INFECTIOUS DISEASES

1. A patient presented with fever. His culture showed gram negative non fermenting
rods. What is the organism
a) Salmonella
b) E.coli
c) Streptococcus
d) Staphylococcus
e) Clostridium difficile
2. Typhoid-H antigen signify:
a) Acute infection
b) Convalescent phase
c) Acute on chronic
d) Previous infection
e) Cured
3. A patient presented in ER after dog bite. He was given HRIG and Vaccine. What will
be the future schedule of vaccine
a) 0,7,14,21
b) 0,3,7,14,21
c) 5,7,14,28
d) 5,7,14,21
e) 0,3,7,14,28
4. A patient presented to you in opd with white plaque over the lateral surface of
tongue. He is HIV positive. Your diagnosis will be?
a) Candidiasis
b) Hairy cell leukopenia
c) HPV infection
d) HSV infection
e) CMV infection
5. What is the common malarial parasite involved in developing nephritic syndrome
a) Plasmodium vivax
b) Plasmodium malarie
c) Plasmodium falciparum
d) Plasmodium ovale
6. Fungal infections are best diagnosed by?
a) Chocolate agar
b) Skin biopsy
c) Wood's light
d) Slit lamp examination
e) Skin scrapings with KOH
7. Vaccine to be given before splenectomy is
a) Hepatitis B
b) BCG
c) Pentavalent
d) Covid
 e) Pneumococcal
8. Most common complication of mumps in adults is:
a) Orchitis
b) Lung abscess
c) Meningitis
d) Pneumonia
e) Encephalitis
9. A diabetic obese adult male presents to you in opd with fever and cough. CXR
showed patchy infiltration. What is most likely organism?
a) Klebsiella
b) H.influenza
c) Pseudomonas
d) Pneumococcus
e) Mycobacterium
10. All of the following causes meningitis except
a) Viral infections
b) H.influenza
c) Osteomyelitis
d) Rabies
11. A patient comes to you with diarrhoea of 6 weeks. He had bulky stools and history
of travel. What is your diagnosis?
a) Shigellosis
b) Giardiasis
c) Amebiasis
d) Salmonella
e) Campylobacter jejuni
12. Malaria resistant to chloroquine is treated with?
a) Mefloquine
b) Primaquine
c) Proguanil
d) Artesunate
e) Metronidazole
13. The most common manifestation of CMV is
a) Esophagitis
b) Hepatitis
c) Meningitis
d) Retinitis
e) Peritonitis
14. A nurse got needle stick injury of a patient who is HbsAg positive. She is not
vaccinated for HBV. How will you manage her?
a) Hep B vaccine only
b) Hep B vaccine and immunoglobulins
c) Hep B vaccine and Ribavirin
d) Peg interferons and ribavirin
e) Reassurance
15. What is the most common malarial parasite involved in nephrotic syndrome
 a) Plasmodium malarie
b) Plasmodiun vivax
c) Plasmodium falciparum
d) Plasmodium ovale
16. 3 hours after meal which included chicken salad and cream pastries, patient
developed diarrhoea what is most like organism
a) Staphylococcus infection
b) Salmonella
c) C botulism
d) Clostridium perfrigens
e) Cryptosporidium
17. Brucella affects mainly:
a) GIT
b) lungs
c) Brain
d) Skin
e) Eyes
18. Causative organism of infective endocarditis in IV drug abusers is
a) Staph aureus
b) Staph epidermidis
c) Streptococcal viridans
d) Enterococci
19. A patient presented in ER with severe watery stools(15-20 episodes per day) for last
24 hours. Labs show increase in urea and creatinine. What is the cause?
a) Vibrio cholera
b) Campylobacter jejuni
c) Yersinia
d) Clostridium perfringens
e) Clostridium difficle
20. What is the complication of meningococcal meningitis
a) Cranial nerve palsy
b) Brain abscess
c) Adrenal insufficiency
d) Scarlet fever
e) Myocarditis
21. A 30-year-old male patient complains of fever and sore throat for several days. The
patient presents to you today with additional complaints of hoarse-ness, difficulty
breathing, and drooling. On examination, the patient is febrile and has inspiratory
stridor. Which of the following is the best course of action?
a) Begin outpatient treatment with ampicillin.
b) Culture throat for β-hemolytic streptococci.
c) Admit to intensive care unit and obtain otolaryngology consultation.
d) Schedule for chest x-ray.
e) Obtain Epstein-Barr serology.
22. A 70-year-old patient with long-standing type 2 diabetes mellitus presents with
complaints of pain in the left ear with purulent drainage. On physical examination,
 the patient is afebrile. The pinna of the left ear is tender, and the external auditory
canal is swollen and edematous. The white blood cell count is normal. Which of the
following organisms is most likely to grow from the purulent drainage?
a) Pseudomonas aeruginosa
b) Streptococcus pneumoniae
c) Candida albicans
d) Haemophilus influenzae
e) Moraxella catarrhalis
23. An 80-year-old male complains of a 3-day history of a painful rash exten-ding over
the left half of his forehead and down to his left eyelid. There are weeping vesicular
lesions on physical examination. Which of the following is the most likely diagnosis?
a) Impetigo
b) Adult chickenpox
c) Herpes zoster
d) Coxsackie A virus
e) Herpes simplex
24. A recent outbreak of severe diarrhea is currently being investigated. Several
adolescents developed bloody diarrhea, and one remains hospitalized with acute
renal failure. A preliminary investigation has determined that all the affected ate at
the same restaurant. The food they consumed was most likely to be which of the
following?
a) Pork chops
b) Hamburger
c) Gefilte fish
d) Sushi
e) Soft-boiled eggs
25. A previously healthy 25-year-old music teacher develops fever and a rash over her
face and chest. The rash is itchy and, on examination, involves multiple papules and
vesicles in varying stages of development. One week later, she complains of cough
and is found to have an infiltrate on x-ray. Which of the following is the most likely
etiology of the infection?
a) Streptococcus pneumoniae
b) Mycoplasma pneumoniae
c) Histoplasma capsulatum
d) Varicella-zoster virus
e) Chlamydia psittaci
26. A man is admitted with E. coli bacteremia. Which of the following is the most
appropriate therapy?
a) Vancomycin
b) Linezolid
c) Quinolones, aminoglycosides, carbapenems,
d) Doxycycline
e) Clindamycin
27. Which of the following antibiotics will cover methicillin-resistant Staphylococcus
aureus (MRSA)?
a) Nafcillin
b) Cefazolin
c) Piperacillin-tazobactam
d) Ceftaroline
e) Azithromycin
28. Which of the following is the most accurate test for an infectious disease?
a) Protein level of fluid
b) Culture
c) IgM Levels
d) IgG Levels
e) Gram stain
29. A 34-year-old woman presents with facial pain, discolored nasal discharge, bad
taste in her mouth, and fever. On physical examination she has facial tenderness.
Which of the following is the most accurate diagnostic test?
a) Sinus biopsy or aspirate
b) CT scan
c) X-ray
d) Culture of the discharge
e) Transillumination
30. Which of the following is the most accurate in determining the etiology of infectious
diarrhea?
a) Recent history of eating chicken
b) Frequency of bowel movements
c) Blood in stool
d) Odor of stool
e) Recent interstate travel
31. Which of the following correlates the best with an increased likelihood of mortality?
a) Bilirubin
b) Prothrombin time
c) ALT
d) AST
e) Alkaline phosphatase
32. Which of the following will become abnormal first after acquiring hepatitis B
infection?
a) Bilirubin
b) E-antigen
c) Surface antigen
d) Core IgM antibody
e) ALT
33. A woman comes to clinic with multiple painful genital vesicles. What is the next step
in management?
 a) Acyclovir orally
b) Acyclovir topically
c) Tzanck prep
d) Viral culture
34. Which of the following is the most sensitive test of CSF for neurosyphilis?
a) VDRL
b) RPR
c) FTA
d) Stain
e) Dark field
35. Infection with Schistosoma haematobium is most strongly associated with:
a) Transitional cell bladder cancer
b) Lung cancer
c) Hepatoma
d) Vulval carcinoma
e) Squamous cell bladder cancer
36. A 15-year-old Russian child who has recently arrived into the country presents with
fever and feeling generally unwell. His temperature is 38.2ºC and pulse 96/min. On
examination a grey coating is seen surrounding the tonsils and there is extensive
cervical lymphadenopathy. What is the most likely diagnosis?
a) Tonsilitis
b) Typhoid
c) Phrangitis
d) Infectious mononucleosis
e) Diphtheria
37. A 35-year-old man is reviewed in clinic having been diagnosed with HIV two years
ago and is stable on anti-retroviral therapy. He has a new regular partner and is
concerned about transmitting the disease to him. What factor is most likely to
increase the risk of transmission?
a) Circumcision
b) Low CD4 count
c) Co-infection with genital warts
d) Diabetes
e) Mucosal ulceration
38. A 48 year old farmer attends the emergency department 7 days after cutting his arm
from falling on barbed wire in his field. He complaints of fever, headache and painful
spasms in his neck and back which last several minutes. You suspect tetanus and
he tells you he has completed a course of tetanus vaccination previously. What is
the most appropriate treatment?
a) Tetanus booster
b) IM tetanus immunoglobulin
c) Tetanus antitoxin
d) I.V tetanus immunoglobulin
 e) Both C & D
39. A 35 year old men attending a clinic presenting with Right hypochondric pain since
last 2 weeks. He is compaining of fever, anorexia and vomiting for last 2 weeks. U/S
abdomen done yesterday & there is rounded, well circumscribed mass in liver. What
is the drug of choice?
a) Metronidazole
b) Ciprofloxacin
c) Flucoxallin
d) Vancomycin
e) Both C & D
40. After 1 week of treatment for liver abcess symptoms does not setteled down. What is
next appropriate next treatment of choice?
a) USG guided aspiration
b) Thoracocentesis
c) Percardiocentesis
d) CT scan
e) V/Q scan
41. A 22-year-old female presents with an offensive vaginal discharge. History and
examination findings are consistent with a diagnosis of bacterial vaginosis. What is
the most appropriate initial management?
a) Oral azithromycin
b) Topical hydrocortisone
c) Oral metronidazole
d) Clotrimazole pessary
e) Advice regarding hygiene and cotton underwear
42. A 24-year-old patient presents to the Emergency Department with watery diarrhoea.
He returned from holiday in Tanzania yesterday. Which of the following pathogens is
the most likely to be responsible for this presentation?
a) Enterotoxigenic E. coli
b) Non-typhoidal Salmonella
c) Campylobacter spp
d) Vibrio cholerae
e) Giardia lamblia
43. A 23-year-old man develops watery diarrhoea 5 days after arriving in Mexico. Which
one of the following is the most likely responsible organism?
a) Salmonella
b) Shigella
c) Campylobacter
d) Escherichia coli
e) Bacillus cereus
44. You review a 14-year-old boy who has recently emigrated from Russia. He was
involved in car accident two years ago and underwent an emergency splenectomy.
 Following this he takes penicillin V on a daily basis. He is unsure of his vaccination
history. Which organism is he particularly suscepitble to?
a) Staphylococcus aureus
b) HIV
c) Haemophilus influenzae
d) Streptococcus pneumoniae
e) Mycobacterium tuberculosi
45. A patient with HIV is reviewed. Which one of the following is an example of a
nucleoside analogue reverse transcriptase inhibitors?
a) Zidovudine
b) Indinavir
c) Ritonavir
d) Ribavirin
e) Efavirenz
46. A 23-year-old student returns from India and develops a febrile illness. Following
investigation he is diagnosed as having Plasmodium vivax malaria. This area is
known to harbour chloroquine-resistant strains of Plasmodium vivax. What is the
most appropriate initial management to treat the acute infection?
a) Primaquine
b) Atovaquone-proguanil
c) Quinine
d) Doxycycline
e) Artemether-lumefantrine
47. A 30-year-old man comes for review. He lives with a woman who has recently been
diagnosed with having tuberculosis. The man was born in the UK, has no past
medical history of note and is currently asymptomatic. What is the most appropriate
test to check for latent tuberculosis?
a) Heaf test
b) Mantoux test
c) Sputum culture
d) Chest x-ray
e) Interferon-gamma blood test
48. A 25-year-old man returns from a gap-year in Central and South America and
presents with a 2 month history of an ulcerating lesion on his lower lip. Examination
of his nasal and oral mucosae reveals widespread involvement. What is the likely
cause?
a) Leishmania brasiliensis
b) Leishmania mexicana
c) Trypanosoma cruzi
d) Basal cell carcinoma
e) Leishmania donovani
49. Which one of the following vaccines uses a protein that attaches to the
polysaccharide outer coat to make the pathogen more immunogenic?
 a) Rabies
b) Yellow fever
c) Oral polio
d) Measles
e) Meningococcus
50. A 31-year-old woman presents as she has noted an offensive, fishy vaginal
discharge. She describes a grey, watery discharge. What is the most likely
diagnosis?
a) Trichomonas vaginalis
b) Candida
c) Chlamydia
d) Bacterial vaginosis
e) Physiological discharge

Endocrinology
51. A 25 year old female is diagnosed as a case of Grave’s disease. Which of the
following is not a feature of high serum thyroid hormone
a) Tachycardia
b) Hypertension
c) Tremors
d) Increased peripheral resistance
e) Diarrhea
52. A 31 year old patient is commenced on carbimazole for hyperthyroidism . How often
should her TFTs be measured for dose alteration?
a) 2 monthly
b) 4 -6 weekly
c) 8 -12 weekly
d) 6 monthly
e) 2-4 weekly
53. Which of the following is the most common skin manifestation of hypothyroidism
a) Alopecia
b) Dry skin
c) Myxedema
d) Onycholysis
e) Yellow skin
54. A 68 Year old female is reffered to u after an abnormal thyroid hormone test which
showed very low TSH and normal T4 and T3. What is the diagnosis
a) Grave’s disease
b) Secondary hyperthyroidism
c) Tertiary hyperthyroidism
d) Subclinical hyperthyroidism
 e) Secondary hypothyroidism
55. Which of the following clinical sign will differentiate between Cushing syndrome and
pseudo Cushing caused by obesity
a) Truncal fats
b) Moon face
c) Buffalo hump
d) Myopathy
e) Abdominal striae
56. Which of the following biochemical profile is commonly present in patients with
Addison disease?
a) Low Na, low K, low Calcium
b) Low Na, high K, low calcium
c) Low Na, high K, high calcium
d) High Na , low K, high calcium
e) High Na, low K, low calcium
57. Which of the following is the best initial medical treatment used in
pheochromocytoma to control B.P?
a) Nifedipine
b) Amlodipine
c) Atenolol
d) Phenoxybenzamine
e) Propranolol
58. Which of the following is the most specific sign of hypocalcemia?
a) Chvostek sign
b) Trousseau sign
c) Prolonged QT interval
d) Short QT interval
e) Laryngospasm
59. Which of the following is the most common cause of hypocalcemia
a) Autoimmune hypoparathyroidism
b) Iatrogenic
c) Hypomagnesemia
d) Vitamin D deficiency
e) Renal disease
60. A 55 year old female is suspected case of adrenocortical insufficiency. Pt has
hyponatremia, hyperkalemia with postural hypotension. Which of the following is
best test to confirm diagnosis
a) Random serum cortisol
b) Random serum ACTH
c) Aldosterone renin ratio
d) ACTH stimulation test
e) CT scan abdomen
61. A 26 year old female who is 11 weeks pregnant is referred to you as she has
gestational diabetes in her first pregnancy. What is the most appropriate
management at this stage
a) Check fasting glucose
b) Check random glucose
c) Check HbA1c
d) Start metformin
e) Perform OGTT
62. Which of the following is considered a risk factor associated with more severe
symptoms of diabetic neuropathy?
a) BMI 21Kg/ m2
b) Young age
c) Dyslipidemia
d) New onset DM
e) Insulin use
63. A 25 year old female presented with recurrent attacks of early morning fits,
associated with urinary incontinence for 2 months. When investigated her fasting
sugar is consistently below 50 for 1 week. Her C peptide and insulin levels are high.
What is the diagnosis?
a) Insulinoma
b) Factitious hypoglycemia
c) Addison disease
d) Functional hypoglycemia
e) Glucagonoma
64. Macrovascular complication of diabetes is
a) Impaired vision
b) Sensory loss
c) Gastroparesis
d) Renal failure
e) Claudication
65. Which of the following is indicator of severe diabetic ketoacidosis
a) Bicarbonate less than 3
b) Blood ketones more than 3
c) Systolic B.P less than 100
d) Anion gap more than 13
e) GCS less than 15
66. Treatment of choice for multinodular goitre is
a) Corticosteroids
b) Block and replace regimen
c) Surgery
d) Radioiodine
e) Anti thyroid drug titration
67. Which of the following is not a symptom of cushing’s syndrome
 a) Moon face
b) Hypotension
c) Osteoporosis
d) Obesity
e) Memory loss
68. Which hormone is responsible for stimulating the body to begin contractions during
childbirth?
a) Oxytocin
b) Prolactin
c) ADH
d) Progesterone
e) Estrogen
69. Which of the following is a symptom of Grave’s disease
a) Low resting metabolic rate
b) Bradycardia
c) Myxedema
d) Decrease in perspiration
e) Heat intolerance
70. A nonfunctioning pituitary macroadenoma would be most likely treated by
a) Radiation therapy alone
b) Dopamine agonists
c) Somatostatin analogs
d) Transsphenoidal surgery
e) NSAIDs
CARDIOLOGY
71. After suffering a streptococcal throat infection, a 12 years old boy develops cardiac
symptoms that are attributed to Rheumatic fever. Years later, at the age of 34 he is
admitted to the hospital with pulmonary edema further examination reveals the
diastolic murmur at the Apex and mitral stenosis is diagnosed. Before surgical
evaluation, which of the following findings can be attributed to the mitral stenosis?
a) Large left ventricle
b) Indentation of the middle third of the esophagus by an enlarged left atrium
c) Notching of the ribs
d) Bounding, full pulse
e) Angina pectoris
72. Which of the following is the most common cause of sudden death asking young
athletes?
a) Mitral valve prolapse syndrome
b) Hypertrophic cardiomyopathy
c) Thyrotoxicosis
d) Anxiety
73. According to the Jones criteria, which of the following sets of symptoms would
indicate a positive diagnosis for Rheumatic fever?(Select all that apply.)
a) Carditis, fever & an elevated WBC count
b) Positive strep throat culture, arthritis, chorea
c) Recent scarlet fever, carditis, fever, arthralgia
d) Elevated C-reactive protein, carditis, fever
74. Based on the recent IE diagnostic criteria, the two most important parameters for the
diagnosis of this infection are
a) Laboratory abnormalities and positive blood cultures
b) Positive blood cultures & echocardiographic changes
c) ECG changes and positive physical findings
d) Positive physical findings and positive blood cultures
75. 64 years old man presents to the emergency department with chest pain, fever,
fatigue and arthralgia. His past medical history is significant for Rheumatic heart
disease and Dental procedure a few weeks before admission. He currently shows no
“stigmata” of endocarditis on physical examination, although endocarditis is
suspected. The most likely organism is
a) Streptococcus viridians
b) Staphylococcus aureus
c) Enterococcus fecalis
d) Pseudomonas
76. Which of the following duke criteria is a major criterium for infective endocarditis?
a) Immunological findings such as glomerulonephritis
b) Predisposing heart condition or intravenous drug use
c) Blood cultures positive for typical infective endocarditis organisms
d) All of the above
77. Modified Duke’s criteria for IE
a) Highly sensitive
b) Highly specific
c) BOTH
d) NONE OF THESE
78. The clinical manifestations of IE result from
a) Cytokines
b) Intracardiac infection
c) Embolization
d) Immunological phenomenon
e) All of the above
79. Which of these findings best constitutes a “positive” exercise treadmill test in aortic
stenosis?
a) Dyspnea at peak exercise
b) Pre-syncope at peak exercise
c) 2mm upsloping ST-depression at peak exercise
d) 60% maximal predicted HR achieved
 e) Asymptomatic intermittent left bundle branch block at peak exercise
80. Which of the following is physical examination finding in a patient with chronic aortic
regurgitation?
a) Becker sign
b) Corrigan pusle (“ water-hammer” pulse)
c) Traube sign (“pistol-shot” pulse)
d) All of the above
81. A 65 years old obese female with known type 2 diabetes presents with one one
week history of unstable angina. She undergoes angiogram and a drug eluting stwnt
was inserted into a 90% stenosis of his LAD. On discharge what should her
anticoagulation regimen be?
a) Aspirin and clopidogrel for 1 month followwed by lifelong aspirin
b) Aspirin and Clipdogrel for 1 month followed by lifelong clopidogrel
c) Aspirin and Clipdogrel for 1 year followed by lifelong aspirin
d) Clopidogrel only lifelong
e) Aspirin only lifelong
82. A 50 year old man is admitted to the hospital after sustaining an acute myocardial
infarction. Eight hours after this event, his blood pressure is 70/50 mmHg, and his
pulse is 42 bpm. An ECG reveals sinus rhythm. Which of the following is the most
appropriate intervention.
a) Administer IV beta blocker
b) Administer IV atropine
c) Perform cardiac catheterization
d) Administer IV doputamine
e) Insert a temporary pacemaker
83. A 20-year-old woman comes to the office for a routine employment physical
examination. She reports no symptoms, and her medical history includes no
significant conditions. The patient has good exercise tolerance and does not take
any medications or use illicit drugs. Her blood pressure is 125/65 mm Hg and pulse
is 80/min. Cardiac auscultation reveals an early diastolic murmur at the left sternal
border that is best heard with expiration. Carotid pulses are normal bilaterally, and
there are no bruits. ECG shows normal sinus rhythm without any significant
abnormalities. What is the best next step in management of this patient?
a) Chest x-ray
b) Coronary CT angiography
c) Echocardiography
d) No further workup
e) Exercise ECG
84. A 42-year-old man with acute renal failure is confused. His serum potassium is 8.1
mEq/L . The most likely abnormal ECG finding is
a) T wave inversion
b) PR interval of 300ms
c) QT interval of 0.4s
 d) U wave
e) Tall tented T waves test
85. A 35 year old woman with a history of rheumatic fever in childhood had had
episodes of congestive heart failure for several years. During the last of her hospital
admissions, she developed massive pulmonary thromboembolism and died. Autopsy
examination showed that her lungs were firm and brown, and microscopically had
widened, edematous and fibrosed alveolar septa, aggregates of heart failure cells in
the alveoli, thickened small muscular arteries, and atherosclerosis in the larger
pulmonary arteries. An acquired valvular disease was found in the heart. Which one
of the following was it most likely to be?
a) MITRAL STENOSIS
b) TRICUSPID STENOSIS
c) AORTIC STENOSIS
d) AORTIC REGURGITATION
e) MITRAL REGURGITATION
86. A patient has persisting >2mm ST elevation in V2-6 two hours following a myocardial
inraction, with hypertesnion of 205/115, he has already been given morphine and
aspirin , what is the next management of choice?
a) IV Nitroglycerine
b) Double-bolus r-PA
c) IV GTN
d) IV streptokinase
e) Subcutaneous heparin
87. Constrictive pericarditis is most likely in
a) Uremia
b) Congestive heart failure
c) Rheumatic fever
d) Myocardial infarction
e) Tuberculosis
88. Pulmonary hypertension is most severe in which untreated valvular disease?
a) Pulmonary stenosis
b) Aortic stenosis
c) Aortic insufficiency
d) Mitral stenosis
e) Mitral insufficiency
89. The most common cause of death of in-hospital patients with myocardial infarctions
a) Cardiogenic shock (severe pump failure)
b) Arrhyrhmia
c) Cardiac free wall rupture
d) Rupture ventricular aneurysm
e) Constrictive pericarditis
90. A 55-year-old man with a history of diabetes, hypertension, hyperlipidemia, and
current smoking presents with a 2-month history of progressively worsening chest
pain on exertion. Which of the following diagnostic procedures is most appropriate
a) Exercise ECG testing
b) Adenosine myocardial perfusion scintigraphy
c) Dobutamine stress echocardiogram D) PET scan
d) Cardiac catheterization
91. What is the most sensitive and specific marker for a myocardial infarction (MI)?
a) AST
b) LDH
c) Troponin I
d) CK-MB
92. A 56-year-old In the past year he has noted chest pain after ascending flight of
stairs. He smokes 2 packs of cigarettes per day. On examination 1-has a blood
pressure of 155/95 mm Hg. Laboratory findings include a tota serum cholesterol of
245 mg/dL with an HDL cholesterol of 22 mg/dL. Which of the following vascular
abnormalities is he most likely to have?
a) Lymphedema
b) Medial calcific sclerosis
c) Atherosclerosis
d) Deep venous thrombosis
93. A 75 year old man is found to be unresponsive. The ward doctor is called to the
patient's bedside. He is not breathing and has no detectable pulse. Which is the
SINGLE most appropriate next step?
a) Get a defibrillator
b) Give two rescue breaths immediately
c) Check notes for a Do Not Attempt Resuscitation (DNAR) order
d) Insert two wide-bore cannulas into each antecubital fossa
e) Start chest compressions at a rate of 30:2
94. A 55 year old man had a myocardial infarction 3 days ago. He now complains of a
shortness of breath and a sharp pain in the chest. The pain increases when he
breathes and is relieved when sitting forward. His respiratory rate is 22
breaths/minute and his heart rate is 95 beats/minute. What is the SINGLE most
likely diagnosis?
a) Myocardial infarction
b) Pericarditis
c) Aortic dissection
d) Pulmonary embolism
e) Cardiac tamponade
95. A 60 year old man had a myocardial infarction 2 weeks ago. He now presents with
dyspnoea a nd pleuritic chest pain. A pericardial friction rub was noticed on
examination. ECG shows widespread ST elevation. A chest X-ray shows an
 enlarged, globular heart. His pulse rate is 95 beats/minute and his respiratory rate is
24 breaths/minute. What is the SINGLE most likely cause of his symptoms?
a) Cardiac tamponade
b) Mitral regurgitation
c) Dressler's syndrome
d) Atrial fibrillation
e) Pulmonary embolism
96. A 56 years-old man known Diabetic and Hypertensive presents in the emergency
department with complain of chest tightness for 2 hours, the Blood pressure was
130/80mmHg and Pulse rate was 102 bpm His ECG was done which shows ST
Elevations in leads II, III, AVF: What is the most likely diagnosis
a) Posterior wall MI
b) Inferior wall MI
c) Anterior wall MI
d) Anterolateral wall MI
97. A 40 year old man was brought into the A&E after being hit by a vehicle. He
sustained trauma to the chest. His neck veins look distended and his heart sounds
are faint. He has a blood pressure of 80/45 mmHg and pulse is 120 bpm. His
trachea is central. What is the SINGLE most appropriate management?
a) Chest drain
b) IV fluids
c) Pericardiocentesis Large-bore cannula into second intercostal space in
midclavicular line
d) Blood transfusion
98. A 6 week old baby presents with the following features of progressive cyanosis, poor
feeding, tachypnoea during the first two weeks of life. A holosystolic murmur is
heard. What is the SINGLE most likely diagnosis?
a) Atrial septal defect
b) Ventricular septal defect
c) Tricuspid atresia
d) Patent ductus arteriosus
e) Tetralogy of Fallot
99. A 38 year old man presents to the emergency department feeling unwell and dizzy.
He has a heart rate of around 35 beats/minute. What is the SINGLE most
appropriate first line treatment?
a) Atropine
b) Adenosine
c) Dopamine
d) Epinephrine
e) Supplemental oxygen
100. A 47 years old obese woman , known case of hypertension presented to
Emergency department with presenting complain of Shortness of breath which
worsens on exertion and on lying down supine, Blood pressure 140/90 mmHg, pulse
 rate 99 bpm, SpO2 96% , On Examination, She has bilateral pitting pedal edema,
She had bi-basal crepitations in chest. ECG shows normal sinus rhythm.
Considering the patient’s findings what do you suspect?
a) Anterior wall M.I
b) Acute exacerbation of Asthma
c) Angina pectoris
d) Left heart failure
e) None of the above
HEMATOLOGY
101. What is the most common cause of anemia in young females
a) Vitamin b12 deficiency
b) Folic acid deficiency
c) Iron deficiency
d) Pyridoxine deficiency
e) Vitamin A deficiency
102. Which drug is responsible for causing folate deficiency?
a) Methotrexate
b) Azithromycin
c) Cefixime
d) Amoxicillin
e) None of the above
103. Young female has presented in medicine with complaints of generalized
weakness from last three month.Rest of the systemic inquiry is unremarkable.she
had history of pica(clay) On examination she had koilonychia. Blood cp showed
WBC=8000, Hb=8.1 MCV 65 Platelet= 385x10*3.what will be your next step?
a) Start iron
b) Peripheral blood film
c) Iron studies
d) IV iron
e) None of the above
104. What is common cause of jaundice in thalasssemia?
a) Hepatitis C
b) Hepatitis B
c) Iron deposition in liver
d) Hemolysis
e) None of the above
105. Half life of platelet is
a) 1-2 days
b) 3-4 days (in transfusion)
c) 5-6 days
d) 7-8 days
e) Non of the above
106. What is the average life span of Red blood cells?
a) 21 days
b) 28 days
c) 45 days
d) 120 days
e) None of the above
107. Which cell is the precursor of platelet and found in bone marrow?
a) Erthyroblast
b) Megakaryocyte
c) Basophil
d) Myelocyte
e) None of the above
108. A child presented to OPD with anemia, jaundice, splenomegaly and frontal
bossing. What is your diagnosis?
a) Iron deficiency anemia
b) Sickle cell anemia
c) Thalassemia Major
d) Sideroblastic anemia
e) None of the above
109. Which test is used to detect hemolytic anemia?
a) Coombs test
b) Genetic testing
c) Schilling test
d) Peripheral blood film
e) None of the above
110. Which vitamin is essential for blood clotting?
a) Vitamin K
b) Vitamin C
c) Vitamin E
d) Vitamin A
e) Vitamin A and E
111. All of the following can cause iron deficiency anemia except
a) Menorrhagia
b) Bleeding from GIT tract
c) Pregnancy
d) Transcobalmin1 deficiency
e) Low iron diet
112. Philadelphia chromosome is present in which type of leukemia?
a) Acute myeloid leukemia
b) Chronic myeloid leukemia
c) Acute lymphocytic leukemia
d) Acute promyelocytic leukemia
e) None of the above
113. Which of the following is most helpful in diagnosis of thalassemia?
a) Peripheral blood film
b) Iron studies
c) Hb electrophoresis
d) Bone marrow biopsy
e) All of the above
114. Which of the following is not a cause of iron deficiency anemia
a) Thalassemia
b) Anemia of chronic disease
c) Iron deficiency anemia
d) Pancytopenia
e) Lead poisoning
115. 16 years old patient presented with fever ,weight loss,loss of apettite ,recurrent
respiratory tract infections.His CBc showed WBC count of 45000 ,Hb=7.1 platelets
=9000.His peripheral blood film was advised which showed 40% blasts.what is the
diagnosis?
a) Chronic leukemia
b) Acute leukemia.
c) Sickle cell disease
d) Thalassemia
e) None of the above
116. What do you understand by term PICA in iron deficienc anemia?
a) Itchiness
b) Jaundice
c) Pallor
d) Desire to eat non food items
e) None of the above
117. Absence of which clotting factor leads to Hemophilia a?
a) Factor VII
b) Factor VIII
c) Factor IX
d) Factor X
e) Factor XIII
118. Which of the following is not present in normal blood?
a) Fibrinogen
b) Thrombin
c) Prothrombin
d) Albumin
e) None of the above
119. Which of the following would prevent transfusion reaction?
a) Administration of plasma free blood
b) Administration of washed RBCs
c) Treatment with immunoglobulins
 d) Treatment with mannitol
e) Proper cross matching of donar red cell with recipient plasma
120. Which organism is responsible for megaloblastic anemia
a) Ascaris
b) Giardia
c) Hookworm
d) Diphyllobothrium latum
e) Amoeba
PULMONOLOGY
121. Which of the following is the standard treatment regimen for the management of
pulmonary TB ?
a) 6 months of initiation phase followed by 2 months of continuation phase
b) 4 month of initiation phase followed by 2 months of continuation phase
c) 2 months of initiation phase followed by 4 months of continuation phase
d) 3 months of initiation phase followed by 2 months of continuation phase
e) 6 months of initiation phase followed by 3 months of continuation phase
122. Regarding CAP (community acquired pneumonia),which one of the following is
not the cause?
a) Streptococcus pneumonia
b) Legionella
c) Myco bacterium TB
d) Myco plasma
e) Chlamydia
123. A patient came in the ER after road traffic accident and had multiple chest
injuries along with shortness of breath. On examination there was absent air entry
into the left side of the chest , which of the following finding is NOT consistent with
diagnosis of pneumothorax?
a) Decrease chest movement on the left side
b) Hyper resonant percussion note on the left side
c) Trachea shifted to the right side
d) Absent breath sound on the left side
e) Stoney dull percussion note on the left side .
124. Among the following, the second line drug used for treatment of tuberculosis is.
a) INH
b) PZA
c) Levofloxacin
d) Ethambutol
e) Rifampin.
125. For the diagnosis of pulmonary TB, which of the following investigations is not
relevant?
a) Sputum staining for AFB (ZN staining)
b) Sputum culture for AFB (LG medium)
c) AFB diagnosis by PCR /gene expert.
 d) Sputum for grams staining and C/S
e) X-ray chest with apical opacity/cavity.
126. A patient admitted in surgical ward for cholecystectomy, 3 days after surgery
patient developed fever cough and chest pain, x-ray chest showed consolidation in
right lung middle zone ,what is your diagnosis?
a) CAP (community acquired pneumonia)
b) HAP (hospital acquired pneumonia)
c) VAP (ventilator associated pneumonia)
d) Bronchogenic CA
e) Pulmonary TB
127. Regarding HAP (hospital acquired pneumonia) , which one of the following
organisms is not causative ?pseudomonas
a) Staph aureus
b) Klebsella
c) Chlamydia
d) Anaerobes.
128. Exudative pleural effusion is seen in which of the following conditions?
a) Pulmonary TB
b) Cardic failure
c) Nephrotic syndrome
d) Cirrhosis of liver
e) Hypothyroidism
129. Which of following organism is likely to cause pneumonia out-brake by infecting
air-conditioning systems?
a) Streptococcus Pneumonia
b) Legionella
c) Myco bacteriam TB
d) Mycoplasma
e) Chlamydia
130. Which of the following feature would favor a diagnosis of COPD against Asthma?
a) Atopical / Allergic disorder started from early childhood
b) Positive family history
c) Reversibility with salbutamol
d) On examination of the chest multiple polyphonic rhonchi in both in both
lung fields
e) FEVI / FVC ratio < 0.7
131. Which one of the following respiratory conditions is not associated with clubbing?
a) Bronchiactasis.
b) Bronchogenic carcinoma.
c) Allergic asthma.
d) Intestitial lung disease.
e) Lung abscess.
132. Which of the following clinical signs suggest right lung consolidation?
a) Deceased right lung air entry with resonant percussion node.
b) Deceased right lung air entry with normal percussion node .
c) Dull percussion node in right lung and with bronchial breathing.
 d) Trachea shifted towards right side.
e) Trachea shifted towards left side.

GASTROENTEROLOGY
133. An otherwise healthy gentleman presented to you with 2-3 episodes of upper GI
bleed in last 02 weeks. Which of the following should be offered first?
a) Laparotomy
b) Barium meal
c) USG abdomen
d) Upper GI endoscopy
e) Oral proton pump inhibitors.
134. 37-year-old lady presented in medical OPD with history of recurrent oral ulcers,
which of the following is associated with oral ulcers?
a) Peptic ulcer disease
b) GERD
c) Inflammatory bowel disease
d) Irritable bowel syndrome
e) Diverticular disease
135. 45-year-old gentleman presented with history of difficulty in swallowing and
vomiting for last 2 months. His barium swallow shows distended stomach with a bird
beak appearance at lower end, what is the most likely diagnosis?
a) Achalasia
b) Neuro degenerative disease
c) Esophageal carcinoma
d) Congenital esophageal webs
e) Foreign body in esophagus
136. A 56-year-old lady presents to you with the history of progressive abdominal
distention, swelling of feet, generalized weakness and one episode of hematemesis.
Examination showed ascites and splenomegaly, her JVP was not raised. Ascetic
fluid R/E showed Transudative ascites, what is the most likely cause of her
presentation?
a) Cirrhosis of liver
b) Tuberculosis
c) GI malignancy
d) Cardiac failure
e) Constrictive pericarditis
137. What is best option to prevent the spread of hepatitis B, C from a dental clinic?
a) Vaccination of all the patients
b) Proper sterilization of the instruments
c) No intramuscular injections
d) Use of clean water to wash the instrument
e) No surgery by junior dentist.
138. Which combination of features explain obstructive jaundice?
a) Vomiting and tender hepatomegaly.
b) Jaundice and dark colored urine
c) Pruritis in the course of Acute Hepatitis
 d) Pruritis and clay-colored stools in a jaundiced patient.
e) Jaundice seen in new born babies.
139. Which statement does not favor Acute Hepatitis?
a) It is Hepatocellular jaundice.
b) Prodromal features have lot of nausea and vomiting.
c) Fever seen in the prodromal phase.
d) History of recurrent biliary colic.
e) Markedly raised S ALT and AST.
140. Pick up the statement indicating bad prognosis in Acute Hepatitis.
a) Severe vomiting leading to dehydration in prodromal phase.
b) Tender hepatomegaly with deep jaundice.
c) Disturbed mental state a week after the onset of jaundice.
d) Pruritis occurring during the course of jaundice.
e) Hepatitis E in a non pregnant female.
141. In the causes of Acute Hepatitis, pick up the commonest cause:
a) Viral hepatitis.
b) Toxic hepatitis due to drugs.
c) Non-alcoholic steatohepatitis(NASH.
d) Alcoholic hepatitis.
e) Autoimmune diseases.
142. Regarding Hepatitis B and C ,which of following will not lead to disease
transmission?
a) Needle stick injury due to infected needle.
b) Needle sharing by drug users.
c) Unhygienic surgical procedures.
d) Unhygienic drinking water source.
e) Unhygienic dental procedures.
143. Which of the following Liver function tests will be seen in “Acute Hepatitis” ?
a) Hyperbilirubinemia with normal Serum ALT.
b) Hyperbilirubinemia with raised Serum ALT.
c) Hyperbilirubinemia with normal Serum ALT but raised Serum Alkaline
phosphatase.
d) Hyperbilirubinemia of the unconjugated type.
e) Hyperbilirubinemia of the conjugated type.
NEPHROLOGY:
144. RBC casts on urinalysis usually signify:
a) Acute glomerulonephritis
b) Chronic pyelonephritis
c) Acute cystitis
d) Nephrotic syndrome
e) Renal vein thrombosis
145. 13-year-old boy presented with history of generalized edema and facial puffiness
for last 3 weeks, he also gives history of frothy urine. What is the most important
investigation for this patient?
a) Urine R/E
 b) Ultrasound Kidney
c) 24 hours urinary proteins
d) Renal function tests
e) Serum electrolytes.
146. Regarding common complication of nephritic syndrome, which of the following
are not related?
a) Hypertension.
b) Hematuria.
c) Generalized edema.
d) Raised urea& creatinine
e) Bleeding from gums and epistaxis.
147. Which of the following is true for AKI (acute kidney injury)?
a) It is disease of one kidney
b) RFTs are always normal
c) Patient don’t need dialysis
d) Patient is always asymptomatic
e) It is potentially reversible disorder in which there is rapidly decrees in renal
function in the matter of days to weeks
148. Which statement is not related with Nephrotic syndrome?
a) Proteinuria
b) Decrease Albumin.
c) Hyperlipidemia
d) Generalized Edema
e) Prolonged PT and INR
149. Best treatment of chronic renal failure with small kidneys on ultrasound are?
a) Anti biotics
b) Dopamine
c) Steroids
d) Hemodialysis/renal transplantation
e) Immunosuppressive agents
150. Management of anemia in CRF patients is by?
a) Folic acid
b) Iron
c) B-12
d) Erythropoietin injection
e) High protein diet