INTERNAL MEDCINE

1. The treatment of choice for anemia of chronic renal disease:

a. Ferrous sulfate
b. Folic acid
c. Erythropoetin
d. blood transfusion
Answer: C P. 1658
2. A patient was brouht to the !" in a comatose state. #erum
electrol$tes drawn on admission showed the followin: %a& 1'' me()*+
, & 8.- me(.l+ Cl /8 me()*+ 0C1' 1' me(.*. !C2 showed absent P
wa3es+ widend 4"# and pea5ed T wa3es. 6hich would b the mot
appropriate initial step:
a. "epeat electrol$te measurement and obser3e
b. Attempt cardio3ersion
c. Administer intravenous calcium gluconate
d. Administer sodium pol$st$rene sulfonate 7,a$e8elate9
Answer: C P. 262
'. *ow serum complement le3el would be seen in patients with
hematuria+ proteinuria and h$pertension resultin from all of the
followin+ !:C!PT:
a. ;i8ed essential cr$olobulinemia
b. 0epatitis C associated membranoproliferati3e
lomerulonephritis
c. <iffuse proliferati3e lupus nephritis
d. enoch!"chonlein purpura
Answer: < P. 168-
=. A '> $.o. man is admitted with confusion. P! showed a ?P of 1=-)>-
with no orthostatic chanes+ normal @uular 3enous pressure and no
edma. #erum chemistries are notable for %a& 12- me()*+ , & =.2
me()*+ 0C1' 2= me()* and a uric acid of 2 m)*. The most li5el$
dianosis is:
a. 0epatic cirrhosis
b. "IAD
c. AddisonAs disease
d. #e3ere 3omitin and diarrhes
Answer: ? p. 256
5. T"B! statement)s about acute poststreptococcal lomerulonephritis
7P#2%9 !:C!PT:
a. The latent period appears to be loner when P#2% is
associated with cutaneous rather than phar$neal infection
b. #eroloic tests for a streptococcal infection ma$ be neati3e if
antimicrobial therap$ is beun earl$
c. P#2% leads to permanent and proressi3e renal insufficienc$
more often in adults than in children
d. Long!term antistreptococcal prophyla#is is indicated a$ter
documented cases o$ %"&N.
Answer: < p. 168-C1681
1
6. The a wa3e of the @uular 3enous pulse 7DEP9 represents:
a. riht 3entricular contraction
b. right atrial contraction
c. 3entricular septal defect
d. atrial septal defect
>. 1ne of the followin is not true in the assessment of acute 2F ?leedin:
a. The presence o$ large 'uantities o$ bright red blood per
rectum rules out the source be$ore the ligament o$ Treit(
b. ;elena almost alwa$s represents B2F?
c. ?lac5 stools can be caused b$ lesions in the colon
d. A bilous %2T return flow in a patient who @ust had hematocheGia
rules out an upper 2F source of hemorrhae
8. 6hich of the followin is true reardin astric ulcer.
a. presence of astric acid e8cludes malinanc$
b. weiht loss is distincti3el$ unusual in benin ulcer
c. ulcers alon the reater cur3e fa3or malinanc$
d. coe#isting duodenal ulcers $avor benign nature o$ gastric
ulcer
/. A 55C$earCold diabetic patient presents with heartburn and acidic
eructation for 2 $ears. !ndoscopic biops$ of a patch of h$peremic
mucosa ' cm. abo3e the astroesophaeal @unction showed s(uamous
epithelium with inflammator$ cells. The patient most li5el$ has:
a. ?arrettAs esophaus
b. &astroesophageal re$lu# disease
c. Candidal esophaitis
d. 0erpes simple8 esophaitis
1-. 6hich of the followin statements does %1T describe secretor$
diarrhea.
a. <iarrhea continues durin fastin
b. "tools are scanty and mucoid
c. Fecal fat is low
d. Cholera can cause it
11. A 16C$earCold male patient presentin with hepatitis s$ndrome has the
followin seroloic e8am findins:
7&9 0?sA2 7C9 AntiC0?e 7&9 0?eA2
7&9 AntiC0AEFm 7&9 Anti 0?cl; 7C9 Anti0?cl2
The patient most li5el$ has
a. Acute epatitis A and Acute epatitis ) simultaneous
in$ection
b. Acute 0epatitis A superimposed on Chronic 0epatitis ? in the
replicati3e phases
c. Acute 0epatitis A superimposed on Chronic 0epatitis ? in the
nonCreplicati3e phase
d. Acute 0epatitis AH a pre3ious immuniGation to 0epatitis ?
12. The most common oranism isolated from the ascitic fluid of patients
with spontaneous bacterial peritonitis is:
a. #treptococcus pneumoniae
b. #taph$lococcus aureus
c. Escherichia coli
d. ?acteroides frailis
2
1'. True of Ascaris infestation:
a. ma$ cause round itch
b. *oefflerAs pneumonitis results from aller$ to ascaris es
c. adult *orms reside mostly in the small intestines
d. the dru of choice in biliar$ ascariasis is ;ebendaGole because
it paral$Ges the worms and pre3ents their further miration
1=. 6hich of the followin ris5 factors has been directl$ associated with
?ronchoenic Carcinoma.
a. Asbestos e8posure
b. Aflato8in inestion
c. Cigarette smo+ing
d. Chronic ?ronchitis
15. This roup of drus reduce airwa$ inflammation in bronchial asthma:
a. Catecholamines
b. ;eth$l8anthines
c. Clucocorticoids
d. Anticholinerics
16. The American Thoracic #ociet$ defines chronic bronchitis as
persistence of couh and e8cessi3e mucus production for most da$s
out of ' months for IIIIIIII successi3e $ears:
a. ,
b. '
c. =
d. 5
1>. A patient with CAP re(uires hospitaliGation when one of the followin is
present:
a. ae J 65 $ears old
b. C-%D in e#acerbation
c. temperature of '8.5C
d. unilobar C:" infiltrate
18. 1ne of the followin is %1T a useful clue to the microbial etiolo$ of
CAP 7Communit$ Ac(uired Pneumonia9
a. edentulous persons li+ely to develop pneumonia due to
anaerobes
b. susceptible people e8posed to an infectious aerosol in
*eionellosis
c. patients with se3ere h$poammalobulinemia at ris5 of infection
with #. pneumoniae
d. anaerobic lun abscess occurin in patients prone to aspiration
1/. Fn a patient suspected of PT!+ presence of this s$mptom heralds the
occurence of pulmonar$ infarction:
a. une8plained d$spnea
b. hemptysis
c. sudden onset of couh
d. s$ncope
3
2-. 2old standard in the dianosis of PT!:
a. 3entilationCperfusion scan
b. pulmonary angiography
c. 0elical)#piral CT #can
d. transesophaeal echocardioraph$
21. 1ne of the disorders below does %1T ha3e 3esicles or bulla as
presentin lesions:
a. Fmpetio
b. Chic5en po8
c. 0erpes #imple8
d. %soriasis
22. Annular lesions with raised er$thematous border and clear centers+
distributed o3er the trun5 area:
a. Tinea unlum
b. Psoriasis
c. Tinea 3ersicolor
d. Tinea corporis
2'. 2rouped 3esicles arraned in a semental pattern o3er the riht side
of the trun5+ T
>C8
le3el:
a. 0erpes #imple8
b. Chic5en po8
c. Eerruca 3ularis
d. erpes .oster
2=. A prenant woman with brown macules with irreular borders+
s$mmetric pattern on her chee5s+ forehead+ upper lips+ nose and chin
most li5el$ has:
a. #*!
b. melasma
c. AddisonAs disease
d. Psoriasis
25. 1ne of the followin statements is %1T true of t$phoid fe3er:
a. #almonella t$phi has no 5nown hosts other than humans.
b. ;ost cases result from inestion of contaminated food or water.
c. Fncubation period ranes from ' to 21 da$s.
d. "tool culture is best done during the $irst *ee+ o$ $ever.
26. Fn t$phoid fe3er+ which of the followin specimen will ha3e the best
sensiti3it$ for culture if a patient has been i3en antibiotics.
a. blood
b. bone marro*
c. stool
d. urine
2>. <ru of choice for #chistosomiasis:
a. AlbendaGole
b. F3ermectin
c. <ieth$lcarbamaGine
d. %ra(i'uantel
4
28. The funus which is a normal inhabitant of the human mucocutaneous
bod$ surfaces and is a fre(uent cause of funemia is:
a. Asperillus
b. Candida
c. Cr$ptococcus
d. 0istoplasma
2/. An 18C$earCold bo$ had se8 with an 0FE& prostitute a wee5 ao. 0e is
frihtened and wants assurance he has not been infected. Kou should:
a. tell him you regret that there is no *ay at this time to tell i$
he has been in$ected or not
b. as5 for an immediate AF<# !*F#A test
c. as5 for an immediate 6estern ?lot test
d. assure him that if it was a one niht affair he probabl$ did not
et infected
'-. The most li5el$ oranism)s causin secondar$ bacteremia followin
manipulation of a furuncle is)are:
a. anaerobes and m 7C9 bacilli
b. anaerobes and #taph aureus
c. #taph aureus and m 7C9 bacilli
d. "taph aureus
'1. 6hich of the followin 3accines is especiall$ indicated in a
splenectomiGed patient:
a. pneumococcal
b. hepatitis ?
c. tetanus
d. polio
'2. A patient with ?ellAs Pals$ has a patholo$ in3ol3in which cranial
ner3e.
a. FFF
b. E
c. /II
d. FFF and EFF
''. A patient suspected to ha3e meninitis underoes spinal tap. Bpon
insertion of the spinal needle+ the openin pressure is recorded to be
mar5edl$ ele3ated. Kou should:
a. continue drainin the C#F to decrease the pressure
b. *ithdra* the needle and run I/ mannitol
c. continue drainin the C#F while runnin FE mannitol
d. withdraw the needle and reinsert at a lower site
'=. The first dru of choice in a patient presentin with fran5 seiGures is:
a. <iphen$lh$dantoin FE
b. Phenobarbital FE
c. CarbamaGepine p.o.
d. Dia(epam I/
'5. *ower motor neuron t$pe of paral$sis is characteriGed b$:
a. hypotonia
b. spasticit$
c. patholoic refle8es
d. in3oluntar$ mo3ement of the affected e8tremities
5
'6. A Ca3ernous sinus lesion could in3ol3e se3eral cranial ner3es. 6hich
of the followin is least li5el$ to be affected.
a. oculomotor ner3e
b. Trochlear ner3e
c. Abducens ner3e
d. $acial nerve
'>. ?itemporal hemianopsia means in3ol3ement of the
a. optic ner3e ipsilateral to the lesion
b. optic chiasm
c. optic tract
d. optic radiation
'8. !le3ated urea in patients with chronic renal disease occurs because of
a. an increased reabsorption of urea b$ the pro8imal tubules
b. decreased secretion of urea b$ the distal tubules
c. decreased urea e#cretion
d. an increased renal blood flow
'/. As$mptomatic bacteriuria should alwa$s be treated in:
a. pregnant *omen
b. catheteriGed elderl$ patients
c. se8uall$ acti3e patient
d. post CE< patients
=-. 6hat is the most conser3ati3e manaement for chronic renal failure.
a. dietary proteins o$ 0.1 g2+g2day
b. allopurinol '-- m 1<
c. dial$sis
d. 5idne$ transplant
=1. 1ne of the followin is %1T a pathoph$sioloic mechanism of <;
nephropath$:
a. in@ur$ of the lomerular filtration barrier manifested b$
microalbuminuria
b. Ig & deposits along &)M resulting in immune comple#
mediated glomerulonephritis
c. mesanial matri8 e8pansion resultin to enlared 5idne$s
d. atherosclerosis of the renal 3ascular bed due to h$pertensi3e
arteriosclerosis
=2. %ot a characteristic laborator$ feature of hepatorenal s$ndrome:
a. ele3ated ?B%
b. Fractional e8cretion of %A& J 1L
c. %roteinuria
d. Brinar$ %a& M =- mmol)*
='. The sinle most important parameter of renal function is:
a. edema
b. Creatinine clearance
c. #erum Creatinine
d. #erum ?B%
6
==. A 5-C$earCold male with !#"< 2
-
diabetic nephropath$ was brouht to
the emerenc$ room because of wea5ness and liht headedness. 0e
has @ust completed his first dial$sis+ and was obser3ed to be somewhat
confused. ?P N /-)=-+ C" N 8-)min.+ "" N 2-)min. The most li5el$
e8planation for his condition is:
a. Dialysis dise'uilibrium syndrome
b. <ial$sis dementia
c. Poor dietar$ inta5e durin dial$sis
d. "educed dial$sate temperature
=5. Fn the presence of anemia+ the abilit$ to produce ade(uate circulatin
red cells is best measured b$:
a. 6?C count
b. #erum iron bindin capacit$
c. Reticulocyte count
d. Total eosinophil count
=6. "eticuloc$tosis is %1T seen in:
a. aplastic anemia
b. acute blood loss
c. hemol$tic anemia
d. treatment of iron deficienc$
=>. All of the followin anemias e8cept one are chronic de3elopin o3er
wee5s. 6hich anemia ma$ de3elop acutel$.
a. aplastic
b. pernicious
c. hemolytic
d. iron deficienc$
=8. Fn the tumor cell c$cle+ the cells refractor$ to chemotherap$ are the:
a. Cells in the 2
2
phase
b. Cells in the ; phase
c. Cells in the &
0
phase
d. Cells in the acti3e # phase
=/. ;ultiple osteol$tic lesions+ h$percalcemia and neuroloic abnormalities
are most often seen in:
a. Prostatic CA
b. %onC0od5inAs l$mphoma
c. %lasma cell myeloma
d. C%# tumors
5-. Thromboc$topenia is not e8pected in:
a. #*!
b. &
1
%D de$iciency
c. Acute *eu5emia
d. <isseminated intra3ascular Coaulation 7<FC9
51. This findin in Chronic ;$eloenous *eu5emia can differentiate it from
leu5emoid reaction:
a. decreased leu+ocyte al+aline phosphatase
b. increased 6?C count
c. anemia
d. h$percellular marrow with increased ranuloc$te precursor
7
52. *un cancer that is associated with sinificant proressi3e d$spnea
and increasin h$po8emia
a. #(uamous cell carcinoma
b. 1at cell CA
c. Adenocarcinoma
d. )ronchoalveolar CA
5'. The most common form of arthritis characteriGed b$ proressi3e
deterioration and loss of articular cartilae:
a. "heumatoid arthritis
b. -steoarthritis
c. 2out$ arthritis
d. #eptic arthritis
5=. The characteristic feature of "heumatoid arthritis is:
a. fibrotic chanes of the s5in
b. osteoporosis
c. persistent in$lammatory synovitis
d. as$mmetric in3ol3ement of lare weihtCbearin @oints
55. 0eberdenAs nodes are found in
a. #$stemic lupus er$thematous 7#*!9
b. 2out$ arthritis
c. -steoarthritis
d. "heumatoid arthritis 7"A9
56. *oss of hair at the lateral part of e$ebrows+ thic5enin of speech+
coarse hair and dr$ s5in+ dullin of intellect+ sluish mo3ements. ;ost
li5el$ dianosis is:
a. CushinAs s$ndrome
b. Adrenal insufficienc$
c. ypothyroidism
d. Acromeal$
5>. Psamomma bodies are characteristic of:
a. Follicular Th$roid CA
b. %apillary Thyroid CA
c. Parath$roid Adenoma
d. Parath$roid CA
58. Dodbasedow phenomenon is:
a. iodide!induced hyperthyroidism
b. bloc5in of oranic bindin of iodine with lare doses of the
substance
c. h$perth$roidism due to h$perfunctionin th$roid adenoma
d. due to a th$ro8ineCproducin o3arian tumor
5/. A 5-C$earCold obese woman with h$pertril$ceridemia without
h$percholesterolemia. The most appropriate first manaement step
would be
a. *eight reduction
b. emfibroGil
c. clofibrate therap$
d. liposuction
8
6-. The dianosis of diabetes mellitus is certain in which of the followin
situations.
a. persistentl$ ele3ated nonfastin serum lucose le3els
b. successive $asting plasma glucose o$ 3456 3176 37, mg2dL
in an other*ise healthy 40!year!old $emale
c. A serum lucose le3el of 1=- m)d* in a prenant woman in her
26th wee5 A12
d. l$cosuria in a '-)F
61. 6hich of the followin medications can cause h$perprolactinemia.
a. Propranolol
b. lucocorticoids
c. metoclopramide
d. le3oth$ro8ine
62. 1bese persons are at increased ris5 for
a. h$poth$roidism
b. T$pe F diabetes mellitus
c. Cholelithiasis
d. ele3ated *<* cholesterol
6'. <ietar$ deficienc$ of thiamine produces which of the followin clinical
s$ndromes.
a. color blindness
b. osteoporosis
c. bruisin
d. peripheral neuropathy
6=. A 2=); who too5 meadoses of 3itamins de3elops se3ere headache
and papilledema. The cause for this is into8ication of
a. Eitamin ?
6
b. Eitamin <
c. /itamin A
d. Eitamin !
65. Fn usin #erum albumin as aue for malnutrition+ which statement is
correct.
a. a low serum albumin alwa$s indicates malnutrition
b. the hal$!li$e o$ albumin in ,3 days6 so it cannot be used to
assess acute malnutrition
c. albumin le3els are unaffected b$ chanes in e8tracellular
3olume
d. the bone marrow s$nthesiGes albumin
66. Proloned fastin causes the intestinal 3illi to
a. h$pertroph$
b. atrophy
c. necrose
d. proliferate
6>. A person with 5nown aller$ to penicillins should not be i3en
a. cotrimo8aGole
b. tetrac$cline
c. er$throm$cin
d. ce$ale#in
68. *$mpho5ines are secreted b$
9
a. pol$morphonuclear cells
b. monoc$tes
c. lymphocytes
d. l$mphoma cells
6/. A '-C$earCold female has se3ere perennial alleric rhinitis. 0er house
is fre(uentl$ flooded. #he has a do and sleeps on 5epo5 pillow. As
part of manaement of her aller$+ $ou should ad3ice her to
a. et a new 5apo5 pillow and launder it fre(uentl$
b. tr$ to scoop out the flooded water as soon as the rain pours
c. 5eep the do out or et a cat instead
d. replace the +apo+ pillo* *ith $oam rubber6 cover the pillo*
and mattress *ith allergen proo$ encasings
>-. F! has hih affinit$ for which t$pe of cells.
a. eosinophils
b. mast cells
c. platelets
d. macrophaes
>1. A 65); is brouht to the !" due to chest pain. 0e suddenl$ becomes
unresponsi3e and pulseless and cardiac monitor re3eals 3entricular
fibrillation. Kou should immediatel$:
a. bein CP"+ followed b$ intubation+ then defibrillation with 1-- D
2-- D '6- D
b. bein CP"+ followed b$ intubation+ then defibrillation startin at
2--D
c. begin C%R6 then de$ibrillation at ,00 86 900 8 then 910 8
d. bein CP"+ defibrillate at 2-- D+ then intubate
>2. Ff despite defibrillation+ a pulseless patient has persistent 3entricular
fibrillation+ the use of which dru would be most appropriate.
a. lidocaine
b. procainamide
c. amiodarone
d. epinephrine
>'. Ff onl$ one person is present to pro3ide basic life support+ chest
compressions should be performed at a rate of IIIIII per minute+
and breaths twice in succession e3er$ 15 seconds
a. 5-
b. :0
c. 6-
d. =-
>=. 1ne of the followin is associated with an increased ris5 of sudden
cardiac death:
a. $re'uent %/C;s <=902min>
b. h$ponatremia
c. smo5in
d. h$perlipidemia
>5. !le3ation of #erum Potassium is to8ic to the:
10
a. 5idne$s
b. brain
c. heart
d. li3er
>6. Anti O Tuberculosis dru that can cause h$peruricemia:

a. FsoniaGid
b. %yra(inamide
c. "ifampicin
d. #treptom$cin
;P*: -.25 p:/6=
>>. 6hich of the followin tests is re(uired to dianose Chronic
1bstructi3e Pulmonar$ <isease:
a. Arterial blood as
b. Chest :Cra$
c. Chest CT scan
d. "pirometry
;P*: -.25 p:1551
>8. ;arantic endocarditis is commonl$ associated with this lun cancer:
a. #(uamous cell
b. *are cell
c. Adenocarcinoma
d. "mall cell
;P*: -.25 p: 5-/
>/. This is considered as the most fre(uent cause of Acute "espirator$
<istress #$ndrome
a. #mo5e inhalation
b. "evere sepsis
c. Pulmonar$ contusion
d. Acute pancreatitis
;P*: -.5- p:15/2
8-. The most common form of *un cancer arisin in lifetime of a non
smo5er $oun women
a. #mall cell carcinoma
b. Adenocarcinoma
c. #(uamous cell carcinoma
d. *are cell carcinoma
;P*: -.5- p: 5->
81. The most common cause of acute renal failure
a. %re renal acute renal $ailure
b. "enal acute renal failure
c. Post renal acute renal failure
d. Pre renal with renal acute renal failure
;P*: -.5- p: 16==
82. The most sinificant ris5 factor for cancer is:
a. "e#
b. Ae
c. %ationalit$
d. <ietar$ factors
;P*: -.5- p: ='5
11
8'. <%A s$nthesis phase
a. 21
b. 22
c. 2-
d. "
;P*: -.''' p: =6/
8=. This is the most common local manifestation of lun cancer at
presentation
a. <$spnea
b. Cough
c. 0emopt$sis
d. Chest pain
;P*: -.5- p: 5-8
85. Painless m$ocardial infarction is reater in patients with
a. hypertension
b. diabetes mellitus
c. homoc$stinemia
d. d$slipidemia
;P*: -.5- p: /55
86. Fn t$poid fe3er this dianostic e8am is not affected b$ prior antibiotic
use:
a. )one marro* culture
b. ?lood culture
c. Brine culture
d. #tool culture
;P*: -.25 p: 8//
8>. ?ritish Thoracic #ociet$ ma@or cateor$ for dianosis of se3ere
pneumonia
a. P)F ratio of J25-
b. ;ultilobar pneumonia
c. #$stolic pressure of less than /- mm0
d. Need $or mechanical ventilation
;P*: -.5- p: 15'2
88. This antiCT? dru ma$ cause Pbarrel 3isionQ
a. "ifampicin
b. FsoniaGid
c. P$raGinamide
d. #treptom$cin
;P*: -.25 p: /61
8/. ;ost common cause of pneumonia in ambulator$ patients:
a. "treptococcus pneumoniae
b. ;$coplasma pneumoniae
c. influenGa 3iruses
d. Chlam$dia pneumoniae
;P*: -.25 p: 15'1
/-. ;ost common etioloic aent in uncomplicated c$stitis:
12
a. Pseudomonas aeruinosa
b. #taph$lococcus aureus
c. Escherichia coli
d. Proteus 3ularis
;P*: -.5- p: 1>15
/1. The best parameter to differentiate chronic bronchitis from emph$sema
a. #imple spirometr$
b. *un 3olume studies
c. DLC-
d. Arterial blood as
;P*: -.''' p: 15-'
/2. The duration of treatment for acute c$stitis in prenant patient :
a. sinle dose
b. ' da$s
c. 5 da$s
d. 5 days
;P*: -.25 p: 152-
/'. <ianosis of <iabetes ;ellitus is defined as:
a. "andom is defined as with reard to time since the last meal.
b. Fastin is defined as no caloric inta5e for at least 12 h.
c. The test should be performed usin a lucose load containin
the e(ui3alent of 5- anh$drous lucose dissol3ed in waterH not
recommended for routine clinical use.
d. A random plasma glucose concentration ?33.3 mmol2L <,00
mg2dL> accompanied by classic symptoms o$ DM <polyuria6
polydipsia6 *eight loss> is su$$icient $or the diagnosis o$
DM
;P*: -.''' p: 215'
/=. T$pe 2 <; is characteriGed b$ one of the pathoph$sioloic
abnormalities:
a. impaired insulin absorption
b. peripheral insulin resistance
c. decrease hepatic lucose production
d. increase luconeoenesis
;P*: -.''' p: 215>
/5. Acute complication of T$pe 2 <iabetes ;ellitus :
a. yperosmolar yperglycemic "tate
b. Coronar$ arter$ disease
c. <; neuropath$
d. 2astroparesis
;P*: -.25 p: 2161
/6. Taret blood pressure in <iabetes ;ellitus
a. 1=-)/-
b. 15-)8-
c. 3902:0
d. 12-)8-
;P*: -.25 p: 21>-
/>. "is5 factor for ad3erse pronosis in h$pertension:
13
A. elderl$
?. female se8
C. smo+ing
<. prenanc$
;P*: -.25 p: 1=66
/8. The most common form of suppurati3e intracranial infection:
A. 3iral meninitis
). bacterial meningitis
C. funal meninitis
<. parasitic meninitis
;P*: -.5- p: 2=>2
//. Precipitatin cause of heart failure:
A. smo5in
?. e8ercise
C. in$ection
<. stro5e
;P*: -.5- p: 1'68
1--. Bnderl$in cause of heart failure:
A. cardiomyopathy
?. cardiac tamponade
C. respirator$ diseases
<. anemia
;P*: -.''' p: 1'68
1-1. ;inor criteria of conesti3e heart failure:
A. #' allop
?. cardiomeal$
C. rales
D. tachycardia
;P*: -.25 p: 1'>1
1-2. *e3ineAs sin:
a. tenderness on palpation
b. slowl$ proressi3e d$spnea
c. clenching o$ the $ist in $ront o$ the sternum
d. difficult$ of breathin
;P*: -.25 p: 1='5
1-'. An important factor predisposin to bacteriuria in men is urethral
obstruction due to:
A. prostatic hypertrophy
?. catheter insertion
C. infection
<. ureteric stones
;P*: -.25 p: 1>16
1-=. The most common findin on ph$sical e8amination in leptospirosis
aside from fe3er:
A. calf tenderness
). con@unctival su$$usion
C. @aundice
<. rash
;P*: -.5- p: //-
14
1-5. The most common cause of partial or eneraliGed epileps$ in the
elderl$ is :
A. stro+e
?. brain tumor
C. infection
<. trauma
;P*: -.5- p: 25'>
1-6. <efinition of se3ere pneumonia b$ American Thoracic #ociet$:
A. need $or mechanical ventilation
?. s$stolic ?P of M/- mm0
C. sinle lobe in3ol3ement
<. Pa12)Fi12 J 2--
;P*: -.''' p: 15'2
1->. Cause of transudati3e pleural effusion:
A. mesothelioma
?. sarcoidosis
C. cirrhosis
<. meis s$ndrome
;P*: -.25 p: 156>
1-8. 0allmar5 of C1P<:
A. air$lo* obstruction
?. clubbin of diits
C. flail chest
<. hoo3erAs sin
;P*: -.25 p: 1551
1-/. ;ost commonl$ in3ol3ed in e8trapulmonar$ T?:
A. menines
?. peritoneum
C. pericardium
D. lymph nodes
;P*: -.25 p: /5>

11-. Primar$ Pulmonar$ T? fre(uentl$ in3ol3ed the:
A. middle lobe
?. lower lobe
C. middle and lo*er lung (ones
<. upper lobe
;P*: -.''' p: /56
111. The most common complication of measles:
A. subacute sclerosing panencephalitis
?. chronic encephalitis
C. otitis e8terna
<. hepatitis
;P*: -.5- p: 115-
112. The dru of choice for primar$ eneraliGed seiGures is:
A. phenytoin
?. carbamaGepine
C. 3alproic acid
<. abapentin
;P*: -.5- p: 2'>=
11'. T$pe of anemia in ;alaria:
15
A. normochromic normocytic
?. h$pochromic normoc$tic
C. h$pochromic microc$tic
<. normochromic microc$tic
;P*: -.''' p: 1226
11=. Cerebral ;alaria is caused b$:
A. %. $alciparum
?. P. malariae
C. P. o3ale
<. P. 3i3a8
;P*: -.25 p: 1222
115. The most common presentation of amoebic infection is:
A. asymptomatic cyst passage
?. amoebic colitis
C. li3er abscess
<. central ner3ous s$stem infection
;P*: -.25 p: 16=-
116. <uodenal ulcer occur /-L located within:
A. 9cm o$ the pylorus
?. =cm of the p$lorus
C. 5 cm of the p$lorus
<. 1- cm of the p$lorus
;P*: -.''' p: 1>=/
11>. The most common t$pe of allstone:
A. cholesterol
?. blac5 piment stone
C. brown piment stone
<. reen piment stone
;P*: -.25 p: 1881
118. 2old standard in dianosin allstone:
A. abdominal 8ra$
). ultrasound
C. CT #can
<. Cholescintiraph$
;P*: -.25 p: 188'
11/. The most common ris5 factor of stro5e :
A. infection
). hypertension
C. diabetes mellitus
<. trauma
;P*: -.25 p: 2'>2
12-. The most specific and characteristic s$mptom of allstone disease:
A. biliary colic
?. 3omitin
C. constipation
<. @aundice
;P*: -.25 p: 188'
121. *ocal complication of acute pancreatitis:
16
A. pancreatic abscess
?. pleural effusion
C. pericardial effusion
<. peptic ulcer disease
;P*: -.5- p.18/8
122. 85L of Pancreatic pseudoc$st are located at the :
A. tail
?. bod$
C. body and tail
<. head
;P*: -.5- p: 1/-1
12'. The most common serious complication of chic5en po8:
A. pneumonia
?. hepatitis
C. meninitis
<. pericarditis
;P*: -.5- p: 1-='
12=. Fncubation period of chic5en po8:
a. 1-C21 da$s
b. 5!30 days
c. 5C1- da$s
d. 21C'-da$s
;P*: -.''' p: 1-='
125. The person recommended to recei3e influenGa 3accine:
A. person = 17 years o$ age
?. women in first trimester of prenanc$
C. h$pertensi3e patients
<. with prodromal phase of upper respirator$ infection
;P*: -.''' p: 1-=2
126. ;ost serious complication of influenGa ? 3irus:
A. pneumonia
?. carditis
C. reye;s syndrome
<. encephalitis
;P*: -.5 p: 1-6>
12>. ;etabolic complication of nephritic s$ndrome
A. h$percalcemia
?. bleedin
C. normoc$tic normochromic
D. hypoalbuminemia
;P*: -.5 p: 168=
128. Primar$ 2lomerulopath$ which is hihl$ steroid responsi3e:
A. membranoproliferati3e
?. membranous
C. focal semental lomerolosclerosis
D. minimal change disease
;P*: -.''' p: 168'
12/. ;ost common cause of idiopathic nephrotic s$ndrome in adult:
17
A. membranoproliferati3e
). membranous
C. focal semental lomerulosclerosis
<. minimal chane disease
;P*: -.5 p: 168>
1'-. 0allmar5 of nephrotic s$ndrome:
A. d$smorphic red blood cell
?. numerous red blood cell cast
C. heavy protenuria
<. wa8$ cast
;P*: -.5 p: 168=
1'1. ;ost common lomerulopath$ worldwide:
A. minimal chane
?. lupus nephritis
C. membranous
D. IgA nephropathy
;P*: -.5 p: 16/-
1'2. ;ost common cause of Fron deficienc$ in adult:
A. chronic blood loss
?. hemol$sis
C. dietar$ deficienc$
<. chronic inflammator$ disease
;P*: -.5 p: 586
1''. Eirus serot$pe associated reatest ris5 for <0F:
A. <!%C1
). DEN!,
C. <!%C'
<. <!%C=
;P*: -.5 p: 1161
1'=. ;ost important laborator$ test for <0F monitorin:
A. emoglobin
?. hematocrit
C. platelet
<. li3er function test
;P*: -.25 p: 1161
1'5. 6hich of the followin is the earliest rabies specific clinical
manifestation:
A. h$drophobia
?. aerophobia
C. tingling sensation at the bite site
<. delirium
;P*: -.''' p: 1115
1'6. The dianostic laborator$ method of choice for t$phoid fe3er in the first
wee5
of illness:
A. bone marrow culture
). blood culture
C. urine culture
<. stool culture
;P*: -.25 p: //1
18
1'>. The most important predictor of multiCdru resistant ;. tuberculosis
oranism
in all studies is:
A. history o$ treatment tuberculosis
?. 0FE
C. noncompliance
<. diabetes mellitus
;P*: -.5 p: /58
1'8. ;ost discriminatin s$mptom of duodenal ulcer:
A. nausea and 3omitin
). pain occur A0 min to 9 hours a$ter a meal
C. relie3ed b$ food inta5e
<. pain awa5ens patient at niht
;P*: -.5 p: 1>51
1'/. *i3er cirrhosis is best dianosed b$:
A. Bltrasound
). Liver biopsy
C. CT scan
<. li3er function tests
;P*: -.25 p: 185/
1=-. <ru of choice for #chistosomiasis:
A. mebendaGole
). pra(i'uantel
C. tinidaGole
<. metronidaGole
;P*: -.5 p: 12>1
1=1. #pasm that is obser3ed first in Tetanus:
A. risus sardonicus
?. abdominal riidit$ onl$ upon stimulation
C. trismus
<. opisthotonus
;P*: -.5 p: 1115
1=2. 2old standard in the treatment of t$phoid fe3er:
A. chloramphenicol
?. penicillin
C. tetrac$cline
<. ceftria8one
;P*: -.25 p: //1
1='. The most common opportunistic funal infection:
A. candida
?. asperillosis
C. pneumocistis @ero3erci
<. fusarium
;P*: -.25 p: 1185
1==. #ource of cholera infection:
19
A. contaminated *ater supply
?. food e8posed to flies and coc5roaches
C. food utensils not properl$ disinfected
<. inestion of li3e oral cholera 3accine
;P*: -.25 p: /-/
1=5. Classical malarial paro8$sms suest infection with:
A. P. malariae
?. P. falciparum
C. ?. microti
D. %. viva#
;P*: -.25 p: 1221
1=6. ;ost common cause of pneumonia in ambulator$ patients:
A. ". pneumoniae
?. ;. pneumoniae
C. influenGa 3iruses
<. C. pneumoniae
;P*: -.25 p: 15'1
1=>. The sinle most useful clinical sin of the se3erit$ of pneumonia:
A. ?P of 12-)8-
). Respiratory rate o$ = 902min
C. Cardiac rate of >6
<. Temperature of '>C
;P*: -.''' p: 15'2
1=8. The most common route for bacterial pneumonia :
A. ross aspiration
?. aerosoliGation
C. microaspiration o$ oropharyngeal secretions
<. hematoenous spread from a distant infected site.
;P*: -.5 p: 152/
1=/. ;ost common site of spinal tuberculosis in adult:
A. upper thoracic spine
). lo*er thoracic spine
C. lumbar spine
<. cer3ical spine
;P*: -.5 p: /58
15-. The most common site of astrointestinal T?:
A. appendi8
?. pro8imal ileum
C. pancreas
D. terminal ileum
;P*: -.5 p: /58
151. ;ost common site of pancreatic cancer:
A. head
?. bod$
C. tail
<. uncus
;P*: -.25 p: 5'>
152. ;ost consistent ris5 factor in pancreatic cancer:
20
A. h$pertension
?. alcoholism
C. cigarette smo+ing
<. obesit$
;P*: -.5 p: 5'>
15'. 0ereditable astrointestinal s$ndromes that has least malinant
potential:
A. ardnerAs s$ndrome
?. turcotAs s$ndrome
C. l$nch s$ndrome
D. @uvenile polyposis
;P*: -.''' p: 528
15=. The most common infectious complication of 3aricella is
A. bacterial superin$ection o$ the s+in
?. seiGure
C. sepsis
<. meninitis
;P*: -.''' p: 1-='
155. The most common e8tracutaneous site of in3ol3ement in children
A. respirator$ s$stem
?. CE#
C. CN"
<. 2FT
;P*: -.5 p: 1-='
156. A deficienc$ of this protease inhibitor is a pro3en enetic ris5 factor for
C1P<
A. alpha 3 anti trypsin
?. alpha 2 anti tr$psin
C. ; protein
<. piRR alpha 2 anti tr$psin
;P*: -.5 p: 15=8
15>. 2lucose oal in patients with <,A:
A. >- C 1-- m)dl
?. 1-- C15- m)dl
C. 370 B ,70 mg2dl
<. 25-C'-- m)dl
;P*: -.5 p: 216-
158. 0eart failure with de3elopment of s$mptoms in less than an ordinar$
acti3it$:
A. Class F
?. Class FF
C. Class III
<. Class FE
;P*: -.25 p: 1'-2
15/. 0eart failure with warm and flushed e8tremities and with widened pulse
pressure
A. *ow output
). igh output
C. <iastolic heart failure
<. #$stolic heart failure
21
;P*: -.5 p: 1'6/
16-. Cardiom$opath$ with primar$ m$ocardial in3ol3ement
A. Fnfecti3e
?. ;etabolic
C. Connecti3e
D. Idiopathic
;P*: -.5 p: 1=-8
161. "e3ersible form of dilated cardiom$opath$
A. Alcohol abuse
?. "iht 3entricular d$splasia
C. Am$loidosis
<. 0emochromatosis
;P*: -.5 p: 1=-/
162. #$stolic 0$pertension with wide pulse pressure
A. Arteriosclerosis
?. Chronic P$elonephritis
C. 1ral contracepti3es
<. Ps$choenic
;P*: -.5 p: 1=6'
16'. Framinham ma@or criteria for <ianosis of C0F :
%iht couh
Pleural effusion
Tach$cardia
%ositive hepato@ugular re$lu#
;P*: -.25 p: 1'>1
16=. Characteristic appearance of stools in patients with cholera:
A. nonCmucoid+ nonCbilious stools
?. mucoid and water$ stools
C. sour and offensi3e odor which is nonCbilious and nonCblood$
D. non!bilious6non!bloody6 gray6 sl. cloudy *ith $lec+s o$
mucus
;P*: -.25 p: /11
165. Primar$ pulmonar$ T? is characteriGed as:
A. t$picall$ in3ol3es the apices of the luns
?. causes rupture of "asmussenAs aneur$sm
C. involves the middle and lo*er lobes in most cases
<. reacti3ation t$pe of infection
;P*: -.5 p: /56
166. Class F recommendations for use of an !arl$ in3asi3e strate$ in
;$ocardial Fnfarction:
A. !F J -.6-
). Recurrent angina at rest2 lo* level activity despite R#
C. PCF J 8 months+ prior CA?2
<. %eati3e stress test
;P*: -.''' p: 1=>>

22
16>. The most common presentin complaint in patients with #T ele3ation
;F:
A. <$snea
?. 6ea5ness
C. %ain
<. Eomitin
;P*: -.5 1==/
168. <e ba5e$ classification of Aortic dissection in which dissection is
limited to the ascendin aorta:
A. T$pe F
). Type II
C. T$pe FFF
<. T$pe FE
;P*: -.5 p: 1=8'
16/. Cardiom$opath$ with primar$ m$ocardial in3ol3ement
A. Fnfecti3e
?. ;etabolic
C. Connecti3e
D. Idiopathic
;P*: -.25 p: 1=-8
1>-. This form of respirator$ failure occurs when al3eolar floodin and
subse(uent
intrapulmonar$ shunt ph$siolo$ occur:
A. Type 3 respiratory $ailure
?. T$pe 2 respirator$ failure
C. T$pe ' respirator$ failure
<. T$pe = respirator$ failure
;P*: -.25 p: 158'
1>1. 0ea3$ drin5ers 7i.e.+ those consumin 1-- of ethanol per da$ for the
precedin 2 $ears9 ha3e a hiher incidence of ac(uirin what t$pe of
oranism in Communit$ ac(uired Pneumonia.
A. ram positi3e oranism
). gram negative organisms
C. anaerobes
<. enterococci
;P*: -.5 p: 15'-
1>2. Associated with pandemics and are restricted to influenGa A 3iruses
A. antigenic shi$t
?. antienic drift
C. antienic transformation
<. antienic rotation
;P*: -.25 p: 1-66
1>'. ;ost common pathoen in intensi3e care unit:
A. ". pneumoniae
?. C. pneumoniae
C. ;. pneumoniae
<. 0. influnGae
;P*: -.25 p: 15'1
1>=. The onl$ 5nown reser3oir for Earicella Goster 3irus is
A. humans
23
?. cats
C. mos(uito
<. rodents
;P*: -.25 p: 1-=2
1>5. The most common infectious complication of 3aricella is
A. bacterial superin$ection o$ the s+in
?. seiGure
C. sepsis
<. meninitis
;P*: -.25 p:1-='
1. The most common site of hypertensive intraparenchymal hemorrhage is:
A. Deep Cerebellum
B. Pons
C. Thalamus
D. Putamen
Page 2390
2. The most common cause of ischemic stroke is
A. mall vessel thrombosis !"acunar#
B. "arge vessel thrombosis
C. Car$io embolism $ue to mural thrombus
D. Artery to artery embolism from caroti$ bifurcation atherosclerosis
Page 2376
%. Currently consi$ere$ the best initial treatment for primarily generali&e$ tonic
clonic sei&ures is:
A. Phenytoin
B. 'alproic aci$
C. Carbama&epine
D. Phenobarbital
Page 2367
(. A$verse e)ects such as gum hyperplasia* hirsutism an$ coarsening of facies is
associate$ +ith long term use of:
A. Carbama&epine
B. 'alproic aci$
C. Phenytoin
D. Topiramate
Page 2368
,. The pathognomonic sign of meningitis is:
A. Presence of fever an$ cranial nerve $e-cit
B. Presence of hemiparesis* hea$ache an$ fever
C. Presence of fever* hea$ache an$ nuchal rigi$ity
D. Presence of nuchal rigi$ity an$ hemiparesis
Page 2473
.. The most common cause of community ac/uire$ bacterial meningitis in a$ults
021 years of age
A. 2. meningiti$es
B. trep. Pneumoniae
C. "isteria monocytogenes
D. 3roup B streptococci
Page 2471
4. 5hich of the follo+ing systemic $isease is 26T associate$ +ith
polyneuropathy:
A. 78' infection
B. Diabetes mellitus
C. Carcinoma
D. Carpal Tunnel yn$rome
Page 2501, 2504
24
9. Compressive :etastatic :yelopathies most commonly involve +hich level of
the spinal cor$
A. Cervical
B. Thoracic
C. "umbar
D. acral
Page 2441
;. 5hich of the follo+ing is true of Trigeminal 2euralgia
A. :ore common in males
B. 6b<ective sign of sensory loss in the face cannot be $emonstrate$ on
e=amination
C. >sually involve the ophthalmic $ivision of the trigeminal nerve
D. A)ects most a$olescents an$ young a$ults
Page 2434
11. 5hich of the follo+ing $isor$ers causes irreversable $ementia?
A. 7ypothyroi$ism
B. Thiamine De-ciency
C. :ulti@infarct
D. Al&heimerAs $isease
Page 2396
11. The most po+erful risk factor for osteoarthritis is:
A. Bemale se=
B. 6besity
C. Age
D. Prior inCammatory <oint $isease
Page 2037
12. Disabilility of patient +ith knee osteoarthritis is strongly associate$ +ith:
A. Da$iographic severity of <oint $amage
B. Eoint pain
C. Fua$riceps muscle +eakness
D. 6besity
Page 2037
1%. 5hich of the follo+ing is the characteristic physical e=amination -n$ing of
patient +ith osteoarthritis?
A. "ocali&e$ ten$erness
B. +elling of bony an$ soft tissue
C. Periarticular muscle atrophy
D. Bony Crepitus
Page 2039
1(. 5hich of the follo+ing is consi$ere$ as the most common form of i$iopathic
osteoarthritis
A. Bouchar$As no$es
B. 7eber$enAs no$es
C. 3elatinous $orsal cyst
D. 6sler no$es
Page 2040
1,. A %1 yGo female +ith "H is note$ to have a prolonge$ partial thromboplastin
time. This abnormality is associate$ +ith:
A. "eukopenia
B. Central nervous system vasculitis
C. Central nervous system hemorrhage
D. Deep venous thrombosis
Page 1964
1.. The best screening test for the $etection of "H is:
A. Anti@m
B. Anti@ $sD2A
C. Antinuclear antibo$ies
D. Anti@Do
Page 1961
25
14. Diagnosis of gouty arthritis is base on the -n$ing of crystals in the synovial
Cui$ an$ +hich of the follo+ing crystals is $iagnostic of gout?
A. Apatite crystals
B. Birefringent nee$le@shape$ crystals
C. Do$@shape$ +eakly birefringent crystals
D. Dhomboi$ strongly birefrintent crystals
Page 2046-2049
19. The preferre$ treatment of acute gouty attack in el$erly patient is:
A. Colchicine
B. 2A8D
C. 8ntraarticular steroi$ infection
D. 6ral steroi$
Page 2046
1;. Eoint pain among patient +ith Dheumatoi$ arthritis is cause mainly by +hich of
the follo+ing mechanism?
A. :uscle spasm
B. tretching of periostal nerve en$ings
C. tretching of the <ointAs ligaments
D. Distention of <oint capsule
Page 1971
21. A=ial !vertebra# <oints involvement in Dheumatoi$ arthritis is usually limite$ to
the:
A. Cervical vertebrae
B. Thoracic vertebrae
C. "umbar vertebra
D. acral vertebrae
Page 1971
21. Hvi$ence suggests that early aggressive treatment of rheumatoi$ arthritic
patient +ith Disease@:o$ifying Antirheumatic Drugs !D:ADD# maybe e)ective
at slo+ing the appearance of bone erosions. 5hich of the D:ADD is currently
consi$ere$ the best initial choice?
A. D@penicillamine
B. 3ol$ compoun$
C. :ethotre=ate
D. ulfasala&ine
Page 1975
22. 5hich of the follo+ing 'itamins is capable of eliciting systemic anaphylactic
reaction?
A. Cobalamine
B. Pyri$o=ine
C. DiboCavin
D. Thiamine
Page 1949
2%. 5hich of the follo+ing me$icine or $rug is 26T e)ective in the treatment of
the acute event of systemic anaphylactic reaction?
A. C Hpinephrine
B. 8' Dopamine
C. 8' Diphenly$ramine
D. 8' 3lucocorticoi$s
Page 1950
2(. :a<ority of acute $iarrheas are $ue to
A. to=ic ingestion
B. me$ications
C. infectious agents
D. ischemia
Page 225
2,. Clostri$ium $e-cile causes acute $iarrhea by
A. mucosal invasion
B. cytoto=in pro$uction
C. pre@forme$ to=in pro$uction
26
D. enteroa$herence
Page 226
2.. :a<ority !0,1I# of all esophageal cancers are of +hich cell type?
A. a$enocarcinoma
B. s/uamous cell carcinoma
C. lymphoma
D. sarcoma
Page 542
24. 2ot consi$ere$ as risk factor for the $evelopment of Pancreatic cancer?
A. smoking
B. cholelithiasis
C. long stan$ing D:
D. obesity
Page 537
29. 5hich of the follo+ing is a protective antibo$y against 7epatitis B infection?
A. Anti@7Be
B. Anti 7Bs
C. 7BsAg
D. Anti 7Bc
Page 1825
2;. Drug that is contrain$icate$ in the treatment of chronic 7epatitis B infection
+ith $ecompensate$ liver is:
$isease
A. 8nterferon
B. "amivu$ine
C. A$efovir
D. Hnterocavir
Page 1847
%1. :inimum amount of ascetic Cui$ +hich can be $etecte$ by shifting $ullness is:
A. 111 cc
B. %11 cc
C. ,11 cc
D. 411 cc
Page 1866
%1. ecretion of +ater an$ bicarbonate rich solution from the pancreas is
stimulate$ by:
A. secretin
B. cholecystokinin
C. gastrin
D. somatostatin
Page 1895
%2. :ost common complication of Peptic >lcer Disease is:
A. perforation
B. penetration
C. blee$ing
D. obstruction
Page 1752
%%. 5hich of the follo+ing isconnsi$ere$ as a non@pharmacologic management of
3astroesophageal DeCu= Disease?
A. +earing tight belts
B. Proton pump inhibitors
C. moking
D. Decrease$ amount of Cui$s at night
Page 1743
%(. 5ho among the follo+ing is consi$ere$ to be $iabetic?
A. a %( yGo male +ho complaine$ of e=cessive thirst* +eight loss an$ casual
bloo$ sugar of
121mgI
B. asymptomatic (1yGo female +ith Basting Bloo$ sugar of 121mgI
C. a (, yGo female +ith polyuria an$ J( sugar in the urine
D. a (1 yGo male e=ecutive +ith 7bAiC of 9I
27
Page 2153
%,. The best +ay to assess bloo$ sugar control is to monitor the:
A. Basting bloo$ sugar
B. Post pran$ial bloo$ sugar
C. 3lycosalate$ 7emoglobin
D. >rine sugar
Page 2172
%.. A patient +ho is 7ypertensive an$ 7ypokalemic* shoul$ make one consi$er
+hich of the ). as the most likely cause of the hypertension?
A. Pheochromocytoma
B. ConnAs yn$rome
C. CushingAs $isease
D. A$$isonAs $isease
Page 2138
%4. 5hat is the most common cell type of Thyroi$ Carcinoma?
A. Bollicular carcinoma
B. Papillary carcinoma
C. :e$ullary carcinoma
D. Anaplastic carcinoma
Page 2125
%9. 5hich of the follo+ing physiologic con$ition can stimulate prolactin secretion
by the pituitary glan$?
A. Phenothia&ines
B. :enstruation
C. tress
D. Post meal
Page 2085
%;. 5hich of the follo+ing is 26T consistent +ith Diabetic Ketoaci$osis?
A. p7 of 4.12
B. 7C6%
@
of 1( mmolG"
C. Bloo$ sugar of 2(1mgI
D. >rine ketone of J(
Page 2159 table 323-4
(1. 5hat is the e=pecte$ laboratory -n$ings in 3raveAs 7yperthyroi$ism?
A. elevate$ thyroi$ hormones +ith lo+ T7
B. elevate$ thyroi$ hormones L T7
C. lo+ thyroi$ hormones L T7
D. elevate$ T7 +ith lo+ thyroi$ hormones
Page 2115
(1. 5hich of the follo+ing is 26T a feature of 7ypocalcemia?
A. short FT interval
B. increase$ urination
C. $epression
D. $iarrhea
Page 2252
(2. 5hich of the follo+ing test is recommen$e$ as the initial screening for
CushingAs y$rome?
A. overnight $e=amethasone test
B. lo+ $ose $e=amethasone test
C. high $ose $e=amethasone test
D. plasma ACT7 $etermination
Page 2135
(%. 5hich of the follo+ing have the most potent glucocorticoi$ e)ect?
A. Triamcinolone
B. Betamethasone
C. De=amethasone
D. Paramethasone
Page 2147
28
((. The most potent risk factor for $evelopment of active TB $isease is:
A. :alnutrition
B. 6l$ age
C. "ate a$olescence
D. 78' co@infection
Page 955
(,. Tuberculosis treatment failure is suspecte$ +hen appropriate regimen is
prescribe$ but:
A. sputum cultures remain positive after % months
B. ABB sputum smears remain positive after , months
C. Hither
D. 2either
Page 963
(.. The most important impe$iment to cure Tuberculosis is:
A. Drug resistance
B. inappropriate assessment of its severity
C. Cheap me$icine
D. non@compliance
Page 962
Case: A ,9 years ol$ male presente$ +ith ( $ays fever an$ lately +eakness an$
$i&&iness +henever he sits or stan$s upM $isorientation. >pon PH:
BPN;1G.1mm7g* PDN112Gmin.* DDN29Gmin.* TN%;.9OC. The only remarkable
-n$ing is an ulcerate$ skin lesions in the lo+er leg +ith black $iscoloration.
"ab tests: 5BCN2*,11cellsGm
%
M gram negative bacilli from smears of the skin
lesion.
(4. This patient has
A. 8D
B. severe sepsis
C. septic shock
D. sepsis
Page 1606
(9. The most probable organism that has causes severe febrile illness +ith
changes in sensorium an$ associate$ +ith ulceration an$ black $iscoloration
of the skin is:
A. . aureus
B. B. anthrasis
C. Cl. Perfringens
D. P. aeruginosa
Page 310
(;. The follo+ing anti microbial agent is e)ective for the treatment of
Pseu$omonas infection:
A. 2afcillin
B. Tetracycline
C. Cefta&i$ime
D. Any of the above
Page 708
,1. The ma<or anatomic site for the establishment an$ propagation of 78'
infection is:
A. 3enital organs
B. "ymphoi$ organs
C. 'ascular system
D. "ymphocytes
Page 1080
,1. Central to the pathogenesis of severe falciparum malaria isGare:
A. cytoa$herence in capillary an$ venular en$othelium
B. rosette formation by non parasiti&e$ DBCAs
C. agglutination of parasiti&e$ DBCAs
D. all of the above
Page 1221
29
,2. e/uestration an$ microcirculatory arrest occur in +hich of the follo+ing
Plasmo$ium?
A. P. falciparum
B. P. viva=
C. P. malariae
D. all of the above
Page 1221
,%. 7ypoglycemia in severe malaria is associate$ +ith poor prognosis an$ it may
result from
A. failure of hepatic gluconeogenesis
B. increase$ glucose consumption by host an$ parasite
C. increase$ insulin secretion in treatment +ith Fuinine
D. all of the above
Page 1222
,(. The $iagnostic test of malaria that is also use$ to monitor response to
treatment is:
A. erology
B. taine$ bloo$ -lm
C. either
D. neither
Page 1224
,,. Dengue 7emorrhagic fever can occur follo+ing:
A. Primary infection +ith a virulent serotype
B. econ$ infection +ith the same serotype
C. econ$ infection +ith a serotype $i)erent from that involve$ in primary
infection
D. All of the above
Page 1164
,.. Diagnosis of Dengue fever is ma$e in a clinically Compatible $isease
manifestation by
A. 8g: H"8A
B. 7emoconcentration
C. "eucopenia
D. Thrombocytopenia
Page 1164
,4. The main clinical manifestations of Chronic chistosomiasis are $epen$ent on
A. pecies
B. site of egg $eposition in the hostAs tissues
C. Both
D. 2either
Page 1269
,9. The follo+ing are e)ects of tetanospasmin HPCHPT
A. bloo$ release of inhibitory neurotransmitters
B. increase$ circulating catecholamine levels
C. block neurotransmitter release at the neuromuscular <unction
D. all of the above
Page 841
,;. The follo+ing laboratory -n$ings are suggestive of 8ron De-ciency Anemia
HPCHPT
A. koilonychias
B. $ecrease$ serum ferritin
C. $ecrease$ total iron bin$ing capacity
D. lo+ reticulocyte response
Page 589
.1. 5hich of the follo+ing statement regar$ing Polycythemia 'era is correct?
A. anemia is common
B. transformation to acute leukemia is common
C. an elevate$ plasma erythropoietin level e=clu$es the $iagnosis
D. phlebotomy is use$ only after hy$ro=yurea an$ interferon have been tire$
30
H. thrombotic risk is mainly attribute$ to Thrombocytosis
Page 627-628
.1. Diagnosis of Acute :yeloi$ "eukemia is establishe$ by the presence of:
A. Q 11I myeloblasts in the bone marro+
B. Q 21I myeloblasts in the bone marro+
C. Q ,I myeloblasts in the bone marro+
D. R ,I myeloblasts in the bone marro+
Page 632
.2. 5hich of the follo+ing syn$rome have autoimmune hemolytic anemia +ith
immune thrombocytopenia?
A. Daynau$As syn$rome
B. Hvans syn$rome
C. 7emolytic uremic syn$rome
D. Thrombotic thrombocytopenic purpura
Page 612
.%. 5hich of the follo+ing is the cytogenetic hallmark of Chronic :yelogenous
"eukemia?
A. t!1,:14#
B. t!;M22#
C. inv 1.
D. t!9M21#
Page 638
.(. 5hat is the most common symptom of patient +ith :yeloma?
A. Bever
B. Blee$ing
C. Bone pain
D. 2umbness
Page 657
.,. Cryoprecipitate is pro$uce$ by centrifugation after tha+ing of this particular
bloo$ component
A. Packe$ DBC
B. ingle $onor apheresis platelet
C. Bresh fro&en plasma
D. Cryosupernate
Page 664
... Asthma is a $isor$er characteri&e$ by:
A. Acute air+ay inCammation follo+e$ by bronchoconstriction
B. Persistent subacute air+ay inCammation
C. ensitivity to metacholine an$ histamine
D. 7ypertrophy an$ hyperplasia of bronchial mucus glan$s
Page 1508
.4. :a<or infectious cause of asthma e=acerbation in a$ults is:
A. Despiratory syncitial virus
B. 8nCuen&a virus
C. treptococcus
D. :ycoplasma
Page 1510
.9. The hallmark of C6PD is airCo+ obstruction as evi$ence$ by
A. 8ncrease$ BH'1GB'C
B. 8ncrease$ BH'1
C. Decrease$ BH'1GB'C
D. Decrease$ resi$ual volume !D'#
Page 1551
.;. Para$o=ical inspiratory in+ar$ movement of the rib cage seen in patients +ith
severe C6PD is calle$ the:
A. PallaAs sign
B. Tripo$ posture
C. 7ammanAs sign
D. 7ooverAs sign
Page 1551
41. The single most useful clinical sign of severe pneumonia among patient
+ithout un$erlying lung $isease is:
A. DD0%1Gmin
B. T0%9OC
C. BPR111 systolic
D. CD0111
Page 1532
31
41. Decurrent pneumonia in the same location is most likely $ue to the presence
of:
A. 8mmuno$e-ciency
B. Bronchial obstruction
C. "ung hypoplasia
D. 8nterstitial lung $isease
Page 1537
42. The presence of pus in the pleural space is terme$ as:
A. Parapneumonic e)usion
B. Chylothora=
C. Hmpyema
D. H=u$ative e)usion
Page 1566
4%. u$$en severe $yspnea* an$ P.H. -n$ing of unilateral absent breath soun$s
an$ hypertesonance in a C6PD patient +ithout antece$ent in<ury shoul$ make
one suspect:
A. Primary spontaneous pneumothora=
B. econ$ary spontaneous pneumothora=
C. Traumatic pneumothora=
D. Tension pneumothora=
Page 1568
4(. ubcutaneous emphysema an$ 7ammanAs sign is seen in:
A. C6PD
B. Pneumome$iastinum
C. Pleural e)usion
D. 7emothora=
Page 1569
4,. 7ospital ac/uire$ pneumonia !7AP# is consi$er if pneumonia occur:
A. 6ccurs 2( hours after being place$ on a respirator
B. 6ccurs (9 hours after hospital a$mission
C. 6ccurs 42 hours after 8C> a$mission
D. 6ccurs rarely in large* variegate$@patient me$ical centers
Page 1538
4.. A ,. yGo female a$mitte$ for Acute Pyelonephritis +as starte$ on Amikacin
,11 mg 8' every . hours. After 4 $ays repeat serum creatinineN,.4 mgG$"
!8nitial +as 1.% mgG$"#. >rinalysis at this time +ill reveal:
A. DBC casts
B. Pus cell casts
C. -ne granular casts
D. mu$$y bro+n granular casts
Page 1649
44. A ., yGo male +ith poorly controlle$ $iabetes ha$ renal colic an$ un$er+ent
an 8'P. 7e $evelop oliguria 1 $ay after the proce$ure. Depeat serum
creatinineN..; mgG$" !8nitialN2.; mgG$"#. The risks factors on this patient that
pre$ispose him to $evelop contrast $ye nephropathy are the follo+ing*
HPCHPT:
A. Diabetes
B. Denal 8nsuSciency
C. 8nfection
D. Hl$erly
Page 1647
49. The -n$ings of eosinophiluria in patient +ith acute Denal Bailure is suggestive
of:
A. Acute Allergic 8nsterstitial 2epritis
B. Acute 3lomerulonephritis
C. Acute Tubular 2ecrosis
D. Acute >ric Aci$ 2ephropathy
Page 1649
4;. 5hich of the follo+ing statement is true regar$ing the measurement of 3BD?
A. B>2 overestimates 3BD because urea is reabsorbe$ by the tubules
32
B. erum creatinine is T after ingestion of cooke$ meat
C. Cockcroft@3ault e/uation is similar for both male an$ female
D. 8nsulin clearance is a)ecte$ by both tubular absorption an$ secretion
Page 246-247
91. A patient +ith Chronic Denal Disease an$ 3BD of (1 mlGmin has serum K of ..2
me/G". the elevate$ K is $ue to the follo+ing* HPCHPT:
A. U urinary K
J
e=cretion
B. constipation
C. T $ietary K
J
intake
D. $rugs that U K
J
secretion in tubules
Page 1655
91. A %. yGo female +ith Chronic Denal Disease complains of restless leg
syn$rome. creatinineN,.2 mgG$". Vou shoul$ a$vice the patient to:
A. consult neurologist
B. therapeutic trial of high $ose B. L B12
C. therapeutic trial of phenytoin
D. initiation of Dialysis
Page 1659
92. A (. yGo hypertensive patient serum creatinineN;.9 mgG$" an$ +ith marke$
pallor. The anemia is primarily $ue to:
A. hemolysis
B. U HP6 synthesis
C. bone marro+ suppression
D. 8ron $e-ciency
Page 1658
9%. The most prominent -n$ings in patient +ith nephritic syn$rome is:
A. hypoalbuminemia
B. e$ema
C. proteinuria 0 %., gmG1.4%m
2
D. hyperlipi$emia
Page 1684
9(. A 21 yGo male* smoker +as a$mitte$ because of oliguria an$ hemoptysis.
8nitial lab: revel serum creatinineN9..mgG$". >rinalysis sho+s rbc casts an$
$ysmorphic rbc. !J# anti 3B: AbAs. The e=pecte$ histopathologic -n$ings is
A. thickene$ glomerular basement membrane
B. prominent mesangial $eposits of 8gA
C. crescents formation
D. glomerulosclerosis
Page 1683
9,. Duration of treatment of acute uncomplicate$ cystitis in non pregnant +oman
is:
A. single $ose
B. % $ays
C. 4 $ays
D. 1( $ays
Page 1419@141;
9.. 5hich of the follo+ing is a chronic clinical manifestation of Atherosclerosis?
A. :yocar$ial infarction
B. Cerebrovascular acci$ent
C. u$$en car$iac $eath
D. table e)ort in$uce$ angina pectoris
Page 1(2,
94. Atherosclerotic pla/ue that ate vulnerable to rupture is characteri&e$ by +hich
of the ).?
A. Thick -brous cap
B. "arge lipi$ cores
C. A high content of lymphocytes
33
D. Abun$ance of smooth muscle cells
Page 1(2;
99. 5hich of the follo+ing risk factors is a coronary heart $isease risk e/uivalent?
A. 7ypertension
B. Diabetes :ellitus
C. Dyslipi$emia
D. 6besity
Page 1(%1
9;. The abnormal lipoprotein pro-le associate$ +ith insulin resistance kno+n as
Diabetic $yslipi$emia?
A. 7igh "D" lo+ 7D"
B. 7igh Triglyceri$e* 7igh "D"
C. 7igh Triglyceri$e* "o+ 7D"
D. "o+ 7D"* "o+ "D"
Page 1(%1
;1. :icrovascular angina is a con$ition cause$ by:
A. Abnormal constriction or failure of normal $ilatation of the coronary
con$uctance
vessels
B. 2ormal constriction the coronary resistance vessels
C. Abnormal constriction or failure of normal $ilatation of the coronary
resistance vessels
D. Abnormal $ilatation of the coronary resistance vessels
Page 1434
;1. The ma<or sites of atherosclerotic $isease are the:
A. Con$uctance vessels
B. Desistance vessels
C. Hpicar$ial arteries
D. Hn$ocar$ial arteries
Page 1434
;2. CAD manifeste$ as symptoms of $yspnea* fatigue an$ faintness is kno+n as
A. >nstable angina pectoris
B. Angina e/uivalent
C. table angina pectoris
D. Angina $ecubitus
Page 1435
;%. The typical physical e=amination -n$ings of patients +ith table Angina
Pectoris is:
A. !J# atrial gallop
B. !J# ventricular gallop
C. :itral systolic murmur
D. 2ormal
Page 1436
;(. 5hich of the follo+ing is typical of hypertensive crises?
A. Diastolic bloo$ pressure is 0 1(1 mm 7g
B. 2ormal mental status
C. 8ron $e-ciency anemia
D. 3ra$e 8 fun$us
Page 1480
;,. Class 8 $rug use$ in the treatment of symptoms of patients +ith Chronic stable
Angina pectoris inclu$e +hich of the follo+ing?
A. Dipyri$amole an$ chelation therapy
B. Clopi$ogrel an$ long acting $ihy$ropiri$ine CCB
C. AA* beta blockers an$ 2T3
D. "ong acting nitrates an$ beta blockers
Page1439
;.. tenosis of the left main coronary artery on three vessel $isease in patients
+ith Diabetes :ellitus or severe "' $ysfunction are best treate$ +ith:
A. Tra$itional me$ical management
B. PC8
34
C. CAB3
D. Thrombolysis
Page 1442
;4. To achieve revasculari&ation of the ischemic myocar$ium in patients +ith
asymptomatic 87D an$ suitable stenoses of the epicar$ial coronary arteries*
the best treatment option is:
A. CAB3
B. PC8
C. Thrombolysis
D. "o+ molecular +eight heparin
Page 1442
;9. The most common presenting symptom of patients +ith THD:8 is:
A. Dyspnea
B. Chocking
C. Deep an$ visceral pain
D. 2ape pain
Page 1449
;;. The initial HC3 changes in TH:8 is:
A. T segment $epression
B. ST segment elevation
C. Deep F
D. Tall T +ave
Page 1450
111. 8n +hich of the follo+ing pattern of :8 +ill the use of morphine be restricte$
because of its
vagotonic e)ect?
A. anterior :8
B. antero lateral :8
C. Postero inferior :8
D. :assive :8
Page 1452
35