2016-04-06

@marimphil wrote:

Lesion in the basal ganglia can cause all of the following features except:
a- Dystonia
b- Ataxia
c- Akathesia
d- Dyskinesia
e- Chorea

A pt. presents with early morning stiffness, which is relieved with activity (h/o Polymyalgia Rheumatica).
a- Muscle weakness
b- mild synovitis
c- Fever
d- Depression

Which of the following is NOT a clinical of hypothyroidism?
a- Pelvic girdle weakness
b- Tremor
c- Small muscle weakness
d- Palpitation

Trigeminal neuralgia can be best treated with which of the following drug?
a- Tricyclic anti-deppresants
b- Phenytoin
c- Carbamezepine

Urinary stones most commonly formed in acid urine are:
a- Magnesium ammonium phosphate
b- Xanthine
c- Phosphate
d- Uric acid
e- Oxalate

A 64 yrs old man complaints of diarrhoea for the last three months duration, which is the least likely cause for his diarrhoea?
a- Campylobacter jejuni
b- Carcinoma of colon
c- Giardia lamlia
d- Surreptitious use of laxatives

In which of the following conditions, hypoxia can be corrected completely by given 100% oxygen?
a- Lung disease
b- Cyanotic heart disease
c- Methhaemoglobinemia

Regarding tuberculosis which is true:
a- Mantouex test is usually negative in milliary tuberculosis

Diabetes mellitus is associated with all of the following except:
a- Acromegaly
b- Prolactin secreting pituitary tumor
c- Hyperthyroidism
d- Hemochromatosis
e- Cushing’s syndrome

Which of the following drug causes hyperkalemia as a side effect:
a- Thiazide
b- Captopril
c- Beta-blockers

Stag horn calculi can be associated with all of the following except:
a- Hyperparathyroidism
b- Hypercalciuria
c- Prolonged immobilization
d- Gout
e- Chronic infection

A 45 yrs old lady presents with palpable lump in her Lt. breast. Which of the following statement is correct regarding her lump?
a- It is considered to be a carcinoma unless proven otherwise

Erythema nodosum occurs in all of the following except:
a- Sarcoidosis
b- Tuberculosis
c- Yersenia infection

A patient picture showing a brown lesion in arm and forearm, hypo-pigmented areas has no pinprick sensation. What would be the probable diagnosis?
a- Sarcoidosis
b- Burns
c- Vitiligo
d- Leprosy

A picture showing crops of lesion over the right eyelid of a 10 yrs old child. What would be the probable diagnosis?
a- Skin tag
b- Warts
c- Molluscum contagiosum
d- Neurofibromatosis

In a jaundice patient, which is likely to assist the diagnosis of obstructive jaundice?
a- Upper lid xanthelasma
b- Scratching marks
c- Large tender liver
d- Heart rate 73/min
e- Enlarge spleen

18 yrs old girl, having fever at home; Her mother says that she has an abnormal behavior which make her suspect that she is on drugs, she’s having lacrimation, rhinorrhoea, diarrhoea and colicy abdominal pain and yawning. She has aches all over her body. Which drug of the following she’s likely to be on?
a- Marihuana
b- L.S.D.
c- Cocaine
d- Heroin
e- Morphine

In differentiating between acute haemolytic anaemia and chronic blood loss:
a- Increased reticulocytic count
b- Decreased haptoglobulin
c- Polychromasia
d- Increased SGOT
e- Enlarge spleen

In a jaundice patient, which will not develop liver cirrhosis?
a- Wikaon’s disease
b- Haemochromatosis
c- Infective hepatitis b
d- Infective mononucleosis
e- Alcoholic hepatitis

Polyuria and polydiosia can occur with which of the following:
a- Gout
b- Liver cirrhosis
c- Sarcoidosis
d- S. D. E.
e- Purictional

A chest x-ray of this woman before therapy would probably reveal all the following except:
a- Air in the right pleural space
b- Shifting of the mediastinum towards the left
c- Compression of the left lung
d- Shifting of the trachea towards the left
e- Fluid in the left pleural cavity

A 23 yrs old woman presents with diplopia and progressive weakness after repeated physical activity. A chest x-ray reveals a mass in the anterior superior mediastinum. Which of the following is most likely?
a- The patient has the Eaton lamberty syndrome associated with carcinoma of the lung
b- The patient has a lymphoma with associated asthenia
c- the patient has myasthenia gravis with an associated thymoma
d- The patient has metastatic carcinoma with cerebral deposits
e- The patient has lymphoma with cerebral toxoplasmosis

A 26 yrs old homosexual male presents with a 2 wks history of dry cough and shortness of breath. A chest xray examination reveals bilateral pulmonary infiltrates sputum culture is negative for bacteria, viruses and fungal. Concerning this patient:
a- The most likely diagnosis is AIDS (HIV) virus infection of the lung
b- T cell subsets performed two months earlier would be excepted to be normal
c- Bronchoscopy and broncho-alveolar lavage would be unlikely to be diagnostic
d- Pneumocytlu clinical to the most likely cause of this man’s pneumonia
e- Kaposi’s sarcoma may present in this way

Hyponatremia may result from which of the following conditions?
a- Diuretic abuse
b- The nephrotic syndrome
c- Cirrhosis
d- Adrenal insufficiency
e- Diabetes insipidus

A female aged 20 yrs presents with hypertension. There is a previous history of enuresis and childhood febrile episodes. This history suggests a likely diagnosis of:
a- Chromic glomerulonephritis
b- Reflux nephropathy
c- Essential hypertension
d- Polycystic disease of the kidneys
e- Analgesic nephropathy

Which of the following is true of chronic renal failure?
a- The anaemia is usually microcytic hypochromic
b- Polyuria is due to an increase in glomerular filtration rate
c- Urine is of fixed specific gravity (1010)
d- Yellow brown discolouration of the skin is due to retention of bile pigments
e- Osteomalacia and osteosclerosis are due to

A 5 yrs old woman complains of loose watery aloola without blood for 6 months. She also has recurrent lower abdominal pain, often worse after meals and has lost 5 kg in weight. She has a slightly tender ill defined mass in the right fossa but no other abnormality. Which of the following is most likely?
a- Chronic appendiceal abscess
b- Meckel’s diverticulum
c- Whipple’s disease
d- Crohn’s disease of the terminal ileum
e- Diverticulosis of the small intestinal

Which of the following provides the best measure of day to day fluid balance in patients with chronic renal failure?
a- Measurement of fluid intake
b- Measurement of 24 hour urine output
c- Haematocrit
d- Urine osmolarity
e- Weight

Staghorn calculus of the kidney may be due to each of the following except:
a- Primary hyperparathyroidism
b- Gout
c- Immobilisation
d- Urinary infection
e- Idiopathic hypercalciuria

Which of the following is not a consistent feature of untreated nephrotic syndrome?
a- Oedema
b- Hypertension
c- Hypertriglyceridaemia
d- Secondary hyperaldosteronism
e- Obliteration of epithelial cell foot processes

Within 6 hours of attending a banquet 10% of the participants develop severe nausea, vomiting, abdominal cramps and diarrhoea. In the majority the disorder subsides spontaneously but several subjects are admitted to hospital because of dehydration. The most likely cause is:
a- Salmonella food poisoning
b- Botulism
c- Staphylococcal food poisoning
d- Giardiasis
e- Clostridium perfringens food poisoning

Primary lactose intolerance (lactose deficiency) in usually associated with each of the following except:
a- An increase in blood glucose of less than 1mmol/l (20mg/100ml) after 50g of lactose orally
b- Steatorrhoea
c- Normal histology of intestinal mucosa
d- An increased prevalence in Asians
e- Normal galactose absorption

Which of the following statements regarding ulcerative colitis all but one are true, which is incorrect?
a- It always affects the rectum
b- It is a mucosa inflammation rater than involving the muscularis mucosa
c-
d- It may be associated with an increased risk of cancer of the colon
e- It may be associated with erythema nodosum

Increasing enlargement of an irregular liver is not a feature of which one of the following?
a- Cirrhosis secondary to alcoholism
b- Secondary metastatic disease of the liver
c- Acute fulminant hepatic necrosis
d- Nodular regeneration of the liver
e- Multifocal hepatocellular carcinoma

Gastrointestinal neoplasia is a complication of:
a- Jejunal Diverticulosis
b- Perniolous anaemia
c- Chronic amebic colitis
d- Crohn’s disease (regional ileocolitis)
e- Reflux oesophagitis

Concerning DIC AOF is true except:
a- Activated fibrinolysis
b- Decrease fibrin degrading products
c- Decrease platelets count
d- Increase fibrin nogen

Concerning Addison’s disease:
a- The commonest cause in Australia is auto immune
b- Hyper kalemia
c- Decrease renin
d- Hyper pigmentation in genital
e- ?

Helicobactor pylori can be associate with a:
a- Duodenal ulcers
b- Gastric ulcers
c- Carcinoma of stomach
d- Liocarcoma of small intestine
e- Malt

COAD with right heart failure is most commonly with:
a- PCO2 retention
b- Blood oxygen less than 60mmHg
c- Abnormal blood gas
d- FEVI less than 10L
e- Pulmonary hypertension (pulmonary edema)?

Otosclerosis is associated with:
a- Dysfunction of the Eustacian tube
b- Redden tympanic membrane
c- Blue sclera

Gullian Barre Syn CSF finding is most consistent with AOF except:
a- No pleocytosis
b- Decrease protein
c- Increase glucose
d- Few cell count
e- Less sugar

A man with ulcerative colitis with recurrent bleeding most excepted blood film will be:
a- Megaloblastic anaemia
b- Iron deficiency anaemia

First sign of puberty in boys is:
a- Increase growth spurt
b- Increase hair growth
c- Change of voice
d- Enlargement of the testies

Concerning reflux (oesophagitis) of gastric content to oesophagus WOF is incorrect:
a- Can occur during the day
b- Can’t occur in normal people
c- Most frequent during the night
d- More common in obese people
e- More common with hiatus hemia

Concerning Medullary sponge kidney:
a- Associated with renal stones
b- Dilatation of ureters
c- Renal failure common
d- Auto somal dominant

Concerning WPW Syn the best management is:
a- verapamil
b- Digoxin
c- Cardio version
d- Beta blockers (Meta prolol)
e- Analapril

The commonest cause of diabetic ketoacidosis is:
a- undiagnosed NIDDM
b- Omission of insulin injection in a IDDM
c- Undiagnosed IDDM
d- Uraemia

Common presentation with vomiting early in the course of disease is seen with :
a- Proximal small intestine obstruction
b- Recent large intestine obstruction
c- Acute pancreatitis
d- Distal small intestine obstruction
e- Appendicitis

A female with thrombocytopenia. The least likely cause:
a- Recent administration of (OCP)
b- Transfusion
c- Viral infection
d- Bacterial infection

Antiepileptic drugs, which of the following is correct:
a- Sodium valproate can cause gum hypertrophy
b- Phenytoin should not be monitored in blood
c- Teratognicity in pregnancy 3x more than non-epileptic
d- Phenytoin is treatment of choice in petit mal
e- In status epilepticus treatment of choice is i. v. barbiturates

A 67 year old man with both legs spasticity. Decreased reflexes no sensory loss, what is the lesion?
a- M.N.D.
b- Cervical Spondylosis
c- M.S.
d- Parkinsonism

A young asthmatic-patient with temperature 38.5c. wheezing, decrease breath sounds, hyperinfiated chest. What is the sequence of management?
a- Peak flow, CxR and blood cultures
b- CxR blood cultures and peak flow
c- Peak flow, blood cultures and CxR
d- CxR
e- CxR blood cultures and sputum cultures

Regarding septic arthritis non-gonococcal:
a- It due to gonococcus

A man with wasting and weakness of small muscles of hand and loss of sensation of medial aspect of arm. Which of the following is true?
a- C.5
b- C6
c- Cervical Spondylosis
d- Exclude duputyren contracture

A 40 yrs old man with generalized muscles pain in all muscles of limbs no sensory loss reflexes decreased. What is the most likely diagnosis?
a- Parkinson’s disease
b- Polymyositis
c- Polymyalgia rheumatica
d- M.N.D.
e- Guillain Barre’s syndrome

A female on piroxican (120mg tds) severe pain for rheumatoid arthritis, C/O of gastric irritation, Hb 9. Which of the following is true?
a- Stop piroxican give paracetamol 500mg with codeine 30mg
b- Give suppositories
c- Reduce dose to 10mg tds
d- Give another NAISD

A female with pain under the eye, boring and severe, prevented by chewing and touching. What do you give her to relieve the pain?
a- Corticosteroids
b- Carbamazepine (Tegretol)
c- A.H.T.
d- Paracetamol and codeine

Allergic rhinitis:
a- Desensitization is better than antihistamines

Atopic dermatitis;
a- Acute self limiting course
b- Is best identified by H.simplex
c- Frequently associated with scalded syndrome
d- IgM increased

Treatment of proven value in multi-infarct dementia with progression is:
a- Vasodialators
b- Antihypertensives
c- Cholinergics
d- Intranasal vasopeptides
e- All of the above

A female complains that her husband has strange behaviour after he had head injury some months ago. The most likely site of lesion is:
a- Frotar lobe
b- Temporal lobe
c- Occipital lobe
d- Non dominant parietal lobe
e- Dominant parietal lobe

A 65 yrs old lady with bruit over left carotid artery with transient ischaemic attacks. Carotid stenosis of 40%. What is true management?
a- Operate immediately
b- Endarterectomy
c- Aspirin
d- Warferin
e- Intracarotid streptokinase

Joseph., Oct 19, 2007

5

.

1.A 35 y old woman develops extremely pruritic, purple, polygonal
papules on her wrists.In association with these skin findings,she is
likely to have:
a. Herpes labial on the lips
b. B. Candidiasis on the vulva
c. Lacy white patches on the buccal mucosa
d. Ulcerations on the conjuctiva
e. Anal fissures

2.The major cause of perinatal death with twin gestation is:
a. Asphyxia during labour
b. Cord prolapse or entanglement
c. Twin-twin transfusion
d. Prematurity
e. Abruptio placenta

3.A 3 day old term infant has episodes of breathing for 10-15
seconds followed by apnea for 5-10 seconds. There are no changes in
skin color or heart rate.Which of the following is the most
appropriate step in management?
a. Administer caffeine
b. Administes theophylline
c. Apply continuous positive airway pressure
d. Provide supplemental oxygen
e. Reassure the parents

4.Which of the foloowing is a correct estatement about hemolytic
anemia?
a. The serum bilirubin is a sensitive indicator of hemolysis
b. In cold agglutinin disease, IgM is detected on the red cell
surface
c. In warm auto-immune hemolytic anemia, the indirect Coombs`s
test is positive
d. Oxidant stress hemolysis is characterized by "bite" cells
e. Approximately 5% of patients with CML will have hemolytic
anemia

5.Concerning the use of pneumococcal vaccine for a 6 month old
child with sickle cell disease,which of the following statements is
correct?
a. Vaccine may be used instead of daily penicillin prophylaxis
b. Immunization at 12 months and annually thereafter prevents
mild as well as serious disease
c. Immunization at any time does not help prevent serious
pneumococcal disease
d. Immunization given at 6 monmths of age will prevent serious
pneumoccocal disease
e. Child should receive prompt medical attention for any
fever,regardless of immunization status

6.The patient most likely to develop adenomatous hyperplasia is:
a. A 24 y old on low dose oral contraceptives
b. An obese female with a history of oligoovulation and
infertility
c. A post-menopausal black female with multiple fibroids
d. A 30 y old G3 P3 female with dysfunctional uterine bleeding
e. A 23 y old student with anorexia nervosa

7.A 50 y old woman notes the onset of generalized itching 3 weeks
after starting estrogen therapy. On physical examination, she has
mild hepatomegaly, jaundice and dry eyes. Wjhich of the following is
the mnost specific diagnostic therapy test?
a. Antinuclear antibodies
b. Antimitochondrial antibodies
c. Anticentromere antibodies
d. Antineutrophil antibodies
e. Antismooth muscle antibodies

A 15 months old child is brought to you by his parents. He was born at 36 weeks by normal vaginal delivery. At 8 months a mother child health centre test for hearing was done. On physical examination, the child appears normal. What will you do?
a- Reassure the parents that this in normal variant
b- Reassure at 18 months
c- Repeat mother child test for hearing
d- Arrange for audiometer testing

An 8 yrs old child comes with a history f a fall. X-ray shows undisclosed fracture of both bones of the left forearm. What is you management?
a- Full plaster cast above elbow to the MCP joint
b- Posterior slab from above elbow to MCP joint
c- Full plaster cast below elbow to the MCP joint
d- Posterior slab from below elbow to MCO joint
e- Crepe bandage only

After a difficult forceps delivery, it is noticed that the baby hangs his arms to the side, and cannot move it. What is likely cause?
a- Fracture humerus
b- Erb’s palsy

38 yrs primi, cervix 4 cm dilated station 0, fetal distress, with mild pre-edampsia. What is next management?
a- Immediate c/s
b- I/V Syntocinon drip
c- Forceps delivery
d- Fatal head p monitoring

Pregnant woman came in contact with rubella patient.
What is next management?
a- Rubella vaccine
b- Immediate delivery
c- Titre of blood now and repeat after 10 days
d- Observation
e- Do nothing

Which combination can cause serotonin syndrome?
a- Fluxetine + Amitriptyline
b- Sertraline + Domlpraline
c- SSRI+MAOIS
d- SSI+TCA

A patient is getting Sertraline (SSRI).
What advice you will give?
a- Patient should be warn about side effect of anticholinergic
b- Drug needs 4 weeks to be effective
c- Patient can discontinue the drug without consulting doctor

A patient had repeated thoughts of getting AIDS who is working in a lab. She believes that this thought is intrusive.
What is the diagnosis?
a- Obsession
b- Compulsion
c- Anxiety
d- GAD
e- Phobia

A patient with OA right hip:
Which movement will be affected first?
a- Flexion
b- Internal rotation
c- Abduction

Colles #.
Which is true?
a- Posterior displacement with ulnar deviation
b- Posterior displacement with redial deviation
c- Anterior displacement with ulnar deviation
d- Anterior displacement with redial deviation

Non-contraception benefit OCP except:
- Benign breast diseases
- Ovarian cancer
- Endometrial cancer
- PID
- Cervix cancer

Post operative second day fluid……..
- 1L N/S gallstone
- +2L 5% Dextrose
- +20mmol K+/lire
- +deficit

AGN confirm by
a- RBC casts
b- Hyaline
c- WBC

Which of the following doesn’t transmit hepatitis B?
a- RBC
b- WBC
c- Factor VIII
d- Alkaline

Which all of the statements are correct except
a- She might have PKD
b- RBC may presents in urine
c- She might have HTN
d- She may suffer septic infection in one kidney

A lady with unilateral pupil dilated, who felt suddenly & teacher admitted her in the hospital.
Initial management:
a- CT
b- Neurological examination
c- Observation
d- Steroid injection

Tennis player hit his right eye. O/E ant. Chamber Haemorrhage seen.
Initial management:
a- Observation
b- AB (Aspiration of blood)
c- Hospital & observation
d- Pressure bandage

What is eye complication of B12 deficiency?
a- Optic neuropathy
b- Optic atrophy

Definitive investigation of gallstone
a- USG
b- LFT
c- Stood analysis
d- CT

All of the following condition can cause hypoglycaemia except:
a- Primary hyperaldosteronism
b- Diabetic patient
c- Addison’s dieses
d- Hypothyroidism

3 yrs old boy passing vegetable******* with stood.
What is the diagnosis?
a- Toddlers Diarrhoea
b- Giardiasis
c- Crohn’s disease
d- IBS

Which of the following can be associated with multi infarct dementia?
a- Progressive
b- May be associated with neurological symptom

All of the following drugs can cause gynecomastia, Except:
a- Spironolactone
b- Digoxin
c- Methyldopa
d- Furosemide
e- TNAH

Which of the following joints is not included in rheumatic arthritis and is more common in osteoarthritis?
a- Carpometacarpal joint of the thumb
b- Temporomandibular joint
c- Cervical spine

All of the following statements about intravenous solutions are true, except
a- Normal (0.9%) sodium chloride solution has an approximately 150 mmol/l Na + 150 mmol/l CI
b- Hartman solution is sodium lactate which consist sodium 135 mmol, calcium 2 mmol and some potassium
c- If 1 liter of Hartman solution is given in 24 hrs it will be sufficient for daily potassium requirement (*)
d- N/5 contains 30ml CI and 30ml Sodium
e- 5% dextrose……..

Hand x-ray, carpal bones, fractured scaphoid. Which of the following is correct?
a- It will result in a vascular necrosis of distal pole
b- Internal fixation is best treatment because of malunion
c- Crepe bandage from elbow to the wrist
d- Immobilization from elbow to the end of the thumb for 6 weeks
e- Plaster from elbow to the wrist

Photo of leg from AMC book (SU-C130)
a- Chronic infection
b- Necrotizing fasciitis
c- Chronic venous hypertension
d- Arterial insufficiency

Patient with a fourth attack of gout in the last 2 years. Knee is swollen, painful. What is most appropriate management?
a- Allopurinol in the first 24 hrs
b- Indomethacin 150mg in the first 24 hrs
c- Hydrocortisone intra-articular
d- Colchicine

Urticaria be associated with all of the following except
a- vasculitis
b- Aspirin sensitivity
c- Tenicultar

Which cause shock in gall-bladder sepsis?
a- Staphylococcus aureus
b- Pseudomonas aeruginosa
c- Enterococcus faecalis
d- Escherichia coli

Patient with severe chest pain, radiating to his back. CXR show widened mediastinum, diastolic murmur ECG – acute inferior M.I.
What is appropriate management?
a- Give streptokinase
b- Give aspirin plus IV morphine
c- Give morphine, B – blocker and arrange for T O E

What is most likely to become chronic?
a- Hepatitis A
b- Hepatitis C
c- Hepatitis B
d- EBV

Spinal cors lesion at level L4 – L5:
a- Absent knee jerk
b- Absent ankle jerk
c- Lost of dorsiflaxion of the ankle
d- Lost of sensation sole of the foot

Patient with chronic cardiac failure on Captopril for hypertension. On long-term Chlorothiazide:
a- Sodium is reduced
b- K is decreased
c- Cholesterol is increased

Patient 3 days after cranial surgery. Na 117, Plasma osmolarity 205 Urine osmolarity 825:
a- D.III
b- SIADH
c- Water intoxication

All of the following are features of Hypercalcemia except
a- Depression
b- Diarrhoea
c- Polyuria
d- Polydipsia

Which of the following is the most urgent requirement for the patient in D.K.A?
a- Infusion of sodium bicarbonate
b- 5% dextrose
c- Infusion of normal saline
d- Glucagon

Builder came to ER with 15% of burns, his weight is 80 kg. Which of the following fluid replacement will be required for the first 24 hrs?
a- 2L Hartman + 2L blood
b- 2L NaCL + 1L blood
c- 3L Hartman + 2L 5% Dextrose
d- 3L Hartman + 2L Blood

After splenectomy for hereditary spherocytosis all can be excepted:
a- Persistence of anemia
b- Persistence of Spherocytes
c- Normal RBC life spam
d- Reticulocytosis

Which of the following is not feature of mycoplasma pneumoniae?
a- Headache
b- Pleuritic pain
c- Temperature
d- Myalgia
e- Cough

Which of the following drugs if stopped during the operation will cause intra operative hypertension?
a- Clonidine
b- Methyldopa
c- Enalapril
d- Propranolol
e- Felodipine

Peripheral pulse will be increased in all of the following except:
a- A-V fistulae
b- Paget disease of the bone
c- VSD
d- Patent ductus arteriosus
e- ASD

Patient playing game squash court suddenly pain in ankle no planer flexion dorsal flexion limited and painful:
a- Rupture of medial ankle ligament
b- Complete rupture of Achilles tendon
c- Rupture of medial head m. solei

Well established scientist was on overseas scientific meeting where he should give lecture. Suddenly after bout of diarrhoea, and profound humiliation he left meeting. He start to change his dresses at night, wandering through the streets, his behaviour than change as well. In the morning he is again OK. He realized something is wrong with him and after a few “speech” therapies he improved. His diagnosis is:
a- Depersonalisation
b- SCH
c- Multiple personality disorder
d- Dementia

about vascular (multi-infarct) dementia. What is COREECT?
a- More common in woman than man
b- Start abruptly with
c- It may be presents with spasticity, tremor and weakness
d- With cognitive impairment

Patient 60yrs has difficulty walking upstairs. On examination wasting of the biceps branchial spasticity in both legs, bilateral brisk lower limb tendon reflexes. The most likely is:
a- Late onset of multiple sclerosis
b- Cervical cord protrusion
c- Motor neurone disease
d- Limber canal stenosis

Hyperkalaemia is seen in all of the following except:
a- Bone metastasis
b- Prim Hyperparathyroidism
c- Chronic Caecilians Pancreatitis

20yrs old man, with one week dark urine, nausea, fever, Liver enzymes elevated ALT 750, ALP 150, GGT 350. It is most likely:
a- Choledolithiasis
b- Acute viral hepatitis
c- Biliary obstruction and cholangitis

The best way to diagnosed GIARDIASIS is:
a- Duodenal aspiration of trophozoites
b- Cyst in stool

Most significant complication of massive blood transfusion (5L) is:
a- Pulmonary oedema
b- Abnormal coagulation
c- Metabolic acidosis
d- Increase C V P

Common organism causing cellulitis is:
a- Group A streptococcus
b- Group B streptococcus
c- Staphylococcus aureus

Child with sore throat, cervical lymphadenopathy, (Clinical picture of inf. Mononucleosis) what are associated findings:
a- ASTO +ve
b- Atypical lymphocytes

Lady with GORD taking H2. What is most of concern regarding her disease?
a- Recent weight loss
b- Dysphagia

14 yrs old girl suddenly collapsed in the school. On examination she is unconscious, pupil unequal gag reflex, Babinski positive, Dolls eye reflex intact, no response to painful stimuli. She has i. v. drip receiving 5% Dextrose

Pulse oximetry: saturation 100%02 BP: 180/110 mm/Hg
Respiratory rate: 14/min
Pulse: 50/min.

You initial management will be:
a- Arrange for urgent CT scan
b- Intubate and ventilate
c- Change 5% Dextrose for Normal saline
d- Referral to neurosurgeon
e- Mannitol i. v. + Dexamethasone

Which of the following is not feature of mycoplasma pneumoniae?
a- Headache
b- Pleuritic pain
c- Temperature
d- Myalgia
e- Cough

What is most likely to become chronic?
a- Hepatitis A
b- Hepatitis C
c- Hepatitis B
d- EBV

A lady with unilateral pupil dilated, who felt suddenly & teacher admitted her in the hospital.
Initial management:
a- CT
b- Neurological examination
c- Observation
d- Steroid injection

20yrs old man, with one week dark urine, nausea, fever, Liver enzymes elevated ALT 750, ALP 150, GGT 350. It is most likely:
a- Choledolithiasis
b- Acute viral hepatitis
c- Biliary obstruction and cholangitis

these r my best guess.

Girl took dishwashing powder (alkali). She has blisters around mouth. What is correct?
a- Reassurance
b- Give her ipecacuanha syrup
c- Admit to hospital with possible Endoscopy
d- Lavage
e- Charcoal

Gastrin is:
a- Secreted from antrum (parietal cells)
b- Increase acid production
c- Cause lower oesophageal sphincter to contract
d- Reduced by vagotomy

Patient with strangulated heamorrhoids. What is appropriate treatment?
a- Ruber band ligation
b- Haemorrhoidectomy
c- Incision and evacuation
d- Glycerine + oil
e- Dilatation of anus

65 years old man with motion passed blood and mucus. It is most likely:
a- Diverticulosis
b- Chron’s disease
c- Carcinoma of colon
d- Ischemic colitis

Coeliec disease (Gluten enteropathy). What is least likely?
a- Normal mucosal villi
b- Asian in origin

Man has pain for the last 3 months, reflexes intact. Urinary urge (Hard to recollect)
a- Spinal cord compression
b- Lumbar disc prolapse
c- Diabetic neuropathy

Man return from tropic. He has persistent diarrhoea for three months. All of the following is true except:
a- Infection with campylobacter jejuni
b- ?
c- Surreptitious use of laxatives
d- Infection with giardia lamb

2yrs old boy, with watery diarrhoea, His older brother has a same symptom 4 days ago:
a- viral gastroenteritis
b- Rotavirus
c- Fecal oral rute/Watery diarrhoea/ cause of severe diarrhoea in young children < 2years
d- Vomiting > 90%, Fever 39° > 30%,
e- Rear incidence = 3-15 months

Q. regarding bereavement (griff):
a- Suicidal ideas are common
b- Emotional response is reduced
c- Ideas of reference can be sign of depressive psychosis

Young man with scrotal mass disappeared when lying down:
a- Varicocele
b- Hernia
c- Hydrocelle (painless scrotal swelling can be transilluminated)
d- ?
e- Epididymitis (painful, tender swelling with scrotal oedema and erythema / 6 ram and Chlamydia trachomatis usually infolued)

The most common diaphragmal hernia is:
a- Sliding hernia
b- Para-oesophageal hernia
c- Bochdalak

Human leucocyte antigen (HLA) is commonly associated with:
a- Kidney transplantation
b- Heart transplantation
c- Liver transplantation
d- Lung Transplantation
e- Pancreas transplantation

Woman had thyroidectomy a few days ago. Now with fever 38c. Tachycardia, most likely:
a- Thyroid crisis
b- Pulmonary embolus
c- TSH

Patient with fever, diagnosed with infective endocarditis. What is correct?
a- usually pathogen is staphylococcus aureus (50%)
b- Is usually spread in rheumatic fever
c- ?
d- Is more on trial than ventricular valve?
e- Vasculitis is common (Vasculitis can be associated)

Patient taking Warfarin. What is your advice?
a- Aspirin and Warfarin should be combined
c- Amoxicillin will potentiate Warfarin

9 yrs old boy with enuresis, weight and height 75 percentile for his age. What is correct?
a- ?
b- Either parent will have enuresis in 20%
c- He has small bladder

Patient with ascitis and hepatic cirrhosis. All of the following will be found except:
a- oral teleangiectasis
b- Palmar erythema
c- Dupuytren contractures
d- Bilateral parotitis
e- Skin pigmentation

Regarding diffuse fibrositing alveolitis:
a- Reduced FEV1/vital capacity
b- Reduced total lung capacity
c- Reduced expiration
d- Decreased O2 tension
e- Decreased CO2 tension

13yrs old girl came with her mother, has peri-oral tingling and paresthesia in upper limb. What is next investigation?
a- Cranial nerves assessment
b- Deep breathing 1 – 2 min.

Regarding management of asthma in adult what is not correct?
a- Salbutamol + tuaoplglin
b- ?
c- Corticosteroids in every attack

Pregnant woman with oedema, hypertension can be excepted to have the elevated blood level is except:
a- Uric acid
b- Creatinine
c- Platelet
d- SGOT
e- BUN

Woman pregnant 28 week, with ruptured membranes. All of the following is correct except:
a- Vaginal swab for bacteria
b- ?
c- Labour at 32 weeks even if there are no signs of infection
d- Give her glucocorticoid

Woman, after labour doesn’t want to lactate. What is most secure way to achieve that?
a- ?
b- Bromocriptine

What of the following is the best prognostic sign in cardio-pulmonary resuscitation?
a- Redial artery pulse
b- Pupillary size and reaction
c- Although is manual cardiac massage is performed properly it will only provide de half of normal perfusion

18yrs old man, heavy lifter has syncope, father died from unknown heart condition at 34 y. o. What investigations will asses his risk for sudden death?
a- Holter monitoring
b- Echocardiography

Regarding cardio-pulmonary resuscitation what is true:
a- Give adrenalin i. v. every 10 minutes
b- Give bicarbonate every 10 minutes
d- It is important to do ECG before Cardioversion

Patient, grandiose character doesn’t care about others, fell unique:
a- histrionic personality
b- Borderline disorder
c- Delusional disorder
d- Schizoid disorder
e- Narcissist personality disorder

Primigravida, 150 cm tall, station 0, and cervix fully effaced, dilated=4cm, on examination short pelvic diameter:
a- Trial of vaginal labour
b- Pelvic radiometry
c- Ultrasound
d- Oxytocin drip
e- Cesario section

Pooled immunoglobulin is given in all of the following except:
a- hepatitis A
b- Mumps (Rubella)
c- Hepatitis B
d- Rabies
e- Tetanus

5 yrs old swallowed battery from his grandparent hearing aid apparatus, 24 hrs ago.
What is most appropriate treatment?
a- Give ipecacuanha syrup
b- Observe
c- Laparotomy

What is first most common presentation of testicular tumour?
a- Swelling
b- Pain
c- Redness

Intermittent claudication, what is most common……
a- ?
b- External iliac
c- Femoris profunda
d- Femoris superficialis

Patient with deep veins thrombosis when leg is elevated he feels pain. What is reason for that?
a- Deep venous perforator incompetence
b- Ischemic pain

Patient with obstructive jaundice. What is cause of deficiency transformation of prothrombin to thrombin in liver?
a- Insufficient absorption of vitamin K (Deficiency of 2, 7, 9, 10 factors)

Severe excruciating abdominal pain can be caused by all of the following except:
a- Aortic aneurism
b- Acute appendicitis
c- Ruptured peptic ulcer
d- Renal colic
e- Pancreatitis

50yrs old man with left hand weakness, after tremor improved:
a- lacunar infarct / left /
b- Lacunar infarct / right

Woman with vaginal discharge, “Clue†cells…………..
a- bacterial vaginosin (formerly gardenera Vaginalis )

Woman wandering in shopping centre. What can distinguish between S C H and organic brain Sy?
a-
b-
c- Altered level of conciseness

65 yrs old man had recurrent UTI with stricture. After long and prolonged/difficult dilatation of urethra, 8 hrs later he is presented with shock a fever:
a- Perforation of urethra
b- Gram negative sepsis

45 yrs old woman, ambulatory patient, has bladder enlarged to the level of umbilicus. No other symptoms. What is most likely?
a- acute retention of urine
b- Chronic retention of urine
c- Pregnancy

All of the following are feature of basal ganglia except:
a- Ataxia
b- Tremor
c- Rigidity
d- Chorea

A baby from diabetic mother a few hours after birth is “jittery” (shivering) which of the following is true
a- Hypoglycaemia
b- Hyperglycaemia
c- Metabolic acidosis
d- Meconium aspiration

A 27 yrs old primipara, 37 week of gestation phones you and said that she didn’t feel baby movement for 24 hours. She is concerned about baby and need you advice. All of the following is correct except:
a- You will tell her that she is unexperienced and it is normal
b- Tell her to come to hospital to do cardio tocography
c- Tell her to come to hospital to do CTG and provoke labour
d- She needs urgent caesarean section

All are features of mycoplasma pneumoniae except:
a- Insidious onset
b- Fever
c- Severe cough
d- Pleuritic rib
e- Headache

4 year old children can do all of the following except:
a- Say his name and surname
b- Hop on one leg
c- Draw six part name
d- Do buttons

Asymptomatic bacteriuria in pregnancy is associated with all of the following
a- Usually in the first trimester
b- Associated with mild proteinuria
c- 25% will lead to pyelonephritis
d- No need for antibiotics

Patient with retinal detachment. What is Rx?
a- Instil atropine
b- Instil Pilocarpine
c- Head “tilt up” back
d- I/V/corticosteroids
e- Acetazolamide

45 yrs old woman complain that for the last 4 weeks she can’t read phone book
a- Presbyopia
b- Myopia
c- Astigmatism
d- Hypermetropia
e- Cataract

3 yrs old boy with undescended testis, what is most commonly associated with?
a- Inguinal hernia (90%)
b- Malignancy
c- Low importance
d- Sterility

Paget disease (Osteitis deformans). What is correct?
a- Majority will lead to osteosarcoma (only 1%)
b- Hypercalcemia
c- Usually normal laboratory studies (serum Ca & Phosphorus normal, APH Elevated)
d- Asymptomatic

All of the following is associated with proteinuria except:
a- Diabetes
b- Captopril
c- Rheumatic arthritis
d- Horshoe kidney

Photo: man with everted umbilicus. What is best description of this photo?
a- It is reducible
b- It is ascites
c- Liquid thrill can be palpated
d- Can be first sign of ascites

Mental Health Act in Australia:
a- Saves lives

Postoperative analgesics with old age:
a- Morphine safer than Pethidine
b- Reduce the dose of otriads in older pts

Diabetic patient has superficial wound on ankle a few days ago. Now presented with inflammation, oedema and redness from ankle to knee. All is correct except:
a- it is usually caused by Streptococcus pyogenes
b- His blood sugar should be checked
c- He needs antibiotics
d- He needs Doppler investigation to exclude DVT

What will give irregular red reflex on direct opthalmoscopy?
a- Vitreous Haemorrhage
b- Cataract

Man pulled unconscious from burned building. He is not cyanosed: his throat/pharynx is black but not found. What is most likely correlate with his condition?
a- PO@ <45 mm/Hg
b- Carbo methemoglobin 35%
c- PCO2 > 68

The most common cause of upper small bowed obstruction in Adult Australia is:
a- Volvulus
b- Intussusception
c- Adhesion
d- Intrinsic and extrinsic tumours

Regarding Mullerian agencies all of the following is true except:
a- Vagina is almost complete and short
b- Is usually with other abnormalities
c- Breast development is normal
d- Is X linked recessive

Patient on antihypertensive therapy. Which of the following drugs if given preoperatively will induce hypotension (not sure hypo or hyper)
a- Clonidine
b- Methyldopa
c- Captopril
d- Enalapril
e- Felodipine (Nifedipine – can cause excessive hypotension)

What is most likely definitive diagnosis of Endometriosis?
a- Ultrasound
b- Pelvic exam
c- Trial of oral contraceptives
d- Primary dysmenorrheal
e- Laparoscopy

9 yrs old average in school, recently deteriorate, has problem with writing
a- Dyslexia
b- Attention Deficit Disorder

Borderline personality is associated with:
a- Mood instability
b- Extremely cleanliness

Photo breast tumour, XR/ mammography = less than 4 cm what is treatment:
a- Observation
b- Simple mastectomy
c- Modified mastectomy
d- Aspiration and cytological exam

Positive Trandelburg thight means:
a- Incompetent perforator of the deep veins

Opening snap, all is correct:
a- Mobility with valve
b- Overlap with S3
c- Not occur with arterial fibrillation
d- Heard at mid axillary line of left border? Apex ?
e- Doesn’t accentuate with MS or second Intercostal space

A baby born with a neurological developmental delay:
a- Uncle has mild mental retardatio
b- Father’s mother has………?
c- Mother has 2 Café-au late spot (Von Recklinghausen)

Neonatal asphyxia (or hypoxia) Immediate treatment is:
a- O 2
b- Glucose
c- Aspiration of upper respiratory tract

A baby has Apgar score at 1st minute = 5, after 5 minutes = 8. Mother had three ampoules of Pethidine, baby has hypoxia
a- Sedation *

What is ominous sign in CTG?
a- Tachycardia + hypoxia
b- Tachycardia + foetal movement
c- Very regular heart beat without variation per beta to beat
d- Tachycardia + uterine contraction

13 years old school student can’t see on the board, Can see on the computer when his vision looks through pinhole improves:
a- Strabismus
b- Myopia
c- Glaucoma
d- Amblyopia
e- Hypermetropia

“Third day blue†postpartum, what is correct:
a- Need not to occurs in next pregnancy
b- At least 50%
c- Doesn’t precipitate to pscychosis/depression

Lesion in the basal ganglia can cause all of the following features except:
a- Dystonia
b- Ataxia///
c- Akathesia
d- Dyskinesia
e- Chorea

A pt. presents with early morning stiffness, which is relieved with activity (h/o Polymyalgia Rheumatica).
a- Muscle weakness//////////
b- mild synovitis
c- Fever
d- Depression

Which of the following is NOT a clinical of hypothyroidism????????
a- Pelvic girdle weakness
b- Tremor
c- Small muscle weakness
d- Palpitation

Trigeminal neuralgia can be best treated with which of the following drug?
a- Tricyclic anti-deppresants
b- Phenytoin
c- Carbamezepine/////////

Urinary stones most commonly formed in acid urine are:
a- Magnesium ammonium phosphate
b- Xanthine
c- Phosphate
d- Uric acid///
e- Oxalate

A 64 yrs old man complaints of diarrhoea for the last three months duration, which is the least likely cause for his diarrhoea?
a- Campylobacter jejuni/////
b- Carcinoma of colon
c- Giardia lamlia
d- Surreptitious use of laxatives

In which of the following conditions, hypoxia can be corrected completely by given 100% oxygen?
a- Lung disease
b- Cyanotic heart disease
c- Methhaemoglobinemia///////////

Regarding tuberculosis which is true:
a- Mantouex test is usually negative in milliary tuberculosis

Diabetes mellitus is associated with all of the following except:
a- Acromegaly
b- Prolactin secreting pituitary tumor////
c- Hyperthyroidism
d- Hemochromatosis
e- Cushing’s syndrome

Which of the following drug causes hyperkalemia as a side effect:
a- Thiazide
b- Captopril/////
c- Beta-blockers

Stag horn calculi can be associated with all of the following except:
a- Hyperparathyroidism
b- Hypercalciuria
c- Prolonged immobilization//
d- Gout
e- Chronic infection (have to be chronic UTI)

A 45 yrs old lady presents with palpable lump in her Lt. breast. Which of the following statement is correct regarding her lump?
a- It is considered to be a carcinoma unless proven otherwise

Erythema nodosum occurs in all of the following except:
a- Sarcoidosis
b- Tuberculosis
c- Yersenia infection

don't know-All are true

A patient picture showing a brown lesion in arm and forearm, hypo-pigmented areas has no pinprick sensation. What would be the probable diagnosis?
a- Sarcoidosis
b- Burns
c- Vitiligo///
d- Leprosy

A picture showing crops of lesion over the right eyelid of a 10 yrs old child. What would be the probable diagnosis?
a- Skin tag
b- Warts
c- Molluscum contagiosum
d- Neurofibromatosis

In a jaundice patient, which is likely to assist the diagnosis of obstructive jaundice?
a- Upper lid xanthelasma
b- Scratching marks
c- Large tender liver///
d- Heart rate 73/min
e- Enlarge spleen

18 yrs old girl, having fever at home; Her mother says that she has an abnormal behavior which make her suspect that she is on drugs, she’s having lacrimation, rhinorrhoea, diarrhoea and colicy abdominal pain and yawning. She has aches all over her body. Which drug of the following she’s likely to be on?
a- Marihuana
b- L.S.D.
c- Cocaine
d- Heroin///
e- Morphine

In differentiating between acute haemolytic anaemia and chronic blood loss:
a- Increased reticulocytic count
b- Decreased haptoglobulin///
c- Polychromasia
d- Increased SGOT
e- Enlarge spleen

In a jaundice patient, which will not develop liver cirrhosis?
a- Wikaon’s disease
b- Haemochromatosis
c- Infective hepatitis b
d- Infective mononucleosis///
e- Alcoholic hepatitis

Polyuria and polydiosia can occur with which of the following:
a- Gout
b- Liver cirrhosis
c- Sarcoidosis
d- S. D. E.
e- Purictional

A chest x-ray of this woman before therapy would probably reveal all the following except:
a- Air in the right pleural space
b- Shifting of the mediastinum towards the left
c- Compression of the left lung
d- Shifting of the trachea towards the left
e- Fluid in the left pleural cavity

A 23 yrs old woman presents with diplopia and progressive weakness after repeated physical activity. A chest x-ray reveals a mass in the anterior superior mediastinum. Which of the following is most likely?
a- The patient has the Eaton lamberty syndrome associated with carcinoma of the lung///
b- The patient has a lymphoma with associated asthenia
c- the patient has myasthenia gravis with an associated thymoma
d- The patient has metastatic carcinoma with cerebral deposits
e- The patient has lymphoma with cerebral toxoplasmosis

A 26 yrs old homosexual male presents with a 2 wks history of dry cough and shortness of breath. A chest xray examination reveals bilateral pulmonary infiltrates sputum culture is negative for bacteria, viruses and fungal. Concerning this patient:
a- The most likely diagnosis is AIDS (HIV) virus infection of the lung
b- T cell subsets performed two months earlier would be excepted to be normal
c- Bronchoscopy and broncho-alveolar lavage would be unlikely to be diagnostic
d- Pneumocytlu clinical to the most likely cause of this man’s pneumonia///
e- Kaposi’s sarcoma may present in this way

Hyponatremia may result from which of the following conditions?
a- Diuretic abuse///
b- The nephrotic syndrome
c- Cirrhosis
d- Adrenal insufficiency///
e- Diabetes insipidus

A female aged 20 yrs presents with hypertension. There is a previous history of enuresis and childhood febrile episodes. This history suggests a likely diagnosis of:
a- Chromic glomerulonephritis
b- Reflux nephropathy///
c- Essential hypertension
d- Polycystic disease of the kidneys
e- Analgesic nephropathy

Which of the following is true of chronic renal failure?
a- The anaemia is usually microcytic hypochromic
b- Polyuria is due to an increase in glomerular filtration rate
c- Urine is of fixed specific gravity (1010)
d- Yellow brown discolouration of the skin is due to retention of bile pigments
e- Osteomalacia and osteosclerosis are due to

A 5 yrs old woman complains of loose watery aloola without blood for 6 months. She also has recurrent lower abdominal pain, often worse after meals and has lost 5 kg in weight. She has a slightly tender ill defined mass in the right fossa but no other abnormality. Which of the following is most likely?
a- Chronic appendiceal abscess
b- Meckel’s diverticulum
c- Whipple’s disease///
d- Crohn’s disease of the terminal ileum
e- Diverticulosis of the small intestinal

Which of the following provides the best measure of day to day fluid balance in patients with chronic renal failure?
a- Measurement of fluid intake
b- Measurement of 24 hour urine output
c- Haematocrit
d- Urine osmolarity
e- Weight///

Staghorn calculus of the kidney may be due to each of the following except:
a- Primary hyperparathyroidism
b- Gout
c- Immobilisation
d- Urinary infection
e- Idiopathic hypercalciuria///

Which of the following is not a consistent feature of untreated nephrotic syndrome?
a- Oedema
b- Hypertension
c- Hypertriglyceridaemia
d- Secondary hyperaldosteronism
e- Obliteration of epithelial cell foot processes///

Diabetic patient has superficial wound on ankle a few days ago. Now presented with inflammation, oedema and redness from ankle to knee. All is correct except:
a- it is usually caused by Streptococcus pyogenes
b- His blood sugar should be checked
c- He needs antibiotics///
d- He needs Doppler investigation to exclude DVT

What will give irregular red reflex on direct opthalmoscopy?
a- Vitreous Haemorrhage
b- Cataract///

Man pulled unconscious from burned building. He is not cyanosed: his throat/pharynx is black but not found. What is most likely correlate with his condition?
a- PO@ <45 mm/Hg
b- Carbo methemoglobin 35%///
c- PCO2 > 68

The most common cause of upper small bowed obstruction in Adult Australia is:
a- Volvulus
b- Intussusception
c- Adhesion///
d- Intrinsic and extrinsic tumours

Regarding Mullerian agencies all of the following is true except:
a- Vagina is almost complete and short
b- Is usually with other abnormalities
c- Breast development is normal
d- Is X linked recessive///

Patient on antihypertensive therapy. Which of the following drugs if given preoperatively will induce hypotension (not sure hypo or hyper)
a- Clonidine///(hyper)
b- Methyldopa
c- Captopril
d- Enalapril
e- Felodipine (Nifedipine – can cause excessive hypotension)

What is most likely definitive diagnosis of Endometriosis?
a- Ultrasound
b- Pelvic exam
c- Trial of oral contraceptives
d- Primary dysmenorrheal
e- Laparoscopy///

9 yrs old average in school, recently deteriorate, has problem with writing
a- Dyslexia///
b- Attention Deficit Disorder

Borderline personality is associated with:
a- Mood instability///
b- Extremely cleanliness

Photo breast tumour, XR/ mammography = less than 4 cm what is treatment:
a- Observation
b- Simple mastectomy
c- Modified mastectomy
d- Aspiration and cytological exam//??

Positive Trandelburg thight means:
a- Incompetent perforator of the deep veins

Opening snap, all is correct:
a- Mobility with valve
b- Overlap with S3
c- Not occur with arterial fibrillation
d- Heard at mid axillary line of left border? Apex ?
e- Doesn’t accentuate with MS or second Intercostal space

A baby born with a neurological developmental delay:
a- Uncle has mild mental retardatio
b- Father’s mother has………?
c- Mother has 2 Café-au late spot (Von Recklinghausen)

Neonatal asphyxia (or hypoxia) Immediate treatment is:
a- O 2///
b- Glucose
c- Aspiration of upper respiratory tract///

A baby has Apgar score at 1st minute = 5, after 5 minutes = 8. Mother had three ampoules of Pethidine, baby has hypoxia
a- Sedation *

What is ominous sign in CTG?
a- Tachycardia + hypoxia
b- Tachycardia + foetal movement
c- Very regular heart beat without variation per beta to beat
d- Tachycardia + uterine contraction

don;t know
13 years old school student can’t see on the board, Can see on the computer when his vision looks through pinhole improves:
a- Strabismus
b- Myopia//
c- Glaucoma
d- Amblyopia
e- Hypermetropia

“Third day blue†postpartum, what is correct:
a- Need not to occurs in next pregnancy
b- At least 50%//
c- Doesn’t precipitate to pscychosis/depression

which of the following is most suggestive of stress incontinence.
a. loss of urine with increase in intra abdominal pressure without detrusor contraction
b. loss of urine associated with detrusor contraction
c. loss of urine associated with increased intra abdominal pressure and detrussor contraction

Which of the following a cause of contagious dementia.
a. Alzheimer’s
B. pick’s disease
c. Creutzfeldt-Jakob Disease

which of the following is least suggestive of somatoform pain disorder
a. pain leading to impaired function
b. multiple somatic complaints
c. involuntary

rheumatoid arthritis patient on gold and NSAID . complaints of heavy protienuria and facial edema. What was your action
a. stop gold
b. stop NSAID
c. stop both
d. give steroids

which of the following is most suggestive of stress incontinence.
a. loss of urine with increase in intra abdominal pressure without detrusor contraction
b. loss of urine associated with detrusor contraction
c. loss of urine associated with increased intra abdominal pressure and detrussor contraction

The Pathology here is increased abdo pr and decreased sphincter tone

Which of the following a cause of contagious dementia.
a. Alzheimer’s
B. pick’s disease
c. Creutzfeldt-Jakob Disease

which of the following is least suggestive of somatoform pain disorder
a. pain leading to impaired function
b. multiple somatic complaints
c. involuntary

rheumatoid arthritis patient on gold and NSAID . complaints of heavy protienuria and facial edema. What was your action
a. stop gold
b. stop NSAID
c. stop both
d. give steroids

1 14 year old boy ,height 5th percentile weight 50th percentile bone age delayed
what is the first investigation
a. growth hormone assay
b. karyotyping
c. testosterone

2 .parents brought a 7 year old boy to you. His height 5th percentile, he is doing good at school. Parents are of normal height. What inv. Will you do first.
a. bone age
b. skeletal survey
c. karyotyping
d. hormonal assay

3 . which of the following first appears in ARDS?
a. low PO2
b. High PCO2 with Low po2

. A 14 years old boy,has regular severe breathing problems that often prevent him from cycling to school. He was diagnosed with asthma some years ago, but treatment with inhalation corticosteroids and beta-2-mimetics do not seem to help. His pediatrician finds no allergies, normal lung function, no bronchial hyperactivity and no decreased
lung function is observed during an ergometry test. These complaints and
findings are most characteristic of:
A. Cystic fibrosis
B. Severe asthma
C. Hyperventilation
D. Exercise-induced asthma

After one week of bed rest following a nasty ankle sprain, a 64-year-old female has developed painful discolouration of the leg. You decide to start a home treatment with an anticoagulant.Your preferred drug in this case would be?
A. Oral aspirin
B. Intravenous heparin
C. Low-molecular heparins sc.
D. Coumarin

Jane’s parents are trying to make her stop from biting her fingernails. They applied a substance with a offensive taste on her nails. Now,when she tries to bite her nails, the taste makes her stop immediately. This is an example of:
A. Flooding
B. Aversive conditioning
C. Desensitization
D.Repression
E. Rejection

4.Jane is also undergoing therapy for her fear of heights. As part of the therapy, she does relaxation exercises in which she imagines to stand on a chair, than on a ladderand finally on top of a roof. Which behavioural therapy is her therapist applying?
A. Systematic desensitization
B. Negative reinforcement
C. Positive reinforcement
D. Flooding======
E. Familiarization

Freud’s psychoanalysis distinguishes itself from other types of psychotherapy because ...?
A. The patient becomes familiar with his/her present feelings
B. The patient gains insight into problems he/she was not aware of before=======
C. Problem behaviour is replaced by wanted behaviour
D. The patient adapts a new way of thinking.

1.pt-pulmonary embolism
A.cyanosis
B.tachycardia
C.hypotension
D.haemoptysis

2.pt had a fall from a roof.B.P reduced,R.R increased

3.pt with rheumatic fever developed anew murmur-lower end of sternum
A.aortic regurgitation
B.pulm regurgitation

4.in kernicterus
A.increased total bilirubin
B.increased uncongugated bilirubin
C.increased congugated bilirubin

5.all of the following can b surgically corrected except
A.fallots tetrology
B.patent ductus
C.vsd
D.transposition of great vessels

6.man presented with a ureteric colic and brought a sample of urine which contained blood and asks for pethidine.on examination nad.rx
A.take another urine sample for blood
B.give him pethidine

7.papilary necrosis caused mostly by
A.diabetes
B.alcohol
C.analgesic nephropathy
D.medulary sponge kidney
E.sickle cell crisis

8.renal failure pt with acidic urine,which is the most commonly found stones
A.uric acid
B.cystine
C.ca oxlate
D.ca carbonate
E.xanthine

9.young women taking ocp's complains of headaches in afternoon over 3 wks.paracetamol did not help.frequency is five days per week.mngt
A.stop ocp
B.relaxation tecniques
C.ergotamine
D.methysergide
E.sumatriptan

10.a school teacher presents with patches of hair loss on scalp.skin of affected area is shiny.all of the following are possible treatment except
A.nystatin ointment
B.metronidazole
C.ketoconazole
D.gresiofulvin
E.nystain cream
. B - Tachycardia (as the embolism can result in decreased LV load and hence BP which is compensated by increased pulse rate)

It seems to me a case of may be 'fat embolism' with resulting increased RR, fall in BP

A- AR (changing murmurs!! - commonest murmur being MR followed by MS & AR)

D. Transposition of Great Vessels - is the most appropriate answer, as the other conditions can be Sx corrected but not this one!! (fact - 1/3rd cases die during 1st week of life and about 90% by 1st yr. without correction)

C. Analgesic nephropathy - should be th right option as it is more common than the rest options. (Sickle cell anaemia is the most common cause for papillary necrosis)

B. Metronidazole - as this is the odd one out the rest of the Dx are anti-fungal !

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