1) Erythropoietin is also produced by ?

A. Pancreas B. Spleen
C. Hepatocytes D. All of the above
.
2) Signs of vascular instability appear with acute blood loss of
A. 5 to 10 % of total blood volume B. 10 to 15 % of total blood volume
C. 15 to 20 % of total blood volume D. 20 to 25% of total blood volume

3) Surface of each platelet has how many GpIIb / IIIa binding sites ?
A. ~ 10,000 B. ~ 25,000
C. ~ 50,000 D. ~ 100,000

4) Which of the following about AntiPhospholipid Syndrome is false:

A. Presence of abnormal LA,anti cardiolipin antibody and Anti-β2-glycoprotein-I
antibody at 12 weeks interval
B. ≥ 1 clinical episodes of arterial, venous, or small vessel thrombosis, in any tissue or
organ
C. ≥ 1 premature births of a morphologically normal neonate before the 34th week of
gestation
D. ≥ 1 unexplained consecutive spontaneous abortions before the 10th week of
gestation,

5) In the 2010 EULAR criteria for rheumatoid arthritis , all the following score 1 except
A. Duration of symptoms > 6 weeks
B. Abnromal CRP or ESR
C. 1-3 small joints involvement
D. 1-10 large joints involvement

6) Which of the following is not true about SLEDAI score?

A. It is a clinical index for the assessment of lupus disease activity in the preceding
30 days
B. It consists of 24 weighted clinical and laboratory variables
C. Disease activity score may range from 0 to 105
D. The SELENA-SLEDAI and SLEDAI-2K have been modified for use to
measure ongoing disease activity over the past 28 to 30 days. 

7) Features of pneumocystis carinii pneumonia are all except

A. Interstitial pneumonitis B. Eosinophilic exudate
C. Vacuolated intraalveolar exudates D.Damage to type II pneumocytes
8) A 65 year old male patient came with complaints of episodes of shortness of breath
and coughing at night which awakens him from sleep .on examination distened neck
veins were observed and S3 was heard on auscultation which of the following
biomarkers can be used for the diagnosis in this patient?
A. Brain natriuretic peptide
B. atrial natriuretic peptide
C. endothelin 1
D. adenomedullin

9) Irreversible dementia seen in all except

A. Wernicke’s encephalopathy
B. Alzeimers
C. Frontotemporal dementia
D. Steel Richardson syndrome

10) Pancytopenia with cellular marrow is seen in all except.

A. Megaloblastic anaemia
B. Myelodysplasia
C. Paroxysmal nocturnal hemoglobinuria
D. G6PD defiency

11) Torsades des pointes may be caused by which one of the following
A. Quinidine
B. Digoxin
C. Phenytoin
D. .Chlorthiazide

12) Pick’s body in pick’s disease in

A.Tau protein B.Alpha synuclein C.Beta syuclein D.A Beta amyloid

13) What term is used in dermatology to describe a coin-shaped lesion?

A. Herpetiform B. Lichenoid C. Morbilliform
D. Nummular E. Polycyclic

14) Anticoagulant factor produced by endothelial cells is ?

A. Heparan proteoglycans B. Antithrombin
C. Thrombomodulin D. All of the above

15) Activated protein C acts as an anticoagulant by cleaving and inactivating activated

factor ?
A. II B. V
C. VI D. X
16) Which of the following cytokines interleukins stimulate platelet production in acute
inflammation ?
A. IL-3 B. IL-6 C. IL-11 D. All of the above

17) Winterbottom’s sign is a classic finding of ?

A. Giardiasis B. Toxoplasmosis
C. Human African Trypanosomiasis D. Balantidiasis

18) IL -1 Cytokine is structurally similar to all except

A.IL-18 B.ECGF
C.PDGF D.FGF

19) What are Rheumatoid factors among the following?

A. AIgG against IgM
B. IgM against IgG
C. IgG against IgD
D. None

20) In the ACR/EULAR Revised Systemic Sclerosis Classification Criteria, the

maximum score is given to
A. Raynaud’s phenomenon
B. Skin thickening of fingers
C. PAH
D. Anti-centromere antibodies

21) TNF- alpha overexpression causes all except

A. Inflammatory Bowel Disease
B. Arthritis
C. Vasculitis
D. SLE

22) Empty heart syndrome is seen in which of the following condition

A. Urticaria
B. Allergy
C. Anaphylaxis
D. Alcohol intoxication
 23) CURB-65 criteria includes
A. Conscious, urine output, respiratory rate, abnormal blood gases
B. Confusion, urea,respiratory rate, blood pressure , age < 65 years.
C. Conscious, urea, respiratory rate, blood pressure
D. Confusion,raised urea, increased respiratory rate,low blood pressure,age >65 yrs

24) A male patient is observed to be hbsag neg, Anti hbe Ab +ve. HBV DNA copies are
observed to be 1,00,000/ ml. SGOT and SGPT are elevated to 6 times the upper limit
of normal value. Most likely diagnosis is
A. HBV surface mutant
B. HBV precore mutant
C. Wild hbsag
D. Inactive HBV carrier
25) Pure motor loss is seen in all except.
A. Hereditary spinal mascular atropy.
B. Adult variant of hexoaminidase defiency.
C. Acute inflammatory demyelinating polyneuropathy.
D. Dapsone toxicity.

26) Which of the following condition Renal involvement is uncommon

A.eGPA B.SLE
C.MPA D.GPA
27) Bone marrow biopsy is absolutely indicated in
A. Acute leukemia B. Megaloblastic anemia
C. Hairy cell leukemia D.Thalassemia

28) Most common cause of chronic cor pulmonale

A. Pulmonary embolism B.MR C.PS D.RHD

29) The test used to diagnose Dubin Johnson syndrome is

A. Serum tansaminases B.Bromsulphalein test
C.Hippurate test D.Gamma glutamyl tansferase level

30) Pontine stroke is associated with all except

A. Bilateral pin point pupil B.Pyrexia
B. C.Vagal palsy D.Quadriparesis

31) All are cardinal feature of DKA except

A.Ketosis B.Metaboic acidosis C.Hyperglycemia D.Bradycardia
32) A 24-year-old woman seeks evaluation for a rash that is present diffusely on her back,
buttocks, elbows, and knees. The rash began abruptly and the patient is complaining of
severe pruritus and burning associated with the rash. A biopsy of the rash demonstrates
neutrophilic dermatitis within the dermal papillae, and immunofluorescence highlights
granular deposition of IgA in the papillary dermis and along the epidermal basement
membrane zone. What treatment do you recommend for this patient?
A. Dapsone 100 mg daily B. Gluten-free diet C. Prednisone 40 mg daily
D. A and B E. All of the above

33) A 62-year-old man is evaluated for anemia. He has a hemoglobin of 9.0 g/dL (normal
hemoglobin value, 15 g/dL), hematocrit of 27.0% (normal hematocrit, 45%), mean cell
volume of 88 fL, mean cell hemoglobin of 28 pg, and mean cell hemoglobin
concentration of 30%. On peripheral blood smear, polychromatophilic macrocytes are
seen. The reticulocyte count is 9%. What is the reticulocyte production index?
A. 0.54 B. 1.67 C. 2.57 D. 4.5 E. 5.4

34) Enlarged, grayish yellow or orange tonsils are pathognomonic of

A. Waldenström’s macroglobulinemia B. Polycythemia vera
C. Wolman disease D. Tangier disease

35) Painful preauricular lymphadenopathy is a feature of ? Harrison’s

A. Cat-scratch disease B. Tularemia
C. Tuberculosis D. Syphilis

36) Frequency of a serious infection following splenectomy is highest within

A. First 6 months B. First 1 year
C. First 3 years D. First 5 years

37) Which of the following about idiopathic outflow tract VT is false ?

A. ~80% of outflow tract VTs originate in LV
B. Not associated with SCD
C. Vagal maneuvers terminate them
D. Adenosine & beta blockers terminate them

38) Patients who have primary VF within first 48 hours of onset of acute infarction have ?
A. Good short-term prognosis B. Good long-term prognosis
C. Poor long-term prognosis D. None of the above

39) Epsilon wave is characteristic ECG finding of ?

A. Arrhythmogenic RV cardiomyopathy / dysplasia B. Brugada Syndrome
C. Long QT syndrome (LQTS) D. Digoxin toxicity
.
40) Schwartz scoring system for diagnosis of LQTS includes all except
A. Genetic information B. ECG features
C. Personal history D. Family history

41) Which of the following is not true about the gastrointestinal involvement in Systemic
sclresosis
A. Chronic GERD
B. Barrets metaphasia
C. ILD due to micro aspiration
D. No risk of adenocarcinoma of esophagus

42) Stimulation of autoantibody is the mechanism of tissue damage in all the below
EXCEPT
A. Grave’s disease
B. Goodpasture’s syndrome
C. Granulomatosis with polyangitis
D. Pemphigus vulgaris

43) In Rheumatoid vasculitis ,all are true except

A.Occurs in long standing disease
B.Hypercomplementia
C. Positive for Anti-CCP
D. Positive for RA

44) ASAS criteria for classification of axial sponduloarthritis is applicable for patients
with back pain for more than
A. 15 days
B. 1 month
C. 2 month
D. 3 months

45) Which of the following is not associated with Sjogren’s disease

a. Arthritis
b. Elevations of serum immunoglobulin G4 
c. Presence of anti–alpha-fodrin antibody
d. .The presence of Rheumatoid Factor

46) Which of the following parasite can enter through intact skin?
A. Giardia B.Whipworm
C. Strongyloides D.Trichinella
47) Name the triad which includes: Myxomas, Lentigines,Endocrineoveractivity
A. Carney complex B. Austrian syndrome
C. Triad of sanblom D. Dieulafoys triad

48) Which drug is usually not preferred in treatment of HIV with TB

A. Efavirenz B.Stavudine C.Lamivudine D.Nevirapine

49) Most common opportunistic infection in renal transplant recipient within one
month after transplant.
A.Herpes virus B. Oral candidias C. UTI D. Hepatitis

50) WPW Syndrome is caused by.

A. Bundle branch block. B.Left bundle branch block
C. Prescence of bundle of kent D.Ectopic pacemaker in atrium

51) Drug used in both type of diabetic mellitus is.

A.Metformin B.Pramelintide C.Coleselvam D.Panconeline.

52) A 44 year old male has developed confusion and keeps bumping into objects.on
examination he has difficulty in differentiating between fingers,cannotwrite,and has
left right disorientation.likely diagnosis?
A. Anton syndrome
B. Gerstmann syndrome
C. Millardgubler syndrome
D. Locked in syndrome

53) Which of the following is true regarding Herpes encephalitis?

A) Seizures are uncommon B) Temporal lobe involvement is common
54) All will cause renal stone except
A.Distal RTA B.Crohn’s disease
C.Gitelmann syndrome D. Bartter syndrome

55) Most Common Haematological problem in sarcoidosis is

A. Anaemia B.Lymphopenia
C. Granulocytopenia D.Thrombocytopenia

56) Pathogenesis of Mitral valve prolapse is due to deficiency of type …..collagen?

A.Type 1 B.Type 2 C.Type 3 D.Type 4

57) Cardiovascular feature of autonomic neuropathy are all except

A. Tachycardia B.Orthostatic hypotension C. Impotence D. Bradycardia
 58) In Alzhemer disease which is not a characteristic microscopic pathological feature
A. Neurofibrillary taughes
B. Beta amyloid plaques
C. Granular degeneration of brain
D. Lewy bodies

59) Gold standared test for diagnosing pulmonary embolism

A. Selective pulmonary angiogram
B. Chest CT scan
C. Echo
D. Venous ultra sound

60) A 22-year-old woman comes to your office concerned about sun exposure. She brings
a few sunblock creams into your office and wants to know which one is best for
preventing wrinkling and blotchiness. She is less concerned about sunburn because
she is trying to get a better tan. Blocking which ultraviolet rays will achieve her
desired result?
A. UV-A B. UV-B C. Both UV-A and UV-B equally
D. Neither UV-A nor UV-B

61) A 45-year-old patient with HIV/AIDS presents to the emergency department. He

complains of a rash that has been slowly spreading up his right arm and is now evident
on his chest and back. The rash consists of small nodules that have a reddish-blue
appearance. Some of them are ulcerated, but there is minimal fluctuance or drainage.
He is unsure when these began. He notes no foreign travel or unusual exposures. He is
homeless and unemployed, but occasionally gets work as a day laborer doing
landscaping and digging. A culture of a skin lesion grows a Mycobacterium in 5 days.
Which of the following is the most likely organism?
A. M. abscessus
B. M. avium
C. M. kansasii
D. M. marinum
E. M. ulcerans

62) In general, which of the following is the greatest risk factor for the development of
cancer?
A. Age B. Alcohol use C. Cigarette smoking
D. Female sex E. Obesity D 99 section

63) Among women younger than 60 years of age who die from cancer, which of the
following is the most common primary organ of origin?
A. Breast B. Cervix C. Colon D. Bone marrow E. Lung
64) Which of the following tumor markers is appropriately matched with the cell type
cancer and can be followed during treatment as an adjunct to assess disease burden?
A.CA-125—Colon cancer
B. Calcitonin—Follicular carcinoma of the thyroid
C. CD30—Hairy cell leukemia
D. Human chorionic gonadotropin—Gestational trophoblastic disease
E. Neuron-specific enolase—Non–small cell carcinoma of the lung

65) Which of the following statements regarding current understanding of the genetic
changes that must occur for a cell to become cancerous is TRUE?
A. Caretaker genes determine when a cell enters into a replicative phase and must acquire
mutations to allow unregulated cell growth.
B. For a cell to become cancerous, it is estimated that a minimum of 20 mutations must
occur.
C. For a tumor suppressor gene to become inactivated and allow unregulated cell growth,
both copies of the gene must have mutations.
D. Oncogenes act in an autosomal recessive fashion. E. Within a cancer, there are
generally two to five cells of origin.

66) “Blue toe” syndrome is best related to ?

A. Frostbite B. Raynaud’s phenomenon
C. Atheroembolism D. Arteriovenous Fistula

67) Which of the following is false about erythromelalgia ?

A. Characterized by burning pain and erythema of extremities
B. Feet involved more frequently than hands
C. Males affected more frequently than females
D. None of the above

68) 1 Venulitis is a feature of ?

A. Thromboangiitis obliterans B. Behçet’s syndrome
C. Homocystinuria D. All of the above

69) Most patients develop HIT after exposure to heparin for how many days ?
A. 1 - 3 days B. 3 - 5 days C. 5 - 14 days D. 14 - 21 days

70) Under normal conditions, the ovary secretes which of the following androgen ?
A. Androstenedione B. Testosterone
C. Dehydroepiandrosterone D. All of the above
71) Which of the following statements about free and wedged hepatic vein pressure is
false ?
a.Wedged hepatic vein pressure is usually normal in presinusoidal portal hypertension
B. Wedged hepatic vein pressure is elevated in sinusoidal portal hypertension
C. Wedged hepatic vein pressure is elevated in postsinusoidal portal hypertension
D. None of the above

72) pANCA associated vasculitis primarily targets which of the following:

A. elastase
B. lactoferritin
C. lysozyme
D. myeloperoxidase

73) Lab findings of Granulomatosis with polyangiitis are all except

A. Mildly elevated RF
B. Thrombocytopenia
C. Increased igA class
D. Mild
anemia

74) About Mepolizumab all are true except

A. Used in patients with eosinophilic Granulomatosis with polyangiitis 
B. Anti IL5 antibody
C. Treatment of severe asthma
D. None

75) All are true regarding Cogan’s syndrome except

A. Interstitial keratitis
B. Vestibulo auditory symptoms
C. Aortitis with sparing of aortic valve
D. Glucocorticoids are the main stay of treatment5

76) Behcet’s syndrome all ARE TRUE EXCEPT

A. Recurrent painful genital ulcers
B. Anterior and posterior uveitis
C. Presence of arthritis
D. Positive pathergy skin testing,defined as the formation of an infected erythematous
papule 2 mm in diameter or larger that appears 48 hours following a skin prick
77) Worst prognosis in severe aortic stenosis is.
A.Syncope B.Angina
C.Congestive cardiac failure D.Asymtomatic.

78) Most common form of diabetic neuropathy is.

A. Distal symmetric sensory neuropathy
B. Distal symmetric sensory & motor neuropathy.
C. Autonomic neuropathy.
D. Motor neuropathy.

79) Keratoderma blennorrhagica is seen in.

A.Reactive arthiritis
B.Rheumatoid arthiritis
C.Psorisis
D.Anklosing arthiritis

80) A CRRI posted in the ER of Surgery dept deals with a HIV positive patient with
severe oropharyngeal candidiasis, sustains a bleeding puncture wound in the right
index finger through the glove. What is the Source code (SC) and Exposure code
(EC)
A. EC-1 SC-2;
B. EC-2 SC-1;
C. EC-2, SC-2;
D. EC-0, SC-2;

81) A 55 year old hypertensive patient has a standing BP : 190/105 and sitting BP :
180/100 he also has irregularly irregular rhythm ,double apical impulse and bilateral
basal crepitations but no murmur heart rate cannot be determined what is likely
cause?
A. left atrial myxoma
B. mitral regurgitation
C. Corpulmonale
D. left ventricular hypertrophy

82) Hypothyroidism is caused by.

A.Lithium B.Hemochromatosis C.Scleroderma D.All of the above
 83) A 65 year old lady presented to the emergency with complaints of difficulty in using
right upper and lower limbs for last 2 days.her admission ecg shows st elevation in
inferior leads with reciprocal changes.she also gives a history of burning sensation in
chest since last 3 hours.ct brain shows no evidence of hemorrhage.what is the best
line of management?
A. Thrombolyse with alteplase
B. Heparinise and antiplatelets
C. Primary PCI with dual antiplatelet therapy
D. Take MRI brain to look for infarct size

84) Amount of pericardial fluid needed to produce cardiac tamponade in acute setting is?
A.100 ml B.200 ml C.300 ml D.400 ml

85) Earliest finding of lung involvement in Systemic sclerosis is

A. Low FVC B.Low FEV1 C.Low DLCO D.Low TLC

86) Coarctation of aorta is associated with all except

A. Turners syndrome B.Bicuspid aortic valve
C. Pulmonary stenosis D.Atresia of aortic arch

87) A 24 year old male presents with recurrent ulcers in the mouth and in genitalia. On
examination tender red nodules on the anterior shins. What is the most probable
diagnosis.
A. Bechet’s syndrome.
B. Reiter’s syndrome
C. Wegner’s granulomatosis.
D. Good Pasteur’s syndrome

88) A 36-year-old man with HIV/AIDS (CD4+ lymphocyte count = 112/μL) develops a
scaly, waxy, yellowish, patchy, crusty, pruritic rash on and around his nose. The rest of
his skin examination is normal. Which of the following is the most likely diagnosis?
A. Molluscum contagiosum B. Kaposi’s sarcoma C. Psoriasis
D. Reactivation herpes zoster E. Seborrheic dermatitis
89) A 34-year-old man seeks the advice of his primary care physician because of an
asymptomatic rash on his chest. There are coalescing light-brown to salmon-colored
macules present on the chest. A scraping of the lesions is viewed after a wet
preparation with 10% potassium hydroxide solution. There are both hyphal and spore
forms present, giving the slide an appearance of “spaghetti and meatballs.” In addition,
the lesions fluoresce to a yellowgreen appearance under a Wood’s lamp. Tinea
versicolor is diagnosed. Which of the following microorganisms is responsible for this
skin infection?
A. Fusarium solani B. Malassezia furfur C. Penicillium marneffei
D. Sporothrix schenckii E. Trichophyton rubrum

90) All the following conditions are associated with an increased incidence of cancer
EXCEPT:
A. Down syndrome B. Fanconi’s anemia C. von Hippel–Lindau syndrome
D. Neurofibromatosis E. Fragile X syndrome

91) Cancer therapy is increasingly personalized with targeted small molecule therapies that
are directed against specific signal transduction pathways that are commonly activated
in a particular cell type of cancer. Which of the following therapies is correctly
matched with its molecular target?
A. Bevacizumab—EGFR B. Erlotinib—VEGF C. Imatinib—Bcr-Abl
D. Rituximab—CD45 E. Sunitinib—RAF

92) Which of the following defines the term epigenetics?

A. Changes that alter the pattern of gene expression caused by mutations in the DNA code
B. Changes that alter the pattern of gene expression that persist across at least one cell
division but are not caused by changes in the DNA code
C. Irreversible ch157anges of the chromatin structure that regulates gene transcription and
cell proliferation without permanent alteration of the DNA code

93) Which of the following patients with metastatic disease is potentially curable by
surgical resection?
A. A 24-year-old man with a history of osteosarcoma of the left femur with a 1-cm
metastasis to his right lower lobe referred for right lower lobectomy
B. A 56-year-old woman with a history of colon cancer with three metastases to the left
lobe of the liver referred for left hepatic lobectomy
C. A 72-year-old man with metastatic prostate cancer to several vertebrae referred for
orchiectomy
D. All of the above E. None of the above

94) Which of the following significantly relieves pain in severe refractory large-duct
chronic pancreatitis ?
 A. UDCA B. Cholestyramine C. Domperidone D. Octreotide

95) Which of the following statements is false for Purtscher’s retinopathy ?

A. Due to occlusion of anterior retinal artery
B. Sudden and severe loss of vision
C. Cotton wool spots & hemorrhages in optical fundus
D. It is a complication of acute pancreatitis

96) Which of the following is an accurate predictor of severity & death when measured
early in the course of acute pancreatitis ?
A. Bradykinin peptides B. Vasoactive substances C. Histamine D. MCP-1 levels

97) Zieve’s syndrome in alcoholics is best related to ?

A. Diarrhoea B. Myocardial infarction C. Hemolytic anemia D. Pneumonia

98) All of the following conditions can lead to dilatation of the ascending aorta except ?
A. Ankylosing spondylitis B. Rheumatoid arthritis
C. Reiter’s syndrome D. Behcet’s disease

99) Upon normalization of TSH levels,patients experience full relief from symptoms
after ?
A. 15 days to 2 months B. 2 to 3 months
C. 3 to 6 months D. 6 months to 1 year

100) Most common ocular manifestation of sarcoidosis is

A. Anterior uveitis
B. Posterior uveitis
C. Retinitis
D. pars planitis

101) Tumefactive lesions are seen in

A. Sarcoidosis
B. SLE
C. IgG4-RD
D. MCTD

102) Gout and psueudogout are differentiated by :

A. Podagra
 B. Pattern of joint involvement
C. Types of crystals
D. Presence of nephropathy

103) Crystals seen as bipyramidal strong birefringence stain with alizarin red S
A. Urate crystals
B. Calcium apatite
C. Calcium oxalosis
D. Calcium pyrophosphate

104) Anti synthetase syndrome all are true except

A. antibodies directed against an aminoacycl transfer RNA synthetase
B. Myositis
C. Polyarthritis
D. Interstitial lung disease
E. None

105) Metabolic abnormality is seen in Bartter’s syndrome are all except.

A. Hypokalemia B. Hypercalciuria
C. Hypomagnesemia D. Decreased urinary prostaglandin excreation.

106) A 40 year old male presents with headache,visual symptoms and weakness of right
side of body.ct angiogram reveals a puff of smoke appearance. which of the
statements regarding the condition is false
A. Occlusive disease of large intracranial arteries
B. Vascular inflammation is absent
C. Dawsons fingers are characteristic
D. Richcolleateral circulation present

107) Which of the following is true for RHD.

A. Chorea & arthiritis always’s present together.
B. Carey coomb’s murmr associated with carditis.
C. Tender subcutaneous nodule.
D. Arthiritis is not migratory.

108) Which of the following is the pathognomonic manifestation of

HCV infection ?
A.Necrolytic acral erythema B. Porphyria cutanea tarda
C. Leucocytoclastic vasculitis D. Lichen planus (LP)

109) Which is not true of Tabes dorsalis

A.Seen in neurosyphilis. B.Deep tendonreflex are retained.
 C.Paresthesia is seen. D.Abdominal pain &visceral symptoms occur

110) Hirsutisum is seen in all except.

A. Steinleventhal syndrome B. Cushing syndrome
C. Testicular feminizing syndrome. D. Congenital adrenal hyperplasia.

111) A 50 year male old presented with c/o sudden onset breathlessness with profuse
sweating,on examination he was tachypnoeic, hypotensive,spo2 was 95%,pulse
112/min,SBP showed more than 10mmhg fall with inspiration,JVP elevated with
prominent x descent,ausculation showed soft S1,S2, with inspiratory creptitations.
A. Acute pulmonary edema
B. Cardiactamponade
C. Restrictive cardiomyopathy
D. Pericarditis

112) Systolic murmur decreased in standing is

A.HOCM b.AS c.MR d.Mitral prolapse

113) Superior quadrantopia with sensory aphasia is seen in which arterial territory infarct?
A. MCA stem occlusion
B. M1 segment MCA occlusion
C. M2 segment MCA-inferior division
D. M2 segment MCA - superior division

114) A middle aged male working in a slaughter house developed chronic intermittent
diarrhoea, his colonoscopy revealed multiple ulcers in his large intestines . What is
the most probable diagnosis?
A. Bartonella infection
B. Rikettsial disease
C. Rotavirus infection
D. Balantidium coli

115) Which of the following is false about Riedel’s thyroiditis ?

A. Painless goiter B. Dense fibrosis of thyroid
C. Thyroid dysfunction common D. Tamoxifen therapy beneficial

116) What percentage of circulating cortisol is in the free, bioavailable form ?

A. < 5 % B. < 20 % C. < 30 % D. < 40 %

117) Which of the following is false about small-fiber polyneuropathy ?

A. Burning, painful dysesthesias B. Sparing of proprioception
C. Sparing of motor function D. Absent tendon reflexes
 118) The site of lesion in Déjerine-Roussy syndrome is in ?
A. Cervical spinal cord B. Thalamus
C. Tegmentum of pons & midbrain D. Lateral medulla

119) Which of the following best depicts Cooley’s anemia?

A. Decreased MCV, increased hemoglobin A2, increased hemoglobin F
B. Decreased MCV, decreased hemoglobin A2, increased hemoglobin F
C. Increased MCV, increased hemoglobin A2, increased hemoglobin F
D. Increased MCV, decreased hemoglobin A2, increased hemoglobin F
E. Increased MCV, increased hemoglobin A2, decreased hemoglobin F

120) Which of the following is correct regarding syphilis?

A. Secondary syphilis is associated with foot drop and wide based gait
B. VDRL and RPR are specific tests for syphilis
C. Tertiary syphilis is associated with pupils being able to constrict to light
D. Secondary syphilis is associated with “nickel and dime” lesions on palms and soles

121) 40-year-old female presents for an annual checkup. She has always had problems
getting her blood pressure under control. She has had no other medical problems. She
has been put on several regimens and is currently on hydrochlorothiazide, nifedipine,
and clonidine. The patient’s blood pressure is still elevated today at 165/110mmHg.
You are now concerned about secondary causes of hypertension. Her
aldosterone:renin ratio is normal. 24-hour urine cortisol is normal. 24-hour urine
metanephrine and catecholamine levels are high. You order a CT scan of the adrenals
that confirms that the patient has a mass. Which of the following is the most
appropriate next step in management?
A. Observe at this time
B. Surgery
C. Phenoxybenzamine, then beta blocker, and then surgery
D. Beta blocker, then phenoxybenzamine, and then surgery
E. Phenoxybenzamine and beta blocker concurrently, then surgery

122) All of the following scenarios require an LDL goal of 100mg/dL, ideally less than
70mg/dL except:
A. 45-year-old female found to have random sugar of 250mg/dL
B. 55-year-old male found to have Non-ST-Segment Myocardial Infarction (NSTEMI)
and undergoes cardiac stenting
C. 68-year-old male smoker found to have 2.5cm abdominal aortic aneurysm on an
ultrasound
D. 51-year-old female with dizziness found to have severe carotid artery stenosis
E. 39-year-old obese male with hypertension on lisinopril
123) Which of the following scenarios is the least likely to be a risk factor for osteoporosis?
A. 35-year-old male has been on phenytoin for several years to control his seizures
B. 62-year-old male takes finasteride for benign prostate hyperplasia
C. 29-year-old female with hypothyroidism takes thyroid replacement therapy, which has
made her euthyroid
D. 51-year-old male with long standing history of severe COPD takes albuterol,
ipratropium, and prednisone
E. 21-year-old female’s labs show her anti-tissue transglutaminase is positive

124) Which of the following scenarios could cause gingival hyperplasia?

A. Patient being treated for either Raynaud’s phenomenon or pulmonary hypertension
with nifedipine
B. Patient being treated for atrial fibrillation with metoprolol
C. Patient taking excessive vitamin C supplements
D. Patient being treated with warfarin for deep venous thrombosis

125) Which of the following is not part of Yamaguchi criteria for Still’s disease
A. Fever ,rash
B. lymphadnopathy
C. spleenomegaly
D. WBC> 4000

126) In Sjogren’s disease all are true except

A. Anti Ro- LA present universally
B. Vagina and skin also affected
C. Biopsy shows lymphocytic infiltration
D. RA and ANA may be present

127) Which hormone deficiency is most common after cranial irradiation?

A.GH B.GONADOTROPIN
C.ACTH D.ADH

128) Shock lung better known as.

A. Alveolar protenious B.Alveolar Hemorrhage
C.Pulmonary edema D.ARDS.

129) High anion gap acidosis is seen in.

A.salicylate poisoning B.Renal tubular acidosis
C.Ureterosigmoidostomy D.Diarrhoea
130) Fulminant hepatitis is hardly ever seen in?
A. Hepatitis A B. Hepatitis B
C. Hepatitis C D. Hepatitis E

131) A 78 year old woman presents with right hemisensory loss followed by agonising
burning paiin the affected regions.the pain responds poorly to analgesics.these
features are classically seen in?
A. Parinaud syndrome
B. Dejerrinesotta syndrome
C. Dejerrineroussy syndrome
D. Raymonds syndrome

132) Plasmapheresis is used in.

A. Multiple sclerosis B.Myasthenia graves C.HUS D.All of the above.

133) A 55 year old female patients with Levine sign ,hiccups,vomiting ,on examination
HR- 50/min ,with BP - 100/60 mmhg with elevated JVP,ECG technician is yet to
arrive, which coronary artery is likely to involved
A. RCA
B. LAD
C. LCX
D. Left main coronary artery

134) Most common indicator for lung transplant.

A. Alpha 1 antitypsin defiency B. Idiopathic pulmonary aterial hyperstasis
C.COPD D.Cystic fibrosis

135) Extrahepatic complications unrelated to immune-complex Injury in chronic hepatitis

C are all except ?
A.Sjögren’s syndrome B. Porphyria cutanea tarda
C.Essential mixed cryoglobulinemia D. Lichen planus

136) Carcinoid syndrome produces valvular disease primarily of

A.Venous valves B.Tricuspid valve
C.Mitral valve D.Aortic valve

137) Which one of the following has the longest half life?
A.TSH B.ACTH
C.GH D.PROLACTIN

138) Which among the following is not an effective treatment for acute cluster headache.
A. subcutaneous sumatriptan injection B.oral sumatriptan
C. nasal spray zomitriptan D.Inhalation of 100% oxygen at 10-20L/min.
 139) Contraindication in HOCM are all except.
A,Diuretics b,Amlodipine c,Diltiazem d,Nitrates.

140) You are studying a new chemotherapeutic agent for use in advanced colorectal
carcinoma and have completed a phase II clinical trial. Which of the following factors
indicates that the drug is suitable for study in a phase III clinical trial?
A. Complete response rates of 10% to 15%
B. Increased disease-free survival rates by 1 month
C. Increased overall survival by 1 month
D. Partial response rate of 20% to 25%
E. Partial response rates of 50% or more

141) Match the following chemotherapeutic agents with their mechanisms of action:.
1. Cisplatin A. Antimetabolite agent
2. Daunorubicin B. Antimitotic agent
3. 5-Fluorouracil C. Antitumor antibiotic
4. Gefitinib D. DNA alkylator
5. Paclitaxel E. Tyrosine kinase inhibitor

142) What is the most common side effect of chemotherapy?

A. Alopecia B. Diarrhea C. Febrile neutropenia
D. Mucositis E. Nausea with or without vomiting

143) A 24-year-old woman is seen in follow-up 12 months after an allogeneic stem cell
transplant for acute myeloid leukemia. She is doing well without evidence of recurrent
disease but has had manifestations of chronic graft-versushost disease. She should be
administered all of the following vaccines EXCEPT:
A. Diphtheria–tetanus B. Influenza C. Measles, mumps, and rubella

D. Poliomyelitis via injection E. 23-Valent pneumococcal polysaccharide

144) A 48-year-old woman presents to her physician with a complaint of an enlarging mole
on her right lower extremity. She had noticed the area about 1 year previously and
believes it has enlarged. She also notes that it recently has become itchy and
occasionally bleeds. On physical examination, the lesion is located on the right mid-
thigh. It measures 7.5 × 6 mm with irregular borders and a variegated hue with some
areas appearing quite black. A biopsy confirms nodular melanoma. Which of the
following is the best predictor of metastatic risk in this patient?
A. Breslow thickness B. Clark level C. Female gender
D. Presence of ulceration E. Site of lesion

145) Which of the following statements is true with regard to the solitary pulmonary nodule?
A. A lobulated and irregular contour is more indicative of malignancy than a smooth
one.
B. About 80% of incidentally found pulmonary nodules are benign.
 C. Absence of growth over a period of 6 to 12 months is sufficient to determine if a
solitary pulmonary nodule is benign.
D. Ground-glass nodules should be regarded as benign.
E. Multiple nodules indicate malignant disease.

146) A 55-year-old man presents with superior vena cava syndrome and is diagnosed with
small cell lung cancer. Which of the following tests are indicated to properly stage this
patient?
A. Bone marrow biopsy
B. CT scan of the abdomen
C. CT or MRI of the brain with intravenous contrast
D. Lumbar puncture
E. B and C
F. All of the above

147) As an oncologist you are considering treatment options for your patients with lung
cancer, including small molecule therapy targeting the epidermal growth factor
receptor (EGFR). Which of the following patients is most likely to have an EGFR
mutation?
A. A 23-year-old man with a hamartoma
B. A 33-year-old woman with a carcinoid tumor
C. A 45-year-old woman who has never smoked with an adenocarcinoma
D. A 56-year-old man with a 100 pack-year history of tobacco with small cell lung
carcinoma
E. A 76-year-old man with squamous cell carcinoma and a history of asbestos
exposure

148) 34-year-old woman is seen by her internist for evaluation of right breast mass. This was
noted approximately 1 week ago when she was showering. She has not had any nipple
discharge or discomfort. She has no other medical problems. On examination, her right
breast has a soft 1 cm × 2 cm mass in the right upper quadrant. There is no axillary
lymphadenopathy present. The contralateral breast is normal. The breast is reexamined
in 3 weeks, and the same findings are present. The cyst is aspirated, and clear fluid is
removed. The mass is no longer palpable. Which of the following statements is true?
A. Breast MRI should be obtained to discern for residual fluid collection.
B. Mammography is required to further evaluate the lesion.
C. She should be evaluated in 1 month for recurrence.
D. She should be referred to a breast surgeon for resection. E. She should not
breastfeed any more children.

149) Which of the following women has the lowest risk of breast cancer?
A. A woman with menarche at 12 years, first child at 24 years, and menopause at
47 years
 B. A woman with menarche at 14 years, first child at 17 years, and menopause at
52 years
C. A woman with menarche at 16 years, first child at 17 years, and menopause at
42 years
D. A woman with menarche at 16 years, first child at 32 years, and menopause at
52 years
E. They are all equal

150) Which of the following tumor characteristics confers a poor prognosis in patients with
breast cancer?
A. Estrogen receptor positive B. Good nuclear grade
C. Low proportion of cells in S-phase D. Overexpression of erbB2 (HER-2/neu)
E. Progesterone receptor positive