Mangsir2071

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1. Avascular necrosis is found in fracture of the following except ?
   1.   Fracture neck of femur
   2.   Scaphoid fracture
   3.   Fracture of talus
   4.   Intertrochanteric fracture of femur
2. Pain that started as backache and radiated towards thigh is seen in ?
   1.   Ankylosing spondylitis
   2.   Sacroilitis
   3.   Prolapsed inter vertebral disc
   4.   Rheumatoid arthritis
3. A child presented with h/o of trauma 1 week back then developed swelling in upper part of tibia, diagnosed as osteomyelitis then how will you treat this case ?
   1.   I.V. antibiotics for 1 week then oral for another 2 weeks against staphylococcus aureus .
   2.   Surgery
   3.   Oral antibiotics for 1 week against staphylococcus aureus
   4.   Drainage
4. A 45 years male presented with h/o of fall and on x-ray examination of hip neck was found to be fracture which was complete but not displaced, a/c to Gardens classification, it is ....?
   1.   Type I
   2.   Type II
   3.   Type III
   4.   Type IV
5. A male presented with h/o of fall then on making fist of both hands, he can't appose index and middle fingers, which nerve is damaged ?
   1.   Radial
   2.   Ulnar
   3.   Median
   4.   Axillary
6. After delivery of baby, presented with extended elbow, pronated forearm and flexed wrist then which was right ?
   1.   Erb's paralysis
   2.   Klumpke's paralysis
   3.   Axillary nerve damage
   4.   Radial nerve damage
7. Anterior boundary of axilla is formed by
   1.   Pectoralis major
   2.   Pectoralis major and minor
   3.   Pectoralis major and subclavius
   4.   Pectoralis minor and subclavius
8. McBurney's point is ?
   1.   Point between medial 1/3rd and lateral 2/3rd of umbilicus and ASIS at left side
   2.   Point between medial 2/3rd and lateral 2/3rd of umbilicus and ASIS at left side
   3.   Point between medial 2/3rd and lateral 1/3rd of umbilicus and ASIS at right side
   4.   Point between medial 1/3rd and lateral 2/3rd of umbilicus and ASIS at right side
9. Portal venous anastomosis is not seen in ?
   1.   Lower end of esophagus
   2.   Anal canal
   3.   Bare area of liver
   4.   Pancreas
10. A patient presented with midline neck swelling, on examination multinodular cyst was found and all thyroid functions are found normal , which is right ?
    1.   Papillary carcinoma
    2.   Follicular carcinoma
    3.   Goiter
    4.   Hashimoto's thyroiditis
11. Which of the following is used in acute esophageal varices ?
    1.   Propranolol
    2.   Frusemide
    3.   Nitrate
    4.   Octreotide
12. Cystic artery is a branch of ?
    1.   Right gastric artery
    2.   Left gastric artery
    3.   Hepatic artery
    4.   Left gastroepiploic artery
13. A patient is undergone appendectomy and on specimen examination adenocarcinoma was seen then ?
    1.   Left as it was
    2.   Right hemicolectomy
    3.   Left hemicolectomy
    4.   Total colectomy
14. Strawberry sign is seen in ?
    1.   Porcelain gallbladder
    2.   Chronic cholecystitis
    3.   Cholesterchosis
    4.   Mucocele of gallbladder
15. An alcoholic patient presented with severe epigastric pain which radiates to back , his BP was 80/40 mm of hg and pulse is 125 b/min then your diagnosis is ?
    1.   Acute cholecystitis
    2.   Acute pancreatitis
    3.   Peptic ulcer
    4.   Acute appendicitis
16. A child presented severe left earache for 4 days, O/E tympanic membrane was found tensed, parents also gave h/o of pharyngitis 5 days back, what is your diagnosis ?
    1.   Chronic otitis media
    2.   Acute otitis media
    3.   Acute otitis externa
    4.   Radiating pain
17. A child presented with decreased hearing at right ear with itching, O/E Whitish mass is seen on EAC, your diagnosis is ?
    1.   Acute otitis externa
    2.   Otomycosis
    3.   Foreign body
    4.   Mucormycosis
18. A 2 years old child presented with elongated face, prominent and crowded upper teeth, high arched palate then your diagnosis is ?
    1.   Foreign body at nose
    2.   Hypertrophied adenoids
    3.   Mass at the tongue
    4.   Acute pharyngitis
19. In developed countries for cataract surgery, which one is followed ?
    1.   SICS
    2.   ECCE
    3.   ICCE
    4.   Phacoemulsification
20. Sclera is continuation of which part of cornea ?
    1.   Epithelium
    2.   Stroma
    3.   Descmet's membrane
    4.   Endothelium
21. In trachoma, SAFE strategy followed by WHO is ?
    1.   Sanitation, antibiotics, facial cleanliness, environmental sanitation
    2.   Surgery, antibiotics, facial cleanliness, environmental sanitation
    3.   Sanitation, antibiotics, free organisms, environmental sanitation
    4.   Surgery, antibiotics, free organisms, environmental sanitation
22. Marked analgesia is produced by ?
    1.   Halothane
    2.   Nitrous oxide
    3.   Isoflurane
    4.   Sevoflurane
23. In shock patients drug of choice in anesthesia is ?
    1.   Propofol
    2.   Ketamine
    3.   STP
    4.   Halothane
24. A child known case of asthma presented with generalized pruritus with scaly papules all over the body, your diagnosis is ?
    1.   Atopic dermatitis
    2.   Seborrhic dermatitis
    3.   Psoriasis
    4.   Contact dermatitis
25. An 8 years girl presented with 5 cm macules over left nasal side for 8 months, sensation was intact, your diagnosis is ?
    1.   Leprosy
    2.   Lupus vulgaris
    3.   Viral infection
    4.   None
26. A 45 years old male presented with painless and indurated ulcer at glans penis, which investigation will you prefer ?
    1.   Culture from ulcer site
    2.   Electron microscopy
    3.   Dark field microscopy
    4.   AFB staining
27. Gallow's traction is used in femur fracture of age group ?
    1.   Below 2 months
    2.   Below 2 years
    3.   2-12 years
    4.   >12 years
28. A 25 years old male presented with inability to extend right wrist after fall then which of the following nerve is injured ?
    1.   Median
    2.   Radial
    3.   Ulnar
    4.   Posterior interossei
29. A patient is suffering from thinking disorder then which one is correct ?
    1.   OCD
    2.   Schizophrenia
    3.   Mania
    4.   Phobia
30. A 2 years child presented with fever and cough for 7 days, O/E Respiratory rate was 45/min, subcostal retraction, added sounds on auscultation, your diagnosis is ?
    1.   Pneumonia
    2.   Severe pneumonia
    3.   Bronchiolitis
    4.   Bronchial asthma
31. Marasmus is due to ?
    1.   Infection
    2.   Protein energy malnutrition
    3.   Infestation
    4.   None
32. A 2 years child of 6.7 kg presented with generalized edema started from face and with grey and brittle hair, your diagnosis is ?
    1.   Nephrotic syndrome
    2.   Liver failure
    3.   PEM
    4.   CCF
33. Which of the following pair is incorrect?
    1.   Janway's spot-infective endocarditis
    2.   Roth's spot-AR
    3.   Osler's nodules-bacterial endocarditis
    4.   Subcutaneous nodules-rheumatic fever
34. A 7 years child presented with massive generalized edema on urine examination protein is 4+ , BP was normal , what is your diagnosis ?
    1.   Nephritic syndrome
    2.   Nephrotic syndrome
    3.   UTI
    4.   None
35. For which of the following abscess , GA is not required ?
    1.   Breast abscess
    2.   Parotid abscess
    3.   Ischiorectal abscess
    4.   Axillary abscess
36. An 8 years old child presented with 12 episodes of diarrhea and oliguria , on urine examination , urea 30 mmol , creatinine 200 mmol , k-6 mmol , what is your diagnosis ?
    1.   Severe dehydration
    2.   Acute renal failure
    3.   Chronic renal failure
    4.   Infective diarrhea
37. In Hirschprung's disease, aganglionic part is ?
    1.   Jejunum
    2.   ileum
    3.   Rectum
    4.   Colon
38. A 1 year old child presented with 7 episodes of diarrhea and 4 episodes of vomiting , O/E child is irritable but drinks eagerly, eye is sunken, tongue is dry, your management plan will be ?
    1.   Ringers lactate immediately
    2.   Breastfeeding only
    3.   NS immediately
    4.   Ringers lactate 75 ml/kg initially along with breastfeeding continuity
39. Which of the following drug is useful in prevention of respiratory distress syndrome ?
    1.   Calcium
    2.   Iron
    3.   Corticosteroids
    4.   Folic acid
40. Folic acid in prevention of neural tube defects is given in ?
    1.   1st trimester
    2.   2nd trimester
    3.   3rd trimester
    4.   Throughout pregnancy
41. Tocolytic drug which causes increased BP is ?
    1.   MgSO4
    2.   Salbutamol
    3.   Isobane
    4.   Terbutaline
42. A child presented with fever for 7 days , O/E neck rigidity present , kerning's sign present, on CSF analysis lymphocyte count increased with neutrophils-80%, glucose-20mg/dl, protein-120mg/dl, what will be your diagnosis ?
    1.   Acute pyogenic meningitis
    2.   Acute viral meningitis
    3.   Tuberculous meningitis
    4.   Fungal meningitis
43. Best time to detect anatomical abnormality in fetus is ?
    1.   10-12 weeks
    2.   14-16 weeks
    3.   14-18 weeks
    4.   >20 weeks
44. Commonest complication of measles in children is ?
    1.   AOM
    2.   Pneumonia
    3.   SSPE
    4.   Bronchitis
45. A 10 years old child presented with fever, neck rigidity and altered sensorium. On CSF analysis cells are polymorphs, glucose is 30 mg/dl, protein is 95 mg/dl then what will be your diagnosis ?
    1.   Bacterial meningitis
    2.   Viral meningitis
    3.   Encephalitis
    4.   Tuberculous meningitis
46. A patient presented with ascending paralysis from lower to upper limbs, on CSF examination protein was elevated, how will you treat this case ?
    1.   Prednisolone
    2.   I.V. Immunoglobulin
    3.   Physiotherapy
    4.   Antibiotics
47. Which of the following doesn't mark the prognosis of bronchial asthma ?
    1.   Use of accessory muscles
    2.   Pulsus paradoxus
    3.   Hypertension
    4.   Degree of wheeze
48. In Addison's disease , which of the following is retained ?
    1.   Na
    2.   K
    3.   Cl
    4.   Water
49. A patient presented with muscle weakness and in ECG there is peaked tall T waves , what will be your diagnosis ?
    1.   Hyponatremia
    2.   Hyperkalemia
    3.   Hypokalemia
    4.   Hypernatremia
50. Which of the following isn't the constituent of Ringers lactate ?
    1.   Na
    2.   Mg
    3.   Ca
    4.   Cl
51. Glasgow coma scale is used in assessment of consciousness in injury of ?
    1.   Head injury
    2.   Abdominal injury
    3.   Splenic injury
    4.   Limbs injury
52. In case of shock, which drug is used ?
    1.   Noradrenaline
    2.   Adrenaline
    3.   Dopamine
    4.   Acetylcholine
53. In case of OP poisoning, which of the following antidote is used ?
    1.   Physostigmine
    2.   Atropine
    3.   Naloxone
    4.   Flumazenil
54. In which of the following , addiction may occur in frequent use ?
    1.   Lorazepam
    2.   Aspirin
    3.   Paracetamol
    4.   Enalapril
55. In hanging, death with asphyxia is due to ?
    1.   Larynx compression
    2.   Occlusion of respiratory tract due to base of tongue
    3.   Cervical fracture
    4.   Tracheal compression
56. A 36 years old female patient presented with bilateral abdominal mass , after surgery , it was found as cystic ovarian tumor, on histology a small apical mucin producing cell was seen, what will be your diagnosis ?
    1.   Fibroid
    2.   Serous cyst adenoma
    3.   Teratoma
    4.   Mucinous cyst adenoma
57. A G3P2 presented with 40 weeks of period of gestation with lower abdominal pain, O/E her Bishop's score was 3 then what will be your management plan further ?
    1.   AROM
    2.   Oxytocin drip
    3.   Swap the membrane and wait
    4.   wait and watch
58. A primigravida presented with lower abdominal pain and per vaginal leakage, O/E head was engaged in this case engagement means ?
    1.   Fitting of biparietal diameter in pelvic inlet
    2.   Fitting of bimastoid diameter in pelvic inlet
    3.   Fitting of biparietal diameter in pelvic outlet
    4.   Fitting of biparietal diameter in mid pelvis
59. A patient has BP 110/80 mm of Hg, what will be the mean arterial pressure ?
    1.   102 mm of Hg
    2.   90 mm of Hg
    3.   85 mm of Hg
    4.   87 mm of Hg
60. An important landmark for hernia in which mid inguinal point is taken as a point, near this .....opens ?
    1.   Superficial inguinal ring
    2.   Deep inguinal ring
    3.   Femoral ring
    4.   None
61. In femoral canal, which of the following lies ?
    1.   Femoral vein
    2.   Femoral nerve
    3.   Femoral artery
    4.   Lymph node of cloquet
62. In which of the following intracranial condition, trauma is necessary ?
    1.   Epidural hematoma
    2.   Subdural hematoma
    3.   Subarachnoid hemorrhage
    4.   Infratentorial hemorrhage
63. What is infective stage of schistosomiasis ?
    1.   Microfilariform larva
    2.   Filariform larva
    3.   Eggs
    4.   Adult stage
64. Which of the following isn't transmitted by mosquito ?
    1.   Malaria
    2.   Kalazar
    3.   Dengue
    4.   Schistosomiasis
65. Which has maximum resistance ?
    1.   Capillaries
    2.   Arterioles
    3.   Venules
    4.   IVC
66. Which is the drug used in kalazar ?
    1.   Artesunate
    2.   Miltifosine
    3.   Chloroquine
    4.   Ciprofloxacin
67. Which of the antituberculer drug crosses blood brain barrier ?
    1.   Rifampicin
    2.   Streptomycin
    3.   Ethambutol
    4.   Isoniazide
68. A 22 years old patient from Birgunj presented with fever with rigor and chills for 10 days, O/E mild spleenomegaly and Hb is 9.08 gm, what will be your diagnosis ?
    1.   Enteric fever
    2.   Malaria
    3.   Hookworm infestation
    4.   ITP
69. In newborn HIV is diagnosed by ?
    1.   PCR
    2.   Western blot
    3.   VDRL
    4.   CD4 count
70. In Asherman's syndrome patient presented with ?
    1.   Metrorragia
    2.   Amenorrhea
    3.   Hypermenorrrhea
    4.   Menorrhagia
71. Most of the head and neck carcinoma are ?
    1.   Adenocarcinoma
    2.   Squamous cell carcinoma
    3.   Transitional cell carcinoma
    4.   Small cell carcinoma
72. Sterile pyuria is seen in ?
    1.   UTI
    2.   Renal tuberculosis
    3.   Perinephric abscess
    4.   Cystitis
73. If a patient survives after declaring death , which is called then ?
    1.   Invalid
    2.   Professional misconduct
    3.   Acts as circumstantial evidence
    4.   None
74. Prevalence is ?
    1.   Calculated by case control study
    2.   All the new cases found in specified population in specified time
    3.   Incidence and prevalence is equal if incubation period is very short
    4.   None
75. Blood supply of nasal septum by all except ?
    1.   Superior labial artery
    2.   Anterior ethmoidal artery
    3.   Posterior ethmoidal artery
    4.   Greater palatine artery
76. A patient presented with trauma over face and you suspected nasal bone fracture at left side then what type of x-ray will you advise ?
    1.   X-ray PNS (water's view)
    2.   Lateral view of suspected side
    3.   Anteroposterior view
    4.   X-ray skull (Towne's view)
77. A 9 year old boy presented with fever and cough for 10 days and there was also subconjuctival hemorrhage, what is your diagnosis ?
    1.   Measles
    2.   Typhoid
    3.   Whooping cough
    4.   Tetanus
78. Sudden painless loss of vision is due to ?
    1.   Central retinal vein occlusion
    2.   Central retinal artery occlusion
    3.   Cataract
    4.   Diabetic retinopathy
79. Commonest position of vermiform appendix is ?
    1.   Pelvic
    2.   Retrocaecal
    3.   Subcaecal
    4.   Paracolic
80. Which of the following is correct about Meckel's Diverticulum ?
    1.   It arises from antrior border of colon
    2.   It contains all layers of the gut
    3.   Causes massive per rectl bleeding
    4.   Presents with abdominal mass
81. CSF from 4th ventricle with spinal cord communicates through ?
    1.   Foramen of Monro
    2.   Foramen of Luska and Magendie
    3.   Arachnoid villi
    4.   Aqueduct of Sylvius
82. In Brown-Sequard syndrome, which of the following will happen about pain touch temperature and vibration ?
    1.   Pain, temperature, touch and vibration lost on the same side
    2.   Pain, touch, temperature on contralateral side and vibration ipsilateral side
    3.   Pain, touch and temperature on contralateral side
    4.   Pain, touch and temperature on ipsilateral side and vibration on contralateral side
83. Massive spleenomegaly is seen in ?
    1.   AML
    2.   ALL
    3.   CML
    4.   CLL
84. Thiamine is type of ?
    1.   Vit C
    2.   Vit B
    3.   Vit D
    4.   Vit A
85. Deficiency of vitamin C causes ?
    1.   Beri Beri
    2.   Osteomalacia
    3.   Scurvy
    4.   Megaloblastic anemia
86. Standard deviation is ?
    1.   Square root of variance
    2.   Square root of square of variance
    3.   Square of variance
    4.   None
87. Which is cyanotic heart disease ?
    1.   ASD
    2.   VSD
    3.   TOF
    4.   PDA
88. Commonest organism to cause UTI is ?
    1.   Salmonella
    2.   E. coli
    3.   Staphylococcus aureus
    4.   Klebsiella
89. Commonest organism to cause osteomyelitis in patent suffering from sickle cell anemia is ?
    1.   Staphylococcus aureus
    2.   Streptococcus
    3.   Salmonella
    4.   E. coli
90. Beir's block means ?
    1.   Subarachnoid block
    2.   Epidural block
    3.   Local nerve block
    4.   Regional nerve block
91. High infectivity and low pathogenecity indicates ?
    1.   Case
    2.   Carrier
    3.   Virulence
    4.   None
92. In PSVT drug of choice is ?
    1.   Amiodarone
    2.   Verapamil
    3.   Adenosine
    4.   Lignocaine
93. Microcytic hypochromic anemia is seen in except ?
    1.   Thallasemia major
    2.   Iron deficiency anemia
    3.   Folic acid deficiency
    4.   Sideroblastic anemia
94. A 3 years old child presented with high grade fever associated with seizure, her parents gave h/o of similar type of episodes occurred in the past, seizure subsides with subsidence of temperature, what will be your first differential diagnosis ?
    1.   GTCS
    2.   Partial tonic clonic seizure
    3.   Febrile convulsion
    4.   Absence seizure
95. Brucellosis is caused by ?
    1.   Bacteria
    2.   Virus
    3.   Protozoa
    4.   Fungi
96. A 11 years old child presented with yellowish discoloration of skin and mucus membrane then what is pre-hepatic cause for this condition ?
    1.   Liver cirrhosis
    2.   Hemolysis
    3.   Budd-chiari syndrome
    4.   Gallstones
97. A child's canine has already erupted, his 3rd molar hasn't erupted yet but 2nd molar just erupted then estimate the age of this child ?
    1.   6-7 years
    2.   7-9 years
    3.   9-11 years
    4.   12-15 years
98. After death of a boy, on examination there was laceration of neck muscles , then what will be mode of death ?
    1.   Hanging
    2.   Partial hanging
    3.   Strangulation
    4.   Autoerotic hanging
99. A patient presented with marked weight loss and dyspnea, after examination it was found that there was small cell carcinoma at upper lobe of lung which resulted in Horner's syndrome, which is incorrect about it ?
    1.   Ipsilateral anhidrosis
    2.   Ptosis
    3.   Enophthalmous
    4.   Compression of parasympathetic chain
100. Pilocarpine is contraindicated in ?
     1.   Malignant glaucoma
     2.   Absolute glaucoma
     3.   Acute congestive glaucoma
     4.   Open angle glaucoma
101. Lumbar puncture is contraindicated in ?
     1.   Encephalitis
     2.   Brain abscess
     3.   Meningitis
     4.   GBS
102. All are routine investigation during pregnancy except ?
     1.   Hb
     2.   TC ,DC
     3.   VDRL
     4.   Platelets
103. Misoprostol is ?
     1.   PGE1 agonist
     2.   PGE2 agonist
     3.   PGF2 agonist
     4.   Smooth muscle relaxant
104. Steroids is used in bronchial asthma and it reduces symptoms by ?
     1.   Bronchodilation
     2.   Reduces inflammation
     3.   Increases vital capacity
     4.   Immunosuppression
105. Maximum upper limit of bilirubin level in physiological jaundice is ?
     1.   5 gm%
     2.   8 gm%
     3.   10 gm%
     4.   18 gm%
106. A 65 years old hypertensive and diabetic presented with sudden onset of left sided weakness, what will be investigation of choice ?
     1.   CT scan head
     2.   CXR PA view
     3.   MRI of head
     4.   PET
107. A 7 years old male child presented with h/o of cough and fever for 10 days and o/e trachea is shifted to same side and percussion note is woody dull on right side , what will be your auscultatory finding in that area ?
     1.   Inspiratory and expiratory phase are equal
     2.   Inspiratory phase longer
     3.   Expiratory phase longer without gap
     4.   Expiratory phase longer with definite gap between two phases
108. Which is true about Japanese encephalitis vaccine used in Nepal ?
     1.   Live attenuated
     2.   It came from Korea
     3.   Given along with DPT
     4.   None
109. Facial nerve exits through ?
     1.   Foramen magnum
     2.   Jugular foramen
     3.   Stylomastoid foramen
     4.   Foramen spinosum
110. Tumor marker of carcinoma of breast is ?
     1.   CEA
     2.   CA 125
     3.   a-AFP
     4.   b-HCG
111. Staphylococcus aureus is differed from Staphylococcus epidermidis because ?
     1.   It is catalase positive
     2.   It is coagulase positive
     3.   It is urease positive
     4.   It is commensal
112. Invertogram is investigation of choice in ?
     1.   Imperforate anus
     2.   Hirschsprung's disease
     3.   Hiatus hernia
     4.   Intusucception
113. A 65 years old male undergone TURP. After 2 days , he developed dizziness and vertigo and disoriented. What will be the cause for that condition ?
     1.   Hypokalemia
     2.   Hyperkalemia
     3.   Hyponatremia
     4.   Hypercalcemia
114. Cause of bacillary dysentry is ?
     1.   Salmonella
     2.   Vibrio cholera
     3.   Shigella
     4.   E. coli
115. A 23 years old male presented with generalized itching marked on the webs of hand , he also complained of some nodules in the scrotum. Such complains were present in his family members also , what drug will you prescribe to treat disease ?
     1.   Terbinafine
     2.   Steroids
     3.   Permethrine
     4.   Cetrizine
116. Blood Picture : Hb. 10 gm%, Serum Ferritin 10 , MCV : 70 . Most likely diagnosis is ?
     1.   Thalassemia Trait
     2.   Vit.B12 Deficiency
     3.   Anemia of chronic disease
     4.   Iron Deficiency anemia
117. In Down's syndrome , commonest cardiac defect is ?
     1.   ASD
     2.   VSD
     3.   Endocardial cushion defect
     4.   Transposition of great arteries
118. Folic acid during pregnancy is given in ?
     1.   1st trimester
     2.   2nd trimester
     3.   3rd trimester
     4.   After delivery
119. Most common lung infection in acquired immunodeficiency ?
     1.   Toxoplasma
     2.   Pneumocystis
     3.   Tuberculosis
     4.   Cryptococcus
120. True about active management of Third Stage of Labour except ?
     1.   I.V. Oxytocin given
     2.   I.M. Oxytocin, uterine massage is given
     3.   I.M. Methergin 0.2 mg is given
     4.   Active cord traction
121. Blood from placenta to fetus is carried by ?
     1.   Umbilical artery
     2.   Umbilical vein
     3.   Vitelline vein
     4.   Vitelline artery
122. Best way to prevent hypotension during spinal anesthesia ?
     1.   Preloading with crystalloids
     2.   Mephentermine
     3.   Dopamine
     4.   Tredelenbug's position
123. The degree to which a test is capable of measuring what it is intended to measure is referred to as ?
     1.   Reliability
     2.   Validity
     3.   Sensitivity
     4.   Specificity
124. A child with hypokalemia, hyponatremia , hypochloremia and metabolic alkalosis. Most probable diagnosis is ?
     1.   Pyloric stenosis
     2.   Celiac disease
     3.   Duodenal atresia
     4.   Chronic pancreatitis
125. Bronchiolitis is caused by ?
     1.   H. influenza
     2.   S. pneumoniae
     3.   Staph aureus
     4.   RSV
126. a - Fetoprotein is increased in all the following except ?
     1.   Increased maternal weight
     2.   Multiple gestation
     3.   Maternal hepatoma
     4.   Abdominal wall defect
127. In a youg female of reproductive age, an absolute contraindication for prescribing oral contraceptive pill is ?
     1.   Diabetes
     2.   Hypertension
     3.   Obesity
     4.   Impaired liver function
128. Drug of choice in Delirium tremens is ?
     1.   Diazepam
     2.   Phenytoin
     3.   Chlordiazepoxide
     4.   Morphine
129. The following are true in papilledema except ?
     1.   Blurring of the disk
     2.   Congestion of retinal veins
     3.   White exudates around the disk
     4.   Sudden loss of vision
130. Best investigation to look for disseminated bone metasis ?
     1.   Bone scan
     2.   CT
     3.   MRI
     4.   X-ray
131. A) A 65 years old female of known case of diabetes presented at emergency with weakness and abdominal pain. On examination, patient was dehydrated, sweet smell on breathing and decreased blood pressure (5 questions are related to above condition) ?
     
     131) What is your diagnosis ?
     
     
     1.   Hypoglycemia
     2.   Hyperglycemia
     3.   Diabetic ketoacidosis
     4.   Diabetic nephropathy
132. Which electrolyte is deranged in this condition ?
     1.   K
     2.   Na
     3.   Ca
     4.   Mg
133. What is the cause of fast breathing in this condition ?
     1.   Hypotension
     2.   Metabolic acidosis
     3.   Hypothermia
     4.   Dehydration
134. What is the fluid of choice to treat this condition ?
     1.   Dextrose
     2.   Dextran
     3.   Normal saline
     4.   Normal saline and dextrose both
135. Sodium bicarbonate is indicated when PH is less than ?
     1.   7.1
     2.   7
     3.   7.2
     4.   7.3
136. B) A 42 years old male presented with painful limitation of the hip joint. He has the history of fall on the ground 8 months back and treated for fracture neck of femur ( 5 questions are related to above condition)
     
     136. What is the cause of pain in this condition ?
     1.   Non union
     2.   Delayed union
     3.   Avascular necrosis of hip joint
     4.   Stiffness of the joint
137. Which of the following is not risk factor for such condition ?
     1.   Alcohol
     2.   Diabetes mellitus
     3.   Rupture of capsule
     4.   Medullary vessels damage
138. What is the mode of treatment in this patient ?
     1.   Total hip replacement
     2.   Hemiarthroplasty
     3.   Leave as it was
     4.   Internal fixation
139. If this condition is in 75 years old male then ?
     1.   Treatment modalities is same
     2.   Treatment modalities is different
     3.   Only conservative treatment is sufficient
     4.   None
140. Imediate after fracture , which nerve is damaged in such condition ?
     1.   Femoral
     2.   Sciatic
     3.   Popliteal
     4.   ilioinguinal
141. C) A 67 years old male presented with history of slow start walking and rapid small steps, he has the expressionless face also (5 questions are related to above condition) ?
     
     141. What is your diagnosis ?
     1.   Wilson's disease
     2.   Parkinson's disease
     3.   Athetosis
     4.   Alzheimer's disease
142. Which is the best drug to treat this condition ?
     1.   Levodopa
     2.   Acetylcholine
     3.   Carbidopa
     4.   Levodopa with carbidopa
143. Drug used in question B has a side effect for that which drug is effective ?
     1.   Pantoprazole
     2.   Metoclopromide
     3.   Paracetamol
     4.   Fexofenadine
144. All of the following clinical features are present except ?
     1.   Bradykinesia
     2.   Rigidity
     3.   Tremor
     4.   Altered sensorium
145. In upper limbs which is most common ?
     1.   Leadpipe rigidity
     2.   Cogwheel rigidity
     3.   Equally present
     4.   None
146. D) A 38 years old patient presented on emergency with burn of head , both upper limbs, chest, abdomen and back ( 5 questions are related to above condition)
     
     146. Calculate the burn % in this patient ?
     1.   63 %
     2.   72 %
     3.   54 %
     4.   48 %
147. If his weight is 50 kg then how much fluid will you give in 24 hours ?
     1.   12600 ml
     2.   14000 ml
     3.   11600 ml
     4.   10000 ml
148. In case of child, how much % would you calculate ?
     1.   63 %
     2.   54 %
     3.   72 %
     4.   48 %
149. Commonest cause of death after 2 days of electrical burn is ?
     1.   Hypovolemia
     2.   Acute renal failure
     3.   Arrhythmia
     4.   Infection
150. What is the criteria to replace fluid in children on the basis of burn % ?
     1.   >12%
     2.   >10%
     3.   >15%
     4.   >20%
151. E) A 6 years old child presented with recurrent epistaxis and petechiae all over the body, there was no organomegaly. On blood picture, hemoglobin was within normal range and mild leucopenia but marked thrombocytopenia ( 5 questions are related to above condition)
     
     151. What is your diagnosis ?
     1.   Aplastic anemia
     2.   ITP
     3.   ALL
     4.   Fanconi's anemia
152. For bleeding child, best modality of treatment is ?
     1.   Immunoglobulin
     2.   Blood transfusion
     3.   Platelet transfusion
     4.   Fresh frozen plasma
153. To start steroid therapy, which condition must be ruled out ?
     1.   Aplastic anemia
     2.   Hemophilia
     3.   Hematological malignancy
     4.   Sickle cell disease
154. If there was pancytopenia without organomegaly, best diagnosis would be ?
     1.   Aplastic anemia
     2.   ITP
     3.   ALL
     4.   Fanconi anemia
155. If child is not relieved after 1st line of treatment then after how many months will you call for follow up ?
     1.   2 months
     2.   3 months
     3.   4 months
     4.   6 months
156. F) A G1P0 has delivered a baby of 3 kg, after self expulsion of placenta, continued to bleed then (5 questions are related to above condition) ?
     
     156. What will be your next step in management ?
     1.   Massage abdomen and explore uterus
     2.   Packing the uterus
     3.   Clamping of internal carotid artery
     4.   Partial hysterectomy
157. Commonest cause of PPH is ?
     1.   Traumatic
     2.   Atonic uterus
     3.   Equally traumatic and atonicity
     4.   None
158. Which drug is best in 2nd stage of labour ?
     1.   Oxytocin
     2.   Ergometrine
     3.   MgSO4
     4.   Misoprostol
159. Last option of treatment in PPH is ?
     1.   Clamping of arteries
     2.   Partial hysterectomy
     3.   Total hysterectomy
     4.   Hysterectomy
160. All the reproductive organs come to its normal anatomical position by ....days ?
     1.   32
     2.   42
     3.   40
     4.   36
161. G) A 52 years old male , known case of hypertension presented in emergency with sudden onset of chest pain which radiated to jaws and arms, sweating and decreased blood pressure ( 5 questions are related to above condition).
     
     161. What will be your 1st investigation of choice to confirm diagnosis?
     1.   Cardiac enzymes
     2.   ECG
     3.   Total blood count
     4.   Chest X-ray
162. Which is the most reliable enzyme marker ?
     1.   LDH
     2.   Troponin T and I
     3.   CK-MB
     4.   AST
163. Commonest cause of death in this condition is ?
     1.   Atrial fibrillation
     2.   Ventricular fibrillation
     3.   Ventricular ectopics
     4.   LVF
164. Not the contraindication of thrombolysis ?
     1.   Active peptic ulcer
     2.   Recent surgery within 1 month
     3.   Pregnancy
     4.   Hypotension
165. If patient came after 2 weeks of attack of MI then what will be the ECG finding ?
     1.   ST elevation
     2.   Tall T wave
     3.   Pathological Q wave
     4.   Abscence of R wave
166. H) A 55 years old male known case of peptic ulcer for 15 years presented in emergency with non-billous vomiting . The patient looks unhealthy and dehydrated (5 questions are related to above condition).
     
     166. What is your diagnosis ?
     1.   Ulcer changed into carcinoma
     2.   Acid peptic disease
     3.   Gastric outlet obstruction
     4.   Intestinal obstruction
167. Due to excessive vomiting , patient may go into ....state ?
     1.   Hyperchloremic alkalosis
     2.   Hypochloremic alkalosis
     3.   Hypochloremic acidosis
     4.   Hyperchloremic acidosis
168. The state which explained in question B is treated with ?
     1.   Isotonic saline and sodium
     2.   Hypertonic saline and potassium
     3.   Isotonic saline and potassium
     4.   Hypertonic saline and sodium
169. Best method to feed the patient before surgery ?
     1.   Gastrostomy
     2.   Jejunostomy
     3.   Gastroduodenostomy
     4.   Gastrojejunostomy
170. Commonest cause of above disorder is ?
     1.   Gastric carcinoma
     2.   Long standing peptic ulcer
     3.   Congenital pyloric stenosis
     4.   None
171. I) A 45 years old female of G8P5 presented with something coming out through vagina for 1 year and her such complains have been in increasing intensity (5 questions are related to above condition)
     
     171. Least common complications you should look for in this condition ?
     1.   Infection of the bladder
     2.   Peritonitis
     3.   Incarceration
     4.   Carcinomatous changes
172. Which is not the indication of pessary treatment ?
     1.   Early pregnancy
     2.   Puerperium
     3.   Completed family
     4.   Waiting for surgery
173. What will be the best modality of treatment in this case ?
     1.   Anterior colporraphy
     2.   Vaginal hysterectomy with PFR
     3.   Paravaginal repair
     4.   Sacral colpopexy
174. O/E it was found that external os protruds outside the vaginal introitus but the uterine body still remains inside the vagina, then what will be the grading of prolapse ?
     1.   1st degree
     2.   2nd degree
     3.   Procidentia
     4.   Complex prolapsed
175. Support of uterus is all of the following except ?
     1.   Uterosacral ligaments
     2.   Angle of uterus with vagina
     3.   Retroverted uterus
     4.   Pericervical ring
176. J) A 32 years old male presented with complaints of respirtory distress for 3 days, fever for 2 months and pain in right chest for 2 months. On examination tympanic note was found on right side of the chest (5 questions are related to above conditons).
     
     176. What is your diagnosis ?
     1.   Pleural effusion
     2.   Pneumothorax
     3.   Hydropneumothorax
     4.   Empyma thorasis
177. On your palpation, what will be the position of trachea in this condition?
     1.   Left side deviated
     2.   Right side deviated
     3.   Centrally placed
     4.   None
178. Which subtype is regarded as medical emergency ?
     1.   Open
     2.   Closed
     3.   Valvular
     4.   B and C both
179. What will be the probable cause for this condition ?
     1.   Rupture of subpleural bleb
     2.   Tuberculosis
     3.   Pulmonary infarction
     4.   Bronchogenic carcinoma
180. Normal intrapleural pressure is ?
     1.   -3 to -8 mm of Hg
     2.   -2.5 to -6 mm of Hg
     3.   -3.5 to -7 mm of Hg
     4.   -3 to -7 mm of Hg