Treatment for multiple sclerosis
a) Interferon alpha
b) Interferon beta
c) Infliximab A
d) Interferon gamma
Correct answer : b) Interferon beta
Pancytopenia with cellular marrow is seen in all except
a) Megaloblastic anemia
b) Myelodysplasia
c) Paroxysmal Noctumal hemoglobinuria
d) G6PD deficiency
Correct answer : d) G6PD deficiency
Persistent low C3 complement level is not found in
a) Post streptococcal glomerulonephritis
b) Mesangiocapillary glomerulonephritis
c) Cryoglobulinemia
d) SLE
Correct answer : a) Post streptococcal glomerulonephritis
Charcots joint is seen in all of the following except
a.Syringomyelia
b.Leprosy
c.Diabetes
d.Arthrogryposis multiplex congenita
Correct answer : d) Arthrogryposis multiplex congenita
Which deleterious effect is least likely to occur in hypothermia
a) Cardiac arryhthmia
b) Decreased peripheral resistance
c) Reversible coagulation
d) Renal failure
Correct answer : b) Decreased peripheral resistance
Reflux disease which cause proteinuria of nephrotic range
a) Membranous glomerulonephritis
b) Focal segmental glomerulosclerosis
e) Nodular glomerulosclerosis
d) Crescenteric glomerulonephritis
Correct answer : b) Focal segmental glomerulosclerosis
Carey Coombs murmur, which is false
a) Delayed diastolic murmur
b) Seen in rheumatic fever
c) Can be associated with A.R.
d) Low pitched murmur
Correct answer : c) Can be associated with A.R.
Mutation in alpha 5 chain of collagen 4, the diagnosis is:
a) Alport’s syndrome
b) Thin membrane disease
c) Nodular glomerulosclerosis
d) Good pasture syndrome
Correct answer : a) Alport’s syndrome
(Alport’ syndrome is a hereditary nephritis characterized by microscopic hematuria and deafness.
A.M.L. with worst prognosis
a) 8/21 translocation
b) Inversion 16
c) Normal cytogenetics
d) Monosomy 7
Correct answer : d) Monosomy 7
Neurocardiogenic syncope, the least useful investigation is :
a) Tilt table
b) Carotid sinus massage
c) Carotid duplex scan
d) Orthostatic blood pressure recording
Correct answer : c) Carotid duplex scan
A 21 year old male presents with anemia and mild hepatosplenomegaly. His hemoglobin is 5 gm/dL history of single blood transfusion is present till date. Most probable diagnosis is :
a) Thalassemia major
b) Thalassemia minor
c) Thalasseniia intermedia
d) Autoimmune hemolytic anemia
Correct answer : d) Autoimmune hemolytic anemia
A boy is suffering from acute pyelonephritis. Most specific urinary finding will be
a) W.B.C. casts
b) Leucocyte esterase test
c) Nitrite test
d) Bacteria in gram stain
Correct answer : a) W.B.C. casts
Most common site of intracranial hemorrhage in hypertensive hemorrhage is :
a) Basal ganglia
b) Brainstem
c) Cerebellum
d) Hippocampus
Correct answer : a) Basal ganglia
30 year male with chronic diarrhoea, anemia, raised liver enzymes. Most likely associated with
a) Antimitochondrial antibody
b) Anti endomysial antibody
c) Anti smooth muscle antibody
d) Antinuclear antibody
Correct answer : b) Anti endomysial antibody
Interstitial nephritis is seen with all except :
a) Beta lactam inhibitors
b) INH
c) Diuretics
d) Allopurinol
Correct answer : b) INH
Nephrocalcinosis is seen in all except :
a) Sarcoidosis
b) Distal RTA
c) Milk alkali syndrome
d) Medullary cystic kidney
Correct answer : d) Medullary cystic kidney
Features seen in hemolytic anemia are all except
a) Tear drop and Burr cells
b) Decreased Haptoglobin
c) Reticulocytosis
d) Hemoglobinuria
Correct answer : a) Tear drop and Burr cells
A female child with virilization, hypertension and low plasma renin. Diagnosis is :
a) 21 alpha hydroxylase deficiency
b) 11 beta hydroxylase deficiency
c) 3 beta hydroxylase deficiency
d) Conn’s syndrome
Correct answer : b) 11 beta hydroxylase deficiency
Ratio of AST/ALT > 1 present in
a) Non alcoholic steatohepatitis
b) Alcoholic hepatitis
c) Wilson’s disease
d) All of the above
Correct answer : b) Alcoholic hepatitis
Increased anion gap metabolic acidosis is seen in all except :
a) Starvation
b) Salicylate poisoning
c) Lactic acidosis
d) Diarrhoea
Correct answer : d) Diarrhoea
Mnemonic for causes of increased anion gap metabolic acidosis: MUDPILES
M-Methanol
U-Uremia (chronic renal failure)
D-Diabetic ketoacidosis
P-Propylene glycol
I-Infection, Iron, Isoniazid
L-Lactic acidosis
E-Ethylene glycol
S-Salicylates, Starvation
All are associated with MEN-2 except :
a) Pheochromocytoma
b) lslet cell hyperplasia
c) Medullary carcinoma thyroid
d) Parathyroid adenoma
Correct answer : b) lslet cell hyperplasia
Addison’s disease is associated with all except
a) Cardiac atrophy
b) Decreased diastolic B.P.
c) Serum cortisol < 8 d) Low renin levels
Correct answer : d) Low renin levels
Which of the following dietary interventions reduces the further risk in MI patients-
a) High fibre diet
b) Sterol esters
c) Potassium supplements
d) n3 polyunsaturated fatty acids
Correct answer : d) n3 polyunsaturated fatty acids
Reticulocytosis is seen in all except :
a) P.N.H.
b) Hemolysis
c) Nutritional anemia
d) Dyserythropoietic syndrome
Correct answer : c) Nutritional anemia
Earliest phenotypic manifestation of Idiopathic hereditary hemochromatosis is :
a) Post prandial increase in serum iron concentration
b) Elevated serum ferritin level
c) Slate grey pigmentation of skin
d) Increased transferrin saturation
Correct answer : d) Increased transferrin saturation
Half and half nail sign, seen in uremia is
a) Due to melanin deposition
b) Increased capillary density at the distal half of nails
c) Hypoproteinemia
d) Circulating toxin
Correct answer : b) Increased capillary density at the distal half of nails
A two year old male child was given 8 days of cefaclor of a 10 days course. The child develops low grade fever, malaise lymphadenopathy, irritability, generalized erythematous rash which are mildly pruritic. Most probable diagnosis is
a) Kawasaki disease
b) Partially treated meningitis
c) Infectious mononucleosis
d) Type 3 hypersensitivity
Correct answer : d) Type 3 hypersensitivity
Kawasaki disease – the child does not have the classical features like non purulent conjunctivitis and cervical adenopathy
Infectious mononucleosis – Usually occurs in adolescents and adults. EBV infection is usually asymptomatic in children.
Atkin‘s diet is
a) Protein restricted low calorie diet
b) Carbohydrate restricted low calorie diet
c) Fat restricted low calorie diet
d) Mineral restricted low calorie diet
Correct answer : b) Carbohydrate restricted low calorie diet
Most common site of histiocytosis is
a) Bone
b) Skin
c) Lung
d) Liver
Correct answer : a) Bone
Best method to monitor intracranial pressure is
a) lntraventricular catheter
b) Subarachnoid bolt
c) Intraparenchymal catheter
d) Epidural catheter
Correct answer : a) lntraventricular catheter
A man takes peanut and develop stridor, neck swelling, tongue swelling and hoarseness of voice. Most probable diagnosis is
a) Foreign body bronchus
b) Parapharyngeal abscess
c) Foreign body larynx
d) Angioneurotic edema
Correct answer : d) Angioneurotic edema
Digital clubbing is seen in all except
a) Endocarditis
b) Pulmonary arteriovenous fistula
c) Tricuspid atresia
d) Aortic dissection
Correct answer : d) Aortic dissection
Life threatening complications of diabetes mellitus are all except :
a) Malignant otitis externa
b) Rhinocerebral mucormycosis
c) Emphysematous pyelonephritis
d) Emphysematous appendicitis
Correct answer : d) Emphysematous appendicitis
In primary pulmonary hypertension basic abnormality in gene lies in
a) Bone morphogenetic protein receptor II
b) Endothelin
c) Homeobox gene
d) PAX-1 1
Correct answer : a) Bone morphogenetic protein receptor II
Which is useful to decrease mortality and renal failure in acute liver disease due to alcoholism
a) Pentoxifylline
b) Orlistat
c) S—Adenosyl methionine
d) Spiramycin
Correct answer : a) Pentoxifylline
Water hammer pulse seen in
a) Aortic stenosis
b) Aortic regurgitation
c) Aortic stenosis and Aortic regurgitation
d) Mitral regurgitation
Correct answer : b) Aortic regurgitation
Causes of raised J.V.P. with hypotension are all except
a) Cardiac tamponade
b) Right ventricular M.I.
c) Heart failure
d) 2nd degree A.V. block
Correct answer : d) 2nd degree A.V. block
Causes of raised JVP with hypotension:
Cardiac tamponade
Right ventricular MI
Right heart failure
Constrictive pericarditis
Restrictive cardiomyopathy
lnfective endocarditis due to pseudomonas is most commonly seen with
a) Intravenous drug abuse of pentazocin
b) HIV patient
c) Chronic steroid therapy
d) Elderly with community acquired pneumonia
Correct answer : a) Intravenous drug abuse of pentazocin
Pseudomonas endocarditis is seen in intravenous drug abusers and those with prosthetic heart valves.
All are associated with pituitary apoplexy except :
a) Hyperthyroidism
b) Diabetes mellitus
c) Sickle cell anemia
d) Hypertension
Correct answer : a) Hyperthyroidism
Due to decrease in TSH secretion, there is hypothyroidism in pituitary apoplexy. The other options are known causes of pituitary apoplexy.
Hemolytic uremic syndrome is associated with all except
a) EHEC
b) Shigella
c) Campylobacter
d) Vibrio cholera
Correct answer : d) Vibrio cholera
Infections causing hemolytic uremic syndrome:
Enterohaemorrhagic E. coli
Shigella dysenteriae type 1
Campylobacter jejuni
Streptococcus pneumoniae
HIV
Most common catheter induced blood infection is due to
a) Staphylococcus aureus
b) Coagulase negative staphylococci
c) Gram negative bacilli
d) Candida
Correct answer : b) Coagulase negative staphylococci
Plasmapheresis (plasma exchange therapy) is used in the treatment of
a) Autoimmune hemolytic anemia
b) Disseminated intravascular coagulation
c) Thrombotic thrombocytopenic purpura
d) Hemolytic uremic syndrome
Correct answer : c) Thrombotic thrombocytopenic purpura
(It can also be used for HUS, but is not as successful)
Arsenic is used in treatment of
a) Acute promyelocytic leukemia
b) A.L.L.
c) CML
d) Transient myeloproliferative disorder
Correct answer : a) Acute promyelocytic leukemia
True regarding Couvade syndrome is?
A. A male experiencing pregnancy symptoms
B. A pregnant female who believes that she is not pregnant
C. Excessive urge for taking drugs
D. Opiods are treatment of choice
Correct answer : A. A male experiencing pregnancy symptoms
Couvade syndrome (sympathetic pregnancy / phantom pregnancy) is a condition in which a man experiences some of the same symptoms and behavior of an expectant mother.
Treatment of severe ulnar neuritis in borderline tuberculoid leprosy is:
A. MDT only
B. MDT + steroid
C. Wait and watch
D. MDT + thalidomide
(MDT = Multi Drug Therapy)
Correct answer : B. MDT + steroid
All of the following organs may be involved in Leprosy except:
A. Uterus
B. Ovary
C. Testes
D. Eye
Correct answer : A. Uterus
Female genital tract is seldom involved in leprosy. Ovary is the most common site of leprosy in the female genital tract.
Which of the following is the classical CSF finding seen in Tuberculous meningitis?
A. Increased protein, decreased sugar, increased lymphocytes
B. Increased protein, sugar and lymphocytes
C. Decreased protein, increased sugar and lymphocytes
D. Increased sugar, protein and neutrophils
Correct answer : A. Increased protein, decreased sugar, increased lymphocytes
The following are components of Brown Sequard syndrome except :
A. Ipsilateral extensor plantar response
B. lpsilateral pyramidal tract involvement
C. Contralateral spinothalamic tract involvement
D. Contralateral posterior column involvement
Correct answer : D. Contralateral posterior column involvement
In brown sequard syndrome ( hemisection of spinal cord ), there is ipsilateral posterior colum involvement.
All of the following statements are true about Benedict’s syndrome, except:
A. Contralateral tremor
B. 3rd nerve palsy
C. Involvement of the penetrating branch of the basilar artery
D. Lesion at the level of the pons
Correct answer : D. Lesion at the level of the pons
Benedict’s syndrome is a dorsal mid brain syndrome.
Millard Gubler syndrome includes the following except :
A. 5th nerve palsy
B. 6th nerve palsy
C. 7th nerve palsy
D. Contralateral hemiparesis
Correct answer : A. 5th nerve palsy
Millard Gubler syndrome (ventral pontine syndrome) is characterised by:
Ipsilateral paresis of lateral rectus (6th nerve)
Ipsilateral UMN type of facial weakness (7th nerve)
Contralateral hemiplegia (pyramidal tract)
Pontine Stroke is associated with all except :
A. Bilateral pin point pupil
B. Pyrexia
C. Vagal palsy
D. Quadriparesis
Correct answer : C. Vagal palsy
Vagal palsy is not a component of pontine stroke.
Increased ICT is associated with all except
A. Paraparesis
B. Abducent paralysis
C. Headache
D. Visual blurring
Correct answer : A. Paraparesis
Increased ICT alone does not cause paraparesis. It can occur if the increased ICT is due to a mass lesion in the parasagittal region.
The following are components of Kawasaki disease except,
A. Purulent conjunctivitis
B. Pedal edema
C. Truncal rash
D. Pharyngeal congestion
Correct answer : A. Purulent conjunctivitis
Non purulent conjunctivitis is seen in Kawasaki disease.
All of the following true about Raynaud’s disease except:
A. More common in females
B. Positive Antinuclear Antibodies
C. Most common cause of raynaud’s phenomenon
D. Has good prognosis
Correct answer : B. Positive Antinuclear Antibodies
Antinuclear Antibodies are seen only in secondary causes of Raynaud’s phenomenon. Raynaud’s disease refers to idiopathic Raynaud’s phenomenon.
Best marker for drug induced lupus is.
A. Anti histone antibodies
B. Anti ds DNA
C. Anti neutrophil antibody
D. Anti Smith antibody
Correct answer : A. Anti histone antibodies
Anti histone antibodies are the best markers for drug induced lupus.
Deposition of Anti ds DNA antibody in kidney, skin, choroid plexus and joints is seen in:
A. SLE
B. Goodpasture syndrome
C. Scleroderma
D. Raynauds disease
Correct answer : A. SLE
Anti ds DNA antibody is specific for SLE.
C- ANCA positivity indicates antibody formed against
A. Proteinase 3
B. Myeloperoxidase
C. Cytoplasmic antinuclear Antibody
D. Anti centromeric Antibody
Correct answer : A. Proteinase 3
Proteinase 3 is the major C ANCA antigen.
Hypophosphatemia is seen in all except:
A. Acute renal failure
B. Resolving phases of diabetic ketocidosis
C. Respiratory alkalosis / COPD
D. Chronic alcoholism
Correct answer : A. Acute renal failure
Hyperphosphatemia is seen in renal failure.
SIADH is associated with the following drug:
A. Vincristine
B. Erythromycin
C. 5 — FU
D. Methotrexate
Correct answer : A. Vincristine
Treatment of choice for Zollinger Ellison Syndrome (ZES) is:
A. PPI
B. Somatostatin analogues
C. Streptozocin
D. Sucralfate
Correct answer : PPI
Which of the following endocrine tumors is most commonly seen in MEN I?
A. lnsulinoma
B. Gastrinoma
C. Glucagonoma
D. Somatostatinoma
Correct answer : Gastrinoma
A 60 year old woman presents with generalized edema, skin ulceration and hypertension. Urine examination shows subnephrotic proteinuria (<2gm) and microscopic hematuria. Serum complement levels are decreased and she is positive for anti-hepatitis C antibodies. The likely diagnosis is :
A. PSGN
B. Essential mixed cryoglobulinemia
C. Membrano proliferative glomerulonephritis
D. Focal segmental glomerulosclerosis
Correct answer : Essential mixed cryoglobulinemia
The test used to diagnose Dubin Johnson syndrome is:
A. Serum transminases
B. Bromsulphalein test (BSP)
C. Hippurate test
D. Gamma glutamyl transferase level
Answer: B. Bromsulphalein test (BSP)
A 30 year old man presents with generalized edema and hypertension. Urine examination shows subnephrotic proteinuria (< 2gm) and microscopic hematuria. Serum complement levels are decreased and he is positive for antihepatitis C antibodies. The most likely diagnosis is:
A. Post streptococcal Glomerulonephritis (PSGN)
B. Mixed cryoglobulinemia
C. Membranoproliferative glomerulonephritis (MPGN)
D. Focal symental Glomerular sclerosis (FSGS)
Answer: C. Membranoproliferative glomerulonephritis (MPGN) > B. Mixed cryoglobulinemia
Most common cause of nephrotic range proteinuria in an adult is:
A. Diabetes Mellitus
B. Amyloidosis
C. Hypertensive nephropathy
D. Wegner`s Granulomatosis
Answer: A. Diabetes Mellitus
A patient presents with chronic small bowel diarrhea, duodenal biopsy shows villous atrophy. Anti endomysial antibodies and IgA TTG antibodies are positive. What is the treatment of choice?
A. Gluten free diet
B. Antibiotics
C. Loperamide
D. 5—ASA
Answer:A. Gluten free diet
The clinical picture and investigation findings are suggestive of coeliac sprue. The treatment is gluten free diet.
A patient with H. Pylori infection is treated with drugs. The best method to detect presence of residual H.Pylori infection in this person is :
A. Rapid urease test
B. Urea breath test
C. Endoscopy and biopsy
D. Serum anti H.Pylori titre
Ans: B. Urea breath test
Recommended test for confirmation of H.pylori eradication – urea breath test.
All of the following drugs are commonly used in regimens against H. pylori except:
A. Oxytetracycline
B. Amoxicillin
C. Bismuth Subcitrate
D. Omeprazole
Answer : A. Oxytetracycline
Oxytetracycline is not a recommended drug for treatment of H.pylori.
A patient presents with decreased vital capacity and total lung volume. What is the most probable diagnosis?
A. Bronchiectasis
B. Sarcoidosis
C. Cystic fibrosis
D. Asthma
Answer : B. Sarcoidosis
A restrictive lung disease causes decrease in vital capacity and total lung volume. Among the options provided, sarcoidosis is the only one causing a restrictive lung disease.
A 70 year old man develops pneumonia and septicemia. Patient goes into renal failure and has a BP of 70/50 mm of Hg. Drug that should be used to maintain BP is:
A. Adrenaline
B. Ephedrine
C. Phenylephrine
D. Nor epinephrine
Answer : D. Nor epinephrine
The patient is in septic shock. Dopamine is the recommended drug for maintenance of BP in a case of septic shock. If there is no response, nor epinephrine should be tried. Since nor epinephrine is the only one given among the options, it is the best answer.
A patient presents with acute anterior wall infarction and hypotension. Which will be the immediate treatment modality for this patient?
A. Intra aortic balloon counter pulsation
B. Anticoagulation
C. Thrombolytic therapy
D. Angiography and Primary angioplasty
Answer: D. Angiography and Primary angioplasty
Angiography and primary angioplasty is the best modality of treatment in case of ST eleveation MI presenting within 12 hours.
A person with mitral regurgitation and atrial fibrillation presents with syncope. On examination the person has a heart rate of 55. What is the most probable cause?
A. Digitalis toxicity
B. Incomplete heart block
C. Stroke
D. Subarachnoid Haemorrhage
Answer : Digitalis toxicity
It is probably a case of digitalis toxicity resulting in complete heart block.
CCF is associated with Increase in all of the following except:
A. Right atrial mean pressure
B. Serum sodium
C. Serum urea
D. Serum norepinephrine
Answer : Serum sodium
Hyponatremia is seen in CCF
The following ECG findings are seen in Hypokalemia:
A. Increased PR interval with ST depression
B. Increased PR interval with peaked T wave
C. Prolonged QT interval with T wave inversion
D. Decreased QT interval with ST depression
Answer : A. Increased PR interval with ST depression
ECG changes in hypokalemia – ST depression, prolonged PR interval, T inversion / flattening, Prominent U waves, Sinoatrial block (rare)
The following is the least useful investigation in multiple myeloma:
A. ESR
B. X-Ray
C. Bone scan
D. Bone marrow biopsy
Answer : Bone scan
Osteoblastic activity is suppressed by myeloma cells. (through secretion of cytokines). Hence these site show no increased uptake during bone scan.
Which is not true regarding Bernard soulier syndrome?
A. Ristocetin aggregation is normal
B. Aggregation with collagen and ADP is normal
C. Large platelets
D. Thrombocytopenia
Answer: A. Ristocetin aggregation is normal
Bernard Soulier platelets react normally to all stimuli except Ristocetin.
The following set of finding is seen in DIC:
A. Increased fibrinogen, increased antithrombin III, increased thrombin – antithrombin III complexes
B. Increased FDP, decreased PT, increased antithrombin III
C. Increased FDP, prolonged PT, increased thrombin-antithrombin complexes
D. Increased FDP, prolonged PT, reduced platelets
Answer : D. Increased FDP, prolonged PT, reduced platelets
A patient on aspirin, will show the following finding?
A. Prolonged BT
B. Prolonged PT
C. Prolonged APTT
D. Prolonged CT
Correct answer : Prolonged BT
Erythropoietin is increased in all of the following conditions except:
A. Hepatocellular carcinoma
B. Renal cell carcinoma
C. Cerebellar Hemangioblastoma
D. Pancreatic carcinoma
Correct answer : Pancreatic carcinoma
Which of the following statements about Mycosis fungoides is not true:
A. lt is the most common form of cutaneous lymphoma
B. Pautriers microabscess
C. lndolent course and easily amenable to treatment
D. Erythroderma seen and spreads to peripheral circulation
Correct answer : Indolent course and easily amenable to treatment
80 year old, asymptomatic man present with a Total Leucocyte Count of 1 lakh, with 80% lymphocytes and 20% PMC’s, What is the most probable diagnosis?
A. HIV
B. CML
C. CLL
D. TB
Correct answer : CLL
ln PML, all of the following are seen except :
A. Retinoic acid is used in treatment
B. 15/17 translocation may be seen
C. CD 15/34 both seen in same cell
D. Associated with Disseminated Intravascular Coagulation (DIC)
Correct answer : CD 15/34 both seen in same cell
Bone marrow biopsy is absolutely indicated in,
A. Acute leukemia
B. Megaloblastic anemia
C. Hairy cell leukemia
D. Thalassemia
Correct answer : Hairy cell leukemia
Pancytopenia with cellular marrow is seen in:
A. PNH
B. G6PD deficiency
C. Acquired aplastic anemia
D. Thalassemia
Correct answer : PNH
A normotensive patient with normal hemoglobin suffered massive blood loss. The following findings would be present in him except:
A. Increased PCV
B. Increased MCV
C. Thrombocytosis
D. Reticulocytosis
Submit your answers in the comments section below!
Which of the following findings is diagnostic of iron deficiency anemia?
A. Increased TIBC, decreased serum ferritin
B. Decreased TIBC, decreased serum ferritin
C. Increased TIBC, increased serum ferritin
D. Decreased TIBC, increased serum ferritin
Correct answer : Increased TIBC, decreased serum ferritin
Autoimmune hemolytic anemia is associated with malignancy of which lineage?
A. T cell
B. B cell
C. Pre B cell
D. Pre T cell
Correct answer : B cell
The most useful therapeutic agent in high altitude pulmonary oedema is:
A. Nitrates
B. Furosemide
C. Digitalis
D. Aminophylline
Correct answer : Furosemide