is increased -

a) Alpha 1 globulin b) Alpha 2 globulin

c) Gamma globulin d) All of the above

174.A 40 year old patient, a known case of cirrhosis develops acute episode of GI bleed. Initial therapy given for

6 hours.Which of the following procedure is useful -

a)Nasogastric aspiration b) Urgent endoscopy , c)Sedation d) Ultrasound

175. A young boy, R. presents with massive hemetemesis. He had fever for 15 days few days back which was

treated. Clinical examination reveal moderate splenomegaly No other history is positive Probable diagnosis is -

a) Drug induced gastritis b) Oesophageal tear,

b) Bleeding duodenal ulcer d) Oesophageal varices

176. A14 year old male child complaints of pain in left hypochondrium since 2 days. Hb-9.69%. His mother gives

history of passing black colored stools 7 days and 2-3 occasions since 2 yrs. During these episodes he had

fatiguability while playing and was not able to play with his peers. Which of the following will maximally help to

arrive at a clinical diagnosis -

a) Pallor b) Jaundice , c)Palpable spleen d) Free fluid in the abdomen

177.An 18 yr old male presents with massive hematemesis, he has history of fever for the past 14 days for which

he was managed with drugs, moderate spleenomegaly is present, diagnosis is -

a) NSAID induced duodenal ulcer

b) Drug induced gastritis

c) Esophageal varices

d) None of the above

178. The most common infectious agent associated with chronic pyelonephritis is -

a) Proteus vulgaris

b) Klebsiella pneumonia

c) Staphylococcus aureus

d) Escherichia coli

179. In pyelonephritis the diagnostic urinary finidng is -

a) RBC cast

c) Pus cells

ci) d) RBCs

180.Microalbuminuria is defined as protein levels os -

a) 100-150 mg/L b) 151-200mg/L

c) 201-300mg/L d)301-600mg/L

181Microalbuminuria refers to urinary albumin excretion rate of -

a) 30-300mg/24 hour b) 400-600 mg/24 hour

c) 700-900 mg/24 hour d) >1000 mg/24 hour

182. A 20-year-old ma

183.

184. le presents with pain in the knee joints for the last two weeks. He also has mild backache and stiffness.

He had fever and diarrhoea four weeks previous to developing these complaints. The patient is afebrile and has
no diarrhoea. His laboratory investigations reveal normal ESR and elevated CRP. What is the most probable

diagnosis?

a) Rheumatoid arthritis

b) Reactive arthritis

c) Enteropathic arthritis

183.All of the following are seen in inflammatory polyarthritis, except -

a) New bone formation

b) Spontaneous flare

c) Increased ESR

d) Morning stiffness more than one hour

184. Which part of the spine is most commonly affected in Rheumatoid arthritis -

a) Cervical b) Lumbar

c) Thoracic d) Sacral

185.Which of the following is true regarding Rheuma toid arthritis -

a) Typically involves small and large joints symmetrically but spares the cervical spine

b) Causes pleural effusion with low sugar

c) Pulmonary nodules are absent

d) Enthesopathy prominent

186. Which of the following is the most specific test for Rheumatoid arthritis -

a) Anti-ccp antibody

b)Anti IgA antibody

c) Anti IgM antibody

d) Anti IgG antibody

187. Type of anemia seen in Rheumatoid arthritis is -

a) Microcytic hypochromic anaemia

b) Macrocytic hypochromic anaemia

c) Normocytic hypochromic anaemia

d) Normocytic normochromic anaemia

188. Which is the most common site of subcutaneous nodules in rheumatoid arthritis –

a) Elbow b) Wrist

c) Achilles tendon d) Occiput

189.The most common cardiac involvement in rheumatoid arthritis -

a) Pancarditis b) Pericarditis

c) Myocarditis d) Endocarditis

190. Which one of the following is least likely to occur in late extra articular sero-positive rheumatoid arthritis -

a) Neutropenia b) Dry eye

c) Leg ulcers d) Hepatitis

191.Which of the following constitute Felty’s syndrome?

a) Rheumatoid arthritis, splenomegaly and neutropenia

b) Rheumatoid arthritis, hepatomegaly and neutropenia

c) Rheumatoid arthritis, psoriasis and anaemia

d) Reactive arthritis, splenomegaly and anaemia

192.Drugs used in treatment of acute gout –

a) Allopurinol b) Colchicine

c) Pamidronate d) Methotrexate

193.Least common site to involved in osteoarthritis amongst the following is -

a) Hip joint

b) Knee joint

c) Metacarpophalangeal joint

194.Gout is a disorder of-

a) Purine metabolism b) Pyrimidine metabolism c) Ketone metabolism d) Protein

metabolism

195. All of the following statements about primary Gouty arthritis are true, Except -

a) 90% of cases are caused by over production of uric acid

b) Uric acid levels may be normal at the time of an acute attack

c) Men are more commonly affected than women (Male > Females)

d) Definitive diagnosis requires aspiration of synovial fluid

196. False regarding gouty arthritis is -

a) Synovial fluid analysis is diagnostic

b) Allopurinol is the treatment of choice in acute gout

c) Arthritis occurs after long attack of hyperuricemia

d) Level of uric acid in blood and severity of gout has good correlation

197.Erosive arthritis is seen in all, except -

a) SLE b)Gout

c) Osteoarthritis d) Old age

198.Which of the following joints findings is most suggestive of an inflammatory, rather than an osteroarthritic
cause of j oints pain ?

a) Painful range of motion

b) Crepitus

a) Bony articular enlargement

d) Swelling and warmth

199.Most specific diagnostic finding in gout is -

a) Uric acid crystals in urine

b) Raised serum uric acid

c) Presence of calcium pyrophosphate crystals in synovial fluid

d) Presence of monosdium crystals in synovial fluid

200.Most common manifestation of cardiac lupu is -

a) Myocarditis b) Libman-Sacks endocardits c) Pericarditis d) Aortic regurgitation

201. A 23 years old woman has experienced episodes < myalgias, pleural effusion, pericarditis an arthralgias

without joint deformity over course < several years. The best laboratory screening test i diagnose her disease

would be -

a) CD lymphocyte count

b) Erythrocyte sedimentation rate

c) Antinuclear antibody

d) Assay for thyroid hormones

202. Anti ds DNA antibody is specific for -

a) SLE b) Systemic sclerosi

c) CREST syndrome d) Sjogren’s syndroi

a) Wegener’s granulomatosis

203. Indications for use of cyclophosphamide in SLE

a) Arthritis

b) Anti DNA antibody + ive patients

c) Diffuse prolifereative glomerulonephritis

d) Oral ulcers

e) Discoid lipus

204. Anti-double stranded DNA is highly specific for -

a) Systemic sclerosis

b) S.L.E.

c) Polymyositis

d) Rheumatic sclerosis
205.Specific antibody for SLE is -

a) Anti-Ro c)Anti-Jo

b) Anti-Sm d) Anti ds DNA e) Anti-La

205. A 23-year old woman has experienced episodes of myalgias, pleural effusion, pericarditis and arthralgias

without joint deformity over course of several years. The best laboratory screening test to diagnose her disease

would be -

a) CD4 lymphocyte count

b) Erythrocyte sedimentation rate

c) Antinuclear antibody

d) Assay for thyroid hormones

206.Characteristic feature of SLE is -

a) Uveitis b) Joint deformity

c) Polyserositis d) Cavitating lesion is lung

207.Autoimmune destruction of platelet is seen in-

a) SLE b) Rheumatoid arthritis

c) Reiter disease d) Polyarteritis nodosa

208. In which of following arthritis erosions are not seen -

a) Rheumatoid arthritis

b) Systemic lupus erthematosus (SLE)

c) Psoriasis

d) Gout

209. Deposition of anti ds DNA Ab in kidney, skin, choroid plexus and joints is seen in-

a) SLE b) Good pasture

c) Scleroderma d) Raynauds disease

210. Joint erosions are not a feature of -

a) Rheumatoid arthritis

b) Psoriasis

c) Multicentric reticulohistiocytosis

d) Systemic lupus erthematosus

211. Erosive arthritis is seen in all, except -

a) SLE b)Gout

c) Osteoarthritis d) Old age

212. A middle aged female presents with polyarthritis with elevated rheumatoid factor ANA analevels, which

among the following will help you to differentiate rheumatoid arthritis from SLE ?
a) Soft tissue swelling at the proximal inter phalangial joint

b) Juxta articular osteoporosis or X-ray

c) Articular erosions on X-ray

d) d) Elevated ESR

213. Laboratory signs in rheumatoid arthritis for monitoring activity of the process:

a. increasing the level of CRP;

b.high ESR;

c. increase the level of anti-CCP antigen;

d.leukocytosis,titer SLA-O.

214. Stiffness in rheumatoid arthritis occurs:

a) duringactivity;

b)after rest.

c) 1 hour after wolking

d) during night time

215.Rheumatoid arthritis often suffer from:

a. girls and young women aged 20-30 years

b. middle-aged women aged 35-55 years

c. old women and the elderly

d. young men aged 20-30 years

 216.In the modern classification of the duration of the early stages of rheumatoid arthritis:

a. less than 6 months b. at least 1 year

c. at least 2 years d. at least 5 years

217. In the modern classification of the duration of late-stage rheumatoid arthritis:

a. more than 6 months b. more than 1 year

c. more than 2 years d. over 5 years

 218.In rheumatoid arthritis, specific autoantibodies to pathogenesis are:

a.antistreptolysin O

b. antinuclear factor

c. antibodies to the circulatingcitruline peptide

d. an antibody to DNA

219. It is characteristic of rheumatoid arthritis:

a. symmetrical inflammation of more than 3 peripheral joints

b. asymmetric inflammation of 2-3 large joints

c. asymmetrical inflammation of the 1st large joints

d. symmetrical inflammation of the sacroiliac joint

220.In rheumatoid arthritis occurs:

a. symmetric polyarthritis

b. asymmetric arthritis

c. an asymmetric oligoarthritis

d. asymmetrical monoarthritis

221. Rheumatoid arthritis is characterized by joint damage following character:

a. the nature of the volatile

b. persistent progressive nature

c. unstable non-progressive in nature

d. fully reversibl

222.For rheumatoid arthritis is characterized by predominant involvement of:

a. the large joints

b. the joints of the lower extremities

c. the knee and small joints of the hands and feet

d. joints of the spine

e. I metatarsophalangeal joints

223.In rheumatoid arthritis, the most commonly affected:

a. knee joints

b. the sacroiliac joints

c. the small joints of the hands

d. small joints of the feet

e. I metatarsophalangeal joints

224.In rheumatoid arthritis, a potentially reversible clinical signs of joint damage are:

a.chondrite b.synovitis

c.ankylosis d.achilles

225. In rheumatoid arthritis clinical signs of irreversible joint damage are:

a) chondritis b) synovitis

c) ankylosis d) achillitis

226. In the early stages of rheumatoid arthritis are the following features of a symmetric polyarthritis:

a) exudative signs of potentially reversible

b) irreversible exudative signs

c) potentially reversible proliferative (fibrotic, sclerotic) signs

d) irreversible proliferative (fibrotic, sclerotic) signs

e) ankylosing

227. In late-stage rheumatoid arthritis are the following features of a symmetric polyarthritis:

a) exudative signs of potentially reversible

b) irreversible exudative signs

c) potentially reversible proliferative (fibrotic, sclerotic) signs

d) irreversible proliferative (fibrotic, sclerotic) signs and ankylosing

 228. For the early stages of rheumatoid arthritis are characterized morning stiffness duration:

a) up to 30 minutes b) from 30 minutes to 1 hour

c) over 2 hours d) during the day e) from 30 sec to 1 min

229.  Late stages of rheumatoid arthritis are characterized morning stiffness duration:

a) up to 30 minutes b) from 30 minutes to 1 hour

c) over 2 hours, sometimes within days d) from 30 sec to 1 min

230. In rheumatoid arthritis symptoms such as rheumatoid nodules, muscle inflammation, lymphadenopathy,

rheumatoid vasculitis, visceritis, nervous system, eyes, and blood system, as well as fever and weight loss are:

a) a complication of the disease b) a low disease activity

c) the systemic manifestations of the disease d) transformation of a systemic lupus

erythematosus

231.The most frequent type of systemic manifestations of rheumatoid arthritis are:

a) rheumatoid nodules b) muscle inflammation

c) lymphadenopathy d) rheumatoidvasculitis

232.  The most frequent type of lesions of the musculoskeletal system at the early stages of rheumatoid

arthritis are myalgia (sometimes myositis):

a) intercostals muscles of the hand b) the muscles of the forearm

c) the muscles of the shoulder girdle d) thigh muscles e) leg muscles

233.  Kidney damage in rheumatoid arthritis is manifested most often:

a) latent glomerulonephritis b) nephrotic glomerulonephritis

c) secondary amyloidosis of the kidneys d) pyelonephritis e) urolithiasis

234.   The most specific laboratory parameters of rheumatoid arthritis is the detection of a high level of

blood:

a) C-reactive protein b) uric acid

c) factor and antinuclear antibodies to DNA d) rheumatoid factors and antibodies to circulating

citrulline peptide

235.  What disease characterized by high levels of rheumatoid factor and antibodies to the circulating peptide

citrulline:
a) acute rheumatic fever b) osteoarthritis

c) gout d) rheumatoid arthritis

236.The most specific radiological sign of rheumatoid arthritis is:

a) periarticular osteoporosis b) osteophytes and osteosclerosis

c) joint space narrowing d) marginal bone erosion

237.What disease characterized by marginal bone erosion in the joints of the X-ray of joints:

a) acute rheumatic fever b) osteoarthritis

c) gout d) rheumatoid arthritis e) ankylosing spondylitis

238. Functions of kidney:

a) excretory, regulatory, endocrine, metabolic; b) protein inhibitor, circulation, transportation,

excretory;

c) protein produced, regulatory, excretory; d) excretory, transportation, metabolic;

239. Glamerular filtration rate is:

a) 100-120ml/min b) 120-160ml/min

c) 80-60ml/min d)1010-1040ml/min.

240. Felty`s syndrome is:

a) the association of splenonegaly and neutropenia with RA;

b) the association of splenomegalia and neutropenia with SLE;

c) the association of hepato-splenomegalia with RA;

d) the association spleno-hepatomegaliawith SLE.

241. Treatmen of gout:

a)NSAIDs, corticosteroids; b)B-blocers;

c) H2inhibitors, NSAIDs; d) all of the above

242.        The time interval when active therapy can effectively slow down the progression of joint damage (so-

called "window of opportunity") for rheumatoid arthritis are as follows:

a) several hours to 2 days b) from a few days up to 2 weeks

c) from several weeks to two months d) from several months to 2 years

243.        Select the "basic" drug in the treatment of rheumatoid arthritis:

a) benzylpenicillin b) Biseptol (septran)

c) methotrexate d) chondroitin sulfate

244.        SLE is more common in:

a) boys and young men b) girls and young women

c) older men d) elderly women

245.        What is the natural factor can exacerbate SLE:

a) solar radiation b) the fog

c) magnetic storms d) high humidity

246.        The specific type of skin lesions in SLE is:

a) vitiligo b) hyperpigmentation

c) periorbital edema d) erythematous skin rashes on the face of the type "butterfly"

247.        Photosensitivity (increased skin sensitivity to sunlight) - is a particular feature:

a) rheumatoid arthritis b) gout

c) osteoarthritis d) systemic lupus erythematosus

248.        For systemic lupus erythematosus is characterized by joint damage in the form of:

a) arthritis of large joints b) arthrosis of large joints

c) unstable and non-progressive arthritis of small joints of the hands and feet

d) persistent and progressive arthritis of small joints of the hands and feet

249.   The young woman in a blood test found high levels of anti-double stranded DNA. What disease is

characterized by:

a) rheumatoid arthritis b) systemic lupus erythematosus

c) osteoarthritis d) ankylosing spondylitis

250. Antimitochondrial antibody is typically seen in:

a) hepatic cirrhosis; b) cardiac cirrhosis;

c) primarysclerosing cholangitis; d) primary biliary cirrhosis; e) hemochromatosis.

251. Which is not a complication of hepatic cirrhosis:

a) spontaneous bacterial peritonitis; b) hepatocellular carcinoma; c) thrombocytosis;

d) portal hypertension; e) portal vein thrombosis.

252. A 21-year-old woman presents with hypertension, fatigue, and mi-

croscopic hematuria. A renal biopsy demonstrates glomerulonephritis second-

ary to focal segmental glomerulosclerosis. Which of the following would be

the most appropriate step to take next in the treatment of this patient's disease:

a) renal dialysis; b) cyclosporine;

c) prednisone; d) cyclophosphamide;

253. A 45-year-old female complaints of increasing widespread joint

pains which are worse in the evening after a stressful day at work. She de-

scribes puffy hands and feet and a painful neck. Her concentration is very

poor and she has recently suffered from marital problems. Rheumatoid factor

is mildly positive. Examination reveals an increased body mass index and

global restriction of movement due to pain, but no synovitis. Which of the fol-
lowing investigations would be useful in this case:

a) anti-cycliccitrullinated peptide antibody; b) ultrasound scan hands and feet;

c) anti-JO-I antibody; d) erythrocyte sedimentation rate and CRP;

254. A 64 year old male presents with a symmetrical arthritis of both

hands with early morning stiffness. His X-rays of his hands done before clinic

show the following: periarticular osteoporosis of the metacarpeal joints; ero-

sion on the ulnar styloid; symmetrical distribution of disease; reduced joint

space at the carpal bones. What is the most likely diagnosis:

a) ankylosing spondylitis; b) rheumatoid arthritis;

c) gout; d) secondary osteoarthritis;

255. Osteoarthritis is characterized by all signs except:

a) degradation of articular cartilage and alterations in other joint tissues;

b) joint space narrowing, subchondral sclerosis, subchondral cysts, and pe-

ripheral osteophytes;

c) pain on movement, typically occurring when movement is initiated or

when the patient begins to walk;

d) morning stiffness in and around the joints, lasting at least 1 h before

maximal improvement;

256. A 25-year-old lady with known systemic lupus erythematosus (SLE)

presents with the nephrotic syndrome. A renalbiopsy is performed and this

confirms diffuse proliferative glomeronephritis (WHO Class IV). Which of the

following treatment regimens would you advise:

Variants of answer:

a) azathioprine alone; b) prednisolone alone;

c) azathioprine and prednisolone; d) prednisolone and intravenous cyclophosphamide;

257. Expected serum parameters in iron deficiency anemia are all except:

a) decresed serum iron level; b) decresed serum TIBC (total iron-binding capacity);

c) decresed MCHC; d) decresed serum ferritin level;

258. The complication of liver cirrhosis

1)esophageal bleeding 2)perforation of the stomach

3)penetration 4)pyloric stenosis

259. Rheumatoid nodules most often occur at the following points:

1) On the foot 2) In the region of the elbow joint

3) on the fingers of the brush 4) in the back of head area

 260.The most frequent type of systemic manifestations of rheumatoid arthritis

are:

a) rheumatoid nodules b) muscle inflammation

c) lymphadenopathy d) rheumatoidvasculitis

261.  Kidney damage in rheumatoid arthritis is manifested most often:

a) latent glomerulonephritis b) nephrotic glomerulonephritis

c) secondary amyloidosis of the kidneys d) pyelonephritis

262.The most specific radiological sign of rheumatoid arthritis is:

a) periarticular osteoporosis b) osteophytes and osteosclerosis

c) joint space narrowing d) marginal bone erosion

263.What disease characterized by marginal bone erosion in the joints of the X-ray of joints:

a) acute rheumatic fever b) osteoarthritis

c) gout d) rheumatoid arthritis

264. Rheumatoid arthritis is an autoimmune disease that is characterized by:

a) synovial inflammation and hyperplasia; b) autoantibody production;

c) cartilage and bone destruction;

d) systemic features, including cardiovascular, pulmonary, psychological,and skeletal disorders;

265. Which of the following is a first line drug for patient with rheumato- id arthritis:

a) ibuprofen;

b) methotrexate;

c) glucosamine sulfates;

d) pantoprazole;

266. Osteoarthritis is characterized by all signs except:

a) degradation of articular cartilage and alterations in other joint tissues;

b) joint space narrowing, subchondral sclerosis, subchondral cysts, and pe-

ripheral osteophytes;

c) pain on movement, typically occurring when movement is initiated or

when the patient begins to walk;

d) morning stiffness in and around the joints, lasting at least 1 h before

maximal improvement;

267. A 25-year-old lady with known systemic lupus erythematosus (SLE) presents with the nephrotic

syndrome. A renal biopsy is performed and this

confirms diffuse proliferative glomeronephritis (WHO Class IV). Which of the

following treatment regimens would you advise:

a) azathioprine alone; b) prednisolone alone;

c) azathioprine and prednisolone; d) prednisolone and intravenous cyclophosphamide;

268. Which is the most common cause of peptic ulcer disease (PUD) of

the following:

a) smoking; b) NSAID’s;

c) Zollinger-Ellison syndrome; d) ethanol excess;

269. Which is the most common complication of peptic ulcer disease:

a) perforation; b) gastric outlet obstruction;

c) penetration; d) haemorrhage;

270. Proton pump inhibitors are most effective when they are given:

a) after meals; b) shortly before meals;

c) along with H2 blockers; d) along with antacides;

271. Which of the following listed drug is given with bismuth salt in Heli-

cobacter pylori infection:

a) antacids; b) antibiotics;

c) ACE inhibitor; d) H2-receptor antagonists;

272. Which of the following is an early sign of hepatic encephalopathy in

a patient with cirrhosis of the liver:

a) restlessness; b) asterixis;

c) decreased serum ammonia levels; d) complaints of fatigue;

273. Ways of infecting in chronic pyelonephritis:

a) lymhpogeneous; b) hematogenous;

c) urogenous; d) all above;

274. General urinalysis in chronic pyelonephritis characterized by:

a) massive proteinuria; b) leucocyturia; c) hematuria; d) nephrotic syndrome;

275.Post-infective glomerulonephritis present as-

a) ARF

b) Nephrotic syndrome

c) Nephritic syndrome

d) Asymptomatic hematuria

276. All are true about rheumatic fever, except -

Common in poor socioeconomic group

Develops after streptococcal pharyngitis

Communicable disease
Seen in 5-15 year of children

277. Earliest valvular lesion in a case of acute rheumatic

fever is-

Mitral regurgitation (MR)

Aortic Regurgitation AR)

Mitral stenosis (MS)

Aortic Stenosis (AS)

278. Osier's nodes are typically seen in which one of the

following-

Chronic Candida endocarditis

Acute staphylococcal endocarditis

Pseudomonas endocarditis

Libman sack's endocarditis

279. Osier's nodes are seen at -

Heart

Knee joint

Tip of Palm &Sole

Anterior abdominal wall

280. Least common site for vegetation is -

Aortic Stenosis (AS)

Mitral Stenosis (MS)

Mitral Regurgitation (MR)

Atrial Septal Defect (ASD)

In a patient of heart disease antibiotic prophylaxis for dental extraction is -

a) Amoxycillin b)Imipenam

c) Gentamycin d) Erythromycin

282. Which one of the following serum levels would help in distinguishing an acute liver disease from chronic

liver disease - a) Aminotransaminase b) Alkaline phosphatase, c)Bilirubin d) Albumin

11. In hepatic cirrhosis, which of the following is increased –

a) Alpha 1 globulin b) Alpha 2 globulin

c) Gamma globulin d) All of the above

283. First line of treatment in severe ascites –

a)Bed rest and salt restriction b)Heavy peracentesis

c)Shunt d)Large dose of diuretics

13. Which of the following is not a precipitating factor for hepatic encephalopathy in patients with chronic liver

disease -

a)Hypokalemia b) Hyponatremia, c)Hypoxia d) Metabolic acidosis

284.Cause of vasodilatation in spider nevi-

a)Estrogen b) Testosterone c) Hepatotoxins d) Hyponatremia

285.A 40 year old patient, a known case of cirrhosis develops acute episode of GI bleed. Initial therapy given for

6 hours.Which of the following procedure is useful -

a)Nasogastric aspiration b) Urgent endoscopy c)Sedation d) Ultrasound

286. A young boy, R. presents with massive hemetemesis. He had fever for 15 days few days back which was

treated. Clinical examination reveal moderate splenomegaly No other history is positive Probable diagnosis is -

a) Drug induced gastritis b) Oesophageal tear b) Bleeding duodenal ulcer d) Oesophageal

varices

287. Adult organism contains:

1) 2-5 g of iron; 2) 4-5 g of iron; 3) 3-5 g

288. Symptoms of iron deaficiency are:

1) hair loss; 2) icteric skin; 3) increase of liver; 4) paresthesia

289. Iron supplementations are prescribed:

1) for 1-2 weeks; 2) for 2-3 month

3) for 2-3 weeks 4) for 1month

290. The level of ferritin in blood serum equal to:

a)10 - 12 mg / l, b)80 - 350 mg / l , c)10 - 30 mg / l, d)15 – 300 mg / l

291.Which of the following contains iron in the form of storage:

a) hemoglobin, b)ferritin, c)transferase, d)transferrin

292.A 45 - year old cirrhotic patient presented with severe haematemesis. The management of choice is-

a) Whole blood transfusion is the best

b) Colloids are preferred over crystalloids

c) Normal saline infusion

d) IV fluid with diuretics

293.An 18 yr old male presents with massive hematemesis, he has history of fever for the past 14 days for

which he was managed with drugs, moderate spleenomegaly is present, diagnosis is -

a) NSAID induced duodenal ulcer

b) Drug induced gastritis

c) Esophageal varices
d) None of the above

294. The criteria for recovery from iron deficiency anemia:

a)appearance of reticulocytic crisis in the first 7-10 days,

b) normalization of ESR,

c)The bone marrow hypoplasia,

d) The total protein level

295. Gastrin is prodused: a) H-cells; b) М-cells;

c). G-cells; d). Р-cells; , e) parietal cells.

296. Typical localization of chronic gastritis type A is: a). antral part of the stomach; b). gastroesophageal part

of the stomach; c). cardia; d). body of the stomach; e). pyloric part of the stomach.

297. A 70-year old male patient presented to the emergency department with pain in epigastrium and difficulty in

breathing for 6 hours. On examination, his heart rate was 56 beats per minute and the blood pressure was

106/60 mm Hg. Chest examination was normal. The patient has been taking omeprazole for gastroesophageal

reflux disease for last 6 months. What should be the intial investigation –

a)AnECG b)An upper GI endoscopy, c)Urgent ultrasound of the abdomen, d)An x-ray chest

298.Is characteristic of cytolytic syndrome:

a). increase: ALT, AST, LDG5 b). increase: direct bilirubin, alkaline phosphatase, uGTP, cholesterol,

c). The increase in indirect bilirubin, ALT decrease, uGTP

299. Is typical for mezenhimal - inflamatori syndrome:

a). reduction: albumin, prothrombin, transferrin, cholesterol b) increase: gammaglobulin ESR,

thymol, CRP c) increase: ALT, AST, LDG5

300. Intrinsic factor is produced in :

a). fundus area of the stomach b). duodenum, c). Serum, d).the wall of the small

intestine

301.The most common type of hepatitis associated with blood transfusion-

a)Hepatitis В, с) Hepatitis A d) Hepatitis D

302. In humans, iron is absorbed from food: a)in the fundal part of the stomach,

b)Duodenum, c)In the transverse colon

d)In the cecum, e)The upstream section of large intestine

303. In hepatic cirrhosis, which of the following is increased –

a) Alpha 1 globulin b) Alpha 2 globulin

c) Gamma globulin d) All of the above

304. Pain in epigastrium after meal is symptom ulcer disease of :a. stomach;

b. distal part of esophagus; c. duodenum.

305. Main clinical symptom in duodenum ulcer disease is:

a. pain on empty stomach; b. diarrhoea; c. eructation; d. early pain after meal;

e. nausea

306. A 27 year old male is is incidentally HBsAg positive. DNA-PCR for hepatitis В revealed 1000 copies/ml.

The patient is suffering from?

a) Active HBV carrier b) Acute hepatitis В с) Chronic hepatitis В d) Inactive HBV carrier

307. Chronic atrophic gastritis is caused by:

a). Antibody response to the G cells of the stomach, which reduces the production of gastrin leads to

achlorhydria; b. mucosal atrophy in patients with atherosclerosis; 

c. long-term use of glucocorticoids; d. NSAIDs.

308. Characteristic of pain in chronic gastritis:

a. localisation in mesogastriumbeginnig in night ;

b. localisation in right hypochandrium with irradiation in right shoulder;

c. localisation in epigastrium which is began after meal;

d. localisation in epigastrium which is redused after meal;

e. localisation in epigastrium, which is indused fat meal.

309. Localisaton of process in chronic gastritis В is:

a. antral part of the stomach; b. gastroesophageal part of the stomach;

c. cardia; d. body of the stomach

310. Parietal cells of stomach mucous produse:

a. gastrin; b. natriahydrocarbonat; c. pepsinigen; d. prostaglandins;

e. chloric acid.

311.Acute hepatocellular failure in a patient of cirrhosi: of liver is precipitated by -

a)Upper gastrointestinal bleeding,

b)Large carbohydrate meal,

c)Portal vein thrombosis,

d)Intravenous albumin infusion

312. Normal levels of Serum Iron :

a) 2-10 mmol / l, b)10-27mmol / l,

c)15-45 mmol / l, d)26-50 mmol / l,

e)8-16 mmol / l

313. For iron deficiency anemia is characteristic:

a)hypochromic anemia,
b)The increase in direct bilirubin, c)normochromic

anemia,

d)The increase in serum iron

314. Iron in the form of reserves is contained in:

a)hemoglobin, b)hemosiderin, c)transferase, d)transferrin

315. In which cases indicated the use of parenteral iron supplements?

a)with abundant hemorrhage,

b)when anemic coma,

c)at a syndrome of impaired intestinal absorption, d)in atrophicgastritis

316.A young man presents with HBsAg positive anti HBcIgM positive, HBeAg negative and normal levels of

AST and ALT. He is asymptomatic. What is the next line of management.

a)Wait and Watch b) Lamivudin

c)Immunoglobulin d) Liver Transplant

317.All the following hepatitis viruses is transmitted by parenteral route except-

a) Hepatitis В virus b) Hepatitis С virus

c) Hepatitis D virus d) Hepatitis E virus

318.Highest chance of transmission after needle stick injury is for -

a) Hepatitis В b) Hepatitis С

с) Hepatitis D d) hepatitis G

319.In the treatment of Hepatitis - С inferferon is combined with which drug?

a) Acyclovir b) Ribavarin

c)Lamivudine d) Indinavir

320. The normal rate of glomerular filtration by endogenous clearance is:

1)80 – 120 ml/min 2) 50 - 75 ml/min

3) 125 – 145 ml/min 4) 150 - 170 ml/min 5) 180 – 200 ml/min

321. What drugs are used to eradicate Helicobacter pylori?

a) amoxicilline, de-nol, metronidasole

b) omeprasole, metronidasole, amoxicilline, de-nol,

c) almagel, metronidasole,

d) sucralfate, metoclopramide

322. Normal serum bilirubin level is:

a. less than 1mg\dl,

b. less than 2mg\dl,

c. less than 3mg\dl,

d. less than 4mg\dl,

323. Post-infective glomerulonephritis present as-

a) ARF

b) Nephrotic syndrome

c) Nephritic syndrome

d) Asymptomatic hematuria

323. A 60 year old woman presents with generalized

edema, skin ulceration and hypertension. Urine examination shows subnephrotic proteinuria (< 2gm) and

microscopic haematuria. Serum complement levels are decreased and she is positive for antihepatitis с

antibodies. The likely diagnosis is -

a) PSGN

b) Essential mixed cryoglobulinemia

c) Membrano proliferative glomerulonephritis

d) Focal segmental glomerulosclerosis

324. A 30 year old man presents with generalized edema and hypertension. Urine examination shows

subnephrotic proteinuria (< 2gm) and microscopic hematuria. Serum complement levels are decreased and he

is positive for antihepatitis С antibodies. The most likely diagnosis is -

a) Post streptococcal Glomerulonephritis (PSGN)

b) Mixed ciyoglobulinemia

c) Membranoproliferative glomerulonephritis (MPGN)

d) Focal symentat glomerular sclerosis (FSGS)

325. Pathological changes of diabetic nephropathy are all except-

a) Fibrin caps and capsular drops

b) Intercapillary glomerulosclerosis

c) Focal sclerosis

d) Capillary basement membrane thickening

326. Urinalysis shows RBC casts; likely source is -

a) Kidney b) Ureter

c) Bladder d) Urethra

327. In hematuria of glomerular origin the urine is characterized by the presence of all of the following except-

(AI 04)

a) Red cell casts b) Acanthocytes

c) Crenated red cells d) Dysmorphic red cells

328. Presence of which of the following in the urine is diagnostic of glomerular injury- (AIIMS June 99)

a) Bright red cells

b) 20% dysmorphic RBC’s

c) 100RBC per high power field

d) Beta 2 micro globulin

329. Features of glomerular haematuria -

a) Dysmorphic R.B.C., R.B.C. cast

b) Fragmeneted R.BG.

c) Full of R.B.C. in high power field

d) Gross haematuria

330. All are used in treatment of Helicobacter pylori, EXCEPT-

a) Colloid bismuth b) Cisapride

c) Clarithromycin d) Metronidazole

331. Which drug is not effective against H.pylori-

a) Colloidal Bismuth b) Metronidazole

c) Amoxicillin d) Erythromycin

332. All are true regarding Helicobacter pylori except -

a) Less prevalent in developing countries

b) Toxigenic strains usually causes ulcers

c) Urea breath is positive

d) Gram negative organism

333. Diagnostic tests for H. Pylori include all of the following except-

a) Urea-breath test

b) Rapid urease test

c) Gastric biopsy & Warthin-starry stain

d) Amylase

334. A patient with H. pylori infection is treated with drugs. The best method to detect presence of residual H.

pylori infection in this person is -

a) Rapid urease test

b) Urea breath test

c) Endoscopy and biopsy

d) Serum anti H. pylori titre

335. All except one are true for hepatitis В -

a) Vertical transmission more important than horizontal

b) Age of onset determines prognosis

c) Period of communicability lasts several months

d) Virus can be found in blood 1 month before jaundice

336. Chronic hepatitis is caused by –

a) Hepatitis A, b) Hepatitis В, Hepatitis С

с) Hepatitis G d) Hepatitis E, Hepatitis C

338. Non-parenteral hepatitis is -

a) Hepatitis E b) Hepatitis В

с) Hepatitis С d) Hepatitis D

339.Most common type of hepatitis responsible for epidemics in India is –

a) Hepatitis A b) Hepatitis В

С) Hepatitis С d) Hepatitis E

340. In Chronic Viral Hepatitis -

a) Hepatitis A virus infection is a common cause in children

b) Morphological classification into Chronic Active Hepatitis and Chronic Persistent Hepatitis are

important

c) Fatty change is pathognomic of Hepatitis С virus infection

d) Grading refers to the extent of necrosis and inflammation

341. A 71-year-old female is brought to your clinic by her daughter with a complaint of severe pain in her

fingers.

Her daughter says, "Mom has horrible problems with her joints and she has never tried to get help". The

patient adds that her fingers have been swollen and painful for a few weeks. She claims that she had a

similar condition in her foot last year. She was given a pain pill, but it was ineffective. She takes a water pill

for her blood pressure. What is the most likely diagnosis in this patient?

A. Rheumatoid nodules

B. Gouty arthritis

C. Severe osteoarthritis

D. Bone tumor

342. 35yo male with epigastric discomfort has been given triple therapy. He has

now returned after 4wks of epigastric discomfort. What inv would you do for

him?

a) ECG

b) H pylori breath test

 c) Endoscopy and biopsy

d) US

350. A 64yo alcoholic who has been dx with liver cirrhosis presents with a massive

ascites. What is the mechanism of fluid accumulation in a pt with liver disease?

a. Cirrhosis

b. Portal HTN

c. Hypoalbuminemia

d. Liver failure

e. Hepatic encephalopathy

351. A 45yo male alcoholic presents after a large hematemesis. He has some spider

naevi on his chest, BP=100/76mmHg, pulse=110bpm. He has a swollen

abdomen with shifting dullness.

a. Gastric ca

b. Peptic ulceration

c. Esophagitis

d. Esophageal varices

352. A 34yo man has an intermittent epigastric pain for 3wks. It is worse by

food but helped by some tablets he obtained from the pharmacy. He had a

similar episode 3yrs ago and his doctor gave him a course of 3 types of tablets

at the time. What is the most appropriate next inv?

a. Abdomen US

b. Barium meal

c. Serum H.Pylori antibodies

d. Urea breath test

e. Upper GI endoscopy

353. A 15yo boy presents with generalized edema. His urinalysis reveals protein

+++, eGFR =110. What is the most likely dx?

a. IgA nephropathy

b. Membranous nephropathy

c. Minimal change disease

d. Lupus nephritis

354. 46yo man, known case of chronic GN presents to OPD. He feels well. BP =

140/90mmHg. Urine dipstick: protein ++, blood ++ and serum

creatinine=106mmol/L. Which medication can prevent the progression of this

dx?

a. ACEi b. Diuretics

c. Cytotoxic meds d. Longterm antibiotics e. Steroids

355. A 27yo man presents with abdominal pain. He says his urine is dark. Exam:

BP=160/105mmHg. What is the most appropriate inv?

a. US b. Renal biopsy c. CT d. Urine protein e. Urine microscopy

356. A 35yo man presented with hematuria, abdominal swelling and has a BP of

190/140. What is the most diagnostic inv?

a. Cystoscopy b. USG c. CT d. Renal biopsy

357. A 32yo man develops hematuria 2wks after a sore throat. What is the dx?

a. Post infection nephritis b. IgA nephropathy

c. Membranous nephritis d. Glomerulonephritis

358. A man has a BP of 160/90mmHg, proteinuria++. KUB US are equally reduced in

size with smooth borders and normal pelvic calyceal system. What is the cause of HTN in the pt?

a. Chronic glomerulonephritis b. Chronic pyelonephritis

c. Bilateral renal artery stenosis d. Essential HTN e. Polycystic kidney

359. 30yo man complains of vague pain in the loin with BP=140/90mmHg. He is

found to have proteinuria and hematuria. What is the inv to confirm the dx?

a. Abdominal US b. ANCA c. ANA

d. Urine microscopy and culture e. Stool culture

360. A child presents with increasing jaundice and pale stools. Choose the most appropriate test?

a. US abdomen b. Sweat test c. TFT d. LFT