MCQ RECALL PAPER - OCTOBER 2001

1. A lady with different marriage problems and problems with husband etc had never gone
on holidays:
a. advise them to go for holiday
b. suffering from depression*
c. refer them to marriage counsellor?

2. Tourette’s Syndrome:
a. tics begin at age 21 years
b. always starts below 18 years*

3. The antidote to opioids:

a. Nalaxone*
b. charcoal
c. .

4. 32 year old lady with mastalgia. Conservative treatment failed – next step:
a. bromoceptine
b. danazol*
c. clomephane
d. progesterone
e.

5. Which of the following indicate ovarian tumour rather than ascites:

a. dull laterally, tympanic anteriorly
b. dull anteriorly, tympanic laterally*
c. shifting dullness

6. Déjà vu – found in:

a. frontal lobe lesion
b. brain stem infarct
c. temporal lobe lesion

7. Cause of pneumonia in AIDS:

a. pneumocystis carnii
b.

8. One of the following is a Calcium channel blocker:

9. One of the immature defences:

a. Projection*
10. Picture of hands:
a. rheumatoid arthritis*
b. leprosy

11. Diagram (picture of a lesion on a child):

a. Strawberry naevus*
b. Psoriasis

15: Picture – skin lesion:

a. cellulitis*

16. If the first child in a family has phenylketonuria, what are the chances of the second
child having the same disease?
a. 1 in 3
b. 1 in 2
c. 1 in 4*
d. 2 in 4
e.

17. What is the cause of recurrent sticky eye?

a. Lacrimal duct block*
b.

18. The most common maternal cause of child developmental delay:

19. Iron deficiency occurs in all except:

a. thalassemia minor
b.

20. A male infant with breast development:

a. abnormal
b. precocious puberty
c. normal in infant*

21. All the following are side effects of steroid therapy except:
a. decrease WBC count
b. increase WBC count*

22. The cause of paralysis of only one limb is:

a. front lobe infarct
b. thalamic infarct
c. lacunar infarct*
23. All the following are indicators of thrombolytic therapy except:
a. ECG showing ST elevation
b. ECG normal (no changes)*

24. What you will get with otoscelerosis :

a) normal tympanic membrane
b) usually ruptured tympanic membrane
c) non-functioning eustachian tube.

25. A 23-year old man returned from Bali with watery diarrhoea (no blood). On physical
examination, he is normal. Which organism is the most likely cause?
a) giardia
b) rota virus
c) toxicogenic E.coli
d) cholera.

26. A seven-week old baby is brought to you by his mother. His mother complains that he
has been vomiting intermittently since birth. On examination, you find no abnormalities
except some weight loss. What is your probably diagnosis?
a) UTI
b) Pyloric stenosis
c) Phenylketonuria
d) DI.

27. Genetic transmission of phenylketonuria, which of the following is correct:

a) one in two regardless of sex
b) one is four regardless of sex
c) female will be affected and male will be carrier
d) male will be affected and female will be carrier.

27a. Question about SIADH

27b A child is brought to you with a fever. On examination you find neck rigidity, protein is
1.2, sugar is normal and lymphocyte is 50x10. What is your probable diagnosis?
a) tuberculosis
b) echo virus
c) bacterial meningitis
d) typhoid
e) rhino virus

28. Which carcinoma does not metastasise into the brain?

a) lung
b) liver
c) kidney
d) prostate
e) testes.

29. A patient after a motor traffic accident with a pelvic fracture. Five days after successful
resuscitation, he develops severe dyspnoea. What is your initial management?
a) oxygen inhalation
b) I/V Heparin
c) intubation and ventilation
d) intensive antibiotic therapy.

30. A patient with COPD came into the Emergency Department with severe dyspnoea,
28% O2 8L given by mask. After one hour, you did arterial blood gases and found that PO2
level was 42mm of Hg, PCO2 was 68mm of Hg. What will you do next?
a) increase O2 inhalation by mask
b) ask the patient for intubation and ventilation
c) increase I/V fluid
a) repeat arterial blood gas level after one hour.
31. Undescended testes is related to:
a) torsion of the testes
b) spermatogenesis will be perfect if the operation is done before 3 years of age
c) developmental delay of the child
d) acute epididymitis.

32. One ECG tracing. What is your diagnosis?

a) WPW syndrome
b) inferior MI
c) complete heart block
d) normal tracing
e) anterior MI.

33. You will get erythema nosodum in all the following conditions, except:
a) sarcoidosis
b) bacterial myocardial infarction
c) tuberculosis
d) yersinia
e) rheumatic fever.

34. A chest X-Ray of a child shows consolidation in the left side. What is your probable
diagnosis?
a) streptococci pneumonia
b) mycoplasma pneumonia
c) tuberculous pneumonia
d) aspergillus pneumonia
e) viral pneumonia.

35. A 22-year old woman comes to you with secondary amenorrhoea. On examination you
find LH:FSH ratio increase. What is your diagnosis?
a) PCO
b) primary ovarian failure
c) non-functioning UT
d) endometriosis
e) valvo-vaginitis.

36. How does Microgynon 30 work?

a) in the hypothalamus
b) in the pituitary gland
c) in the ovaries
d) in the Uterus
e) on both ovaries and Uterus.

37. In a patient with acute severe excruciating abdominal pain, which of the following is
least likely:
a) acute MI
b) rupture of aortic aneurism
c) acute appendicitis
d) renal colic
e) mesenteric artery occlusion.

38. For Wernicke’s encephalopathy, what is the appropriate treatment?

a) I/V thiamine followed by glucose
b) oral glucose only
c) I/V glucose.

39. After a splenectomy, you will get all the following except:
a) persistent anaemia
b) normal RBC life span.

40. Neuropathy ulcer in the metatarsal of the foot. What is the most common cause of this
type of ulcer?
a) diabetic neuropathy
b) ischaemic ulcer.

41. All of the following cause facial nerve palsy, except:

a) chronic parotitis
b) cancer of the parotid gland
c) fracture at the base of the skull
d) mastoiditis
e) fracture of the mandible.

42. After peritonial fluid aspiration, you get malignant cells in the fluid. Which of the
following is the most reliable sign in this condition?
a) palpable lymph node in P/R examination
b) supraclavicular lymph node palpable.

43. With ventricular tachycardia, which of the following sign is the successful resuscitation:

a) pupillary reaction to light

b) ECG.

44. The following statements about a panic attack are all true, except:
a) precipitating factor should be avoided
b) 20% occur in the general population
c) it is more likely to occur in females than males
d) preceded by sweating and hyper-ventilation.

45. A primigravida woman’s height is 150cm. At 38 weeks gestation she is in labour. On

pelvic examination, you think that the pelvis is apparently reduced but the cervix is fully
effaced and 4cm dilated. The baby is in the longitudinal position and head is at 0 station.
What is your management plan:
a) trial of labour
b) X-Ray pelvimetry
c) start I/V oxytocin
d) immediate caesarean section
e) wait and see.

46. Which one of the following conditions is most related to colonic carcinoma:
a) melanosis coli
b) ulcerative colitis
c) colon irradiation
d) diverticulosis.

47. (A picture of a big goiter). What is your diagnosis?

a) multinodular goiter
b) Graves disease
c) diffuse goiter
d) thyroid carcinoma.

48. A child can babble, laugh when he looks in the mirror, can roll over and can sit without
support with an arched back. He can also walk with support. Which of the following is the
most consistent with his developmental age?
a) 6 years
b) 3 months
c) 7 months
d) 9 months
e) 12 months.

49. A pregnant woman presents to you at 38 weeks gestation with 1000ml of blood loss
and lower abdominal pain. Which of the following is not indicative of abruptio placenta?
a) foetus dead
b) uterus tense and distended
c) foetal head is high up
d) BP is 180/110
e) Normal pulse rate.

50. All of the following can cause sever hypokalaemia, except:

a) pyloric stenosis
b) chronic renal failure
c) Conn’s disease (primary hyperaldosteronism).

51. In a bed-ridden patient, what is the most common cause of diarrhoea?

a) diverticulitis
b) fecal impaction
c) ischaemic colitis
d) ulcerative colitis.

52. With a diabetic ulcer, what is your appropriate Rx:

a) Amoxicillin + penicillin
b) Ampicillin + Gentamycin + Metronidazol.
c) Flucloxacillin + Gentamycin
d) Ampicillin + Cloxacillin.

53. What is the most common cause of bleeding from the nipple?
a) intraductal papilloma
b) ductal carcinoma
c) Paget’s disease
d) mastitis.

54. A child comes to you with a minor, cleaned, contaminated wound but he doesn’t have
any history of previous immunisation. What is your management plan:
a) Tetanus immunoglobulin
b) TT
c) DTP
d) just clean the wound
e) local antibiotic.
55. What is the cause of unilateral exopthalmos?
a) maxillary antral tumour
b) thyrotoxicosis (Graves disease)
c) simple goiter.

56. After a difficult catheterisation, blood pressure suddenly decreases. What would be
your diagnosis?
a) internal haemorrhage
b) septicaemia
c) pylonephritis.

57. What is the absolute contradiction of OCP?

a) focal migraine
b) varicose vein
c) smoking
d) mild hypertension.

58. After the first delivery in a twin pregnancy, you will do all of the following in the second
delivery, except:
a) external podalic version
b) check the fetal lie
c) check the bleeding
d) check the fetal heart sound
e) check the vaginal laceration/s.

59. How would you treat a bee sting?

a) I/M adrenalin
b) I/V hydrocortisone
c) I/V fluid
d) I/V antibiotic.

60. Which vitamin will be deficient in a breast-fed baby:

a) vitamin A
b) vitamin K
c) vitamin D
d) vitamin B12
e) vitamin E.

61. An eight ( year old obese boy presents to you. On examination, his weight is 48kg,
which is more than the 98th percentile and his height is 140cm, which is more than the
90th percentile. Otherwise all normal. Which of the following is correct in relation to this
boy?
a) advanced bone age
b) increased blood sugar level
c) primary hyperaldesteronism
d) thyroitoxicosis
e) hypothyroidism.

62. A 35-year old lady nullipara wishes to conceive, but has fibroid uterus, bleeding 60ml,
Hb level is 90g/l, O/E ut is boggy to the level of the umbilicus. What is your management?
a) correct the anaemia the myomectomy
b) suppression of the fibroid by GnRH analogue for 3 months the myomectomy
c) hysterectomy
d) hysterectomy & oophorectomy
e) observe 6 months the myomectomy

67. Infective endocarditis: what is the most common organism?

a) staphylococcus aureus
b) streptococci viridans
c) streptococci fecalis
d) coxiella
e) viruses

68. A patient came to you with severe chest pain ECG done but it is normal. What is your
management?
a) Thrombolytic therapy should not be given if ECG is normal
b) discharge the patient for going home
c) I/V heparin and nitrates are contraindicated
d) exercise test is to be done immediately
e) ECG should not be repeated unless pain once again

69. A 22 year old man came to you complaining of snake bite 2 hours before. O/E there is
abrasion in the leg otherwise normal. What is your management?
a) give antivenom
b) observe for 24 hours
c) give an incision and let bleed for 5 minutes
d) clean the wound and give bandage and let him go
e) do nothing

70. A 22 months-old child came to you with respiratory distress, unilateral wheeze.
Previously he was well. What is your management?
a) measure O2 level
b) do an x-ray chest inspiratory and expiratory
c) give antibiotic
d) give bronchodilator

71. A bisexual man diarrhoea for one month, has mouth ulcers, artharalgia, one joint of
hand is painful; 2nd toe pain, ulcers on palms and soles. What is the diagnosis?
a) Reiters disease
b) Behcet’s disease
c) AIDS
d) syphilis
e) reactive arthritis

72. Retinal neovascularization:

a) glaucoma
b) retinal V thrombosis
c) malignant melanoma
d) hypertension
e) Diabetes mellitus

73. 23 year-old girl has abdominal colic, 2 weeks back she had viral infection, perpural
rash. Most probable diagnosis is:
a) ITP
b) Ischaemic colitis
c) Henoch-schonlein purpura
d) glandular fever

74. What differentiates between haemolytic and iron deficiency anaemia?

a) polycythaemia
b) polychromasia
c) normal platelet count

75. Oxytocin:
a) is secreted from ant pituitary
b) acts by enzyme oxynase
c) causes contraction of various involuntary muscles like ut & breast
d) causes contraction of ut only

76. Progesterone can cause AOF expect:

a) mild hypertension
b) amenorrhoea after 3rd injection
c) infertility may occur up to 6 months after stopping
d) breakthrough bleeding

77. In a 65 year-old woman having ovarian tumour and endometrial hyperplasia WOF is
correct?
a) fibroma
b) granulosa cell tumour
c) teratoma
78. A 50 year-old woman came to you with complaint of slight vaginal bleeding. She also
complains that she has amoenorrhoea for 11 months. What is your diagnosis?
a) endometrial carcinoma
b) ca. cervix
c) oestrogenic stimulation of the ovary
d) vaginal atrophy
e) cervical polyp

79. A woman 16 weeks pregnant having hypertension 110/95mm of Hg. proteinurea +++
mild oedema. What is your diagnosis?
a) preclampsia
b) renal hypertension
c) glomerulonephritis

80. 30 year old cystic fibrosis with chest pain treated with nebulised tobramycin th./ DM,
recent weight loss, steathhorrea. Correct management?
a) decreased carbohydrated diet and stabilising glycaemic contro
b) pancreatic enzyme
c) continue nebulised tobramycin for another 3 weeks
d) chest physiotherapy

81. Difficult breathing after penicillin for U.R.T.I has generalised urticaria and blood
pressure 90mm Mg. Correct management?
a) IV I.M adrenalin 1:10,000
b) S.C adrenalin 1:1000
c) I.V. pneumothorax
d) airway assessment
e) 500ml IV colloid

82. Each is important host defence against bacterial meningitis:

a) IgA
b) ciliary activity
c) mucosal epithelium
d) complement
e) IgM

83. Factor least likely to affect prognosis of breast ca:

a) tumour size
b) oestrogen receptor status
c) menopause
d) involvement of axillary lymph node
e) percent 8 cell in s-phase
84. Nephrotic Syndrome commonly caused by EXCEPT?
a) post glomerulonephritis
b) result decrease in plasma volume
 c) plasma cholesterol normal but HDL
d) result in renal salt wasting

85. 37 year-old man with depression presents to emergency, drowsy and aggressive. He
has taken a bottle of doxepin and scotch together. Important management include:
a) admin for ECG monitoring for 4 hours
b) serial doses of charcoal orally
c) do serum paracetamol as the only drug screen
d) as the patient is conscious significant T.C.A. overdose can be ruled out
e) alkalisation of urine will aid excretion of doxepine, and will protect against arrhythmia

86. A fifteen year-old girl presents with fever and painful left forearm two days after her
cat had clawed the arm. There is regional lymph adenopathy present and temperature is
39oC. Which of the following statement is true?
a) the implicated bacterium E.coli
b) most suffer of cat fever are >60
c) complication may include involvement liver, spleen, central nervous system, bowel and
skin
d) ampicillin and cephalosporin are inadequate therapy
e) lympadenopathy in the field of drainage is invariable

87. A 71 year-old woman presents with crushing chestpain, a ECG shown. She is pale and
diaphoretic, peripheral vein. The most likely cause of the hypotension is?
a) chordae rupture causing acute mitral regurgitation
b) S.B.E.
c) right ventricular myocardial infarction
d) second degree AV Block
e) pericardial tamponade

88. Insulin resistance is a complication of on-going insulin therapy requiring increasing

doses. Which of the following is the most common cause?
a) anti-insulin antibody
b) switching from procine to human insulin
c) obesity*
d) the somoguy effect
e) non-compliance

89. Condition that are associated with Lichen planus includes all of the following with the
exception of?
a) primary billiary chirrhosis
b) graft versus host disease
c) chronic active hepatitis
d) amalgam in dental fillings
e) chronic myeloid leukemia*

90. Lipid lowering drugs are a complex group of drugs with a spectrum of side effects.
Which of the following indication is correct?
a) gemfibrozol is indicated for hypercholesterolaemia
b) simvastatin is effective for hypertrigliceridemia
c) fish oils are suite for treating hypercholesterolaemia
d) fluvastatin is effective for combined hypercholesterolaemia and hypertrigliceridaemia*
e) individual without coronary heart disease with LDL-cholesterol lever > 4.5 mmol/l
should not receive such drugs because of side effect profiles

91. Which of the statement concerns infantile spasm is correct?

a) age of onset is usually 18 months
b) they occur less frequent with physical activity
c) ECG is usually normal
d) developmental milestone are unaffected
e) aetiology is frequently idiopathic*

92. A girl infant is brought to your rooms for investigation of abdominal pain manifested by
colic and progressive constipation. Other siblings are well. Which of the following is LEAST
likely to be implicated?
a) lead poisoning
b) hypo thyroidism
c) hirsprung disease
d) hypocalcaemia*
e) infantile botulism

93. Louis, a 5 year-old boy is brought to you for testing his free lead level, which is
significantly elevated. His physical and locomotor examination is completely normal. On
questioning, the parents state that they have recently moved to an old terrace. The initial
most appropriate management would be to?
a) commence decontamination of the house
b) commence a chelating agent
c) commence d-penicillamine for 2-6 months
d) check the free erthrocyte protoporphyrin*
e) check the urinary excretion of lead after administration of calcium EDTA

94. Alf, a 74 year-old man recently admitted for management of respiratory failure asks
about home-oxygen. The following are criteria for long-term continuous oxygen therapy
except:
a) PaO2 <55mmHg
b) O2 saturation <88%
c) treating the Hypoxia associated with the sleep apnoea
d) if the patient has mental impairment oxygen should be withheld for safety reasons
e) congestive heart failure with intractable angina

95. All of the following statements about inflammatory bowel disease are true except:
a) pseudopolyps developing in ulcerative colitis do not become malignant
b) development of fistula between bowel and skin or bladder suggests granulomatous
bowel disease, such as a regional enteritis
c) severe hypotension with fever, leucocytocis and abdominal distention suggests
development of toxic megacolon which usually requires immediate surgery
d) occult bleeding occurs in both ulcerative colitis and regional enteritis but gross bleeding
is more characteristic of ulcerative colitis
e) metronidazole may help to control acute diarrhoea in crohn’s disease

96. Jose, 6 months-old boy is referred back to you by the local hospital where he has
presented several times over three months due to a series of falls at home. The question
of non-accidental injury (child abuse) has been raised. Your initial assessment would
include:
a) developmental milestone assessment
b) a skeletal survey with radiograph of AP CXR, AP Pelvis AP views of extremities, AP
lateral views of skull
c) confrontation of
d) prompt referral to a paediatrician
e) funduscopy

97. William, 13 year-old presents several times over 10 days with a facial abscess that has
not responded to local drainage and oral cephalexin. The next appropriate action would
include:
a) commence flucloxacillin
b) check the blood sugar
c) admit for IV penicillin and flucloxacillin
d) check full blood count
e) question the boy about side effect of cephalexin to assess compliance

98. The management of jaundice patient for 9 days in a 12 day old would include?
a) phototherapy with reassurance to the parent
b) investigation with full blood count, reticulocyte and coomb’s test
c) cessation of breast feeding
d) work up for bacterial infection
e) exchange transfusion

99. Which of the following is a valid reason for hospitalising a psych patient:
a) suicidal threat
b) underlying medical problem
c) when personality is the underlying problem
d) to improve compliance to treatment
e) to adjust psychiatric treatment

100. Petechia seen on the following except?

a) ITP
b) platelet dysfunction due to aspirin overdose
c) chronic liver disease
d) chronic renal failure
e) hypersplenism

101. Screening program is part of medical practice following an accepted procedure in

medical practice:
a) perform rectal exam for prostatomegaly
b) prostate specific antigen
c) annual breast examination by general practice

102. 35 year-old man, fever, myalgia, arthralgia, photophobia, dry cough for 5 days.
Antibotic given 3 days ago, now this patient develops mouth ulcer, erythematosis, macular
papular rash. Full blood count:
a) infectious mononucleosis
b) HIV
c) CMV
d) gonococal infection
e) rubella

103. Assessment of breast lump in 35 year-old woman on a month self-examination:

a) medical examination mammography then re-assure if it not suspicious
b) diagnosis of impapable lesion is best by open biopsy
c) mammography to be checked by radiologist
d) B/c mammography not ideal screening under 50 refer to a surgeon initially
e) USG (real time)

104. With respect to standard clinical standards except”

a) waiting time relative to triage scale
b) hysterectomy in women younger than 35 years
c) attending for CME paint in general practice
d) turn around time for serum kit request for emergency
e) anastomotic break down rates in colorectal surgery

105. Upper quadrant abdominal pain in someone who denies drinking alcohol intake:
ψ Hbe Ag ψ Anti Hbc Igm
Antiψ Hbs Ag ⊕ HCV
AST 620 ALP 170
ALT 303 Tot bil 37
GGT 3000

Most appropriate course of action:

a) refer for liver biopsy
b) check AFP
c) evaluated alcohol intake
d) prefer serology for HBV DNA

106. 4 months-old baby temperature 39.2oC 10 minute prolonged seizure. Immediate

management is?
a) cerebral CT
b) lumbar puncture following CT
c) urinalysis and bacteriology
d) use rectal diazepam
e) advice that febrile convulsion is benign and no medical interference

107. Neonatal sepsis most commonly associated with:

a) A B streptococus haemolyticus
b) E coli
c) group B B strep
d) group D stret
e) S aureus

108. Intusucception:
a) most frequent cause of intestinal obstruction
b) blood stool are invariable
c) woman increased than men
d) abdominal mass 20% (actually 60-90% cases)
e) non operative movements are seldom successful

109. 43 year-old man admit ICU for head injury, early evening hour, He has indwelling
catheter in situ: Na + 132. K+ 3.4 cl*10 MCOs*20 His low urine output due to:
a) pain
b) thiazide diuretic
c) pneumonia
d) delirium tremens
e) head trauma

109. 19 year-old man with genital ulcer presents for reviewing 24 hours following onset
dysuria, pruritus. Otherwise well. The following are applicable:
a) immediate acyclovir, it will decrease likelihood of recurrence
b) doxycycline should be considered
c) P24 Ag test should be performed
d) urethral swab for gonorrhoea
e) HSV is implicated

110. Most common cause of infective endocarditis:

111. Cause of Traveller’s diarrhoea

a) E. Coli

112. In Haemochromatosis there is:

transferrin↑a)
↓b) transferrin

113. Indication of spleenectomy – blood picture given

a) ITP

114. Opening snap in MS proves:

a) mobility of valves

115. Most common site of undescended testis

a) inguinal canal

116. Which one does NOT cause facial N palsy:

a) parotitis
b) parotid cancer – deep lobe

117. Mucosal ulcer + genital ulcer + lymphadenopathy

a) syphilis
b) SLE

118. A child with ‘jittery’ – cause

119. Third heart sound (S3) normal:

a) young children

120. Opening snap – indicates:

a) mobility of valve with MS

121. Sudden syncope – cause

122. Severe pain abd – all causes EXCEPT:

a) Acute appendicitis

122. Inferior infarction shown:

a) leed II, III and aVF

123. Premorbid condition for schizophrenia

a) idea of reference

124. Man with trauma – hospitalised after 3 days – agitated. Cause:

a) alcohol withdrawal

125. Main cause of recurrent abortion?

a) cervical incompetence

126. In chronic pain management

a) regulate dose

127. LH/FSH ratio is reversed with

a) PCO

128. Vaginal – greenish, smelly, secretion in all except:

a) ‘Ca’ endometrium

129. Treatment with progestrone causes:

130. Oxytocin help with all except:

a) production of milk
b) secretion of milk

130. Commonest cause of bleeding PR in elderly

a) ‘ca’ rectum
b) piles

131. Backpain and abd pain + BP:

a) ruptured aortic aneurysm

132. Cause of infective endocorditis

a) strepto viridans (30- )

pCo2 etc = COAD↑133.

O2 and then do ABG↓a)

134. Tension pneumothorax Rx:

a) needle into thorax

135. Resp failure + cor-pulmonale

a) emphyseme (Davidson – 326)
136. Proverb – ‘cognitive’ testing and mental test for:
a) delusion
b) dementia

137. Lady with lower limbs paralysis in a wheel chair:

a) refer to psychiatrist
b) refer to physio
c) refer to ortho

138. Low platelet count

a) intracranial haemorrhage

139. Bone metastasis mostly from:

a) prostate cancer
b) breast cancer

140. Radio nuclear conf:

a) thyroid

141. Normal anion gap?

142. Tumour marker CA125 in:

a) ovarian cancer

142. In hydatid disease following will be raised:

a) B-hCG

143. VWB syndrome – measure:

144. Best test for heparin:

a) INR
b) APTT

144. All are hepatotoxic drugs except:

145. Rx for Wernick’s Encephalopathy:

a) thiamine

145. Desputeryn’s contractive which is correct?

a) Palmar aponeurosis fibrosis

146. Two days after surgery – calf pain

a) angiography
b) doppler u/s

147. Horner syndrome may be present in: Carcinoma lung

148. Tics occurs in:

149. TIA = Ant. Carotid Artery block
150. Frontal lobe – meningioma
151. poisoning small pupil + something = antidote Naloxone
152. low platelets = Intracranial Haemorrhage
153. All give brain mets.:. except from prostate
154. swelling hernia in child disappears Rx= surgery
155. Erysipelas Rx = penicillin
156. high JVP = TR
157. confirmatory diagnosis of MI = clinical history
158. hemorrhoids pt gets a) no pain b) pain
159. Rh-ve mother - ? Rx
160. Narscicist personality disorder definition
161. short height in children all causes except:
162. Rx of Wernicke’s Encephalopathy
163. Diagnosis of ovarian cyst
164. panic disorder treatment
165. cirrhosis with palmar erythema = Ascitis
166. pituitary adenoma Rx=Bromocryptin
167. Pneumonia lower (Rt) lobe
168. HIV Ab in blood appears when ?
169. very small cyst in ovary Rx= call after 4 wks for USG
170. Rheumtic fever Rx =
171. Sarcoidosis diagnosis =
172. Seborrhic dermatosis mainly found on = exposed surfaces
173. Acute cholecystitis
174. Vertebro basillar insufficiency presentation =
175. Anaemia of chronic illness = blood picture
176. Post traumatic stress disorder = diagnosis
177. Asthma at least 2 Q
178. Green paste like nipple discharge diagnosis=
179. Anorexia Nervosa most common =tachycardia..
180. Hep B = becomes chronic
181. VWB disease
182. Dementia ‘definition’
183. Duodenal Ulcer = no anorexia
184. Ectopic pregnancy,pain abdomen, 17 wks all except:
185. UTI in child
186. Fibrosing allergic alveolitis
test GTT↑187. Obesity and height
188. Glomerulonephritis main cause =
189. Carpal tunnel syndrome common in = pregnancy
190. DM autonomic neuropathy= tachycardia
191. DM ulcer = neuropathy
192. Osteolytic malignant hypercalcaemia
193. Normal anion gap disease D/D= renal tubular acidosis
194. Syncope diagnostic description
195. Oedema leg
196. Nephrotic syndrome children
197. Retro orbital pain in 10 yr child main cause =
198. Posterior fossa tumour in children most common one is =
199. Aspirin induced gastritis present as=
200. Mycoplasma pneumonia description given
201. Jaundice ? difference in obstructive & haemolytic
202. Post menopausal bleed most coomon cause= ‘Ca” endometrium
203. Adrenogenital syndrome ?
204. Definition of fistula
205. ACE inhibitor S/E
206. TCA S/E = impotence
207. ischaemic colitis case given
208. Age 7 months = developmental picture
209. Inguinal hernia to differentiate direct or indirect
210. Rx for mastalgia= danazol
211. APH – Abruption placenta all except = BP-180/110
212. Colles Fracture – Pic
213. Infected sebaceous cyst -pic
214. strepto pneumonia in child – pic
215. tinea scalp – pic
216. multinodular goitre – pic
217. supply ant 2/3 of tongue = facial nerve
218. Nasopharyngeal cancer Rx = radiation
219. uncomplicated piles = no pain
220. thought disorder definition
221. conversion reaction case given.
222. Hyponogagic hallucination
a) occurs in normal people before falling asleep

223. Breast cancer – all are precipitating (risk) factors except:

a) artificial menopause
b) history of breast cancer in mother and sister
c) breast cancer in other breast
d) history of cancer in uterine body
e) first child after the age of 35 years
224. Metastatis to brain,all primary site are except:
a) prostate

225. Febrile convulsion

a) occurs in 6 months to 4 yrs of age

226. 12 weeks pregnant woman with the 14 wks size uterus with P/V bleeding – the most
important aspect in follow up:
a) B-HCGT measurement weekly for 1 month
b) contraceptive for 6 months
c) CT scan of lungs and brain

227. In uncomplicated mucosal haemorrhoid, which of the following does not occur:
a) pruritus
b) fresh blood per rectum
c) something coming down per rectum
d) pain the anal region
e) mucous discharge

228. Anti D immunoglobulin should be given to a negative mother in which of the

situation:
a) child born having B+ve blood group
b) must be given within 24 hours of delivery
the chance of immune↓c) one dose given in 2nd trimester reaction in mother
d) to be given to all mother with o-ve blood group

229. 4 yrs old child with early morning headache, which is progressive for the last 6 wks
vomiting
a) posterior fossa tumour
b)

230. A pt presented with vomiting, papilloedema, blurring of vision – diagnosis:

a) Cerebral infarct
b) vertebrobasilar infarct

231. 25 years old man c/o fever, cough (nonproductive) for 3 wks, CXR shown bilateral
diffuse patchy infettrates – diagnosis is?
a) pneumocystis carni
b) mycoplasma
c) strept pneumonae
d) klebiella pneumonia
e) staphylococcul pneumonia
232. A young man presenting with low grade fever, malaise, weakness (generalised) CXR –
bilateral hilar lymphadenopathy – M. tuberculosis

233. A man 30 years of age presented with pleuritic chest pain with fever of 38.8 c o/e –
Rt lower lung field in full on percussion, bad breath round with bronchial breath round over
the dull area of the back side of right chest. Dx in:
a) Rt pleural effusion
b) Rt sided consolidation (lower lobe)
c) Rt lower lobe collapse
d) lung car

230. All of the following can happen in ulcerative colitis except:

a) Erythema nodosum
b) pericholangitis
c) peripheral neuropathy
d) episcleritis
e) seronegative arthritis

231. Erythema nodosum – does not occur in:

a) streptococcal infection
b) rheumatic fever
c) sarcoidosis
d) yersenia infection
e) fungal infection

232. An infant with diarrhoea which of the following is the cause in convulsions:
a) serum sodium 156 mmol/L
b) serum sodium 126 mmol/L
potassium↓c)
HCO3↑d)

233. 67 year-old man developed abdominal pain, bloody diarrhoea. Exam shows – pulse
108/m; BP-90/50 mm g crepitation in lung base, P/R shows – blood in the rectum:
a) diverticular disease
b) Ca colon
c) mesentric artery occlusion
d) haemorrhoid

234. Carpal tunnel syndrome in pregnancy, which one of the following is the correct
response:
a) diuretic treatment
b) surgical intervention
c) splinting of the hand in mid extension position
d) immediate termination of pregnancy
e) ACE inhibitor

235. Which one of the following is not found in autonomic neuropathy in a diabetic patient?

a) urinary retention
b) urinary frequency
c) bradycardia
d) constipation
e) nocturnal diarrhoea

236. A 6 year-old child has fever 40oC. CXR showing (Picture given) Rt lower lobe
consolidation:
a) H influence
b) S pneumonae
c) viral
d) mycoplasma pneumonae
e) …

237. Causes of hypokalemia except:

a) pyloric
b) hyperaldosteronism
c) CRP
d) chronic use of purgatives

238. Causes of proteinuria except:

Rhematoid arthritis
Diabetes mellitus

239. Definition of fistula

243. D & C is most appropriate in

a) before stating normal therapy for menoochigie
b) cervical incompetence in 10% cases
c) diagnosis and evaluation of postcoital bleeding
d) indicated for post menopausal bleeding

240. a woman with mastalgia that has failed to respond to other conservative measure,
the appropriate therapy would be:
a) medroxy porgesterone
b) danazol
c) stilbesterol
d) bromcroptine
e) diethyl estradiol

241. Which of the following is indicated for primary dysmerocibvrea except:

a) paracetamol
b) bromocriptine
c) mefenamic acid
d) OCP
e) indomethacin

242. A 35 year old lady with galactorrhea has a pituitary adenoma which is in 3mm of
optic chaisma had a prolactin level of 2500 U/L. Which of the following is the most
appropriate initial management:
a) transfrontal surgery
b) transphenoidal surgery
c) bromcriptine
d) danazol

243. Regarding oxytocin

a) secreted from amt pituitary
b) has antidiuretic effect
c) is a steroid hormone
d) formed by the enzyme oxytocinase
e) stimulates all involuntary muscles

244. Causes of acute pancreatitis except:

a) mumps
b) alcohol
c) cholelithiasis
d) islets all tumour

245. Tourette disorder

246. Impotence causing drug:

a) gilibenclamide
b) metformin
c) TCA
d) benzodiazepine
e) Ace inhibitor
(70 year old man taking Glibeaclemide with Mefforman for diabetes. Also taking ACE
inhibitor for TCA with benzo and TCA for depression)
246. Déjà vu is found in which of the following?
a) temporal lobe lesion
b) frontal lobe lesion
c) occipital lobe lesion
d) brain stem infarct

247. 28 year old man presenting with a right inguinoncrotal swelling Dx:
a) direct inguinal hernia
b) hydrocele
c) varicocele
d) testicular tumour
e) spermatocide

248. A mother brought her 1 year old child with the c/o of a swelling which she noticed 2
days ago but now there is no swelling on examination. The most appropriate action would
be:
a) referral for surgical intervention

249. In fat embolism which of the following is true?

a) peteche in the upper half
b) peteche in the whole body
c) peteche in the dependent part
d) peteche in the palm and sole
e) peteche in the lower part of the body

250. Hepatotoxic drug except

a) chlorpromazine
b) paracetamol
c) OGP
d) halothane
e) warfarin

251. Diabetic patient with ulcer over the 3rd metatarsal head, wof in the course
a) microvasular disease
b) neuropathy
c) ill fitting shoe
d) infection

252. Hereditary sphescocytosis, wof does not occur after splenectomy – except:
a) osmatic fragility
b) anaemia persistence
c) normal life span of RBC
d) presence of spherocytes in PBF
253. 29 year old man with 6 months h/o crampy abd pain, mucoid stool after food,
specially after breakfast, incomplete passage of bowel, his weight was normal. Dx is?
a) ca rectum
b) ca colon
c) LBS
d) Chronic amoebiasis

254. 68 year old man with vomiting, passage of food particles and ed appetite, weight
loss. He has a h/o duodenal ulcer 8 years back ↓vomitus. which was treated with
cimetidine, currently he takes aspirin for pain. Dx in:
a) gastric & duo ulcer
b) gastritis
c) ca oesophagus
d) ca cardia

255. A picture of multinodular goitre

256. A picture of a kin lesion (malignant) on the domain of the hand
257. A picture of colles #
258. A picture of scalp (T.capitiol Alopecia areata)

259. 17 weeks gestation with rt illiac fossa pain except:

a) red degeneration of fibroid
b) acute appendicitis
c) UT1
d) Ectopic pregnancy
e) ?

260. Newborn with cataract, jaundice, two of his brothers/sisters had same problem.
Diagnosis?
a) rubella embryopathy
b) galactomaemia
c) glaucoma (congenital)
d) toxoplasmosis
e) CMV infection

261. Newborn baby of 1 week is found in the cot with cyanosis tachypnea. There was no
palpable murmur, pulse palpable. Diagnosis is?
a) TOF
b) hypoplastic left heart
c) PDA
d) tramparition of great vessel with USD

262. Amniocentesis of 16 weeks. All of the following can be diagnosed except?

a) Down’s
b) cystic fibrosis
c) spina bifida
d) TOF

263. First step of management of a asphyxiated newborn:

a) O2 by face mask
b) pharyngeal aspiration
c) endotracheal intubation
d) I/V glucose
e) naloxone

264. 9 days old neonate with vomiting, dehydration.

Invest – Na 120 mmol/L
K 7.7 mmol/L
M63 30 mmol/L

Diagnosis:
a) congenital hypothyroidism
b) neonatal diabetes
c) pyloric stenosis
d) congenital adrenal hypoplasia

265. WOF is not caused by Hi Pylori:

a) gastric cancer
b) duodenal ulcer
c) gastric-oesophageal reflux
d) antra cancer
e) gastritis

266. A patient had been treated with anti H. pylori regimen. Which of the following is the
proper test to evaluate effectiveness of proper therapy?
a) serology
b) urea broth test
c) biopsy
d) serum gastrin
266. A 30 year old man was brought to the emergency dept with depressed respiration,
pin pointed pupil. Only history is taking a I/V unknown drug. What is the right measure to
reverse his acute condition?
a) atropine
b) physostigmine
c) naloxone
d) naltraxone
e) thiamine
267. In the resuscitation procedure of a patient with cardiac arrhythmia with arrest, wof is
the right thing to assess the response to Rx?
a) femoral pulse
b) radial pulse
c) skin circulation
d) size and reaction of pupil
e) urinary output

268. In wof ca. colon is most likely to develop:

a) diverticulitis
b) Crohn’s
c) ulcerative colitis
d) ischaemic colitis
e) radiation introitus

269. Least likely to happen in anorexia nervosa:

a) amenorrhoea
b) bradycardia
c) lanugo hair
d) flight of idea
e) denial
270. A man of 35 years always think himself someone special, grandiose ideas, self
shameless attitude about his honour:
a) obsessive compulsive personality disorder
b) histrionic personality disorder
c) narcissistic personality disorder
d) borderline personality disorder

271. Panic attack without agoraphobia?

272. In fibrosing alveolitis, wof is not true:

a) clubbing
b) inspiratory crackles
c) mild hypoxemia
d) normal FEV, 1 FVC ratio excludes diagnosis
e) restrictive lung function

273. A man with bilateral wasting of the small muscles of the hand:
a) multiple sclerosis
b) GB syndrome
c) cervical spondylitis
d) cervical rib
e) syringomyelia

274. A new born baby after delivery by mid forceps was unable to move height hand –
diagnosis:
a) brain haemorrhage
b) Erb’s palsy
c) cephalohaematoma

275. A patient treated with heparin, wof do you check to monitor therapy?
a) APTT
b) INR
c) Prothrombin time

276. A patient with von willbrand’s disease has been bleeding profusely. Which test do you
perform?
a) APTT
b) Bleeding time
c) INR

277. A female patient with dysuria, frequency of urine, fever was found to have leucexytes
100/HPF with ecoli of 100,000/ml and treated with antibiotics. After treatment repeat urine
shoed normal report:
a) IVU
b) cystoscopy
c) MCV
d) repeat c/s of urine
e) treat in future if only develop symptoms

278. Pseudodementia:
a) schizophrenia
b) depression
c) conversion disorder
d) alcohol
e) drugs

279. A 28 year old female has the h/o enuresis up to the age of 13 years. Now developed
BP of 140/90 mm of Hg. Her two sisters had these type of problems:
a) reflux nephropathy
b) horseshoe kidney
c) post streptococcal x.n
d) congenital nephritis
280. Short stature is associated with wof except:
a) CAH
b) Precocial puberty
c) obesity

281. A 7 year-old boy often completing immunisation developed progressive weakness

with loss of reflexes. Diagnosis:
a) G B syndrome
b) poliomyelitis
c) encephalitis
d) subdual haematoma

282. A 65 year-old lady occasionally develops unilateral weakness of the body with
unilocular loss of union. Diagnosis:
a) vertebrobasilar insufficiency
b) carotid artery stenosis
c) brain stem infarct
d) Wernke’s
e) extradural haematoma

283. WOF becomes chronic:

a) hepatitis A
b) hepatitis B
c) hepatitis C
d) hepatitis D

284. In wof disease, amylodosis is not associated:

a) rheumatoid arthritis
b) chr active hepatitis
c) tuberculosis
d) leprosy
e) gluocoma

285. An old lady of 70 years developed lethargy, confusion, constipation for the last 4
months. Before that period she was alright. Investigations revealed:
s.calcium 2.88 mmol/L
s.phosphate N
urinary calcium - N

a) primary hyperparathyroidism
b) osteolytic bone lesion
c) idiopathic hypercalcemia
d) Paget’s disease

286. A child with ankle oedema, puffy face, wof does not occur? (protenuria +++ )
lipid is inversely proportional to albumin↑a)
b) focal and regimental glomerulsclerosis
c) response to steroid in 90% cases
d) penicillin prophylaxis

286. A 50 year-old patient is on treatment with hydro chloro-thiazide with B blocker for 10
years. He is obese and recently developed polyuria with thirst. RBS was 17 mmol/L with no
ketonuria. WOF action would be appropriate?
a) GTT
b) withdrawal of drugs with review
c) weight reduction
d) insulin
e) sulphonyluria

287. An elderly patient (hypertensive) developed atrial fibrillation, transephogphageal echo

showed echogenic shadow is found in the atrium. Wof action would be appropriate?
a) aspirin
b) warfarin
c) cardioversion
BP↓d)

287. longevity in M1 patients:↑Wof does not

a) streptokinase
b) aspirin
c) ACE inhibitor
d) B blockers
e) nifedipine

288. In which of the following situations, gamma globulin does not work:
a) varicella
b) mumps
c) hepatitis A
d) hepatitis B
e) rabies

289. Aim of surgical Rx in morbid obesity (except)

length of satiety centre↑a)
b) reduce calorie intake
banal metabolic rate↑c)
290. A pregnant lady at 16 weeks of pregnancy develops proteinuria (+++), proteinuria,
BP –140/95 mm of Hg. Wof might be the case:
a) pre-eclampsia
b) pre-existing renal disease

291. Hutchison’s melanoic freckle – not true:

a) irregular margin
b) irregular surface
c) elderly people
d) occurs in underclothing area

292. A young man when lifting in last 2 occasions developed syncope. His father died
suddenly with same problem. wof test most useful:
a) ..
b) angiography
c) ECG
d) supine with resting BP measurement
e) CXR

293. A woman taking injectable progesterone. wof is not side effect?

a) mid HTN
b) irregular menstruation
c) depression
d) weight gain

294. Pseudo-dementia

295. Haemolysis with acute blood picture

296. Anion gap

297. Pseudodementia

298. Mammography

AMC MCQ recall-paper October 2001

Medicine
1.A 18 yrs old lady came with hypertension. She has a history of enuresis up to 13 years.
WOF is the most likely diagnosis?
a) Reflux nephropathy
b) Hypertension
c)

2. Erythema nodosum can occur in all of the following condition except

a) streptococcal infection
b) TB
c) Rheumatic fever
d) SLE
e) Leprosy

3.A picture of scalp with hairless round area

a) Tinea capitis

4. A picture of hand with scaly shiny things on it

a) Psoriasis

5.How can we monitor heparin?

a) INR
b) APTT (activated partial thromboplastin time)
c) Fibrinogen

6.A pt with von Willbrand’s disease . What is the most likely she has
a) Prolonged bleeding time

7.A 62 yr old man has a long history of COPD and dyspnoea, blood gas showed pCO2 68
mm Hg pO2 60 mmHg. He was given28% O2 therapy. After an hour the blood gas showed
7.37, pO2 80mm of Hg and pco2 40 mm of Hg but the pts clinical condition didn’t
improved. WOF IS NEXT THERAPY
a) Bronchodilator
b) Hydrocortisone
c) Intubations and ventilation

8.ABOUT AMYLOIDOSIS all of them are associated except

a) Leprosy
b) TB
c) Multiple myeloma

9. On 3rd postoperative day serum Na+ 165 mmol/L and urine osm is 250.wof is the cause

a) Thiazide diuretic too high

b) DM
c) Diabetes insipidus
d) SIADH
e) ?
10. Where can you find fat embolism
a) Whole body
b) Upper part of the body
c) depending sites of the skin
d) ?

11.WOF nerve supply the anterior 2/3rd of tongue?

a) Facial nerve
b) Hypoglossal N (XI)

12.WOF IS THE SIDE effect of Ca-channel blocker?

a) Angio-oedema
b) Peripheral edema

13.WOF IS NOT THE SIDE EFFECT OF prednisolone?

a) Leucopoenia
b) leukocytosis

14.How would you differentiate between hemolytic anemia and anemia of chronic blood
loss?
a) Decreased heptoglobulin
b) Raised ferritin

15.A pt with COPD and polycythaemia. What is the best measure you can take to reduce
his attendance to the hospital?
a) Home O2 therapy
b) Phlebotomy

16.A 55 yr old women come to you with the complaint of tremor. Her hands are shaking
when she answered the phone but it stopped when she look at her hand. On examination
you found coarse tremor in resting. What is the most appropriate Rx?
a) Benzihel
b) Propranolol
c) levadopa

17.What is the cause of diarrhea in a bed-ridden pt

a) Ulcerative colitis
b) Facial impaction
c) ischaemic colitis

18.A pt with 1.8 cm tumor in the pituitary and 3mm on optic chiasm. What is the initial Rx
a) Transfrontal resection
b) Transphenoidal resection
c) Bromocriptine

19.A pt with H/O intermittent diarrhea, urethral discharge culture is negative, he has
ulcers in the mouth and arthritis and he has sausage shaped 2nd toe. What is the most
likely Dx

a) Reiter’s ds
b) Behet’s ds

20. A pt with miosis and ptosis. What is the most likely cause?
a) Bronchogenic Ca
b) Carotid sinus thrombosis

21.A60 yr man is taking thiazide diuretics and other hypertensive drugs, now found serum
glucose level is high what would be the management
a) Stop the drug and check the serum level again
b) GTT
c) Starting antidiabetic drug for diabetes

22. A 23-year-old lady came with complain of dysuria. You give antibiotic. After a week she
is completely symptom free. What will you do next?
a) Check the urine
b) Give some prophylactic antibiotic
c) Give nothing until she has got any problem

23.Indication of operation in aortic stenosis in a pt with pressure gradient 55% WOF most
likely
a) Ejection fraction
c) ?

24. A pt comes with swelling in the periorbital region and feet. Urine examination shows
red cell cast. What is the most likely Dx

a) Glomerulonepritis
c) ?

25.In Aborigine and Torres state islander all of the following can be present except

a) Depression
b) Anxiety
c) Alcohol abuse
26. What is the most common cause of the infective endocarditic?
a) Staphylococcus aerious
d) ?

27. A 23 yr old lady come with progressive weakness over both hands and wasting. WOF
will be the most likely Dx
a) Multiple sclerosis
b) Syringomyelia
c) ?

28. Regarding immunology, WOF statement is correct?

a) killer cells are T- subsets and kill tumor cells

b) B cells produce first IgM and later IgG
c) IgM need the help of complement

29. In case of heamochromotesis WOF IS the most important to make the Dx

a) Serum iron
b) ?

30. All of them could be the cause of proteinuria except?

a) Glomerulonephritis
b) Polycentric kidney
c) Horse shoe kidney

31. A lady with a H/O headache, she wakes up from the sleep at the same time every day.
What would be the most likely the preventive Rx for her?
a) Methyl sergide
b) ?

32. A man came from ‘Bali’ he has got watery diarrhea. What is the most likely cause?
a) E. coli
b) Salmonella
c) Shigella

33. A pt came with bee sting and has got anaphylactic reaction. What would be the most
likely the immediate management?
a) Adrenalin
b) Hydrocortisone
c) ?

34. Which type of hepatitis most likely become chronic?

a) Hep A
b) Hep B
c) Hep c
35 WOF should use immuglobinal injection except
a) Mumps
b) Varicose
c) ?

36. WOF Ca metastasizes to the brain except

a) Breast
b) Lung
c) Melanoma
d) Prostate
e) Renal

37. 20 YO male lift heavy thing over his head and scope twice the next step
a) Holter monitoring
b) X-ray
c) BP
d) Ultra sound of the heart

38. WOF acidosis with normal anion gap

a) Aspirin

39. WOF metastases to brain except

a) Breast
b) Lung
c) Renal
d) Melanoma
e) Prostate

40 HIV (+) what does it mean

a) Salivary spreading
b) He/she will get life long infection and infertility
c)

41WOF are diabetes auto neuropathy

a) Impotency
b) Bradycardia
c) Urinary retention
d) Diarrhea

42 diarrheas for 2 years

a) Cohn’s disease
b) Ulcer disease
c) Viral
d) ?

43VW (Vonwillebrands) factors

a) Prolong bleeding
b) ?
c) ?

44 anemia with MCV>110 (70 yo) lady blood picture HB 9.9 WBC 2.2 109 plates dropped
a) Intestine infection
b) Pernicious anemia
c) AML
d) Autoimmune hemorrhagic anemia

45 CSF with normal glucose lymph cytes 100

a) Herpes virus
b) ECHO virus
c) Bacteria

46 WOF are true about duodenal ulcer except

a) Hunger pain
b) Loss of appetite
c) Weight gain

47. A man with pleuretic chest pain and cough. There are no breath sounds in the right
lower zone, but bronchial breathing is noted in the right middle zone.WOF is most likely
a) Right lower lobe consolidation
b) Right lower lobe collapse
c) Pleural effusion
d) Right pneumothorax
48. WOF can cleancelly cause hypo K except
a) Diuretics
b) Chronic kaxiture abuse
c) Pyponic stenosis
d) Hyper aldodemia
e) Chronic renal failure

49 All can cuse drug induced hepatic damage except

a) Halothane
b) Paracetamol
c) Cabamamazpine/chlorpromazine
d) Warfarin
e) Oral contraceptive
GYNOCOLOGY-2001 OCT

1. About twin delivery, after the delivery of 1st baby you will do all of them except
a) Palpate another baby
b) Per vaginal exam
c) Look any blood come out
d) Do a external version in case of breech
e) ?

2.A 32 weeks pregnant lady with herpes infection. What is not correct
a) Do caesarean section at term
b) ?
c) ?
d) ?

3 A 32 WEEKS PREGNANT lady with motor vehicle accident came to you. On examination
you some laceration on her abdomen otherwise she is normal. You will do all of them
except
a) Immediate delivery of the baby as she may have abruptio placentae
b) ?
c) ?
d) ?

4 In abruptio placenta WOF is not correct

a) Abdomen tender
b) Painless bleeding
c) ?
d) ?
e) ?

5 A 14 YR old girl with phenytoin. She came to you for ocp .WOF IS MOST APPROPRIATE
a) Microgynon 30
b) Microgynon 50
d) Diane 35

6 About oral pill in which level it act

a) Pituitary
b) Hypothalamus
c) Ovary
d) Eudiometry

7.About oxytocin
a) It has an antidiuretic effect
b) ?

8. Absolute contraindication of OCP

a) Thrombophlebitis
b) Migraine with hemiplegic aura
c) smocking
d) Diabetes

9. What is the most dangerous sign of CTG

a) Acceleration due to contraction

b) Decelerations due to sleep
c) Very regular heart beat (variation less than 5)

10. A lady with 8 wks pregnancy passing some hydropic mole through the vagina. What
would be the most likely management?

a) Measure HCG regularly until it becomes negative

b) ?
c) ?

11. A pregnant lady comes with 17 weeks pregnancy with bleeding per vagina.
WOF is the least likely

a) Ectopic pregnancy
b) ?
c) ?

12. A 8 weeks pregnant lady come with vaginal bleeding. You will do USG due to all of the
following reason except
a) To see the cause of bleeding
b) To determine the gestational age
c) To see the foetal malformation (molar pregnancy),
d) the position of the sac in the uterus
e) check the viability of the fetus

13. A LADY DELIVERED a still born baby. WOF you will not do to confirm dx
a) post mortem of the baby
b) ?
c) ?
14. A women who has previously delivered a 4kg baby with troublesome delivery. She is
para –2 and gravida 3. You should do all of the following except

a) Do x-ray pelvimetry
b) Induction of labour in 37-38 weeks
d) Do caesarean section at term
e) Check blood glucose level regularly from 30 weeks

15. A pt come with 16 week pregnancy, she has high blood pressure180/120 with
protinuria, what is the most likely cause

a) She has pre existing renal disease

c) She may have multiple pregnancy
d) ?

16. A 19 year old primi 38 weeks gestation with hyper reflexia, hypertension and oedema
might be expected to have the elevated blood levels except
a) Uric acid
b) Creatinine
c) Platetate
d) SGOT
e) BUN

17. A LADY CAME WITH VAGINAL BLEEDING after 2yrs of menopause WOF is diagnosis
a) Atrophic vaginitis

18 Short stature pregnant lady with 38 weeks, what is next step

d) X-ray
e) Cesarean

19 A girl with abdominal pain. US examination showed 3 cysts in the right ovary with 2, 3
and 4 cm
b) Observe and 4 week repeat US
c) Reassuring
d) Laporescopy
e) Aspiration

20. No bleeding after withdrawing contraceptive pills would be due to

a) Ovary
b) Uterus
c) Pituitary
d) Hypothalamus
21.a pt forms a solid tumour which was solid, uterine curettage shows endometrium
hyperplasia. What is the cause?
a) cyst
b) teratoma
c) dysgerminoma
d) granulosa cell tumor

22. Effect of progesteron on kidney in pregnancy

a) relax only ureter
b) relax both pelvis and ureter
c) ?
d) ?

23. All of the following could be cause of greenish foul smell discharge except
a) trichomoniasis
b) gardenella
c) FB
d) Cervical cancer
e) ?

24. A primigravida 38 wks in labour. On P/V pelvis was reduced. Station 0 cervix 4 cm
dilated, membrane intact
a) x-ray pelvimetry
b) C/S
c) Oxytocin
d) Continious trial labour
e) ?

25.a mother of 3 child has mastalgia. She is not responding usual treatment. Next
appropriate treatment
a) OCP
b) Danazol
c) Bromocriptine
d) ?

26. a37 weeks pregnant painful vaginal bleeding (1000ml blood loss). WOF is not
consistent with abruptio placentae
a) Foetal death
b) BP 110/80
c) Uterus firm and contract
d) Fetal head high in presentation

27. a pt who has difficulties with pregnancy. She lost her 3 pregnancy in 6, 8, 10 weeks.
Before that she had terminate 2 baby at 10 and12 wks. What could be the cause
a) cervical in competence
b) deficient luteal phase

28. find out in correct association with pregnant lady which cause foetal effect on
pregnancy
a) IUGR- anticardiolipin
b) platelet count 100,000 – intracranial haemorrhage
c) heart block –antibody

29.25 yr old women galactorrhoea and amenorrohoea. CT scan shows 3mm on optic
chiasma. Prolactin >1500. Best Rx
a) transfrontal
b) transphenoidal
c) bromocriptine
d) OCP
e) Clomiphene

30. a lady 3 days after giving birth become irritable and tearful. WOF is correct
a) seen in at least 50%
b) not occur inC/S pt
c) ?

31. A women came to you 2 yrs after menopause asking for treatment to reduce the
postmenopausal symptom. HRT oestrogen 1st28days and progestrogen 12.
You are explaining all except
a) she will have premenstrual like symptom
b) will have withdrawal bleeding in every month
c) will reverse the action of progesterone
d) progesterone will increase HDL MORE THAN OESTROGEN
e) progesterone will augment the action ofoestrogenfor prevention of osteoporosis

32. Primary dysmenorrohoea all true except

a) bromocriptine
b) indomethacine
c) mefenamic acid
d) OCP

33.. pregnancy with group B streptococcus. Which is not true

a) infection in 32 wks is absolute indication forC/S
b) CAN LEAD TO NEONATAL MENINGITIS
c) Can lead to neonatal infection
d) ?
34.pregnancy with carpal tunnel syndrome
a) become better as pregnancy
b) treatment with siling and arm elevation
c) required surgery
d) ?
e) ??

35. pregnant women wake up at night due to pain tingling and numbness in rt hand . WOF
the cause
a) carpal tunnel syndrome
b) ulnar palsy
c) brachial palsy

36. 26 year old nulliparous recently married. Wants baby complaining of severe
menorrhagia. O/ESWELLING IN THE ABDOMEN UPTO UMBLICUS
a) total hysterectomy
b) open myomectomy after correcting her anaemia with BT
c) ?
d) ?

37. cleft lip in 2nd child what is the chance

a) 2%
b) 3-5%
c) 25%
d) 9%

38.Rh(-) mother Rh(+) baby

a) good result if given in 2nd trimester

39 a baby is brought by his parents. They think he is OK and no other abnormities except
he weight 98% and height 95%, he is most likely to have
a) increase bone age
b) increase blood glucose
c) increase auto

PEADIATRICS

1. A 2 YEAR OLD boy with minimal contaminated cut injury he didn’t immunised before
what is the most likely treatment
a) T.T (Tetanus toxoid
b) DPT
c) TIG
d) Antibiotics
2. A 2 YEARS OLD BOYCAME WITH UNILATERAL WHEEZE . from amc book
a) Foreign body

3. A chest x-ray of pneumonia

a) Mycoplasma
b) Streptococcus A
c) ?

4. A boy can roll over, can prone to supine and hold his head. He bounches in supported
standing. He laughs and babbles. What is the age
a) 3 month
b) 7 month
c) 10month

5. What is normal in a new born baby

a) Hypertrophy of clitoris
b) Engorgement of breast

6. A baby with jitteriness which will be the immediate management

a) Serum glucose level
b) ?
c) ?

7. A 3 yrs old boy with hip pain. WOF is the most likely cause?
a) Perth’s ds
b) Tenosynovitis

8.A 8 wks baby with intermittent vomiting WOF most likely cause
a) Urinary tract infection
b) Pyloric stenosis

9. A 9 week old baby with force full vomiting his serum k 7.7
a) Pyloric stenosis

10. All of the following could be the cause of aneamia in infancy except
a) Prematurity
b) Multiple pregnancy

11. A boy with weakness of both leg he has a history of viral fever without reflex WOF Dx
a) Gillian Barrie syndrome
b) ?

12.A boy was bitten by a 1 meter long black snake WOF management
a) Observation
b) Antisnakevenom and apply tourniquet
c)

12. Baby fails to thrive

a) Parents deletion
b) Environment

13. Convulsion
a) Hyper Na
b) Hypo Na
c) Hyper K
d) Hypo K
e)
14. A child with multiple subperiostial hamotoma and calcification
a) Scurvy
b) Accidental injury
c) Unacidental injury
d) Osteomyelitis

15. A boy can’t see blackboard L8/20, R 10/20. He can see the letters on the screen of PC.
After wearing holeglasses sight improves
a) Myopia
b) Amblyopia
c) Astigmatism

16. A child was born normally WT3.2 kg. Apger score was 5 in 1 min and 8 in 5 min. He
has delayed development. WOF condition is associated with his developmental delay?
a) Paternal uncle has intellectual deficit
b) Father is a alcoholic
c) Sister has febrile seizure
d) Mother has 2 café’s lait spots
e) Paternal grandmother has hypothyroidism
PSYCHIATRY

1. About mental health act WOF IS correct

a) Identical in every state
b) May be life saving
c) ?
2.what is the prodormal feature of schizophrenia?
a) Idea of reference
b) Unemployment
d) Dysfunctional parenting

3.hypnagogic halucination WOF correct

a) It can happen in normal sleep
b) ?
c) ?

4.about diagnosis of tourette disorder all of the following are essential except
a) tic’s bou 3-4times a day
b) pt does not distress by tics
c) always start before the age of 18
d) ?

5.WOF is the distinguishing feature of schizophrenia and acute organic brain syndrome
a) Difficulty in sustaining attention
b) Fluctuation disturbances of consciousness
c) Visual hallucination
d) Auditory hallucination

3. What is the best prognostic feature of schizophrenia?

a) Presence of affective disorder

7.all of the following cause of serotonine syndrome

a) Haloperidol
b) Clonazepam
c) Moclobomide
d) Dextrometherphan

8. A bank manager was robbed 3 wks ago WOF MOST LIKELY

a) Out burst of anger
b) Depression
c) Panic attack
d)

9. A man is saying, “ Wheat is good for health. Wheat 5 types. What is the do
a) Confabulation
b) ?
10 Déjà vu can be seen commonly in WOF lobe
a) Tempo
b) Front
c)

11 The parents of an adopted girl, who has schizophrenic coming to ask about the chance
of their genetic daughter getting schizophrenia. WOF answer you would give
a) Nil
b) Less than 2%
c) 10%
d) 30-40%

12. 35 female comes to you with history of menorrhagia and anxiety. Recently she feels
her husband is detached from her and her is not close to him as she used to be. She has 2
children living in a rented house and brought all household things on higher purchase and
they have to pay it off regularly. They cannot afford to go out together for a dinner. Exam
normal. What is your next step management?
a) Refer her to a psychiatrist
b) Send her to marriage consoling
c) Have a interview with her husband
d) Advise to have a holiday
e) Refer to a gynecologist

13. WOF is right

a) Postpartum blues predispose to postpartum psychosis
b) More than 50 of women suffer from postpartum blues
c) She requires anti-psychotic medication
d) Requires ECT

14. Narcissistic personality

15. 36 YO bus driver complain he can’t sleep at night apart from the driving stress. You
notice that the driver drinks 6 can beer and 10 cups of coffee weekly. What is next step
a) Tell him to go on sickness break
b) Treat for sleep apnea
c) Prescribe diazepam
d) Tell him to cut down on alcohol and change to different coffee.
e) Tell him nothing needs to be changed ?

Surgery

1The most common cause of blood fluid from nipple of breast is

a) Intraductal papiloma
b) Breast Ca
c) Trauma
d)

2 The most likely for a male (22 YO) ingurino-scrocal swelling with swelling disappeared on
lying down

e) Direct inguinal hernia

f) Varicocoele
g) Saphaena varix
h) Lymphoma

3 Contacted dermatitis except

i) avoiding antigen
j) Steroid IV
k) Don’t use steroids
l)

4 WOF not related with breast Ca

a) Contras breast Ca
b) Family history
c) Uterine Ca
d) Artificial menopause
e)

5.The most likely for a breast with toothpaste and nipple retracted
m) Breast ca
n) Pages’ disease
o) Mammary duct dysphasia
p) Papillary

4. (picture) a lesion on the back of hand)

a) Malignant skin cancer
b) infected solar keratosis
b) keratoacanthoma
c) ?
5. The goals of surgery for mobility of obesity are all the following except
a) Reduce energy
b) ?
c) ?
d) ?

9. 50 YO female acute abdominal pain for half day, the most likely diagnosis is
a) Omentum arterial vessel blocking
b) ?
c) ?
d)
10. Hutchinson melanoma freckle except
a) covered area
b) irregular edges
c) ?
d) ?

11. (picture) a big neck swelling

a) goiter
b) Graves

12. (x-ray) tibia and fibula opening fracture

a) debridama internal fix
b) If no contaminations, debridma is unnecessary
c) External fix
d) Close cut to prevent further infection
e) Anti tenustoids + antibiotics

13 (picture) Colles fracture. What is the most likely complication?

a) malunion
b) Wrist stiffness
c)
14. (Picture) figures deformation
a) Rumatoid arthritis
b) Contracted tendon
c) ?

15. (ECG) ECG preoperative exam

a)LBBB
a) RBBB
b) WPW
c) ?

16.A spinal L4,5 slipped disc produces

a) Absent ankle jerk
b) Lost of dorsiiflexion
c) Loss of sensation on the medial calf
d)

17 After falling injury, X-ray showed pelvic injury and blood clots at external urinary
meatus. WOF are appropriate
a) Flory catheter
b) IVP
c) Tap
d) Urethrography

18. Undescended testis in children is most commonly associated with

a) Infertility
b) Indirect inguinal hernia
c) Malignancy
d) Torsion

19. The most common tumor to metatarsals to bone is

a) Stomach
b) Ovarian
c) Breast
d) Rectum
e) Colon

20 A diabetic with heel ulcer. The cause is

a) Blood vessel
b) Infection
c) Peripheral never
d)

21 Management of Wernick syndrome with low plasma sugar should be

a) IV 5% glucose
b) Vit B1 and then 5% glucose
c) ?
d) ?

22. The advantage of mammography is

a) Painless
b) Early detection than self examination
c) ?

23. Fistula
a) Two opening between

24 A patient with acidic urine WOF most