MEC Common Entrance Exam (MD/MS) 2023
Click on the Options to reveal answers.MEDICINE
1. A patient has prolonged PT/INR and obstructive jaundice. His PT/INR is likely to improve after administration of:
Correct Answer: a
2. In an adult with a normal lung function, oxygen therapy is most useful in:
Correct Answer: a
3. HbsAg positive only with all other normal serological markers indicates:
Correct Answer: c
4. Increased sweat chloride is seen in which of the following conditions?
Correct Answer: b
5. Hemoptysis is a characteristic feature of:
Correct Answer: a
6. All are true in iron deficiency anemia EXCEPT:
Correct Answer: b
7. The most sensitive test for diagnosis of DIC is:
Correct Answer: b
8. All are manifestations of increased portal pressure in portal hypertension EXCEPT:
Correct Answer: a
9. A patient presented with fever, night sweats, and B/L facial nerve palsy. Examination revealed leukocytosis, erythema nodosum and bilateral hilar lymphadenopathy. The most probable diagnosis is:
Correct Answer: a
10. Which of the following causes secondary hyperparathyroidism?
Correct Answer: a
11. In the case of hyperkalemia, which of the following will facilitate potassium removal from the body?
Correct Answer: c
12. Which of the following is a late feature of acromegaly?
Correct Answer: c
13. The correct statement about polycythemia is:
Correct Answer: a
14. An icteric patient with cirrhosis has a distended abdomen, a fever of 100-102°F, and abdominal pain. On ascitic tapping, 500 mL of fluid was drained out. Ascitic fluid cytology shows gram-negative bacilli. What is the diagnosis?
Correct Answer: a
15. Investigation of choice for patients with a high likelihood of pulmonary embolism is:
Correct Answer: b
16. A middle-aged man came to your OPD with complaints of hyperpigmentation over the nape of the neck and axilla. Which investigation would you prefer next?
Correct Answer: d
17. For a person diagnosed with DVT under warfarin therapy, INR should be maintained in the range of:
Correct Answer: b
18. Somatostatin analogs are used in the treatment of:
Correct Answer: a
SURGERY
19. Spastic neurogenic bladder is due to:
Correct Answer: d
20. Treatment of Grade II hemorrhoids in 3, 7 and 11 O'clock is:
Correct Answer: b
21. A 68-year-old male with an indirect inguinal hernia. Maximum systemic symptoms are present if the hernia is:
Correct Answer: b
22. A 67-year-old male with BPH S/P TURP complaints of vomiting and drowsiness. What is the likely cause?
Correct Answer: a
23. Noninflammatory visceral pain is due to:
Correct Answer: b
24. Germinal membrane of hydatid cyst is:
Correct Answer: a
25. Mass coming out of the rectum during defecation and going back spontaneously. It is grade........of internal hemorrhoids.
Correct Answer: b
26. Ranson criteria in acute pancreatitis is used to access:
Correct Answer: c
27. A 27-year-old female complains of lower back pain which is dull in nature. On examination, renal angle tenderness is positive. A kidney stone is seen on USG at the pelviureteric junction. X-ray KUB is normal. The most likely stone in the patient is:
Correct Answer: b
28. A 25-year-old male after RTA complains of testicular pain. On examination, the scrotum was swollen with overlying erythema. The most likely diagnosis is:
Correct Answer: b
29. Gas used for creating pneumoperitoneum is:
Correct Answer: b
30. A 12-year-old child presents to your OPD. On examination, Murphy's sign was positive. This is seen in:
Correct Answer: a
31. Obstructive jaundice causing biliary tract compression is due to posterior growth of:
Correct Answer: a
32. ERCP is indicated for:
Correct Answer: a
33. Vitamin K is preferred in which condition that will help to halt the progression of the disease?
Correct Answer: c
34. Iodine therapy is given prior to subtotal thyroidectomy in Grave's disease. The reason behind this is:
Correct Answer: a
35. Triple regimen for Helicobacter pylori includes all of the following EXCEPT:
Correct Answer: c
36. Mallory Weiss tear site is:
Correct Answer: b
OBSTETRICS AND GYNECOLOGY
37. A 34-year-old female at 12 WOG made an appointment for counseling in Gynae OPD with her husband. During her first normal delivery, there was a 3rd-degree perineal tear with the tear of the anal sphincter for which repair was done. She is worried about the second delivery and concerned about the mode of delivery this time. The best approach is:
Correct Answer: d
38. A rural PHC conducted a camp for a female of reproductive age for cervical cancer screening. Acetowhite areas were seen on VIA. The next line of management is:
Correct Answer: c
39. What will be the color change with acetic acid in cervical cancer?
Correct Answer: c
40. The most common cause of death of women postpartum in Nepal is:
Correct Answer: b
41. Investigation of choice in case of ectopic pregnancy is:
Correct Answer: a
42. Mechanism of action of CuT:
Correct Answer: d
43. A postpartum lady complains of mild fever and shivering. Which drug is responsible for this?
Correct Answer: b
44. A 36-year-old female complained of intense pruritus with curdy white vaginal discharge which was not improved by genital hygiene. Most probable diagnosis is:
Correct Answer: c
45. A 37-year-old pregnant lady at 34 WOG presents with painless vaginal bleeding. She had similar episodes 1 week before. The most likely diagnosis is:
Correct Answer: a
46. During normal labor, 10 units of oxytocin were given but the placenta could not be removed 40 minutes post-delivery. There are no signs of separation. What is your next step?
Correct Answer: c
47. A G2P1L1 female at 30 WOG with preeclampsia has a history of asthma. Her blood pressure remained elevated even after the delivery. Which of the antihypertensive medicines can be given?
Correct Answer: a
48. A 30-year-old G2P1 into her 3 months of pregnancy presents with symptoms of heat intolerance. There is low TSH, high T3, and high T4. The drug of choice for this case is:
Correct Answer: a
PEDIATRICS
49. A child of diabetes mellitus with toxic features of dehydration, high-grade fever 102°F, low BP, tachycardia with elevated blood sugar. Immediate management is:
Correct Answer: a
50. Delayed puberty in females is said to be present when there is no menarche by the age of:
Correct Answer: b
51. A child with multiple episodes of diarrhea is presented in the emergency department. His lab values are Na 125 mEq/L, K 2.3 mEq/L, and pH 7.2. The best fluid management for this condition is with:
Correct Answer: c
52. A 2-year-old child presented 2 hours after accidentally swallowing an ear implant battery of his mother which was lodged in the esophagus. The best management is:
Correct Answer: b
53. Which is elevated in breastfeeding jaundice?
Correct Answer: a
54. Which structure is involved in RDS in neonates?
Correct Answer: b
55. The most likely underlying condition in children with recurrent UTI is:
Correct Answer: a
56. A 10-year-old child with icterus, fever, and abdominal pain had a history of vomiting for 5 days. He now becomes drowsy suddenly for an hour. What needs to be done immediately?
Correct Answer: d
57. Sensitive marker of suspected spinal defect in a child:
Correct Answer: a
58. A child presented to the emergency department with toxic features. He has low BP and tachycardia. He was diagnosed with tonsillitis. What is your immediate next step?
Correct Answer: a
59. Which of the following criteria is diagnostic for bronchial asthma?
Correct Answer: b
60. Rescue breath in children prior to chest compressions is given because:
Correct Answer: a
ORTHOPEDICS
61. Perthes' disease is most common in the age group of:
Correct Answer: b
62. 84-year-old elderly patient with history of an intertrochanteric fracture following a trivial trauma. Why is surgical treatment required?
Correct Answer: a
63. A 10-year-old presented in PHC with a history of falling from a tree with an outstretched hand. X-ray shows fracture of middle 1/3rd clavicle which was displaced and overlapped. Which is the best management of the case?
Correct Answer: b
64. A pregnant lady complained of sensory loss in her right thumb, index finger, and half-ring finger. Which nerve may be affected?
Correct Answer: c
65. Following a humerus fracture, a patient had a wrist drop. The affected nerve is:
Correct Answer: c
66. The earliest sign of compartment syndrome is:
Correct Answer: a
67. The best prognosis for nerve injury is seen with:
Correct Answer: a
68. Soap bubble appearance is seen in:
Correct Answer: a
69. An elderly patient presented with multiple fractures. Her serum calcium level is 11.5 mg/dL, PO4 is 2.5 mg/dL and ALP is 940 IU/L. What is the most probable diagnosis?
Correct Answer: a
70. Which of the following complications can be attributed to rib fractures?
Correct Answer: a
ENT
71. A middle-aged woman has a conductive hearing loss in PTA with normal TM. What is the next line of investigation?
Correct Answer: a
72. Most common malignant tumor of the submandibular gland is:
Correct Answer: d
73. A 12-year-old girl has an alleged history of slap on the cheek due to which her tympanic membrane was ruptured 50%. Best treatment is:
Correct Answer: b
74. A case of epistaxis from Little's area was initially managed with chemical cautery. The bleeding was not controlled. What is the next line of management?
Correct Answer: c
75. A 75-year-old male complained of recurrent nasal bleeding. Most common site of epistaxis in this patient is:
Correct Answer: a
76. A child with toxic features of dehydration and a high-grade fever of 102°F. Soft tissue lateral view X-ray of the neck shows increased prevertebral space. This is suggestive of:
Correct Answer: b
77. Marker of CSF rhinorrhea is:
Correct Answer: d
78. A 30-year-old male, teacher by profession complaints of sustained vertigo, tinnitus of 7 days duration with severe SNHL. What is the most likely diagnosis?
Correct Answer: a
79. A 40-year-old male had an alleged history of temporal bone fracture with Grade IV facial palsy presented 2 days after the episode. What is the earliest best treatment?
Correct Answer: b
80. A 21-year-old sexually active woman with a painful ulcer over the lower lip, recurrent, and mostly during the menstrual cycle. What is the likely diagnosis?
Correct Answer: b
OPHTHALMOLOGY
81. Unwanted growth of eyelashes is associated with which anti-glaucoma drug?
Correct Answer: a
82. Earliest characteristic finding in glaucoma is:
Correct Answer: b
83. Direct Ophthalmoscope magnification is:
Correct Answer: c
84. A 50-year-old male was examined in ophthalmology OPD. He had findings of flame-shaped hemorrhage, arteriolar attenuation, and cotton wool spots. The most probable diagnosis is:
Correct Answer: b
85. Maximum refraction of light is done by:
Correct Answer: a
86. Regardless of the etiology of the corneal ulcer, which drug is given to all patients?
Correct Answer: a
87. Diagnosis of a primary open-angle glaucoma is done by observing:
Correct Answer: a
ANESTHESIA
88. Level of block in spinal anesthesia by Hyperbaric Bupivacaine depends upon:
Correct Answer: a
89. Mallampati grading is used to assess:
Correct Answer: b
90. Cannot intubate cannot ventilate. What is your next immediate approach?
Correct Answer: b
91. Hypoxemia is present when PaO2 is below:
Correct Answer: d
92. 10 units of packed cells were transfused in a patient. Massive blood transfusion causes:
Correct Answer: a
93. Which of the following is an inodilator?
Correct Answer: b
94. Which type of hemorrhage is seen in the first 24 hours post-operative period?
Correct Answer: d
PSYCHIATRY
95. Which one of the following will have the highest risk of suicide?
Correct Answer: a
96. A patient who previously used to consume alcohol was admitted to the ICU. This morning the patient had confusion, tremors, and irrelevant talks. The most likely diagnosis is:
Correct Answer: a
97. A patient has OCD with predominant obsessions. He doesn't want pharmacotherapy. What is the preferred non-pharmacological treatment in this case?
Correct Answer: a
98. A person was scolded in the office by his boss. He goes home and is nasty to his wife. What is the defense mechanism?
Correct Answer: a
99. A patient after RTA is unable to recall events prior to the accident. This is best termed as:
Correct Answer: b
100. A 12-year-old girl has multiple fainting episodes lasting for up to 30 minutes, with stiffening of her body. There are no injuries and the episodes never occur during sleep. No bowel or bladder incontinence. Most likely diagnosis is:
Correct Answer: a
101. A patient took Haloperidol 10 mg for one day from the local pharmacy due to anxiety and tension. She presented with protruded tongue since last night and she is unable to retract her tongue back. What is the likely cause?
Correct Answer: a
RADIOLOGY
102. The minimum duration of fasting before hepatobiliary USG is:
Correct Answer: b
103. A 25-year-old lactating female with a soft painful breast mass visited OPD. The investigation of choice in this case is:
Correct Answer: b
104. X-ray abdomen shows gas in both the inside and outside walls of the intestine. The likely diagnosis is:
Correct Answer: b
105. The best way to prevent contrast-induced nephropathy is:
Correct Answer: a
106. Hounsfield unit of zero is seen in:
Correct Answer: c
107. Which investigation helps to visualize the terminal ileum?
Correct Answer: c
108. Bat wing appearance of pulmonary edema in X-ray is a classic finding associated with:
Correct Answer: a
DERMATOLOGY
109. A 52-year-old male presented with frontal and temporal loss of hair. On further asking, he said his uncle also had a similar pattern of hair loss. The most likely diagnosis is:
Correct Answer: a
110. A patient has plaques with silvery scales over the extensor surface knee, and elbow. These features are seen in:
Correct Answer: a
111. A 50-year-old man presents to the dermatology OPD with clear multiple patches of hair loss. An exclamation mark sign is seen. What is the treatment?
Correct Answer: b
112. A 60 years old man presented with multiple fluid-filled lesions on the trunk with excoriation and crusting. The hemorrhagic fluid-filled lesions burst open themselves in 2-3 days. Likely diagnosis:
Correct Answer: b
113. Vitiligo is caused due to:
Correct Answer: a
114. Specific finding which is characteristic of atopic dermatitis:
Correct Answer: a
115. What is the causative agent of tinea versicolor?
Correct Answer: a
ANATOMY
116. A patient presents with dental caries with referred pain to the ear. Which nerve is likely involved?
Correct Answer: b
117. The spinal cord ends at the L1 level. Nerve roots below this level are present as:
Correct Answer: b
118. A 38-year-old man was diagnosed with external hemorrhoids. He has pain during defecation. The pain is carried by:
Correct Answer: a
119. All are accessory GI organs EXCEPT:
Correct Answer: b
120. Blood supply distribution of the liver is:
Correct Answer: c
121. Which is the major support of the cervical portion of the uterus?
Correct Answer: a
122. Which of the following is not a content of femoral sheath?
Correct Answer: a
123. Preganglionic fibers of submandibular glands are supplied by:
Correct Answer: b
124. All are Rotator cuff muscles EXCEPT:
Correct Answer: d
125. Obscurity of the right heart border is evident on X-ray. Consolidation is seen on which lobe of the lung?
Correct Answer: a
126. A patient had painful vesicles over the right forehead and right side of the nose. Involvement of which nerve will lead to blindness?
Correct Answer: a
127. Cartwheel appearance of the nucleus is seen in:
Correct Answer: a
PHYSIOLOGY
128. Least immunogenic for an organ transplantation is:
Correct Answer: a
129. ADH is mainly released in response to:
Correct Answer: c
130. Major regulator of cerebral blood flow in the ischemic part of the brain is by:
Correct Answer: d
131. A person went to Namche bazaar. After acclimatization, the earliest parameter that returns to normal will be:
Correct Answer: d
132. An adult male has a respiratory rate of 12/hr, a tidal volume of 600 mL, and a dead space of 150 mL. Calculate the alveolar ventilation.
Correct Answer: a
133. In moderate exercise, the respiratory rate is increased due to the response of:
Correct Answer: a
134. A healthy, 25-year-old male participates in a 10 km marathon. Which of the following muscles are involved in expiration with labored breathing?
Correct Answer: d
135. Total peripheral resistance is increased by:
Correct Answer: a
136. Which of the following components is absent in cryoprecipitate?
Correct Answer: d
137. Pain and temperature of the contralateral body are carried by which fiber?
Correct Answer: c
138. Goosebumps are due to reflex mediated by which layer of the skin?
Correct Answer: c
139. A 40-year-old patient had pituitary resection surgery. Which function of the adrenal gland will be preserved in the immediate post-operative period?
Correct Answer: b
PATHOLOGY
140. Factor VIII deficiency in severe hemophilia is:
Correct Answer: a
141. Auer rods are present in:
Correct Answer: c
142. A patient presents with recurrent bleeding. On investigation, platelet count, PT, and aPTT were normal. The most likely diagnosis is:
Correct Answer: b
143. Esophageal columnar metaplasia is a characteristic feature of:
Correct Answer: a
144. Autoantibodies against Ach Receptor at the neuromuscular junction is a characteristic pathology of:
Correct Answer: c
145. Which of the following is a risk factor for tumor lysis syndrome?
Correct Answer: b
146. Leukotrienes are derived from:
Correct Answer: b
147. FNAC was done for a thyroid swelling in a 22-year-old female. The result is most likely to represent:
Correct Answer: a
148. Urinary retention is seen in the case of BPH. The most commonly involved lobe in BPH is:
Correct Answer: c
149. A patient with pneumonia has cyanosis of the fingers. What is the most likely cause of anemia?
Correct Answer: d
PHARMACOLOGY
150. Dose adjustment of Amphotericin B is done in:
Correct Answer: a
151. Tranexamic acid used to control:
Correct Answer: a
152. Which of the antianginal/antiarrhythmic drugs causes reflex tachycardia as a side effect?
Correct Answer: a
153. A patient under ACE inhibitor medication complained of dry cough. The reason for the side effect is:
Correct Answer: a
154. Drugs given to prevent motion sickness is:
Correct Answer: a
155. Which of the following anti-arrhythmic drugs contains iodine and causes thyrotoxicosis?
Correct Answer: a
156. The main reason for avoiding the combined administration of levodopa and an inhibitor of monoamine oxidase is to prevent:
Correct Answer: b
157. Mechanism of Action of cyclophosphamide:
Correct Answer: a
158. A cancer patient is on methotrexate therapy. Urinary alkalization needs to be done. What is the rationale behind this?
Correct Answer: c
159. Action of Pilocarpine on the pupil is:
Correct Answer: a
BIOCHEMISTRY
160. Vit B12 deficiency diagnosis can be done by urine analysis by the measurement of:
Correct Answer: a
161. An icteric patient with urobilinogen in urine but absent bilirubin. This is a significant finding of:
Correct Answer: a
162. Hemoglobin and myoglobin can be differentiated on the basis of molecular size by:
Correct Answer: b
163. Glucose-6-Phosphate to 6-Phosphogluconolactone in the HMP pathway is carried out by the enzyme:
Correct Answer: d
164. Mutation leading to stop codon:
Correct Answer: a
165. A lady presents with anemia which was associated with brittle spoon-shaped nails, and hair loss. She follows a strict vegan diet. What is the likely cause?
Correct Answer: a
166. Which of the following is the cause of death in CO poisoning that is the most dangerous mechanism for death?
Correct Answer: a
167. In which of the following conditions, there is maximum absorption of alcohol?
Correct Answer: d
MICROBIOLOGY
168. You are working in a PHC. What is used for rapid diagnosis that is the fastest and most sensitive test for diagnosis of tuberculosis?
Correct Answer: a
169. E. coli is not flushed by urine because of:
Correct Answer: d
170. Which among the following is used to stain malarial parasites?
Correct Answer: c
171. Media used to differentiate between lactose fermenter and non fermenters is:
Correct Answer: b
172. Natural active immunity is received from:
Correct Answer: d
173. Most commonly used method of antibiotic sensitivity testing is based on:
Correct Answer: b
174. Spores can be killed by:
Correct Answer: d
175. Which form of Plasmodium is transferred from the mosquito to the human?
Correct Answer: c
COMMUNITY MEDICINE
176. The purpose of random assignment in clinical trials is:
Correct Answer: b
177. Which vaccine causes thrombocytopenia?
Correct Answer: a
178. Diagnostic power of a screening test is reflected by:
Correct Answer: c
179. A medical recorder collected a sample of data regarding total deaths due to RTA, total cases of cholera, total cases of AIDS, total cases of measles, and number of drug addicts. The data is best termed as:
Correct Answer: c
180. Early Warning and Reporting System (EWARS) in Nepal is:
Correct Answer: d
181. Total Fertility Rate of a country is 2.5. What does it signify?
Correct Answer: a
182. A randomized control trial was done on prisoners. Which is the most accurate?
Correct Answer: b
183. You are giving awareness in a Community. One person asked about the risk factors for developing asthma. Least risk of occupational asthma is seen with:
Correct Answer: c
184. A newly married woman with a history of irregular menstruation comes for contraception counseling. She plans to have a baby only after 1 year. What is the appropriate method of contraception?
Correct Answer: b
185. What is the duration of prophylaxis for patients of rheumatic fever with carditis without residual valvular heart disease?
Correct Answer: d
FORENSIC MEDICINE
186. Organophosphate poisons are exceptionally prone to be stored in:
Correct Answer: d
187. Insecticide safe to use in the kitchen is:
Correct Answer: c
188. Unconscious patient was brought to the emergency without relatives. The operating surgeon performed emergency surgery as no one was there to give consent. This represents:
Correct Answer: b
189. Acrodynia is caused by poisoning due to:
Correct Answer: a
190. First muscle to be involved in rigor mortis is:
Correct Answer: c
CPD (Clinical/Personal Development)
191. Which of the following best prevents the irrational use of drugs?
Correct Answer: a
192. Unresponsive child while resuscitation develops tension pneumothorax. What is your immediate response?
Correct Answer: a
193. A patient after a road traffic accident presented with tension pneumothorax. What is immediate management?
Correct Answer: a
194. Communication skill is planned to be included in the medical curriculum. What do you think about this?
Correct Answer: a
195. Truth-telling is based on the principle of:
Correct Answer: a
196. In health management, good managers are those who ensures use the resources appropriately with no wastage. This is best represented as:
Correct Answer: a
197. An unresponsive child was presented to the ER. He was pulseless on all peripheral arteries. ECG has normal QRS in the monitor. All are components of treatment for the child EXCEPT:
Correct Answer: c
198. You want to swiftly decrease the temperature of the body for a patient with high-grade fever. The most effective method for decreasing external temperature is:
Correct Answer: a
199. At a family party, a child eats peanut butter. After some time, he presented with diarrhea, vomiting, and acute onset of shortness of breath. Which is the best immediate management?
Correct Answer: a
200. The Department of Drug Administration works for the promotion of rational drug use by healthcare workers. It comes under which of the following strategies?
Correct Answer: a