MCQ 31

A 38-year-old pregnant woman with a past medical history significant for
chronic hypertension presents with a blood pressure of 158/105 mm Hg. Which of the following antihypertensive agents would be most suitable for initial therapy in this patient?   
   A. Bumetanide
   B. Fosinopril
   C. Hydrochlorothiazide
   D. Methyldopa
   E. Valsartan

MCQ 30

Organism which causes pancreatitis

a. Mumps
b. Measles
c. Candida
d. Treponema

Answer

MCQ 29

A 35 year old  HIV infected homosexual man presents with fever, pain of the right upper quadrant, and a CT scan of the liver that shows a 10 cm, oval, hypoechoic cyst in the right lobe. An ELISA assay detects the presence of antibodies to Entamoeba histolytica; cysts from the same organism are found in a stool specimen. Which of the following is the most appropriate next step in the management?

a. Administration of metronidazole
b. Administration of chloroquine
c. Drainage of the hepatic lesion for therapeutic purposes
d. Aspiration of the hepatic lesion for diagnosis
e. Hepatic resection

Answer and explanation

MCQ 28

A 45 year old man says that for the past year he occasionally has regurgitated food particles eaten several days earlier. His wife complains that his breath has been foul smelling. He has had occasional dysphagia for solid foods. The most likely diagnosis is

a. Gastric outlet obstruction
b. Scleroderma
c. Achalasia
d. Zenker's diverticulum
e. Diabetic gastroparesis

Answer and explanation

MCQ 27

Somatostatin is secreted by

a. D-cell
b. A-cell
c. B-cell
d. D1-cell

Answer

MCQ 26

Picture frame vertebrae is seen in
a. ankylosing spondylitis
b. pagets disease
c. multiple myeloma
d. histioctosis

Answer

MCQ 25

A 30 year old G1 with twin gestation at 28 wks is being evaluated for vaginal bleeding and uterine contractions. A bedside ultrasound examination rules out the presence of a placenta previa. Fetal heart rate tracing is reactive on both twins, and the uterine contractions are every 2 to 3 minutes and last for 60 sec. A sterile speculum examination is negative for rupture membranes. A digital examination indicates that the cervix is 2 to 3 cm dilated and 50% effaced, and the presenting part is at -3 station. Tocolysis with magnesium sulfate is initiated and intravenous antibiotics are started for group B streptococcus prophylaxis. Betamethasone, a corticosteroid is also administered. Which of the following statements regarding the use of betamethasone in the treatment of preterm labor is most accurate?

a. Betamethasone enhances the tocolytic effect of magnesium sulfate and decreases the risk of preterm delivery.

b. Betamethasone has been shown to decrease intraamniotic infections.

c. Betamethasone promotes fetal lung maturity and decreases the risk of respiratory distress syndrome.

d, The anti inflammatory effect of betamethasone decreases the risk of GBS sepsis in the newborn.

e. Betamethasone is the only corticosteroid proven to cross the placenta.

Answer and explanation

MCQ 24

All of the following drugs are commonly used in regimens against H.pylori except

a. Oxytetracycline
b. Amoxicillin
c. Bismuth subcitrate
d. Omeprazole

Answer

MCQ 23

Non-parenteral hepatitis is

a. Hepatitis E
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D

Answer

MCQ 22

Growth factors promote cell growth by acting on

a. cAMP
b. Tyrosine kinase
c. cGMP
d. TRM

Answer

MCQ 21

Menopause is defined as cessation of menstruation for

a. 03 consecutive months
b. 06 consecutive months
c. 09 consecutive months
d. 12 consecutive months
e. 15 consecutive months

Answer

MCQ 20

Which of the following is the drug of choice for the treatment of inappropriate anti-diuretic hormone secretion?

a. Furosemide
b. Hydrochlorothiazide
c. Spironolactone
d. Demeclocycline

Answer

MCQ 19

Which of the following is the most common type of pituitary adenoma?

a. Thyrotropinoma
b. Gonadotropinoma
c. Prolactinoma
d. Corticotropinoma.

Answer

MCQ 18

A healthy 9 yr old girl is brought to her pediatrician by her concerned parents. Previously very friendly with everyone, she now bursts into tears when she is approached by unfamiliar adult. Which of the following best describes this child's behavior?

a. Separation anxiety
b. Insecure attachment
c. Simple phobia
d. Depressive position
e. Stranger anxiety

Answer and explanation

MCQ 17

A 36 yr old woman is hospitalized for treatment of a stomach ulcer that has been getting progressively worse over several months. Radiographic studies reveal the site of involvement to be along the greater curvature, approximately 4 cm away from the pyloric sphincter. That night ulcer perforates, and there is considerable intra abdominal bleeding. Surgery reveals that the ulcer eroded through the stomach wall and has damaged the artery supplying the involved region of the stomach. Which artery was likely involved?

a. Left gastric
b. Left gastroepiploic
c. Right gastric
d. Right gastroepiploic
e. Short gastric

Answer and explanation

MCQ 16

The posterior pituitary secretes arginine vasopressin (antidiuretic hormone) under which of the following stressors?

a. Hyperosmolarity
b. Hypernatremia
c. Volume depletion
d. A and B
e. A and C

Answer and explanation

MCQ 15

A 75 year old man with a 40 pack year history of smoking and hypercholestremia is diagnosed with severe atherosclerosis. Atherosclerotic occlusion of which of the following arteries would result in insufficient perfusion o f the urinary bladder?

a. External iliac
b. Inferior epigastric
c. Internal iliac
d. Internal pudendal
e. Lateral sacral

Answer and explanation

MCQ 14

A 90 year old male complains of hip and back pain. He has also developed headache, hearing loss, and tinnitus. On physical examination the skull appears enlarged, with prominent superficial veins. There is a marked kyphosis , and the bones of the leg appear deformed. Plasma alkaline phosphatase is elevated. A skull X-ray shows sharply demarcated lucencies in the frontal, parietal, and occipital bones. X-rays of the hip show thickening of the pelvic brim. The most likely diagnosis is

a. Multiple myeloma
b. Paget's disease
c. Hypercalcemia
d. Metastatic bone disease

Answer and explanation

MCQ 13

An infant who sits with only minimal support, attempts to attain a toy beyond reach, and rolls over from the supine to the prone position, but does not have a pincer grasp, is at a developmental level of
a. 2 months
b. 4 months
c. 6 months
d. 9 months
e. 1 year

Answer and explanation

MCQ 12

A 30-year-old male patient complains of fever and sore throat for several days. The patient
presents to you today with additional complaints of hoarseness, difficulty breathing, and
drooling. On examination, the patient is febrile and has inspiratory stridor. Which of the
following is the best course of action?

a. Begin outpatient treatment with ampicillin
b. Culture throat for β-hemolytic streptococci
c. Admit to intensive care unit and obtain otolaryngology consultation
d. Schedule for chest x-ray

Answer and explanation

MCQ 11

True statements concerning vaccines include

a. Inactivated vaccines are hazardous to the mother
b. Cases of congenital rubella syndrome have been reported in fetuses born to mothers
    who were immunized   early in pregnancy
c. Inactivated vaccines are hazardous to the fetus
d. The polio virus has the ability to spread from the vaccine to susceptible persons in the
    immediate environment
e. Nonimmune pregnant women who are exposed to children who recently received the
    measles-mumps-rubella (MMR) vaccine are at high risk of delivery of an infected fetus

Answer and explanation

MCQ 10

You are called to a delivery of a term infant, about to be born via cesarean section to a mother with multiple medical problems including a 1-month history of a seizure disorder, for which she takes phenytoin; rheumatic heart disease, for which she must take penicillin daily for life; hypertension, for which she takes propanolol; acid reflux, for which she takes aluminum hydroxide; and a deep venous thrombosis in her left calf diagnosed two days ago, for which she was started on a heparin infusion.The obstetrician is concerned about the possible effects of the mother’s multiple medications on the newborn infant. You correctly note that the one medication most likely to cause harm in this newborn infant at delivery is
a. Propanolol
b. Penicillin
c. Aluminum hydroxide
d. Phenytoin
e. Heparin

MCQ 9

A 35-year-old alcoholic male is admitted for nausea, vomiting, and abdominal pain that radiates to the back. The laboratory value that suggests a poor prognosis in this patient is
a. Elevated serum lipase
b. Elevated serum amylase
c. Leukocytosis of 20,000/μm
d. Diastolic blood pressure greater than 90 mmHg

Answer and explanation :

MCQ 8

Which one of the following is not a precipitating factor for chronic pancreatitis?

a)chronic smoking
b)malnutrition
c)viral infections
d)alcoholism

Answer and explanation

MCQ 7

Which of the following cannot be assessed by an ultrasound?
a) placental age
b) fetal kidney function
c) fetal breathing
d) oesophageal atresia.

 Answer and explanation

MCQ 6

A 25 year old woman presents with vaginal spotting and right lower quadrant abdominal pain.There is minimal dark blood in the vaginal vault,and her cervix is closed and thick.Quantitative serum hCG is 4000 mIU/ml. A transvaginal ultrasound (TVUS) shows no evidence of pregnancy inside the uterus. What is the most likely diagnosis?
a. Hydatidiform mole
b. Ectopic pregnancy
c. Appendicitis
d. Endometriosis

Answer and explanation :

MCQ5

Which tumour is not seen in AIDS?
a. Kaposi sarcoma
b. GI adenocarcinoma
c. Non Hodgkins lymphoma
d. Astrocytoma

Answer and explanation

MCQ 4

Q4.The most useful and predictive tool in evaluating the condition of a patient with an acute asthmatic attack and in assessing response to therapy is
  A. Chest radiography
  B. Arterial blood gas measurement
  C. Measurement of pulsus paradoxus
  D. Observation of accessory muscles use
  E.  Measurement of peak expiratory flow or FEV1

Answer and explanation

MCQ 3

Q3.A young male is brought to the emergency dept after having been submerged for a prolonged period of time at a nearby pond.CPR was performed at the scene.The patient is being ventilated by a mask and bag upon arrival in the emergency dept.A brief examination reveals that the patient has no obvious sites of trauma and is conscious but not communicative.His BP is 90/60,pulse 120, temp 36 degree C and RR 30.Cardiac rhythm reveals sinus tachycardia.Pulse oximetry reveals O2 saturation of 83 percent.Which of the following is best method to reverse the patient's apparent hypoxemia?

  A. Administration of sodium bicarbonate.

  B. Administration of acetazolamide

  C. Administration of supplemental oxygen

  D. Application of continuous positive airway pressure and administration of supplemental oxygen

  E. Administration of supplemental oxygen and endotracheal suction to remove aspirated fluid

Answer and explanation

MCQ 2

Q2. A 54-year-old male with acute lymphocytic leukemia develops a blast crisis. 
He is treated with intensive systemic chemotherapy. Following treatment,
the patient will be at increased risk for the development of
A. bile pigment gallstones
B. cholesterol gallstones
C. cystine kidney stones
D. struvite kidney stones
E. uric acid kidney stones 


Answer and explanation:

MCQ 1

Which of the following would shift the oxygen-hemoglobin dissociation curve

to the right?
A. Carbon monoxide poisoning
B. Decreased PCO2
C. Decreased pH
D. Decreased temperature
E. Decreased 2,3-DPG 

Answer and explanation :