Post: Assistant Professor in General Medicine, Senior lecturer in General Medicine
Department: Medical Education
Category Code: 418/2016, 145/2017, 146/2017
Question Paper: 111/18
Qualification: MD (General Medicine)/ DNB (General Medicine) + Permanent Registration under State Medical Council
Date of Test: 16-11-2018
If you find mistakes, comment below
- Which organism is associated with rapid decline in pulmonary function and poor clinical prognosis in cystic fibrosis?
- Burkholderia cepacia
- Pseudomonas aeruginosa
- Staphylococcus aureus
- Staphylococcus epidermidis
- Which of the following is not associated with dilatation of ascending aorta?
- Syphilis
- Takayasu’s arteritis
- Giant cell arteritis
- Rheumatoid arthritis
Question Error
- Beck’s triad in cardiac tamponade includes all except :
- Hypotension
- Muffled heart sounds
- Jugular venous distention
- Friction rub
- Bullae can be a manifestation of all of the following except :
- Clostridium perfringens
- Sporothrix shenckii
- Staphylococcus aureus
- Vibrio vulnificans
- Which of the following patients is most likely to have an EGFR mutation in lung cancer?
- 23 year old man with hamartoma
- 45 year old female non-smoker with adenocarcinoma
- 56 year old male smoker with small cell lung carcinoma
- 76 year old man with squamous cell carcinoma
- Commonest cause of hypothyroidism worldwide is :
- Hashimoto’s thyroiditis
- Latrogenic hypothyroidism
- Iodine deficiency
- Radiation exposure
- Hyperprolactinemia can be seen in all except :
- Cirrhosis
- Opiate abuse
- Rathke’s cyst
- Hirsutism
- All the following are useful in diagnosing myasthenia gravis except :
- Acetyl colene receptor antibodies
- Edrophonium
- Electrodiagnostic testing
- VGCC antibodies
- Most sensitive indicator of myositis is :
- Aldolase
- Creatinine kynase
- Glutamate oxaloacetate transaminase
- Lactate dehydrogenase
- Fever with greyish white papulovesicular lesions in the oral cavity are typical of which infection?
- Candida
- Coxsackie
- Herpes
- Staphylococcus
- Which of the following is NOT an indication for permanent pacemaker implantation?
- Symptomatic AV block
- Intermittent complete heart block
- Paroxysmal atrial fibrillation
- Recurrent syncope with carotid sinus massage causing asystole 3 sec
- Upper lobe predominance in ILD is characteristic of all EXCEPT :
- Ankylosing spondylitis
- Silicosis
- Langerhan’s cell histiocytosis
- Asbestosis
- Acute severe asthma is characterized by all EXCEPT :
- Resp rate> 28/mt
- Pulse > 110/mt
- Pulsus paradoxus > 25
- Normal FEV1/FVC ratio
- Which of the following patients requires Infective endocarditis prophylaxis?
- VSD undergoing rigid bronchoscopy
- Mitral stenosis before dental extraction
- VSD undergoing fibreoptic bronchoscopy
- MVP for vaginal delivery
- Patients taking which of the following drugs should avoid grapefruit juice?
- Amoxycillin
- Aspirin
- Atorvastatin
- Sildenafil
- BMI likely to be lethal in males?
- 11
- 13
- 16
- 18.5
- In which stage of sleep parasomnias somnambulism and night terrors most likely to occur?
- Stage 1
- Stage 2
- Slow-wave sleep
- REM sleep
- All the following cause urethritis in men except :
- GARDENERELLA VAGINALIS
- Mycoplasma genitalium
- Neisseria gonorrhoeae
- Trichomonas vaginalis
- All the following are upregulated in cardiac failure with reduced ejection fraction EXCEPT :
- Angiotensin 2
- BNP
- Norepinephrine
- Calcium uptake into sarcoplasmic reticulum
- All are direct complications of short bowel syndrome EXCEPT :
- CHOLESTEROL GALL stoness
- Coronary artery disease
- Renal calculi
- Gastric hypersecretion
- Which of the following autoantibodies is least likely to be present in a patient with SLE?
- Antids DNA
- Antiphospholipid
- Antierythrocyte
- Anti La
- Which of the following is the most common extraarticular manifestation of ankylosing spondylitis?
- Anterior uveitis
- Aortic insufficiency
- Inflammatory bowel disease
- Pulmonary fibrosis
- Which is not a criteria for diagnosis of Behcet’s disease?
- Pathergy test
- Recurrent oral ulcers
- Recurrent genital ulcers
- Large vessel vasculitis
- All are consistent with diagnosis of DKA EXCEPT :
- Arterial pH 7.1
- Glucose 550
- Plasma ketone strongly positive
- Plasma osmolality 380
- Stem cell therapy has been found to have in vivo benefit in :
- Cirrhosis
- Ischemic heart disease
- Spinal cord injury
- Parkinson disease
- Type of nystagmus most commonly associated with peripheral vertigo :
- Unidirectional horizontal
- Downbeat
- Gaze- evoked
- Rebound
- Which of the following gases is NOT produced by small intestinal bacteria?
- Carbon dioxide
- Hydrogen
- Methane
- Nitrogen
- CT imaging in a 42 yr old woman with stage 3 ovarian cancer after 6 cycles of chemo with carboplatin and paclitaxel shows 25% reduction in tumour burden. What is her response to therapy?
- Complete response
- Partial response
- Progressive disease
- Stable disease
- 53 yr old man with a hematocrit of 59%, WBC count 18,400 with normal DC, Platelet of 5 lakhs has SpO2 95%. He has a palpable spleen. What is the recommended therapy?
- Hydroxyurea
- Imatinib
- Phlebotomy
- Warfarin
- Organism causing pneumonia in patient on maintanence dialysis?
- Acinetobacter
- MRSA
- MDR enterobacter
- Pseudomonas
- 35 yr old man with AML relapse post BMT presents with neutropenic sepsis, septic shock. He has haemorragic vesicles on his skin. What is the likely causative organism?
- Neisseria
- Pseudomonas
- Rickettsia
- Vibrio vulnificans
- Unique side effect of Abacavir among ARV treatment drugs?
- Severe hypersensitivity
- Famconi’s anemia
- Lactic acidosis
- Lipoatrophy
- Treatment of choice in a patient with wide QRS tachycardia brought in shock?
- Amiodarone 150 mg IV
- Lidocaine 1mg IV
- Metoprolol 10 mg IV
- DC defibrillation
- Which is true of RVOT origin VT?
- Abnormal MRI
- LBBB pattern in ECG
- Right upper quadrant axis
- Precipitated by vagal stimulation
- All are risk factors for postpartum cardiomyopathy EXCEPT :
- Aged mother
- Twin pregnancy
- Primiparous
- Use of tocolytics
- Which is TRUE?
- Degenerative arthritis is associated with morning Stiffness
- Pain worsening with movement indicates mechanical problem
- Acute onset monoarthritis is most often infection related
- Synovial fluid analysis has no role in acute monoarthritis
- Active urinary sediment indicates renal damage in all EXCEPT :
- SLE
- Vasculitis
- Bacterial endocarditis
- Gout
- Which is unlikely in inflammatory arthritis?
- Locking
- Swelling of joint
- Morning stiffness
- Tenderness
- CPP crystal arthritis is :
- Common in younger individuals
- Haemochromatosis may cause
- Deposition of calcium carbonate
- Polyarticular
Question Error
- Skin findings in reactive arthritis include all EXCEPT :
- Erythema chronicum migrans
- Circinate balanitis
- Keratoderma blenorrhagicum
- Psoriasiform plaques
- Giant cell arteritis has all EXCEPT :
- Older than 50 yrs
- Anterior ischemic optic neuritis
- 80% may have negative temporal artery biopsy
- Associated with polymyalgia rheumatica
- Causes of lumbar canal stenosis includes all EXCEPT :
- Achondroplasia
- Paget’s
- Fluorosis
- Rheumatoid arthritis
- Which of the following statements is TRUE?
- Dermatomyositis may be associated with lymphoproliferative disorders
- Progression to lymphoma in sjogren may be associated with disappearance of rheumatoid factor
- Ovarian malignancy is commonly seen in SLE
- Splenomegaly is a feature of malignancy in scleroderma
- Which of the following associations is INCORRECT in SLE?
- antidsDNA with nephritis
- Antiribosomal P with CNS manifestations
- Anti Ro with neonatal lupus
- Antiphospholipid antibody with arthritis
- Which of the following associations is INCORRECT?
- HCG- gonadal germ cell tumour
- CD25- adult T cell lymphoma-leukemia
- AFP- lymphoma
- CA125- ovarian cancer
- Which is true about mortality in ARDS?
- Age >75 higher risk
- Post surgical patients have better outcome
- Underlying systemic diseases do not influence
- Primary lung disease have better survival
Question Error
- All are true regarding lymphocytic hypophysitis EXCEPT :
- MRI shows a prominent pituitary mass
- May cause permanent hypopituitarism
- Post partum patients present with headache or visual disturbance
- Surgery is the treatment of choice
- MEN 1 includes all EXCEPT :
- Hyperparathyroidism
- Pituitary adenoma
- Atrial myxoma
- Pancreatic neuroendocrine tumours
- Which feature distinguishes pituitary ACTH secretion from Ectopic?
- Rapid onset of clinical picture in ectopic
- Hypokalemia more common in pituitary
- Overnight low dose dexa suppression test result with cortisol > 5 microg distinguishes pituitary secretion
- Urinary free cortisol is suppressed in ectopic
- Itai-itai disease was due to contamination with :
- Arsenic
- Lead
- Cadmium
- Mercury
- Which is NOT a feature of chronic arsenic poisoning?
- Haemorrhagic gastroenteritis
- Guttate hyperpigmentation
- Mee’s lines
- Sensory polyneuropathy
- Which of the following chemotherapeutic agents causes sensory neural hearing loss?
- Paclitaxel
- Doxorubicin
- 5 fluoro uracil
- Cisplatin
- Which statin is least myotoxic?
- Pravastatin
- Simvastatin
- Atorvastatin
- Lovastatin
- A 45 yr old lady with Crohn’s disease and small intestinal fistulae develops tetany while on TPN. her investigations are as follows :
Ca : 8.2 K : 3.2 Na : 135 Cl : 103 Po4 : 2.4 Alb : 2.4 pH : 7.48 HCO3 : 25 Cause of her tetany?- hyperventillation
- hypocalcemia
- focal seizure
- hypomagnesemia
- Best management for a patient presenting to casualty with mild right sided pleuritic pain with Xray showing <1 cm free air :
- tube thoracostomy
- underwaterseal drainage
- observation
- needle aspiration
- All are true about amiodarone induced thyroid dysfunction EXCEPT :
- hyperthyroidism is common in iodine deficient areas
- hypothyroidism commoner in men
- amiodarone inhibits deiodinase activity
- amiodarone treatment is associated with decreased T4 levels initially
- All are seen in cardiac tamponade EXCEPT :
- pulsus paradoxicus
- diastolic RV collapse in echo
- electrical alternans
- kussmaul’s sign
- Which of the following causes calcified pulmonary metastasis?
- adenocarcinoma kidney
- squamous cell carcinoma
- seminoma
- carcinoma thyroid
- Balint’s syndrome has all the following features EXCEPT :
- Simultagnosia
- Oculomotor apraxia
- Optic ataxia
- Riddoh phenomenon
- Differentiation syndrome has all the following features EXCEPT :
- Low grade lymphoma transforms to high grade
- Promyelocytic leukemia on treatment with ATRA
- Characterised by fever and pleuropericarditis
- SIRS mediated by interleukins
- Which is NOT TRUE regarding strongyliodosis?
- Infection is always symptomatic
- Immunosuppression leads to increase worm burden
- hyperinfection may lead to bacterial translocation
- Filiform larvae may be demonstrated from skin lesions
- Which of the following causes swollen optic disc with sudden visual loss?
- Caverous sinus thrombosis
- Glaucoma
- Optic neuritis
- Retinal vein occlusion
- Heberden’s nodes are:
- Associated with rheumatoid arthritis
- Affect proximal interphalangeal joints
- Disease of the elderly
- Needs to be treated with DMARDS
- Rivaroxaban belongs to which category of drugs?
- Factor Xa inhibitor
- Direct thrombin inhibitor
- Vit K antagonist
- Low molecular weight heparin
- WALLENBERG syndrome. What is not true?
- Ipsilateral horner’s
- Ipsilateral loss of taste
- Chronic loss of pain in the arm
- Chronic atrophy of tongue
- Which of the following is not a component of syndrome Z?
- Obstructive sleep apnoea
- BP > 130/85
- Fasting triglyceride > 150
- LDL > 100
- Most common cause of lobar haemorrhage in elderly :
- Hypertension
- Vascular malformation
- Coagulopathy
- Amyloid angiopathy
- Most common preceding infection in bone marrow failure syndrome :
- Parvo B19
- Ebstein barr virus
- HIV
- Hepatitis
- Which of the following statements is wrong?
- Light chains are normally produced slightly in excess in plasma cells
- Qualitation of M component can be done by electrophoresis
- M components may be present in CML
- 20% myeloma proteins produce light chains
- Artery that is spared in polyarteritis nodosa is :
- Bronchial artery
- Renal
- Coronary
- Pulmonary
- Generalised painless lymphadenopathy is seen in :
- Rocky mountain spotted fever
- Scrub typhus
- Epidemic typhus
- Q fever
- Protein losing enteropathy with mucosal erosion is seen in :
- Lymphoma
- Coeliac disease
- Menetrier’s disease
- SLE
- Hepatitis C infection – all are true EXCEPT :
- Serum transaminitis is a good predictor of degree of liver fibrosis
- Telaprevir is effective in management
- 3% risk of vertical transmission
- Sharing tooth brushes is a risk factor for transmission
- Effects of chronic hypoxia include all EXCEPT :
- Elevated production of erythrocytes
- Reduced pulmonary artery resistance
- Reduced systemic arterial resistance
- Upregulation of vascular endothelial growth factor
- Treatment of choice for a 72 year old man with asymptomatic MGUS with no organ dysfunction and <5% plasma cells in bone marrow is :
- Yearly serum protein electrophoresis
- Low dose prednisolone
- Rituximab
- Thalidomide
- A 76 yr old smoker presents with unilateral limb oedema and elevated D-Dimer, he gives h/o past similar episode. Which of the following makes D Dimer less predictive of DVT in this patient?
- Smoking
- Negative Homan sign
- Age > 70 yrs
- Previous DVT
- In an ECG with wide QRS tachycardia, which of the following strongly favours ventricular tachycardia?
- A-V dissociation
- RBBB pattern
- Irregularly irregular rhythm with varying QRS complexes
- QRS duration > 120 msec
- Which of the following is true coma?
- Akinetic mutism
- Metabolic encephalopathy
- Locked in state
- Catatonia
- A 55 yr old woman, is found to have a 14 cm cyst in liver with daughter cysts extending to liver edge, causing biliary dilatation. Appropriate management for the condition?
- Albendazole followed by surgery
- Needle biopsy
- PAIR
- Serological testing for Echinococcosis
- All are true regarding Ascaris Lumbricoides EXCEPT :
- May be asymptomatic
- Fever and meningeal signs
- Non productive cough and pleurisy
- Small bowel obstruction
- The military operation launched by the Indian Army to flush out militants from Jammu and Kashmir in 2017 :
- Operation Meghdoot
- Operation All Out
- Operation Checkmate
- Operation Vijay
- E C George Sudarshan who died recently was a famous :
- Botanist
- Bureaucrat
- Physicist
- Archeologist
- The sex ratio in Kerala according to 2011 census :
- 1052
- 1084
- 1098
- 1104
- Mount Abu is situated in :
- Punjab
- Madhya Pradesh
- Karnataka
- Rajasthan
- Surya Sen is related with :
- Chittagong Armoury Raid
- 1857 Revolt
- Lahore conspiracy Case
- Indian Naval Mutiny
- Who was the Prime Minister of United Kingdom during the time of India’s independence?
- Clement Attlee
- Sir Winston Churchill
- Lloyd George
- Ramsay MacDonald
- Which was the first Indian state introduced the mid-day meals programme in India?
- Kerala
- Tamil Nadu
- Gujarat
- Bihar
- North East Frontier Agency is presently Known as :
- Mizoram
- Manipur
- Tripura
- Arunachal Pradesh
- Which State is known as the spice garden of India?
- Andhra Pradesh
- Kerala
- Telangana
- Tamil Nadu
- The International Agreement which aims to reduce the greenhouse gases :
- Kyoto Protocol
- Geneva Covenant
- Nonproliferation Agreement
- Bretton Wood Agreement
- Discovery of India was written by :
- Dr. Rajendra Prasad
- Mahatma Gandhi
- Jawaharlal Nehru
- Dr. Zakir Hussian
- Chand minor is situated in :
- New Delhi
- Daulatabad
- Hyderabad
- Mumbai
- Samathwa Samajam was founded by :
- Brahmananda Shivayogi
- Mithavadi Krishnan
- Thycaud Ayya
- Vaikunda swamikal
- The biggest river island in India :
- Sunder bans
- Valley of flowers
- Darjeeling
- Majuli
- The Golden Ball Award in FIFA World Cup 2018 :
- Kylian Mbappe
- Harry Kane
- Luka Modric
- Thibaut Courtois
- Which type of soil is suitable for cotton cultivation?
- Alluvial soil
- Red soil
- Black soil
- Laterite soil
- “Ente Jeevitha smaranakal” was the autobiography of :
- K Kelappan
- V T Bhattatiripad
- C V Kunjuraman
- Mannathu Padmanabhan
- Sardar Sarovar project is constructed in the river :
- Narmada
- Godavari
- Yamuna
- Mahanadi
- Mahatma Gandhi was elected as the President of Indian National Congress in :
- 1920
- 1922
- 1924
- 1932
- Prathyaksha Raksha Daiva Sabha was social reform movement started by :
- Kumara Guru
- Pampady John Joseph
- Ayyankali
- Pandit Karuppan
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