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Medicine MCQs exam question

by mediconepal

October 20, 2019

Medicine MCQ questions for the MBBS or for other level exam for practicing. This would help for NMC, MCI, PMDC ...

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 100x10⁹, 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 3^rd 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 150x109, WCC 10.4x109. 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

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