EXAMINATION

PAPERS MEDICINE-I
1. Which of the nwntions a long
following is X-Iinked history of alcohol
recessive disorder: abuse and his past
A. Marfan medical history shows
syndrome deranged liver
B. Gardener function tests. Which
syndrome Of the following
Duchenne clinical signs does not
muscular form part Of chronic
dystrophy liver disease: A.
Jaundice
D. Polycystic
K
kidney disease
o
E. Digeorge
i
syndrome
l
o
2. A middle aged female n
presented to y
outpatient department c
with complain of h
itching all over the i
body with scratch a
marks, On
examination there C
was hepatomegaly .
and altered liver
function lest with P
raised alkaline a
phosphatase. Which l
one of the following m
test should be carried e
out for diagnosis: A. r
Anti Jo-l antibodies
Anti-mitochondrial e
antibody r
C, 24 urinary copper y
level
t
D. Ceruloplasmin h
level e
E. Ferritin level m
a
3, A 67-years old man t
presents with feeling
unwell and D
complaining or .
general malaise. He

page |1
 S ventricular
p hypertrophy on ECG
i 6. A 22-years old
d unconscious man
e is brought into
r
Mechanical ventilgܯ
n IN
a IfV
I/V
e
Methadone
v
i accident and
emergency. He
4, A 45-years old male
has a respiratory
presented with loin rate Of 10 and
pain and vomiting pinpoint pupils.
since 02 days. His most
ultrasound of kidneys appropriate
Shows renal abscess treatment is: A.
and Small pus in
renal medulla. C.
What is your D,
diagnosis: E.
A. Cortical necrosis
of kidney 7. What-medicine
Acute would you start
pyelonephritis as secondary
C. UTI prophylaxis 10
reduce the
D. Acute chance of further
glomerulonephrit
Bariceal
is
hemorrhage in
E. Acute renal the future:
function A
,
5. Which Of the
following may
A
distinguish acute
kidney injury from t
chronic kidney e
disease; Renal size n
on ultrasound scan o
l
B. Hypophosphate o
mia l
C. Hyperkalemia
D. An increased P
urinary sodium r
excretion Len o
p

page |2
r 9. A 12-years old
a female with
n asthma presents
o to you with
l sudden onset of
o breathlessness
and chest
C tightness. Which
. of the following
feature suggests
L life threatening
o attack:
s A. Peak expiratory
a flow rate 33 to
r
O
t
,
a
n
S
,
i
D, *Ramipril
l
E. C!pPidogral
e
'Which or the n
following t
statements is
most nsistent c
with h
immunoglobulin e
deficiency: s
A, It may require t
immunoglobulin
replacement C
therapy ,

B. It is unlikely in R
myeloma e
It is not s
associated with p
end organ i
damage r
D. It has no a
t
association o
with r
autoimmune y
disease It
commonly r
presents with a
opportunistic t
in fection e

page |3
 4 f
0 l
/
u
m
i e
n n
D. Heart rate z
125/min a
E. Use of accessory
muscles
D
10. A patient presents .
with worsening
pneumonia C
associated with
production of large h
quantities of red- l
brown sputum. a
Chest X-ray shows m
cavity in right
y
upper lobe With
fluid level. The d
most likely i ecting i
organism is; a
Streptococcus
pneumonia
B. Klebsiella p
pneumonia n
C e
. u
m
H o
a n
e i
m a
o E, Legionella
p pneumophilia
h 11. In which of the
following conditions
i might acute type-I
respiratory failure be
l expected: A. Opioid
toxicity Lobar
u collapse
s C. Obstructive sleep
apnea (OSA)
i D. Flail chest injury
n

page |4
 E. Lymphangitis presented with "eight
c»arcinomatosis loss.
blood in
12. A 24-years Old male sputum and
is brought to the fever since
emergency with weeks. You
breathlessness after advised chest
being bitten by a bee. X-ray. Which
He has given oxygen Of the
inhalation. What will following
be the first line radiological
treatment in patient: findirws is
A. Diphenhydramin matchable to
e your
B. Salbutamol diagnosis:
C. Prednisolone A. Fibrosis at
Adrenaline middle zone
E. Promethazine B. Pulmonary
calcification
13. Which of the C. Bilateral h ilar
following statements lymphadenopath
best describes y
complement Cavitation
deficiency: A. It can atlupper zone
be routinely treated E. Pulmonyrynodule
with complement
replacement therapy
15. A 26-years Old
man has a sudden
B. It is not
chest pain. He feels
associated
breathless and
with recurrent
nauseated but does
infection Cl
not vomit. He has
inhibitor
no other medical
deficiency
problems. There is
leads to a low
no breath sound at
C3 even
theright side Of
between
chest. Which is the
attacks of
most likely
angioedema
diagnosis:
D. It is associated A. Costochondritis
with connective
B. Acute
tissue disease E. It
is not influenced pericarditis
by complement Pneumothorax
control proteins D. Pulmonary
embolus
14. A 33-years Old E. Community
female is living in acquired
crowded room with pneumonia
poor nutrition

page |5
16. A 25-years Old treatnwnt of this
female presented patient:
with BP Of 180/1(H) A. Azathioprine
mmHg. What is the B. Liver
commonest cause of transplantationa
hypertension in this C. Cyclosporin
patient: e. Zinc
A. Pheochromocyto tulose
ma
B. B. A patient of diagnosis
Hypothyroidism with pulmonary
Renovascular tuberculosis. Which
disease of the following test
D. Conn's disease will assess multidrug
E. Congenital resÉtanee:
adrenal A. H
hyperplasia RCT
Scan
17. A 69-years old man B. L
presented with a 02 ung
weeks history Of biop
abdominal pain. On sy
examination the C.
patient is jaundiced Ches
and the abdomen is t x-
distended with ray
tenderness in the Gen
epigastric region. e
Smooth expe
hepatornegaly and rt
shifting dullness Bronchoscopy
positive. Which Of
the following is a 20. A 20-years Old
most likely wolnan presents
diagn(Bis•. with a 03 day
A. Iron deficiency history of difTtuse
anemia acute abdominal
B. Ulcerative colitis pain. On
Budd chiari
syndrome examination skin
D. Left-sided heart turgor is reduced
failure and a fruity odour
E. Crohn's disease can be smelt. most
likely diagnosis is:
18. A 22-years old male A. Liver failure B.
pi'ésented with gait Pancreatitis
ataxia, mental Diabetic
disturbance and ketoaeidosis
jaundice. Which of D. Maple syrup
the following is the urine disease
E. Acute porphyria

page |6
21. A 25-years old department with a 04
female presented day history Of chest
with severe pain and mild
abdominal pain and shortness of breath.
vomiting since 02 He feels that the pain
days. On is worse on lying
examination there is flat, coughing and
tenderness over deep breathing. It is
epigastrium. relieved by sitting
What will you forward and has
advise next: improved with
A. CT scan ibuprofen. He was
recently unwell with
abdomen
nonspecific viral
B. Ultrasound infection. What is
abdomen the most likely cause
Serum amylase Of the chest pain:
D. Serum A. Musculoskeletal
paracetamol level chest pain
E. I-FT Pericarditis
C. Myocardial in
22. A 60-years old farction
lady hypertensive D. Pulmonary
presented with embolism
palpitation remains E. Aortic dissection
for few minutes.
During the period 24. A 55-years Old
she noted that her smoker presented
pulse become rapid with shortness Of
and irregular. Her breath and mild
resting ECG is cough. On
normal at that examination
time. percussion note is
The best tool to hyper-resonant on
diagnose her both sides Of chest.
condition is: Chest X-ray shows
A. Stress hyper-inflated lung
echocardiography fields. What is the
B. Echocardiograph most appropriate
y diagnosis:
Holter A. Pneumonia
monitoring e. Emphysema
D. Exercise C. Pneumothorax
tolerance test D. Chronic
(EWE) bronchitis
E. Nuclear cardiac
E. None of the abo ve
scanning

23. A 25-years old man 25. A 50-years Old male

presents to the diagnosed ease Of
emergency aortic regurgitation.
Which of the

page |7
 following is D. Carcinoma of
bettersign for head of pancreas
diagnosis: Liver abscess
A. Low volume 28. What is seen
pulse earliest in an ECG
Water hammer of pulmonary
pulse embolism:
C. Anacrotic pulse A. AV dissociation
D. Pulsus B. Sine wave
paradoxicus C. Flattened P-wave
E. Pulsus bisferiens D. QRS widening
Right ventricular
26. A 55-years mal" strain &
diagnosed to ascites tachycuardia
due to cirrhosis 03 29. An 80-years old man
weeks. His ascitic having an ejection
fluid shows WBC systolic murmur, a
700 cimmand parasternal thrill.
albumin 0.8 Wd'. What is the most
Which of the likely diagnosis:
following treatment A. Large atrial
woulgxou offer. A. septal defect
Linezolid O. Aortic
IN stenosis
cefotaxime C. Mitral stenosis
C. Oral D. Right ventricular
metronidaz@l€ hypertrophy
D. Rifaxamine E. Pulmonary
E. Gentamicin hypertensi

27. A 40-years old 30. Which of the

patient presented to following is
you with complain mosecommonly
Of high grade fever treated by steroid
with rigor and chills, enema in
upper quadrant ulcerative colitis:
abdominal pain. On A. Transverse.li
examination he was
Proctitis
mild icteric and
D QPerianal a
tender right upper
quadrant. What is
your most likely
diagnosis: The drug of choice
A. Pancreatitis for Wilson's disease
is:
B. Peptic ulcer
e. Penicillamine
disease
B. 'Ursodeoxycholi
C. Acute c acid
appendicitis C. Dapsone
D. Venesection

page |8
 Entecavir transudative leural
effusion:
• . Which of the Nephrotic sy
following ndrome
organisms would
typically be found B. Pulmonary
in a patient with infarction
atypical community C. Drug-induced
acquired pleural effusion
pneumonia: A. D. Tuberculosis
PseudomonzLs spp
E. Rheumatoid
Legionella
arthritis
pneumophilia
C. Staphylococcus a 35. A 69-years Old
ureus woman presents to
D. Haemophilus infl accident and
uenza emergency in a
E. Streptococcus distressed state. She
pneumonia is extremely
breathless and an
33. A 19-years old man is audible wheeze can
recently diagnosed be heard, frothy clear
with type1 diabetes sputum is produced
and attends your each time she coughs.
clinic to ask about A gallop rhythm and
possible widespread wheezes
complications in the and crackles are
future. He mentions heard on auscultation.
an uncle who has The most likely
end-stage renal diagnosis is:
disease due to poorly A. Acute asthma
controlled diabetes attack
and specifically B. Emphysema
enquires about testing C. Pneumonia
for early signs of D. COPD
renal impairment. e. Pulmonary edema
The most appropriate 36. A 45-years old man
investigation is:
taking
A. Urine dipstick for antituberculosis drugs
glucose since two months
B. Blood pressure ago, presents to you
C. Serum creatinine with a complains of
D. Serum pins and needles
electrolytes sensation in his
Microalbuminuri hancLs and feet with
a associated numbness.
Which of the
34. Which Of the following drugs is
following is a responsible:
Cause Of a O. Isoniazid

page |9
 B examination there
. was clubbing, coarse
crepitations audible
P all over the chest.
y most likely diagnostic
r test is:
a
O. Sweat chloride test
z
i B
n .
a
m S
i p
d u
e t
u
C m
.
c
R
u
i
f l
a t
m u
p r
i e
c s
i
n C
.
D
. B
r
S
o
t
r n
e c
p h
t o
o s
m c
y o
c p
i y
n D, Gene expert
E. Ethambutol E. CT scan
37. A 17-years Old male
presented with 38. A patient in your
history Of Warå*s diagnosed wi
breathlessness and hepatoeellular
diarrhea since many carcinorna. You are
years. On asked to perform a
tumor marker level

page | 10
 on this patient. Which dominant
of the following disorder
tunu»r markers are Hypokalemia
elevated in occurs in all
hepatocellular types Of RTA
carcinomy,J
A. CA 15-3 B. CA 41, A 23-years old man
125 toxicity after
Alpha fetoprote• deliberately
D. Carcinoæmbryon ingesting a
ic antigen (CEA) carbamate
E. HCG insecticide. Clinical
features include
39. A SO-years old male headache, diarrhea,
patient known case of hyper-salivation,
cirrhosis secondary abdominal pain,
presented to the tachycardia, muscle
emergency weakness,
department with fasciculations.
altered level of Which one Of the
consciousness. He is following is an
drowsy but easily example of a
arousable, lethargic
cholinergic
and occasional
(muscarinic) effect'.
aggressive behavior.
What is your A. Fasciculation.
treatment: Salivation
A. V•asopressor e.g. C. Respiratory
Terlipressin le paral
B. Proton pump D. Mydriasis
inhibitor E. 'Tachycardi

C. Antibiotics D. 78-•years old male

Acyclovir with coronary artery
Lac tulose disease presents with
40. Concerning renal several nu»nths of
postprandial
tubular acidosis
generalized
which of the abdominal pain that
following is not true: typically lasts 3060
A. RTA-2 associated minutes. He has
with become fearful of
aminoaciduria eating and lost 15
B. Renal stone pounds of weight.
formation Occurs What is nwst likely
in RTA-I diagnosis:
C. Oral bicarbonate •AZ
requirement is A
greater in RTA-2 c
than RTA-I u
D. Primary RTA-I is t
an autosomal e

page | 11
 e
d c
i y
v s
e t
r i
t t
i i
c s
u
l D
i .
t
i A
s c
u
I t
n e
t
e p
s a
t n
i c
n r
a e
l a
o t
b i
s t
t i
r s
u Mesenteric
c ischemia
t
i 43. Which or the
o following is causing
n secretory diarrhea:
C Zollinger Ellison
. syndrome
B. Pseudomembran
A ous colitis
c C. TB ileitis
u D. Irritable bowel
t syndr01ne
e E. Short bowel
syndrome
c
h 44. You are questioned
o by your registrar
l regarding bacteria

page | 12
 respomsible for a
causing blood stained l
diarrhea. From the
list below select the
b
organism which is not
responsible for u
causing blood stained m
diarrhea: i
A. Campylobacter n
spp
B. Shigella spp C
C. Escherichia coli .
Staphylococcus
spp S
E. Salmonella spp e
r
45. A 72-years old man is
found to have acute u
kidney injury (AKI). m
Urine microscopy
A. Hemolytic uremic syndrome
reveals the presence b
of red cell casts. i
What is the most l
likely etiology of his
i
renal failure:
r
Microscopic
polyangitis u
b
C. Sclerodermic i
renal crisis n
D. Acute tubular D. Encephalopathy
necrosis E. Prothrombin time

E. None of the above 47. Which of the

following is included
46. Which Of the in the criteria of
following is not hepatorenal
included in child syndrome:
pugh score: e. Doubling of serum
Alpha fetoprotein creatinine over
B 02 weeks without
. treatment Of
diuretics
S B. Serum creatinine
e more than 05
r mg/dl
u C. Ascitic protein
m more than 03 g/dl
D. Urine DR shows
protein 3+

page | 13
 E. Hemorrhagic B. Empyema
aseites C. Bronchoscopic
carcinoma
48. Which of the COPD
following condition is E. Mesothelioma
an example Of
paraneoplastic 51. A patient presents
syndrome: with non-suppurative,
A. Irritable bowel painful, palpable
syndrome nodular lesions at
B. Hypoglycemia shins. He is
C. Variceal diagnosed case Of
hemorrhage D. inflammatory bowel
Dilated pupil disease. The best
Hypercalcaemia diagnosis of these
lesion is:
49. A 21-years old man A. Eczema
complains his urine h B. Erythema
s turned a faint red in multiform
the last week. He Erythema
denies any significant nodosum
changes in his diet or D. Drug induced
lifestyle and has eruption
sensorineural E. Purpura
deafness diagnosed
when he was young. 52. An 18-years old
On examination you woman presents
notice retinal necks with a sore throat
and urine dipstick and suspected acute
confirms protein and rheumatic fever.
The most likely Which Of the
diagnosis A. Down following is a
syndro minor
B. IgA nephropathy manifestation of
C. Benign familia I acute rheumatic
hemat fever:
D. Wolfram A. Chorea
syndrome B. Carditis
O. Alport' s syndrome C. Subcutaneous
nodules
50. A 30-year•s old man D. Erythema
presents to your clinic marginatum
with a cough and Raised C-
finger clubbing. From reactive protein
the list below which
of these answers is 53. You have called by
not a respiratory for a
cause of finger young female with
clubbing: shortness of breath.
A. Cystic fibrosis She has low volume

page | 14
 pulse with mid- reticulonodular
diastolic murmur. pattern. What is the
What is your diagnosis:
diagnosis: O. A. COPD
MitraVGGsis• B. Bronchial asthma
B. vsDL C. Bronchiectasis
D. PulnmaryTB
c. D Idiopathic
D ective endocarå@is
pulmonary
Pulmonary fibrosis
stenosis>
57, Which of the
54. What is seen following is not a
earliest in an ECG symptom of
of pulmonary hypokalemia:
emlxjlism: Seizures
A. Flattened P-wave
B. Constipation
B. QRS widening
C. Sine wave C. Muscle weakness
Right D. Paralysis
ventricul E. Ileus
ar strain 58. A 65-years old man
& presents with a 04
tachycar week history of
dia AV general malaise and
dissociat lethargy. He attends
ion the emergency
department and he
55. A SS-years Old is admitted to
man presents with hospital with a
pitting edema Of fever. He has Some
his ankles. Blood blood cultures taken
results show low and he undergoes
albumin and a urine an echocardiogram
dipstick is positive which shows a
for protein. The mass on his mitral
most appropriate valve. What is the
management is: most likely
A. High protein diet organism that will
B. Diuretics be grown from his
C. Bed rest blood cultures:
D. Prophylactic A, Staphylococcus
anticoagulation aureus
ACE inhibitor B
.
56. A 60-years old man S
has shortness of t
breath and clubbing r
since OS years. His e
chest X-ray shows p

page | 15
t t
o o
c c
o o
c c
c c
u u
s s

f g
a a
e l
c l
a o
l l
i y
s t
i
C c
, u
S s
t Viridians
a streptococci
p
h 59. Which is not a cause
y
Of normal anion gap
l
o metabolic acidosis:
c A. Acetazolamide
o High dose
c conicosteroids
c C. Renal tubular
u acidosis
s D. Diarrhea
e E. Pancreatic fistula
p
i 60. The S2 in atrial septal
d defect is best defined
e as:
r A. Thrill always
m with S2
i B. Narrow splitting
d C. Soft P2
i D. Loud S2
s
Wide Splitting of
D S2
.
S 61. A 55-years Old
t woman is seen in
r clinic. she has a ten
e years history of type-
p 2 diabetes treated

page | 16
 with glibenclamide. A. Streptococcus
Her blood pressure is pneumonia
148/93 mmHg with M
new onset y
proteinuria. A renal c
bi0JßY shows the o
presence of p
kimmelsteil: A. Start l
renal dialysis a
Start ACE s
inhibitors m
C, Increase oral a
hypoglycemic
D. Calcium channel p
blocker n
E. Start cholesterol e
loweringÅhérapy u
m
62. You see an years o
Old woman With n
rheurnatoid arthritis i
in your clinic. She a
was referred by her
GP after her ALP C
levels were found .
to be abnormally
high at 300 11.1/1.. K
In addition she also l
found to be serum e
anti-mitochondrial b
antibody (AMA) s
positive. The most i
likely diagnosis is: e
A. Hereditary l
hemoehromatosis l
B. Alcoholic liver a
disease
p
C. Primary
n
sclerosing cholangitis
e
D. Wilson's disease
u
Primary biliary
m
cirrhosis
o
63. A 35-years Old male n
admitted in hospital i
with pneumonia and a
hemolytic anemia. D. Legionella
Most likely organism pneumophilia
respomsible for this: E. Chlamydia
pneumonia

page | 17
64. Which of the on auscultation.
following organisms Which of the
responsible for following athologies
causing chronic could explain the
pneumonia and is
most commonly Mitr
found in patients with al
longstanding cystic incompet
fibrosis: ence B.
A. Streptococcus Mechani
pneumonia B. cal mitral
Burkholderiacepacia valve
Pseudomonas replacem
aeruginosa ent
D. L pneumophilia C
E. H. influenza .

A
65. Most common o
r
cardiac abnormality
t
in patients with i
carcinoid syndrome c
is:
A. Mitral stenosis i
Pulmonary Steno n
C. Aortic regurgi c
Catio o
D. VSD m
E. Aortic stenosis p
e
66. A 30-years old t
e
male presents with
n
shortness of breath, c
swelling of feet and e
pericardial knock.
What is the D
diagnosis; .
Pericarditis
E
s
i). Pericardial s
effusion e
Constrictive n
t
pericarditis
i
a
67. A S6-years old man
l
presents with a
history of -headache. h
He is noted to have a y
loud second heart und p

page | 18
 e r
r y
t
e W
n e
s i
i
s
o
n
T
E e
, a
r
P
o C
s .
t
u C
r i
a r
l
r
h h
y o
p s
o i
t s
e
n O
s f
i
o l
n i
v
68. A 40-years Old
e
alcoholic admitted in
r
emergency
D. Reflux
department with
esophagitis
severe vomiting
followed by small E. Peptic ulcer
amount of blood in
his vomit. The most 69. A 28-years old
likely diagnosis is: woman is rushed to
A. Acute hepatitis accident and
O
in a confused state.
. Empty aspirin
packets were found
M close to the patient,
a the partner
l estimates it 45
l minutes since the
o patient rnay have
ingested the pills.

page | 19
 The most 72. Which of the
appropriate first following physical
line management signs is associated
would be: with left ventricular
A. IV sodium failure:
bicarbonate A. A gallop rhythm
with a fourth heart
B. Gastric lavage
sound
C. Intravenous B. A quiet first heart
fluids & electrolytes sound
Activated A gallop
charcoal rhythm with a
Hemodialysis third heart
70. Which one of the sound D. A
following loud second
statements is true? heart sound
Light' s criteria E. Fixed splitting of
includes: the second heart
A. Pleural fluid, sound
serum protein ratio
0.5 B. Pleural fluid 73. A 55-years Old man
LDH, serum LDH has just arrived in
ratio > 05 accidentan
emergency
C. Pleural fluid,
complaining of 20
serum protein minutes of central
ratio 0.6 crushing chest pain.
D. Pleural fluid Which feature is
LDH two thirds mosc important
of the upper limit indicator Of
of normal serum myocardial infarction
LDH at this moment in
e. Pleural fluid time: A. ST
lactate depression
dehydrogenase S
(LDH) two T
thirds Of the
upper limit Of e
normal serum l
LDH e
v
71. The most common a
cause Of pneumonia t
in Aids is: i
A. Pyogenic bacteria o
O. Pneumocystis n
carini
C. M. tuberculosis C
D. Cytomegalovirus .
E. Cryptococcus
Q

page | 20
 B. Chromosome 10
w Absence of X
a chromosome
v D. Chromosome 17
e E. Mitochondrial
s abnormalities
D, Inverted T waves
E. Raised troponins 76. Indicati01B for H.
pylori eradication
74. Which of the include:
following blood iats A. Asymptomatic
showSuccessful Long term
vaccination against NSAID uses
hepatitis-B: C. Maltoma
Anti-HB D. Non-ulcer
B dyspepsia
. E. Gastro
esophageal reflux
A disease
n
t 77. Most common
i precipitating factor
- for hepatic
H encephalopathy is:
B A. Fever
e B. CNS stimulant
drugs C. Paracetamol
C toxicity
.
High protein diet
H
E. Diarrhea
B
s 78. One Of the
A following is usually
g not present in
D. Anti-HBc nephrotic
E. Anti-HBc lgd syndrome:
75. A 20-years old female O. Oliguria
presented with short B. Hypoalbuminemi
stature and a
oligomenorrhea. The C. Hypercholesterol
diagnosis is made emi
with Turner D. Edema
syndrome. Where
will be defect in this E. Sodium retention»
disorder:
A. Deletion Of BCR 79. Oxygen Saturation
ABL translocation SP02 is measured
by a pulse oxy
n*ter that would be

page | 21
 attached to fingertip 82. A patient with acute
or ear lobule. exacerbation Of
Normal range SP02 COPD present with
is: following features
90%Qi except one:
A. An increase in
c. < 80% purulence or sputum
Fever

80. A male patient of 40 C. An increase in

years having history amount Of
of recurrent Of cough Sputum
with sputum at early D. Worsening of
morning. The sputum dyspnea
was foul smelling. On
examination clubbing E. Fluid retention
positive and coarse 83. What is the most
crepitation audible all clinically
over the chest. The significant change
most likely diagnosis in the
is: gastrointestinal
A. Pneumonia tract with aging:
B. Carcinoma Of Reduction in gut
lung nwtility
Bronchiectasis B. Reduction in
D. Pulmonary pancreatic secretions
tuberculosis C. Increased
E. Chronic prevalence of
bronchitis atrophic gastritis
D. Reduction in
81. A 60-years old small intestinal
smoker male absorptive area E.
presented in ER. On Increased prevalence
investigation his of helicobacter pylori
arterial blood gases in festation
P02 less than 60
mmHg and PC02 55
84. A 60-years Old
mmHg. What is the
smoker brought in ER
diagnosis:
with history of
A. Metabolic breathless. On
acidosis investigation his
B. Type-I arterial blood gases
respiratory failure show pH 7.1, PC02 is
C. Respiratory 60 mmHg, P02 is 55
acidosis mmHg, HC03 20
D. Respiratory nunol/L. The
alkalosis appropriate
Type-Il interpretation for
respiratory ABG is:
failure

page | 22
 A. Respiratory p
alkalosis B. e
Metabolic acidosis r
Respiratory D
acidosis ,
D. Ketoacidosis I
E. Metabolic n
alkalosis c
r
85. A 70-years Old e
man with a
osteoarthritis s
developed acute e
renal failure. Ille s
nu»st likely e
underlying catLse r
is: u
e. Excessive use Of m
NSAIDS c
B. Atherosclerosis e
C. Enlarged prostate r
D. Hypertension u
E. Cardiac failure l
o
86. Biochemical features p
of Wilson's disease s: !
A. Normal serum p
eeruloplasm s
Increase urinary m
copper excretion 100 x
hours E. Increase Serum
C copper
.
D 87. In a patient Of
e chronic renal
c failure
r erythropoietin is
e given to correct:
a A. Renal 09strophy
s Anemia
e C. Uremia
h
D. HyperphoSPhåte
e
p E. Hypercalcae
a
88. Which of the
ti
following is most
c
reliable sign of
c
hypovolemia:
o
A. Loss of skin
p
turgOr

page | 23
 B. Elevated JVP B. 'Probioticsk•
C. Sinus
tachycardia D. The ECG finding
Sunken eyes Of acute
Postural drop in myocardial
BP infarction is the
E. Gastric aspirate elevation or
A.
90. A 30-years old male T-
farmer planned to se
brought in g
enKwgency m
hospital. He has en
history of snake bite t
on the right lower m
limb at the site of or
field. Patient's vitals e
are stable. On th
clinical examination an
the blood in oozing P-
from the biting area w
while other system av
examinations are e
unremarkable. The B.
most appropriate (I
pre-hospital T-
management will se
be: g
A. Application Of m
ice en
B. Application Of t
tourniquet m
C. Incision & or
suction to the e
bite site th
Application of an
splint to the 02
bitten extremity m
E. Application Of m
antibiotics e.
ST-
91. Factor which can seg
trigger onset of men
irritable bowel t
syndrome is: mor
A. Pelvic traum e
B. Psychosis than
O. Panic disord&• 01
A. Gastrointestinal mm
%ifectya D.

page | 24
 In- E. Optic atrophy
seg
men 94. The commonest
t organism causing
Imr UTI in female in
e community is:
than Escherichia coli
03 B. Staphylococcus
mm epidermidis
ST-segment C. Proteus
more than 05 D. Streptococci
mm E. Pseudomonas
species
'3. A characteristic 95. Indication of
feature Of surgery in
fundoscopy in ulcerative colitis
infective (UC):
A. Presence of
endocarditis: malignancy
Roth spots B. Perforation
B. Papilledema Mild
C. Silver wiring hemorrhage
D. Hard exudates D. Failure of medical
therapy
A st
.
C. Tu ati
ber c
culi ja
n un
test di
ing ce
D. Lar E. Rais
yng ed
eal IC
swa P
b
b 97. A
A 2
P 0-
C. Car
u y
otid e
sin ar
us s
syn O
dro ld
me m
D. Ch al
ole
E. Toxic megacolon
89. The first line Of investigation for a patient Of cough, fever and weight loss is:
the following is not a cause of sinus |
page 25
 e la
A. It is d
met d
abo er
lic .
dis P
ord at
er ie
B. It is nt
mit fo
och u
ond n
rial d
dis al
ord er
er t,
O. B
Thi .P
s is 9
aut 0/
oso 6
mal 0
do m
min m
ant H
D. Thi g,
s is p
aut ul
oso se
mal ra
rec te
essi 5
ve 5
E. It is b
X- e
Iin at
ked s/
m
98. A in
.
H
e
c
o
m
pl
ai
nt
of
b

page | 26
 a m
cA. on
Sep it
tic or
sho in
ck g
B. D.
Ob E
stru xe
ctiv rc
e is
sho e
ck to
C. le
Hy ra
pov nc
ole e
mic te
sho st
ck (
D. E.
An N
aph uc
yla le
ctic ar
sho sc
ck an
Ne ni
uro ng
gen
ic 100.
sho A
ck 3
0
-
y
e
ar
s
A.
ol
B.
d
Ech m
oca al
rdi e
ogr p
aph re
y s
Hol e
ter nt
e

page | 27
 d ar
A. Gas te
tric ry
ulc C
er ar
ot
B. 11Ti id
table ar
bow te
el ry
synd E.
rom R
e ad
C. Gas ial
tro ar
par te
esis ry
O. 10
No 2.
n- A
ulc 16
-
er
ye
dy ar
spe s
psi gi
a rl
E. pr
De es
pre en
ssi ts
on wi
th
101. fe
A. ve
r
Fe
an
mo d
ral re
arte d
ry ho
B. t
s
Bra
w
chi ol
al le
arte n
ry w
ris
C. ts
Pop an
lite d
al kn
ee

page | 28
s. li
O/ ke
E ly
pin di
k ag
rin no
g si
sha s:
ped A. S
ras L
h E
on B.Rhe
shi
u
n,
mid m
- at
dia oi
stol d
ic ar
mu th
rm rit
ur is
at C.Ank
mit yl
ral os
are in
a
g
on
aws sp
cult on
atio dy
n. lit
Blo is
od O.
pict R
ure he
sho u
ws m
leu ati
koc
c
yto
sis fe
wit ve
h r
rais E.
ed In
ES fe
R. cti
Wh ve
at en
is do
the ca
mo
st

page | 29
 rdit ni
is a

A. 1
fibr O
ino -
us ye
B. He ar
mo s
rrh Ol
agi d
c bo
Transud y
ative pr
D. Pur es
ule en
nt te
E. Ex d
uda wi
tive th
fe
10 99.
Tu ve
r, E.
ber
cul s
osis w
ea
Ac ti
ute ng
bro nd
nch sh
itis or
Ple tn
ural es
eff s
usi of
on br
D. ea
• - th
Pul .
mo O
nar n
y ex
em a
boli m
sm in
I- ati
epa on
r th
pne er
u e
mo ar

page | 30
e en
spli do
nter ca
he rd
mo iti
rrh s
age Di
s, ss
pan e
- m
syst in
olic at
mu ed
rm in
ur tr
at av
mit as
ral cu
are la
a r
and co
spl ag
eno ul
me ati
gal on
y. S
Wh ys
at te
is m
the ic
mo lu
st pu
like s
ly er
dia yt
gno he
sis: m
Ven at
tric os
ular us
sep
ta] 106
def .
ect A
Syp
hili 6
s 4
Inf -
ecti y
ve e

page | 31
 a di
A. Sys se
tem as
ic e
lup B.Cys
us tic
ery fi
the br
mat os
osu is
s C.Do
B. Sar w
coi n
dosi sy
s nd
que ro
stio m
n is e
wro D.
ng Di
as
tran ab
sud et
ativ es
e ne
ple lli
ural tu
effu
sion s
C. T
Ure ur
mia ne
a r
lwa sy
ys nd
bila ro
tera m
l D. e
Pul
mo 108.A
nar k
y n
em o
boli w
sm n
Congest p
ive at
heart ie
failure nt
O
107 w f
e
A. Cel C
iac O
P
disease. On examination short stature with
page | 32
D D.
Ide In
al sp
con ir
cen ati
trat on
ion E.
Of E
02/ xe
L rc
be is
giv e
en:
A. 110.
40 Hypo
% n
B. at
50 re
% m
c. ia
60 a
% n
D. d
35 e
% u
0 v
24- ol
28 e
% m
1 ia
is
Ex di
pira a
tion g
B. n
Sex o
ual se
inte d
rco w
urs h
e e
C. n:
Str A.
aini Pa
ng tie
on nt
mic w
turi ou
tion ld
be

page | 33
 hav m
ing ai
cirr n
hos ca
is us
O. It e
oc E.
cu W
rs at
in er
pri de
ma pr
ry iv
po ati
ly on
di is
psi ha
a ll
or m
ra ar
pi k
d
I/ 111.
V Regar
de di
xtr n
os g
e h
sol e
uti p
on at
C. it
AD is
H C
lev vi
el r
mu u
st s
be f
sup ol
pre lo
sse w
d in
D. g
Ant st
ico at
nvu e
lsa m
nt e
are nt

page | 34
t C
in
M di
ore ca
tha te
n s
80 ch
% ro
de ni
vel c
op in
chr fe
oni cti
c on
inf E.
ect Ig
i G
B. an
H ti
Be F
Ag H.
is B
a C
ma i
rke S
r a
of m
vir ar
al ke
rep r
lic O
ati f
on re
C. co
Per ve
inat ry
al 112.
tran Eryth
smi e
ssio m
nO a
s n
rare o
. d
D. o
Ig s
M u
anti m
- a
HB

page | 35
 n tei
dSarcoid ne
osis D. F
B. All or
ergi ce
c d
ast di
hm ur
a es
C. Sys is
tem E. Acti
ic I va
upu te
s d
eryt ch
he ar
mat co
osu al
s 114.
D. Pne T
um h
oni e
a
E. Rh s
i
eu
x
mat t
oid y
arth
ritis y
e
113 A. a
He r
mo
dial o
ysis l
B. d
Gas
m
tric a
lav n
age
s p
r
Intr e
ave s
nou e
s n
N- t
aee e
tyl d
cys

page | 36
 i pr
nA. ob
)ef
An rå.
aph s
yla
ctic 1
sho 1
ck 6.
B. H
Car e
dio m
gen o
ic rr
sho h
ck a
C. üi
Hy e
po a
vol s
e ci
mic te
sho s
ck fl
D. ui
Ne d
uro is
gen s
ic e
sho e
ck n
in
Sep :
tic
A.
sho
C
ck
hr
on
1A.
ic
Dy
pa
sph
n
asia
M
B.
ali
Str
gn
oke
an
Tremor cy
s
C
D. Apr
'v
axi
le
a
ig
E. Visu
al
's

page | 37
 syn iti
drti s
ne du
T e
ube to
rcul tr
osis au
E. m
Cir a
rho
si' 118.
A
117 O.
Sp p
on a
tan t
eo i
us e
ba n
cte t
ria
l o
pe n
rit
on a
itis n
B. Tu t
i
ber
-
cul
t
ous
u
peri
b
toni
e
tis
r
C. Inf
c
ecti
u
ve
l
peri
o
toni
u
tis
s
D. Pri
mar t
y h
me e
sot r
heli a
om p
a y
E. Per
iton w

page | 38
 Wh B.
at P
pos ne
sibl u
e m
sid on
e ia
effe Right
cts sided
he pleura
has l
dev effusio
elo n
ped D.Coll
: ap
A. se
Fev O
er f
& ri
ras gh
h t
B. lu
GI ng
T E. CO
ups P
ets D
C. 1
Flu 2
like 0.
illn F
ess ol
D. lo
Ble w
edi in
ng g
pro is
ble n
ms ot
e. a
He fe
pa at
titi u
s re
119. o
A.
f
Fib
m
rosi
al
s of
a
lun
b
g

page | 39
A. Par m
est R
hes ed
ia uc
e
B. Acr
IA
ode hy
rma dr
titis ox
C. Nig yl
ht as
blin e
dne ac
ss tiv
D. ity
Bo in
ne ki
dn
pai
ey
ns di
Blurring se
Of as
vision e
D.xl A
121 A.
hy
Ch
dr
ole
ox
eal
yl
ei
as
fer
e
ol
ac
hyd
ti
rox
vi
ylat
ty
e to
is
25-
in
cho
cr
lec
ea
alci
se
fer
d
ol
in
B, 1,25
(O ki
H) dn
2 ey
D3 di
can se
cau as
se e
hyp E. 1,25
erth (
yroi O
dis

page | 40
 H) E. Pain
2 fu
D3 l
lev he
el pa
is to
incr m
eas eg
ed al
in y
kid
ney 123.O
dis st
eas e
e o
d
1A. y
Pul st
sus ro
par p
ado h
xic y
us is
alw a
ays m
Arise in et
JVP a
during b
inspirati ol
on ic
C. Ele b
vat o
ed n
JV e
P di
wit se
h as
typi e
cal in
des c
cen hr
t o
D. Ra ni
pid c
irre re
gul n
ar al
pul fa
se il
ur

page | 41
e. m
Se ia
co
nd 1
ar 2
y 4.
hy A
pe c
rp ut
ara e
th fa
yr tt
oi y
dis li
m v
B. er
Re O
nal f
I e.
alp Tr
ha ea
hyd t
rox m
yla en
se t
defi is
cie i
nc m
C. m
Pri ed
mar iat
y e
hyp de
erp li
arat ve
hyr ry
oidi O
sm f
D. fe
Hy tu
pop .
hos B,
pha It
tem ca
ia n
E. ca
Hy us
poc e
alc ac
ae ut

page | 42
 e tr
hep e
atic at
fail e
ure d
C. in
The :
cau A.
se S
of ho
fatt ul
y d
live st
r is ay
in
nan e
cy m
D. er
It ge
occ nc
urs y
in de
tri pa
me rt
ster m
E. en
The t
cau til
vis l
unk re
no co
wn ve
ry
125 B.
H
os
pi
tal
iz
ed
in
pu
l
m
on
ar
y
un
it
fo

page | 43
 r s
cou s
ple
Of a
day n
s C. d
Ca
n p
be a
trea l
ted e
in n
em e
erg s
enc s
y .
dep
art O
me n
nt
& e
dis x
cha a
rge m
d i
on n
the a
sec t
ond i
day o
D. n
Sho
uld l
rec e
eiv u
e k
ven o
tilat n
ory y
sup c
por h
t in i
ED a
,

126 k
o
i
l
o

page | 44
A. Up er
per sy
G.I. nd
T ro
end m
osc e
opy D.
alo T
ne ur
B. Bo ne
ne r
mar sy
row nd
asp ro
irat m
e e
C. Col E.
ono Tr
sco is
py o
D. He m
mo y
g 18
lobi
n 128.
ele A
ctro
2
pho
0
resi -
s y
Comple e
te blood a
picture, r
serum s
ferritin,
TIBC O
l
127 Down d
syndro
me m
a
B.
l
Dia e
bet
es p
mel r
litu é
s C. S
Kli e
ne n
fell t

page | 45
A. Blo i
od a
tran
sfu f
sio o
n r
B. Ora
l, d
inta i
ke a
Of g
flui n
ds o
C. Ino s
u•o i
pic s
sup
port o
f
IN
antibioti r
cs h
e
29. u
D m
u a
c t
k i
e c
'
s f
e
j v
o e
n r
e
s i
n
m c
i l
n u
o d
r e
:
c A.
r Hi
i st
t or
e y
r of

page | 46
rec
ent w
sca i
rlet t
fev h
er
f
Leukoc
e
ytosis v
Asotitre e
Erythe r
ma
margina f
tum o
Positive r
throat
cultures l
a
s
t

t
h
r
e
e

w
e
e
k
s
.

H
e

m
u
s
t

b
e

i
n
v
e
s
t
i
g
a

page | 47
 P ra
ulm y
ona ch
ry es
tub t
erc P
ulo A
sis vi
C. e
Lu w
ng E.
abs C
ces ar
s di
D. ac
Car en
cin zy
om m
a of es
bro
nch 132.
us A
E.
Pne 1
um 5
oni -
a y
e
1 a
Echo r
cardi s
ograp
hy o
B. l
Cli d
nic
al b
exa o
min y
atio
n h
C. a
Ele s
ctro
car p
dio r
gra e
phy s
D. e
X- n

page | 48
A. C.
Alb P
umi ne
n u
2g m
m/2 ot
4 ho
hou ra
rs x
B. H
Glo ae
buli m
n ot
lgm ho
/24 ra
hou x
rs E.
C. N
Alb ec
umi k
n pa
lgm in
/24
hou 1
rs 3
4.
Albu T
min h
3gm/ e
24 b
hours es
E. t
No te
ne st
Of to
the id
abo e
ve nt
1 if
A. y
Sev n
ere o
sep n-
tice o
mia p
B. a
Per q
iton u
itis e
re

page | 49
 A, C.Nor
Plai m
n al
X- re
ray na
B. Ult l
ras fu
oun nc
d ti
abd on
om High
en dose
C. I.V. ACE
U inhibit
D. Ra ors
dio E.
nuc A
lide sc
sca ite
n s
CT scan
1
135 A. 3
Dig 7.
oxi T
n h
e
Bis re
opr as
olol o
n
C. Pro
of
pra
re
nol
n
ol
al
D. Diu fa
reti il
cs ur
E. Dilt e
iaz in
em m
y
136 Ac
A. el
eta o
zol m
ami a
de a
B. Ple A.Plas
ural m
effu a
sion

page | 50
 cell sy
pau st
city ol
B. Am ic
yloi m
dos ur
is m
wit ur
h at
hea C.Hea
vy vi
ch ng
Light ap
chain ex
deposit be
disease. at
D, D.Clu
He bb
avy in
cha g
in E. Soft
cast
nep 139.T
hro h
pat e
hy c
E. h
Hy ar
per a
kal ct
emi er
c is
nep ti
hro c
pat s
hy o
f
mit is
ral c
ste h
nos e
is: m
e. ic
Op c
eni ar
ng di
sna a
p c
B. Pan c
- h

page | 51
A. It is tu
sha re
rp sy
cutt nd
ing ro
like m
B. It is e
not COPD
reli D.Pul
eve m
d on
by ar
rest y
C. It is tu
spo be
nta rc
neo ul
us os
not is
rela E. Mes
ted ot
to he
exe li
rtio o
n m
D. Ch a
est 141.
pai M
n is i
not c
radi r
ate o
d a
l
It is b
loc u
ate m
d in i
cen n
ter u
Of r
che i
st a

A. Ast i
hm s
a
B. Go d
od i
pas a

page | 52
A. re
2.5 hy
gm dr
B. 0. cx
03 ep
gm ha
O. lu
0.0 s
3-
0.3 1
gm 4
D. 3.
0.3 W
- hi
0.5 c
gm h
E. o
0.5 ft
-01 h
gm e
f
142 A. ol
Le lo
wy w
bod in
y g
dis is
eas n
e» ot
Cerebro a
vascular ri
di s
C. Par k
kin fa
son ct
's o
dis r
eas f
e o
D. Alz r
hei 't
mer u
's b
dis e
eas r
e c
E. Nor u
mal l
pre o
ssu

page | 53
 sis n
3 i
A. c
Dia
bet c
es i
mel g
litu a
s B. r
Ste e
roi t
dS t
W e
inte
r s
seå m
son o
D. k
Qln e
flix r
ima
b
E. e
CtF v
mot e
her l
apy o
p
44. e
O d
-
y c
e o
a u
r g
s h

O w
l i
d t
h
m
a s
l p
e u
t
c u
h m
r
o m

page | 54
i n
x .
e
d O
n
w
i e
t x
h a
m
s i
t n
r a
e t
a i
k o
s n

O c
f l
u
b b
l b
o i
o n
d g

a p
n o
d s
i
r t
i i
g v
h e
t .
s
i T
d h
e e
d
m
c o
h s
e t
s
t l
p i
a k
i e

page | 55
 l c
y h
i
d n
i g
a
g b
n l
o i
s s
i t
s e
r
i s
s
: o
Bronchi v
al e
carcino r
ma
B. e
Cys l
tic b
fibr o
osis w
C. s
Pul ,
mo
nar k
y n
tub e
erc e
ulo s
sis
D. a
Pne n
um d
oni
a E. b
CO u
PD t
t
145 o
c
k
s

w
i
t

page | 56
 e. la
Up ct
per at
G.I. e
T le
end ve
osc l
opy D.Dec
for re
vill as
ous e
atro pu
phy Is
B. Bio e
psy of
Of pa
ski tie
n nt
lesi E. Incr
on ea
C. Bo se
ne d
mar ri
row gh
bio t
psy at
D. HI ri
al
V
pr
scr
es
een
su
ing
re
E. Ser
um 147.A
glu 1
cag 4-
on y
lev e
el ar
s
146 Increas O
ed BP ld
Of the b
patient o
C. De y
cre pr
ase es
d e
ser nt
um s

page | 57
 A, s
SL B.
E P
nep ne
hrit u
is m
B. ot
Ant ho
i- ra
pho x
sph Acute
olip corona
id ry
anti syndro
bod me
y D.
syn M
dro od
me er
C, at
IgA e
nep pe
hro ri
pat ca
hy rd
Henoch ial
- ef
schonlei fu
n si
purpura on
E. E.
Ma M
sen yo
gio ca
cap rd
illa iti
ry s
glo
mer
ulo
nep
hrit
is A.
B.
148 A.
Ac
E.
ute
peri
car
diti

page | 58
 dia e
gno f
sis f
is: e
A. c
Go t
ut
B. O
Ost f
eoa
rthr
w
i C.
Rh h
eu i
Pseudog c
out h
E.
Sep o
tic f
arth
riti t
h
151 e

f
o
l
l
o
w
i
n
g

a
n
t
i
t
u
b
e
r
c
u
l
o
s
i
s

page | 59
 A. ng
Cy sp
clo on
seri dy
ne lit
B. is
Iso E.
nia R
zid he
u
St m
re at
pt oi
o d
m ar
y th
ci rit
n is
D
. 153.
R T
if h
a e
m
pi c
ci o
n m
E. m
Pyr o
azi n
na e
mid s
e t

152 Inf
A. o
ecti r
ve g
end a
oca n
rdit i
is s
B. SL m
E
Rheum c
atic a
fever u
D. s
An i
kyl n
osi g

page | 60
A. He ph
mo y
phil D. E
us ch
infl oc
uen ar
za di
B. My og
cop ra
las ph
ma y
pne
um T
oni W
a O
set
Str s
ept Of
oco Tr
ccu op
on
s
in
pne
•
um
oni
a 1
D. Leg 5
ion 5
ella Ä
E. Chl 2
am 2
ydi -
a y
e
154 Ch
A. ar
est s
x- O
ray ld
B. Re b
pea o
t y
EC p
G re
afte s
r e
03 nt
hou e
rs d
C. An w
gio it
gra h

page | 61
h th

149.A

150.A

A.
last an
On ra
e di
mo al
nth. pu
(Y be
E .
pul T
se he
is m
78 os
b/m t
, li
and ke
B.P ly
is di
170 ag
/10 no
0 si
mm s
Hg. is:
Fe A.
mo '
ral A
pul or
se tic
is an
del eu
aye
d

page | 62
 rys c
m o
Co u
arct g
atio h
n ,
of
aort f
a e
Re v
nal e
arte r
ry
ste a
nos n
is d
Tak
aya w
su's e
arte i
ritis g
Car h
dio t
my
opa l
thy o
s
156 s

i
s
:
A.
G
as
tri
c
as
pi
ra
te
B.
S
pu
tu
m
fo
r

page | 63
 AF
B s
e. e
Ra l
dio e
log c
y t
Of
ch b
est e
D. s
La t
ryn
ge o
al n
sw e
ab :
E. Tr
Tu ac
ber he
culi a
n ce
test nt
ing ra
l
157 Bronc
hial
breath
sound
C. Pe
rc
us
si
on
no
te
du
ll
D. C
he
st
m
ov
e
m
en
t
de
cr
ea

page | 64
 sed t
on
affe s
cte i
d d
sid e
e d
E. Fin
e c
cre h
pita e
tion s
t
158
p
a
i
n
,

b
l
o
o
d

i
n

s
p
u
t
u
m

a
n
d

s
h
o
r
t
n
e
s
s

page | 65
 CT B.
pulmon Se
ary ve
angiogr n
am ye
ar
C. Do
s
ppl af
er te
ultr r
aso la
und st
Of ep
leg is
D. CB od
C e
and C.
blo Te
od n
cult ye
ure ar
E. Ch s
est af
x- te
ray r
and la
EC st
G ep
159 is
e. .Ten od
yea e
r D.
afte Ti
r ll
last th
epi e
sod ag
e or e
40 of
yea 30
rs ye
of ar
age s
whi E.
che Fi
ver ve
is ye
late ar
r s
af

page | 66
 ter
last b
epi r
sod e
e a
t
160 h

o
n

c
l
i
m
b
i
n
g

s
t
a
i
r
s
.
S
h
e

i
s

k
n
o
w
n

c
a
s
e

O
f

h
y

page | 67
 Cardiac B. V
failure en
with tri
reduced cu
rejectio la
n r
fraction se
B. pt
Ven al
tric de
ular fe
sep ct
tal C. M
def itr
ect al
C. st
Rec en
ent os
my is
oca D. M
rdia itr
l al
infa re
rcti gu
on rg
D. ita
Pri ti
mar on
y E. Acu
pul te
mo rh
nar eu
y m
hyp ati
erte c
nsi fe
on ve
E. r
Mo
der 162.A
ate 4
peri 7
car -
dial y
eff e
usi ar
on s
m
161 Atrial al
myxoma e

page | 68
A. Ac cu
ute lt
infl ur
am es
mat C.
ory G
res en
pon e
se ex
syn pe
dro rt
me fo
B. Acu r
te- A
kid F
ney B
inju D.
ry S
Septice w
mia ea
with t
multi ch
organ lo
damage ri
D. Hy de
pov te
ole st
mic O.
sho cr
ck ch
E. Ac es
ute t
my
oca
164.A
rdia
4
l
5-
ipfa
y
rcti
e
on
ar
s
163 A. ol
d
Br
fe
onc
m
hos
al
cop
e
y
pr
B.
es
Sp
e
utu
nt
m
e

page | 69
 exa D. Ps
min eu
atio do
n go
she ut
is E. Rea
pyr cti
exi ve
al, ar
mil th
d rit
spl is
eno
me 165.
gal A
y
and 5
CB 5
C -
sho y
ws e
neu a
tro r
pen s
ia.
Mo O
st l
like d
ly
dia f
gno e
sis m
is: a
O. l
Felt e
ys
syn p
dro a
me t
B. Ost i
eoa e
rthr n
itis t
C. Dru
g w
ind h
uce o
d
arth i
ritis s

page | 70
 A. ey
Pri es
mm Rheu
y mat
my nodule
nau L
d's E
phe E
no s
me cl
non e
Second •
aly •
raynaud S
's
phenom 167
enon .
C. O
Bu n
erg e
er's
D. o
Inte f
rmi
tten t
t h
cla e
udi
cati f
oh o
E. l
Ac l
ute o
lim w
b'S i
cO n
emi g
a
c
A. 1
Re h
de a
ye r
B. Epi a
scle c
ritis t
r e
C. 'Dr r
yne i
ss s
of t

page | 71
 A. B.
Pitt Er
ing yt
ede he
ma m
B. a
Car m
dio ar
me gi
gal na
y tu
JVP not m
raised C.
D. Ple A
ural S
eff O
usi tit
ons er
E. Pul >
mo 25
nar 0
y u
ede D. P
ma os
iti
168 A. ve
Str th
ept ro
om at
yci cu
n lt
B. ur
Rif e
am E. Hist
pici or
n y
Isoniazi of
d re
D. Eth ce
am nt
but sc
ol ua
E. Pyr rl
azi et
na fe
mid ve
e r

169 Leukoc 170.

ytosis T

page | 72
 Shifting L
of ar
trachea yn
ge
C. Bul al
gin s
g w
of ab
che E.
st T
wal ub
l er
D. De cu
cre li
ase n
d te
che sti
st ng
mo
ve 1
me 7
nts 2.
H
E. Bro
e
nch
a
ial
v
bre
y
athi
s
ng
m
171 o
A. ki
Ra n
diol g
ogy in
of cr
che e
st a
O. s
Spu e
tum s
for th
AF e
B ri
C. s
Gas k
tric o
asp f:
irat
ion
D.

page | 73
A. Ast m
hm eg
a al
B. Me y
sot Anemi
heli a
om
a 174.A
COPD 4
D. 8-
Go y
od e
pas ar
ture s
syn ol
dro d
me m
E. al
Pul e
mo s
nar m
y o
tub k
erc er
ulo w
sis it
h
A. Eos re
ino p
phil e
ia at
B. Ly e
mp d
hop at
eni ta
a c
C. Mi k
cro of
cyti s
c h
ane or
mia tn
D. Thr es
om s
boc of
yto br
sis e
and at
spl h,
eno w

page | 74
 A. D.
Pea R
k he
exp u
irat m
ory at
flo oi
w d
rate a
B. E.
Ech St
oca ill
rdi di
ogr se
aph
y 176.
A
Spi 5
ro 0
met -
ry y
D.
e
HR
CT ar
of s
che O
st ld
E. m
Ch al
est e
X- s
ray m
175 B
o
.
k
Sa er
rc d
oi e
do v
sis el
-•: o
O. p
Rh e
eu
d
ma
s
tic
fe u
ve d
r d
e

page | 75
 A. HLAB
No 27
ho C.MR
mo I
gen of
eou hi
s p
infi jo
ltra in
tion t
Vertical D. X
radioluc -
ent ra
border y
and loss O
of f
vascular hi
marking p
s jo
in
C. We t
dge E.Sto
sha ol
ped cu
Opa
lt
city
ur
D. Air e
flui an
d d
leve C
l B
E. Ra C
dio
178.
opa
A
city
at
2
rig
2
ht
-
low
y
er
e
zon
a
e
r
177 A. s
CR
o
P
l
and
d
ES
R
f

page | 76
A. Aut c
oim h
mu e
ne st
dis p
eas a
e i
B. Rea n
ctiv si
e n
arth c
ritis e
C. Pol 3
ym d
yal a
gia
xhe
y
urn s.
atié (
Fib Y
ro E
my t
algi h
a e
eu r
ma e
coi
w
d
arth a
ritis s
d
3 e
0 c
ye r
ar e
m a
ale s
his e
tor d
y c
Of h
co e
ug st
h, r
fe m
ve v
r, e
lef m
t e
sid n
e ts

page | 77
on IN
th Clinda
e mycin
lef
180.
t
Y
sid o
e u
wi
th a
br r
on e
ch
ial a
Ge s
at k
e
hi d
ng
, t
th o
e
m e
ost x
ap a
pr m
op i
n
ria
e
te
tre t
at h
m e
en
t p
is: u
e. l
An s
oxi e
c
illi O
n f
B.
Lin 5
zol 5
id
y
IN e
ceftriax a
one r
Oral
azithro O
mycin l
d

page | 78
 B, n
Wa ,
ter
ha w
mm h
o
er
pul
g
se a
C. Pul v
sus e
alte
rna h
ns i
D. Pul s
sus t
o
bisf
r
iren y
ce
Anacrot o
ic pulse f

181 s
u
d
d
e
n

u
n
c
o
n
s
c
i
o
u
s
n
e
s
s

w
i
t
h
o
u
t

page | 79
 A. el
Epi ev
lept ati
ic on
fit 2
B. m
Car m
otid in
sin V
us 5-
syn V
dro 6
me C.ST
e. se
Car g
dia m
c en
syn t
c el
ope ev
D. ati
Vas on
ova 2
gal m
syn m
dro in
me 11
E. ,1
Pos 11
tura ,
l A
hyp V
ote R
nsi D.ST
on se
g
182 e. m
ST en
ele t
vati el
on ev
2 ati
mm on
in 2
VI m
-V3 m
B. ST in
seg A
me V
nt F

page | 80
E. ST a
seg d
me e
nt
ele f
vati e
on v
2 e
mm r
in ,
AV
L s
h
183 o
r
t
n
e
s
s

o
f

b
r
e
a
t
h

a
n
d

c
o
u
g
h
.

T
h
e

d
i
a
g

page | 81
 The pn
mo eu
st m
co on
mm ia
on
org 184.A
ani 2
sm 4-
is: y
A. e
Leg ar
ion s
ella ol
pne d
um m
oni al
a e
pr
Str es
ept e
oco nt
ccu e
s d
pne w
um it
oni h
a c
C. Sta o
phy u
loc g
occ h
us a
aur n
eus d
pne la
um rg
oni e
a a
D. He m
mo o
phil u
us nt
infl O
uen f
za gr
e
E. My
e
cop
n
las
c
ma

page | 82
 o lu
l
A. All ng
ergi
c
bro
nch
opu
lmo
nar
y
asp
ergi
llos
is
B. Pne
um
oni
a
C. Bro di
nch se
ial as
ast e
hm
a C
C on
ysti ge
c sti
fibr ve
osis ca
E. rd
Lu ia
ng c
abs fa
ces il
s ur
E.
185 Aty
A. R
pic he
al u
pne m
um at
oni oi
a d
B. Bro lu
nch ng
iect di
asis
C. Inte
186.
rstit
A
ial 4

page | 83
 Reactiv ita
ation of ti
tub+•u on
losis D.Acu
B. te
Ne rh
phr eu
opa m
thy ati
c
C. fe
Gas ve
triti r
s E. Ven
D. tri
Sev cu
ere la
hea r
dac se
he pt
E. al
Ost de
eo fe
mal ct
aci 188
a .
P
187 o
0.
Inf r
ecti t
ve a
end l
oca
rdit
h
is y
B. Pos p
t e
pne r
um t
oni e
c n
sep s
tice i
mia o
C. Mit
n
ral
i
reg
n
urg
a

page | 84
 Carved de
ilol pe
B. Ald nd
act up
one on
C. Fur :
ose A.
mid Te
e m
D. Lac pe
tolu ra
se tu
re
E. Me
B,
tro
se
nid
x
azo
C.
le
Bl
oo
A. 1
Cir
d
rho
S
sis
ug
of
ar
live
W
r
B
B. Hy
C
pot
co
hyr
un
oidi
t
sm
E.
C. CC
U
F
re
D. Ne a
phr
otic 193.
syn A
dro
me 2
TB 2
abdome -
n y
e
190 a
r
s

o
l
d

page | 85
 P
Ch D
est
X- 195.1
ray 1
B. Ly 1
mp a
h p
nod at
e ie
bio nt
psy w
C. CT it
sca h
n a
nec c
k& ut
me e
dia
stin th
um e
D. Ma b
nto a
ux d
test p
E. Full r
blo o
od g
cou n
nt
o
194 A. st
ic
Lu
fa
ng
ct
fibr
o
osis
r
Lung
abscess
A.
C. E
Bro nl
nch ar
iti s ge
d
D. li
Tu ve
ber r
cul B.
osis L
E. o
CO w

page | 86
 plat e
elet w
s e
High e
k
bilirubi s.
n O
D. Hig n
h e
sc;v x
r a
E. Lo m
w in
SG at
PT io
n
wit
hi
h s
hig p
h ul
PT se
is
1
0
4/
m
in
ut
e,
B
P
is
1
6
0/
1
O
O
m
m
H
g
a
n
d
e
d
e
m
a
fe
et
p
o

page | 87
• . C. A
Di so
ur tit
eti re
c D. Er
& yt
A he
R m
B a
& m
bet ar
a gi
bl na
oc tu
ke m
r E. Posi
B. ti
Bet ve
a th
blo ro
cke at
rs cu
onl lt
y ur
C. es
Diu 201.
reti A
cs
onl 2
y 0
D. -
y
Dig
e
oxi a
n r
E. s
Cal
ciu y
m o
blo u
cke n
rs g
onl
y m
a
n

h
a
s

page | 88
 The na
like ry
ly e
cau m
se bo
Of lis
this m
pai C. Pne
n u
is: m
A. Pan ot
cre ho
atiti ra
s x
B. Eso D. Pleu
pha ra
giti l
s ef
C. Ch fu
ole si
cys o
titis m
Gastritis =
E. E. e
Ap of
pen th
dici e
tis a
b
202.Pneumo o
nia; T v
B. Pul e
mo
200.A 20-years old boy C. Disseminated
presented with fever, intravascular
sweating and coagulation D.
shortness Of breath. Systemic lupus
On examination there erythematosus
are splinter Infective
hemorrhages, endocarditis
pansystolic murmur
at mitral area and
splenomegaly. "hat is
the most likely
diagnosis:
A. Ventricular
septal defect
B. Syphilis

page | 89
203Ä55-years Old 204.A 40-years male has

197.111

198.

199.Ducke's

smoker presented presented with

with shortness Of cough, low grade
breath and mild fever and shortness
cough. On Of breath for last
examination two or three
percussion note is months. On
hyper-resonant on examination he is
both sides of chest. vitally stable with
Chest X-ray shows lean built having
hyper-inflated lung weight 33kgs. His
fields. What is the X-ray shows cavity
most appropriate in the right upper
diagnosis: zone. The most
A. likely diagnosis is:
bro A. COPD
nchi B. Pneumonia
tis C. Bronchial
B. asthma
Bro O. Pulmonary
nchi tuberculosis
ecta E. Bronchitis
sis
Em 205.A 65-years old
phy male came for a
sem routine clinical
a examination. On
E. Pneumothorax examination pulse
rate 72/min

page | 90
 regular, BP 120/90 e
mmHg, thrusting a
apex beat and an t
ejection systolic h
murmur audible on i
auscultation. The n
most probable g
diagnosis is:
A. Mitral stenosis D
B. Pulmonary .
stenosis
C. Aortic I
regurgitation n
Aortic stenosis s
E. Atrial septal defect p
i
206.All of the r
following are the a
risk factors for t
ischemic heart o
disease, except: r
High calcium y
B. Smoking
c
C. Hypertension r
D. High cholesterol e
E. Blood sugar p
t
207.The most s
important
E. Increased VF &
clinical findings
in case Of VR
bronchial asthma
is: A. Expiratory 208.Patient with acute
crepts Bilateral exacerbation of
wheeze COPD present with
C following features
. except one:
A. Fluid retention
B B. Worsening of
r dyspnea
o C. An increase in
n amount of
c sputum
h D. An increase in
i purulence of
a sputum
l Fever

b 209.A 50-years old male

r smoker since last 10

page | 91
 years has presented
with retrosternal pain E
and sweating while .
climbing stairs of his
flat. On examination N
pulse 106/min, BP o
140/100 mmHg. This n
patient should be e
given following
o
drugs as first aid
f
therapy:
A. Proton pump t
inhibitors h
B. Soluble aspirin e
C. H2 receptor
blockers a
D. Soluble aspirin b
plus sublingual o
nit!ates v
Sublingual e
nitrates
211.A 17-yearS'Old
210.Hepatoma is male has presented
suspected clinically with severe
when. headache for last
A. Liver is soft two weeks, not
smooth w responding to
p margins paracetamol. On
B. Liver is enlarged examination pulse
& soft 84/min, BP
C, Liver is shrinken 154/100 mmHg.
in size Further
L examination reveals
i left renal bruit.
v What imyestigation
e will be useful for
r diagnosis:
A. Renal angiogram
i B. Blood urea
s C. ECG
D. Urine DR
e
Ultrasound
n
l
212. Common pulse
a
abnormality seen
r
g
in patients with
e
mitral stenosis is:
d A. Pulsus alternals
B. Collapsing pulse
&

page | 92
 C. Slow rising for hepatic
pulse encephalopathy is:
D. Premature A. CNS stimulant
ventricular dru
contractions O. High protein die
Atrial fibrillation C. Constipation
213.The characteristic D. Paracetamoltoxi
of umstable angina city
are following, Fever
except:
A. It is worsening '16. A young num has
angina presented with loss
B. It may be of appetite for last
prolonged & two weeks. On
severe examination
C. Recent onset jaundice is -
angina positive with no
e. It cannot happen at visceromegaly.
rest The most
E. Unstable angina is •mportant test in
part of acute this patient will
coronary be:
syndronr A. Urine DR
B. Ultrasound
214.A 15-years Old abdomen
boy who has LFr
suffered from acute
D. Blood CP
rheumatic fever
E. H. pylori
and has got
antibodies
residual heart
disease. 217.Which of the
Long term following is the
prophylaxis should clinical feature Of
be continued for: mitral stenosis:
A. Five years after Loud Sl
last episode
B. Pan systolic
B. Ten years after
murmur at mitral
last episode
area
C. Seven years
C. soft S2
after last episode D.
Till the age of 30 D. Clubbing
years E. Heaving apex
Ten years after beat
last episode—or 40
years Of age 218.For the diagnosis of
pulmonary
whichevyr
tuberculosis, the
most important tool
215.Most comnwn is:
precipitating factor A. Tuberculin test

page | 93
 B. MRI test B. Increase
C. X-ray chest carbohydrates in
S the food
p Reduce weight
u D
t .
u
m I
n
A c
F r
B e
a
E s
. e

B f
l a
o t
o
d i
n
C
P t
h
219.Vitamin K is given e
in a patient Of cirrhosis:
A. TO decrease f
ascites o
B. To o
albumin d
To correct PT
D. To decrease SGPT E
To decrease .
bilirubin
220.A 30-years old obese I
and smoker n
complains of c
indigestion and r
regurgitation of food e
since last two a
months. On s
examination there is e
no positive finding.
To reduce the s
symptom along with m
drug treatment you
o
will advise:
k
A. Small meals 04
i
times a day

page | 94
 n beetal nuts has
g presented with
dysphagia for last
221 One Of the following one month. On
statement about examination she is
hepatitis-A virus is anemic having
correct: koilonychi%us with
A. Clinical illness is no splenomegaly.
more severe in There is no history of
children than weight loss. The
adult most likely diagnosis
B. Incubation is:
period averages e. Plummer vinson
30 days syndrome
Chronic carrier B. Atrophic
state is not seen gastritis
D. Mortality C. Chronic gastritis
rate for D. Ca stomach
hepatitis A is E. Ca esophagus
very high E.
Fulminant 226. Regarding asthma
hepatitis A is following is true:
common A. It is an infective
disorder
222. Which Of the B. It is related to A. Calciunyu
following is not a smoking
risk factor for C. It is an
tuberculosis: autoimmune
A. Chemotherapy disorder
B. Steroids It is an allergic
C. Diabetes disorder
mellitus
223.Henwrrhagic E. It is related to insipidus
D. Infliximab
cotton factories
e. Winter season 227.1n advanced chronic mellitus
kidney disease, the
Malignancy most likely
B. Meig's syndrome hematological
C. Cirrhosis manifestation is: A.
D. Chronic
224.Best site for Leukopenia
pancreatitis Normocytic
E. Tuberculosis normochromic
anemia
C. Meg
O. Sclera aloblasti
B. Tongue c anemia
C. Conjunctiva D. Incr
11 Nails
eased
E. Ear lope
clotting
225.A 20-years young time E.
lady habitual of Thrombo

page | 95
 cytopeni s
a t
i
228.A 20-years Old c
male presented in
COD with the k
Complaints of loose i
watery stools. His d
BP is 80/50 mmHg, n
pulse 120/minute, e
low volume. Skin y
turgor is delayed.
Treatment Of choice d
for this patient is: i
A. Blood s
transfusion e
B. Oral intake Of a
fluids s
C. Inotropic e
support
e. Rapid E
E. IN antibiotics .

229.Which one the C

following h
electrolytes nmst r
be restricted in o
patient with acute n
renal failure: i
c

p
y
e
l
230.FoIlowingare the
o
recognized causes Of
n
CKD,
e
p
h
r
D i
. t
i
P s
o
l 231.1n critically ill
y patient upper
c gastrointestinal
y bleeding due to

page | 96
 ulceration is t
treated with: i
Proton pump c
inhibitors Calcium blocker
B. H2 receptor D. Aspiration
blockers E. Beta blocker
(antagonists)
233.A SO-years Old
male patient Of
smoker developed
sudden onset of
232.A 65-years Old lady shortness of breath
came to the and right sided
emergency with the chest pain. On
complaint of chest examination
pain during rest. Her trachea is shifted to
ECG showed left side and
segment elevation percussion note
that resolves was hyper-
spontaneously resonant. The most
without appropriate
The radiological
most useful finding on chest
therapeutic agent for Xray would be:
this condition is: Vertical
A radiolucent
. border loss of
vascular
A marking
C
B. Radio-opacity at
E
right lower zone
i C. Wedge shaped
n opacity
h D. Air fluid level
i E. NO homogenous
b infiltration
i
t 234.A 47-years old
o male presented to
r casualty for
shortness Of breath
B since 02 days. On
. examination the
pulse was 120
D beats/min,
i respiration rate 45
u breaths/min, blood
r pressure 90/40
e mmHg,

page | 97
 temperature 102•F right hip joint with
and no urine output high grade fever
since morning. The and diarrhea since
patient's condition 07 days. Her CBC
best described in: shows
A. leukocytusis, uric
Hypovolem acid level, renal
ic shock B. function test, urine
Acute DR were nor-null.
inflammato The most likely
ry response test for the
syndrome diagnosis' would
C. Acute kidney be:
injury
Septi
cemia
with multi
organ
damage E.
Acute 237.A 64-year•s Old
myocardia woman found to
l have a rightsided
infarction pleural effusion on
chest X-ray. Analysis
235.A SS-years old of the pleural fluid
female presented protein was 3.8 g/dl,
with severe left sided lactate
chest pain followed dehydrogenase
by excessive (LDH) level Of 500
sweating. IU and a ratio Of
When she brought in LI)H concentration
the casualty her B.P in pleural fluid to
60/0 mmHg, serum of 0.7.
puLseless and JVP The most
was 09 cm above appropriate
sternal edge. What diagnosis in this
will you do next for patient is:
saving life of patient: A. Pulmonary
IV frusemide infarction
IV infusion Of B. Tuberculosis
dobutamine C. Congestive heart
C. IV steroids failure
D. IV streptokinase D. Cirrhosis
Malignant
E. 03 liters Of
effusion
normal saline
immediatel
238.1n a 30-years old
236.A 26-years old male history Of
female presented cough, fever, left
with acute pain in sided chest pain

page | 98
since 03 days. 239.A 55-years Old
()/E there was smoker presented
decrease chest with shortness Of
movement on left breath and mild
side with cough. On
bronchial examination
breathing. note is
The most hyper-resonant on
appropriate both sides of chest.
treatment Chest X-ray shows
is: A. IV hyper-inflated lung
clindamyci fields. What is the
n most appropriate
B diagnosis:
.

L
i
n
e
z 240.You are4asked
o forexamine the pulse
l of 55 years old male
i who has aortic
d steng»is. The
character Of the pulse
is best a" eÄ.
C
Pulsus alternans B.
. Pulsus bisfirence
Anacrotic pulse
O D. Pulsus
r paradoxus
a
E. hammer
l
pulse
a 241.'A 22-years boy
z presented with headache
i for last
t One month. O/E
h pulse is 78
r beats/min, B.P
o 170/100
m
Hg and the
y femoral pulse is
c delayed than radial
i pulse. The likely
n diagnosis is: A.
e. Amoxicillin Takayasu's arteritis
E. IV ceftriaxone C
o
a

page | 99
r t
c e
t n
a o
t s
i i
o s
n
E
o .
f
C
a a
o r
r d
t i
a o
m
C y
. o
p
A a
o t
r h
t y
i
c 242.A middle aged
person with
a hemoptysis and
n cough was
e investigated with X-
u ray chest showed
r
cavity at right upper
y
zone. The
s
m investigation of
choice is:
D A. Pulmonary
. angiogram
B. Serum IgE level
R C. CBC
e D. HRCTchest
n Sputum smear
a for AFB
l

a 243.A 60-years old

r lady hypertensive
t presented with
e palpitation
r remains for few
y minutes. During
the period she
s noted that her

page | 100
 puLse become examination there
rapid and was pulsus alternans,
irregular. Her B.P 90/40 mmHg and
resting ECG is a systolic murmur
normal at that over left sterna]
time. edge. What is your
The best tool to diagnosis: A-
diagnose her Primary pulmonary
condition is: hypertension
Holter monitoring B- Recent
B. Nuclear cardiac myocardial infarction
scanning C. Ventricular septal
defect
C. Stress e. Cardiac failure
echoeardiograph with reduced
y ejection fraction
D. Echocardiograph E. Moderate
y pericardial
E. Exercise effusion
tolerance test
(EIT) 246. He nnrrhagic
244.A 15.years old ascites is seen in:
female came to the A. Cirrhosis
physician with B. Chronic
complain of pancreatitiS
malaise, fatigue Malignancy
and weight loss. D
On examination .
there is an early
diastolic murmur. M
The most probable e
diagnosis is: i
A. Mitral stenosis g
B. Ventricular '
septal defect
C. Acute rheumatic s
[evec D. Mitral
regurgitation s
Atrial myxoma y
n
245.A 65•years old d
female presented r
with shortness of o
breath on climbing m
two steps of stairs. e
She is known case of
hypertension, E
ischemic heart .
disease. On
T

page | 101
 u r
b i
e n
r c
c l
u u
l d
o e
s :
i A
s ,
A
247. s
D o
u ti
c tl
k e
e' >
s 2
j
248.A 5
o 0 is grossly anemic,
n Y
e L
s B,
m P
i os
n iti
o ve
r th
c ro
ri at
t e
e u!
ri tu
a re
r L
o eu
r k
r oc
h yt
e os
u is
m
a
ti
c
r 04 months. On
e koilonychia and
v hard and fixed
e palpable cervical
ly mph nodes.

page | 102
 What is the cancer
mos"ikely C.
diagnosis: A- Gastric
Esophageal ulcer
erosion A%uej2 P
Carcinomak or
a
esophag
n
C- Plummer vi nson c
syndrome r
D. Chronic e
gastritisæ a
E. Benign t
esophageal i
structure c
249.A 70-years female
t
after 02 days of hip
u
replacement
m
surgery developed
o
severe dyspnea. On
r
examination she is
tachypneic with E
respiratory rate of .
30 breath/minute.
B.P 70/50 mmHg G
and X-ray chest is a
norntal. The most s
appropriate t
diagnosis is: r
Lobar pneumonia i
Pulmonary c
embolism
v
C. Pericardial
a
tamponade
r
D. Pulmonary i
edema c
e
E. Aortic dissection s
250.Endoscopic
ultrasound is helpful in 251.FolIowing is one
diagnosis of: Of the cause Of
A. Es type-I respiratory
ophage failure:
al A, COPD
obstruc B. Gullian-barre
tion syndrome
B. Es C. Myasthenia
ophage gravis
al

page | 103
 D. Severe acute ni
asthma n
e. Pulmonary edema g
2S2.An 18-years old E.
college student girl S
brought in medical al
emergency with ic
consumption or a yl
liquid poison. Her at
vitals reveal Pulse e
110 b/m, B.P 140/90 p
mmHg, Respiratory oi
rate is 28 Wm. On s
clinical examination o
her skin is cold and ni
clammy, excessive n
salivation and basal g
crepitations. On CNS
exam reveals all the 253.The genetic
04 limbs are flexed inheritance pattern or
with cystic fibrosis is:
_éfasciculations A, X-Iinked
positive. The most recessive
appropriate diagnosis B, X-Iinked
will be: dominant with
A. Barbituratespoi complete penetrance
soning C. Autosomal
B. Copper dominant
poisoning A
C. XOpioids u
poisoning t
o
0.
s
O
o
rg
m
a
a
n
l
o
p
r
h
e
o
c
s
e
p
s
h
s
at
i
e
v
p
e
oi
s
E
o
.

page | 104
 tube for airway
X protection
- E. Reassurance
I since snake bite
i cause sem
n limited problems
k
e 2SS.A 20-years old
d male presented
with COD with the
d complaints or loose
o watery stools. His
m B.P is 85/55 mm
i Hg, Pulse 120/min,
n low volume, skin
a turgor is delayed.
n Treatment of
t choice for this
patient is:
254.A 20-years old A, Blood tra nsfusion
woman admitted in B. Inotropic
the medical support
enwrgency, the C. I/V antibiotics
patient admitted is D. Oral intake Of
bitten by snake fluids
since one hour Rapid
back. Acute replacement of
medical treatment IV fluids
is given containing
IV nuid and local 256. Indications for
wound care cardiac surgery in
immediately. Her infective
legs begin to swell endocarditis:
and she became A. Abscess
tachypneie. Her formation in
other vital signs organs
are stable. B. Failure Of
Laboratory reports antibiotics
show low serum C. Fungal and
fibrinogen level, protozoal
The most infections
appropriate
immediate critical Lar
treatment of this ge
patient now is: veg
Anti-venom etat
B. Heparin ion
C. Physostigmine on
D. Insertions of an righ
endotracheal

page | 105
 t 259.The clinical finding
side which differentiate
E. lun fibrosis from
Lar is:
ge A. Bronchial
veg breathing
etat B. Depression Of
ion chest wall
on C. Decreased chest
left movements D.
side Increased VF & VR
Shifting ortrachea
257.Hepatobiliary
disorder seen in 260.A 12-years
Crohn's disease (CD) boyeame in OPD
is: with complaint of
A. Jaundice failure to thrive
B. Itching and difficulty in
C. Cholecystitis hearing. On
O. Primary sclerosing examination short
cholangitis height according to
E. Granuloma age, eyes slanting
venerum with flat face,
small ears and
258.A 60-years old single palmar
COPD patient crease seen. Rest
presented with Of physical
shortness of breath. findings are
On examination unremarkable.
B.P 120/60 mmHg. What is diagnosis:
Pedal edema and Down syndrome
right parasternal B
heave. The most .
appropriate
diagnosis D
A. Cardiac failure i
Cor pulmonale a
C. b
inf e
arct t
ion e
D. s
Pne
um m
oni e
a l
l
i
t
u

page | 106
s s
o
C m
. y

K 1
l 8
i
n 261.A 73-years Old man
e presented with a
f shuffling gait and
e increasing
l forgetfulness, which
t had been Of gradual
e onset. He had a
r longstanding history
of hypertension and
s diabetes mellitus.
y He had a myocardial
n infarction 03 years
d previously and a
r stroke 02 years
o previously. What is
n the most likely
r diagnusis:
D A. Alzheimer's
. disease
Cerebrovascular
T disease
u C. Lewy body
r disease
n D. Normal pressure
e hydrocephalus
r E. Parkinson's
disease
s
y 262.The best drug to
n control heart rate in
d heart failure
r
o Bisoprolol
m B. Digoxin
e C. Diltiazem
D. Diuretics
E
E. Propranolol
.

T 263.The organism found

r conunonly in
i

page | 107
 pyogenic liver l
abscess is: s
A. Bacterioids g
E.coli r
C. Enterococc 's Eaton lambert
fecal is syndrome
D. Streptococcus -Myasthenia
melleri gravis
E. Staphylococcusa
ureuS> 26S.A 60-years old lady
with WO longstanding
264.Neuromuscular -hypertension
dE;order causing presented to you
dysphagia: with history Of
•. Multiple Sc lerosis alpitation which
B remains for few
. minutes. During the
period she noted that
her pulse become
M
rapid and irregular.
o
Her resting ECG is
t normal. The best tool
o to diagnose her
r condition is:
n A. Exercise
e tolerance test
u (EIT)
r B. Echocardiograph
o y
n e. Holter monitoring
D. Nuclear
d
scanning
i
s E. Stress
e echocardiograph
a y
s 266.The treatment Of
e hyperkalemia include:
A. ß-blockers
C
O. IV calcium
.
gluconate if ECG
changes suggestive
B
Of hyperkalemia
u
l C. Spironolactone
b D. Steroids
a E. NSAIDs
r
267.You are asked for
p examine the pulse of
a SS-years old male

page | 108
 who has aortic and temperature
stenosis. The 102•F.
character Of the The most likely
pulse is best assessed diagnosis is:
in which of the A
following artery: .
A.
B P
r u
a l
c m
h o
i n
a a
l r
y
a
r e
t m
e b
r o
y l
i
C s
a m
r
o B
t .
i
d P
n
a e
r u
t m
e o
r l
y h
C. Femoral artery o
D. Popliteal artery r
E. Radial artery a
268.A young man has x
presented with Pneumonia
short history of D. Pleural effusion
cough, fever and E. Pleural effusion
left sided chest
pain for last two 269.In pathogenesis Of
days. O/E decrease ulcerative colitis
chest movement on (UC):
left side with
bronchial breathing

page | 109
 A. Appendectomy calcium gluconate IV
has protective slowly but patient
role did not respond. The
B. Cigarette next invetigation to
smoking has no be done this patient
detrimental should be:
effect A. Blood sugar
C. 6 to 16% Of B. Serum potassi
patients affected C. Serum sodium
with ulcerative D. Serum
colitis have one phosphate
or more relatives Serurvnagnesium
with disease The T
patient may
improve with 272.A 55-year old male
broad spectrum smokefpresented
antibiotics with sudden sharp
pain at the left side
E. Envimnmental
of the chest after
factor are more
lifting heavy weight.
important than
On examination the
genetic factor
pulse is 110/min,
270.Clinical features of respiratory rate
30/min. Chest
constrictive
expansion is reduced
pericarditis usually
on left side.
seen in the patients
Percussion note is
is:
hyperresonant and
A rise in J VP breath sounds are not
during inspiration audible On left side
B. Elevated JVP of chest. What is the
with typical descent most likely
C. Painful diagnosis:
hepatomegaly A. Emphysema
D. Pulses B. Lung collapse
paradoxious always Pneumothorax
E. Rapid irregular
D. Pneumonia
pulse
E. Pulmonary
271.A young man embolism
suffering from
273. Character Of the
chronic diarrhea håS
pulse seen in
presented in
hypertrophy
emergency
department with
cardiomyopathy:
A. Displaced apical
spasm of hands and
impulse
muscle twitching
since last night. He B. High volume pulse
vitally stable with BP Jerky pulse
Of 150/100 mmHg. D. Normal JVP
He was given

page | 110
 E. Palpable 4th i77.Patient with acute
heart sound due exacerbation of
to atrial COPD present with
hypotrophy following features,
except:
274.A 60-years old lady -AZAn increase in
who needs hip amount Of sputum
replacement. The B. An increase in
best option to purulence of
prevent pulmonary sputum
embolism is:
C. Fluid retention
A. Aspirin 75
mg/day
D. Worsening of
dyspnea
B. Aspirin 325
mg/day Fever
C. Cilastazol 100
278.Which or the
mg
following is not a
D. Clopidogril 75
risk factor Of
mg/day
tuberculosis:
Warfarinwith
A. Chemotherapy
INR(1.5-2.5)
B. Diabetes mellitus
275.Factors that C. Infliximab
predispose to aortic D. Steroids
dRsecti0n include: e. Winter season
A. Aortic 279.Microalbuminuria
regurgitation is diagnosed when
e. Hypertension 24 hour urine
C. Old age protein levels are:
D. Pregnancy im1G A. 0.03 g
trimester 0.03 -0.3 g
E. Pregnancy.in all C. 0.3-0.5 g
trimesters D
.
276.0ne of the
following 0
complication of .
peptic ulcer needs 5
urgent surgical -
intervention: A.
1
Gastric outlev
obstruction g
Hemorrhage
C. Ulcer E
e. Ulcer perforation .
Recurrenyulcer
following gastric €
surgery 2
.
5

page | 111
 diastolic murmur at
g cardiac apex.
Which of the
following structure
280.A 14-year old is involved:
presents with A. T
arthralgia, purpura, ricus
abdominal pain, pid
microscopic valve
hematuria, B. P
proteinuria. ulmo
Azotemia and nary
proliferative valve
glomerulonephritis Mitra
with IgA deposits. l
What is likely valve
diagnosis: D.
A. Antiphospholipid Pulm
antibody syndrome onary
Henoch schonlein trunk
purpura E. Aortic valve
C. IgA nephropathy
D. SLE nephritis 283.The commonest
E. None Of above organism causing
urinary tract
281.The best indicator infection in the
Of chronic renal community is:
disease on E. coli
ultrasound B. Klebsiella
examination is: C. Proteus
Small kidneys D. Pseudomonas
B. Dilatation of E. Streptococcus
collecting
system 284.Nephrotic
C. Ectopic kidney syndrome
D, Increase in the is
kidney size characteriz
E. Normal ed by:
corticomedullary A. Low serum
distinction cholesterol
B. Low blood
282.A 20-years Old pressure C. Non-
girl presented in pitting edema
OPD with history Raised urinary
ol' shortness of albu
breath on exertion. E. Raised serum
On examination albumin
you hear a loud Sl
(first heart sound) 285.What is the
and a soft rumbling most

page | 112
 comman r
failure: r
A. Acute interstitial h
nephritß a
B. Acutg.glonlerulo g
nephritis e
C. Acute s
renovascular
syndrome E
D. Acute renal .
papillary
necrosis Acute S
tubular necrofis p
E. Streptomycin i
d
288.The biochemical e
changes in hemolytic r
jaundice are:
A. Low serum n
heptoglobulin le vel e
Low v
urobilinogen i
level
C. Normal serum 290.Enlarged and
ALT level tender liver is a frature
D. Normal alkaline of:
phosphatase & A. Fatty liver
serum albumin B. COPD
level C. 'Hydatid cyst
E. Raised level of O. Acute viral hepa
serum bilirubin
4 E. Hem hromatpsis
289.F0110wing is not a 291.A nurse of 24 years
feature Of liver old presented to the
cirrhosis: physician with
A. Cyanosis history of needle
B. Clubbing stick injury. Which
C. Jaundice one of the
R following test
e indicates of
t hepatitis C after 01
i month of needle
n stick injury:
a -Av• Anti-HCV
l antibody
'B. Genotyping
h O HCvRNA
e D
m .
o

page | 113
 L E
i .
v
e L
r i
v
f e
u r
n
c b
t i
i o
o p
n s
y
t
e 292.Which one Of the
s following is the most
t common organism
causing pneumonia:
or renal Streptococcus pneumonia H.
influenza
Klebsiella
Legionella
Staphylococcus aureuS
B. C.
D. E.
286.The most unlikely 293.The clinical
complication of acute finding which
viral hepatitis is: differentiates lung
A. Acute liver fibrosis from
failure consolidation is:
B. Cholestatic A. Bronchial
hepatitis breathing
C. Aplastic anemia B. Bulging of chest
D. Chronic liver wall
disease & C. Decreased chest
cirrhosis movements D.
Acute renal Increased VF&VR
failure Shifting of
trachea
287.Among 1st line anti-
tuberculosis 294.The most common
medicine, the most cause Of pleural
hepatotoxic agent is: effusion in our
Isoniazid country is:
B. Ethambutol A. Pneumonia
C. Pyrazinamide B. Cardiac failure
Tuberculosis

page | 114
D. Rifampicin Carcinoma of lung
D. Pu Imonary infarction D
295.A patient on anti- .
tubercul(Bis
therapy complaints T
of loss of appetite, r
nausea and a
vomiting after two c
weeks. Laboratory h
shows raised e
alkaline a
phosphatase and
bilirubin. The drug E
responsible to de- .
arranged LFT is:
A. T
B. h
Stre r
pto o
my a
cin t
D. Ethambutol
Pyrazinamide
failure:
296.The gold standard A. Anemia
investigation for the B. Edema
diagnosis Of C. Chest pain
pulmonary D. Palpitation
tuberculosis in a Dyspnea
patient who have
cough with sputum
ror more than three failure:
weeks, fever and A
weight loss is: .
Sputum for AFB
culture A
B. Tuberculin b
testing d
C. Radiology of o
chest m
D. Gastric aspirate i
E. Laryngeal swab n
a
297.Asthma is a disease l
of:
A. Lung [
parenchyma S
B. Pleura a
i
n

page | 115
 A. Gastro-
B esophageal reflux
. disease (GERD)
Angina
C C. Unstable
y angina
a
D. Pericarditis
n
E. None Of the
o
above
s
i
303.A patient of 25
Edema years complaint of
D. Clubbi chest pain that is
E. Dyspnea relieved by barding
forward. He has
300.Which of the A. X-ray rub on
pericardial
following is
auscultation. 02
the cause of
weeks ago he has
mitral
history of upper
stenosis:
respiratory tract
Rheumatic
infections. What is
fever
the choice Of
B. Throat infection investigation:
C. Congenital ASD
D. Bacterial B. TmpT
endocarditis E. C. Blood cp, ESR
Myocardial infarction ECG
E. None-of the
301. Which Of the above
following
investigation Of 304.X5å-years old
choice for diagnosis patient known
of . pericardial case of high
effusion ? blood pressure
A. X-ray chest and diabetes
B. ECG Myocardial infarction
complains Of
Echocardiograph Pericardial infarction
severe central
298. y Pulmonaryembolism
chest pain and
D. Angiography the above
excessive
E. MRI chest sweating since
302.A patient aged 50 03 hours. What
years complaint of is the most
chest pain only on likely diagnosis:
severe exertion that inhibitor
299.Which is relieved by channel blocker
taking nitroglycerin
sublingually. What blocker
is the most likely the above
diagnosis:

page | 116
1,305.A 40-years old C.
patient having Dissecti
blood pressure of on of
180/110 mmHg. He aorta
has history Of
allergic asthma.
D.
Myocar
Which group of dial
drugs are infarctio
contraindicated in n
this None of
the
above
308.A
man of
30 years
complai
nts of
306.Chronic breathin
uncontrolled ess
hypertension can since
produce cardiac one
effects. Which one nu»nth.
of the following is On
examina
Left tion JVP
is
ventricular
raised.
failure He has
B. Right pedal
ventricular edema.
failure X-ray
C. Pericardial shows
effusion cardiom
D. Cardiac egaly.
arrhythmias What is
E. None Of the most
above likely
diagnosi
307.A patient aged 60 s:
years complaints A. Bronchial asthma
of central chest Cardiac failure
pain since 03 C. Nephmtic
hours. ECG syndrome
shows ST D. Pleural effusion
depression and E. None Of the
Trop-T is above
negative. What is
the most likely 309.A young woman
diagnosis: came with history of
A. Pericarditis fever and cough since
Unstable angina 05 days. On

page | 117
 examination Of chest the most likely
crept and wheezing diagnosis:
sound is audible. He e. Allergic asthma
has no any past B. COPD
history of wheezing: C. Pulmonary TB
e
D. Pneumonia
.
E. None of the abo ve
A
311.A 15-years old
c
person having
u
recurrent e infection
t
from childhood. He
e
has history Of
sinusitis. On
b
examination
r
clubbing is positive
o
and has nasal polyp.
n
The important for
c
diagnosis
h
A. Blood CP/ESR
i
C. Constrictive
t
pericarditis
i
s Pericardial
effusion
B E. Dilated
. cardiomyopathy

314.Common cause for

S
acute pericarditis:
i
n Acute myocardial
u infarction
s B. Malignant
i disease
t C. Systemic lupus
i erythematosus
s D. Trauma E.
Uremia
C. Allergic asthma
D. Allergic cough 315.Tachycardia is a
E. None of the above feature Of:
A. Hypothermia
310.A boy Of 16 years
B. Hypothyroidism
complaints Of
breathiness since 06 Hypoglycemia
days. He has history D.
of same attacks 5 to 6 R
times per year. On ai
examination patient se
has bilateral d
wheezing. What is in

page | 118
 tr 317.1n the acute
ac pancreatitis clinical
ra presentation is:
ni Ep
ål igastric
pr pain &
es radiati
s on to
ur back
g B.
E. Histor
Il- y of
bl excessi
oc ve fat
ke intake
r Excess
tts ive
ic alcohol
i intake
ty Fever &
abdominal
316.The characieristic distention
of ischemic cardiac Leukocytosis &
chest pain is: elevated serum
I amylase
t is-
loc 318.Regarding clinical
ate features Of ulcerative
d in
cen A. In limited disease
ter tenesmes,
Of constipation &
che rectal bleeding
st occurs
B.
Ch
est
pai
n is
not
rad
C, "Itis sharp cutting
like
3D] It is.
spontaneous
not related to
exertion E.
It-js reliev by
rest

page | 119
 B. X-ray chest PA viewif serum hlot otherwise E
OPTION B.
TB
In extensive disease bloody diarrålea, abdominal
C. Rapid Systemic
CORRECT features Of
D. Sweat sodium weight loss,
ncentrat• fever &
e. None of the above tachycardia is
312.A 65-year•OId male seen
Came ror a rGutine O.
clinical examination. Sympto
On examination it ms tends
was found to have to
pulse rate 72, regular present
BP 120/90 mm Hg, a
acutely
thrusting apex beat
E. It
and an ejection
systolic murmur. may be
most probable insidiou
diagnosis is: s in
A. Atrial septal onset
defect
B. Aortic 319.A 45-year old lady
presented with
regurgitation
dysphagia since 04
Aortic stenosis months. On
D. Mitral stenos is examination she was
E. Pulmonary grossly anemic,
stenosis koilonychia and
palpable cervical
313.A SS-year old man lymph node. What is
came to emergency the nujst likely
with complain Of diagnosis: A.
retrosternal Esophageal erosion
heaviness. On Carcinoma or
examination pulse esophagus
rate 80. BP is
C. Plummer vinson
120/80, heart sounds
were muffled. syndrome
Resting ECG was of D. Chronic gastritis
low voltage. Chest E. Benign
X-ray shows esophageal
cardiomegaly. The stricture
most probable
diagnosis is: 320.You are asked for
A. Acute examine the pulse Of
pericarditis 55-year Old male
B. Cardiac who has aortic
tamponade stenosis, the
cramps is character of the pulse
predominant is best assessed in

page | 120
 which of the k
following artery:
A. Brachial artery E
.
e. Carotid artery
C. F
R
emor
i
al g
artery h
D. P t
oplite
al a
artery t
E. r
Radia i
l u
artery m

321.A 20-years Old girl 322.A 24-year Old

presented in OPI) man present with
with history of increasing
shortness of breath shortness of breath
on exertion. On for few months.
examination you On examination he
hear a loud Sl and a has an ejection
soft rumbling systolic murmur.
diastolic murmur at The best modality
cardiac apex. Which to diagnose
of the following valvular heart
structure will be seen disease is:
prominent on chest A. Coronary
X-ray: A, Arch Of angiography
aorta C. C-reactive
B. Left ventricle protein
Left atri um D. Plain X-ray
D abdomen
.
Serum lipase
P
328.A 30-year old male
u
presented with
l
fever, cough,
m
o
hemoptysis and
n chest pain. X-ray
a chest shows
r homogenous
y opacity in right
mid zone. most
t appropriate
r diagnosis is:
u A. Br
n onchop

page | 121
 neumon E. Pulmonary
ia infarction
B. Fib
rosing 329.A SS-year Old male
alveolit sniOker presented
is C. with sudden sharp
Hypers pain at the left side
ensitivit of chest after lifting
y heavy weighL On
Lobar examination pulse
pneumonia 110/min, respiratory
rate 30/min. Chest

Echocardiogra
E. X-ray
phy ches
t
32 Themossensitiv
3. helicobacte
t e
Urea
rA. breat beadjusted
if patient
i
B. Endoscopi
h s
C. cMicrobiologic
O. Rapid
al ureas
E. Serolo
e
gy
324.Th neurologic
e al acute
develo onseOf
p malais and
t anorexia
bilateral
e lymphadenopathy
.
diagnosi
.
s:
32 Mostcommo
5. n

B. EIT diagn(ßis is:

C. ECG

A. Apraxia B.
Dysphasia
C, Stroke
Tremors E. page | 122
Visual problems

encephalopathy is:
A. CNS stimulant dill
B. Diarrhea
C. Fever
 expansion reduced percussion note and
On left side with absent breath sounds.
hyper-resonant The nujst likely
High protein t
diet o
E. Paracetamol s
toxicity i
s
326.Enlarged and
tender liver a 327.Regarding the
feature of: diagnosis Of acute
A. Fatty liver pancreatitis,
B. COPD following is best
C. Hydatidcyst option:
A A. Serum amylase
c B. 24 hours
u urinary
t amylase
e 332.A male patient of
40-year having
v history of
recurrent Of
i cough with
r sputum at early
a morning. The
l sputum was foul
smelling. On
h examination
e patient have
p clubbing and
a coarse crepitation
t all over the chest.
i What is most
t likely diagnosis:
i A. Pu Imonary
s TB
Bronchiectasis
E C
. .
H C
e h
m r
o o
c n
h i
r c
o
m b
a r

page | 123
 o biopsy is
n perfornrd
c under
h ulIrasound
i E. cr chest
t 334.The gold standard
i investigation for
s the diagnosis of
pulmonary
D tuberculosis in a
. patient who has
history of cough,
P fever and weight
n loss for more than
e three weeks:
u Sputum for
m AFB culture
o B. Tuberculin
n testing
i C. Radiology Of
a chest
E. Carcinoma Of D. Gastric •.Lspirate
lung E. Laryngeal
333.A 60-year old swab
male smoker with
70 packs/year. 335. In a patient
His CT scan with pleural
shows effusion
peripherally clinical
situated mass in examination
left hemithorax of the chest
with rib erosion. will reveal:
How will you Decreased
confirm the chest
diagnosis: movement
A. X-ray chest on the
B. Percutaneous affected side
lung biopsy B. Hyper-resonant
is not note on the affected
performed side
under C. Normal chest
radiology movement on the
Percutaneous affected, siåe
lung biopsy D. Normal
is useful for percussion note On
peripheral the affect Sid E.
lung lesions Trachea pulled on
D. the affected Sid
Transbro
nchial

page | 124
336.An 18-year girl
referred from dextrose water
OPD f D. IN soda
physician bicarbonate
opinion with E. IN glucose and
complaint of insulin
prinury
amenorrhea 338.Which of the
and short following
stature. No feature
history Of differentiate
diabetes CRF from
mellitus, celiac ARE: A.
disease and Acidosis B.
thyroid disease. Anemia
On C. Bleeding
examination D. Infections
short stature Renal
Witw webbing osteodystrophy
Of neck and
poorly 339.Nephrotic
developed syndrome is
secondary characterized by:
sexual A. Low serum
characteristics. cholesterol
What is-your B. Low blood
diagnosis: pressure
A. Celiac C. Non-pitting
disease edema
B.
Cystig•fibrosis
C. Down
syndrome
D. Diabetes
mellitus
Turner s O
yndrome .

337-The best R
treatment a
option for i
hyperkalemia in s
acute e
emergency is: d
A. Dialysis
B. Inhaled B2 u
agonists r
i
IN calcium n
gluconate 10 a
ml Of

page | 125
 r
y r
e
a t
l e
b n
u t
m i
i o
n n

E E
. .

R O
a t
i o
s t
e o
d x
i
s c
e i
r t
u y
m
341.An 80-yearold
a woman presented
l to her general
practitioner with
a 24-hour history
340.All the following of profuse
are side effects of diarrhea and mild
loop diuretics, abdominal pain.
except: Her type 2
A. diabetes mellitus
B. had been
em treated
ia with
C.
Hy
r metformin for 10
kal years. Two days
em previously she
ia had been
W dÉcharged from
a hospital
t following
e treatment for
r community-

page | 126
 acquired i
pneumonia. c
Her medication
was onrprazole s
20 mg once h
daily and o
metformin 500 c
twice daily. k
What is the
most likely B
explanation for .
her diarrhea:
Clostridium C
difficile a
toxin r
'Be Constipation d
with overflow i
Diverticulitis o
D. Metformin g
E. Omeprazole e
n
342.The sixty year i
Old man c
presented in
medical with s
tachypnea, on h
arrival BP 90/50 o
mmHg, pulse c
rate 100/min,
k
bounding pulses
with warm C. Hypo vole mic
extermition. shock
Laboratory D. Neurogenic
reports shows shock
TLC e. Septic shock
18000/cmm, 343.A 20-year female
patient is taken 20 tablets of
suffering from: aspirin to attempt
A suicide. Patient is
. admitted in the
intensive Care unit,
A vitals and clinical
n examinations was
a noted and baseline
p investigations was
h sent. Her serum
y concentration Of
l salicylate is above
a 700 mg/dl. At this
c stage what is the
t most appropriate

page | 127
 treatment of this B. Lupus nephritis
patient will be: A. C. Minimal
Activate charcoal change disease
Hemodialysi O. Membranous
s nephropathy
C. Intravenous E. Rheumatoid
sodium arthritis
bicarbonate
D. Intravenous 347.Which one of the
fluid Of following is the
dextrose & best clinical feature
saline of constrictive
pericarditis:
E. Urinary
A. Elevated J VP
alkalization
with typical
344. Most
descent
appropriate
B. Rapid irregular
treatment in
pulse
organophosphat
A rise in JVP
e poisoning in during inspiration
emergency:
D
O. Atropine & .
pralidoxime
B. Flumazenil P
C. Glucose u
D. Naloxone l
E. Pyridoxine s
e
345.Metab01ic
acidosis with
p
normal anion gap
a
may result from:
r
A. Diabetic
a
ketoacidosis
d
B. Renal failure
o
C. Aspirin
x
poisoning i
D. Methanol
o
poisoning u
Renal s
tubular
acidosis a
l
346. Most common w
etiology of a
nephrotic y
syndrome in s
adults is:
A. IgA E
nephropathy .

page | 128
 week. He appears
P unwell, include
a pansystolic murmur
i at the apex that
n radiates to the axilla
f and a soft 1 st heart
u sound. He has
l linear hemorrhage
under finger nails
h and painful, tender
e erythematous
p nodules on Some of
a the finger tips
t Which one of the
o following is true:
m Infective
e endocarditis
g B. Rheumatic
a heart disease
l C. Pericarditis
y D. Mitral stenos is
E. Aortic
348.Which one insufficiency
Of the
following is 350.A 23-years Old
theimportant man develops
risk factor sharp left sided
for sudden chest pain, fever
death in and friction rub
hypertrophie heard at the lower
cardiomyopa left sternal border
thy : unaffected by
A. Recurrent respiration. Ille
syncope pain is aLso
B. Exercise aggravated by
induced chest lying down and
pain relieved by
C. Increase in sitting up. He is
lefvventricular • otherwise well with
Repeated attack no other symptoms.
Of ventricular Which of the
tachycardia following is the
E. A historyof most likely cause
previous T.I.A for his symptoms:
A. Ml
349.A 42-years Old O. Pericarditis
male with known C. T
valvular heart uber
disease develops culo
a feverforone sis

page | 129
 D. o
fe l
ve i
r s
E. m
Pn
eu E
m .
on
ia M
i
351.A SS-years Old t
male presents to r
the hospital with a
a new 01Bet of !
chest pain, i
breathlessness n
and sweating. s
The pain is u
severe, located
in the center of f
his chest and f
radiates into his i
left arm. The c
pain lasts more i
than 30 minutes. e
What is rnost n
likely diagnosis: c
A. Aortic y
dissectipn:
B. Angina 352.X6S-years old
0. female deve101xs
Myocardialinfarc exertional angina
ti has had tuo
D episodes Of
. syncope.
Examination shows
P a systolic ejection
u murmur which
l radiates to the
m carotids and a soft
o S2. Which one of
n the following the
a most likely
r diagnosis:
y A
.
e
m *
b A

page | 130
o
r s
t t
i e
c n
o
i s
n i
s s
u T
f r
f i
i c
c u
i s
e p
n i
c d
y
s
B t
. e
n
M o
i s
t i
r s
a
l A
o
i r
n t
s i
u c
f
f s
i t
c e
i n
e o
n s
c i
y s

M 353.A 16-years Old

i male presented
t with high BP.
r On examination
a the blood
l pressure in arms

page | 131
 is higher than 355.A 52-years Old
in his legs by man presents with
more than 10 one week history
mmHg. of a cough
Which one Of productive of
the following green sputum with
is the most occasional blood
likely necks. He is also
diagnosis: complaining Of
Coarctation shortness Of
Of aorta breath and on
B. Aortic insu examination he is
fficiency pyrexial,
C. Normal tachypneic,
variant tachycardiac. What
D. Ventricular is most likely
aneurysm diagnosis:
E. VSD P
n
354.A SS-years old e
male presented in u
the emergency m
department with o
severe chest pain n
Of one hour i
duration. His a
ECG shows ST
elevation in VI- B
V4. The most .
likely vessel
blockade by P
thrombus in this u
patient is: l
A. Left 1min m
coronary artery o
Left anterior n
descending artery a
C. Left r
circumflex y
artery
D. Right e
coronary m
artery b
E. Posterior o
descending l
branch Of i
right s
coronary m
artery

page | 132
 C. ventilationperf
S usion
a mismatch
r
c
D. The FEVI[FV
o ratio is reduced
E. Exacerbation
i often occurs as
d
a result of an
o
upper
s
respiratory
i
s
tract infection
D. 357.A 50-years Old
A male with emphysema
s and a chest
t
X-ray that has
h
shown apical blebs
m
develops the
a
Sudden onset of
shortness Of
E
breath and left-
.
sided pleuritic
chest pain.
C
Pneumothorax is
O
suspected.
P
Physical
D
examination
356.A 30-years Old findings that
athlete with would confirm the
asthma is also a diagnosis are:
cigarette A. Localized
smoker. Which wheezes at the left
of the following base
is characteristic e. Hyper-
Of asthma but resonance of
not other the left chest
obstructive lung with de
disease: breath
A. Hyperinflation sounds
is present on
chest X-ray C. Increased
Airway tractile
obstruction fremitus on the
is reversible left side
D. Decreased
C. Hypoxia breath sounds
occurs as a on the left
consequence side'wi
Of deviation Of

page | 133
 the trachea breathlessness. On
to the left examination she
E. Dull tachypneic,
percussion cyamxsed, BP
note on left 70/50, x-ray chest
side with is normal. What is
shifting o appropriate
apex beat on diagnosis:
right side A. Ml
e. Pulmonary
embolism
358. Which Of the
following C. Pericardial
regarding tamponade
treatment or D. Pulmonary
acute edema
exacerbation of E. Aortic
COPD are true, dissection
except:
A. Short acting 360.A 70-years old
B2-agonist farmer presents
by nebulizer with imsidiously
progressive
B. Oral disabling dyspnea,
prednisOIOn dry cough, joint
e i pain and weight
mpmve•lung loss. On
function examination
High clubbing Of
concentratio fingers noted,
n Of oxygen chest may shows
D. If PHS7.35 bilateral diffuse
and polar in reticule nodular
ing•eåsing shadowing at the
consider bases. What is the
ventilatOry most likely
support diagnosis:
A
E. Mechanical .
ventilation
considered if B
there is r
concomitant o
pneumonia n
c
359.A female of 70- h
years old, after i
02 days of hip a
joint replacement l
surgery
developed severe c

page | 134
 a diagnosis of
r pulmonary
c tuberculosis:
i A. X-ray chest
n
o
m
a

B 362.Most cases of
. community-
acquired
R pneumonia are
h cawsed by which
e one Of the
u following:
m Streptococcus
a pneumonia
t 8B. Mycoplasma
o pneumonia
i C. Staphylococcu
d saureus
D. Haemophiltis
a influenza
r Viral
t ppgumonia
h
r 363.A 45-years old
i female presented
t with severe itching,
i recent pale stools
s and dark urine O/E
C. Military there -is
tuberculosis pigmentation,
Idiopathic xanthelasma and
pulmonary hepatomegaly. JHer
fibrosis LFT shows bilirubin
E. Mesothelioma 15 mg/dl, alkaline
phosphatase 1500
361.A 40-years Old ipv'l. Her UIS show
male normal biliary tract
complaining of and no any
low grade fever, obstruction. What is
weight Imss likely diagnosis:
since three Primary biliary
months. Which cirrhosis
one Of the B. Primary
following sclerosing
investigation will cholangitis
confirm the

page | 135
 C. Carcinoma rectal enema of
of pancreas 5-ASA is better
D. Carcinoma D. In extension
Of gallbladder E. disease 5-ASA
Gallstones Of
corticosteroids
364.1n treatment of are requ ired
ulcerative colitis:
A. For induction E. In limited
of remission disease oral
corticosteroid are corticosteroids
co are used
ns
id 365.Most important of
er the following
ed factors which leads
fir to gastro-
st esophageal reflux
lin is:
e A. Amenorrhea
ag Body mass
en index 28 kg/m2
t
5-
C. Bulimia
nervosa
A
S D. Pregnancy
A, E. Betel nut
Su chewing
lp 366.A 45-years old
ha woman is
sal diagnosed with a
az duodenal ulcer.
in Which one of the
e following is the
ar most sensitive test
e for detecting
re current infection
qu with helicobacter
ire pylori:
d A. A gastric
fo fundal biopsy
r B. Culture Of a
in gastric biopsy
di O. The (13C) urea
ca breath test
tio D. The presence
n Of helicobacter
pylori serum
C. Combination antibodies
of oral and

page | 136
 E. The urease n
test on o
gastric m
biopsy a

367.A 43-years E
Old lady with .
a 15 years
history Of H
hepatitis C is e
admitted with m
abdominal a
distention. CT n
abdomen g
confirmed the i
presence of a o
hepatic mass m
on a a
background
368.A 52-years Old
Of small, man wishes to
cirrhotic liver. commence therapy
What is the likely ror chronic
diagnosis: hepatitis C virus
A. Hepatic infection. He
metastasis wishes to take a
B. Hepatic regimen which has
abscess the best chance of
C. Fatty conferring
infiltration sustained
virological success.
Which o Of the
H
following treatment
e optioms would you
p recommend:
a A. Alpha interferon
t alone
o
Alpha interferon
c
with ribavirin
e
l C. Riba
l virin
u alone
l D. Riba
a virin
r with
lamivudi
c ne E.
a Lamiv
r udine
c alone
i

page | 137
369. Which one Of 371.Disease
the is most commonly
likev true ißsociated with
regarding the acute
hepatitis B: nephritic
A. Incubation syndrome are:
period is A
between 3 to 5 .
weeks B.
Transmission R
ishy droplet
h
infection e
HBe antigenis
u
the serological
marker Of m
active viral a
replication T t
o
D. 10 to 15% i
present with d
acut€hepatiti
s a
E. Carrier rate r
in adults is' t
370.A 55-year•s old h
man has "on- r
infective i
necrotizing t
ulcers on his i
lower limbs. A s
diagnosis Of
pyoderrna B
gangrenosum is .
made. Which of
the following S
condition is y
associated with
s
this disorder:
t
Inflammatory
e
bowel disease
m
B. Hemochrom
i
atosis
c
C. Gout
D. Non-
s
Hodgkin's
c
lynvhoma
l
E. Autoimmune
e
thrombocyto
r
penia
o
s

page | 138
 i P
s l
Systemic a
lupus s
erythematosus m
D. Liver a
abscess
E. Subacute c
bacterial e
endocarditis l
l
372.The reason for
renal failure in p
myeloma are: a
A. Heavy chain n
cast nephropathy c
O i
. t
y
L D. Hyperkalemic
i nephropathy
g E. Amyloidosis
h with heavy
t chain

373.In renin angiotensin

c
system, renin
h
release is controlled
a
by:
i
A. Pressure in the
n
efferent arteriole
d O. Pressure in the
e afferent arteriole
p C. Parasympatheti
o c tone
s D. Local
i prostacylianele
t ase
E. Sodium
d chloride
i concentration
s in distal tubule
e
a 374.As regard to
s sodium
e reabsorption, the
most Of filtered
C sodium load is
. reabsorbed in:

page | 139
 Proximal 1 vomiting and
ubule T diarrhea
B. Loop of henle
(Ascendiitg limb) 376.AIl interventions
C "Loop Of henle to prevent falls in
(De nding limb) old age is correct,
Distal tubule except:
A. Rationalization
Of medication
375.1n the specially
approa sedative drugs
ch to B. Correction of
patients visual
with impairment
hypoka
lemia: C. Balance and
syndro exercise
me is training
associa D. Hazards
ted assessment and
with safety
normal education Bed
blood rest
pressur
e 377.Regarding antidote
which one is incorrect:
Liddle's
syndrome is A. Cyanid
associated Sodium
with thiosulphate
hypokalemia B. Mucury
and normal DMPS
blood C. Opioid
pressure Naloxone
Renal D. Calcium
tubular channel blocker
acidosis type IV glucagone
IV Beta antagonist
associated Adrenaline
with
hypokalemia 378.General features
D. Discretic Of shock are all
therapy Of the following,
results in except:
hypokalemia A. Systolic blood
and acidosis pressure less
E. Urine is high than 100
in B. Tachycardia
hypokalemia more than 100
due to C. Cold clammy
skin

page | 140
 U C. Webbed neck
rine A
outp b
ut s
about e
50 n
ml t
per
hour p
E. a
Dro r
wsy a
conf t
use h
irrita y
ble r
o
379. All are the i
features Of SIRS, d
except:
A. Temperature E
>3800r <360 .
B. Heart rate
above 90 per H
minute y
Systolic blood p
pressure •90 e
mm Hg r
D. Respiratory rate c
> 20 a
l
c
380.Regarding e
IOinefelter's m
syndrome all are i
correct, except: a
A. Infertility
B. Small testis 382.A 25-years old
C. Gynecomasti male patient
a presented with low
47 XYY grade fever and
E. Phenotypically weight loss. On
are males examination of
chest nu»vements
381.Typical feature of are decreased on
Di-george syndrome right side with
is: decreased vocal
fremitus, dull
A. Gynecomasti percussion note and
a absent breath
B. Short stature sounds. The trachea

page | 141
 shifted to left, e
most likely m
diagnosis is: A. o
Pneumothorax p
Pleural h
effusion
i
C. Pneumonic l
consolidation u
D, Emphysema s
E. Bronehiectasis
i
383.A 26-year n
pregnant f
ladyusingf l
ollowing u
antitubercu e
losis drugs. n
Which of z
the drug a
best

avoided: A. D
INH .
B. Rifampicin
C. Ethambutol C
D. Pyrazinamid h
Streptomyci l
n a
m
384.Majority y
Of the d
cases Of i
community a
acquired
pneumonia p
(CAP) are n
caused by: e
A. u
Mycoplasm
m
a
pneumonia o
Streptococcu n
s pneumonia i
a
C
. E. Staphylococcus
aureus
H

page | 142
385.A SS-years male pneumon
during ia
performing Hajj Legionella
at Saudi Arabia pneumophilia
suddenly pneumonia
developed
headache, cough, 386.A business man
confusion, developed low
myalgia, high grade fever, malaise
grade fever and with protracted
diarrhea. illness. On
Laboratory tests examination there
show is
hyponatremia, hepatosplenomegal
abnormal y. On further
LFTs, elevated enquiry he said that
creatinine kinase recently he has
and decreased imported parrots
serum albumin and domestic
level. The most ducks. What is the
likely diagnosis most likely cause:
is: Chlamydia
A. psittaci pneumonia
Myco B. Coxiella
plasm burnetti (Q
a fever)
pneu pneumonia
monia C. Influenza
pneu pneumonia
monia D. Para influenza
B. pneumonia
Chla
E. LegioneUa
mydia
pneumophilia
pneu
pneumonia
monia
pneu 387.Regarding the
monia best option for
C. tussisted
Strepto ventilator therapy
coccal in patients with
pneum acute severe
onia asthma is:
pneum
onia Pa02 mm Hg
D. B. PaC02
Hemo
philus mmHg
influen C. Confusion
za

page | 143
388.Which Of the syndrome &
following is/are multiple
predisposing myeloma
factors, C. Hypoglobuline
predisposing mia
acute D. Hypoparathyro
pancreatitis: idism
AV Gallstones E. Non
. Alcohol abuse obstructive
C. Viral nephropathy
infection
D. Hyperlipide 391.A 29-years old
mia wonun is found
O. All of the on routine
above annual testing
389.A SO-years old to have an
male presented increase in
with difficulty in unconjugated
hearing and nasal bilirubin. There
septum is no evidence
perforation. His of hemolysis
B.P was 130/100 and
mmHg. His urine liver tests are
DIR showed red
normal. Which of
cells casts,
protein 2+, Chest the following is
X-ray had most likely
multiple diagnosis:
opacities. The A
must likely cause .
is:
A. Tuberculosis C
B. Amyloidosis r
C. Good i
pasture g
syndrome g
D. Kawasaki l
disease e
e. Wagener' s r
granulomatous
390.F0110wing N
disorders cause a
renal tubular j
acidosis (RTA): a
A. r
Hyperaldostemni
sm s
Wilson's y
disease, n
banconi's d
r

page | 144
o r
m a
e p
y
B
. E
.
D
u R
b o
i b
n i
n
J '
o
h s
n
s s
o y
n n
d
s r
y o
n m
d e
r
o 392.A diabetic patient
m presents with blood
e urea 200 mg/ and
Gilbert serum creatinine
4.5 mg'. His
syndrome
potassium level
D was 7.2 mmol/L
. What immediate
treatment will you
P start:
r A. Hemodialysis
e B. Peritoneal
g dialysis
n IN calcium
a gluconate
n D. IN magnesium
e
E. Nebulization
d
with vemiolls
i
solution
o
l 393. Liver cirrhosis
predisposing in
t Which of the
h following:
e

page | 145
A e
. p
a
G t
y o
n c
e e
c l
o l
m u
a l
s a
t r
i e. All of the above
a
assigned with H-
B Pylori:
. O. Chronic active
gastritis
H B. Congenital
e C. Crohn's disease
m D. Ulcerative
colitisthe following
394.Which Of
o
r E. Gastric stress
r ulcers of stom
h
o 39S.Acute inferior wall
i MI is
d A. Bradycardia in
s ECG
C B. Complete heart
. block
C. ST segment
S depression in
p D. ST segment
l elevation
e LAVL
n O. ST segment ele
o vation in Il, Ill AVF
m
396.The passage of dark
e
tarry stools are called:
g
A. Hematocheria
a
O. Malena T
l
y C. Both of above
D. Hematemesis
D E. None Of above
.
397.An 18-years old
H woman was

page | 146
 diagnosed 07 Which Of the
years earlier with disorder is most
precocious likely in this
pseudo puberty patient:
secondary to A. Congestive
ovarian tumor.
heart failure
Physical
examination B. Nephritic
reveals oral and syndmme
lingual dark C. Cirrhosis Of
pigmentation. liver
Which Of the O
following is the .
most likely
diagnosis: P
A. a
syn r
dro a
me p
B. n
pol e
yp u
osi m
s o
C. n
Ly i
nch c
syn
dro e
me f
Peutz f
Jeghers u
syndrome s
E. Turcot's i
syndrome o
398.A 27-years male n
presented with
high grade fever E
and right sided .
pleural effusion.
Pleural fluid C
reveals ratio of o
concentration of r
proteins in p
pleural fluid to u
serum protein l
70.5, LI)H level e
lu. LDH
concentration in m
pleural fluid to a
serum 70.6. n

page | 147
 u B. Verapamil
l (calcium
e channel
blockers)
399.Which Of the Captopril
following is the D. Furosemide
cause Of (diuretics)
hyponatremia: E. Aspirin
A. Diabetes
B. Decrease 402.All statements
water intake are correct
C. Total regarding
parenteral Crohn's disease,
nutrition except: A.
D. Hyperosmola Many
r diabetic symptoms are
abdominal pain,
coma
diarrhea,
Excessive weight loss
use More common
ofdiuretics in non-
smokers Or
400.A 35-years Old
female presented ex-smokers
with joint pain
and swelling for C. It is more
01 year that has common in
increased in early smokers
•norning hours.
On examination D. Ulcerative
she has nodules colitis &
on extensor Crohn's disease
aspect Offorearm. with HLA-B
What is the likely' 27 are more
diagnosis: prone to
A. Osteoarthriti develop
s ankylo
B. Septic E. CYohn's disease
arthritis is characterized
C. Chondo- by ring span
calcinosis dylitis by skip
Rheumatoid lesion in small
arthritis intestine
-ES SLE
403.Pericardial
401.1n heart which of effusion is best
the following diagnosed by:
have proved to A. C
improve linical
survival: exami
A. Digoxin nation

page | 148
 B. D. FVC (forced to
ogr vital capacity)
aph FEVI /FVC
y C. ratio
Car
diac 406. Following are the
enz signs of pneumonic
yme consolidation,
s select the best one:
Echocardiog A. Decreased
raphy chest
E. X-ray chest PA movement on
view affected side
404.Regarding B. Dull
Wilson's disease percussion note
all are true, select on affected
the best one: side
O. Increased C. Chest
urinary copper crepitation on
level affected side
B. Liver e
transplant in .
treatment of
choice B
C. Parkinsonis r
m is rare o
feature n
ofWilson's c
disease h
D. Renal i
tubular a
acidosis is a l
common
complication b
E. Serum r
ceruloplasmi e
n is a
increased t
h
405.111 diagnosis Of i
COPD all are true, n
select the best g

A. PEER E
B. TLC (total .
lung
capacity) S
C. Gas transfer h
factor i
f

page | 149
 t E
i .
n
g O
t
O o
f t
o
t x
r i
a c
c i
h t
e y
a
408.Homocysteinuria:
407.AII of the A
following are .
side effects of
loop diuretics, I
except: s
A.
kal a
em u
ia t
B. o
em s
ia o
C. m
Hy a
per l
kal
em d
ia o
W m
a i
t n
e a
r n
t
r
e t
t
e B
n .
t
i I
o s
n
c

page | 150
h plemented
a diet
r
a 409.Which of the
c following is noticed
t in sarcoidosis:
e A. Elevated uric
r acid leyel—
i B. Hyperphosphate
z m@5'
e
C. Hypogamma
d
globinemia
e.
b
Incr
y
ease
d
h
leve
o
l of
m
seru
o
m
c
calc
y
ium
s
E.
t
Leu
i
kop
n
enia
e
410.A 10-years old
e. Propranolo
m boy was presented
e with increased
t hunger, fever
h 1020F and
i weakness. At the
o time or
n examination blood
i sugar was 350
n mg/dl. What will
e be next step for
C, Causes this boy:
hyperpigmentatio Admit in
n Of skin hospital &
D. Is not the Start insulin,
cause of fluids
seizure &
B. Let him go to
osteoporosi
home on oral
s Is neated
hypoglycemia
by
drugs
pyridoxine
& C. Start insulin as
'gystinesup outdoor patient

page | 151
 D. Encourage failure E.
water intake, Dressler'
antibiotics s yndr
administratio
n 413.A 25-
E. Repeat blood yearsfemale
sugar after presented
02 days With episode
41 LCharacteristics Of palpitation.
of right heart failure O/E pulse is
are, except: irregular.
A. Raised JVP Which of the
Pulmonary following is
edema best treatmery:
C. Hepatomegal
y
D. Ascites
E. Peripheral
pitting
edema
'414.Dysentery (bloody
412. A 40-years old diarrhea) is not caused
male present by:
with dyspnea A. Clostridium
on exertion. On
difficile
examination
raised JVP with
Entamoeba
paradoxical rise
during histolytica
inspiration, D. Entero-invasive
hepatomegaly Escherichia coli
and ascites.
Chest X-ray
shows a small 415.A 40-years old
heart with previously well
calcification. woman present
The most likely with pruritis. She is
diagnosis A. not taking any
Viral medicine has drinks
pericarditis alcohols. Physical
Constrictive examination
pericarditis entirely normal.
C. C LFT show 3
ardiac times raised
tempo alkaline
nade phosphatase.
Ultrasound
D. C abdomen
ongesti shows normal
on liver and
cardiac gallbladder.

page | 152
Which of
the U
following lt
most ra
appropriate s
next step in o
diagnosis: u
A. Prothrombin n
time of d
B. Antinuclear of
antibodies a
C. Protein b
immune- d
electrophore o
sis m
O e
. n

A 416.A 38 years old lady

n develops mild
t epigastric pain
i along with nausea
- & vomiting since
m 02 days. On
i examination Of
t abdomen there is
o tender epigastrium
c otherwise nothing
h significant. Her
o TLC is 13000/m1,
n amylase 300 U/L
d (25-135). mich Of
r the following is
i most common
a predisposing
l factor:
A. Drugs
a Gallstones
n C
t .
i
b M
o a
d l
i i
e g
s n
a
E n
. c

page | 153
 y A. Pleural
effusion
D B. Tuberculosis
. c. ccp
D. Chronic
A
bronchitis
l
Bronchiectasis
c
o
419.Regarding mitral
h
o
stenosis:
l A. Always due
Hypertriglyceri to rheumatic
demia heart disease
417.Regarding chest B. is soft
pain: Mid-diastolic
A. Pain of acute murmur
pericarditis D
relieved by .
nitrates In
acute A
pneumothora p
x it is sudden e
and x
increased on
expiration b
C. Chest pain e
increased on a
exertion t
relieved by
rest in s
pneumomam h
i
D. Tearing chest f
pain t
radiating to e
leg and loss d
of pulse
t
o
E. Crepitus at
the site Of
a
chest pain
x
indicate
i
acute
l
pleurisy
l
a
418.Respiratory
cause Of finger
E
clubbing is:
.

page | 154
 u
E r
j e
e +
c v
t e
i f
o o
n r
A
s F
y B
s
t E
o .
l H
i i
c g
h
m
u E
r S
m R
u
r 421.111 H. Pylori
associated ulcers.
420.Best A. There is
investigation for normal acid
diagnosis Of production
pulmonary TB is: B. Increased acid
A. Cavitation production in the
on X-ray cause of. yater C,
chest The gastric ulcers
B. Mantox test are more common
+ve e.
C. Sputum Th
Smear +ve e
for AFB du
od
S ena
p I
u ulc
t ers
u are
m mo
re
c e
u E.
l H.
t Pyl

page | 155
 o i
r c
i
u p
l a
c
e i
r l
s l
a '
r C. The pain is
e squeezing in
n nature
o D. The pain is not
t relieved by
c food
u E. Nausea,
r vomiting or
. weight loss are
b not present
l
e 423.The drug Of
choice for the
422. Clinical treatment of
features Of peptic ulcer are:
peptic A. Antibiotics
ulcertdiseas Proton pump
e are: A. It inhibitors
causes right
C. H2 receptor
hypochondr
antagonist
ial pain
D. Antacids
I E. All of the
t above

424.The bacterial
c
causes Of acute
a
infectiotrs diarrhea
u
s A. Entamoeba
e histolytica
s
B. Giardia lamb
lia
e
C. Rota virus
p
i e. E. coli
g E. H. pylori
a
s 425.1n chronic
t diarrhea:
r

page | 156
 A. Diarrhea is C. Maintain
for less than 4 airway
weeks D. Check blood
Diarrhea is cp
for more E "Check
than 4 urea/electrol tes
weeks
C. Drugs are Organophosphate
leading poisoning is more
cause such common is
as H2
receptor Workins
blocker fields
D. Inflammat (agricultural
ory cause land)
is irritable B. Garment
bowel factories
disease C. Hospitals
E. Motility D. Cotton
disorder factories
causes Cement
fever and factories
weight loss
I".Regarding the
426.A young boy clinical features Of
brought to shock:
casualty with O. Tachycardia
history Of with low volume
snake bite pulse
since last few B. Hypertension
hours. The C. Polyuria
foot of the D. Bounding
boy is swollen pulse
and blood is E, Slow
oozing from respiration
his wound.
His pulse is 429.F0110wing is
90/min, BP the cause Of type-I
10000 mm respiration failure:
Hg. The Pneumonia
important Stroke
steps in the C. H
management ead
of thiypatient injur
are: A. Keep y
patient warm D. M
Arrange yoca
the blood rdial
& ASV infar
ction

page | 157
 E. C. It is low in
CJ antiphospholipi
B d syndrome
sy D. It is normal in
nd hemophilia
ro E. It is decreased
me in Von
Willebrand
430.Recognized disease
clinical
feature of 433.A 30-years Old
raised I.C.P woman complains
(intracranial Of intolerance to
pressure): cold water and
Papilloede dysphagia. On
ma examination she
B. Tachycardia has beaked nose,
C. Down going fish mouth, facial
planter telangiectasia,
D.3rd cranial satLsage like digits
nerve palsy E. and tapered fingers.
Systolic Which one is the
hypotension best test to diagnose
this disease:
431.Recognized A. R.A factor
clinical feature
B. Blood cp
ofParkinson's
C. X-ray chest
disease:
Anti
A. Intention
centrome
uemors
re
Rigidity antinucle
C. Ataxia ar
antibody
D. Waddling E.
gait Barium
Decreased swallow
tone
432.One of the 434.Disease which
following present as
statement is true innamrnatory
for activated monoarthritis is:
partial A. Reactive
thromboplastin arthritis
time (AITT): B. Psoriasis
A. It assesses C. Ankylosing
extrinsic pathway spondylitis
of coagulation Septic arthritis
O. It helps in E. Post viral
monitoring arthritis
heparin therapy

page | 158
435.Main clinical .
criteria for the
diagnosis of U
rheumatoid r
arthritis: e
A. Mornin l
g h
stiffness r
03 i
hours t
B. Arthralg i
ia of s
three or
less 436.Methotrexate is
joints used for:
Symmet A. The only disease
rical toyeat R.A
arthritis
Of hand It is the drug
join and Of choice by
more many
than 6 physicians
weeks D. Oral vitamin
D B6 is given wi!
. bit to counter
its side effects
A E. It is given
s monthly,
y
m 437.Following drug is
m included as disease
e modifying anti-
t rheumatic drugs
r (DMARDs):
i A. Corticosteroids
c B. NSAIDS
a C. Tetracycline
l L
e
a f
r u
t n
h a
r m
i i
t d
i e
s
E
E .

page | 159
 C. Hemangioma
I D. Hepatoblastom
n a
f E. Cholangiocarci
l n
i
x 441.Which of the
i following is a
m B)téntial
a complication Of
b severe reflLLx
esophagitis:
438.The major A
stimulus for .
gallbladder
emptying is: P
A. Vagal a
stimulation n
B. Sympathetic c
stimulation r
e
Cholecystokinin a
D. Secretin t
i
E. HCL t
secretion i
439.The most s
frequent cause
of pyogenic B
liver abscess is: .
Ascending
cholangitis G
B. Hematogeno a
us s
C. Septicemia t
D. Direct spread r
from i
intraperitone c
al infections
E. Trauma to C
liver a
n
440.Which Of the Esophageal
following is most cancer
common primary D Ä)uodenal ulcer
tumor of liver: Pernicious ane
A. Hepatic
adenoma 2.Which0f the
Hepatocellular following is not
carcinoma thought to be

page | 160
helpful in lu
management of bl
chronic e
pancreatitis: A. • vi
*Alcohol ta
abstinence m
Cholecystect in
omy su
C. p
O pl
r e
a m
l e
nt
p s
a A
n n
c al
r g
e es
a ic
t dr
i u
c gs

e 443.Most important
n single factor to be
z comsidered before
y tramsplantation
m between donor and
e recipient is:
A. Mix
r lymphoeytic culture
e assays
p e. HLA typing
l C. ABO blood
a typing
c D. Peripheral T-
e cell count Of
m recipient
e E. Closeness Of
n relationship
t between donor
& recipient
F
a 444.A 35-years old
t female presented
with sudden
s onset Of
o shortness of

page | 161
breath while D. Increased
sitting in her partial pressure
car. She was of oxygen
healthy Decreased
Otherwise. She partial pressure
has been on Of carbon
birth control dioxide
pills for the 445.A 40-years old non-
last 06 months. smoking male
On physical presents in the
examination falahee clinic with
her respiratory shortness of breath
rate was which has gradually
35/minute, BP worsened over 03
120/80 mm months.
Hg, Examination
temperature 99 reveals a JVP of
and pulse rate 18cm, a displaced
87 regular. On apex beat and a
cardiac diastolic thrill in the
auscultation aortic area. On
her second auscultation he has
heart sound a soft SI, a blowing
was systolic murmur at
prominent. the apex radiating
Rest Of the to the left axilla and
physical a 3/6 dizßtolic
murmur along the
examination
left sternal border
was
best heard with the
unremarkable.
patient learning
On chest X-ray
forward with the
she oligemia
breath held in
of her right
expiration. What is
lower lung an echocardiogram
zone. What (with color flow
would you Doppler) most
expect arterial likely to show:
blood gases: A. Mitral stenosis
A. Normal & aortic
partial stenosis
pressure Of
B. Mitral
oxygen
regurgitation &
B. Increased aortic stenosis
carbon
C. Mitral
dioxide
regurgitation &
partial
mitral stenosis
pressure
Mitral
C. Increased
regurgitation
base excess
& aortic

page | 162
 regurgitation CT scan of
E. Mitral chest
stenosis & E. Abdominal CT
aortic scan
regurgitation
447.You are at
446.A 17-years Old genetic council
male comes to clinic, a lady "ith
your clinic with thalassemia trait
complaints of ask you the risk
cough with thick Of thalassemia
tenacious major in her
sputum, dyspnea child. You will
on exertion and advise:
hemoptysis A. C
since childhood. horion
He also has a ic
history Of villou
p(ßtprandial s
abdominal pain, sampli
chronic diarrhea ng
and inability to B. G
gain weight. enetic
Occmsionally couns
his productive eling
cough Worsens C. Hb
and he needs a electr
course of oral ophor
antibiotics. One esis
of his siblings Genetic gesting
gives a similar Of her partner
history of chest E. Ultrasigund pelvis
disorder. What
investigation 448.Which of the
will help you following statement
determine the is true regarding
etioloky in this theophylline
case: poisoning
Estimation A. Hyperkalemia
of sweat is. feature
chloride B. Activated
concentratio charcoal is of
n little value
B. Ultrasonogra C. Ipecacusnha is
phy of the method Of
abdomen choice to
C. Chest x-ray reduce output
D. High absorption
resolution

page | 163
 Convulsions tract infection
are a recognized two weeks ago,
feature had develop a of
E. Assisted power in his both
elimination lower limbs since
should be last 02 days. On
avoided examination
there is arenexia
449.A 65-years in legs with
aged farmer intact sensation.
presented with CSF examination
low grade reveals increased
fever and proteins most
bleeding possible
gums. On diagnosis will be:
examination A. Alcoh
he is anernic olic
with purpuric neuro
spots all over pathy
body and B. Acute
moderate transv
spleen. Blood erse
picture reveals myeli
pancytopenia tis
and a dry tap Cord
on bone infarc
marrow tion
aspiration. Guillain Barre
Most sy
appropriate E. Diabetic
diagnosis will neuropathy
be:
A. Acute
451.A 63-years old
lymphoblasti male smoker,
c leukemia hypertensive
B. Aplastic having repeated
anemia attacks or TIA's in
C. Hypersplenis last '08 months.
m On examination
e. Myeloiibrosis his BP is 180/110
E. Megaloblastic mm Hg, audible
anemia carotm bruit.
Investigation
450.A 36-years reveals serum
young diabetic cholesterol of 276
for last 04 mg and critical
years is left carotid
alcoholic stenosis on
having had a angiography. The
respiratory best treatment

page | 164
option to reduce ow
the risk Of eri
stroke will be: ng
A. ag
Anticoagulant ent
therapy Revascularizati
Antihyperten on & zEspirin
sive agent
C 35-years of age
. acidotic patient of
g chronic renal
A failure is one ACE
n inhibitor to control
t his blood pressure
i brought to an
p emergency with
l C/O fatigue and
a breathlessness. His
t serum K level in
e 7Smeq/L and ECG
l shows absent P-
e wave and tall T-
t wave.
a Your first step in
g the management
g will be:
r A. IN furosemide
e B. IN insulin &
g glucose
a IN calcium
t gluconate
i D
n .
g
I
f N
a
c b
t i
o c
r a
D r
. b
L o
i n
p a
i t
d e

l E

page | 165
 . hematemesis with
black colored stools
D for last 03 days,
i there is no
a abdominal pain. He
l is pale and BP
recorded is 80/60
y
mmHg with 20
s mmHg fall in
i standing position,
s his Hb level found
to be 6.6 g Initial
453.A 50-years old step in the
individual management will
smoker and long be:
standing COPD Blood
develop cough transfusion
with hemoptysis, B. Upper GI
pain in right endoscopy &
upper Chest and sclerotherapy
aching C. I/V sandostatin
extremities infusion
especially both D. Rol's tube
wrists. On aspiration to
examination his avoid
both wrists are encephalopathy
swollen, warm
E. Start
and tender and
terlipressin
bilateral clubbing
therapy
is positive. Your
initial 455.A young male air
investigation to condition mechanic
achieve a develop fever,
diagnosis: bodyache, GI upset
e. X-ray Of chest and respiratory tract
B. X-ray of infection, this
wrist joint serological test are
C. Aspirate that awaited keeping a
synovial possible diagnosis
fluid Of of legionnaire
wrist joint disease. The
D. m factor antibiotic of 1st
E. Sputum choice will be:
examination A. Azithromycin
B. Clarithromycin
454.A 40-years Old
male known C. Doxycycline
cirrhotic brought O. Erythromycin
in an emergency E. Moxifloxacin
department
having WO two 456.A 19-years
bouts of college student

page | 166
 having H/() E. Hepatiti"B.core
polyarthralgia antigen
rash over her positive
cheeks. Banosi
examination 458.A 27-years male
reveal malnourished
generalized patient having
edema with bilateral extensive
mild right sided pulmonary
tuberculosis, he is
pleural
on ATT: but the
effusion. respolße is poor.
Investigations Since last three
show weeks he has
pancytopenia noticed edema of
and proteinuria face and feet. Most
of 2+. The best likely possibility is:
test to assess A. Corpulmonale
active lupus B. Constrictive
nephritis will pericarditis
be: C. Intestinal
A. ESR tuberculosis
estimation leading to
B. GFR malabsorption
estimation D. Malnutrition
O. Anti-DNA Renal
antibody levels amyloidosis
D. Serum
complement 459.A SS-years Old
levels heavy smoker man
E. Renal biopsy presents with
progressive
457.A medical dilliculty in
student has swallowing food
completed his and water followed
hepatitis B by vomiting and
vaccination retr(ßternal
schedule. Her burning. He has Of
hepatitis B appetite and weight.
profile reveal: What is diagnosis:
A. A positive A. Stricture of
hepatitis B esophagus
surface antigen Carcinoma Of
O A positive esophagus
HBsAb C. Hiatus hernia
C. HI) core D. GERD
antibody E. Achalasia
positive cardia
D. Hepatitis B
antibody 460.A 50-years old lady
positive complaims of pain

page | 167
 and vomiting for Fleural effusion
six months. She Lung abscess
also gives history Empyemathora
of weight loss, eis
black stools and D. Pulmonary
loss Of appetite. embolism
She chew pan Pneumoihorax
with tobacco for
last 15 years. 462.A 50-years
What is the most farmer went for
appropriate prolong surgery
investigation to of abdomen. He
reach diagnosis: is known
A. Ultrasound hypertensive
abdomen and diabetic 'for
B. Barium meal 05 years. On the
C. Stool 5th
examination postoperative
Upper GI day he uddenly
endoscopy developed chest
gastroscopy pain, difficulty
E. Manometry in breathing and
cough. What he
46 LA 20-years suffered from:
young A
ladydeveloped .
high grade
fever and M
cough for 05 y
days. She was o
given broad c
spectrum a
antibiotics for r
07 days, She d
was i
recovering but a
she developed l
fever, cough
and left chest i
pain. On n
examination f
her left lower a
chest is tender, r
red and dull, c
breathing t
sounds are i
absent. o
What n
complication she
h" developed: B

page | 168
 . m
i
P a
n
e D
u .
m
o F
n o
i l
a i
Pulmonary c
embolism
D. Pneumothorax a
E, Acute c
coronary i
syndrome d

463.A 65-years Old d

man presents e
with weakness f
and paresthesia, i
numbness of c
lower limbs. On i
examination he is e
anemic with red n
and sore tongue. c
His blood y
absolute value E. Anemia of
show MCV 124. chronic
What is
diagnosis: 464.Chronic hepatitis
A. Hemolytic C is treated by:
anemia A. Pegylated
B. Thalassemia interferon
intermedia B. Conventional
P interferon
e Pegylated
r interferon &
n ribavirin
i D. Adefovir
c E. Conventional
i interferon &
o tenofovir
u
s 465.A 30-years old
male with a family
a history of adult
n polycystic kidney
e disease wished to

page | 169
 be screened for investigation in
the condition. elucidating the
His mother was diagnosis:
affected and a A. Thyroid
paternal aunt ultrasound
had recently B. Radioiodine
suffered a thyroid scan
subarachnoid Fine needle
hemorrhage as aspiration Of the
a result of a thyroid gland
ruptured berry D. Total plasma
aneurysm. thyroxine
What is the concentration
standard E. cr scan chest
screening 467.A 50-years old
investigation of woman presented
choice: A. CT with a two day
scan abdomen history of
Renal increasing difficulty
ultrasound with swallowing a
C. CT scan regurgitation of
brain food. Over the
D. Genotype of preceding two three
APCKD months she had also
antigen e experienced
E. Urinalysis difficulty climbing
stairs, raising her
466.A 23-years old arms above the and
woman presented arising from a
with a painless sitting or lying
swelling in her position with some
neck. There was associated lower
no history Of a back pain. On
recent viral examination she
illness. The was found to have
patient did not symmetrical
have symptoms proximal muscle
of hyper or weakness with
hypothyroidism. normal tone.
She was not sensation and deep
taking any tendon reflexes.
medicine. On Cranial nerve
examination 2cm examination
painless mass revealed weakness
(thyroid lump) Of the bulbar
associated with muscles. What the
cervical likely cause Of her
lymphadenopathy muscle weakness%
. What is the
most useful

page | 170
 C
e
l
i
a
468. Reliable test in c
diagnosis Of celiac
disease is: d
A. Serum anti- i
gliadin test s
O. Anti- e
transglutaminase a
antibody test s
C. Anti- e
reticulin
antibody test E
D. Fecal fat .
analysis
E. Abnormal G
shifting test E
R
469.Reliable test to D
assess the
exocrine 471.A patient
pancreatic develops jaundice
function is: and C/O blackish
A. Secretin urine for last two
stimulation days. LET shows
test increased
B. Undigested bilirubin with
meal fibers normal enzymes.
in stools What is probable
C. Stool fat diagnosis:
content A. Rifampicin
Fecal stool intake
elastase test B. Vitamin B 12
deficiency
E. Fecal nitrogen
Hemolytic
test
crises
470.1)ermatitis D
herpetiformis is a .
cutaneous variant
of: O
A. Peptic ulcer b
B. Ch•ohn's s
disease t
C. Ulcerating r
colitis u
c

page | 171
 t D. Entacavir is the
i drug of choice
v Pegylated
e interferon is
the preferred
j drug
a
u 473.A 30-yearsold
n lady with past
d history Of
i postpartum
c hemorrhage
e developed loss of
axillary, pubic
E and body hairs.
. Later on noticed
change of voice.
H Tasting
e glucose, serum
p FSH, LH were
a low with ormal
t TSH. What is
i your
t diagnosis: A.
Hypothyroidis
i
m
s
Sheehan's
syndrome
472.Regarding delta
Virus: C. A
ddiso
A. It is an RNA
n's
detective
disea
virus w •ch
se
has
independente D. H
xistence emoc
hrom
B. Simultaneou
atosi
s infection
s E.
along with
Hypo
hepatitis B is
gona
called Super
dism
infectious
C 'Infection of 474.A school teacher
hepatitis b in the presented with
preexisting tender swelling in
hepatitis front Of neck,
B patientS moves to
called swallowing. TSH
eoinfection was suppressed
with raised ESR.

page | 172
RAI uptake was r
low. c
Most likely she is i
suffering from: n
A. Grave's o
disease m
B. Thyroid a
adenoma
C. Hashimoto's 475.A college student
thyroiditis known case Of
O type-I diabetes for
. 17 years complaints
of alternating bouts
D nocturnal Of
e diarrhea lost 8 kg
weight loss during
Q illness. His blood
u glucose Showed
e unexpected
r fluctuations and
v variable levels after
a meaLs since last 03
i months, The
n condition you
labelled as:
t A. Irritable bowel
h syndrome
y Gastroparesis
r C. Infective
o diarrhea
i
d D. Drug induced
i diarrhea
t E. Ca colon
i 476.A 60-years old
s male presented ER
with severe
E headach€% CT
. showed SAH and
admitted in ICU.
T He recovered fully
and clinically stable
h
but at 101b day he
y developed left
r hemiparesis. What
o could be
i possibility:
d A. Meningitis
B. Recurrent
c stroke
a

page | 173
 Infarction D.
due to Tido
vasospasm vidin
D, Encephalitis e
E. Cerebral durin
abscess g
pregn
477.A bus driver ancy
developed high and
grade fever, E.
headache and Leci
severe body —u
ache. ()/E his
vidin
eyes were red
and e in
maculopapular last
rash all over trime
body except ster
palms and soles.
Platelets were 479.A young lady
Diagn presented with
(ßis will be: fatigue and pallor
A. Malaria within 03 days. O/E
anemia positive,
B. Enteric fever
spleen was just
Meningococ palpable. Her blood
cemia sent for cross
D. Sepsis matching and for
E. Viral complete picture.
hemorrhagic Lab technician find
fever difficulty during
cross matching and
478.A HIV positive her Irripheral smear
pregnant lady showed
came to you spherocytes. She 9
clinic. She is suffering from: A.
very much tensed Sideroblastieanemi
about risk of a
transmission of
HIV to her child. Hemolyücanemia
What will you C. C
advise: old
A. Therapeutic agglu
abortion tinin
because Of disea
high risk Of se
transmission D. S
B. Continue ickle
pregnancy, cell
no risk of anem
transmission ia E.
Avoid breast Drug
feeding

page | 174
 rea i
cti n
op e

480.A middle age 481.A 43-years Old

lady newly male is admitted
diagnosed as to the coronary
case of RA care unit with on
stated
DMARDS by
acute interior
physician. myocardial
After 6 months infarction two
of therapy she hours after
developed admission blood
diarrhea, loss pressure is 86/52
Of hairs, and mmHg, heart
dranultic rate is 50 beats
weight loss. per minute with
LET was sinus rhythm.
disturbed.
Which of the
Which drug is
culprit: A. following would
Sulfasalazine be the most
B. Lefunemide appropriate
C. Ritiximate initial therapy:
e A. Immediate
. insertion of a
temporary
M intravenous
e pacemaker
t B. Intravenous
h administration
o of atrophic
u sulfate 0.6 mg
e Intravenous
x administration
a Of normal
t saline 300 ml
e over 15 min
Intravenous
E administration
. Of dobutamine
0.35 mg
C E. Intravenous
h administration of
l isoproterenol 5.0
o
r
o 482.Acute
q hyperkalemia is
u associated with
which of the

page | 175
 following combined use
electrocardiograp Of
hic changes: prednisone &
QRS cyclophospha
widening T mide
B. Fredonpasto B. His 5 year
n Of the ST survival is
seguent less than
C. A decrease Single lung
'in the PR transplantatio
interval n should be
D. Prominent considered if
ofvy waves E. T- he continues
wåve flattening to exhibit
clinieal
483.What is the most deterioration
appropriate while on
immediate medical
treatment for therapy
severe D. Interferon
hemoptysisz A. gamma of has
Bronchoscopy. been shown to
Bronchial improve
artery survival in all
embolization patients with
C, Chest CUP this disease
D. Lung E. Glucocorticoid
transplantati s alone are the
on best therapy
E. Stygical
resection 485.A 50-years old
male is admitted to
4.Atdiagnosis the hospital with
Of pneumonia. He
idiopathic does well after the
pulmonary administration of
fibrosis is antibiotics but his
de. What do sodium is noted to
you the rise from
patient 140 to 154
about the meq/L, over 2
treatment days he reports
and thirst and had
prognosis: a urine output of
A. His approximately 5
survival & liters per day.
quality of Which of the
life will be following is the
improved most appropriate
with the next step to

page | 176
evaluate the ture 98,
patients RIR 30
disorders: breaths/mi
Measuremen n. O/E
t of serum Chest B/L
osmolality wheezes,
Measuremen according
t Of serum to patients
vasopressin attendant
level she has
WO
C. 24th ingestion
measure pesticide
ment of three
urinary hours
sodium back.
D. Tri What will
al of be next
arginine manageny
vasopre ent step:
ssin E. A. Gastric
Trat Of lavage B-
free Maintain
water IN line
restricti C. IN atropine
on D. Pralidoxime
486.A Mechanical
30- ventilation
years
old
female
brought
in
emerge
ncy
departm
ent with
WO
unconsc
iousness
for 01
hour.
O/E
pulse
120
beats/mi
n,BP
90/60
mmHg,
tempera

page | 177
487. Which one or the following antimalarial drugs will

488.

eliminate tissue schizonts of the malarial parasite:

page | 178