DR.

KAYYAREDI

NEXT LEARNING CENTRE

MEDICINE Discussion

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Q.1
CAI
A 65-year-old male patient presented with chest pain, exertional
dyspnea and syncope, What is the most likely diagnosis?
Discussion canny
On
sinceBirthlong
thyaegenera

child Indi

BloodFlowTocoronary Young

I
a) Tricuspid regurgitation

b) Aortic regurgitation world

fever
AutoImmune
toast Iggy
Heart Angina
c) Mitral stenosis

d) Aortic stenosis

inn II Valvuloplasty

Q.2 IS toSAI
A 55-year-old male patient presents the hospital with Discussion Replace

palpitations. On examination, a diastolic murmur is heard in the left

se holes
Sigg
third intercostal space and pistol shot sound is heard over the

femoral arteries. What is the most likely diagnosis?
ERB

Traubesign Pansystolicmurmur etatP'm
space

diastolic
a) Aortic regurgitation Ms MDM

b) Aortic stenosis IfMD has murmur

SystolicMurmur

c) Tricuspid regurgitation HasPas As ps hasna Mid

d) Mitral regurgitation
MatShaMao Ar Murmur
EarlydiastolicHammer

I sign water
Q.3 showy
A 16-year-old girl comes to the hospital with a history of chest pain Discussion

corrigen

and shortness of breath. On the physical examination, the patient Traube sign
has difficulty breathing, wheezing, and shortness of breath. During

cardiac auscultation, a pronounced pansystolic heart murmur and

a pronounced third heart sound can be heard. A chest x-ray shows

a significant enlargement of the heart. The patient dies despite
intensive supportive measures. At autopsy, microscopic

examination of the myocardium reveals aggregates of

mononuclear cells arranged around centrally located deposits of

eosinophilic collagen. What is the correct diagnosis?

AschoffBody

FIBRINOIDNecrosis Rheumaticgranuloma
a) Acute bacterial endocarditis

b) Rheumatic heart disease CheckASOTITRE
c) Subacute bacterial endocarditis

d) Viral myocarditis

Q.4 A 26-year-old woman undergoing evaluation for panic disorder was Discussion
referred to the physician for complaints of palpitations and

breathlessness. Detailed history revealed the presence of chest
pain, which was substernal and not related to exercise. On

auscultation, Pan systolic murmur was audible. What is the most

Trmeismup
likely diagnosis?

a) Unstable angina

b) Aortic stenosis

c) Mitral valve prolapse

d) Mitral regurgitation

Q.5 A 25-year-old road traffic accident victim presents with chest pain Discussion

and breathlessness. On examination, his BP was 80/60mmHgoOn shock
Tricuspidinspection, his neck veins were distended and on auscultation, his shock

heart sounds were muffled, Which of the following clinical features AJUP Triad
EE.IE
stenosis

is likely to be seen in this patient? sounds
antwan

on m h

a) Pericardial knockop ydescento made

b) Kussmaul’s sign X
ftp.ficardiocentespqisusparadoxisitbpontmp
Iregaghphese

c) Third heart soundcar
Constrictive

d) Pulsus paradoxus
CT If pennyyg

Q.6 Water hammer pulse is seen in which of the following conditions? Discussion gg
BEV

qq.gg
a) Aortic stenosis
Eywave

b) Aortic regurgitation

c) Mitral stenosis

d) Mitral regurgitation

Q.7 A 37-year-old male patient comes to the clinic with complaints of Discussion

weakness, restlessness, and chest pain. On examination, his

blood pressure is found to be 90/60 mmHg, his heart sounds are

muffled, and his neck veins are distended. What is the typical JVP

finding in this patient?

a) Absent a wave

b) Prominent a wave

c) Rapid y descent

d) Absent y descent

Q.8 A 70-year-old man with a known history of DM and HTN on regular Discussion
medications presents with a history of progressively worsening

dyspnoea on exertion, On examination, there is elevated JVP,

positive hepatojugular reflux, crackles at the lung bases,

hepatomegaly, ascites, and pedal oedema What is your provisional

diagnosis?

Emigham Fiji dealt

Congestive
a) Heart failure

b) Hypertrophic cardiomyopathySADashgate

c) Mitral regurgitation
dyspnoe

d) Portal hypertension

Q.9 A 65-year-old male patient came with complaints of episodes of Discussion
shortness of breath and coughing at night which awakens him from

sleep. On examination, distended neck veins were observed and

S3 was heard on auscultation. Which of the following biomarkers

can be used for the diagnosis in this patient?
CHF

Galectin 3 Echo digoxin

Me Ino

tropes

a) Brain natriuretic peptide (BNP)
shockNorAdrenaline

b) Troponin I If PulmonaryEdema FUROSEMIDE
Cardiogenic

c) Cystatin D kiddse ACEI ARB

d) Copeptin
MI
man Bestdungforlongevity

Q.10 A 60-year-old man comes to the clinic complaining of in his chest Discussion
classical after climbing stairs for the past few months. The pain subsides on

rest. His past medical history is insignificant. The patient's current
Angina

vitals are all normal. Physical examination is unremarkable. An
Stable

ECG was performed, which did not show any major problems that

could cause this patient's current symptoms. The physician
decides to do a treadmill exercise stress test. Which score is

calculated during the performance of this test?

SimmFor 80msec in 2 orMoreleads _py

M STdepression

a) Duke Score IfTue CAD

b) Child Pugh Score thenAngiography Angioplasty ORCABG

c) Jones Score usedincirrhosis

d) DeBakey Score

Q.11 A 60-year-old man with a history of ischemic heart disease is Discussion

brought to the emergency in an unconscious state. He has been

neglecting symptoms of dizziness and palpitations for the past few
days. His ECG is given below. The most possible diagnosis is:

him 15
0,1 250

a) Monomorphic VT

b) Polymorphic VT

c) Ventricular fibrillation

d) Torsades de pointes Dog MgSox


HR 601min BRADYCARDIA

I AtropineAdy
Pacemaker

Q12) Patient complains of palpitations. On examination irregularly 100mineTachycardia

irregular radial pulse is present and ECG shows absent P wave,

variable RR interval. Which of the following condition is likely ? qq.ggshock
cardio versionEDC

A) Atrial fibrillation Re ABCDAmiodarone 9060 drugs canbe

B) PSVT B If Bp y
used

CCB

C) Ventricular tachycardia But Fails
Digoxin

D) Ventricular fibrillation
gpyyy
3501min

TACHYCARDIA WIDEQRs43BIsV.T MM Dot Amiodarone Ifnitwaves

lignocaine

Ifpo Narrowars SVT PS'T cart'dioversion

HighlyIrregular
Jgustachy Adenosine

Dog Verapamic NopulseNoBP

II CCB
Q.13 A 56-year-old woman was brought to the emergency room after Discussion

she lost consciousness briefly during a speech. An ECG was taken FIB

immediately. What is the most likely diagnosis? I Immediate
V FIBE

desynchronized

Dcshock

missing It Tatline

mortitzblookTI
20AvBlock regulardrop Ii Fitbit s

fyi

11213,4 t.at ay

a) Mobitz type II block

mobitz t startCprAsap t
b) Mobitz type I block

No c) Complete Heart block aptthendrop
relation sometimesQrsmissin
d) 1st Degree AV block

n missingORS
Q.14 A 32-year-old man is brought to the casualty after he developed Discussion

sudden onset dyspnea, chest pain, and palpitations at a party. His

blood pressure is 100/62 mmHg. His ECG is shown below, What is

the drug of choice to treat his condition?

mmm unite 0min

SIT

pwaveonarrowarsregular union

Doc Adenosine

a) Procainamide

b) Adenosine

c) Verapamil
I

d) Propranolol

Q.15 A 40-year-old man presented with nausea, dizziness, and 14 Discussion

hyperventilation. His arterial blood gas analysis and serum 04

electrolyte levels revealed metabolic acidosis with a normal anion

gap. Which of the following is the possible reason for this

condition?
al Aniongap Nat 9 1103
k
t.it
penaltubular Acidosis

a) Lactic acidosismagma all other AddisonDse

b) Chronic renal failure magma are EMAHigh
AnionGAP

Acetazolamide

c) Renal tubular acidosisMAGMA Diarrhea

d) Methanol toxicity

4geneEthanolglycol
Etc
Q.16 A patient has just been diagnosed with migraine. Which of the Discussion

following drugs can you prescribe for prophylaxis?

Pound pulsatile

onedayrums

a) Sumatriptan
µ mild NSA UK

Doc Jjpgfan flighty

b) Ergotamine

c) Domperidone

d) propranolol Px B propranolol

d
Q.17 The gas analysis of a patient reveals a pH of 7.55, pC0254 mmHg, Discussion

and HC03- 40 mEq/L. What is the underlying disorder?

ACIDOSIS

metalle PH 735 E

PH 745
ALKALOSIS If Acidosis

a) Mixed acid-base disorder Alk Compensat

THC05 Metabolic Alk BothareAcidos

b) Metabolic alkalosis with compensatory respiratory acidosis

MetabolicAcidosis Ifmanacosis

c) Respiratory acidosis with compensatory metabolic alkalosisdeHoz

d) Respiratory alkalosis with compensatory metabolic acidosis pacoz RespAcid
mixes

1 Pacoz Resp Alk g n'compensated

Q.18 A 47 year hypertensive male doesn't show adequate blood Discussion

pressure control on lisinopril. Which of the following drug can be

added as step 2 therapy for the patient? At Ctd ggpggyyy.gg

554orDm

1stAcey addCCB drin 55yr CtaTD

GARB
a) Amlodipine
diuretics Mie
If 3drugsfailspironolactone

b) Valsartan

c) Labetalol
d) Thiazide
Isthprey pheochromocytoma

Q.19 Identify the structure shown by arrow in the histological diagram Discussion

shown below. This patient presented with rest tremor, rigidity

(stiffness), bradykinesia (slowing), and postural instability PARKINSONISM

t disease

LewyBody in Parkinson's

Madison

Dementia
Body

Alsoseenin Lewy Atrophy

Multisystem

Doc ROPINIROLE

I Carbidopa

OldPt's LDopat

a) Lewy bodies

b) Neuritic plaques ABetaAmyloid Abe

Docdone
c) Fibrillar nature of tangles Taoprotein pazil

d) None of the above

Q.20 A 47-year-old obese female comes to the office for the evaluation Discussion
of recent episodes of mood instability. Her mood varies between

sad and irritable. She denies any other symptoms, except for some

mild forgetfulness She tearfully shares that she is convinced that

she is going to die, as her father also developed similar symptoms

around the same age and died subsequently, also CAG repeats
are seen on chromosome 4. On physical examination, chorea

movements of the extremities are prominent . This patient's clinical

presentation is most consistent with ?

TETRABENAZINE

a) Alzheimer's disease

b) Pseudodementia Tx

c) Huntington's disease
d) Hypothyroidism
Agg

Q.21 What is the first-line agent for treating a patient with generalized Discussion

tonic-clonic seizures?

StatusEpilepticus

a) Phenytoin
stilpoor performance

b) Carbamazepine
c) Ethosuximide Thisniggling any
d) Valproate

Q.22 A 34-year-old man is brought to the emergency department with Discussion

violent shaking of arms and legs for the past 30 min. IV lorazepam
S 5min
STATUS

and phenytoin are administered to this patient. After 5 minutes, the GTC

seizures have not stopped. What is the next best step in the
1Epilepticus
phenytoin

management of this patient? givelorazepam

midazolam

t
a) Phenobarbitone

Barbitone
Pheno
fails

gtfo

O

b) ketamine

c) Propofol lastR
d) Thiamine infusion

Q.23 A 42-year-old man who presented with progressive weakness was Discussion
found to have a mix of upper and lower motor neuron findings on

examination. His father and his cousin had passed away in their ALS

40s due to similar symptoms. A mutation of the gene encoding t

which of the following enzymes is likely implicated here? Babinski

IQ sensory

ocular

a) Superoxide dismutase Sop motor limbs bulbar

b) NADPH oxidase
t

c) Myeloperoxidase
LE
E RILUZOO

d) Glutathione peroxidase RAV

EDA NE

Q.24 Which of the following is referred to as bulbar paralysis? Discussion

LMNTI0I12 Face Tongue pharynxmuscle

a) UMN palsy of cranial nerves 1 to 6 deviate

Tongue

b) LMN palsy of cranial nerves 1 to 6

sameside
c) UMN palsy of cranial nerves 9 to 12

Bulbar
Pseudo
d) LMN palsy of cranial nerves 9 to 12

TonguetopositeSide
Q.25 A patient presented with right sided hemiparesis that completely Discussion

resolved in 4-6 hours. What score will you use to determine the

risk of a future stroke in this patient?

FocalNeuraldeficit 224hours

Yee
foratrialfibrillation TrdusientIschemicAttack

a) CHADS2-VASc

b) CURB-65 pnetimom STROKE Antiplat

24ms
Re Thrombolysis

c) ABCD2
dataRate
ACCT Black Infarct

d) APACHE II
foricu
mortality
4 white Hmghaemorrhage

yepbyco

Q.26 Infarction of area of distribution of which of the following arteries is Discussion

most likely to be seen in a patient with hemiplegia?

Internalcapsule

a) Vertebral artery
b) Middle cerebral artery
IYTIATEbranches

CharcotArtery
c) Anterior spinal artery

d) Posterior cerebral artery

Q.27 A 45-year-old patient comes with complaints of progressive Discussion

weakness as the day progresses. He is found to have antibodies

against nicotinic acetylcholine receptors. Which is the most

common ocular finding in this disease?

MyastheniaGravis Eveningweaken

BILAsymmetricalptosis

Bulbarlimbweakness


iii
a) Diplopia

b) Lagophthalmos oldie Eun set

c) Exophthalmos EdrophominTest

d) Ptosis

Q.28 A patient is diagnosed with Brown— Sequard syndrome with a Discussion
lesion on the right side. Which of the following sensations on the

right side will be affected? on

Hemisectionofcord lossof au sarge

side

a) Pain PainLenalossopp
But
opp

b) Crude touch
opp
horner Brownseq feature

c) Proprioceptionsame
d) Temperature
If ataxia wdenberglateralmedullary

crudeoppOPP syndrome

PICA or VertebralA mic
Q.29 Which of the following conditions will you suspect in a patient who Discussion

has bladder dysfunction early in the progression of the disease?

Anesthesia
on

a) Cauda equina syndrome UIL SaddleAnesthesis Anisdisorder BowelBladderdysfunction Impoten

b) Conus medullaris syndrome
BIL Anus
c) Guillian-Barre syndrome

Ascendingparalysis
d) Amyotrophic lateral sclerosis

Q.30 All of the following are major criteria in the diagnosis of Acute Discussion
Rheumatic Fever, Except:

RevisedJONES CRITERIA

minor
a) Migratory Polyarthralgia

b) Subcutaneous Nodules

c) Chorea

d) Carditis

Q.31 Diabetic patient is brought with complaints of vomiting and
abdominal pain. On examination patient is found to have dehydration

assumed hyperventilation and hypotension is seen. Blood glucose - 320 to BP

mg/dL and Urine ketones are present. What is the next step in
Breathing

management of this patient ?
psis DKA

A) IV insulin drip

B) IV soda bicarbonate

C) Check blood ketone levels

D) IV fluids & insulin Insulin o lunit1kg h
regular

IS Add Kt Bicarb

Q.32 A 70-years-old retired military person with good previous medical Discussion

record complains of bi-temporal headache. He states that he gets
relief by giving pressure over bilateral temples. Diagnosis is:

NSAIDs

No other features R

a) Chronic tension headache B L Shortlasting
Tryptant02

b) cluster headache MSF cry redeye okPain R CCB
c) Migraine Px

d) Fibromyalgia

Q.33 In metabolic encephalopathy, EEG will most likely show: Discussion

closed

a) Alpha activity eye

sleep

b) Beta activity eye openIRem Activity

c) Gamma activity no Intensemental

d) Delta activity Slowestwave o 3Hz

alsoseen in deepNremsleep

Q34. Which of the following not used in NSTEMI ?

A) Clopidagrel MYNA
B) Heparin minateaserin

C) Aspirin

moving
D) Streptokinase

agopiagmgjgu.ggIimIme
aerateme type Nothrombolysis streptokinase

Q35. Diabetes mellitus, hyperglycemia, Necrolytic migratory

erythema is seen in

A) Insulinoma
B) Glucagonoma
HIDEFattiness 4insulin c peptide

C) Gastrinoma Pepticulcer Acidity crampsdiarrhea Zollinger Ellison

D) VIPoma

secret
Diarrhea
cramps
Q.36 Which of the following is diagnostic of acute hepatitis B infection? Discussion

antigen HbsAg Infection Interferoncame

antibody
HbeAg Infectivity
Replication anting
Igm
a) IgM anti-Hbc

Étforwin

b) IgG anti-Hbc
c) IgM anti-Hbe
IgG
InftChronic
e

ÉÉ
Iggy
Infection
d) anti-Hbs antibody Anti HBS Ag

Vaccinated AntiHBO
If PastInfection HB

If
Q.37 A nurse has been found to be seropositive for both HbsAg and Discussion

HbeAg. She is suffering from:

a) Acute infectious hepatitis B

0
b) Concurrent hepatitis B and hepatitis E infection
Prey
c) Chronic hepatitis B infection
Hep c

n antiHbc
AntiHBSAb

d) Past history of hepatitis infection

Igg
O

Q.38 An elderly female presented with blockade, nasal discharge, Discussion

diplopia and facial swelling. On examination, there is blackish
discharge from the nasal cavity with necrosis of nasal mucosa,
pyo

facial skin and palate. There is fixation of the right globe. There is
elevated blood sugar and urinary ketones are positive. Which of

the following would be the medication to be used in this patient?

Isis Mucormycosis

a) Amphotericin B FLUCYTOSINE

b) Itraconazole

c) Ketoconazole

d) Broad spectrum antibiotics

Q.39 A boy presented with a history of fever, headache and vomiting Discussion

since 3 days and disorientation since Ist day. On examination,

neck rigidity was positive. He also had 1 episode of generalized

tonic clonic seizures (GTC) and then he became unconscious.

CECT was found to be normal. CSF examination reveals a cell

count of 300 cells/mm3 (polymorphs: 50-70%), protein 70 mg/dL,

sugar 50 mg/dL (blood: 95 mg/dL). Which of the following is the

most likely diagnosis?

vancomycin

a) Pyogenic meningitis
Receftriaxone

b) Tubercular meningitis

c) Herpes encephalitis haemorrhagicmeningitis

d) Cerebral malaria
Trim

12Chloroquine
Quinine safe inpregest

artesunate ive
Q.40 Which of the following drugs is effective as a replacement for Discussion

sodium valproate in a female of childbearing age group for

treatment of juvenile monoclinic epilepsy?

Eeg EpileptFormSpikes mm

a) Levetiracetam
Re Valproate Doc addFolicacid MI

dontstop
b) Lincosamide

c) Carbamazepine 9
But If alreadyTaking 4kgday

d) Phenytoin
ToConciene give omgd
Foo
levetiracetam
notPregButWant

Q.41
If
An elderly, hypertensive patient presented with sudden onset
lamotrigine
Discussion

headache, vomiting, neck rigidity without focal neurological deficit.

Diagnosis: It NotStroke
Notmeningitis

BerryaneussymReclipping
ofAnenezm
a) Subarachnoid hemorrhage

b) Ischemic stroke

Bridgingveins
c) Subdural hemorrhage

d) Meningitis

fewest
Q.42 Addison's disease was first reported by Thomas Addison. It is still Discussion

being widely reported from various parts of the world. Which of the

following is the most common cause of Addisons's disease in

India?

a) Tuberculous adrenalitis

sheehan
b) Post-partum pituitary insufficiency
c) Autoimmune adrenalitis worldwide

d) HIV infection of adenals

Q.43 All of the following are indications for thrombolysis in a patient with Discussion
stroke except:

Alteplase

Reteplase

a) Age 18 years or more

b) Sustained BP >185/110 mm despite treatment

Bp 185

Edens 13

c) On CT scan, edema less than 1/3rd of middle cerebral artery territory

If wait
upto4 5hr
d) Acute ischemic stroke within 3 hours of onset

Q.44 A female patient has TSH elevated above normal and subnormal Discussion

free T4. What is the likely diagnosis?

Hypothyroidism 474
s

ReLevothyroxine Is

a) Primary hypothyroidism
TSH low secondaryHypothyroidism

b) Secondary hypothyroidism
IfTSHT
I eg pituitarylesion

c) Hyperthyroidism
itypothyrodism

d) Subclinical hypothyroidism

q Thyroditis
Mcc Hashimoto

Q.45 A 23 years old boy, a badminton player, sustained injury of left Discussion

ankle. He was immobilized for 3 months, the cast was removed

and patient was able to walk normally. Later he complained of pain

and swelling in the left calf, left ankle and foot. His mother

massaged him for 30 minutes. After a while he developed acute

onset of breathlessness and was brought to emergency and died.

Most likely cause of death is:

psis DVT

a) Pulmonary thromboembolism PulmonaryEmbolism

b) Congestive cardiac failure CrisIOC angiography d

DIMER
c) Massive stroke Goldstd pulmonary

d) Hypovolemic shock B morphine

02 laterwarfarin

Q.46 CURB-65 score includes all except:

man Discussion

a) Age > 65 years

b) Confusion and elevated blood urea nitrogen > 7 mmol/L 301min

c) Respiratory rate > 30/min 90160mmhg

d) Systolic BP < 100 mm Hg and Diastolic BP < 60 mmHg

o r homelopetx

Q.47 2 3 Admit
A 50 years old male presented with frontal bossing, enlarged nasal Discussion

bone, enlarged jaw and spade like fingers. Which of the following 4 5 Ico

Hand

test will you do for diagnosis?

a) IGF1

b) ACTH Cushing
Acromegaly

B octreotide
c) TSH
Thyroid lanreotide

d) Serum cortisol Cushing

Q48. Female washing clothes and her hands in cold water exhibit

color changes from white to red. Which of the following drugs is

best suited for this patient ?

A) ACEI
B) CCB Vasodilator

C) Thiazides

D) Alpha blockers

Q.49 Window period for thrombolysis in a stroke patient is: Discussion

a) 1.5 hours

b) 2.5 hours

c) 3.5 hours

d) 4.5 hours

Best3hrs

Q.50 A female patient was brought to the ER with altered sensorium. On Discussion

examination BP was 88/67mm with a pulse of 60/min. Rectal

temperature was 34 Celsius. There was associated history of

weight gain, increased sleep,constipation, dry skin and

menorrhagia. What is the diagnosis?

Hypothyroidism

online
a) Myxedema Coma
Doc 40THyr

b) Septic Shock Ab's LEITH

tagenaline
ROXINE

c) Hypothermia Osbornwaves

Cover
d) Cardiogenic Shock
Heath

Noradrenaline

atropine
vagalshock B
Vaso Discussion

0.5M Ilm

Anaphylactic R adrenaline
11000

If iv 1 10,000

Q.51 A 10-year-old boy complains of multiple episodes of acute severe Discussion

pain in his fingers and toes which resolves on its own for the past 1

year. On evaluation shown finding was observed in peripheral

smear. Which of the following conditions is he most likely suffering

Ine I SkullonHairEnd

from?
Dy Hydroxy area If Chipmunkfacies
I

Thalassemia

BT Ironchelators

II desperroxamine

Hereditary

Targeted Ift osmoticfragility
NESTROFT Spherocytosis

sicklecell

TyAntimalarial Hemolytic
Anemia

G
Gpp

a) Alpha-thalassemia.

b) Beta-thalassemia

c) Sickle cell anemia

d) Von Willebrand disease type 1

Discussion

Q.52 A 30-year-old male presents to the ER with the chief complaint of Discussion

headache. On examination, he is seen sweating and has

palpitations. Which of the following tests will you perform?

a) 24-hours Urine Metanephrine Levels

b) Serotonin Levels

c) Uric Acid levels In Blood

d) TSH Levels

Q.52 A 25-year-old patient presents with complaints of chronic diarrhea, Discussion

fatigue, and tiredness. General physical examination findings are

in the given image. On lab workup his Hb= 8gm%. Which of the

following is the best treatment approach for this case?

spogisongittt

I

IDA SrFront

to
ferettin

ATIBC
a) Iron supplements SIDEROBLASTIC

b) FA plus B12 injections

Opposite is

c) Metronidazole chronicdse IEretin

Annieof

mega
d) Doxycycline I TIBC
Anemia

Microcytic Hypochromia
Anomie IIA

looms asideroblastic ID Thalammi
3C s

IMMA
featureorAnemia
neurological
O supplements

omocysteine
Q.54
Pernicious
A 50-year-old male patient comes with complaints of fatigue and Discussion
Ileum

limb weakness, especially in the evening. His symptoms improved

lesion after administering edrophonium. What is the most probable

diagnosis?
deficiency
2

seBqEfyjiA

a) Lambert Eaton syndrome

b) Myasthenia gravis

c) Botulism

d) Amyotrophic lateral sclerosis

Q.55 Comment on the diagnosis of the Flow volume curve shown below: Discussion

a) COPD

b) Interstitial lung disease RID

c) Retrosternal Goiter

d) Tracheal stenosisJextrathoracic

Q.56 A 6-year-old child weighs 12 kg. The urine output of the child is Discussion

only 0.5ml/kg/hour for the last 12 hours and serum creatinine has

shown a doubling over the baseline. What is the stage of AKI by

KDIGO criteria?
Tcreatinine Urine

GERI

0.5116hr
1.5

a) 1
RISK 0.5412hr

b) 2
2x

c) 3
Injury y

d) 4 37 O3424hr

Failure 1st

Q.57 A child presents with short episodes of vacant stare several times Discussion
a day. The vacant episode begins abruptly and the child remains

unresponsive during the episode. There is no associated history of

aura or postictal confusion and the child is otherwise normal. The

likely diagnosis is:

Mlscontract relax

Loc

GTes

a) Grandmal seizures Ethosuximided

b) Absence seizures Doc

c) Complex partial seizures

d) Day dreaming

Q.58 A 32-Year-old female develops symptoms secondary to dry mouth Discussion

& dry eyes. She has enlarged salivary glands. Studies for

autoantibodies to Ro (SS-A) are positive salivary gland biopsy

reveals lymphocytic infiltration. Which of the following is the most

likely diagnosis?

a) Sarcoidosis

steroids

b) Primary Sjögren’s syndrome Re pilocarpine

Asen

c) Human immunodeficiency virus (HIV) infection

d) Lymphoma

Q.59 A 20-year-old man has a cough and history of bronchitis with thick Discussion
greenish sputum. There is no history of cigarette smoking. The

patient has also been treated for abdominal cramping and

malabsorption. What is the most likely diagnosis?

a) Silicosis

b) Eosinophilic pneumonia

c) Cystic fibrosis

d) Asbestosis

Q.60 IOC for patient presenting with shown clinical features: Discussion

Obesity I redpurplestride
Cortisol

Dsi CushingSx A

Cushingdse

If PACTHhigh

Ioc

a) dexamethasone suppression test

b) dexamethasone stimulation test
c) Plasma ACTH
d) Plasma CRH