————— tit GOMAL MEDICAL COLLEGE, MTI, D.LKHAN Meds Written Test 4” YEAR MBBS (Block-L) Date: 25" September, 2023 Name of Student Roll No - Please encircle the correct answer with blue/black pen Poper 1 COTE TIME ALLOWED: 02-110UR'S TOTAL MARKS: 120 Note: Attempt ALL questio NE; best answer. Each question carries 01 mack from this sect QH1: A as.year-old woman presents with hypertension, hypokalemia, and metabolic alkalosis. She has no history of renal disease of heart failure. Her plasma renin activity is low and her serum aldosterone level is high. What is the most likely cause of her condition? a) Renal artery stenosis 4) Ectopic aldosterone-secreting tumor b) Aldosterone-producing adrenal adenoma e) Familial hyperaldosteronism type 1 €)__Renin-producing tumor QH2: A 30 year old woman presents with abdominal pain and distension for the last two months. On physic hhas multiple angiofibromas on her face and ash-leaf spots on her trunk. A pelvic examination reveals an enlarged uterus. Laboratory tests show normal renal function and negative pregnancy test. A pelvic ultrasound shows multiple eysts in both ovaties, A renal ultrasound shows multiple cysts in both kidneys and multiple solid masses in the cortex and medulla. A contrast- enhanced CT scan confirms the presence of bilateral renal angiomyolipomas. Which of the following cells are most likely to be found in these tumors? a) Mature adipose cells 4) Eosinophilic granular cells b) Immature cartilage cells fe) Multinucleated giant cells €) Malignant epithelial cells QH3: A 6S year old man presents with painless hematuria and a palpable mass in the lower abdomen. Cystoscopy reveals @ large, irregular, and ulcerated tumor involving the posterior wall of the Urinary bladder. Biopsy shows a high grade urothelial al examination, she carcinoma with extensive squamous differentiation. What is the most likely stage of this tumor according to the TNM system? aT 4) 74 ») 72 ) od 3 #4: 55 year old woman undergoes transurethral resection of a small papillary tumor in the bladder. Histologic examination shows a low grade urothelial carcinoma with thin fibrovascular cores and orderly arrangement of cells. Immunohistochemistry shows positive staining for CK20 in the superficial cells and negative staining for CK7 in the basal cells. What is the most appropriate diagnosis for this tumor? a) Papilloma ©) Low grade papillary urothelial carcinoma ) Papillary urothelial neoplasm of low malignant d) High grade papillary urothelial carcinoma potential €) Invasive urothelial carcinoma QHS: A 30 year old female presented with solitary thyroid nodule. She complained of hoarseness of voice. On clinical ‘examination cervical Iymph node is also palpable. On thyroid scan it was cold solid nodule. FNAC of nodule showed intranuclear inclusions in aspirated cells. On biopsy the tumor cells showed orphan annie eye nuclei. What is the diagnosis? a) Anaplastic Carcinoma ) Medullary Carcinoma b) Follicular Carcinoma e) Papillary Carcinoma ¢) Hurthle cell Carcinoma [Qi6: A 50 year old woman complained of post-menopausal bleeding. On examination her cervix was eroded and ulcerative, Biopsy was taken and diagnosis of Squamous intraepithelial neoplasm was made on the basis of nuclear changes along with cytoplasmic halos having perinuclear vacuoles termed kollocyticatypia. Which of the following is associated with koilocyticatypia? a) EBV 4d) HPV protein ES b) High Ki-67 e) Keratin formation ¢) High CEA level {QN7: A.50 year old male patient presented with costovertebral pain, palpable mass & hematuria. He also complained with fever, weight loss & malaise. On biopsy of renal mass, the diagnosis of Clear cell carcinoma was made. Which gene mutation is responsible for clear cell carcinoma? a) Loss of VHL d) Mutated MET gene b) Mutated BHO gene €) VEGF inhibition ) Mutated FH gene ‘Qua: A patient presented with weight loss, sweating, palpitation, lid lag, exophthalmos, tachycardia tremors and a goiter. Upon thyroid scan, there appears to be increased intake of lodine. What is the pathogenesis of this disease? 2). Infection 4) Idiopathic b) Immune complex mediated e) Autoimmune mediated ¢) Hashimoto's Thyroid {QH9: A patient who is presented with increased growth of skeletal and soft tissues, hypertension, arthritis, menstrual disturbances, and diabetes mellites. When oral glucose administered, which one of the following level will increase? a) Growth hormone ‘)_ insulin like growth factor 'b) antidiuretic hormone 4d) None of the above e) both A and ¢‘elovated. Sotuim OSMOFAINY 15 10¥7 Ugg, nL peesenty with polyuria andl increaged Uiest Serum glucose is not eleva fe ofthe following. 1s careect? J) Serum ADH As ily oth Mand 0 Coa waver septs ation test, thw aymolaity Is still low Wiel on a) Probtenn a yituttary 1b) problentin kidneys ” ©) Patton tas a ANIA, Patients with diab a) Cataracts 1b) tnfections ° havo an increased risk for all of the following except? 4d) Peripheral Neuropathy Pancreatic Carcinoma ()_tncreased athorosclevosts N12} White ofthe following He for papillary thyrold carcinoma? 4) May have psammoma bodies 4) associated with MENT 1h) teast common type fe) Most comman in elderly population 6) Worst proxnoss sna? QNAAE The most common cause of hypathyroldism in third world counties fs which one of the following: a) Pituitary dystunction «d) Hashimoto's thyrotditis b)Dequervain’s thyroiditis ©) lodine deficlency 6) Graves disease QN14: tive person for hdney transplantation, wh estigations you will not do? a) blood grouping d) Renin hormone by tA, ¢) Renal tract study RFT. QW15; In A nephropathy, histological finding Is a) padacyte fusion 4d) Increasedmesengial matrix b) thick glomerular basement membean )_segmentalglomerulosclerosis QW16; Cushing's triad Is a) Increase ICP, HTN, Bradycardia )_ Increase ICP, HTN, tachycardia b) Increase ICP, hypotension, bradycardia €) Decrease ICP, HTN, tachycardia ©) Increase ICP, hypotension, tachyeardla N17: 432 years old female patient with diagnosed case of ovarian tumor with ascites and pleural effusion. All these findings are present in which of the following condition? 8) Basal cell carcinoma, 4d) Meigs syndrome. b) Carcinoid tumor. @) Pseudomyxomaperitonel, ©) Krukenberg tumor. QN28: 4 28 years old female patient with history of primary infertility, dysmenorchea, painful stool defecation and abnormal bieeding, Laparoscopic findings show ectopic endometrial tissue with red hemorrhagic spots at the site outside the uterus, What will be the most likely diagnosis? a) Adenomyosts, 4) Oophoritis. UV) Endometriosis. ©) Salpingitis. Molar pregnancy. (9: The most commen type of thyroid carcinoma is? 8) Anaplastic carcinoma. 4) Papillary carcinoma. b)- Follicular carcinoma, e) Small cell carcinoma. ©) Medullary carcinoma. al sclerosis in glomeruli e) seamen 1:20: the following selective medium is used to isolate Nelsserla Gonorrhea. a) flood agar d) Mannitol salt agar b) Chocolate agar ) Modified Thayer-Martin medium ©) MacConkey’s medium ‘Qu21: DIRECT Microscopy smear examination of purulent discharge from genital tract can give definitely diagnosis of Neisseria gonorthea in ? a) Diabetics 4d) Pelvic inflammatory disease patient b) children e) woman ; Man : 22: Fibroid uterus may present with all of the following except? a) Amenorthoea d) Pelvic mass bb) trregular menstrual cycle e) Poly menorthoea ©) Infertility Qn23:_ Which gland Is under direct neural regulation of hypothalamus? a) Adrenal gland 4) Posterior pituitary gland b) Anterior pituitary gland €) Thyroid gland €) Parathyroid glands{anich of the following, study de fe and an outcorne provided 10 a) Case-control study A) Feotogicsl study b) Cohort study Cross sectional ps re Innes most appropriate for investigating the 6 ical issue is mavalvedd? fleet rotatio between an 6) teandarnied contalled teal study archer wants to study the risk factors of a rare di like Sarcoidosis, Which study design is best suited for fentitying sk factors for a rare disease? a) Case-control study a) uly b) Cohort study 6) Handomnized controlled trial ©) Cross-sectional study #26 A researcher wants to study prevalence of protein energy maln Which study design ts mast w atul for studying, the pr udy 2 of age in a village: jalence of ad) a) Case-cantrol st b) Cohort study Cro 6) Randomized conteatled tr. sectional study Q#27._A renowned pharmacologist claimed that his new deug,for type 2 control of diabetes than alder drugs availa effectiveness of a new drug therapy? a} Case-control study betes mel shud designs is eno: 1 showing, nore promising, approps sults in efor evaluating, the le. Which of the following 4) Ecological study b) Cohort study 6) Randornized controlled telat 6) Crostsectional study ON2B. Which of the following study designs is most appropriate for studying the natural history of a disease? 3) Case-control study 4) Ecological study b) Cohort 6) fandornized conteolled trial Cross-sectional study QH29: Which of the following study designs is most appropriate for avsessing, the impact of an int vention in a comrnunity? a) Case-control study 4) Ecological study b) Cohort study ©) perimental study ©) Cross-sectional study 2830: A study was conducted on 10,000 an jatal women fromn first tiene smoking on birth weight of new born, Out of 10,000 warnen 2000 we both groups. What type of study design is this? a) Case control 4) Quast experimental b) Cohort ¢) Randomized control trial ©) Cross sectional er visit til their tern dt smoker’, 100 low birth we clivery to see the effect of ht children were born in wa: A researcher wanted to study the time sequence to prove the concept of causality. He started studying the healthy people, Researcher wanted to see if high fat diet consumption has any role in ischemic heart disease development. Which design of study should be preferred by the researcher? a) Casereport 4) Longitudinal b) Case series report ©) Quasi experimental ) Cross-sectional QH32: Smoking leads to esophageal carcinoma. Alcohol intake it related to smoking and als iso has its role in esophageal carcinoma development. This factor can distort the results of the study which intends to prove ‘and esophageal cancer. What type of effect is this? ‘an association between smoking a) Confounding 4) One to one relationship b) Dose response relation €) Strength of association ©) Multiple causation (QH33:_ An expert in the field of public health is required to estimate the magnitude of a health problem for adequate provision of hospital facilities, logistics, finances and human resources. Which rate would he calculate for this purpose? a) Case fatality 4) Prevalence b) Cause specific mortality 2 ©) Incidence Proportionate mortality (QH34: HPV is the major cause of cervical carcinoma. What is the probable contribution of HPV in Ca Cervix? a) 90% 8) 99% b) 92% e) 29% ) 95% In 1993 WHO promoted a program to improve infant and young children nutritional health known 2s? 3) IMNCI 4) WASH b) MNCH ) MAMI 0 BFK (#36: & 23 year old para 1 delivered a baby boy last month. She wants to plan for contraception advised. She is feeding her baby ts breast fed, feeding frequency is more at night. What is the best to way to avoid conception in first 04 months of elivery? 2) Oral contraceptive €)._ Injectable contraceptive Db) Male Ptis ) 1uco #\ Na Canteace> Cae oon Peto cent many anette soem aber Fst ee a) 03 a) 06 ae b) 048 ) 07 POR, 05 pays 138: Keepingin mind the stationary population pyramid of Austria. Which of the following features is most obvious? a) High fertity id) High dependency ratio b) high mortality ©) towsexratio ©) Low birth and low death rates Q#39:_ The total number of population of an area during a specified time is called: a) Average a} Propecten, b) census ) fate Count QD: The extent to which atest gives same results on repeat measurements under same conditions is a quality measure of ‘ this test. Which of the following refers to this quality of test? a) Reliability d) True-positive value b) Sensitivity e) Validity ©) Specificity QHa1: In pregnancy, enlargement of uterus at pubic level is seen in the following weeks: a) weeks 1d) 2aweeks b) 8weeks fe) 36weeks ©) 12weeks Qwa2:_ False virgin is who has: a) Elastic hymen b) No hymen ©) _imperforated hymen d) Annular hymen fe) Septate hymen (Q#43:_ A habituated female (i.e. female who had frequent sexual intercourse) shows torn hymen known as: a) Carunculae hymenalis d)_ Marginal hymen b) Linea Nigra e) Imperforated hymen ©) Carunculae myrtiformes (#44: A female who had given birth to child exhibits only remnants of hymen known as: a) Carunculae hymenalis )_ Marginal hymen b). Unea Nigra €) Imperforated hymen ©) Carunculae myrtiformes Q#45: The spermatozoa in a case of sexual intercourse can be seen in vagina tl: a) 1-7 days d) aweeks b) 10 days e) 8weeks c) 2weeks 848: Sin of Gomorra is: a) Anal coitus 4) Lesbianism b) Buccal coitus €) Indecent assault <} incest Q#87: The pregnancy caused by rape can be terminated under the following ground: a) Therapeutic 4) Social b) Eugenic e) None ©) Humanitarian #48: 475 year old woman being investigated for recurrent UTIs ( proteus on culture report) has a stag horn calculus on CT scan what is the most lkely stone composition? a) Cystine a) Calcium oxalate b) Uricacid €) Hydrogen ) Struvite, 49: Which one ofthe following symptoms snot related to urinary tract infections ? a) Burning micturition ) cloudy urine b) Fever (low grade). ) None )__ Strong persistent urge to urinate ‘Q#S0: nephrectomy is primarily indicated in which of the following conditions? a) Polycystic kidney disease. @) ut b) Renal cell carcinoma. e) BOTH Cand D. )_nephrolithiasis {Q4S1: What is the primary treatment goal for small kidney stones that can be passed naturally? a) Surgical removal d) Advice to increase fluid intake b) Pain Management e) None )_ Prevention of future stonesdescended testes is also referred to as 2) Inguinal hernia 4) hydrocote b)_varicocle e) both Bandc )_eryptorchidism, 3: Hysterascopy is a technique used to 3) Remove ureteric stone a) Tose bow for polyps b) Look inside uterus for abnormalities e) Examine oesophagus. ©) Remove testicular masses 54: Which one of the following can cause urinary retention? 2). Direct inguinal hernia 4d) bladder stone bb) benign prostate hyperplasia, e) Allexcept A. ©) urethral stricture QHSS: Chocolate cyst a complication of endometriosis occurs in ? a) Kidney 4) ovary. b) urethra, e) pouch of Douglas 0 Vigina ‘QHS6: Which of the following is a common complication following thyroid (total thyroidectomy) Surgery? a) Diabetes. 4) Hypokalaemia, b) Hypertension. €) None of the above ©) Hypocalcaemia QHS7: 48 years female under goes laparotomy because of a pelvic mass intraoperative it was unilateral ovarian mass a complete by omental involvement on frozen section serouscystadeno carcinoma was found most appropriate action will be ) Bilateral salpingoophorectomy + omentectommy b) Total abdominal hysterectomy + Bilateral salpingoophorectomy ©) Ovarian cystectomy and omentectomy 8} unilateral oophorectomy + omental resection e)_ Peritoneal washings +Total abdominal hysterectomy + Bilateral salpingoophorectomy + omental resection QHSB: A 53 years female complaint of pain abdomen on workup there is 4 cm bilateral ovarian mass with septations were Present on ultrasound, next step of management is a) OCPS and anti-inflammatory 4) Ultrasound guided aspiration b) Send tumor markers and decide accordingly @) Wait for three months and decide on follow up ©) Surgery QH59: A G2P2 34 years at 29 weeks came to emergency department with sudden acute abdominal pain on workup there is S*6 ‘em right ovarian mass. What is most common ovarian tumor in pregnancy? a) Brenner's tumor 4) serouscystadenoma b) dermoid cyst e) Krukenberg tumor ©) dysgerminoma Q#60; An adolescent girl with complaint of lower abdominal fullness, on and of pain came to PD on ultrasound 10*Bemn ‘ovarian mass was found. Serum LOH is raised. What preferred mode of treatment you will suggest? a) Cystectomy with radio therapy b) Cophorectomy + radiotherapy ©) Surgery with preservation of uterus and normal ovary followed by chemotherapy 4) Ultrasound aspiration followed by chemotherapy e) Total abdominal hysterectomy + Bilateral salpingoophorectomy Qu61: A 32 years old patient came to OPD with ultrasound report which shows bilateral ovarian masses with increased vascularity, and septations. She also gives history of weight loss and bloating there is family history of ovarian cancer on her ‘maternal side. What is the percentage of malignant ovarian tumors having genetic predisposition? a) $-10% 22-25% b) 10-15% a) 40-50% €)1.2% Qu62: There are different treatment modalities for cervical malignancy the decision is based on staging of CX cervix, we can proceed towards radical surgery before chemo and radio. Which of the following stage? a) stage 1a and Stage 1b ©) Stage 32 b) stage 2a 4d) Stage 3b e) Stage 2b QH63:_ To prevent cervical cancer cervical screening program had been started. All women should be screened at the following age group a) 12-S0years ¢) 18-60 years b) 15-60 years €) 20-64 years ) 25-64 years Qu64: You are sitting in gynae clinic a patient para 6 has visted you with the report of cervical screening which showed ‘moderate dyskaryosis with positive HPV testing. What will you do next? a) Counsel patient & call for routine follow up visit d) Referral for colposcopy b) Advise hysterectomy €) Give symptomatic treatment only ©) Repeat smear testingfith foul smelling tang, 7 & ting atong with foul smelling darts, 7 y§ and had been in pun cig spot 1 pain, patient husb quite envious. Whet f post-menopausal ith tower abdominal marked pallor and she is {Q#65: 56 years old para 7 presented with the complaint of also complaining of dysuria and urinary hesitancy along wi for many years. On per speculum examination patient she has diagnosis? a caval phe ‘ a) Menopause symptoms Seager b) Pelvic inflammatory disease ) ©) Cervical malignancy nd dysuria On Ber spec rmenstrval bleeding 2 QH66: A 47 year old para 5 presented to OPD with postcoital bleeding, intermenstr istopathology came out to Be cervical examination there is flashy growth that is involving the cervix biopsy was taken 2nd histor om malignancy. How will you proceed further to stage the disease? he ly jing is histopathalogically a) Staging is done mainly radio logically d) Staging is done histon: b) CX cervix is staged surgically e) None of the above S)|_Staehne & cone cinicaly ant department with 2 complaint of (QH67: 52 years old lady had her last menstrual period 12 months back, presented in out-patle changes? hot fushes, Bloating abdomen and ial, Which ofthe fllwng hormones i responsible fr these vasomotor cha a) Decreased levels of LH. 4) Increased level of Prolactin. 'b) Decreased levels of Progesterone. e) Reduced Estrogen level €)__ Increased level of FSH. ‘Q#EB: ASO years old para 6 has experienced a complaint of mood changes, hot flushes, anxious about her symptoms and wants to get them treated. Which one of the following is an abso! hormone replacement therapy (HRT)? a) Chronic iver disease. 4). Uncontrolled Hypertension. b) Increased bone mineral density. €) Uterine Fibroid, €) Previous history of benign breast disease. QH69: 55 years old woman who has gone through her menopause, is very concerned that she may develop bone fractures. ‘What is the most effective way of preventing pathological fractures in post-menopausal women? 3) Clonidine 4). Selective Serotonin Reuptake Inhibitors. b) Combined Oral Estrogen & Progesterone pills. €) Vaginal Estrogen. €)__ Phytoestrogens. 2470: 49 years old lady who is amenortheic for the last 12 months, is complaining of increased sweating at night, hot flushes and disturbed sleep pattern? She went to her GP where her laboratory tests were done in which she had raised FSH levels. ‘Which one of the following is most appropriate for the diagnosis of menopause? 2) Absent menstruation for 1 year at this age. 4). History of night sweats. ) Bloating and irritability ) Raised level of FSH. }_ Changes in sleep pattern. 37%: A 22 years old girl has a secondary amenorthea of 12 months. She was being diagnosed with premature ovarien -ney. Which one of the following is responsible for this condition? 3) increased Estradiol level d)_ Raised FSH, Low Estradiol level »). LH reduced and FSH increased. @) Raised Gonadotrophins. ©) Lew FSH, Raised LH ‘#974: A 20 years old patient presents in outpatient department with a history of 2 months emenorrhes and vaginal bleeding. Her ultrasound report shows & weeks single viable intrauterine pregnancy. Per speculum examination shows close cervical Os irritability and loss of libido. She is very Jute contraindication to “wish no active bleeding. What is your management in this case? | a) Oral antibiotics 4) Oral tranxamic acid i b) Oral misoprostol €) Supportive treatment €)_ Oral mifeprstone 73: 4.25 years old patient is presented in outpatient department with history of irregular menstrual bleeding. Her urine pregnancy test is positive and her ultrasound report shows 7 weeks intrauterine pregnancy with absent cardiac ectivty. What is your diagnosis? a) Ectopic preganacy 4) Missed abortion b) Incomplete abortion ©) Threatened abortion ©) Inevitable abortion QH74: A 28 years old patient presented in emergency with a complaint of amenorrhea of 2 months, lower abdominal pain and heavy vaginal bleeding. Her urine pregnancy test is positive. Her blood pressure is 80/60mmHg, pulse is feeble and speculum examination shows open cervical os with a passage of clots and fleshy pieces protruding through the cervical os. What is your management? a) Bed rest and reassurance d) Intravenous tranxamic acid 'b) Immediate evacuation and currettage €) Oral misoprostol ©) Intravenous antibiotics #75: A 22 years old nulliparous patient presents in outpatient department with a history of complete miscarriages at 8 weeks gestation. What are the most common aetiological factors for first trimester miscarriage? {a} Chromosomal abnormalities ¢)_ Perinatal infections b) Drugs / chemicals e) Uterine abnormalities ©) Medical disorder6 years old patient presents with vaginal bleeding, and positive pregnancy test. Her ultrasound report shows a 8 weeks fle intrauterine pregnancy. What would it be reasonable to offer her, choose single best answer? '3) Laparoscopy 4) Progesterone b) Methotrexate ©) Misoprostol 77; A 85-year-old woman with a history of obesity and hypertension visits her ByNa ports having ittegular vaginal bleeding for the past two months. She is not taking any medications and has no family history of ‘cancer, The gynaecologist suspects that she may have endometrial cancer and orders a biopsy of her endometrium. What type of endometrial cancer is most likely in this case? a) Adenoacanthoma 4) Endometrioid adenocarcinoma b} Adenocarcinoma with squamous differentiation fe) Uterine serous carcinoma ©). Clear cell carcinoma w78: A 60-year-old woman presents to her gynaecologist with postmenopausal bleeding. She has no history of hormone replacement therapy. What is the most common clinical feature of endometrial carcinoma? 2) Abdominal pain d) Urinary incontinence b) Dyspareunia e) Vaginal discharge €)__ Postmenopausal bleeding 79: A S2.year-old woman with a history of obesity and diabetes is diagnosed with stage | endometrioid adenocarcinot® citer experiencing abnormal sterine bleeding. She undergoes a total hysterectomy with bilateral salpingo-Oophorectomy. The ‘al or ovarian fe) Serum heg measurements, .cologist for a routine check-up. She pathology report shows @ grade 1 tumor with no myometrial Invasion or Iymphovascular Invasion. No cervic involvement is seen, What is the most appropriate adjuvant therapy for her case? a) Chemotherapy d) No adjuvant therapy is required b) Combined chemotherapy and radiotherapy e) Vaginal brachytherapy ) External beam pelvic radiotherapy iis: A 45-year-old woman with a history of breast cancer Is prescribed tamoxifen, a selective estrogen receptor modulator {£RM), es part of her adjuvant therapy. She is aware that tamoxifen can reduce the risk of breast cancer recurrence, but 2150 increase the risk of endometrial cancer. She asks her oncologist what she can do to prevent endometrial cancer while taking tamoxifen. What is the best advice that the oncologist can give her? a) Avoid consuming alcohol. 4d) Should take a low-dose aspirin daily b) Maintain a healthy weight and exercise regularly fe) Undergo regular endometrial biopsies to detect ‘¢) Stop taking tamoxifen & switch to another medication si: 15 years old unmarried girl presented with marked anemia and haemoglobin of 5 gm /dl .she gave history of heavy irregular cyele since menarche ;her blood clotting profile is normal with normal platelets count. The most probable diagnosis is? a) Chronic anemia d) Vb factor deficiency b) Heamophilia e) Worm infection ©) Pubertal menorrhagia iis2: 435 years old women presented with heavy regular menses she has experienced spontaneous miscarriages over past 5 years ,her pelvic examination demonstrates an enlarged irregular uterus .her haemoglobin is 8 gm/dlLher urine pregnancy test is negative what is the most likely diagnosis in this case? a) Adenaxal torsion 4d) Pregnancy b) Ovarian teratoma e) Fibroid uterus ©) Endometriosis ‘#83: A 20 years old obese unmarried glel presented with ammenorrhea for two months, she gave history of infrequent menses with scanty flow .she developed facial hairs and temporal baldness.on ultrasound her uterus is normal with enlarged polysystic ovaries.whats the diagnosis? a) Cushing syndrime d) Pregnancy b) Ovarian cysts e) Miscarriage ©) Polycystic ovariam syndrome ‘Qi84: A34 years old female pare 4 had contraceptive injection one month ago she presented with continous per vaginal spotting .there is no bleed free days she is very wortied what could be the possible treatment.? a) Tab primulut N 4d) No treatment b) Tab panadol e) Admit patient give iv antibiotics )_Reassure and cap transamin QuBS: A 4 6 years old patient para 5 presented with irregular bleeding her family is completed and she want cure for her disease. She had history of blood transfusion twice.she had multiple fibroids on ultrasound .whats the treatment? a) No treatment d) ne b)_ Myomectomy e) Cap transamin )_Hystectomy QH86: Fibroid uterus is a a) Benign tumor of smooth muscle of uterus ) Malignant tumor of ovaries b) Malignant tumor of smooth muscle of uterus, €) None of the above ©) Benign tumor of ovariesage is 4 mart ol reproductive a £AH7, The most comman heniun gynecological wunor of won 4s) endometrial carcino: Or 4) Corviealintraepithohal neopla fo) Mone of the above ° b) Follicular avarion cyst © teiomyama un: HihroMd uterus ave we 4) agressive in nature 8) Asymptama ee althe stove D) Symptomatic Ce bethal QHN9: Gro¥Ah oF NbrOld Ws dependent on ierone a) thiragan 8) Estrogen and propesteran 1b) Progestorons 6) Hone of the above © Contiot lly 1 used for fibroids? 8) Ultrasound rive, nt ©) xnay QN91: A 28 year old wornan tryin {you with some vaginal spotting Where isan empty uterus with son 4) Ruptured appendis Y) Acute chotecystit ©) Ruptured ectopic pr N92: A 26 year old 1 vio had sudden fainting in itehen. She abdomen examination there Ist 8) Cr scan €) Hone of the above 10 conceive for the pa nd severe 1 4 years is having, history of irregular cycles. Now has presented to in in the right lower quadrant of abdornen. On her initial ultrasound scan in ER * collection in pouch of douglus i reported. The ost likely diagnosis in her case is: 4d) thesenteric lymphadenitis ¢) Cecal perforation A vaginal delivery 14 months back has been brought to Emergency department with history of * looking, pale on examination with pulze rate of 120 beats per minutes, BP 20/60 mm Hg. Per utiness in lower abdomen, On vaginal examination, cervical movements are very tender. The ‘Mout appropriate management option for her would be : 4) Conservative management with blood transfusion 4) b) Preparation for urgent laparotorny ©) Dilatation and curettage QN93: 0.34 year old woman who wiv, under investigation for primary inte days and urine pregnancy test fs positive. Her ultrasound sean reports er ‘mass about 4 % 4 cm with increased vascularity. There is no free fll option in her would bs a) 1/4 Methotraxate with serial hCG b) Posterior colpotomy WN Antibiotics ©) Diagnostic laparoscopy tility presented with history of amenorrhea for mpty uterine cavity but presence of right sided adnexal jn pouch of douglus. The most appropriate treatment 4) Exploratory laparotomy €) Serum Progesterone levels : ©) Diagnostic laparoscopy 7 GA. « 36 year old patient has received an IM Methotraxate injection as Medical lin © of management for her right sid jrownarey days ago. She has now come for follow up wth fesh ACG level reports, What lawl of Pace ean “v4 eallslatory response t ha Methotavate? ate nal evel the initial level | 22% Or mare below the inital level 4) 5% or below the init r 1/5 old Gy has presented for her Ante-natal check-up at 16 weeks Period of Gestation. Her sean * savity but presence of an alive intra-abdominal fetus. What is the most commonly used appro, 1 Intra-amniotic sac Methotraxate o 1) Expectant management until patient is hemodynamically stable Umbilical artery embolization placental response ) Fetal intra-cardiac KCI (QH96: bilqees Is 38 year old women. She presented in OPD with complaint of profuse per vagin of miscartiage 4 months ago. On examination Uterus is soft & bulky, both ovari Positive, The most likely diagnosis in above scenario is? ) Abnormal uterine bleeding due to hormonal Q imbalance 4) b) Fibroid uterus e) QH97: Hameeda is 34 years old women diagnosed case of molar pregnancy. ‘What is the most appropriate method of treatment in this case? a) Hysterotomy ¢) b)Hystrectomy ©) Medical induction with prostaglandin e)yeat-old woman Is being treated with r ‘alosifene for osteoporosis. Which of “ne fatlownag Is a concern with this 7) Breast cancer. “f), Endometrial cancer, 4} Hyperchotesceroteria ‘Venous thrombosis, €) Hypochalesterolemia 26-year-old female is using injectabl le medroxyprogest J A ferone acetate as a method of contraception Wi ing adverse effects Is a concern if she wishes to use this therapy long-term? a) Hyperkalemia eo We b)_ Male pattern baldness €) Osteoporosis hich one of i qs: whi the folowing is drug of choice for pregnant female suspected of having a baby with congenial adrena! yperplasi’ a) Betameth: ) ’ason 4) Hydrocortisone b) Beclamethasone e) Prednisolone c} Dexamethasone ‘Q301. A 60 year old male patient taking medicine for treatment of BPH for 6 month. Which may cause reflex tachycardia 4d) Weight loss, fe) Hypokatemia ‘and/or postural hypotension intial administration? a) Atenolol )_ Prazosin b)Hy¢rochotorothiazide fe). Verapamil ©) Metoproiol (@"102: Which of the following isa Selective Estrogen Receptor Modulat postmenopausal women? a) Clomiphene Citrate 4) Alendronate b). Raloxifene fe) BothB&C ©) Ormeloxifene {Q#103: Addition of a Progestin for 10 to 12 days eact recommended because the Progestin: 'a) Block the increased risk of myocardial infarction due to Estrogen bb) Block the increased risk of endomterial carcinoma due to Estrogen c) Reverses vulval atrophy occuring in postmenopausal women 4) B0thA&B e) Allare correct ‘quia: A 32-year-old woman who has been using @ copper intrauterine device (IUD) as her chosen method of contraception for the past five years. She has had no issues with her IUD during this time, and it has been an effective means of preventing pregnancy for her. How does the copper 1UD primarlly prevent pregnancy? 3) By thickening cervical mucus, making it diffult for sperm to enter the uterus b) By suppressing ovulation and preventing the release of ees ¢) By releasing hormones that inhibit sperm motility and fertilization, 4) By creating an unfavorable environment fr sperm, impatring their abilty to fertilize an eB8, fe) None of the above {Q#105: In which of the following conditions, Estroge ‘) Dysfunctional uterine bleeding b) Menopausal syndrome 1) Osteoprosis 106: A 30-year-old female preser and cloudy urine. She has a history “antibiotic would be the most appropriate choice for treating her UTI? a) Ciprofloxacin 4) Doxyeyeline e) _Erythromyci for that improves bone mineral density in a th month to Estrogen Replacement Therapy in a postmenopausal women is nis not the primary drug but us added to Progestin as adjuvant? d)__Atrophic viginitis e) Allof the above sats to the clinie with symptoms of a urinary tract infection (UT), including dysuria, frequency, of penicilin allergy. The urine culture confirms the presence of Escherichia coll. Whi b) Amoxicillin €)__Trimethoprim-sulfamethoxazole (TMP-SMX) ‘107: 419 year old medical student presented with complaints of weight loss, polyuria and polydipsia. He was otherwise Stable. His labs were as under: FBS. 397mg/dL, HbAIC: >15 %. What will be the treatment strategy? a) Metformin ¢) Insulin b) Sulfonylureas fe) Diet and life style modification ¢) DDPA inhibitors ‘av108: 35 years old female presented to emergency department with polyuria. She is diabetic for past 2 years and using -limepiride 4mg. Now, she got pregnant with gestational amenorrhea of 4months. Her labs are as under: RBS 250mg/dl, HbAIC 7.4%. What will be the treatment strategy? ‘a) Continue glimepiride and add Metformin. 4) Stop glimepiride and switch to insulin 'b) Stop glimepiride and start on GP-1 analogue e) Continue glimepiride and add insulin ©) Continue glimepiride and add DOP 4 inhibitors€aH109: 30 year old lady has obesity nfertity hirsutism and depression, Whats the most HFely cancion she suffering frarn? a) Hypothyroidism dd) Potyplanduta syndrome b)_ Morbid obesity f¢) Type tdiabetes metitus ¢) Polycystic ovary syndrome ‘iso: 12 yeor'otd female presented to emergency department in the state of coma and fever, he has ay fanart sett senyrated her GCS 1/18, Pub 100, 100/60, bod gs Ive ae ‘iso ma/al. What fs the best treatment option for this patient a) Metformin 4) Hydration with saline & Humulin (DKA protacal) b) Gliclaxide fe) OPPinhibitors ) Long acting insulin {a#111: 30 year old diabetic patient presented with polyuria, burning micturition. Her blood glucose levels are 250 ing/d despite on oral medications. She has this unary complaint for last few months. What are the best investigations plans for her management? a) Urine routine analysis/A6S 4) Urine culture Habe, AS 'b) Fasting blood glucose daily f¢) Ultrasound abdomen pelvis «) Blood culture, RBS 112: P7, post:menopausal for 3 years, presented in OPD with heavy P/V bleeding - on TVS, endometrial thickness H+ 430mm e- normal pelvic structure, What will be the next investigation to proceed for diagnosis? a) Hysteroscopy d) Hysterascopy direct Biopsy b) Pap smear @) Cone biopsy €) Colposcopy {@¥123: lodine deficiency can cause a) Goiter @) Thyroiditis b) Thyroid cancer @) Hone of the above 6) Solitary Nodules 24: Hyperparathyroidism couses 2) Heatintolerance 4) Headache b) High blood sugar €) Both Aande ©) Increased urination (#125: Most common cause of Cushing syndrome 2) ACTH Secreting tumor 4) Adrenal Carcinoma b) Adrenal adenoma €) Allof the above <)_ Exogenous steroids ‘aw126: A young Asthmatic previously taking Exogenous steroids came to emergency vith vomiting, abdominal pain, Yow BP, ry mucous Membranes blood sugar 120mg/dl mostlikely Dx is ‘a) Cushing syndrome 8) Addisonian crisis b) Diabetes metus @) None of the above <0) Diabetes insipidus cqns17: the ost common euse of permanent congenial hypothyroidism 2) Dyshormonogeness 3) fect of odie anspor 8) Thyroid dyegenes! ended syndrome G}. IODINE deficiency geste: che tne tooming accurate regrdngurne tdles in nephratisynrome? a crores 200mg of wary rte of more, colin with iis of sgormore one or more red blood cli per heh-power eld na win sediment eaminton i requted or agnosis of micronematura Seana ene oD me of ttl poten present in» 2shour urine callin supzests ea nephot syncrome 8a ine protein to urine cestiine>2leindcatesnephvoirange protein 6} None ofthe above gests: antentaged same of une, definition of signficant puis: 3° eukecyes per high power its @)_>5 levkoetesfeumm 3) Saoteatoortes per high power field €} Hone ofthe above @). >to eukoeyes/eumm cqrsz0: hich one no on appropriate weatment for Grave's csease? 3) Beta blockers 6) atithyoid dues : 8) Surgical removal of thyroid and @) Thyronne ; ) adloacive odine ‘