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Medicine Subject Final

1)Elevated jugular venous pressure occurs in:

A) Right heart failure

B) Cirrhosis of liver

C) Cardiac temponade

D) Left heart failure

E) Constrictive pericarditis

2)The abnormalities of the jugular venous pulse are associated with the following disorders

A) Cannon waves-pulmonary hypertension

B) Giant a waves-tricuspid stenosis

c) V waves- tricuspid regurgitations

d) inspiratory rise of JVP-pericardial tamponades

e) Absent a wave-atrioventricular dissociation

3)Cannon 'a' wave is found in:

a) Complete heart block

b) Ventricular tachycardia

c) Junctional rhythm

D) Sinus bradycardia

E) Paraxysmal atrial tachycardia

4)ECG change(s) in hyperkalemia is(are)

A) Tall peaked narrow based T wave

B) Prolonged QT interval

C) Tall P wave

d) ST depression

e) U wave

5. ECG finding/s of atrial fibrillation is/are

A) Absence of T wave

B) Presence of U wave

C) Absence of P wave

D) Presence of RsR pattern in V1

E) Irregularly irregular R wave

6)Heart rate is accelerated by

а) Hypoxia

b) Exercise

C) anger

D) brainbridge reflex

e) Increased intracranial pressure

7)Causes of non-cardiac chest pain include

A) Huge ascites

B) Dissecting aneurysm of aorta

C) Herpes zoster infection

D) Peptic ulcer disease

E) Lumbar spondylosis

8)Signs of left ventricular failure are

a) Raised jugular venous pressure

B) Pulsus bisferiens

C) Cyanosis

d) Gallop rhythm

E) Bilateral basal crepitation

9)Features of acute massive pulmonary embolism are

A) soft P2.

B) tachycardia

C) hypertension

d) right ventricular gallop

E) severe cyanosis

10. Features of massive pulmonary embolism include

A) Raised JVP

b) Pleuritic chest pain

c) Syncope

d) Central cyanosis

e) G wave in lead I, III & VL on ECG

11)Ejection systolic murmur is present in

a) aortic stenosis

b) tricuspid regurgitation

C) aortic regurgitation [Aortic flow murmur]

D) pulmonary stenosis

e) atrial septal defect [Pulmonary flow murmur]

12)Causes of pansystolic murmur are

A) Mitral stenosis

B) VSD

C) Aortic stenosis

D) Mitral regurgitation

E) PDA

13)Features of innocent heart murmur are

A) Mid systolic

B) Heard at left sterna edge

c) Pansystolic

D) Loud with associated trill

E) No radiation

14)Causes of mitral valve regurgitation

a) Atherosclerosis

B) Calcific aortic stenosis

C) Myocardial infarction

D) Rheumatic heart disease

E) Senile degeneration

15). Haemoptysis may occur in

A) Mitral regurgitation

b) Mitral stenosis

C) Rupture of aortic aneurysm

D) Pulmonary embolism

E) Atrial septal defect

16)Major criteria of acute rheumatic fever

A) migratory arthritis

B) chorea

C) subcutaneous nodules

d) prolonged P-R interval

E) fever

17)Aortic incompetence

A) Is associated with bicuspid aortic valve

B) Causes pistol shot sounds at the femoral arteries

C) Causes capillary pulsation in the nail bed

d) Can result from type B aortic dissection

E) Has a severity which is proportional to the intensity of the diastolic murmur

18)Tetralogy of fallot consists of

A) ASD

b) VSD

C) Dextroposition of the aorta

D) Pulmonary stenosis

E) Right ventricular hypertrophy

19)Factor(s) predisposing to pneumonia include(s)

A) cigarette smoking

b) herpes zoster

C) glucocoticoid therapy

d) cytomegalovirus infection

E) indoor air pollution

20)Complication(s) of pneumonia is (are)

A) empyema

B) hypercapnea

C) ARDS

D) hypernatremia

E) atrial fibrillation

21)Cavitary lung disease are

A) Tuberculosis

B) Chronic obstructive airways disease

Bronchiectasis

D) Lung absces

E) Obstructive sleep apnoea

22)Pleural effusion with high protein content occurs in

A) Cardiac failure

B) Cirrhosis of the liver

c) Lung carcinoma

D) Myxedema

E) Pulmonary infarction

23). Causes of transudative pleural effusion include

a) CCF

B) Protein losing eneropathy

C) Pulmonary infarction

D) Nephrotic syndrome

Mesothelioma

24)Causes of exudative pleural effusion include

A) Mesothelioma

b) Congestive cardiac failure

c) Hypoalbuminaemia

D) Tuberculosis

E) Pulmonary infarction

25)Type-1 respiratory failure may occur in

a) neuromuscular disorder

B) flail chest

C) pneumothorax

d) pulmonary fibrosis

E) acute exacerbation of COPD

26) Type Il respiratory failure occurs in

A) Severe acute asthma

B) Pulmonary embolism

C) Idiopathic pulmonary fibrosis

D) Poliomyelitis

E) Exacerbation of COPD

27) A patient with carbon dioxide retention is likely to have

A) Metabolic acidosis

b) Alkaline urine

C) Cool extremities

D) Raised cerbral blood flow

Raised plasma bicarbonate

28)Compared to obstructive lung disease, a case of restrictive lung disease has a lower

A) residual volume

B) FEV1/FVC

FEV1

Functional residual capacity

) compliance of the lungs

29)Causes of bronchiectasis include

A) Inhaled foreign body

b) Primary tuberculosis

C) Ankylosing spondylitis

D) Bronchial tumors

E) Kyphoscoliosis

30) Features of bronchiectasis include

A) Hemoptysis

b) Purulent sputum

c) Weight gain

D) Halitosis

e) Pleural effusion

31)Cause(s) of elevation of hemidiaphragm is(are)

A)phrenic nerve palsy

B) pneumonic consolidation

c) pulmonary collapse

D) diaphragmatic hernia

E) subphrenic abscess

32)Cortisol plays a permissive role in the

A) Lipolytic effect of catecholamines

B) vasopressor effect of catecholamines

) Lipolytic effect of glucagon

D) Calorigenic effects of glucagon

E) Lipolytic effect of thyroxine

33)Feature(s) of paraneoplastic syndrome of bronchial carcinoma is(are)

a) hirsuitism

b) clubbing

C) polyneuropathy

D) optic atrophy

E) nephrotic syndrome

34) In COPD there is decrease in:

A) Vital capacity

B) Total lung capacity

C) FEV1/FVC ratio

D) Functional residual capacity

PEFR

35)Microcytic anemia usually occurs in the following conditions

A) Evan's syndrome

B) thalassemia

C) iron deficiency anemia

d) hypothyroidism

E) sideroblastic anemia

36)Causes of anemia in chronic renal failure are

a) Anorexia

b) Increased blood loss

E) Erythropoietin deficiency

D) Bone marrow depression

E) Faulty globin synthesis

36)Microcytic hypochromic anaemia is found in

a) Acute blood loss

b) Chronic renal failure

c) Lymphoma

Sideroblastic anaeamia

E) Thalassaemia major

37)Features of anemia of chronic disease are

a) Normal or low ferritin

b) High total iron binding capacity

C) Low reticulocyte count

D) High soluble transferring receptor

E) Raised hepcidin level

38)Features of haemolysis are

a) Increased Bilirubin

B) Increased LDH

C) Decreased Reticulocytes

D) Increased Haptoglobin

E) Increased Urobilinogen

39)The following enzyme deficienci lead to hemolytic anemia -

A) Lactate dehydrogenase

B) Pyruvate kinase

C) Pyruvater dehydrogenase complex

D) Glucose 6 phosphate dehydrogenase

E) NADPH oxidase

40)Megaloblastic anaemia is associated with

A) Achalasia Cardia

B) Tropical sprue

c) Methotrexate therapy

D) Tapeworm infestation

e) Meckels diverticulitis

41). Folic acid deficiency can be caused by -

A) Phenytoin

B) INH

C) Pyrimethamine

D) Sulphamethoxazole

E) Tetracycline

42)Target cells appear in peripheral blood film in

A) Thalassaemia

B) Sickle cell anemia

c) Aplastic anemia

d) Pernicious anemia

e) Iron deficiency anemia

43)Iron deficiency anaemia can be differentiated from anaemia of chronic disease by

A) Low serum iron level

Raised serum transferin receptor level

C) Low serum ferritin level

D) Low transferin saturation

e) Raised TIBC

44)Dietary inorganic iron absorption is increased by

A) Vitamin C

B) Calcium

c) Hepcidin

D) Alcohol

E) Fructose

45)Laboratory test for iron deficiency anemia shows

A) Reduced serum ferritin

B) Reduced serum iron

C) Reduced total iron binding capacity (TIBC)

D) Increased percentage of saturation of the TIBC

E) Microcytic hypochromic RBC

46)Causes of acquired aplastic anemia

A) Viral hepatitis

B) Radiation

c) Paroxysmal nocturnal hemoglobinuria

D) Plasmodium falciparum

e) Azathioprine

47)Drugs causing aplastic anemia are –

A) Streptomycin

b) Indomethacin

C) Perdnisolone

D) Ciprofloxacin

E) Chloramphenicol

48)Leucoerythroblastic blood picture may be found in following conditions

A) Myelofibrosis

B) Sideroblastic anemia

C) Metastatic carcinoma

D) Anemia of chronic disorder

E) Aplastic anemia

49)Thalassemia major -

A) is a hereditary disease

b) is due to anomaly in chromosome 16

c) can be diagnosed by hemoglobin electrophoresis

D) is incurable

e) Patients rarely survive beyoud 5 year without treatment

50)Thrombocytopenia may be found in.

A)Henoch-Schonlein purpura

b)cirrhosis of fiver

C)dengue

D) DIC

E)Scurvy

51)Recognized features of Hypersplenism include

A) Erythroid hyperplasia

B) Splenomegaly

C) Jaundice

D) Pancytopenia

E) Megaloblastic anaemia

52)Pyelonephritis is characterized by

A) Lower abdominal pain

B) Vomiting

C) High grade fever with chilis

d) Hematuria

e) Burning sensation during micturition

53)Causes of polyuria in children are

A) diabetes insipidus

B) hypokalaemia

C) diabetes mellitus

D) hyponatraemia

e) hypomagnesemia

54)Fanconi syndrome is characterized by

A) Growth failure

B) Acidosis

C) Hypochloremia

D) Glycosuria

e) Hyperphosphatemia

55). Proteinuria of more than 15-20 gm/day occurs in

A) analgesic nephropathy

B) amyloidosis

c) renal vein thrornbosis

d) acute tubular necrosis

E)fanconis syndrome

56)Haematuria, macroscopic or microscopic is an expected finding in:

A) Membranous glomerulonephritis

B) Renal amyloidosis

c) Malignant hypertension

D)Renal infarction

E) Infective endocarditis

57) Causes of polyuria includes

A) Diabetes insipidus

B) Chronic renal failure

C) Hypocalcemia

D)hyperkalaemia

e) Renal tubular acidosis

58)Renin secretion is increased in

A) essential hypertension

B) over hydration

c) sodium depletion

D) diuretic therapy

E) renal artery stenosis

59)Cause(s) of metabolic acidosis with wide anion gap include(s)

a) diabetic ketoacidosis

B) gastrointestinal HCO3 loss

starvation acidosis

d) lactic acidosis

C) renal tubular acidosis

60)Type 1 renal tubular acidosis is characterized by

A) low sodium

B) hypercalcemia

C) high serum potassium

D) failure of H+ ion secretion

E) normal anion gap

61)Pyuria without significant bacteriuria are present in

A) Renal tuerculosis

B) Early urinary tract infection

c) Leptospirosis

d) Patient under antibiotic treatment

) Diabetes

62)Following are the indications for renal biopsy

A)Steroid resistant nephrotic syndrome

b)Frequent relapsing nephrotic syndrome

C) Post streptococcal glomerulonephritis

d)Lupus nephritis

E)Deterioration of graft function

63)Features of acute post streptococcal glomerulonephritis are -

A) Hypertension

b) 24 hours urinary protein above 0.5g/day

C) Polyuria

d) Hematuria

E) Hypervolemia

64) Following conditions present with features of acute nephritic syndrome

A) Mesangiocapillary glomerulonephritis

B) End stage renal failure

C) Minimal change glomerulonephritis

D) Focal segmental glomerulosclerosis

) IgA nephropathy

65)Nephrotic syndrome is characterized by

A) Microscopic haematuria

b) Generalized oedema

C) Massive proteinuria

d) Hypertension

E) Hypoalbuminaemia

66)Pre renal causes of acute kidney injury include

A) Tumour lysis syndrome

b) Diarrhoea

d) Hypotersion

C)hepatorenal syndrome

e)burn

67)Clinical features of adult polycystic kidney disease are

A)Haematuria

B) Anaemia

C) Anuria

D)Oedema

E)Hypertension

68)Drugs causing acute tubular necrosis are

A) Radio contrast media

b) Aminoglycosides

) Paracetamol overdose

D) NSAIDs

E) ACE inhibitors

69)The clinical features of adult polycystic kidney disease include

a. An autosomal recessive mode of inheritance

B, cystic disease of the liver and pancreas

C renal angle pain and haematuria

D. Normal blood pressure

E aneurysms of Circle of Willis

70)Absent ankle jerk with extensor plantar response occurs in

a) subacute combined degeneration of spinal cord

b) Guillain-Barre syndrome

C) motor neuron disease

D) cauda equina syndrome

E) Friedrich's ataxia

71)Red flag symptoms in headache are

A) Vomiting

B) Weight loss

C) Sudden onset

D) Photophobia

E) Raised intracranial pressure

72)Lumbar puncture is contraindicated in

A) depressed level of consciousness

B) aspirin therapy

C) thrombolytic therapy

D) subarachnoid hemorrhage

E) Hydrocephalous with papilledema

73)Features of raised intracranial pressure are

A) Headache

B) Papiloedema

D Vomiting

D) Convulsion

E)Tinnitus

74)Essential features of brain death are

A) Flat ECG

B) No gag reflex

C) Absence of spinal Reflex

D) No respiration when PCO2 exceeds 7kPa

E) Dolls eye Test negative

75)Third cranial nerve palsy may cause

A) Ocular oedema

B) Divergent squint

c) Ptosis

d) Pupillary dilatation

E) Synechia

76)Bell's palsy may be associated with

A) Inability to wrinkle forehead

b) Loss of taste sensation in anterior two thirds of the tongue

C) Upper motor neuron type of facial palsy

D) Parotid tumor

E) Ipsilateral partial ptosis

77)Severe headache with 3rd nerve palsy is Seen in

A) Cavernous sinus thrombosis

b) Pituitary apoplexy

C) Lacrimal abscess

D) Anterior communicating artery aneurysm

E) Intracranial hemorrhage

78)Features of Horner's syndrome include -

A) Partial ptosis

B) Facial palsy

C) Anhydrosis

D) Eicopthalmos

E) External opthalmoplegia

79)Non-dominant parietal lobe lesions cause/s

A) constructional apraxia

B) astereognosis

C) receptive aphasia

D) personality change

E) hallucination

80)Lower motor neuron lesions are characterized by

A) Flaccidity

B) Spasticity

c) Loss of tendon reflexes

D) Increased tendon reflexes

E) Wasting of muscles

81)Clinical features of Upper motor neuron lesion are

A) Flaccid paralysis

b) Visible fasciculation of muscles

C) No muscular atrophy

d) Increased reflexes

e) Upward plantar response

82)The features of the extrapyramidal lesion are

A) Loss of co-ordination

B) Spasticity

) Rigidity

D) Hypokinesia

E) Dysdiadochokinesia

83)Characteristics of cerebellar lesion include

a) Nystagmus

B) Spastic paralysis

c) Tremor

D) Rigidity

E) Aphasia

84)Features of Wallenberg syndrome

A) medial medullary lesion

B) Spastic paralysis

c) Tremor

D) Rigidity

e) Aphasia

85)Causes of pseudobulbar palsy are -

A) Motor neuron disease

B) cerebral vasculitis

C) Gullain-Barre syndrome

D) Myasthenia gravis

E) Lyme disease

87)The followings have intracellular receptors

A) Steroid hormone

B) Insulin

C) ACTH

D) Thyroxine

E) Retinoic acid

88.Hormones acting via CAMP are

a)TSH

B) Calcitriol

C) Testosterone

D) ADH

E) Parathormone

89. During sleep, there is a fall of plasma level of

A) Cortisol

B) Insulin

C) Adrenaline

D) ADH

E) Growth hormone

90.Hormones those use the phospholipase C second messenger system are-

A) Oxytocin

b) Growth hormone

C) Thyrotropin releasing hormone

D) Glucagon

E) Vasopressin

91.Hormones that act by activation of gene include-

A) Aldosterone

B) Thyroid hormones

C) Calcitriol

D) Glucagon

E) Insulin

92.Factors that stimulate growth hormone secretion-

A) Decreased blood glucose

b) free fatty acid

C) Increased blood glucose

D) Testosterone

) Somatostatin

93.The following hormones influence calcium metabolism-

A) Insulin

B) Oestrogen

C) Prolactin

D) Growth hormone

E) Testosterone

94.Causes of hirsutism include

A) Polycystic ovary syndrome

B) Medullary carcinoma of thyroid

C) Adrenal adenoma

D) Polycystic kidney disease

e) Congenital adrenal hyperplasia

95.Gynaecomastia is caused by-

A) Spironolactone

b) Methyldopa

c) Digoxin

D) Growth hormone

E) Furosemide

96.Addison's disease is characterized by:

) Hypoglycemia

B) Hyponatremia

c) Hypokalemia

d) Metabolic acidosis

E) Hypertension

97.Premalignant Conditions for esophageal carcinoma are-

A) Achalasia

B) Barrett s esophagus

c) Obesity

D) Esophageal stricture

Esophageal candidiasis

98.Followings are the causes of dysphagia

A) Pseudobulbar palsy

B) Antral gastric carcinoma

C) Progressive systemic sclerosis

d) Achalasia cardia

E) Large esophageal varices

99. In ulcerative colitis

A) Rectum is usually spared

B) Skip lesion is characteristic

c) Common presentation is bloody diarrhoea

D) Small gut is rarely involved

E) Acute attack may be precipitated by NSAID

100.Complications of acute pancreatitis include

a) Hypercarbia

b) Hypercalcaemia

C) Hyperglycemia

D) Hypoalbuminaemia

E) Variceal hemorrhage

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