Streptokinase and urokinase are contraindicated in:

  1. A patient presents with following parameters pH 7.5, p CO2 30 mmHg, pO2 102 mmhg and HCO3 16 meq/I. Which of the following correctly describes the compensatory mechanisms?
    A. Respiratory alkalosis
    B. Metabolic Alkalosis
    C. Respiratory Acidosis
    D. Metabolic Acidosis
    Ans: D.

  2. A 29 year old anxious lady presents with a history of progressive
    breathlessness and exercise intolerance since four months. Her FVC is 90% and FEV 1 / FVC is 86%. Oxygen saturation after exercise was observed to drop from 92% to 86%. What is the likely diagnosis?
    A. Primary alveolar hypoventilation
    B. Primary pulmonary hypertension
    C. Anxiety disorder
    D. Interstitial lung disease
    Ans: B.

  3. Accelerated Idioventricular Rhythm (AIVR) is the most common arrhythmia associated with:
    A. Dilated cardiomyopathy
    B. Myocardial Reperfusion
    C. Digitalis intoxication
    D. Myocarditis
    Ans: B.

  4. Streptokinase and urokinase are contraindicated in:
    A. Intracranial malignancy
    B. Pulmonary embolism
    C. A V fistula
    D. Thrombophlebitis
    Ans: A.

  5. A truck driver presented with history of fever since four weeks, and dry cough.He also gives a history of weight loss of about 10 kg. X-ray shows bilateral reticulonodular infiltrates. The most likely diagnosis is:
    A. Tuberculosis
    B. Pneumocystis carinii Pneumonia
    C. Pneumococcal pneumonia
    D. Interstitial lung disease
    Ans: B.

  6. Cavitatory lesions in lung are seen in:
    A. Primary pulmonary tuberculosis
    B. Staphylococcal pneumonia
    C. Preumoconiosis
    D. Interstitial lung disease
    Ans: B.

  7. Pre-renal azotemia is characterized by all of the following except:
    A. Fractional excretion of Na < 1%
    B. Urinary osmolality > 500 mosm/kg
    C. Urinary sodium concentration > 40 meq/l
    D. Reversible with replacement fluids
    Ans: C.

  8. A patient is found to be positive for HBs Ag on routine laboratory evaluation. Other serological tests for hepatitis are unremarkable. He is clinically asymptomatic and liver enzymes are within the normal range. Which of the following best describes his diagnosis?
    A. Inactive HBV carrier
    B. Acute Hepatitis B
    C. Chronic Hepatitis B
    D. Active HBV carrier
    Ans: A.

  9. A male patient is observed to be HBs Ag antigen positive HBe Ag antigen
    negative and anti-HBe antibody positive. HBV DNA copies are observed to be 100,000/ml while SGOT and SGPT are elevated to 6 times the upper limit of normal value. What is the likely diagnosis?
    A. HBV surface mutant
    B. HBV precore mutant
    C. Wild HBs Ag
    D. Inactive HBV carrier
    Ans: B.

  10. (a) A patient presents with unconjugated hyperbilirubinemia and
    presence of urobilinogen in urine. Which amongst the following is the least likely diagnosis?
    A. Hemolytic jaundice
    B. Crigler Najjar syndrome
    C. Gilbert’s syndrome
    D. Dubin Johnson syndrome
    Ans: D.

(b) A patient presents with unconjugated hyperbilirubinemia and elevated
urobilinogen levels in urine. The most diagnosis is:
A. Hemolytic Jaundice
B. Crigler Najjar syndrome
C. Gilbert’s Syndrome
D. Dubin Johnson Syndrome
Ans: A.

  1. A lady presented with no progressive dysphagia only for solids. Barium study showed proximal esophageal dilatation with distal constriction. The most likely
    diagnosis is:
    A. Peptic Stricture
    B. Carcinoma esophagus
    C. Achalasia cardia
    D. Lower esophageal ring
    Ans: D.

  2. A young girl presents with abdominal pain and a recent change in
    bowel habit, with passage of mucus instool. There is no associated blood in stool and symptoms are increased with stress.
    The most likely diagnosis is:
    A. Irritable bowel syndrome
    B. Ulcerative colitis
    C. Crohn’s disease
    D. Amebiasis
    Ans: A.

  3. Which of the following statements about lung carcinoma is true:
    A. Squammous cell variant accounts for 70% of all lung cancers
    B. Oat cell variant typically present with cavitation
    C. Oat cell variant is typically associated with hilar adenopathy
    D. Adenocarcinoma variant is typically central in location
    Ans: C.

  4. Plasma urea / creatinine ratio of 20:1
    may be seen in:
    A. Rhabdomyolysis
    B. Ureteric calculi
    C. Pre-renal failure
    D. Chronic Glomerulonephritis
    Ans: C.

  5. An elderly patient presents with a prolonged history of weakness and
    lethargy. On examination he is found to be anemic and stool is positive for occult blood. Which of the following is the investigation of choice?
    A. Colonoscopy
    B. Barium meal
    C. Barium enema
    D. CT abdomen
    Ans: A.

  6. Which of the following statements about Wilson’s disease is true:
    A. Low serum ceruloplasmin and low
    urinary copper
    B. Low serum ceruloplasmin and high
    urinary copper
    C. High serum ceruloplasmin and low
    urinary copper
    D. High Serum ceruloplasmin and high
    urinary copper
    Ans: B
    .

  7. Gout is a disorder of:
    A. Purine metabolism
    B. Pyrimidine metabolism
    C. Ketone metabolism
    D. Protein metabolism
    Ans: A.

  8. Which of the following is recommended in a woman with antiphospholipid antibodies and history of prior abortions / still birth?
    A. Aspirin only
    B. Aspirin + low molecular weight
    heparin
    C. Aspirin + Low molecular weight
    heparin + prednisolone
    D. No treatment
    Ans: B.

  9. All of the following may be associated with Thymoma, except:
    A. SIADH
    B. Myaesthenia gravis
    C. Hypogammaglobulinemia
    D. Cushing’s syndrome
    Ans: A.

  10. Plasmapharesis is used in all of the following except:
    A. Myaesthenic crisis
    B. Cholingergic crisis
    C. Gullian barre syndrome
    D. Polymyositis
    Ans: B.

  11. All of the following statements about primary Gout Arthritis are true, except:
    A. 90% of cases are caused by over
    production of uric acid
    B. Uric acid levels may be normal at the
    time of an acute attack
    C. Men are more commonly affected than
    women (Male > Females)
    D. Definitive diagnosis requires aspiration
    of synovial fluid
    Ans: A.

  12. Antiphospholipid Antibody (APLA)syndrome is associated with all of the
    following except:
    A. Bleeding disorders
    B. Thrombotic disorders
    C. Coagulation disorders
    D. Recurrent fetal loss
    Ans: A.

  13. All of the following statements about Antiphospholipid antibody syndrome(APLAb) are true except:
    A. Single titre anticardiolipin is diagnostic
    B. Commonly presents with recurrent
    fetal loss
    C. May cause pulmonary hypertension
    D. Warfarin is given as treatment
    Ans: A.

  14. Low calcium and high phosphate is seen in:
    A. Hyperparathyroidism
    B. Hypoparathyroidism
    C. Hyperthyroidism
    D. Hypothyroidism
    Ans: A.

  15. All of the following statements about Pseudohypoparathyroidism are true,except:
    A. Decrease serum PTH
    B. Decrease serum calcium
    C. Increase serum phosphate
    D. Albreight’s hereditary osteodystrophy
    Ans: A.

  16. A patient presents with symptoms of Hypoglycemia. Investigations reveal decreased blood glucose and increased insulin levels. C-peptide assay is done which shows normal level of C-peptide. The most likely diagnosis is:
    A. Insulinoma
    B. Accidental sulfonylurea ingestion
    C. Accidental exogenous insulin
    administration
    D. Accidental metformin ingestion
    Ans: C.

  17. Which of the following is associated with peripheral artery disease, coronary
    heart disease and stroke?
    A. Insulin deficiency
    B. Hyperstrogenemia
    C. Hypothyroidism
    D. Hyperprogesteronemia
    Ans: A.

  18. All of the following statements about hyponatremia are true, except:
    A. Pseudohyponatremia is associated with low plasma osmolality
    B. Hyponatremia associated with
    hyperglycemia has high plasma
    osmolality
    C. Hyponatremia associated with SIADH
    is normovolemic
    D. NSAIDs incrase the potency of
    vasopressin
    Ans: A.

  19. A patient presents with ataxia, urinary incontinence and dementia. The
    likely diagnosis is:
    A. Alzheimer’s disease
    B. Parkinson’s disease
    C. Steel richardson syndrome
    D. Normal pressure hydrocephalus
    Ans: D.

  20. A patient known to have mitral stenosis and atrial fibrillation, presents
    with acute onset of weakness in the left upper limb which recovered completely in two weeks. The most likely diagnosis is:
    A. Transient ischemic attack
    B. Ischemic stroke
    C. Hemorrhagic stroke
    D. Vasculitis
    Ans: B.

  21. A 25 year old person presents with acute onset of fever and focal seizures. MRI scan shows hyperintensity in the temporal lobe and frontal lobe with enhancement. The most likely diagnosis
    is:
    A. Meningococcal meningitis
    B. Herpes simplex encephalitis
    C. Japanese encephalitis
    D.-----------
    Ans: B.

  22. IN a patient with head injury damage in the brain is aggravated by
    A. Hyperglycemia
    B. Hypothermia
    C. Hypocapnia
    D. Serum osmolality
    Ans: A > C.

  23. (a) All of the following are associated with hypergonadotrophic
    hypogonadism in males, except:
    A. Viral orchitis
    B. Klinefelter’s syndrome
    C. Kallman’s syndrome
    D. Noonan syndrome
    Ans: C
    .
    (b) Which of the following is the most common cause of hypogonadotrophic
    hypogonadism in males?
    A. Viral orchitis
    B. Klinefelter’s syndrome
    C. Kallman’s syndrome
    D. Noonan syndrome
    Ans: B.