Final Year Past UHS MCQs By MED ZONE JUNE 19, 2020 MED ZONE [Company address-2012Nv. eudent presenta with. diabllng, recurrent. attacks of migtalienys i not used for prophylaxsis of migraine: 2) beta blockers @) Amiteptyling 3) Calckum channe blockers fe) Sumatigtan © Segum valerate ‘A23 years old university student presents with the fever and pain lower ‘abdomen for the last six weeks. The following is not a features of ulcerative 3) Postive meumatels factor 3) Bleed and mocus in stools © Coreinagencsis A 60 years old taxi defver pres ui Sores eran |A 50 years old gentioman presonts te the emergency with hacmatemesis, he is taking oral Corticosteroids for his arthritis. The following Is not Indicated in this emergency: a) Clotting profite "d) Upper Gl ensosceny 1D) Sucraitate 10) Barium sraiiow <) TV proton pump inhinters |A'54 years old man presents with » transudative ascites which ix not # feature of: 1) Congestive cardine fatore ‘¢) Abdominal tubercelosts health and growth retardation, She has been whlch dons wot have a knows association with liver biopsy are true except for: Ube stormed oar eral wnat $) iSite onea7 a8 a9 Q.20 eat az “e) Dengue virus has fou serotypes ‘proseras winh THC of 2100. Which of sheen tm nok & Hnewn 4 guenensensies do yours etd presents vin gonaatze Inge, Joy 9 (0°07 lett uopes sts ens nay a maatvclyeniorgec spleen, The folowing 905 ‘ocomen. 01 exten Beer ms lintel condition: vont malas a) Canonic yard Yeukumd 1) Typha fever 1) Pelycyememia rvora vere oe sears ond novan it gresente with cavers, gaara, waans Se Meng, = 158, yeas oi nas re tonowing tinang cannot be explain. ys ise Proce: Dy Raed teucecyte covet "B Rawed CY 8) ased fern levels fe) Messicbaa Macrecytous on penal smear ‘of fof eye an vents with fever, “ago. Which of the faliowing statements ‘an 18 years old student press ‘antibiotics for urethritis not true: 4) Ha should immediately De treated wih <6) Typical rash found in this condition ‘keratoderma blennorthagica 16) 158 form of reactive artes gured cry fetion lady presents with low grade fever, pain and sities otf eens ih i ree atte bah anes. The esta7 ‘eadclee's cis Nay on a futlon neck up is tound to hove ous of 74/nupepatae wah io edaa Sanestan men ses ere grata a tea deeetenne trey otter iy mavkcwreapaa erat ‘S venureutar septa detect, Steves, 3 2} Pulmonary Q28 plicated hypertension detectas on a routine insurance ‘xamination with's GP of 160/110. Which of the folowing agents nat fist tne agent fer hn %} upton receptor Wee Q.29 At the time of the discharge after » smesth recovery a 55 years old, normotensive pation. ‘recovering from an acute myscardia! infarction should im Foutine be nat prescribed the fewiny secondary prevention: 3) statine 4) Cael chanel ackers 3) soni S) ck store 2) Oat ones : 12 for the rapid atta Milton could be established in» 62 years 0 retired army officer 230 He ctc incrough investigations: The folowing spert i ot inccated for his concen, 2) Wartanm seam : Seem 1B} Preprenciet ) Antepatelets e) nevates 1.31 A555 yeors old gentleman presents with recurrent blackouts The following investigations may be 0 en 249m, on reps atthe both bases. The MOR ‘Gnrenic broncos €e) Pulmonary tubercles ‘cast Infections, He as » high eet seco ‘chvonta in cer “a Gowan reowsotlon 6) Pevrat hasana7 38 939 240 oat 24a Tao years oa nic AN CCLEQUFESHT siomine Vener imptintod te Gerangea liver functions. Go () Pyrazinamide (cause hapatitie: 3) Para Amino Salicylic Acid(PAS) S'Stanoien >) ine Enonbutt ‘ . samen in status etait, Te allowing oget nat neat fr Me rs old gentleman ese A 20 mars old 98 1 septal at 3) benzosaninne £) xygen therapy bronchial asthma dev nto be suffering {rom wn te eeatnlessness. Which of the following 1 severe right sided cote patient Kno Axe Yesia tech exacernotion of Brea’ aren or 6) Decreases chest mevements on the BesStamt broth sounds ern fern towe ) Absent lung markings onthe effected side 2) er cfmeciostium towards he effected 3) Sermea clubbing, breathlessness, productive cough and fever. ars old oplum addlet presents with clubbing, breathlessness, o 4,0 Saori sttement i not true Tor a hing abscess 4) Can couse massive moemoptyss pierce ert se Dros recaes oem Eek gyihy Reece aoe 56 years old heavy smoker presents ‘with his diagnosis of co ‘etzed JvP with prominent 8 waves 4) Tat R waves in leads Vi and V2 on ECG ) Left para-sternat heave 6) ater easeve Basal erepetations €) Loud pulmonary component of 2nd heart ic cough and breathlessness. This clinical sign is ure motor weakness is not a feature of: 2) Motor neurone disease 3) Mute seerosis ©) Fotomveltis Lead poisioning ebymiyostn. is horizontal nystagron an ‘A.22 years old secretary proscnts with suaon we. in hot water tub on a cold winter morning. jer mater ti "} Sooo Covntined dee Snslent nchmie attack D) Multiple sclerosis : cord ©) Syrmgemyelia (©) Cervical compressive myelopathy A 49 years old gentleman with long standing diabetes presents with the following symptoms. ‘Which of the them is not consistent with the diagnosis of autonomic neuropathy: 3) Male impotence 4) Diplopie ) Nocturnal diarrhoea ©) Gustatory sweating ©) Postural hypotension 4.15 years old girl complaining of vertigo is found to have clinically significant nystagmus, The following statement is nat true for nystagni 4), Vestibutae nystagmus i lateralzed 4) Ceorebaeltsr nystagnius 6 arereived towards the site of lesion towards the ean 1) Asymmetrical nystagmus Isa feature of ©) 15 commonty seen in miners ‘brain stem lesions ‘@) Vestibular nystagmus Is accompanied by ‘vertigo ‘An 8 years old student presonts with sudden sever headache follow ‘drowsiness. On examination he is comatosed with neck stiffness and slu {to light. The following should be undertaken Immediately except for: 2) CAT san brain 1) Opthaimoscopy (6) Echocardiogram to exclude cerebral ‘embolism ‘A 19 years old medical studer wi {conte hineas, "folowing ste in her 2) Nerve conduction studies wil be helpful in rmakng the diagnosis Folemstiss the mest ety dagnass 3 CSF examination ts generally norma! in the cary couse of the Sackse7 idencation mark except ‘lume oly. a | Which ts th 8) Blood ures St, !O¥SStIaatI0n to excuce early saben 2) setae Gera 3 MM cholesterol -e) Renal biopsy Bae Being evaluated for fever weight wae over wsiht lone an pranti: On examinatian tars uber consistancy Inthe ah epracovicla foes one yp noe Is enlarged tm below the centat margins, Chenery enews TB Weiphadenopaiy, Which of te fling you nade ete most 4) Wodakin's ance p Beal etaenta woaits imme Oe Infsieed (THF-« anobody) ©” Janie, He has been consuming acohal In excess ath tenderness in the upper aocomem snd serine nemrapenia ana turonbocyopenta: 0 Penrose = Raa tomameenelite sro IysainD Je9yez. rena si eof rng oes ax inhibitors ing inthe past He presente svn whieh is hot renpuina to “There i eyanesis of hanesan BE ie victor nate ah ea ot srs ieytic anemia "es eae carcinoma ©) Drug induced joundice 4) Slomoidoscopy ©) Ci scan abdomen Jo wl choose se fat. ti trstmant fr» paint orl 10 Presents with anxiety and com; ne 1) Cott canna Beckers 3 Varcoltr oye Age 20 years trom 9 remote ts and tenesmus. ‘She has tow of 47 tretable bowl syndrome ) Malasorption synorome ged 40 has been suffering from right sided hemicranial headaches for the Inet lice" "are always on the right she c: hand. Occesionally tere ore vlnual syonotamns ving possibilities is likely: 4) tnraeranial vaznular materi ©) Brain tumour jal gastrectomy for trestment of gastric ulcer ten yea NHB Is 8G/al, MCHC value is normal, MCV value is inerasred. hat “lusaino Jaayez{ha one teas fine of "9 conditions you i osu stig ne 1M mide ober Which ote fling sonia uit? a 3 costume © rene ae congas (rombocynpene Purpura © Vases purpura cos eae ee sens 3 Sec tia @) tr tenet, 3 eben © “prars with rles itil res he falning inversion = a OO red ep = her face, painful joint, fever ane postive ANA ang lyseinD JeeueZ 4) olvmyaiga maurice 1) Souty ariesPhysical slog oastointen 905 points out 4) Cpt mec ©) Ovorrone Contre de rite cod taste shaw btirstinntmg/ dt SIs Bositive, Which af the follwing aos 9 Stretomyen 9) Injection stain 8 comolec : rent id nl xu ©) Subercnnssggere i © Bran ances Pema pee ee ae reakod spat 4) iting wader of the eet ‘9 Ching of he frges Incidental ning of» pansystlle mirmi at ‘Out the most kly posisty: mc | yee Sa NG eee 3 As eematen © =e etre. wigbteed Pecsigpia t00/e0. On samiation tenes paaseatvecl | at ea issn @ wu _anovo, which ofthe following druge should be administered in 4) Thromtoss of Spero vena cava 1) Chronic ver asease IyseinD JeeyeZMED-113ANUAL , A> at, 3 Ee, | [S82 84s years old woman has a oman has pain in fingers of beth hands, artheal MAS Jen id woman fi arthralgia and fingers turn blue on set ‘alt She also complaing of dittculty of swallowing food. Which isthe ron Iikely : 0) Seer serosa ) Rheumatoid arthnts ; " see ®) Oesophageal turnour 42 This you eo fevoate ran, St 25 Years ge has cough fever and lft sided d chest pairi for one week. Stood Tiga POIs with 80% Neutroptils, X-ray chest a iven below. Which of following 12) Tubereulosus plural effusion ‘®) Poeumon ») Bronchiactasis 1) Carenome bronchus ) Pulmonary embolism Q.43 This 45 years old gentleman presented with chest pain for she hours radiating to the left orm What is the diagnosis with this £C6 below? a. noney walt develops faba ox ith a tang cls be Somerset Sg me 9 eamgas save been administered. Following this Ne gina er our arm veh concen oie Bi cecemonary hypertension Sytem hyerension Putmonaryreourgaten ©) Fate rere Sobbing tes recognizes tenture ft 8) Rheumatic fever” aes ©) Petarats cor 3 Net eae Wve endocarditis Tsao eeraetanomenen in above ear sockiereresented 8} Shore P.Rintervs! °F) rotnged Gr itera ER Interval with wide Rs eomplor reatesivelenutenng oP ena by 8 atop be beyond upper te 6) envi apex bet tu 28 hear uns 4) bral reguepaton ) Polyereme se 3 matic fever: jag it» known complaton of Rheum fe ee : 1) Eley fase re emp a 9 eran Cm seco chavo nh es sate 8 See eat ae na Qa Accentuateg mney secre FEE cong Be ee &) Progressive lengtnening of PR eval aw By Be Ae_- Zaheer Qureshi 28 fallowing anti Nestoomas e pete lt munpecte rama ecamle tac cra shld ae ince thn s Mabertur €rU8y con eng © Sst seme 1) Dir vwous snares By WEnevenens Sorat retenes FaZaheer Qureshi Mi 4 Esenoel ttn ete shank miguel» sma (b) i Gamat er in ebeenags — 3 aeestwe Sera egarement ay 9) 19 ani order tn ng vous —— 2 nod nays be invent deta Treated al ia rugs iste on racine abdominal werasounsOY CoeNicioes is eftective in preventies cf attacks 2\@- ® ©) Thlaide ciuretic isan ettective trea ALeKeumatoia arthritis: ©) Gout 9) Aplastic anemia Bini 9) Rheumatoid arthritis @. ©) Gonococcal arthritis e& lysainD JaayeZ 3} Boed cuttures ae mostly negative °) 'e8 Is common 1} Sytem scteroate &- : iTotal Marks: 45 Time Allowed: 01 hour a3 a4 as 26 Q7 Zaheer Qureshi MBBS FINAL PROFESSIONAL Medicine and Allied-1 (Multiple Choice Questions) |. Read the instructions on the MCQ Response Form carefully. Attempt all questions. Choose the Single Best Answer for each question, Mi. Question Paper to be returned along with MCQ Response Form Candidotes are strictly prohibited to give any identiNeation mark except oll No. & Signature in the specified columns only sustained several inj @ Road Traffic Accident, she 100/minute and fave inversions. Tramponade ) Myocardial Contuston b) Myocarditis ) Aortic Dissection in 75 mg dally, rel 7: 2 401 king Aspirin 75 mg dally, Clopidogr ee cot “frepetine) ») 6 months ©) 12 months _ ‘A 44 year old male has been ardiology us Murmur. Echocardiogram shows Mitral: Valve. Regurgitation reveals Enterococci, Which one ofthe followin 2) Progressively lengthening PR interval on ecG ) Mitral Regurgitation a presents with complaint of shortness of breathe which has started 5 monthe back and tx gradually worsening. Me Ieresves with oeettoe Se with Orthopnea. Pracordial examination aheus’ an ejection svete Ravan Recent ‘adiating to both carotids. What ifthe choke pf Procedure rie fee alee 9) sore valve fepor ms P ) Ouretcs B) Aare vale replacement 9) ACE bors ©) ort baton valley hype’ A.65 year old mate who is» diagnoséd case of Hypertension presents in Emergency Room with complaint of severe unbearable chest pain radiating straight to back. Pain fe not to mrewieation. On examination, is Pulse is 100/min, BP 190/6OmmMg on right and 110/60 mong on left arm, Precordial examination shows a normal first heart sound and s muffied secong Von e ‘sound, An early diastolic murmur is audible In aortic area. The diagnosis is a) Marfan syndrome 4) Takayasu's arteritis b) Myocardial infarction — ) Pulmonary Embolism, ) Aortic Dissection leadiig to Aone Incompetence A 45 year old female presents to the GI clinic complaining of epigastric pain for the last two months. She states that the pain is aggravated by eating food and it does not radiate to backs oho has no complaint of nausea and vomiting. Her symptoms do not improve by Antacids. She also has mitral valve prolapse. The patient states that she is allergic to Posiclling Which one of the following is the best course of action before doing 7 28) Prophylactic use of Ampicilin 4) Prophylactic ute of Ampiclin ang Gentamicin b) Prophylactic use of Amaxicilin ©) Propyaci se of Cdamyen +e) No propos requred ‘A 35 year old right handed male presented with Dysphasia, Acalculls, Dyslexia, Apraxia and }0sia. The most likely site of lesion is: ae igs ight frontal lobe a> Diarra ae ®) Left temporal lobe ) Left frontal lobees Zaheer Qureshi oom vin ation aes tegayrarn cent Sano nmin, bn nn Or ae iy responsible Yor as nearer 4) Cakcium channel lockers ©) Sebutame! sat noc tragpoan which iss whhd @ patter eat oer oat 1.0 yur od teat coma a ee nae ny chest ain. syncope, © palpitations. She is w ot Frngrenons to synones at Tat She eecien mstory i ign motery Tivereiocis ‘er-amaker ana nonionic, He bo wy reapiretary rate ‘Laymiin istension, bicterel ante ndenee Calcicatons. Which one ‘of the Tination id ender Mopars dings mont tka to be preven In this patient? Sites m per venous pune SG 3) Mypstension ageseon 6) Paneystale muemur a left lower sternal 2) water hammer pve and pasta set toa fovsres ©) Tapping apex beat and malar fush Platelets "$60,000/emm. Cold agglutination test ts microorganisms is most likely responsible for this, 4.51 year old male developed Adult ‘On the third ICU day, he is sedated, intul Pressure (PEEP) of 12 Emwater, and an 100 to 140/min; SO ilemaace eras 3 ea Rete ee estes eres eraser incuba spredpreeryied girl asliothd moc: nay Speocc? steel ont 3 Nesenare ine “complaint of moderate to severe burning central chest pain, ‘not radiate, It Is relieved by taking Antacids and is Of bitter taste. He states that he has lost 10 Ibs yy for the last 20 ible. Chest-X ray, next step in the 4) Esophagoscopy ) Esophageal pH monitoring 6) CT Colonogrem “D)e), Therapeutic trial of Ciproftoxacin ang “eMetronidazole for 4 months. she has noted progressive fatigue and ‘but no vomiting and denies changes in her bowel ly for Hypothyroidlam for which she is taking bic, ’she is mildly icteric, has spider angiomata on Zem below/the costal margin. The remainder of the Upper Quadrant Ultrasound confirms your suspicion of mn findings is expected to be present in t 4) Urinary Bence Jones proteins fe) Renal stones on Ultrasound abdomen admitted with deteriorating confusion and is mildly jaundiced, has temperature of 102°F, Is * FF tremor ef the outstretched hands. Abdominal Sapa/air rec 10,200/emm, Na A42mmol/I, K 4.2mmol/|, ures Taemg/dl. Ascitic tap reveals cell count of S50/emm, 4) Intravenous Ciprofloxacin e) Oral Neomycin, of yellowish discoloration of eyes in the month of it old similar problem last Ramadan which resolved "except for Jaundice. LFT's are as: Direct Bilirubin rig/al (raised), SGPT 34 1U/t. (Normal), SGOT 30 1U/L Malet Serology Negative, CBC and peripheral film are 4) Viral Hepatitis fe) CA Pancreas 13 episodes of haematemesis and meiena over Ia int ia receiving Aldactone 100m Per ee = Which one of Fy ysroacry gel theropy fe) TerlipressinZaheer Qureshi 14.23 year old boy presented with complaint of involuntary, Jerky, semipurposive moveme fhands and legs. Hs elder slater died of liver dlacase at age of 38 years, On €X3™ination, tone ie Increased In ii four limbs. Tnere Is no focal neurological defick. Which One ot the folowing ‘conditions is complication ofthis disease? €) berry Aneurysm 6) brematore Ateroscleross 40 year old female presents with complaint of high grade fever and pain in right quadrant of liver. On examination, he has an enlarged and tender liver. On Ultrasound abdomen, there is. Tver abscess in left lobe of liver. Which one of the following is the best treatment option for 64) Seriat monitoring of Liver Abscess with Litrasound ) Drainage, culture ond sensibvity ang ‘empirical Antibiotic therapy te tecwec eo ene et ae a magenta ye car naatgeact Sethgcn a ra Sera euecetoe od morte Fini cttens iano tne ven 4) one marrow transplant ‘and engorged retin: the following tests will lead to the diagnosis? ), Hematocrit 1))Periphera} fim 1), Acute Lymphob! e}yPotycytneria Ri easy ity and shortness of breath. He has got history of 3 months. Hemoglobin is 10.3 g/dl, MCV is 68 fL, serum Iron is '200 g/dL (250-370 9/ét}, and Transferrin saturation is ‘most likely explanation for his anemia? 9) Sideroblastic anemia ) Occult renal disease the following investigations; Hb 9mg/dL, MCV 68 11, {normal 17-300 meg/L) and serum Iron 26meg/dL (78- Hepatosplenomegaly. A sibling has similar illness. 9) Paroxysmal haemoglobinuria €) Autoimmune haemolytic anemia Cardiomyopathy. X-ray of the knee shows linear ‘by which one of the following? 1d) Rheumatoid factor ‘e) Anti-Nuclear Antibody (ANA) palate. There is no history of Hb 12.39/41, TLC 2200/cmm, ‘proteinuria and some casts. USG ‘test should be recommended to{ Q.42 A. 38 year old right handed drilling worker presents pub ae eas ae cman oe oe a a iste moa ily agonist a a. 8, Which one of the following vat THIN ne Mheumotold Arthritis we 1) Deduervali tenosynovits s} Guilencbarré syndeome = €) Amyotrophic Lateral Sclerosis Q.43 ASS year old man Is suffering from Ankylosing Spondylitis with involvement of wrists, elbows knee joints, Which one of the following drugs can be effective at this stage? ” hosphamide 0) Tumor Necrosis Factor alpha inhitttor Folic acid supplementation @) Higher dose Steroids in the range of 20 Cyclosporine mg of Prednisone per day Hing of small joints of hands, elbow accompanied by dysuria. There are imologist for redness of eyes. man presented with complaint of He complains of fever for last few a ‘on urine examination. He is consulting pithy the following Is an indication for systemic Sterolde? d) Anterior Uveitis fe) Arthritis Jd woman has pain in her fingers on exposure | food, What is the best diagnostic test? dl 4) GUN and Creatinine duction of symptoms and findings ¢) ct — of hands in cold water « ces) epPage Lof'& FINAL PROFESSIONAL MBBS EXAMINATION 2007 MEDICINE (PAPER ~ 1) MCOs MODEL PAPER Marks: 45 Time Allowed: hour Total No. of MCQs: 45 01. Ayoung female presents with dyspnoea, cough, productive of blood tinged frothy sputum. Cardiac auscultation reveals a loud S, and ‘rumbling mid diastolic murmur. Chest X-ray is likely to show: a, Left atrial enlargement. b. Left atrial and left ventricular enlargement, ¢. Boot shaped heart d. Prominent aortic knuckle. ¢. Pericardial effusion. Key: 02. Aninfant presents with patent ductus arteriosis what can be given to ‘stimulate duct closure: a. PGE. . Indomethacin . Aspirin, d, Oxygen. e, PGI, Key: b 03. Frusemide is started in a patient of cardiac failure. This drug can cause: 4. Hypokalaemia. bi Hyperkalaernia, . Dysiipidaemia. 4d, Hypocalceemia, e. Hypertension. Key: a (04, 49 years old mate suddenly develops atrial fibrillation. His pulse is likely to be: 4, Irregular in rate but regular in volume. b. Irregular in rate as well as irregular in vokime, ¢. Collapsing. d, Regularly irregular , Paradoxical. Key: b 05. AS6 years old female is admitted with history of central chest pain, heaviness radiating to the lower jaw and left shoulder. Her Trop-T test is positive. Her ECG is likely to show: ‘a, Elevation of P.R. segment. b. Concave upward ST elevation, ¢, Prominent u-waves. 4. P, Pulmonale, ©. Convex upward ST elevation. Key: 06, An elderly lady complains of light headedness and syncope. Her pulse is 40 bpm and neck veins show Cannon Waves. She is likely to have: ‘a, Severe hypothyroidism. b, Raised intracranial pressure. c. Complete (3° degree) heart block. 4, Pericardial effusion, . Tricuspid regurgitation, Key:07. os. 10. 11. 12, Page 2of 8 FINAL PROFESSIONAL MBBS EXAMINATION 2007 mi APER — I) MCI MODEL PAPER ‘4.60 year old man on long term treatment of cardiac failure develops ‘nausea, yorniting and yellow vision. He has bigeminis pulse. He has most likely developed: 2. Migraine. b. Digoxin toxicity. . Vestibular neuronitis. d, Excessive diuresis, @, Treatment failure, Key: b ‘Respiratory System A patient presents with worsening pneumonia associated with the production of large quantities of red-brown sputum. Chest X-ray ‘shows a cavity in the right upper lobe with a fluid level. The most likely infecting agent is: ‘a, Streptococcus pneumoneae, b. Klebsiella ¢. Legionella pneumophila dd. Haemophilus influenzae. e. Chlamydia pneumoneae. Key: b ‘The most common cause of pneumonia in AIDS a. Cytomegalovirus, b. M. tuberculosis. ‘c. Cryptococcus. 4, Pheumeytis carinil. fe. Pyogenic bacteria, Key: A worker in a coal mine has complains of shortness of breath and blue finger nails. His ventilatory function tests reveal an FVC (forced vital, ‘capacity) much lower than predicted normal for him and a within normal predicted FEV,/FVC. His pulmonary pathology is likely to be: ‘2, Restrictive lung disease. . Obstructive lung disease. ¢, Preumothorax. d, Alpha-antkrypsin deficiency. ‘e, Hepatopulmonary syndrome. Key! A patient has been started on antituberculous therapy. On follow up he ‘complains of passing orange-red urine. This is likely to be due to: a, Lack of fluid intake. b. Haematuria due to low platelet count. c. Rifempicin side effect. d, Ethambutol side effect, €¢. Factitious complaint. male presents with cough productive of copious ul smelling sputum and haemoptysis. Bronchiectasis is ‘suspected. The investigation of choice is: a. Xeray chest-PA. b, High resolution CT-scan, c. Bronchography. 4, Sputum examination. , Serum immunoglobulins, Key: b13. 14, 47, 18, aan Hey? FINAL PROFESSIONAL MBBS EXAMINATION 2007 MEDICINE (PAPER 1) MCQs_ MODEL PAPER A thirty year old villager presents with dyspnoea. Examination of chest reveals trachea shifted to the left, vocal resonance and fremitus decreased on the right, dullness to percussion on the right side along with absent breath sounds on the right. The likely cause is: ‘a, Left sided apical TB. , Massive lobar consolidation on the right side. . Left lung collapse. 4. Right pleural effusion. e, Right tensian pneumothorax, Key:d ‘60 year old gentleman has hemoptysis, copious production of foul ‘smelling sputum and clubbing. Most likely diagnosis is: a, Bronchiectasis b. Mitral stenosis. Pulmonary 7.8. d. Br. Asthma. , COPD, Keyra cus A patient presents with sudden onset of weakness of right upper timb ‘that completely recovers in 12 hours. This is a case of: a. Completed stroke. Stroke in evolution, ©. Minor stroke. 4. T.LA, (Transient tschaemic Attack) . Crossed hemiplegia. Key: d A.50 years old man presents with sudden onset of occipital headache with deteriorating conscious level. His BP is 210/110; he is afebrile ‘but has positive sign of meningeal irritation. His most likely diagnosis would be: a, Sub-Brachnoid haemorrhage. b. Sub-dural haematoma, . An attack of migraine. di, Brain tumor, . Transient ischaeme attack (T-1.A.) Key: ‘A 60 years old man presents with headaches, drowsiness and confusion. CT brain shows subdural hematoma, This is caused by: a, Damage to the artery following skull fracture. b. AV. malformation. . Berry-Aneurysm. d, Head injury causing rupture of a vein, ¢. Bleeding dathesis, Key:d A patient of epilepsy on long term treatment has developed gum hypertrophy, hypertrichosis, osteomalacia and folate deficiency. He is likely to be on one of the foliowing medications: ‘a, Phenobarbitone. b. Carbamazepine. . Phenytoin. 4. Lamotrigine. ¢. Gabapentin, Keyre20, 24, 22. 23. 24, Page tof 8 FINAL PROFESSIONAL MBBS EXAMINATION 2007 MEDICINE (PAPER - 1) MCOs- MODEL PAPER ‘An old man has small irregular pupils which do not constrict to light ‘stimulus but do constrict on convergence. He is likely to have: ‘a, Holmes-Adle pupils, b. Homer's syndrome. c. Occulomotor nerve palsy. . Argyll Robertson pupils. . Nystagmus. Key: ‘4.30 years old woman a fortnight after recovering from “flu” develops: paresis of lower limbs, Examination reveals power 2/6; tone decreased; reflexes absent and plantars non-responsive. CSF reveals normal pressure and cell count, normal glucose but moderately elevated CSF proteins. She has likely developed: a, Tetanus, b. T.B. spine, ¢, Guillain-Barre syndrome. d. Brown-sequard syndrome. @. Syringomyelia. Key: ‘AAS year old giel presents with jerky, non-repetitive, semipurposive ‘movements of her limbs, resulting in frequent falls. These movements disappear when she falls asleep. She is likely to be suffering from: a. chorea. », Early Parkinsonism. © Cerebellar tumor. 4. Meningitis . Encephalitis. keyia ar ‘30 year old lady with many months history of dysphagia begins to develop recurrent pneumonias. Ba-swallow shows a massively dilated with a smooth pencil tip tapering at the lower end. The Barlum fais to enter the stomach in appreciable quantity. She is likely saheres a, Achalasia of cardia. b. Esophageal malignancy of lower end, ¢. Plummer-Vinson syndrome. 4d, Pharyngeal pouch. ‘e. Esophageal varices (Massive) Key: Which of the following is the most important risk factor for colorectal carcinoma: ‘a, Family history. b. Nitrosamines. . Low fiber diet. d. High fiber diet. , Smoking, Key: A previously fit and well 14 weeks primigravida in one of her bouts of ‘severe vomiting and wretchng vomits out about 30cc of bright red blood. She is most likely to have developed: a. Bleeding disorder. b, Mallory-Welss tear. ¢, Carcinoma stomach d, Gastric ulcer. ¢, Duodenal ulcer. Key: b27. 28. 30. Page Sof 8 i (PAPER — 1) MC MODEL PAPER Tong run he is at risk of developing: ‘a, Myocardial infarction, b. Mallory-Weiss tear. ¢, Pharyngeal pouch. 4d. Barrett's esophagus. ‘@. Squamous cell carcinoma, Keyrd A patient with diarrhoea with blood is diagnosed to have ulcerative colitis. He is at risk of developing: a, Perianal abscess, b. Ischiorectal abscess. ¢. Toxic megacolon. d. Fistula in ano, , Anorectal fistula. Key: ¢ ‘A 14 years old boy with persistent diarrhoea and iron deficiency has villous atrophy on distal duodenal biopsies and has a positive anti- transglutaminare antibodies. His diagnosis is: a, Tropical sprue. b. Crohn's disease, Abdominal T.B. 4, Blind loop syndrome. €, Coeliac disease key: In a case of obstructive jaundice if the gall bladder is palpably ‘enlarged it is unlikely to be case of: 2. Carcinoma of gall bladder. , Carcinoma of head of pancreas. ¢. Cholanglocarcinoma. d, Stones in the common bile duct. , Ascaris obstructing the common bile duct, Key:d Liver, Gall Bladder, Pancreas After a full three doses course of hepatitis B vaccine which one of the following blood tests indicate successful uptake of the vaccine: HBsAg. Anti-HBe 19M Ant HBsAg. Ant-HBe 19. Anti-HBe, Keyre Hepatitis A is the most common type of viral hepatitis in this part of the world. Which of the following measures can help prevent hepatitis A ‘2. Screening of all blood donors. . Avoid getting a shave from barbers: ¢. Always using a disposable syringe. 4. Avoid meat intake. €. Prevention of fecal contamination of food and water. Key:aa. 32, 33. 34, 35. 36. Paye 6 of 8 FINAL PROFESSIONAL MBBS EXAMINATION 2007 MEDICINE (PAPER — MODEL PAPER A.45 years old female presents with pruritis and jaundice. She has Xanthelasmas bilaterally. Bili 16 mg/dl, ALT 145 IU, AST 110 1.U, Alkaline phosphatase 1116 I.U. Antimitochondrial antibodies are b, Carcinoma head of pancrease. c. Heamochromatosis. 4. Primary biliary cirrhosis, A patient presents with severe epigastric pain, nausea and vomiting, there is upper abdominal tenderness. Serum amylase is 1025 1.U. This condition has one of the following risk factors: 2, Gall stones, b. Hypacalcaemia. Colonic diverticulae. d. Hyperthyroidism. @, Diabetes mellitus. Key:a A patient with known cirrhosis presents with haemetemesis. After initial resuscitation which one of the following drugs will be most useful: a. Inj. vit . Inj, terfipressin. . Inj. omeprazole. 4. Inj. metronidazole, What is the most probable diagnosis of an aparently normal school boy ‘oF 12 years who has the following lab results: Hb 14. gMm/4l Bil 2-8 ‘m9/dl, conjugated 1.4 mg/l; Act 26 1.0 (N=less than 40), AST 32 (N=less than 40); Alk. phosphatase 270 (N=less than 275) ‘Chronic Repatis b. Excessive hemolysis. ©. Gibert’s syndrome. 4. Huemochromatosts. , Gaucher's disease, keyre Bale looking female has the following iab results: hypochromic; Target cells present; Serum or-nonmal, Serum TIBC normal: What fe the most key diagnosis: a, Folate deficiency anaemia, b. Chronic alcoholism. c. Aplastic anaemia. dd, Thallasaemia minor. fe, Anaemia secondary to hemolysis. Key: ‘A 25 years old patient presents with fatigue and pallor. She is found to have iron deficiency anaemia. Iron therapy is started. The patient's response can be monitored by: @, Serum iron, b.. Serum ferntin, , TIBC, d, Serum transferrin. fe. Reticulocyte count and Hb,37. 39, a. 42. Page 7of 8 FINAL PROFESSIONAL MBBS EXAMINATION 2007 MEDICINE (PAPER ~ 1) MCQs MODEL PAPER A young male presents with anaemia, bleeding and infection. Blood ‘count shows pancytopaenia. The most valuable diagnostic investigation in this case i ‘8, Complete blood count. b. Bone-marrow examination. ‘¢. Coagulation screen. d, Plasma LDH. @. CT-chest & abdomen, Key: b 55 years old man with thirty five years history of Addisonian Pernicious Anaemia being treated with parenteral Vit B,. develops rapid weight loss, anorexia and malaena. There is a high degree of suspicion that he may have developed: 4, Gastric carcinoma. b. Gastric ulcer. ¢. Duodenal ulcer. 4, Esophageal varices. ‘e, Phummer-Vinson syndrome. Keyra A middle aged lady is on long standing methotrexate for Rheumatoid Arthritis, She is likely to develop: a. Vit By, deficiency. b. Iron deficiency. ¢. Folate deficiency. d. Calcium deficiency. ©. Vit D deficiency. Key: ¢ ‘Rheumatology A.40 years old male presents with painful, swollen, big toe. Serum uric ‘acid is raised. Synovial fluid examination is likely to reveal: ‘a, Many neutrophils and gram negative bacill b. Many neutrophils and gram positive bacill. . Positively birefringent crystals d, Needle like crystals which are negatively birefringent. @, Normal synovial fluid. Key: A young male presents with fever, dysurea, conjunctivitis and arthritis involving lower limbs. There is history of attack of dysentery 2 weeks before. His diagnosis is likely to be: a, Septic arthritis. b, Felty's syndrome. c. Gonococtal arthritis. 4d. Reiter's syndrome. fe. Behcet's syndrome. Key: ‘A 60 years old woman presents with the symptoms of dry eyes and dry ‘mouth. She has arthritis as well. Which one of the following arthritis: ‘she is likely to be suffering from: a, Rheumatoid arthetis, b. Gonococcal arthritis. c. Gouty arthritis d, Osteoarthritis. €, Pseudo gout. Key:a43. 4s. Which one of the following tests is most specific for SLE: a. ANA. . Ant-dsoNA. c. Anti-Ro, di, Anti-La ‘e. Anticardiolipin antibodies. Key: b ‘A 60 years old female patient presents with severe headache and scalp tenderness, She also has fever, fatigue and weight loss. Examination reveals thickened and tender temporal arteries. In this patient: ‘a, NSAIDs are the treatment of choice. b, Corticosteroids may be used. ¢. Corticosteroids are obligatory and should be started immediately. d. Only symptomatic treatment is required. . Immunosuppressive agents should be started. Keyre In which of the following is an increased risk of a atianto-axial dislocation with spinal cord injury: ‘a, Ankylosing Spondylitis i. Psonatic Arthropathy. ©. Gout. dd, Subdural haematoma with raised Intracranial pressure. fe. Rheumatoid arthritis,b fh Vor TP POYnH s FB alla) 32% lM 11349 am Parade tll an 2 3 October, 6337 pm ‘rushing chest pain forthe fret Une. He b transferred lego primary parcata ‘rosteriet coronary artery. Angioplasty one Incy enamges to have Occurred om ECU durlag rostoat ys Pf Sowsornieacewes 1) ST elevation in ends VI-VS- V6 ressan ess and ave 3) Marae oid female having progressive shortness of breath for the last 6 years presents with scute aytonee ond palpitation. On echecardlagrapny the ie having: mnral slenesia: Surges! vention Is decided. Which one ofthe following s the mcicstion for 1) Lam strum fee tombe SED Red and exo 3 Normale ‘8 Sntzanesymetome 3) Pamonarystenou 3 i. Ose Dressure 155/ 5mnitg. The most SF yocaraad tarcion Capewedecon er gf comeaien oon ae he be eg tome Gh reamatenes Et ieee s Community scquired preumonia? ey 6 tienen gree Sees lam would typically be found In» patient with eae a eat eal ree th wneud coh In Lverin nd wai at On x etione dtagrosisct waerculcsst * Sputum tor AFD Rifts are tor myecbacenumavereonn 8 ESR Steve 109 GeneleetnH @ B alla) 32% 11:49 am Parade tll w A @10 830 year og sien mi Year old tomate presents with pain and “ ts stone Sgver Sed tethargy tr tnt 3 marth There hered neduins itn. mer ray chest lateral hilar tymphadanopathy but hong parchchyea'l siseal nar renal functions are ‘normal. what a the preferree Tat nether py thie patient? rane “Rinrcprine NSAIDS and rensurance 1) tence tumor necro actor nennbtor +8) Comeonterag ‘A.24 year ots boy presents with sudden shortness of breath and chest pain, Wit X-ray chest show! leh sided prevmetnaras, There It me history of such preblem br'the paw Surgical reuredesis e tecommanded Cav Fomong one Ta aeack wo ponents co he f= oF @ Fotiomeng 2 fst stack of prewnothoran ‘rat pense meh uecondary 1 Itret recommended in peemary ©) Inint pataents mtn preumethoras Peeumostoras aby 2 days ogo developed sudden drapnes and chest wschypnete: er ie was 110/min and her chest wes cleat- se mont Common fing in this patient? 1) Mgnt bundte branch tock #) Len buna Branca Hock jeroida. Cardiologia! Investigations are normal. Sich athe ftowing nine monttmay Gagrona? 2°") 2) tang roe cy Len veocwar tone 44 A43 year old woman with unexpected weightloss, loss of agpetite and shortness of breath O44 recone ta you i ci. On deamon thet reduced Bi antfV ved sslanes to nin {height long. A pleural tap le performed and the aspirate bamples sent for analysis: You are tong that the resus feveat # protein content af >309/L- Prom the est betow, select the most Westy Gy Sencrogene arename 2) Congestive arse fare 2) negheote syndrome 2 Rig syecrome © Occ cemess 1S 4 30 year ol¢ woman Is reterted by GP for upper GI endoscopy following 4 months history of enric pain despite the treatment with antacids and proton pump iahnitors, Her endencory Semonsirafed » daccenal ulcer couple witha pasts halcebactas lhe erpentams Sine wee ive two week course of arige to eradicate the hellcotacter prior New "you wi wessee the Sroatotion ot helconacter pyar bys non inven method Vtrhenecoscee etedy tet 1) Rapid urease test al aig tex 1) Merebaogiatcotere of gest opiate tology ef gare mucosa - 216 A midcie aged person ts ncmited with nawsen, vomiting 8nd upper abdominal distension for last {,montha iis vomiting ie f tage quontiies-and containe toed Tngested 34 hous ge: Hte te hevieg metabolic alkalis mith acide urine: What isthe mont Uhly dtopmoste 2) aes goatee @) Rated Warectora! pressure Bi hoa pepe disease 5) hdnons osese Ca fonire oase cescen (047 A.14 year old boy presenta with loose motions and weightloss for inet many years. Kis darrhaa improves with avoldsnce of whta( proSocls He ip SOBROSEY hon cane of Coslne deans. WOM ghee the fttwing features i nok Conslatent with hie flepresis? = Boer etc Tmostred gucose tolerance eve 2 Bea ) High Sindness ADE anH e® s FB alla) 32% lM 11349 am < ia didianalie an 2 Seen test wrt ath ne et = tnd narrowed slong with normal areas in between. What te tne most Huety cinanesis? ST" Uceratve cot "a covane suense Rusercuoss of tdomen ) frmepies encase fe} ers onan 2:19 All of the folowing facts are true regarding wcerstive cole EXCEPT &) Inearatey ewatves te reco are 1) Sevencs erenenaty mn socemwoun insane area canine id women presents with © 24 hour histary of matare digrrhes. She how opened ber (ents after tearing ‘ote seve repinorent and the rest efter Family has ha slenar Rdreston ot waren Rat serraratcn| G21 Which of the folowing combinations fs not seen in a cage malabworption? 2) venmin A cencheey spe ener Ta etamin setesency -« usie wasting 8) Wien #1 aetuieney s rwersn wna & getcnney = beng + 6) Maamin © detonney becaeg phe 224.20 year old boy presents mith fever, vomiting lows of appetite and right woper quadrant pain. 072 Ga exuminnion haf Joondicad wih palpable en ee Ps ALY ana AST are raues fee tees line upper hen of mermat. Win sikalime phonphalacs talon milly increseed. Wi ‘mont ‘ly disgnon a Wate nevates 1) Obstructive sevice Pyare ver abscess 18 Prenary bay cross Neti. angers 1.23 Following are the complications of portal hypertension EXCEPT: 2) vancea teeing 2} Preonged PL yra tw 2) troersptemam epate we cathy €) fron eaheeney anemia 2.24 4.40 year oid woman presents with frtigue and pruttys forthe last many years. There Ie mild Coper'noht quadrant dacomfort but ne fever She sso complains of bone pins, On examination ‘the be mip jaundiced wth muldly enlarged tender ver, Wer ALY te SOU/L sed AST ASU/L and naling phoaphetate le GOOU/L- What the most Whaly ? ‘Ghrone brass (3) Prmary baary cxvronn 3) menos anaemia ‘) Centracve noice €) Prmary scour helangts eas 4.26 year oi tenata in bar 34 SSK of pevaton prevaoe with hypertesion, pretel ont ‘uid Trenton Wor sino tats show'&bbin Sogs/ec ALY 400 UPL ahaline phsapmetnns 0 1U/L, tow Hs fragmented RACa and raised D dimers WRETTE the moot inet Cots fettthayncrone ‘d neae crtesigns ef pregnancy Yeats tty bre of prerancy #) hate benaoee M1 2017 Annual Mcqs paper... not available anywhere.nne® om 2 Eye Beecier ty Dr Hafiz Bilal a” Ae tony None funn Eroents teeteg wer ond cometeinng of nenarntmainice We wenn Fist maint Satery Boek Setpnpea weer mci tls Whe te owing chien on Ses Po Frm pa cee +1) Tow cutee imei °) Per ery Nnosce €) Soe rene 28 4.60 year ot ght heed male omapnd and brag ecergemcy a I wan ch on Trewin respon. went be the first investigation in thie patient? aoe CE bran oan ce 10) Ragrene resonance orgogrtehy ©) Complete boos count and ESR 2040 year old mate ponents with esha of et Dal Mia vibration, ouch aia 9 Dropeloceptive sensations #8 ban woe pein alscrvminainon, stereounen Bend ‘riers *) Somat crs 30 the diene ln mug sseronie EXCEPT fees —————— scat ace 7 3 Nisan eat edhnnts with epee Nendache, nach atetanns Kern sg AZETIM lar poncioe wee sone ard CHF report shows protsinn 7Omge/ Total ucocyte Poms 108 cobs with Te trmpborriet, Which b tha mont Hehy agnosie? 3) Coreen mans rebercaioes meng 3} Progen mennaton ‘enceghate, 2) Wear meng 1h 20 year od mate prevents with vovts onect cf headache, fever, wesanens of em log end (032 A Jace His CY pean wat done which shows low ‘lesions in the temporal lobe, What t= the 2 fe © Poko ' Herpes umplen PICEDARI -e) Subacute scleroung panencepnairs: on arm enema 0.23 4.66 year old woman complaing of suttness and weakness ci! Tension und dat comtroieg type 2 diabetes, OF x47 Serkness hip Rao a 4-75 bilateral Tinigin auadecaps, Knee extenaiom 47. Dorsilenion and plant Nave and ene reionee ace litte, bs well 9» ponitire Nofiman's Summation tnd crenlal nerves are.normal. Her pulea ts regul Tre7@?, What the most Mnely Bagnenin? 2) Mrasivone oon, 1D) Goabeoe neraty ©) Moms @.34 A patient in your ward Is élagnosed with hepatocellular carcinoma. You are ashed to perform 8 tomer marnur level an this patient, Which Of the Tollowing tumor markers are elevated In ocelalar carcinoma? CG) ster neuron snease wasuple Scrat (MS) aye tapeten, res Caronmemoryens aren (CEA) @) Cans ais 235 4.40 year old female presents with fflgut, wesidne and drapAea. On examination whee ‘marty pate ity peice-aaysin wed BO-ASG7ES. har investigations. show HD 70/d TLE ‘7003 fers MCW be SOM. Wor trenatarin saturetion te Aue and serum ferritin fy 28g/t. What It tha most Maly cause of har anemia, ad ——= eee Siecle OSes. == ‘owas ot ehvone CeaseRr mea Ber 49440 yur cnt mata pron wth nn seston nat ne urn nary ed elt gn dren en san St eat fe who Falowing finding bs not in consistence with diagnosis of chronic myeiokd ieunern) arenas Bee a tet a 3 coer Reenter sores and 037 pregnant woman presented with blood report showing, WO. g/dl, MEV S30 me Tne we ested san tous vee and cobotomin, Hr Ho nranved to 10 9/64 dering fremont of tharapy but ten h sapped effort her tea Perio Imcrocyic and mncrocytic ete Now ou wl proved Sy nce ne core tenons 4) caremue te treatment 2 ch } Ines te cow of tare § Sree sscnes hrpcenemie 73 Ge ssonone con ewer < i 1.28 “43 year oft woman etter from Cros Zameen A bond tee shows the folawing rent Memagiabin 1039/4 neviven Matte eon 290¢10%/6 ost hay ingneais me Wrenecronsey 1 type 0.39 For the siagnosia for matipie mysioma, which of the following t nat required 1) tneresseg matgnard sme cs he ein he ews ‘one marrow iypeesicara and hyposibuminersa 1) Para proton eetrosherests = ©) Unnary prota eectropneresn @40 4.20 year old mate presente with rapid onset pain Invalving the first matatarsephalanges! foint ‘Sitn Sosucloted setting and tencermess. Pain reached to ia maximal saverity e few Rowre. MO ; 4) Fete nid eetcency Inerna of rere onense ct eter Jones What Inthe first Kee of treatment in thin patient? Gera nnion 1) Protenecid 4 ©) Sutmprrarone () Feturostat QAL In which of the following conditions symmetrical polyarthrils._resembling RA (Rheumatoid ‘Arva) can occur By Aneyesny somncvits 4 2) Ontos Rronaoe ores 1) Reactive ats 3) Cntnesopae artes G42 In patients with limited cutaneous system sclerosis which of the folowing antibodies la most fans topoomerae { aetoses ©) Are Sm arias 2 1 al Lo onttoder ph Dei maeRomere ameces 43 4 60 year old mate presents with headache In richt temporat and eciptal region with scatp endemness. He ‘ise hee pein in Jow during chewing and talking. There ws aia reduces colosr perception: what te he wftering Has? a aia Sy Tatoyses See 9) Custer heasache fBycoant ces erent ©) Petrmratgle meumence que ae bs ‘she comer ta seek advice ancy. Which ofthe tatlowing trope ie nae its Perensss with central sterred to 4 AS0,year old man presents with central crushing chest pain forthe fist time. He fe rans ine closest carne nif underg » primary geretza fo he rt Une: Hee traneerred to ry. Angioplasty and stemting carried. what are the most ity changes to have occurred on EC on x Old atlent wha is hypertensive for the last 8 year pr gressive shortness rdystunction, wn, anktkular bypertrophy ond’ on eschsearaneoteere re eines asl dysfunction. Which of the toliowlng ree iy goes tes 37d dizziness in the emergency, his ECG is done la (lorsade de pointes), Which one of the ©) Hypermognesemva ‘4 2 year old female having progressive shortness of breath forthe ast intervention ts decinea mation OM echocardiography she: le having. ital wtencele Sergiy 2) Lem avn hes ane nan One OF he totoming lathe nacation for mitral rave sepascennents om tree of wombs A) Rig aod eaiched valve mitra regurgtason ©) Signtican symptoms SL recurrent infections, now presents with shortness of bhp S a} Piery puloary neato ASO Pe mer ‘60 year old man presents to accident and Ehest pain. The patient describes the palm a's Sheng, chest and radiating straight through to his back between’ Tooks in Pressure 155/oSeneien arc neatt fate fe 95, respesiory rate is 20; emperatane Shee eet oks Bressure 155/95mmMg. The most likely diagnosis i ) Myocardial itarcion @) Pulmonary embstism B). Myocardial chemo ©) Preumons 4) Jere dissection rea for the previous 3-4 months. She had apparentiy Secneen Year earlier. On ECG there is low voRage, especially im tre tore is Pericardial calcification. The presumptive clagnosis le somresn Aeliowing physical signs would be consistent with this? Increased jugular datention on inspwradicn 4) Rates at beth tung bases ‘Shear sound ©) Lous first and seeand hesrt sound ©) Fourth nest sound 8) Streptococcus prewmona 8) Staphylococcus aureus _Di Pseudomonas spp ©) Haemophis iuenze Ca) mycoptssma pnecmonise fr 18 Year 2 female presents with unexplained cough for fst 3 monte and weight fav chest there le pom pacity in the right apical region. Which of the is required for teetiane Tuberculosis? Spatim for 2) cibture Yor myesboctern bereits Gene Xpertboy presents with sudden shortness of bresth and chest pain. His X-ray chest 1A S0 year old woman le referred by GP for upper GI endoacopy folowing 4 months history of frie pain despite the treatment with antocids and proton pump Inhibitors. Nev endorcopy ‘Semonstrated a duodenal vier couple with « postive helicobacter ike organism. She ellcobecter pylor. Mow You will sasess the 4 middle aged person 1s admitted with nausea, vomiting and upper abdominal distension for last 6 months. His vomiting is of large quantities and contains food lngested 24 hows ago. He be having metaboc sikalosis with aeiic urine. Wat i the most likely dlognosis? 'A 16 year old boy presents with loose motions and weight improves with avoidance of whebl prbducls He Is GIbghOsed ‘one ofthe following features it not consietent with fle Soa 3) Grom rearaaven, LET iain gucoveclerance eu 5) Wight loss ©) tigre binaness ©) OseomonacCA Ny ER mccated en ern tins sia ‘She has opened har 220 S2zetr oid woman proants wih « 24 jour nisery at waenranernec ‘ Serre de ra a ens ou upon gona ae osm ae Thea eps than Faison and he rex Bar Tay hat had sae Mearowasereate seers 1) Aamoion for mervenous arco 2) Sis ate roy ane auchrge om ae ax ot, AEB2334.66 yoo old momen: nett mennnae cio stg nein of sae Irrthness Mp Nenion in 4/5 bliatesiy, tin Duntrat ws SBE Gh" geadncepe Knee extngion 475. Goninon te (024 A patient in your ward ie iagnoted with hepetncnllar carcinoma. You are asked te pertocm » Jerse mac level on thi patient. Which ths Youowing Tuma merters See tees ie Seitz alioua, wasiiees and dranses, On examiation she nd FA20/86. Vie lnvestgntonn anew We. 75/4 Te wrin saaration e189 and serum fern 1tsg/C whatFe eer eneneen emanate nce Pear sret re teem cod eet 4,30 year old mate pencots with rapid onset palo evsving the Text metatarzophelanges!jlet ‘ith Acsolated swing tancernest Pain reached to hs mean Taras oe ae iS oat » acne testa Ge Se st pete me fate Kaeo an i es tre te eee coerce mas Gar i= ce ieaame ‘Sacocitted sbominat pein snd tele suffering fo 2) Beooose tromcrtopend papery ae Setar prtgnont. She omen to you te seek sdvice ‘Satin eaancy. Which ofthe flowing droge ie valeMCQ Key Medicine 1 - Annual 2016 chronic pancreatitis > ultrasound / CT? 2. adult > HCOM 3, Reactive arthritis Sickle cell <> salmonella 4 5. Tachyarrythmia © amoidarone ?? 6. ALS > neurological 7. 8. _ PAS > Whipple GBS?? 9. Esophagus => AdenoCA 10. Zinc+ illamin 11. Crohn TB © Caseation??. 12. Birthday boy Na Valproate 13. Occupational => Emphysema 14, Sarcoidosis > Biopsy 15. Asthma HTN © Thiazide 16. Diplopia > Acetaz 17. H. pylori = duo 18. Gout = indomethacin + lasnoprazole 19. woman purpura © ITP 20. child bruise > Hemophilia B 21, Carotid > Endarterectomy ?? 22. Lung pneumonia > Staph aureus 23. Air crescent hallo > aspergilloma 24. face > huntington chorea??? 25. Osteoporosis <> HRT ?? 26. PBC > AMA antibodies 27. temponade > NoY descent 28. Pneumothorax = needle aspiration 29, Polyeythemia> Jak 2 mutation 30. Inferior infaction > RCA 31, Stroke > posterior inferior cerebellar ~ artery? 32. Lobectomy © Adult ARDS 33. Varices © Band ligation| 34, Enzyme <> Myoglobin 35. Jaundice © Gilbert 36, Proximal muscle > ESR 37. UC © Rectal mesalazine 38. Coombs test?? 39. dysphagia © stricture 40. Carpometacarpal joint > OA/ dequirven tenosynovitis?? 41. Asthma © Methacholine challenge 42. 43. 44, IBS > Nocturnal diarrhea 45. Polyarthritis > Acute Rheumatic fever Z langitisMedicine Supply Key 2017 Oral Asa Barium Swallow Gastric Ulcer Bladder Symptoms Aspetic Meningitis( Bechet) Asepticmeningoencphalitis Reative Arthirit Guam Barre Terlipressin/propanolol Propanolol in Essential Tremor Z Admit + Maintain without Meds &S Tabes Dorsalis 5 oe Second Intercosal Chest T G Vaccination Hep c Plu: ion He; Folate Def ae Decrease In Caroti Ww Pennicilliminé Zinc a tpa/aspi S Chorea In “\ deer old Heparin In Warfarin Pregnancy Post Splenectomy B Blood Group Fev1/Abgs ? Nephrotic Syndrome Deld Sleep Rythmn HypothyroidismPyrizinamide B12 Def In Dementia CABG Systolic Murmur. To Carotids Gentamycin 50% SonsMEDICINE - 1 ANNUAL 2014 MCQs KEY 41. Up-going planter, Peripheral neuropathy (Absent ankle jerk) > Multiple sclerosis, 2. Apex beat displaced, falling heart, cardiothoracic ratio > right ventricular dilation because apex upward 43. Criteria for Rheumatoid arthritis according to the 2010 American system “> A score of 6 or Above is required for diagnosis Sixty years old + Osteophytes + Subchondral sclerosis > Osteoarthritis 5. AnthHBE Antigen with infectivity for > hepatitis 8 6. Serum lipase more accurate for the diagnosis of -> Acute pancreatitis 7. Primary biliary clthosis > Prurtis + middle aged woman ‘8. Azathioprine > Need to check CBC+ LFTs + because it can cause leucopenia and Hepatitis 9. Drug causing constipation -> Ca++ channel blocks 10, First drugs with low ejection fraction “> ACE inhibitor + Diuretics 11, Grave sign * Silent chest 22, Patient with hepatic cirhosis,oliguria or raised serum creatinine due to -> Hepato-renal syndr 13, GBS Nerve conduction study > can't be acellular with high proteins (CSF has normal Bronchitis > FEVI/FVC <70% 15, Warfarin mechanism -> reduction of Vitk epoxide reductase 16. Chest xray 17, Angina & Syncope > Aortic stenosis 18. Sudden of contrast investigation of choice 19, Muscle biopsy for > Myositis 20. Loud $2 he ht inter-coastal space > Pulmonary hypertension 21. Scanario of autoimmune hepatitis (amenorrhea) > Anti smooth muscle 23, Shock state, diarrhea + old age (Carcinoid , Vipoma) > Ca 25. Vitamin B12 deficiency > terminal ileum resection 26. 27.70 year old person with pain and paresthesia, mild weak 28, Patient hemo-dynamically stable, eardio-ve bodies asia + hemiplegia on right side > Middle cerebral a 24, Young male with steatorthea -> Celiac disease ¢ neuron (spasticity & brisk raflexes) > Stiff circumduetion IRI spine, DEXA, Bone nucleotide scan) -> MRI spine F tachycardia more commonly farone, 200 J, 300 J, 2001) > Amiodarone 30, Outcome in adult Acute promyelocytic leukemia > t (15:17) get cells > thalassemia 133. Nifedipine > for achlasia symptomatic relief sum scenario of typical Bachet disease - calf pain due to thromboembolism > typical for sarcoidosis 36. Myasthenia NM junction 37. ASO titer for > rheumatic fever 39. AST raised with neurological deficits in young patient > WILSON DISEASE thas acute mono-arthritis after a week of diarrhea and the conflict of aspirate from joint has high neutrophils mnge a pacemaker 42. Hb levels to be maintained at 8 with co-morbidities 43. H. pylori > drugs amoxicillin, metronidazole, omeprazole (only one option had triple regime hence easy) ‘44, Increase translucency on right apex with no other abnormality on x ray (Options bullae emphysema ca lung) > Bullae 45. LAP (leukocyte alkaline phosphate) score Is increased in (Options Myelofibrosis, CML, TTP) > CML First Aid Book Series by Dr Hafiz Bilal 29. Trophozoites from duodenum > amebia 431. AT prolongation > hypo-magnesemiaMedicine 1 Annual Key 2018 (errors may be there.)* 1. Tonsillectomy, raised APTT: vWWBD. 2. Not a DD of Cavity on Xcaw: Mycoplasm pneumonia 3. Right hypachoodriuim pain with high grade fever: liver abscess. 4. Blood donor with Normal LFTs: Hep C / gilbert not sure 5. Alcoholic, IV drug user with bilateral infiltrate: pneumocystis carinii, 6. Episodes of loss of vision, bilateral carotid bruit, investigation: MR angiography of brain and carotid 7. Past history of A fib, now has acute abdomen: ischaemic colitis 8. Major criteria of Rheumatic fever: Carditis 9. Drug for bath skin and joint lesion in psoriasis: methotrexate 10. Previous 4/0 pulmonary embolism, has hepatosplenomegaly, ascites: budd chian syndrome 11. Arthritis, canjuctivitis, urethritis: Reiter syndrome 12. Peptic ulcer disease/GERD: columnar metaplasia of esophagus 13. Monitoring in GBS: vital capacity 14, Drug fer legionella pneumonia: Clarithromycin 15. Lady has antinhosphlipid syndrome, now presents with DVT, anticoagulant therapy for her: add LMWH 16. On ATT, has Dark urine and jaundice: stop all drugs: 17. Prevent progression of emnysema: stop smoking 18. Pain of shoulder and hip: Polymyalgia rheumatic 19. Optic neusitis.:Multiple sclerosis: 20. Plethoric face... splenomegaly: polycythemia Vera 21. Next investigation for pancytopenia on blood count/Aplasti¢ anemia: ; Bone marrow aspiration 22. Bleeding after tooth o 23. Kew an nth on Ke: os 24. Treatment V fb 2S. Antipacietal cell antibody/B12_ 26. Raynauds phenomenon, beaked nose telangestasia: anti 27. Not feature of Crahns: inflammation confined to mucosa or [Protected with trial version of Visual Wat 28. Post partum haemosthage with low fibrinogen levels: DIC 29, Basophilc stippling: Lead poisoning 30. Lady came from Australia, complains of shortness of breath: pulmonary embolism ‘31. Fever, joint swelling, purposeless movements: Rheumatic chorea: 32. Feature of hypertrophic cardiomyopathy: systolic anterior motion of sitral valve +33. Fitz tonic-clanic. :Sadium Valproate 34. Cardiac enzymé=Myoglobin 35. Cause of atrial extrasystole in a young boy: anxiety 37. Alcoholic with Weight Loss, ascites, hepatomegaly, next best investigation: endoscopy and biopsy 138. Pruritis, xanthelasmas, raised cholesterol, ALT, AST. Antibody seen: ‘antimitechandtialantibodies in PBC 39. SBP: Neutnos 100,protein 3.9,1ymph 10 40, Fever, headache with lesions in temporal and frontal lobe: Herpes simplex encephalitis ‘Left parietal lobe lesion: right inferior homonymous hemianopia . Wasting of hynothenar, unable to do abduction of fingers and ‘edguction of thumb. Damage to Ulnar nerve \ 43. | Not'fo do in Hep B patient: core antigen mark. Full version doesn't put this mark], thee {ij Zaheer Qureshi Vi - % Q7 Qe Lp. 6, . Ws bor ue Question Paper to be retur along with! . e Stanature in the speciied column: only, ] A.patlent visite you wits fttowing ‘aby, ser 2eamte/t, serum a odie Bead tune level: 180mp/ WWW.PAKMEDICALWORLD.COM M2 2012 ANUALa0 Qat qua Que Qa Qao 9 reed 6) Aualtery nemuenabons pseudomembranous colitis is due to: are 2) Shigella infection 2 Sogn aureus , 'b) Costrigium aitticke ah 4) Camppobacer infection Pes ‘ Cone important feature of Infectious mononucleosis s: (@) aronrs © 2 Rempecin nduced rash in 90M cases @) Deep Jouni * ©) Mase 5 ic tne aang ogee pedece mS: deficiency anemia? ‘Ancylostoma deodennie 4 3 Steven eres ion ©) Asano erga “S a eee Aes — “ae d) Excess of phosphorus ie ors Te wewnen QC gh eons 5 Payee \S Which of the following: ‘treatment of mausea in pregnancy & carse! tunnel ») BZ A d) a2 ey é ©) 66 recognizes symptom oft 4) Bereavement ) Schizophrenia cesens! 2) Does not aveid fear situations 0) Is created suceeisfully by cystemouc rapidly t group therepy zation, shee 4 Choracterced by esters 6 mv 1) Onaracenzed by recurene mast bose e ©) Seeman Somat complaios with orgorse Basis, ‘ 1 Characteristic feature of psychotic depression Include folowing except: 2) Racing thowges Kewtog xen $} Cusung of un or gue Recognised aaneae: ‘Eity mamng wencnng paranoid schitephrenia ectuse: ‘Gaturvance ot recent meinory M2 2012 ANUALQo Qat az qs ae a ‘statement avout Down's syndrome | coiled Is more lly to rave born re wont sl) > nae pee wy and black rat would be ‘moltipie Maced wansteis aI ove ere lagnesis? ‘Steven Jotugan synci ome 1) Patefe genest cers ©) Butovs ervpuon A® years old child presented with nypoplomented, dry, Sealy patches over the face for past fronts. What would be the mos liely aiognasis? 8) igo 9) ayes versculnr 2B) Masts abe ©) Tinea fe ©) Leprosy : mpaires glucose tolerance on an oral glucose tolerance test (GTT) is indicated 2) Fasting plasma sugar > 126 male 1) Fasting bleed sugar < a ming eens te gta Ss atta 3) faeay Beeest Aw ‘hucese iad 140-200 ma/e ‘Pucote toad >200 me/e! «) Random bioed supac > 200 pret ‘A.36 years ota female aresents with theos months history of agitationy Weight loss and menstrval Geeputartytxaminaticn reveals 2 tremor art alps 2 lowing would must likely be present in this pawent? Sb} nyros mcronamat sncberoes 41 acu t 8) myo gr-geidove sntoosies ©) 1544 2) Tokteeceptor mnorang snbwodes Mabaut. Which of the Which of the ellowing feature does net f jonic adrenal i acess prgmentavon 0) Hy Hrpeterae, <} eghe po 4.35 years alc lady presented ‘trumination ravealee Dtempora super diphofitioe, and off & on heavacre. Ker Seemaeerane'ts ibe ‘svogriptepar wnat “it be one’s 3 ee j ¢) Visual hetas, : bad ore 9) Winter poncun 6) Kory sease Y Me Sn a ©) mypoattanarie M2 2012 ANUALoo MBBS FINAL PROFESSIONAL Medicine (Paper-z1) (Multiple Choice Questions) Pages 4 3, Med pretterk ees. = eae ‘Signature of Candidate Roll No. Total Marks: 40 ‘Time Allowed: 1 hour cq Peper 10 (HTBTETATE TS Tso Tete Tee Instructions: Read the Instructions onthe NCQ Response Frm caret i. Attempt aif questions. Neg E ih Question Pper tobe return along with CQ Response Farm. Iv. Gondisetes are strictly proted to gue = sdetheaton mark except Ral NO, & Skynet nthe species clon oy Qt A.30 years old man presents to you with acute onset of e Three weeks age hha was treated with oral penicilin for sore throat. On examination pulse 8Obpm, B.P 160/440 mma, temperature=37°C with oedema of lees. No rash, na Joint or chest pain were present. Lab Study showed BUN 30mg/dh, creatinine 1.3mg/dL, normal electrolytes, serum complement CHO, C4 reduced by $0%, ASO titre increased, anti GBM and anti ANCA normal, urinalysis 4+ proteins, A tblood and no glucose, 3-4 RBC casts/HPF, many RBC, WBC, no bacteria visible. Which of the following ts most kely cause of acute renal syndrome? a) SE 3) Post streptococcal GN ©) Good pasture’ syndrome 4) immunaglobuln & (IgA) nephropathy 6) Allergle reaction to perielin, 2 _A45 years old man attends OPO with nephrotic syndrome but his condition rapidly progressed ith Sedma of his feet extending to mid calves. On examination UP 153/100, pulse 80/min, Gompersture, 237°C, Heart. lung normal. Abdominabmild ascites with hepatic size normaly Wobseme to mila calf blood ures nitrogen 10mg/l, ereatinine 1.0 mg/dL, urinalysis showed Aiprotein, 1 RBC/HPE, no RBC cast, 24 Nours urine contained 9.69 proteins. Which of the fotfowing is likely to account for nis lines? 1) Poststentococeal GN 4) amytoicosis ‘9, Hameraneus nepaopathy 18) Diabetes metus ) igus nephts 1Q.3 Ins patient with heavy proteinuria a renal biopsy to determine the nature of slomerular disease trabsolutely contraindicated In which ofthe following situations? 1) Potent has serum creatinine of 2.5 (N 'a) The patient nas undergon iseL.0 mg/l) Tanal Biopsy tb) Patent 65 years of ane or alder 9 sue } The patent hes castle BP of 120mmHg pervious ‘4 65 year old man following cholecystectomy for gallstone had fits derstetent drainage from biliary catheter, He was treated with eer ng tout limes » day for 20 days, Over the pervious four days serum creatinine, Soe ete Pau, urine output 15L/day hed not diminished, scrum creatinine level rose to Te rns vied na evidence of obstruction. Which of the following ts likely cause of 4) Cephalathin induced acute renal fare §) Seite tomerutonephac 0 oe elapse nies mates shen soe le ay aes anes eters, 18) Hypoaldosteraniem complaints of left Flank pain witha "periods of Urine eurpnten past hist ing outeut. ne yf il of notes Bt Ae bladerQ7 424 years old male had left knee su for pa rescribed acetaminophen ‘examination revealed Pulse 75/; ©) Normal saline Poor prognostic feat ) Need for mechanical ventiation. ) Gastrointestinal manifestation as 2) Microagglutination test 1) Dark Meld micrescopy for ieptospira 3d culture A 22 years old lady has been dia antibiotic? Tetracyclein 2) Metronidale Proeain pentcin Q4A 26 years old male presents at OPD with fever ‘sexual partners In the last years. On examination inguinal region. Spleen not pal following are reasonable initial management EXCE + node in cervical drug abuser with fever, hi of cies See ‘min, BP 125/75mmHg, Joint, no redness or sign of in ‘cocci in clusters. Identification of organism ora Wee eam gery repair for torn ligaments. Post operatively he was one day later he reports worsening of pain. Physi respiration 14/min, temperature 37% ection. Serum electrolytes are as follows therapy at this time? 4) Vancomycin @) Morphine tures In leptospirosis include all EXCEPT: 2) Acute respiratory distress syndrome ‘) Renal fallure €) Mult organ fallure rly diagnostic test for leptospirosis: + 4) Blood for leptospira tol GIA ®) Increased wac }osed as having primary syphilis, Which one is an appropriate 4) Spectinomycin ) Benzathene penicilin ight sweat for ten days. He had three female hhas multiple soft non-tender movable lymph ble, rest of physical examination is ‘) Fine needle aspiration ) Complete blood count blood culture obtained 24 hours later nding. The Vancomycin *} Ciretoxecn sney room with swollen right knee joint. of feeling feverish and having muscle a tular skin lesion and mildly at this point would be: «d) Serum complement assay ') Skin biopsy are true EXCEPT: 4) Secondary syphilis is associated with rash ‘on hands and feet 2) Gummas are formed in late syphilis HeQue his oh with history of recurrent eruption of vesicles and crust at oy ater cesk and lower back. The tkely diagnosis ist, fouke b) Scabies 4) Herpes zoster ©) Ba deficiency @) Dermatitis herpetiformis 19 For tinea capitis the choles of treatment is: a) Shaving the sealp hate : lntur suphide lotion ) Oral griseotuvin, Ci ae €) Topica griseofulvin @20 Phototoxi reaction occurs with al ofthe dr a) Chlorpromazine aces ride ese 9 Tine 9) mesttcone G21 Semmticmymptoms of depression include sl &XCEPT: 4) owt deeenee © tnceased fatigue 8} Diued ies 3} ihcreaed tds i peices 22 deal arug for depression i: ‘®) Haloperidol 1) Olanzapene ‘b) Respiradot ‘e) SSRI (selective serotonin re uptake + A agesan inners) 23. Audhory haltcinations are characteristics of which ofthe flowing? omer 2) schizophrenia : 1) Oce(abeersive compulsive dsorders) 3 Ralasteyrtome oe Q.24 32 year old man complains of unilateral headache. Headaches start with stabbing pain just bbelow the right eye. The affected eye feels Irritated (redness with increased lacrimation). Pain last 60 fo 90 minutes with discrete episode each day. Neurological examination including cranial ‘nerve is normal. What is best approach to treatment? 3) ‘oral sumatriptan for use at the 4) Begin propransiol 20 mg 81D. lume of headache f f) Refer fo neuropsychiatric testing 1) Obtain PIRI scan of head with godalonium : Bete esas 2 won i Doe 02s yahes old man le brousht to OPD by his tary becouse of intellectual deétine over the past ; ieee Beet ge eceeg peceroaces whe ayscenic peakurtog: fle toner ee async 4) Huntington disease ) Cerebellar degeneration develope increasing weakness in his legs. Co-worker had not “rhe patient has bilateral foot drop and atrophy, wrist weakness "siood tim snows besophallc mining, Which ofthe foley 4) Over use syndrome €) Lead poisoning 4) Sinusitis ‘¢) Temporal arteries40 Year old boy presente flip roeeeganted to you with verte! asus ing atthe angle of mouth, swt redness 3 Monn Indicate the vitamin defne urng mace amin Bt 3 Rone A aAseR of which ofthe following has the highest calories: ) Jack fre Leo ©} Banana . 8) Potomts ) Taber dora "Meine seiency gence 4) brary noth 5) Conve hypatyrcae, 3 tte reine (©) Enzyme deficiency goitre: e oe 35 Among causes of short stature the most common cause ist 1a) Idopatie growth hormone detiency 1) systemic daease of bone cartinne candi rowdy oe G36 A 58 years old man with type IX DM feels well with HUAIC 6.4%, mild hypertension nd Which one ofthe following, tie patient? sonal 1) Referred to neurologist for peipbersl ‘europathy evaluation ‘lated Eye examination tice 2 3) Ramesastag ot tne Woe sen ce 19) hours urine protein anny 125 year old tady taking oral contraceptive has developed amanonorshoea. Which is the most ‘cause: peeeen ae = 8) tary tumor woman had delivered a normal fl term infant three weeks previously. Following it taming tae gut potent dunn ervitan sat ans ‘he looked. tichae on extremities. HE 6.39; Hsomstacrt sis, mn BUN 84/9 and eresinne BSmo/ehs cer ANCA, near Se ence ‘multiple schistocytes, urinalysis showed RBC caste. which of the diagnesis? © 8) Haemoiytic uaemie symieame 12) Drug encton tion of causes of nephrolithiasis. Over the past Paternal srnafatner he Kidney stones Scrom oe une lowing ta the mont katy ) Calum ohosphate siones €) Mapneaiim amen, alum ‘hosphate stones2olY | ej MBBS FINAL PROFESSIONAL Medicine (Paper-II) | (Multiple Choice Questions) Pages 5 Signature of Candidate vf Tet rt Roll Ne. Ime Allowed, Swed? 1 hour ("CQ Peper io (8 @TFTSTiTaTalelsTala13) Instructions: i 5 I Aaad the Instructions on the MQ Response For crefty, Ik, Atom aff uestons Question Paper to be etumed along with MCQ Response Form, . Candidates are “Strictly prohibited to giv ae any Idetfcation mark except Roll No. & Signature in the specified columns only. 2 vr O55 yer dai wh» ogee i dlabetas melts is on trestment with rast eiea gaerses Your ckchonges yor/dey force a ston eeeen ee Bertonea!aalatencuaes whieh othe lana ‘hs ee onibuminwerie ® Hypoatycaemie 5) sypotension ater drainage of dasate 3) UR at eaten @ Woercholestoloemis eae 22 £50 reert male with Intermittent Cluudcation was found to have renal dlebase investigation eran, S. teatinine 280 ummol/L (60-100) an procures ne, Meaul seas rmestigation fait Maney of 7 cm .tePtKdney of 40 em. witch invesionten io sneiaaramound revealed Brena srterogrhy 4 Cysoecony ) Ineyenoutoropaphy 3 Setope renoorphy es rine analy ows clomerull with irregular basement membre 1¢ lamina densa, The mesangial matrix is increased ‘Which of the following is most likely diagno ‘) Polycystic Kaney disease 1) Diabetes melts 50 year male mosed to, have diabetes yvellitus at age of 2 GS Sontrlied end hanes topes sary Smvaes saan wf a of 3 ‘most likely to haver| to : ‘Papliary necrosis ) Acute tubular necrosis i ¢ yelonephitis ; 2) Nodular glomerulsclerosis Be" Gresentic glomerulonephtis f bean treated ten days beck for bronchopreumonis. she has Sod cin rash for’ days, Perphsralbsod ust shew sosooyh alysis ion jeant past history. Her HBAIC Is normal what tr mast Q) drug induced interestat nephritis 8) Post streptococcal glomervionephritis“ QB A 40 year old man with HT usinat pnemocystis carin nthretrovial test PCP pneumonia with bilateral prenuaretnoraces: He has been on act patiretroviral therapy with limivudine, ef and Zidovidine for 18 months. CD 4 count nore s @favirend and zidavidine for. 18 ; ais Mie Carents at Your office to seek advice to discontinue proplnyint® {current CD4 T cell count i930 /uL and he nadir coun eto this patient, 2” 200/H with undetectable viral load for 9 months. What advice should You OV 9) He can safely top PCP prophylaxis as his Jecause he had complicated pneumonia ‘$D4 count has been more thea soca Oe is a tatersanth we discontinugus PCP prophylaxis 1) He wil be able to stop PCP prophylaxis } He wll be able to stop PCP prophylaxis Safely when his Coa count has boas safely when his viral foad has been >200/mi for one year Undetecabie for one year Ne can safely stop PCP prophylaxis because his viral load has been, Undetectable for six months Qs What should you do for this patient? 2) Inliate antibiotic therapy with Reassure the patient that her illness Is ‘Gindamyein. ne ‘and no further treatment Is b) Ask the patient to g0 to nearest Hecessary if she can maintain adequate ‘emergency department for resuscitation hydration ‘with Intravenous fuld, ©) Defer the patient for Cr to assess for appendicitis €) Refer patient for admission for LV. vancomycin because of her Immunocompromised state resulting form sarcoidosis (Same Scenario for Q.10 89.11) Qi0 22 vears old male college student presents to you with unproductive cough, mild headache and {eerie ie on no medication. Ha had a painful maculopapulor rash over hans feet for portions, days. Temperature 402% pulea 110/inin Resp. 20/minute P='130/20 mmtig pulse Oareaes n 3% on room alr, He had narmal breath sounds bilaterally X-ray chest showed biiateret aie, . Infiltrates. The most likaly diagnosis Is: 4) Herpes simplex virus 4) Influence virus ‘Mycoplasma pneumonia ®@) H. influenzae ©) Chalamydia psittacosls, _The most appropriate therapy for the above patients Is: 4) Acyelobir ©) Amantadine pean wh acta aes tte tek pla ranting to artsy insta a8 See St ans rpc 4) Pan xray of abdomen ans @) Ultrasound of abdomen ee cee mae ty tueAll the following are indication for th 3 nation of haemostasis exc ®) Acute renal failure with potassium of os a) eotey 7 4) Salicylate Ingestion with mental changes ‘8.0mm. and E66 sbrormaltics ©) iron taney daca wh astro 29 ®) hronleKiney disease with an estimated ” Staal and ental sas changes GeatningGearance of 20m nin perl.73m? ‘Acute renal failure anurie with evidence of pulmonary oedema Q.16 A 24 years old female nursing student is brought to emergency by her parents after being found ‘unconscious at home. Finger stick glucose is 29 mg/di. After administration 50 mi of I.V 50% Setiroes. she rapidly gains coconsciousness. This occurred for the fourth time in a mene oe Is raya ge ey eee eet ee ter tn ae abate itn, wets ner y ee gta aces guna ee 31mg/dt. Plasma insulin levels are elevate. C peptide levels are low. Which of the wing is saat hey eset BSurrpttioas tsuin oe 4) ctucagonams 2) Gpide overdove . Bobet eects ©) inslenoma 247 A 51 yoar old lady attends your clinic for routine health screening. Family history is notable for osteoporosis of mother. She has had hot flushes and mood changes over the last year, her last menstrual period ‘Age appropriate itometry scan (Dexa) wer DEXA shows multiple sites with t-scores more than -2.8 SD below the mean. All the following are reasonable recommendation except: a) Caldum supplementation ® Exercise ) Vitamin D supplementation ) Tamoxiin ©) Weekly alendronate Q.18 A685 year old male known case of athal fbiilation, Ischemic heart disease and depression has presented with tirodness. He Is taking medication for hs above mentioned complaints. thyrold function tests shows free T4 25.7pmol/L (10-22) free T3 3-1 pmol/L (5-10) and TSH ‘m/l. (0.4-5). What is most likely explanatior: of these results ‘Amiodarone therapy 2 1a) Slek euthyroid syndrome 1b) Hashitoricosis : =). Subciniat Rypertnyrodism “Uthlum therapy A 50 year old obese male has presented with type 2D.M. He is uncontrolled on diet alone, Which ‘ ee tame terrane tic trating nan sone wod 4) Pioglitazone Metformin winch ofthe following: hi 1) IgM antbodies f) cond d bath9:26 Factors decreasing iron absorption are all except: © Vitamin c 4) Excess of phosphorus in det ) High res and cetulase n let oe Bo ) Excess tea or ctfee 9.27 Out of liquid drink which contains highest calories: 8) Tomato sup (ass 240:2) 3 Caco water (1. gassea0e®) rile (1 glass=240ce ) Soda water (i glass=240ce Bute rach Searezsoe, ae Q.28 Fever in elderly due to infective causes inclu a) Endocarditis ‘@) Intra-abaominal sepsis cos : @ Meares ee 2.29 Antibiot therapy In senior iizen may have all ofthe below given problem except! 1. a) They need half of adult dosage. "d) Reduced hepatic ‘There is increased incidence of Isonianid hypertxicty hypersensitivity reaction. 9) Increased GT disturbance By ©) Due to impaired renal function Nephrotoxiety is more with cephalosporin ‘amino-alycosices A previously fit 30 year old female presents with four day history of intractable pruritis and Urticaria, What is the most appropriate initial management? ae ‘@ Chiorpheneramine 5) Prednisone . 5 Rane 2) Topi! mepyramine j 5 ‘Topical hydrocortisone "1 5 31 Antipeychotic erugs cause which se effets due to dopamine blockage: hes Urner terion “ mg) chotestate Joundice “ Tardive dyskinesia 2 : @) Mania Bry moth : eek eso following are features of hallucinations excOpts or perceptual stimulus Diesiitartarina eve see See rains se aime eee a re wing is a feature: d) Wr sulcide note iencsareet iin bipolar disorder. His psychiatrist thinks that the dose iyeptom. Which of the following symptoms many be a : Payenosts Helucnations, tremors and atexia to have tachycardia, dilated ‘mood, pressure of speech ae‘man has a history of heavy alcohol use and is admitted with confusion. 19 the ‘hat the nurse want to stab him with a knife. Which of the following llucinations rather than delirium? 4) Keeping all the patient up at night ©) Hypotension 1e very talkative and is ry hat a Procycidine ) Flodxetine female has insomnia, excited mood, Is talking excessively and wants everybody tO ‘she's messenger. She Is taking antidepressants since last three mor ) Schizophrenia ) Anxtetyeer Qureshi M) . FINAL PROFESSIONAL MBBS EXMAINATION MEDICINE (PAPER-1!) MCQs Daeer Qrasrslea* Marks: 45, Total No. of McQs: 45 Time Allowed: 1 hour £26 year old woman presents with episodes of dizziness mainly on Standing. Her biochemical profile shows hyperkalaemic acidosis. ‘Which underlying condition is she most likely to have? 3) Cushing's syndrome. 0) Addons dese b ©) Conn's syndrome. 4) Type renal tubular acidosis €) Bulimia nervosa. In acromegaly: 2) Excess of growth hormone is secreted by posterior pituitary, b) _Thereiis overgrowth of soft tissues of skin and tongue ) Theres no diabetes mellitus. 4) Postural hypertension is commonly found, €) Life expectancy is unaffected. Which one of the following can cause secondary diabetes mellitus: a) Haemochromatosis b) Addison's disease. A ) ACE inhibitors. 4) Hypothyroidism. €) Alpha 1 antitrypsin deficiency. 16 year old male with a day history of malaise, weakness and Vomiting. He was diagnosed with insulin dependent diabetes mellitus 3 years previously. Which one of the following support supports a diagnosis of Diabetic ketoacidosis: a) Abdominal pain at onset. b) serum bicarbonate of 10 mmol. <)—_ Aserum glucose 300 mg% 4) Decreased appetite in the past few days. €) Shallow respirations ‘470 year old male receiving amiodarone 200 mg daily for intermittent Atrial fibrillation. However, he was aware of tiredness and lethargy. He red clinically euthyroid with no palpable goiter. Investigations jealed: free 14 23pmol/t (9-26) freT3 0.8nmol/t (0.92.8) bSerum TSH 8.2 mU /L(<5) Which ofthe following statements would explain these resy,, a) Abnormal thyroxin binding globulin b) Amiodarone - induced hypothyroidism b c)_Sickeuthyroid syndrome. 4) Spontaneous hypothyroidism. 6. 45 year old man regular haemodialysis complained of weakness ‘and exertional fatigue. On examination, his blood pressure was 170/105 mmHg (pre-dialysis) and 160/95 mmHg (post ~ Dialysis). Investigations pre-dialysis revealed: Haemoglobine 9.08 / dl Serum potassium 6.9 Serum creatinine 12.50 Serum corrected calcium 2.1 mmol / L Which intervention is most likely to improve his symptoms? 2) Increase haemoglobin with erythropoietin. b) Increase the length of each dialysis session. ©) Lower the potassium in the dialysate fluid. 4) Improve blood pressure control with ramipril. €) Correct hypocalcaemia with alfacalcidol. 75 year old man presents with a long history of shortness of breath and ankle ordema. His serum biochemistry shows: sodium 122 mmols /1and potassium of 2.9 mmols/ 1. He now complains of weakness, Which of the following is likely to explain the above biochemical Picture: a) Addison's disease. b) Nephroticsyndrome. ‘)_ Primary hyperaldosteronism d) SIADH. ) Diuretictherapy. vt zi Zaheer Qureshi In chronic untreated renal failure which of the following finding Characteristics: a) Metabolic alkalosis. 'b) Hypokalaemia. Hyperosmolar dehydration. Urinary excretion.[mo ) Sphingomyelinase. d ©) Arylsulphatase 4) B-Glucosidase e) Iduronidase 15 A73 year male presented with an acute attack of gout in his left Knee. What is the most likely underlying metabolic cause? a) Decreased renal excretion of uric acid. a b) Endogenous overproduction of uric acid ©) Excessive dietary protein intake. 4) Lactic acidosis, €) Starvation 16 _A30 year old man developed a febrile illness seven days after Returning from summer holidays in Karachi. He was admitted ‘complaining of severe myalgia. On examination he was febrile (39 C) with a diffuse macular rash on the trunk. There was not lymphadenopathy. Investigations revealed:- Haemoglobin 15.1 g / dl (13.0-18.0) White cell count 7.5 x10 / L (4-11) Platelet count 105x10 /L (150-400) Serum total bilirubin 18 mmol / t (1-22) ‘Serum alanine aminotransferase 120 U/L (5-35) What is the most likely diagnosis: a) Acute HIV infection (seroconversion illness). b)_ Dengue fever, c) Hepatitis E. d) Secondary syphilis. e) Thyroid. eer Qureshi Zal Ihich of the following is correct regarding infection with salmonella: Children are particularly likely to become carries. Jost carries are female jecal culture is almost always positive during the first week of illness. spse does not occur if antibiotics are taken for 2 week. inated individuals who develop the disease will have a mild illness. ‘A32 year old man presents with diarrhea after returning from a visit family in Gujranwala, Punjab. He is afebrile and also lower abdominal pain. His stools do not contain blood. likely diagnosis:Zaheer Qureshi 19 modification i 2 Regarding the epid Statement i a) b) ¢ d) e) fees iOl0RY Of infections, which the following i Resistant vivax malaria isa major in Pakistan Diphtheria has been eradicated in most parts of the world Polio has been eradicated in most parts of the world. Tetanus has been eradicated in the most part of the world. The AIDS epidemic seems to be declining worldwide. a.tetracycline. b.gentamycine Cerythtomycine. d.ceftriaxone e.chloramphenicol Fever, Palpable spleen, normal WBC count with high ESR are not found Enteric fever. Malaria Brucellosis, Kalazar. “Amosbic liver abscess, ‘A25 year old woman arried at Lahore from Kashmir with a three ‘month history of weight loss and intermittent fevers. On examination, the patient was emaciated, febrile (102 F) pale with an enlarged liver below the costal margin) and spleen ( 10 cm below the cost: |. Investigation revealed: lobin 7.2 g/ dl (11.5-16.5) Il count 2.4X10 / (4-11) ‘count 117 X10 /t (150-400) and thin films no parasites identified jormal most likely diagnosis: ion, ntation of a sensory image. € c A 60 year old patient with long standing diabetes has a creatinine of 3.6 which le for several years.Which of the following anti ies requires the most dosage in patient with chronic renal failure? 6Zaheer Qureshi 24 age not actually present. anim ee, social, cultural and b) Perceptual representation soi €)_ Fixed false belief which is Keeping OM ‘educational Back ground. d) Pathological self preoccupat e) Dissociative fugue. tion. ful apprehension she feared fh and pounding of heart. vol ie ee Rest of her history and She is likely to suffer with: ‘Associated with shortness that she was going to die or would physical examination were normal. a) Acute psychotic episode. b) Hypochondriasis.. ) Panic attacks. 4d) Generalized anxiety disorder. ) Conversion disorder. A patient of obsessional state is most likely to present: a) In middle age. +b) With repetitive thoughts that he cannot resist. ©) History of traumatic events. 4) Suicidal thought ‘A52 year old man comes to a physician with the chief complaint of Feeling sad for two months. He has lost 15 pounds of weight in last 6 ‘Weeks, loss of energy and though of committing suicide. The most Pobable diagnosis is: a) Schizophrenia. b) Generalized anxiety disorder. ©) Depressive iliness d) Anorexia nervosa. e) Acute psychotic episode. ‘A 32 year old woman is found standing in the middle of a busy Highway wearing bright clothes controlling traffic. She has pressure of Speech and claims the head of the sate. Her most probable diagnosis is: a) Delirium. b) Bipolar affective disorder, mania €) Bipolar affective disorder, mixed state. d)_Cyclothymia. _e) Dchizophrenia. 19 year old girl presented with history of sudden blindness after jing her parents in a fight at home. She had normal neurogolical . She is likely to suffer from: sion disorder. riaZaheer Qureshi ©) Factitious disorder. dd) Malingering. 5 e) Delusional disorder. 9 Aneighteen year old male is: brought to emergency with oculogyric Fu, torte, and sifness ofthe body. Parents report that he has Recently started treatment by a psychiatrist. The most likely Intervention that could cause the presentation may be: a) Haloperidol. b) Promethazine. c) ECT 2 4) Imipramine. e) Diazepam 30 A74 year old woman with progressive decline in recent memory and Difficulty in naming objects and in performing daily activities for last 10 years with no history of disturbance in movements or mood is like To suffer from: a) Huntington's disease. b) Multi infarct dementia ©) Creutzteldt dementia, €) Picks disease 31, 20 year old girl present with nocturnal itching for last 2 weeks. Her __ S months old brother has itchy papulo ~ pustular eruptions on palms and soles. The most likely diagnosis is: 6 by 6 cms red painful lump with multiple 45 on nape of neck for the last 10 days with high