Cardiology

1. Patient with CCF, Treatment.... diuretics+ACE+Beta blockers

2. Left sided pleuratic chest pain, normal CXR, history of chest intubation 7days back,On ECG

old MI,cause of chest pain.......... Dressler syndrome

3. Systolic murmur,absent lung markings on CXR,RV dilation on Echo......... pulmonary

stenosis

4. Chest pain for one hour,MI suspected,next investigation....serum myoglobin

5. Rapidly given IV K+ causes......arrest in diastole

6. Recurrent episodes of loss of consciousness for a minute,with extreme pallor,next

appropriate investigation.........Holter monitoring(ambulatory ECG)

7. Middle aged male having heaviness in left arm,ECH normal,next........ excercise tolerance

test

8. Exeecisional dyspnea,echo and angiography normal,next investigation........CXR

9. Old lady has chest pain and right arm pain for many days but stays for 10 minutes,then

decreases at rest,cause......Angina

10. Patient of aortic dissection and not stable,next step......transesophageal echo,if asked for

confirmatory test then CT/MR Angiography(Harrison 1921)

11. Episodic loss of consciousness,next.....holter monitoring

12. Purpuric rash after coronary angiography,next best investigation......RFTs

13. Chest pain,ecg normal with sinus dysarthemia, management.......observe/monitor

14. A patient with lightheadedness,on ecg pause 2.5secomds,next management......24hr

monitoring

15. Patient with unstable angina,drug to be given.....aspirin

16. Patient with angina,ECG normal,next step......aspirin

17. SOB on exertion,chest pain radiating to right arm,settled after 10 minutes,

diagnosis.......Angina

18. Diagnostic for Aortic dissection...... Angiography

19. Exertional dyspnea with chest pain,ECG and CXR normal,next........ Thallium scan/ETT
20. Smoker with heaviness in left arm after brisk walk,ECG normal,next..,.......ETT

21. Unstable angina sceniorio,Tx...... aspirin

22. Cause of death in subacute bacterial endocarditis.......Valve rupture (Davidson),

overall.....LVF

23. Cause of mitral stenosis in middle age...... Rheumatic heart disease

24. Substernal chest pain,having history of RTA 3weems back,pain is constant worsens on

lying flat,having friction rub.......Viral pericarditis

25. MVP.......benign course (Harison page 1822)

26. Anterior wall MI with 3rd degree heart block...... Pacemaker

27. Investigation for HOCM......Echo

28. Other murmur with AR..... Austin flint murmer

29. MI secondary to Cocain abuse,ist step...... aspirin, clopidogrel and LMWH if asked best

then PCI,if PCI not available then Thrombolysis

30. Pt has HOCM,drug not to be given....... Digoxin,other are ACEIs and Nitrates

31. Patient with sore throat and fever not responding to antibiotics,now joint pain,best

test.....ASO titre

32. Common anti-arrythmic used in CPR....... AMIODARONE

33. Relevent sign of mitral stenosis..... presystolic accentuation of murmur

34. AF with PVCs.......amiodarone

35. Diagnostic feature for COA....... absent femoral pulses

36. Investigation of choice for Aortic dissection......CT angiography

37. SOB,CXR normal,ECHO shows LV Hypertrophy,cause...... Systolic heart failure

38. Pt with flushing of face and body,best drug......IM Adrenaline

39. Pt in PE and shock, Treatment......... Thrombolytics

40. IHD patient already on drugs having Hyperkalemia,drug responsible......Losartan

41. Sign which confirm acute pericarditis...... Pericardial rub

42. PCWP is approximate pressure of........Left atrium

43. Pt with extensive pulmonary TB, suddenly developed facial puffiness with pedal edema,

hepatosplenomegaly,JVP raised, diagnosis if Patient not improved with ATT.......

constrictive pericarditis

44. PVCs after MI, Asymptomatic, Treatment......just oberve(Davidson)

45. Patient with pulseless VT,next.......One shock

46. Cocain induced MI,what should be avoided...... Atenolol(betablockers)

47. Definitive indication of DC in CPR.......V.Fib

48. Common symptom of mitral stenosis...... dyspnea

49. Anterior wall MI of 6hrs duration,best Treatment option..........PCI

50. AF with clear chest,rate control........ Atenolol

51. ST segment elevations in lead 2,3 and AVF, artery involved........RCA

52. CCF patient already on maximum Treatment, having right arm pain,drug responsible........

furosemide

53. AF with SOB,having lung crackles, Treatment of choice...... Digoxin+diuretics

54. DC shock contraindication....... Digoxin toxicity(kumar)

55. Exertional dyspnea,2 episodes of syncope,has ejection Systolic murmer on left sternal

edge with soft s2........AS

56. Exertional dyspnea, palpitations,had clubbing with PSM at left sternal edge,oligemic lung

fields,RBBB,adopts squatting position, diagnosis........TOF

57. Pt with inferior MI,pulse 40/min,BP 80/50mmHg,simus rythm,next.......IV fluids (typical

sceniorio of almagraby)

58. Transient loss of vision in right eye, curtain is falling off in front of eye, diagnostic

investigation......Right sided carotid Doppler

59. Occasional syncope during play,caused died at age of 20, investigation of

choice......ECHO(for HOCM)

60. Mitral commissurotomy........sever pulmonary hypertension

61. For diagnosis and monitoring of progression of cardiomyopathy.......ECHO(Kumar)

62. Female,loss of consciousness,all four limbs pulses absent,ESR raised,having normocytic

anemia..... diagnosis........ Takayasu arteritis

63. Digoxin useful in ..........AF with CCF

64. Cardiac abnormality associated with RA........AR(Davidson Page 1098)

65. Digoxin toxicity increases with....... Hypokalemia

66. 65 yrs age,having hypertension,drug of choice.......CCB(Nice guidelines/JNC-8 Guidelines)

67. Broad complex tachycardia except....... hyperglycaemia

68. Diabetic with chest pain, having q waves on ECG, anterior wall MI,next step.......TPA with

heparin

69. Favours cardiac tamponade rather than constrictive pericarditis.........No Y decent on

JVP(Harison)

70. AS with no symptoms, aortic valve gradient 40mmHg, management......... regular

cardiology outpatient review

71. Post MI 3 months with palpitations and diziness, investigation of choice........Holter

monitoring

72. Common cause of death in infectious endocarditis......LVF(30-40%, Harison)

73. Reverse shunt in PDA...... cyanosis in lower extremities

74. Thrombolysis more effective in...... anterior wall MI

75. Tall tented T-waves with broad GRS,next step.....serum electrolytes(Harison)

76. Change in retina secondry to uncontrolled hypertension......cotton wool spots

77. Not a feature of viral pericarditis.....ST depression

78. TOF....... cyanotic heart disease

79. Common cause of Stokes’ adam attack..... complete heart block(kumar)

80. Diabetic already on medication,become over wight,drug responsible.......Gliclazide

81. Best for HOCM.......ICD implantation

82. ECG finding in acute pericarditis....ST Elevation with upward concavity,PR depression is

more specific but not in option

83. Feature of MS..... Presystolic accentuation of murmur

84. Diagnostic for Aortic dissection.......CT chest was in option(CT ANGIOGRAPHY is

best...harison)

85. SOB with settling in 20 minutes,cause.....low cardiovascular reserve

86. Swans Ganz cather does not measure directly.......cardiac output

87. Drug which prevents intermittent AF to continous AF......Beta blockers Davidson page 566

88. Eight weeks after prosthetic valve,pt developed IE,organism responsible.......Staph

epidermidis

89. Chest pain,MI 2 months ago...... Dressler syndrome

90. Cardiac temponade,next best step.....pericardial paracentesis

91. Ist agent for MI to be given..... aspirin

92. Laterl wall MI, artery involved......LCX

93. ECG changes in hypercalcemia....short QT interval

94. Major criteria for rheumatic fever....... Erythema marginatum

 Gastroenterology
1) Specific to diagnose SBP....... Absolute Neutrophilic
count.
2) Dose dependent hepatcellular demage caused by......
acetaminophen.
3) Parenteral nutrition is most helpful for ............short
bowl syndrome.
4) Lactulose..........reduces proliferation of ammonia
producing bacteria.
5) Antibiotics prior to ERCP...... Ciprofloxacin.
6) Common symptom of duedenal ulcer.... Epigastric
pain.
7) Pigment liden macrophages....... melanosis coli.
8) Common cause of backache in PBC..... Osteomalacia.
9) Best response to treatment........ genotype 3a on
PCR(HCV Types).
10) Risk of Ca in ulcerative colitis.....Early onset
disease.
11) Not a feature of IBD...... Bloating.
12) Uncomplicated ascities due to portal
hypertension from cirrhosis.....SAAG>1.1.
13) Difference b/w malabsorption and
maldiagetion.....D-Xylose absorption test.
14) Best for upper GI bleed.....Upper GI endoscopy.
15) Treatment of choice for varices.....Band ligation.
16) Diagnostic test for PBC....AMA.
17) Next investigation for acute hepatitis.....
Ultrasound Abdomen.
18) IBD subtype causes renal stones...... Crohn’s
disease.
19) Ultrasound features disappears in liver
absces......6 months(Harison 1572).
20) Difficulty for swallowing solids at supine position
but improves with standing..... Achalasia.
21) Chroinc Hepatis c having enlarged liver,AFP
normal........ Hemangioma.
22) Initial management of bleeding varices.....IV
resuscitation.
23) Gastrinoma usually situated in.....Neck of
pancreas (mostly in Gastrinoma triangle CMDT).
24) Risk for CA stomach.....H.Pylori.
25) Before liver transplantation (awaited)....TIPSS.
26) Common cause of NASH.... Obesity.
27) Isotonic diarhea.....VIPoms.
28) Common cause of pyogenic liver abscess.....
Cholangitis.
29) Known case of celiac diaease with weight loss
next....... Endoscopic Biopsy.
30) DM, pigmentation, hypogonadism, cirrhosis.....
Hemochromatosis.
31) Unconjugated hyperbilurbinemis , urobilinogen
negative..... Gilbert.
32) Acute and chronic liver failure.......PT.
33) Neuropsychiatric symptoms with deranged
RFTs..... Wilson’s disease.
34) Diarhea.....normal anion gap.
35) Heart burn with weight loss....upper GI
endoscopy.
36) Common cause of SBP........E.Coli.
37) Chronic diarhea with IDA.... celiac diaease.
38) Macrovasicular steatosis......NASH.
39) IBD associated with ....... Ankylosing spondylitis.
40) Crohn’s vs ulcerative colitis....... granuloma.
41) Retrosternal pain aggrevates by leaning
forward..... Esopheal.
42) Treatment of MALTOMA......h.pylori eradication.
43) H.Pylori eradication therapy consists of .......
penicillin,clarithromycin,PPI.
44) Monitoring of hepatic failure......PT.
45) Not a risk factor for CA stomach.......O blood
group
46) Best to diagnose ideopathic.
Hemochromatosis.......liver biopsy (CMDT).
47) Most sensitive for for detecting h.pylori.......urea
breath test.
48) Marker of CA liver.........AFP.
49) Bleeding,PT/APTT increased, vitamin K inj
doesnt improve bleeding....... fulminant Hepatitis.
50) Foul smelling diarhea,stool floates over
water...... pancreatic insufficiency.
51) During OGD Patient collapsed.......
hypoglycemia....give hypertonic.
52) Common cause of death in acute pancreatitis.....
respiratory failure.
53) Diagnostic test for Wilson......liver
biopsy......Harison page 2983.
54) Investigation normal in Celia disease..... barium
follow through.
55) Conjugated obstructive pattern.......CA pancreas.
56) Right hemicolectomy,now with pleural
effusion,next investigation...... Pleural cytology for
malignant cells.
57) Common comorbidity associated with IBD.....
autoimmune hepatitis.
58) Common tumor of small intestine.....
adenocarcinoma.
59) Common location for duodenal ulcer......
anterior wall of stomach, perforation anterior wall,
bleeding posterior wall (Davidson 875).
60) Chronic diarhea with RIF mass...... Crohn’s
61) Burning pain after hot tea..... ESOPHAGITIS.
62) To detect presence of ascites...... puddle sign.
63) Abdominal pain after ERCP......acute
pancreatitis.
64) Recurrent episodes of jaundice,fever, weight
loss,on exam palpable lymph nodes around umbilical
area,how you will proceed.....CT abdomen.
65) Not a complication of celiac diaease.....
hypersplenism (there is hyposplenism)
66) Cause of recurrent duedenal ulcer....H.pylori.
67) Yellow sclera,LFTs normal......Carotenemia.
68) Third trimester with high grade,rigors and
chills,low albumin 3,ALT 47,ALP 950,
diagnosis......AFLD(low albumin points toward
AFLD(almagraby).
69) 30 yrs old,low grade fever, colitis, chroinc
diarhea and ascities, diagnosis...... Abdominal TB.
70) 3rd grade student with pain Abdomen,
indigestion and alternating bowl habits for last two
months,mild tendeness RIF.........IBS.
71) Diagnose case of ulcerative colitis,on TPN,now
presented wiy dermatitis and alopecia,cause......Zinc
deficiency.
72) Common dermatological complication of IBD.....
Erythema nodusum.
73) Charecterestics features of Crohn’s diseas.......
inflammation confined to mucosa and submucosa
(it’s a feature of UC).
74) Pt with hemetemesis,o/E mass in epigastric
area..... diagnosis.......OGD.
75) Female with blood in stools for last 2days,(4-
6/day), having history of intermittent loose stools for
one year,best to do...... sigmoldoscopy/colonoscopy.
76) Differentiate Crohn’s from ulcerative
colitis.....non-caseating granuloma.
77) Chroinc alcoholic middle aged female with
severe abdominal pain, weight lose,passing bulky
stools.....CT Abdomen
78) Middle aged female with epigastri.c pain,
anything he takes,vomits, diagnosis....... pylori
 ulcer(if pain,then ulcer,if not then Pylori
obstruction).
79) To check massive ascities......fluid thrill(Davidson
938).
80) Jejunal biopsy shows macrophage containing
PAS +ve granules...... Whipple’s disaese (Harison
2226).
81) Strong association with H.pylori.......Duedenal
ulceration.
82) Hep c +ve patient,had two episodes of
hemetemesis in last 3years,BP normal,
Treatment......Beta blockers (Harison 2412 )
83) PSC associated with Ulcerative colitis.
84) Electrolyte abnormality in villous adenoma.....
Hypokalemia (Harison).
85) Antibodies in PBC........AMA.
86) Watery diarhea last two weeks,stool osmolarity
270,serum 280,likely cause.......Villous adenoma
(osmotic gap less than 25, secretary,hence villous
adenoma).
87) Supports a diagnosis of VIPoma.......
achlorhydria (harison).
88) Chroinc Hepatis,HB is high(19.5g/dl),tender
liver, investigation.......AFP.
89) Alcoholic,GERD taking PPIs,now worsening of
symptoms and weight loss, investigation to
proceed.......Upper GI endoscopy.
90) Risk factor for h.pylori infection.........low
socioeconomic indicators (Harison 2224).
91) Ulcerative colitis with jaundice,raised bilirubin
and abnormal, diagnosis......ERCP(for PSC).
92) Risk factor for CA stomach.......h.pylori infection.
93) Female, history of loose stools,passes 3-4
stools/day with bleeding,8kg weight loss, palpable
liver with hard modules,next......
proctosigmoidoscopy (MRCP notes).
94) Epigastric pain radiating to back,next.....serum
lipase.
95) Precisely localise a bleeding site in GIT, reliable
test......radiolebeled scan(CT angiography is superior
than radiolebeled scan... Harison/cmdt),but it was
not in option.
96) Dangerous complication of ulcerative
colitis.......toxic megacolon.
97) Deferentiate between chronic acute hepatitis
from chronic persistent Hepatitis by.......liver
histology (Harison 2375).
98) In celiac disease,the most common lesion
is.......vilous atrophy.
99) Crohn’s disease,type of stones....... Oxylate
stones(Hyperoxaluria with Nephrolithiasis Harrison
2264).
100) 28 weeks pregnant lady developed abdominal
pain and vomiting,Her ALT,AST are raised,best
Treatment...... Termination of pregnancy.
101) Diagnose case of CA colon admitted in
emergency,If mets then next investigation......CT
abdomen with IV contrast (CECT).
102) Indigestions for last 2 months,OGD was showing
a polyp 2cm in the stomach,next step.....polyp
resection and Biopsy.
103) Young girl with lactase deficiency,all true
except........ Bleeding PR.
104) Known case of PRV with abdominal pain, ascities
and jaundice, diagnosis........ Hepatis vein
thrombosis(CMDT/Harison/Davidson).
105) Marker for liver function in acute and chronic
liver disase.......PT.
106) Sceniorio of Hemochromatosis,lab finding...........
increased serum ferritin and decrease TIBC
107) Vincent angina occurs at ..........Gums(Harison).
108) Young male with diarhea,O/E rash on elbows
and knees,His lab endomysial antibody +ve,
suggestion....... avoid gluten in diet.
109) Not associated with celiac disease.....more in
males(common in female Kumar).
110) Tumor marker of CA colon is.......CEA.
111) Common complication of Achalasia......
bronchitis (Harison 2213).
112) Male, alcoholic with severe epigastric pain and
vomiting.......acute pancreatitis.
113) Most serious complication of ulcerative
colitis..... toxic megacolon
114) Elderly male having signs and symptoms of
hypercalcemia, abdominal pain and mass in right
iliac fosaa,intial management.....I/V N/saline.
115) Fever from last 20days,right hypochondrical
pain,SOB,on chest xray right sided pleural effusion,
diagnosis........... Ruptured hepatic abscess.
116) Jaundice,LFTs normal,cause.....familial
hyperbilirubenemia..
117) Carcinoma gall bladder associated with.....gall
stones.
118) Pt with Hemochromatosis developed hepatic
vein thrombosis,Tx.......liver transplantation.
119) Adult female with right sided abdominal
pain,ALP is high(>600), bilirubin 8mg/dl, diagnosis.....
Obstructive jaundice.
120) Known pt of CCF with abdominal pain
aggrevated by meal after 1 hr, diagnosis.... ischemic
colitis(Harison).
121) Common cause of hemetemesis.....dudenal
ulcer(upper GI bleed >50% by PUD(Harison),and
Duedenal ulcer is more common (kumar).
122) 68 years alcoholic male with liver cirrhosis and
mild ascities, feature present.......reduced urnary
sodium.
123) Young man with bouts of hemetemesis,O/E
pulse 106/min,BP 90/60,most appropriate after
initial resuscitation......OGD.
124) Colonoscopy is contraindicated in..........Toxic
megacolon.
125) Alcoholic pt has chronic pancreatitis already on
mercaptopurine,cause........ alcohol.
126) Most common cause of upper GI
bleed.....dudenal ulcer(Harison).
127) Known case of hereditary
Hemochromatosis,serum iron 30, ferritin 500,Hb
 13.6,TLC 6.7,most appropriate step..........
venesection.
128) String sign seen in .........in stenotic and non-
stenotic phase of Crohn’s disease(Harison page 2264
typical mcq).
129) Female with PBC,Tx of choice.....liver
transplantation.
130) Epigastric pain worsen day by day,driver by
profession........ duodenal ulcer (driver and tea).
131) IV drug abuser laying on road, having
Dupuytren’s contractures,cause............Hepatic
Encephalopathy
132) Patient has amoebic liver disease,he took
metronidazole,and abscess subsided,after
completion,what Treatment should be goven
next......Diloxanide furoate(Davidson).
133) Epigastric pain,deranged LFTs,ERCP normal,
diagnosis.......acute hepatitis.
134) Pt with GI bleeding, endoscopy and colonoscopy
was normal,next investigation to localise site.......
mesenteric angiography.
135) Investigation of choice for HCC...... Biphasic
CT/triphasic CT.
136) Claw sign is seen in....... Barium enema(for
intussusception).
137) Women with progressive jaundice, xerostomia,
Pruritis and fatigue,U/S shows normal texture of
liver with normal biliary channels, bilirubin 1.2,ALT
65,ALP 290, likely cause.......PBC.
138) Investigation of choice for hepatic adenoma
is......CT Abdomen
139) Diagnose case of decompensated liver disase
presents to you in ER with abdominal pain,fever and
ascities,best diagnostic test would be..... ascitic fluid
examination.
140) Non-alcoholic fatty liver disease is associated
with....... Obesity.
141) Pt with copius diarhea,chest tightness and red
complexion,you will suspect..... Carcinoid syndrome.
142) Decompensated liver cirrhosis has fever and
pain Abdomen, appreciate diagnosis...... subacute
peritonitis.
143) Favours of ulcerative colitis than Crohn’s
disease.....rectal involvement.
144) Foul smelling stools, occasionally floating.....
pancreatitis insufficiency.
145) Pancreatitis is associated with All except......
hypotension.
146) Old pt having constipation, weight loss 4Kg,pale,
diagnosis.........Ca Colon.
147) Pt present with hemetemesis has mass in
epigastrium,what to do next...... Endoscopy.
148) Common complication of ulcerative colitis
include all except...... Dermatitis.
149) Altered bleeding habits and bleeding per
rectum,nodule in liver...... proctosigmoidoscopy
150) anti-endomysial antibodies are......IgA(Harison).
151) worsening of jaundice,weight loss,stool for
occult blood +ve, ultrasound abdomen shows
enlarged liver,ALP 900, diagnosis......CA head
pancrease.
152) 89 yrs old with multiple diverticulae on
Colonoscopy, appropriate next step..... increased
intake of dietry fibers.
153) Squamous cell carcinoma is a complication
of...... Achalasia.
154) Lady with BMI 36,right hypochondrical pain and
mild derangement of LFTs with negative viral
profile,what would be the cause.... Non-alcoholic
fatty liver disase.
155) Investigation of choice for GERD......24hr
investigation of choice for GERD.
 Pulmonology
1) 65 years old male with hemoptysis,sputum cytology contains
malignant cells,CXR normal,next .........bronchoscopic
washing and bruishings.
2) 3rd trimy pregnant lady with PE, investigation......V/Q Scan.
3) COPD with cor-pulmonale,tx........long term domiciliary
oxygen therapy.
4) CXR finding with lobar Pneumonia.......air bronchogram with
non-homogenous consolidation.
5) COPD exacerbations with CXR multiple
shadows........S.aureus.
6) Myesthenia gravis with mediastenal mass......thymoma.
7) PFTs for Obstructive lung disease........FEV1 decreased,TLC
and RV increased.
8) Pursing of lips to prevent......... atelectasis.
9) Indications for mechanical ventilation.......PaO2 50mmHG.
10) 40years male with hemoptysis, hematuria, diagnosis.......
Wegner’s granulomatosis.
11) 55 years old male with dey cough,fever, recurrent attakes
of asthma,weight loss and joint pain,ON CBC eosinophils are
20%,CXR bilateral fluffy shadows, diagnosis..........CSS.
12) Large pleural effusions,next..... therapeutic tap.
13) Investigation of choice for asthma....... spirometry with
reversibility.
14) Common infection in CF......Pseudomonas.
15) Least common in squamous cell carcinoma......HOPA.
16) Known Patient of ABPA presents with exacerbations,
Treatment of choice.........oral glucocorticoids (Harison page
1536).
17) COPD patient with ABGs,PH 7.30,pCO2 56mmHg,pO2
66mmHg,next action........NIV.
18) Hemoptysis with scanty sputum,already on OCPs,CXR
normal, diagnosis.......bronchial adenoma.
19) Known asthmatic with retrosternal chest pain,CXR,ECG
normal, diagnosis.......GERD.
20) PE, Treatment of choice....... warfarin.
21) Dry cough, bilateral lymphedenopathy on CXR,
unlikely........ amyloidosis.
22) Lung CA with cavitary lesions....... squamous cell
carcinomas.
23) True regarding ARDS.........PaP may increase
24) Smoker with obstructive PFTs.......COPD.
25) Known TB Patient having a ball like cavity with air fluid
level..........aspergeloma.
26) Known COPD with type 2 respiratory failure,O2 therapy in
medical ward.......Taper O2 to 1-2L/min.
27) Pt with fever,SOB,dry cough for 5days, preceding flu like
symptoms,now erythematous rash over body,organism
responsible........ Mycoplasma.
28) Pregnant lady with ABGs,PH 7.5,PCO2 28,PO2 99,HCO3
26,next.......Rebreathing in a Bag.
29) Measuring volume and diffusion capacity of each
lung......differencial bronchospirometry.
30) Patient has bronchial asthma but her respiratory and
cardiovascular examination is normal,cause......GERD.
31) Smoker known case of COPD,presents with upper limb
weakness and occullar muscles, diagnosis...... Lambert eaten
syndrome.
32) Fracture of femor 2 months back,POP placed now
hemoptysis and chest pain, diagnosis....... pulmonary
embolism/infarction? Depends on cpsp.
33) Young boy with chronic dry cough,chest exam
normal......bronchial asthma (cough varient).
34) Drug causing pulmonary fibrosis...... cyclophosphamide.
35) Female having productive cough, clubbing and bilateral
coarse crackles...........Bronchectesis.
36) Pleuratic chest pain with 1.5cm pneumothorax,next
step......... discharge with chest xray on OPD basis.
37) Known case of asthma,less likely diagnostic point.....
tingling dueing episodes of dyspnea.
38) Not a feature of sever acute asthma.......PEFR<30%.
39) To diagnose sarcoidosis..... lymph node biopsy.
40) Not a Risk factor for COPD........aniline dye.
41) Aspirated nodles,CXR shwoing air fluid level.......lung
abscess.
42) To monitor severity and response to treatment for
asthma..........PEFR.
43) Not causing pulmonary fibrosis.......methyl dopa.
44) Not causing lung collapse.......pleural effusion.
45) Pt has bronchial asthma, CXR showing fluffy
shadows,serum IgE 15423, diagnosis.......ABPA.
46) Side effect of busulphan...... pulmonary fibrosis.
47) Dry cough,SOB,CT shows lower lung fibrosis......fibrosing
alveolitis.
48) Not a feature of Obstructive sleep apnea.....impotence
49) Secondary Pneumothorax.......chest tube.
50) Regarding spirometry........depends on age,sex,weight and
ethnicity.
51) Decreased esinophils....... steroid administration.
52) Pt with emphyema thoracis.....chest tube.
53) Common cause of spontaneous primary
pneumothorax.......... Rupture of bleb.
54) Fever and chest pain,dullness on percussion,next step......
CXR.
55) Same in Obstructive and restrictive lung disease........TV.
56) Diabetic and day time sleep.......OSA.
57) Bus driver with fever,weight loss, hemoptysis and ESR
65,next........Sputum for AFB.
58) Pt with SOB,PCO2 60,cause..... hypoventilation.
59) Coin lesion on CXR,next....... review previous films.
60) Typical feature of atypical pneumonia..........Non-
productive cough.
61) Best Treatment for bronchiectasis...... antibiotics and
postural drainage.
62) Tall man with sudden SOB,absent breath sounds........
pneumothorax.
63) ARDS............inverse inspiratory ato expiratory pressure to
maintain auto PEEP.
64) Differentiate ARDS from cardiogenic pulmonary
edema........PCWP.
65) Diagnose case of RA with obstructive pattern......
bronchiolitis obliterans.
66) Extubated 2days back now strider, and swelling in
neck,next best investigation...... fibre-optic bronchoscopy.
67) Pt has rhinorrhea and headach,xray PNS shwing
haziness...... chronic sinusitis.
68) DVT, autopsy finding.......atheroembolism.
69) Symptoms of chest tightness during working hours,test to
diagnose............PEFR.
70) Good prognostic feature in sarcoidosis........ presence of
erythema nodusum.
71) SOB after trauma,absent breath sounds and decreased
breath movements on right side, diagnosis....... tension
pneumothorax.
72) Major effect of glucocorticoids in asthma........ anti-
inflammatory.
73) RA with pleural effusion,best test......pleural fluid for
glucose.
74) Known case of PTB, developed facial puffiness and pedal
edema, hepatosplenomegaly,cause......... constructive
pericarditis.
75) Pulmonary embolism,machinsm...... decrease perfusion of
effected area.
76) Pneumothorax secondry to........duat particles
77) Diabetic with thin walled cavitary lesion in lung......
Klebsiella(harison).
78) Alcoholic with SOB,sputum grows mixed growth,
diagnosis....... aspiration pneumonia.
79) Massive pulmonary embolism presentation........shock.
80) Known case of TB, developed cavitary lesion after
treatment.......aspergilloma.
81) Absolute contraindication to flexible
bronchoscopy......unstable neck.
82) Pt with cough and fever, foreign tour......... Legionella
(harison).
83) Regarding pulmonary embolism.......right axis deviation on
ECG.
84) SOB on exerty,fine crackles,ECG normal,next..,....HRCT.
85) Most helpful in Pleural effusion.......protein level.
86) Non productive cough after 3days of surgery
abdomen,cause....... pneumonia.
87) Farmer lung seen in...........mouldy hey.
88) Pleural Biopsy indicated....... mesothelioma.
89) Rusty colored sputum,organism...... streptococcus
pneumoniae.
90) Common cause of secondry pneumothorax......COPD.
91) Moderate sever asthma.......... respiratory alkalosis.
92) Adhesion in pleural space,lymph drainage...... axillary
lymph nodes.
93) 2days after abdominal surgery,pt has SOB, tachycardia and
tachypnea......... atelectasis.
94) Athmatic already on Treatment has hoarseness of
voice,cause...........inhaled corticosteroids.
95) Shopkeeper has dry cough, dyspnea on exertion,crackles,
bilateral wheeze, important in history taking.........birds
exposure.
96) Right hemicolectomy for CA colon,now pleural
effusion,best next step.........pleural tap for cytology.
97) Known CA lung now having hypercalcaemia,cause.......
squamous cell carcinomas of lung.
98) Associated with cystic fibrosis (common)........ hemoptysis.
99) Pt has history of fever,weigh loss, CXR showing apical
cavity, diagnosis.........TB.
100) ARDS......... capillary leakage.
101) COPD with cor-pulmonale, Treatment.........LTOT.
Hematology and Oncology
1) Common Cause mets in brain............Lung Ca.
2) Subtype of Hodgkin’s lymphoma caries the best
prognosis............. lymphocyte predominant.
3) Female with recurrent abortions,aPTT increased,
diagnosis........APLS.
4) Bleeding feom anysite occurs in deficiency of which
vitamin.......... vitamin K.
5) Chromosomal translocation 9:22,cause..........CML.
6) Fever, hemoglobinuria,raised LDH and reduced
heptoglobin,machanism......... intravascular hemolysis.
7) Best prognosis after Splenectomy......... Hereditary
Spherocytosis.
8) Not a cause of purpura........ Vitamin D.
9) Bone suppression by parvovirus, retic count normal.......
aplastic crisis.
10) Cancer not associated with occupation......Breast CA.
11) Poor prognostic factor in Hodgkin’s
lymphoma........fever.
12) 1st presentation of female in ITP........ menorrhagia.
13) Female with weakness, lethargy and fever,in CBC,Hb
8g/dl,TLC 2900,PLT 45000,Retic count decreased,
diagnostic............Bone marrow Biopsy.
14) Tumor marker for breast CA.........CA 15-3.
15) Risk factor for developing bladder cancer.........Aniline
dye Exposure.
16) Pregnant lady developed DVT, history of OCPs in
past,cause........... Factor V laden Mutation.
17) Best coagulation test for vWB disease..........PT.
18) Causes autoimmune hemolytic anemia........
methydopa.
19) Known patient of hemophilia needs urgent blood
transfusion but factor VIII concentrates are not
available,next choice......... Cryoprecipitate.
20) Diagnosed case of ITP with platlet count 45000 and
asymptomatic,what to do next.....,.Observe.
21) Bone pain with hepatosplenomegaly in a 3 year child,
diagnosis...........ALL.
22) Common presentation of haemophilia A.......
Hemarthrosis.
23) Old aged Patient with generalized weakness and
Exertional dyspnea,CBC shows HB 6,TLC 3.6,PLT 7000,MCV
125,most appropriate diagnosis....... Megaloblastic
anemia.
24) Elderly patient with petechiae on thighs,
diagnosis.....Vitamin C deficiency.
25) Young girl with DVT, normal PT and raised aPTT,not
responding to FFP, diagnosis.......APLS.
26) Anemia of chronic disease......decrease release of iron
from macrophages.
27) Which inhinits dihydrofolate reductase and
thymidalte synthetase............. Methotrexate.
28) Macrocytosis doesnt occure in ..........chronic
infections.
29) Joint swelling and effusions, family history,test to
do......APTT.
30) Translocation associated with Burkitt’s
lymphoma........t(8:14).
31) Bleeding from nose and mouth, purpuric rash, initial
test.........CBC.
32) Macrocytic anemia...........blind loop syndrome.
33) Deferentiate between absolute and relative
polycythemia............RBCs mass.
34) Charecterestics feature of pure red cell aplasia.......
normocytic normochromic anemia.
35) To diagnose PRV.......JAK-2 mutation.
36) Intermittent jaundice, hypochondrical pain right
side,past history of gall stones,pale,spllen was palpable,Hb
10,MCV 70,MCHC 38, diagnosis....... Hereditary
Spherocytosis.
37) Palpable painless swelling in neck, inguinal area and
axilla,night sweats,lost 24Ib weight, lymphedenopathy
which is non tender,nor red or hot, diagnosis.......NHL.
38) Deferentiate between primary and secondary
polycythemia........JAK-2 mutation.
39) Diagnoy test for hemophilia......dec factor 8.
40) Child with multiple transfusions with
hepatosplenomegaly, investigation of choice for
diagnosis.........HB electrophoresis.
41) CLL.......... frequently asymptomatic.
42) Monitoring of Ca Colon........CEA.
43) Coombs negative hemolytic anemia......PNH
44) Permanent disability after hemolytic reaction........
kernicterus.
45) Myelofibrosis presentation common......... lethargy.
46) Male with generalized lymphedenopathy, CBC shows
Hb 10,TLC 69000, diagnosis.......ALL.
47) Coombs +ve hemolytic anemia ............SLE.
48) Post Splenectomy common complication........
infection.
49) Mycoplasma causes hemolytic anemia,for
confirmation ..........Serum LDH.
50) Newborn baby has bleeding from umbilical
stump,have family history of same problm,test to
do......APTT.
51) Cause of extravascular hemolysis....... Hereditary
Spherocytosis.
52) DVT resistant to heparin.......... antithrombin III
deficiency.
53) Pt has history of weight loss and fatigue, generalized
lymphedenopathy,painful lymphedenopathy after
alcoholic intake,diagnosis.......... Hodgkin’s lymphoma.
54) Pt with anemia,blood film shows leukoerthroblasts,
diagnostic test.........bone marrow biopsy.
55) Diagnosed case of beta thalesemia minor,HB 10,
charecterestic......... increased amount of fetal Hb or HBA2.
56) Female with hemorrhagic petechiae,CBC shows HB
normal,TLC normal,PLT 19000,test to reaveal
diagnosis.......Bone marrow biopsy.
57) Not a feature of PNH......... Hemarthrosis.
58) Acute promyelocytic leukemia......t(15:17).
59) Peripheral blood shows howel jolly bodies,target
cells, diagnosis.....post Splenectomy.
60) Strong association with thymoma.........red cell
aplasia.
61) Diabetic investigated for dysphagia, endoscopy shows
Obstructive lesion,having history of GERD,biopsy will
confirm............ Adenocarcinoma of eaophagus.
62) Pernicious anemia associated with........cushing
syndrome.
63) Not a faeture of EPO........no risk of thrombosis.
64) Girl with microcytic anemia, diagnosed as
thalesemia,HB increased in alpha thalesemia.......HbH.
65) Charecterestic of acute promyelocytic
leukemia......DIC.
66) Not occur in maasive spleenomegally.......
hypocalcemia.
67) Child with Hemarthrosis, CBC shiws Hb 11,TLC 11,PLT
220,PT 11,aPTT 80,factor VIII is normal,like cause.......
Hemophilia B.
68) Feature of anemia of chronic disase........ decreased
TIBC.
69) PRV with abdominal pain and ascities,
diagnosis......hepatic vein thrombosis.
70) Pt with epistaxis will exhibit.......platelet dysfunction.
71) Maximum reticulocytosis after irin replacement seen
in..........7days(harison 7-10.5days page 687).
72) Pt with TTP would have........microangiopathic
hemolytic anemia.
73) Severe bleedy after hernia repair,no family
history,her PT and aPTT normal,reason of bleeding.......
factor 13 deficiency(harison 830).
74) Machanism of action of cisplastin.......cross linking of
of DNA.
75) Pt with dark colored urine, CBC shows Hb 6,TLC 4,PLT
7000, diagnosis...... intravascular hemolysis.
76) Middle aged male with IDA, recurrent nose bleeds
and dyspnea is found to have a pulmonary AV
malformation on pulmonary Angiography, diagnosis.......
hereditary hemorrhagic telangiectesia.
77) Not a side effect of EPO.........long bones fracture.
78) Young boy with intermittent jaundice and cola
colored urine, diagnosis......G6PD.
79) Reliable finding in p smear for TTP......schistocytes.
80) Elderly female with Hb 9,PLT 88,, massive
spleenomegally,bone marrow aspiration dry
tap,diagnosis........... myelofibrosis.
81) Pt with epistaxis, coagulation profile BT 15,PT
16,APTT 50, diagnosis.........vWB disease.
82) Charecterestic feature of intravascular
hemolysis........dec heptoglobin.
83) Not true regarding PRV........ presence of
thrombocytosis excludes the diagnosis.
84) Old female with fever,blood test shows Hb 9,TLC
N,PLT 55, diagnosis.......TTP.
85) APLS screening........aPTT.
86) Diagnostic for IDA.........serum ferritin.
87) Nasopharyngeal carcinoma caused by .......ebstein bar
virus.
88) Pt with Bleeding from gums and nose,bone
pains,febrile,with hepatosplenomegaly,Hb 9,TLC
174.diagnosis...............acute leukemia.
89) Not a feature of vWB disease ....... Hemarthrosis.
90) Least effecive in ITP........ Platlet transfusion.
91) Plays a role in platlet aggregation...... calcium.
92) SLE with prolonged aPTT,he is prone to develop.......
recurrent arterial and venous thrombosis.
93) Hemoglobinuria.......black water fever.
94) Pt with generalized weakness,lab shows dec Hb,TLC
normal,Plt decreased,retic count decreased,MCV 67,
diagnosis...............iron deficiency anemia.
95) a young male presented in er with hx of trauma to the
right leg, then he developed hematoma, normal BT, PT, CT,
diagnosis..................... factor 11 deficiency
96) Normal Bone marrow with increase iron deposit in
it.Normal all cell indexes.Only Rise Platelets and rise ESR.pt
complains were fatigue and headache.Diagnosis ........Bone
marrow dysplasia.
 Nephrology
1) Type Of Casts Seen in Glomerulonephritis

→ RBCs Cast.

2) Common Cause of papillary Necrosis

→ Diabetes (Davidson 505).
3) Treatment of anemia in CKD
→ Epo .
4) Between proximal and distal RTA
→ Serum HCO3.
5) Glomerulonephritis responsive to steroid
→ minimal Change disease.
6) HSP Seen in
→Childhood.
7) Thickening of GBM

→Membranous GN.

8) least likely Cause of AKI

→ Intravascular hemolysis.

9) young boy with peri-orbital Swelling, bilateral edema, Increased Urinary proteins,
dyslipidemia

→ Nephrotic Syndrome .

10) not a risk factor for stone formation

→ cystinosis .

11) common organism in UTI

→ E.coli.

12) patient in ICU oliguria ,urine:plasma urea is 40,

→ pre renal.
13)MI three days back undergone angiography deranged RFTs

→ contrast induced. nephropathy

14)peritoneal dialysis contra indicated in

→ Ascites.

15) glumerolonephritis associated with streptococcal infection

→diffused proliferative GN.

16) Diabetic With left flank pain Now oliguria

→ renal papillary Necrosis.

17) Painless hematuria, ultrasound abdomen normal, next test

→ Cystoscopy.

18) Diabetic hypertensive patent with tall tented T-waves

→Hyperkalemia.

19) DVT in Nephrotic Syndwme

→ loss of anti-thrombin 3.

20) Renal Osteodystrophy in CKD

→ Vitamin D3 deficiency .

21) A Women urinates while laughing

→Stress incontinence.

22) Decreased urinary Chloride

→vomiting.
23) Management of renal failure with Co-agulopathy

→ Desmopressin.

24) Protein losing enteropathy

→ Menetriers's disease .

25) passing blood at the end of micturation

→cystoscopy.

26) Low backach, Na 135, K 2.8, pH 7.3, HCO3 14, Ca 8.4 Alp.........RTA Type 2.

27) Normal anion gap acidosis

→Diarrhea.

28) Peritoneal dialysis preferred over hemodialysis

→LVF (Hypotension) .

29) Patient with diarrhea and deranged RFTs

→ pre-renal.

30) Reversible cause of Aki

→ ATN.

31) After taking ACE inhibitors for hypertension RFTs become deranged

→Renal artery stenosis.

32) Decreased urinary output after quick medications

→ATN.
33) GN associated with partial lipodystrophy

→Mesangiocapillary GN.

34) peritoneal dialysis best in

→LV Dysfunction post MI.

35) Least common cause of membranous GN

→Cryoglubinemia.

36) Raised myoglubin, raised ALT, billirubin and ALP normal

→Rhabdomylysis.

37) Deafness plus hematuria

→Alport syndrome.

38) Not a cause of renal papillary necrosis

→Multiple myloma.

39) Renal failure after antibiotics

→AIN.

40) After renal transplant patient is on azathioprine and cyclosporine

→Lymphoproliferative disorder.

41) abdominal surger with deranged RFTs

→ATN.

42) Sensitive marker of DM

→micro-albuminuria.
43)CCF, urine biochemistry shows

→decrease urine Na.

44)CKD best treatment

→renal transplant.

45)Acute GN is unusually

→ secondary to vascutilis.

46)Tubulo interstial disease

→hypercholeremic metabolic alkalosis.

47) investigation of choice in HUS

→ stool. R/E.

48) after donations of kidney decrease function

→ creatinine clearance.

49) recurrent UTI next best investigation

→ urine c/s.

50) Patient with oxyluria

→ Nephrolithiasis.

51) Common causes of CKD

→ DM.

52) Important finding of pre renal azotemia

 → Urine Na < 20.

53) ATT induced renal impairment

→ interstitial Nephritis (Davidson page 694) (Rifampicine).

54) Frank hematuria, BP 180/110 palpable lumber mass

→ ADPKD.

55) Beef burger, now hematuria oligouria

→ HUS.

56) Early investigation in diabetic Nephropathy

→ micro albuminuria.

57) Not a complication of ATN

→ metabolic alkalosis.

58) Normal Complement level

→ Good pasture's Syndrome.

59) T.B finding in urine

→ Sterile Pyuria .

60) Nephropathy in AIDS patient

→ FSGS (Harrison 2149)

61) Hemoptysis + hematuria

→ Good pasture's Syndrome.

62) Urine Shows Scanty protein ++linear IgG on biopsy

→ Lupus Nephritis.

63) Anemia 0f Uremia

 → Normochromic microcytic.

64) Hexagonal Crystals in urine

→ cystinuria .

68) Recurrent UTI, Urine C/S… Shows mixed growth

→U/s Abdomen.

76) CKD with k+ 7mg/dl ,now palpitations, next best step

→ calcium gluconate.

77) investigation of choice for reflexe nephropathy

→ micturating cystourethrography.

80) nephrotic syndrome,biopsy ,microscopy and dye study normal

→ minimal change disease.

81) GN associated with Hep B

→ membranous.

82) uretic stones,next investigation

→ spiral CT.

83) ATN

→ Raised K+.

84) CKD patient needs dental extraction, treatment

→Desmopressin.
 ENDOCRINOLOGY
1) Female patient with polyurea and weakness.....RBS.
2) Pt with thyroid nodule,FNAC shows follicular
sheets,Tx.......Total thyroidectomy plus RAI(kumar).
3) Common cause of cushing disease...... pituitary adenoma.
4) Side effects of insulin except.....weight loss.
5) Known case of Cranial DI, already on desmopressin,
complication........water intoxication.
6) Pt with exophthalmos and myxedema,cause.....graves
disease.
7) Young girl with excessive facial hair,cause....... congenital
adrenal hyperplasia.
8) After radioactive iodine,rotine blood tests reveal FT3
10.3,TSH 13.2,total cholesterol 7.7mmol/L,TG 2.5mmol/L,
appropriate treatment...... thyroxin replacement.
9) Important feature of hyperfunctioning thyroid......
tachycardia.
10) Common menifestation of MEN-1...... primary
hyperparathyroidism.
11) Increased serum cortisol and ACTH,.........cushing
disease.
12) Low dose dexa doesn’t suppress but high dose
supresses serum cortisol,plasma ACTH is raised,
diagnosis.........cushing disease.
13) Pt with weakness and increase urination and
frequency,RBS normal,next.........water deprivation test.
14) Hypertensive pt with no medications,lab shows Na
158,HCO3 31,K 3.1, diagnosis....... Conn’s Syndrome.
15) True regarding vit D deficiency.......low calcium,low vit
D,low PO4 and high PTH.
16) Diabetic mother,not a risk for baby......... ketonuria.
17) IDDM,her RBS is high,cause.......missing dose.
18) Important feature of agranulocytosis........sore throat.
19) Deferentiate cushing diaease from cushing
syndrome........high dose dexa.
20) Releases vasopressin.......volume receptors in left
atrium.
21) Pt with cataract,ct shows basal ganglia calcifications,
diagnosis....... Hypoparathyroidism.
22) Investigation of choice for hypothyroidism.......serum
TSH.
23) Growth hormone deficiency,test..... insulin tolerance
test(harison page 2668).
24) Cushing syndrome is most imp feature of .........
steroids abuse.
25) Addison..........water diuresis impaired.
26) Charecterestic of diabetic neuropathy....... usually
bilateral.
27) Manic patient already on medications developed
plyurea,nocturia and thirst,diagny.......Diabetes insipidus.
28) Test for acromegaly......GTT.
29) Patient has amenorrhea after heavy bleed secondary
to delivery,next test........ Pituitary function test.
30) Lady with recurrent fits,light headadness,
diplopia,fasting sugar 5mmol/L,c-peptide
raised(2.5mmol/L, diagnosis.........insulinoma.
31) Amenorrhea,loss of libido, galactorrhoea and
infertility are features of.........Prolactinoma..
32) Common biochemical manifestation of
osteomalacia....... decreased vitamin D.
33) Pt on thyroxin,when to check TFTs....,.6weeks.
34) Pt with Abdominal pain episodic, headach,
palpitations, diagnosis...... pheochromocytoma.
35) Treatment of MNG.......RAI(Davidson).
36) Commy menifestation of anterior hyposecretion
........... amenorrhea.
37) Regarding insulin.........glargine cant be mixed with
soluble insulin (NPH).
38) Stage 1 diabetic nephropathy,true about
it.......hyperfiltration.
39) Pregant lady with hyperthyroidism,drug of
choice......... propylthiouracil.
40) Diabetic becomes unconscious while
playing,cause......... hypoglycemia.
41) 69 yeras female with hyperthyroidism,
Treatment...........RAI
42) Ist trimester preganant develop hyperthyroidism,drug
contraindicated.....RAI.
43) Diabetic obese female with HBA1C 8.6,
Treatment........ Metformin.
44) Best test for diagnosis and monitoring of
disease.......TSH.
45) Diagnosis of Sheehan’s syndrome.....,.... Pituitary
function test.
46) Young male with speem count 100/ml,next
test......serum LH+FSH.
47) Small stature,underweight,having short 4th
metacarpal,low calcium........ Pseudohypoparathyroidism.
48) Similar effect on calcium and phosphate..........
vitamin D.
49) School girl with diffuse goiter,TSH high,T4 normal,
cholesterol high, diagnosis..... subclinical hypothyroidism.
50) Pt with weakness and lethargy,serum Na 122,K
5.9,TSH normal,T4 low,next........short synthcen
test(Harison 3735).
51) Pt has high serum calcium and decreased PTH,
diagnosis..... malignancy.
52) Diabetic with IHD, Treatment............long acting
insulin.
53) Pregnant lady with MNG.........prophylthiouracil.
54) In HONK which statement is wrong........serum
osmolality of 300mosmol/kg.
55) Pt with right sided waekness and serum Na
110mEq/L, diagnosis...,.....SIADH.
56) Pregnant lady with RBS 170mg/dl,next.........OGTT.
57) ADH exerts its effect on ......... collecting ducts.
58) Pt with bitemporal hemianopia and spade like
handa,best to confirm diagnosis.....OGTT with GH
measurement.
59) Known Graves disaese patient developed eye
symptoms after treatment,what could be rhe
reason...............RAI(exacerbates eye symptoms, Harison
page 2706).
60) Test for insulinoma...........supervised fasting.
61) Skin menifestation of hypothyroidism.........Dry
skin(harison 2700).
62) Seizures after abdominal surgery,serum Na is 111,
diagnosis.......water intoxication.
63) Tangling and numbness after thyroid
surgery,cause......... hypoparathyroidism.
64) Old male with hyperthyroidism, Treatment......RAI.
65) Minimum HBA1C level to diagnose DM..........6.5%.
66) Erectile dysfunction of diabetic, Treatment..........
sildenafil.
67) How to reduce risk of thyroid eye disease.........stop
smoking(harison 2707).
68) Common cause of cushing syndrome in old age..........
Ectopic ACTH.
69) Common cause of thyroiditis........ Hashimoto
thyroiditis.
70) Treatment of choice for young girl for
hyperthyroidism....... antithyroid drugs.
71) Thyroid nodule with TFTs normal...........FNAC.
72) Treatment of thyroid nodules with TFTs
deranged............RAI.
73) Feature of hypothyroidism....... alopecia.
74) Old lady chronic backache with normal Ca And
phosphate, Treatment.........Vitamin
D/Calcium/Bisphosphonates.
75) Signs and symptoms of diabetes ,ist diagnostic
test........ fasting glucose.
76) False regarding hyperfunctioning of thyroid..........
increased vascular resistance.
77) Difference between cushing and
obesity.............proximal myopathy.
78) Young female presented with palpitation,on exam her
BP 140/110, presented with abdominal pain..........
pheochromocytoma.
79) Pregnant lady with diabetes............OGTT.
 Rheumatology
1) To confirm polymyositis.......muscle biopsy.
2) True regarding........anti-Ds DNA to mitor disease.
3) Pain of big toe,serum uric acid normal, diagnosis.....Gout.
4) Severe right knee joint swelling,red hot tender joints,
diagnosis........peudogout
5) History of joint pain,rash on l.egs and buttocks and
hematuria.........HSP.
6) Young male with pain in joints and abdomen,rash on
bottocks and extensor durfaces of body, diagnosis......HSP
7) CREST Syndrome except......... Scleroderma.
8) DIP joint involvement and hyperkeratosis, diagnosis......
Psoriatic arthritis.
9) Ulcer in oral and on genital region with joint
pain......Behcet's disaese.
10) Backache,early morning stiffness improves with
activity........ Ankylosing spondylitis.
11) Deferentiate pseudogout and gout....... positive
birefregent crystals.
12) Pain and swelling in right knee with no
comorbidity......pesudogout.
13) Female with sudden stiffness and pain of her right
shoulder and upper thighs,ESR 110mm/hr,
diagnosis......PMR.
14) Pt with joint pain,facial rash and photosensitivity,
initial screening test.........ANA.
15) Pt with bone pains,urine shows hydroxyproline.......
Paget disaese.
16) Osteoarthritis location.........Knee.
17) Pt with right shoulder pain,worsen on active
movement,but not on passive movement, diagnosis......
Tendonitis (harison 2646,also in kumar).
18) Young Patient with joint knee pain and pustule.......
gonococcal arthritis.
19) Common location of tophus.......breast.
20) Pt has pulmonary TB, already on ATT,has developed
joint pain, diagnosis......gout.
21) Right big toe pain after running........acute gout.
22) Drug of choice for acute attack of gout...... NSAIDS.
23) RA patient developed periorbital
edema,cause......rensl amyloidosis.
24) RA with periorbital edema.........renal failure.
25) Pt with hearing aids and bilateral leg pain,xray shows
both femur fractures, diagnosis....... Paget disaese.
26) Obese female with lower back pain radiating to right
leg,next investigation.......MRI lumbosacral.
27) Low backache,xray shows lytic lesions,ALP 900,Ca
8.9mg/dl, diagnosis........paget disease (harison page
2962),calcium is normal in paget disaese.
28) Cause of weakness in low calcium,low K and low
magnecium.........low K.
29) RA,CCF Patient got respiratory infection, potassium is
raised after treatment, antibiotic responsible.......Co-
trimoxazole.
30) Pt with malar rash, vasculitis and Raynaud’s,
investigation finding......C1 complement level.
31) RA+anemia+thrombocytopenia, diagnosis.....Felty
syndrome.
32) CREST Syndrome except.........GERD.
33) RA patient on steroids developed diffuse abdominal
pain along with shoulder tip pain,test.........CXR.
34) Hydroxyproline in urine....... Paget disaese
35) Blanching fingers on cold exposure, increasing edema,
and finger tips infarcts,heart failure, diagnosis.......
Scleroderma.
36) Not a cause of adrenocortical insufficiency.......DM.
37) True regarding RA in pregnancy.......low dose of
steroids dont disturb HP axis.
38) Long term side effect of low dose steroid......
osteoporotic fractures.
39) False regarding thrombolitis obliterans.......not
related to smoking.
40) Pt with RA presents with inability to climb and comb
hairs, investigation.......MRI cervical spine.
41) Lift rods for construction, developed weakness in
right leg, investigation.....MRI spine.
42) Mother of five children has pain in both
shouldera,next step.......vitamin D levels.
43) Disease causing death by Hypertensive renal
Disease....... scleroderma.
44) True regarding HSP.....40% has renal
manifestations(harison 10-50%).
45) Male with jaundice, diarhea and joint pain,
diagnosis.....PAN.
46) Patient diagnosed as temporal arteritis,next step.....
temporal artery biopsy+IV steroids.
 Neurology
1) Treatment of essential tremors........ propranolol.
2) Patient mentally retarded since childhood,now seizures
and vertical gaze......... Arnold chiari malformation.
3) Young male presents with resting tremors,regidity and
bradykinesia,having history of loss of consciousness in
tiolet one year back........ parkinsonism 2nd to CO
poisoning.
4) Huntington diease..... autosomal dominant.
5) Spastic paraplegia,UMN signs and dysphagia, diagnosis......
Pseudobulbar palsy.
6) Young female having double vision,on horizontal eye
movement has nystagmus of left eye and impaired
adduction of right eye,lesion site........right MLF.
7) Pt with postural hypotension....... multiple system atrophy.
8) Typical feature of cavernous sinus thrombosis......
complete opthalmoplegia.
9) Not a feature of wenicke's encephalopathy...... seizures.
10) BPPV can be cured by ......Epley maneuver.
11) 20 years age having generalized primary
epilepsy,drug.......valproate.
12) Diagnose case of TBM,took ATT,now presented with
altered sensorium,focal neurological signs and decreased
cognition....... Hydrocephalous.
13) Right sided waekness, started 24hrs ago,CT ruled out
hemorrhage,next plan.......Antiplatelet therapy.
14) Occulomotor nerve palsy....... ptosis and dilated pupil.
15) Opd lady having disturbed gait, memory loss and
Urinary incontinence..........NPH.
16) 20 yrs boy e periodic episodes f severely dec vision
followed by ataxia 'dysarthria 'tinnitus lasting for 30
minutes which is followed by throbbing headache .most
likely dx is ? basilar migrain.
17) Patient presents wid generalised tonic clonic seizure
is emergency her ct scan was done which shows 5 cms
multicenrric madden lesion in right frontal love with
vasongenic edema .wht wil b your diagnosis .......
Glioblastoma.
18) Mri brain of young boy shows triangular clarification
in parietal lobe .wht s your diagnosis .........Glioblastoma
multiform.
19) Subdural hemorrhage is commonly.......venous in
origin
20) Subacute combined degeneration of spinal cord......
neurological finding can precede hematological findings.
21) Benedikt syndrome.... occlusion of paramedian
branches of basilar artery.
22) Dancing movements with skin modules.....Chorea.
23) Not interect with warfarin.......llamotrigine.
24) MRI shows triangular calcification in parietal lobe,
diagnosis............ Glioblastoma multiform.
25) Meningitis with rash........... Meningococcal serology.
26) Interferon is used for........... Relapsing remiting MS.
27) Regarding ALS......... Respiratory muscle involvement
(harison page 3142).
28) Backache after lifting objects,tender spine,next
diagnostic test.........MRI Spine.
29) Planing motor movements........Frontal lobe.
30) Female already taking valproate,now preganant,next
line of action........No change in treatment.
31) How you will start anti-epileptic.........start with one
drug with lowest effective dose.
32) Meningitis with focal neurological signs,
investigation.......CT brain.
33) Status epilepticus initial management.........airway
maintenance.
34) Pt having vertigo,deafness and nystagmus,CT brain
showing hypodense area at CP angle...........Schwanoma.
35) Headache with red eye and lacrimation.......cluster
headach.
36) Regarding increased ICP,true........ papilledema is a
reliable sign.
37) Ethosuximide...... absence seizures
38) Glove and stocking sensory type neuropathy with
absent ankle jerks...........DM.
39) Not a poor prognostic factor.....low anti-GM1 anti
bodies titre.
40) Temporal arteritis,tx..........IV steroids.
41) Known RA Patient with cervical pain and reduced
power in upper limbs,next investigation......MRI cervical
spine.
42) Dilated pupil and persistent later gaze.......3rd nerve
palsy.
43) Levy body dementia.......visual hallucinations.
44) Anemia improved with folic acid but still
paraesthesia,cause......vitamin b12 deficiency.
45) GBS Tx.......IV immunuglubulin.
46) Common in Parkinson disease...... bradykinesia.
47) Cauese demyelination...... vitamin B12 deficiency.
48) Arnorld chiari malformation...... downbeat
nystagmus.
49) Supports Supranuclear rather than Parkinson........
postural instability.
50) Feature of ideopathic Parkinson diaease........ unilteral
tremors.
51) Raised ICP is unlikely in presence of.........sinus
tachycardia.
52) Features of Meningitis but no focal neurological
signs,next investigation............LP.
53) Paraplegia with urinary urgency,next test.......MRI
spine.
54) Billeter lower limb weakness with SOB after chest
infection..........GBS.
55) GBS........ sudden onset(harison).
56) Common feature of MS........optic neuritis (30%
harison).
57) Blackouts,blured vision and loss of consciousness
after watching TV...... Epilepsy.
58) Common type of MND.......ALS.
59) A Pt presents to you in ER with sudden onset of
vertigo , dysarthria and visual disturbance . On further
examination you notice that he has ipsilateral facial
numbness , ipsilateral ataxia and contralateral loss of pain
and temperature of the body . Where is the lesion
........PICA.
60) Sudden unset of nystagmus, unilateral hypotonia and
ataxia......... cerebellar infarct.
61) Vitamin B12 deficiency affected site......white matter.
62) Not true regarding GBS.........ankle clonus.
63) Pt with Abdominal pain and vomiting,bowl sounds
normal,power is reduced,ankle and knee reflexes
absent,Hb 10,MCV<70, diagnosis.......Lead poisoning
(harison page 3133).
64) Alcoholic found unconscious in bed room,cause......
subdural hematoma.
65) Deferentiate SCD of spinal cord from MS......absent
ankle jerk.
66) Transverse myelitis,tx.........IV steroids.
67) An old man presented with dizziness and fear of fall
what could be the most treatable cause in this Pt......
diuretics.
 68) In extrapulomonary tuberculosis, out of the following
which is the least commonly involved site?
A. Meninges✓✓✓✓
B. Pleura
C. Genitourinary
D. Bones and joints
Note:- decending order----common lymph nodes
decending order;-
LN,pleura, genitourinary,bone and joint,meninges,
peritoneum, pericardium,so least pericardium,but not in
option....... Harison 1243.
69) Alport's Syndrome
>>>>>X-linked Dominant
>>>>>Deafness earlier than RF
>>>>>sensorineural hearing loss
>>>>>Type 4 collagen defect.
70) SAH--------non-contrast CT within 24hrs......>>>not
detected.....>>>LP......>to locate site.....>>>>CTA.
71) Xanthochromia in SAH
1)6-12 hrs ... Harrison
2)12hrs........Davidson+Kumar
 3)2hrs..........CMDT,click 6hrs.
72) left superior homonynaous hemianopia occurs at which
level.............right tempral lobe(PITS).
73) sign suggest peripheral vertigo.......tinitis.
74) Tabes dorsalis.......charcoat joints.
75) Patient is on valproate,not controling fits,next.....check
drug level.
76) drug of choice in myoclonic epilepsy...... valproate.
77) meningitis in HIV...... cryptococcal.
78) primary tumor of brain in adults......glioma.
79) difficulty in speaking,eating,absent gag reflex,unable to
protrude tongue........ Pseudobulbar palsy.
80) known schizophrenic having generalized regidity and
febrile.........NMS.
81) muscle wasting, Fasciculations and planters are
downgoing,suspection of.........LMN.
82) pathognomonic of neurofibromatosis....... axillary freckling
83) status epilepticus,give.......iv lorazepam.
84) collapsed in street,CT normal, CXR showing lobar
Pneumonia,serum sodium 114,has quadraplegia,brisk reflexes
and upgoing planters,no gag reflex, diagnosis.....central pontine
myelinosis.
 85) woman,obese,having headache, vomiting,LP shows
increased ICP,CSF normal...........ideaophatic intracranial
hypertension.
86) backache,most alarming sign.........acute onset.
87) young girl mentally retarded,having seizures since
childhood, associated with sign............. adenoma sebaceum.
87) spastic paraplegia and mood liability....... pseudobulbar
palsy.
88) cause of pure motor neuropathy.......MND.
89) pathognomonic for Parkinson.......lewy bodies.
90) Known CLD, history of fall, fluctuating concious level, ct
shows frontoparietal hematona.wat to do.......FFP.
91) B12 therapy for in patient of neurological signs......life
long(Harison).
91) lady with blurred vision, difficulty in walking, increased
tone,brisk reflexes.........MS.
infectious diseases
1) Rabies vaccination schedule......0,3,7,14,28.
2) Common cause of mortility in influenza..... pneumonia.
3) HIV +ve with white plaque over the lateral surface of tongue,
diagnosis...... Hairy cell leukoplakia.
4) Avian flue transmitted by.......bird to man.
5) Maleria patient developed vasicular rash at angle of mouth,
complication..... meningitis.
6) Organism causing diarhea in HIV..... Cryptosporidium.
7) Malaria affects....more than two cell lines.
8) Erysipelas caused by........ Streptococcus.
9) Polyvalent vaccine...... influenza.
10) Primaquine used for.......vivax and ovale.
11) Food poisoning.....staph aueus.
12) Pt on ATT, follow up visit to OPD,ist question........
compliance.
13) Regarding HIV .........EIA is screening test.
14) In cystic fibrosis, recurrent chest infection caused by......
Pseudomonas (kumar).
15) Complication of Meningococcal meningitis........adrenal
insufficiency.
16) Young girl with dysuria, vesicular lesion with erythematous
base on her vulva,tender lymphedenopathy,organism......HSV-2.
17) Causes of meningitis except.........rabies.
18) Imfective endocarditis in IV drug abuser........staph aureus.
19) Known case of PTB,not responding and developed renal
failure,cause..... renal amyloidosis.
20) Watery stools with deranged RFTs..........vibrio cholerae.
21) Brucella affects mainly........RES.
22) Hemoglobinuria occurs in.......... blackwater fever.
23) Burning micturition,urine c/s grows diplococci,tx.....IM
Ceftriaxone+Doxycycline.
24) False regarding typhoid vaccine......VI antigen showns active
disease.
25) Malignant tertian malaria causes by......palciparum malaria.
26) Pt with creatinine 1.2mg/dl,which ATT to start first.......INH.
27) Contraindicated in HIV..,..Yellow fever vaccine.
28) Pt on OCPS, Meningococcal meningitis prophylaxis.......
Ciprofloxacin.
29) Hemoglobinuria occurs in ....... blackwater fever.
30) Diarhea for long duration after travel..... giardiasis.
31) TB complication in males......... epididymitis.
32) Pregnant lady developed varicella zoster infection,next......
acyclovir (kumar/cmdt).
33) Toxoplasmosis in pregnancy,tx........spiramycin.
34) Bilateral lower limb edema with anguinal
lymphedenopathy,foreign tour..........wocheria Bancrofti.
35) Common cause of MDR TB........ irregular Treatment.
36) Primay site of localisation in lymphatics...... filariasis (harison
1630).
37) Pt with fever and rubbery cervical lymphedenopathy,after
giving ampicillin developed skin rash......... infectious
mononucleosis.
38) Organism responsible for neonatal sepsis after
PROM(premature rupture of membranes)........group B
Streptococcus.
39) One year child,what to do regarding rubella vaccination........
should be vaccinated now.
40) True regarding tetanus............ provides active immunity.
41) Vaccine before Splenectomy...,.... pneumococal.
42) Young Patient with Milky urethral discharge, diagnosis......
gonorrhea.
43) 2 days of fever,pain Abdomen and jaundice, appropriate
investigation..........HAV IgM.
44) Young boy taking ATT for abdominal TB, present with joint
pain,drug responsible........PZA.
45) Increased risk of HIV transmission........ heterosexuals.
46) Young male with Toxoplasmosis.......no treatment required.
47) HBSAg +ve and HBeAg +ve, treatment.......
vaccine+immunuglubulin.
48) Pt with high grade fever, body aches with non blanching
purpura, diagnosis......... Dengue fever.
49) HIV +ve developed esophagitis,cause........ Candidiasis.
50) Drug of choice for anthrax.......... Ciprofloxacin.
51) Pt on ATT, developed peripheral neuropathy,cause........INH.
52) Old age, diabetic and alcoholic pneumonia....... Klebsiella.
53) Ring worm best diagnoed by.......skin scrapings with KOH.
54) Infection seen in health worker....... Hepatitis.
55) Common complication of mumps in adults....... Orchitis.
56) Treatment of actinomycosis....... penicillin.
57) Test for mumps.......serum amylase.
58) Example of passive immunity.......anti-tetanus
immunuglubulin.
59) Complication of mumps..... Orchitis.
60) Pneumococal vaccine........capsular antigen.
61) Contraindications for rubella...... pregnant women(Harison).
62) Persistent HBV infection will show......HBS Ag anti HBc(IgG).
63) Common organism in UTI.......E.Coli.
64) Common manifestation of CMV....... Esophagitis.
65) How to prevent Hepatitis..........boiling of water.
66) Common organism in SBP........E.Coli.
67) Longest incubation period is.......polio.
68) Malaria resistant to chloroquine is treated by....artesunate.
69) Visceral leishmaniasis complications.......... ascities and
edema(harison 1596).
70) Nurse got needle stick injury from HBSag +ve patient,what
to do....... vaccination and immunuglubulin.
71) Pt from Balochistan with abdominal pain and massive
spleenomegally, diagnosis........ leshmaniasis.
72) Pt with cough and sputum, CXR showing multiple cavities,
organism......... staphylococcal.
73) Pt has HBSAg +ve and HBeAg -ve,it means.....active infection
with high infectivity.
74) CBC of a patient with salmonella infection will show........
leucopenia and lymphocytosis.
75) Female with Abdominal pain and joint pain,sdenexal
tenderness,likely organism...... Gonorrhea.
76) Regarding MDR-TB correct statement.......sputum is possitive
after 2 months of ttherapy.
77) HIV bacterial colotis,which organism involved.........C.deficile.
78) XDR TB means............ resistant to INH,
rifampicin,aminoglucosdides and fluroquinolones.
79) Water diarhea after seven days travel.......E.coli.
80) Conference between Pakistan and south africa........congue.
81) Staph areus food poisoning presentation.......severe
vomiting.
82) Rare complication of shigellosis...... meningitis (harison).
83) Specific for syphilis......FTA.
84) Vertical transmission of hep C......3%.
85) Hematuria with oval shaped eggs....... schistosomiasis.
86) Pt cames out to be HBSAg +ve, management......counciling.
87) Charecterestics of scabies...... burrows interdigital space.
88) A tourist wants to travel Pakistan, malaria
prophylaxis......start antimalarial one week before.
89) Pt with urethral discharge given inj Ceftriaxone but not
improved,cause..... Chlamydial infection.
90) Stage of plasmodium attacks RBCs........ merozoite (Davidson
page 354).
91) True regarding palciparum malaria......sample from ear
lobule gives the highest yield.
92) Pt with fever and non-ferminenting gram positive rods,
organism......E.coli.
93) Regarding leprosy.......spread by nasal droplets.
94) Abdominal surgery,using antibiotics now developed
diarrhea,cause.......C.deficile.
95) Typhoid H antigen shows...... previous infection.
 DERMATALOGY
1) Female with erythematous symmetrical lesion with orange
peel texture over both shins, diagnosis...... pretibial
myxedema (harison page 2704).
2) Least associated with pruritus....... pemphigus vulgaris.
3) Common cause of urticaria......food.
4) Knwon RA having hair growth all over his body,drug
responsible..... cyclosporine.
5) True regarding erysipelas...... involves neck area.
6) Drug of choice for urticaria in a 7 week pregnant........
diphenhydramine.
7) Pruritus all over body,itching at night, examination reveals
erythematous lesions in between fingers, diagnosis........
scabies.
8) Complication of PUVA therapy....... squamous cell
carcinoma (kumar).
9) Painless ulcer on fingers........ primary chancre.
10) Young lady with hypopigmented skin lesion on chest
and back,tanned skin,lesions are scaly,diagnosis.........
pityriasis versiclor.
11) Bulous lesions on trunk and multiple erosions in oral
cavity, diagnosis.........IgA pemphigus.
12) Least associated with TB.......Lupus pernio..
13) Scaly erythematous plagues on face and trunk,HB
10.4,TLC 3900,PLT 90000, diagnosis.......SLE.
14) Skin rashes having sore throat...... infectious
mononucleosis.
15) Pt having red, pruritic plaques with scales on trunk
along rib margins....... pityriasis rosaea.
16) Nodular lesion on calf which ulcerates, already on
ATT.......erythema induratum.
17) Farmer with verrocous lesion on dorsum of foot.......
chromoblastomycosis.
18) Important prognostic factor of melignant
melanoma.......depth of melanoma.
19) Female with itchy polygonal papules on flexors of
forearm,papules are coalesced to plaques,
diagnosis.......lichen planus.
20) Ulcerated lesion on shin with sorounding
erythema,daignosis.......Gumma.
21) Diagnosed as cutenous leshmaniasis,tx.........
stibogluconate.
22) Keloids are mostly formed on ........sternum (kumar).
23) For contact dermatitis.......skin patch test.
24) Strong association with Erythema
multiform.......Herpes simplex virus.
25) Neuropsychiatric symptoms with growing short hairs
with atoers ends and short broken terminal hairs,
diagnosis........ trichotillomania.
26) Patch of hair loss with family history of atopia..........
alopecia areata.
27) Wide spread skin lesions on extensors surfaces with
white superficial scales, diagnosis........ psoriasis.
28) Antibodies in CSS........pANCA.
29) Leastly associated with scal hair loss..........porphyria
cutenia tarda.
30) Diabetic with Ulcerative lesions in inguinal area with
discharge sinuses,case of actinomycosis,tx........ penicillin.
31) Drug of choice for scabies......permethrin.
32) Drug of choice for Norwegian scabies........ ivermectin.