1. A 45 - year-old patient presented to emergency 7.

The following are observational studies

with RIF pain and showed single liver abscess EXCEPT:
with features of appendicitis on CT scan. What is (B) Cohort
likely etiology ? (A) Ecological
(A) Bacterial (C) Field Trials (D) Case Control
(B) Metastatic colon cancer
8. Apatient visits the OPD and Complains of large
{e) Amoebic fluid-filled blisters. The patient was diagnosed as
(D) Fungal a case of Bullous Pemphigoid. Autoantibodies to
which of the following cell junctions is most
2 A29 year old male reported to emergency with likely to be affected ?
alleged history of being beaten by the neighbour.
On examination, a dark brown color bruise was (A) Hemidésmosomes (B) Tight junction
present over back of left forearm in the lower
(C) Gap junction (D) Desmosomes
third part. Vesicles were present on the site and
the patient was itching the site of bruise. What is 9. What is the imaging of choice for suspected
the most likely causative factor in this case ?
acute osteomyelitis?
(A) Blunt trauma
(A) CT scan (B) X-ray
(B) Calotropis gigantea
() Single edge weapon () Ultrasonography (D) MRI
(D) Double edge weapon 10. A 45-year-old woman presents with fever, chills
and muscle aches after a recent visit to rural
3. Which of the following statements is wrong
about Gabapentin? India. Malaria was diagnosed by blood smear,
which shows Plasmodium falciparum infection
(A) Its oral absorption is dose proportionate and with a parasitemia level of 4%. She complains of
well metabolized in humans. abdominal pain, nausea and mild confusion. Her
(B) It is not bound to plasma proteins and is vital signs are temperature 39.5°C, pulse
excreted unchanged. 120 bpm, blood pressure 90/60 mmHg and
oxygen saturation 93% on room air.
(C) It has no known interactions with other anti
seizure drugs. What is the most appropriate initial
management ?
(D) It is effective for focal seizures, with and
with-out progression to tonic-clonic (A) Admit to the hospital and start oral
seizures. chloroquine
4. Austin Flint murmur mimics the murmur of: (B) Administer artesunate intravenously and
(A) Mitral stenosis admit to the ICU

(B) Patent Ductus arteriosus (C) Begin oral artemisinin-based combination

therapy and observe
(C) Tricuspid regurgitation
(D) Atrial Septal Defect (D) Prescribe atovaquone-proguanil as an

5 At what age does a child start imaginative outpatient

play ? 11, Following is the direct mode of transmission of
(B) 3 years infectious diseases :
(A) 2 years
(C) 4years (D) 5 years (A) Fomite Borne
6. Presence of which vitamin in the gut enhances (B) Contact with soil
the absorption of iron ?
(B) Vitamin B6 (C) Unclean hands and fingers
kA) Vitamin C
(C) Vitamin B12 (D) Vitamin B9 (D) Air-Borne

23XY 2
12. A10-month-old child presented with fever,
pallor, liver and spleen up to the umbilicus. The 17. Which of the following is not used for treatment
complete blood counts revealed Hb of 7 gm/dL, of pulmonary hypertension ?
total leukocyte counts of 40000/mm?, and (A) Endothelin receptor antagonists
platelets counts of 30000/nmm³. His bone marrow
examination revealed B-acute lymphoblastic (B) Phosphodiesterase-5 inhibitors
leukemia by flow cytometry, and his () Prostanoids
cytogenetics study showed the presence of
hyperdiploidy. (D) Beta blockers
Which of the following criteria makes him a 18. A 24-year-old primigravida presents in active
high-risk leukemia ? labour at 39 weeks of gestation. Her BMI is
(A) Age 35 kg/m². After the delivery of fetal head, the
(B) TLC counts shoulders fail to deliver with normal traction.
Which of the following maneuver is not done in
() Bulky organomegaly this condition ?
(D) Hyperdiploidy (A) McRoberts maneuver
13. Publichealth care delivery system is developed (B) Wood's maneuver
on the philosophy of :
(C) Ritgen maneuver
(A) Primary health care
(B) Secondary health care (D) Zavanelli maneuver
(C) Tertiary health care 19. Thomas test of thehip joint is done to diagnose:
(D) Primordial health care (A) Fixed Flexion Deformity of hip joint
14. X-rays are produced when accelerated electrons (B) Fixed Adduction Deformity of hip joint
hit:
(A) Cathode () Fixed Abduction deformity of hip joint
(B) Diode (D) Internal Rotation deformity of hip joint
(C) Voltage regulators 20. An 8-year-old girl was taking 800 mg
(D) Anode
carbamazepine daily and was prescribed 1 g of
erythromycin for 14 days. Within 2 days she
15. Multipurpose worker scheme in India was began to experience balancing difficulties and
introduced following the recommendation of: ataxia. What could be the cause of her
(A) Srivastava Committee symptoms ?
(B) Bhore Committee (A) She is experierncing relapse of epileptic
(C) Kartar Singh Committee symptoms.
(D) Mudaliar Committee (B) She is experiencing carbamazepine toxicity.
16. A couple is known to be hostile to each other. (C) She is experiencing erythromycin toxicity.
The wife is seen buying arsenic allegedly for (D) She is experiencing
killing rats on a particular day. The husband dies reaction.
hypersensitivity
of arsenic poisoning the next day. Police raids
the house and finds th¡t there is arsenic in food, 21, Which of the following modality imaging
which the wife prepared. What type of evidence method is used for acute suspicion of stroke ?
is this?
(A) Diffusion weighted MRI
(A) Direct evidence
(B) T2 weighted MRI
(B) Hearsay evidence
() Documentary evidence UC) Contrast enhanced MRI
(D) Circumstantial evidence (D) MR Spectroscopy
23XY P.T.O.
 22.. Following are the CLINICAL TESTS of 27. Which of the following is incorrect regarding th.
assessment of vestibular functions EXCEPT : effects of combined oral contraceptive pill ?
(A) Spontaneous nystagmus
(B) Fistula Test (A) Increased menstrual cycle regularity
blood loss
() Romberg Test (B) Reduced menstrual
cance
(D) Caloric Test (C) Reduced endometrial and ovarian
23. Which risk
statement is not true regarding
differentiated thyroid cancers ? (D) Reduced bone mass
(A) Papillary thyroid carcinoma has to the
a female 28. Which amino acid majorly contributes
preponderance. nitrogen in urea biosynthesis ?
(B) Follicular thyroid carcinoma
disseminates (A) Lysine (B) Arginine
primarily via the lymphatic route.
(C) Hurthle cel carcinoma usually affect (C) Glutamine (D) Ornithine
older
population. 29. A 65-year-old male presents with a sudden loss
(D) Follicular Thyroid Carcinoma cannot be of vision in his right eye. A dilated fundus
reliably diagnosed by FNAC. examination reveals a pale retina with a well
24. A 23-year-old boy presented with complaints of defined "cherry-red spot" at the fovea. What is
diplopia, dysphagia and dysphonia following the most likely diagnosis ?
consumption of food from a roadside vendor. (A) Central retinal artery occlusion
On examination he was found to have ptosis and
dysarthria also. A diagnosis of Botulism was (B) Central retinal vein occlusion
made. Botulinum toxin Bcauses these symptoms
by : (C) Diabeticretinopathy
(A) Cleaving Synaptobrevin (D) Retinal detachment
(B) Cleaving SNAP 25 30. A 40-year-old man undergoes a routine eye
(C) Cleaving Ras exam with an irregular pupil that is non-reactive
to light but accommodates. What is the most
(D) Cleaving Rab likely cause of this finding ?
25. Which of the following vaccines is to be given by
oral route ? (A) Adie's tonic pupil
(A) Pneumococcal polysaccharide (B) Horner's syndrome
B) Rotavirus (C) Third nerve palsy
() DPT
(D) ArgyllRobertson pupil
(D) Meningococcal
31. Sickle cell anemia is inherited in which pattern ?
26. In the grading of trachoma, trachomatous
inflammations follicular is defined as the (A) Autosomal dominant
presence of :
(B) X-linked recessive
(A) Five or more follicles in the lower tarsal
(C) Autosomal recessive
conjunctiva
(B) Three or more follicles in the lower tarsal (D) Mitochondrial inheritance
conjunctiva 32. Which of the following cells play a key role in
SC) Five or more follicles in the upper tarsal asthma inflammation ?
conjunctiva
(A) Red blood cells (B) Eosinophils,
(D) Three or more follicles in the upper tarsal
conjunctiva (C) Neutrophils (D) Platelets

23XY
a4 A52-year-old
3-day history of diabetic patient
redness, warmthpresents with a 37. What is the primary mode of transmission for
the right lower leg. On and swelling in tuberculosis ?
tender, erythenatous and examination, the area is (A) Blood transfusion
has
borders. The patient is afebrile poorly defined
and reports mild (B) Airborne droplets
pain in the affected
area. What is the most (C) Contaminated food
appropriate initial
patient ? management for this (D) Skin contact
of feeding
(A) Prescribe topical 38. Incision given for placement
elevation of the limb.antibiotics and advise gastrostomy is a :
(A) Contaminated wound
(B) Administer
intravenous vancomycin (B) Clean wound
immediately. wound
(9) Start oral antibiotics (C) Clean contaminated
effective against (D) Dirty Wound
Streptococcus and Staphylococcus species, history of palpable
such
cephalexin amoxicillin 39. A 55-year-old female withmammography. Her
clavulanate. breast lump underwent
mammography categorized the lesion
as
(D) Order a CT scan to confirm the BIRADS 0. The interpretation of test result is :
before starting treatment.
diagnosis
(A) Negative (B) Inconclusive
34. A 35-year-old patient presented to the ER with (C Benign (D) Probably Benign
chest pain and syncope. On ECG, the following
rhythm was observed. Which drug willyou give 40. A publicity campaign aimed at promoting
for rapid termination of this condition? particular product in a favorable light, so that
people accept it without further exploring
(A) IV digoxin various details, is called :
(B) IV propranolol
(C) V adenosine (A) Health Education
(D) IV atropine
(B) Behavior change communication
35. Which of the following statements is
INCORRECT about breath-holding spells ? ( ) Propaganda
(A) Differential diagnoses include seizure and (D) Advocacy
cardiac arrhythmias. 41. False statement regarding screening
mammography is :
(B The peak age of onset is 6 months to 2 years.
(C) In Some cases, the child becomes
(A) Screering mammography is performed in
asymptomatic women.
unconscious or hypotonic. (B) Annual sCreening mammography is
(D) The essential component of management is recommended for Women older than
parenteral reassurance. 40 years.
36. A pedestrian crossing the road met with a road (C) Younger women with a previous breast
traffic accident. He has presented to the cancer, significant family history of breast
emergency with left foot drop. Power in tibialis cancer should also be rcommend for
anterior, extensor digitorum longus, and screening mammography.
extensor hallucis longus is 0/5. While power in (D) The goal of screening mammography is
tibialis posterior, gastrocnemius is 4/5. What is detecting occult breast cancer with better
the likely site of injury ? prognosis than cancers identified by
palpation.
(A) Supracondylar fracture of left femur
42. Which of the following is not a long-acting
(B) Fracture neck of left fibula insulin ?
head:
(C) Posterior dislocation of femur (A) Glargine (B) Lispro
(D) Left ankle fracture (C) Detemir (D) Degludec
23XY 5 P.T.0.
 43. A a soft sign on clinical examination
55-vear-old male with a history of 47. Which

hypertension and smoking presents to the case of peripheral vascular injury ?

emergency department with sudden onset of (A) Pulsatile bleeding
severe chest pain radiating to his left arm (B) Expanding hematoma
jaw. He is sweating profusely and
and
anxious. An electrocardiogram (ECG)appears ( ) Audible bruít
shows
ST-segment elevation with elevated Troponin
and Creatine kinase-MB (D) Diminished but palpable distal pulse
(CK-MB) enzyme
markers. What is the likely diagnosis 48. Which of the following is not a limitation ot
? intravenousroute of administration ?
(A) Angina
(A) Increased risk of adverse effects
B) Myocardial infarction (MI)
(C) Gastroesophageal reflux disease (GERD) (B) Must inject solutions slowly as a rule .
(D) Pulmonary embolism () Not suitable for oily solutions or porly
soluble substances
44. All are tests for Anterior (D) May interfere with interpretation of Creatine
Cruciate Ligament
deficiency of the Knee, except : Kinase test
(A) Lachman's 49, All of the following medications are effective in
(B) Anterior Drawer test treating both psoriatic arthritis and the skin
(C) Pivot shift test disease of psoriasis EXCEPT :
(A) Adalimumab (B) Infliximab
(D) McMurray's test
45. Assessment of Vitamin B12 (C) Rituximab (P) Secukinumab
nutritional status can
be done by determining the urinary levels of : 50. A farmer was brought to the emergerncy room
SA) Cobalamin after he accidentally consumed a liquid. He had
(B) Folic acid
four episodes of vomiting and copious secretions
from his mouth. His blood pressure was
(C) Methylmalonic acid unrecordable and had pin-point pupils. What is
the poison consumed ?
(D) Propionyl CoA
(A) Acetone (B) Atropine
46. A 76-year-old woman presents with 3 days of
fever and 1 day of severe pain in her left knee to () Ethanol (D) Malathion
the point where she can no longer stand.She has 51. Which of the following is the recommended
no past medical history. She is not sexually modality for breast cancer screening in a
active. On examination, her temperature is 32-year-old with BRCA mutation ?
102°F_ Her heart rate is 100 beats/min, with (A) Annual Screerning Mammogram
blood pressure of 108/65. Her left knee is tender,
with erythema and a palpable effusion. Her (B) Annual Screening Mammogram and Breast
MRI
cardiac, lung and abdominal examinations are
all normal. Which of the following should you (C) 6monthly ultrasound
do ? (D) Clinical breast examination 3
monthly
(A) Draw blood cultures and perform joint 52. A dead body was brought for
aspiration. examination. On examination of the postmortem
eyes, sclera
(B) Draw blood cultures, perform an x-ray of showed triangular shaped discolored areas.
the left knee and initiate vancomycin. What is this known as ?
) Draw blood cultures, perform joint (A) Kevorkian sign
aspiration and initiate vancomycin. (B) Tache noire
(D) Initiate vancomycin and perform an x-ray of (C) La facies sympathique.
the left knee. (D) Lazarus syndrome

23XY 6
 53. A 18 year old male presented to
emergency 59. Modified Wells criteria for predicting deep vein
room with history of pain abdomen, anorexia thrombosis DO NOT include :
and nausea since last 24 hours. On clinical
examination patient was febrile with tenderness (A) Previous DVT
over right lower quadrant of abdomen but no
rebound tenderness. His total leucocyte count (B) Pitting Oedema
was 13000/mm.His ´Alvaradoscore' is : (C) Intravenous drug abuse
(A) 7 (B) 8 (D) Entire limb not swollen
() 9 (D) 6
54. Any direct or indirect intervention taken 60. Walk in coolers (WIC) are used for storage of the
by the following vaccines EXCEPT :
government to bring change in the existing
behaviour: (A) OPV Vaccine (B) BCG
(A) Service approach () Hepatitis B (D) DPT
(B) Regulatory approach
61. Which of the following risk factors is associated
(C) Health education approach with both adenocarcinoma and squamous cell
(D) Primary healthcare approach carcinoma of the esophagus ?
55. Modification of a defective
enzyme to restore (A) Barrett esophagus
functional enzyme activity of cultured human
pluripotent stem cells can be achieved by which (B) Chronic gastroesophageal reflux disease,
one of the following methods ? (C) Cigarette smoking
(A) Nucleotide base excision repair. (D) Male sex
(B) CRISPR/Cas9-based gene editing
62. 70 year old hypertensive male discontinued his
(C) Mismatch repair medicines. He suffered a hemorrhagic stroke
(D) Gene cloning involving inferior parietal lobule. Which of the
following symptoms may be observed as a result
56. A 30-year-old GiP0 woman is admitted with of this damage ?
complaints of excessive nausea and vomiting at
11 weeks of gestation. On admission, (A) Inability to recognize familiar face
hemoglobin is 9 g/dL and a mean corpuscular (B) Nonsense speech full of jargon
volume of 116 fL. Which of the following is the
mostly likely cause of anaemia in this case ? (C) Impairment of calculation ability
(A) Iron deficiency (D) Ignorance of stimuli on one side of the body
(B) Physiological anemia of pregnancy 63. A 20-year-old male was hit on the temple with a
C) Folate deficiency baseball bat and became unconscious. After
some time after he regains consciousness, he
(D) Thalassemia becomes lethargic over the next two hours with
57. Which of the following imaging modality does unequal pupils. With the provisional diagnosis
of intracranial hemorrhage in mind, which of the
not produce harmful ionic radiation ? following arteries is most likely injured, leading
(A) X-ray/ (B) MRI to hemorrhage ?
(C) PET-scan (D) CT scan (A) Anterior cerebral artery
58. Following agent is NOT suitable for disinfection (B) Middle meningeal artery
of faeces and urine
(C) Basilar artery
(A) Bleaching Powder (B) Salt Solution
(C) Cresol P) Formalin (D) Anterior conmunicating artery
7 P.T.O.
23XY
 69. A45 year old woman comes to hospital for her
64. A 45-year-old male presents with a executive health check up. Her Blood Pressure is
history of chronic cough, night sweats,3-month
weight while lying and
loss and occasional hemoptysis. He has found to be same while
no standing. Which of the following changes is seen
history of recent travel or contact with known ?
standing positions
tuberculosis patients. Chest X-ray shows cavitary in lying to
lesions in the upper lobes of the lungs. Which Heart rate - increased
the following is the most appropriate next of
a
Preload - decreased

for step b
diagnosing pulmonary tuberculosis ? C.
Heart rate -
decreased

(A) Start empirical antitubercular therapy d

Preload - increased

without further testing. (B) b, c

AA) a, b
(B) Order a complete blood count (CBC) and (D) a, d
liver function tests (LFTs). (C) c, d
may be seen in all of
VO) Perform a sputum smear and culture for 70. Prominent corneal nerves
acid-fast bacilli tAFB) and conduct a nucleic the following EXCEPT :
acid amplification test (NAAT) for (A) Keratoconus
Mycobacterium huberculosis.
(B) Herpes simplex keratitis
(D) Obtain a CT Scan of the chest for better
visualization of the cavitary lesions. (C) Leprosy
(D) Neurofibromatosis
65. Which is not an etiology of obstructive shock ?
71. Which is not a characteristic feature of Achalasia
(A) Massive pulmonary embolism cardia ?
(B) Tension Pneumothorax (A) The classic triad of presenting symptoms
(C) Cardiac Tamponade consists of dysphagia, regurgitation and
weight loss.
D) Myocardial infarction
66. A village is affected with epidemic of cholera, B) Dysphagia often begins with liquids and
progresses to solids.
what is the first step which should be taken in
village to decrease deaths form cholera ? (C) Dysphagia progresses rapidly during the
course of disease.
A) Safe water supply and sanitation
(D) Achalasia known to be a premalignant
(B) Cholera vaccination to all individuals
condition of the esophagus.
() Primary chemoprophylaxis 72. A person was found dead by his wife in his
(D) Treat everyone in village with tetracycline garage with his car running. Carbon monoxide
67. An obese diabetic on metformin 1gm twice a gas poisoning was confirmed to be the cause
his death. What will be the color of postmortem
day presents with a recent history of acute
staining in this case ?
coronary event and uncontrolled blood sugar
levels. Which anti-diabetic drug is preferred as (A) Cherry red (B) Brick red
an add-on to metformin in this patient ?
(C) Grayish / black
(D) Chocolate brown
(A) Empagliflozin AB) Pioglitazone 73. Correct match of Indications of prenatal
(C) Linagliptin (D) Gliclazide diagnosis with methods used is :
68. Facial nerve leaves the brainstem at : (A) Biochemical Disorders - Protein Assay
(A) Pontomedullary junction (B) Chromosomal anomaly Biochemical
analysis of fluid
(B) Posterior Cranial Fossa
(C) Metabolic defects - Culture and karyotypina
(C) Internal acousticmeatus of fetal cells from amniotic fluid
AD) Stylomastoid foramen (D) Neural Tube Defects - DNADiagnosis
23XY 8
74. A6-year-old child presents to the emergency 78, A 45-year-old woman is admitted to the
department with a4-day history of sore throat, emergency room after a first episode of
low-grade fever and difficulty swallowing. On witnessed generalized tonic-clonic seizure. She is
examination, the child has cervical administered lorazepam 2 mg with cessation of
lymphadenopathy, a swollen neck, and a thick, seizure activity. All the following are likely
gravish-white menmbrane covering the tonsils possible causes of her seizure EXCEPT:
and pharynx that bleeds when attempts are (A) Alcohol withdrawal
made to remove it The child is unvaccinated.
What is the most appropriate next step in (B) Autoantibodies
management ? (C) Brain tumor
(A) Prescribe oral antibiotics and discharge the (D) Genetic disorder
patient with follow-up.
79. A 27 year old male sustained injury to the right
B) Admit the patient, isolate them, administer eye in an assault. He subsequently developed
diphtheria antitoxin and start intravenous
antibiotics. right corneal opacity following injury resulting
in impairment of vision. Medicolegally such
(C) Schedule an outpatient appointment injury is labelled as :
for a
throat culture before starting treatment. (A) Simple -(B) Grievous
(D) Perform a throat swab for rapid strep testing (C) Dangerous (D) Serious
and provide supportive care only.
80, Onodi and Haller cells of ethmoid labyrinth are
75. A 36-year-old man presents to the clinic found in relation to which of the following
reporting ankle swelling. On examination, his structures ?
blood pressure is elevated at 172/90, and he has
bilateral ankle edema. There are no other (A) Opticnerve and floor of orbit
abnormalities on physical examination. (B) Opticnerve and nasolacrimal duct .
Laboratory studies show a potassium of 2.9 and (C) Orbital floor and nasolacrimal duct
normal creatinine. Which of the following
studies is recommended next ? (D) Optic nerve and internal carotid artery
(A) AM cortisol 81. Which of the following structures do not form
the boundary of the triangle of Koch containing
(B) CT of adrenals the atrioventricular node and its connections ?
c) Plasma renin and aldosterone (A) Corornary sinus opening
(D) Thyroid-stimulating hormone (B) Tendon of Todaro
76. Foundation of Indian Public Health system was
laid on the basis of which committee
() Septal leaflet of tricuspid valve
recommnendations ? (D) Limbus fossa ovalis
82. PHCwhich conducts more than 20 deliveries in
(A) Health survey and development committee a month is designated as:
(B) Health survey and planning committee (A) Type "A" (B) Type "B" .
(C) Integration of health service committee () Type "C" (D) Type "D"
(D) Health and sanitation committee 83. Which of the following statements is
77. When we take a clinical history, from a patient, it INCORRECT for cephalohematoma ?
is an example of : (A) It lies over the parietal bone between the
JA) Structured interview skull and periosteum.
(B) Unstructured interview (B) It crosses the suture line and does not have a
(C) Health education
distinct margin.
(C) It usually resolves over 3-6 weeks.
(D) Counseling
(D) Itcan cause hyperbilirubinemia.
23XY 9 P.T.O.
 84. A 58-year-old woman with a history of breast 90. A 25-year-old G2PLO woman is seen at
cancer presents with back pain and weakness in 31 weeks period of gestation with complaints of
her legs. Imaging reveals lytic lesions in her right calf pain and swelling. Bilateral lower limb
spine. What is the most likely cause of her doppler ultrasound showed deep venous
symptoms ? thrombosis in right leg and she was started on
(A) Degenerative disc disease unfractionated heparin. Which of the following
the side-effect of long-term heparin therapy ?
(B) Osteoporosis (B) Diabetes mellitusd
C) Metastasis of breast cancer to the bone
(A) Thrombophilia
() Hypertension , (D) Osteoporosis
(D) Pulled muscle Corneal
91. Secondary glaucoma following
85. Unfavourable factor for non-operative perforation is due to
enterocutaneous fistula closure: (A) Anterior synechiae formation
(A) Length of fistula tract less than 2cm
(B) Peripheral synechiae
(B) Fistula output less than 200 ml/24 hours
(C) Hyphema
(C) Fistula formation secondary to appendicitis (D) Angle disruption
or diverticulitis
92. A 20year old presents to emergency with history
(D) Distal fistula of severe vomiting for last 2 days and orthostatic
86. All are features of Neurogenic Shock EXCEPT : hypotension. Which of the following is metabolic
abnormality that can be seern in thispatient ?
(A) Low Systolic BP Hypokalemia
(B) Bradycardia b. Hypochloremia
(C) Cool and Clammy Skin C. Metabolic alkalosis

(D) Reduced UrinaryOutput . d. Respiratory alkalosis

87. Which of the following s nost commonly (A) a, d (B) a, b, c
involved semicircular canal in berign (C) a, b, d (D) b, d
paroxysmal positional vertigo ? 93. A 70-year-old woman with a history of chronic
(A) Lateral (B) Superior obstructive pulmonary disease (COPD) and
(C) Posterior
diabetes mellitus presents to her primary care
(D) Saccle physician in early flu season with a 3-day history
88. A 50 year old woman presents with heat of fever, malaise, productive cough and
intolerance, warm soft skin, protruding eyeball, dyspnea. She is vaccinated for seasonal influenza
nervousness, increased pulse rate, high plasma every year. On examination, her temperature is
T4 and T3 but low plasma TSH level. She is 38.2°C and her lung exam reveals diffuse
advised to take methimazole. Which of the wheezes but no crackles. Her oxygen saturation
is 94% on room air.
following might not be the underlying cause of
her clinical condition ? What is the most appropriate management
approach for this patient ?
(A) Graves disease
(A) Admnit her to the hospital and start
(B) Myxedema oseltamivir and antibiotics
(C) Solitary toxic adenoma
(B) Discharge with supportive care and close
(D) Toxic multinodular goiter outpatient follow-up
89. Prion diseases are transmitted by (C) Perform RIDT, initiate oseltamivir if positive
and send her homne
(A) DNA (B) RNA ,
(D) Prescribe antibiotics for possible secondary
() Carbohydrates (D) Proteins
bacterial infection only
23XY 10
94. The best way of teaching urban
ORS is
women about 98. All of the following are typical causes of
secondary membranous glomerulonephritis
(A) Lecture (B) Demonstration, EXCEPT:

(C) Flash cards (D) Role play (A) Hepatitis C

95. A 10 year old boy presents (B) Nonsteroidal anti-inflammatory drug use
with sudden
unprovoked nasal bleed which was noticed by
(C) Systemic lupus erythematosus
his friend while playing an afternoon cricket (D) Tuberculosis
match. On examination, his pulse is
dehydration, dry posterior pharyngeal84/wall.min, no 99. Ideal treatment for Unstable Extracapsular
comes with a partially soaked He Fracture Neck Femur in 72-year-old male patient
Which of the following statements handkerchief. 1S:
is correct
pertaining to the clinical scenario ? (A) Cemented Bipolar Hemiarthroplasty
(A) In majority of these cases, epistaxis (B) Open reduction and internal fixation with
originates from the septal branches of typically DHS

posterior ethmoid artery. (C) Closed reduction and Intramedullary

(B) Management includes firm pressure over Nailing

the nose with head backwards for 20 (D) Open reduction and internal fixation with
minutes. CCS

(C) Placement of absorbable nasal pack is the 100.Treatment of choice for middle third Clavicle
Fracture in 30-year-old male patient with 1 cm
gold starndard for controlling arterial bleed.
gap between fracture fragments is :
(D) Nasal clots should be gently suctioned (A) Closed Reduction and Intramedullary
under vision to identify the site of bleeding. Nailing
96. A 2 month old child presents with noisy (B) Conservative Treatment
breathing for 3 weeks. Examination reveals
noisy breathing on inspiration with a pulse rate (C) Open Reduction and Intramedullary Nailing.
of 157/min, respiratory rate of 48/min with (D) Open Reduction and Internal Fixation with
suprasternal retractions. Noisy breathing and Broad DCP
retractions reduce on proning. Which of the
following is the unlikely cause for airway -o0o
obstruction ?

(A) Laryngomalacia
(B) Vallecular cyst
(C) Micro-retrognathia
(D) Subglottic hemangioma
97. When a doctor is giving talk to that the vaccines
used in the vaccination programme not lead to
the impotence among the vaccinated children in
their later life. What type of barrier to
communication is the doctor trying toovercome
in presernt scenario ?
(A) Physical barrier
(B) Cultural barrier
(C) Environmental barrier
(D) Psychological barrier
23XY 11 P.T.0.