CEE PG MDMS Nepal 2021/22 2078 Previous Year Questions

MEC Common Entrance Exam (MD/MS) 2021

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MEDICINE
1. A patient presented with a fever peaking in the morning and evening, accompanied by blackish skin discoloration. The patient was diagnosed with Kala-azar. Which of the following is the drug of choice for Kala-azar?
  • a. Sodium Antimony Gluconate
  • b. Amphotericin B
  • c. Pentamidine
  • d. Pentavalent antimony
Correct Answer: b
2. A patient was diagnosed with pulmonary tuberculosis (TB) and began treatment. After five months of treatment, the patient remains sputum-positive. This is classified as a:
  • a. Failure case
  • b. Relapse case
  • c. Primary TB
  • d. Secondary TB
Correct Answer: a
3. A 28-year-old female being treated for hypothyroidism with Levothyroxine plans to become pregnant. What advice should be provided?
  • a. Defer pregnancy until euthyroid
  • b. Change from Levothyroxine to Triiodothyronine
  • c. Perform a TFT and likely increase the dose of Levothyroxine
  • d. Continue the same treatment
Correct Answer: c
4. A boy develops endocarditis two months after undergoing prosthetic valve replacement. Which of the following is the most likely causative organism?
  • a. Staph. aureus
  • b. Staph. epidermidis
  • c. Strepto. viridans
  • d. Pseudomonas
Correct Answer: b
5. A 28-year-old female presented to the OPD with complaints of amenorrhea, galactorrhea, and an inability to conceive after two years of marriage. Investigations revealed elevated prolactin levels. Which of the following may be the cause of her condition?
  • a. Diabetes mellitus
  • b. Hypothyroidism
  • c. Hyperthyroidism
  • d. Diabetes insipidus
Correct Answer: b
6. Which of the following statements regarding dengue is true?
  • a. The incubation period is 3–5 days
  • b. Dengue shock syndrome is more likely to occur during the first episode
  • c. The tourniquet test is a reliable guide for capillary fragility in the critical phase
  • d. Hypervolemia is not uncommon and is an important cause of mortality during treatment
Correct Answer: d
7. A patient presents with hemoptysis and is diagnosed with lung carcinoma. Laboratory investigations reveal hypercalcemia. Which of the following drugs should be avoided in this patient?
  • a. Thiazide diuretics
  • b. Potassium-sparing diuretics
  • c. Loop diuretics
  • d. Mannitol
Correct Answer: a
8. A boy presents with purpuric rashes all over his body and is diagnosed with Henoch-Schönlein purpura (HSP). On the third day of admission, he complains of abdominal pain. What is the next step in management?
  • a. Surgical consultation
  • b. Steroids
  • c. H2 blocker
  • d. Antibiotics
Correct Answer: b
9. A patient with a known case of congestive cardiac failure presents with difficulty breathing, extreme weakness, and dizziness. Which of the following findings is most likely present in this patient?
  • a. Pulsus alternans
  • b. Fixed S2 split
  • c. S4 gallop
  • d. Water hammer pulse
Correct Answer: a
10. An alcoholic patient with cirrhosis and chronic liver disease has developed peritonitis with bacterial infiltration. Which of the following findings may be seen?
  • a. ANC > 250 cells/mm³
  • b. Perforation
  • c. Edema
  • d. Eosinophilia
Correct Answer: a
11. A 24-year-old primigravida underwent LSCS for fetal distress. On the second postoperative day, she developed tachycardia and hypotension followed by anuria. Renal function tests showed elevated urea and creatinine. What is the most probable cause?
  • a. Intrinsic renal AKI
  • b. Post-renal AKI
  • c. Anaesthetic hazard
  • d. Prerenal AKI
Correct Answer: d
12. A patient presents with upper limb weakness but no urinary incontinence. Which of the following is the most probable diagnosis if cervical and thoracic lesions are present?
  • a. Central cord syndrome
  • b. Cauda equina
  • c. Motor neuron disease
  • d. Anterior cord syndrome
Correct Answer: a
13. A patient presented with nausea, vomiting, headache, and seizures. Examination showed a BP of 110/70 mmHg and unremarkable chest and abdomen findings. Investigations showed sodium 116 mg/dl and potassium 4.6 mg/dl. The patient was treated with 3% saline in the ICU. After 3 days, she developed dysarthria, dysphagia, and weakness in all four limbs. What is the most probable cause of deterioration?
  • a. Osmotic demyelination syndrome
  • b. Cerebral edema
  • c. Ischemic stroke
  • d. Pontine hemorrhage
Correct Answer: a
14. A patient on antipsychotic medication appears restless with a frequent urge to move. What is this disorder called?
  • a. Akathisia
  • b. Tardive dyskinesia
  • c. Drug-induced parkinsonism
  • d. Dystonia
Correct Answer: a
15. A patient presents with ptosis and is suspected of having myasthenia gravis. As a diagnostic tool, continuous muscle stimulation was performed. Which of the following responses favors a diagnosis of myasthenia gravis?
  • a. Decrease in response
  • b. No response
  • c. Increase in response
  • d. Some response
Correct Answer: a
16. A patient diagnosed with hypertension is currently taking medication. Laboratory investigations show sodium at 144 mEq/L and potassium at 2.3 mEq/L. Which of the following findings is most likely to be seen on this patient's arterial blood gas (ABG) analysis?
  • a. Metabolic acidosis
  • b. Metabolic alkalosis
  • c. Respiratory acidosis
  • d. Respiratory alkalosis
Correct Answer: b
17. A 62-year-old male presents with a two-month history of intermittent fever and excessive night sweats. Physical examination reveals cervical lymphadenopathy. What is the presumptive diagnosis?
  • a. Sarcoidosis
  • b. SLE
  • c. Hodgkin's lymphoma
  • d. Infectious mononucleosis
Correct Answer: c
18. Dependent edema is typically seen in which of the following conditions?
  • a. Cardiac disease
  • b. Nephrogenic disease
  • c. Hypoalbuminemia
  • d. Liver disease
Correct Answer: a
19. Ladd's operation is performed for which of the following conditions?
  • a. Malrotation
  • b. Pyloric stenosis
  • c. Intussusception
  • d. Duodenal atresia
Correct Answer: a
20. According to the Forrest classification for bleeding ulcers, which of the following is classified as Grade Ib?
  • a. Oozing hemorrhage
  • b. Normal tortuous vein
  • c. Brisk bleeding
  • d. Clean base
Correct Answer: a
21. Which of the following statements is most accurate regarding Crohn's disease?
  • a. Acute and chronic transmural infection
  • b. Non-caseating granulomas along the entire bowel
  • c. Crypt abscesses
  • d. Pseudopolyps
Correct Answer: b
22. A 28-year-old male presents following a road traffic accident (RTA) with blood at the urinary meatus. Radiography reveals a pelvic fracture and the patient is diagnosed with a rupture of the bulbous urethra. Where is the site for extravasation of urine in a case of anterior urethral rupture?
  • a. Superficial perineal pouch
  • b. Deep perineal pouch
  • c. Ischiorectal fossa
  • d. Pelvic fossa
Correct Answer: a
23. According to the revised Atlanta classification, moderately severe acute pancreatitis includes which of the following?
  • a. Local or systemic complications without persistent organ failure
  • b. No organ failure
  • c. Persistent organ failure
  • d. No local or systemic complications
Correct Answer: a
24. What is the major disadvantage of using an open drain compared to a closed drain?
  • a. High risk of ascending infection
  • b. Difficulty in monitoring fluid characteristics
  • c. Collapse of dead space
  • d. Requirement of negative pressure for drainage
Correct Answer: a
25. What is the best treatment for a 2 cm thyroid nodule in a 50-year-old man when FNAC reveals it to be a papillary carcinoma?
  • a. Hemithyroidectomy
  • b. Subtotal thyroidectomy with modified neck dissection
  • c. Near-total thyroidectomy with modified neck dissection
  • d. Hemithyroidectomy with modified neck dissection
Correct Answer: c
26. A female patient has cholesterol gallstones. Which of the following might be a risk factor?
  • a. Use of oral contraceptive pills
  • b. Crohn's disease
  • c. Infection
  • d. Hemolytic disease
Correct Answer: a
27. A 31-year-old male presents to the emergency department with chest pain and shortness of breath following a fall. On examination, his BP is 80/60 mmHg and chest movements are absent on the right side. Auscultation reveals no air entry on the right side. What is the immediate management?
  • a. Chest tube insertion through the 2nd intercostal space
  • b. Needle thoracostomy through the 2nd intercostal space
  • c. Chest tube insertion through the 5th intercostal space
  • d. Needle thoracostomy through the 5th intercostal space
Correct Answer: d
28. What is a drawback of using silk suture over polypropylene?
  • a. Risk of infection
  • b. Memory
  • c. Cost
  • d. Slippage
Correct Answer: a
29. A patient presents with hematuria. Urine examination reveals dysmorphic RBCs. A lesion in which of the following organs is responsible for these dysmorphic RBCs?
  • a. Kidney
  • b. Bladder
  • c. Ureter
  • d. Urethra
Correct Answer: a
30. A man presents with anuria following an RTA in which his bladder was injured. Which of the following is the most likely occurrence?
  • a. Intraperitoneal bladder rupture
  • b. Extraperitoneal bladder rupture
  • c. Neurogenic bladder
  • d. Urethral injury
Correct Answer: b
31. A 39-year-old female presents with right upper quadrant pain, fever, and vomiting. On examination, tenderness is noted at the lateral border of the rectus abdominis muscle in the subcostal region. Laboratory results show an elevated white blood cell (WBC) count. What is the most likely diagnosis?
  • a. Biliary colic
  • b. Acute appendicitis
  • c. Perforated peptic ulcer
  • d. Acute cholecystitis
Correct Answer: d
32. An elderly man presents to the emergency department following a bout of prolonged vomiting and excessive hematemesis after alcohol ingestion. What is he most likely suffering from?
  • a. Mallory-Weiss syndrome
  • b. Esophageal varices
  • c. Gastric cancer
  • d. Bleeding disorder
Correct Answer: a
33. A patient was brought to the hospital with a history of a road traffic accident (RTA) eight hours prior. A few drops of blood were noted at the external urethral meatus. The patient has not passed urine, and his bladder is palpable on abdominal examination. What is the most probable diagnosis?
  • a. Urethral injury
  • b. Bladder rupture
  • c. Urethral injury with extravasation of urine into the retroperitoneum
  • d. Anuria due to hypovolemia
Correct Answer: a
34. In which of the following conditions are oxalate stones commonly seen?
  • a. Crohn's disease
  • b. Ulcerative colitis
  • c. Diverticulitis
  • d. Irritable bowel syndrome
Correct Answer: a
35. Which of the following pathological changes does not occur in achalasia cardia?
  • a. Loss of ganglion cells in the Auerbach's plexus
  • b. Loss of ganglion cells in the Myenteric plexus
  • c. Loss of ganglion cells in the Meissner's plexus
  • d. Inability to relax the lower esophageal sphincter
Correct Answer: c
36. What is the primary advantage of a no-scalpel vasectomy compared to a traditional scalpel vasectomy?
  • a. Easier reversal
  • b. Decreased sperm granuloma
  • c. Increased effectiveness
  • d. Decreased hematoma formation
Correct Answer: d
37. What is the most important diameter of the pelvis to consider during labor?
  • a. Interspinous diameter of the outlet
  • b. Oblique diameter of the inlet
  • c. Anteroposterior (AP) diameter of the outlet
  • d. Intertuberous diameter
Correct Answer: a
38. A diagnosis is made of a uterus with a normal cervix but possessing two horns. Which of the following is the correct diagnosis?
  • a. Uterus didelphys
  • b. Septate uterus
  • c. Bicornuate uterus
  • d. Unicornuate uterus
Correct Answer: c
39. Which of the following is a component typically used in post-coital (emergency) contraception?
  • a. Levonorgestrel
  • b. Norethisterone
  • c. Danazol
  • d. Misoprostol
Correct Answer: a
40. A postmenopausal woman presents with vaginal bleeding. On examination, her endometrial thickness is measured at 5.5 mm. What is the most probable cause?
  • a. Endometrial carcinoma
  • b. Cervical carcinoma
  • c. Endometritis
  • d. Endometrial atrophy
Correct Answer: a
41. A woman has a history of recurrent abortions and tests positive for anti-cardiolipin antibodies. Which of the following would be the most appropriate management?
  • a. Low-dose aspirin and heparin
  • b. Warfarin
  • c. Steroids
  • d. Methotrexate
Correct Answer: a
42. A 45-year-old lady complains of contact bleeding. She has a positive Pap smear. What is the next line of management?
  • a. Colposcopy-directed biopsy
  • b. Cone biopsy
  • c. Repeat Pap smear
  • d. Hysterectomy
Correct Answer: a
43. All of the following are causes of vesicovaginal fistula (VVF) EXCEPT:
  • a. Hysterectomy
  • b. Endometriosis
  • c. Pelvic radiation
  • d. Obstructed labor
Correct Answer: b
44. A 25-year-old woman, who recently gave birth to a male baby, comes to the office due to vision problems. Over the last six weeks, she has had several "near-misses" while driving because she didn't see cars coming from the left or right. She also reports frequent headaches but takes no medications and does not use tobacco, alcohol, or illicit drugs. Physical examination reveals deficits in bilateral temporal visual fields, but the remainder of the neurological examination is normal. What is the most likely cause of this condition?
  • a. Sheehan syndrome
  • b. Asherman syndrome
  • c. Hyperthyroidism
  • d. Pheochromocytoma
Correct Answer: a
45. A hypertensive pregnant woman at 34 weeks of gestation presents with a history of abdominal pain, vaginal bleeding, and loss of fetal movements. On examination, the uterus is contracted with increased uterine tone, and fetal heart sounds are absent. What is the most likely diagnosis?
  • a. Placenta previa
  • b. Hydramnios
  • c. Premature labor
  • d. Abruptio placentae
Correct Answer: d
46. A 21-year-old newly married woman presents with pain during sexual penetration one month after marriage. What is the most likely cause of her pain?
  • a. Narrow introitus
  • b. Endometriosis
  • c. PID
  • d. Atrophic vaginitis
Correct Answer: a
47. A 24-year-old female presents to the emergency room with amenorrhea for eight weeks and a positive urine pregnancy test. An ultrasound scan reveals an empty uterine cavity but shows a mass in the right adnexal region. What is the most likely diagnosis?
  • a. Endometritis
  • b. Ovarian carcinoma
  • c. Ectopic pregnancy
  • d. Ovarian cyst
Correct Answer: c
48. A 35-year-old woman presents to the outpatient department (OPD) with complaints of irregular menses. Her urine pregnancy test is negative, and an ultrasound of the abdomen/pelvis and thyroid function tests are normal. What is the most appropriate management?
  • a. OCP
  • b. Progestins
  • c. Dilatation and curettage
  • d. Hysterectomy
Correct Answer: b
49. A four-day-old baby born to a diabetic mother is evaluated. Which of the following findings is pathognomonic for a baby born to a diabetic mother?
  • a. Caudal regression syndrome
  • b. Transposition of great vessels
  • c. Holoprosencephaly
  • d. Meningomyelocele
Correct Answer: a
50. A child is able to walk backward and build a tower of three blocks. What is the most likely age of the child?
  • a. 12 months
  • b. 15 months
  • c. 18 months
  • d. 9 months
Correct Answer: c
51. Which fontanelle typically closes between 18 months and 2 years of age?
  • a. Anterior
  • b. Posterior
  • c. Lambdoid
  • d. Metopic
Correct Answer: a
52. A baby was brought to the emergency room (ER) crying. Upon examination, a cyanotic episode was observed after the crying. What is the most likely diagnosis for this child?
  • a. Breath-holding spell
  • b. Epileptic seizure
  • c. Vasovagal syncope
  • d. Cardiac arrhythmia
Correct Answer: a
53. Which of the following statements regarding neonatal hyperbilirubinemia is incorrect?
  • a. Breastfeeding jaundice is an example of physiological jaundice
  • b. Breast milk jaundice occurs due to decreased conjugation
  • c. Physiological jaundice does not occur on the first day
  • d. Pathological jaundice may be seen on the first day
Correct Answer: a
54. What is the primary rationale for the addition of glucose to Oral Rehydration Salts (ORS)?
  • a. To facilitate the absorption of sodium
  • b. To facilitate the absorption of water
  • c. For calorie fulfillment
  • d. To avoid seizures
Correct Answer: a
55. An infant presents with features of septicemia. Which of the following is the most reliable and fastest indicator for septicemia in this case?
  • a. Fever
  • b. Lethargy
  • c. Tachycardia
  • d. Low body temperature
Correct Answer: b
56. A pregnant woman is diagnosed as HBsAg positive. What is the best method to prevent the transmission of infection to the child?
  • a. Administer hepatitis vaccine to the child
  • b. Administer a full course of hepatitis B vaccine and immunoglobulin to the child
  • c. Administer hepatitis B immunoglobulin to the mother
  • d. Administer hepatitis B immunization to the mother
Correct Answer: b
57. A "white strawberry tongue" is a clinical feature associated with:
  • a. Scarlet fever
  • b. Kawasaki disease
  • c. Vitamin B12 deficiency
  • d. Food and drug allergies
Correct Answer: a
58. A patient presents with a two-day history of cervical lymphadenopathy, sore throat, and halitosis. What is the most likely diagnosis?
  • a. Lymphoma
  • b. Diphtheria
  • c. EBV (Epstein-Barr Virus)
  • d. Tuberculosis
Correct Answer: c
59. Why is the bivalent Oral Polio Vaccine (bOPV) currently administered instead of the trivalent version?
  • a. To decrease the risk of paralysis
  • b. To decrease cost
  • c. To decrease adverse effects
  • d. To increase efficacy
Correct Answer: a
60. A 3-year-old child was brought to the pediatric OPD with fever and cough. Examination revealed elevated blood pressure and an abdominal mass. What is the most likely diagnosis?
  • a. Neuroblastoma
  • b. Nephroblastoma
  • c. Non-Hodgkin's lymphoma
  • d. Renal cell carcinoma
Correct Answer: b
61. A patient presents with pain and swelling in the great toe. What is the most probable diagnosis?
  • a. Gout
  • b. Pseudo gout
  • c. Osteoarthritis
  • d. Septic arthritis
Correct Answer: a
62. A patient complains of leg pain after sustaining an injury in an accident. On examination, compartment syndrome is diagnosed. Which of the following findings is most suggestive of compartment syndrome?
  • a. Pain out of proportion
  • b. Absent distal pulse
  • c. Pallor
  • d. Paresthesia
Correct Answer: a
63. A patient with a shoulder dislocation underwent closed reduction with internal fixation. Several days later, the patient presents with an inability to abduct the shoulder more than 90 degrees and complains of pain. On examination, deltoid muscle atrophy is observed. Which of the following structures might be injured?
  • a. Supraspinatus
  • b. Trapezius
  • c. Axillary nerve
  • d. Deltoid muscle
Correct Answer: c
64. In spondylolisthesis, the underlying cause is a defect in the:
  • a. Pars interarticularis
  • b. Interspinous
  • c. Interlaminar
  • d. Interbody
Correct Answer: a
65. A football player sustained a right knee injury several months ago. He now presents with complaints of pain and a feeling of instability in the right knee joint. What is the most probable cause?
  • a. Anterior cruciate ligament injury
  • b. Osteoarthritis Dessicans
  • c. Meniscus injury
  • d. MCL injury
Correct Answer: a
66. Which of the following organisms is the most common cause of osteomyelitis in intravenous (IV) drug users?
  • a. Staph aureus
  • b. Salmonella
  • c. Pseudomonas
  • d. Streptococcus agalactie
Correct Answer: a
67. A patient presents with a loss of appetite, fever, and back pain that is mostly exaggerated at night. An X-ray was performed, and no bony abnormalities were found. Which of the following investigations would be best for diagnosis at this time?
  • a. MRI
  • b. CT
  • c. Blood work up
  • d. PET scan
Correct Answer: a
68. A patient presents to the emergency room with an open fracture sustained 20 hours ago. Which of the following is the best management plan?
  • a. Debridement and delayed closure
  • b. Debridement and early closure
  • c. ORIF
  • d. Debride and leave for wound healing by secondary intention
Correct Answer: a
69. A 48-year-old female was admitted for a fracture of the femoral shaft. 72 hours after the injury, she developed breathlessness, and her oxygen saturation was 70%. What is the most likely cause of this deterioration?
  • a. Fat embolism
  • b. Air embolism
  • c. Pulmonary edema
  • d. Thromboembolic pulmonary embolism
Correct Answer: a
70. A patient presents with Heberden's nodes on the fingers. Which of the following joints is involved?
  • a. DIP
  • b. Wrist joint
  • c. MCP
  • d. PIP
Correct Answer: a
71. A patient is diagnosed with a vestibular schwannoma. Which of the following implants is performed for hearing restoration?
  • a. Brainstem implant
  • b. Unilateral cochlear implant
  • c. Bilateral cochlear implant
  • d. Middle ear implant
Correct Answer: a
72. Which of the following is the correct position for bronchoscopy?
  • a. Boyce's position
  • b. Rose position
  • c. Killian position
  • d. Reverse killian position
Correct Answer: a
73. A cough reflex occurred while cleaning the ear. Which of the following cranial nerves (CN) is responsible for this?
  • a. 7th CN
  • b. 8th CN
  • c. 9th CN
  • d. 10th CN
Correct Answer: d
74. A patient presents with hearing loss. Otoscopic examination reveals three perforations in the tympanic membrane. What is the most likely cause of multiple perforations of the tympanic membrane?
  • a. Syphilis
  • b. Tuberculous
  • c. Fungal
  • d. Bacterial
Correct Answer: b
75. A patient experiences excessive daytime sleepiness, snoring at night, and apnea. Which of the following is the best diagnostic test for this condition?
  • a. Phlesthysmography
  • b. Polysomnography
  • c. Home sleep apnea test
  • d. Breathing test
Correct Answer: b
76. A patient presents to the outpatient department (OPD) with a history of a muffled voice. On examination, the uvula is pushed to the opposite side and the tonsils are enlarged. What is the most likely diagnosis?
  • a. Peritonsillar abscess
  • b. Retropharyngeal abscess
  • c. Paratonsillar abscess
  • d. Tonsilolith
Correct Answer: a
77. A patient presents with epistaxis, postnasal drip, and a cough, and is diagnosed with Rhinosporidiosis. Which of the following is the drug of choice for this patient?
  • a. Dapsone
  • b. Clindamycin
  • c. Rifampicin
  • d. Streptomycin
Correct Answer: a
78. A patient with a history of nasal trauma presents with nasal obstruction. On examination, a mass is found in the bilateral nasal cavity that is separate from the lateral walls of the nostrils. Which of the following is the most likely diagnosis?
  • a. Septal hematoma
  • b. Antrochoanal polyp
  • c. Foreign body
  • d. Ethmoidal polyp
Correct Answer: a
79. A 62-year-old male presents with cervical lymphadenopathy, fever, weight loss, and temporal wasting. Which of the following is the most likely cause?
  • a. HIV
  • b. Fungal infection
  • c. Non-Hodgkin Lymphoma
  • d. Sarcoidosis
Correct Answer: a
80. A 34-year-old male presents with a chronic discharge from the left ear and decreased hearing. Which of the following investigations would lead to a diagnosis?
  • a. X-ray mastoid
  • b. CT Head
  • c. MRI head
  • d. HRCT temporal bone
Correct Answer: d
81. In age-related macular degeneration, the loss of vision is typically:
  • a. Central
  • b. Paracentral
  • c. Peripheral
  • d. Tubular
Correct Answer: a
82. A 6-month-old infant presents with a white pupillary reflex and microphthalmia. The infant had a low birth weight, and examination reveals a long ciliary body. What is the most probable condition?
  • a. Retinoblastoma
  • b. Premature retinopathy
  • c. PHPV
  • d. Toxoplasma
Correct Answer: c
83. Which of the following is a cause of sudden, painless loss of vision?
  • a. ACG
  • b. CRAO
  • c. Papilledema
  • d. Papillitis
Correct Answer: b
84. A patient presents with features of acute congestive glaucoma. Which investigation should be performed next?
  • a. Intraocular pressure monitoring
  • b. Corneal thickness
  • c. Refraction
  • d. Gonioscopy
Correct Answer: a
85. A farmer presents with a painless sensation in the eye. Which of the following is a cause of decreased sensation?
  • a. Herpes simplex Keratitis
  • b. Nummular Keratitis
  • c. Fungal Keratitis
  • d. Bacterial Keratitis
Correct Answer: a
86. Which of the following muscles is responsible for the constriction of the pupil?
  • a. Dilator pupillae
  • b. Sphincter pupillae
  • c. Longitudinal fibers of ciliary body
  • d. Radial fibers of ciliary body
Correct Answer: b
87. What is the most common cause of unilateral exophthalmos?
  • a. Graves disease
  • b. Meningioma
  • c. Metastasis
  • d. Cavernous sinus thrombosis
Correct Answer: a
88. What is the most common complication of central venous catheterization?
  • a. Carotid artery injury
  • b. Arrhythmia
  • c. Infection
  • d. Hematoma at the place of catheter insertion
Correct Answer: b
89. A man with burn injuries presents to the hospital. Which of the following is used for rapid sequence intubation in this patient?
  • a. Rocuronium
  • b. Succinylcholine
  • c. Vecuronium
  • d. Atracurium
Correct Answer: a
90. Which of the following is the inhalational anesthetic of choice for surgery in children?
  • a. Sevoflurane
  • b. Isoflurane
  • c. Nitric oxide
  • d. Halothane
Correct Answer: a
91. A patient is scheduled for surgery, and pancuronium is used for intubation. Which of the following drugs should not be administered alongside pancuronium?
  • a. NSAIDs
  • b. Succinylcholine
  • c. Lithium
  • d. Diltiazem
Correct Answer: c
92. A 60-year-old male underwent a hemorrhoidectomy under spinal anesthesia. Three days after the surgery, he complains of back pain radiating to both thighs and knees. What is the most likely cause of this pain?
  • a. Abscess
  • b. Hematoma
  • c. Anesthetic toxicity
  • d. Sympathetic block
Correct Answer: b
93. In a patient experiencing cardiac arrest, what is the best method for confirming the correct placement of an endotracheal tube in the trachea?
  • a. Capnography
  • b. Direct visualization
  • c. Transillumination
  • d. Auscultation of the axillae
Correct Answer: b
94. A patient undergoing a surgical procedure develops shock (hypotension), a feeble pulse, and tachycardia. The ECG monitor shows broad QRS complexes with a heart rate exceeding 130 bpm. Which of the following should be used for treatment?
  • a. Defibrillator
  • b. Lidocaine
  • c. Amiodarone
  • d. Procainamide
Correct Answer: a
95. A female patient has experienced three to six recurrent manic episodes every six months over several years. What is the most probable diagnosis?
  • a. Mania
  • b. Bipolar disorder
  • c. Rapid cycling
  • d. Cyclothymia
Correct Answer: c
96. A woman diagnosed with depression and treated with sertraline presents with sweating, fever, and a headache. What is the most likely cause of these symptoms?
  • a. Serotonin syndrome
  • b. Malignant hyperthermia
  • c. Neuroleptic malignant syndrome
  • d. Anticholinergic toxicity
Correct Answer: a
97. A patient diagnosed with depression and taking antidepressant medication presents to the emergency room with QT prolongation. Which of the following drugs is the most likely cause?
  • a. Amitriptyline
  • b. Risperidone
  • c. Sertraline
  • d. Duloxetine
Correct Answer: a
98. A 50-year-old chronic alcoholic patient presents to the emergency department with sweating, tremors, and incoherent speech. His last alcoholic drink was three days ago. What is the most probable diagnosis?
  • a. Delirium tremens
  • b. Korsakoff psychosis
  • c. Post-acute withdrawal syndrome
  • d. Discontinuation syndrome
Correct Answer: a
99. A pregnant woman presents to the emergency room exhibiting aggressive and agitated behavior. Which of the following drugs is used for her management?
  • a. Oral lorazepam
  • b. IV lorazepam
  • c. ECT
  • d. Haloperidol
Correct Answer: d
100. Which of the following best describes an emotion?
  • a. A subjective, psychological, and behavioral response
  • b. An objective, physiological, and behavioral response
  • c. A subjective, physiological, and behavioral response
  • d. An objective, physiological, and behavioral response
Correct Answer: c
101. The father of a 25-year-old male with schizophrenia reports that his son has an expressionless face, lacks motivation, no longer socializes, and has lost interest in previously enjoyed activities. What are these clinical features called?
  • a. Negative symptoms
  • b. Positive symptoms
  • c. Depressive symptoms
  • d. Schneider's first-rank symptoms
Correct Answer: a
102. A 28-year-old female presents with a headache, seizures, and vomiting. A CT scan of the head reveals an irregular, heterogeneous, hypodense lesion with a midline shift in the cerebral hemisphere. What is the most likely diagnosis?
  • a. Glioblastoma
  • b. Meningioma
  • c. Cerebral lymphoma
  • d. Oligodendroglioma
Correct Answer: a
103. A 58-year-old male underwent a CT scan for a persistent headache. The scan showed a calcified structure in the midline, posterior to the third ventricle. What is this calcified structure?
  • a. Pineal gland
  • b. Pituitary gland
  • c. Amygdala
  • d. Hippocampus
Correct Answer: a
104. Which structures form the lung hilum as seen on a chest X-ray?
  • a. Superior vena cava and pulmonary artery
  • b. Superior pulmonary vein and descending pulmonary artery
  • c. Lymphatics and lymph nodes
  • d. Aorta
Correct Answer: b
105. Which of the following is the investigation of choice (IOC) for ureteric colic?
  • a. Intravenous urography
  • b. CT KUB
  • c. X-ray KUB
  • d. Ultrasound (USG)
Correct Answer: b
106. A patient presents with seizures. A CT scan reveals a calcified mass in the frontotemporal cortex. Which of the following might be the cause of this finding?
  • a. Toxoplasmosis
  • b. HSV
  • c. Neurocysticercosis
  • d. Tuberculosis
Correct Answer: b
107. In which of the following conditions is an "onion skin" appearance seen on radiography?
  • a. Ewing's sarcoma
  • b. Giant cell tumour
  • c. Osteosarcoma
  • d. Chondroma
Correct Answer: a
108. A 26-year-old female presents to the OPD with a complaint of spinal curvature that has persisted since childhood. What is the next step in management?
  • a. Blood workup
  • b. Observation and follow-up
  • c. Positional correction advice
  • d. X-ray of the spine to calculate the Cobb's angle
Correct Answer: d
109. A patient undergoing treatment for leprosy presents with tender nodules on the legs, fever, joint pain, and testicular pain. What is the best treatment for this condition?
  • a. Thalidomide
  • b. Steroids
  • c. Clofazimine
  • d. Chloroquine
Correct Answer: b
110. Which of the following statements regarding Norwegian scabies is false?
  • a. Intense itching is present
  • b. Crusting is common
  • c. It is common in immunocompromised patients
  • d. Innumerable mites are seen on microscopy
Correct Answer: a
111. In which of the following dermatological conditions is a "collarette" of scale seen?
  • a. Pityriasis rosea
  • b. Tinea versicolor
  • c. Lichen planus
  • d. Psoriasis
Correct Answer: a
112. A patient presents with macules and papules on the hand. Laboratory investigations show a positive TPHA test. What is the most likely diagnosis?
  • a. Primary syphilis
  • b. Secondary syphilis
  • c. Tertiary syphilis
  • d. Congenital syphilis
Correct Answer: b
113. A 32-year-old woman presents to the OPD with a leg ulcer and enlarged inguinal lymph nodes. She reports a history of a thorn prick. Which organism is the most likely cause?
  • a. Cladosporium
  • b. Sporothrix
  • c. Histoplasma
  • d. Candida
Correct Answer: b
114. A 22-year-old female presents with an erythematous lesion on her forearm exhibiting a "target sign." What is the most probable prior associated infection?
  • a. EBV
  • b. HSV
  • c. CMV
  • d. HIV
Correct Answer: b
115. A 55-year-old woman presents with stiffening of the fingers, bluish discoloration of the fingers on exposure to cold, fingertip ulcers, hypertension, shortness of breath, and dysphagia. Which of the following investigations should be ordered?
  • a. Antinuclear antibody
  • b. Anticentromere antibody
  • c. Anti-Scl-70 antibody
  • d. Anticytoplasmic antibody
Correct Answer: b
116. A patient presents with decreased lacrimal secretion. A lesion in which of the following structures is the cause?
  • a. Ciliary ganglion
  • b. Pterygopalatine ganglion
  • c. Superior cervical ganglion
  • d. Otic ganglion
Correct Answer: b
117. A patient presents with a loss of sensation in the ring and small fingers and is unable to abduct the fingers. Which nerve injury causes this?
  • a. AIN (Anterior Interosseous Nerve)
  • b. PIN (Posterior Interosseous Nerve)
  • c. Ulnar nerve
  • d. Radial nerve
Correct Answer: c
118. The hypoglossal nerve, which passes through the hypoglossal canal, supplies which of the following muscles?
  • a. Genioglossus
  • b. Palatoglossus
  • c. Hypoglossus
  • d. Geniohyoid
Correct Answer: a
119. During the second month of intrauterine life, the rotation of the midgut occurs around the axis of the:
  • a. Superior mesenteric artery (SMA)
  • b. Inferior mesenteric artery (IMA)
  • c. Coeliac trunk
  • d. Right colic artery
Correct Answer: a
120. Which of the following is a tongue-like projection or bulge found in the liver?
  • a. Riedel's lobe
  • b. Caudate lobe
  • c. Quadrate lobe
  • d. Left lobe
Correct Answer: a
121. A procedure is being performed on the kidney using a posterior approach. Which of the following nerves is not injured?
  • a. Anterior rami L2-L4
  • b. Ilioinguinal
  • c. Iliohypogastric
  • d. Dorsal rami of L2-L4
Correct Answer: d
122. If a finger is placed in the epiploic foramen, which structure will be located directly below the finger?
  • a. 1st part of duodenum
  • b. Liver
  • c. IVC
  • d. Free edge of lesser omentum
Correct Answer: a
123. The maternal portion of the placenta is derived from the:
  • a. Decidua basalis
  • b. Decidua capsularis
  • c. Decidua parietalis
  • d. Decidua vera
Correct Answer: a
124. Which of the following rotator cuff muscles does not primarily participate in rotation?
  • a. Supraspinatus
  • b. Infraspinatus
  • c. Teres minor
  • d. Subscapularis
Correct Answer: a
125. During a midline episiotomy, which of the following structures will be incised?
  • a. Superficial perineal muscle
  • b. Levator ani
  • c. Coccygeus
  • d. Sphincters
Correct Answer: d
126. A patient presents with epiphora (tearing from the eye). History reveals trauma to the nose from an eraser. In which of the following areas has an obstruction most likely occurred?
  • a. Inferior meatus
  • b. Middle meatus
  • c. Superior meatus
  • d. Supreme meatus
Correct Answer: a
127. Which of the following ligaments is injured in a posterior dislocation of the hip?
  • a. Ischio-femoral ligament
  • b. Ilio-femoral ligament
  • c. Pubo-femoral ligament
  • d. Ilio-lumbar ligament
Correct Answer: a
128. A male patient undergoing an infertility workup is found to have azoospermia. Testicular biopsy shows Sertoli cells comprising more than 50% of the cells, while germ cells account for less than 50%. What is the most likely diagnosis?
  • a. Sertoli cell-only syndrome
  • b. Normal
  • c. Leydig cell hyperplasia
  • d. Maturation arrest
Correct Answer: a
129. All of the following statements regarding action potentials are correct EXCEPT:
  • a. It is an "all-or-none" phenomenon
  • b. The power of skeletal muscle contraction depends upon the amplitude of the nerve fiber action potential
  • c. Its waveform can differ in different tissues
  • d. It can travel in all directions
Correct Answer: b
130. Smooth muscle differs from skeletal muscle in that:
  • a. They possess gap junctions
  • b. Smooth muscle is under voluntary control
  • c. Smooth muscle does not have innervation
  • d. Smooth muscle lacks pacemaker activity
Correct Answer: a
131. Increased intracranial pressure (ICP) is typically observed in which of the following?
  • a. Hyperventilation
  • b. Early morning
  • c. Head elevation
  • d. Lumbar puncture
Correct Answer: b
132. Features of both upper and lower motor neuron palsy are seen in:
  • a. Poliomyelitis
  • b. Amyotrophic lateral sclerosis (ALS)
  • c. Syringomyelia
  • d. Multiple sclerosis
Correct Answer: b
133. Actin filaments and the Z line are joined together by:
  • a. Titin
  • b. Dystrophin
  • c. Actinin
  • d. Tropomodulin
Correct Answer: c
134. If a fluorescent dye is injected into one cell and subsequently appears in all adjacent cells, which of the following structures is responsible for the transfer?
  • a. Gap junction
  • b. Tight junction
  • c. Desmosomes
  • d. Adherens junction
Correct Answer: a
135. Which of the following is NOT controlled by a negative feedback mechanism?
  • a. LH surge
  • b. Temperature
  • c. Blood pressure (BP)
  • d. TSH
Correct Answer: a
136. Which of the following is the fastest mechanism for the regulation of blood pressure (BP)?
  • a. RAAS
  • b. ANP
  • c. Baroreceptor response
  • d. Chemoreceptor
Correct Answer: c
137. Regarding the rate of diffusion of a gas across a membrane, which of the following statements is NOT true?
  • a. It is directly proportional to the area of the diffusing surface
  • b. It is directly proportional to the pressure gradient of the gas on the two sides of the membrane
  • c. It is directly proportional to the solubility of the gas
  • d. It is directly proportional to the thickness of the diffusing membrane
Correct Answer: d
138. Vagal stimulation of the heart leads to:
  • a. Increased conduction velocity
  • b. Decreased heart rate
  • c. Increased heart rate
  • d. Decreased diastolic filling time
Correct Answer: b
139. Decerebrate posturing can be eliminated by:
  • a. Transection of the dorsal column
  • b. Inhibition of Ia fibers
  • c. Alpha fiber inhibition
  • d. Transection of the vestibular nerve fibers
Correct Answer: d
140. Which of the following is a marker for gastric carcinoma?
  • a. APC
  • b. P53
  • c. FHIT
  • d. MYC and RAS
Correct Answer: b
141. All of the following are considered premalignant polyps EXCEPT:
  • a. Villous
  • b. Tubular
  • c. Juvenile
  • d. Tubulovillous
Correct Answer: c
142. Which of the following is a hallmark of irreversible cell injury?
  • a. Severe cell membrane damage with leakage of cytochromes outside the cell
  • b. Blebbing
  • c. Loss of function
  • d. Clumping of nuclear chromatin
Correct Answer: a
143. A patient underwent an appendectomy 10 days ago. The wound has healed and the sutures were removed. On examination, a lump is noted at the operative site. The patient is afebrile and hemodynamically stable. What is the most likely finding?
  • a. Suture granuloma
  • b. Stump appendicitis
  • c. Keloid
  • d. Hypertrophic scar
Correct Answer: a
144. "Ground-glass opacity" of hepatocytes is a characteristic finding in which of the following types of hepatitis?
  • a. Hepatitis A
  • b. Hepatitis B
  • c. Hepatitis C
  • d. Hepatitis D
Correct Answer: b
145. Which of the following findings is used to diagnose Thalassemia minor?
  • a. HbA2
  • b. Fetal hemoglobin
  • c. Hb Bart
  • d. HbH
Correct Answer: a
146. A 60-year-old man has had untreated hypertension (HTN) for many years. Which of the following changes is most likely to be found in his heart?
  • a. Hypertrophy
  • b. Hyperplasia
  • c. Dysplasia
  • d. Metaplasia
Correct Answer: a
147. Alpha-1 antitrypsin (Alpha-1 AT) deficiency can lead to which of the following conditions?
  • a. Centriacinar emphysema
  • b. Panacinar emphysema
  • c. Chronic bronchitis
  • d. Bronchiectasis
Correct Answer: b
148. UV light exposure can lead to mutations in the P53 tumor suppressor gene. Which phase of the cell cycle is regulated by the P53 gene?
  • a. G0
  • b. G1-S
  • c. S
  • d. M
Correct Answer: b
149. In patients with uremia, gastric injury typically occurs due to:
  • a. Ischemia
  • b. Infection
  • c. Altered mucosal function
  • d. Electrolyte imbalance
Correct Answer: c
150. A 54-year-old female receiving chemotherapy for breast cancer develops swelling and pain in her left leg. Which of the following drugs was likely used for her chemotherapy?
  • a. Raloxifene
  • b. Clomiphene
  • c. Tamoxifene
  • d. Exemestane
Correct Answer: c
151. A patient presents with QT prolongation and is currently taking an antimalarial drug. Which drug is most likely responsible for this condition?
  • a. Quinine
  • b. Lithium
  • c. Chloroquine
  • d. Primaquine
Correct Answer: a
152. To double the steady-state concentration of a drug, what adjustment should be made to the dosage?
  • a. Double the loading dose and keep the maintenance dose the same
  • b. Keep the loading dose the same and double the maintenance dose
  • c. Double both the loading and maintenance doses
  • d. Change the route of administration
Correct Answer: c
153. What is the primary rationale for using carbidopa in the treatment of Parkinson's disease?
  • a. To inhibit central decarboxylation
  • b. To inhibit peripheral decarboxylation
  • c. To inhibit COMT
  • d. To inhibit NMDA receptors
Correct Answer: b
154. A patient diagnosed with Kala-azar is currently being treated with Amphotericin B. Which of the following parameters must be closely monitored in the patient's blood report?
  • a. Sodium
  • b. Potassium
  • c. Blood glucose
  • d. Calcium
Correct Answer: b
155. Which of the following immunosuppressant drugs is known to cause diabetes as a side effect?
  • a. Tacrolimus
  • b. Cyclosporine
  • c. Azathioprine
  • d. Mycophenolate mofetil
Correct Answer: a
156. Which of the following is a natural derivative of the opium poppy, Papaver somniferum?
  • a. Codeine
  • b. Heroin
  • c. Methadone
  • d. Fentanyl
Correct Answer: a
157. Which of the following diabetes medications works by increasing the excretion of glucose in the urine?
  • a. Canagliflozin
  • b. Metformin
  • c. Chlorpropamide
  • d. Pioglitazone
Correct Answer: a
158. A patient presents with polyuria and is diagnosed with nephrogenic diabetes insipidus (DI). Which of the following drugs can be used to reduce their urine output?
  • a. Thiazide
  • b. Mannitol
  • c. Loop diuretics
  • d. Vasopressin
Correct Answer: a
159. Which of the following drugs can cause a rise in creatinine levels through a mechanism that is independent of the Glomerular Filtration Rate (GFR)?
  • a. Amikacin
  • b. NSAIDs
  • c. Aminoglutethimide
  • d. Cyclosporine
Correct Answer: a
160. Which of the following is required for the conversion of retinal to retinol?
  • a. NADPH + H+
  • b. NADH + H+
  • c. FAD + H+
  • d. NAD + H+
Correct Answer: b
161. In a patient with argininosuccinate synthase deficiency, which of the following will be found at elevated levels in the blood?
  • a. Increased level of citrulline only
  • b. Increased orotic acid
  • c. Increased levels of both citrulline and orotic acid
  • d. Increased blood urea levels
Correct Answer: c
162. Vitamin K is a necessary cofactor for which of the following chemical reactions?
  • a. Hydroxylation
  • b. Chelation
  • c. Transamination
  • d. Carboxylation
Correct Answer: d
163. Which of the following proteins is required for the joining of sister chromatids?
  • a. Topoisomerase
  • b. Histone
  • c. Cohesin
  • d. Helicase
Correct Answer: c
164. If a DNA sample consists of 20% Adenine, what is the percentage of Cytosine present?
  • a. 30%
  • b. 40%
  • c. 20%
  • d. 10%
Correct Answer: a
165. In nucleic acids, which of the following nitrogenous bases is methylated?
  • a. Uracil
  • b. Cytosine
  • c. Thymine
  • d. Adenine
Correct Answer: c
166. What is the primary reason for adding glucose to Oral Rehydration Salts (ORS)?
  • a. To allow Sodium (Na+) to enter intestinal epithelial cells via the Na+-glucose cotransport system
  • b. Hypoglycemia can occur in dehydrated patients
  • c. Glucose helps in decreasing stool volume
  • d. Glucose is actively absorbed
Correct Answer: a
167. Acetyl CoA can be directly converted into all of the following EXCEPT:
  • a. Glucose
  • b. Fatty acids
  • c. Cholesterol
  • d. Ketone bodies
Correct Answer: a
168. A patient presents with a wound caused by a cat bite. Which of the following is the most likely causative organism?
  • a. Pasteurella
  • b. Yersinia pestis
  • c. Eikenella
  • d. Fusobacterium
Correct Answer: a
169. During the examination of a skin smear from a leprosy patient, which index represents the proportion of live bacilli?
  • a. Bacteriological index
  • b. Morphological index
  • c. Variability index
  • d. Sterilization index
Correct Answer: b
170. Which of the following statements is most appropriate regarding Neisseria gonorrhoeae?
  • a. Urethral swabs are the best sample for microbiological diagnosis
  • b. Gram stain of discharge shows only intracellular diplococcus
  • c. A polysaccharide capsule is responsible for virulence
  • d. Pelvic inflammatory disease is not commonly caused by N. gonorrhoeae
Correct Answer: a
171. Which of the following is considered a negative stain in microbiology?
  • a. Giemsa
  • b. Nigrosine
  • c. Safranine
  • d. Methylene blue
Correct Answer: b
172. Culture plates are typically sterilized using which method?
  • a. Autoclave
  • b. Incineration
  • c. Hot air oven
  • d. Ionizing radiation
Correct Answer: a
173. Cholera toxin exerts its effects by acting on:
  • a. GM2 gangliosides
  • b. GM1 gangliosides
  • c. Increase phospholipase C
  • d. Decrease phospholipase C
Correct Answer: b
174. A person returned from India and had diarrhea for 24 hours. For which of the following organisms is testing most likely NOT needed?
  • a. Shigella
  • b. Entamoeba histolytica
  • c. Rota and Norwalk
  • d. E. Coli
Correct Answer: c
175. Pityriasis versicolor is caused by:
  • a. Candida
  • b. Malassezia
  • c. Aspergillus
  • d. Sporothrix
Correct Answer: b
176. According to the National Immunization Programme, at what ages is the PCV (Pneumococcal Conjugate Vaccine) administered?
  • a. 6, 10, 14 weeks
  • b. 6, 10 weeks and 9 months
  • c. 6 and 9 months
  • d. 12 and 15 months
Correct Answer: b
177. A local health initiative (Dhamijharki) providing ORS for diarrhea is an example of:
  • a. Cultural accommodation
  • b. Imposition
  • c. Acculturation
  • d. Inculturation
Correct Answer: a
178. The "standard error of mean" is defined as the:
  • a. Standard deviation of sample means from the population mean
  • b. Standard deviation of error size during sample collection
  • c. Standard deviation of the sample data
  • d. Standard deviation in the population
Correct Answer: a
179. Epidemiologists are conducting a case study. The average duration of a disease is 2 years, and the total population is 2000. If 10 new cases are detected in 1 year, what is the prevalence of the disease for a 2-year period?
  • a. 10/1000
  • b. 10/2000
  • c. 20/1000
  • d. 20/2000
Correct Answer: a
180. During an influenza epidemic, which is the best sample for microbiological diagnosis?
  • a. Oropharyngeal swab
  • b. Nasopharyngeal swab
  • c. Bronchoalveolar lavage
  • d. Blood
Correct Answer: b
181. True morbidity in a population is best measured by which of the following?
  • a. Active surveillance
  • b. Passive surveillance
  • c. Sentinel surveillance
  • d. Continuous surveillance
Correct Answer: c
182. In which phase of a clinical trial is the toxicity of a new drug primarily assessed?
  • a. Phase I
  • b. Phase II
  • c. Phase III
  • d. Phase IV
Correct Answer: a
183. The "Soiling index" is a parameter used to measure:
  • a. Air pollution
  • b. Water pollution
  • c. Soil pollution
  • d. Noise pollution
Correct Answer: a
184. Which of the following is the best way to represent the correlation between two quantitative or continuous variables, such as height and weight?
  • a. Line chart
  • b. Scatter diagram
  • c. Histogram
  • d. Pie chart
Correct Answer: c
185. A study began in 1970 with a group of 5,000 adults who were asked about their alcohol consumption. The occurrence of cancer was then studied in this group between 1990 and 1995. This is an example of a:
  • a. Cross-sectional study
  • b. Retrospective cohort
  • c. Concurrent cohort
  • d. Case-control study
Correct Answer: c
186. A dead body was found in water. Which of the following findings most strongly supports a diagnosis of antemortem drowning?
  • a. Emphysema aquosum
  • b. Watershed man
  • c. Edema aquosum
  • d. Washerwoman's hand
Correct Answer: a
187. A surgeon performed an operation while under the influence of alcohol. In medical ethics, this behavior is classified as:
  • a. Professional misconduct
  • b. Res Ipsa Loquitur
  • c. Vicarious liability
  • d. Adultery
Correct Answer: a
188. What does "therapeutic privilege" mean in a clinical context?
  • a. A physician can hide harmful information if they feel telling the truth further worsens the situation
  • b. A physician can treat patients according to their own will
  • c. A physician can reject patient treatment
  • d. A physician can charge for their work
Correct Answer: a
189. A man presents with a "tyre mark" on his body. This type of injury is classified as a/an:
  • a. Graze abrasion
  • b. Imprint abrasion
  • c. Laceration
  • d. Bruise
Correct Answer: b
190. In a case of mechanical asphyxia, there is vasodilation of the blood vessels in the visceral organs (including the lungs) with stasis of blood. This leads to:
  • a. Petechiae formation
  • b. Post-mortem lividity
  • c. Visceral congestion
  • d. Marbling
Correct Answer: c
191. A woman comes to your office with chest pain. What should be the physician's first response to build rapport?
  • a. "Come, let's talk about your chest pain."
  • b. "Take these medications for chest pain."
  • c. "Chest pain is common; you don't need to worry."
  • d. "I will refer you to the best chest physician."
Correct Answer: a
192. A mother visits the office for a check-up. During the visit, she starts crying, and further inquiry reveals she lost her son two months ago due to COVID-19. What is the best empathetic response?
  • a. "I can feel your pain."
  • b. "I can understand what you are going through."
  • c. "Lots of young people have died of COVID."
  • d. "One must die one day when you are born."
Correct Answer: b
193. Which of the following is true regarding the criteria for high-quality CPR?
  • a. Depth of CPR should be 5–6 cm
  • b. 90–100 compressions per minute
  • c. Pressing before full recoil
  • d. Compression-ventilation ratio should be 15:2
Correct Answer: a
194. Which of the following is considered a "non-shockable" cardiac rhythm?
  • a. Ventricular fibrillation
  • b. Pulseless ventricular fibrillation
  • c. Pulseless electrical activity (PEA)
  • d. Ventricular tachycardia
Correct Answer: c
195. In which of the following cases is the application of the Hippocratic Oath considered most controversial?
  • a. Suicidal help by a doctor
  • b. Therapeutic misadventure
  • c. Euthanasia
  • d. Privileged communication
Correct Answer: c
196. A patient is diagnosed with COVID-19. To prevent hypotension, how should remdesivir be administered?
  • a. Slow infusion in IV
  • b. Orally
  • c. IM (Intramuscularly)
  • d. Administer loading dose and observe
Correct Answer: a
197. A patient presents to the emergency room with wheezing. History reveals a peanut allergy and consumption of peanut-containing food minutes prior. what is the immediate treatment?
  • a. Epinephrine
  • b. Antihistaminic
  • c. Steroid
  • d. Inhaled salbutamol
Correct Answer: a
198. A postoperative patient develops a fever and signs of infection. Subsequently, other patients in the same ward develop similar symptoms. What is the most effective measure to prevent the spread of such infections?
  • a. Start antibiotics for all patients in the ward
  • b. Start antibiotics for the symptomatic patient only
  • c. Implement handwashing before touching each patient
  • d. Disinfect the ICU immediately
Correct Answer: c
199. What is the primary importance of developing a standard treatment protocol?
  • a. Rational use of drugs
  • b. Decreasing the disease burden in the community
  • c. Identifying missing cases
  • d. Ensuring accessibility to treatment
Correct Answer: a
200. The publication of an essential drug list in a Primary Health Center (PHC) serves as an indicator of:
  • a. Quality of service
  • b. Service delivery
  • c. Health status of the community
  • d. Estimate of annual drug supply requirements
Correct Answer: b

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