 1.

30 years old girl came with c/o palpitation, O/E u find mid systolic click rest
of the findings are normal. What would u give her?

A. Nifidipine

B. Propanol

C. BB

D .Diuretic

 2. 42 years old female patient came with c/o blood in stool and mild abdominal
discomfort for which she took bismuth salt before coming to your office the other
family members also suffered from food poisoning but they recovered O/E
BP=160/90, pulse=90, Temp=37c , moist mucosa, on P/R exam u found only blood
stained soft consistency stool and on abdominal examination there was only mild
abdominal discomfort what would u do?

A. Admit for observation for workup for active bleeding.

B. Send home with CBC, U/C/E and oral rehydration and be back next day.

C. Call consultant for endoscopy

D. Resuscitate her now

 4. what is the best indicator of good hydration in a child?

A. Depressed fontanel

B. moist mucosa

C. Decrease skin turgor D. sunken eyes

 5. what is the DOC for otitis media caused by s. pneumonia?

A. Augmentin

B. dicloxacillin

C. cefuroxime.

D. Amoxil

 6. A female patient G4P3+0 , previous 1c/s and 2 SVDs, H/O HSV in previous
pregnancy during labour, (nothing was mentioned about current status) admitted in
LR for trial of labour after 1 hour she beacme 3-4cm , Cx soft, Membranes intact, if this
patient ends up in c/s what will be the indication?

A. Prev scar

B. Non progress of labour

C. Prev h/o HSV

D. Multiparity

 7. what is the recommended physical activity per day for a 12 years old boy?

A. 30minutes

B. 1hours

C.2-3hours

D 3-4hours

 8. Best drug that can be given to a patient with Schz, mania patient ?

A.Risperidon

B.TCA

C. Clozapine
  9. A female patient avoid going zoo , hills what is the diagnosis?

A. Panic disorder

B. Agoraphobia

C. Depression

 10. A child has 3-4 episodes of Otitis media despite of treatment what should be the
next action?

A. Repeat Abx course again for 1month

B. Do audiometry

C. Do tubotmpanoplasty

 11. A boy 13 years old came with H/o SOB on exertion,and mild cough, there was no
cynosis which resolve itself in few days. O/E u find only crackles B/L, no murmur what
would be next investigation?

A. Echo

B. CXR

C. blood test

D. Spirometry

 12. A 48 years old male patient came with c/o epigastric pain and burning he was on
ppi since few weeks and it was under control but after taking junk food recently it has
aggravated he also started taking aspirin for his joint pain recently. What should be
the next action?

A. Endoscopy

B. Stop Aspirin

C. Add antibiotics

D .Add sucrulfates
  13. A female patient G2P1+0 , prev SVD admitted for IOL , she became fully dilated
after 5hours she is on synto infusion, optimum contractions, O/E, vitals: normal, on
CTG there was normal base line with variable deceleration, what should be the
action?

A. Stop infusion,

B. Change position

C. Do c/s

 14. A female patient 40 years old, premenopausal, P3+0 previous all C/s with tubal
ligation she never used ocps now came with c/o dyspareunia what should be the
treatment

A. Ask her to use vaginal dilators

B. Trail of nsaids

C. Give Estrogen cream as lubricants

 15. In a couple father and mother both are carrier for thalesemia minor what would
be the risk to their child for having thalesemia major?

A .50%

B.25%

C. 100%.

D. 0%
  16. Father came with complaint that his baby boy 4 years old is unable to walk
properly he started to walk normally in the beginning but since few months he is
unable to walk her mother is again pregnant what would be the chance of having this
disease to next baby?

A. 50%

B. 25%

C.100%

D.0%

 17. A male patient came to u after having junk food with c/o facial edema and
difficulty in breathing, Vitals normal ,chest clear. there was no significant past medical
hx what is the diagnosis?

A. Bells palsy

B. Angioedema

C. Urticaria

 18. A female patient came with c/o facial edema , joint pain no h/o rash investigation
show Proteinuria , ANA positive. Diagnosis?

A. Lupus

B. R.Arhritis

C. Systemic sclerosis
 19. A male patient c/o with c/o decrease vision since few days headache jaw
claudication, no h/o fall or loss of consciousness, Bp=150/90, A/F, investigations:
ESR=70 , Diagnosis?

A. SAH

B. Glaucoma

C. Temporal arteritis

 20. A male patient came with c/o sudden loss of vision there is no h/o trauma. There
were few significant fundal findings, Diagnosis?

A. MS

B. Prolactinoma

C. Craniopharyngioma

 21. A farmer came with c/o RHC pain a pic was given in which there was a solid mass
in liver .what could have caused it?

A. Alcohol use

B. Animal handling in farms

C. Tick bite

D. Sanitary hygiene

 22. A female patient came with h/o ocp use asking for risk of Ca breast what would u
tell her?

A. it increases risk

B. It increases risk of ca cx

C. It decreases risk of ca ovary.

 23. A female patient came with h/o SVD 10days back c/o breast pain O/E. Temp=103F,
pulse ,92, chest clear, p/v findings normal she is B/F what could be the cause

A. Mastitis

B. Endometritis

C. Ca breast

D. Fibrocystic changes

 24. A female patient came with c/o back ache she was just pushing table and after
that she developed back pain O/E u find tenderness over LS spines what would u do .

A. Physio

B. massage

C. Avoid rest

 25. A male patient came due watery discharge from right eye with redness there was
no vision impairment diagnosis?

A. Bacterial conjunctivitis

B. vial conjunctivitis

C. Glaucoma

D. Allergic conjunctivitis

 26. A child came with h/o trauma to left leg on xray u found fracture of tibia, Vitals
normal.what would u do before referral to orthopedic?

A. splint

B. ice application

C. i/v fluids
 27. A Copd patient what would give mortality benefit?

A. Oxygen

B. vaccine

C. Antibiotics

 28. A female patient came with c/o obesity, fatigue, skin bruising polydipsia B=160/90,
temp=37 , RBS= 180, what would be the next investiagation.

A. ACTH level

B. 24 hours urinary cortisol

C. metanephrin level

D.OGTT

 29. On examination of hypertensive patient u found A/v nipping (av nicking) he is

hypertensive since 20yrs no h/o vision loss what will be the stage?

A. stage I

B. stage II

C. stage III

D. stage Iv

 30. A known patient of Alzheimer's family is asking for treatment

A. New methods of daily activity

B. vitamins

C. Give him easy tasks

 31. An old age patient k/c of DM what vaccine u can give him.

A Influenza vaccine per year

B. Pneumococcal vaccine each year

C. influenza vaccine every 5 year

 32. A patient came with c/o depressive mood , loss of appetite ,decrease sleep what's
the diagnosis?

A. Dysthmia

B. Major depressive disorder

C. Panic disorder

 33. An obese patient came with c/o Sob on n off , u found uvular edema what would u
advice

A. CPAP

B Antibiotics

C. Tonsillectomy

D. weight reduction

 34. A female patient came with c/o BMI 32 u will advice?

A. Decrease calorie in diet B. interdisciplinary action C. Cut off fats from diet

 35. A known smoker came with painless ulcer on tongue what can be the diagnosis?

A. Sq .cell carcinoma

B. Candidiasis

C. Kaposi

D. melanoma

 36. Why we give influenza vaccine yearly?

A. Genetic drift

B. formula changing

c. mutation of virus
 37. A model came with diagnosis of rosacea u will advise

A. Laser treatment

B. Steroids

C. Antibiotics

 38. A picture of fundus was given asking for diagnosis.

A. Normal

B. Glaucoma

C. Hypertensive changes

D. Diabetic retinopathy

 39. A baby with genital rash treatment?

A. zinc oxide +steroids + antifungal

B. Zinc oxide + antibiotics +steroids

C. Steroids+ Abx

 40. A female patient came with c/o nausea vomiting she was on low dose OCPs, LMP
was 6 weeks back O/E . Vitals normal, u found blue discoloration of cx, BHCG=1500,
what can be the diagnosis?

A. Early pregnancy

B. Pill amenorrhea

C. Endometritis

D. Ectopic
 41. A female patient came with c/o 32 weeks Gestation and B/L pedal edema there
was no c/o headache u found Bp=160/90 , B/L pedal edema and on P/A Ex fundal
height 28cm. Urinary protiens 3+. What could be the cause of IUGR ?

A. High Bp

B. Elevated liver enzymes

C. Nephrotic syndrome

D. GDM

 42. A 50 yrs old male patient came with c/o constipation and fatigue since few days.
There is no epigastric pain O/E Bp=130/80, pulse=79 , CBC=HB=13, TLC=7,
platelets=290, Mcv=102 , FOB=nil what should be the next investigation?

A .Endoscopy

B. Colonoscopy

C. Cortisol levels

D. TSH

 43. A 3 years old boy came with c/o lethargy, G.weakness ,he was fine till 1 year when
he was on cow milk and after that he was switched to solid diet , O/E BP=100/60,
pulse=96, temp=37 CBC shows HB=8.7 , MCV=102 , TLC=6 Platelets=350000 what
should be added

A. ferrous SO4

B. Ca supplements

C. Folic acid

D. Vitamin B12
 44. An old age female patient ,menopausal newly diagnosed as c/o osteoporosis what
should be added

A. Bisphosphonate

B. Calcium

C. Vitamin D

D. Estrogen

 45. A patient works in dusty environment came with c/o Red itchy eyes with watery
discharge what should be the treatment?

A. Tobramycin eye drops

B. Acyclovir

C. Steroids

D. Olopatadine eye drops

 46. Patient came with c/o light headedness, tachycardia relieved by lying down h/o GI
surgery 2months back.

A.GERD

B. IBD

C. Dumping syndrome

 47. Regarding low back pain which is true?

A. Pain of long duration is always pathological

B. Duration and location determine outcome

C. Duration and location determine biological origin

 48. A patient with positive PPD what should be next investigation

A. CXR

B. Monteux

C.PPD

D. sputum AFB

 49. A patient came with HBsAg +ve, HBeAg +ve, HBcAB +ve whats the explanation?

A. Chronic Hepatitis B

B. Acute hepatitis B

C. Acute Hepatitis D

C. Recovery phase

 50. A 6months old baby came with c/o fever , cough O/E chest congested with
wheezing what’s the most common cause ?

A.RSV

B.H.influenza

C.S. pneumonia

D.Asthma

 51. There were 3 numerical type qs asking to calculate incidence and RR.

 52. 1-2 qs with ECG