medicine and pediatrics march 2011

MEDICINE
1. Which of the following changes of megaloblastic anemia CANNOT be corrected by administration of folic acid?
a. Megaloblastic hyperplasia of bone marrow
b. Macrocytic changes in RBCs
c. Neurological changes*
d. Diarrhea and achlorhydia
2. The following worm infestation may result in malabsorption
a. Ascar’s lumbricoides
b. Ancylostoma duodenlae
c. Giardia lamblia
d. Necator americanus
3. A 45 yrs old male presented with increasing abdominal discomfort with abdominal enlargement for past 2 yrs. On examination, massive splenomegaly was noted. Most likely diagnosis is
a. Sickle cell anemia
b. Infectious mononucleosis
c. Myelofibrosis*
d. Hemochromatosis
4. Common radiographic finding on chest X-ray of a pateitn with sarcoidosis is
a. Bronchiectasis
b. Coin lesion
c. Cavitation
d. Hilar nodes*
5. Most common cause of hypercapneic respiratory failure is
a. Interstitial lung disease
b. Bronchial asthma
c. Chronic obstructive pulmonary disease*
d. Pneuothorax
6. Which of the following statements regarding pyrexia of unknown origin (PUO) is FLASE?
a. Duration of fever>3 weeks
b. Fever more than 1010F on several occasions
c. Failure to reach a diagnosis despite 2 OPD visits*
d. Failure to reach a diagnosis despite 3 days of inpatient investigations
7. Which of the following pressure is best suitable to monitor the fluid status of a patients in shock?
a. Systolic arterial blood pressure
b. Diastolic arterial blood pressure
c. Pulse pressure
d. Central venous pressure*
8. Which of the following is not seen in thrombotic thrombocytopenic Purpura(TTP)
a. Fever
b. Hemolytic anemia
c. Thrombocytosis*
d. Renal failure
9. Which of the following parameters is the most important factor for prognosis of a patient with malignant melanoma?
a. Size of tumor
b. Location of tumor
c. Age of patient
d. Level of invasion and tumor thickness*
10. Non specific aortic aneurysm is most commonly seen in
a. Ascending aorta
b. Arch of aorta
c. Descending thoracic aorta*
d. Infra renal abdominal aorta
11. All of the following are risk factors for obstructive sleep apnea syndrome except
a. Obesity
b. Male gender
c. Acromegaly
d. Protuberant mandible*
12. Which of the following parameter is used to assess the renal perfusiojn adequacy during shock?
a. Serum creatinine
b. Hourly urine output*
c. Blood pressure
d. Blood uea
13. Hemotysis is a feature of
a. Miliary tuberculosis
b. Tropical pulmonary eosinophlia
c. Pneumoconiosis
d. Pulmonary embolism*
14. Rapid correction of which of the following metabolic abnormality can result in pontine myelinolysis?
a. Hyponatremia*
b. Hypokalemia
c. Hypocalcemia
d. Hypomagnesemia
15. The most specific antibody associated with primary biliary cirrhosis is
a. Anti mitochondrial antibody
b. Anti nuclear antibody
c. Anti netrophil cytoplasmic antibody
d. Anti actin antibody
16. D-Xylose test may be abnormal in all of the following except
a. Chronic pancreatitis *
b. Bacterial overgrowth syndrome
c. Celiac sprue
d. Intestinal lymphangiectasia
17. Which of the following serum marker suggest the pressure of acute hepatitis B
a. ALT level =30 IU
b. HBeAg
c. Anti HBc*
d. Anti HBs
18. True statement regarding pleural effusion is
a. Hemorrhagic pleural effusion clearly indicates malignancy
b. In congestive heart failure, bilateral pleural effusion is the rule
c. In tubercular pleural effusion, mycobacteria are commonly isolated
d. In pancreatic pleural effusion, amylase content is usually high *
19. Which of the following tumor is most commonly associated with Tumor lysis syndrome?
a. Plasmacytoma
b. Hairy Cell leukemia
c. Seminoma
d. Burkitt’s lymphoma *
20. Dermatitis herpetiformis is associated with
a. Glucagonoma
b. Celiac disease *
c. Crohn’s disease
d. Zollinger Ellison syndrome
21. Commonest cause of acute nephritis in children is
a. Urinary tract infection
b. Drugs
c. Immunologic*
d. Trauma
22. Fresh frozen plasma is used to correct
a. Protein deficiency
b. Immune deficiency
c. Coagulation factor deficiency *
d. Platelet deficiency
23. Which of the following sign indicates severity of bronchial asthma
a. Bilateral extensive wheeze*
b. Bradycardia
c. Tachypnoea
d. Pulsus paradoxus
24. Which of the following drug should be avoided un hypertrophic obstructive cardiomyopathy?
a. Beta blockers
b. Digoxin*
c. Amiodarone
d. Verapamil
25. All the following require zinc except
a. Spermatogenesis
b. Fetal growth
c. DNA and RNA synthesis
d. Coagulation pathway*
26. All of the following are prognostic factors for lymphoma except
a. Constitutional symptoms*
b. Size of lymph node
c. Stage of disease
d. Histological type of lymphoma
27. Congenial malformation in the fetus can occur due to excessive intake of
a. Vitamin A*
b. Vitamin B12
c. Vitamin C
d. Folic acid
28. Obesity is diagnosed when the waist circumference is above this in men
a. 80
b. 85
c. 90*
d. 95
29. Massive blood transfusion in a previously healthy adult male can result in bleeding, because of
a. Dilutional thrombocytopenia*
b. Increased tPA
c. Hypofibronogenemia
d. Vitamin K deficiency
30. Which of the following organ is commonly involved in Mushroom poisoning?
a. Heart
b. Liver
c. Kidney
d. Nerves*
31. Investigation of choice in acute subarachnoid hemorrhage is
a. Ultrasound
b. Non contract CT
c. Contrast enhanced CT*
d. Contrast enhanced MRI
32. All of the following are seen in disseminated intravascular coagulopathy except
a. Thrombocytopenia
b. Decreased fibrinogen
c. Decreased aPTT*
d. Increased aPTT
33. Triad of massive blood loss and transfusion in characterized by
a. Alkalosis, hypothermia and coagulopathy
b. Acidosis, hypothermia and coagulopathy*
c. Alkalosis, hypotension and coagulopathy
d. Acidosis, hypotension and oligouria
34. Neoadjuvant chemotherapy is recommended in carcinoma breast patients for
a. Curing distant metastasis
b. Improveing survival
c. Down staging and considering breast conservation*
d. Preventing distant metastasis
35. Which type of IV fluid should not be used in hemorrhagic shock
a. Normal saline
b. Ringer lactate
c. 5% dextrose
d. Albumin*
36. Antobody having the best sensitivity and specificity for the diagnosis of celiac disease is
a. Anti-endomysial antibody*
b. Anti-tissue transglutaminase antibody
c. Anti-gliadin antibody
d. Anti-reticulin antibody
37. WPW syndrome is associated with which one of the following congenital anomaly?
a. Fallot’s tetralogy
b. Ebstein’s anomaly*
c. Lutembacher syndrome
d. Patent ductus arteriosus
38. Long term prognosis in COPD can be improved by treatment with
a. Long term O2 therapy*
b. Inhaled B2 agonists
c. Ihaled steroids
d. Oral steroids
39. Treatment of choice for small bowel lymphoma is
a. Surgery*
b. Radiotherapy
c. Chemotherapy
d. None of the above
40. All of the following cancers are associated with HV infection except
a. Kaposi’s sarcoma
b. Non-Hodkin lymphoma
c. Carcinoma of cervix
d. Carcinoma of stomach*
41. Which of the following is not a metabolic cause of abdominal pain?
a. Diabetic ketoacidosis
b. Sickle cell anemia*
c. Porphyria
d. Hyperparathyroidism
42. Kussmaul’s sign is absent in
a. Constrictive pericarditis
b. Cardiac tamponade*
c. Right Ventricular Myocardial Infarction (RVMI)
d. Severe right heart failure
PEADIATRICS
43. The most common virus responsible for acute bronchilotis in infancy is
a. Respiratory syncytial virus*
b. Influenza virus
c. Parainfluenza virus
d. Rhinovirus
44. Boot shaped heart is seen in
a. Atrial septal defect
b. Ventricular septal defect
c. Tetralogy of Fallot*
d. Patent ductus arteriosus
45. As compared to cow’s milk, breast milk has more content of
a. Vitamin K
b. Proteins
c. Minerals
d. Vitamin C and D*
46. During breastfeeding the infant should have “Good attachment” to mother’s breast. It includes all of the following except
a. Mouth of infant is wide open
b. Chin of the infant touches mother’s breast
c. Lower lip of infant is inverted*
d. Upper part of areola is visible more than the lower part
47. At what age a child normally attains a height of 100cm?
a. 2 years
b. 3 years
c. 4 years*
d. 5 years
48. The most common type of seizure in a neonate is
a. Tonic
b. Clonic
c. Myoclonic
d. Subtle*
49. All of the following are useful in the treatment of meconium aspiration syndrome except
a. Positive pressure ventilation
b. Antibiotic
c. Corticosteroids*
d. Correction of acidosis
50. Which of the following is not seen in Marasmus?
a. Severe muscle wasting
b. Minimal Subcutaneous fat
c. Edema*
d. ear normal serum albumin values