1 - A 20 year female taken 20 tablets of
aspirin to attempt suicide. Patient is
admitted in the intensive care unit vitals
and clinical examinations was noted and
base line investigations was sent. Her
serum concentration of salicylate is
above 700 mg/dl. At this stage what is
the most appropriate treatment of this
patient will be :
A. Activated charcoal
B. Haemodylesis T
C. Intravenous sodium bicarbonate
D. Intravenous fluid of dextrose
and saline
E. Urinary alkalization
2 - Most appropriate treatment in
organophosphate poisoning in
emergency:
A. Atropine and pralidoxime T
B. Flumazenil
C. Glucose
D. Naloxone
E. Pyridoxine
3 - Metabolic acidosis with normal anion
gap may result from :
A. Diabetic ketoacidosis
B. Renal failure
C. Aspirin poisoning
D. Methanol poisoning
E. Renal tubular necrosis T
4 - Most common etiology of nephrotic
syndrome :
A. IgA nephropathy
B. Lupus nephritis
C. Minimal change disease
D. Membranous nephropathy T
E. Rheumatoid arthritis
5 - A 65 year old male came for a routine
clinical examinations. On examination, it
was found to have pulse rate 72, regular
BP 120/90 mmHg a thrusting apex beat
and an ejection systolic murmur. The
most probable diagnosis is :
A. Atrial septal defect
B. Aortic regurgitation
C. Aortic stenosis T
D. Mitral stenosis
E. Pulmonary stenosis
6 - A 55 year old man came to emergency
with complain of retrosternal heaviness.
On examination pulse rate was 80, BP is
120/80, heart sounds were muffled.
Resting ECG was of low voltage. Chest X -
ray shows cardiomegaly. The most
probable diagnosis is :
A. Acute pericarditis
B. Cardiac temponade
C. Constrictive pericarditis
D. Pericardial effusion T
E. Dilated cardiomyopathy T
7 - Common cause for acute pericarditis :
A. Acute myocardial infarction T
B. Malignant disease
C. Systemic lupus erthyematosus
D. Trauma
E. Uremia
8 - Tachycardia is a feature of :
A. Hypothermia
B. Hypothyroidism
C. Hypoglycaemia T
D. Raised intracranial pressure
E. B - Blocker toxicity
9 - The characteristic of ischemic cardiac
chest pain is :
A. It is located in center of chest T
B. Chest pain is not radiated
C. It is sharp cutting like
D. It is spontaneous not related to
exertion
E. It is not relieved by rest
10 - In the acute pancreatitis clinical
presentation is :
A. Epigastric pain and radiation to back
T history of recurrent of cough with sputum
B. History of excessive fat intake
C. Excessive alcohol intake
D. Fever and abdominal distention
E. Leukocytosis and elevated seum
amylase
11 - A 45 year old lady presented with
dysphagia since 04 months. One
examination she was grossly anemic,
koilonychia and palpable cervical
lymphnodes. What is the most likely
diagnosis :
A. Esophageal erosion
B. Carcinoma of oesophagus T
C. Plummer vinson syndrome T
D. Chronic gastritis
E. Benign esophageal stricture
12 - you are asked for the examine the
pulse of 55 - year old male who has
Aortic stenosis. The character of pulse is
best assessed in which of the following
artery:
A. Brachial artery
B. Carotid artery T
C. Femoral artery
D. Popliteal artery
E. Radial artery
13 - Regarding clinical features of
ulcerative colitis :
A. It may be insidious in onset
B. Symptoms tends to present acutely
C. Systemic feature of weight loss,fever
and tachycardia are seen
D. In limited disease tenesmes,
constipation and rectal bleeding occurs
E. In extensive disease bloody diarrhea,
abdominal cramps is predominant T
14 - A male patient of 40 year having
at early morning. The sputm was foul
smelling. On examination patient have
clubbing and coarse crepitation all over
the chest. What is most likely diagnosis :
A. Pulmonary TB
B. Bronchiectasis T
C. Chronic bronchitis
D. Pneumonia
E. Carcinoma of lung
15 - A 60 year old male smoker with 70 -
packs year. His CT scan shows
peripherally situated mass in left
himothorax with rib erosion. How will
you confirm the diagnosis :
A. X - ray chest
B. CT chest
C. Percutaneous lungs biopsy is not
performed under radiology
D. Percutaneous lungs biopsy is useful for
peripheral lung lesions T
E. Transbronchial biopsy is performed
under ultrasound T
16 - The gold standard investigation for
the diagnosis of pulmonary tuberculosis
in a patient who has history of cough,
fever and weight loss for more than three
weeks :
A. Sputum for AFB culture T
B. Tuberculin testing
C. Radiology of chest
D. Gastric aspirate
E. Laryngeal swab
17 - In a patient with pleural effusion
clinical examination of the chest will
reveal :
A. Trachea pulled on the affected side
B. Hyper resonant note on the affected
side
C. Normal chest movement on the
affected side
D. Decreased chest movement on the
affected side T
E. Normal percussion note on the
affected side
18 - A 18 year girl reffered from
gynaecology OPD for physician opinion
with complaint of primary amenorrhea
and short stature. No history of diabetes
mellitus. On examination short stature
with webbing of neck and poorly
developed secondary sexual characters.
What is diagnosis :
A. Celiec disease
B. Cystic fibrosis
C. Down's syndrome
D. Diabetes mellitus
E. Turner's syndrome T
19 - The best treatment option for
hyperkalemia in acute emergency is :
A. Dialysis
B. Inhaled B2 agonists
C. I/V soda bicarbonate
D. I/V glucose and insulin
E. I/V calcium Gluconate 10 ml T
20 - Which of the following feature
differentiate CRF from ARF :
A. Acidosis T
B. Anemia
C. Bleeding
D. Infections
E. Renal osteodystrophy T
21 - Nephrotic syndrome is characterized
by :
A. Low serum cholestrol
B. Low blood pressure
C. NoN pitting oedema
D. Raised urinary albumin T
E. Raised serum albumin
22 - All of the following are side effects of
loop diuretics except :
A. Hypokalemia
B. Hyperkalemia
C. Hypomagnesemia
D. Water retention T
E. Ototoxicity
23 - An 80 year old woman presented to
her general practitioner with a 24 hour
history of profuse diarrhea and mild
abdominal pain. Her type 2 diabetes
mellitus had been treated with
metformin for 10 years. Two days
previously, she had been discharged from
hospital following treatment for
community acquired pneumonia. Her
medication was omeprazole 20 mg once
daily and metformin 500 mg twice daily.
What is the most likely explanation for
her diarrhea:
A. Metformin
B. Omeparazole
C. Diverticulitis
D. Clostridium difficile toxin T
E. Constipation with overflow
24 - A 60 year old presented in
emergency with tachypnea. On arrival
BP 90/50 mmHg, pulse rate 100/min,
bounding pulse with warm extremities.
Laboratory report shows TLC
18000/cmm. Patient is suffering from :
A. Anaphylactic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Neurogenic shock
E. Septic shock T
25 - A 20 year old girl presented in OPD
with history of shortness of breath on
exertion. On examination you hear a loud
S1 and a soft rumbling diastolic murmur
at cardiac apex. Which of the following
structure will be seen prominent on chest
X - ray :
A. Arch of aorta
B. Left ventricle
C. Left atrium T
D. Pulmonary trunk
E. Right atrium
26 - A 24 year old man present with
increasing shortness of breath for few
months. On examination he has an
ejection systolic murmur. The best
modality to diagnose Valvular heart
disease is :
A. ECG
B. ETT
C. Echocardiography T
D. Coronary angiography
E. X - ray chest Pa view
27 - The most sensitive invasive test for
the diagnosis of helicobacter pylori
infection in peptic ulcer is :
A. Serology
B. Urea breath test T
C. Endoscopic biopsy T
D. Rapid urease test
E. Microbiological culture
28 - The neurological problem in
Wilson disease is :
A. Aprexia
B. Dyphasia
C. Stroke
D. Tremor T
E. Visual problems
29 - Most common precipitating factor
for hepatic encephalopathy is :
A. Fever
B. Diarrhea
C. CNS stimulant drugs
D. High protein diet T
E. Paracetamol toxicity T
30 - Enlarged and tender liver is a feature
of :
A. Fatty liver
B. COPD
C. Hydatid cyst
D. Acute viral hepatitis T
E. Hemochromatosis
31 - Regarding the diagnosis of acute
pancreatitis, following is best option :
A. Serum amylase
B. Serum lipase T
C. Plain X - ray abdomen
D. C - reactive protein
E. 24 hour urinary amylase
32 - A 30 year old male presented with
fever, cough, hemoptysis and chest
pain. X - ray chest shows homogenous
opacity in right mid zone. The most
appropriate diagnosis is :
A. Broncho pneumonia
B. Fibrosingalveolitis
C. Hypersensitivity
D. Lobar pneumonia T
E. Pulmonary infarction
33 - A 55 year old male smoker presented
with sudden sharp pain at the left side of
chest after lifting heavy weight. On
examination pulse 110/min, respiratory
rate 30/min. Chest expansion reduced on
left side with hyper resonant
percussion note and absent breath
sounds. The most likely diagnosis is :
A. Emphysema
B. Lung collapse
C. Pneumothorax T
D. Pneumonia
E. Pulmonary embolism
34 - The dose of rifampicin is to be
adjusted if patient having :
A. Diabetes mellitus
B. HIV
C. Hepatitis ( Hepatic encephalopathy) T
D. Pregnancy
E. Renal failure
35 - A 27 year old women develop acute
onset of erythema nodosum, fever,
malaise and anorexia. Chest X - ray
reveals bilateral lymphadenopathy.
The following is most likely diagnosis is :
A. AIDS
B. Bronchogenic carcinoma
C. Rheumatic fever
D. Sarcoidosis T
E. Tuberculosis
36 - A female of 70 years old, after 2 days
of hip joint replacement surgery,
developed severe breathlessness. On
examination she is tachyponic, cyanosed,
BP 70/50 mmHg, X - ray chest is normal.
What is appropriate diagnosis :
A. Pulmonary embolism T
B. MI
C. Pericardial tamponade
D. Pulmonary oedema
E. Aortic dissection
37 - A 70 year old farmer presents with
insidiously progressive disabling
Dysponea, joit pain and weight loss. On
examination clubbing of fingers noted
chest may be shows bilateral diffuse
reticule nodular shadowing at the bases.
What is the most likely diagnosis :
A. Idopathic pulmonary fibrosis T
B. Bronchial carcinoma
C. Rheumatoid arthritis
D. Miliary tuberculosis
E. Mesenthiloma
38 - A 40 year old male, complaining of
low grade fever, weight loss since three
months. Which one of the following
investigations will confirm the diagnosis
of pulmonary tuberculosis :
A. Sputum for AFB and culture T
B. X - ray chest
C. Mountex test
D. Blood CP
E. CAT Scan test
39 - Most cases of community acquired
pneumonia are caused by which one of
the following :
A. Streptococcus pneumoniae T
B. Mycoplasma pneumoniae
C. Viram pneumonia
D. Staphylococcus aureus
E. Haemophilus influenzae
40 - A 45 year old female presented with
severe iching, recent pale stools and dark
urine. On examination there's
pigmentation, xanthelasma and
hepatomegaly. Her LFT shows bilirubin 15
mg/dl, alkaline phosphatase 1500 LU/L.
Her ultrasound examination show normal
biliary tract and no any obstruction.
What is likely diagnosis:
A. Primary Biliary Cirrhosis T
B. Primary sclerosing cholangitis
C. Carcinoma of pancreas
D. Carcinoma of gall bladder
E. Gall Stones
41 - Most important of the following
factors which leads gastroesophageal
reflux is :
A. Body mass index 28 kg/m2 T?
B. Amenorrhea
C. Pregnancy T?
D. Betel nut chewing
E. Bulimia nervosa
42 - A 43 year old lady with a 15 year
history of hepatitis C is admitted with
abdominal distention. CT abdomen
confirmed the presence of a hepatic mass
on a background of small, cirrhotic liver.
What is the likely diagnosis :
A. Hepatocellular carcinoma T
B. Hepatic metastasis
C. Fatty infiltration
D. Hepatic abscess
E. Hemangioma
43 - A 52 year old man wishes to
commence therapy for chronic hepatitis C
virus infection. He wishes to take a
regimen which has the best chance of
conferring sustained virological success.
Which one of the following treatment
option would you recommended :
A. Alpha interferon with ribavirin T
B. Alpha interferon alone
C. Ribavirin alone
D. Ribavirin with lamivudine
E. Lamivudine alone
44 - A 55 year old man has non - infective
necrotizing ulcers on his lower limbs. A
diagnosis of pyoderma gangrenosum is
made. Which of the following condition is
associated with this disorder :
A. Inflammatory bowel disease T
B. Haemochrometosis
C. Gout
D. NoN - Hodgkin's lymphoma
E. Autoimmune thrombocytopenia
45 - Disease commonly associated with
the acute nephritic syndrome are :
A. Systemic lupus erythematosus T
B. Liver abscess
C. Rheumatoid arthritis
D. Subacute bacterial endocarditis
E. Systemic sclerosis
46 - The reason for renal failure in
myeloma are :
A. Light chain deposit disease T
B. Heavy chain cast nephropathy
C. Plasma cell pancity
D. Hyperkalemic nephropathy
E. Amyloidosis with heavy chain
47 - As regard to sodium reabsorption,
the most of filtered sodium load is
reabsorbed in :
A. Proximal tubule T
B. Distal tubule
C. Collecting ducts
D. Loop henle: ascending limb
E. Loop of henle: descending limb
48 - Regarding antidote which one is
incorrect :
A. Mucurry --- DMPS
B. Cyanid ---- sodium thiosulphate
C. Opiod --- naloxone
D. Calcium channel blocker--IV glucagone
E. Beta antagonist --- adrenaline T
49 - General features of shock all of the
following except :
A. Urine output about 50 ml per hour T
B. Cold clammy skin
C. Tachycardia more than 100
D. Systolic blood pressure less than 100
E. Drowsy confuse irritable
50 - Regarding Klinefelter’s syndrome
all are correct except :
A. Phenotypically are males T
B. Infertility
C. Small testes
D. Gynecomastia
E. 47 XYY T
51 - Typical feature of digeorge syndrome 55 - A 26 year pregnant lady using
is : following anti - tuberculosis drugs. Which
of the drug is best avoided :
A. Absent parathyroid T
B. Webbed neck A. Streptomycin T
C. Short stature B. INH
D. Gynecomastia C. Rifampicin
E. Hypercalcemia D. Ethambutol
E. Pyrazinamide T
52 - Pericardial effusion is best diagnosed
by : 56 - A 25 years old male patient
presented with low grade fever and
A. Echocardiography T weight loss. On examination of chest
B. Cardiac enzymes movements are decreased on right side
C. X - ray chest Pa view with with decreased vocal fermitus, dull
D. Electrocardiography percussion note and absent breath
E. Clinical examination sounds. The trachea shifted to left. Most
likely diagnosis is :
53 - In diagnosis of COPD all are true:
select best one : A. Pneumonic consotidation
B. Pneumothorax
A. FEVI/FVC ratio T C. Pleural effusion T
B. PEFR D. Emphysema
C. TLC E. Bronchietasis
D. FVC
E. Gas transfer facfor 57 - Liver cirrhosis predisposing to which
of the following :
54 - All of the following are side effects of
loop diuretics except : A. Gynaecomastia
B. Haemorroids
A. Water retention T C. Spleenomegaly
B. Hypokalemia D. Heaptocellular
C. Hyperkalemia E. All of above T
D. Hyplrmagnesemia
E. Ototoxicity 58 - Acute inferior wall MI is diagnosed
by :

A. ST segment elevation in II III AVF T

B. ST segment depression in II III AVF
C. Bradycardia in ECG
D. Complete heart block
59 - Which of the following condition is
commonly associated with H. pylori :
A. Chronic active gastritis T
B. Congenital pylori stenosis
C. Crohn's disease
D. Ulcerative colitis
E. Gastic stress ulcers of stomach
60 - A diabetic patient presents with
blood urea 200 mg and serum creatinine
6.5 mg His potassium level level was 7.2
mmol/L. What immediate treatment will
you start:
A. I/V calcium gluconate T
B. I/V magnesium
C. Hemodialysis
D. Peritoneal dialysis
E. Nebulization with ventolin solution
61 - A 29 year old woman is found on
routine annual testing to have an
increase in unconjugated bilirubin. There
is no evidence of hemolysis and liver tests
are normal. Which of the following is
most likely diagnosis :
A. Gilbert syndrome T
B. Criglernajjar syndrome
C. Dubinjhonson syndrome
D. Pregnanediol therapy
E. Rotor's syndrome
62 - A 50 years old male presented with
difficulty in hearing and nasal septum
perforation. His BP was 150/100 mmHg.
His urine DR showed red cells casts,
protein 2. Chest X - ray had multiple
opacities. The most likely cause is :
A. Good pasture syndrome T
B. Tuberculosis
C. Amyloidosis
D. Kawasaki's disease
E. Wegener's granulomatosis T
63 - Which of following are predisposing
factors of acute pancreatitis :
A. Gallstone
B. Alcohol abuse
C. Viral infection
D. Hyperlipidemias
E. All of above T
64 - The passage of dark, Tarry stools
are called :
A. Malena T
B. Hematochezia
C. Both of above
D. Hematemesis
E. None of above
65 - An 18 year old woman was
diagnosed 7 years with prococious
pseudo puberty secondary to ovarian
tumor. Physical examination reveals oral
and lingual dark pigmentation. Which of
the following is the most likely diagnosis :
A. Peutzjeghers syndrome T
B. Gardner's syndrome
C. Juvenile polyposis
D. Turcot's syndrome
E. Lynch syndrome
66 - Which of the following is cause of
hyponatremia :
A. Excessive use of diuretics T
B. Diabetes insipidus
C. Decrease water intake
D. Total parentral nutrition
E. Hyper osmolar diabetic coma
67 - A 27 year male presented with high
grade fever& right sided pleuraleffusion.
Pleural fluid reveals ratio of
concentration of protein Pl: fluid to
serum protein >0.5 LDH level > 200 Iu.
LDH concentration in pleural fluid to
serum >0.6. Which of the disorder is most
likely in this patient:
A. Para - pneumonic effusion T
B. Cirrhosis of liver
C. Nephritic syndrome
D. Congestive heart failure
E. Corpulemanale
68 - In heart, which of the following have
proved to improve survival :
A. Captopril T
B. Digoxin
C. Verapamil (calcium channel blockers)
D. Forsemide (Diuretics)
E. Aspirin T
69 - A 35 years old female presented with
joint pain and swelling for 01 year, that
has increased in early morning hours. On
examination she has nodules on extensor
aspect of forearm. What is the likely
diagnosis :
A. Rheumatoid arthritis T
B. Osteoarthritis
C. Septic arthritis
D. SLE
E. Chondo calcinosis
70 - Characteristics of right heart
failure are, Except :
A. Pulmonary edema T
B. Raised JVP
C. Hematomegaly
D. Ascites
E. Peripheral pitting edema
71 - A 40 years old male present with
Dysponea on exertion. On examination
raised JVP with paradoxical rise during
inspiration, hepatomegaly and ascites.
Chest X - ray shows a small heart with
calcification. The most likely diagnosis is :
A. Constrictive pericarditis T
B. Viral pericarditis
C. Cardiac tamponade
D. Congestion cardiac failure
72 - Dysentery (bloody diarrhea) is not
caused by :
A. Rota Virus T
B. Shigella
C. Clostridium dificile
D. Entamoebahistolytica
E. Entroinivasiveescherichia coli
73 - A 23 years old man develops sharp
left sided chest pain, fever and friction
rub heared at the left sternal borders,
unaffected by respiration. The pain is also
aggravated by lying down and relieved
by sitting up. He is otherwise well with no
other symptoms. Which of following is
the most likely cause for his symptoms :
A. Pericarditis T
B. MI
C. Tuberculosis
D. Rheumatic fever
E. Pneumonia
74 - A 55 years old man presents to the
hospital with new onset of chest pain,
breathlessness and sweating. The pain is
severe, located in the center of his chest
and radiates into his left side. Pain lasts
more than 30 minute. What is most likely
diagnosis :
A. Myocardial infarction T
B. Pulmonary embolism
C. Angina
D. Aortic dissection
E. Mitral insufficiency
75 - A 42 years old male with known
valvular heart disease develops a fever
for one week. He appear unwell, findings
include a pansystolic murmur at the apex
that radiates to axilla and heart sound.
He has linear hemorrhage under finger
nails and painful, tender erythematous
nodules on some of the finger tips. Which
one following is true:
A. Infective endocarditis T
B. Rheumatic heart disease
C. Pericarditis
D. Mitral stenosis
E. Aortic insufficiency
76 - A 40 years old previously well women
present with pruritus. She is not taking
any medicine but drinks alcohol. Physical
examination entirely normal. LFT show 3
time raised alkaline phosphatase.
Ultrasound abdomen shows normal
liver and gall bladder. Which of the
following most appropriate next step in
diagnosis :
A. Antimitochondrial antibodies T
B. Prothrombin time or INP
C. Antinuclear antibodies
D. Ultrasound of abdomen
E. Protein immunoelectrophoresic
77 - A business man developed low -
grade fever malaise with protacted
illness.
On examination there is hepato-
spleenomegaly on further enquiry he said
that recently imported parrots and
domestic ducks without the most likely:
A. Chlamydia psittaci pneumonia T
B. Influenza pneumonia
C. Leigionellapneumophilia pneumonia
D. Para influenza pneumonia
E. Coxiellaburnetii pneumonia (Q fever)
78 - Regarding the best option for
assisted ventilator therapy in patients
with acute severe asthma is :
A. PaO2 < 60 mmHg T
B. PaCO2 < 60 mmHg
C. Confusion
D. pH < 7.30
E. Asteresis
79 - A 55 years male during performing 83 - Organophosphorus poisoning is more
Hajj at saudiarabia suddenly developed common in persons :
headache, cough, confusion, myalgia,
high grade fever &diarrhea. Laboratory A. Working in fields (agriculture land) T
test shows: hyponatraemia abnormal B. Hospitals
LFTs elevated creatine kinase and C. Cotto factories
decreased serum albumin level. The most D. Cement factories
likely diagnosis is : E. Garment factories

A. Leigionellapneumophilia pneumonia T 84 - A 24 year old female presents with

B. Mycoplasma pneumonia pneumonia history of of diarrhoea and vomiting one
C. Chlamydia pneumonia pneumonia week back. Now she has developed
D. Hemophilus Influenza pneumonia paraplegia. On examination, her reflexes
E. Streptococcal pneumonia pneumonia are absent. There is no sensory loss.
What is the likely diagnosis?
80 - The bacterial cause of acute
infectious diarrhea are : A. Guillain barre syndrome T
B. Transverse myelitis
A. E. Coli T C. Pott's disease
B. H. Pylori D. Sub acute combined degenration of
C. E. Histolytica spinal cord
D. G. Lambia E. Freidrich's ataxia
E. Rota virus
85 - Recongnized Clinical feature of
81 - The drug of choice for treatment of Parkinson's disease :
peptic ulcer are :
A. Rigidity T
A. Proton pump inhibitors T B. Intention tremors
B. Antibiotics C. Ataxia
C. H2 receptor antagonist D. Waddling gait
D. Antacids E. Decreased tone
E. All of above
86 - Following is the cause of type - 1
82 - clincal features of peptic ulcer respiration failure :
disease are :
A. Pneumonia T
A. It causes epigastric pain T B. Stroke
B. It causes right hypochondrial pain C. Head injury
C. The pain is suqeezing in nature D. Myocardial infarction
D. The pain is not relieved by food E. GB syndrome
E. Nusea, vomiting or weight loss are not
present
87 - Regarding the clinical feature of 92 - In renin angiotensin system renin
shock : release is controlled by :

A. Tachycardia with low volume pulse T A. Pressure in afferent arteriole T

B. Hypertension B. Pressure in efferent arteriole
C. Polyuria C. Para sympathetic tone
D. Bounding pulse D. Sodium chloride concentration in distal
E. Slow respiration tubule

88 T- Recognized clinical feature of 93 - In treatment of ulcerative colitis :

raised ICP (intracranial pressure) :
A. 5 - ASA, Sulphasalazine are required
A. Papilioedema T for indication T
B. Tachycardia B. In limited disease oral corticosteroid
C. Down going planter are used
D. 3rd cranial nerve palsy C. Combination of oral and rectal enema
E. Systolic hypotension of 5 ASA is better
D. In extension disease 5 ASA of corti-
89 - Legionnare's disease is characterized costeroid are required T
by : E. For indication of remission corti-
costeroid are considered 1st line agent
A. Hypokalemia
B. Hyperkalemia 94 - Which of the following is sign of
C. Hyponatremia T right heart failure :
D. Hypernatraemia
E. Hyperglycemia A. Raised JVP with hepatic congestion T
B. Heaving apex
90 - Anti CCP antibody is +ve in : C. Systolic murmur at apex
D. Crepitations at lung bases
A. Rheumatoid arthritis T E. 3rd heart sound gyllop at apex
B. SLE
C. Psoriasis 95 - Following all are sign of pneumonic
D. Systemic sclerosis consolidation select best one :
E. Dermatomyositis
A. Bronchial breathing T
91 - Characteristic of left heart failure B. Shifting of trachea
are Except : C. Decreased chest movement on
affected side T???
A. JVP not raised D. Dull percussion note on affected side
B. Cardiomgaly E. Chest creptation on affected side
C. Pulmonary edema
D. Pitting edema T
E. Pleural effusion
96 - Hemorrhagic ascites is seen in : 101 - Hepatobiliary disorder seen in
cirrhosis is :
A. Malignancy T
B. Cirrhosis A. Cholecystitis
C. Tuberculosis B. Primary sclerosing cholangitis T
D. Chronic pancreatitis C. Itching
D. Nusea
97 - Duke's jones minor criteria for E. Juandice
diagnosis of :
102 - Neuromuscular disorder causing
A. Leukocytosis T dysphagia :
B. Positive throat culture
C. History of recent scarlet fever A. Mysthenia gravis T
D. Asotiter> 250U B. Bulbar palsy
E. Erythema margination C. Motor neuron disease
D. Multiple sclerosis
98 - Endoscopic ultrasound is helpful in
diagnosis of : 103 - The clinical findings which
differentiate lung fibrosis from
A. Pancreatic tumor T consolidation is :
B. Gastric ulcer
C. Esophageal cancer T??? A. Decreased chest movement T
D. Esophageal obstruction B. Shifting of trachea T
E. Esophageal varices C. Broncialbreating
D. Depression of chest wall
99 - The genetic inheritance pattern of
cystic fibrosis is : 104 - Which of the following is not a risk
factor of tuberculosis :
A. Autosomal recessive T
B. Autosomal dominant A. Winter season T
C. X - linked recessive B. Chemotherapy
D. X - linked dominant C. Diabetes mellitus
D. Steroids
100 - Following is the cause of type - 1 E. Infliximab
respiratory failure :
105 - One of the following complication
A. Pulmonary edema T of peptic ulcer needs urgent surgical
B. Severe acute asthma intervention :
C. COPD
D. GB syndrome A. Ulcer perforation T
E. Mysthenia gravis B. Hemorrhage
C. Gastric outlet obstruction
D. Recurrent ulcer following gastric
surgery
 110 - A 55 year old male presented in
106 - Factor that predispose to aortic
emergency department with severe chest
dissection include:
pain of one hour duration. His ECG shows
ST elevation in V1 - V4. The most likely
A. Old age T
vessel blockade by thrombus in this
B. Hypertension T
patient is :
C. Aortic regurgitation
D. Pregnancy in 1st trimester
A. Left anterior descending artery T
E. Pregnancy in all trimester
B. Left main coronary artery
C. Left circumflex artery
107 - Clinical feature of constrictive
D. Right coronary artery
pericarditis usually seen in patient is :
E. Posterior descending branch of right
coronary artery
A. Arise in JVP during inspiration T
B. Painful hepatomegaly
111 - A 52 year old man presents with
C. Rapid irregular pulse
one week history of cough productive of
D. Elevated JVP
green sputum. With occasional blood
E. Pulses paradoxus always
flecks. He is also complaining of
shortness of breath and on examination
108 - A 63 years old female develops
he is pyrexia, tachyponic and
exertional angina and had two episodes
tachycardic. What is most likely
of syncope. Examination shows a systolic
diagnosis:
ejection murmur which radiates to
carotid and a soft S2. Which one of the
A. Pneumonia T
following is most likely diagnosis :
B. Pulmonary embolism
C. Sarcoidosis
A. Aortic stenosis T
D. Asthma
B. Aortic insufficiency
E. COPD
C. Mitral stenosis
D. Mitral insufficiency
112 - A 50 year old male with
E. Tricuspid stenosis
emphysema and a chest X - ray that has
shown apical blebs develops the sudden
109 - A 16 year old male presented with
onset of shortness of breath and left
high BP. On examination blood pressure
sided pleuritic chest pain. Pneumothorax
in his arms higher in his legs by more
is suspected: physical examination
than 10 mmHg. Which one of the
findings that would confirm the diagnosis
following is most likely diagnosis :
are :
A. Coarctation of aorta T
A. Hyperresonance of the left chest with
B. Aortic insufficiency
decreased breath sounds T
C. Normal variant
B. Localized wheezes at the left base
D. VSD
C. Increased tactile fermitus on the left
E. Ventricular aneurysm
side
D. Dull percussion note on the left side
with shiftingof apex beat on right side
E. Decreased breath sound on the left
side with deviation of trachea to the left
113 - Which of the following regarding
treatment of acute exacerbation of COPD
are true except :
A. High concentration of oxygen T
B. Short acting B2 agonost by nebulizer
C. Oral prednisolome improve lung
infection
D. Mechanical ventilation is considered if
there is concomitant pneumonia
E. If pH < 7.35 and polar in increasing
consider ventilator suppore
114 - A 30 year old athlete with asthma is
also a cigarette smoker. Which of the is
characteristic of asthma but no other
obstructive lung disease :
A. Airway obstruction is reversible T
B. Hyperinflation is present on chest X -
ray
C. The FEVI/FV ratio is reduced
D. Hypoxia occurs as consequence of
ventilation - perfusion mismatch
E. Exacerbation often occurs as a result of
an upper respiratory tract infection
115 - which one of the following is
important risk factor for sudden death in
hypertrophic cardiomyopathy :
A. Recurrent syncope
B. Exercise induce chest pain T
C. Increase in left ventricular wall
thickness
D. Repelid attack of ventricular
tachycardia
E. A history of previous T.I.A
116 - Best investigation for diagnosis if
pulmonary TB is :
A. Sputum culture +Ve for AFB T
B. Sputum smear +Ve for AFB
C. Mountox test +Ve
D. HIgh ESR
117 - Respiratory cause of finger clubbing
is :
A. Bronchietasis T
B. CCF
C. Tuberculosis
D. Pleural effusion
E. Chronic bronchitis
118 - Regarding Mitral stenosis :
A. Mid - Diastolic Murmur T
B. Apex heat shifted to axilla
C. Ejection Sytolic Murmur
D. Always due to rheumatic heart disease
119 - In H - Pylori associated ulcers :
A. The doudenal ulcer are more common
T
B. The gastric ulcerare more common
C. There is normal acid production
120 - All statements are correct about
Crohn's disease except :
A. More common in nonsmoker or ex-
smoker T
B. It is more common in smokers
C. Many symptoms are abdominal pain,
diarrhoea weight loss
D. Crohn's disease is characterized by ring
span dylitis by skip lesion in samll
intestine
E. Ulcerative colitis & Crohn's disease
with HLA - B 27 are more pronon to
develop ankylo
121 - Which of the following is noticed 126 - Drug of choice for enteric fever :
in sarcoidosis : ☆ Ciprofloxacin

A. Elevated uric acid level 127 - Most sensitive and specific test for
B. Leukopenia T H. Pylori is:
C. Hyperphosphataemia
D. Increased level of serum calcium ☆ Urea Breath Test
E. Hypogammaglobinemia
128 - common cause of dementia in old
122 - Homocystiunuria :. people is :

A. It is treated by pyridoxine &cystine ☆ back out

supplemented diet T
B. It is autosomal dominant trait 129 - Nephritic Syndrome best
C. Causes hyperpigmentation of skin characterized by :

123 - Regarding the complication of ☆ Oliguria and Hematuria

central venous cannulation :
130 - Management of Cardiogenic shock :
A. Endocarditis T
B. Headache ☆ Dopamine + Dobutamine
C. Tachycardia
D. Cardiac failure 131 - Due to which drug urine color
E. Vomiting changes to Orange :

124 - Regarding critically ill patient ☆ Rifampicin

recognising feature :
132 - Treatment for paracetamol
A. Pulse > 140 T poisoning :
B. Fever of 102 °F
C. Vomiting
☆ N Acetylcysteine
D. Cough
E. Epigastric pain
133 - Character of JVP :

125 - All are features of SIRS, Except :

☆ Two upstrokes with with every cardiac
cycles
A. Systolic blood pressure < 90 mmHg T
B. Temperature > 38° or < 36°
134 - Mode of action of Clopidogrel :
C. Heart rate above 90 per min
D. Respiratory rate > 20
☆Inhibition ADP synthesis
E. WBC > 12 × 10°/L or < 4×10° L
135 - Vomiting of food after 2 hour of
intake :
☆ Pyloric stenosis
136 - Pneumonia patient + Hyponatremia
diagnostic investigation is :
☆ Ligionella antibody titer
137 - Diabetic patient on metformin come
with dehydration and blood glucose 250
mg/dl :
☆ Lactic acidosis type B
138 - Short stature, peak linear streat
ovary :
☆Turner syndrome
139 - A patient presented with raised BP
on examination P2 is loud, otherwise all
examination is normal :
☆Pulmonary hypertension
140 - First step in management of
cyanosis + severe breathlessness :
☆ Oxygen
141 - Chest pain, dull percussion note
decreased heart sound :
☆ Pleural effusion
142 - Case with Ejection systolic murmur
+ Mid diastolic Rumble:
☆ Mitral stenosis and trucuspid
regurgitation??????
143 - Regarding small cell bronchogenic
carcinoma :
☆ Radiotherapy increased survival rate
144 - Inferior MI involve :
☆ Lead II, III and AVF
145 - Regarding Organophosphorus
corrcet :
☆ Increase Salivation
146 - Postural hypotension and sinus
tachycardia sign of :
☆ Hypovolemia
147 - Drug of in case of urinary tract
infection in pregnancy is :
☆cephalaxin and cefuroxime
148 - Treatment of severe hyperkalemia :
☆ I/V calcium Gluconate
149 - Chronic cough with foul smelling
sputum clinical feature of which of
following :
☆ Bronchietasis
150 - Localised, tapping apex beat occur
in :
☆ Mitral stenosis
151 - pan systolic murmur, soft S1, S3
wide splitting S2 occur in :
☆Mitral regurgitation
152 - Low volume, slow rising pulse occur 160 - The first line investigation for
in : patient of cough fever, weight loss :
☆ Radiology of chest
☆ Aortic stenosis
161 - Indication of Surgery in ulcerative
153 - ANA +Ve found in : colitis is :

☆ Autoummune hepatitis ☆ Failure of medical therapy

154 - Previous infection of HBV is : 162 - Hypertensive disease in pregnancy :

☆HbsAg negative ☆ Preeclampsia is seen in 25% case

154 - Fresh blood in stool in GI bleeding 163 - The best test to identify Non
causes is : opaque renal stone is :

☆ Deverticular disease ☆ I.V.U

155 - Which of the following is not 164 - Acute fatty liver of pregnancy :
feature of right sided heart failure :
☆ Treatment is immediate delivery of
☆Pulmonary edema fetus

156 - Jerky carotid pulse and double 165 - The common symptom of Crohn's
apical pulsation occur in : disease is :

☆ Hypertrophic cardiomyopathy ☆ Diarrhea is 70%

157 - Heavy smoking increased risk of : 166 - Erythroprotein release is increased

in :
☆ COPD
☆ Polycystic kidney disease
158 - The cause of hyperlipidemia include
: 167 - The most common cause of acute
liver failure worldwide is :
☆ Nephrotic syndrome
☆ Acute Viral Hepatitis
159 - Aspirin can induce:

☆ Asthma
168 - Patient taking proton pump
inhibitor drug but no more response in
epigastric pain. Next investigation step
will be :
☆ Upper GI endoscopy
169 - Carotid stroke weak and delay
occur in :
☆ Aortic stenosis
170 - High volume of collapsing pulse
found in :
☆ Aortic regurgitation
171 - Renal failure cause in patient of
osteoarthritis is :
☆ NSAID
172 - Pharyngeal nocturnal dyspnea
feature of :
☆ Chronic heart failure
173 - On examination dull percussion
note, decreased chest movement and
absent breath sound. The most likely
diagnosis :
☆ Pleural effusion
174 - Gold standard test of celiac disease
is :
☆ Small bowel biopsy
175 - Patient with chronic renal failure
treatment is :
☆ Calcium chloride/sodium bicarbonate
176 - Prominent finding on ECG of mitral
stenosis is :
☆ Left Artrial Enlargement
177 - The dose of is to be adjusted if
patient having :
☆ Hepatic encephalopathy
178 - History bee sting , got itchy rashes
all over body. Patient is dysponea. On
ascultation bilateral wheeze were
audible. Which of the following is
appropriate medicine should be
administered first to this patient :
☆ Diphenhydramine
179 - A patient with irregular pulse,
increase JVP without a wave in
thrombosis in left atrium. Which of the
following is best treatment option for
this patient is :
☆ Propranolol
180 - Patient of rheumatoid arthritis and
taking only NSAIDS previously 5 years.
The cause is:
☆ Acute basement membrane
181 - Treatment of severe dehydration :
☆ IV fluid immediately step