FMGE/NEXT PROGRAM

MEDICINE TEST neuron lesion is characterized by which of the

following?
1. Severity of mitral stenosis is determined by:
a. Weakness and spasticity
a. Intensity of S1 heart sound
b. Fasciculation's
b. Diastolic murmur duration
c. Rigidity
c. Opening snap
d. Muscle atrophy
d. Intensity of diastolic murmur
10. In restrictive lung disease:
2. Malignant hypertension can lead to all of the
a. FVC is high
following EXCEPT
b. FEV1 is high
a. Hypertensive retinopathy
c. FEV1/FVC is high
b. Respiratory failure
d. All of the above
c. Renal failure
11. A 49 year old man, presented with 10 days history of
d. Stroke
progressive worsening dyspnea on exertion, A chest
3. Which is the most common arrhythmia:
radiograph confirmed a large left pleural effusion.
a. Inappropriate sinus tachycardia
Which of the following feature and finding you won't
b. Junctional premature complexes
see in this case ?
c. Atrial fibrillation
a. Horizontal fluid level
d. Atrial flutter
b. Low lung volume
4. Preferred biochemical marker(s) in patients
c. Muffled heart sound
presenting with myocardial infarction:
d. Decreased chest movements
a. Myoglobin
12. In the given ECG widespread concave ST elevation and
b. Cardiac specific Troponins
PR depression is present throughout the precordial
c. CK-MB
(V2-6) and limb leads (I, II, aVL, aVF).There is
d. All of the above
reciprocalST depression and PR elevation in aVR.
5. On ECG, ST segment elevation is seen in all of the
What is the diagnosis ?
following conditions EXCEPT:
a. Left ventricular aneurysm
b. Acute pericarditis
c. Myocardial infarction
d. Hypocalcemia
6. Most common cause of death in patient on chronic
hemodialysis:-
a. Uremia a. Acute myocardial infarction
b. Infection b. Pericarditis
c. Cardiovascular disease c. Digoxin toxicity
d. Malnutrition d. Hypertrophic obstructive cardiomyopathy
7. A 39 year old male presents with fever, cough and 13. MC joint involved in diabetes is?
anorexia. He is sputum positive for AFB. In order to a. Ankle
consider this as a case of XDR-TB, which of the b. Knee
following should he be resistant to ? c. Shoulder
a. Resistance to at least INH & rifampicin +/- other d. Foot
drugs 14. All are true about steps followed in management of
b. Resistance to any of the 3 first line drugs ventricular fibrillation except?
c. Resistance to all 1st line drugs & any 3 second line a. CPR cycle duration is 2 minutes
injectable drugs b. Chest compressions at 100-120/min
d. Resistance to at least INH & rifampicin + any c. Start CPR followed by immediate defibrillation
quinolones + at least 1 injectable 2nd line drug d. Intravenous access followed by Immediate
8. Acromegaly is associated with all of the following defibrillation
EXCEPT: 15. Which of following leads to a continuous murmur ?
a. Protruding supraorbital ridges a. Peripheral Pulmonic stenosis
b. Increased heel pad thickness b. Severe Pulmonary artery hypertension
c. Diabetes mellitus c. Type A aortic dissection
d. Muscle hypertrophy d. Rupture of cardiac chamber
9. A 44 year old man presents to emergency room with 16. A 45-year patient working in a factory for past 20
Progressive atrophy andweakness of hands. On years presents with breathlessness. HRCT chest shows
further examination he is found to have brisk jaw pleural thickening and fibrosis. Diagnosis is?
jerk, Fasciculations, spasticity of lower leg and Bulbar a. Asbestosis
palsy. In the given clinical scenario Upper motor b. Coal worker pneumoconiosis
c. Silicosis
MEDICINE BY DR MANISH SONI
 FMGE/NEXT PROGRAM

d. Berylliosis c. Paroxysmal Ventricular Tachycardia

17. What is the name of this appearance which is seen in d. Torsades de Pointes
pellagra? 24. The type of arteritis which may lead to myocardial
infarction in children is:
a. Kawasaki disease
b. Takayasu arteritis
c. Polyarteritis nodosa
d. Microscopic polyangitis
25. A 25 year old man comes with left sided chest pain
that began suddenly 2days ago at rest. He is an
drinker and smoker. His BP is 120/80 mm Hg, PR
80/min and regular, RR is 22/min. Chest examination
reveals decreased tactile fremitus, hyperresonance,
a. Burn and diminished breath sounds in the left hemithroax.
b. Castle neck appearance Select likely diagnosis:
c. Shawl sign a. Acute Pericarditis
d. Gottron's papule b. Spontaneous Pneumothorax
18. A 35 year old man presented to the emergency with c. Angina Pectoris
worsening respiratory distress (SpO2-56%), back ache, d. Myocardial Infarction
cough and history of fever and anosmia for 7 days. 26. A patient of CHF was on Digoxin therapy started
The X-ray shows bilateral groundglass opacities. experiencing palpitations, diaphoresis, chest pain and
Which is the type of respiratory failure seen in this serum levels of Digoxin, was found to be elevated.
patient? Physician was suspecting NPAT. What is the drug of
a. Type 1 RF choice?
b. Type 2 RF a. Propranolol
c. Type 3 RF b. Lignocaine
d. Type 4 RF c. Procainamide
19. A patient presents to the emergency in unconscious d. Adenosine
state and BP 220/140 mm Hg. No neurological deficit 27. A patient with prinzmetal angina is administered
is seen. Which drug may be used? isosorbide mononitrate and is noticed to have
a. IV Nitroprusside symptomatic relief. What is the mechanism of action
b. SL Nitroglycerine in this case?
c. SL Nifedipine a. Reduced cardiac contractility
d. Oral Amlodipine b. Endothelin independent coronary vasodilation
20. All the following are included in major criteria for c. Increased left ventricular end diastolic volume
rheumatic fever, except? d. Decreased diastolic perfusion pressure
a. Pancarditis 28. Which of the following is not indicated as a first line
b. Deforming arthritis drug in cases of uncomplicated essential
c. Subcutaneous nodules hypertension?
d. Chorea a. Calcium Channel Blockers
21. In JVP y descent is absent and x wave is prominent. b. Thiazide Diuretics
This is suggestive of? c. Alpha Blockers
a. Restrictive Cardiomyopathy d. ACE Inhibitors
b. Constrictive Pericarditis 29. What is the treatment of choice in a hypertensive
c. Right Ventricular Failure patient with diabetes?
d. Cardiac Tamponade a. ACE Inhibitors
22. Pulsus paradoxus is seen in all except? b. Beta Blockers
a. Mitral Regurgitation c. Thiazides
b. Acute Asthma d. Calcium Channel Blockers
c. Cor pulmonale 30. Which of the following drug is associated with QT
d. SVC Obstruction prolongation?
23. A 22 year old woman complains of palpitations and a. Lignocaine
has a regular heartbeat at a rate of 170/min, with a b. Quinidine
BP of 110/75 mm Hg. The rate abruptly changes to c. Magnesium Sulfate
75/min after applyinng carotid sinus pressure. Which d. All of the above
of the following is the most likely diagnosis? 31. A 28 year old female presents with a history of 9 kg
a. Paroxysmal Atrial Flutter weight loss in the last 3 months despite an increased
b. Paroxysmal SupraVentricular Tachycardia appetite. She also complains of diarrhea, anxiety and

MEDICINE BY DR MANISH SONI


amenorrhea. Examination reveals fine tremor, brisk
reflexes and systolic murmur is heard throughout the
precordium.Her urine pregnancy test came negative.
What is the most likely finding on examining the
pulse?
a. Pulsus alternans
b. Irregularly irregular pulse
c. Pulsus paradoxus
d. Collapsing pulse
32. A 17 year old female with a history of pleuritic chest
pain and joint pains came to her doctor because she
noticed an erythematous rash on her face. Further
workup showed a positive antinuclear antibodies
(ANA) titer, anemia, leukopenia and mild
thrombocytopenia. The liver and renal profiles are
within normal range. Echocardiography revealed
vegetations present in the undersurface of valves.
Which type of endocarditis is seen in this condition?
a. Nonbacterial thrombotic endocarditis (NBTE)
b. Infective endocarditis
c. Libman-sacks endocarditis
d. Rheumatic heart disease
33. A 43 year old man is admitted to the hospital due to
chest pain for the last 3 hours.He has a history of
smoking a pack of cigarettes daily for the last 7 years,
no drinking habit, but his family history has cardiac
events. On cardiac examination heart rate is 51 bpm,
ECG shows sinus bradycardia and ST elevation in lead
II.What is the diagnosis?
a. Increased in vagal tone and the person is healthy.
b. Left ventricular aneurysm.
c. Bradycardia due to reflex of increased stroke
volume.
d. Ischemic Myocardial Infarction in inferior wall.
34. A 19 year old male sprinter suddenly collapsed during
a 100m sprint. He was rushed to the hospital where
he was declared dead. Family gave a history of similar
death in his sibling. The most likely diagnosis is?
a. Restrictive Cardiomyopthy
b. Constrictive Pericarditis
c. Dilated Cardiomyopathy
d. Hypertrophic Cardiomyopathy
35. A 49 year old female patient presented with exercise
intolerance, dyspnea on exertion, chest tightness and
repeate episodes of fever and elevated CRP.
Auscultation reveals a plop sound. EchoCG reveals
decreased LVEF and a mass in left atrium prolapsing in
left ventricle during diastole. HPE on resection of
mass is given. Likely diagnosis?
FMGE/NEXT PROGRAM
a. Mitral Stenosis
b. Rhabdomyosarcoma
c. Atrial Myxoma
d. Takotsubo Cardiomyopathy
36. A 70 year-old male came into OPD due to 6 weeks of
progressive dyspnea. He had a nonproductive cough
for 4 months. He worked in an asbestos mining
industry for 40 years. Upon physical examination,
there are decreased breath sounds and dullness on
percussion at the base of the left lung. Chest CT scan
reveals left-sided pleural effusion and diffuse nodular
thickening of the pleura. Lung parenchyma is intact.
What is the probable diagnosis?
a. Small cell carcinoma
b. Squamous cell carcinoma
c. Carcinoid lung tumor
d. Malignant Mesothelioma
37. A 35 year-old male presents to OPD with fever for 2
weeks, non-productive cough and significant weight
loss. His past medical history revealed he has HIV. He
is a non-smoker and a non-alcoholic. Chest x-ray is
given below. What is the probable diagnosis?
a. Mycoplasma pneumonia
b. Pneumococcal pneumonia
c. Pneumocystis jirovecii pneumonia
d. Klebsiella pneumonia
38. A 35 year-old man presented to OPD with complaints
of intermittent fever for 5 days, productive cough
with shortness of breath. On physical examination,“E”
is heard as “A”and tubular bronchial breathing is
heard over the right mammary area. Chest x-ray is
given below. What is the probable diagnosis?
a. Right lower lobe consolidation
b. Right middle lobe consolidation
c. Right sided pleural effusion
d. Lingular consolidation
39. A 30 year-old female was admitted to casualty with
hysteria and anxiety. The physician extracted blood
for arterial blood gas (ABG) interpretation. The ABG
report revealed pH of 7.55; HCO3- of 24 mEq/ L and
PCO2 of 27 mm Hg.What is the interpretation of this
report?
a. Metabolic acidosis
b. Metabolic alkalosis
MEDICINE BY DR MANISH SONI
 FMGE/NEXT PROGRAM

c. Respiratory alkalosis 65mg% with S.K+ 6.5meq/L. Which of the following is

d. Respiratory acidosis best recommended for this patient?
a. Calcium gluconate
40. An asthmatic patient presents with C/O black sputum b. Insulin drip
plugs. The auscultatory findings are persistent coarse c. Patiromer
crepitations and Ig E levels in this patient is elevated d. Furosemide drip
and CT Chest is suggestive of central bronchiectasis. 46. A 35 year old lady is having complaints of bilateral
What is the most likely diagnosis? drooping of eyelids on watching television, chewing
muscle and shoulder girdle weakness. Which test
would be useful for diagnosis?
a. Anti-topoisomerase antibodies
b. Anti-PIQ voltage gated channel antibodies
c. Anti-Ach receptor antibodies
d. Anti-CCP antibodies
a. Cystic Fibrosis
47. A known epileptic patient who is non-compliant is
b. Mounier Kuhn Syndrome having seizures for past 10 minutes. IV access could
c. William Campbell Syndrome not be obtained. Which medication would be most
d. Allergic Bronchopulmonary Aspergillosis suitable to administer at this stage to treat the
41. A 70 year old male patient had a smoking history of
patient’s seizure?
20pack a year and history of cerebral infarction twice. a. Sodium valproate
He presents with weight loss, fatigue, mild b. Levetiracetam
hemoptysis and infiltrates on chest x-rays and red cell
c. Midazolam
casts in the urine, a valuable diagnostic test is?
d. Lorazepam
a. Lung function tests 48. A 20 year old male presents with recurrent attacks of
b. Quantification of albumin in the urine deep seated retro-orbital pain lasting for 30 min and
c. ANCA levels in the blood
conjunctival injection along with watering from eyes.
d. CT Chest What will be the first line management?
42. In cases of bronchial asthma which is the 5- a. Sumatriptan
Lipoxygenase inhibitor prescribed to the patients? b. Flunarizine
a. Zafirlukast
c. Steroids
b. Sodium Chromoglycate d. High flow O2
c. Zileuton 49. Which among the following anticonvulsant drug
d. Deriphylline
would be most appropriate as first-line therapy for a
43. What is the likely diagnosis based on the below given
21year old woman recently diagnosed with complex
xray? partial seizures?
a. Carbamazepine
b. Topiramate
c. Phenytoin
d. Lamotrigine
50. A patient post thyroid surgery is having complaints of
dry mouth with peri-oral numbness and tingling
sensations also in the finger tips. Which of the
following is the next best step for this patient?
a. Flial Chest
a. Reassure and draw blood sample for potassium
b. Hydropneumothroax
levels
c. Pleural Effusion
b. Reassure and apply BP cuff to check trousseau sign
d. Lung Abscess
c. Give 10ml of 10% Calcium Gluconate
44. A patient presented with excessive foul smelling
d. Start IV Fluids and give Alendronate
purulent sputum and recurrent lung infections. The
51. A 65 year old woman is brought to ER as she became
patient gives history of Cystic Fibrosis. What is the
unconscious and her symptoms started acutely 5 days
most likely diagnosis?
ago. Her BP-95/70mmHg, PR-120/min and GPE shows
a. Lobar Pneumonia
thin lady with dry oral mucosa and increased urine
b. Bronchiectasis
output. Lab shows RBS-410mg/dl, Insulin is elevated
c. Emphysema
and urine dipstick is negative for ketone bodies.
d. Tuberculosis
Which of the following is first step in management?
45. A patient of chronic renal failure has presented with
a. IV Regular Insulin infusion
fatigue. On examination, pallor is noted with a fistula
b. SC Insulin infusion
in left hand for recurrent hemodialysis. Blood urea-
c. IV Ringer Lactate

MEDICINE BY DR MANISH SONI


d. IV Normal Saline
52. A 50 year old Chinese man presents to ER with
headache, vomiting, seizures and altered sensorium.
NCCT Head is given below. Which drug is used in this
patient?
a. Mannitol
b. Acetazolamide
c. Furosemide
d. Steroids
53. A 14 year old child is brought by his mother to
medicine OPD with complaints of early morning jerks.
EEG reveals 4-6Hz polyspike pattern on
hyperventilation. Which among the following drug is
prescribed?
a. Carbamazepine
b. Na Valproate
c. Ethosuximide
d. Diazepam
54. A young patient developed sudden onset fever and
agitated behaviour for 2 days. No meningeal signs
were noted, EEG reveals periodic lateralized focal
temporal lobe spikes. CSF analysis shows 60 cells with
predominant lymphocytes, elevated proteins and
normal CSF glucose. Which of the following drug shall
be started in this patient?
a. ATT
b. IV Ceftriaxone
c. Liposomal Amphotericin B
d. Acyclovir
55. A 45 year old male with a history of alcoholic liver
disease presents with increasing confusion. On
assessment, he is noted to be obtunded with a GCS of
14 out of 15, has a wide based gait and nystagmus.
There is no history or signs of recent trauma. What is
the most specific finding on brain MRI for this
patient’s condition?
a. Left sided subdural hematoma
b. Generalized cerebral atrophy
c. Hydrocephalus
d. Enhancement of the mamillary bodies
56. A 28 year old female presents with pain in joints of
hand with rash on dorsum of hand with extensive skin
induration and tightening. She also complains of dry
mouth, dysphagia and dyspnea. Which among the
FMGE/NEXT PROGRAM
following antibody will be used for diagnosis of this
condition?
a. Anti-smith antibody
b. Anti-CCP antibody
c. Anti-centromere antibody
d. Anti-topoisomerase antibody
57. An elderly patient, known case of CAD was brought
with recent onset dysphagia, hoarseness, hiccups,
vertigo, ataxia and loss of pain and temperature from
ipsilateral face. Which among the following vessel
occlusion can cause this syndrome?
a. P1 PCA
b. Basilar artery
c. Anterior spinal artery
d. Vertebral artery
58. A 45 year old woman is evaluated for uncontrolled
hypertension of 170/100mmHg. Her symptoms are
nocturia, frequent headache and muscle cramps. Her
lab values are Na- 148meq/L and K- 3.5meq/L. Oral
salt loading test shows lack of aldosterone
suppression. CT abdomen reveals bilateral adrenal
hyperplasia. What is the next line of management?
a. Laparoscopic bilateral adrenalectomy
b. Amiloride
c. Spironolactone
d. MRI Abdomen
59. A 40 year old patient was having complaints of
resting tremors, stiffness, expressionless facies,
stooped posture and shuffling gait. Which among the
following treatment is recommended in this
condition?
a. Levadopa + Carbidopa + Entacapone
b. Benzhexol
c. Deep brain stimulation
d. Pramipexole
60. A 35 year old female patient presented to the OPD 3
months ago with complains of pain and redness as
shown. On joint aspiration, needle shaped negatively
birefringent crystals were found under microscopy.
The physician says patient is not responding to usual
drugs, what is recommended?
a. Start Colchicine
b. Change to Febuxostat
c. Start Inj. Pegloticase
d. Give Methotrexate
61. A patient presents to hospital with hematuria and
hemoptysis. BP is 170/100 mm Hg and urine dipstick
shows 1+ proteinuria. A renal biopsy shows IgG and
C3 deposits. Likely diagnosis?
MEDICINE BY DR MANISH SONI
 FMGE/NEXT PROGRAM

a. Granulomatosis with Polyangitis albuminuria. Which among the following is correct as

b. Focal Segmental Glomerulonephritis a treatment option in this patient?
c. Polyarteritis Nodosa a. Start Lisinopril and Valsartan
d. Good Pasture Syndrome b. Increase dose of metformin
62. A 65 year old patient was diagnosed with CLL, she c. Allogenic Kidney Transplant
was started on fludarabine. She presents to ER with d. Shift patient to Insulin
features of AKI and you suspect Tumor Lysis 68. A 30 year old female presents with weakness and dry
Syndrome. All are true regarding the condition skin. On auscultation, soft heard sounds were noted
except? and HR-50/min. Lab values show high TSH, and anti-
a. Hyperkalemia TPO antibody is positive. Which of the following is the
b. Hypercalcemia likely diagnosis?
c. Hyperphosphatemia a. Grave’s disease
d. Hyperuricemia b. Thyroid Carcinoma
63. A 35 year old female presents with paresthesia and c. De Quiervan’s thyroiditis
rigidity in upper limbs. Ophthalmology consultation d. Hashimoto’s thyroiditis
shows Marcus Gun Pupil, so he underwent MRI on 69. A known hypertensive patient is brought to ER with
which Dawson Figures were seen. Likely diagnosis is? palpitations and breathlessness. On examination, BP-
a. Multiple Myeloma 210/120 mm Hg with development of
b. Alzheimer's Disease encephalopathy. All of the following can be given as
c. Creutzfeldt Jakob Disease treatment options except?
d. Multiple Sclerosis
64. Which of the following is associated with elevated
alkaline phosphate, low calcium, low phosphate and
elevated PTH levels. Which among the following is the
cause of this condition?
a. Parathyroid adenoma a. IV Mannitol
b. Renal Osteodystrophy b. IV Nicardipine
c. GNAS gene defect c. IV Esmolol
d. Iatrogenic d. IV Sodium nitroprusside
65. A 65 year old man presents with excessive cold 70. A female patient while washing clothes in cold water
intolerance, hypertension and diminished ankle jerks. exhibit colour changes of her hands from white to
His TFT shows TSH 16 IU/L and low T3 and T4 values. red. Which of the following drug is best suited for this
What is the appropriate management? patient?
a. Start Eltroxin 25mcg and increase dose gradually a. ACE Inhibitors
b. Start Eltroxin at 100mcg and decrease dose b. Thiazides
gradually c. Calcium channel blockers
c. Start Carbimazole 50mg d. Alpha 2 Agonists
d. Start T3 and T4 together
66. A young female presents to you with facial puffiness
and frothy urine. On examination, erythematous rash
is found on the cheeks and bridge of nose and BP-
150/90mmHg. On investigation, anti-dsDNA ab and 3+
proteinuria is noted. What is the diagnosis?

a. FSGS
b. Lupus nephritis
c. Diabetic nephropathy
d. AD PCKD
67. A patient of DM-2 presents with decreased urine
output and headache. BP- 150/100mmHg and GFR is
50ml/min and spot urinary sample reveals

MEDICINE BY DR MANISH SONI