MEDICINE-I IMPORTANT BCQS

1. Portal hypertension in a cirrhotic patient is best treated with:

A. Carvedilol T
B. Aldactone
C. Furosemide
D. Lactoluse
E. Metronidazole

2. Exudative ascites is seen in patients having:

A. Cirrhosis of liver
B. Hypothyroidism T
C. CCF
D. Nephrotic syndrome
E. TB abdomen

3. A young man has presented with loss of appetite for last two weeks. On examination
jaundice is positive with no visceromegaly. The most important test in this patient will be:
A. Ultrasound abdomen
B. H. pylori antibodies
C. Urine DR
D. LFT
E. Blood CP

4. The most important test for management purpose in a patient having ascites is:
A. LFT
B. Viral profile
C. Serum protein AG ratio
D. Ascitic fluid DR T
E. Ultrasound abdomen

5. Prognosis of pneumonia in a patient of 70 years depend upon:

A. Temperature
B. Sex T
C. Blood sugar
D. WBC count
E. Urea

6. A 22-years old female presented with fever, sweating at night and weight loss. On
examination she has palpable painless cervical lymph nodes with normal chest
examination. The most appropriate investigation would be:
A. Chest X-ray T
B. Lymph node biopsy
C. CT scan neck & mediastinum
D. Mantoux test
E. Full blood count
7. A 25-years old male has presented with high grade fever, chest pain and cough with rusty
sputum for last three days. On examination he is having temperature 104˚F. Chest
examination shows bronchial breathing over right lower lobe. What complication can this
patient develop:
A. Lung fibrosis
B. Lung abscess T
C. Bronchitis
D. Tuberculosis
E. COPD

8. In a patient with acute hepatitis the bad prognostic factor is:

A. Enlarged liver
B. Low platelets
C. High bilirubin
D. High SGPT
E. Low SGPT with high PT T

9. A 60-years old male known case of hypertension has presented with dyspnea for last
three weeks. On examination his pulse is 104/minute, BP is 160/100 mmHg and edema
feet positive. This patient should be treated with:
A. Diuretic & ARB & beta blocker T
B. Beta blockers only
C. Diuretics only
D. Digoxin
E. Calcium blockers only

10. In the management of emphysema, the most important factor along with drug treatment
is:
A. Avoid smoking T
B. Control blood sugar
C. Avoid exertion
D. Reduce weight
E. Control blood pressure

11. To treat hepatitis B you have to give Tenofovir tablet for:

A. Two years
B. Three years
C. Six months
D. One year T
E. Three months

12. Ducke’s jones minor criteria for diagnosis of rheumatic fever include:
A. History of recent scarlet fever
B. Leukocytosis T
C. Asotitre >250u
D. Erythema marginatum
E. Positive throat cultures
13. A 20-years old boy presented with fever, sweating and shortness of breath. On
examination there are splinter hemorrhages, pansystolic murmur at mitral area and
splenomegaly. What is the most likely diagnosis:
A. Ventricular septal defect
B. Syphilis
C. Disseminated intravascular coagulation
D. Systemic lupus erythematosus
E. Infective endocarditis T

14. A 20-years young man has presented with abdominal pain and vomiting for last 24 hours.
Yesterday he had a meal with friends at hotel outside city. He is also occasional smoker.
He is vitally stable with tenderness in the epigastrium. The likely cause of this pain is:
A. Pancreatitis
B. Esophagitis
C. Cholecystitis
D. Gastritis T
E. Appendicitis

15. In a young man, short history of cough, fever and left sided chest pain. On examination
decrease chest movement on left side with bronchial breathing. The most likely diagnosis
is:
A. Pneumonia T
B. Pulmonary embolism
C. Pneumothorax
D. Pleural effusion
E. None of the above

16. A 55-years old smoker presented with shortness of breath and mild cough. On
examination percussion note is hyper-resonant on both sides of chest. Chest X-ray shows
hyper-inflated lung fields. What is the most appropriate diagnosis:
A. Chronic bronchitis
B. Pneumonia
C. Bronchiectasis
D. Emphysema T
E. Pneumothorax

17. A 40-years male has presented with cough, low grade fever and shortness of breath for
last two or three months. On examination he is vitally stable with lean built having weight
33kgs. His X-ray shows cavity in the right upper zone. The most likely diagnosis is:
A. COPD
B. Pneumonia
C. Bronchial asthma
D. Pulmonary tuberculosis T
E. Bronchitis
18. A 65-years old male came for a routine clinical examination. On examination pulse rate
72/min regular, BP 120/90 mmHg, thrusting apex beat and an ejection systolic murmur
audible on auscultation. The most probable diagnosis is:
A. Mitral stenosis
B. Pulmonary stenosis
C. Aortic regurgitation
D. Aortic stenosis T
E. Atrial septal defect

19. All of the following are the risk factors for ischemic heart disease, except:
A. High calcium T
B. Smoking
C. Hypertension
D. High cholesterol
E. Blood sugar

20. The most important clinical findings in case of bronchial asthma is:
A. Expiratory crepts
B. Bilateral wheeze T
C. Bronchial breathing
D. Inspiratory crepts
E. Increased VF & VR

21. Patient with acute exacerbation of COPD present with following features except one:
A. Fluid retention
B. Worsening of dyspnea
C. An increase in amount of sputum
D. An increase in purulence of sputum
E. Fever T

22. A 50-years old male smoker since last 10 years has presented with retrosternal pain and
sweating while climbing stairs of his flat. On examination pulse 106/min, BP 140/100
mmHg. This patient should be given following drugs as first aid therapy:
A. Proton pump inhibitors
B. Soluble aspirin
C. H2 receptor blockers
D. Soluble aspirin plus sublingual nitrates
E. Sublingual nitrates T

23. Hepatoma is suspected clinically when:

A. Liver is soft smooth with sharp margins
B. Liver is enlarged & soft
C. Liver is shrinken in size
D. Liver is enlarged & hard T
E. None of the above
24. A 17-years old male has presented with severe headache for last two weeks, not
responding to paracetamol. On examination pulse 84/min, BP 154/100 mmHg. Further
examination reveals left renal bruit. What investigation will be useful for diagnosis:
A. Renal angiogram
B. Blood urea
C. ECG
D. Urine DR
E. Ultrasound T

25. Common pulse abnormality seen in patients with mitral stenosis is:
A. Pulsus alternals
B. Collapsing pulse
C. Slow rising pulse
D. Premature ventricular contractions
E. Atrial fibrillation T

26. The characteristic of unstable angina are following, except:

A. It is worsening angina
B. It may be prolonged & severe
C. Recent onset angina
D. It cannot happen at rest T
E. Unstable angina is part of acute coronary syndrome

27. A 15-years old boy who has suffered from acute rheumatic fever and has got residual
heart disease. Long term prophylaxis should be continued for:
A. Five years after last episode
B. Ten years after last episode
C. Seven years after last episode
D. Till the age of 30 years
E. Ten years after last episode or 40 years of age whichever is later T

28. Most common precipitating factor for hepatic encephalopathy is:

A. CNS stimulant drugs
B. High protein diet T
C. Constipation
D. Paracetamol toxicity
E. Fever

29. A young man has presented with loss of appetite for last two weeks. On examination
jaundice is positive with no visceromegaly. The most important test in this patient will be:
A. Urine DR
B. Ultrasound abdomen
C. LFT
D. Blood CP T
E. H. pylori antibodies
30. Which of the following is the clinical feature of mitral stenosis:
A. Loud S1 T
B. Pan systolic murmur at mitral area
C. Soft S2
D. Clubbing
E. Heaving apex beat

31. For the diagnosis of pulmonary tuberculosis, the most important tool is:
A. Tuberculin test
B. MRI test
C. X-ray chest
D. Sputum AFB T
E. Blood CP

32. Vitamin K is given in a patient of cirrhosis:

A. To decrease ascites
B. To increase albumin
C. To correct PT T
D. To decrease SGPT
E. To decrease bilirubin

33. A 30-years old obese and smoker complains of indigestion and regurgitation of food since
last two months. On examination there is no positive finding. To reduce the symptom
along with drug treatment you will advise:
A. Small meals 04 times a day
B. Increase carbohydrates in the food
C. Reduce weight T
D. Increase fat in the food
E. Increase smoking

34. One of the following statement about hepatitis-A virus is correct:

A. Clinical illness is more severe in children than adult
B. Incubation period averages 30 days
C. Chronic carrier state is not seen T
D. Mortality rate for hepatitis A is very high
E. Fulminant hepatitis A is common

35. Which of the following is not a risk factor for tuberculosis:

A. Chemotherapy
B. Steroids
C. Diabetes mellitus
D. Infliximab
E. Winter season T

36. Hemorrhagic ascites fluid is seen in:

A. Malignancy T
B. Meig’s syndrome
C. Cirrhosis
D. Chronic pancreatitis
E. Tuberculosis
37. Best site for examination of jaundice is:
A. Sclera T
B. Tongue
C. Conjunctiva
D. Nails
E. Ear lobule

38. A 20-years young lady habitual of beetal nuts has presented with dysphagia for last one
month. On examination she is anemic having koilonychias with no splenomegaly. There is
no history of weight loss. The most likely diagnosis is:
A. Plummer vinson syndrome
B. Atrophic gastritis
C. Chronic gastritis
D. Ca stomach
E. Ca esophagus T

39. Regarding asthma following is true:

A. It is an infective disorder
B. It is related to smoking
C. It is an autoimmune disorder
D. It is an allergic disorder T
E. It is related to cotton factories

40. In advanced chronic kidney disease, the most likely hematological manifestation is:
A. Leukopenia
B. Normocytic normochromic anemia T
C. Megaloblastic anemia
D. Increased clotting time
E. Thrombocytopenia

41. A 20-years old male presented in COD with the complaints of loose watery stools. His BP
is 80/50 mmHg, pulse 120/minute, low volume. Skin turgor is delayed. Treatment of
choice for this patient is:
A. Blood transfusion
B. Oral intake of fluids
C. Inotropic support
D. Rapid replacement of I/V fluids T
E. I/V antibiotics

42. Which one of the following electrolytes must be restricted in patient with acute renal
failure:
A. Calcium
B. Sodium
C. Bicarbonate
D. Chloride
E. Potassium T
43. Following are the recognized causes of CKD, except:
A. Diabetes insipidus T
B. Hypertension
C. Diabetes mellitus
D. Polycystic kidney disease
E. Chronic pyelonephritis

44. In critically ill patient upper gastrointestinal bleeding due to ulceration is treated with:
A. H2 receptor blockers (antagonists)
B. Sucralfate
C. Misoprostol
D. Antacids
E. Proton pump inhibitors T

45. A 65-years old lady came to the emergency with the complaint of chest pain during rest.
Her ECG showed S-T segment elevation that resolves spontaneously without ----------------
-----. The most useful therapeutic agent for this condition is:
A. ACE inhibitor
B. Diuretic
C. Calcium blocker
D. Aspirin T
E. Beta blocker

46. A 50-years old male patient of smoker developed sudden onset of shortness of breath and
right sided chest pain. On examination trachea is shifted to left side and percussion note
was hyper-resonant. The most appropriate radiological finding on chest X-ray would be:
A. Vertical radiolucent border & loss of vascular marking T
B. Radio-opacity at right lower zone
C. Wedge shaped opacity
D. Air fluid level
E. No homogenous infiltration

47. A 47-years old male presented to casualty for shortness of breath since 02 days. On
examination the pulse was 120 beats/min, respiration rate 45 breaths/min, blood pressure
90/40 mmHg, temperature 102˚F and no urine output since morning. The patient’s
condition best described in:
A. Hypovolemic shock
B. Acute inflammatory response syndrome
C. Acute kidney injury T
D. Septicemia with multi organ damage
E. Acute myocardial infarction

48. A 55-years old female presented with severe left sided chest pain followed by excessive
sweating. When she brought in the casualty her B.P was 60/0 mmHg, pulseless and JVP
was 09 cm above sternal edge. What will you do next for saving life of patient:
A. IV frusemide
B. IV infusion of dobutamine T
C. IV steroids
D. IV streptokinase
E. 03 liters of normal saline immediately
49. A 26-years old female presented with acute pain in right hip joint with high grade fever
and diarrhea since 07 days. Her CBC shows leukocytosis, uric acid level, renal function
test, urine DR were normal. The most likely test for the diagnosis would be:
A. MRI of hip joint
B. CRP & ESR T
C. X-ray of hip joint
D. Stool culture & CBC
E. HLA B27

50. A 64-years old woman is found to have a right-sided pleural effusion on chest X-ray.
Analysis of the pleural fluid protein was 3.8 g/dl, lactate dehydrogenase (LDH) level of
500 IU and a ratio of LDH concentration in pleural fluid to serum of 0.7. The most
appropriate diagnosis in this patient is:
A. Pulmonary infarction
B. Tuberculosis
C. Congestive heart failure
D. Cirrhosis
E. Malignant effusion

51. In a 30-years old male history of cough, fever, left sided chest pain since 03 days. O/E
there was decrease chest movement on left side with bronchial breathing. The most
appropriate treatment is:
A. IV clindamycin
B. Linezolid
C. Oral azithromycin
D. Amoxicillin T
E. IV ceftriaxone

52. A 55-years old smoker presented with shortness of breath and mild cough. On
examination percussion note is hyper-resonant on both sides of chest. Chest X-ray shows
hyper-inflated lung fields. What is the most appropriate diagnosis:
A. Pneumonia
B. Chronic bronchitis
C. Bronchiectasis
D. Pneumothorax
E. Emphysema T

53. You are asked for examine the pulse of 55 years old male who has aortic stenosis. The
character of the pulse is best defined as:
A. Pulsus bisfirence
B. Anacrotic pulse
C. Pulsus paradoxus
D. Water hammer pulse
E. Pulsus alternans T
54. A 22-years boy presented with headache for last one month. O/E pulse is 78 beats/min,
B.P 170/100 mmHg and the femoral pulse is delayed than radial pulse. The likely
diagnosis is:
A. Takayasu’s arteritis
B. Coarctation of aorta T
C. Aortic aneurysm
D. Renal artery stenosis
E. Cardiomyopathy

55. A middle aged person with hemoptysis and cough was investigated with X-ray chest
showed cavity at right upper zone. The investigation of choice is:
A. Pulmonary angiogram
B. Serum IgE level
C. CBC
D. HRCT chest
E. Sputum smear for AFB T

56. A 60-years old lady hypertensive presented with palpitation remains for few minutes.
During the period she noted that her pulse become rapid and irregular. Her resting ECG
is normal at that time. The best tool to diagnose her condition is:
A. Holter monitoring
B. Nuclear cardiac scanning
C. Stress echocardiography T
D. Echocardiography
E. Exercise tolerance test (ETT)

57. A 15-years old female came to the physician with complain of malaise, fatigue and weight
loss. On examination there is an early diastolic murmur. The most probable diagnosis is:
A. Mitral stenosis
B. Ventricular septal defect
C. Acute rheumatic fever
D. Mitral regurgitation T
E. Atrial myxoma

58. A 65-years old female presented with shortness of breath on climbing two steps of stairs.
She is known case of hypertension, ischemic heart disease. On examination there was
pulsus alternans, B.P 90/40 mmHg and a systolic murmur over left sternal edge. What is
your diagnosis:
A. Primary pulmonary hypertension
B. Recent myocardial infarction
C. Ventricular septal defect
D. Cardiac failure with reduced ejection fraction
E. Moderate pericardial effusion