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1. Most characteristic finding of diabetic nephropathy?

a) Kimmelstein Wilson disease
b) Diffuse glomerulosclerosis
c) Focal segmental glomerulosclerosis
d) Armani Ebstein change c

2. Most sensitive indicator for Iron deficiency anaemia?

a) Serum Ferrtin
b) TIBC
c) Percentage saturation of transferrin
d) Bone marrow iron
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3. All are true about apoptosis EXCEPT?
a) Inflammation is present
b) Chromosomal breakage
c) Clumping of chromatin
d) Cell shrinkage

4. Curschmann spirals are characteristic of which of the following airway disease?

a) Chronic bronchitis
b) Emphysema
c) Atelectasis
d) Bronchial asthma
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5. What is the diagnosis?

a) Lymphoblast
b) Myeloblast
c) Megakaryoblast
d) Normoblast

6. Spot the diagnosis

a) Iron deficiency anaemia

b) Thalassemia
c) Acute leukemia
d) Hodgkin Lymphoma
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7. A person with hepatic jaundice, deranged liver function tests and presence of a clinical finding as
shown Alongside?

a) Huntington chorea
b) Wilson's disease
c) Leigh syndrome
d) Hemochromatosis

8. A tall male teenager presented with gynecomastia. On examination, absence of secondary sexual
charachteristics. he has average cognition characteristics a deep voice, beard, and male distribution of
pubic hair. His genetic analysis was performed and he had the presence of a barr body. What is the
likely diagnosis of this condition?
a) Turner syndrome
b) Klinefelter syndrome
c) Swyer syndrome
d) Down syndrome
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9. Which of the following is the mode of inheritance in the patient suffering from color blindness?
a) Autosomal dominant
b) Autosomal recessive
c) X linked dominant
d) X linked recessive

10. Circle of Willis does not get a contributi on from:

a) Anterior cerebral artery
b) Middle cerebral artery
c) Posterior communicati ng artery
d) Posterior cerebral artery
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11. Which of the following laryngeal carti lages is not paired?
a) Arytenoid
b) Corniculate
c) Cricoid
d) Cuneiform

12. Spermatozoa attain motility in:

a) Seminiferous tubules
b) Vas deferens
c) Epididymis
d) Ejaculatory duct
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13. A 26-year-old male presented with sudden onset of visual loss. He was diagnosed to have a condition
called Leber's hereditary optic neuropathy (LHON), which is mitochondrially inherited. What is the
origin of the inherited mitochondrial DNA?
a) Paternal only
b) Maternal only
c) 50% paternal and 50% maternal
d) Either paternal or maternal

14. What is the most common anatomical positi on of the appendix?

a) Preileal
b) Retrocaecal
c) Paracolic
d) Subcaecal
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15. Foot drop is caused by damage to:
a) Common peroneal nerve
b) Femoral nerve
c) Tibial nerve
d) Sciati c nerve

16. A young traveller hailing from north India is planning for a trip to an area where malaria is endemic.
Subsequently, he was given antimalarial drug prophylactically but he unfortunately developed
hemolytic anemia. The most likely cause of hemolysis?
a) GLUT 2 receptor defect
b) Pyruvate kinase deficiency
c) SGLT-2 defect
d) G6PD deficiency
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17. A 42 year old lady working as a school teacher presents to Endocrinology OPD with flushing of face,
signs of pulmonary edema, diarrhea and dermatitis. Further workup reveals an appendicular mass,
which among the following compound can be detected in the urine of this patient?
a) FIGLU
b) 5-HIAA
c) VMA
d) Myoglobin

18. Aconitase is an enzyme in the TCA cycle and it is non-competitively inhibited by fluoroacetate, a
molecule found in the rat poison. Which of the following change in kinetic parameters of aconitase is
most likely to be seen in the presence of fluoroacetate?
a) Decrease in Km
b) Decrease in Vmax
c) No change in Vmax
d) Decrease in both Km and Vmax
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19. A 12 yr. old child presents with fever and cervical lymphadenopathy. Oral examinati on shows a grey
membrane on the right tonsil. Which of the following will be ideal for rapid identi ficati on of the
pathogen:
a) Nutrient agar
b) Blood agar
c) Loeffler’s serum slope
d) Lowenstein Jensen slope

20. In the iceberg phenomenon of disease, which of the following does not represent the submerged
portion of the iceberg?
a) Pre-symptomati c cases
b) Latent cases
c) Diagnosed cases
d) Undiagnosed cases
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21. You advise a reproducti ve-age woman to vaccinate against HPV. What is this type of preventi on
called?
a) Primordial preventi on
b) Primary preventi on
c) Secondary prevention
d) Terti ary prevention

22. An OT technician is sterilizing surgical instruments in the following device. What temperature should
be maintained?

a) 121 degrees C for 10-15 minutes

b) 140 degrees C for 90-120 minutes
c) 134 degrees C for 10-20 minutes
d) 160 degrees C for 15-20 minutes
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23. In a community, there are usually 40-50 reported cases of dengue every week. This week, there were
48 reported cases.
a) Epidemic
b) Endemic
c) Sporadic
d) Outbreak

24. What is the unit of observati on in ecological studies?

a) Population
b) Patient
c) Healthy individuals
d) Case
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25. Identify the type of epidemic depicted from the following epidemic curve

a) Point-source epidemic
b) Conti nuous epidemic
c) Progressive epidemic
d) Propagated epidemic

26. What are prevalence studies also known as?

a) Longitudinal studies
b) Cohort studies
c) Case-control studies
d) Cross-sectional studies
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27. A study was conducted among a group of 500 patients with lung cancer and another group of 300
people chosen from the general population. Both the groups were questioned about their exposure to
smoking. What kind of study is this?
a) Cohort Study
b) Cross-secti onal study
c) Correlati onal study
d) Case-control study

28. What is the ratio of the incidence of the disease in the exposed to that of the nonexposed?
a) Attributable risk
b) Odds ratio
c) Relative risk
d) Population attributable risk
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29. Following admission of a road traffic accident case, there is spillage of blood on the hospital floor.
Which disinfectant will you use to clean the floor?
a) Ethyl alcohol
b) Chlorhexidine
c) Sodium hypochlorite
d) Formaldehyde

30. A clinical trial was done between two groups to measure their blood pressure aft er treatment. Which
of the following tests would be appropriate to use?
a) Paired t test
b) Unpaired t test
c) ANOVA
d) Chi-square test
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31. The following diagram charts the population change over years from 1983 to 1989 in a given place.
What is the statistical diagram used here?

a) Histogram
b) Line diagram
c) Component bar graph
d) Multiple bar graphs

32. For a population of 10,000, what does a sex ratio of more than 1000 mean?
a) Males are less than 500
b) Females are less than 500
c) Males are less than 5000
d) Females are less than 5000
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33. In which stage of the demographic cycle does the birth rate start declining?
a) stage 2
b) stage 3
c) stage 4
d) stage 5

e)

34. Which of the following is gas was responsible for the Bhopal Gas Tragedy?
a) Methyl isocyanate
b) Potassium isothiocyanate
c) Sodium isothiocyanate
d) Methyl isothiocyanate
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35. You are working in a Covid ward. Aft er doffing, where will you dispose of the plastic coverall? s
a) Red bin
b) Black bag
c) Yellow bin
d) Blue

36. A pregnant woman at 12 weeks of gestati on was diagnosed with falciparum malaria. What is the drug
of choice?
a) Quinine
b) Artemisinin-based combinati on therapy
c) Chloroquine
d) Primaquine
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37. A woman with 20 weeks pregnancy presents with bleeding per vaginum. On speculum examinati on
the os is open but no products have come out. The diagnosis is:
a) Missed abortion
b) Incomplete abortion
c) Inevitable abortion
d) Complete abortion

38. Identify the procedure shown in the image:

a) Leopold's procedure
b) Mc roberts procedure
c) Pawlik’ procedure
d) Fundal palpati on
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39. Depict the picture ?

a) Patau syndrome
b) Edward syndrome
c) Turner syndrome
d) Downs syndrome

40. You were posted in surgery department, while taking rounds you notice a patient having given finding
while taking BP and she complains of numbness and paresthesia. She underwent Total Thyroidectomy
for Medullary carcinoma 2 days prior. The most likely cause for this condition is:

a) Bilateral RLN injury

b) Hypothyroidism
c) Parathyroid insufficiency
d) Hypercalcemia
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41. Microanuerysms are seen in which of the following diseases?
a) Retinal detatchment
b) Diabetic retinopathy
c) Uveitis
d) Glaucoma

42. The following image depicts a particular type of cataract. What history should be elicited from the
patient to come to a diagnosis?

a) Penetrating trauma
b) Steroid use
c) Diabetes
d) Blunt trauma
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43. A lady was found to have a height of more than 95 percentile for his age and an arm span to height
ratio of more than 1.05. On further examination, she had flat feet, mild scoliosis, and long slender
fingers. An image of her hand showing two characteristic signs is provided below. What is the most
common ocular complication expected in this child?

a) Hypertensive retinopathy
b) Rosette cataract
c) Retinitis pigmentosa
d) Subluxati on of lens

44. A 26-year-old patient came with complaints of blurring of vision, photophobia, and pain in the eye.
There was also congestion of the eyes and joint pain. All ocular complaints are unilateral. Which of the
following Major Histocompati bility Complex can be associated with this condition?
a) HLA B27
b) HLA BSI
c) HLA B47
d) HCA 357
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45. The patient presents with miosis, anhidrosis and mild drooping of eyelids and a small pupil that
remains small even in darkness. The likely diagnosis is?
a) Adie's tonic pupil
b) Horner syndrome
c) Blind eye
d) Argyll Robertson pupil

46. A tumor in the anterior pituitary pressing on the opti c chiasma will present as a case of:
a) Homonymous hemianopia
b) Inferior quadrantic hemianopia
c) Bitemporal hemianopia
d) Superior quadranti c hemianopia
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47. A 5-year-old boy was brought to the ophthalmology OPD with complaints of intense itching,
photopobia and ropy discharge from his eyes. Moreover, on examinati on the following finding is
present. What is the most probable diagnosis of this patient?

a) Trachoma
b) Vernal keratoconjuncti viti s
c) Phlyctenular conjuncti viti s
d) Xerophthalmia

48. Identify the condition which presents as painless loss of vision:

a) Central retinal vein occlusion (CRVO)

b) Branched retinal vein occlusion (BRVO)
c) Central retinal arterial occlusion (CRAO)
d) Branched retinal artery occlusion (BRAO)
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49. Which of the following is the gold standard for measuring intraocular pressure?
a) Gonioscope
b) Goldmann applanatt on tonometer
c) Hertel's exophthalmometer
d) Tonopen

50. The given sago-grain appearance of conjunctiva is caused by:

a) Chlamydia Trachomati s
b) Neisseria gonorrhoeae
c) Hemophilus influenza
d) Vitamin A deficiency
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51. Regarding developmental milestones wrong is ?
a) At 12 month = Stands without support
b) At 18 month = Spontaneous scribbling
c) At 3month = Ocular fixati on occurs
d) At 9 month = Mature pincer grasp develops.

52. Identify the condition on the basis of infant – gram shown in the image?

a) Congenital diaphragmatic hernia

b) Cystic adenomatoid malformation
c) Pneumomediasti num
d) Fish vertebra
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53. Which of the following defines Pentalogy of Fallot?
a) TOF with ASD
b) TOF with PDA
c) TOF with CoA
d) TOF with Polysplenia

54. Which of the following is not a symptom of severe dehydration?

a) Drowsy child
b) Skin pinch retracts slowly
c) sunken fontanelle
d) Thirsty child
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55. What is the IOC of vesicoureteric reflux?
a) Ultrasound Obs
b) MRI
c) DMSA scan
d) Voiding cystourethrogram

56. A 35 year old pregnant female complains of bilateral gradually progressive hearing loss, which
aggravated since last few weeks. The patient was advised tympanometry, which of the following
graph will be seen?

a) .

b)
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c)

d)

57. A patient presents with frank bleeding from nose to emergency. Bleeding is not controlled by pressure
and the bleeding site could not be identified. What is the next best step in treatment?
a) Chemical cauterization
b) Sphenopalatine artery ligation
c) Anterior and posterior nasal packing
d) Maxillary artery ligation
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58. Which sinus is never visible on the below given view of X-ray PNS?

a) Sphenoid Sinus
b) Frontal Sinus
c) Anterior Ethmoidal air cells
d) Posterior Ethmoidal air cells

59. A patient underwent superficial parotidectomy for pleomorphic adenoma. Few months later, the
patient complains of facial sweating and skin flushing when he eats food as shown in the image. Which
nerve injury is responsible for his condition?

a) Chorda tympani nerve

b) Greater auricular nerve
c) Auriculotemporal nerve
d) Vidian nerve
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60. A teacher has been taking frequent, long and uninterrupted sessions before the final examinations of
students. He has been complaining of hoarseness of voice for last 1 month and says 2 different
frequency sounds are heard whenever she speaks now. His Laryngeal endoscopy picture is given in
the image. What would be the best management of this patient?

a) Oral Steroids
b) Vocal rest
c) Microlaryngeal surgery
d) Speech Therapy

61. What is the significance of given line in the image?

a) Total Maxillectomy in carcinoma of maxillary sinus

b) Partial Maxillectomy in carcinoma of maxillary sinus
c) Prognostic evaluation of carcinoma of maxillary sinus
d) Total laryngectomy in carcinoma of larynx
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62. A 32-year-old man is brought to the psychiatric OPD with complaints that he misidentifies familiar
person as stranger. What is this syndrome called?
A) Cotard syndrome
B) Capgras syndrome
C) Fregoli syndrome
D) Magnan syndrome

63. What is the fear of open spaces known as?

A) Aleurophobia
B) Algophobia
C) Agoraphobia
D) Acrophobia
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64. A 35-year-old lady presents to the casualty with symptoms of acute-onset breathlessness, palpitations,
sweating, feel like she will die and nausea. Physical examination and laboratory workup were
unremarkable. Which of the following best explains the episode?
A) Phobia
B) Acute respiratory distress syndrome
C) Generalized anxiety disorder
D) Panic attack

65. A middle-aged man was brought to the ED with suspected morphine overdose. He was intubated and
mechanical ventilation was started. What is the drug of choice to be administered in this patient?
A) IV Naloxone
B) IM Methadone
C) IV Clonidine
D) Oral Naltrexone
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66. A 16-year-old girl has intense cravings for food. She eats large amounts of food, which is followed by self-
induced vomiting. What is the probable diagnosis?
A) Anorexia nervosa
B) Bulimia nervosa
C) Atypical depression
D) Binge eating disorder

67. The second gas effect is seen with which anesthetic?

A) Cyclopropane
B) Nitrous oxide
C) Ether
D) Methoxyflurane
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68. A school student is brought to the casualty unresponsive following trauma to the head. The NCCT image is
shown below. Which vessel might be damaged?

A) MCA
B) Bridging veins
C) Middle meningeal A
D) Berry aneurysm

69.
70. A child was administered an anesthetic for fracture reduction in the ER. He could open his eyes, was
blabbering and breathing spontaneously but did not feel any pain. Later reported hallucinations in post op
wards. Which anesthetic agent was administered?
A) Ketamine
B) Propofol
C) Etomidate
D) Thiopentone
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71. A 25-year-old male patient came with complaints of palpitations, sweating, and restlessness. He has a
complaint of sweaty palms. Clinical findings are depicted in the image given below. What is the diagnostic
finding seen in this patient?

A) Anti-thyroglobulin antibody
B) Anti-thyroid peroxidase antibody
C) Thyroid receptor antibody
D) Elevated ultrasensitive thyrotropin levels

72. A 55-year-old man is noted to have moderately severe congestive heart failure with impaired systolic
function. Which of the following drugs would most likely lower his risk of mortality?
A) Angiotensin-converting enzyme inhibitors
B) Loop Diuretics
C) Digoxin
D) Aspirin
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73. A 32-year-old woman has a history of chronic diarrhea and gallstones and now has rectovaginal fistula.
Which of the following is the most likely diagnosis?
A) Crohn disease
B) Ulcerative Colitis
C) Systemic lupus erythematosus
D) Laxative abuse
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74. Multidrug-resistant (MDR) tuberculosis shows resistance to which of the following drugs?
A) Isoniazid, rifampicin, and fluoroquinolone
B) Fluoroquinolones
C) Isoniazid and rifampicin
D) Isoniazid, rifampicin, and kanamycin

75. A 55-year-old ship building factory worker presents with dyspnoea. He has been working in this industry
for the past 25 years. Which is the most specific malignancy that we can expect in this patient?
A) Adenocarcinoma of lung
B) Malignant mesothelioma
C) Small cell carcinoma of lung
D) Squamous cell carcinoma of lung
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76. What is the GCS of a patient with a head injury who opens her eyes in response to a loud voice, localizes
pain, and is confused and disoriented?
A) E3M5V4
B) E3M6V5
C) E4M4V5
D) E3M5V5
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77. A 65-year-old male patient presented with chest pain, exertional dyspnea and syncope, Mid Systolic
Murmur was heard on auscultation near 2nd right intercostal space What is the most likely diagnosis?
A) Tricuspid regurgitation
B) Aortic regurgitation
C) Mitral stenosis
D) Aortic stenosis

78. A 26-year-old woman undergoing evaluation for panic disorder was referred to the physician for
complaints of palpitations and breathlessness. On auscultation, Pan systolic murmur was audible.
What is the most likely diagnosis?
A) Unstable angina
B) Aortic stenosis
C) Mitral valve prolapse
D) Mitral Stenosis
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79. A 37-year-old male patient comes to the clinic with complaints of weakness, restlessness, and chest
pain. On examination, his blood pressure is found to be 90/60 mmHg, his heart sounds are muffled,
and his neck veins are distended. What is the typical JVP finding in this patient?
A) Absent a wave
B) Prominent a wave
C) Rapid y descent
D) Absent y descent

80. A 70-year-old man with a known history of DM and HTN on regular medications presents with a
history of progressively worsening dyspnoea on exertion, On examination, there is elevated JVP,
positive hepatojugular reflux, crackles at the lung bases, hepatomegaly, ascites, and pedal oedema
What is your provisional diagnosis?
A) Congestive Heart failure
B) Hypertrophic cardiomyopathy
C) CAD
D) Portal hypertension
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81. Patient complains of palpitations. On examination irregularly irregular radial pulse is present and ECG
shows absent P wave, variable RR interval. Which of the following condition is likely ?
A) Atrial fibrillation
B) PSVT
C) Ventricular tachycardia
D) Ventricular fibrillation

82. A 32-year-old man is brought to the casualty after he developed sudden onset dyspnea, chest pain,
and palpitations at a party. His blood pressure is 100/62 mmHg. His ECG is shown below, What is the
drug of choice to treat his condition?

A) Procainamide
B) Adenosine
C) Verapamil
D) Propranolol
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83. A 40-year-old man presented with nausea, dizziness, and hyperventilation. His arterial blood gas
analysis and serum electrolyte levels revealed metabolic acidosis with a normal anion gap. Which of
the following is the possible reason for this condition?
A) Lactic acidosis
B) Chronic renal failure
C) Renal tubular acidosis
D) Methanol toxicity

84. The gas analysis of a patient reveals a pH of 7.55, pC0254 mmHg, and HC03- 40 mEq/L. What is the
underlying disorder?
A) Mixed acid-base disorder
B) Metabolic alkalosis with compensatory respiratory acidosis
C) Respiratory acidosis with compensatory metabolic alkalosis
D) Respiratory alkalosis with compensatory metabolic acidosis
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85. A 47 year hypertensive male doesn't show adequate blood pressure control on lisinopril. Which of
the following drug can be added as step 2 therapy for the patient?
A) Amlodipine
B) Valsartan
C) Labetalol
D) Thiazide

86. Identify the structure shown by arrow in the histological diagram shown below. This patient
presented with rest tremor, rigidity (stiffness), bradykinesia (slowing), and postural instability

A) Lewy bodies
B) Neuritic plaques
C) Fibrillar nature of tangles
D) None of the above
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87. A 34-year-old man is brought to the emergency department with violent shaking of arms and legs for
the past 30 min. IV lorazepam and phenytoin are administered to this patient. After 5 minutes, the
seizures have not stopped. What is the next best step in the management of this patient?
A) Phenobarbitone
B) Ketamine
C) Propranolol
D) Thiamine infusion

88. A patient presented with right sided hemiparesis that completely resolved in 4-6 hours. What score
will you use to determine the risk of a future stroke in this patient?
A) CHADS2-VASc
B) CURB-65
C) ABCD2
D) APACHE II
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89. A patient is diagnosed with Brown— Sequard syndrome with a lesion on the right side. Which of the
following sensations on the right side will be affected?
A) Pain
B) Crude touch
C) Proprioception
D) Temperature

90. Which of the following is diagnostic of acute hepatitis B infection?

A) IgM anti-Hbc
B) IgG anti-Hbc
C) IgM anti-Hbe
D) anti-Hbs antibody
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91. An elderly female presented with blockade, nasal discharge, diplopia and facial swelling. On
examination, there is blackish discharge from the nasal cavity with necrosis of nasal mucosa, facial
skin and palate. There is fixation of the right globe. There is elevated blood sugar and urinary ketones
are positive. Which of the following would be the medication to be used in this patient?
A) Amphotericin B
B) Itraconazole
C) Ketoconazole
D) Broad spectrum antibiotics

92. A boy presented with a history of fever, headache and vomiting since 3 days and disorientation since
Ist day. On examination, neck rigidity was positive. He also had 1 episode of generalized tonic clonic
seizures (GTC) and then he became unconscious. CECT was found to be normal. CSF examination
reveals a cell count of 300 cells/mm3 (polymorphs: 50-70%), protein 70 mg/dL, sugar 50 mg/dL
(blood: 95 mg/dL). Which of the following is the most likely diagnosis?
A) Pyogenic meningitis
B) Tubercular meningitis
C) Herpes encephalitis
D) Cerebral malaria
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93. An elderly, hypertensive patient presented with sudden onset headache, vomiting, neck rigidity
without focal neurological deficit. Diagnosis:
A) Subarachnoid hemorrhage
B) Ischemic stroke
C) Subdural hemorrhage
D) Meningitis

94. Female washing clothes and her hands in cold water exhibit color changes from white to red. Which
of the following drugs is best suited for this patient?
A) ACEI
B) CCB
C) Thiazides
D) Alpha blockers
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95. A female patient was brought to the ER with altered sensorium. On examination BP was 88/67mm
with a pulse of 60/min. Rectal temperature was 34 Celsius. There was associated history of weight
gain, increased sleep,constipation, dry skin and menorrhagia. What is the diagnosis?
A) Myxedema Coma
B) Septic Shock
C) Hypothermia
D) Cardiogenic Shock

96. A 30-year-old male presents to the ER with the chief complaint of headache. On examination, he is
seen sweating and has palpitations. Which of the following tests will you perform?
A) 24-hours Urine Metanephrine Levels
B) Serotonin Levels
C) Uric Acid levels In Blood
D) TSH Levels
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97. A 50-year-old male patient comes with complaints of fatigue and limb weakness, especially in the
evening. His symptoms improved after administering edrophonium. What is the most probable
diagnosis?
A) Lambert Eaton syndrome
B) Myasthenia gravis
C) Botulism
D) Amyotrophic lateral sclerosis

98. A child presents with short episodes of vacant stare several times a day. The vacant episode begins
abruptly and the child remains unresponsive during the episode. There is no associated history of
aura or postictal confusion and the child is otherwise normal. The likely diagnosis is:
A) Grandmal seizures
B) Absence seizures
C) Complex partial seizures
D) Day dreaming
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99. A 32-Year-old female develops symptoms secondary to dry mouth & dry eyes. She has enlarged
salivary glands. Studies for autoantibodies to Ro (SS-A) are positive salivary gland biopsy reveals
lymphocytic infiltration. Which of the following is the most likely diagnosis?
A) Sarcoidosis
B) Primary Sjögren’s syndrome
C) Human immunodeficiency virus (HIV) infection
D) Lymphoma