PANEL 1

1) 60 years male DM patient for almost 10 years. Medications mentioned. Visit for annual visit,
fundoscopy done, which of the following is a hall mark of diabetic retinopathy

a) Blot hemorrhage

b) Cotton wool sopts

c) Neovascularization

d) Optic atrophy

2) Which of the following not character of metabolic syndrome

a) Hypertension

b) Hyperthyroidism

c) Obesity

d) insulin resistance

3) For complications of diabetes how much of beta cells should be destructed

a) 20 t0 30%

b) 70 to 80 %

c) 100%

d) 30 to 40%

4) In case of DKA which is the most important keton body

a) Aceton

b) Betahdroxybutarate

c) Acetoacatic acid

5) Which of the following cause manifestations of DKA

a) Increased free fatty acids

b) Increased glucagon

c) Increased insulin

d) Increased aminoacids

Acetoacotic for urine

6) Which type of nutrients is best included in diet for treatment of hypertriglyceridemia

a) Cholesterol

b) Long chain triglycerides

c) Medium chain triglycerides

d) High carbohydrates

7) In type 1 diabetes pancreas with destructed islets is infiltrated with which of the following
cells

a) Delta cells

b) Lymphocytes

c) Macrophages

d) Fibroblasts

8) Diabetic patent developed proteinuria and which is the antihypertensive drug of choice
regardless blood pressure readings

a) Furosemide

b) Thiazide

c) enalapril

d) Spironolactone

9) Which of the following is not cause of abortion before 20 weeks

a) Malaria

b) Spirochetes

c) Rubella

d) Toxoplasmosis
10) Drug used for induced abortion by acting on progesterone receptors in the uterus

a) Misoprostol

b) Mifepristone

c) Gemeprost

d) All of the above

11) Most common cause of first trimester abortion

a) Autosomal trisomy

b) Infection

c) Old paternal age

d) old maternal age

12) which of the following associated with old paternal age

a) down syndrome

b) turners syndrome

c) marfans syndrome

d) Edwards syndrome

13) which of the following associated with old maternal age

a) down syndrome

b) turners syndrome

c) marfans syndrome

d) Edwards syndrome

14) Coal miner worker had an accident and crushed his right leg which of the following

Is most associated pathology with compartment syndrome

a) Nerve entrapment

b) Muscle edema

c) Arterial injury
d) Venous thrombosis

15) Which of the following regions is commonly involved in compartment syndrome

a) Forearm

b) Thigh

c) Abdominal muscle

d) Pelvic muscles

16) Which is the most common type of injury associated with compartment syndrome

a) Open fracture

b) Closed fractures

c) Iatrogenic

17) This is a biopsy stained positive by PAS which is the most likely diagnosis

a) Chrons disease

b) Ulcerative colitis

c) Whipples disease

d) Coeliac disease

18) If the affected part was terminal ilium what will be the expected deficiency

a) Vit B6

b) Calcium

c) vit B12

d) vit B1

19) if same patient shows prolonged bleeding time and tendency to bleed what would be the
expected deficiency

a) Vit B6

b) Calcium
c) vit B12

d) Vit K

20) What is the antidote of warfarin

a) Dicumarol sulphate

b) Vit K

c) Cryoprecipitate

d) Vit C

21) Which of the following is associated with appearance of string sign in barium study

a) Chrons disease

b) Ulcerative colitis

c) Whipples disease

d) Intestinal carcinoma

22) Picture of barium study which of the following risk factor for GERD associated with defective
peristalsis

a) Stomach cancer

b) Hiatal hernia

c) Obesity

d) All of the above

23) Which of the following foods contraindicated in GERD

a) Tomato

b) Spicy food

c) Peppermint

d) All of the above

24) Use of PPI is associated with which of the following

a) Bleeding

b) Strictures

c) Obstruction

d) Non of the above

25) Use of PPI increases risk of colitis caused by which of the following

a) H pylori

b) Clostridium deficil

c) Rota virus

26) Which hormone is responsible for maintaining basal metabolism

a) Leptin

b) Corticosteroid

c) Ghrelin

d) Thyroid hormone

27) Which hormone has negative feedback inhibitory effect on the hypothalamus

a) Leptin

b) Corticosteroid

c) Ghrelin

d) Thyroid hormone

28) Which malignancy metastize most to the adrenal gland

a) Breast cancer

b) Bone cancer

c) Lymphoma

d) Melonoma

29) Bone formation in bone and fascia after elbow trauma

a) Osteosarcoma
b) Dermatomyocitis

c) Dystrophic calcification

d) Myositis ossifcans

30) Which of the following is a cause of dystrophic calcification? (This question was not there in
Septem 25, 2020 exam as far as I remember)

a) Osteosarcoma

b) Dermatomyocitis

c) Dystrophic calcification

d) Myositis ossifcans

31) Which of the following drugs cause pancytopenia

a) Linezolide

b) Chloramphenicol

c) Beta lactam inhibtors

d) Phenytoin

32) An x-ray for a child showing bow legs what is the likely diagnosis

a) Osteoporosis

b) Osteogenesis imperfect

c) Rickets

d) Pagets disease

33) In same patients if there is normal level of 25 hydroxycholecalcepherol and hyperparathroid

manifestation what would be the defective organ

a) Liver

b) Lung

c) Kidney

d) Bone
34) In same patient plus vitamin supplement what would you add for treatment

a) Ca phosphate

b) Mg

c) Zinc

Note= No calcium was there in choice

35) In the same patient what is expected lab. Findings

a) Low serum Ca

b) Low active vitamin D

c) Hyperparathyroidism

d) All of the above

36) Hand picture with wicham stria which is the diagnosis

a) Lichen sclerosis

b) Lichen planus

c) Psoriasis vulgaris

d) Contact dermatitis

Note = The question was same but I could not find the pic that was in exam.

37) Diagnosis :

a. Guttate Psoriasis

b. contact dermatitis

38) Same question which is the infection associated with guttate psoriasis

a) HSV
b) HCV

c) Betahemolytic streptococci

39) Which of the following cells important in staging ofAIDS

a) CD4 cells

b) Cd5 cells

c) Lymphocytes

d) Macrophages

40) Test specific for assessment of exocrine pancreatic functions

a) Secretin test

b) Lipase

41) Which of the following is responsible for maturation of RBCs

a) Essential fatty acids

b) Folic acid

c) Iron

d) Vit C

42) Which of the following is usual site of acne

a) Face

b) Chest

c) Back

d) All of the above

43) Drug used in acne causing hypercholesterolemia

a) Antibiotics

b) Selenium

c) Isotretenoin

d) Glucocorticoids
44) Drug which cause worsening of acne

a) Antibiotics

b) Selenium

c) Isotretenoin

d) Glucocorticoids

45) Which of the following is x-linked lysosomal storage disease

a) Tay sash disease

b) Fabreys disease

c) Gausher disease

46) Drug of choice in low renin hypertension with renal fibrosis

a) Spironolactone

b) Losartan

c) Furosemide

47) Patient with stroke suffering from motor aphasia which of the following is motor speech
area of the brain (articulate speech);

a) Temporal lope

b) Pons

c) Brocas area

d) Wernics area

48) Which of the following PFT result is diagnostic to Idiopathic Pulmonary Fibrosis;

a) Increased Total Lung Capacity

b) Increase Residual Volume

c) Increased or normal FEV1/FVC

d) Decreased FEV1/FVC

49) Same patient of IPF, which of the following is characteristic to long standing extensive
disease;
a) Respiratory ronchi

b) Clubbing

c) Wheezy chest

d) Productive cough

50) Same patient of IPF, which of the following antibodies are common in all types of lung
fibrosis;

a) Anti ds DNA

b) Anti nuclear antibody`

51)Heavy smoker patient diagnosed to have COPD which of the following is diagnostic

Decreased TLC

Increased FEV1

Decreased FEV1

Decreased RV

52) Most important factor that improves diagnosis in previous patient?

Corticosteroids

Albuterol

Smoking cessation

Long acting beta agonist

53) which of the following is cause of transudate pleural effusion?

Tb

Pneumonia

Liver cirrhosis

Malignancy

54) Which is the criteria for transudate effusion? (LIGHT CRITERIA)

a. serum to pleural fluidprotein is more than 0.5

b. serum to pleural fluid LDH is more than 0.6

c. Pleural fluid LDH is more than two thirds of normal value

d. none of above

55) If pleural fluid aspiration shows milky white fluid which is expected in:

a. tb

b. pneumonia

c. LIver cirrhosis

d. thoracic duct obstruction

56. If pleural effusion is separating layers of pleura by 10mm what is to be done next

a. Decortication

b. Thoracocenthesis

c. Lobectomy

d. Diuretics

57) How much calorie gained from burning 1 gram of fat?

a. 4

b. 9

c.12

d. 10

58) Patient diagnosed to have SLE with no renal involvement which is antibodies associated with
thrombogenic glomerulopathy;

a. Anti ds DNA

b. ANA

c. Antiphospholipids

d.Anti basement membrane

59) Which is most common type of hepatitis associated with SLE

a. Hep B

b. Hep C

c. Hep A

d. All of the above

60) Which type of membrano proliferative glomerulonephritis is caused by SLE

a. Type 1

b. Type 2

c. Type 3

d. All of the above

61) In some patient which is site of immune complex deposition

a. Sub epithelial
b. Sub endothelial
c. Parenchymal
d. Mesangeal

62) Microscopic picture of gram negative diplococcic which is the organism

a) N meningitides

b) Campylobacter

c) Streptococci

d) Klebsiella

63) History of old patient with chest infection and hypotension which nasopharyngeal inhabitant
stained as gram negative cocci can cause this condition

a) N meningitides
b) Campylobacter
c) Streptococci
d) Klebsiella

64) Which of the following cause adrenal hemorrhage as part of water house fredrikson
syndrome

a) N meningitides

b) Campylobacter

c) Streptococci

d) Klebsiella

65) Most common infections causing of PID

a) Gonnorhea

b) HSV

c) Toxoplasmosis

d) Syphilis

66) Cause of silent PID that cause more destruction and invasion

a) Gonnorhea

b) HSV

c) Toxoplasmosis

d) Chlamydia

67) Which of the following SSRI is not P450 inhibitor

a) Fluoxetine

b) Sertraline

c) Ecitalopram

68) Patient diagnosed to have MI two years ago….no suffering from AF and has signs of left
ventricular failure which is the most appropriate drug for prevention of further attacks

a) Sotalol
b) Adenosine

c) Digitalis

d) Flecainide

69) What is the expected HR in AF patient if he supposed to have high vagal tone

a) 140 to 160

b) 120 to 140

c) above200

d) Below 100

70) AF patient on long term anti arrhythmic drugs ..start to develop apathic attitude with weight
gain which is the probable drug that cause those manifestations

a) Adenosine

b) Digitalis

c) Flecainide

d) Amiodaraon

71) Patient admitted to the hospital with chest pain...SOB…diagnosed as MI. later for further
investigation ECG was done showing global left heart dysfunction. treadmill test was done what
is expected to be the most important finding

a) Hypotension

b) Chest pain

c) Tachycardia

d) Non of the above

72) ECG findings in CHF

a) St segment elevation

b) Left ventricular hypertrophy

c) Prolonged QRS

d) Abnormal Q wave
73) Potassium sparing diuretic acting via inhibition of sodium reabsorption at DCT

a) Furosemide

b) Thiazide

c) Metolazon

d) Amiloride

74) Drug used to restore volume in patient with heart failure with good ejection fraction

a) Furosemide

b) Thiazide

c) Metolazon

d) Spironolactone

75) In previous patient which element should be restricted in his diet

a) K

b) Mg

c) Na

d) Cholesterol

76) Cause of delusion seizures

a) Epilepsy

b) Depression

c) Alcohol withdrawal

77) Alcohol acts via enhancing which of the following

a) Serotonin

b) GABA

c) Glutamate

78) Alcohol abuse causes deficiency of which vitamin

a) Vit K

b) Vit E

c) Vit B1

d) Vit B3

79) Drug of choice for treatment of alcohol withdrawal

a) Carbamazepine

b) Diazepam

c) Phenytoin

d) Lithium

80) Type of seizures in alcohol withdrawal

a) Simple partial

b) Generalized tonic clonic

c) Tonic only

d) Clonic only

81) Which drug is used to control and decrease frequency of withdrawal seizures and improve
psychomotor effect of alcohol cessation

a) Carbamazepine

b) Diazepam

c) Phenytoin

d) Lithium

82) 60 year old patient having chest infection for 3 months came to ER and patien sudden SOB
what would be the likely diagnosis. No X ray was given

a) Pleural effusion

b) Pneumothorax

c) ARDS
d) Pulmonary edema

83) Traumatic patient reach the ER un cooperative after investigation there was equalization of
pressure in heart chambers what would be the diagnosis.

a) Pleural effusion

b) Pneumothorax

c) Cardiac tamponade

d) Pulmonary edema

84) Old patient with LL edema, protuberant abdomen, excertional dyspnea ,faint S3 heard over
the apex what would be the diagnosis

a) Constrictive pericarditis

b) Cardiac tamponade

c) Acute MI

d) Restrictive cardiomyopathy

https://www.amboss.com/us/knowledge/Cardiomyopathy

85) Which is the most common cause of restrictive heart disease

a) Infection

b) Sarcoidosis

c) Amyloidosis

86) Old patient with sluggish movement and speech and kinetic tremors which neurotransmitter
supposed to de deficient in this patient

a) Serotonin

b) GABA

c) Dopamine

d) Acetylecholine

87) Which of the following cause secondary parkinsonism

a) Lithium

b) Amiodaron

c) chlorpromazinea

d) all of the above

88) In previous patient which drug in course of treatment can cause tardive dyskinesia

a) Amantadine

b) L DOPA

c) Phenytoin

d) promocreptin

89) Which of the folloing is associated with autoimmune polyglandular syndrome type 1

a) Chlamedia

b) Candida

c) EBV

d) HPV

90) Which is most common site for TB arthritis

a) Knee

b) Shoulder

c) Hip

d) Vertebrae

91) GAD is common to occur in which patients

a) Mania

b) OCD

c) Depression
d) Schizophrenia

92) Most common feature of GAD

a) Poor concentration

b) Delusions

c) Mania

d) Depression

93) Picture what is this sign

a. Clubbing

94) Concerning bladder pain syndrome

a) Common in females

b) No signs of inflammation in cystoscopy

c) Associated with other immune diseases

d) Pentosan polysulphate is the only approved drug by FDA for treatment

Note= 1. a,b,c= true 2. b,c,d = true 3. a,b,c,d = true

Every optionsa was having b as true so i selected all options are true.

95) Which of the following is true about screening test

a) For common diseases

b) Concerned with early detection and prevention of diseases

c) Associated with increasing survival rate of patient in all studied diseases

d) Deal with diseases with long standing duration

96) Case control study

a) Designed to detect risk factors of diseases

b) Control group are chosen randomly away from main group

c) Study is done in specific period of time

d) Reliable and economic

97) Known case of bulimia nervosa which is true

a) Presence of lanugo hair

b) Binge eating

c) Hypokalemia

d) Hypochloremia

98) Concerning obstructive sleep apnea

a) Obesity is most common cause

b) it can cause dysrhythmias and stroke

c) alcohol s not a risk factor

d) it is divided into central and peripheral OSA

99) concerning narcolepsy in a child who has a family history as one of his uncles has same
condition

a) Sleep study may be helpful in diagnosis

b) caring of sleep hygiene is part of treatment plan

c) lithium and mood stabilizers used for treatment

d) amphetamines got no role in treatment

100) regarding bells palsy

a) most cases are bilateral

b) there is swelling of geniculate ganglion

c) there is blisters in external auditory canal and skin around

d) herpes zoster account for more than one third of cases

101) regarding patient autonomy

a) maintain patient confidentiality

b) informed consent and helping patent to take his own decision

c) providing best medical services to the patient

d) Avoid patient deception

102) Regarding delirium tremens

a) Seizures occur after 1 to 2 weeks

b) It is a brief self limiting event

c) Dilantin got no role in treatment

d) Tricyclic antidepressant are contraindicated

103) Regarding TB arthritis

a) Involve small non weight bearing joints

b) Usually progressive monoarthritis

c) Aspiration of synovial fluid doesn’t contain mycobacteria

d) Commonly associated with systemic manifestation

104) Regarding spermatocele

a) It is painless

b) Doesn’t trans illuminate

c) Epididymal cyst

d) It doesn’t affect fertility

105) Which of the following increased in tumoral calcinosis

a) Calcium

b) Phosphate

c) ALP

106) Patient developed contact dermatitis what is type of hypersensitivity reaction

a) Type 1

b) Type 2
c) Type 3

d) Type 4

107) In same patent which cell is responsible for immune response

a) T cells

b) B cells

c) Macrophages

108) Long scenario of Hypertensive patient admitted hospital after sudden hypotension

a) Pituitary adenoma

b) Pituitary apoplexy

c) Ischemic stroke

109) Clutton join…. Sacroiliitia…… tabes dorsals

a) congenital syphilis

b) Secondary syphilis

c) Tertiary syphilis

110) Concerning wound healing (( …unopposed open edges….open then closed later opposed
wound edges)))

a) Primary intention

b) Secondary intention

c) Tertiary intention

111) Concerning wound management ((hydrocolloid… debridement…polyemeric materials))

a) Necrotic ulcer

b) Tissue loss

c) Wound suture

112) eclampsia…pregnancy induced hypertension Preeclampsia…

a) Hypertension and proteinuria

b) Hypertension and convulsions

c) Hypertension after 20 weeks of pregnancy

113) colchicine Allopurinol…… …probenecid

a) hypersensitivity

b) bloody diarrhea

c) water retension

114) Mitral prolapse… aortic regurge... Mitral stenosis….

a) Opening snap

b) Whooping murmur

c) Corrigan sign

115) pyelonephritis….Glomerulonephritis… Graft rejecton

a) RBCs cast

b) WBCs cast

c) Tubular epithelial cast

116) SAnode…AV node…. bundle of his

a) Right atrium

b) Sulcus terminalis

c) Inter ventricular septum

117) carcinoid…. sideroplastic anaemia.. Alcoholism….

a) Vit B1

b) Vit B3
c) Vit B6

118) Albers Schonberg disease….. Maccune Albright syndrome... buschke ollendroff syndrome

a) Fibrous dysplasia

b) Osteopetrosis

c) Osteopikilosis

119) …. Korsacoff syndrome ….Wernics encephalopathy Cerebellar atrophy

a) Ophthalmoplegia

b) Anterograde amnesia

c) Gait disturbance

120 Lactotrophs… gonadotrophs ) Somstotrophs….

a) IGF 1

b) Dopamine

c) Inhibin

121 Acyclovir...... Aminoglycosides.....Amphotericin B

a) Tubular necrosis

b) Renal vasoconstriction

c) Tubular obstruction

THANK YOU HAAD GROUP