CEE MD/MS BASED MODEL TEST

Saturday, Poush 13

Questions Answers Explanations (QAE)

Medicine
1. For calculating GFR by Cockcroft-Gault formula, the value is multiplied by what factor for women? a. 0.55
b. 0.65
c. 0.75
d. 0.85

2. Which of the following is false in prerenal azotemia?

a. Urine sodium (UNa) <20 meq/L
b. Urine osmolality >500 mosmol/L H2O
c. Fractional excretion of sodium (FENa) >2%
d. Urine/plasma creatinine (UCr/PCr) >40

3. In LBBB, the major QRS vector is oriented ?

a. Anteriorly and to right
b. Anteriorly and to left
c. Posteriorly and to right
d. Posteriorly and to left

4. A 69-year-old man present with a 2-week history of abdominal pain which has worsened over the last few days. On
examination, the patient is jaundiced and the abdomen is distended with tenderness in the epigastric region. In addition,
there is a smooth hepatomegaly and shifting dullness. Which of the following is a cause of hepatomegaly? a. Iron deficiency
Anaemia
b. Budd–Chiari syndrome
c. Crohn‘s disease
d. Left-sided heart failure

5. Henoch-Schönlein purpura lesions are most commonly distributed over?

a. Buttocks and lower extremities
b. Neck and upper limbs
c. Chest and abdomen
d. Face
6. Which of the following is not a feature of TTP ?
a. Microangiopathic hemolytic anemia
b. Renal failure
c. Hepatic failure
d. Neurologic dysfunction
7. Which of the following clinical features of diabetes insipidus is false?
a. Daily urine volume is >50 mL/kg body weight
b. Urine osmolarity is <300 mosmol/L
c. Dehydration is common
d. Enuresis is common
8. Which hormone deficiency is most common after cranial irradiation?
a. GH
b. Gonadotropin
c. ACTH
d. ADH
9. Which of the following is true during “gap” or “window” period in acute HBV infection?
a. Absence of HBsAg
b. Absence of anti-HBs
c. Presence of IgM anti-HBc
d. All of the above

10. Most common cause of nephrotic syndrome in the elderly is?

a. Minimal Change Disease (MCD)
b. Focal segmental glomerulosclerosis (FSGS)
c. Membranous glomerulonephritis (MGN)
d. Mesangioproliferative glomerulonephritis

11. The classic triad of myeloma consists of all, EXCEPT?

a. Marrow plasmacytosis (>10%)
b. Bence Jones proteins in urine
c. Lytic bone lesion
d. Serum and/or urine M component
.

12. Dopaminergic fibers in brain arise in which of the following?

a. Amygdala
b. Hippocampus
c. Ventral tegmental area (VTA)
d. Nucleus accumbens
13. Muscle cramps often occur in which of the following neurogenic disorders?
a. Motor neuron disease
b. Radiculopathies
c. Polyneuropathies
d. All of the above

14. Iridocyclitis is a feature of ?

a. Systemic lupus erythematosus
b. CNS sarcoidosis
c. Wegener‘s granulomatosis
d. Behçet‘s syndrome

15. Which out of the following is the less common cause of cardiac tamponade?
a. Neoplastic disease
b. Tuberculosis
c. Idiopathic pericarditis
d. Renal failure
16. Which of the following sign/symptoms tends to occur earlier in CKD patients?
a. Hyperparathyroidism
b. Anemia
c. Hypertension
d. Metabolic acidosis

17. Which of the following best relates to heparin-induced thrombocytopenia(HIT)? a.

Antibodies of the IgMiso type
b. AntibodiesagainstneoantigenonPF4
c. More common in medical than surgical patients
d. More frequent in males than in females
• .
18. Tropical eosinophilia is usually caused by ?
a. Wuchereriabancrofti
b. Ascaris
c. Ancyclostoma
d. Strongyloidesstercoralis

Surgery
19. A 62-year-old woman complains of painful enlargement of her right breast. She has no family history of breast cancer.
The right breast reveals warmth, redness, and right axilla nontender adenopathy. Which of the following is the best next
step?
a. Oral antibiotic therapy
b. IV antibiotic therapy
c. Biopsy
d. Observation

20. A 26-year-old man is brought into the emergency center for severe chest pain and upper abdominal pain. He is diagnosed
with esophageal perforation. Which of the following is the most likely etiology of his condition? a. Trauma
b. Congenital
c. Iatrogenic (endoscopy)
d. Spontaneous rupture (Boerhaave syndrome)
21. In MEN-2B prophylactic surgery in children is indicated at:
a. Less than 1 yr
b. Less than 3 yr
c. Less than 5 yr
d. Less than 10 yr
22. A 58-year-old airline pilot has confirmed prostatism. He is being treated for his condition but seeks treatment in the ED
for dizziness, which precludes his flying. Which of the following is the most likely problem? a. Drug side effect
b. Unrecognized Parkinson disease
c. Undiagnosed metastatic prostate cancer
d. Urinary tract infection

23. A 24-year-old medical student notes some numbness and tingling of her right hand. She states that primarily her little
finger is affected. Which of the following is the most likely etiology?
a. Median nerve
b. Radial nerve
c. Ulnar nerve
d. Lateral cutaneous nerve

24. In modified radical neck dissection, structure not preserved is?

a. Sternocleidomastoid
b. Internaljugularvein
c. Accessory nerve
d. Submandibular gland
25. Which of the following diagnostic modalities has the greatest specificity in identifying the source of lower GI tract
bleeding?
a. Tagged RBC scan
b. Barium enema
c. Colonoscopy
d. CT scan

26. An 18-year-old skier who was not wearing a helmet runs into a tree during a downhill run. He is brought to the ED
with normal BP, does not open eyes to painful stimuli, has abnormal flexion of the upper extremities with pain, and moans
with painful stimuli. Which of the following is the most appropriate next step?
a. 2000-mL IV fluid bolus.
 b. IV mannitol.
c. Contact the neurosurgeon.
d. Endotracheal intubation.

27. A 42-year-old male presented to the hospital for evaluation of a midline neck swelling. On further evaluation the
regional lymph node was found to be positive. Metastasis through lymphatics is common is - a. Medullary carcinoma thyroid
b. Papillary carcinoma thyroid
c. Follicular carcinoma thyroid
d. Anaplastic carcinoma thyroid
28. A 28-year-old man is noted to have a leiomyosarcoma of the right leg. Upon investigation, he is noted to have metastatic
involvement. Which of the following is the most likely site of metastasis?
a. Lymph nodes
b. Liver
c. Lungs
d. Bone

29. A 45-year-old women with polyhydramnios delivers a male infant with Down syndrome. Shortly after birth, the infant
vomits greenish-yellow fluid. Imaging reveals two distinct pockets of air in the abdominal region. Diagnosis is: a. Duodenal
atresia
b. Pyloric stenosis
c. Jejuna obstruction
d. Ileal obstruction
30. A patient complains of urinary symptoms. Urine is sent for microscopy and culture and sterile pyuria was found.
“Thimble bladder‟ on imaging and “golf hole” ureter on cystoscopy was observed. What could be the possible diagnosis? a.
Urinary Bladder polyp
b. Benign enlargement of prostate
c. Tuberculosis of urinary bladder
d. Congenital anomaly

31. Meckel‟s diverticulum is a persistent remnant of the vitello intestinal duct. Which of the following is not true of its clinical
presentation?
a. Painful dark rectal bleed or melena
b. Diverticulitis may present as acute appendicitis
c. Intussusception
d. Intestinal obstruction

32. While assessing a 38-year-old man who has respiratory complaints, physician‟s differential diagnosis is pleural effusion
versus pneumothorax. Which one of the following findings is more likely to be found in pleural effusion and not
pneumothorax?
a. Respiratory rate of 33 breaths/min
b. Agitation
c. Somnolence
d. Dullness to percussion over the chest wall on the affected side

33.A 27-year-old man presents to the ER after a high-speed motor vehicle collision with chest pain and marked respiratory
distress. On physical examination, he is hypotensive with distended neck veins and absence of breath sounds in the left chest.
Which of the following is the proper initial treatment?
a. Intubation
b. Pericardiocentesis
c. Chest decompression with a needle
d. Emergent thoracotomy
34. Which of the following conditions has been shown to have detrimental effects on wound
healing? a. Obesity
b. Hyperthyroidism
 c. C-reactive protein deficiency
d. Diabetes mellitus
35. Which of the following is the most common cause of gastrointestinal tract fistulas? a.
Peptic ulcer disease
b. Crohn disease
c. Ulcerative colitis
d. Diverticulitis
36. Which of the following is a complication associated with abdominal aorticaneurysms? a.
Early satiety
b. Colonic obstruction
c. Painful discoloration of the great toe
d. Hematuria
Obstetrics and Gynecology
37. A 36-year-old female presented to the Gynae OPD with symptoms of foul smelling greenish yellow vaginal discharge.
Which of the following gives positive Whiff test?
a. Candida
b. Trichomonas
c. Chlamydia
d. Bacterial vaginosis

38. A 32-year-old female is taken to the OT for open laparotomy. During the operation, the surgeons identify the Ureter by:
a. Peristaltic movement
b. Rich arterial plexus
c. Relation to lumber plexus
d. Accompanied by renal vein

39. A 32-year-old woman at 34 weeks‟ gestation comes into the obstetrical unit for vaginal bleeding. The suspicion is placental
abruption. Besides smoking and trauma, which of the following is the most significant risk factor for abruption? a. Obesity
b. Preeclampsia
c. Prior cesarean
d. Diabetes mellitus
40. A 28-year-old woman is wheeled into the operating room for a c-section and placed on the operating room table. As
monitors are placed, her BP is 68/40 and she reports feeling dizzy. You first response is which of the following? a. Left
uterine displacement
b. Fluid administration
c. Pressor administration
d. Oxygen by nasal cannula
41. The most common site of vulval cancer:
a. Labia majora
b. Labia minora
c. Prepuce of the clitoris
d. Bartholin‘s gland Ans: a

42. Spermicides contain:

a. Nonoxynol–9
b. Octoxynol
c. Benzalkonium chloride
d. All of the above
43. For what time duration does early puerperium lasts?
a. Upto 24 hours
b. Upto 7 days
c. Upto 21 days
d. Upto 42 days
44. What is the satisfactory rate of cervical dilatation in active phase of labor in a primipara? a. 0.5 cm/hr
b. 1 cm/hr
c. 1.5 cm/hr
d. 2 cm/hr
45. What is not a feature of placenta previa?
a. Placenta in upper segment
b. Recurrent painless antepartum bleeding
c. Uterus is soft and relaxed
d. None

46. Minimum number of ultrasound scans recommended by WHO for antenatal checkup is: a. 1
b. 2
c. 3
d. 4
47. False regarding cephalhematoma is:
a. Present few hours after birth
b. Does not cross suture lines
c. Fluctuation seen
d. Present at birth
48. Poor prognostic factor for Hydatidiform mole is?
a. Prior molar pregnancy
b. Metastasis to lung
c. No Prior Chemotherapy
d. WHO Score >8

Pediatrics
49. Which is the most common chronic relapsing skin disease seen in infancy and childhood? a. Ichthyosis
b. Allergic contact dermatitis
c. Impetigo
d. Atopic dermatitis

50. The diet of a 3-year-old child with cystic fibrosis should be supplemented with which of the following? a. Folate
 b. Sodium
c. Vitamin B12
d. Vitamin D

51. A 13-year-old adolescent female complains of dry cough, slight fever, and fatigue over the past 2 weeks. She noted
increased chest congestion and coughing yesterday when walking outside in the cold air. She denies nasal
congestion, rhinorrhea, emesis, or diarrhea. Her mother declares her daughter is generally healthy with a history
of only summertime allergies. Her vital signs, respiratory effort, and chest examination are normal. Which of the
following is the most likely pathogen?
a. H influenzae
b. M pneumoniae
c. Respiratory syncytial virus
d. S pneumonia
52. An 8-year-old, mentally delayed child ingests the contents of a mercury thermometer. Which of the following
symptoms are most likely to be seen?
a. Ataxia, dysarthria, and paresthesias
b. Chest pain and dyspnea
c. Gingivostomatitis, tremor, and neuropsychiatric disturbances
d. No symptoms
53. What is the MOST reliable sign of a dislocated hip in a 4-month-old infant? a. Limitation of abduction
b. Apparent shortening of the thigh
c. Proximal location of the greater trochanter
d. Asymmetry of the gluteal or thigh folds

54. What is the leading cause of morbidity and mortality in young children withMarfan syndrome (MFS)? a.
Supraventricular arrhythmias
b. Mitral valve dysfunction
c. Ventricular dysrhythmias
d. Dilated cardiomyopathy\

55. Which of the following factors considered protective against development of birth brachial plexus palsy? a.
Multiparous mothers
b. Mothers with excessive weight gain
c. Cephalic presentation
d. Twins

56. A 2 year old male presents with high-grade fever, cough, conjunctivitis and coryza. Correct about measles vaccine:
a. Edmonston-Zagreb strain
b. Primary Vaccine failure by maternal antibodies in 15%
c. During outbreaks given at 6 months
d. All of the above
57. An adolescent obese heavy smoker female presents with multiple pruritic painful erythematous nodules
progressed to deep abscesses then contracted scars confined to axillae, anogenital area, and breasts. These lesions
are found for the last 2 years punctuated by relapses and partial remissions with episodic inflammatory arthritis.
Of the following, the MOST likely diagnosis is
a. furuncles
b. scrofuloderma
c. actinomycosis
d. hidradenitis suppurativa
58. What is the first clinical manifestation of retinitis pigmentosa?
a. Impairment of night vision
b. Progressive loss of peripheral vision
c. Strabismus
d. Leukocoria
59. All are true about posterior urethral valve except?
a. Palpable bladder
b. Hydronephrosis
c. Painful stress incontinence
d. Recurrent UTI

60. Which of the following bacterial meningitis increased in children withcochlear implants? a. Staphylococcal
bacterial meningitis
b. Anaerobic bacterial meningitis
c. Gram-negative enteric bacterial meningitis
d. Pneumococcal bacterial meningitis

Orthopedics
61. Pathologic fracture can occur in all except
a. Metabolic bone disease
b. Osteosarcoma
c. Giant cell tumor
d. Fluorosis

62. A 20-year-old young male presented to hospital with complains of pain and swelling over his lower leg for the past 3 weeks.
X ray picture revealed as presence of new bone and typical Sunray appearance. The likely condition of the patient is?
a. Chondrosarcoma
b. Ewing‘s tumor
c. Osteoclastoma
d. Osteosarcoma

63. Which of the following is defective in osteogenesis imperfecta?

a. Osteoblasts
b. Osteoclasts
c. Collagen
d. None
64. Absence of lamina dura in the alveolus occurs in
a. Rickets
b. Osteomalacia
c. Paget‘s disease
d. Hyperparathyroidism
65. A 62-year-old male presented with history of back pain and weakness of lower limbs. On evaluation, his ankle jerk is
normal but was weak dorsi flexion of foot occurs. The likely region for disc prolapseis: a. L2 – L3
b. L3 – L4
c. L4 – L5
d. L5 – S1
66. Test used for prolapsed lumbar intervertebral disc is:
a. Coin test
b. Lasegue test
c. Thomas test
d. Apley‘s grinding test
67. Nerve injured in supracondylar humeral fracture is:
a. Brachial plexus
b. Axillary nerve
c. Radial nerve
d. Median nerve
68. All are true regarding Galeazzi fracture except:
a. Fracture lower end of the radius
b. Dislocation of the inferior radioulnar joint
 c. Dislocation of the superior radioulnar joint
d. Generally managed surgically
69. Which of the following test is positive in anterior dislocation of shoulder? a. Thomas test
b. Barlow's test
c. McMurrry‘s test
d. Dugas‘ test
70. Downward-arched forefoot is:
a. Pes valgus
b. Pes cavus
c. Pes plantaris
d. Hallux valgus

ENT
71. Which of the following is false about tympanic membrane?
a. Cone of light is anteroinferior
b. Shrapnell‘s membrane is also known as pars flaccida
c. Healed perforation has three layers
d. All of the above

72. False about septal hematoma is:

a. It can occur spontaneously in bleeding disorder.
b. Bilateral nasal obstruction is the commonest symptom.
c. The mass is usually soft and fluctuant on palpation.
d. Large hematomas can be aspirated with a wide bore needle.
73. Threshold for severe hearing loss is:
a. 26-40 dB
b. 56-70 dB
c. 71-91 dB
d. More than 91 Db

74. The sinus which is most superior in face is:

a. Maxillary
b. Frontal
c. Ethmoid
d. Sphenoid
75. Sleep apnea is cessation of breathing during sleep that lasts for at least: a. 15 seconds
b. 10 seconds
c. 30 seconds
d. 20 seconds

76. Nasal cycle is the cyclical alternate nasal blockage occurring:

a. Every 6-12 hours
b. Every 2-4 hours
c. Every 4-8 hours
d. Every 12-24 hours
77. Dehiscence of anterior wall of the external auditory canal cause infection in the parotid canal via a.
Fissure of Santorini
b. Notch of ramus
c. Petrous fissure
d. Retropharyngeal fissure

78. Surgical landmark for endolymphatic sac during surgery is:

a. Solid angle
b. Bill‘s island
 c. Citelli's angle
d. Donaldson line
• .
79. What is not a feature of Pierre-Robin syndrome?
a. Cleft lip
b. Cleft palate
c. Glossoptosis
d. Micrognathia

80. Location of Woodruff plexus is:

a. Posterior end of middle turbinate
b. Anterior end of septum
c. Posterior end of inferior turbinate
d. Posterior end of superior turbinate
Ophthalmology
81. Eyes turn down & inward with which of the following lesion?
a. Frontal lobe lesions
b. Thalamic lesions
c. Pontine lesions
d. Medullary lesions

82. Which of the following is not associated with rubeosis iridis?

a. Proliferative diabetic retinopathy
b. Retinopathy of prematurity
c. Central serous retinopathy
d. Eales' disease

83. A 24-year-old alcoholic pancreatic patient presents with sudden onset of painless loss of vision in both eyes. The most
likely diagnosis is:
a. Acute congestive glaucoma
b. Central retinal artery obstruction
c. Optic neuritis
d. Purtschers retinopathy

84. Which of the following statements about eyes in a state of coma is correct?
a. Eyes look toward hemispheral lesion & away from brainstemlesion
b. Eyes look away from hemispheral lesion & toward abrainstem lesion
c. Eyes look away from hemispheral or a brainstem lesion
d. Eyes look towards hemispheral or a brainstem lesion
85. Blue sclera is not seen in:
a. Osteogenesis imperfecta
b. High myopia
c. Healed scleritis
d. None

86. Which of the following statements about amaurosis fugax is false?

a. Briefer duration than migraine
b. Occurs in both eyes
c. Not followed by headache
d. Associated with antiphospholipid antibody syndrome
87. In hypertensive putaminal hemorrhage, the eyes deviate towards which side?
a. Away from the side of hemiparesis
b. Towards the side of hemiparesis
c. Remain in the center
d. Rotate upwards
Anesthesia
88. A 47-year-old woman is in the recovery room following GA for arthroscopic surgery of the knee. You are called because
her SpO2 is 88% and her RR is 4 breaths/minute. The most likely cause of her decreased oxygen saturation is which of
the following?
a. Residual inhalational anesthetics
b. Inadequate reversal of neuromuscular blocking agents
c. Narcotic overdose
d. Oxygen tank equipment malfunction
89. A 19-year-old man in the ED has facial burns, carbonaceous sputum, and bilateral wheezing. He is agitated and confused.
Abnormalities in which of the following most likely explain his neurological dysfunction? a. Platelet count
b. Hemoglobin level
c. Carboxyhemoglobin level
d. Prothrombin time

90. What is the spinal level of pain conduction from bladder?

a. T10 – L1
b. T10 – L2
c. T11 – L2
d. S2 – S4

91. During injection of local anesthetic in the epidural space, the patient loses consciousness. You suspect which of the
following?
a. Vagal reaction
b. Drug overdose
c. Subdural injection
d. Dehydration
A 24-year-old male following a massive RTA was taken to OT for intracranial bleeding with mass effect. The
anesthesiologist prior to the surgery evaluates the case and categorizes the patient as; a. ASA Class VI
b. ASA Class IV
c. ASA Class III
d. ASA Class V

92. Murphy‟s eye is seen in:

a. Macintosh blade
b. Miller blade
c. Endotracheal tube
d. All
93. A 40-year-old woman with myasthenia gravis presents for abdominal surgery. She has no other comorbidities or risk
factors. Which the following tests is most likely to be useful at the pre-anesthetic visit? a. Pulmonary function tests
b. Electrocardiogram
c. Chest x-ray
d. CBC
Psychiatry
95. A 30-year-old man presents for the evaluation of a depressed mood. He states that at least since his mid-20s he has felt
depressed. He notes poor self-esteem and low energy, and feels hopeless about his situation, though he denies suicidal
ideation. He states he does not use drugs or alcohol, and has no medical problems. His last physical examination by his
physician 1 month ago was entirely normal. Which of the following treatment options should be tried first? a. ECT
b. Hospitalization
c. Psychoanalysis
d. Venlafaxine
96. A 56-year-old man is admitted to the hospital after a stroke. The stroke is localized to the border of the somatosensory
and association areas in the posterior parietal lobe. Which of the following symptoms would be displayed upon
neurological testing?
a. Loss of proprioception
b. Loss of vibratory sensation
c. Loss of the ability to recognize items based on touch
d. Loss of pressure sensation

97. What is false about obsessive-compulsive disorder?

a. One‘s own idea is perceived as ego-alien
b. Insight is absent
c. Patient tries to resist but is unable to resist
d. Failure to resist leads to marked distress

98. A 58-year-old man has a brain lesion that causes him to feel euphoric, laugh uncontrollably, and joke and make puns.
Where is this brain lesion most likely located?
a. Fornix
b. Right prefrontal cortex
c. Hippocampus
d. Left orbitofrontal cortex

99. Condition in which a thought never entertained before is incorrectly regarded as a repetition of a previous thought: a.
Déjà vu
b. Jamais vu
c. Déjà entendu
d. Déjà pence
100. A 20-month-old boy loves running around and exploring the environment, but every few minutes he returns to his mother
to check on her and solicit a quick hug. Which of the following best describes this behavior? a. Depressive position
b. Secure attachment
c. Insecure attachment
d. Rapprochement
101. A healthy 9-month-old infant is brought by her concerned parents. Previously very friendly with everyone, she now
bursts into tears when she is approached by an unfamiliar adult. Which of the following best describes this infant‟s behavior?
a. Separation anxiety
b. Insecure attachment
c. Depressive position
d. Stranger anxiety
Dermatology
102. Antibodies to Desmoglein 1 are pathogenic in:
a. Pemphigus vulgaris
b. Pemphigus foliaceus
c. Both a and b
d. None
103. During evaluation of a condition, tangential pressure was applied over normal skin that resulted in development of a
new bulla. This condition is likely seen in;
a. Pemphigus vulgaris
b. Pemphigus Foliaceous
c. Stevens Johnson Syndrome
d. All of the above
104. Which scabicidal drug is contraindicated in infant?
a. Permethrin
b. Crotamiton
c. Sulphur
d. Lindane
105. Which of the following skin lesions is most frequent in CD?
 a. Erythema nodosum (EN)
b. Pyoderma gangrenosum (PG)
c. Psoriasis
d. Perianal skin tags

106. Toxic epidermal necrolysis (TEN) involves body surface area:

a. <10 %
b. 10-20%
c. 10-30%
d. >30 %
107. Which of the following is a highly infectious lesion in syphilis ?
a. Chancre
b. Lues maligna
c. Condylomatalata
d. Mucous patch
.
108. All of the following are associated with dermatitis herpetiform is except:
a. Dapsone used in treatment
b. Affect mainly flexor aspect
c. Associated with gluten sensitive enteropathy
d. Asymptomatic oral mucosal involvement frequent

Radiology
109. In color flow Doppler imaging of heart, which colour represents blood flow towards the transducer? a. Blue
b. Red
c. Yellow
d. Green

110. “Tram tracks” and “ring shadows” are chest radiological signs seen in ?
a. Bronchopneumonia
b. Bronchiectasis
c. Bronchogenic carcinoma
d. Aspergillosis

111. Stenver‟s View is used for?

a. Superior orbital foramen
b. Inferior orbital foramen
c. Internal auditory canal
d. Sella turcica

112. Sail sign is found in the auscultation of which of the following cardiac pathology? a. HOCM
b. Ebstein anomaly
c. Aortic regurgitation
d. ASD
113. Water lily appearance in a chest radiograph suggests:
a. Metastasis
b. Cavitating metastasis
c. Aspergilloma
d. Ruptured hydatid cyst
114. A radiologist evaluates a chest radiograph of a 19-year-old woman who was upended while riding her bicycle by a pickup
truck. Which of the following findings is most likely to suggest a diagnosis of ruptured thoracic aorta? a. A loss of aortic
knob contour
b. Pneumomediastinum
c. Thoracic transverse process fracture
d. Markedly enlarged cardiac silhouette
115. Which of the following is the earliest radiological sign in RA ?
a. Soft tissue swelling
b. Juxta-articular osteopenia
c. Loss of articular cartilage
d. Bone erosions

Anatomy
116. Which structure passes through the gap between the superior and middle constrictor muscles? a. Recurrent laryngeal
artery
b. Internal laryngeal nerve
c. Superior laryngeal artery
d. Glossopharyngeal nerve

117. A dentist uses local anesthesia to prepare for a procedure on a lower molar tooth. Which of the following nerves is the
dentist blocking?
a. Submental
b. Maxillary
c. Mandibular
d. Vagus

118. Hypogastric Sheath is a condensation of:

a. Scarpa‘s fascia
b. Cole‘s fascia
c. Pelvic fascia
d. Inferior layer of Urogenital diaphragm

119. Injury to the male urethra below the perineal membrane causes urine to accumulate in: a. Superficial perineal pouch
b. Deep perineal pouch
c. Space of Retzius
d. Pouch of Douglas

120. During the lumbar spinal puncture, the needle usually should be inserted inthe midline between the spinal processes of
the
a. L1 and L2 vertebrae
b. L2 and L3 vertebrae
c. L3 and L4 vertebrae
d. L5 and S1 vertebrae

121. Which of the following cranial nerve is associated with special somatic afferent nuclei?
a. V
b. VI
c. VII
d. VIII
122. An important function of the rotator cuff is
a. Depression of the clavicle
b. Elevation of the clavicle
c. Costoclavicular support
d. Stabilization of the humeral head

123. Pain sensitive area of brain is:

a. Dural sheath surrounding vascular sinuses
b. Middle meningeal artery
c. Falx cerebri
d. All of the above
124. Asterion is
a. Junction of greater wing of sphenoid, squamous temporal, frontal, and parietal bones; overlies course of anterior division of
middle meningeal artery
b. Point on calvaria at junction of lambdoid and sagittal sutures
c. Superior point of neurocranium, in middle with cranium oriented in anatomical (orbitomeatal) or Frankfort plane.
d. Located at junction of three sutures: parietomastoid, occipitomastoid, and lambdoid

125. Vidian nerve passes through

a. Inferior orbital fissure
b. Foramen lacerum
c. Tympano-mastoid fissure
d. Pterygoid canal

126. Maxilla doesn‟t articulate with:

a. Lacrimal bone
b. Plate of sphenoid bone
c. Frontal bone
d. Ethmoid bone

127. Meckel‟s cave is related to:

a. Submandibular ganglion
b. Trigeminal ganglion
c. Otic ganglion
d. Pterygopalatine ganglion

Physiology
128. When VA/Q is infinity:
a. Partial pressure of oxygen is zero
b. Partial pressure of carbon dioxide is zero
c. No exchange of gases
d. Partial pressure of both oxygen and carbon dioxide remains same

129. The actions of GH are mediated in part by which of the following? a. Insulin
b. Somatomedins
c. Thyroid hormone
d. Estrogen
130. A 24-year-old male has been lacking the production of testosterone since early childhood and has not been treated. He
will likely exhibit which of the following signs?
a. Be somewhat taller than average
b. Have a deep voice
c. Have abundant chest hair
d. Have no pubic or axillary hair

131. Insulin like growth factor is produced by:

a. Pituitary gland
b. Adrenal gland
c. Liver
d. Pancreas
132. Withdrawal of which of the following hormones results in menstruation? a. Estradiol
b. FSH
c. Progesterone
d. LH

133. What important lactation hormone enhances contraception and inhibits ovulation? a. Estrogen
b. Oxytocin
 c. Progesterone
d. Prolactin
.

134. All of these are Actions of Atrial Natriuretic peptide except:

a. Afferent arteriole dilatation
b. Decrease sodium resorption in PCT
c. Mesangial contraction
d. Increase capillary permeability

135. Which of the following is the major neurotransmitter released by most neurons within the basal ganglia? a. Acetylcholine
b. Dopamine
c. GABA
d. Glutamate
136. The principal site of absorption of sodium is:
a. Proximal convoluted tubule
b. Distal convoluted tubule
c. Loop of Henle (thick portion)
d. Collecting duct

137. An 18-year-old man with pernicious anemia lacks intrinsic factor, which is necessary for the absorption of
cyanocobalamin. Vitamin B12 is absorbed primarily in which portion of the gastrointestinal (GI) tract? a. Stomach
b. Duodenum
c. Jejunum
d. Ileum

138. Eukaryotic plasma membrane is made up of all except:

a. Carbohydrates
b. Triglycerides
c. Lecithin
d. Cholesterol
139. A 27-year-old patient with a chief complaint of mild vertigo of 3-month duration is seen by a neurologist. Examination
reveals a positional (horizontal and vertical) nystagmus that is bidirectional. The patient reports the absence of tinnitus.
Which of the following is the most likely etiology of the vertigo?
a. Labyrinthitis
b. Lesion of the flocculonodular lobe of the cerebellum
c. Lesion of the spinocerebellum
d. Ménière syndrome

Pathology
140. What produces boot shaped heart?
a. Left atrium hypertrophy
b. Left ventricular hypertrophy
c. Right atrium hypertrophy
d. Right ventricular hypertrophy
141. Pancreatic cancer arises most commonly in which part?
a. Head
b. Neck
c. Body
d. Tail

142. Which of the following is not a feature of anaplastic tumor cells?

a. Cellular pleomorphism visible
b. Cells undergo atypical mitoses
c. Specialized functional activities intact
 d. Loss of polarity
143. What is false about morphological findings in bronchial asthma?
a. Thickening of airway wall
b. Occlusion of bronchi & bronchioles by Curschmann spirals
c. Decreased submucosal vascularity
d. Sub-basement membrane fibrosis
144. False about Panacinar emphysema is:
a. It occurs more commonly in the upper lung zones
b. It is associated with α1-antitrypsin deficiency
c. It is not associated with smoking
d. None
145. Oxygen dependent killing is done through
a. NADPH oxidase
b. Superoxide dismutase
c. Catalase
d. Glutathione peroxidase
146. .Sure sign of malignancy is:
a. Mitoses
b. Polychromasia
c. Nuclear pleomorphism
d. Metastasis
147. A patient with bleeding upon further investigation was found to have defect in GpIb. What is the associated defect? a.
Bernard-Soulier syndrome
b. Von Willebrand disease
c. Glanzmann thrombasthenia
d. None
148. Most potent stimulator of naive T cell is?
a. Mature dendritic cell
b. Follicular dendritic cell
c. Macrophages
d. B cell

149. A 2-year-old child with testicular swelling was found to have elevated alpha fetoprotein level. The mass upon
histological examination shows presence of Schiller-Duval bodies. The likely cause is: a. Seminoma
b. Spermatocytic tumor
c. Choriocarcinoma
d. Yolk sac tumor

Pharmacology
150. Drug used in mild hemophilia is:
a. Corticosteroids
b. DDAVP
c. Vitamin K
d. Tranexamic acid
151. Drug remaining in the body after 3 half-lives is:
a. 12.5%
b. 75%
c. 87.5%
d. 94%

152. A patient who was transported by ambulance to the emergency department took a potentially lethal overdose of aspirin.
Which of the following drugs would be a helpful adjunct to manage this severe aspirin poisoning? a. Amphetamines (e.g.,
dextroamphetamine)
b. N-acetylcysteine
c. Phenobarbital
 d. Sodium bicarbonate

153. Effect of combination is greater than the individual effects of the components is: a. Potentiation
b. Additive
c. Agonism
d. Antagonism

154. Zileuton a 5 lipoxygenase inhibitor acts by which of following mechanism: a. LTC4

b. LTB4
c. LTD4
d. All
155. A 26-year-old woman with acquired immunodeficiency syndrome (AIDS) develops cryptococcal meningitis. She refuses
intravenous medication. Which of the following antifungal agents is the best choice for oral therapy of the meningitis?
a. Amphotericin B
b. Fluconazole
c. Ketoconazole
d. Nystatin
156. Alpha I blocker without any effect on blood pressure is:
a. Tamsulosin
b. Prazosin
c. Doxazosin
d. Terazosin

157. Which of the following drug is useful in acute attack of migraine?

a. Bromocriptine
b. Cinnarizine
c. Sumatriptan
d. Ondansetron

158. Narrow spectrum penicillin, both penicillinase-sensitive and -resistant, have relatively poor activity against
gramnegative bacteria. Which of the following is the main property or characteristic that explains why these
microorganisms do not respond well to the penicillin?
a. Actively transport any absorbed penicillin back to the extracellular space
b. Have an outer membrane that serves as a physical barrier to the penicillin
c. Lack a surface enzyme necessary to metabolically activate the penicillin
d. Lack penicillin-binding proteins

159. Characteristic feature of antagonist is:

a. Has affinity only
b. Has affinity as well as intrinsic activity
c. Has intrinsic activity only
d. Neither has affinity nor activity

Biochemistry
160. Maple syrup disease is:
a. Due to deficiency of transaminase
b. Due to deficiency of deaminase
c. Due to deficiency of keto decarboxylase
d. Due to deficiency of dehydrogenase
161. Which is derived from Arginine?
a. Creatine
b. Histamine
c. Glutathione
d. Taurine
162. Enzyme deficient in McArdle syndrome is?
 a. Glycogen synthase
b. Glucose-6-phosphatase
c. Muscle phosphorylase
d. Liver phosphorylase

163. Acetyl CoA can be directly converted to all except:

a. Glucose
b. Fatty acids
c. Cholesterol
d. Ketone bodies

164. In a well fed state, the carnitine palmitate acyl transferase on the outer mitochondrial membrane is most potently
inhibited by:
a. Glucose
b. Palmitoyl CoA
c. Acetyl CoA
d. Malonyl CoA

165. Uronic acid pathway is not involved in:

a. Conjugation of bilirubin
b. GAG Synthesis
c. Vitamin C Synthesis
d. Biotransformation

166. How many ATP are produced per turn of citric acid cycle?
a. 6
b. 10
c. 20
d. 36
167. Glycogenin is a:
a. Polypeptide
b. Polysaccharide
c. Lipid
d. Glycosaminoglycan

168. Tryptophan is glucogenic and ketogenic by producing:

a. Arginine and Alanine
b. Acetoacetate and fumarate
c. Acetoacetate and arginine
d. Alanine and Acetyl CoA

169. Essential pentosuria is due to deficiency of -

a. Gulonolactone oxidase
b. Phosphoglucomutase
c. Xylulose dehydrogenase
d. Fructokinase

Microbiology
170. A 35-year-old male was treated with an aminoglycoside for an infection with a gram-negative rod. Which of the
following bacterial processes is involved in transport of this antibiotic into the cell? a. Facilitated diffusion
b. Group translocation
c. Oxidative phosphorylation
d. Transpeptidation
171. A 62-year-old woman with diagnosed type 2DM lived alone and did essentially nothing to manage her illness, including
disregarding her doctor‟s instructions. She was taken to her ER with severe, multiple infected foot lesions, which
yielded a variety of opportunistic microbes with a mixture of antibiotic susceptibilities. The physician decided to treat
with systemic and topical antimicrobials. Which of the following antimicrobial agents must only be used topically? a.
Bacitracin
b. Gentamicin
c. Itraconazole
d. Vancomycin
172. HHV-6 causes:
a. Carcinoma cervix
b. Kaposi‘s sarcoma
c. Focal encephalitis
d. Clear cell carcinoma
173. Patients with C5 through C9 complement deficiencies are most likely to be susceptible to which of the following
infections?
a. AIDS
b. Histoplasmosis
c. Neisserial infection
d. Pneumococcal infection
174. A patient with a long history of consuming poorly cooked pork meat presents with generalized myalgia and a
lowgrade fever. Striated muscle biopsy reveals multiple cysts. Eosinophilia is also present with elevated levels of which of the
following immunoglobulins most likely involved in parasitic infections? a. IgA
b. IgM
c. IgD
d. IgE
175. A young boy presented with pustules showing gram positive cocci, beta hemolysis, catalase negative. To show it is
group A streptococci, which of the following test is done
a. Bacitracin sensitivity
b. Optochin sensitivity
c. Novobiocin sensitivity
d. Bile solubility

Community Medicine
176. Which of the following is the principal source of air pollution?
a. Agricultural use of pesticides
b. Industrial waste
c. Natural sources
d. Fuel combustion

177. In chemical and biologic terrorism, patients can be classified as having primarily respiratory, neuromuscular, or
dermatologic manifestations. In this regard, which of the following agents has prominent dermatologic findings? a.
Mustard
b. Anthrax
c. Chlorine
d. Phosgene
178. Regular drinking of which of the following can help prevent Urinary tract infection (UTI)? a. Grape juice
b. Orange juice
c. Cranberry juice
d. Raspberry juice

179. Web of causation of disease, which statement is most appropriate?

a. Mostly applicable for common diseases
b. Requires complete understanding of all factors associated with causation of disease
c. Epidemiological ratio
d. Helps to suggest ways to interrupt the risk of transmission
180. First clinical sign of Vitamin A deficiency is:
a. Night blindness
b. Conjunctival xerosis
c. Bitot‘s spots
d. Keratomalacia

181. Leprosy is not targeted for global eradication because:

a. No effective vaccine
b. Highly infectious but low Pathogenicity
c. Only humans are reservoir
d. Long incubation period

182. There is an outbreak of MRSA infection in a ward of a hospital. What is the best way to control the infection? a.
Vancomycin given empirically to all the patients
b. Frequent fumigation of the ward
c. Wearing masks before any invasive procedure inICU
d. Washing of hands before and after attending the patients
183. Smallpox vaccine was introduced by:
a. Paul Ehrlich
b. Robert Koch
c. Louis Pasteur
d. Edward Jenner
184. Case acts it own control in which type of study:
a. Case control study
b. Prospective study
c. Concurrent study
d. Cross over study
185. A radiation therapist prescribes a new chemo-immunotherapy for a patient of Malignant melanoma which prolongs
survival of melanoma patients. How will it affect the epidemiology of the disease?
a. Decreased incidence but no effect on prevalence
b. Increases both incidence and prevalence
c. Decreases both incidence and prevalence
d. No effect on incidence but increased prevalence

Forensic Medicine
186. Which of the following is the earliest manifestation of neurotoxicity after neurotoxic snake envenomation? a. Upper limb
weakness
b. Ptosis
c. Respiratory muscles weakness
d. Flaccid paralysis
187. Heat hematoma resembles:
a. Subdural hematoma
b. Subarachnoid hematoma
c. Extradural hematoma
d. Intracranial hematoma
.

188. Skin Incision for Medico legal autopsy include all except:
a. I shaped
b. Y shaped
c. Modified I shaped
d. Modified Y shaped
189. Hostile witness is one who:
a. Threatens the judge
 b. Threatens the prosecutor
c. Refuses to answer
d. Willfully gives false evidence
190. Electra complex is a form of sexual deviance which involves:
a. Hostage and criminal
b. Father and daughter
c. Mother and son
d. Close friends

Mandatory CPD Topics

191. Which of the following chelators is preferred for chronic inorganic mercury poisoning? a. Succimer (DMSA)
b. D-Penicillamine
c. N-acetyl-D, L-penicillamine
d. Calcium disodium edetate (CaNa2EDTA)

192. In CPR performed by two persons, the ratio of compressions to breaths is? a. 10: 1
b. 10: 2
c. 15: 1
d. 15: 2
193. In ventricular fibrillation, initial shock with a monophasic wave-form defibrillator should be? a. 100 J
b. 200 J
c. 300 J
d. 360 J
194. A 24-year-old man is involved in aRTA in which he veered off the road and hit a tree. In his evaluation, there
are no overt bleeding sites. Which of the following findings is most likely associated with bleeding? a.
Hypertension
b. Tachycardia
c. Polyuria
d. Elevated INR

195. Patient counselling should be done by:

a. Treating physician
b. Nursing staff who takes care
c. Health administrator
d. Junior doctor who attends round
196. A 41-year-old woman is involved in a “head on” motor vehicle accident at a highway. She was wearing a seat
belt, and the air bags deployed. An ECG is performed revealing nonspecific ST-T wave changes. Which of
the following should be considered?
a. Pericarditis
b. Myocardial infarction
c. Heart failure
d. Aortic injury
197. The concept of self-determination includes which of the following?
a. It requires a physician to do anything a patient requests.
b. It is a replacement for informed consent.
c. It is not valid if the patient is unconscious or incompetent to makedecisions.
d. It affirms the principle of patient autonomy.

198. You are working in a postop room as a medical officer, and you receive a 60-year-old patient who appears weak and is
struggling to breathe following emergent open cholecystectomy. The patient‟s SpO2 is 85%. You suspect inadequate
reversal or neuromuscular blocking agents. Your first step should be which of the following? a. Sit the head of the bed up
higher.
b. Assist the patient‘s ventilation with bag mask.
c. Administer neostigmine.
d. Administer midazolam for amnesia.
199. Which of the following is ethically correct?
a. A physician should not enter into any emotional or sexual relationship with patient
b. A physician should not enter into any emotional or sexual relationship with patient but can do with member of patient's
family at personal level
c. A physician can enter into any emotional or sexual relationship with patient, if they have affair
d. There is no ethical recommendation if the relationship is private

200. Which of the following statements regarding DNR/DNI is most accurate?

a. It is irrevocable and unchangeable once stated.
b. It is an expression of a patient‘s choice to limit health care.
c. It can be applied only when expressed by an awake, competent patient.
d. It is invalid in the operating room.