Microsoft word - medicine track final mbbs mcqs _11 march 2004_ draft 2.doc

1. Which of the following about severe mitral regurgitation is TRUE? As far as possible, mitral valve repair is preferred over replacement 2. In which of the following is endocarditis prophylaxis NOT indicated? Mitral valve prolapse with regurgitation 3. Which drug is NOT the standardized for use in IHD? 4. The physiological mechanism for essential hypertension is an increase in 5. Which is the most suitable anti~hypertensive to use in the elderly? 6. Which is true about atrial fibrillation? Can cause cardiomyopathy if tachycardia is left untreated for a long period Is not associated with an increased risk of embolisation Rate during exercise is better controlled with digoxin than with β~blockers 7. 40 year old obese lady with chest pain for past 3 days, associated with non~productive cough, now presents with respiratory distress? Which investigation would you NOT do? More sensitive than creatinine kinase in detecting AMI Cleared from the circulation within 72 hours Confers the same risk benefits for MI as for stroke 10. Lipid panel : TG 2.5, TC 5.2, HDL 0.7, LDL 2.8?? Most appropriate therapy? Fast CT is the diagnostic investigation of choice Usually shows a wedge shaped lesion on CXR 12. Causes of pulmonary fibrosis include the following EXCEPT 13. Woman develops left sided pleural effusion. Which is FALSE? Negative microscopy of malignant cells excludes lung cancer 14. 56 year old man presents with fever, tachycardia, & respiratory distress within 48 hours of an abdominal operation. What is the most likely aetiology? 15. The following are causes of decreased lung diffusion capacity of carbon monoxide 16. The following are true of Cheyne-Stokes breathing EXCEPT 17. A 25 year old man complains of fever, chills & rigours & right sided chest pain. Examination revealed classic features of consolidation on the right. Which is FALSE? Streptococcus pneumoniae is the most likely aetiological agent Antibiotics should be instituted before results of culture May be associated with blood stained sputum Erythromycin is better than Benzyl Penicillin in treatment 16. A middle-aged lady presents with left sided pleural effusion. Which is TRUE? She will need a pleural tap & biopsy Absence of malignant cells excludes a cancer 17. 65 year old smoker with chronic bronchitis suddenly develops a fever, cough & SOB. 18. 19 year~old with acute respiratory distress, is diagnosed to have a right pneumothorax. What would be your findings on examination? Decreased resonance to percussion on right 19. What is true for patient with small spontaneous pneumothorax for the first time Admit for the night to watch for complications Aspirate with fine needle & send home 20. In an asthmatic well~controlled on oral theophylline, what could trigger off an attack? Usually does not require mechanical ventilation 23. Causes of acute renal failure include the following EXCEPT : 24. Diagnosis if the urine cannot be acidified below a pH of 5.2 25. The following are complications of NSAIDS EXCEPT 26. Which of the following causes of acute renal failure carries the best prognosis? Rapidly progressive glomerulonephritis (RPGN) 27. Which condition is least likely to predispose to UTIs? 28. Drug of choice for status epilepticus is 29. 1st line drug in status epilepticus is 30. The following are true about CNS infections EXCEPT Empirical therapy should be started before CSF results are obtained 31. Normal pressure hydrocephalus presents with the triad of ataxia, dementia & 32. What is NOT seen in complete third nerve palsy? 33. Common peroneal nerve palsy, UNTRUE Absence of sensation over the lateral calf 34. If the jaw jerk is hyperreflexic, where is the lesion likely to be? 35. Which finding effectively rules out a lesion of the corticospinal tract in the brain? 36. 56 year old otherwise healthy Indian presents with 3 days of vomiting following his usual heavy alcoholic binge. His vomitus is found to contain blood. What is the most 37. Which is the first / earliest sign of circulatory hypovolaemia in someone with an acute Postural drop in systolic BP by > 20 mmHg 38. Obese man who complains of heartburn after meals, especially chocolates & coffee, & whose OGD shows erosions of the lower oesophagus is likely to have Inappropriate relaxation of the lower oesophageal sphincter 39. Which is true about ulcerative colitis? 40. 37 year old man with hepatitis has the following results : Chronic hepatitis B infection with superimposed Hepatitis A Chronic hepatitis B with probable “seroconversion” Hepatitis B carrier with Hepatitis D superinfection 26. What is true about patient presenting with RHC pain & jaundice? Absence of RHC mass excludes pancreatic tumour Investigation of choice would be abdominal ultrasound 27. Young woman with history of jaundice now has …. 2cm liver & 4 cm spleen? 28. Stool culture of patient with diarrhoea showed leukocytes mixed with mucus. What is 29. Which of the following is true for a 50 year old lady presenting with cholestatic If there is no abdominal pain, gallstones are unlikely If the gallbladder is impalpable, carcinoma of the pancreas is unlikely The next investigation of choice would be an oral cholecystogram The next investigation of choice would be an ultrasound of the hepatobiliary If the jaundice resolves spontaneously, acute hepatitis is unlikely Loss of libido of amenorrhoea, or both are often early features Aldosterone will be low, predisposing to postural hypotension Hyponatraemia is likely to occur in times of stress Once glucocorticoid levels are adequately replaced, further adjustments of dose are In males, potency is rarely achieved even with adequate replacement 31. In autoimmune hypoaldosteronism, what will manifest 32. Diabetes Mellitus can occur with the following EXCEPT 33. Which of the following causes microangiopathic haemolysis? 35. An elderly woman with multiple myeloma presents in a stuporous state. Which is the most important immediate investigation to perform? 36. Which cancer has been proven to have the greatest decrease in mortality following 37. Immediate treatment for spinal cord compression from metastatic tumour would be Watch & wait for spontaneous remission 38. Which is FALSE about the chemotherapeutic agent & its adverse effect? Cyclophosphamide – haemorrhagic cystitis 39. Which is NOT found in tumour lysis syndrome? 40. An anterior mediastinal mass in a 55 year old man cannot be 42. Old lady with bone pain & anaemia presents with seizures altered mental status for the 43. The following are used in the treatment of rheumatoid arthritis EXCEPT 44. In a young lady with facial rash & promixal muscle weakness, the most likely 45. Rheumatoid Arthritis can cause the following lung lesions EXCEPT Allopurinol is used in the acute treatment 47. What is true about Polyarthritis nodosa? 49. American College of Rheumatologists’ diagnositic criteria for SLE does NOT include 50. Which is not usually harboured in healthy adults? Antivirals are effective in its treatment 52. In an asymptomatic patient, normal physical examination findings with a VDRL titre of 1:8 & reactive / positive TPHA, what is the most likely diagnosis? 53. The following predispose to candidal vaginitis EXCEPT Use of topical broad-spectrum antibiotics Diagnosed by antigen detection in nasopharyngeal aspirates 55. Mycoplasma pneumoniae can cause the following 56. 1st line treatment for community~acquired pneumonia includes the following EXCEPT !57. Patients with atopic eczema are prone to viral infections because of 58. Skin manifestations of malignancy include : Typically affects the fingers, hands, forearms, face & neck Is excluded in someone working at the same job for the past 10 years "60. An elderly patient with K+ of 2.5 mmol could be due to 62. Symptoms of hypercalcaemia include : 63. 52 year old lady presented with oliguria. Laboratory investigations revealed the following : K 6.8 mmol/L, Na 136 mmol/L, Urea 2.5 mmol/L, Creatinine 510 mmol / L. 65. Which is NOT a cause of faecal incontinence in the elderly? 66. Causes for falls in the elderly include the following EXCEPT 67. Which is true about palliative care? Parenteral morphine preferred for its greater efficacy Should be cautious about prescribing opioids in such elderly patients !68. Patients taking monoamine oxidase inhibitors should not be on 69. Which drug can be prescribed at the usual dose in renal impairment? 71. Which is NOT a contraindication for beta blockers? Left ventricular systolic failure / dysfunction 72. Which is an early sign of salicylate poisoning? 74. Which anti-diabetic drug has the longest duration of action & is thence most likely to 75. The following are features of hypoperfusion EXCEPT 77. Causes of generalised pruritis without any skin lesions is most likely to be due to Recovery phase of acute tubular necrosis 79. Causes of painful ulcers in the mouth & genital area include : 81. Kid who pulls to stand, has a well~developed pincer grip & waves bye-bye & has a 83. Boy with acute scrotal pain after playing develops fever. What is the immediate 84. Patients with Marfan Syndrome are predisposed to 85. In a 2 year old kid with acute onset of stridor without preceding history, what is most 86. Child asthmatic suddenly develops SOB & found to be tachycardic with bilateral widespread rhonchi. What is the immediate management? 90. 1 year old boy with UTI . What is true? Diagnosis of UTI confirmed by bag urine culture of >105 single colony organisms 91. Teen with recurrent UTIs & nocturnal enuresis till age 6 has urea of 50 & creatinine of 200 & small scarred kidney on DMSA. What is the most likely cause? 92. Kid with vomiting, truncal ataxia & other signs of raised ICP. Most likely diagnosis is 93. Which is true about infantile spasms? Good prognosis with no learning impairment 94. Most common type of cerebral palsy is 95. 2 year old boy who has never learnt to sit has wasting below the knees & areflexia. 96. Girl with unilateral headaches occurring once a month lasting several hours at a time but still able to carry out normal activities. What is your management? Ergot with onset of subsequent headaches 98. 3 year old with painless rectal bleeding 1-2 times a week for the past 7 weeks, whose blood is fresh & amounting to 100 ml each time is likely to have 99. Parents complain that their 4 month old kid passes 8-10 stools per day, which are soft & yellow. Kid is fed purely breast milk. Birth weight was 3.5 kg & weighed ?? at 21 100. Parents complain that their 4 week old child is still jaundiced. What would be the most Did the kid receive phototherapy at birth? 101. 2 month old kid presents with bilious vomiting. What is the investigation of choice? 102. What is true about management of diabetic ketoacidosis? Rehydration solution of choice is normal saline NaHCO3 should be given routinely if pH is 7.2 K+ replacement is not needed if K+ is normal Rehydration should be done over 24 hours if Na+ is 147 mmol / L 103. Infant born 2 hours ago noted to have blood sugar of 1.5 mmol / L? Cause? 104. 2 year old girl with presents with bilateral breast buds. What is the most important 105. 3 year old with 4 weeks history of jaundice & pallor is likely to have 106. Hand Foot & Mouth Disease patient can return to school within Developed encephalopathy previously to DPT Developed high fever of > 40°C previously to DPT 108. Standard therapy for Kawasaki Disease 109. 3 year old girl with fever & purpuric rash on the extensor surfaces of LL? What 110. 3 year old kid with eczema over develops diarrhoea after consuming eggs for the first Avoid immunizations containing egg white Allergy to egg white can be diagnosed by measuring IgE levels to egg white 111. Management of 3 year old with eczema over flexure, ears & face? Sedating antihistamines at night to relieve pruritis 112. Man claims to have a long history of some rare disease dating back to 1803. He claims only the men are affected but they never pass the disease to their sons. What 113. 35 weeks pregnant mother finds that her foetus has spina bifida & some malformation at the head. She is reluctant to terminate the pregnancy & her husband says that he will abide by her decision. What would you do? Refer them to the Spina Bifida support group 114. Child born with swollen LL. Pulses difficult to palpate while UL pulses full. Diagnosis? 115. Common treatments for bipolar disorder include all except 116. Which has the lowest suicide risk? 117. Which is NOT a feature of depression? 121. Which is unsuitable for behavioural therapy? Poor prognostic factors are avolition & asociality 124. What is NOT true about hypochondriacal disorder? 125. The appropriate treatment of recurrent mania would be 126. The following are true about ADHD except Short attention span hinders academic performance 128. In which situation is Behavioural therapy not advised? Common goals between therapist & patient 129. The following theories have been used to explain schizophrenia 130. Drug of choice in acutely violent patient is

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