Medicine MCQ questions for the MBBS or for other level exam for practicing. This would help for NMC, MCI, PMDC or other similar exam . Please find your answers yourself . thanks
1) Raised troponins in all except:
- ACS
- chronic renal failure
- heart failure
- sepsis (? Gram negative septicaemia? Or is it another question?)
- Mitral stenosis
2) Which of the following does not cause raised serum amylase?
- Intestinal obstruction
- DKA
- splenectomy
- Lung cancer
- Renal failure
3) A child can copy a circle and a cross but not a square. He can name 3 colours. Dev age?
- 2 year
- 3 year
- 4 year
- 5 year
- 6 years
4) A child can sit on his own, pull to stand, crawls, claps hands and has pincer grip. what is his likely devel age?
- 6 months
- 8 months
- 10 months
- 12 months
- 14 months
5) A mother noticed her 5 yr-old son is having more difficulties climbing stairs. Which relative might have a similar problem from the family history?
- a) maternal uncle
- b) maternal aunt
- c) paternal uncle
- d) paternal aunt
- e) grandparent (wrong answer)
6) OSA in a child. Likely complication of it.
- adenotonsilar hypertrophy
- rhinitis
- b) difficulty falling asleep at night
- c) neurocognitive developmental delay
7) 3 year old boy has ALL with WCC 100×109, what is he at risk of on starting therapy?
- hyperphosphatemia
- hypoca
- hypok
- hypoglycaemia
8) Which is true?
- Atypical antipsychotics can cause hyperglycemia
- Atypical more effective than typical
- Antipsychotics not useful in acute tx of mania
- Atypical antipsychotics rarely cause EPSEs
- ?
9) Clubbing may occur in
- ASD
- PDA
- Pleural mesothelioma
- Primary pulmonary hypertension
10) Mumps
- DNA virus
- Live attenuated vaccine
- Contraindicated in pregnant mothers
11) A man has this set of Hep B serology: anti-HBs +ve, anti-HBc +ve, HBs Ag +ve. What is not true?
- He is a carrier and is infective
- He has acute hepatitis
- He is a carrier and is not infective
- HBe Ag indicates active replication
12) HBV vaccine
- confer some protection to non A non B hepatitis
- hazardous to HBV carrier
- 90% of recipients respond to it after 1 single dose
- can be given with HBV Ig with no adverse outcome
- cause a rise in both HBs and HBc Ag
13) Important feature of vitamin A deficiency.
- Cockscrew hair
- Hypopigmentation
- Thinning of hair
- Ecchymosis
- ?
14) NS man bitten by a swarm of hornets. Reddish brown urine next day. What is the likely cause?
- Hemoglobinuria
- Hematuria
- Preceding ingestion of promethazine
- Dehydration
15) Pulsus paradoxus, ascites and low pulse pressure suggestive of
- restrictive pericarditis
- portal vein thrombosis
- cor pulmonale
- ?CCF
16) What is the most suggestive feature of left heart failure?
- Sacral edema
- Ankle edema
- Basal lung crepitations
- Elevated JVP
- Ascites
17) Blood in stools is not found in:
- amoebic colitis
- giardiasis
- UC
- Crohn’s disease
- TB of the ileum
18) Toxic megacolon not found in
- Cholera
- UC
- Ischaemic bowel disease
- jejuni
- Pseudomembranous colitis
19) hyperpigmented skin is not found in
- scleroderma
- hematochromatosis
- addison’s disease
- lung cancer
20) the specific antidote for paracetamol poisoning is
- N-acetylcysteine
21) 4-month old infant who weighs 5.5kg, not weaned yet. Amount of milk intake per day
- 120ml x 7x/day
- 120ml x 5x/day
- 100ml x 7x/day
- 100ml x 5x/day
- 90ml x 5x/day
22) Mother brought 1-month old to see you. Concerned about not feeding enough: breastfeeds 2-3 hourly and sucks for 10 min, and formula milk 60ml 2-3 times a day. Birth weight 3kg, now 3.6kg. What would u advise the mum?
- Assure her. Tell her not to worry.
- Advise her to express her breast milk so as to quantify the amount of milk fed
- Give the baby breast milk after feeding her with the formula milk to see how much the baby feeds when hungry.
- ?
23) Liver cyt P450 enzyme induced in chronic ingestion of
- Digoxin
- Oral estrogen and progesterone contraceptives
- Sulfamethaxole
- Sodium valporate
- ?
24) Acute theophylline toxicity
- only occurs when given in the IV route
- early oral activated charcoal is of help
- hemodialysis not usually indicated
25) Most toxic cause of death due to tricyclic antidepressant overdose
- hepatic
- renal
- cardiac
- hematological
26) Girl ingested 15g of aspirin after quarrel with boyfriend. All is correct except
- NG tube and gastric lavage
- Activated charcoal
- may get metabolic alkalosis
- may get hypoglycemia
- urine alkalinization is of help
27) Not a feature of organophosphate toxicity
- anhidroisis
- pin-point pupil
- muscle fasciculations
- bronchoconstriction
- salivation
28) Toxoplasmosis does NOT cause
- hydrocephalus in the neonate
- in-utero infection
- chorio-retinitis
- chronic diarrhea in adults
- generalized lymphadenopathy
29) Leptospirosis
- cannot be cultured in artificial medium
- usually symptomatic and causes jaundice
- benzylpenicillin used only when there is established renal and hepatic toxicity
- arthropod-borne disease
- doxyxycline shown to be of preventive use
30) Increased aPTT is found in
- von willebrand disease
- aplastic anaemia
- vitamin K deficiency
- ? ALL
31) Increased bleeding time is seen in
- von willebrand disease
- classical haemophilia
- oral anticoagulation therapy
- heparin use
32) Classical hemophilia:
- Factor VIII less than 10%
- X-linked dominant
- Cryoprecipitate is not of help
33) 15 year old boy with no signs of puberty, bilateral testes 3ml. height at 3rd percentile, proportionate. Likely cause.
- Constitutional growth delay
- Klinefelter’s
- Kallman syndrome/disease
- Gonadotrophin deficiency
- Craniopharynioma
34) A boy with generalized lethargy, pallor after diarrhoeal illness. Hb 7.4, platelet 150×109, WCC 10.4×109. Reticulocytes 12%. Hct 53%. PE: hepatosplenomegaly. Urine dipstick –ve for rbc but +ve for urobilinogen. PBF: spherocytes +anisocytosis, poikilocytosis
- Acute hemolytic anemia
- Hemolytic ureamic syndrome
- Aplastic anaemia
- Acute leukemia
- DIVC
35) 6 month old infant at A & E. brought in because of generalized seizure and vomiting. PE: ant fontanelle bulging. Trunk and lower limbs multiple bruises of varying ages. Important diagnosis to consider
- non-accidental injury
- ?
36) Absolute contraindication to doing a LP
- Neck stiffness
- Severe vomiting and headache
- Full anterior fontanelle in an infant
- Irregular breathing with apnoea
- Localized back tenderness
37) Which of the following has symptoms that can mimic an AMI?
- Left frozen shoulder
- Reflux esophagitis
- Osteochondritis
- Hepatic abscess
- pleurisy
38) GI bleed and completely normal skin examination.
- Ehler-Danlos
- Peutz-Jeghers
- Acute drug-induced gastric erosions
- Pseudoxanthoma elasticum
- Liver cirrhosis
39) What is not a skin characteristics in diabetes mellitus?
- Granuloma annulare
- Erythema nodosum
- Acanthosis nigricans
- Vitiligo
- Eruptive xanthoma
40) Man with photosensitive rash on face and upper limbs. Face puffy and he felt weak. Likely cause
- Dematomyositis
- Drug eruption
- Porphyria cutanea tarda
- SLE
- Pellegra
41) Definitive treatment for PDA in premature infant
- High frequency ventilation
- Indomethacin
- prostaglandin E
- Asprin
42) Dengue infection
- hypernatremia a sign of impending shock
- unilateral pleural effusion that occurs at day 5 should be tapped and cultured
- DHF typically occurs at day 2-3 of the fever
- Pulmonary oedema occurs 2-3 days after shock
43) Pneumococcal vaccine
- yearly boosters indicated in post-splenectomy patients
- contraindicated in egg allergy
- ? confers better protection after 1 year of age due to maximal effect on immune system
- protects against meningitis
44) Measles incubation period
- 3 days
- 7 days
- 11 days
- 14 days
- 21 days
45) What to do to prevent cerebral edema in bacterial meningitis?
- Keep 100% hydration
- Keep Arterial paCO2 at 35-40mmHg
- High dose Dexamethasone
- Treat fever
46) Boy with congenital cyanotic heart disease that is unrepaired. Fever 4 days and threw 1 focal seizure. Diagnosis
- complex febrile seizure
- pyogenic cerebral abscess
47) Non-consanguinous parents with a child with isolated VSD. What the the chance of having another child with VSD?
- 0%
- 3-4%
- 25%
- 50%
- 100%
48) A boy with steroid-resistant nephritic syndrome. Grossly edematous. BP 86/64. serum Na 110. most appropriate IV solution
- dextrose-saline
- 20% albumin
- frusemide
- normal saline infusion
49) boy with vomiting and watery diarrhea. Given IV dextrose and saline for 24 hours. Urine o/p noted to be low. What is the next appropriate step?
- Ultrasound kidneys
- IV frusemide
- Check electrolyte of urine
50) A child with fever of 5 days, polymorphous rash on skin, red lips. What is the most appropriate management?
- High dose salicyclate and IVIG
- IV corticosteroids
51) Most toxic effect if IV extravasation
- Platinum analogues
- Alkylating agents
- Etoposide
- 5 fluorouracil
- Anthracyclines
52) Hypochondriasis
- Fear that one has a physical illness
- Delusional belief that one has serious physical illness
- Belief that one will contract a serious physical illness (unsure?)
- Belief that one has serious physical illness
- Pre-occupation with one’s health
53) Causes depression
- DM
- Parkinson’s
- Alcohol
- Interferon
- All of above
54) Psychiatric problems with alcohol are
- Anxiety
- Depression
- Dementia
- Hallucinations
- All of the above
55) Man in coma, 3 hours after ingesting methylated spirits. Low toxic levels of methanol in blood. Treatment?
- Hemoperfusion
- IV ethanol
- Gastric lavage
- Charcoal
56) High potassium 7.1mmol/L in man with CRF now in junctional bradycardia. What not to do?
- Sodium bicarbonate
- Atropine
- Dialysis
- Calcium chloride
- IV dextrose with soluble insulin
57) Chronic lead poisoning
- nephropathy
- dermatitis
- pulmonary fibrosis
- DVT of LL
58) Scabies: EXCEPT?
- occurs frequently in interdigital folds
- occurs frequently on scalp
- occurs frequently on buttocks
- Transmitted by close contact
- Itch worse at night
60) Young lady with difficulty swallowing, double vision, ptosis of a single eye. What test most specific for diagnosis?
- edrophonium test
- anti-acetylcholine receptor antibody test
- nerve conduction tests
- MRI of brain
61) Painless penile ulcer
- bowen’s disease
- syphilis
- chancroid
- herpes simplex ulcer
62) >1g proteinuria most likely cause
- Pyelonephritis
- Polycystic kidney
- GN
- Analgesic nephropathy
63) Bronchiolitis in a child. What not to do?
- Inhaled steroids
- Trial of bronchodilators
- oxygen
- NG tube feeding if severely tachypneic
- prepare for assisted ventilation
64) Long winded history about elderly patient with unwitnessed fall and left hip fracture. Not likely direct contributing factor?
- OA of left hip
- Use of hearing aid
- use of bifocals
- nifedipine
- urinary tract infection
65) Long winded history about elderly patient with hypertension and depression on multiple meds including hydrochlorothiazide, vitamin D, calcium, fluoxetine. Hyponatremia 120mmol/L Most likely cause?
- Medication
- age related change in sodium levels
- dehydration
- heart failure
66) Elderly patient with severe pain from bony metastasis. Prognosis 2-4 months. Best treatment.
- Morphine only after trial of oral diclofenac and codeine
- Regular dosing of morphine with breakthrough pain control
- doubling dose every week
- absolute contraindication to IV morphine
67) Woman with rash and terminal IPJ arthritis.
- Psoriasis
- SLE
- gonococcal septicaemia
- RA
68) Primary gout associations, except
- CHD
- DM
- Hypertension
- Hyperlipidemia
- RA
69) Causes of constipation except
- cytotoxic drugs
- chronic laxative abuse
- MgSO4
- Ba contrast
70) Causes of secondary amyloidosis except
- leprosy
- miliary TB
- RA
- chronic OM
- bronchiectasis
71) Causes of anemia important in RA except
- B12 deficiency
- hypersplenism
- chronic disease
- hypoplastic bone marrow
- iron deficiency
72) Most likely cause of drug induced lupus
- hydralazine
- methyldopa
- sulfamethaxole
- phenytoin
- carbimazole
73) Not useful in treatment of alcohol withdrawal
- diazepam
- haloperidol
- chlorpromazine
- chlorodiaxozide
- all of the above
74) Drowning not associated with
- cerebral edema
- hyperkalemia
- metabolic acidosis
- metabolic alkalosis
- hyperchloraemia
76) Young child swallowed coin, brought to A&E. X-ray showed radioopaque coin in stomach. Next course of action?
- Induce vomitting using Ipecac
- Attempt flexible endoscopic removal of coin
- Send child home and instruct the mother to observe for coin in faeces
- Admit the child and observe for signs of intestinal obstruction
- Immediate surgery to remove the foreign body is indicated
77) Cause of central pontine myelinolysis
- sudden hypotension
- rapid correction of hyponatremia
78) 32 weeks infant born with grade II Intra Ventricular Haemorrhage. What likely outcome?
- spastic diplegia CP
- spastic quadriplegia CP
- dyskinetic CP
- mixed CP
- ataxic CP
79) Where lesion if there is CNIII palsy with contralateral hemiparesis
- midbrain
- medulla
- hypothalamus
80) Where lesion if there is lateral medullary syndrome
- pons
- medulla
81) What happens if there is lesion to radial nerve at humerus
- wrist drop
- ? claw hand deformity
- wasting of muscles of the hand
82) Acromegaly not associated with
- hypercalciuria
- goiter
- hyperthyroidism
- gynaecomastia
- DM
83) Not a cause of hypercalcemia
- CRF
- chronic pancreatitis
- thyrotoxicosis
- prolonged immobility
84) Polycythemia rubra vera supported by what investigation
- PaO2 65 mmHg
- leukocytosis and thrombocytosis
- normal RBC cell volume and low plasma volume
- mass in right loin
- (uncertain blood test) findings of methaemoglobin and sulphaemoglobin
86) Genogram showing AD inheritance. What possible disease?
- Vitamin D resistant hyperphosphatemic rickets
- G6PD deficiency
- Marfan’s
- Beta thal major
- Down syndrome
87) Retroperitoneal bleeding in woman on warfarin for MVR, just given some pills for migraine. Which is the likely culprit?
- ergotamine
- mefenemic acid
- paracetamol
- sumitriptan
- paracetamol
88) the following is true of coronary artery disease:
- sudden death can be the 1st presentation of CAD
- all patients should be investigated with coronary angiogram
- cannot have CCF without previous AMI
89) drugs to improve mortality rate in AMI except:
- nifedipine
- aspirin
- captopril
- pravastatin
- atenolol
90) which statement about malaria is true?
- chemoprophylaxis offers 100% protection
- falciparum infection is a medical emergency
- is a waning problem in Asia
- can be excluded by 3 negative blood films
91) Hepatitis C virus
- is a DNA virus
- usually causes symptomatic acute infections
- Causes fulminant hepatic failure especially in pregnant women
- Causes extrahepatic effects like agranulocytosis
92) secondary causes of diabetes except:
- phaechromocytoma
- hyperthyroidism
- acromegaly
- Cushing’s
- Addison’s
93) which is not associated with decreased complement level?
- Ig A glomerulonephritis
- Lupus nephritis
- Mesangiocapillary GN
- Post-infectious GN
- Infective endocarditis
94) which one has the best response to steroids?
- minimal change nephropathy
- acute post-streptococcal GN
95) renal transplant… which is true?
- hypertension is a side effect of some immunosuppressants
- cadaveric kidney has longer life span
- HLA incompatibility is an absolute contraindication
- HIV infection is not a contraindication
96) Newborn neonate TSH 30 (normal upper limit 25). Next course of action?
- Recheck TFT 5 days later
- Check for thyroid microsomal antibodies
- Start L-thyroxine immediately
- Arrange for thyroid scan
- Start ? carbimazole immediately
97) Adult polycystic kidney disease – which of following is true.
- AR inheritance
- Almost always associated with hypertension
- Associated with intracranial aneurysms
- not a/w other cysts extra-renal
98) Boy suffered from measles. After which had 2 years of cough productive of foul-smelling sputum. On examination found to have clubbing. Cause?
- Bronchiectasis
- Chronic bronchitis
- Lung abscess
- Bronchial carcinoma
- ?
99) Causes of asymmetrical Moro’s reflex, EXCEPT
- Erb’s palsy
- Osteomyelitis
- Left-handedness
- Cerebral palsy
- Clavicle fracture
100) Caput succedaneum
- fluctuates
- transilluminates
- non-pitting
- likely to resolve over next few days
- occurs over occipital region
101) Paraneoplastic manifestations of CA lung
- Cushing’s
- Polycythaemia
- Hypercalcemia
- SIADH
- Lambert-Eaton
102) Catabolic rather than anabolic
- Insulin
- Aldosterone
- Epinephrine
- Oestradiol
- Gut insulin-like peptides
103) Normal electrolyte values for 3 yr old child
- a) fluid requirement is 100ml/kg/d
- b) Na need is 5-10mmol/kg/d
- c) K need is 20-30mmol/kg/d
- d) hypernatraemia should calculate and correct by 3-4hrs
- e) ?
104) ECT
- a) more effective in milder forms of depression
- b) less effective if delusions are present
- c) less effective if hallucinations are present
- d) cannot be used in cancer because it will cause metastatic spread
- e) Safer than pharmacotherapy in debilitated people
105) Elderly w/o comorb. Which HTN drug?
- a) HCTZ
- b) atenolol
- c) enalapril
- d) nifidepine
- e) hydralazine
106) Erythropoetin side effect?
- a) hypertension
- b) impotence
- c) cataracts
- d) DM
- e) seizures
107) Valproate
- Therapeutic drug monitoring not useful
- Cannot be prescribed together with folate in women of childbearing age
- Cannot be prescribed to brestfeeding mothers
- Helpful in chronic schizophrenic patients with predominantly negative symptoms
- Hepatic enzyme inducer
108) Which of the following has shortest duration of action?
- Midazolam
- Nitrazepam
- Flurazepam
- Zopiclone
- Diazepam
109) A woman has perinatal depression:
- Occurs in 5% of pregnant women
- Incidence higher than her lifetime risk of depressive disorder
- Risk-benefit analysis of using antidepressants has to take into account patient’s ability to consent to treatment (questioning the mother’s ability to consent to treatment)
- Involves only mother-child pair and not other members of family
- Pregnancy is a protective factor
110) Goal of CBT is?
- Symptom relief
- Understanding how beliefs and feelings influence behaviour
- Understanding unconscious motivations
- Challenging assumptions which are dysfunctional
- Suppressing negative automatic thoughts
111) Delirium characteristic
- Clouding of consciousness and inattention
112) The following statements are true about the Mental disorders and Treatment Act (MDTA) EXCEPT
- Form 1 is used on a patient who poses to himself and others
- Form 1 can allow detention up to 72 hours
- Form 2 can allow detention up to 1 month
- Can only be used in Woodbridge hospital
- Able to detain patient but cannot treat without patient’s consent
The Act allows involuntary detention of a person who is of potential harm to himself/ others against his will but does not allow the doctor to administer treatment without the patient’s consent. |
113) CBT is conducted using:
- Freudian principles
- Free association
- Talking about past experiences
- Recognising how thoughts and feelings translate into behaviour
- ?
114) 3-day-old baby who had not passed any meconium since birth, was brought in for persistent non bilous vomiting, constipation, poor feeding. Which single investigation will allow you to make the diagnosis immediately?
- a) Abdominal X-ray
- b) ?
- c) Barium swallow and follow through
- d) Barium enema
- e) Rectal suction biopsy
115) Which of the following statements is true about intussception?
- Age 2 to 5 years old
- AXR shows gas in bowel walls of the affected segment
- A mass is usually palpable in the right iliac fossa
- The ileocaecal and ileocolic forms are the commonest
- Surgery is the first line of treatment
116) Girl with urticaria and SOB 10 minutes after ingestion of peanuts. What is the best acute measure?
- Oral (antihistamine)
- IV hydrocortisone
- Inhaled salbutamol
- Subcutaneous epinephrine
117) Which of the following requires further investigations?
- 12 year old boy presenting with vomiting.
- Urine dipstick ketone +ve
- Boy with mid-stream urine sample of 103-104 colony forming units of bacteria under microscope
- Boy with serum creatinine of 90umol/L
118) Which drug is most nephrotoxic?
- gentamicin
- erythromycin
- a
- nystatin
119)
Psychiatry
P1) Which is true?
- Atypical antipsychotics can cause hyperglycemia
- Atypical more effective than typical
- Antipsychotics not useful in acute tx of mania
- Atypical antipsychotics rarely cause EPSEs
P2) Hypochondriasis
- Fear that one has a physical illness
- Delusional belief that one has serious physical illness
- Belief that one will contract a serious physical illness (unsure?)
- Belief that one has serious physical illness
- Pre-occupation with one’s health
P3) Causes depression
- DM
- Parkinson’s
- Alcohol
- Interferon
- All of above
P4) Psychiatric problems with alcohol are
- Anxiety
- Depression
- Dementia
- Hallucinations
- All of the above
P5) Not useful in treatment of alcohol withdrawal
- diazepam
- haloperidol
- chlorpromazine
- chlorodiaxozide
- all of the above
P6) ECT
- more effective in milder forms of depression
- less effective if delusions are present
- less effective if hallucinations are present
- cannot be used in cancer because it will cause metastatic spread
- Safer than pharmacotherapy in debilitated people
P7) Valproate
- Therapeutic drug monitoring not useful
- Cannot be prescribed together with folate in women of childbearing age
- Cannot be prescribed to brestfeeding mothers
- Helpful in chronic schizophrenic patients with predominantly negative symptoms
- ?
P8) Which of the following has shortest duration of action?
- Midazolam
- Nitrazepam
- Flurazepam
- Zopiclone
- Diazepam
P9) A woman has perinatal depression:
- Occurs in 5% of pregnant women
- Incidence higher than her lifetime risk of depressive disorder
- Risk-benefit analysis of using antidepressants has to take into account patient’s ability to consent to treatment (questioning the mother’s ability to consent to treatment)
- Involves only mother-child pair and not other members of family
- Pregnancy is a protective factor
P10) Goal of CBT is?
- Symptom relief
- ?
- ?
- Challenging assumptions which are dysfunctional
- Suppressing negative automatic thoughts
P11) Delirium characteristic
- Clouding of consciousness and inattention
P12) The following statements are true about the Mental disorders and Treatment Act (MDTA) EXCEPT
- Form 1 is used on a patient who poses to himself and others
- Form 1 can allow detention up to 72 hours
- Form 2 can allow detention up to 1 month
- Can only be used in Woodbridge hospital
- Able to detain patient but cannot treat without patient’s consent
P13) CBT is conducted using:
- Freudian principles
- Free association
- Talking about past experiences
- Recognising how thoughts and feelings translate into behaviour
- ?
P14) Differential diagnoses of catatonia:
- schizo
- depression
- neuroligic conditions
- neuroleptic malignant syndrome
- all of the above
P15 Treatable cause of dementia
- parkinson’s
- stroke
- huntington’s
- alzheimer’s (not sure whether this was the option given)
- normopressure hydrocephalus