Medicine I BCQs

NOTE: ALL QUESTIONS TAKEN FROM DIFFEFENT PAST

PAPERS OF LUMHS

Ali Akbar Soomro ( IMC/2k15 )...........

Q1 A male patient 40 years having history of recurrent of cough with sputum at

early morning. The sputum was foul smelling. O/E patient have clubbing and
coarse crepitation all over the chest. What is most likely diagnosis
A) Pulmonary TB
B) Bronchiectasis
C) Chronic Bronchitis
D) Pneumonia
E) Carcinoma of lung
Q2 A 60 year old male smoker with 70 packs year. His CT scan shows peripheral
situated mass in left hemithorax with rib erosion. How will you confirm diagnose
A) X-ray chest
B) Percutaneous lung biopsy is not performed under radiology
C) Percutaneous lung biopsy is useful for peripheral lung lesion
D) Trans bronchial biopsy is performed under ultrasound
E) CT chest
Q3 Gold standard investigation for pulmonary diagnosis of pulmonary
tuberculosis in a patient who has history of cough, fever and weight loss for more
than three weeks
A) Sputum for AFB culture
B) Tuberculin test
C) Radiology of chest
D) Gastric aspirate
 E) Laryngeal swab
Q4 In a patient with pleural effusion clinical examination of chest will reveal
A) Decreased chest movement on affected side
B) Hyper resonant note on affected side
C) Normal chest movement on the affected side
D) Trachea pulled on the affected side
Q5 A 18 year old girl referred from gynaecology OPD for physician opinion with
complain of primary amenorrhea and short stature , no history of diabetic
mellitus, celiac disease and thyroid disease. O/E short stature with webbing of
neck and poorly developed secondary sexual characteristic. what is diagnosis
A) Celiac disease
B) Cystic fibrosis
C) Down’s syndrome
D) Diabetes mellitus
E) Turner syndrome
Q5 The best treatment for hyperkalaemia in acute emergency
A) Dialysis
B) Inhaled B2 agonists
C) IV calcium gluconate 10 ml of 10% dextrose water
D) IV soda bicarbonate
E) IV glucose and insulin
Q6 Which of the following feature differentiate CRF from ARF
A) Acidosis
B) Anaemia
C) Bleeding
D) Infections
E) Renal osteodystrophy
Q7 Nephrotic syndrome is characterised by
A) Low serum cholesterol
B) Low blood pressure
 C) Non pitting oedema
D) Raised urinary albumin
E) Raised serum albumin
Q8 All of the following are side effects of loop diuretics except:
A) Hypokalaemia
B) Hypomagnesaemia
C) Hyperkalaemia
D) Water retention
E) Ototoxicity
Q9 A 80 years old lady presented to her general practitioner with a 24 hours
history of profuse diarrhoea and mild abdominal pain. Her type 2 diabetes
mellitus had been treated with metformin for 10 years. Two days previously, she
had been discharged from hospital, following treatment for community acquired
pneumonia. Her medication was omeprazole 20mg once daily and metformin
500mg twice daily. What is most likely explanation for her diarrhoea
A) Clostridium deficile toxin
B) Constipation with overflow
C) Diverticulitis
D) Metformin
E) Omeprazole
Q10 The 60 years old man presented in medical emergency with tachypnea, on
arrival BP 90/50mm Hg , pulse 100/min, bounding pulses with warm extermition,
lab report shows TLC 18000/cmm. Patient is suffering from
A) Anaphylactic shock
B) Cardiogenic shock
C) Hypovolemic shock
D) Neurogenic shock
E) Septic shock
Q11 20 years female taken 20 tablets of aspirin to attempt suicide. Patient is
admitted in the intensive care unit, vitals and clinical examinations was noted and
base line investigation was sent. Her serum concentration of salicylate is above
700mg/dl. At this stage what is the most appropriate treatment of this patient will
be
A) Activated charcoal
B) Haemodialysis
C) IV sodium bicarbonate
D) IV fluid of dextrose and saline
E) Urinary alkalization
Q12 Most appropriate treatment in organophosphorus poisoning in emergency
A) Atropine and paralidoxime
B) Flumazenil
C) Glucose
D) Naloxone
E) Pyridoxine
Q13 Metabolic acidosis with normal anion gap may result from
A) Diabetic ketoacidosis
B) Renal failure
C) Aspirin poisoning
D) Methanol poisoning
E) Renal tubular acidosis
Q14 the most common etiology of nephrotic syndrome in adult is
A) IgA nephropathy
B) Lupus nephritis
C) Minimal change disease
D) Membranous nephropathy
E) Rheumatoid arthritis
Q15 A 65 years old male came for a routine clinical examination, it was found to
have pulse rate 72, regular BP 12/90mm Hg, a thrusting apex beat and an ejection
systolic murmur. The most probable diagnosis
A) Atrial septal defect
B) Aortic regurgitation
C) Aortic stenosis
 D) Mitral stenosis
E) Pulmonary stenosis
Q16 55 years old man came to emergency with complain of retrosternal
heaviness. On examination pulse rate was 80, BP is 120/80, heart sounds were
muffled, resting ECG was low voltage, chest x-ray shows cardiomegaly. The most
probable diagnosis is 3
A) Acute pericarditis
B) Cardiac tamponed
C) Constrictive pericarditis
D) Pericardial effusion
E) Dilated cardiomegaly
Q17 Common cause of acute pericarditis
A) Acute myocardial infarction
B) Malignant disease
C) SLE
D) Trauma
E) Uraemia
Q18 Tachycardia is feature of
A) Hypothermia
B) Hypothyroidism
C) Hypoglycaemia
D) Raised intracranial pressure
E) Beta blocker toxicity
Q19 The characteristic of ischemic cardiac chest pain is
A) It is located in centre of chest
B) Chest pain is not radiated
C) It is sharp cutting like
D) It is spontaneous not related to exertion
E) It is not relieved by rest
Q20 In the acute pancreatitis clinical presentation is
 A) Epigastric pain and radiate to back
B) History of excessive fat intake
C) Fever and abdominal distension
D) Excessive alcohol intake
E) Leucocytosis and elevated serum amylase
Q21 Regarding clinical feature of ulcerative colitis
A) In limited disease tenesmes, constipation and rectal bleeding occur
B) In extensive disease bloody diarrhoea, abdominal cramps is predominate
C) Systemic feature of weight loss, fever and tachycardia are seen
D) Symptoms tends to present acutely
E) It may be insidious in onset
Q22 A 45 years old lady presented with dysphagia since 4 months. On
examination she was grossly anaemic, koilonychia and palpable cervical lymph
nodes. What is most likely diagnosis
A) Esophageal erosion
B) Carcinoma of oesophagus
C) Plummer Vinson syndrome
D) Chronic gastritis
E) Benign esophageal stricture
Q23 you are asked to examine pulse of 55 years old male who has aortic stenosis,
the character of pulse is best assessed in which of the following artery
A) Brachial artery
B) Carotid artery
C) Femoral artery
D) Popliteal artery
E) Radial artery
Q24 Characteristic of right heart failure are, except
A) Raise JVP
B) Pulmonary oedema
C) Ascites
D) Peripheral pitting edema
 E) Hepatomegaly
Q25 A 40 years old male present with dyspnoea on exertion, on examination
raised JVP with paradoxical rise during inspiration, hepatomegaly and ascites.
Chest x-ray shows a small heart with calcification. The most likely diagnosis
A) Viral pericarditis
B) Constrictive pericarditis
C) Cardiac tamponed
D) Congestive cardiac failure
E) Down’s syndrome
Q26 Dysentery ( bloody diarrhoea ) is not caused by
A) Clostridium deficile
B) Shigella
C) E.coli
D) Rotavirus
Q27 Which one of the following is the best clinical feature of constrictive
pericarditis
A) Elevated JVP with typical ..
B) Rapid irregular pulse
C) A raise in JVP during inspiration
D) Pulses paradoxicus always
E) Painful hepatomegaly
Q28 Which of the following is important factor for sudden death in hypertrophic
cardiomyopathy
A) Recurrent syncope
B) Exercise induced chest pain
C) Increased in left ventricular wall thickness
D) Repeated attack of ventricular tachycardia
E) A history of previous T.I.A
Q29 A 42 years old male with known valvular heart disease develops fever for one
week . he appears unwell. Finding include pan systolic murmur at the apex that
radiates to the axillae and soft 1st heart sound. He has linear haemorrhage under
finger nails and painful, tender erythematous nodules on some of the finger tips.
Which one of the following is true
A) Infective endocarditis
B) Rheumatic heart disease
C) Pericarditis
D) Mitral stenosis
E) Aortic insufficiency
Q30 A 2e years old man developed sharp left sided chest pain , fever and friction
rub heard at the lower left sternal border, unaffected by respiration. The pain is
also aggravated by lying down and relieved by sitting up. He is otherwise well with
no other symptoms. Which of the following is most likely cause for his symptoms
A) M.I
B) Pericarditis
C) Tuberculosis
D) Rheumatic fever
E) Pneumonia
Q31 A 55 years old male present with a new onset of a chest pain, breathlessness
and sweating. The pain is severe , located in the centre of his chest and radiates
into left arm. The pain lasts more than 30 minutes. The most likely diagnosis
A) Aortic dissection
B) Angina
C) Myocardial infarction
D) Pulmonary embolism
E) Mitral insufficiency
Q32 Characteristic of left heart failure are, except
A) JVP not raised
B) Pulmonary oedema
C) Cardiomegaly
D) Pleural effusion
E) Pitting oedema
Q33 Anti CCP antibody is positive in:
 A) SLE
B) Rheumatoid arthritis
C) Psoriasis
D) Systemic sclerosis
E) Dermatomycosis
Q34 Pericardial effusion is best diagnosed by
A) Clinical examination
B) Electrocardiography
C) Cardiac enzymes
D) Echocardiography
E) X-ray chest PA view
Q35 Regarding Wilson disease all are true, select the best one
A) Increased urinary copper level
B) Liver transplant is treatment of 1st choice
C) Parkinsonism is rare feature of Wilson disease
D) Renal tubular acidosis is a common complication
E) Serum ceruoplasmin is increased
Q36 In diagnosis of COPD all are true; select best one
A) PEFR
B) TLC ( total lung capacity )
C) Gas transfer factor
D) FVC ( forced to vital capacity )
E) FEVI/FVC ratio
Q37 Following are the signs of pneumonic consolidation; select best one
A) Decreased chest movement on affected side
B) Dull percussion note on affected side
C) Chest crepitation on affected side
D) Bronchial breathing
E) Shifting of trachea
Q38 Which of the following noticed in sarcoidosis
 A) Elevated uric acid level
B) Hypophosphatemia
C) Hypogamma globinemia
D) Increased level of serum calcium
E) Leukopenia
Q39 10 years old boy was presented with increased hunger, fever 102 F and
weakness. At the time of examination blood sugar was 350mg/dl. What will be
next step for this boy
A) Admit in hospital and start insulin, fluids
B) Let him go to home on oral hypoglycaemia drugs
C) Start insulin as out door patient
D) Encourage water intake, antibiotics administration
E) Repeat blood sugar after 2 days
Q40 A 25 years old male patient present with low grade fever and weight loss, on
examination of chest movement are decreased on right side with decrease vocal
fremitus , dull percussion note and absent breath sounds, trachea shifted to left.
Most likely diagnosis is
A) Pneumothorax
B) Pleural effusion
C) Pneumonic consolidation
D) Emphysema
E) Bronchiectasis
Q41 A 26 years pregnant lady using following anti tuberculosis drugs. Which of
the following is best avoided
A) INH
B) Rifampicin
C) Ethambutol
D) Pyrazinamide
E) Streptomycin
Q42 Majority of the cases of community acquired pneumonia are caused by
A) Mycoplasma pneumoniae
 B) Streptococcus pneumoniae
C) Haemophilus influenza
D) Clamydia pneumoniae
E) Staphylococcus aureus
Q43 A 55 years old male during performing Hajj at Saudi Arabia, suddenly
developed headache, cough, confusion, myalgia, high grade fever and diarrhoea.
Lab test shows, hyponatraemia abnormal elevated LFTs, elevated creatine kinase
and decreased serum albumin level. The most likely diagnosis
A) Mycoplasma pneumonia, pneumonia
B) Clamydia pneumonia, pneumonia
C) Streptococcal pneumonia, pneumonia
D) Haemophilus influenza pneumonia
E) Legionella pneumonia, pneumonia

Q44 Regarding the best option for assisted ventilator therapy in patient with
acute fever asthma is ;
A) PaO2 < 60mmHg
B) PaCO2 < 60mmHg
C) Confusion
D) PH < 7.3
E)
Q45 A businessman developed low grade fever, malaise with protracted illness.
On examination there is hepatosplenomegaly on further enquiry he said, he has
imported parrot and domestic ducks
A) Coxella bumetti ( Q Fever ) Pneumonia
B) Influenza pneumonia
C) Para influenza pneumonia
D) Chlamydia paittaci pneumonia
E) Legionella pneumophilia pneumonia
Q46 A 24 years old female presents with history of diarrhoea and vomiting one
week back, now she has developed paraplegia. On examination, her reflexes are
absent. There is no sensory level. What is the likely diagnosis
A) Transverse myelitis
B) Pott’s disease
C) Sub acute combined degeneration of spinal cord
D) Gulalian Barre syndrome
E) Frederic ataxia
Q47 Regarding the clinical feature of shock
A) Tachycardia with low volume pulse
B) Hypertension
C) Polyuria
D) Bounding pulse
E) Slow respiration
Q48 Following is the cause of respiration failure
A) Pneumonia
B) Stroke
C) Head injury
D) Myocardial infarction
E) GB syndrome
Q49 Recognized clinical feature of raised ICP ( intracranial pressure )
A) Papilledema
B) Tachycardia
C) Down going planter
D) 3rd cranial nerve palsy
E) Systole hypertension
Q50 Recognized clinical feature of Parkinson disease
A) Intension tremors
B) Rigidity
C) Ataxia
D) Waddling gait
 E) Decreased tone
Q51 Which of the following is sign of right heart failure
A) Crepitation at lung bases
B) 3rd heart sound gyllop at apex
C) Systolic murmur at apex
D) Heaving apex
E) Raised JVP with hepatic congestion
Q52 Regarding treatment of heart failure
A) Loop diuretic cause hypokalaemia
B) ACE inhibitor are contraindicate in hyperkalaemia
C) Digoxin therapy increase myocardial contractility
D) ACE inhibitor reduce preload
E) Warm in treatment of choice in arterial fibrillation
Q53 Acute inferior wall MI is diagnosed by:
A) Bradycardia on ECG
B) Complete Heart block
C) ST segment depression in II,III, AVF
D) ST segment elevation in, I, AVF
E) ST segment elevation in II,III, AVF
Q54 In heart, which of the following is proved to improve survival
A) Digoxin
B) Verapamil ( calcium channel blocker )
C) Captopril
D) Aspirin
Q55 All statements are correct about crohn’s disease except
A) Main symptoms are , abdominal pain, diarrhoea and weight loss
B) More common in non smokers or ex smokers
C) It is common in smokers
D) Ulcerative colitis and crohn’s disease with HLA-B27 are more prone to
develop
 E) Crohn’s disease is characterized by ring by skip lesion in small
intestine
Q56 A 35 years old female presented with joint pain and swelling for 1 year, that
has increased in early morning hours. On examination she has nodules on
extensor aspects of forearm. What is most likely diagnosis
A) Osteoarthritis
B) Septic arthritis
C)
D) Rheumatoid arthritis
E) SLE
Q57 Which of the following is cause of hyponatremia
A) Diabetes insipidus
B) Decrease water intake
C)
D) Hyper osmolar diabetic coma
E) Excessive use of diuretic
Q58 A 27 years old male presented with high grade fever and right sided pleural
effusion. Pleural fluid reveals concentration of protein in pl: fluid to serum protein
70.5, LDH level >200 Iu. LDH concentration in pleural fluid in serum 70.6. which of
the following disorder present in this patient
A) Congestive heart failure
B) Nephrotic syndrome
C) Cirrhosis of liver
D) Parapneumonic effusion
E)
Q59 Most cases of community acquired pneumonia are caused by which one of
the following
A) Streptococcus pneumonia
B) Mycoplasma pneumonia
C) Staphylococcus aureus
D) Haemophilus influenza
 E) Viral pneumoniae
Q60 In treatment od ulcerative colitis:
A) For induction of remission corticosteroid are considered 1st line agent
B) Combination of oral and rectal enema of 5 ASA is better
C) 5 ASA, Sulphasazine are required for indication
D) In extension disease 5. ASA of corticosteroid are require
E) In limited disease oral corticosteroid are used
Q61 Haemorrhagic ascites is seen in
A) Cirrhosis
B) Chronic pancreatitis
C) Malignancy
D) Meigs syndrome
E) T.B
Q62 Duke’s jones minor criteria for diagnosis of :
A) ASO titter > 250
B) Positive throat culture
C) Leukocytosis
D) Erythema marginatum
Q63 Endoscopic ultrasound is helpful in diagnosis of
A) Esophageal obstruction
B) Esophageal cancer
C) Gastric ulcer
D) Pancreatic tumor
E) Gastric varices
Q64 The generic inheritance pattern of cystic fibrosis is
A) X linked recessive
B) X linked dominant with complete penetrance
C) Autosomal dominant
D) Autosomal recessive
E) X linked dominant
Q65 Following is the one of cause of type I respiratory failure
A) COPD
B) GB Syndrome
C) Myasthenia gravis
D) Severe acute asthma
E) Pulmonary oedema
Q66 A 45 years old lady presented with dysphagia since 4 months , on
examination she is grossly anaemic, koilonychia and palpable cervical lymph node.
What is most likely diagnosis
A) Esophageal erosion
B) Carcinoma of oesophagus
C) Plummer Vinson syndrome
D) Benign esophageal stricture
Q67 A 70 years old female after 2 days of trip replacement surgery developed
severe dyspnoea. On examination she is tachypnic with R.R 30/min, BP 70/50mm
Hg and chest x ray is normal. What is most likely diagnosis
A) Lobar pneumonia
B) Pulmonary embolism
C) Pericardial tamponed
D) Aortic dissection aortic
Q68 A 18 years old college student girl brought to medical emergency with
consumption of liquid poison. Her vitals reveal pulse 110/min, BP 140/90 mm Hg,
R.R is 28/min. On examination her skin is cold, excessive salivation and basal
crepitation. On CNS exams reveals all 4 limbs were fixed with fasciculation
positive. Most likely diagnosis will be
A) Bicarbonate poisoning
B) Copper poisoning
C) Organophosphate poisoning
D) Salicylate poisoning
Q69 A 20 years old lady admitted in medical emergency, the patient admitted is
bitten by snake sine 1 hour back. Acute medical treatment is given, containing IV
fluid and local wound care immediately, her leg begins to swell and she become
tachypnic. Her other vital signs are stable. Lab report shows low serum fibrinogen
level. The most appropriate immediate critical treatment of this patient now
A) Anti venom
B) Heparin
C) Phenobarbitone
D) Insertion of endotracheal tube for airway protection
E) Reassurance since snake bite cause some limited problem
Q70 Indication for cardiac surgery on infective endocarditis except
A) Abscess formation in organ
B) Failure of antibiotics
C) Fungal and protozoal infection
D) Large vegetation on right side
E) Large vegetation on left side
Q71 Hepatic biliary disease seen in crohn’s disease is:
A) Jaundice
B) Itching
C) Cholecystitis
D) Primary sclerosing cholangitis
Q72 The best drug to control heart rate in heart failure is :
A) Bisoprolol
B) Digoxin
C) Propranolol
Q73 Neuromuscular disorder causing dysphagia:
A) Multiple sclerosing
B) Motor neuron disease
C) Bulbar palsy
D) Eaton lumbart syndrome
E) Myasthenia gravis
Q74 The treatment of hyperkalaemia include :
 A) Beta blocker
B) Spironolactone
C) Steroids
D) IV calcium gluconate if ECG changes suggestive of hyperkalaemia
Q75 The organism found most commonly in pyogenic liver abscess is
A) Bacteroids
B) E.coli
C) Enterococcus facelius
D) Staphylococcus aureus
E) Streptococcus melleri
Q76 The clinical findings which differentiate lung fibrosis from consolidation is:
A) Bronchial breathing
B) Depression of chest wall
C) Decreased chest movement
D) Shifting of trachea
Q77 A 60 years old COPD patient presented with shortness of breath. On
examination, BP 120/60mm Hg, pedal edema and right presented heave. The
most appropriate diagnosis is
A) Cardiac failure
B) Cor pulmonale
C) Myocardial infarction
Q78 A 12 years old boy comes in OPD with complain of failure to thrive and
difficulty in hearing. On examination short height according to age , eye staining
with flat face, small ears and single palmar crease seen, rest of the physical
findings are unremarkable. What is most likely diagnosis
A) Down’s syndrome
B) Turner’s syndrome
C) Klienfelter syndrome
Q79 A 20 years old make presented in OPD with complain of loose watery stools,
his BP is 85/55 mm Hg, pulse 120/min, skin turgor is delayed. Treatment of choice
for this patient is
 A) Blood transfusion
B) Inotropic support
C) IV antibiotics
D) Oral intake of fluids
E) Rapid replacement of IV fluid
Q80 A 73 years old man presented with a shuffling gait and increasing forget
fullness, which had been of gradual onset, he had long standing history of
hypertension an DM. He had previously myocardial infarction 3 year and stroke 2
year previously. What is most likely diagnosis
A) Alzheimer’s disease
B) Parkinson’s disease
C) Cerebrovascular disease
D) Lewy bloody disease
Q81 A 60 years old lady with history of hypertension, presented to you with
history of palpitation which remain for few minutes, during period she noted that
her pulse become rapid and irregular, her resting ECG is normal. The best tool to
diagnose her condition is
A) Exercise tolerance test
B) Halter monitoring
C) Nuclear scanning
D) Stress echocardiography
Q82 A 55 years old male smoker presented with sudden sharp pain at left side of
chest after lifting heavy weight. On examination pulse is 110/min, R.R 30/min,
chest expansion is reduce on left side, percussion note is hyper resonate and
breath sound were not audible on left side of chest. What is most likely diagnosis
A) Pneumonia
B) Pulmonary embolism
C) Pneumothorax
Q83 A young man suffering from chronic diarrhoea has presented in emergency
department with spasm of hands and muscles twitching sine last night. He is
vitally stable with BP 150/100mm Hg. He was given calcium gluconate IV slowly
but patient did not responded. The next investigation to be done in this patient
should be
A) Blood Sugar
B) Serum Potassium
C) Serum Sodium
D) Serum Phosphate
E) Serum Magnesia level
Q84 A young man has presented with short history of cough, fever and left sided
chest pain for last two days. On examination decrease chest movement on left
side with bronchial breathing, temp 102F. The most likely diagnosis
A) Pneumonia
B) Pleural effusion
C) Pulmonary embolism
Q86 In pathogenesis of ulcerative colitis:
A) Appendectomy has protective role
B) Ciggrate smoking has no determinantal effect
C) 6-10% patients affected with UC have one or more relative with disease
D) The patient may improve with broad spectrum antibiotics
E) Environmental factors are more important than genetic factor
Q87 Character of pulse is seen in hypertrophied cardiomyopathy
A) Displaced apical impulse
B) High volume pulse
C) Jerky pulse
D) Palpable 4th heart sound due to arterial hypertrophy
E) Normal JVP
Q88 Factor that predispose to aortic dissection include
A) Aortic regurgitation
B) Hypertension
C) Old age
D) Pregnancy in 1st trimester
E) Pregnancy in all trimester
Q89 One of the following complication of peptic ulcer need urgent surgical
intervention
A) Gastric outlet obstruction
B) Haemorrhage
C) Ulcer penetration
D) Ulcer perforation
E) Recurrent ulcer following gastric surgery
Q90 Patient with acute exacerbation of COPD present with following features
except
A) An increased in amount of sputum
B) An increased in purulence of sputum
C) Fluid retention
D) Worsening of dyspnoea
E) Fever
Q91 Which of the following is not a risk factor of tuberculosis
A) Chemotherapy
B) Diabetic mellitus
C) Infliximab
D) Steroids
E) Winter season
Q92 A 14 years old present with arthralgia, purpura, azotaemia and proliferative
glomerulonephritis with IgA deposition. What is most likely diagnosis
A) Anti phospholipid antibody syndrome
B) Henoch sclerosis purpura
C) IgA nephropathy
D) SLE nephritis
Q93 Farmer has been brought in emergency department with history of bee sting.
He has got itchy rashes all over body, patient is dyspnic. On auscultation bilateral
wheeze were audible. Appropriate medicine should be administer first
A) Diphenhydramine
Q94 Patient taking PPI drugs but no more response in epigastric pain, next
investigation will be
A) Upper GI Endoscopy
Q95 The reason for renal failure in myeloma are:
A) Heavy chain cast nephropathy
B) Light chain deposit disease
C) Plasma cell pancity
D) Hyperkaliaemic nephropathy
E) Amyloidosis with heavy chain
Q96 A 5t years old man has non infective, necrotising ulcers on his lower limbs, a
diagnosis of pyoderma gangrenosum is made. Which of the following condition is
associated with disorder
A) Inflammatory bowel disease
B) Haemochromatosis
C) Gout
D) Non-Hodgkin Lymphoma
E) Autoimmune thrombocytopenia
Q97 Disease commonly associated with the acute nephritic syndrome:
A) Rheumatoid arthritis
B) Systemic sclerosis
C) SLE
D) Liver Abscess
E) Sab acute bacterial endocarditis
Q98 which of the following feature is most likely true regarding Hepatitis B
A) Incubation period is 3-5 weeks
B) Transmission is by droplet infection
C) HBe-antigen is the serologic marker of active viral replication
D) 10-15% present with acute hepatitis
E) Carrier rate in adult is 90%
Q99 In renin angiotensin system renin release is controlled by:
 A) Pressure in efferent arteriole
B) Pressure in the afferent arteriole
C) Para sympathetic tone
D) Local prostacyclin release
E) Sodium chloride concentration in distil tubule
Q100 Regarding sodium reabsorption, most of filtered sodium is reabsorbed in:
A) Proximal tubule
B) Loop of Henle ascending limb
C) Loop of Henle descending limb
D) Distil tubule
E) Collecting duct
Q101 The passage of dark, terry stools are called
A) Haematochezia
B) Melena
C) Both A and B
D) Hematemesis
E) None of the above
Q102 which of the following is/are predisposing factors, predisposing acute
pancreatitis
A) Gallstone
B) Alcohol abuse
C) Viral infections
D) Hyperlipidaemia
E) All of the above
Q103 A 50 years old male presented with difficulty in breathing and nasal septa
perforation . his BP was 150/100 mm Hg. His urine D/R showed red cell cast,
protein , chest x-ray shows multiple opacities. The most likely cause is
A) Tuberculosis
B) Amyloidosis
C) Good pasture syndrome
D) Kawasaki disease
 E) Wegener’s granulomatous
Q104 Pericardial effusion is best diagnosed by :
A) Clinical examination
B) Electrocardiography
C) Cardiac enzymes
D) Echocardiography
E) X-ray chest PA view
Q105 A 40 years old previously well woman present with pruritus, she is not
taking any medicines has drinks alcohol. Physical examination entirely normal.
LFTs show 3 times raise alkaline phosphate, ultrasound abdomen shows normal
liver and gall bladder. Which of the following is most appropriate step in diagnosis
A)
B) Antinuclear antibody
C)
D) Antimitrochondrial antibodies
E) Ultrasound of abdomen
Q106 A 30 years old lady develop mild epigastric pain along with nausea and
vomiting since 2 days, on examination of abdomen there is tender epigastrium
otherwise nothing significant. Her TLC 13000/ml, amylase 300U/L ( 25-125).
Which one of the following is most common predisposing factor
A) Drugs
B) Gallstone
C) Malignancy
D) Alcohol
E) Hypertriglyceridemia
Q107 Legionnaires disease is characterised by :
A) Hypokalaemia
B) Hyponatremia
C) Hyperkalaemia
D) Hypernatremia
E) Hyperglycaemia
Q108 18 years old female was diagnosed 7 years earlier with precocious puberty
secondary to ovarian tumor. Physical examination reveals oral and lingual dark
pigmentation. Which of the following is most likely diagnosis
A) Gardner’s syndrome
B) Juvenile polyposis
C) Lynch syndrome
D) Peutz Jeghers syndrome
E) Turcot’s syndrome
Q109 XXY karyotype is
A) Klienfelter syndrome
Q110 ECG finding of acute myocardial infarction is elevation of ;
A) ST segment more than 1mm
Q111 Aspirin can induce Asthma
Q112 Renin is secreted by Juxtaglomerular Apparatus
Q113 A 20 years old boy present with fever, sweating and shortness of breath. On
examination there are splinter haemorrhage, pan systolic murmur at mitral area
and splenomegaly. What is your most likely diagnosis
A) Infective endocarditis
Q114 A 20 years old girl presented in OPD with history of fever, cough,
haemoptysis and chest pain. X-ray show homogeneous opacity in right middle
zone. Most appropriate diagnosis is
A) Lobar pneumonia
Q115 A 27 years old woman develop acute onset of erythema nodosum, fever,
malaise and anorexia . chest x-ray show bilateral lymphadenopathy. Most likely
diagnosis is
A) Sarcoidosis
Q116 The drug of choice for enteric fever is Ceftriaxone ( Ciprofloxacin )
Q117 Most specific and sensitive test for H.Pylori is: Urea Breath Test