The most common cause of sudden death is:

Ventricular tachycardia

Cerebrovascular accident

Ventricular asystole

Acute renal failure

In case of coma, a common cause of death is:

The tongue falling back and obstructing the airway

Secretions obstructing the airway

Cardiac arrest

Epilepsy

Smoking can cause:

Lung cancer

Thromboangiitis obliterans

Chronic bronchitis

Myocardial ischemia

Thromboangiitis obliterans involves which vessels:

Femoral

Popliteal

Anterior and posterior tibial

Aortoiliac

Which of these are included in the treatment of tobacco addiction?

Nicotine

Bupropion

Dopamine

Adenine

A female taking alcohol is more prone to develop toxicity and cirrhosis compared with male when the same amount of alcohol is taken due to:

Decreased alcohol dehydrogenase in stomach

Decreased absorption

Large body size

Genetic factors

The characteristic feature of Korsakoffs syndrome is:

Disorientation

Coarse tremor

Delirium

Amnesia

Which is seen in opioid poisoning?

Hyperventilation

Raised blood pressure

Bradypnea

Dyspnea

Low PO2 levels are found in:

Anemia

CO poisoning

Methemoglobinemia

Hypoventilation

Oxygen content of the arterial blood is reduced in all except:

Methemoglobinemia

Fallots tetralogy

CO poisoning

Fibrosing alveolitis

ASLO titres are used in the diagnosis of:

Acute rheumatoid arthritis

Acute rheumatic fever

Scarlet fever

Post infectious glomerulonephritis

Increased levels of CPK are seen in:

Cirrhosis

Hemoglobinopathies

Exhausting exercise

Hypothyroidism

Postural hypotension is not seen in:

Diabetes

Hypoglycemia

Tabes dorsalis

Use of antihypertensive drugs

Periorbital edema is not seen in:

Hypothyroidism

Acute renal failure

Cardiac failure

It is seen in all of the above

All of the following cause weight loss except:

Diabetes mellitus

Pheochromocytoma

Hyperthyroidism

Insulinoma

Plasmapheresis is recommended in all of the following except:

Hyperviscosity syndrome

Macroglobulinemia

Immune complex glomerulonephritis

Chronic active hepatitis

Sepsis syndrome includes the following:

Evidence of infective focus

Normal pulse

Tachypnea

Organ failure

A massive splenomegaly is seen in:

Chronic myelogenous leukemia

Visceral leishmaniasis

Gauchers disease

Myelodysplasia

Horners syndrome associated with pain shoulder and arm is suggestive of:

Aortic aneurysm

Myocardial infarction

Cervical spondylosis

Pancoast tumor

LDH is increased in:

Acute pancreatitis

Myocardial infarction

Pneumothorax

Cystic fibrosis

Macroglossia is seen in following except:

Amyloidosis

Acromegaly

Hyperthyroidism

Downs syndrome

Clubbing is seen in:

Hepatorenal syndrome

Left-to-right shunt

Childhood asthma

Suppurative pneumonia

Carotid massage causes:

Increase of vagal tone

Decrease of sympathetic discharge

Decrease of vagal tone

Tachycardia

Rhabdomyolysis is characterized by:

Weakness of the affected muscles

Increased Mg+2

Increased K+

Decreased Ca+2

All of the following metabolic diseases may cause chronic or recurrent abdominal pain, except:

Acute intermittent porphyria

Addisons disease

Hypercalcemia

Hyperkalemia

Sudden death can occur in all of the following cardiovascular conditions except:

Ventricular fibrillation

Massive myocardial infarction

Atrial fibrillation

Rupture of the aorta from dissecting aneurysm

Cor pulmonale may be seen in:

COPD

Marked obesity

Mitral stenosis

Kyphoscoliosis

Cyanosis is classically described as occurring:

If 1.5 g/dL of deoxyhemoglobin is present

If 3 g/dL of deoxygenated hemoglobin is present

If 5 g/dL of reduced hemoglobin is present

All of the above

If a third heart sound is heard, it is:

Always pathological

Indicative of aortic stenosis

Suggestive of poor left ventricular function

Suggestive of mitral stenosis

All of these produce a continuous murmur except:

Arteriovenous malformations

Ruptured aneurysm of sinus of Valsalva

Patent ductus arteriosus

Mitral valve prolapse

TTS pg. 11 Best way to treat street wounds a) Immediate suturing b) Cleaning with Saline & Debridement c) Oral Abx d) Leave it alone 2 Erythema Nodosum can be caused by a) Sarcoidosis b) Post prim. Tbc c) Sulphonamide Therapy d) Streptococcal Pharyngitis 3 Pruritus is seen in all except a) Hodgkin Lymphoma b) Obstructive Jaundice c) Prim. Biliary Cirrhosis d) Lead Poisoning 4 Acne Vulgaris is rare in/on a) Face b) Back c) Leg d) Scalp 5 Basal Cell Carc. of the Skin a) Accounts for the majority of cancers on the exposed skin b) Is almost unknown in blacks c) Is an important hazard of radiotherapy d) May be caused by prolonged exposure to arsenic 6 Ecthyma is a a) Deep Viral Infect. b) Superficial Bacterial Infect. c) Deep Bacterial Infect. d) Non-infect. Inflammation TTS pg. 27 Which of the following methods is thee best for controlling an outbreak of MRSA of wounds in post-operative ward a) Use of face masks by the personal b) Washing hands thoroughly before & after dressing the wounds c) Through fumigation of the room d) Pre-op Vancomycin to every patient 8 Strawberry Tongue followed by Raspberry Tongue is characteristic for a) Mumps b) Measles c) Scarlet Fever d) Small Pox e) Chicken Pox 9 Erysipelas is a) Lymphangitis due to Staphylococcus b) Lymphangitis due to Streptococcus c) Subcut. Inflam. due to Streptococcus d) Anaerobic Infection 10 Extensive chr. Candidiasis should arouse suspicion of a) HIV b) Tbc c) Histoplasmosis d) Leprosy 11 Langhans Giant Cells are seen in a) Sarcoid Granuloma b) Tuberculous Granuloma c) Leprosy d) Syphilis 12 Which are not features of Botulism a) Deranged pupillary reflexes b) Spasticity c) Akinesia d) Rigidity TTS pg. 313 The following is true about Tetanus a) Centrally placed spasm b) Contagious c) Local Necrosis d) Prevented by Immunisation 14 Features of Klebsiella Pneumonia is/are a) High mortality b) Upper lobes are involved c) Systemic disturbances d) Chocolate coloured sputum e) All of the above 15 Staphylococcus Aureus commonly inhabits a) Nose b) Throat c) Ear d) Skin 16 TBC is exacerbated by a) Gastrectomy b) Alcoholism c) Diabetes d) All of the above 17 Lyme disease is caused by a) Borrelia Burgdorferi b) Borrelia Dutoni c) Borrelia Recurrentis d) Borrelia Turicate 18 Toxic Shock syndrome is caused by a) Pseudomonas b) Staphylococcus c) Gonococcus d) Penumococcus TTS pg. 419 Bull neck in Diphtheria is due to a) Cellulitis b) Lymphadenopathy c) Retropharyngeal Abscess d) Laryngeal Edema 20 All of the following may be complications of Pulmonary Tbc, except a) Empyema b) Bronchopleural Fistula c) Bronchiectasis d) Pulmonary Haemorrhage e) CO2 Retention 21 The best single laboratory aid in Dx of Tbc a) Skin Test b) Chest X-Ray c) Sputum Examination d) Histology e) Physical Examination 22 Which of the following is NOT associated with Streptococcus a) Rheumatic Fever b) Scarlet Fever c) Acute Glomerulonephritis d) Scalded skin syndrome 23 In prim. Syphilis the lesion seen is a) Indurated Ulcer b) Multiplicity of Lesion c) Painful Ulcer d) Bleeding Ulcer 24 Following can be used for Dx of H. Pylori except a) Rapid Urease Test b) Urea Breath Test c) Gastric Biopsy & staining with Giemsa d) SAFA Test TTS pg. 525 Which of the following Ig is characteristically elevated in a parasitic infection with Filariasis a) IgA b) IgE c) IgG d) IgM 26 Which of the following is false about H. Pylori a) Endoscopy is best for Dx b) Urease activity becomes negative in a chronic carrier c) Unless treated it will remain life long d) Gastric Carcinoma can develop in chronic disease 27 A farmer rearing sheep presented with complaints ofFever, Weakness and Hepatomegaly. Biopsy of the liver showed non-caseating Granulomas. These are most likely due to an infection with a) Brucella Melitensis b) Brucella Canis c) Francisella Tularensis d) Yersinia Pestis 28 Botulinum Toxin is used in the Tx of a) Facial Dystonia & Tics b) Tetanus c) Guillain-Barre Syndrome d) Botulisms 29 Method of choice to confirm H. Pylori eradication is a) Urea Breath Test b) Culture c) Serology d) Microscopy 30 Most common X-Ray finding of Pulmonary Tbc in AIDS is a) Upper zone haziness b) Diffuse Infiltrates Multiple cavities d) Pneumonic Patch

1. Most common cause of spontaneous pneumothorax is:a. Rupture of sub pleural blebb. TBCc. Traumad. Asthma2. All of the following cause transudation in pleural cavity except:a. Empyemab. Congestive heart failurec. Nephritisd. Meigs syndrome3. Pleural fluid low in glucose is seen in:a. RAb. TBCc. Mesotheliomad. Empyema4. Causes of hemorrhagic pleural effusions are:a. Pulmonary infarctionb. Mesotheliomac. Bronchial adenomad. TBC5. Bilateral pleural effusion are seen in:a. Nephrotic syndromeb. Constrictive pericarditisc. Congestive heart failured. All of the above6. Bilateral malignant pleura effusion is most often seen in:a. Breast cancerb. Lung cancerc. Mesotheliomad. Lymphoma7. Best position to see small pleura effusions on chest X-ray is:a. Anterior-post viewb. Posterior-ant viewc. Latero-lateral viewd. Lateral decubitus view8. Increased amylase in pleural fluid is seen in:a. Malignancyb. RAc. Pulmonary infarctiond. TBC9. All are features of ARDS except:a. Pulmonary hypertensionb. Normal pulmonary artery wedge pressurec. Hypoxemiad. Low protein pulmonary edema10. The thing that differentiate ARDS from cardiogenic pulmonary edema is:a. Normal PO2b. Normal pulmonary artery wedge pressurec. Normal arterial-alveolar gradientd. Normal PCO211. ARDS is associated with:a. Acute pancreatitisb. Traumac. Severe Falciparum malaria12. The following about Klebsiella pneumonia are true except:a. Red jelly sputumb. Seen in alchoholicsc. Seen in older peopled. Penicillin is the drug of choice13. Post-influenza bacterial infection of the lung is caused by:a. Staphylococcusb. Streptococcusc. Pneumococcusd. Hemophilus14. Primary atypical pneumonia is caused by:a. Mycoplasmab. Mycobacterium kansaslic. Photochromogensd. Pneumocystis carinii15. A person who has high fever, tachycardia, hemoptysis and lobar consolidation on chestX-ray has:a. Bronchopneumoniab. Lobar pneumoniac. Pulmonary edemad. Pulmonary infarction16. Nosocomial pneumonia is caused most often by:a. Streptococcib. Mycoplasmac. Gram-neg. bacteriad. Virus17. All of the following organisms can cause interstitial pneumonia, except:a. Pneumocystis cariniib. Mycoplasma pneumoniac. Legionella pneumophiliad. Hemophilus influenza18. Viruses causing pneumonia are all except:a. CMVb. Mumpsc. Herpesd. Measles19. True about Legionella pneumonia include:a. Occurs in epidemicsb. Treated with penicillinc. Associated with splenomegalyd. Diagnosed from sputume. Are more common in children20. Common presenting symptom of pneumocystis carinii is:a. Cavity on chest X-rayb. Hemoptysisc. Breathlessnessd. Purulent sputum21. Complications of lobar pneumonia does not include:a. Lung abscessb. Amyloidosisc. Suppurative arthritisd. Infective endocarditis22. All are seen in emphysema except:a. Decreased vital capacityb. Hyperinflationc. Ronchid. Damage to alveoli23. Which pulmonary function change is not seen in COPD?:a. Decreased residual volumeb. Decreased FEVc. Low mid expiratory flow rated. Decreased diffusion capacity24. Lung involvement in chronic bronchitis is:a. Bilateralb. Segmentalc. Lobard. Unilateral25. All are true in the definition of chronic bronchitis exept:a. Cough for 3 monthsb. Productive coughc. Symptoms more than 2 consecutive monthsd. Hemoptysis26. Pulmonary hypertension in COPD are due to:a. Constriction of pulmonary vesselsb. Hypoxiac. Interstitial fibrosisd. Bronchoconstriction27. Lung function tests in emphysema reveals:a. Increased vital capacityb. Decreased diffusion capacity for carbon monoxidec. Increased diffusion capacity for carbon monoxided. Decreased total lung capacitye. Decreased FEV128. True statements about emphysema is:a. Breathlessness are always thereb. Diffusion rate of carbon monoxide is reducedc. Restrictive pattern of lung diseased. Long-term bronchodilators is not effective29. The earliest manifestation of pulmonary embolism are:a. Cyanosisb. Hemoptysisc. Dyspnead. Chest pain30. Pulmonary embolism causes:a. Bradycardiab. Decreased cardiac outputc. Arterial hypoxemiad. Acute load on right ventricle31. Pulmonary embolism is most commonly caused by which of the following:a. Traumab. Atherosclerosisc. Thrombosis of the pelvis vesselsd. None of the above32. I acute pulmonary embolism the most frequent ECG-finding is:a. Sinus tachycardiab. P-pulmonalec. Right axis deviation

Atherosclerosis is inversely proportional to:

a) LDL levelb) VLDL levelc) Chylomicron leveld) HDL levelPrinzmetal angina has the following characteristics, except:Pain at rest

ST elevation during the attack

Normal ECG without pain

Represents transmural ischemia

ST depression with pain

What is called the widows artery:Superior mesenteric artery

Uterine artery

Internal mammary artery

Left anterior descending coronary artery

Enzyme appearing early in myocardial infarction:

a) CPKb) LDHc) SGOTd) SGPT

The indication of percutaneur transluminal coronary angioplasy is:

a) Angina refractory to medical treatmentb) Single vessel diseasec) Proximal non calcified stenosisd) Patient who had by pass surgerye) All

The drug contraindicated in prinzmetal angina is:

a) Nifedipineb) Amyl nitratec) Propranolold) Calcium channel blocker

The critical narrowing of coronary vessels to cause angina is:

a) More than 50%b) More than 60%c) More than 70%d) More than 80%

Duration of pain in angina is:

a) 2-5 minb) 5-30 minc) 30-60 mind) > 1h

Drug of choice in prinzmetal angina is:

a) Nitratesb) Diltiazemc) Verapamild) Propranolol

Indication for coronary bypass operation include all of the following except:

a) Severe angina not responding to medical therapyb) Occlusive disease of the left main coronary arteryc) Tripple vessel diseased) Previous infarction and congestive cardiac failure

Critical narrowing of coronary blood vessel is:

a) 70%b) 60%c) 80%d) 90%

Riskc factors for coronary arterial disease:

a) High HDLb) Low LDLc) Increased homocystein levelsd) Decreased fibrinogen levelse) Increased lipoproteins

Excersise testing is absolutely contraindicated in which of the following:

a) One week following myocardial infarctionb) Unstable anginac) Aortic stenosisd) Peripheral vascular disease

Hypertriglyceridemia is not caused by:

a) Diabetes mellitusb) Obesityc) Alcohold) Cigarette smoking

What is diagnostic of fresh myocardial infarction in ECG:

a) QT interval prolongationb) P mitralec) ST segment elevationd) ST segment depression

All of the following are indications for Treadmill testing, except:

a) To evaluate unstable anginab) To evaluate unstable myocardial infarctionc) To asses outcome after coronary revascularizationd) To diagnose and evaluate the treatement of exercise induced arrhythmias.

All of the following are risk factors for atherosclerosis except:

a) Increased waist-hip ratiob) Hyperhomocysteinemiac) Decreased fibrinogen levelsd) Decreased HLS levels

Acute coronary syndrome includes all except:

a) STEMIb) NSTEMIc) Stable anginad) Unstable angina

Which of the following is common risc factor for coronary heart disease except:

a) Family H/O of IHDb) Decreased homocysteinemiac) HDL < 40 mg/dLd) Type 1 DM

Myocardial infarction most often results in:

a) Mitral stenosisb) Aortic regurgitationc) Aortic stenosis)d) Mitral regurgitation

Thrombolytic therapy in acute MI is contraindicated in all except:

a) Healed peptic ulcerb) Recent invasive procedurec) Pulmonary hypertensiond) Pulmonary thromb embolism

Right ventricular infarction is associated with all except:

a) Cardiomegalyb) Arrythmiac) Hypotensiond) Normal JVP

Transient myocardial infarction in ECG is characterized by:

a) ST segment elevationb) Prolonged QRSc) Pathological Q wavesd) T wave inversion

Fibrous scar in myocardial infarction is well established by:

a) 6 weeksb) 6 monthsc) 6 daysd) 30 days

The complication of MI are all, except:

a) Pulmonary embolismb) Systemic embolismc) Dissection of aortad) Ventricular fibrillation

Drugs of choice to relieve pain in myocardial infarction:

a) Morphineb) Fortwinc) Diazepamd) NSAID

Drugs useful in acute MI are all, except:

a) Nifedipineb) Aspirinc) ACE inhibitorsd) Metoprolol

All of the following may cause ST segment elevation on ECG, except:

a) Early repolarization variantb) Constrictive pericarditisc) Ventricular aneurysmd) Prinzmetal angina

The amino acit which is associated with atherosclerosis is:

a) Lysineb) Homocysteinc) Cysteind) Alanine

A patient presents with intense chest pain of 2 hrs duration. ECG shows ST depression in leads I and V1-V5. There is associated T inversion and the CPK-MB is elevated. Which of the following should be included in his management:

a) Nitroglycerine dripb) Aspirinc) Coronary angiographyd) Streptokinasee) i.v metoprolol Correct :1)d2)c,e3)d4)a5)All6)c7)c8)a9)a10)d11)a12)c,e13)c14)d15)c16)a17)c18)c19)b20)d21)a,c,d22)d23)c24)a25)c26)a27)a28)b29)b30)All

Hypertension

1 Quick reduction of blood pressure is done in:Cerebral infarct

Hypertensive encephalopathy

Myocardial infarction

Any patient with hypertension

2 Hypertention can be caused by:Renin

Antigiotensin 1

Angiotension 2

PG

3 Hypertension with increased renin levels is seen in:Segmental infarction

Fibromuscular hyperplasia of renal artery

Aortic stenosis

Hyperaldosteronism

4 Renin dependent hypertension includesPrimary hyperaldosteronism

Essential hypertension

Renovascular hypertension

Pheochromocytoma Hypertension

5 Benign hypertension is characterised by :Hyaline arteriosclerosis

Fibrinoid necrosis

Calcified vessel wall

Berry aneurysm

6 Which does not cause hypertension Dobutamine

Ritodrine

Dopamine

Methoxamine

7 Malignant hypertension is diagnosed when-Associated malignancy is present

Diastolic bloodpressure 120mgHg

Papilledema associated with elevated Bloodpressure

All of the above

8 Treatment of hypertension emergency is-Hydralazine

Glukokinase

Propranolol

Furosemide9 Calcium blocking agents of use in treatment of hypertension include-Prazosin

Verapamil

Captopril

Nifedipine

Lidoflazine

10 Severity of blood pressure is graded mainly by Systolic B.P.

Pulse pressure

Diastolic pressure

Response to treatment

11Renin plays important role in Renovascular hypertension

Malignant hypertension

Coronary artery disease

Essential hypertension

12 Which of the following antihypertensives will you not prescribe to a truck driver Clonidine

Hydralazine

Aldomet

Propranolol

13 Which one of the following is of most serious prognostic significance in a patient of essential hypertension Diastolic B.P. greater than 130mmHg

Transient ischaemic attacks

Left ventricular hypertrophy

Papilloedema and progressive renal failure

14 In benign hypertension commonest vascular pathology is Atherosclerosis

Fatty infiltration of intima

Fibrinoid necrosis

Hyaline arteriosclerosis

14 Pathological change in malignant HT is Benign nephrosclerosis

Hyperplastic arteriosclerosis

Cystic medical necrosis

Hyaline arteriosclerosis

15 All of the following are feature of malignant hypertension EXCEPT Grade IV hypertensive retinopathy

Haemolytic blood picture

Renal failure

Respiratoy failure

16 Drug of choise for hypertensive crisis associated with acute nephritis is Sodium nitroprusside

Hydralazine

Reserpine

Calcium channel blockers

Propranolol

17 A young patient presented with B.P. of 190/120 mmHg without any clinical symptom and fundus examination is normal, treatment od choice Oral Nitroglycerine

IV Nitroglycerine

Oral Enalapril

IV Enalapril

Sublingual short acting Nifedine

A 40 years old male patient, is suffering from type II diabetes mellitus and hypertension. Which of the following antihypertensive drug should not be used in such patients Lisinopril

Hydrochlorthiazide

Losartan

Trandolpril

A young hypertensive patient has serum K 2.8 meq/2 and increased aldesterone level with decreased plasma renin activity. The likely is/are Renal artery stenosis

Ectopic ACTH syndrome

Diuretic therapy

Conns syndrome

Liddles syndrome

HeartFailure

Examination of a patient in a supine position reveals jugular veins from the base of the neck to the angle of the jaw. This finding indicates:decreased venous return.

increased central venous pressure.

increased pulmonary artery capillary pressure.

left-sided heart failure.

What is not a primary cause of CHF?Cardiomyopathy

High blood pressure

Coronary artery disease

Poliomyelitis

Congestive heart failure is a condition which is chronic and which requires constant attention to diet, a reduction of stress, and daily medicines. Which of the following would most increase the burden on an already-weakened heart?Narcolepsy

Having a drink

Obesity

Medicine is an important component of treatment for congestive heart failure. Which one of these is NOT prescribed routinely for CHF?Benzodiazepine

Digitalis

ACE-inhibitors

Diuretics

What is the technical term which describes the coronary arteries as being narrowed by hardened plaque, which limits the free flow of oxygen and overworks the heart?Aoritis

Thrombosis

Artherosclerosis

Atherosclerosis

Sometimes, people with congestive heart failure develop arrhythmias of the heart. These irregular rhythms can be conducive to developing a blood clot. Physicians frequently treat people with 'blood thinning' medicines which require regulation of the density of the blood. Which of these is the name for a blood-thinner?Tetracycline

Erythromycin

Warfarin

Amoxicillin

There are two kinds of CHF, depending on which of the heart's two ventricles are affected. If the problem stems from the left ventricle, the prime pumping mechanism in the heart, which symptoms tend to dominate?Diarrhea

Enterophathy

shortness of breath and fatigue

Hepatic dysfunction

What is the name for shortness of breath when lying down?Apnea

Orthopnea

Platypnea

Epistaxis

What is the condition in which the lungs retain extra fluid? This condition is a part of left ventricular impairment.pulmonary edema

Asthma

Whooping cough

Pneumonia

Which of the following is NOT a risk factor for cardiovascular disease?Smoking Elevated blood cholesterol

Stress

Consumption of aspirin

Obesity

Which of the following decreases blood volume by increasing the excretion of sodium and fluids?Aspirin

Diuretics

Nitroglycerin

Digitalis

Renin

Which of the following is used to treat the symptoms of heart failure by increasing the strength of heart contractions (positive inotropy)?Diuretics

Digitalis

Nitroglycerin

Renin

The components of fallots tetralogy are ?VSD

Pulmonary stenosis

Dextra position of aorta

Right ventricular hypertrophy

All are correct

Commonest type of cong.heart disease seen in adults ?ASDVSDTOFFDABiscupid aortic valve

A continous murmur is heard in ?PDAVSDASDTOF

Congenital heart disease usually not associated with syncope is ?Ebsteins anomaly

Tetralogy of fallot

ASD

Pulmonary stenosis

Most common type of ASD is ?Ostium primum

Ostium secundum

Sinusvenosus type

Endocardial cushion defect

Causes of death in untreated coarctation of aorta may include all of the following except ?Bacterial endocarditis and aortitis

Rupture of aorta

Myocardial infarction

Congestive heart failure

Cerebrovascular accidents

Which is incorrect about PDA ?Right to left shunt

Endocarditis is common

Can calcify

In untreated leads to pulmonary hypertension

Causes of cyanosis ?TOF

PDA

Tricuspid atresia

Eisenmengers complex

TGA

Left ventricular hypertrophy is seen in ?ASD

MS

Aortic stenosis

Carcinoid syndrome

Clinical features of ostium secondum type of atrial septal defect are all except. ?Occurrence of congestive failure in childhood

Atrial arrhythmias

Wide and fixed splitting of the second heart sound

Mid diastolic rumble along the left sterna border

Sudden death is common in ?Mitral stenosis

Atrial VSD

Aortic stenosis

PDA

In aortic regurgitation the left ventricle is ?Hypertrophic

Dilated

Small

Atrophic

In aortic regurgitation the murmur is ?Early diastolic

Late systolic

Early systolic

Mid diastolic

Hemoptysis is seen in ?Aortic stenosis

Pulmonary stenosis

Mitral stenosis

Tricuspid stenosis

Angina pectoris occurs most commonly in ?MS

AS

MR

AR

Murmur of pulmonary stenosis is best heard over ?2nd left intercostals space

4th left intercostals space

6th intercostals space on left side in midclavicular line

None of the above

Normal size of the mitral valve ?2-4cm

4-6cm

1-2cm

6-10cm

Aortic regurgitation is seen in all except ?Rheumatic fever

Infective endocarditis

Marfan syndrome

Myocardial infarction

Angina & syncope in same patient is seen in ?Aortic stenosis

MVP

MS

AR

Which one of the following is characteristic of mitral valve prolapsed syndrome ?Rough mid diastolic murmur

Collapsing pulse

Loud first heart sound

Mid systolic click

Earliest sign of deep vein thrombosis is ?Calf tenderness

Rise in temperature

Swelling of calf muscle

None of the above

White leg is due to ?Femoral vein thrombosis and lymphatic obstruction

Deep femoral vein thrombosis

Lymphatic obstruction only

None of the above

All of the following are seen in deep vein thrombosis except ?Pain

Discolouration

Swelling

Claudication

Varicose veins are seen in ?DVT

superficial venous thrombosis

AV fistula

Prolonged standing

Obesity

Which of the following is true about varicocele except ?Incompetent valves of testicular vein are responsible for varicocele

90% are on the left side

Asymptomatic cases require surgery

None of the above

Small vessel vasculitis are ?Classical PAN

Wegeners granulomatosis

Giant cell arteritis

HSP

Churg-struass syndrome

Kawasakis disease has the following features except ?Coronary artery aneurysm

Conjunctival suffusion

Thrombocytopenia

Desquamation of the skin of fingers and toes

In takayasu arteritis there is ?Intimal fibrosis

Renal hypertension

Coronary aneurysm

Alla of the above

Skin manifestations of polyarteritis include ?Livido reticulosis

Hyper pigmentation

Subcutaneous infarct

Bullous dermatitis

Treatment of wegners granulomatosis is ?Steroids

Cyclosporine

Radiotherapy

cyclophosphamide

All of following may be associated with peptic ulcer except:Alcoholic cirrhosis

Zollinger ellison syndrome

Plummer vinson syndrome

Primary Hyperparathyrodism

The most common cause of drug induced esophagitis is:Flagyl

Indomethacin

Doxycycline

Steroids

Which is true about achalasia cardia:Failure of relxation of lower oesophageal sphincterAssociated with Vit. A dificiencyNot a premalignant conditionIt is a normal phenomenon

Following is true about Barret`s esophagus:Occurs in 3rd decade

Lined by transitional epithelium

Not reversible by medical therapy

It is a physiological condition

Treatment of drug induced gastritis:Mesoprostol

H2- receptor blockers

Antacids

Famotidine

Following are sites of Cushing`s ulcer except:Oesophagus

Stomach

Proximal duodenum

Distal duodenum

Progressive dysphagia is seen in:Esophagus Carcinoma

Globus hystericus

Presbyesophagus

Achalasia

True regarding GERD is all except:Avoid coffee & Tea

Transient lower esophageal relaxation

Lower esophageal sphincter length and its pressure is important

Proton pump inhibitor is the treatment of choice

All are complications of ulcerative colitis exept:Haemorrhage

Stricture

Malignant change

Polyposis

Oesophageal varices

Post diarrhoeal paralytic ileus occurs in:Hypokalaemia

Hypomagnesemia

Hupocalcemia

All of the above

Jejunal lactase deficiency lead to diarrhoea with the ingestion of:Milk

Gluten

Meat

Rice

Specific test for malabsorption:D-xylose test

Schilling test

Fecal fatestimation

Hydrogen breath test

Patient with congenital lactose deficiency will experience distention, flatulence and diarrhea on ingestion of:Glucose

Sucarose

Milk

Eggs

Rare complication of ulcerative colitis:Pseudopolypi

Carcinoma

Toxic dilatation

Massive hemorrhage

There are other diseases associated with celiac disease, which:About 10% have an itchy rash on the extremities, buttocks, neck, trunk, and scalp, called dermatitis herpetiformis.

Recurrent painful mouth ulcers,

Insulin-dependent diabetes

Autoimmune thyroid disease

All of the above

With celiac disease, malabsorption means:Poor absorption of food nutrients

Absence of absorption of food nutrients

Slow absorption of food nutrients

Fast absorption of food nutrients

Hemoblia is characterised by:Jaundice

Biliary colic

Malena

Fever

Whenever there is a stone in bile duct which of the following:Bile salts

Bilirubin

Amylase

SGPT

Conjugated hyperbillirubinemia is seen in:Gilberts syndrom

Criggler Najjar Typ 1

Criggler Najjar Typ 2

All of the above

Dubin Jonsons syndrome

The characteristic feature of chronic alcoholic liver disease is:Fatty liver

Cirrhosis

Perivenular fibrosis

Hyaline Sclerosis

In heapatic cirrhosis, which of the following is increased:Alpha 1 globulin

Alpha 2 globulin

Gama globulin

All of the above

Antibiotics are usful in all of the following condition except:Whipple disease

Tropical syndrome

Celiac disease

Blind loop syndrome

Which of the following is associated with acute pancreatitis:Hypoparathyroidism

Thiazides

Pregnancy

Corticosteroids

Acute pancreatitis can be caused by:Alcohol

Hypertriglyceridemia

Azathioprine

All of the above

What are contraindications for the use of oral antidiabetic drugs:Pregnancy

breastfeeding

severe infection

Renal dysfunction

All

If a person is receiving an insulin drip, what is likely to happen to potassium levels?Decrease

Increase

Most common tumor of pancreas is:Insulinoma

Gastrinoma

APUD`S omas

VIPoma

Complications of chronic pancreatitis include the following except:Portal hypertension

Obstructive jaundice

Duodenal obstruction

Renal artery aneurysm

Serum amylase levels raised in all except:Duodenal ulcer perforation

Pancreatitis

Appendicitis

Small bowel strangulation

A 33-year-old man has never been vaccinated for hepatitis B. Serologic tests reveal negative hepatitis B surface antigen (HBsAg) and positive antibody to surface antigen. Which of the following conditions does this serologic pattern best fit with?previous hepatitis B infection

chronic active hepatitis

acute hepatitis B infection

poor prognosis

need for vaccine to hepatitis B

A 33-year-old woman develops mild epigastric abdominal pain with nausea and vomiting of 2 days duration. Her abdomen is tender on palpation in the epigastric region, and the remaining examination is normal. Her white count is 13,000/mL, and amylase is 300 U/L (25125 U/L). Which of the following is the most common predisposing factor for this disorder?

drugs

gallstones

malignancy

alcohol

Which of the following is a risk factor for Helicobacter pylori infection:excess exposure to antibiotics

female sex

alpha1-antitrypsin deficiency

low socioeconomic indicators

proton pump inhibitor therapy

1.Acromegaly is characterised by all except:Diabetes

Muscular hypertrophy

Enlarged nasal sinuses

Increased heel pad thickness

2 . Hyperprolactinemia is an adverse side effect of :Amantidine

Bromocriptine

Levodopa

Metoclopramide

3 .Diabetes insipidus is treated with:Thiazides

Oxytocin

Desmopressin

Glibenclamide

4.A patient sustained,head trauma leading to transection of pituitary stalk,all,occur exeptDM

Adrenocortical insufficiency

Dibetes insipidus

Hypothyroidism

5 .Causes of hypopituitarism are all,exceptCancer breast

Cancer bronchus

Chromophillic adenoma

Acidophilic tumor

6.Empty sella syndrome is often characterized by:Pituitary tumour

Cretinism

Acromegaly

None of above

7. In a patient presenting with polyouria and polydipsia the diagnosis is likely be:Diabetes mellitus

Diabetes Insipidus

Psychological

Hyperthyroidism

8.Cardiac manifestations of Grave's disease would include all of the following except:Wide pulse pressure

Atrial fibrillation

Pleuropricardial scratch

Aortic insufficiency

9 .All are feauture of subacute thyroiditis except:Pain in the neck

Fever

Raised ESR

Raised readioactive 131 I uptake

Correct:1.b ,2 .d, 3 a,c , 4.a, 5.d, 6.d, 7.a,bc, 8.d , 9 d

10.All of the following conditions are known to cause diabetes insipidus except:Multiple sclerosis

Head injury

Histiocytosis

Viral encephalitis

11.The early feature of hypothyroidism is :Low T3

Low T4

Rise in TSH

Delayed deep tendon reflexes

12.Which is not a feauture of hypothyroidism:Myxedema

Carpal tunnel syndrome

Menorrhagia

Increased appetite

13.Radio iodine uptake in endemic goitreNormal

Increased

Decreased

Erratic

14.Features of hyperthyroidism are:Pericardial effusion

Menorrhagia

Delayed ankle relaxation

Diarrhoea

Heat intolerance

15.Regarding myxedema the following are true except:Swollen,Oedematous look of face

Impotency,amenorrhoea

B,M.R increaed by 30-45%

Dullness,Loss of Memory

16.Commonest symptom of endemic goitreAsymptomatic

Hypothyroidism

Lump in neck

Hyperthyroidism

17.Regarding Hashimotos thyroiditis which is false:Autoimmune thryoditis

Plasma cell and lymphocytic infiltration

Hypothyroid state

Hypoparathyroid state

Correct:10.a ,11.c, 12 .d, 13.b 14.d,e, 15.c, 16.a ,17.d

18.Treatment in Hashimoto's diseaseCarbimazole

Thyroxine

Radio iodine

Subtotal thyroidectomy

19 .Cardiopulmonary manifestations of hyperthyroidism :Tachycardia

Sinus bradycardia

Cardiomyopathy

Low output cardiac failure

20 .The feautres of Addison's disease is/are:Weight loss

Skin pigmentation

Hyponatremia

Hyperkalemia

all Above

21 .A 50-year-old female is 170 cm tall and weighs 75 kg. There is a family history of diabetes mellitus. Fasting blood glucose is 150 mg/dL on two occasions. She is asymptomatic, and physical exam shows no abnormalities. The treatment of choice is Observation

Medical nutrition therapy

Insulin

Oral hypoglycemic agent

22 Insulin resistance syndrome includesDyslipidemia

Hypertension

Hyperuricemia

High HDL

23 . A 15-year-old is brought to the emergency department in a coma. An alert ambulance attendant notes that the patient's breath smells like acetone. This observation is most consistent with which of the following diagnoses?Alcohol intoxication

Diabetic hyperosmolar coma

Diabetic ketoacidosis

Heroin overdose

Profound hypoglycemia

24 .Which one of the following investigations is most sensitive for early diagnosis of diabetic nephropathy:Serum creatinine level

Creatine clearance

Glucose Tolerance Test

Microalbuminuria

25 .Fungal lung infection commonly seen in diabetics is:Actiomycosis

Murcomycosis

Aspergillosis

Coccidiodomycosis

26 .Which of the following statements is true regarding type 1 diabetes mellitus:Family history is present in 90 % cases

Dependent on insulin to prevent ketoacidosis

Time of onset is usually predictable

Autoimmune destruction of beta cells occur

Mostly occurs in chlidren

27 .Which is the feauture of Dawn phenomenon:Early morning hypoglycemia

Early morning hyperglycemia

Breakfast hypoglycemia

Post prandial coma

28. Somogyi phenomenon is:Hypoglycemia followed by hyperglycemia

Hypeglycemia followed by hypoglycemia

Glycosuria with normal blood sugar

Reactive hypoglycemia

29 .All of the following are assosiated with insulin resistance except:Acantosis nigricans

Lipodystrophy

Gout

Werner Syndrome

30. Impaired glucose tolerance can cause:Neuropathy

Nephropathy

Retinopathy

IHD(ischemic heart disease)

Correct :18.b 19.a,c, 20.e 21.b 22a,b, 23.b 24.d 25 b 26.b,d,e 27.b 28.a 29.c 30.d

. UMF-Tgm, General medicine 6th year (topics with quastions and answers for the final exam in familymedicine)Topics: ENT, Ophtalmology and Nephrology.

ENT and Ophtalmology.

Downbeat nystagmus is characterized by:

a. post fossa lessionsb. vestibular lesionsc. labyrinthin lesiond. cerebellar lesion

Ataxic nystagmus is seen in leisions of:

a. medial longitudinal fasciculus b.Cerebellumc. Labyrinthd. Vestibular Nc.

At birth the following structures are of adult size except:

a.Typanic cavityb. Mastoid antrumc. Malleolusd. Tympanic ring

A patient with furuncle of ear is presented. What is the commonest treatment?

a. Ear pack with 10% ichtamon in glycerine wickb. Antibiotic and restc. antibiotic and drainaged. Analgesic

In which sinus is sinusitis in children most common?

a. Frontalb. Maxillaryc. Ethmoidd. Sphenoidal

Most common sinusitis in children is?

a. Frontalb. Maxillaryc. Ethmoid. Sphenoidal

7.The components of Horner's syndrome are all except:a. Anhydrosisb. Miosisc. Proptosisd. Enophtalmosis

8. The normal AV-ratio in fundoscopy is:a. 3:4b. 3:2c. 1:2d. 1:3

9. Commonest cause of papilloedema is:a. Rise in intracranial tensionb. Optic neuritisc. Optic atrophyd. Chronic nephritis

10. All are causes of Argyll-Robertson pupil except:a. Syringomyeliab. Disseminated sclerosisc. Chronic alcoholism d. Asyphyxia and deep anaesthesia

11. Horner's syndrome is characterized by all except:a. Miosisb. Exophtalmusc. Anhydrosis d. Loss of cilliospinal reflex12. Gaze nysrtagmus is seen in:a. Minersb. Infantsc. Myastena gravisd. Diabetes mellitus

13. Ataxic nystagmus means a lesion in the:a. labyrinthb. Cerebellumc. Vestibuled. Medial longitudunal fasciculus

14. See-Saw nystagmus is usually seen with:a. Craniopharyngomasb. Pineal tumorsc. Hydrocephalusd. Viral encephalitis

15. Retinitis pigmentosa is transmitted as:a. Sporadicb. Autozonal recessivec. X-linkedd. All of these

16. Suconjuctival hemorrage occurs in all conditions except:a.passive venous conjesionb.Pertusisc. Traumad. high intraoccular tension

17. in patients with acute glaucoma the prophylactic treatment for the other eye is:a. Peripheral iridectomyb. Anterior sclerotomyc. Irienclesisd. Scheie's operation

Nephrology

18. Majority of primary infection of the urinary tract are caused by:a. E.colib. streptococcus fecalisc. Pseudomonasd. Proteus19. polycystic kidneys kan be associated with:a. Cysts in liver and Lungsb. Coarctation of aortac. Berry aneurismsd. a and c are correct

20. Worst prognosis in renal cell carcinoma is associated with:a. Haematuriab. Size > 5cmc. Invasion of renal veind. Pulmonary secondary metastases

21.Which of the following findings in urnalysis is correct regarding acute glomerulonephritis? a. Proteinureab. White blood cell castsc. Redblood cell castsd.Hyaline casts

Which of the following treatments is adequate in slowing down the evolution of renal disease in a diabetic patient with proteinurea on urinalysis?

a. Calcium chanell blockersb. ACE-inhibitorsc. Beta blockersd. Loop diuretics

Which of the following alternatives is most indicative in the screening of prostate cancer?

a. prostate ultrasoundb. DRE (digital rectal examination)c. PSA (prostate specific antigen)d. PSA & DRE

Which of the following changes is seen in a patient with chronic kidney failure due to chronic analgesic (NSAID) ingestion?

a.Glomerulosclerosisb. Papillary necrosis and tubulointerstitial inflamationc.Cortical necrosisd. Tubular necrosis

In a 65 years old male patient with reccurent severe artritis in his big toes and elevated creatinine levels. Which the most likely cause to his symtoms?

a.Glomerulonephritisb.Vascular injuryc. Renal parenchymal uric acid cristalsd. Uric acid kidney stones

26.In which part of the normal kidney nephron is most of the water reabsobed from?a. Ascending loop of Henleb. Descending loop of Henlec. Proximal convulted tubuled. Collecting duct

In a young patient with renal colic, urinalysis showing hexagonal crystals and a cyanide-nitroprusede test of urine is positive. Which of the following is the most likely diagnosis?

a. Cystineuriab. Thalasemiac. Sarcoidosisd. hereditary glycinuria

In pasient with sepsis, hypotension and oliguria following a pneumonia infection. Despite antibiotic treatment and i.v fluids with the evolutin of (ARF) acute renal failure. Which of the following is the most likely cause of ARF?

a. Antibiotic treatmentb. Acute infectiouse (GN) Glomerulonephritisc.Contrast nephropathyd. (ATN) Acute tubular necrosis

Which of the following findings is not compatible with diabetic nephropathy?

a. Nephrotic range proteinuriab. Microalbuminuriac. Hypertensiond. Red blood cell (RBC) casts in urine

A 27-year-old woman with well-controlled bipolar affective disorder, treated with lithium,

develops polyuria and polydipsia.Which of the following statments is the correct cause of her symtoms? a. Central diabetes insipidus (DI)b. Nephrogenic DIc. Primary polydipsiad. Osmotic diuresis

'Which of the following is true of iron deficiency anemiaIron binding capacity is decreased

Increased number of sideroblast

Serum iron concentration is decreased

All of above

Anemia can manifest as all exceptHeadache

Vertigo

Delirium

Tinnitus

Low serum iron is seen in-Iron deficiency anemia

Sideroblastic anemia

Thalasemia traits

Sickle cell anemia

Microcytic hypochronic anemia is seen in-Sideroblastik anemia

Thalasemia

Vitamin C deficiency

All of above

Treatment of choice for aplastic anemia is-Blood transfusions

Oxymethalone

Bone marrow transplantation

Azathioprime

Aplastic anemia can be caused by all except-Cholramphenicol

Hepatitis A

Analgin

Kanamycin

All are true features of sickle cell anemia except-Leucopenia

Pulmonary hypertension

Heart enlargement

Fish mouth vertebra

The total daily loss of iron amounths to about-0.1 mg

0.5 mg

1 mg

10 mg

Most iron is stored in combination with-Sulphate

Ferritin

Transferin

Ascorbic acid

Diagnostic of iron deficiency anemia is-Decreased serum iron

Decreased ferritin

Decreased Hb A2

Microcytic hypochronic anemia

Megaloblastic anemia in blindloop syndrome is due to-Vitamin B12 deficiency

Intrinsic factor deficiency

Iron absorbtion defect

Folate deficienc

Bone marrow transplantation is not indicated in-Aplastic anemia

Congenital spherocytosis

Thalasemia

Acute myeloid leukemia in first remission

A 16 years old female presents with generalized weakness and plapitations. Her Hb is 7g/dl and peripheral smear shows microcytic hypochromic anemia, reticulocyt count is 0,8 % serum bilirubin is 1 mg%. whats is the most likely diagnosis?Iron deficiency

Hemolytic anemia

Aplastic anemia

Folic acid deficiency

A child 5 years old presents with anemia. On examination his MVC was 70 and MCH wa 22. Blood erythrocyt protoporphyrin was high. Whats the probably diagnosis? Thalasemia

Iron deficiency syndrome

Porphyria

Sickle cell anemia

Viral infection in hemolysis is seen in-Hepatitis BHepatitis CProlonged feverHepatitis ACMVAnemia in chronic renal failure (CRF) is due to-Decreased erythropoietin productionIron deficiencyHypoplastic bone marrowDecreased vitamin- B 12Decreased folate levetIron absorbtion is increased in- Iron deficiency anemia Pregnancy All types of anemia MalignancyMacrolytic anemia

Polycythemia: Causes of secondary polycythemia may include- Chronic cor pulminale

Renal carcinoma

Cerebellar haemangioblastoma

All of above

True about polycycthemia vera is all exept-BleedingThrombosisDecreased ESR infectionLymphoma: lymphadenopathy is seen in all of the following except-primary syphilisdonovanosisLGVChancroidTreatment of choice for stage III a Hodgkins lymphoma-ChemotherapyRadiotherapy Combination of chemotherapy and radiotherapyexcisionstage B symptom of Hodgkins lymphoma include-weight loss feverbone marrow infiltrationpruritusanemiaMyeloma: multiple myeloma is characterized by all exept-CRF (chronic renal failure)Gum hyperplasia Lytic bone lesionsRespiratory infectionsIn multiple myeloma following are seen-Increased calcium Sclerotic bone lesion Bone deposition Renal failureLeukemia:Regarding leukemia which of the following is correct-ALL is common in children ALL is seen in the fifth decadeBone marrow transplant is done in ALLd) Bleeding tendency in AML

Leukemoid reaction is seen in-acute infectionmyelomatosishemorrhageerythroleukemiablast crisis in CML is indicated by all except-lympadenopathyhigh feversudden enlargement of spleenbleeding tendenciesa patient suffering from chronic myeloid leukemia, Hb falls from 11 g% to 4g%. in a short span of time, and splenomegaly occurs. The cause could be-accelerated CMLCML in blast crisisIneffective erythropoiesisMyelofibrosisLeukemia is predisposed to by-Blooms syndromeFanconis anemicAtaxia telangiectesiaKlinefelthers syndromeB cell prolymphocytic leukemia patients differ from those with B cell chronic lymphocytic leukemia in-Presenting at a younger age Having a lower total leucocyte countHaving prominent lymphadenopathyHaving a shorter survival

Neuropsychiatric disorders

Neurologic

1. Spinal puncture should be used to determinea) spinal fluid pressureb) wheter a block existsc) types and number of cells presentd) protein and sugar levelse) all of the above

2. The condition where babinski sign is positive but deep tendon jerks are absent is -a) cerebral hemorrhageb) cerebral palsyc) cerebral tumord) Frederich's ataxia

3. Primary optic nerve atrophy is a recognized complication of:a) glaucomab) disseminated sclerosisc) Paget's disease of the skulld) neurosyphilise) ethambutol therapy

4. Recognized causes of motor neuropathy include:a) diabetes mellitusb) porphyriac) Guillain-Barre syndromed) Friedrich's ataxiae) diphtheria

5. Pin point pupils, loss of consciousness and hyperpyrexia is seen ina) subarachnoid hemorrhage b) pontine hemorrhagec) cerebral infarctiond) thalamic syndrome

6. Which of the following statements about hallucinations are correct?a) acoustic hallucinations are a common complication of amphetaminebsychosisb) paranoid symptoms are characteristic of "cocaine psychosis"c) amphetamines can induce hallucinationsd) hallucinations are inevitable symptoms of schizophreniae) purely visual hallucinations suggest a functional abnormality

7. Neuropsychiatric symptoms of hepatic insufficiency include:a) a reverse sleep patternb) Argyll-Robertson pupilsc) myelopathy with paraplegiad) perseveration signse) diagnostic EEG abnormalities

8. A classic type migraine is characterized by which of the following?a) it cannot be diagnosed if there are no prodromal symptomsb) it shows a gradual progressionc) a homonymous hemianopsia is presentd) there is edema of the papillae) frequently occuring acoustic hallucinations

9. The most common complication of vagotomy isa) diarrheab) dryness of the mouthc) tachycardiad) bleaching

10. Intentional tremor in young patients is commonly due toa) Cerebellar diseaseb) Wilson's diseasec)Parkinsonsd) Head injuries

11. Mask like faces is seen ina) Parkinsonsb) Disseminated sclerosisc) after strokesd) Pseudo bulbar palsy

12. Brain tumor has the following symptoms excepta) bitemporal hemianopiab) loss of consciousnessc) headached) vomiting

13. Brain death means loss ofa) cortical functionb) brain stem functionc) spinal reflexesd) corneal reflex

14. Cerebral edema is characteristically seen in poisoning bya) Methanolb) Leadc) Carbon monoxided) All of the above

15. A 40 year old female presents with a history of sudden onset of headache and nausea which passed off with rest and analgesics. Later she developed blurring of vision for a few days. On the day of admission she had developed third nerve palsy with neck rigidity. The temperature was 37,7C. The most likely diagnose isa) acute attack of migraneb) viral encephalitisc) sub-arachnoid hemorrhage d) severe hypertension

16. The following are true in early onset Alzheimer's diseasea) Associated with chromosomal anomaliesb) profound retardation is seen c) necrosis if brain neuronsd) none

17. Cervical cord injury does NOT causea) Horner's syndromeb) loss of sensation over facec) spasticity of footd) atrophy with fasciculations of lower limb

18. Demyeliation is seen in a) Multiple Sclerosisb) AIDSc) Progressive multifocal leukoencephalopathyd) Poliomyelitise) Leukodystrophy

19. True about Alzheimer's diseasea) mutation in the APP geneb) Autoantibodiesc) Aluminium is arisk factord) viral infections have increased riske) Hereditary

20. In amyotrophic lateral sclerosis true isa) present with seizuresb) lesion in anterior horn cells c) corticospinal tractd) hyporeflexia

21. Progressive dementia is seen in a) Alzheimers diseaseb) Creutzfeld-Jakob diseasec) Huntingtons diseased) All

22. Which is a feature of classical migranea) Symptoms are better with increasing ageb) No aurac) early treatment aborts attackd) does not respond to ergotamine

23. A35 year old male with no history of DM or hypertension presents with sudden onset bursting headache and altered sensorium. Most prbable cause would bea) Meningitisb) Encephalitisc) Intracerebral hemorrhaged) Intracranial tumor

24. Anterior cerebral arterial occlusion can causea) controlateral lower leg weaknessb) urinary incontinencec) Hemianopiad) Hemianesthesia of controlateral half of face

25. Features of Parkinsons diseasea) decreased blinkingb) Spasticityc) on-off phenomenond) decreased muscular powere) Tremor

26. A middle aged man presents with progressive atrophy and weakness of hands and forearms. On examination he is found to have slight spasticity of the legs, generalized hyper-reflexia and increased signal in the cortoco-spinal tracts on MRI. The most likely diagnosis isa) Multiple Sclerosisb) Amyotrophic lateral sclerosisc) Subacute combined degeneration d) Progressive spinal muscular atrophy

Psychiatric

27. Which of the following observations help to differentiate neurosisfrom psychosis?a) neurotic patients characteristically disclaim realityb) endogenous experiences cause excitation in neurosisc) real illusions can occur in neurosisd) associative function is not affected in neurosise) the 'ego' is intact in neurotic patients

28. A 15-year-old girl presents to the emergency room with severeweight loss. On examination she is cachectic, bradycardic, andhypotensive. The first course of action should be to:a) determine the family dynamicsb) administer a high-protein and carbohydrate dietc) draw blood for a serum electrolyte determination and thenstart intravenous feedingd) arrange to have the patient admitted to the psychiatric warde) prepare for electroconvulsive therapy

29. Common complications of alcoholism include:a) cerebral damageb) gastritisc) suicided) polyneuropathye) all of the above

30. Which of the following has an etiologic role in anorexia nervosa?a) cultural influencesb) hypothalamic-pituitary abnormalitiesc) parental over-regulationd) schizophrenia

31. Case Study:A 62-year-old man seeks evaluation for weakness, a loss of initiative,a loss of weight, and abdominal discomfort. He appears to bedepressed. Possible diagnoses can include:a) dementiab) hyperthyroidismc) pain killer abused) pancreatic carcinoma

32. Characteristic symptoms of schizophrenia include:a) compulsive thoughtsb) progressive dementiac) depersonalizationd) waking up early in the morninge) thought withdrawal

33. Characteristic symptoms of morphine withdrawal include:a) excessive yawningb) hypotensionc) muscle spasmsd) dry conjunctivae) diarrhea

34. Characteristic symptoms of acute manic psychosis include:a) lack of insightb) flight of ideasc) confabulationd) distractibilitye) depression in the family history

35. Characteristic symptoms of depression include:a) diminished concentrationb) hallucinationsc) hypochondriasisd) delusions of persecutione) weight loss