Nash Qbank

Q.1. One of the following does not cause hypokalemia?

A:

Metabolic alkalosis

B:

Furosemide

C:

Hyperaldosteronism

D:

Acute tubular necrosis

Q.2. What anatomical structure or landmark lies just above the midpoint of the inguinal ligament?

A:

Femoral artery pulse felt

B:

McBurney’s point

C:

Stellate ganglion

D:

Deep inguinal ring

Q.3. Child presented with jaundice, vomiting, hepatomegaly etc. Which hepatitis virus is more likely to be the cause?

A:

A

B:

B

C:

C

D:

D

Q.4. Child newly diagnosed with asthma and allergy to dust mite. What will you advise the parents?

A:

Advice to remove all the carpet and rugs

B:

Cover his bed and pillow with impermeable covers

C:

Wash the clothes and linen in hot water

D:

Humid house with 80 % humidity

Q.5. True regarding ischemic heart disease?

A:

Prevalence is the number of case discovered yearly

B:

Incidence is new cases yearly

C:

There is association between HTN & ischemic heart disease

D:

Smoking is an absolute cause of IHD

Q.6. Women complains of non-fluctuated tender cyst in the vulva. Came with pain during coitus & walking, diagnosed Bartholin’s cyst. What is the treatment?

A:

Incision & drainage

B:

Refer to surgery for excision

C:

Reassurance

D:

Give Antibiotics

Q.7. Which of the following is appropriate method to prevent brucellosis?

A:

Killing the vectors

B:

Prophylactic antibiotics

C:

Pasteurization of the milk

D:

Maintain hygiene

Q.8. Patient presents with high blood pressure (systolic 200), tachycardia, mydriasis (dilated pupils), sweating. What is the toxicity?

A:

Anticholinergic

B:

Sympathomimetic drug

C:

Tricyclic antidepressant

D:

Organophosphorous compounds

Q.9. 27 year old man has asymmetric oligoarthritis involving knee & elbow associated with painful oral ulcers for 10 years. What is the diagnosis?

A:

Behcets disease

B:

SLE

C:

Reiters disease

D:

Ulcerative colitis

Q.10. A 3 year old boy is brought to A&E after having a generalized tonic-clonic seizure that lasted approximately 5 minutes. The parents say that he was previously well but started developing symptom s of a cold earlier in the morning. He is noted to have a fever of 39 C. What is the most likely diagnosis?

A:

Infantile spasms

B:

Absence seizures

C:

Febrile convulsion

D:

Partial complex seizure

Q.11. What's the high risk for developing colon cancer in young male?

A:

Smoking, high alcohol intake, low fat diet

B:

Smoking, low alcohol intake, high fat diet

C:

Red meat diet, garden’s disease (Gardner syndrome)

D:

Inactivity, smoking

Q.12. A 2 year old has atrophy of the buttocks. He has often had bloating of his abdomen with frequent offensive, smelly stools that are difficult to flush. He looks pale on examination. What is the most appropriate initial investigation?

A:

Sweat chloride test

B:

Anti-endomysial antibodies

C:

Upper gastrointestinal endoscopy

D:

Colonoscopy

Q.13. A 6 week old child is brought to A&E with persistent non-bilious vomiting. The child feels hungry and wants to feed despite constant vomiting. Biochemistry shows K+ of 3.1 mmol/L. What is the most likely diagnosis?

A:

Pyloric stenosis

B:

Duodenal atresia

C:

Tracheo-oesophageal fistula

D:

Malrotation

Q.14. Secondary amenorrhea occurs due to?

A:

Due to gonadal agenesis

B:

Sheehan’s syndrome

C:

It is always pathological

D:

Local cause

Q.15. Patient came with pitting edema grade 1. Where is the fluid accumulated?

A:

Capillary

B:

Interstitial

C:

Lymph space

D:

Muscle space

Q.16. Female presented to ER with HCL burn on her face, there was partial thickness burn. What's the management?

A:

Irrigation with water

B:

Irrigation with soda bicarb

C:

Immediate debridement

D:

Topical antibiotics

Q.17. A 4 month old child is brought to Accident & Emergency by her parents. She is found to weigh 4.1 kg. She presents with multiple bruises on her left and right lower leg. Her left ankle is swollen and she refuses to move it. She appears irritable and she also has a runny nose. What is the most likely diagnosis?

A:

Haemophilia

B:

Thrombocytopenia

C:

Non-accidental injury

D:

Osteogenesis imperfecta

Q.18. Newborn with 300 bpm, normal BP, normal RR. How will you manage this newborn?

A:

Cardiac Cardiversion

B:

Verapamil

C:

Digoxin

D:

Diltiazem IV

Q.19. All are the causes of weight loss, except?

A:

AIDS

B:

Cancer

C:

Hypothyroidism

D:

Kwashiorkor

Q.20. Most difficult method to prevent transmission?

A:

Person to person

B:

Vector

C:

Droplet

D:

Air-borne

Q.21. 42 year old in his normal state of health presented with decreased visual acuity bilaterally without any defect in visual field. His VA in Rt eye= 20/100, VA in Lt eye=20/160, fundoscopic exam showed early signs of cataract with irregular pigmentations. No macular edema or neovascularisation. What is the appropriate action beside antioxidants and Zn?

A:

Refer the patient for emergency laser therapy

B:

See the patient next month

C:

Refere the patient for cataract surgery

D:

No need to do anything

Q.22. 48 year old man with pyloric stenosis presents with severe vomiting comes to the hospital, there is marked dehydration, and the urine output 20 ml/hour. HCT 48, BUN 64mg, HCO3 –33mEq/l, Cl 70 mEq/l, and K 2.5 mEq/l. What's the predominant abnormality?

A:

Metabolic acidosis

B:

Hypochloremic alkalosis

C:

Salt-losing enteropathy

D:

Intrinsic renal disease

Q.23. A city with 1500 persons, 105 births, 5 are stillbirths, 4 die at first month, 2 die before age of one year. What's the perinatal mortality?

A:

4

B:

5

C:

6

D:

8

Q.24. What's the most lethal injury to the chest?

A:

Pneumothorax

B:

Rupture aorta

C:

Flail chest

D:

Cardiac contusion

Q.25. Paediatric patient from a developing country presented with muscle wasting, weight loss without oedema. What is the diagnosis?

A:

Marasmus

B:

Kwashiorkor

C:

Muscle wasting syndrome

D:

Nutritional deficiency

Q.26. 73 year old patient, a farmer, comes complaining of dry eyes. He is smoker for 20 years and smokes 2 packs/ day. What do you advice?

A:

Advise him to exercise

B:

Stop smoking

C:

Wear sunglasses

D:

Prescribe eye drops

Q.27. An 8 year old child is brought into A&E with a fractured leg. The parents are unable to explain how the leg fractured. X-rays reveal several other fractures in various stages of healing. The parents cannot explain what might have caused them. On examination, the child has a blue sclerae and difficulty hearing. What is the most likely diagnosis?

A:

Osteogenesis imperfecta

B:

Non accidental injury

C:

Haemophilia

D:

Achondrogenesis

Q.28. 3 months old child presented with low-grade fever & wheezing. CXR shows hyperinflation and some infiltrate. What’s the diagnosis?

A:

Croup

B:

Epiglottitis

C:

Bronchial asthma

D:

Transient tachpnea of newborn

Q.29. A child presented with sore throat and fever. She had history of impetigo and was resolved completely during an appropriate course of antibiotic, ASO titer was positive. The same antibiotic was prescribed for her present condition. What is the duration of the course?

A:

5 days

B:

7 days

C:

10 days

D:

14 days

Q.30. Patient complains of opposite eye moving laterally when he covers the one eye. What is the cause?

A:

Strabismus

B:

Amblyopia

C:

3 rd nerve palsy

D:

6th nerve palsy

Q.31. What is the antidote for organophosphorus poisoning?

A:

Atropine

B:

Physostigmine

C:

Neostigmine

D:

Pilocarpine

Q.32. A 2 year old male presents to the Emergency Department with a left-sided reducible firm swelling near the groin. The swelling descends when the child cries. On examination, both testicles are palpable in the scrotum. What is the most appropriate management?

A:

Reassurance

B:

Elective herniotomy

C:

Emergency herniotomy and orchidopexy

D:

Elective herniotomy and orchidopexy

Q.33. A 37 year old man has a nonhealing ulcer on the skin of the right medial malleolus. Which lymph node is likely to be involved?

A:

Axillary lymph nodes

B:

Pre-aortic lymph node

C:

Inguinal lymph node

D:

External iliac lymph nodes

Q.34. A boy was bitten by his brother, has laceration 1 cm. He took TT shot 6 months ago. You cleaned his wound. What will you do next?

A:

Give Augmentin

B:

Suture the wound

C:

Give booster tetanus shot

D:

Send home with close observation and return in 48 hours

Q.35. A 30 year old lady comes to the emergency department with palpitations and chest pain. ECG shows sinus tachycardia. Her pulse rate is 110 beats/minute. She has a history of asthma and her GP recently changed her medications. What is the most appropriate management?

A:

Atenolol

B:

Review medications

C:

Lidocaine

D:

Labetalol

Q.36. 15 year old boy with dark urine, dark brown stool, positive occult blood. What is the next appropriate step?

A:

Abdomen ultrasound

B:

CBC

C:

Barium scan

D:

Isotope scan

Q.37. Patient exaggerates his symptoms when people around. What is it called?

A:

Somatization

B:

Malingering

C:

Bipolar affective disorder

D:

Attention seeking syndrome

Q.38. Regarding screening for cancer, which of the following is true?

A:

Screening for cervical cancer has decreased in recent years

B:

Screening for breast cancer has decreased in recent years

C:

Screening for Colorectal cancer is inadequate for the high-risk groups

D:

Screening for lung cancer has reduced the mortality rate of lung cancer

Q.39. A 5 year old boy is brought to clinic by his mother. The young boy has a distinct nasal speech and snores heavily at night. He is hyperactive during the day but has poor concentration. He is noted to be constantly breathing through his mouth. What is the most appropriate action?

A:

Arrange hearing test

B:

Assess developmental milestones

C:

Refer to ENT surgeon

D:

Arrange a magnetic resonance imaging scan

Q.40. What's true about Delusion?

A:

Perception of sensation in absence of an external stimulus

B:

Misinterpretation of stimulus

C:

False belief not in accordance of a persons culture

D:

History of hallucinations present

Q.41. A 2 year old male presents to the Emergency Department with a left-sided reducible firm swelling near the groin. The swelling descends when the child cries. On examination, both testicles are palpable in the scrotum. What is the most appropriate management?

A:

Emergency herniotomy

B:

Elective herniotomy and orchidopexy

C:

Elective herniotomy

D:

Reassurance

Q.42. A 24 year old man presents to A&E after an injury to his hand while playing basketball. Examination of his hand reveals an avulsion of the extensor digitorum tendon from the distal phalanx. What is the most likely deformity?

A:

Dinner fork deformity

B:

Gamekeeper thumb

C:

Mallet finger

D:

Gunstock deformity

Q.43. What's the best food during travelling?

A:

Boiled water

B:

Cooked meals

C:

Packaged food

D:

Partial cooked fish and meat

Q.44. All of the following antihypertensive medications are considered safe for short term use in pregnancy except?

A:

Captopril

B:

Methyldopa

C:

Hydralazine

D:

Nifedipine

Q.45. Blood culture shows gram negative rod shaped organism that grows only on charcoal free. What is the organism?

A:

Staph. Aureus

B:

Chlamydia

C:

Klebsiella

D:

Mycoplasma

Q.46. A 6 month old boy is admitted with persistent irritability. He is lethargic and is not feeding well. He has a temperature of 38.2 C, a capillary refill time of 2 seconds and a respiratory rate of 34 breaths/minute. A urinalysis reveals leukocyte esterase positive and nitrite negative. What is the investigation most likely to lead to diagnosis?

A:

Blood culture

B:

Chest X-ray

C:

Ultrasound

D:

Urine culture and sensitivity

Q.47. Male patient has hair loss started from fronto-temporal area and moving toward the vertex (top of the head). What is the diagnosis?

A:

Androgenic alopecia

B:

Tinea Capitus

C:

Fungal infection

D:

Alopecia acreta

Q.48. 43 year old female patient presented to ER with history of paralysis of both lower limbs and parasthesia in both upper limbs since 2 hours, she was seen lying on stretcher & unable to move her lower limbs. A neurologist was called but he couldn't relate her clinical findings to any medical disease. When history was taken, she reports physical abuse by her husband. What's the most likely diagnosis?

A:

Complicated anxiety disorder

B:

Somatization disorder

C:

Conversion disorder

D:

Psychogenic paralysis

Q.49. What is the most important factor in the development of spinal headaches after spinal anesthesia?

A:

The level of the anesthesia

B:

The gauge of the needle used

C:

The closing pressure after the injection of tetracycline

D:

Its occurrence in the elderly

Q.50. Which of the following combination is safe?

A:

Diclofenac and Nitrofurantoin

B:

Digoxin and Amiodarone

C:

Warfarin and propranolol

D:

Furosemide and gentamicin

Q.51. Clonidine decreases the effect of?

A:

Benzotropin

B:

Levodopa

C:

PPI

D:

Amitriptyline

Q.52. A 1 day old male infant has developed abdominal distension, bilious vomiting and meconium ileus was present. Prenatal ultrasound had previously revealed echogenic bowel. Which of the following is the most likely diagnosis?

A:

Duodenal atresia

B:

Cystic fibrosis

C:

Hirschsprung disease

D:

Malrotation and volvulus

Q.53. A 48 year old man with renal cell carcinoma had radiotherapy for metastatic spinal cord compression at the 11th thoracic vertebra 4 weeks ago. He has retained sensation of his legs but is unable to stand due to muscle weakness and pain. He has pain around his lower trunk which is relieved by regular oral morphine however he has been increasingly distressed due to his painful muscle spasms on his right leg. What is the SINGLE most appropriate management to treat his symptoms?

A:

Amitriptyline

B:

Fentanyl patch

C:

Gabapentin

D:

Baclofen

Q.54. A 12 year old boy attends A&E with pain after falling off his bicycle. A lateral X- ray of his wrist shows a fracture at the distal radius with the distal fracture fragment displaced anteriorly. What is the most likely diagnosis?

A:

Dinner fork deformity

B:

Colle's fracture

C:

Gunstock deformity

D:

Garden spade deformity

Q.55. A 7 year old boy falls on his right hand with the arm extended. He has severe pain around the elbow. X-ray imaging showed a supracondylar fracture of the humerus. The distal fragment is displaced posteriorly. What is the most likely structure to be damaged?

A:

Anterior ulnar recurrent artery

B:

Posterior ulnar recurrent artery

C:

Brachial artery

D:

Ulnar artery

Q.56. A paediatric patient brought by her parents complains of vaginal discharge, what is the cause?

A:

Foreign body

B:

Gonorrhea

C:

Bacterial vaginosis

D:

Candida infection

Q.57. A 3 month old infant presents with recurrent infections and feeding difficulties. His face looks dysmorphic and has a cleft palate. A chest X-ray shows absent thymic shadow. What is the most likely diagnosis?

A:

Down’s syndrome

B:

Fragile X syndrome

C:

DiGeorge syndrome

D:

Edward’s syndrome

Q.58. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

A:

Pelvic fracture

B:

Femoral shaft fracture

C:

Bursitis

D:

Femoral neck fracture

Q.59. Patient needs central venous line for TPN, doctor orders to give 2 units of packed RBCs and the nurse gave it through CVL, after 2 hours patient become unconscious and comatose. What is the cause?

A:

Late complication of blood transfusion

B:

Electrolyte imbalance

C:

Hypocalcemia

D:

Septic shock

Q.60. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

A:

Pelvic fracture

B:

Femoral shaft fracture

C:

Bursitis

D:

Femoral neck fracture

Q.61. What is the Sodium amount in Normal Saline [ 0.9% NaCl ]?

A:

75 mmol

B:

90 mmol

C:

154 mmol

D:

200 mmol

Q.62. During blood transfusion, the patient developed fever and pain at the infusion site. What's your action?

A:

Slow infusion + antibiotic

B:

Slow infusion + acetaminophen

C:

Stop infusion + crystalloid fluid

D:

Stop infusion+ monitor + acetaminophen

Q.63. A 31 year old female with known gallstones undergoes a cholecystectomy. Unfortunately, she continues to have pain, and her liver function tests suggest an obstructive jaundice. An ERCP is performed which demonstrates a calculus lodged in the second part of the duodenum. What is the most likely place that the stone was lodged?

A:

Hepatopancreatic ampulla

B:

Cystic duct

C:

Accessory pancreatic duct

D:

Common hepatic duct

Q.64. The drug which is used in seizures of eclamptic origin?

A:

Magnesium sulfate

B:

Diazepam

C:

Phenytoin

D:

Phenobarbital

Q.65. Shoulder pain is most commonly due to?

A:

Infraspinatus muscle injury

B:

Referred pain due to cardiac ischemia

C:

Acute cholecystitis

D:

Rotator cuff injury

Q.66. What's the action of progestin only contraceptive pills?

A:

Suppresses ovulation

B:

Increases cervical mucus

C:

Associated with increased incidence of breakthrough bleeding

D:

May cause menorrhagia

Q.67. Which one of the following is a component of TOF?

A:

ASD

B:

VSD

C:

Left ventricular failure

D:

Co arctation of aorta

Q.68. A 32 year old man on psychiatric medications complains of the inability to ejaculate. What is the most likely medication he is taking?

A:

Lithium

B:

Haloperidol

C:

Chlorpromazine

D:

Fluoxetine

Q.69. A 4 year old girl attends clinic with a history of diarrhoea, bloating and abdominal pain. She is failing to thrive. Blood tests reveal a hypochromic microcytic anaemia. Alpha gliadin antibodies are positive. What is the most likely diagnosis?

A:

Pernicious anaemia

B:

Crohn’s disease

C:

Ulcerative colitis

D:

Coeliac disease

Q.70. Mother who is breast feeding, wants to take MMR vaccine. What is your advice?

A:

Can be given safely during lactation

B:

Contains live bacteria that will be transmitted to the baby

C:

Stop breast feeding for 72 hrs after taking the vaccine

D:

Contraindicated in lactation

Q.71. Before giving influenza vaccine, you should know if the patient allergy to which of the following?

A:

Sea food

B:

Egg

C:

Penicillin

D:

None

Q.72. Patient has urethritis now presented with left knee pain, urethral swab shows positive pus cell but negative for Neisseria meningitidis and chlamydia. What's the diagnosis?

A:

Rheumatoid arthritis

B:

Reiter's disease

C:

Gonococcal infection

D:

Septic arthritis

Q.73. What is the best diagnostic test for maxillary sinusitis?

A:

CT scan

B:

X ray

C:

Biopsy

D:

MRI

Q.74. A 5 month old child is unable to speak but makes sounds. She can hold things with her palm, but not with her fingers. She smiles and laughs and is not shy. She cannot sit independently but can hold her hand and sit when propped up against pillows. What is the best development stage to describe this child?

A:

Delayed speech and language development

B:

Delayed fine motor development

C:

Delayed gross motor development

D:

Normal

Q.75. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

A:

Pelvic fracture

B:

Femoral shaft fracture

C:

Bursitis

D:

Femoral neck fracture

Q.76. Patient with hypertension, renography showed right kidney 14 cm left kidney 7 cm. Arteriogram shows left renal artery stenosis. What's the confirmatory test?

A:

MRI

B:

Renogram

C:

CT scan

D:

Biopsy

Q.77. An old man undergoing brain surgery is on aspirin. What does he need prior to surgery?

A:

Vitamin K parenterally

B:

Vitamin K orally

C:

Delay surgery for 2 days

D:

Delay surgery for 1 week

Q.78. Paraplegia patient with ulcer in lower back 2x2 cm with loss of dermis and epidermis. What is the stage of ulcer?

A:

I

B:

II

C:

III

D:

IV

Q.79. A 2 year old male presents to the Emergency Department with a left-sided reducible firm swelling near the groin. The swelling descends when the child cries. On examination, both testicles are palpable in the scrotum. What is the most appropriate management?

A:

Emergency herniotomy

B:

Elective herniotomy and orchidopexy

C:

Elective herniotomy

D:

Reassurance

Q.80. 70 year-old man fell on outstretched hand. On examination both radial and ulnar pulses intact with dinner fork deformity. Tender radial head. What is the diagnosis?

A:

Fracture of distal ulna & displacement of radial head

B:

Fracture of shaft of radius with displacement of head of ulna

C:

Colle’s fracture

D:

Spiral fracture

Q.81. A 7 year old child is brought in by her mother with complaints of having a fever, sore throat and feeling unwell. She has a maculopapular rash on her trunk and back which appeared a few hours ago. On examination of the throat, there is a white coating on the tongue and tonsils have pale exudates. She has a temperature of 39 C. What is the most likely diagnosis?

A:

Roseola infantum

B:

Scarlet fever

C:

Parvovirus B19

D:

Rubella

Q.82. What is the most important factor in attempt of successful cessation of smoking?

A:

The pharmacological agents used in the smoking cessation program

B:

The smoker’s desire to stop smoking

C:

Frequent clinic follow ups

D:

Family support

Q.83. 100% O2 given for prolonged period can cause all except?

A:

Retrosternal Pain

B:

Seizures

C:

Depression

D:

Ocular Toxicity

Q.84. What's the normal daily caloric intake?

A:

0.3 kcal/kg

B:

1.3 kcal/kg

C:

2.0 kcal/kg

D:

35 kcal/kg

Q.85. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

A:

Pelvic fracture

B:

Femoral shaft fracture

C:

Bursitis

D:

Femoral neck fracture

Q.86. Which of the following describes the end of early inflammatory phase?

A:

Formation of scar

B:

Formation of ground base of collagen

C:

End of angiogenesis

D:

Suture the wound

Q.87. Normal pregnancy in the 2nd trimester is characterized by all of the following EXCEPT?

A:

Elevated fasting plasma glucose

B:

Decreased fasting plasma glucose

C:

Elevated postprandial plasma insulin

D:

Elevated postprandial plasma glucose

Q.88. Which of the following would most likely indicate a haemolytic transfusion reaction in an anesthetized patient?

A:

Severe chills and muscle spasm

B:

Bleeding and hypotension

C:

Fever and oliguria

D:

Hyperpyrexia and hypotension

Q.89. What's the most serious symptom of CO poisoning?

A:

Hypotension

B:

Arrhythmia

C:

Cyanosis

D:

Seizures

Q.90. What is the mode of inheritance of Adult Polycystic kidney?

A:

Autosomal dominant

B:

Autosomal rescessive

C:

X linked Dominant

D:

None

Q.91. A 33 year old man had fall on his outstretched arm. He is tender over the distal radius with no scaphoid tenderness. There is no obvious deformity on clinical examination. X-ray reveals a non-displaced distal radial fracture. Analgesia was given. What is the most appropriate next step in management?

A:

Wrist splint

B:

Below elbow backslab

C:

Full plaster of Paris

D:

Reassure

Q.92. Young boy presented to the ER with inguinal mass, pain and vomiting. O/E the mass is tender to touch, erythematous skin over scrotum, (blue dotes) in the pole of testis, intact cremasteric reflex. What's the diagnosis?

A:

Testicular torsion

B:

Testicular hematoma

C:

Incarcerated hernia

D:

Incarcerated hernia

Q.93. What does the vasoconstriction property of nasal decongestant cause?

A:

Rhinitis sicca

B:

Rebound phenomena

C:

Nasal septal perforation

D:

Dryness

Q.94. A lady who's a computer programmer developed bilateral tingling sensation of hands, +ve tinel test. Management includes splintage of both hands in which position?

A:

Hyperflexion

B:

Extension

C:

Abduction

D:

Dorsiflexion

Q.95. What is not true about hypokalemia?

A:

ST changes

B:

Hyperosmolar non ketotic state

C:

PR changes

D:

All are true

Q.96. Which drug is contraindicated in Acute cholecystitis?

A:

Naproxen

B:

Acetaminophen

C:

Morphine

D:

Diclofenac

Q.97. Parents of a 2 month old baby are worried about cot death as their close friend recently lost their infant to sudden infant death syndrome (SIDS). She comes to you asking for advice on the best method to reduce her infant’s risk of SIDS. What is the SINGLE most appropriate advice to give in regards to sleeping position and bedding?

A:

Place baby in a prone position and at the middle of the cot to sleep

B:

Place baby on his back with his feet at the foot of the cot to sleep

C:

Place baby on his back and at the head end of the cot to sleep

D:

Sleep with baby on bed by your side

Q.98. Patient with cystic nodule (acne) and scars. What is the best treatment?

A:

Retinoin

B:

Erythromycin

C:

Doxycyclin

D:

Clindamycin

Q.99. A 6 week old child is brought to A&E with persistent non-bilious vomiting. The child feels hungry and wants to feed despite constant vomiting. Biochemistry shows K+ of 3.1 mmol/L. What is the most likely diagnosis?

A:

Pyloric stenosis

B:

Duodenal atresia

C:

Tracheo-oesophageal fistula

D:

Achalasia cardia

Q.100. What's the most common cause of chronic interrupted rectal bleeding?

A:

Diverticulosis

B:

Hemorrhoids

C:

Angiodysplasia

D:

Anal fissure

Q.101. A 3 year old child is brought to the emergency department by his mother with bruises and swelling over the medial aspect of the left arm. The mother gives a history of her son falling down the stairs a few hours ago. Bruises on the child’s back and left chest are seen on examination. X-ray of the chest shows multiple callus formation in the ribs. Analgesia has been given. What is the most appropriate next step?

A:

DEXA scan

B:

Involve social services

C:

Skeletal survey

D:

Serum calcium

Q.102. What is the most common cause of precocious puberty?

A:

Idiopathic

B:

Functional ovary cysts

C:

Ovary tumor

D:

Brain tumor

Q.103. What is the most common cause of otorrhea?

A:

Cholesteatoma

B:

Acute otitis media

C:

Leakage of cerumen

D:

Eustachian tube dysfunction

Q.104. A 7 year old child is brought in by her mother with complaints of having a fever, sore throat and feeling unwell. She has a maculopapular rash on her trunk and back which appeared a few hours ago. On examination of the throat, there is a white coating on the tongue and tonsils have pale exudates. She has a temperature of 39 C. What is the most likely diagnosis?

A:

Roseola infantum

B:

Measles

C:

Scarlet fever

D:

Rubella

Q.105. A 12 month old male infant presents to clinic because his mother is concerned that the child cannot sit on his own, crawling but not standing with support, unable to pick up small items, and is not socially interactive with his older sibling. What is the best management?

A:

Arrange hearing test

B:

Assess developmental milestones

C:

Reassure

D:

MRI brain

Q.106. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

A:

Pelvic fracture

B:

Femoral shaft fracture

C:

Bursitis

D:

Femoral neck fracture

Q.107. A newborn Apgar score is 3 (cyanotic, limp, decrease breathing, HR less than 60). What's your action?

A:

Volume expansion

B:

Atropine

C:

Ventilation

D:

Oxygen

Q.108. 48 year old woman presented with right abdominal pain, nausea & vomiting. On examination she has tenderness in the right hypochondrium. Investigations showed high WBC count, high alkaline phosphatase & high bilirubin level. What's the most likely diagnosis?

A:

Acute cholecystitis

B:

Acute appendicitis

C:

Perforated peptic ulcer

D:

Acute Pancreatitis

Q.109. A 9 year old girl, known case of asthma, presents to the Emergency Department with a 1 day history of shortness of breath that is increasing in severity. She had a previous upper respiratory tract infection 1 week prior which had resolved. Chest x-ray reveals bilateral hyperinflation. On arrival, she was given oxygen, nebulized beta-2 agonist, and oral prednisolone. She is now drowsy, respiratory rate is 30 and her SpO2 is 90%. Which of the following is the most appropriate investigation?

A:

Arterial blood gas

B:

Pulse oximetry

C:

Spirometry

D:

Peak flow meter

Q.110. An 8 year old boy is brought by his mother to the emergency department with bruises on his lower back and a left shoulder dislocation. The child currently lives with his stepfather. The young boy is quiet and makes no eye contact while in conversatikon. What is the most likely diagnosis?

A:

Non accidental injury

B:

Malnutrition

C:

Thrombocytopaenia

D:

Osteogenesis imperfecta

Q.111. All of the following are signs of malignant thyroid except?

A:

Irradiation to the head and neck

B:

Fixity to tissues

C:

Multiple nodules

D:

Axillary lymph nodes

Q.112. A 10 month old male infant presents with a 6 hour history of crying and passage of loose, bloody stool. On examination, the infant is irritable, with intermittent drawing up of his knees to his chest, and a temperature of 38.8 C. A currant jelly- coloured blood is seen in his stools. What is the most likely diagnosis?

A:

Constipation

B:

Intussusception

C:

Gastroenteritis

D:

Meckel’s diverticulum

Q.113. A 33 year old man suffered a mandibular fracture and now has loss of sensation over the chin and mucosal surface of the lower lip. Which nerve is most likely to be involved?

A:

Mandibular nerve

B:

Inferior alveolar nerve

C:

Buccal nerve

D:

Facial nerve

Q.114. A 12 month old male infant presents to clinic because his mother is concerned that the child cannot sit on his own, crawling but not standing with support, unable to pick up small items, and is not socially interactive with his older sibling. What is the best management?

A:

Arrange hearing test

B:

Assess developmental milestones

C:

MRI brain

D:

Reassure

Q.115. A male presented with headache, tinnitus and nausea, he thinks he has a brain tumor. He had just secured a job in a prestigious company, he thinks that he might not meet its standards. CNS exam, CT all normal. What is the diagnosis?

A:

Generalized Anxiety disoreder

B:

Hypochondriasis

C:

Conversion reaction

D:

Panic attack

Q.116. What's the best investigation to visualize cystic breast masses?

A:

FNAC

B:

CT

C:

Mammogram

D:

USG

Q.117. 9 year old female presented to ER after ingestion of almost 20 tablets of OCP and 3 tablets of another medication. She is clinically stable and there were no signs and symptoms. What will you do?

A:

Refer her to gynecologist

B:

Refer her to psychiatrist

C:

Toxicology study

D:

No need for intervention

Q.118. A 56 year old man whose pain was relieved by oral Morphine, now presents with progressively worsening pain. Increasing the dose of oral morphine helps to relieve his pain. However, he now complains that the increased morphine makes him drowsy and he is unable to carry out his daily activities. What is the most appropriate next step?

A:

Replace oral morphine with oral oxycodone

B:

Replace oral morphine with oral tramadol

C:

Patient-controlled analgesia (PCA)

D:

Intravenous fentanyl

Q.119. Child came to ER because of asthma attack and when you advice father about not smoking in the home he seems not interested. What will you do?

A:

Inform child protection

B:

Ignore the father and focus on treating the child

C:

Inform hospital authorities

D:

You have no right to advice the father

Q.120. Complication of laparoscopic cholecystectomy are all except?

A:

Bile leak

B:

Persistent pneumoperitonium

C:

Shoulder tip pain

D:

Ascites

Q.121. What's the maximum dose of ibuprofen per day?

A:

800

B:

1600

C:

3000

D:

3200

Q.122. Patient got pulmonary TB and treated accordingly. After treatment developed liver failure and is admitted to ICU. Son gets angry and wants to sue the doctor alleging medical negligence. What is your response?

A:

Tell him that can happen to anybody

B:

Complaint to the hospital management

C:

Calm him down and tell him the case will be investigated

D:

Explore his anger

Q.123. In a study they are selecting the 10th family in each group, what is the type of study?

A:

Systemic study

B:

Non randomized study

C:

Stratified study

D:

Non Systemic study

Q.124. A 2 year old boy presents to the Emergency Department with painless rectal bleeding for the past 2 days. On examination, the child is afebrile, tachycardic, alert, playful, and feeding well. Abdominal examination was normal. Which of the following is the most likely diagnosis?

A:

Intussusception

B:

Ulcerative colitis

C:

Hirschsprung disease

D:

Meckel’s diverticulum

Q.125. Parents came with their son who was recently diagnosed with lung disease, doctor informed the parents that now he will explain the case to them, go through management and then he will answer their questions. What is technique is the doctor using?

A:

Probing

B:

Agenda setting

C:

Para phrasing

D:

Safe netting

Q.126. 20 year old man sustained a deep laceration on the anterior surface of the wrist. What does the median nerve injury cause?

A:

Claw hand

B:

Wrist drop

C:

Sensory deficit only

D:

Inability to oppose the thumb to other fingers

Q.127. A 13 month old female baby presents to the emergency department with dificulty in breathing. On examination, she has intercostal recessions and a bilateral widespread wheeze. Her temperature is 37.9 C and respiratory rate is 35 breaths/minute. What is the most likely diagnosis?

A:

Bacterial upper respiratory tract infection

B:

Pneumonia

C:

Bronchiolitis

D:

Respiratory distress syndrome

Q.128. A baby can sit without assistance, stand holding the furniture, say “dada” and uses pincer grasp. What's baby's age?

A:

6 months

B:

8 months

C:

12 months

D:

18 months

Q.129. A 65 year old with a diagnosis of terminal prostate cancer with bone metastasis has his pain usually well controlled with a fentanyl patch. He is on the palliative register. For the past several weeks, he has shooting pains radiating down both his arms to his hands. He describes it as a stabbing pain. What is the most appropriate pain relief?

A:

Gabapentin

B:

Radiotherapy

C:

Local ibuprofen gel

D:

Oral morphine

Q.130. Patient complains of diplopia, weakness, and frequent aspiration pneumonia in last 2 months. On examination there is spasticity and fasciculation. What's the diagnosis?

A:

Myasthenia gravis

B:

Lambert eaton syndrome

C:

Motor neuron disease

D:

Ocular Toxicity

Q.131. A 24 year old patient was lying down on the operating table in a position with his arms hanging down for 3 hours. Soon after he woke up, he complains of numbness and weakness on his left hand and has a wrist drop. There is a loss of sensation over a small area between the dorsal aspect of 1st and 2nd metacarpals. What is the most likely structure to be damaged?

A:

Radial nerve

B:

Median nerve

C:

Ulnar nerve

D:

Suprascapular nerve

Q.132. Patient presented with overdose of a medication. He is in coma and absent gag reflex. What's the treatment?

A:

Intubation

B:

Naloxone IV

C:

Flumazenil IV

D:

Ceftriaxone

Q.133. What's true regarding Paracetamol toxicity?

A:

Not toxic if dose exceeds 150-180 mg

B:

N acetyl cysteine is the treatment

C:

Therapeutic effect after 4 hours

D:

Use Deferoxamine

Q.134. A 55 year old man presents with an ulcer of the scrotum. Which is the SINGLE most likely lymph node involved in it’s lymphatic drainage?

A:

External iliac lymph node

B:

Inguinal lymph node

C:

Pre-aortic lymph node

D:

Cervical lymph node

Q.135. 35 year old female with negative pap smear. How often should you advice to repeat pap smear?

A:

6 months

B:

12 months

C:

18 months

D:

No need to repeat

Q.136. Complains of diffuse abdominal pain “in wave like pattern” associated with vomiting. What's the diagnosis?

A:

Pancreatitis

B:

Appendicitis

C:

Bowel obstruction

D:

Cholelithiasis

Q.137. What's true about positive predictive value?

A:

Correlation between those of high risk and have the disease

B:

Correlation between those of low risk and have the disease

C:

Correlation between those of high risk and not have the disease

D:

Associated with increased incidence of breakthrough bleeding

Q.138. The most common presenting symptom of ectopic pregnancy is?

A:

Profuse vaginal bleeding

B:

Abdominal pain

C:

Syncope

D:

Vomiting

Q.139. A child was playing and fell down, his leg got trapped and twisted and is not able to walk since yesterday. What's the diagnosis?

A:

Ankle sprain

B:

Tibial chip fracture

C:

Spiral tibial fracture

D:

Femur neck fracture

Q.140. Child complains of fever, sore throat. All examination is normal. What is the treatment?

A:

Take warm fluids

B:

Ceftriaxone

C:

Give paracetamol and take pharyngeal swab

D:

Betadine gargle

Q.141. What is the drug of choice for schistosomiasis?

A:

Praziquantel

B:

Oxaminiquine

C:

Artemether

D:

Pilocarpine

Q.142. A otherwise healthy boy wants to go walking. History of death of his brother after going on a brisk walk. Which of the following must be excluded?

A:

PDA

B:

VSD

C:

Hypertrophic cardiomyopathy

D:

Dilated cardiomyopathy

Q.143. A 33 year old woman who is 39 weeks pregnant is concerned about her child having developmental dysplasia of the hip as she suffered from developmental dysplasia of the hip when she was a child and had to undergo corrective surgery. Which one of the following is a risk factor for developmental dysplasia of the hip?

A:

Breech presentation

B:

Caesarean section

C:

Polyhydramnios

D:

Previous abdominal surgery

Q.144. Mass in the upper back with punctum that releases white frothy material. What is the management?

A:

It must be removed as a whole to keep the dermis intact

B:

It's likely to be infected and antibiotic must be given before removal

C:

Steroid will decrease its size

D:

It can be treated with cryotherapy

Q.145. A 12 year old girl presents to clinic with sudden onset of pallor, palpitations, and difficulty breathing while running on the school track. After 30 minutes, her symptoms resolved. This is a first time event and she has never been cyanotic. Cardiac examination was normal. Chest x-ray and echocardiogram were normal. ECG reveals evidence of pre-excitation, delta waves, and prolonged QRS. What is the most likely diagnosis?

A:

Paroxysmal ventricular tachycardia

B:

Paroxysmal supraventricular tachycardia

C:

Wolff-Parkinson-White syndrome

D:

Excessive stress during exercise

Q.146. What is true regarding Ischemic limb?

A:

Golden period 4-16 hrs

B:

Nerves are first structure to be damaged

C:

Angiogram is done in all patients

D:

Parasthesia patients are more critical than those with pain

Q.147. A 44 year old man weighing 80 kg presented for an operative procedure and was given 20 ml of 1% lidocaine without epinephrine prior to the procedure. If the maximum allowed dose is 4 mg/kg, how much more of 1% lidocaine can be given?

A:

4 ml

B:

12 ml

C:

100 ml

D:

10 ml

Q.148. Patient on glaucoma medication for weeks came with SOB & cough. What is the cause?

A:

Timolol

B:

Betoxolol

C:

Pilocarpine

D:

Labetolol

Q.149. Gestational diabetes is associated with an increased risk of all of the following EXCECPT?

A:

Cesarean section

B:

Shoulder dystocia

C:

Intrauterine growth restriction

D:

Fetal macrosomia

Q.150. Comparing the prospective and retrospective studies, all are true except?

A:

Retrospective are typically more biased than prospective

B:

Retrospective studies are typically quicker than prospective

C:

Prospective allocation of person into group depends on whether he has the disease or not

D:

Prospective costs more than retrospective

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MOCK TEST 3

Q.1. One of the following does not cause hypokalemia?

Q.2. What anatomical structure or landmark lies just above the midpoint of the inguinal ligament?

Q.3. Child presented with jaundice, vomiting, hepatomegaly etc. Which hepatitis virus is more likely to be the cause?

Q.4. Child newly diagnosed with asthma and allergy to dust mite. What will you advise the parents?

Q.5. True regarding ischemic heart disease?

Q.6. Women complains of non-fluctuated tender cyst in the vulva. Came with pain during coitus & walking, diagnosed Bartholin’s cyst. What is the treatment?

Q.7. Which of the following is appropriate method to prevent brucellosis?

Q.8. Patient presents with high blood pressure (systolic 200), tachycardia, mydriasis (dilated pupils), sweating. What is the toxicity?

Q.9. 27 year old man has asymmetric oligoarthritis involving knee & elbow associated with painful oral ulcers for 10 years. What is the diagnosis?

Q.11. What's the high risk for developing colon cancer in young male?

Q.12. A 2 year old has atrophy of the buttocks. He has often had bloating of his abdomen with frequent offensive, smelly stools that are difficult to flush. He looks pale on examination. What is the most appropriate initial investigation?

Q.13. A 6 week old child is brought to A&E with persistent non-bilious vomiting. The child feels hungry and wants to feed despite constant vomiting. Biochemistry shows K+ of 3.1 mmol/L. What is the most likely diagnosis?

Q.14. Secondary amenorrhea occurs due to?

Q.15. Patient came with pitting edema grade 1. Where is the fluid accumulated?

Q.16. Female presented to ER with HCL burn on her face, there was partial thickness burn. What's the management?

Q.18. Newborn with 300 bpm, normal BP, normal RR. How will you manage this newborn?

Q.19. All are the causes of weight loss, except?

Q.20. Most difficult method to prevent transmission?

Q.22. 48 year old man with pyloric stenosis presents with severe vomiting comes to the hospital, there is marked dehydration, and the urine output 20 ml/hour. HCT 48, BUN 64mg, HCO3 –33mEq/l, Cl 70 mEq/l, and K 2.5 mEq/l. What's the predominant abnormality?

Q.23. A city with 1500 persons, 105 births, 5 are stillbirths, 4 die at first month, 2 die before age of one year. What's the perinatal mortality?

Q.24. What's the most lethal injury to the chest?

Q.25. Paediatric patient from a developing country presented with muscle wasting, weight loss without oedema. What is the diagnosis?

Q.26. 73 year old patient, a farmer, comes complaining of dry eyes. He is smoker for 20 years and smokes 2 packs/ day. What do you advice?

Q.28. 3 months old child presented with low-grade fever & wheezing. CXR shows hyperinflation and some infiltrate. What’s the diagnosis?

Q.29. A child presented with sore throat and fever. She had history of impetigo and was resolved completely during an appropriate course of antibiotic, ASO titer was positive. The same antibiotic was prescribed for her present condition. What is the duration of the course?

Q.30. Patient complains of opposite eye moving laterally when he covers the one eye. What is the cause?

Q.31. What is the antidote for organophosphorus poisoning?

Q.32. A 2 year old male presents to the Emergency Department with a left-sided reducible firm swelling near the groin. The swelling descends when the child cries. On examination, both testicles are palpable in the scrotum. What is the most appropriate management?

Q.33. A 37 year old man has a nonhealing ulcer on the skin of the right medial malleolus. Which lymph node is likely to be involved?

Q.34. A boy was bitten by his brother, has laceration 1 cm. He took TT shot 6 months ago. You cleaned his wound. What will you do next?

Q.35. A 30 year old lady comes to the emergency department with palpitations and chest pain. ECG shows sinus tachycardia. Her pulse rate is 110 beats/minute. She has a history of asthma and her GP recently changed her medications. What is the most appropriate management?

Q.36. 15 year old boy with dark urine, dark brown stool, positive occult blood. What is the next appropriate step?

Q.37. Patient exaggerates his symptoms when people around. What is it called?

Q.38. Regarding screening for cancer, which of the following is true?

Q.39. A 5 year old boy is brought to clinic by his mother. The young boy has a distinct nasal speech and snores heavily at night. He is hyperactive during the day but has poor concentration. He is noted to be constantly breathing through his mouth. What is the most appropriate action?

Q.40. What's true about Delusion?

Q.41. A 2 year old male presents to the Emergency Department with a left-sided reducible firm swelling near the groin. The swelling descends when the child cries. On examination, both testicles are palpable in the scrotum. What is the most appropriate management?

Q.42. A 24 year old man presents to A&E after an injury to his hand while playing basketball. Examination of his hand reveals an avulsion of the extensor digitorum tendon from the distal phalanx. What is the most likely deformity?

Q.43. What's the best food during travelling?

Q.44. All of the following antihypertensive medications are considered safe for short term use in pregnancy except?

Q.45. Blood culture shows gram negative rod shaped organism that grows only on charcoal free. What is the organism?

Q.47. Male patient has hair loss started from fronto-temporal area and moving toward the vertex (top of the head). What is the diagnosis?

Q.49. What is the most important factor in the development of spinal headaches after spinal anesthesia?

Q.50. Which of the following combination is safe?

Q.51. Clonidine decreases the effect of?

Q.52. A 1 day old male infant has developed abdominal distension, bilious vomiting and meconium ileus was present. Prenatal ultrasound had previously revealed echogenic bowel. Which of the following is the most likely diagnosis?

Q.54. A 12 year old boy attends A&E with pain after falling off his bicycle. A lateral X- ray of his wrist shows a fracture at the distal radius with the distal fracture fragment displaced anteriorly. What is the most likely diagnosis?

Q.55. A 7 year old boy falls on his right hand with the arm extended. He has severe pain around the elbow. X-ray imaging showed a supracondylar fracture of the humerus. The distal fragment is displaced posteriorly. What is the most likely structure to be damaged?

Q.56. A paediatric patient brought by her parents complains of vaginal discharge, what is the cause?

Q.57. A 3 month old infant presents with recurrent infections and feeding difficulties. His face looks dysmorphic and has a cleft palate. A chest X-ray shows absent thymic shadow. What is the most likely diagnosis?

Q.58. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

Q.59. Patient needs central venous line for TPN, doctor orders to give 2 units of packed RBCs and the nurse gave it through CVL, after 2 hours patient become unconscious and comatose. What is the cause?

Q.60. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

Q.61. What is the Sodium amount in Normal Saline [ 0.9% NaCl ]?

Q.62. During blood transfusion, the patient developed fever and pain at the infusion site. What's your action?

Q.64. The drug which is used in seizures of eclamptic origin?

Q.65. Shoulder pain is most commonly due to?

Q.66. What's the action of progestin only contraceptive pills?

Q.67. Which one of the following is a component of TOF?

Q.68. A 32 year old man on psychiatric medications complains of the inability to ejaculate. What is the most likely medication he is taking?

Q.69. A 4 year old girl attends clinic with a history of diarrhoea, bloating and abdominal pain. She is failing to thrive. Blood tests reveal a hypochromic microcytic anaemia. Alpha gliadin antibodies are positive. What is the most likely diagnosis?

Q.70. Mother who is breast feeding, wants to take MMR vaccine. What is your advice?

Q.71. Before giving influenza vaccine, you should know if the patient allergy to which of the following?

Q.72. Patient has urethritis now presented with left knee pain, urethral swab shows positive pus cell but negative for Neisseria meningitidis and chlamydia. What's the diagnosis?

Q.73. What is the best diagnostic test for maxillary sinusitis?

Q.75. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

Q.76. Patient with hypertension, renography showed right kidney 14 cm left kidney 7 cm. Arteriogram shows left renal artery stenosis. What's the confirmatory test?

Q.77. An old man undergoing brain surgery is on aspirin. What does he need prior to surgery?

Q.78. Paraplegia patient with ulcer in lower back 2x2 cm with loss of dermis and epidermis. What is the stage of ulcer?

Q.79. A 2 year old male presents to the Emergency Department with a left-sided reducible firm swelling near the groin. The swelling descends when the child cries. On examination, both testicles are palpable in the scrotum. What is the most appropriate management?

Q.80. 70 year-old man fell on outstretched hand. On examination both radial and ulnar pulses intact with dinner fork deformity. Tender radial head. What is the diagnosis?

Q.82. What is the most important factor in attempt of successful cessation of smoking?

Q.83. 100% O2 given for prolonged period can cause all except?

Q.84. What's the normal daily caloric intake?

Q.85. A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the most likely diagnosis?

Q.86. Which of the following describes the end of early inflammatory phase?