NMCLE SPECIAL EXAMINATION 2081 -INTERNAL MEDICINE - COLLECTED BY:

DR PKC AND ABINASH

1. A 53-year-old female with the dry eye and mouth has got Parotid enlargement with
lymphocyte infiltration on biopsy what is the diagnosis:
a. Sjogren’s Syndrome
b. Sarcoidosis
c. Rheumatoid arthritis
d. igG4 -related disease

2. A 60-year-old female has for Progressive shortness of breath for 2 years with examination
findings of the bibasilar fine crepts, what is the likely diagnosis?
A. Interstitial lung Disease
B. Chronic Heart Failure
C. Chronic Bronchitis
D. Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

3. A 40-year-old female with the history of rheumatic heart disease for 10 years has got the
auscultatory findings of Mid diastolic murmur
A. MS
B. TR
C. MR

4. From where the maximal sodium is reabosorbed-

A. PCT
B. DCT
C. ASCENDING LOOP OF HENLE

5. Which of the following isn't the mechanism of action of the LMWH

A. INHIBITS ANTITHROMBIN 3
B. INHIBITS 2A
C. INHIBITS 10A

6. A 40-year-old male presented with the shortness of breath with the examination findings of
erythema nodusum and hilar lymphadenopathy what is the diagnosis
A. SARCOIDOSIS
B. SJOGREN SYNDROME
C. LUNG CANER

7. A female with the history of bodyache joint pain in different parts of body with the lab value
of increased ESR with negative RA CCP, what is the diagnosis
A. PMR
B. RA
C. ANKYLOSIS SPONDYLOSIS

8. Most common manifestation of the MS

A. OPTIC NEURITS
B. HEMIPARESIS
C. PERIPHERAL NEUROPAHTY

9. which of the following is the feature of brown sequard syndrome-

 A. IPSILATERAL PROPIOCEPTION
B. IPSILATERAL PAIN LOSS
C. CONTRALATERAL PROPIOCEPTION
10. A 40-year-old male underwent GI surgery and on the post op day 3 he has got the sodium of
158 with decreed urine osmolarity what is the diagnosis
A. DI
B. SIDAH
C. AKI

11. A 30-Year-old male has got the vomiting diarrhea for 4 days with increased creatinine level
which of the following is the lab finding in this patient
A. INCREASED URINE OSMOLARITY
B. DECREASED URINE OSMOLARITY
C. INCREASED URINE SODIUM

12. A 70-year-old male with the history of syncope has got a murmur which increase on
valsalva which of the following drug is the ist line of treatment of this patient
A. BETA BLOCKER
B. ASPIRIN
C. ACE I

13. what is the definition of malignant hypertension-

A. HTN WITH PAPILODEMA
B. HTN WITH RENAL DAMAGE
C. HTN WITHOUT END ORGAN DAMAGE

14. what is the definition of the resistant hypertesnion

A. 3 DRUGS INCLUDING DIURETICS
B. BB+ ACE
C. CCB +BB

15. A 50-year-old female undergoing chemotherapy for the non-Hodgkin lymphoma with 2
weeks post chemo developed tingling buring sensation with decreased deep tendon, what is
the culprit
A. VINCRITTEE
B. RITUXIMAB

16. What is the drug of choice used in the Prinz metal angina-
A. CCB
B. ASPIRIN
C. STATIN

17. Patient with the history of syncope and chest pain has got aortic stenosis, which of the
following is correct regarding the symptoms and prognosis of AS
A. HEART FAILURE 2 YEARS
B. ANGINA 3 YEARS
C. HEART FAILURE 5 YEARS

18. A 55-Year-old diabetic male with the history of the chest pain passed out at home 4 hours
ago, with CPR done according to ACLS protocol, what is the cause of death in this patient
A. VENTRICULAR FIBLRATION
 B. ISCHEMIC CVA

19. A 17-year-old female with the amenorrhea has got well developed breast but NO PUBIC
AND AXILLARY HAIR and normal external genitalia, she did not want a pelvic and lab
investigation, what is the likely diagnosis form above information
A. ANDROGEN INSENSITIVITY
B. GONAD DYSGENSIS
C. CAH

20. A 20-year-old female with the perfectionism of body dysmorphism with?? DISTORTED
BODY SHAPE what is the diagnosis
A. ANOREXIA NERVOSA
B. Borderline PD
C. HYPOCONDRIASIS

21. Which of the following murmur don’t need further evaluation

A.ANY SYSTOLIC MURMUR
B. ANY DIASTOLIC MURMUR
C. ANY PAN-SYSTOLIC MURMUR

22. A 45-year-old male with the high grade fever and murmur with echo findings of IE.what is
the diagnosis
A. ACUTE ENDOCARDITIS
b. SUBACUTE ENDOCARDITIS
C. ATIRAL MYXOMA

23. 14-year-old female with the fever and the altered sensorium has got the csf findings
suggestive of the meningitis with lab showing diplococci what is the organism
A. NEISSERIA
B. HEMOPHILUS
C. STREPTOCOCUS

24. A Patient admitted for pneumonia was given the codeine for cough and now has developed
acute delirium with co2 retention what is the findings
A. Type 1 RF
B. Type 2 RF
C. Type 3 RF

25. A 20-year-old male with alleged history of cut by the glass with grade 3 wound and last
tetanus taken 6 years back, what is the management now
A. TT+ IG
B. TT
C. follow up only

26. A Patient with the history of the hepatitis B immunization has got which of the following lab
findings
A. HEPATITIS B ANTI HBS
B. HEPATITIS b ANTI HBC

27. A patient with the lab findings of the HEPATITIS ANTI HBS in blood which of the
following is likely
A. VACCINATED
 B. CARRIER
C. MUTANT

28. Drug of choice for Polymorphic VT- (INCOMPLETE QUESTION)

A. MAGNESIUM IV
B. AMIODARONE IV
C. IV LIGNOCAINE

29. What is wrong about the following statement with regards to SUBCLINICAL
HYPOTHYROIDISM
A. OLDER PATIENT DON'T NEED TREATMENT
B. HIGH TITER NEED TREATMENT
C. TSH >10 REQUIRES TREATMENT

30. A 60-year-old male with the masked face stopped posture and the festinating gait, what is
the diagnosis
A. PARKINSON
B. PSP
C. MSA

31. Which of the following is the defect in the PARKISNSON

A. NIAGROSTIRTAL PATHWAY
B. Mesolimbic pathway
C. Tubuloinfudiburlar pathway

32. A patient was taking hydralazine and developed the SlE like features, which of the following
the lab investigation for the drug induced Lupus
A- ANTI HISTONE
B. ANTI- CCP
C. ANA

33. A 40-year-old with the history of the Pulmonary Tuberculosis taking medication Developed
pain the right big toe which of the following drug is the culprit
A. ISNONIAZID
B. RIFAMPICIN
C. PYRIZINAMIDE

34. A Young patient with the newly diagnosed hypertension has got BP of 145/ 85, when will
the best time for the follow up
A. 3 MONTHS
B. 6 MONTHS
C. 12 MONTHS

35. A patient taking Amlodipine medication for the hypertension for 4 years now has got the
urine albumin plus. What is the best line of management
A. CONTINUE SAME MEDICATION
B. ADD ACEI
C. ADD BB

36. Which of the following cancer has got obesity as risk factor
A. COLON CANCER
B. LUNG CANCER
 C. GB CANCER

37. which of the anti-diabetic drug has got the fracture risk as aside effect
A. PIOGLITOZONE
B. METFORMIN’
C. REPAGLIDINE

38. Which of the following is the classical findings of PITUITARY ADEOMA-

A. BI-TEMPORAL HEMIANOPIA
B. HOMONYMOUS HEMIANOPIA
C. ENLARGEMENT OF BLIND SPOT

39. A 40-year-old male with the history of APD which of the following is the endoscopic biopsy
findings
A. GASTRIC ATROPHY
B. PARIETAL CELL HYPERPLASIA
C. POLYPS

40. A Female has got anemia with the history of the TEA AND TOAST diet, which of the
following is likely diagnosis.?? UNCLEAR HISTORY AND INFORMATION.??????
A. IRON DEFICENCY
B. THIAMINE DEFICIENCY
C. NICOTINAMIDE DEFICIENCY
D. B 12 DEFICIENCY? ANS

41. WHICH OF THE FOLLOWING CONDITION IS RELATED TO DIGOXIN TOXICITY–

A. HYPOKALEMIA
B. HYPOCALEMIA
C. HYPERCALEMIA

42. A patient presents with the hypokemia, hypochloremia with the metabolic alkalosis what is
the diagnosis
A. PANCREATITIS
B. CELIAC DISEASE
C. PYLORIC STENOIS

43. A young female presents with the hyponatremia, decreased BP, Pain abdomen what is the
diagnosis
A. ADRENAL INSUFFICIENCY
B. CARDIOGENIC SHOCK
C. SEPTIC SHOCK

44. WHICH OF THE FOLLOWING REGARDING THE TREATMENT OF MYXEDEMA

COMA WRONG
A. SUPPLEMENT WITH DOSE OF 2-5 MCG TDS
B. GRADUAL REWARMING
C. SALINE HYDRATION
D. HYDROCORTISONE 100 TDS

45. COPD PATIENT WHICH OF THE FOLLOWING IS CORRECT

A. BIPAP IF DECREASED PH
B. FI02 40 %
46. WHICH OF THE FOLLOWING HAS NO EFFECT IN LONG TERM MORTALITY
DECREASE IN COPD-
A. SALMETROL
B. TIOTROPIUM
C. TRIPLE THERPY

47. A PATIENT TAKING A MEDICATION FOR THE ARRHYTHMIA NOW HAS GOT THE
NECK SWELLING LIKLEY CULPRIT IS
A. AMIODARONE
B. BB
C. CCB

48. HOW WILL YOU DIAGNOSE THE CASE OF THE CELIAC DISEASE
A. UGI ENDOSCOPY WITH SMALL BOWL BIOPSY
B. COLONSCOPY
C. SMALL BOWEL BARIUM

49. WHICH OF THE FOLLOWING LUNG CANCER IS RADIOSENESITIVE

A. SMALL CELL CARCINOMA
B. SQUAMOUS CELL
C.ADENOCARCINOMA

50. A PATIENT WITH THE BICYTOPENIA HAS GOT THE BONE MARROW BIOPSY
SHOWING TEAR DROP CELL WITH FIBROSIS, WHAT IS THE DIAGNOSIS
A. MYELOPFIBROIS
B. CML
C. HODGKIN LYMPHOMA

51. REGARDING SGLT2 INHIBITOR WHICH IS CORRECT

A. CAN BE USED IN PATIENT WITHOUT DIABETIC BUT WITH CKD AND
PROTEINURIA
B. CKD WITHOUT PROTEIURIA
C. AKI

52. A PATIENT WITH THE NSTEMI TAKING ASPIRIN AND TICAGREOLOL IS

PLANNING TO UNDERGO CAG, WHICH OF WHIHC DURG IS GIVEN BEFORE
ANGIOGPHY
A. FONDAPANIUX
B. CLOPIDEGROL
C. ASPIRIN

53. WHICH OF THE FOLLOWING DIFFERENTIATES SEIZURE AND SNYCOPE-

A. POST ICTAL PROLONGED MALAISE
B. TOUNGE BITE

54. WHICH OF THE FOLLOWING DRUG CAN BE USED AS MODD STABILIZER-

A. SODIUM VALOPRATE
B. PHENYTOIN
C. LEVETERACETAM
55. A YOUNG GIRL PRESENTS WITH THE RASH PURPURA WITH GUM BLEED
WHICH IS THE DIAGNOSIS
A. ITP
B. TTP
C. HEMOPHILIA

56. WHICH OF THE FOLLOWING IS THE NON-INVASIVE TEST OF THE CHOICE FOR
LIVER FIBORIS
A. FIBROSCAN
B. USG
C. MRI WITH GADOLINIUM ENHANCEMENT

57. WHICH OF THE FOLLOWING IS CORRECT REGARDING THE CONTRAST

INDUCED AKI
A. RESOLVE AFTER 7 DAYS
B. RESOLVE AFTER 14 DAYS
C. RESOLVE AFTER 3 DAYS

58. CLD WITH THE 700 MICRO/L BUT HAS POLYMICROBIA WHAT IS THE
DIAGNOSIS (INCOMPLETE QUESTION, HINTS QUITE NOTE CLEAR)
A. SECONDARY B PERIOTONITS
B. SPONTANEOUS BACTERIAL PERITONITS
C. CHYLOUS ASCITES

59. WHICH OF THE FOLLOWING DONT CASUSE EOSIONPHILIA

A. DRUG HYPERSENTIVITY
B. VIS LEISMANIASIS
C. TOXOCARA

60. WHAT IS THE DIAGNOSTIC CRITERIA FOR THE SEVERE NEUTROPENIA

A. ANC <500
B.ANC <1000
C. ANC <1500

61. WHICH OF THE FOLLOWING ORGANISM DON'T CAUSE THE BLOODY

DIARRHEA
A. GIARDIA
2 . CAMPYLOBACTER
C. SHIGELLA

62. WHICH OF THE FOLLOWING DON'T CAUSE THE BLOODY DIARRHEA

A. CRYPTOSPORIDUM
B. SHIGEELA
C. ENTAMEOBA

63. A PATIENT HAS GOT PICTURE OF THE HUS WHICH OF THE CULPRIT IS THERE
A. E H E COLI
B. CAMPYLO
C. GIARDIA

64. A PATIENT WITH LONG HISTORY OF ABDOMINAL PAIN HAS NORMAL

COLONOSCOPY, WHAT IS THE DIANOGIS
 A. IBS
B. CROHNS
C. ULCERATIVE COLITIS

65. ULCERATIVE COLITIS WHICH OF THE FOLLOWING IS RIGHT

A. ASSOCIATED WITH AS
B. ANCA ASSCIATED
C. PELVIC ABSCESS

66. WHICH OF THE FOLLOWING IS TURE ABOUT ENTERIC FEVER-

A. WIDAL TEST HAS LIMITED ROLE
B. ABRUPT ONSET FEVER
C. INCUBATION PERIOD OF 3-7 DAYS

67. A YOUNG PATIENT WITH THE DIFFICULT SWALLOWING LIQUID THAN SOLID
HAS RAT RAIL ON BARIUM, WHAT IS THE DIAGNOSIS
A. ACALASIA CARDIA
B. ESOPHAGEAL CACNER
C. DES

68. KUSSUMAL’S SIGN IS PRESENT IN WHICH OF THE FOLLOWING

A. CON PERICARDITS
B. CARDIAC TAMPONADE
C. PERICARDIAL EFFUSION

69. REGARDING MALIGNANCY SCREENING WHICH OF THE FOLLOWING IS

CORRECT –
A. CEA COLORECTAL CANCER
B. CA 19-9 – OVARIN CANCER
C. PSA- LUNG CANCER

70. A CLD PATIENT WITH THE LOW SAAG AND HIGH TG (500) DIAGNOSIS IS:
A. CHYLOUS ACITES
B. CHF
C. PERITONEAL CARICINOMA

71. WHICH OF THE FOLLOWING IS WRONG REGARDING THE MS WITH AF

A. PRESYSTOLIC ACCENTUATION PRESENT
B. VARIABLE S1
C. MID DIASTOLIC MURMUR

72. WHICH OF THE FOLLOWING DONT NEED ENDOCARDITIS PROPHYLAXIS OF

DENTAL PROCEDURE-
A. LV HPERTROHPHY
B. PROSTHETIC VALVE
C. CYANOTIC UNIMPAIRED HEART DISEASE

73. WHICH IS THE BAD PROGNOSTIC IN ACUTE PANCREATITS

A. AGE 55 YEARS
B LOW PA02
C. LOW BG
74. TYPICAL DHATURA POISON QUESTION – DILATED PUPIL

75. A YOUNG FEMALE WITH AGITATION, TACHY, HTN, PINPOINT PUPIL

LACRIMATION WHAT IS THE CONDITION CAUSING
A. OPIUM POISONING
B. OP POISONING
C. DHATURA

76. WHICH DON'T FORM THE PORTAL VEIN

A. RIGHT GASTIC VEIN
B. SMV
C. SPLENIC VEIN

77. A PATIENT WITH PNEUMONIA AFTER DAY 3 DEVELOPS ACUTE ONSET

HALLUCINATION, AGITATION WHAT IS THE DIAGNOSIS
A. ACUTE DELERIUM
B. SCHIZHOPHRENIA
C. MEINGITIS

78. WHICH OF THE FOLLOWING CAUSES THRMBOSIS

A. PNH
B. HODGKIN LYMPHOMA
C. MYELOFIRBOSIS

79. A PATIENT WITH THE HERPES ZOSTER ON GENICULATE GANGLION HAS

WHICH OF THE FOLLOWING FINDINGS
A. HYPERACUSIS
B. HEMIPARESIS
C. VISION LOSS

80. WHAT IS THE DRUG USED IN PREVENTION AND TREATMENT OF THE ACUTE
MOUNTAIN SICKNESS
A. ACETAZOLAMIDE
B. DIURETICS
C. NITRATES