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2009 DIAMS Medicine

Medicine Haematology 11. Which is most likely to be increased in Vit. K


1. Elevated serum ferritin, serum iron and deficiency
percent transferrin saturation are most a. P.T.T
consistent with the diagnosis of b. P.T
a. Iron deficiency anemia c. Platelet count
b. Anemia of chronic disease d. Fibrinogen time
c. Prophyria 12. Most common type of Hodgkin’s lymphoma
d. Megaloblastic anemia is
2. Most sensitive and specific test for a. Nodular sclerosis
diagnosis of iron deficiency is b. Lymphocyte predominance
a. Serum iron levels c. Mixed cellularity
b. Serum ferritin levels d. Lymphocyte depletion
c. Serum transferritin receptor 13. Most common type of hodgkin’s lymphoma
population in India is
d. Transferrin saturation a. Nodular sclerosis
3. All are true regarding anemia of chronic b. Lymphocyte predominance
a. Decreased serum Fe c. Mixed nodulatory
b. Decreased ferritin d. Lymphocyte depletion
c. Decreased total Fe binding 14. The classification proposed by the
capacity international Lymphoma study Group for
d. Increased bone marrow Fe non-Hodgkin’s lymphoma is know as
4. All are true for sickle cell anemia except a. Kiel classification
a. Pulmonary arterial hypertension b. Real classification
b. Fish vertebra c. WHO classification
c. Leukopenia d. Reppaport classification
d. Increased size of heart 15. Which is not seen in multiple myeloma
5. All are seen is Hemolytic anemia except a. Anemia
a. Hemosiderinuria b. Increased alkaline phosphatase
b. Reticulocytosis c. Hypercalcemia
c. Spherocytosis d. ↑ed ESR
d. Increased Haptoglobin 16. Maximum ESR is seen in
6. Splenectomy is most useful in a. CHE
a. Thrombocytopenia b. Polycythemia vera
b. Hereditary spherocytosis c. Multiple myeloma
c. H.S. purpura d. Sickle cell anemia
d. Sickle cell anemia 17. While handling a febrile neutropenic patient
7. Which of the following conditions is all are essential except
associated with Coomb’s positive a. Repeated hand washing of hospital
hemolytic aneima person
a. Thrombotic thrombocytopenic b. While cell infusion
anemia c. Prophylactic antibiotic
b. Progressive systemic sclerosis d. Colony stimulating factor for
c. Systemic lupus erythematosus macrophages
d. Polyarteritis nodosa Cardiovascular System
8. Cause of ITP is 18. All of the following heart sounds occur
a. Vasculitis shortly after S2except
b. Antibody to vascular epithelium a. Opening snap
c. Antibody to platelets b. Pericardial knock
d. Antibody to clotting factors c. Ejection click
9. Platelet transfusion is not indicated in d. Tumor plop
a. Dilutional Thrombocytopenia 19. ST elevation is seen in all of the following
b. Immunogenic Thrombocytopenia conditions except
c. Aplastic anemia a. Myocardial infarction
d. DIC b. Coronary artery spasm
10. All are true about hemophilia except c. Constrictive pericarditis
a. Increased bleeding time d. Ventricular aneurysm
b. Decreased factor VIII 20. All are ECG changes in hypokalemia, except
c. Decreased factor IX a. U wave
d. Increased partial thromboplastin b. ST segment sagging
time c. T – wave flattening or inversion
d. QT interval prolongation

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21. Radiofrequency ablation is done for b. Rheumatic fever


a. Ventricular tachycardia c. Thromobocytopenic purpura
b. PSVT d. None
c. WPW 33. The most common type of congenital heart
d. Atrial tachycaredia disease is
22. Drug of choice in PSVT is a. ASD
a. Aminodarone b. VSD
b. Lingnocaine c. TOF
c. Quinidine d. PDA
d. Adenosine 34. QT interval is shortened in
23. Kussmaul’s sign is NOT seen in a. Hypocalcemia
a. Restrictive cardiomyopathy b. Hypokalemia
b. Constrictive pericarditis c. Hypercalcemia
c. Cardiac tamponade d. Hyperkalcemia
d. RV infarct 35. Hypercalcemia in EGC is diagnosed by
24. True statement about cardiac myxoma is a. Increased QT interval
a. Commonest site is left atrium b. Decreased QT interval
b. Rarely reoccurs after excision c. Greatly increased PT interval
c. Distant metastasis are seen d. Tall “T” waves
d. More common in females 36. Pericardial effusion are best diagnosed by
25. In MI, which enzyme is raised in 4 to 6 hrs. a. Ultrasound
& decreases in 3 to 4 days b. Angiography
a. SGOT c. Gallium scan
b. LDH d. Fluoroscopy
c. CPK 37. Centrally acting antihypertensisve drugs are
d. SGPT A/E
26. Infective endocarditis is least likely to a. Alpha methldopa
occur in b. Clonidine
a. Atrial septal defect c. Guanabenz
b. Small ventricular septal defect d. Trimethophan
c. Mitral valve prolapse 38. Cannon wave in the JVP is seen in
d. Tetrology of Fallot’s a. Pulmonary stenosis
27. Most common heart valve involved in IV b. Junctional Rhythm
drug user is c. Tricuspid stenosis
a. Mitral valve d. Pulmonary regurgitation
b. Aortic valve 39. In ECG, Mobitz type 1 heart block is seen as
c. Pulmonary valve a. Progressie PR interval prolongation
d. Tricuspid valve b. Static PR interval prolongation
28. Osler’s nodes are seen at c. QRS prolongation
a. Heart d. P wave
b. Knee joint Respiratory System
c. Tip of Palm & Sole 40. Features of restrictive lung disease is
d. Anterior abdominal wall a. FEV1/ FVC decreases and
29. Loud first heart sound is heard in compliance decreases
a. Mitral stenosis b. FEV1/ FVC increases and compliance
b. MR decreases
c. MV prolapse c. FEV1/ FVC decreases and
d. Calcified mitral leaflet compliance increases
30. The most common organism causing d. FEV1/ FVC increases and compliance
infective endocarditis decreases
a. Streptococcus viridans 41. All of the following drugs useful in the
b. Streptococcus faecalis treatment of a patient with acute bronchial
c. Coxiella burnetti asthma except
d. Staphylococcus aureus a. Ipratropium
31. The normal axis of ECG in adult male is b. Salbutamol
a. –30 to +30 c. Montelukast
b. –30 to + 110 d. Hydrocortisone
c. –0 to +180 42. All are used in bronchial asthma except
d. –90 to +90 a. Salbutamol
32. Roth’s spot are seen in b. Morphine
a. Subacute bacterial endocarditis c. Aminophylline

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d. Steroid b. Kidney
43. Nosocomial pneumonia is most commonly c. Breast
caused by d. Stomach
a. Gram – ve bacilli 53. Which of the following disease coexist with
b. Gram + ve bacilli silicosis
c. Gram – ve cocci a. Sarcoidosis
d. Mycoplasma b. Tuberculosis
44. All the following are used in the treatment c. Lymphoma
of Pneumocystis carinii except d. Rheumatoid arthritis
a. Pentamidine 54. Cotton dust causes one of the following
b. Dapsone occupational lung disease
c. Cotrimoxazole a. Bagassosis
d. Fluoroquinolones b. Berylliosis
45. All are features of primary tuberculosis c. Silicosis
a. Pleural effusion d. Byssinosis
b. Consolidation 55. Which of the following is not a feature of
c. Pulmonary fibrosis Kartangener’s syndrome
d. Lymphadenopathy a. Bronchiectasis
46. True regarding presentation of primary b. Pancreatic insufficiency
a. B/L pleural effusion with negative c. Sinusitis
Tuberculin test d. Situs inversus
b. U/L hilar lymphaenopathy 56. Miliary motting of lung is seen in all except
c. Sustained chronic pyrexia a. Silicosis
d. B/L pleural effusion with positive b. Aspergillosis
tuberculin test c. Haemosiderosis
47. A man presents with fever, wt loss and d. Tuberculosis
cough; Mantous reads an induration of 17 57. Best position to reveal small effusions on
x 9 mm; Sputum cytology is negative for chest X- ray is
AFB. Most likely diagnosis is a. AP view
a. Pulm tuberculosis b. PA view
b. Fungal infection c. Lateral view
c. Viral infection d. Lateral decubitus view
d. Pneumonia 58. Stony dull note on percussion is
48. Tuberculous pleural effusion is characteristic of
characterized by all of the following a. Pleural effusion
features except effusion b. Consolidation
a. Harmorrhagic effusion c. Pleurisy
b. Pleural fluid LDH more than 60 % d. Tuberculosis cavity
that of serum LDH 59. Brochoalveolar lavage is beneficial in the
c. Increased deaminase evaluation of
d. Increased mesothelial cells a. Interstitial lung diseases
49. Most common cause of Mediastinitis is b. Acute bronchitis
a. Tracheal rupture c. Bronchopleural fistula
b. Esophageal rupture d. Pneumothorax
c. Drugs 60. Silent chest is seen in
d. Idiopathic a. Very severe asthma
50. Most common bronchogenic carcinoma is b. Chronic bronchitis
a. Small cell carcinoma c. Emphysema
b. Squamous cell carcinoma d. Bronchiectasis
c. Mixed cell carcinoma 61. Most common clinical sign of pulmonary
d. Adenocarcinoma embolism is
51. Commonest type of lung carcinoma in a. Tachypnoea
nonsmokers is b. Tachycardia
a. Squamous cell carcinoma c. Cyanosis
b. Adenocarcinoma d. Sweating
c. Alveolar cell carcinoma 62. Tension pneumothorax results in
d. Small cell carcinoma a. Alkalosis
52. A patient presents with secondaries to the b. Increased cardiac output
adrenals. The most common site of c. Decreased venus return
primary is d. Decreased output
a. Lung 63. Most common cause hypoxemia is

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a. Lowered insipired oxygen 73. Increased IgA deposits are seen in


b. Hypoventilation a. Henoch Schonlein Purpura
c. Intracardiac shunting b. Minimal change Glomemlonephritis
d. Ventilation perfusion mistmatch c. Chronic Pyelonephritis
64. Respiratory alkalosis occurs in d. Haemolytic uremic syndrome
a. Diabetic ketosis 74. Most common pathological feature in
b. Pyloric stenosis diabetes mellitus is
c. Primary aldosteronism a. Papillary necrosis
d. Excessive ventilation b. Diffuse glomerulosclerosing
Kidney and Urinary Tract c. Renal atherosclerosis
65. Most unlikely cause of acute tubular d. Chronic pyelonephritis
necrosis amongst the following is 75. Disease, does not recur in the kidney after
a. Severe – bacterial – infection renal transplant is
b. Massive burn a. Alport syndrome
c. Severe crush injury in the foot b. Amyloidosis
d. Rupture of aortic aneursym c. Good Pasteur;s syndrome
66. Renal papillary necrosis is almost always d. Diabetic nephropathy
associated with one of the following 76. All of the following statements are true
conditions about Hemolytic uremic syndrome except
a. Diabetes – mellitus a. Uraemia
b. Analgesic nephropathy b. Hypofibrinogenemia
c. Chronic pyelonephritis c. Thrombocytopenia
d. Post streptococcal GN d. Positive coomb’s test
67. Metabolic complication in CRF include all 77. Most common cause of reanl artery stenosis
of the following except in young adults in India is
a. Hyperkalemia a. Atherosclerosis
b. Hypophosphatemia b. Non specific aorto-aortisis
c. Hypocalcemia c. Fibro muscular dysplasia
d. Hypokalemia d. None of the above
68. Renal damage due to amphotericin B are 78. Medullary cystic disease of the kidney is
all, except best diagnosed by
a. Azotemia a. Ultrasound
b. Renal tubular acidosis b. Nuclear scan
c. Glomerulonephritis c. Urography
d. Hypokalemia d. Biopsy
69. All are true of Nephrotic syndrome, except 79. Adult polycystic kidney is inherited is
a. RBC casts in urine a. Autosomal-co-dominant
b. Hypo proteinemia b. Autosomal dominant
c. Oedema c. Autosomal recessive
d. Hyperlipidemia d. X-linked dominant
70. True about light microscopy in minimal 80. Charcteristic finding in AGN
change disease is a. Red cell cast
a. Loss of foot process seen b. Hematuria
b. Anti GBM Abs seen c. Proteinuria
c. IgA deposits seen d. Epithelial cells
d. No change seen 81. Hematuria, RBC, casts and proteinuria are
71. Crescent formation is characteristic of the suggestive of
following glomerular disease a. Nephritic syndrome
a. Minimal change disease b. Renal cell carcinoma
b. Rapidly progressive c. Acute nephritis
glomerulonephritis d. Chronic renal failure
c. Focal and segmental 82. In membranoproliferative
glomerulonephritis glomerulonephritis the charcteristic feature
d. Rapidly non progressive is
glomerulonephritis a. Thickening and splitting of
72. IgA nephropathy is seen in basement membrane
a. Membranous glomerulonephritis b. Nil lesion
b. Mesangioproliferative c. Mesangial cell proliferation
glomerulonephritis d. Fibrin cap
c. Focal glomerulonephritis 83. What is oliguria
d. Cresentic glomerulonephritis

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a. Excretion of less than 300 ml in 24 93. Adenocarcinoma of esophagus is commonly


hrs found in
b. Excretion of less than 500 ml in 24 a. Achlasia acardia
hrs b. Barret’s oesophagus
c. Excretion of less than 300 ml in 12 c. Plummer vinson syndrome
hrs d. Chronic smoking
d. Excretion of less than 100 ml in 24 94. Most common site for squamous cell ca.
hrs esophagus is
84. The term end-stage renal disease (ESRD) a. Upper third
is considered appropriate when GFR falls b. Middle third
to c. Lower third
a. 50% of normal d. Gastro – esophageal junction
b. 25% of normal 95. Commonest site of peptic ulcer is
c. 10-25% of normal a. Ist part of Duodenum
d. 5-10% of normal b. IInd part of duodenum
85. In chronic renal failure there is c. Distal 1/3 of stomach
a. Decrease anion gap d. Pylorus of the stomach
b. Normal anion gap 96. Diagnostic tests for H. Pylori include all of
c. Increased anion gap the following except
d. Metabolic alkalosis a. Urea – breath test
86. What percentage of cardiac output passes b. Rapid urease test
through the kidney normally c. Gastric biopsy & Warthin – starry
a. 1 % stain
b. 5 % d. SAFA test
c. 20 % 97. All are used in treatment of Helicobactor
d. 30 % pylori, except
87. Uremia occurs when total GFR is reduced a. Colloid bismuth
by b. Cisapride
a. 25 % c. Clarihromycin
b. 50 % d. Metronisazole
c. 60 % 98. In a case of hypertrophic pyloric stenosis,
d. 80 % the metabolic disturbance is
88. Mosaic pattern of cement line is a. Respiratory alkalosis
characteristically seen in b. Metabolic acidosis
a. Hyperparathyroid c. Metabolic alkalosis with pseudoxical
b. Paget’s disease of bone aciduria
c. Renal osteodystrophy d. Metabolic alkalosis with alkaline
d. Osteomalacia urine
89. Autosomal dominant is 99. All are complication of ileal resection except
a. Adult polycystic kidney a. Megaloblastic anaemia
b. Childhood polycystic disease b. Iron deficiency anaemia
c. Haemophilia A c. Gastric hypersecretion
d. Duchenne muscular dystrophy d. Malabsorption syndrome
90. Fanconi’s syndrome is caused due to 100. Massive bleeding per rectum in a 70 yr old
a. Gentamicin patient is due to
b. Degraded tetracyclines a. Diverticulosis
c. Chromosomal aberrations b. Carcinoma colon
d. Idiopathic c. Colitis
Gastrointestinal System d. Polyps
91. All are true regarding Plummer Vinson 101. In Peutz – Jeghers syndrome, polyps are
syndrome, except seen in
a. Oesophageal web a. Colon
b. Predisposes to malignancy b. Rectum
c. Koilonchia c. Small bowel
d. Common in elderly males d. Stomach
92. The following are predisposing factors for 102. All the following are causes of Acute
Eophageal carcinoma except Pancreatitis except
a. Plummer Vinson syndrome a. Gall stomes
b. Tylosis palmaris b. Alcohol
c. Chronic Achalasia c. Hemochromatosis
d. Benzene therapy d. Hypercalcemia

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103. Increased amylase may be seen in all of c. Intercourse


the following except d. IV injection
a. Pancreatic pseudocyst 114. Which hepatitis is most dangerous in
b. Appendicitis pregnancy
c. Perforated peptic ulcer a. Hepatitis A
d. Perforated peptic ulcer b. Hepatitis B
104. pH of the gastric acid is c. Hepatitis C
a. 1.5 to 2.0 d. Hepatitis E
b. 0.5 to 2.5 115. Most common type of hepatitis
c. 2.5 to 3.0 responsible for epidemics in India is
d. 3.0 to 3.5 a. Hepatitis A
105. Colchicine is used in all except b. Hepatitis B
a. Adrenal adenoma c. Hepatitis C
b. Amyloidosis d. Hepatitis E
c. Familial Mediterranean fever 116. Which of the following enzyme assay is
d. Cirrhosis of liver useful to diagnose alcoholism
106. Dumping syndrome is due to a. SGOT
a. Vagotomy b. SGPT
b. Small stomach c. Alkaline phosphatase
c. Hypertonic fluid contents in bowel d. Glutamyl aminotransferase
d. None of the above 117. In patients with cirrhosis of the liver the
107. In celiac sprue there is a deficiency of all site of obstruction in the portal system is in
except the
a. Vitamin A a. Hepatic vein
b. Vitamin B12 b. Post sinusoidal
c. Folic acid c. Extra hepatic portal vein
d. Iron d. Sinusoids
108. Serum amylase is raised in 118. What is the most common cause for Budd
a. Rubella chiari syndrome
b. Measles a. Right ventricular failure
c. Mumps b. PNH
d. Chickenpox c. Valve in hepatic veins
109. Pancreatic insufficiency is best d. Polycythemia vera
diagnosed by 119. Most common symptom of primary biliary
a. Abnormal Schilling test corrected cirrhosis is
by pancreatic enzyme a. Pruritis
administration b. Abdominal pain
b. Ba meal study c. Jaundice
c. Amylase levels d. Bleeding
d. Lipase levels 120. In patients with acute liver failure, the
Liver and Biliary Tract best prognostic indicator is
110. Increased B12 level is seen in all, except a. Serum albumin
a. Cirrhosis b. Serum alpha feto protein
b. Primary hepatocellular Ca c. Serum bilirubin
c. Hepatitis d. Factor V estimation
d. Cholestatic jaundice 121. All the following are features of Wilson’s
111. Which of the following hepatitis, viruses disease except
have significant perinatal transmission a. Increased copper content in liver
a. Hepatitis E virus b. Increased cerulolasmin
b. Hepatitis C virus c. Mental changes
c. Hepatitis B virus d. Features of chronic active hepatitis
d. Hepatitis A virus 122. All of the following are risk factors for
112. Non – parented hepatitis is Hepatocelular carcinoma except
a. Hepatitis E a. Hepatitis C infection
b. Hep B b. Alcoholism
c. Hep C c. Alfatoxins
d. Hep D d. Animal fat in diet
113. The most common route of spread in 123. Dane particle pertains to
hepatitis E is a. HAV
a. Blood transfusion b. HBV
b. Feco – oral c. HCV

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d. HDV 134. Excess Aldosterone is associated with all


124. Antigen which doest not appear in blood the following except
in hepatitis B a. Hypokalemia
a. HbcAg b. Hyperkalemia
b. HbeAg c. Sodium retention
c. HbsAg d. Hypertension
d. None of the above 135. Diabetes mellitus is associated with all of
125. The marker of hepatitis B in the window the following except
period is a. Encephalopathy
a. HbsAg b. Myopathy
b. Anti – HBs Ag c. Myelopathy
c. Anti – HBc d. Myelitis
d. HBs Ag e. Neuropathy
126. Incubation period of hepatitis B is 136. Glycosylated haemoglobin percentage
a. 6 weeks to 6 months which indicates good control of diabetes
b. 6 days to 6 weeks a. 8%
c. 6 months to 6 years b. 10%
d. More than 6 years c. 15%
127. Following is a cause of unconjugated d. 20%
hyperbilirubinaemia except 137. “Hour-glass” vertebrae and “tritiated
a. Large haematoma pelvis” are seen radiologically in
b. Haemolytic anemia a. Thyrotoxicosis
c. Megaloblastic anemia b. Myxoedema
d. Rotor’s syndrome c. Cretinism
128. The most common cause of d. Hyperparathyroidism
hepatocellular carcinoma in India 138. Sudden loss of vision in a patient with
a. Hepatitis A diabetic retinopathy is due to
b. Hepatitis B a. Cataract
c. Non A Non B hepatitis b. Glaucoma
d. Alcoholic cirrhosis c. Vitreous haemorrhage
129. Spider naevi can occur in d. Papilloedema
a. Rheumatoid arthritis 139. Hashimoto’s thyroiditis all are true except
b. Cirhossis of the liver a. Maximum incidence in children
c. Pregnancy b. Neutrophilic infiltration
d. All of the above c. Pain
Endocrinology d. None of the above
130. All of the following are features of MEN II 140. Diabetic coma is caused by
a, except a. Ketosis
a. Pituitary tumor b. Hyperglycaemia with hyperosmolar
b. Pheochromocytoma ketosis
c. Medullary ca thyroid c. Simple hyperglycaemia
d. Neuromas d. Hyperkalaemia
131. All of the following are clinical features 141. Most common site of carcinoid is
of Cushing’s syndrome except a. Ileum
a. Insulin resistance b. Liver
b. Menorrhagia c. Rectum
c. Violaceous striae d. Appendix
d. Centripetal obesity 142. Chvostek and Trousseau’s signs positive
132. Most common cause of adrenal and hyperreflexia indicate the deficiency of
insufficiency in India is a. Calcium
a. Autoimmune b. Magnesium
b. Surgery c. Potassium
c. Steroid withdrawal d. Sodium
d. Tuberculosis 143. Obesity lead to all except
133. Which is NOT a clinical feature of a. Decrease retardation
Addison’s disease b. Decrease GH
a. Hypoglycemia c. Decrease hyperglycaemia
b. Hyponatremia d. Decrease growth rate
c. Hypoclacemia 144. Best antithyroid durg to be used to
d. Hyperkalemia pregnancy is
a. Carbinmazole

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b. Metrimazole
c. Propylthiouracil
d. Radioactive I2
145. The chromosomal anomaly in
Klinefelter’s syndrome is
a. 47 XXY
b. 45 XO
c. 47 XXX
d. 47 XXXX
146. True in Klinefelter syndrome is
a. Short stature
b. Pituitary adenoma
c. Subnormal intellgence
d. Breast adenoma
147. Hot flush in menopause is due to
a. Low estrogen
b. LH surge
c. FSH
d. Genetic
148. Most common cause of ashermann’s
syndrome is
a. Trauma
b. CuT insertion
c. Curettage
d. Forceps application
149. Microalbuminuria refers to urinary
albumin excretion rate of
a. 30-300 mg/24 hour
b. 400-600 mg/24 hour
c. 700-900 mg/24 hour
d. >100 mg/24 hour
150. Short stature with widely spread nipples
and webbing of neck is seen in
a. Down’s syndrome
b. Turner’s syndrome
c. Klinetelter’s syndrome
d. Edward’s syndrome

Answer Key

1. C 17. B 33. C
2. B 18. C 34. C
3. B 19. C 35. B
4. C 20. D 36. A
5. D 21. C 37. D
6. B 22. D 38. B
7. C 23. C 39. A
8. C 24. A 40. D
9. B 25. C 41. C
10. A 26. A 42. B
11. B 27. D 43. A
12. A 28. C 44. D
13. A 29. A 45. A
14. B 30. A 46. B
15. B 31. B 47. A
16. C 32. A 48. D

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49. B 83. A 117. D


50. D 84. D 118. D
51. B 85. C 119. A
52. A 86. C 120. D
53. B 87. D 121. B
54. D 88. B 122. D
55. B 89. A 123. B
56. B 90. B 124. A
57. D 91. D 125. C
58. A 92. D 126. A
59. A 93. B 127. D
60. A 94. B 128. B
61. A 95. A 129. D
62. C 96. D 130. A
63. D 97. B 131. B
64. D 98. C 132. D
65. D 99. B 133. C
66. A 100. A 134. B
67. B 101. C 135. C, D
68. C 102. C 136. A
69. A 103. B 137. D
70. D 104. A 138. C
71. B 105. A 139. A
72. B 106. C 140. B
73. A 107. B 141. D
74. B 108. C 142. A
75. A 109. D 143. D
76. D 110. D 144. C
77. B 111. C 145. A
78. D 112. A 146. C
79. B 113. B 147. D
80. A 114. D 148. C
81. C 115. D 149. A
82. A 116. A 150. B

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