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Final Chraitra 2078

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0% found this document useful (0 votes)
44 views12 pages

Final Chraitra 2078

Uploaded by

stdneenavaidya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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1.

A 46 years old female presented to emergency with shortness of breath, chest


pain, palpitations and syncopal attack. On examination, her pulse was 48 bpm
and BP was 100/70 mmHg. Her ECG showed prolong PR interval. What is most
likely diagnosis?
a) First degree heart block
b) Mobitz type 1 heart block
c) Mobitz type 2 heart block
d) Third degree heart block

2. A 48 years old female presented with palpitations since last 24 hours. Her ECG
shows narrow complex tachycardia. What is important in terms of
management?
a) Rate Control
b) Rhythm control
c) Transoesophageal ECHO to see thrombus
d) Immediate electro cardioversion

3. A 34 years old male came to OPD with complain of pain over upper abdomen,
burning in nature which is usually severe at night after going to bed. He also
gives history of black tarry stool few days back. What is the most likely
diagnosis?
a) Gastric Ulcer
b) Duodenal ulcer
c) Oesophagitis
d) Diverticulitis

4. A 23 years old male presented with loose stool mixed with mucous and few
streaks of blood. He also complained of fever and cramping abdominal pain
intermittently. His stool culture showed isolated shigella. Which part of intestine
is this infection located?
a) Duodenum
b) Jejunum
c) Ilium
d) Colon
5. A 37 years old male came to emergency department with complain of severe
pain abdomen and vomiting since last 6 hours. On examination his vitals were
stable. There was tenderness over epigastric region and murphy’s sign was
negative. His previous USG revealed multiple gall stone. What is the choice of
investigation for this patient?
a) UGI Endoscopy
b) USG abdomen
c) Amylase
d) CT abdomen

6. A 18 years old male was brought to emergency with the in stuporous condition
following 6 hours of paracetamol overdose. What is the most important
investigation indicating liver failure?
a) Total protein
b) Liver enzymes
c) PT/INR
d) APTT

7. A 32 years high risk female came with jaundice and pain abdomen. On
examination she was icteric and had tender hepatomegaly. Lab investigation
was positive for HBsAg. What is the investigation of choice to detect replicating
stage?
a) Anti HBs Ig G
b) Anti HBs Ig M
c) HBeAg
d) HBcAg

8. A 58 years old alcoholic male presented with difficulty in breathing. On


examination he had gross ascites, decreased axillary hair, testicular atrophy. His
AST/ALT ratio was more than 2 and discriminant function was more than 32.
What is the drug that could improve survival in this patient?
a) Alpha interferon
b) TNF alpha
c) Lamivudine
d) Glucocorticoid
9. A 29 years old male with complain of uneasiness over abdomen and bloating
sensation. On examination he was anemic and stool examination revealed eggs
of Trichuris Trichuria. What is the drug of choice?
a) Albendazole
b) Pyrantel pamoate
c) Praziquantel
d) Triclabendazole

10.A 20 years old non smoker male presented with blood mixed loose stool 4-6
episodes since last few months. Colonoscopic findings was suggestive of
hemorrhagic, edematous, mucosa involving rectum and extending proximally to
involve all or part of the colon. What is the diagnosis?
a) Ulcerative colitis
b) Chron’s disease
c) TB Infection
d) Salmonella infection

11.A 30 years old male was brought to emergency following a physical assault. He
had injury over his right arm with right wrist drop. X ray revealed fracture of
shaft of right humerus. What is the possible cause of wrist drop?
a) Radial nerve injury
b) Median nerve injury
c) Ulnar nerve injury
d) Interoesseous nerve injury

12.A 24 years cricket player injured his shoulder while bowling. On examination his
Dugas’ test was positive. What is the possible diagnosis?
a) Fracture humerus
b) Dislocation of shoulder
c) Acrominoclavicular joint disruption
d) Elbow dislocation

13.A 19 years old male diagnosed as rheumatic heart disease on Benzyl penicillin
came for his regular dose. After injecting the patient collapsed. BP was not
palpable and pulse was feable. What is the drug of choice for this patient?
a) Dopamine
b) Dobutamine
c) Adrenaline
d) Noradrenaline

14.A 25 years old female came to emergency with complain of pain abdomen and
PV bleeding. She also complains of syncopal attack. Her BP was 80/60 mm Hg,
Pulse 100 bpm and her pregnancy test was positive. What is the diagnosis that
needs to be confirmed first?
a) Miscarriage
b) Ectopic pregnancy
c) Normal pregnancy
d) Molar pregnancy

15.A 28 weeks primi came for her regular ANC visit. Om examination her BP was
found to be 140/80 mmHg and her urine protein was 2+. What is the best
management for this baby?
a) Methyldopa
b) MgSO4
c) Termination
d) Observation

16.A 30 years old male came with history of road traffic accident. He gives history
of brief loss of consciousness following trauma. On examination he had injury
over temporal region, other examination was normal. The patient came back
unconscious following 6 hours of discharge. What is the possible diagnosis?
a) Extradural hemorrhage
b) Subdural hemorrhage
c) Intracerebellar hemorrhage
d) Diffuse axonal injury

17.A patient complaint that their 2 years old son is having fever and noisy breathing
for 2 days. On examination he was oriented, conscious but febrile, respiratory
rate was 60 bpm with subcostal indrawing. According to WHO classification on
ARI for under 5, the possible diagnosis is
a) No pneumonia
b) Pneumonia
c) Severe pneumonia
d) Very severe pneumonia

18.A 6 months old child is brought to ER with the complaint of frequent loose stool,
no vomiting and tolerating feed. The child looks lethargic and on enquiry the
mother gives the history that her child has not passed urine for 12 hours. What
is your priority of management?
a) Bolus IV fluid
b) Maintenance IV fluid
c) ORS
d) Breast feeding

19.A 12 years male child presents to ER with severe abdomen pain. On examination
he has slight swelling over his right knee which is tender. There are non-palpable
purpuric rashes over buttock and lower limbs. His hematological investigations
are normal. Urine shows proteinuria 2+ and USG abdomen and x-ray right knee
is normal. Which of the following statement is false?
a) Pain abdomen is also known as abdominal angina
b) Renal involvement is one of the indications to use steroid
c) Swelling of knee is usually septic
d) Histopathology shows fibrinoid necrosis of vessels

20.A 35 years old male presents with complain of repeated vomiting and not
passing stool and flatus for 3 days. He has a history of laparotomy in past for
perforated ileum. On examination his bowel sound was hyper dynamic and
abdomen was tender. Which is the most likely cause for this condition?
a) Adhesive band
b) Reperforation
c) Obstructed hernia
d) Carcinoma

21.A 34 years old lady came to OPD with easy fatigue, muscle cramps and
constipation. Her pulse was 56 bpm, other clinical findings were normal. Her
investigations reports were as follows: TSH: 20 µIU/L, serum calcium: 9 mg/dl.
What is the possible diagnosis?
a) Hypercalcaemia
b) Hypocalcaemia
c) Hyperthyroidism
d) Hypothyroidism

22.A 40 years old male presented to emergency with BP of 190/100 mmHg. His
fundus examination, ECG and renal functions were normal. His neurological
examination is also normal. What is the most possible diagnosis?
a) Hypertensive emergency
b) Hypertensive encephalopathy
c) Hypertensive urgency
d) Malignant hypertension

23.A 3 years old child presents to emergency department with stridor since last 4
hours. She has slight cough, is unable to drink. The child looked toxic and was
sitting with neck extended. Examination revealed drooling of saliva, febrile and
chest examination was unremarkable. What is your possible diagnosis?
a) Bacterial tracheitis
b) Epiglottis
c) Croup
d) Diphtheria

24.A young male is brought to emergency following road traffic accident. The
patient is dyspneic, trachea is shifted to right side, tachycardic, raised JVP and
left chest is hyper resonant with decreased air entry on same side. What is the
important next step?
a) Chest tube drainage
b) Needle decompression
c) Refer to thoracic surgeon
d) Send chest x-ray

25.A 25 years male presents with severe abdominal pain. He gives history of black
stool since last few days. On examination the patient was tachycardiac,
abdomen was rigid and bowel sound was absent. On duty staff orders x-ray
abdomen erect with dome of diaphragm. Why was the x-ray ordered?
a) Air fluid level can be seen in erect x-ray
b) Gas under diaphragm can be identified
c) Maximum dilatation of bowel can be seen
d) Whole abdomen could be visualized

26.A 20 years old male is brought to emergency department following road traffic
accident. On presentation the patient was very pale and bruising over left
subcoastal region. Abdominal examination showed signs of peritonitis. What is
the organ most likely to be injured?
a) Colon
b) Kidney
c) Liver
d) Spleen

27.A 65 years old male presents weakness of right half of the body. He is a known
case of hypertension on medication. At present his BP is 170/100 mmHg with
pulse 72 bpm. What is the most appropriate statement?
a) Aspirin should be given immediately
b) CT head should be sent
c) Treat hypertension
d) Observe the patient

28.Most common gall bladder stone is:


a) Cholesterol stone
b) Black pigmented stone
c) Brown pigmented stone
d) Mixed stone

29.A 28 years old female came to OPD with complain of headache since last 6
months, She complaints of loss of interest and low mood since last 6 months.
What is the possible diagnosis?
a) Anxiety disorder
b) Depression
c) Mood disorder
d) Schizoaffective disorder

30.A male presented with fever since last three weeks. He also gives history of loss
of appetite and pain abdomen. On examination the patient has
hepatosplenomegaly. Lab reports shows: HCT 27%, WBC: 3.7 with myelocytes
and metamyelocytes, platelets 100,000. What is the possible diagnosis?
a) AML
b) ALL
c) CML
d) CLL

31.A 60 years old male came to emergency with sudden onset of SOB. On
examination his pulse is 130 bpm, low volume, BP is 90/40 mmHg and has cold
periphery. On auscultation of chest, he has S3 gallop with bilateral basal fine
crepitation. Which of the following statement is more appropriate for this
patient?
a) Dobutamine is drug of choice as it has both ionotrophic and chronotrophic
action
b) Dobutamine causes pulmonary vasodilation so it is a good choice
c) Dobutamine should be given only when BP is less than 90 mmHg
d) Dobutamine also has vasoconstrictive effect

32.Most common site of spread of choriocarcinoma is:


a) Lung
b) Brain
c) Liver
d) Bone

33.Pap smear in pregnancy is:


a) Contraindicated
b) Routine as apart of screening
c) Not useful
d) Done in every patient
34.Corpus luteum activity is maintained by
a) FSH
b) Estrogen
c) LH
d) Progesteron

35.In Pre-eclampsia all true except


a) Pre-eclampsia can cause disseminated intravascular coagulopathy
b) If pre-eclampsia necessitates delivery prior to 34 weeks gestation, screening
for antiphospholipid syndrome is indicated
c) Pre-eclampsia commonly necessitates the use of antihypertensive agents in
the puerperium
d) Use of low dose aspirin does not reduce pre-eclampsia

36.A 36 years old female who has completed her family ten years back has a huge
fibroid uterus. The choice of surgery for her would be
a) Total abdominal hysterectomy
b) TAH + BSO
c) Bilateral oophorectomy
d) Unilateral oophorectomy

37.The following require antibiotic prophylaxis for endocarditis during delivery


except
a) Ventricular sepal defect
b) Prosthetic mitral valve
c) Bicuspid aortic valve
d) WPW Syndrome

38.In patient who is 10 years menopausal


a) Vaginal bleeding is indicative of endometrial cancer
b) Osteoporosis is the most serious health hazard
c) Post-menopausal uterine bleeding
d) Fibroid uterus
39.Treatment options for diabetes in pregnancy all true except
a) Gliclazide is teratogenic
b) ACE inhibitors should be stopped after confirmation of pregnancy
c) Folate (5 mg/day) should be taken before conception and for the first
trimester
d) Postprandial testing of glucose enables tighter control of diabetes than pre-
prandial testing

40.An autosomal dominant characteristic in only the male partner is found in what
percentage of offspring
a) 25 %
b) 50 %
c) 75 %
d) 100 %

41.The most common karyotype of a patient with down syndrome is


a) 18 trisomy
b) 14/21 translocation
c) 21 trisomy
d) 13 trisomy

42.A 16 years old girl presented to orthopedic OPD with cubitus valgus deformity
of left elbow. She had history of lateral condyle of left humerus fracture at the
age of 7 years which was treated conservatively at the local hospital with plaster
for 4 weeks. Which nerve injury is likely to develop in this patient?
a) Median nerve
b) Posterior interosseous nerve
c) Radial nerve
d) Ulnar nerve

43.A 35 years lady presented in emergency department with left posterior hip
dislocation for 6 hours duration. She is planned for closed reduction of the
dislocation. Which of the following anesthesia is used for closed reduction?
a) Epidural anesthesia
b) General anesthesia
c) Local anesthesia
d) Spinal anesthesia

44.Regarding the management of major trauma


a) Deaths follows a trimodal distribution
b) X-rays after the primary survey should be of AP cervical spine, chest and
pelvis
c) Cardiac tamponade is characterized by raised BP, low JVP and muffled heart
sounds
d) Assessment of uncomplicated limb fractures should occur during the primary
survey

45.Regarding appendicitis
a) The risk of developing the illness increase with advancing age
b) Majority of appendices are extraperitoneal in a retrocaecal position
c) Antibiotics are always indicated postoperatively
d) Appendicitis is a possible diagnosis in the absence of abdominal tenderness

46.Regarding stones in the gallbladder


a) Cholesterol stones are the most common
b) Pigment stones are due to increased excretion of polymerized conjugated
bilirubin
c) Are not risk factor for the development of gallbladder carcinoma
d) 90 % of gallstones are radio-opaque

47.Stones in the common bile duct


a) Are found in 50% of patients undergoing cholecystectomy (without pre-op
ERCP)
b) Are suggested by a bile duct diameter >8 mm on ultrasound
c) Laparoscopic CBD exploration is now the treatment of choice
d) If removed by exploration of the common bile duct the T-tube can be
removed after 3 days

48.Regarding crystalloid solutions


a) Normal saline contains 164 mmol sodium & 164 mmol of chloride per litre
b) 3 litres of dextrose saline in a day will provide 154 mmol of sodium
c) 2 grams of potassium chloride is equal to 57 mmol of the salt
d) Hartmann’s solution contains calcium and bicarbonate

49.A case of severe head injury arrived in the ER. The patient was planned for
elective mechanical ventilation. He was then transferred to the ICU. What is the
most common oxygen cylinders used in transferring the patient?
a) D cylinders
b) E cylinders
c) H cylinders
d) M cylinders

50.A patient having severe diarrhea for 24 hours was admitted in the step down
and later transferred to the ICU as the condition was getting worse. Arterial
blood gas shows pH: 7.42, PaCO2: 36 mmHg and HCO3: 30 mmHg. The status
now is:
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis

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