(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
2.
--- Content provided by FirstRanker.com ---
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes forfollow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
(b) Glimepiride
--- Content provided by FirstRanker.com ---
(c) Enalapril(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
--- Content provided by FirstRanker.com ---
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
--- Content provided by FirstRanker.com ---
(c) Marfan?s syndrome(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
--- Content provided by FirstRanker.com ---
(b) To evaluate stable angina(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
--- Content provided by FirstRanker.com ---
6.
Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
--- Content provided by FirstRanker.com ---
(b) Hypothyroidism(c) Hypertension
(d) Acute myocardial infarction
FirstRanker.com - FirstRanker's Choice
--- Content provided by FirstRanker.com ---
Combined Medical Services Examination-2020Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
--- Content provided by FirstRanker.com ---
(a) Ventricular fibrillation(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
2.
--- Content provided by FirstRanker.com ---
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes forfollow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
(b) Glimepiride
--- Content provided by FirstRanker.com ---
(c) Enalapril(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
--- Content provided by FirstRanker.com ---
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
--- Content provided by FirstRanker.com ---
(c) Marfan?s syndrome(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
--- Content provided by FirstRanker.com ---
(b) To evaluate stable angina(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
--- Content provided by FirstRanker.com ---
6.
Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
--- Content provided by FirstRanker.com ---
(b) Hypothyroidism(c) Hypertension
(d) Acute myocardial infarction
7.
--- Content provided by FirstRanker.com ---
In an ECG recording, P wave is produced by:(a) Atrial depolarisation
(b) Atrial repolarisation
(c) Ventricular depolarisation
--- Content provided by FirstRanker.com ---
(d) Ventricular repolarisation8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
--- Content provided by FirstRanker.com ---
(a) DC Cardioversion(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
9.
--- Content provided by FirstRanker.com ---
Which one of the following drugs is a Direct Renin Inhibitor?(a) Benedipine
(b) Azilsartan
(c) Aliskiren
--- Content provided by FirstRanker.com ---
(d) Lisinopril10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Aortic regurgitation
--- Content provided by FirstRanker.com ---
(b) Thyrotoxicosis(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
Signet-ring sign on CT-chest is suggestive of:
--- Content provided by FirstRanker.com ---
(a) Bronchiectasis(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
12.
--- Content provided by FirstRanker.com ---
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when itis:
(a) Mild persistent
(b) Moderate persistent
(c) Severe persistent
--- Content provided by FirstRanker.com ---
(d) Very severe persistent13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
--- Content provided by FirstRanker.com ---
(b) CT-chest(c) Lung biopsy
(d) DNA sequencing study
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
--- Content provided by FirstRanker.com ---
Paper-I1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
(a) Ventricular fibrillation
--- Content provided by FirstRanker.com ---
(b) Ventricular premature complex(c) Atrial flutter
(d) Atrial fibrillation
2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
--- Content provided by FirstRanker.com ---
follow-up, with complaints of muscle pains. Which one of the following drugs could be themost likely cause?
(a) Aspirin
(b) Glimepiride
(c) Enalapril
--- Content provided by FirstRanker.com ---
(d) Atorvastatin3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
--- Content provided by FirstRanker.com ---
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the followingdiseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
(c) Marfan?s syndrome
--- Content provided by FirstRanker.com ---
(d) Rheumatic heart disease-Mitral regurgitation4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
--- Content provided by FirstRanker.com ---
(c) To assess outcome after coronary revascularization(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Massive Pulmonary Embolism(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
--- Content provided by FirstRanker.com ---
6.Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
(b) Hypothyroidism
--- Content provided by FirstRanker.com ---
(c) Hypertension(d) Acute myocardial infarction
7.
In an ECG recording, P wave is produced by:
--- Content provided by FirstRanker.com ---
(a) Atrial depolarisation
(b) Atrial repolarisation
(c) Ventricular depolarisation
(d) Ventricular repolarisation
--- Content provided by FirstRanker.com ---
8.Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
(a) DC Cardioversion
--- Content provided by FirstRanker.com ---
(b) Injection Lignocaine(c) Injection Amiodarone
(d) Injection Adenosine
9.
Which one of the following drugs is a Direct Renin Inhibitor?
--- Content provided by FirstRanker.com ---
(a) Benedipine
(b) Azilsartan
(c) Aliskiren
(d) Lisinopril
--- Content provided by FirstRanker.com ---
10.All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Aortic regurgitation
(b) Thyrotoxicosis
--- Content provided by FirstRanker.com ---
(c) Patent ductus arteriosus(d) Aortic stenosis
11.
Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
--- Content provided by FirstRanker.com ---
(b) Active alveolitis(c) Aspergilloma
(d) Sarcoidosis
12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
--- Content provided by FirstRanker.com ---
is:(a) Mild persistent
(b) Moderate persistent
(c) Severe persistent
(d) Very severe persistent
--- Content provided by FirstRanker.com ---
13.An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
(b) CT-chest
--- Content provided by FirstRanker.com ---
(c) Lung biopsy(d) DNA sequencing study
14.
Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
--- Content provided by FirstRanker.com ---
(a) Penicillium(b) Actinomycetes
(c) Aspergillus
(d) Candida
15.
--- Content provided by FirstRanker.com ---
The Gene X-pert test used for MTB detection has the additional advantage of detection ofwhich of the following?
(a) INH resistance
(b) Rifampicin resistance
--- Content provided by FirstRanker.com ---
(c) Multi drug resistance(d) Ethambutol resistance
16.
The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
--- Content provided by FirstRanker.com ---
(b) Severe COPD(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
17.
The most frequent symptom in respiratory diseases is:
--- Content provided by FirstRanker.com ---
(a) Breathlessness(b) Chest pain
(c) Hemoptysis
(d) Cough
18.
--- Content provided by FirstRanker.com ---
A 26-year old young lady attends medical emergency and is labelled as acute severe asthmaby the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
(a) Albuterol
--- Content provided by FirstRanker.com ---
(b) Anti-leukotrienes(c) Aminophylline
(d) Magnesium sulfate
19.
Consider the following statements with regard to respiratory examination:
--- Content provided by FirstRanker.com ---
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
--- Content provided by FirstRanker.com ---
4. Hyper-resonant note on percussion is characteristic of pnemothoraxWhich of the above statements are correct?
(a) 1 and 3
(b) 2 and 4 only
--- Content provided by FirstRanker.com ---
(c) 1, 2 and 4(d) 2, 3 and 4
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-I
--- Content provided by FirstRanker.com ---
1.A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
(a) Ventricular fibrillation
(b) Ventricular premature complex
--- Content provided by FirstRanker.com ---
(c) Atrial flutter(d) Atrial fibrillation
2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
--- Content provided by FirstRanker.com ---
most likely cause?(a) Aspirin
(b) Glimepiride
(c) Enalapril
(d) Atorvastatin
--- Content provided by FirstRanker.com ---
3.A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
--- Content provided by FirstRanker.com ---
diseases is most likely?(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
--- Content provided by FirstRanker.com ---
4.All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
--- Content provided by FirstRanker.com ---
(d) To evaluate the treatment efficacy of antianginal drugs5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
(a) Massive Pulmonary Embolism
--- Content provided by FirstRanker.com ---
(b) Restrictive Cardiomyopathy(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
6.
--- Content provided by FirstRanker.com ---
Which one of the following is NOT a common cause of atrial fibrillation?(a) Mitral regurgitation
(b) Hypothyroidism
(c) Hypertension
--- Content provided by FirstRanker.com ---
(d) Acute myocardial infarction7.
In an ECG recording, P wave is produced by:
--- Content provided by FirstRanker.com ---
(a) Atrial depolarisation(b) Atrial repolarisation
(c) Ventricular depolarisation
(d) Ventricular repolarisation
8.
--- Content provided by FirstRanker.com ---
Which one of the following modalities is NOT used in the treatment of ventriculartachycardia?
(a) DC Cardioversion
(b) Injection Lignocaine
--- Content provided by FirstRanker.com ---
(c) Injection Amiodarone(d) Injection Adenosine
9.
Which one of the following drugs is a Direct Renin Inhibitor?
--- Content provided by FirstRanker.com ---
(a) Benedipine(b) Azilsartan
(c) Aliskiren
(d) Lisinopril
10.
--- Content provided by FirstRanker.com ---
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:(a) Aortic regurgitation
(b) Thyrotoxicosis
(c) Patent ductus arteriosus
--- Content provided by FirstRanker.com ---
(d) Aortic stenosis11.
Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
(b) Active alveolitis
--- Content provided by FirstRanker.com ---
(c) Aspergilloma(d) Sarcoidosis
12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
--- Content provided by FirstRanker.com ---
(a) Mild persistent(b) Moderate persistent
(c) Severe persistent
(d) Very severe persistent
13.
--- Content provided by FirstRanker.com ---
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome andbilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
(b) CT-chest
(c) Lung biopsy
--- Content provided by FirstRanker.com ---
(d) DNA sequencing study14.
Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
(a) Penicillium
--- Content provided by FirstRanker.com ---
(b) Actinomycetes(c) Aspergillus
(d) Candida
15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
--- Content provided by FirstRanker.com ---
which of the following?(a) INH resistance
(b) Rifampicin resistance
(c) Multi drug resistance
--- Content provided by FirstRanker.com ---
(d) Ethambutol resistance16.
The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
(b) Severe COPD
--- Content provided by FirstRanker.com ---
(c) Severe bronchial asthma(d) Severe pulmonary thromboembolism
17.
The most frequent symptom in respiratory diseases is:
(a) Breathlessness
--- Content provided by FirstRanker.com ---
(b) Chest pain(c) Hemoptysis
(d) Cough
18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
--- Content provided by FirstRanker.com ---
by the emergency physician. Which one of the following is unlikely to be a part of theprescription?
(a) Albuterol
(b) Anti-leukotrienes
--- Content provided by FirstRanker.com ---
(c) Aminophylline(d) Magnesium sulfate
19.
Consider the following statements with regard to respiratory examination:
--- Content provided by FirstRanker.com ---
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic ofinterstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
--- Content provided by FirstRanker.com ---
Which of the above statements are correct?
(a) 1 and 3
(b) 2 and 4 only
(c) 1, 2 and 4
--- Content provided by FirstRanker.com ---
(d) 2, 3 and 420.
All of the following are the causes of exudative Pleural Effusion, EXCEPT:
(a) SVC obstruction
(b) Fungal infection
--- Content provided by FirstRanker.com ---
(c) SLE(d) Meig syndrome
21.
Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
--- Content provided by FirstRanker.com ---
(b) It decreases gastric emptying(c) It increases acid secretion
(d) Fasting increases its secretion
22.
Fecal elastase test is used for diagnosing which one of the following conditions?
--- Content provided by FirstRanker.com ---
(a) Lactose intolerance(b) Mucosal inflammation
(c) Bile acid secretory defects
(d) Pancreatic dysfunction
23.
--- Content provided by FirstRanker.com ---
The recent classification system for listing a patient as a candidate for liver transplantation is:(a) Child Pugh score
(b) APACHE score
(c) MELD score
(d) Metavir score
--- Content provided by FirstRanker.com ---
24.The blood supply of liver consists of:
(a) 50 % hepatic artery and 50 % portal vein
(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
--- Content provided by FirstRanker.com ---
(d) 70 % hepatic artery and 30 % portal vein25.
All of the following conditions are associated with Glomerulonephritis with low complement
level, EXCEPT:
(a) Subacute bacterial endocarditis
--- Content provided by FirstRanker.com ---
(b) IgA nephropathy(c) Systemic lupus erythematosus
(d) Cryoglobulinaemia
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-I
1.
--- Content provided by FirstRanker.com ---
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of thefollowing Arrhythmia is most likely?
(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
--- Content provided by FirstRanker.com ---
(d) Atrial fibrillation2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
--- Content provided by FirstRanker.com ---
(a) Aspirin(b) Glimepiride
(c) Enalapril
(d) Atorvastatin
3.
--- Content provided by FirstRanker.com ---
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. Thechest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
--- Content provided by FirstRanker.com ---
(a) Takayasu?s arteritis(b) Raynaud?s syndrome
(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
--- Content provided by FirstRanker.com ---
All of the following are indications for treadmill testing/exercise-testing EXCEPT:(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
--- Content provided by FirstRanker.com ---
5.Kussmaul?s sign is present in all of the following conditions, EXCEPT:
(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
--- Content provided by FirstRanker.com ---
(c) Hypertrophic Cardiomyopathy(d) Right Ventricular Infarction
6.
Which one of the following is NOT a common cause of atrial fibrillation?
--- Content provided by FirstRanker.com ---
(a) Mitral regurgitation
(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
--- Content provided by FirstRanker.com ---
7.
In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
--- Content provided by FirstRanker.com ---
(b) Atrial repolarisation(c) Ventricular depolarisation
(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
--- Content provided by FirstRanker.com ---
tachycardia?(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
--- Content provided by FirstRanker.com ---
(d) Injection Adenosine9.
Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
--- Content provided by FirstRanker.com ---
(b) Azilsartan(c) Aliskiren
(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Aortic regurgitation
(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
--- Content provided by FirstRanker.com ---
11.Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
--- Content provided by FirstRanker.com ---
(d) Sarcoidosis12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
--- Content provided by FirstRanker.com ---
(b) Moderate persistent(c) Severe persistent
(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
--- Content provided by FirstRanker.com ---
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:(a) 24 hour fecal fat-estimation
(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
--- Content provided by FirstRanker.com ---
14.Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
(a) Penicillium
(b) Actinomycetes
--- Content provided by FirstRanker.com ---
(c) Aspergillus(d) Candida
15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
--- Content provided by FirstRanker.com ---
(a) INH resistance
(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
--- Content provided by FirstRanker.com ---
16.The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
--- Content provided by FirstRanker.com ---
(d) Severe pulmonary thromboembolism17.
The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
--- Content provided by FirstRanker.com ---
(c) Hemoptysis(d) Cough
18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
--- Content provided by FirstRanker.com ---
prescription?(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
--- Content provided by FirstRanker.com ---
(d) Magnesium sulfate19.
Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
--- Content provided by FirstRanker.com ---
interstitial fibrosis2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
--- Content provided by FirstRanker.com ---
Which of the above statements are correct?(a) 1 and 3
(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
--- Content provided by FirstRanker.com ---
20.All of the following are the causes of exudative Pleural Effusion, EXCEPT:
(a) SVC obstruction
(b) Fungal infection
(c) SLE
--- Content provided by FirstRanker.com ---
(d) Meig syndrome21.
Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
--- Content provided by FirstRanker.com ---
(c) It increases acid secretion(d) Fasting increases its secretion
22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
--- Content provided by FirstRanker.com ---
(b) Mucosal inflammation(c) Bile acid secretory defects
(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
--- Content provided by FirstRanker.com ---
(a) Child Pugh score(b) APACHE score
(c) MELD score
(d) Metavir score
24.
--- Content provided by FirstRanker.com ---
The blood supply of liver consists of:(a) 50 % hepatic artery and 50 % portal vein
(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
--- Content provided by FirstRanker.com ---
25.All of the following conditions are associated with Glomerulonephritis with low complement
level, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
--- Content provided by FirstRanker.com ---
(c) Systemic lupus erythematosus(d) Cryoglobulinaemia
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
26.Consider the following statements with regard to oral aphthous ulcers:
1. They are superficial and painful
2. They may occur in women just prior to menstruation
--- Content provided by FirstRanker.com ---
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases4. They are pre-malignant and progress over few years to squamous cell carcinoma of
the oral cavity
Which of the above statements are correct?
--- Content provided by FirstRanker.com ---
(a) 1 and 4 only
(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
--- Content provided by FirstRanker.com ---
27.Which one of the following statements about Barrett?s Oesophagus is NOT correct?
(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
--- Content provided by FirstRanker.com ---
cells(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
cells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
--- Content provided by FirstRanker.com ---
28.The most common cause of acute hepatitis outbreaks in India is:
(a) Hepatitis E
(b) Hepatitis C
--- Content provided by FirstRanker.com ---
(c) Hepatitis B(d) Hepatitis A
29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
--- Content provided by FirstRanker.com ---
characteristically seen in which one of the following conditions?(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
--- Content provided by FirstRanker.com ---
(d) Barrett?s oesophagus30.
Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Unexplained vitamin B12 deficiency(b) Idiopathic thrombocytopenic purpura
(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
--- Content provided by FirstRanker.com ---
FirstRanker.com - FirstRanker's ChoiceCombined Medical Services Examination-2020
Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
--- Content provided by FirstRanker.com ---
following Arrhythmia is most likely?(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
--- Content provided by FirstRanker.com ---
2.An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
--- Content provided by FirstRanker.com ---
(b) Glimepiride(c) Enalapril
(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
--- Content provided by FirstRanker.com ---
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of bodyhabitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
--- Content provided by FirstRanker.com ---
(b) Raynaud?s syndrome(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
--- Content provided by FirstRanker.com ---
(a) To confirm the diagnosis of angina(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
--- Content provided by FirstRanker.com ---
Kussmaul?s sign is present in all of the following conditions, EXCEPT:(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
--- Content provided by FirstRanker.com ---
(d) Right Ventricular Infarction6.
Which one of the following is NOT a common cause of atrial fibrillation?
--- Content provided by FirstRanker.com ---
(a) Mitral regurgitation(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
--- Content provided by FirstRanker.com ---
7.In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
(b) Atrial repolarisation
--- Content provided by FirstRanker.com ---
(c) Ventricular depolarisation(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
--- Content provided by FirstRanker.com ---
(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
--- Content provided by FirstRanker.com ---
9.Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
(b) Azilsartan
--- Content provided by FirstRanker.com ---
(c) Aliskiren(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Aortic regurgitation(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
--- Content provided by FirstRanker.com ---
Signet-ring sign on CT-chest is suggestive of:(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
--- Content provided by FirstRanker.com ---
12.Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
(b) Moderate persistent
--- Content provided by FirstRanker.com ---
(c) Severe persistent(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
--- Content provided by FirstRanker.com ---
(a) 24 hour fecal fat-estimation(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
14.
--- Content provided by FirstRanker.com ---
Which one of the following antigens is commonly associated with causation of Farmer?slung?
(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
--- Content provided by FirstRanker.com ---
(d) Candida15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
--- Content provided by FirstRanker.com ---
(a) INH resistance(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
16.
--- Content provided by FirstRanker.com ---
The most common cause of chronic type II respiratory failure is:(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
--- Content provided by FirstRanker.com ---
17.The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
--- Content provided by FirstRanker.com ---
(d) Cough18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
--- Content provided by FirstRanker.com ---
(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
--- Content provided by FirstRanker.com ---
19.Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
--- Content provided by FirstRanker.com ---
2. Whispered pectoriloquy is characteristic of lung consolidation3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
--- Content provided by FirstRanker.com ---
(a) 1 and 3(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
20.
--- Content provided by FirstRanker.com ---
All of the following are the causes of exudative Pleural Effusion, EXCEPT:(a) SVC obstruction
(b) Fungal infection
(c) SLE
(d) Meig syndrome
--- Content provided by FirstRanker.com ---
21.Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
--- Content provided by FirstRanker.com ---
(d) Fasting increases its secretion22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
--- Content provided by FirstRanker.com ---
(c) Bile acid secretory defects(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
--- Content provided by FirstRanker.com ---
(b) APACHE score(c) MELD score
(d) Metavir score
24.
The blood supply of liver consists of:
--- Content provided by FirstRanker.com ---
(a) 50 % hepatic artery and 50 % portal vein(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
--- Content provided by FirstRanker.com ---
All of the following conditions are associated with Glomerulonephritis with low complementlevel, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
--- Content provided by FirstRanker.com ---
(d) Cryoglobulinaemia--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
26.
--- Content provided by FirstRanker.com ---
Consider the following statements with regard to oral aphthous ulcers:1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
--- Content provided by FirstRanker.com ---
4. They are pre-malignant and progress over few years to squamous cell carcinoma ofthe oral cavity
Which of the above statements are correct?
--- Content provided by FirstRanker.com ---
(a) 1 and 4 only(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
--- Content provided by FirstRanker.com ---
Which one of the following statements about Barrett?s Oesophagus is NOT correct?(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
--- Content provided by FirstRanker.com ---
(c) Normal columnar cells lining the lower oesophagus are replaced by squamouscells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
--- Content provided by FirstRanker.com ---
The most common cause of acute hepatitis outbreaks in India is:(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
--- Content provided by FirstRanker.com ---
(d) Hepatitis A29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
--- Content provided by FirstRanker.com ---
(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
--- Content provided by FirstRanker.com ---
30.Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
--- Content provided by FirstRanker.com ---
(b) Idiopathic thrombocytopenic purpura(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
31.
--- Content provided by FirstRanker.com ---
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidneydisease patient?
(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
--- Content provided by FirstRanker.com ---
(d) 13 to 14 gm/dL32.
Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
--- Content provided by FirstRanker.com ---
(b) Tumoral calcinosis(c) Osteitis fibrosa cystic
(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) It is inherited as autosomal dominant trait(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
--- Content provided by FirstRanker.com ---
Consider the following statements in relation to an adult patient:1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
--- Content provided by FirstRanker.com ---
Which of the statements given above are correct?
(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
--- Content provided by FirstRanker.com ---
(d) 1, 2 and 335.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
--- Content provided by FirstRanker.com ---
(b) Pyelonephritis(c) Renal stone disease
(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
--- Content provided by FirstRanker.com ---
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable forlow C
3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
--- Content provided by FirstRanker.com ---
(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
--- Content provided by FirstRanker.com ---
FirstRanker.com - FirstRanker's ChoiceCombined Medical Services Examination-2020
Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
--- Content provided by FirstRanker.com ---
following Arrhythmia is most likely?(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
--- Content provided by FirstRanker.com ---
2.An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
--- Content provided by FirstRanker.com ---
(b) Glimepiride(c) Enalapril
(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
--- Content provided by FirstRanker.com ---
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of bodyhabitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
--- Content provided by FirstRanker.com ---
(b) Raynaud?s syndrome(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
--- Content provided by FirstRanker.com ---
(a) To confirm the diagnosis of angina(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
--- Content provided by FirstRanker.com ---
Kussmaul?s sign is present in all of the following conditions, EXCEPT:(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
--- Content provided by FirstRanker.com ---
(d) Right Ventricular Infarction6.
Which one of the following is NOT a common cause of atrial fibrillation?
--- Content provided by FirstRanker.com ---
(a) Mitral regurgitation(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
--- Content provided by FirstRanker.com ---
7.In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
(b) Atrial repolarisation
--- Content provided by FirstRanker.com ---
(c) Ventricular depolarisation(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
--- Content provided by FirstRanker.com ---
(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
--- Content provided by FirstRanker.com ---
9.Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
(b) Azilsartan
--- Content provided by FirstRanker.com ---
(c) Aliskiren(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Aortic regurgitation(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
--- Content provided by FirstRanker.com ---
Signet-ring sign on CT-chest is suggestive of:(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
--- Content provided by FirstRanker.com ---
12.Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
(b) Moderate persistent
--- Content provided by FirstRanker.com ---
(c) Severe persistent(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
--- Content provided by FirstRanker.com ---
(a) 24 hour fecal fat-estimation(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
14.
--- Content provided by FirstRanker.com ---
Which one of the following antigens is commonly associated with causation of Farmer?slung?
(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
--- Content provided by FirstRanker.com ---
(d) Candida15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
--- Content provided by FirstRanker.com ---
(a) INH resistance(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
16.
--- Content provided by FirstRanker.com ---
The most common cause of chronic type II respiratory failure is:(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
--- Content provided by FirstRanker.com ---
17.The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
--- Content provided by FirstRanker.com ---
(d) Cough18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
--- Content provided by FirstRanker.com ---
(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
--- Content provided by FirstRanker.com ---
19.Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
--- Content provided by FirstRanker.com ---
2. Whispered pectoriloquy is characteristic of lung consolidation3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
--- Content provided by FirstRanker.com ---
(a) 1 and 3(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
20.
--- Content provided by FirstRanker.com ---
All of the following are the causes of exudative Pleural Effusion, EXCEPT:(a) SVC obstruction
(b) Fungal infection
(c) SLE
(d) Meig syndrome
--- Content provided by FirstRanker.com ---
21.Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
--- Content provided by FirstRanker.com ---
(d) Fasting increases its secretion22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
--- Content provided by FirstRanker.com ---
(c) Bile acid secretory defects(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
--- Content provided by FirstRanker.com ---
(b) APACHE score(c) MELD score
(d) Metavir score
24.
The blood supply of liver consists of:
--- Content provided by FirstRanker.com ---
(a) 50 % hepatic artery and 50 % portal vein(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
--- Content provided by FirstRanker.com ---
All of the following conditions are associated with Glomerulonephritis with low complementlevel, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
--- Content provided by FirstRanker.com ---
(d) Cryoglobulinaemia--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
26.
--- Content provided by FirstRanker.com ---
Consider the following statements with regard to oral aphthous ulcers:1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
--- Content provided by FirstRanker.com ---
4. They are pre-malignant and progress over few years to squamous cell carcinoma ofthe oral cavity
Which of the above statements are correct?
--- Content provided by FirstRanker.com ---
(a) 1 and 4 only(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
--- Content provided by FirstRanker.com ---
Which one of the following statements about Barrett?s Oesophagus is NOT correct?(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
--- Content provided by FirstRanker.com ---
(c) Normal columnar cells lining the lower oesophagus are replaced by squamouscells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
--- Content provided by FirstRanker.com ---
The most common cause of acute hepatitis outbreaks in India is:(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
--- Content provided by FirstRanker.com ---
(d) Hepatitis A29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
--- Content provided by FirstRanker.com ---
(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
--- Content provided by FirstRanker.com ---
30.Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
--- Content provided by FirstRanker.com ---
(b) Idiopathic thrombocytopenic purpura(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
31.
--- Content provided by FirstRanker.com ---
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidneydisease patient?
(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
--- Content provided by FirstRanker.com ---
(d) 13 to 14 gm/dL32.
Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
--- Content provided by FirstRanker.com ---
(b) Tumoral calcinosis(c) Osteitis fibrosa cystic
(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) It is inherited as autosomal dominant trait(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
--- Content provided by FirstRanker.com ---
Consider the following statements in relation to an adult patient:1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
--- Content provided by FirstRanker.com ---
Which of the statements given above are correct?
(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
--- Content provided by FirstRanker.com ---
(d) 1, 2 and 335.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
--- Content provided by FirstRanker.com ---
(b) Pyelonephritis(c) Renal stone disease
(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
--- Content provided by FirstRanker.com ---
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable forlow C
3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
--- Content provided by FirstRanker.com ---
(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
--- Content provided by FirstRanker.com ---
37.Which one of the following statements is NOT correct regarding the risk factors for
nephrolithiasis?
(a) Higher dietary calcium increases risk
--- Content provided by FirstRanker.com ---
(b) Higher animal protein intake increases risk(c) Higher dietary potassium intake lowers risk
(d) Lower urine citrate increases the risk
38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
--- Content provided by FirstRanker.com ---
He has history of fever and headache for the preceding 3 days. The CSF examination isunremarkable. What would be the probable diagnosis?
(a) Multiple sclerosis
(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
--- Content provided by FirstRanker.com ---
(d) Viral encephalitis39.
Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
(b) Aceclofenac
--- Content provided by FirstRanker.com ---
(c) Thiamine(d) Prednisdone
40.
Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
--- Content provided by FirstRanker.com ---
(b) Non dominant parietal lobe(c) Frontal lobe
(d) Non dominant temporal lobe
41.
--- Content provided by FirstRanker.com ---
Vertical gaze palsy with convergence retraction nystagmus is seen in:(a) Weber syndrome
(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
--- Content provided by FirstRanker.com ---
42.A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
(a) Left 3
rd
--- Content provided by FirstRanker.com ---
nerve palsy(b) Left 6
th
nerve palsy
(c) Right 4
--- Content provided by FirstRanker.com ---
thnerve palsy
(d) Right 3
rd
nerve palsy
--- Content provided by FirstRanker.com ---
43.All of the following are features of Cauda Equina syndrome EXCEPT:
(a) Low back pain
(b) Lower limb areflexia
--- Content provided by FirstRanker.com ---
(c) Loss of bladder function(d) Extensor plantar response
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
--- Content provided by FirstRanker.com ---
Paper-I1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
(a) Ventricular fibrillation
--- Content provided by FirstRanker.com ---
(b) Ventricular premature complex(c) Atrial flutter
(d) Atrial fibrillation
2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
--- Content provided by FirstRanker.com ---
follow-up, with complaints of muscle pains. Which one of the following drugs could be themost likely cause?
(a) Aspirin
(b) Glimepiride
(c) Enalapril
--- Content provided by FirstRanker.com ---
(d) Atorvastatin3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
--- Content provided by FirstRanker.com ---
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the followingdiseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
(c) Marfan?s syndrome
--- Content provided by FirstRanker.com ---
(d) Rheumatic heart disease-Mitral regurgitation4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
--- Content provided by FirstRanker.com ---
(c) To assess outcome after coronary revascularization(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Massive Pulmonary Embolism(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
--- Content provided by FirstRanker.com ---
6.Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
(b) Hypothyroidism
--- Content provided by FirstRanker.com ---
(c) Hypertension(d) Acute myocardial infarction
7.
In an ECG recording, P wave is produced by:
--- Content provided by FirstRanker.com ---
(a) Atrial depolarisation
(b) Atrial repolarisation
(c) Ventricular depolarisation
(d) Ventricular repolarisation
--- Content provided by FirstRanker.com ---
8.Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
(a) DC Cardioversion
--- Content provided by FirstRanker.com ---
(b) Injection Lignocaine(c) Injection Amiodarone
(d) Injection Adenosine
9.
Which one of the following drugs is a Direct Renin Inhibitor?
--- Content provided by FirstRanker.com ---
(a) Benedipine
(b) Azilsartan
(c) Aliskiren
(d) Lisinopril
--- Content provided by FirstRanker.com ---
10.All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Aortic regurgitation
(b) Thyrotoxicosis
--- Content provided by FirstRanker.com ---
(c) Patent ductus arteriosus(d) Aortic stenosis
11.
Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
--- Content provided by FirstRanker.com ---
(b) Active alveolitis(c) Aspergilloma
(d) Sarcoidosis
12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
--- Content provided by FirstRanker.com ---
is:(a) Mild persistent
(b) Moderate persistent
(c) Severe persistent
(d) Very severe persistent
--- Content provided by FirstRanker.com ---
13.An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
(b) CT-chest
--- Content provided by FirstRanker.com ---
(c) Lung biopsy(d) DNA sequencing study
14.
Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
--- Content provided by FirstRanker.com ---
(a) Penicillium(b) Actinomycetes
(c) Aspergillus
(d) Candida
15.
--- Content provided by FirstRanker.com ---
The Gene X-pert test used for MTB detection has the additional advantage of detection ofwhich of the following?
(a) INH resistance
(b) Rifampicin resistance
--- Content provided by FirstRanker.com ---
(c) Multi drug resistance(d) Ethambutol resistance
16.
The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
--- Content provided by FirstRanker.com ---
(b) Severe COPD(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
17.
The most frequent symptom in respiratory diseases is:
--- Content provided by FirstRanker.com ---
(a) Breathlessness(b) Chest pain
(c) Hemoptysis
(d) Cough
18.
--- Content provided by FirstRanker.com ---
A 26-year old young lady attends medical emergency and is labelled as acute severe asthmaby the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
(a) Albuterol
--- Content provided by FirstRanker.com ---
(b) Anti-leukotrienes(c) Aminophylline
(d) Magnesium sulfate
19.
Consider the following statements with regard to respiratory examination:
--- Content provided by FirstRanker.com ---
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
--- Content provided by FirstRanker.com ---
4. Hyper-resonant note on percussion is characteristic of pnemothoraxWhich of the above statements are correct?
(a) 1 and 3
(b) 2 and 4 only
--- Content provided by FirstRanker.com ---
(c) 1, 2 and 4(d) 2, 3 and 4
20.
All of the following are the causes of exudative Pleural Effusion, EXCEPT:
(a) SVC obstruction
--- Content provided by FirstRanker.com ---
(b) Fungal infection(c) SLE
(d) Meig syndrome
21.
Which one of the following is NOT true about Ghrelin?
--- Content provided by FirstRanker.com ---
(a) It stimulates appetite(b) It decreases gastric emptying
(c) It increases acid secretion
(d) Fasting increases its secretion
22.
--- Content provided by FirstRanker.com ---
Fecal elastase test is used for diagnosing which one of the following conditions?(a) Lactose intolerance
(b) Mucosal inflammation
(c) Bile acid secretory defects
(d) Pancreatic dysfunction
--- Content provided by FirstRanker.com ---
23.The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
(b) APACHE score
(c) MELD score
--- Content provided by FirstRanker.com ---
(d) Metavir score24.
The blood supply of liver consists of:
(a) 50 % hepatic artery and 50 % portal vein
(b) 80 % portal vein and 20 % hepatic artery
--- Content provided by FirstRanker.com ---
(c) 80 % hepatic artery and 20 % portal vein(d) 70 % hepatic artery and 30 % portal vein
25.
All of the following conditions are associated with Glomerulonephritis with low complement
level, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Subacute bacterial endocarditis(b) IgA nephropathy
(c) Systemic lupus erythematosus
(d) Cryoglobulinaemia
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
26.
Consider the following statements with regard to oral aphthous ulcers:
--- Content provided by FirstRanker.com ---
1. They are superficial and painful2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
4. They are pre-malignant and progress over few years to squamous cell carcinoma of
the oral cavity
--- Content provided by FirstRanker.com ---
Which of the above statements are correct?
(a) 1 and 4 only
(b) 2 and 3 only
--- Content provided by FirstRanker.com ---
(c) 1, 2 and 3 only(d) 1, 2, 3 and 4
27.
Which one of the following statements about Barrett?s Oesophagus is NOT correct?
--- Content provided by FirstRanker.com ---
(a) It is a pre-malignant condition(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
cells
--- Content provided by FirstRanker.com ---
(d) It is an adaptive response to chronic gastro-oesophageal reflux28.
The most common cause of acute hepatitis outbreaks in India is:
--- Content provided by FirstRanker.com ---
(a) Hepatitis E(b) Hepatitis C
(c) Hepatitis B
(d) Hepatitis A
--- Content provided by FirstRanker.com ---
29.Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
(a) Menetrier?s disease
--- Content provided by FirstRanker.com ---
(b) Boerhaave?s syndrome(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
30.
Eradication of helicobacter pylori infection may prove beneficial in the following extra-
--- Content provided by FirstRanker.com ---
gastric disorders EXCEPT:(a) Unexplained vitamin B12 deficiency
(b) Idiopathic thrombocytopenic purpura
(c) Iron deficiency anaemia without gastro-intestinal bleeding
--- Content provided by FirstRanker.com ---
(d) Acute glomerulonephritis31.
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
disease patient?
--- Content provided by FirstRanker.com ---
(a) 8 to 10 gm/dL(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
(d) 13 to 14 gm/dL
32.
--- Content provided by FirstRanker.com ---
Which one of the following complications of chronic kidney disease is observed in patientswith low parathyroid hormone levels?
(a) Adynamic bone disease
(b) Tumoral calcinosis
(c) Osteitis fibrosa cystic
--- Content provided by FirstRanker.com ---
(d) Calciphylaxis33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
(a) It is inherited as autosomal dominant trait
(b) It is usually associated with marked proteinuria
--- Content provided by FirstRanker.com ---
(c) It is usually associated with systematic hypertension, from young age(d) It is associated with Berry aneurysm
34.
Consider the following statements in relation to an adult patient:
--- Content provided by FirstRanker.com ---
1. Oliguria is defined as passage of urine less than 300 ml per day2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
Which of the statements given above are correct?
--- Content provided by FirstRanker.com ---
(a) 1 and 3 only(b) 2 and 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
--- Content provided by FirstRanker.com ---
35.White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
(b) Pyelonephritis
(c) Renal stone disease
--- Content provided by FirstRanker.com ---
(d) Papillitis36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
low C
--- Content provided by FirstRanker.com ---
3and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
(a) Renal biopsy is rarely required for making diagnosis
--- Content provided by FirstRanker.com ---
(b) Antibiotic treatment is given for streptococcal infection(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
37.
Which one of the following statements is NOT correct regarding the risk factors for
--- Content provided by FirstRanker.com ---
nephrolithiasis?(a) Higher dietary calcium increases risk
(b) Higher animal protein intake increases risk
(c) Higher dietary potassium intake lowers risk
--- Content provided by FirstRanker.com ---
(d) Lower urine citrate increases the risk38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
He has history of fever and headache for the preceding 3 days. The CSF examination is
unremarkable. What would be the probable diagnosis?
--- Content provided by FirstRanker.com ---
(a) Multiple sclerosis(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
(d) Viral encephalitis
39.
--- Content provided by FirstRanker.com ---
Drug of choice for the treatment of Trigeminal Neuralgia is:(a) Carbamazepine
(b) Aceclofenac
(c) Thiamine
(d) Prednisdone
--- Content provided by FirstRanker.com ---
40.Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
(b) Non dominant parietal lobe
(c) Frontal lobe
--- Content provided by FirstRanker.com ---
(d) Non dominant temporal lobe41.
Vertical gaze palsy with convergence retraction nystagmus is seen in:
(a) Weber syndrome
--- Content provided by FirstRanker.com ---
(b) Millard Gubler syndrome(c) Claude syndrome
(d) Parinaud syndrome
42.
A patient on looking forward was found to have his right eye deviated downwards and
--- Content provided by FirstRanker.com ---
outwards with pupil dilated. He is suffering from:(a) Left 3
rd
nerve palsy
(b) Left 6
--- Content provided by FirstRanker.com ---
thnerve palsy
(c) Right 4
th
nerve palsy
--- Content provided by FirstRanker.com ---
(d) Right 3rd
nerve palsy
43.
All of the following are features of Cauda Equina syndrome EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Low back pain
(b) Lower limb areflexia
(c) Loss of bladder function
(d) Extensor plantar response
--- Content provided by FirstRanker.com ---
44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
examination, he had resting tremor, bradykinesia, rigidity and postural instability. This
patient is suffering most likely from:
--- Content provided by FirstRanker.com ---
(a) Parkinson?s disease
(b) Vascular dementia
(c) Alzheimer?s disease
(d) Frunto temporal dementia
--- Content provided by FirstRanker.com ---
45.An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
turns. Heal-Shin test is normal. Which one of the following is most likely disorder?
(a) Cerebellar ataxia
--- Content provided by FirstRanker.com ---
(b) Sensory ataxia(c) Frontal gait disorder
(d) Parkinson?s disease
46.
Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
--- Content provided by FirstRanker.com ---
EXCEPT:(a) Bradycardia
(b) Hypertension
(c) Irregular respiration
(d) Hypothermia
--- Content provided by FirstRanker.com ---
47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
(LP) and a day later reports worsening of headache. Which one of the following features is
--- Content provided by FirstRanker.com ---
NOT consistent with diagnosis of ?Post-LP? headache?(a) Post-LP headache usually begins within 48 hours
(b) Post-LP headache worsens in sitting position
(c) Post-LP headache is most severe upon waking up
--- Content provided by FirstRanker.com ---
(d) Post-LP headache may improve with caffeine intake48.
Which one of the following investigations is NOT appropriate in a case of recurrent
thrombosis?
(a) Antiphospholipid antibodies
--- Content provided by FirstRanker.com ---
(b) Bcr-Abl assay(c) Protein C and S assays
(d) Antithrombin level
49.
All of the following are causes of reactive thrombocytosis, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Hemolytic anemia(b) Megaloblastic anemia
(c) Post splenectomy
(d) Chronic inflammatory disorders
--- Content provided by FirstRanker.com ---
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-I
1.
--- Content provided by FirstRanker.com ---
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of thefollowing Arrhythmia is most likely?
(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
--- Content provided by FirstRanker.com ---
(d) Atrial fibrillation2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
--- Content provided by FirstRanker.com ---
(a) Aspirin(b) Glimepiride
(c) Enalapril
(d) Atorvastatin
3.
--- Content provided by FirstRanker.com ---
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. Thechest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
--- Content provided by FirstRanker.com ---
(a) Takayasu?s arteritis(b) Raynaud?s syndrome
(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
--- Content provided by FirstRanker.com ---
All of the following are indications for treadmill testing/exercise-testing EXCEPT:(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
--- Content provided by FirstRanker.com ---
5.Kussmaul?s sign is present in all of the following conditions, EXCEPT:
(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
--- Content provided by FirstRanker.com ---
(c) Hypertrophic Cardiomyopathy(d) Right Ventricular Infarction
6.
Which one of the following is NOT a common cause of atrial fibrillation?
--- Content provided by FirstRanker.com ---
(a) Mitral regurgitation
(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
--- Content provided by FirstRanker.com ---
7.
In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
--- Content provided by FirstRanker.com ---
(b) Atrial repolarisation(c) Ventricular depolarisation
(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
--- Content provided by FirstRanker.com ---
tachycardia?(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
--- Content provided by FirstRanker.com ---
(d) Injection Adenosine9.
Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
--- Content provided by FirstRanker.com ---
(b) Azilsartan(c) Aliskiren
(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Aortic regurgitation
(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
--- Content provided by FirstRanker.com ---
11.Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
--- Content provided by FirstRanker.com ---
(d) Sarcoidosis12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
--- Content provided by FirstRanker.com ---
(b) Moderate persistent(c) Severe persistent
(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
--- Content provided by FirstRanker.com ---
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:(a) 24 hour fecal fat-estimation
(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
--- Content provided by FirstRanker.com ---
14.Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
(a) Penicillium
(b) Actinomycetes
--- Content provided by FirstRanker.com ---
(c) Aspergillus(d) Candida
15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
--- Content provided by FirstRanker.com ---
(a) INH resistance
(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
--- Content provided by FirstRanker.com ---
16.The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
--- Content provided by FirstRanker.com ---
(d) Severe pulmonary thromboembolism17.
The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
--- Content provided by FirstRanker.com ---
(c) Hemoptysis(d) Cough
18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
--- Content provided by FirstRanker.com ---
prescription?(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
--- Content provided by FirstRanker.com ---
(d) Magnesium sulfate19.
Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
--- Content provided by FirstRanker.com ---
interstitial fibrosis2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
--- Content provided by FirstRanker.com ---
Which of the above statements are correct?(a) 1 and 3
(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
--- Content provided by FirstRanker.com ---
20.All of the following are the causes of exudative Pleural Effusion, EXCEPT:
(a) SVC obstruction
(b) Fungal infection
(c) SLE
--- Content provided by FirstRanker.com ---
(d) Meig syndrome21.
Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
--- Content provided by FirstRanker.com ---
(c) It increases acid secretion(d) Fasting increases its secretion
22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
--- Content provided by FirstRanker.com ---
(b) Mucosal inflammation(c) Bile acid secretory defects
(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
--- Content provided by FirstRanker.com ---
(a) Child Pugh score(b) APACHE score
(c) MELD score
(d) Metavir score
24.
--- Content provided by FirstRanker.com ---
The blood supply of liver consists of:(a) 50 % hepatic artery and 50 % portal vein
(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
--- Content provided by FirstRanker.com ---
25.All of the following conditions are associated with Glomerulonephritis with low complement
level, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
--- Content provided by FirstRanker.com ---
(c) Systemic lupus erythematosus(d) Cryoglobulinaemia
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
26.Consider the following statements with regard to oral aphthous ulcers:
1. They are superficial and painful
2. They may occur in women just prior to menstruation
--- Content provided by FirstRanker.com ---
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases4. They are pre-malignant and progress over few years to squamous cell carcinoma of
the oral cavity
Which of the above statements are correct?
--- Content provided by FirstRanker.com ---
(a) 1 and 4 only
(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
--- Content provided by FirstRanker.com ---
27.Which one of the following statements about Barrett?s Oesophagus is NOT correct?
(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
--- Content provided by FirstRanker.com ---
cells(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
cells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
--- Content provided by FirstRanker.com ---
28.The most common cause of acute hepatitis outbreaks in India is:
(a) Hepatitis E
(b) Hepatitis C
--- Content provided by FirstRanker.com ---
(c) Hepatitis B(d) Hepatitis A
29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
--- Content provided by FirstRanker.com ---
characteristically seen in which one of the following conditions?(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
--- Content provided by FirstRanker.com ---
(d) Barrett?s oesophagus30.
Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Unexplained vitamin B12 deficiency(b) Idiopathic thrombocytopenic purpura
(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
--- Content provided by FirstRanker.com ---
31.What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
disease patient?
(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
--- Content provided by FirstRanker.com ---
(c) 12 to 13 gm/dL(d) 13 to 14 gm/dL
32.
Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
--- Content provided by FirstRanker.com ---
(a) Adynamic bone disease(b) Tumoral calcinosis
(c) Osteitis fibrosa cystic
(d) Calciphylaxis
33.
--- Content provided by FirstRanker.com ---
All of the following statements about adult polycystic kidney disease are true, EXCEPT:(a) It is inherited as autosomal dominant trait
(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
--- Content provided by FirstRanker.com ---
34.Consider the following statements in relation to an adult patient:
1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
--- Content provided by FirstRanker.com ---
3. Polyuria is defined as urine volume in excess of 3 litre per dayWhich of the statements given above are correct?
(a) 1 and 3 only
(b) 2 and 3 only
--- Content provided by FirstRanker.com ---
(c) 1 and 2 only(d) 1, 2 and 3
35.
White cell casts in urine examination are strongly suggestive of:
--- Content provided by FirstRanker.com ---
(a) Nephritis(b) Pyelonephritis
(c) Renal stone disease
(d) Papillitis
36.
--- Content provided by FirstRanker.com ---
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has historyof sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
low C
3
and increased titres of ASO and antiDNase. Which one of the following statements is
--- Content provided by FirstRanker.com ---
NOT correct about management for this condition?(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
--- Content provided by FirstRanker.com ---
(d) Immunosuppressants are to be used for crescentic glomerulonephritis37.
Which one of the following statements is NOT correct regarding the risk factors for
nephrolithiasis?
--- Content provided by FirstRanker.com ---
(a) Higher dietary calcium increases risk(b) Higher animal protein intake increases risk
(c) Higher dietary potassium intake lowers risk
(d) Lower urine citrate increases the risk
38.
--- Content provided by FirstRanker.com ---
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.He has history of fever and headache for the preceding 3 days. The CSF examination is
unremarkable. What would be the probable diagnosis?
(a) Multiple sclerosis
(b) Tubercular meningitis
--- Content provided by FirstRanker.com ---
(c) Pyogenic (bacterial) meningitis(d) Viral encephalitis
39.
Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
--- Content provided by FirstRanker.com ---
(b) Aceclofenac(c) Thiamine
(d) Prednisdone
40.
Constructional skills is a function of which lobe?
--- Content provided by FirstRanker.com ---
(a) Dominant temporal lobe(b) Non dominant parietal lobe
(c) Frontal lobe
(d) Non dominant temporal lobe
--- Content provided by FirstRanker.com ---
41.Vertical gaze palsy with convergence retraction nystagmus is seen in:
(a) Weber syndrome
(b) Millard Gubler syndrome
(c) Claude syndrome
--- Content provided by FirstRanker.com ---
(d) Parinaud syndrome42.
A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
(a) Left 3
--- Content provided by FirstRanker.com ---
rdnerve palsy
(b) Left 6
th
nerve palsy
--- Content provided by FirstRanker.com ---
(c) Right 4th
nerve palsy
(d) Right 3
rd
--- Content provided by FirstRanker.com ---
nerve palsy43.
All of the following are features of Cauda Equina syndrome EXCEPT:
(a) Low back pain
--- Content provided by FirstRanker.com ---
(b) Lower limb areflexia(c) Loss of bladder function
(d) Extensor plantar response
44.
--- Content provided by FirstRanker.com ---
A 68-year old male presented in OPD with complaints of progressive small handwriting. Onexamination, he had resting tremor, bradykinesia, rigidity and postural instability. This
patient is suffering most likely from:
(a) Parkinson?s disease
--- Content provided by FirstRanker.com ---
(b) Vascular dementia(c) Alzheimer?s disease
(d) Frunto temporal dementia
45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
--- Content provided by FirstRanker.com ---
imbalance, comprising short strides, shuffling along the floor and difficulty with starts andturns. Heal-Shin test is normal. Which one of the following is most likely disorder?
(a) Cerebellar ataxia
(b) Sensory ataxia
(c) Frontal gait disorder
--- Content provided by FirstRanker.com ---
(d) Parkinson?s disease46.
Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
EXCEPT:
(a) Bradycardia
--- Content provided by FirstRanker.com ---
(b) Hypertension(c) Irregular respiration
(d) Hypothermia
47.
--- Content provided by FirstRanker.com ---
A 35 year old man presents with history of low grade fever and headache for last five weeks.Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
(LP) and a day later reports worsening of headache. Which one of the following features is
NOT consistent with diagnosis of ?Post-LP? headache?
--- Content provided by FirstRanker.com ---
(a) Post-LP headache usually begins within 48 hours(b) Post-LP headache worsens in sitting position
(c) Post-LP headache is most severe upon waking up
(d) Post-LP headache may improve with caffeine intake
48.
--- Content provided by FirstRanker.com ---
Which one of the following investigations is NOT appropriate in a case of recurrentthrombosis?
(a) Antiphospholipid antibodies
(b) Bcr-Abl assay
(c) Protein C and S assays
--- Content provided by FirstRanker.com ---
(d) Antithrombin level49.
All of the following are causes of reactive thrombocytosis, EXCEPT:
(a) Hemolytic anemia
(b) Megaloblastic anemia
--- Content provided by FirstRanker.com ---
(c) Post splenectomy(d) Chronic inflammatory disorders
50.
--- Content provided by FirstRanker.com ---
Cryoprecipitate cannot be used for treatment of which one of the following conditions?(a) Von Willebrand disease
(b) Hypofibrinogenemia
(c) Hemophilia?B
(d) Hemphilia?A
--- Content provided by FirstRanker.com ---
51.Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic
anaemia. The disorder is inherited as an:
(a) Autosomal recessive trait
--- Content provided by FirstRanker.com ---
(b) X-linked recessive trait(c) Autosomal dominant trait
(d) X-linked dominant trait
52.
Sickle cell disease may be associated with any of the following EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Acute chest syndrome
(b) Aplastic crisis
(c) Splenic sequestration crisis
(d) Conn?s syndrome
--- Content provided by FirstRanker.com ---
53.
Fever with splenomegaly and lymphadenopathy can be seen in
(a) Infectious mononucleosis
(b) Chronic leukaemia
--- Content provided by FirstRanker.com ---
(c) Both infectious mononucleosis and chronic leukaemia(d) Neither infectious mononucleosis nor chronic leukaemia
54.
Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
--- Content provided by FirstRanker.com ---
(a) Haemoglobin X disease(b) Haemoglobin H disease
(c) Haemoglobin F disease
(d) Hydrops fetalis
55.
--- Content provided by FirstRanker.com ---
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?(a) It is a clonal malignancy of haematopoetic stem
(b) Risk of developing CML is increased in monozygotic turns
(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
FirstRanker.com - FirstRanker's Choice
--- Content provided by FirstRanker.com ---
Combined Medical Services Examination-2020Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
--- Content provided by FirstRanker.com ---
(a) Ventricular fibrillation(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
2.
--- Content provided by FirstRanker.com ---
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes forfollow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
(b) Glimepiride
--- Content provided by FirstRanker.com ---
(c) Enalapril(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
--- Content provided by FirstRanker.com ---
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
--- Content provided by FirstRanker.com ---
(c) Marfan?s syndrome(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
--- Content provided by FirstRanker.com ---
(b) To evaluate stable angina(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
--- Content provided by FirstRanker.com ---
6.
Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
--- Content provided by FirstRanker.com ---
(b) Hypothyroidism(c) Hypertension
(d) Acute myocardial infarction
7.
--- Content provided by FirstRanker.com ---
In an ECG recording, P wave is produced by:(a) Atrial depolarisation
(b) Atrial repolarisation
(c) Ventricular depolarisation
--- Content provided by FirstRanker.com ---
(d) Ventricular repolarisation8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
--- Content provided by FirstRanker.com ---
(a) DC Cardioversion(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
9.
--- Content provided by FirstRanker.com ---
Which one of the following drugs is a Direct Renin Inhibitor?(a) Benedipine
(b) Azilsartan
(c) Aliskiren
--- Content provided by FirstRanker.com ---
(d) Lisinopril10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Aortic regurgitation
--- Content provided by FirstRanker.com ---
(b) Thyrotoxicosis(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
Signet-ring sign on CT-chest is suggestive of:
--- Content provided by FirstRanker.com ---
(a) Bronchiectasis(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
12.
--- Content provided by FirstRanker.com ---
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when itis:
(a) Mild persistent
(b) Moderate persistent
(c) Severe persistent
--- Content provided by FirstRanker.com ---
(d) Very severe persistent13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
--- Content provided by FirstRanker.com ---
(b) CT-chest(c) Lung biopsy
(d) DNA sequencing study
14.
Which one of the following antigens is commonly associated with causation of Farmer?s
--- Content provided by FirstRanker.com ---
lung?(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
(d) Candida
--- Content provided by FirstRanker.com ---
15.The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
(a) INH resistance
--- Content provided by FirstRanker.com ---
(b) Rifampicin resistance(c) Multi drug resistance
(d) Ethambutol resistance
16.
The most common cause of chronic type II respiratory failure is:
--- Content provided by FirstRanker.com ---
(a) Severe pneumonia(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
17.
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The most frequent symptom in respiratory diseases is:(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
(d) Cough
--- Content provided by FirstRanker.com ---
18.A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
--- Content provided by FirstRanker.com ---
(a) Albuterol(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
19.
--- Content provided by FirstRanker.com ---
Consider the following statements with regard to respiratory examination:1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
--- Content provided by FirstRanker.com ---
3. Monophonic wheeze is characteristic of asthma4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
(a) 1 and 3
--- Content provided by FirstRanker.com ---
(b) 2 and 4 only(c) 1, 2 and 4
(d) 2, 3 and 4
20.
All of the following are the causes of exudative Pleural Effusion, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) SVC obstruction(b) Fungal infection
(c) SLE
(d) Meig syndrome
21.
--- Content provided by FirstRanker.com ---
Which one of the following is NOT true about Ghrelin?(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
(d) Fasting increases its secretion
--- Content provided by FirstRanker.com ---
22.Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
(c) Bile acid secretory defects
--- Content provided by FirstRanker.com ---
(d) Pancreatic dysfunction23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
(b) APACHE score
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(c) MELD score(d) Metavir score
24.
The blood supply of liver consists of:
(a) 50 % hepatic artery and 50 % portal vein
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(b) 80 % portal vein and 20 % hepatic artery(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
All of the following conditions are associated with Glomerulonephritis with low complement
--- Content provided by FirstRanker.com ---
level, EXCEPT:(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
(d) Cryoglobulinaemia
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
26.
Consider the following statements with regard to oral aphthous ulcers:
--- Content provided by FirstRanker.com ---
1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
4. They are pre-malignant and progress over few years to squamous cell carcinoma of
--- Content provided by FirstRanker.com ---
the oral cavityWhich of the above statements are correct?
(a) 1 and 4 only
--- Content provided by FirstRanker.com ---
(b) 2 and 3 only(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
Which one of the following statements about Barrett?s Oesophagus is NOT correct?
--- Content provided by FirstRanker.com ---
(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
--- Content provided by FirstRanker.com ---
cells(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
The most common cause of acute hepatitis outbreaks in India is:
--- Content provided by FirstRanker.com ---
(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
(d) Hepatitis A
--- Content provided by FirstRanker.com ---
29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
--- Content provided by FirstRanker.com ---
(a) Menetrier?s disease(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
30.
--- Content provided by FirstRanker.com ---
Eradication of helicobacter pylori infection may prove beneficial in the following extra-gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
(b) Idiopathic thrombocytopenic purpura
--- Content provided by FirstRanker.com ---
(c) Iron deficiency anaemia without gastro-intestinal bleeding(d) Acute glomerulonephritis
31.
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
--- Content provided by FirstRanker.com ---
disease patient?(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
(d) 13 to 14 gm/dL
--- Content provided by FirstRanker.com ---
32.Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
(b) Tumoral calcinosis
--- Content provided by FirstRanker.com ---
(c) Osteitis fibrosa cystic(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
(a) It is inherited as autosomal dominant trait
--- Content provided by FirstRanker.com ---
(b) It is usually associated with marked proteinuria(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
Consider the following statements in relation to an adult patient:
--- Content provided by FirstRanker.com ---
1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
--- Content provided by FirstRanker.com ---
Which of the statements given above are correct?(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
--- Content provided by FirstRanker.com ---
35.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
(b) Pyelonephritis
--- Content provided by FirstRanker.com ---
(c) Renal stone disease(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
--- Content provided by FirstRanker.com ---
low C3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
--- Content provided by FirstRanker.com ---
(a) Renal biopsy is rarely required for making diagnosis(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
37.
--- Content provided by FirstRanker.com ---
Which one of the following statements is NOT correct regarding the risk factors fornephrolithiasis?
(a) Higher dietary calcium increases risk
(b) Higher animal protein intake increases risk
--- Content provided by FirstRanker.com ---
(c) Higher dietary potassium intake lowers risk(d) Lower urine citrate increases the risk
38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
He has history of fever and headache for the preceding 3 days. The CSF examination is
--- Content provided by FirstRanker.com ---
unremarkable. What would be the probable diagnosis?(a) Multiple sclerosis
(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
(d) Viral encephalitis
--- Content provided by FirstRanker.com ---
39.Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
(b) Aceclofenac
(c) Thiamine
--- Content provided by FirstRanker.com ---
(d) Prednisdone40.
Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
(b) Non dominant parietal lobe
--- Content provided by FirstRanker.com ---
(c) Frontal lobe(d) Non dominant temporal lobe
41.
Vertical gaze palsy with convergence retraction nystagmus is seen in:
--- Content provided by FirstRanker.com ---
(a) Weber syndrome(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
42.
--- Content provided by FirstRanker.com ---
A patient on looking forward was found to have his right eye deviated downwards andoutwards with pupil dilated. He is suffering from:
(a) Left 3
rd
nerve palsy
--- Content provided by FirstRanker.com ---
(b) Left 6th
nerve palsy
(c) Right 4
th
--- Content provided by FirstRanker.com ---
nerve palsy(d) Right 3
rd
nerve palsy
43.
--- Content provided by FirstRanker.com ---
All of the following are features of Cauda Equina syndrome EXCEPT:(a) Low back pain
(b) Lower limb areflexia
(c) Loss of bladder function
--- Content provided by FirstRanker.com ---
(d) Extensor plantar response44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
examination, he had resting tremor, bradykinesia, rigidity and postural instability. This
--- Content provided by FirstRanker.com ---
patient is suffering most likely from:(a) Parkinson?s disease
(b) Vascular dementia
(c) Alzheimer?s disease
--- Content provided by FirstRanker.com ---
(d) Frunto temporal dementia45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
turns. Heal-Shin test is normal. Which one of the following is most likely disorder?
--- Content provided by FirstRanker.com ---
(a) Cerebellar ataxia(b) Sensory ataxia
(c) Frontal gait disorder
(d) Parkinson?s disease
46.
--- Content provided by FirstRanker.com ---
Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the followingEXCEPT:
(a) Bradycardia
(b) Hypertension
(c) Irregular respiration
--- Content provided by FirstRanker.com ---
(d) Hypothermia47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
--- Content provided by FirstRanker.com ---
(LP) and a day later reports worsening of headache. Which one of the following features isNOT consistent with diagnosis of ?Post-LP? headache?
(a) Post-LP headache usually begins within 48 hours
(b) Post-LP headache worsens in sitting position
--- Content provided by FirstRanker.com ---
(c) Post-LP headache is most severe upon waking up(d) Post-LP headache may improve with caffeine intake
48.
Which one of the following investigations is NOT appropriate in a case of recurrent
thrombosis?
--- Content provided by FirstRanker.com ---
(a) Antiphospholipid antibodies(b) Bcr-Abl assay
(c) Protein C and S assays
(d) Antithrombin level
49.
--- Content provided by FirstRanker.com ---
All of the following are causes of reactive thrombocytosis, EXCEPT:(a) Hemolytic anemia
(b) Megaloblastic anemia
(c) Post splenectomy
(d) Chronic inflammatory disorders
--- Content provided by FirstRanker.com ---
50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
(a) Von Willebrand disease
--- Content provided by FirstRanker.com ---
(b) Hypofibrinogenemia(c) Hemophilia?B
(d) Hemphilia?A
51.
Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic
--- Content provided by FirstRanker.com ---
anaemia. The disorder is inherited as an:(a) Autosomal recessive trait
(b) X-linked recessive trait
(c) Autosomal dominant trait
--- Content provided by FirstRanker.com ---
(d) X-linked dominant trait52.
Sickle cell disease may be associated with any of the following EXCEPT:
(a) Acute chest syndrome
--- Content provided by FirstRanker.com ---
(b) Aplastic crisis(c) Splenic sequestration crisis
(d) Conn?s syndrome
53.
--- Content provided by FirstRanker.com ---
Fever with splenomegaly and lymphadenopathy can be seen in(a) Infectious mononucleosis
(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
(d) Neither infectious mononucleosis nor chronic leukaemia
--- Content provided by FirstRanker.com ---
54.Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
(a) Haemoglobin X disease
(b) Haemoglobin H disease
--- Content provided by FirstRanker.com ---
(c) Haemoglobin F disease(d) Hydrops fetalis
55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
(a) It is a clonal malignancy of haematopoetic stem
--- Content provided by FirstRanker.com ---
(b) Risk of developing CML is increased in monozygotic turns(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
56.
Diagnostic criteria of multiple myeloma includes which of the following?
--- Content provided by FirstRanker.com ---
1. Increased malignant plasma cells in the bone marrow2. Serum and/or urinary M protein
3. Skeletal lytic lesions
4. Skeletal blastic lesions
--- Content provided by FirstRanker.com ---
Select the correct answer using the code given below:(a) 1, 2 and 3
(b) 1, 3 and 4
(c) 1, 2 and 4
(d) 2, 3 and 4
--- Content provided by FirstRanker.com ---
57.The most predominant type of serum immunoglobulin involved in patients with plasma cell
disorder is:
(a) Ig G
(b) Ig A
--- Content provided by FirstRanker.com ---
(c) Ig D(d) Light chains
58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
pregnancy?
--- Content provided by FirstRanker.com ---
(a) There is an increase in the metabolism of thyroxine by placenta(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
(d) Impaired cognitive impairment may be seen in the offspring of mother with
--- Content provided by FirstRanker.com ---
subclinical hypothyroidism59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL
--- Content provided by FirstRanker.com ---
(b) HbA1c ? 6.5 %(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ? 110 mg/dL
60.
A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight
--- Content provided by FirstRanker.com ---
gain, hair loss, tiredness and weakness. What will be the investigation of choice?(a) FSH & LH level
(b) Estrogen level
(c) Free T
3
--- Content provided by FirstRanker.com ---
and free T4
level
(d) Free T
4
--- Content provided by FirstRanker.com ---
and TSH level--- Content provided by FirstRanker.com ---
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
--- Content provided by FirstRanker.com ---
Paper-I1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
(a) Ventricular fibrillation
--- Content provided by FirstRanker.com ---
(b) Ventricular premature complex(c) Atrial flutter
(d) Atrial fibrillation
2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
--- Content provided by FirstRanker.com ---
follow-up, with complaints of muscle pains. Which one of the following drugs could be themost likely cause?
(a) Aspirin
(b) Glimepiride
(c) Enalapril
--- Content provided by FirstRanker.com ---
(d) Atorvastatin3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
--- Content provided by FirstRanker.com ---
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the followingdiseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
(c) Marfan?s syndrome
--- Content provided by FirstRanker.com ---
(d) Rheumatic heart disease-Mitral regurgitation4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
--- Content provided by FirstRanker.com ---
(c) To assess outcome after coronary revascularization(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Massive Pulmonary Embolism(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
--- Content provided by FirstRanker.com ---
6.Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
(b) Hypothyroidism
--- Content provided by FirstRanker.com ---
(c) Hypertension(d) Acute myocardial infarction
7.
In an ECG recording, P wave is produced by:
--- Content provided by FirstRanker.com ---
(a) Atrial depolarisation
(b) Atrial repolarisation
(c) Ventricular depolarisation
(d) Ventricular repolarisation
--- Content provided by FirstRanker.com ---
8.Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
(a) DC Cardioversion
--- Content provided by FirstRanker.com ---
(b) Injection Lignocaine(c) Injection Amiodarone
(d) Injection Adenosine
9.
Which one of the following drugs is a Direct Renin Inhibitor?
--- Content provided by FirstRanker.com ---
(a) Benedipine
(b) Azilsartan
(c) Aliskiren
(d) Lisinopril
--- Content provided by FirstRanker.com ---
10.All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Aortic regurgitation
(b) Thyrotoxicosis
--- Content provided by FirstRanker.com ---
(c) Patent ductus arteriosus(d) Aortic stenosis
11.
Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
--- Content provided by FirstRanker.com ---
(b) Active alveolitis(c) Aspergilloma
(d) Sarcoidosis
12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
--- Content provided by FirstRanker.com ---
is:(a) Mild persistent
(b) Moderate persistent
(c) Severe persistent
(d) Very severe persistent
--- Content provided by FirstRanker.com ---
13.An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
(b) CT-chest
--- Content provided by FirstRanker.com ---
(c) Lung biopsy(d) DNA sequencing study
14.
Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
--- Content provided by FirstRanker.com ---
(a) Penicillium(b) Actinomycetes
(c) Aspergillus
(d) Candida
15.
--- Content provided by FirstRanker.com ---
The Gene X-pert test used for MTB detection has the additional advantage of detection ofwhich of the following?
(a) INH resistance
(b) Rifampicin resistance
--- Content provided by FirstRanker.com ---
(c) Multi drug resistance(d) Ethambutol resistance
16.
The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
--- Content provided by FirstRanker.com ---
(b) Severe COPD(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
17.
The most frequent symptom in respiratory diseases is:
--- Content provided by FirstRanker.com ---
(a) Breathlessness(b) Chest pain
(c) Hemoptysis
(d) Cough
18.
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A 26-year old young lady attends medical emergency and is labelled as acute severe asthmaby the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
(a) Albuterol
--- Content provided by FirstRanker.com ---
(b) Anti-leukotrienes(c) Aminophylline
(d) Magnesium sulfate
19.
Consider the following statements with regard to respiratory examination:
--- Content provided by FirstRanker.com ---
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
--- Content provided by FirstRanker.com ---
4. Hyper-resonant note on percussion is characteristic of pnemothoraxWhich of the above statements are correct?
(a) 1 and 3
(b) 2 and 4 only
--- Content provided by FirstRanker.com ---
(c) 1, 2 and 4(d) 2, 3 and 4
20.
All of the following are the causes of exudative Pleural Effusion, EXCEPT:
(a) SVC obstruction
--- Content provided by FirstRanker.com ---
(b) Fungal infection(c) SLE
(d) Meig syndrome
21.
Which one of the following is NOT true about Ghrelin?
--- Content provided by FirstRanker.com ---
(a) It stimulates appetite(b) It decreases gastric emptying
(c) It increases acid secretion
(d) Fasting increases its secretion
22.
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Fecal elastase test is used for diagnosing which one of the following conditions?(a) Lactose intolerance
(b) Mucosal inflammation
(c) Bile acid secretory defects
(d) Pancreatic dysfunction
--- Content provided by FirstRanker.com ---
23.The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
(b) APACHE score
(c) MELD score
--- Content provided by FirstRanker.com ---
(d) Metavir score24.
The blood supply of liver consists of:
(a) 50 % hepatic artery and 50 % portal vein
(b) 80 % portal vein and 20 % hepatic artery
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(c) 80 % hepatic artery and 20 % portal vein(d) 70 % hepatic artery and 30 % portal vein
25.
All of the following conditions are associated with Glomerulonephritis with low complement
level, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Subacute bacterial endocarditis(b) IgA nephropathy
(c) Systemic lupus erythematosus
(d) Cryoglobulinaemia
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
26.
Consider the following statements with regard to oral aphthous ulcers:
--- Content provided by FirstRanker.com ---
1. They are superficial and painful2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
4. They are pre-malignant and progress over few years to squamous cell carcinoma of
the oral cavity
--- Content provided by FirstRanker.com ---
Which of the above statements are correct?
(a) 1 and 4 only
(b) 2 and 3 only
--- Content provided by FirstRanker.com ---
(c) 1, 2 and 3 only(d) 1, 2, 3 and 4
27.
Which one of the following statements about Barrett?s Oesophagus is NOT correct?
--- Content provided by FirstRanker.com ---
(a) It is a pre-malignant condition(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
cells
--- Content provided by FirstRanker.com ---
(d) It is an adaptive response to chronic gastro-oesophageal reflux28.
The most common cause of acute hepatitis outbreaks in India is:
--- Content provided by FirstRanker.com ---
(a) Hepatitis E(b) Hepatitis C
(c) Hepatitis B
(d) Hepatitis A
--- Content provided by FirstRanker.com ---
29.Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
(a) Menetrier?s disease
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(b) Boerhaave?s syndrome(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
30.
Eradication of helicobacter pylori infection may prove beneficial in the following extra-
--- Content provided by FirstRanker.com ---
gastric disorders EXCEPT:(a) Unexplained vitamin B12 deficiency
(b) Idiopathic thrombocytopenic purpura
(c) Iron deficiency anaemia without gastro-intestinal bleeding
--- Content provided by FirstRanker.com ---
(d) Acute glomerulonephritis31.
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
disease patient?
--- Content provided by FirstRanker.com ---
(a) 8 to 10 gm/dL(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
(d) 13 to 14 gm/dL
32.
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Which one of the following complications of chronic kidney disease is observed in patientswith low parathyroid hormone levels?
(a) Adynamic bone disease
(b) Tumoral calcinosis
(c) Osteitis fibrosa cystic
--- Content provided by FirstRanker.com ---
(d) Calciphylaxis33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
(a) It is inherited as autosomal dominant trait
(b) It is usually associated with marked proteinuria
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(c) It is usually associated with systematic hypertension, from young age(d) It is associated with Berry aneurysm
34.
Consider the following statements in relation to an adult patient:
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1. Oliguria is defined as passage of urine less than 300 ml per day2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
Which of the statements given above are correct?
--- Content provided by FirstRanker.com ---
(a) 1 and 3 only(b) 2 and 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
--- Content provided by FirstRanker.com ---
35.White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
(b) Pyelonephritis
(c) Renal stone disease
--- Content provided by FirstRanker.com ---
(d) Papillitis36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
low C
--- Content provided by FirstRanker.com ---
3and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
(a) Renal biopsy is rarely required for making diagnosis
--- Content provided by FirstRanker.com ---
(b) Antibiotic treatment is given for streptococcal infection(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
37.
Which one of the following statements is NOT correct regarding the risk factors for
--- Content provided by FirstRanker.com ---
nephrolithiasis?(a) Higher dietary calcium increases risk
(b) Higher animal protein intake increases risk
(c) Higher dietary potassium intake lowers risk
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(d) Lower urine citrate increases the risk38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
He has history of fever and headache for the preceding 3 days. The CSF examination is
unremarkable. What would be the probable diagnosis?
--- Content provided by FirstRanker.com ---
(a) Multiple sclerosis(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
(d) Viral encephalitis
39.
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Drug of choice for the treatment of Trigeminal Neuralgia is:(a) Carbamazepine
(b) Aceclofenac
(c) Thiamine
(d) Prednisdone
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40.Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
(b) Non dominant parietal lobe
(c) Frontal lobe
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(d) Non dominant temporal lobe41.
Vertical gaze palsy with convergence retraction nystagmus is seen in:
(a) Weber syndrome
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(b) Millard Gubler syndrome(c) Claude syndrome
(d) Parinaud syndrome
42.
A patient on looking forward was found to have his right eye deviated downwards and
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outwards with pupil dilated. He is suffering from:(a) Left 3
rd
nerve palsy
(b) Left 6
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thnerve palsy
(c) Right 4
th
nerve palsy
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(d) Right 3rd
nerve palsy
43.
All of the following are features of Cauda Equina syndrome EXCEPT:
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(a) Low back pain
(b) Lower limb areflexia
(c) Loss of bladder function
(d) Extensor plantar response
--- Content provided by FirstRanker.com ---
44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
examination, he had resting tremor, bradykinesia, rigidity and postural instability. This
patient is suffering most likely from:
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(a) Parkinson?s disease
(b) Vascular dementia
(c) Alzheimer?s disease
(d) Frunto temporal dementia
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45.An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
turns. Heal-Shin test is normal. Which one of the following is most likely disorder?
(a) Cerebellar ataxia
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(b) Sensory ataxia(c) Frontal gait disorder
(d) Parkinson?s disease
46.
Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
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EXCEPT:(a) Bradycardia
(b) Hypertension
(c) Irregular respiration
(d) Hypothermia
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47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
(LP) and a day later reports worsening of headache. Which one of the following features is
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NOT consistent with diagnosis of ?Post-LP? headache?(a) Post-LP headache usually begins within 48 hours
(b) Post-LP headache worsens in sitting position
(c) Post-LP headache is most severe upon waking up
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(d) Post-LP headache may improve with caffeine intake48.
Which one of the following investigations is NOT appropriate in a case of recurrent
thrombosis?
(a) Antiphospholipid antibodies
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(b) Bcr-Abl assay(c) Protein C and S assays
(d) Antithrombin level
49.
All of the following are causes of reactive thrombocytosis, EXCEPT:
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(a) Hemolytic anemia(b) Megaloblastic anemia
(c) Post splenectomy
(d) Chronic inflammatory disorders
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50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
(a) Von Willebrand disease
(b) Hypofibrinogenemia
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(c) Hemophilia?B(d) Hemphilia?A
51.
Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic
anaemia. The disorder is inherited as an:
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(a) Autosomal recessive trait
(b) X-linked recessive trait
(c) Autosomal dominant trait
(d) X-linked dominant trait
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52.Sickle cell disease may be associated with any of the following EXCEPT:
(a) Acute chest syndrome
(b) Aplastic crisis
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(c) Splenic sequestration crisis(d) Conn?s syndrome
53.
Fever with splenomegaly and lymphadenopathy can be seen in
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(a) Infectious mononucleosis(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
(d) Neither infectious mononucleosis nor chronic leukaemia
54.
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Every individual carries four alpha gene alleles. Deletion of three alleles leads todevelopment of:
(a) Haemoglobin X disease
(b) Haemoglobin H disease
(c) Haemoglobin F disease
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(d) Hydrops fetalis55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
(a) It is a clonal malignancy of haematopoetic stem
(b) Risk of developing CML is increased in monozygotic turns
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(c) CML is defined by presence of BCR-ABL 1 fusion gene(d) 10 year survival with TKI therapy is 85%
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
56.
Diagnostic criteria of multiple myeloma includes which of the following?
1. Increased malignant plasma cells in the bone marrow
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2. Serum and/or urinary M protein3. Skeletal lytic lesions
4. Skeletal blastic lesions
Select the correct answer using the code given below:
--- Content provided by FirstRanker.com ---
(a) 1, 2 and 3(b) 1, 3 and 4
(c) 1, 2 and 4
(d) 2, 3 and 4
57.
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The most predominant type of serum immunoglobulin involved in patients with plasma celldisorder is:
(a) Ig G
(b) Ig A
(c) Ig D
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(d) Light chains58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
pregnancy?
(a) There is an increase in the metabolism of thyroxine by placenta
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(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
(d) Impaired cognitive impairment may be seen in the offspring of mother with
subclinical hypothyroidism
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59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL
(b) HbA1c ? 6.5 %
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(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test(d) Fasting plasma glucose ? 110 mg/dL
60.
A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight
gain, hair loss, tiredness and weakness. What will be the investigation of choice?
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(a) FSH & LH level(b) Estrogen level
(c) Free T
3
and free T
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4level
(d) Free T
4
and TSH level
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61.
Consider the following statements about erectile dysfunction in diabetic males:
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1. It affects 60 % of males2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
4. Endocrine disorders like hyperprolactinemia may cause it
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Which of the statements given above are true?(a) 1 and 2
(b) 2 and 3
(c) 2 and 4
(d) 3 and 4
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62.All of the following can cause Hyperprolactinemia, EXCEPT:
(a) Craniopharyngioma
(b) Hyperthyroidism
(c) Stress
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(d) Chronic renal failure63.
All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
(a) Atrial fibrillation
(b) Periodic paralysis
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(c) Deafness(d) Osteoporosis
64.
Which one of the following hormones acts via the receptor tyrosine kinase?
(a) FSH
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(b) TSH(c) IGF-1
(d) PTH
65.
Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a
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(MEN 2a):1. Primary Hyperparathyroidism
2. Pituitary tumours
3. Medullary carcinoma of thyroid
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4. PheochromocytomaWhich of the above are correct?:
(a) 1, 2 and 4
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(b) 1, 2 and 3(c) 1, 3 and 4
(d) 2, 3 and 4
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FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-I
--- Content provided by FirstRanker.com ---
1.A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
(a) Ventricular fibrillation
(b) Ventricular premature complex
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(c) Atrial flutter(d) Atrial fibrillation
2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
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most likely cause?(a) Aspirin
(b) Glimepiride
(c) Enalapril
(d) Atorvastatin
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3.A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
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diseases is most likely?(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
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4.All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
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(d) To evaluate the treatment efficacy of antianginal drugs5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
(a) Massive Pulmonary Embolism
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(b) Restrictive Cardiomyopathy(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
6.
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Which one of the following is NOT a common cause of atrial fibrillation?(a) Mitral regurgitation
(b) Hypothyroidism
(c) Hypertension
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(d) Acute myocardial infarction7.
In an ECG recording, P wave is produced by:
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(a) Atrial depolarisation(b) Atrial repolarisation
(c) Ventricular depolarisation
(d) Ventricular repolarisation
8.
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Which one of the following modalities is NOT used in the treatment of ventriculartachycardia?
(a) DC Cardioversion
(b) Injection Lignocaine
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(c) Injection Amiodarone(d) Injection Adenosine
9.
Which one of the following drugs is a Direct Renin Inhibitor?
--- Content provided by FirstRanker.com ---
(a) Benedipine(b) Azilsartan
(c) Aliskiren
(d) Lisinopril
10.
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All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:(a) Aortic regurgitation
(b) Thyrotoxicosis
(c) Patent ductus arteriosus
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(d) Aortic stenosis11.
Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
(b) Active alveolitis
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(c) Aspergilloma(d) Sarcoidosis
12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
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(a) Mild persistent(b) Moderate persistent
(c) Severe persistent
(d) Very severe persistent
13.
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An 18-year old male has insulin dependent diabetes, with malabsorption syndrome andbilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
(b) CT-chest
(c) Lung biopsy
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(d) DNA sequencing study14.
Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
(a) Penicillium
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(b) Actinomycetes(c) Aspergillus
(d) Candida
15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
--- Content provided by FirstRanker.com ---
which of the following?(a) INH resistance
(b) Rifampicin resistance
(c) Multi drug resistance
--- Content provided by FirstRanker.com ---
(d) Ethambutol resistance16.
The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
(b) Severe COPD
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(c) Severe bronchial asthma(d) Severe pulmonary thromboembolism
17.
The most frequent symptom in respiratory diseases is:
(a) Breathlessness
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(b) Chest pain(c) Hemoptysis
(d) Cough
18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
--- Content provided by FirstRanker.com ---
by the emergency physician. Which one of the following is unlikely to be a part of theprescription?
(a) Albuterol
(b) Anti-leukotrienes
--- Content provided by FirstRanker.com ---
(c) Aminophylline(d) Magnesium sulfate
19.
Consider the following statements with regard to respiratory examination:
--- Content provided by FirstRanker.com ---
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic ofinterstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
--- Content provided by FirstRanker.com ---
Which of the above statements are correct?
(a) 1 and 3
(b) 2 and 4 only
(c) 1, 2 and 4
--- Content provided by FirstRanker.com ---
(d) 2, 3 and 420.
All of the following are the causes of exudative Pleural Effusion, EXCEPT:
(a) SVC obstruction
(b) Fungal infection
--- Content provided by FirstRanker.com ---
(c) SLE(d) Meig syndrome
21.
Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
--- Content provided by FirstRanker.com ---
(b) It decreases gastric emptying(c) It increases acid secretion
(d) Fasting increases its secretion
22.
Fecal elastase test is used for diagnosing which one of the following conditions?
--- Content provided by FirstRanker.com ---
(a) Lactose intolerance(b) Mucosal inflammation
(c) Bile acid secretory defects
(d) Pancreatic dysfunction
23.
--- Content provided by FirstRanker.com ---
The recent classification system for listing a patient as a candidate for liver transplantation is:(a) Child Pugh score
(b) APACHE score
(c) MELD score
(d) Metavir score
--- Content provided by FirstRanker.com ---
24.The blood supply of liver consists of:
(a) 50 % hepatic artery and 50 % portal vein
(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
--- Content provided by FirstRanker.com ---
(d) 70 % hepatic artery and 30 % portal vein25.
All of the following conditions are associated with Glomerulonephritis with low complement
level, EXCEPT:
(a) Subacute bacterial endocarditis
--- Content provided by FirstRanker.com ---
(b) IgA nephropathy(c) Systemic lupus erythematosus
(d) Cryoglobulinaemia
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
26.
Consider the following statements with regard to oral aphthous ulcers:
1. They are superficial and painful
--- Content provided by FirstRanker.com ---
2. They may occur in women just prior to menstruation3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
4. They are pre-malignant and progress over few years to squamous cell carcinoma of
the oral cavity
--- Content provided by FirstRanker.com ---
Which of the above statements are correct?(a) 1 and 4 only
(b) 2 and 3 only
(c) 1, 2 and 3 only
--- Content provided by FirstRanker.com ---
(d) 1, 2, 3 and 427.
Which one of the following statements about Barrett?s Oesophagus is NOT correct?
(a) It is a pre-malignant condition
--- Content provided by FirstRanker.com ---
(b) Normal squamous cells lining the lower oesophagus are replaced by columnarcells
(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
cells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
--- Content provided by FirstRanker.com ---
28.
The most common cause of acute hepatitis outbreaks in India is:
(a) Hepatitis E
--- Content provided by FirstRanker.com ---
(b) Hepatitis C(c) Hepatitis B
(d) Hepatitis A
29.
--- Content provided by FirstRanker.com ---
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching ischaracteristically seen in which one of the following conditions?
(a) Menetrier?s disease
(b) Boerhaave?s syndrome
--- Content provided by FirstRanker.com ---
(c) Achalasia of the oesophagus(d) Barrett?s oesophagus
30.
Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
--- Content provided by FirstRanker.com ---
(a) Unexplained vitamin B12 deficiency
(b) Idiopathic thrombocytopenic purpura
(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
--- Content provided by FirstRanker.com ---
31.
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
disease patient?
(a) 8 to 10 gm/dL
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(b) 10 to 12 gm/dL(c) 12 to 13 gm/dL
(d) 13 to 14 gm/dL
32.
Which one of the following complications of chronic kidney disease is observed in patients
--- Content provided by FirstRanker.com ---
with low parathyroid hormone levels?(a) Adynamic bone disease
(b) Tumoral calcinosis
(c) Osteitis fibrosa cystic
(d) Calciphylaxis
--- Content provided by FirstRanker.com ---
33.All of the following statements about adult polycystic kidney disease are true, EXCEPT:
(a) It is inherited as autosomal dominant trait
(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
--- Content provided by FirstRanker.com ---
(d) It is associated with Berry aneurysm34.
Consider the following statements in relation to an adult patient:
1. Oliguria is defined as passage of urine less than 300 ml per day
--- Content provided by FirstRanker.com ---
2. Anuria is said to exist when less than 50 ml urine is passed per day3. Polyuria is defined as urine volume in excess of 3 litre per day
Which of the statements given above are correct?
(a) 1 and 3 only
--- Content provided by FirstRanker.com ---
(b) 2 and 3 only(c) 1 and 2 only
(d) 1, 2 and 3
35.
--- Content provided by FirstRanker.com ---
White cell casts in urine examination are strongly suggestive of:(a) Nephritis
(b) Pyelonephritis
(c) Renal stone disease
(d) Papillitis
--- Content provided by FirstRanker.com ---
36.A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
low C
3
--- Content provided by FirstRanker.com ---
and increased titres of ASO and antiDNase. Which one of the following statements isNOT correct about management for this condition?
(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
--- Content provided by FirstRanker.com ---
(c) Treatment is largely supportive(d) Immunosuppressants are to be used for crescentic glomerulonephritis
37.
Which one of the following statements is NOT correct regarding the risk factors for
nephrolithiasis?
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(a) Higher dietary calcium increases risk
(b) Higher animal protein intake increases risk
(c) Higher dietary potassium intake lowers risk
(d) Lower urine citrate increases the risk
--- Content provided by FirstRanker.com ---
38.A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
He has history of fever and headache for the preceding 3 days. The CSF examination is
unremarkable. What would be the probable diagnosis?
(a) Multiple sclerosis
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(b) Tubercular meningitis(c) Pyogenic (bacterial) meningitis
(d) Viral encephalitis
39.
Drug of choice for the treatment of Trigeminal Neuralgia is:
--- Content provided by FirstRanker.com ---
(a) Carbamazepine(b) Aceclofenac
(c) Thiamine
(d) Prednisdone
40.
--- Content provided by FirstRanker.com ---
Constructional skills is a function of which lobe?(a) Dominant temporal lobe
(b) Non dominant parietal lobe
(c) Frontal lobe
(d) Non dominant temporal lobe
--- Content provided by FirstRanker.com ---
41.
Vertical gaze palsy with convergence retraction nystagmus is seen in:
(a) Weber syndrome
(b) Millard Gubler syndrome
--- Content provided by FirstRanker.com ---
(c) Claude syndrome(d) Parinaud syndrome
42.
A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
--- Content provided by FirstRanker.com ---
(a) Left 3rd
nerve palsy
(b) Left 6
th
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nerve palsy(c) Right 4
th
nerve palsy
(d) Right 3
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rdnerve palsy
43.
All of the following are features of Cauda Equina syndrome EXCEPT:
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(a) Low back pain(b) Lower limb areflexia
(c) Loss of bladder function
(d) Extensor plantar response
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44.A 68-year old male presented in OPD with complaints of progressive small handwriting. On
examination, he had resting tremor, bradykinesia, rigidity and postural instability. This
patient is suffering most likely from:
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(a) Parkinson?s disease(b) Vascular dementia
(c) Alzheimer?s disease
(d) Frunto temporal dementia
45.
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An elderly patient presents with abnormal gait. He has a wide base freezing gait withimbalance, comprising short strides, shuffling along the floor and difficulty with starts and
turns. Heal-Shin test is normal. Which one of the following is most likely disorder?
(a) Cerebellar ataxia
(b) Sensory ataxia
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(c) Frontal gait disorder(d) Parkinson?s disease
46.
Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
EXCEPT:
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(a) Bradycardia(b) Hypertension
(c) Irregular respiration
(d) Hypothermia
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47.A 35 year old man presents with history of low grade fever and headache for last five weeks.
Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
(LP) and a day later reports worsening of headache. Which one of the following features is
NOT consistent with diagnosis of ?Post-LP? headache?
--- Content provided by FirstRanker.com ---
(a) Post-LP headache usually begins within 48 hours
(b) Post-LP headache worsens in sitting position
(c) Post-LP headache is most severe upon waking up
(d) Post-LP headache may improve with caffeine intake
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48.Which one of the following investigations is NOT appropriate in a case of recurrent
thrombosis?
(a) Antiphospholipid antibodies
(b) Bcr-Abl assay
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(c) Protein C and S assays(d) Antithrombin level
49.
All of the following are causes of reactive thrombocytosis, EXCEPT:
(a) Hemolytic anemia
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(b) Megaloblastic anemia(c) Post splenectomy
(d) Chronic inflammatory disorders
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50.Cryoprecipitate cannot be used for treatment of which one of the following conditions?
(a) Von Willebrand disease
(b) Hypofibrinogenemia
(c) Hemophilia?B
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(d) Hemphilia?A51.
Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic
anaemia. The disorder is inherited as an:
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(a) Autosomal recessive trait(b) X-linked recessive trait
(c) Autosomal dominant trait
(d) X-linked dominant trait
52.
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Sickle cell disease may be associated with any of the following EXCEPT:(a) Acute chest syndrome
(b) Aplastic crisis
(c) Splenic sequestration crisis
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(d) Conn?s syndrome53.
Fever with splenomegaly and lymphadenopathy can be seen in
(a) Infectious mononucleosis
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(b) Chronic leukaemia(c) Both infectious mononucleosis and chronic leukaemia
(d) Neither infectious mononucleosis nor chronic leukaemia
54.
Every individual carries four alpha gene alleles. Deletion of three alleles leads to
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development of:(a) Haemoglobin X disease
(b) Haemoglobin H disease
(c) Haemoglobin F disease
(d) Hydrops fetalis
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55.Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
(a) It is a clonal malignancy of haematopoetic stem
(b) Risk of developing CML is increased in monozygotic turns
(c) CML is defined by presence of BCR-ABL 1 fusion gene
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(d) 10 year survival with TKI therapy is 85%--- Content provided by FirstRanker.com ---
--- Content provided by FirstRanker.com ---
56.Diagnostic criteria of multiple myeloma includes which of the following?
1. Increased malignant plasma cells in the bone marrow
2. Serum and/or urinary M protein
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3. Skeletal lytic lesions4. Skeletal blastic lesions
Select the correct answer using the code given below:
(a) 1, 2 and 3
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(b) 1, 3 and 4(c) 1, 2 and 4
(d) 2, 3 and 4
57.
The most predominant type of serum immunoglobulin involved in patients with plasma cell
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disorder is:(a) Ig G
(b) Ig A
(c) Ig D
(d) Light chains
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58.Which one of the following statements is NOT true regarding the thyroid function/disorder in
pregnancy?
(a) There is an increase in the metabolism of thyroxine by placenta
(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
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(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early inpregnancy
(d) Impaired cognitive impairment may be seen in the offspring of mother with
subclinical hypothyroidism
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59.Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL
(b) HbA1c ? 6.5 %
(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
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(d) Fasting plasma glucose ? 110 mg/dL60.
A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight
gain, hair loss, tiredness and weakness. What will be the investigation of choice?
(a) FSH & LH level
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(b) Estrogen level(c) Free T
3
and free T
4
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level(d) Free T
4
and TSH level
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--- Content provided by FirstRanker.com ---
61.
Consider the following statements about erectile dysfunction in diabetic males:
1. It affects 60 % of males
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2. Its common cause is an underlying neuro-vascular pathology3. It may be aggravated by beta-adrenergic agonist drugs
4. Endocrine disorders like hyperprolactinemia may cause it
Which of the statements given above are true?
--- Content provided by FirstRanker.com ---
(a) 1 and 2(b) 2 and 3
(c) 2 and 4
(d) 3 and 4
62.
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All of the following can cause Hyperprolactinemia, EXCEPT:(a) Craniopharyngioma
(b) Hyperthyroidism
(c) Stress
(d) Chronic renal failure
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63.All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
(a) Atrial fibrillation
(b) Periodic paralysis
(c) Deafness
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(d) Osteoporosis64.
Which one of the following hormones acts via the receptor tyrosine kinase?
(a) FSH
(b) TSH
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(c) IGF-1(d) PTH
65.
Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a
(MEN 2a):
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1. Primary Hyperparathyroidism
2. Pituitary tumours
3. Medullary carcinoma of thyroid
4. Pheochromocytoma
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Which of the above are correct?:
(a) 1, 2 and 4
(b) 1, 2 and 3
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(c) 1, 3 and 4(d) 2, 3 and 4
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66.
Consider the following statements with regard to Graves? ophthalmopathy :
1. Proptosis is often asymmetric and can even appear to be unilateral
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2. It is a clinical diagnosis3. Worsening of symptoms upon glucocorticoid withdrawal is common
4. Radiation therapy is very effective in treatment
Which of the above statements are correct?
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(a) 1 and 2 only
(b) 1, 2 and 3
(c) 2, 3 and 4
(d) 1 and 4 only
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67.All of the following are common aetiologies of delirium EXCEPT:
(a) Hyperthyroidism
(b) Hypothyroidism
(c) Hyperparathyroidism
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(d) Hypoparathyroidism68.
Key anthropometric measurements important for evaluating the degree of obesity are:
(a) Weight, height and waist circumference
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(b) Weight, height and hip circumference(c) Weight, height and mid-thigh circumference
(d) Weight, height and chest circumference
69.
What is the minimum BMI (Body Mass Index) recommended for considering adjuvant
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pharmacologic treatment in obesity with comorbidity?(a) 23 kg/m
2
(b) 25 kg/m
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2(c) 27 kg/m
2
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(d) 30 kg/m2
70.
A young medical student while working in HIV ward got pricked accidently on the finger by
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a syringe needle which was used to draw blood from a patient. Patient?s infection status is notknown. Which one of the following therapeutic interventions will be the best interest of this
student?
(a) To start Dolultegravir immediately
(b) To wash wound with soap and water and start Emtricitabine
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(c) To give Dolutegravir + Tenofovir + Emtricitabine(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin
71.
Cryptococcal infection is acquired through:
(a) Inhalation route
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(b) Bite of Culex mosquito(c) Direct skin contact
(d) Ingestion of spores
FirstRanker.com - FirstRanker's Choice
--- Content provided by FirstRanker.com ---
Combined Medical Services Examination-2020Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
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(a) Ventricular fibrillation(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
2.
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An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes forfollow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
(b) Glimepiride
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(c) Enalapril(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
--- Content provided by FirstRanker.com ---
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
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(c) Marfan?s syndrome(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
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(b) To evaluate stable angina(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
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(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
--- Content provided by FirstRanker.com ---
6.
Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
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(b) Hypothyroidism(c) Hypertension
(d) Acute myocardial infarction
7.
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In an ECG recording, P wave is produced by:(a) Atrial depolarisation
(b) Atrial repolarisation
(c) Ventricular depolarisation
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(d) Ventricular repolarisation8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
--- Content provided by FirstRanker.com ---
(a) DC Cardioversion(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
9.
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Which one of the following drugs is a Direct Renin Inhibitor?(a) Benedipine
(b) Azilsartan
(c) Aliskiren
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(d) Lisinopril10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Aortic regurgitation
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(b) Thyrotoxicosis(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
Signet-ring sign on CT-chest is suggestive of:
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(a) Bronchiectasis(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
12.
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Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when itis:
(a) Mild persistent
(b) Moderate persistent
(c) Severe persistent
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(d) Very severe persistent13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
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(b) CT-chest(c) Lung biopsy
(d) DNA sequencing study
14.
Which one of the following antigens is commonly associated with causation of Farmer?s
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lung?(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
(d) Candida
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15.The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
(a) INH resistance
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(b) Rifampicin resistance(c) Multi drug resistance
(d) Ethambutol resistance
16.
The most common cause of chronic type II respiratory failure is:
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(a) Severe pneumonia(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
17.
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The most frequent symptom in respiratory diseases is:(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
(d) Cough
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18.A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
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(a) Albuterol(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
19.
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Consider the following statements with regard to respiratory examination:1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
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3. Monophonic wheeze is characteristic of asthma4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
(a) 1 and 3
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(b) 2 and 4 only(c) 1, 2 and 4
(d) 2, 3 and 4
20.
All of the following are the causes of exudative Pleural Effusion, EXCEPT:
--- Content provided by FirstRanker.com ---
(a) SVC obstruction(b) Fungal infection
(c) SLE
(d) Meig syndrome
21.
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Which one of the following is NOT true about Ghrelin?(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
(d) Fasting increases its secretion
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22.Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
(c) Bile acid secretory defects
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(d) Pancreatic dysfunction23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
(b) APACHE score
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(c) MELD score(d) Metavir score
24.
The blood supply of liver consists of:
(a) 50 % hepatic artery and 50 % portal vein
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(b) 80 % portal vein and 20 % hepatic artery(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
All of the following conditions are associated with Glomerulonephritis with low complement
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level, EXCEPT:(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
(d) Cryoglobulinaemia
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26.
Consider the following statements with regard to oral aphthous ulcers:
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1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
4. They are pre-malignant and progress over few years to squamous cell carcinoma of
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the oral cavityWhich of the above statements are correct?
(a) 1 and 4 only
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(b) 2 and 3 only(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
Which one of the following statements about Barrett?s Oesophagus is NOT correct?
--- Content provided by FirstRanker.com ---
(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
--- Content provided by FirstRanker.com ---
cells(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
The most common cause of acute hepatitis outbreaks in India is:
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(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
(d) Hepatitis A
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29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
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(a) Menetrier?s disease(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
30.
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Eradication of helicobacter pylori infection may prove beneficial in the following extra-gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
(b) Idiopathic thrombocytopenic purpura
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(c) Iron deficiency anaemia without gastro-intestinal bleeding(d) Acute glomerulonephritis
31.
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
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disease patient?(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
(d) 13 to 14 gm/dL
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32.Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
(b) Tumoral calcinosis
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(c) Osteitis fibrosa cystic(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
(a) It is inherited as autosomal dominant trait
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(b) It is usually associated with marked proteinuria(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
Consider the following statements in relation to an adult patient:
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1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
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Which of the statements given above are correct?(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
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35.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
(b) Pyelonephritis
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(c) Renal stone disease(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
--- Content provided by FirstRanker.com ---
low C3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
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(a) Renal biopsy is rarely required for making diagnosis(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
37.
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Which one of the following statements is NOT correct regarding the risk factors fornephrolithiasis?
(a) Higher dietary calcium increases risk
(b) Higher animal protein intake increases risk
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(c) Higher dietary potassium intake lowers risk(d) Lower urine citrate increases the risk
38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
He has history of fever and headache for the preceding 3 days. The CSF examination is
--- Content provided by FirstRanker.com ---
unremarkable. What would be the probable diagnosis?(a) Multiple sclerosis
(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
(d) Viral encephalitis
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39.Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
(b) Aceclofenac
(c) Thiamine
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(d) Prednisdone40.
Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
(b) Non dominant parietal lobe
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(c) Frontal lobe(d) Non dominant temporal lobe
41.
Vertical gaze palsy with convergence retraction nystagmus is seen in:
--- Content provided by FirstRanker.com ---
(a) Weber syndrome(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
42.
--- Content provided by FirstRanker.com ---
A patient on looking forward was found to have his right eye deviated downwards andoutwards with pupil dilated. He is suffering from:
(a) Left 3
rd
nerve palsy
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(b) Left 6th
nerve palsy
(c) Right 4
th
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nerve palsy(d) Right 3
rd
nerve palsy
43.
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All of the following are features of Cauda Equina syndrome EXCEPT:(a) Low back pain
(b) Lower limb areflexia
(c) Loss of bladder function
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(d) Extensor plantar response44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
examination, he had resting tremor, bradykinesia, rigidity and postural instability. This
--- Content provided by FirstRanker.com ---
patient is suffering most likely from:(a) Parkinson?s disease
(b) Vascular dementia
(c) Alzheimer?s disease
--- Content provided by FirstRanker.com ---
(d) Frunto temporal dementia45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
turns. Heal-Shin test is normal. Which one of the following is most likely disorder?
--- Content provided by FirstRanker.com ---
(a) Cerebellar ataxia(b) Sensory ataxia
(c) Frontal gait disorder
(d) Parkinson?s disease
46.
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Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the followingEXCEPT:
(a) Bradycardia
(b) Hypertension
(c) Irregular respiration
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(d) Hypothermia47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
--- Content provided by FirstRanker.com ---
(LP) and a day later reports worsening of headache. Which one of the following features isNOT consistent with diagnosis of ?Post-LP? headache?
(a) Post-LP headache usually begins within 48 hours
(b) Post-LP headache worsens in sitting position
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(c) Post-LP headache is most severe upon waking up(d) Post-LP headache may improve with caffeine intake
48.
Which one of the following investigations is NOT appropriate in a case of recurrent
thrombosis?
--- Content provided by FirstRanker.com ---
(a) Antiphospholipid antibodies(b) Bcr-Abl assay
(c) Protein C and S assays
(d) Antithrombin level
49.
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All of the following are causes of reactive thrombocytosis, EXCEPT:(a) Hemolytic anemia
(b) Megaloblastic anemia
(c) Post splenectomy
(d) Chronic inflammatory disorders
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50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
(a) Von Willebrand disease
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(b) Hypofibrinogenemia(c) Hemophilia?B
(d) Hemphilia?A
51.
Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic
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anaemia. The disorder is inherited as an:(a) Autosomal recessive trait
(b) X-linked recessive trait
(c) Autosomal dominant trait
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(d) X-linked dominant trait52.
Sickle cell disease may be associated with any of the following EXCEPT:
(a) Acute chest syndrome
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(b) Aplastic crisis(c) Splenic sequestration crisis
(d) Conn?s syndrome
53.
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Fever with splenomegaly and lymphadenopathy can be seen in(a) Infectious mononucleosis
(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
(d) Neither infectious mononucleosis nor chronic leukaemia
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54.Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
(a) Haemoglobin X disease
(b) Haemoglobin H disease
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(c) Haemoglobin F disease(d) Hydrops fetalis
55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
(a) It is a clonal malignancy of haematopoetic stem
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(b) Risk of developing CML is increased in monozygotic turns(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
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56.
Diagnostic criteria of multiple myeloma includes which of the following?
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1. Increased malignant plasma cells in the bone marrow2. Serum and/or urinary M protein
3. Skeletal lytic lesions
4. Skeletal blastic lesions
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Select the correct answer using the code given below:(a) 1, 2 and 3
(b) 1, 3 and 4
(c) 1, 2 and 4
(d) 2, 3 and 4
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57.The most predominant type of serum immunoglobulin involved in patients with plasma cell
disorder is:
(a) Ig G
(b) Ig A
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(c) Ig D(d) Light chains
58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
pregnancy?
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(a) There is an increase in the metabolism of thyroxine by placenta(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
(d) Impaired cognitive impairment may be seen in the offspring of mother with
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subclinical hypothyroidism59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL
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(b) HbA1c ? 6.5 %(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ? 110 mg/dL
60.
A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight
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gain, hair loss, tiredness and weakness. What will be the investigation of choice?(a) FSH & LH level
(b) Estrogen level
(c) Free T
3
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and free T4
level
(d) Free T
4
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and TSH level--- Content provided by FirstRanker.com ---
61.
Consider the following statements about erectile dysfunction in diabetic males:
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1. It affects 60 % of males
2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
4. Endocrine disorders like hyperprolactinemia may cause it
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Which of the statements given above are true?
(a) 1 and 2
(b) 2 and 3
(c) 2 and 4
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(d) 3 and 462.
All of the following can cause Hyperprolactinemia, EXCEPT:
(a) Craniopharyngioma
(b) Hyperthyroidism
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(c) Stress(d) Chronic renal failure
63.
All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
(a) Atrial fibrillation
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(b) Periodic paralysis(c) Deafness
(d) Osteoporosis
64.
Which one of the following hormones acts via the receptor tyrosine kinase?
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(a) FSH(b) TSH
(c) IGF-1
(d) PTH
65.
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Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a(MEN 2a):
1. Primary Hyperparathyroidism
2. Pituitary tumours
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3. Medullary carcinoma of thyroid4. Pheochromocytoma
Which of the above are correct?:
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(a) 1, 2 and 4(b) 1, 2 and 3
(c) 1, 3 and 4
(d) 2, 3 and 4
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66.
Consider the following statements with regard to Graves? ophthalmopathy :
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1. Proptosis is often asymmetric and can even appear to be unilateral
2. It is a clinical diagnosis
3. Worsening of symptoms upon glucocorticoid withdrawal is common
4. Radiation therapy is very effective in treatment
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Which of the above statements are correct?
(a) 1 and 2 only
(b) 1, 2 and 3
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(c) 2, 3 and 4(d) 1 and 4 only
67.
All of the following are common aetiologies of delirium EXCEPT:
(a) Hyperthyroidism
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(b) Hypothyroidism(c) Hyperparathyroidism
(d) Hypoparathyroidism
68.
Key anthropometric measurements important for evaluating the degree of obesity are:
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(a) Weight, height and waist circumference
(b) Weight, height and hip circumference
(c) Weight, height and mid-thigh circumference
(d) Weight, height and chest circumference
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69.What is the minimum BMI (Body Mass Index) recommended for considering adjuvant
pharmacologic treatment in obesity with comorbidity?
(a) 23 kg/m
2
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(b) 25 kg/m
2
(c) 27 kg/m
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2(d) 30 kg/m
2
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70.A young medical student while working in HIV ward got pricked accidently on the finger by
a syringe needle which was used to draw blood from a patient. Patient?s infection status is not
known. Which one of the following therapeutic interventions will be the best interest of this
student?
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(a) To start Dolultegravir immediately(b) To wash wound with soap and water and start Emtricitabine
(c) To give Dolutegravir + Tenofovir + Emtricitabine
(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin
71.
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Cryptococcal infection is acquired through:(a) Inhalation route
(b) Bite of Culex mosquito
(c) Direct skin contact
(d) Ingestion of spores
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72.
Which one of the following is NOT appropriate treatment for Echinococcus granulosus and
hydatid disease?
(a) Albendazole 400 mg twice in a day for 3 months
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(b) Diethylcarbamazine 2 mg/kg thrice in a day for 12 days(c) PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)
(d) Praziquantel (20 mg/kg twice daily for 14 days)
73.
Which one of the following infections is NOT amenable to post-exposure prophylaxis with
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specific immunoglobulins?(a) Hepatitis B
(b) HIV
(c) Tetanus
(d) Rabies
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74.Echinocandins are a class of:
(a) Antiviral agents
(b) Antiparasitic agents
(c) Antitubercular agents
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(d) Antifungal agents75.
Recommended first time drug for initial treatment of tuberculosis include all EXCEPT:
(a) Isoniazid
(b) Rifampin
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(c) Ethambutol(d) Ethionamide
76.
The most frequent adverse reaction of significance among people treated for drug-susceptible
tuberculosis is:
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(a) Colitis(b) Hepatitis
(c) Cystitis
(d) Enteritis
77.
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All adult patients in whom anti-tubercular treatment is being started should undergo baselineassessment of:
(a) Complete blood count
(b) Liver function test
(c) Lipid profile
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(d) Pulmonary function test78.
A 30 year old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea.
On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative
bradycardia and rose spots rash. The most likely diagnosis is:
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(a) Malaria fever
(b) Enteric fever
(c) Leptospirosis
(d) Dengue fever
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FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-I
1.
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A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of thefollowing Arrhythmia is most likely?
(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
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(d) Atrial fibrillation2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
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(a) Aspirin(b) Glimepiride
(c) Enalapril
(d) Atorvastatin
3.
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A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. Thechest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
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(a) Takayasu?s arteritis(b) Raynaud?s syndrome
(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
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All of the following are indications for treadmill testing/exercise-testing EXCEPT:(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
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5.Kussmaul?s sign is present in all of the following conditions, EXCEPT:
(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
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(c) Hypertrophic Cardiomyopathy(d) Right Ventricular Infarction
6.
Which one of the following is NOT a common cause of atrial fibrillation?
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(a) Mitral regurgitation
(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
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7.
In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
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(b) Atrial repolarisation(c) Ventricular depolarisation
(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
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tachycardia?(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
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(d) Injection Adenosine9.
Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
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(b) Azilsartan(c) Aliskiren
(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
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(a) Aortic regurgitation
(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
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11.Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
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(d) Sarcoidosis12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
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(b) Moderate persistent(c) Severe persistent
(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
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bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:(a) 24 hour fecal fat-estimation
(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
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14.Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
(a) Penicillium
(b) Actinomycetes
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(c) Aspergillus(d) Candida
15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
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(a) INH resistance
(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
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16.The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
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(d) Severe pulmonary thromboembolism17.
The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
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(c) Hemoptysis(d) Cough
18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
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prescription?(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
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(d) Magnesium sulfate19.
Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
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interstitial fibrosis2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
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Which of the above statements are correct?(a) 1 and 3
(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
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20.All of the following are the causes of exudative Pleural Effusion, EXCEPT:
(a) SVC obstruction
(b) Fungal infection
(c) SLE
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(d) Meig syndrome21.
Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
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(c) It increases acid secretion(d) Fasting increases its secretion
22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
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(b) Mucosal inflammation(c) Bile acid secretory defects
(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
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(a) Child Pugh score(b) APACHE score
(c) MELD score
(d) Metavir score
24.
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The blood supply of liver consists of:(a) 50 % hepatic artery and 50 % portal vein
(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
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25.All of the following conditions are associated with Glomerulonephritis with low complement
level, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
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(c) Systemic lupus erythematosus(d) Cryoglobulinaemia
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26.Consider the following statements with regard to oral aphthous ulcers:
1. They are superficial and painful
2. They may occur in women just prior to menstruation
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3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases4. They are pre-malignant and progress over few years to squamous cell carcinoma of
the oral cavity
Which of the above statements are correct?
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(a) 1 and 4 only
(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
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27.Which one of the following statements about Barrett?s Oesophagus is NOT correct?
(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
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cells(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
cells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
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28.The most common cause of acute hepatitis outbreaks in India is:
(a) Hepatitis E
(b) Hepatitis C
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(c) Hepatitis B(d) Hepatitis A
29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
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characteristically seen in which one of the following conditions?(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
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(d) Barrett?s oesophagus30.
Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
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(a) Unexplained vitamin B12 deficiency(b) Idiopathic thrombocytopenic purpura
(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
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31.What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
disease patient?
(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
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(c) 12 to 13 gm/dL(d) 13 to 14 gm/dL
32.
Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
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(a) Adynamic bone disease(b) Tumoral calcinosis
(c) Osteitis fibrosa cystic
(d) Calciphylaxis
33.
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All of the following statements about adult polycystic kidney disease are true, EXCEPT:(a) It is inherited as autosomal dominant trait
(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
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34.Consider the following statements in relation to an adult patient:
1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
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3. Polyuria is defined as urine volume in excess of 3 litre per dayWhich of the statements given above are correct?
(a) 1 and 3 only
(b) 2 and 3 only
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(c) 1 and 2 only(d) 1, 2 and 3
35.
White cell casts in urine examination are strongly suggestive of:
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(a) Nephritis(b) Pyelonephritis
(c) Renal stone disease
(d) Papillitis
36.
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A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has historyof sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
low C
3
and increased titres of ASO and antiDNase. Which one of the following statements is
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NOT correct about management for this condition?(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
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(d) Immunosuppressants are to be used for crescentic glomerulonephritis37.
Which one of the following statements is NOT correct regarding the risk factors for
nephrolithiasis?
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(a) Higher dietary calcium increases risk(b) Higher animal protein intake increases risk
(c) Higher dietary potassium intake lowers risk
(d) Lower urine citrate increases the risk
38.
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A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.He has history of fever and headache for the preceding 3 days. The CSF examination is
unremarkable. What would be the probable diagnosis?
(a) Multiple sclerosis
(b) Tubercular meningitis
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(c) Pyogenic (bacterial) meningitis(d) Viral encephalitis
39.
Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
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(b) Aceclofenac(c) Thiamine
(d) Prednisdone
40.
Constructional skills is a function of which lobe?
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(a) Dominant temporal lobe(b) Non dominant parietal lobe
(c) Frontal lobe
(d) Non dominant temporal lobe
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41.Vertical gaze palsy with convergence retraction nystagmus is seen in:
(a) Weber syndrome
(b) Millard Gubler syndrome
(c) Claude syndrome
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(d) Parinaud syndrome42.
A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
(a) Left 3
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rdnerve palsy
(b) Left 6
th
nerve palsy
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(c) Right 4th
nerve palsy
(d) Right 3
rd
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nerve palsy43.
All of the following are features of Cauda Equina syndrome EXCEPT:
(a) Low back pain
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(b) Lower limb areflexia(c) Loss of bladder function
(d) Extensor plantar response
44.
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A 68-year old male presented in OPD with complaints of progressive small handwriting. Onexamination, he had resting tremor, bradykinesia, rigidity and postural instability. This
patient is suffering most likely from:
(a) Parkinson?s disease
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(b) Vascular dementia(c) Alzheimer?s disease
(d) Frunto temporal dementia
45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
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imbalance, comprising short strides, shuffling along the floor and difficulty with starts andturns. Heal-Shin test is normal. Which one of the following is most likely disorder?
(a) Cerebellar ataxia
(b) Sensory ataxia
(c) Frontal gait disorder
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(d) Parkinson?s disease46.
Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
EXCEPT:
(a) Bradycardia
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(b) Hypertension(c) Irregular respiration
(d) Hypothermia
47.
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A 35 year old man presents with history of low grade fever and headache for last five weeks.Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
(LP) and a day later reports worsening of headache. Which one of the following features is
NOT consistent with diagnosis of ?Post-LP? headache?
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(a) Post-LP headache usually begins within 48 hours(b) Post-LP headache worsens in sitting position
(c) Post-LP headache is most severe upon waking up
(d) Post-LP headache may improve with caffeine intake
48.
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Which one of the following investigations is NOT appropriate in a case of recurrentthrombosis?
(a) Antiphospholipid antibodies
(b) Bcr-Abl assay
(c) Protein C and S assays
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(d) Antithrombin level49.
All of the following are causes of reactive thrombocytosis, EXCEPT:
(a) Hemolytic anemia
(b) Megaloblastic anemia
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(c) Post splenectomy(d) Chronic inflammatory disorders
50.
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Cryoprecipitate cannot be used for treatment of which one of the following conditions?(a) Von Willebrand disease
(b) Hypofibrinogenemia
(c) Hemophilia?B
(d) Hemphilia?A
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51.Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic
anaemia. The disorder is inherited as an:
(a) Autosomal recessive trait
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(b) X-linked recessive trait(c) Autosomal dominant trait
(d) X-linked dominant trait
52.
Sickle cell disease may be associated with any of the following EXCEPT:
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(a) Acute chest syndrome
(b) Aplastic crisis
(c) Splenic sequestration crisis
(d) Conn?s syndrome
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53.
Fever with splenomegaly and lymphadenopathy can be seen in
(a) Infectious mononucleosis
(b) Chronic leukaemia
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(c) Both infectious mononucleosis and chronic leukaemia(d) Neither infectious mononucleosis nor chronic leukaemia
54.
Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
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(a) Haemoglobin X disease(b) Haemoglobin H disease
(c) Haemoglobin F disease
(d) Hydrops fetalis
55.
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Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?(a) It is a clonal malignancy of haematopoetic stem
(b) Risk of developing CML is increased in monozygotic turns
(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
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56.
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Diagnostic criteria of multiple myeloma includes which of the following?1. Increased malignant plasma cells in the bone marrow
2. Serum and/or urinary M protein
3. Skeletal lytic lesions
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4. Skeletal blastic lesionsSelect the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1, 3 and 4
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(c) 1, 2 and 4(d) 2, 3 and 4
57.
The most predominant type of serum immunoglobulin involved in patients with plasma cell
disorder is:
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(a) Ig G(b) Ig A
(c) Ig D
(d) Light chains
58.
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Which one of the following statements is NOT true regarding the thyroid function/disorder inpregnancy?
(a) There is an increase in the metabolism of thyroxine by placenta
(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
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pregnancy(d) Impaired cognitive impairment may be seen in the offspring of mother with
subclinical hypothyroidism
59.
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Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL
(b) HbA1c ? 6.5 %
(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ? 110 mg/dL
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60.A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight
gain, hair loss, tiredness and weakness. What will be the investigation of choice?
(a) FSH & LH level
(b) Estrogen level
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(c) Free T3
and free T
4
level
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(d) Free T4
and TSH level
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61.Consider the following statements about erectile dysfunction in diabetic males:
1. It affects 60 % of males
2. Its common cause is an underlying neuro-vascular pathology
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3. It may be aggravated by beta-adrenergic agonist drugs4. Endocrine disorders like hyperprolactinemia may cause it
Which of the statements given above are true?
(a) 1 and 2
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(b) 2 and 3(c) 2 and 4
(d) 3 and 4
62.
All of the following can cause Hyperprolactinemia, EXCEPT:
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(a) Craniopharyngioma(b) Hyperthyroidism
(c) Stress
(d) Chronic renal failure
63.
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All of the following can be seen in a case of thyrotoxicosis, EXCEPT:(a) Atrial fibrillation
(b) Periodic paralysis
(c) Deafness
(d) Osteoporosis
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64.Which one of the following hormones acts via the receptor tyrosine kinase?
(a) FSH
(b) TSH
(c) IGF-1
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(d) PTH65.
Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a
(MEN 2a):
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1. Primary Hyperparathyroidism2. Pituitary tumours
3. Medullary carcinoma of thyroid
4. Pheochromocytoma
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Which of the above are correct?:(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4
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(d) 2, 3 and 4--- Content provided by FirstRanker.com ---
66.Consider the following statements with regard to Graves? ophthalmopathy :
1. Proptosis is often asymmetric and can even appear to be unilateral
2. It is a clinical diagnosis
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3. Worsening of symptoms upon glucocorticoid withdrawal is common4. Radiation therapy is very effective in treatment
Which of the above statements are correct?
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(a) 1 and 2 only(b) 1, 2 and 3
(c) 2, 3 and 4
(d) 1 and 4 only
67.
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All of the following are common aetiologies of delirium EXCEPT:(a) Hyperthyroidism
(b) Hypothyroidism
(c) Hyperparathyroidism
(d) Hypoparathyroidism
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68.Key anthropometric measurements important for evaluating the degree of obesity are:
(a) Weight, height and waist circumference
(b) Weight, height and hip circumference
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(c) Weight, height and mid-thigh circumference(d) Weight, height and chest circumference
69.
What is the minimum BMI (Body Mass Index) recommended for considering adjuvant
pharmacologic treatment in obesity with comorbidity?
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(a) 23 kg/m2
(b) 25 kg/m
2
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(c) 27 kg/m
2
(d) 30 kg/m
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270.
A young medical student while working in HIV ward got pricked accidently on the finger by
a syringe needle which was used to draw blood from a patient. Patient?s infection status is not
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known. Which one of the following therapeutic interventions will be the best interest of thisstudent?
(a) To start Dolultegravir immediately
(b) To wash wound with soap and water and start Emtricitabine
(c) To give Dolutegravir + Tenofovir + Emtricitabine
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(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin71.
Cryptococcal infection is acquired through:
(a) Inhalation route
(b) Bite of Culex mosquito
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(c) Direct skin contact(d) Ingestion of spores
72.
Which one of the following is NOT appropriate treatment for Echinococcus granulosus and
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hydatid disease?(a) Albendazole 400 mg twice in a day for 3 months
(b) Diethylcarbamazine 2 mg/kg thrice in a day for 12 days
(c) PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)
(d) Praziquantel (20 mg/kg twice daily for 14 days)
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73.Which one of the following infections is NOT amenable to post-exposure prophylaxis with
specific immunoglobulins?
(a) Hepatitis B
(b) HIV
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(c) Tetanus(d) Rabies
74.
Echinocandins are a class of:
(a) Antiviral agents
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(b) Antiparasitic agents(c) Antitubercular agents
(d) Antifungal agents
75.
Recommended first time drug for initial treatment of tuberculosis include all EXCEPT:
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(a) Isoniazid(b) Rifampin
(c) Ethambutol
(d) Ethionamide
76.
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The most frequent adverse reaction of significance among people treated for drug-susceptibletuberculosis is:
(a) Colitis
(b) Hepatitis
(c) Cystitis
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(d) Enteritis77.
All adult patients in whom anti-tubercular treatment is being started should undergo baseline
assessment of:
(a) Complete blood count
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(b) Liver function test(c) Lipid profile
(d) Pulmonary function test
78.
A 30 year old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea.
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On examination tongue is coated with abdominal tenderness, soft splenomegaly, relativebradycardia and rose spots rash. The most likely diagnosis is:
(a) Malaria fever
(b) Enteric fever
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(c) Leptospirosis(d) Dengue fever
79.
The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:
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(a) Lymph node TB(b) Genitourinary TB
(c) Skeletal TB
(d) Skull TB
80.
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Which of the following is NOT a clinical feature of Botulism?(a) Impaired alertness
(b) Dysphagia
(c) Diplopia
(d) Ptosis
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81.Post exposure prophylaxis (PEP) for HIV should contain:
(a) 2 antiretroviral drugs administered for 4 weeks
(b) 2 antiretroviral drugs administered for 6 weeks
(c) 3 antiretroviral drugs administered for 4 weeks
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(d) 3 antiretroviral drugs administered for 6 weeks82.
Paralytic rabies is characterized by:
(a) Maculopapular rash
(b) Flaccid muscle weakness
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(c) Spastic muscle weakness(d) Hyperexcitability and facial weakness
83.
All of the following are seen in Marasmus EXCEPT:
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(a) Reduced triceps skinfold(b) Reduced mid arm circumference
(c) Protein wasting
(d) Decreased body mass index
84.
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A 20 year young lady presents with high grade fever for five days and palpable purpura overextremities. She is found to be confused, with presence of neck stiffness. Which of the
following is the most likely diagnosis?
(a) Disseminated intravascular coagulation
(b) Acute meningococcemia
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(c) Antiphospholipid antibody syndrome(d) Thrombotic thrombocytopenic purpura
85.
Fibroblast Growth Factor 23 (FGF 23) is increased in which one of the following conditions?
(a) Osteomalacia
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(b) Osteoporosis(c) Paget?s disease
(d) Renal Osteodystrophy
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FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
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Paper-I1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
(a) Ventricular fibrillation
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(b) Ventricular premature complex(c) Atrial flutter
(d) Atrial fibrillation
2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
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follow-up, with complaints of muscle pains. Which one of the following drugs could be themost likely cause?
(a) Aspirin
(b) Glimepiride
(c) Enalapril
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(d) Atorvastatin3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
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joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the followingdiseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
(c) Marfan?s syndrome
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(d) Rheumatic heart disease-Mitral regurgitation4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
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(c) To assess outcome after coronary revascularization(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
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(a) Massive Pulmonary Embolism(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
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6.Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
(b) Hypothyroidism
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(c) Hypertension(d) Acute myocardial infarction
7.
In an ECG recording, P wave is produced by:
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(a) Atrial depolarisation
(b) Atrial repolarisation
(c) Ventricular depolarisation
(d) Ventricular repolarisation
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8.Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
(a) DC Cardioversion
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(b) Injection Lignocaine(c) Injection Amiodarone
(d) Injection Adenosine
9.
Which one of the following drugs is a Direct Renin Inhibitor?
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(a) Benedipine
(b) Azilsartan
(c) Aliskiren
(d) Lisinopril
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10.All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Aortic regurgitation
(b) Thyrotoxicosis
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(c) Patent ductus arteriosus(d) Aortic stenosis
11.
Signet-ring sign on CT-chest is suggestive of:
(a) Bronchiectasis
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(b) Active alveolitis(c) Aspergilloma
(d) Sarcoidosis
12.
Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
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is:(a) Mild persistent
(b) Moderate persistent
(c) Severe persistent
(d) Very severe persistent
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13.An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
(b) CT-chest
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(c) Lung biopsy(d) DNA sequencing study
14.
Which one of the following antigens is commonly associated with causation of Farmer?s
lung?
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(a) Penicillium(b) Actinomycetes
(c) Aspergillus
(d) Candida
15.
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The Gene X-pert test used for MTB detection has the additional advantage of detection ofwhich of the following?
(a) INH resistance
(b) Rifampicin resistance
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(c) Multi drug resistance(d) Ethambutol resistance
16.
The most common cause of chronic type II respiratory failure is:
(a) Severe pneumonia
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(b) Severe COPD(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
17.
The most frequent symptom in respiratory diseases is:
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(a) Breathlessness(b) Chest pain
(c) Hemoptysis
(d) Cough
18.
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A 26-year old young lady attends medical emergency and is labelled as acute severe asthmaby the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
(a) Albuterol
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(b) Anti-leukotrienes(c) Aminophylline
(d) Magnesium sulfate
19.
Consider the following statements with regard to respiratory examination:
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1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
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4. Hyper-resonant note on percussion is characteristic of pnemothoraxWhich of the above statements are correct?
(a) 1 and 3
(b) 2 and 4 only
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(c) 1, 2 and 4(d) 2, 3 and 4
20.
All of the following are the causes of exudative Pleural Effusion, EXCEPT:
(a) SVC obstruction
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(b) Fungal infection(c) SLE
(d) Meig syndrome
21.
Which one of the following is NOT true about Ghrelin?
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(a) It stimulates appetite(b) It decreases gastric emptying
(c) It increases acid secretion
(d) Fasting increases its secretion
22.
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Fecal elastase test is used for diagnosing which one of the following conditions?(a) Lactose intolerance
(b) Mucosal inflammation
(c) Bile acid secretory defects
(d) Pancreatic dysfunction
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23.The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
(b) APACHE score
(c) MELD score
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(d) Metavir score24.
The blood supply of liver consists of:
(a) 50 % hepatic artery and 50 % portal vein
(b) 80 % portal vein and 20 % hepatic artery
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(c) 80 % hepatic artery and 20 % portal vein(d) 70 % hepatic artery and 30 % portal vein
25.
All of the following conditions are associated with Glomerulonephritis with low complement
level, EXCEPT:
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(a) Subacute bacterial endocarditis(b) IgA nephropathy
(c) Systemic lupus erythematosus
(d) Cryoglobulinaemia
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26.
Consider the following statements with regard to oral aphthous ulcers:
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1. They are superficial and painful2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
4. They are pre-malignant and progress over few years to squamous cell carcinoma of
the oral cavity
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Which of the above statements are correct?
(a) 1 and 4 only
(b) 2 and 3 only
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(c) 1, 2 and 3 only(d) 1, 2, 3 and 4
27.
Which one of the following statements about Barrett?s Oesophagus is NOT correct?
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(a) It is a pre-malignant condition(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
cells
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(d) It is an adaptive response to chronic gastro-oesophageal reflux28.
The most common cause of acute hepatitis outbreaks in India is:
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(a) Hepatitis E(b) Hepatitis C
(c) Hepatitis B
(d) Hepatitis A
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29.Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
(a) Menetrier?s disease
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(b) Boerhaave?s syndrome(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
30.
Eradication of helicobacter pylori infection may prove beneficial in the following extra-
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gastric disorders EXCEPT:(a) Unexplained vitamin B12 deficiency
(b) Idiopathic thrombocytopenic purpura
(c) Iron deficiency anaemia without gastro-intestinal bleeding
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(d) Acute glomerulonephritis31.
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
disease patient?
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(a) 8 to 10 gm/dL(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
(d) 13 to 14 gm/dL
32.
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Which one of the following complications of chronic kidney disease is observed in patientswith low parathyroid hormone levels?
(a) Adynamic bone disease
(b) Tumoral calcinosis
(c) Osteitis fibrosa cystic
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(d) Calciphylaxis33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
(a) It is inherited as autosomal dominant trait
(b) It is usually associated with marked proteinuria
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(c) It is usually associated with systematic hypertension, from young age(d) It is associated with Berry aneurysm
34.
Consider the following statements in relation to an adult patient:
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1. Oliguria is defined as passage of urine less than 300 ml per day2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
Which of the statements given above are correct?
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(a) 1 and 3 only(b) 2 and 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
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35.White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
(b) Pyelonephritis
(c) Renal stone disease
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(d) Papillitis36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
low C
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3and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
(a) Renal biopsy is rarely required for making diagnosis
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(b) Antibiotic treatment is given for streptococcal infection(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
37.
Which one of the following statements is NOT correct regarding the risk factors for
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nephrolithiasis?(a) Higher dietary calcium increases risk
(b) Higher animal protein intake increases risk
(c) Higher dietary potassium intake lowers risk
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(d) Lower urine citrate increases the risk38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
He has history of fever and headache for the preceding 3 days. The CSF examination is
unremarkable. What would be the probable diagnosis?
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(a) Multiple sclerosis(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
(d) Viral encephalitis
39.
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Drug of choice for the treatment of Trigeminal Neuralgia is:(a) Carbamazepine
(b) Aceclofenac
(c) Thiamine
(d) Prednisdone
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40.Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
(b) Non dominant parietal lobe
(c) Frontal lobe
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(d) Non dominant temporal lobe41.
Vertical gaze palsy with convergence retraction nystagmus is seen in:
(a) Weber syndrome
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(b) Millard Gubler syndrome(c) Claude syndrome
(d) Parinaud syndrome
42.
A patient on looking forward was found to have his right eye deviated downwards and
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outwards with pupil dilated. He is suffering from:(a) Left 3
rd
nerve palsy
(b) Left 6
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thnerve palsy
(c) Right 4
th
nerve palsy
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(d) Right 3rd
nerve palsy
43.
All of the following are features of Cauda Equina syndrome EXCEPT:
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(a) Low back pain
(b) Lower limb areflexia
(c) Loss of bladder function
(d) Extensor plantar response
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44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
examination, he had resting tremor, bradykinesia, rigidity and postural instability. This
patient is suffering most likely from:
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(a) Parkinson?s disease
(b) Vascular dementia
(c) Alzheimer?s disease
(d) Frunto temporal dementia
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45.An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
turns. Heal-Shin test is normal. Which one of the following is most likely disorder?
(a) Cerebellar ataxia
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(b) Sensory ataxia(c) Frontal gait disorder
(d) Parkinson?s disease
46.
Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
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EXCEPT:(a) Bradycardia
(b) Hypertension
(c) Irregular respiration
(d) Hypothermia
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47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
(LP) and a day later reports worsening of headache. Which one of the following features is
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NOT consistent with diagnosis of ?Post-LP? headache?(a) Post-LP headache usually begins within 48 hours
(b) Post-LP headache worsens in sitting position
(c) Post-LP headache is most severe upon waking up
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(d) Post-LP headache may improve with caffeine intake48.
Which one of the following investigations is NOT appropriate in a case of recurrent
thrombosis?
(a) Antiphospholipid antibodies
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(b) Bcr-Abl assay(c) Protein C and S assays
(d) Antithrombin level
49.
All of the following are causes of reactive thrombocytosis, EXCEPT:
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(a) Hemolytic anemia(b) Megaloblastic anemia
(c) Post splenectomy
(d) Chronic inflammatory disorders
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50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
(a) Von Willebrand disease
(b) Hypofibrinogenemia
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(c) Hemophilia?B(d) Hemphilia?A
51.
Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic
anaemia. The disorder is inherited as an:
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(a) Autosomal recessive trait
(b) X-linked recessive trait
(c) Autosomal dominant trait
(d) X-linked dominant trait
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52.Sickle cell disease may be associated with any of the following EXCEPT:
(a) Acute chest syndrome
(b) Aplastic crisis
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(c) Splenic sequestration crisis(d) Conn?s syndrome
53.
Fever with splenomegaly and lymphadenopathy can be seen in
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(a) Infectious mononucleosis(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
(d) Neither infectious mononucleosis nor chronic leukaemia
54.
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Every individual carries four alpha gene alleles. Deletion of three alleles leads todevelopment of:
(a) Haemoglobin X disease
(b) Haemoglobin H disease
(c) Haemoglobin F disease
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(d) Hydrops fetalis55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
(a) It is a clonal malignancy of haematopoetic stem
(b) Risk of developing CML is increased in monozygotic turns
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(c) CML is defined by presence of BCR-ABL 1 fusion gene(d) 10 year survival with TKI therapy is 85%
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56.
Diagnostic criteria of multiple myeloma includes which of the following?
1. Increased malignant plasma cells in the bone marrow
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2. Serum and/or urinary M protein3. Skeletal lytic lesions
4. Skeletal blastic lesions
Select the correct answer using the code given below:
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(a) 1, 2 and 3(b) 1, 3 and 4
(c) 1, 2 and 4
(d) 2, 3 and 4
57.
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The most predominant type of serum immunoglobulin involved in patients with plasma celldisorder is:
(a) Ig G
(b) Ig A
(c) Ig D
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(d) Light chains58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
pregnancy?
(a) There is an increase in the metabolism of thyroxine by placenta
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(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
(d) Impaired cognitive impairment may be seen in the offspring of mother with
subclinical hypothyroidism
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59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL
(b) HbA1c ? 6.5 %
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(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test(d) Fasting plasma glucose ? 110 mg/dL
60.
A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight
gain, hair loss, tiredness and weakness. What will be the investigation of choice?
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(a) FSH & LH level(b) Estrogen level
(c) Free T
3
and free T
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4level
(d) Free T
4
and TSH level
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61.
Consider the following statements about erectile dysfunction in diabetic males:
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1. It affects 60 % of males2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
4. Endocrine disorders like hyperprolactinemia may cause it
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Which of the statements given above are true?(a) 1 and 2
(b) 2 and 3
(c) 2 and 4
(d) 3 and 4
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62.All of the following can cause Hyperprolactinemia, EXCEPT:
(a) Craniopharyngioma
(b) Hyperthyroidism
(c) Stress
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(d) Chronic renal failure63.
All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
(a) Atrial fibrillation
(b) Periodic paralysis
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(c) Deafness(d) Osteoporosis
64.
Which one of the following hormones acts via the receptor tyrosine kinase?
(a) FSH
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(b) TSH(c) IGF-1
(d) PTH
65.
Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a
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(MEN 2a):1. Primary Hyperparathyroidism
2. Pituitary tumours
3. Medullary carcinoma of thyroid
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4. PheochromocytomaWhich of the above are correct?:
(a) 1, 2 and 4
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(b) 1, 2 and 3(c) 1, 3 and 4
(d) 2, 3 and 4
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66.
Consider the following statements with regard to Graves? ophthalmopathy :
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1. Proptosis is often asymmetric and can even appear to be unilateral2. It is a clinical diagnosis
3. Worsening of symptoms upon glucocorticoid withdrawal is common
4. Radiation therapy is very effective in treatment
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Which of the above statements are correct?(a) 1 and 2 only
(b) 1, 2 and 3
(c) 2, 3 and 4
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(d) 1 and 4 only67.
All of the following are common aetiologies of delirium EXCEPT:
(a) Hyperthyroidism
(b) Hypothyroidism
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(c) Hyperparathyroidism(d) Hypoparathyroidism
68.
Key anthropometric measurements important for evaluating the degree of obesity are:
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(a) Weight, height and waist circumference(b) Weight, height and hip circumference
(c) Weight, height and mid-thigh circumference
(d) Weight, height and chest circumference
69.
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What is the minimum BMI (Body Mass Index) recommended for considering adjuvantpharmacologic treatment in obesity with comorbidity?
(a) 23 kg/m
2
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(b) 25 kg/m2
(c) 27 kg/m
2
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(d) 30 kg/m
2
70.
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A young medical student while working in HIV ward got pricked accidently on the finger bya syringe needle which was used to draw blood from a patient. Patient?s infection status is not
known. Which one of the following therapeutic interventions will be the best interest of this
student?
(a) To start Dolultegravir immediately
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(b) To wash wound with soap and water and start Emtricitabine(c) To give Dolutegravir + Tenofovir + Emtricitabine
(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin
71.
Cryptococcal infection is acquired through:
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(a) Inhalation route(b) Bite of Culex mosquito
(c) Direct skin contact
(d) Ingestion of spores
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72.Which one of the following is NOT appropriate treatment for Echinococcus granulosus and
hydatid disease?
(a) Albendazole 400 mg twice in a day for 3 months
(b) Diethylcarbamazine 2 mg/kg thrice in a day for 12 days
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(c) PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)(d) Praziquantel (20 mg/kg twice daily for 14 days)
73.
Which one of the following infections is NOT amenable to post-exposure prophylaxis with
specific immunoglobulins?
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(a) Hepatitis B(b) HIV
(c) Tetanus
(d) Rabies
74.
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Echinocandins are a class of:(a) Antiviral agents
(b) Antiparasitic agents
(c) Antitubercular agents
(d) Antifungal agents
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75.Recommended first time drug for initial treatment of tuberculosis include all EXCEPT:
(a) Isoniazid
(b) Rifampin
(c) Ethambutol
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(d) Ethionamide76.
The most frequent adverse reaction of significance among people treated for drug-susceptible
tuberculosis is:
(a) Colitis
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(b) Hepatitis(c) Cystitis
(d) Enteritis
77.
All adult patients in whom anti-tubercular treatment is being started should undergo baseline
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assessment of:(a) Complete blood count
(b) Liver function test
(c) Lipid profile
(d) Pulmonary function test
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78.A 30 year old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea.
On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative
bradycardia and rose spots rash. The most likely diagnosis is:
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(a) Malaria fever(b) Enteric fever
(c) Leptospirosis
(d) Dengue fever
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79.The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:
(a) Lymph node TB
(b) Genitourinary TB
(c) Skeletal TB
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(d) Skull TB80.
Which of the following is NOT a clinical feature of Botulism?
(a) Impaired alertness
(b) Dysphagia
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(c) Diplopia(d) Ptosis
81.
Post exposure prophylaxis (PEP) for HIV should contain:
(a) 2 antiretroviral drugs administered for 4 weeks
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(b) 2 antiretroviral drugs administered for 6 weeks(c) 3 antiretroviral drugs administered for 4 weeks
(d) 3 antiretroviral drugs administered for 6 weeks
82.
Paralytic rabies is characterized by:
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(a) Maculopapular rash(b) Flaccid muscle weakness
(c) Spastic muscle weakness
(d) Hyperexcitability and facial weakness
83.
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All of the following are seen in Marasmus EXCEPT:(a) Reduced triceps skinfold
(b) Reduced mid arm circumference
(c) Protein wasting
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(d) Decreased body mass index84.
A 20 year young lady presents with high grade fever for five days and palpable purpura over
extremities. She is found to be confused, with presence of neck stiffness. Which of the
following is the most likely diagnosis?
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(a) Disseminated intravascular coagulation(b) Acute meningococcemia
(c) Antiphospholipid antibody syndrome
(d) Thrombotic thrombocytopenic purpura
85.
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Fibroblast Growth Factor 23 (FGF 23) is increased in which one of the following conditions?(a) Osteomalacia
(b) Osteoporosis
(c) Paget?s disease
(d) Renal Osteodystrophy
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86.Which of the following crystals are deposited in a case of pseudogout?
(a) Monosodium urate
(b) Calcium phosphate
(c) Cholestrol crystals
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(d) Calcium pyrophosphate dehydrate (CPPD)87.
Which of the following features are associated with poor prognosis in Diffuse Cutaneous
Systemic Sclerosis?
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1. Older age2. A high gas transfer factor for carbon monoxide (TLCO)
3. Proteinuria
4. Diffuse skin disease
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Select the correct answer using the code given below:(a) 1, 2 and 4
(b) 3 and 4 only
(c) 1, 3 and 4
(d) 1, 2 and 3
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88.
Which of the following statements regarding pegloticase are correct?
1. It is enzyme conjugate
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2. It is useful in chronic Gout management3. The main adverse effects are infusion reactions and development of antibodies
Select the correct answer using the code given below:
(a) 1 and 2 only
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(b) 2 and 3 only(c) 1 and 3 only
(d) 1, 2 and 3
89.
The most common cause of sensorineural hearing loss in adults is:
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(a) Otosclerosis(b) Meniere?s disease
(c) Presbycusis
(d) Meningitis
90.
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A 50-year old male presents with dizziness. Which one of the following clinical findings doesNOT favour a central cause?
(a) Poor saccades
(b) Gaze evoked nystagmus
(c) Inhibition by visual fixation
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(d) Presence of diplopia, dysarthria--- Content provided by FirstRanker.com ---
FirstRanker.com - FirstRanker's ChoiceCombined Medical Services Examination-2020
Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
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following Arrhythmia is most likely?(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
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2.An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
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(b) Glimepiride(c) Enalapril
(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
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chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of bodyhabitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
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(b) Raynaud?s syndrome(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
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(a) To confirm the diagnosis of angina(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
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Kussmaul?s sign is present in all of the following conditions, EXCEPT:(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
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(d) Right Ventricular Infarction6.
Which one of the following is NOT a common cause of atrial fibrillation?
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(a) Mitral regurgitation(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
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7.In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
(b) Atrial repolarisation
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(c) Ventricular depolarisation(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
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(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
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9.Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
(b) Azilsartan
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(c) Aliskiren(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
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(a) Aortic regurgitation(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
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Signet-ring sign on CT-chest is suggestive of:(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
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12.Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
(b) Moderate persistent
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(c) Severe persistent(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
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(a) 24 hour fecal fat-estimation(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
14.
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Which one of the following antigens is commonly associated with causation of Farmer?slung?
(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
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(d) Candida15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
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(a) INH resistance(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
16.
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The most common cause of chronic type II respiratory failure is:(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
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17.The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
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(d) Cough18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
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(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
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19.Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
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2. Whispered pectoriloquy is characteristic of lung consolidation3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
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(a) 1 and 3(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
20.
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All of the following are the causes of exudative Pleural Effusion, EXCEPT:(a) SVC obstruction
(b) Fungal infection
(c) SLE
(d) Meig syndrome
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21.Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
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(d) Fasting increases its secretion22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
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(c) Bile acid secretory defects(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
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(b) APACHE score(c) MELD score
(d) Metavir score
24.
The blood supply of liver consists of:
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(a) 50 % hepatic artery and 50 % portal vein(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
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All of the following conditions are associated with Glomerulonephritis with low complementlevel, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
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(d) Cryoglobulinaemia--- Content provided by FirstRanker.com ---
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26.
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Consider the following statements with regard to oral aphthous ulcers:1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
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4. They are pre-malignant and progress over few years to squamous cell carcinoma ofthe oral cavity
Which of the above statements are correct?
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(a) 1 and 4 only(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
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Which one of the following statements about Barrett?s Oesophagus is NOT correct?(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
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(c) Normal columnar cells lining the lower oesophagus are replaced by squamouscells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
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The most common cause of acute hepatitis outbreaks in India is:(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
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(d) Hepatitis A29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
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(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
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30.Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
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(b) Idiopathic thrombocytopenic purpura(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
31.
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What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidneydisease patient?
(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
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(d) 13 to 14 gm/dL32.
Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
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(b) Tumoral calcinosis(c) Osteitis fibrosa cystic
(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
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(a) It is inherited as autosomal dominant trait(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
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Consider the following statements in relation to an adult patient:1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
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Which of the statements given above are correct?
(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
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(d) 1, 2 and 335.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
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(b) Pyelonephritis(c) Renal stone disease
(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
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of sore throat two weeks prior to presentation. Laboratory investigations are remarkable forlow C
3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
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(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
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37.Which one of the following statements is NOT correct regarding the risk factors for
nephrolithiasis?
(a) Higher dietary calcium increases risk
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(b) Higher animal protein intake increases risk(c) Higher dietary potassium intake lowers risk
(d) Lower urine citrate increases the risk
38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
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He has history of fever and headache for the preceding 3 days. The CSF examination isunremarkable. What would be the probable diagnosis?
(a) Multiple sclerosis
(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
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(d) Viral encephalitis39.
Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
(b) Aceclofenac
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(c) Thiamine(d) Prednisdone
40.
Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
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(b) Non dominant parietal lobe(c) Frontal lobe
(d) Non dominant temporal lobe
41.
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Vertical gaze palsy with convergence retraction nystagmus is seen in:(a) Weber syndrome
(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
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42.A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
(a) Left 3
rd
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nerve palsy(b) Left 6
th
nerve palsy
(c) Right 4
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thnerve palsy
(d) Right 3
rd
nerve palsy
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43.All of the following are features of Cauda Equina syndrome EXCEPT:
(a) Low back pain
(b) Lower limb areflexia
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(c) Loss of bladder function(d) Extensor plantar response
44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
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examination, he had resting tremor, bradykinesia, rigidity and postural instability. Thispatient is suffering most likely from:
(a) Parkinson?s disease
(b) Vascular dementia
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(c) Alzheimer?s disease(d) Frunto temporal dementia
45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
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turns. Heal-Shin test is normal. Which one of the following is most likely disorder?(a) Cerebellar ataxia
(b) Sensory ataxia
(c) Frontal gait disorder
(d) Parkinson?s disease
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46.Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
EXCEPT:
(a) Bradycardia
(b) Hypertension
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(c) Irregular respiration(d) Hypothermia
47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
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Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture(LP) and a day later reports worsening of headache. Which one of the following features is
NOT consistent with diagnosis of ?Post-LP? headache?
(a) Post-LP headache usually begins within 48 hours
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(b) Post-LP headache worsens in sitting position(c) Post-LP headache is most severe upon waking up
(d) Post-LP headache may improve with caffeine intake
48.
Which one of the following investigations is NOT appropriate in a case of recurrent
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thrombosis?(a) Antiphospholipid antibodies
(b) Bcr-Abl assay
(c) Protein C and S assays
(d) Antithrombin level
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49.All of the following are causes of reactive thrombocytosis, EXCEPT:
(a) Hemolytic anemia
(b) Megaloblastic anemia
(c) Post splenectomy
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(d) Chronic inflammatory disorders50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
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(a) Von Willebrand disease(b) Hypofibrinogenemia
(c) Hemophilia?B
(d) Hemphilia?A
51.
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Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolyticanaemia. The disorder is inherited as an:
(a) Autosomal recessive trait
(b) X-linked recessive trait
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(c) Autosomal dominant trait(d) X-linked dominant trait
52.
Sickle cell disease may be associated with any of the following EXCEPT:
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(a) Acute chest syndrome(b) Aplastic crisis
(c) Splenic sequestration crisis
(d) Conn?s syndrome
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53.Fever with splenomegaly and lymphadenopathy can be seen in
(a) Infectious mononucleosis
(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
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(d) Neither infectious mononucleosis nor chronic leukaemia54.
Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
(a) Haemoglobin X disease
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(b) Haemoglobin H disease(c) Haemoglobin F disease
(d) Hydrops fetalis
55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
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(a) It is a clonal malignancy of haematopoetic stem(b) Risk of developing CML is increased in monozygotic turns
(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
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56.
Diagnostic criteria of multiple myeloma includes which of the following?
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1. Increased malignant plasma cells in the bone marrow
2. Serum and/or urinary M protein
3. Skeletal lytic lesions
4. Skeletal blastic lesions
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Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1, 3 and 4
(c) 1, 2 and 4
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(d) 2, 3 and 457.
The most predominant type of serum immunoglobulin involved in patients with plasma cell
disorder is:
(a) Ig G
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(b) Ig A(c) Ig D
(d) Light chains
58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
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pregnancy?(a) There is an increase in the metabolism of thyroxine by placenta
(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
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(d) Impaired cognitive impairment may be seen in the offspring of mother withsubclinical hypothyroidism
59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
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(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL(b) HbA1c ? 6.5 %
(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ? 110 mg/dL
60.
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A young lady presents in outdoor clinic with complaints of menstrual irregularity, weightgain, hair loss, tiredness and weakness. What will be the investigation of choice?
(a) FSH & LH level
(b) Estrogen level
(c) Free T
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3and free T
4
level
(d) Free T
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4and TSH level
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61.
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Consider the following statements about erectile dysfunction in diabetic males:1. It affects 60 % of males
2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
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4. Endocrine disorders like hyperprolactinemia may cause itWhich of the statements given above are true?
(a) 1 and 2
(b) 2 and 3
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(c) 2 and 4(d) 3 and 4
62.
All of the following can cause Hyperprolactinemia, EXCEPT:
(a) Craniopharyngioma
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(b) Hyperthyroidism(c) Stress
(d) Chronic renal failure
63.
All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
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(a) Atrial fibrillation(b) Periodic paralysis
(c) Deafness
(d) Osteoporosis
64.
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Which one of the following hormones acts via the receptor tyrosine kinase?(a) FSH
(b) TSH
(c) IGF-1
(d) PTH
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65.Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a
(MEN 2a):
1. Primary Hyperparathyroidism
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2. Pituitary tumours3. Medullary carcinoma of thyroid
4. Pheochromocytoma
Which of the above are correct?:
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(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4
(d) 2, 3 and 4
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66.
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Consider the following statements with regard to Graves? ophthalmopathy :1. Proptosis is often asymmetric and can even appear to be unilateral
2. It is a clinical diagnosis
3. Worsening of symptoms upon glucocorticoid withdrawal is common
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4. Radiation therapy is very effective in treatmentWhich of the above statements are correct?
(a) 1 and 2 only
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(b) 1, 2 and 3(c) 2, 3 and 4
(d) 1 and 4 only
67.
All of the following are common aetiologies of delirium EXCEPT:
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(a) Hyperthyroidism(b) Hypothyroidism
(c) Hyperparathyroidism
(d) Hypoparathyroidism
68.
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Key anthropometric measurements important for evaluating the degree of obesity are:(a) Weight, height and waist circumference
(b) Weight, height and hip circumference
(c) Weight, height and mid-thigh circumference
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(d) Weight, height and chest circumference69.
What is the minimum BMI (Body Mass Index) recommended for considering adjuvant
pharmacologic treatment in obesity with comorbidity?
(a) 23 kg/m
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2(b) 25 kg/m
2
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(c) 27 kg/m2
(d) 30 kg/m
2
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70.
A young medical student while working in HIV ward got pricked accidently on the finger by
a syringe needle which was used to draw blood from a patient. Patient?s infection status is not
known. Which one of the following therapeutic interventions will be the best interest of this
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student?(a) To start Dolultegravir immediately
(b) To wash wound with soap and water and start Emtricitabine
(c) To give Dolutegravir + Tenofovir + Emtricitabine
(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin
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71.Cryptococcal infection is acquired through:
(a) Inhalation route
(b) Bite of Culex mosquito
(c) Direct skin contact
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(d) Ingestion of spores72.
Which one of the following is NOT appropriate treatment for Echinococcus granulosus and
hydatid disease?
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(a) Albendazole 400 mg twice in a day for 3 months(b) Diethylcarbamazine 2 mg/kg thrice in a day for 12 days
(c) PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)
(d) Praziquantel (20 mg/kg twice daily for 14 days)
73.
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Which one of the following infections is NOT amenable to post-exposure prophylaxis withspecific immunoglobulins?
(a) Hepatitis B
(b) HIV
(c) Tetanus
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(d) Rabies74.
Echinocandins are a class of:
(a) Antiviral agents
(b) Antiparasitic agents
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(c) Antitubercular agents(d) Antifungal agents
75.
Recommended first time drug for initial treatment of tuberculosis include all EXCEPT:
(a) Isoniazid
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(b) Rifampin(c) Ethambutol
(d) Ethionamide
76.
The most frequent adverse reaction of significance among people treated for drug-susceptible
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tuberculosis is:(a) Colitis
(b) Hepatitis
(c) Cystitis
(d) Enteritis
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77.All adult patients in whom anti-tubercular treatment is being started should undergo baseline
assessment of:
(a) Complete blood count
(b) Liver function test
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(c) Lipid profile(d) Pulmonary function test
78.
A 30 year old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea.
On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative
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bradycardia and rose spots rash. The most likely diagnosis is:(a) Malaria fever
(b) Enteric fever
(c) Leptospirosis
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(d) Dengue fever79.
The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:
(a) Lymph node TB
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(b) Genitourinary TB(c) Skeletal TB
(d) Skull TB
80.
Which of the following is NOT a clinical feature of Botulism?
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(a) Impaired alertness(b) Dysphagia
(c) Diplopia
(d) Ptosis
81.
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Post exposure prophylaxis (PEP) for HIV should contain:(a) 2 antiretroviral drugs administered for 4 weeks
(b) 2 antiretroviral drugs administered for 6 weeks
(c) 3 antiretroviral drugs administered for 4 weeks
(d) 3 antiretroviral drugs administered for 6 weeks
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82.Paralytic rabies is characterized by:
(a) Maculopapular rash
(b) Flaccid muscle weakness
(c) Spastic muscle weakness
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(d) Hyperexcitability and facial weakness83.
All of the following are seen in Marasmus EXCEPT:
(a) Reduced triceps skinfold
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(b) Reduced mid arm circumference(c) Protein wasting
(d) Decreased body mass index
84.
A 20 year young lady presents with high grade fever for five days and palpable purpura over
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extremities. She is found to be confused, with presence of neck stiffness. Which of thefollowing is the most likely diagnosis?
(a) Disseminated intravascular coagulation
(b) Acute meningococcemia
(c) Antiphospholipid antibody syndrome
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(d) Thrombotic thrombocytopenic purpura85.
Fibroblast Growth Factor 23 (FGF 23) is increased in which one of the following conditions?
(a) Osteomalacia
(b) Osteoporosis
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(c) Paget?s disease(d) Renal Osteodystrophy
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86.
Which of the following crystals are deposited in a case of pseudogout?
(a) Monosodium urate
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(b) Calcium phosphate(c) Cholestrol crystals
(d) Calcium pyrophosphate dehydrate (CPPD)
87.
Which of the following features are associated with poor prognosis in Diffuse Cutaneous
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Systemic Sclerosis?1. Older age
2. A high gas transfer factor for carbon monoxide (TLCO)
3. Proteinuria
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4. Diffuse skin diseaseSelect the correct answer using the code given below:
(a) 1, 2 and 4
(b) 3 and 4 only
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(c) 1, 3 and 4(d) 1, 2 and 3
88.
Which of the following statements regarding pegloticase are correct?
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1. It is enzyme conjugate
2. It is useful in chronic Gout management
3. The main adverse effects are infusion reactions and development of antibodies
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Select the correct answer using the code given below:(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
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89.The most common cause of sensorineural hearing loss in adults is:
(a) Otosclerosis
(b) Meniere?s disease
(c) Presbycusis
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(d) Meningitis90.
A 50-year old male presents with dizziness. Which one of the following clinical findings does
NOT favour a central cause?
(a) Poor saccades
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(b) Gaze evoked nystagmus(c) Inhibition by visual fixation
(d) Presence of diplopia, dysarthria
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91.
A young primigravida with 11 weeks pregnancy presents with sudden onset pain and
swelling of left lower limb. Homan?s sign is positive. Duplex ultrasonogram shows non-
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compressibility of veins in the affected region, with absent flow. The drug of choice fortreatment is:
(a) Enoxaparin
(b) Amoxycillin?Clavulanic acid
(c) Warfarin
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(d) Limb elevation only92.
All of the following are clinical features of hypovolaemic shock EXCEPT:
(a) Cold clammy skin
(b) Bradycardia
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(c) Hypotension(d) Oliguria
93.
Which one of the following is most appropriate to describe classic heat stroke?
(a) Patients core body temperature rises above 44?C with headache, nausea and loss of
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consciousness(b) Patients core body temperature rises above 40 ?C with muscle tremors, confusion,
loss of consciousness and loss of sweating
(c) Patients core body temperature rises above 38 ?C with increased sweating,
tachypnoea, tachycardia and loss of consciousness
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(d) Patients core body temperature is above 40 ?C with disorientation, increasedsweating, peripheral vasodilation, tachycardia and loss of consciousness
94.
Which of the following is NOT a priority in the initial management of shock from venomous
snake?
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(a) Aggressive volume resuscitation
(b) Vasopressor support
(c) Anti-venom administration
(d) All of these are undertaken simultaneously
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95.
Which one of the following is NOT an appropriate criterion for diagnosis of Systemic
Inflammatory Response Syndrome (SIRS)?
(a) Respiratory rate > 20/mm
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(b) Heart rate > 90/min(c) Total leucocyte count > 16 ? 10
9
per Litre
(d) Temperature > 38
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0C
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FirstRanker.com - FirstRanker's ChoiceCombined Medical Services Examination-2020
Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
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following Arrhythmia is most likely?(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
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2.An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
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(b) Glimepiride(c) Enalapril
(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
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chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of bodyhabitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
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(b) Raynaud?s syndrome(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
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(a) To confirm the diagnosis of angina(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
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Kussmaul?s sign is present in all of the following conditions, EXCEPT:(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
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(d) Right Ventricular Infarction6.
Which one of the following is NOT a common cause of atrial fibrillation?
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(a) Mitral regurgitation(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
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7.In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
(b) Atrial repolarisation
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(c) Ventricular depolarisation(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
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(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
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9.Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
(b) Azilsartan
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(c) Aliskiren(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
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(a) Aortic regurgitation(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
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Signet-ring sign on CT-chest is suggestive of:(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
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12.Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
(b) Moderate persistent
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(c) Severe persistent(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
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(a) 24 hour fecal fat-estimation(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
14.
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Which one of the following antigens is commonly associated with causation of Farmer?slung?
(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
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(d) Candida15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
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(a) INH resistance(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
16.
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The most common cause of chronic type II respiratory failure is:(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
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17.The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
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(d) Cough18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
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(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
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19.Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
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2. Whispered pectoriloquy is characteristic of lung consolidation3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
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(a) 1 and 3(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
20.
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All of the following are the causes of exudative Pleural Effusion, EXCEPT:(a) SVC obstruction
(b) Fungal infection
(c) SLE
(d) Meig syndrome
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21.Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
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(d) Fasting increases its secretion22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
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(c) Bile acid secretory defects(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
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(b) APACHE score(c) MELD score
(d) Metavir score
24.
The blood supply of liver consists of:
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(a) 50 % hepatic artery and 50 % portal vein(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
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All of the following conditions are associated with Glomerulonephritis with low complementlevel, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
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(d) Cryoglobulinaemia--- Content provided by FirstRanker.com ---
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26.
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Consider the following statements with regard to oral aphthous ulcers:1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
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4. They are pre-malignant and progress over few years to squamous cell carcinoma ofthe oral cavity
Which of the above statements are correct?
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(a) 1 and 4 only(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
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Which one of the following statements about Barrett?s Oesophagus is NOT correct?(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
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(c) Normal columnar cells lining the lower oesophagus are replaced by squamouscells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
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The most common cause of acute hepatitis outbreaks in India is:(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
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(d) Hepatitis A29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
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(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
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30.Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
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(b) Idiopathic thrombocytopenic purpura(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
31.
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What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidneydisease patient?
(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
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(d) 13 to 14 gm/dL32.
Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
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(b) Tumoral calcinosis(c) Osteitis fibrosa cystic
(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
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(a) It is inherited as autosomal dominant trait(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
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Consider the following statements in relation to an adult patient:1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
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Which of the statements given above are correct?
(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
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(d) 1, 2 and 335.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
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(b) Pyelonephritis(c) Renal stone disease
(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
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of sore throat two weeks prior to presentation. Laboratory investigations are remarkable forlow C
3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
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(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
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37.Which one of the following statements is NOT correct regarding the risk factors for
nephrolithiasis?
(a) Higher dietary calcium increases risk
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(b) Higher animal protein intake increases risk(c) Higher dietary potassium intake lowers risk
(d) Lower urine citrate increases the risk
38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
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He has history of fever and headache for the preceding 3 days. The CSF examination isunremarkable. What would be the probable diagnosis?
(a) Multiple sclerosis
(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
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(d) Viral encephalitis39.
Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
(b) Aceclofenac
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(c) Thiamine(d) Prednisdone
40.
Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
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(b) Non dominant parietal lobe(c) Frontal lobe
(d) Non dominant temporal lobe
41.
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Vertical gaze palsy with convergence retraction nystagmus is seen in:(a) Weber syndrome
(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
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42.A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
(a) Left 3
rd
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nerve palsy(b) Left 6
th
nerve palsy
(c) Right 4
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thnerve palsy
(d) Right 3
rd
nerve palsy
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43.All of the following are features of Cauda Equina syndrome EXCEPT:
(a) Low back pain
(b) Lower limb areflexia
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(c) Loss of bladder function(d) Extensor plantar response
44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
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examination, he had resting tremor, bradykinesia, rigidity and postural instability. Thispatient is suffering most likely from:
(a) Parkinson?s disease
(b) Vascular dementia
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(c) Alzheimer?s disease(d) Frunto temporal dementia
45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
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turns. Heal-Shin test is normal. Which one of the following is most likely disorder?(a) Cerebellar ataxia
(b) Sensory ataxia
(c) Frontal gait disorder
(d) Parkinson?s disease
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46.Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
EXCEPT:
(a) Bradycardia
(b) Hypertension
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(c) Irregular respiration(d) Hypothermia
47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
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Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture(LP) and a day later reports worsening of headache. Which one of the following features is
NOT consistent with diagnosis of ?Post-LP? headache?
(a) Post-LP headache usually begins within 48 hours
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(b) Post-LP headache worsens in sitting position(c) Post-LP headache is most severe upon waking up
(d) Post-LP headache may improve with caffeine intake
48.
Which one of the following investigations is NOT appropriate in a case of recurrent
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thrombosis?(a) Antiphospholipid antibodies
(b) Bcr-Abl assay
(c) Protein C and S assays
(d) Antithrombin level
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49.All of the following are causes of reactive thrombocytosis, EXCEPT:
(a) Hemolytic anemia
(b) Megaloblastic anemia
(c) Post splenectomy
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(d) Chronic inflammatory disorders50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
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(a) Von Willebrand disease(b) Hypofibrinogenemia
(c) Hemophilia?B
(d) Hemphilia?A
51.
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Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolyticanaemia. The disorder is inherited as an:
(a) Autosomal recessive trait
(b) X-linked recessive trait
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(c) Autosomal dominant trait(d) X-linked dominant trait
52.
Sickle cell disease may be associated with any of the following EXCEPT:
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(a) Acute chest syndrome(b) Aplastic crisis
(c) Splenic sequestration crisis
(d) Conn?s syndrome
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53.Fever with splenomegaly and lymphadenopathy can be seen in
(a) Infectious mononucleosis
(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
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(d) Neither infectious mononucleosis nor chronic leukaemia54.
Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
(a) Haemoglobin X disease
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(b) Haemoglobin H disease(c) Haemoglobin F disease
(d) Hydrops fetalis
55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
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(a) It is a clonal malignancy of haematopoetic stem(b) Risk of developing CML is increased in monozygotic turns
(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
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56.
Diagnostic criteria of multiple myeloma includes which of the following?
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1. Increased malignant plasma cells in the bone marrow
2. Serum and/or urinary M protein
3. Skeletal lytic lesions
4. Skeletal blastic lesions
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Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1, 3 and 4
(c) 1, 2 and 4
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(d) 2, 3 and 457.
The most predominant type of serum immunoglobulin involved in patients with plasma cell
disorder is:
(a) Ig G
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(b) Ig A(c) Ig D
(d) Light chains
58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
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pregnancy?(a) There is an increase in the metabolism of thyroxine by placenta
(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
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(d) Impaired cognitive impairment may be seen in the offspring of mother withsubclinical hypothyroidism
59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
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(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL(b) HbA1c ? 6.5 %
(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ? 110 mg/dL
60.
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A young lady presents in outdoor clinic with complaints of menstrual irregularity, weightgain, hair loss, tiredness and weakness. What will be the investigation of choice?
(a) FSH & LH level
(b) Estrogen level
(c) Free T
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3and free T
4
level
(d) Free T
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4and TSH level
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61.
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Consider the following statements about erectile dysfunction in diabetic males:1. It affects 60 % of males
2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
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4. Endocrine disorders like hyperprolactinemia may cause itWhich of the statements given above are true?
(a) 1 and 2
(b) 2 and 3
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(c) 2 and 4(d) 3 and 4
62.
All of the following can cause Hyperprolactinemia, EXCEPT:
(a) Craniopharyngioma
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(b) Hyperthyroidism(c) Stress
(d) Chronic renal failure
63.
All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
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(a) Atrial fibrillation(b) Periodic paralysis
(c) Deafness
(d) Osteoporosis
64.
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Which one of the following hormones acts via the receptor tyrosine kinase?(a) FSH
(b) TSH
(c) IGF-1
(d) PTH
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65.Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a
(MEN 2a):
1. Primary Hyperparathyroidism
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2. Pituitary tumours3. Medullary carcinoma of thyroid
4. Pheochromocytoma
Which of the above are correct?:
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(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4
(d) 2, 3 and 4
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66.
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Consider the following statements with regard to Graves? ophthalmopathy :1. Proptosis is often asymmetric and can even appear to be unilateral
2. It is a clinical diagnosis
3. Worsening of symptoms upon glucocorticoid withdrawal is common
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4. Radiation therapy is very effective in treatmentWhich of the above statements are correct?
(a) 1 and 2 only
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(b) 1, 2 and 3(c) 2, 3 and 4
(d) 1 and 4 only
67.
All of the following are common aetiologies of delirium EXCEPT:
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(a) Hyperthyroidism(b) Hypothyroidism
(c) Hyperparathyroidism
(d) Hypoparathyroidism
68.
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Key anthropometric measurements important for evaluating the degree of obesity are:(a) Weight, height and waist circumference
(b) Weight, height and hip circumference
(c) Weight, height and mid-thigh circumference
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(d) Weight, height and chest circumference69.
What is the minimum BMI (Body Mass Index) recommended for considering adjuvant
pharmacologic treatment in obesity with comorbidity?
(a) 23 kg/m
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2(b) 25 kg/m
2
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(c) 27 kg/m2
(d) 30 kg/m
2
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70.
A young medical student while working in HIV ward got pricked accidently on the finger by
a syringe needle which was used to draw blood from a patient. Patient?s infection status is not
known. Which one of the following therapeutic interventions will be the best interest of this
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student?(a) To start Dolultegravir immediately
(b) To wash wound with soap and water and start Emtricitabine
(c) To give Dolutegravir + Tenofovir + Emtricitabine
(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin
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71.Cryptococcal infection is acquired through:
(a) Inhalation route
(b) Bite of Culex mosquito
(c) Direct skin contact
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(d) Ingestion of spores72.
Which one of the following is NOT appropriate treatment for Echinococcus granulosus and
hydatid disease?
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(a) Albendazole 400 mg twice in a day for 3 months(b) Diethylcarbamazine 2 mg/kg thrice in a day for 12 days
(c) PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)
(d) Praziquantel (20 mg/kg twice daily for 14 days)
73.
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Which one of the following infections is NOT amenable to post-exposure prophylaxis withspecific immunoglobulins?
(a) Hepatitis B
(b) HIV
(c) Tetanus
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(d) Rabies74.
Echinocandins are a class of:
(a) Antiviral agents
(b) Antiparasitic agents
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(c) Antitubercular agents(d) Antifungal agents
75.
Recommended first time drug for initial treatment of tuberculosis include all EXCEPT:
(a) Isoniazid
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(b) Rifampin(c) Ethambutol
(d) Ethionamide
76.
The most frequent adverse reaction of significance among people treated for drug-susceptible
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tuberculosis is:(a) Colitis
(b) Hepatitis
(c) Cystitis
(d) Enteritis
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77.All adult patients in whom anti-tubercular treatment is being started should undergo baseline
assessment of:
(a) Complete blood count
(b) Liver function test
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(c) Lipid profile(d) Pulmonary function test
78.
A 30 year old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea.
On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative
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bradycardia and rose spots rash. The most likely diagnosis is:(a) Malaria fever
(b) Enteric fever
(c) Leptospirosis
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(d) Dengue fever79.
The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:
(a) Lymph node TB
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(b) Genitourinary TB(c) Skeletal TB
(d) Skull TB
80.
Which of the following is NOT a clinical feature of Botulism?
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(a) Impaired alertness(b) Dysphagia
(c) Diplopia
(d) Ptosis
81.
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Post exposure prophylaxis (PEP) for HIV should contain:(a) 2 antiretroviral drugs administered for 4 weeks
(b) 2 antiretroviral drugs administered for 6 weeks
(c) 3 antiretroviral drugs administered for 4 weeks
(d) 3 antiretroviral drugs administered for 6 weeks
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82.Paralytic rabies is characterized by:
(a) Maculopapular rash
(b) Flaccid muscle weakness
(c) Spastic muscle weakness
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(d) Hyperexcitability and facial weakness83.
All of the following are seen in Marasmus EXCEPT:
(a) Reduced triceps skinfold
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(b) Reduced mid arm circumference(c) Protein wasting
(d) Decreased body mass index
84.
A 20 year young lady presents with high grade fever for five days and palpable purpura over
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extremities. She is found to be confused, with presence of neck stiffness. Which of thefollowing is the most likely diagnosis?
(a) Disseminated intravascular coagulation
(b) Acute meningococcemia
(c) Antiphospholipid antibody syndrome
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(d) Thrombotic thrombocytopenic purpura85.
Fibroblast Growth Factor 23 (FGF 23) is increased in which one of the following conditions?
(a) Osteomalacia
(b) Osteoporosis
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(c) Paget?s disease(d) Renal Osteodystrophy
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86.
Which of the following crystals are deposited in a case of pseudogout?
(a) Monosodium urate
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(b) Calcium phosphate(c) Cholestrol crystals
(d) Calcium pyrophosphate dehydrate (CPPD)
87.
Which of the following features are associated with poor prognosis in Diffuse Cutaneous
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Systemic Sclerosis?1. Older age
2. A high gas transfer factor for carbon monoxide (TLCO)
3. Proteinuria
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4. Diffuse skin diseaseSelect the correct answer using the code given below:
(a) 1, 2 and 4
(b) 3 and 4 only
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(c) 1, 3 and 4(d) 1, 2 and 3
88.
Which of the following statements regarding pegloticase are correct?
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1. It is enzyme conjugate
2. It is useful in chronic Gout management
3. The main adverse effects are infusion reactions and development of antibodies
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Select the correct answer using the code given below:(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
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89.The most common cause of sensorineural hearing loss in adults is:
(a) Otosclerosis
(b) Meniere?s disease
(c) Presbycusis
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(d) Meningitis90.
A 50-year old male presents with dizziness. Which one of the following clinical findings does
NOT favour a central cause?
(a) Poor saccades
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(b) Gaze evoked nystagmus(c) Inhibition by visual fixation
(d) Presence of diplopia, dysarthria
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91.
A young primigravida with 11 weeks pregnancy presents with sudden onset pain and
swelling of left lower limb. Homan?s sign is positive. Duplex ultrasonogram shows non-
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compressibility of veins in the affected region, with absent flow. The drug of choice fortreatment is:
(a) Enoxaparin
(b) Amoxycillin?Clavulanic acid
(c) Warfarin
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(d) Limb elevation only92.
All of the following are clinical features of hypovolaemic shock EXCEPT:
(a) Cold clammy skin
(b) Bradycardia
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(c) Hypotension(d) Oliguria
93.
Which one of the following is most appropriate to describe classic heat stroke?
(a) Patients core body temperature rises above 44?C with headache, nausea and loss of
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consciousness(b) Patients core body temperature rises above 40 ?C with muscle tremors, confusion,
loss of consciousness and loss of sweating
(c) Patients core body temperature rises above 38 ?C with increased sweating,
tachypnoea, tachycardia and loss of consciousness
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(d) Patients core body temperature is above 40 ?C with disorientation, increasedsweating, peripheral vasodilation, tachycardia and loss of consciousness
94.
Which of the following is NOT a priority in the initial management of shock from venomous
snake?
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(a) Aggressive volume resuscitation
(b) Vasopressor support
(c) Anti-venom administration
(d) All of these are undertaken simultaneously
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95.
Which one of the following is NOT an appropriate criterion for diagnosis of Systemic
Inflammatory Response Syndrome (SIRS)?
(a) Respiratory rate > 20/mm
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(b) Heart rate > 90/min(c) Total leucocyte count > 16 ? 10
9
per Litre
(d) Temperature > 38
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0C
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96.All of the following predispose to Acute Respiratory Distress Syndrome EXCEPT:
(a) Acute Pancreatitis
(b) Toxic gas inhalation
(c) Aspiration of gastric contents
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(d) Severe Bronchial asthma97.
An 8 year old child has consumed a few tablets of a drug that were being taken by his mother
on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and
hepatic necrosis. Which is the most likely drug?
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(a) Multivitamins(b) Calcium carbonate
(c) Folic acid
(d) Iron
98.
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A newborn weighing 1.5 kg at birth presents at 6 hours of age with lethargy, weak and highpitched cry and difficulty in feeding. What is the next step in management?
(a) Estimation of blood sugar
(b) Estimation of serum calcium
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(c) Supplementary oxygen(d) Bedside electrocardiogram
99.
In a child with acute organophosphorus poisoning, which one of the following drugs will act
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as anti-sialogogue and peripheral parasympatholytic agent?(a) Carbamates
(b) Atropine
(c) Benzodiazepine
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(d) Pralidoxime100.
A 6-year old child needs to undergo a central Catheter placement for total parental nutrition.
The procedure is likely to evoke pain and anxiety. Which of the following is the most
appropriate drug for sedation and analgesia in this child?
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(a) Chloral hydrate
(b) Midozolam
(c) Propofol
(d) Ketamine
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101.Which one of the following is the drug of choice in a child presenting with supraventricular
tachycardia?
(a) Atropine
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(b) Lidocaine(c) Adenosine
(d) Nalaxone
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FirstRanker.com - FirstRanker's ChoiceCombined Medical Services Examination-2020
Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
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following Arrhythmia is most likely?(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
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2.An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
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(b) Glimepiride(c) Enalapril
(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
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chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of bodyhabitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
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(b) Raynaud?s syndrome(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
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(a) To confirm the diagnosis of angina(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
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Kussmaul?s sign is present in all of the following conditions, EXCEPT:(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
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(d) Right Ventricular Infarction6.
Which one of the following is NOT a common cause of atrial fibrillation?
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(a) Mitral regurgitation(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
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7.In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
(b) Atrial repolarisation
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(c) Ventricular depolarisation(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
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(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
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9.Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
(b) Azilsartan
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(c) Aliskiren(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
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(a) Aortic regurgitation(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
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Signet-ring sign on CT-chest is suggestive of:(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
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12.Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
(b) Moderate persistent
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(c) Severe persistent(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
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(a) 24 hour fecal fat-estimation(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
14.
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Which one of the following antigens is commonly associated with causation of Farmer?slung?
(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
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(d) Candida15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
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(a) INH resistance(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
16.
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The most common cause of chronic type II respiratory failure is:(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
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17.The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
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(d) Cough18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
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(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
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19.Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
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2. Whispered pectoriloquy is characteristic of lung consolidation3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
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(a) 1 and 3(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
20.
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All of the following are the causes of exudative Pleural Effusion, EXCEPT:(a) SVC obstruction
(b) Fungal infection
(c) SLE
(d) Meig syndrome
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21.Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
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(d) Fasting increases its secretion22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
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(c) Bile acid secretory defects(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
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(b) APACHE score(c) MELD score
(d) Metavir score
24.
The blood supply of liver consists of:
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(a) 50 % hepatic artery and 50 % portal vein(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
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All of the following conditions are associated with Glomerulonephritis with low complementlevel, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
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(d) Cryoglobulinaemia--- Content provided by FirstRanker.com ---
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26.
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Consider the following statements with regard to oral aphthous ulcers:1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
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4. They are pre-malignant and progress over few years to squamous cell carcinoma ofthe oral cavity
Which of the above statements are correct?
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(a) 1 and 4 only(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
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Which one of the following statements about Barrett?s Oesophagus is NOT correct?(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
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(c) Normal columnar cells lining the lower oesophagus are replaced by squamouscells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
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The most common cause of acute hepatitis outbreaks in India is:(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
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(d) Hepatitis A29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
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(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
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30.Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
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(b) Idiopathic thrombocytopenic purpura(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
31.
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What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidneydisease patient?
(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
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(d) 13 to 14 gm/dL32.
Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
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(b) Tumoral calcinosis(c) Osteitis fibrosa cystic
(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
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(a) It is inherited as autosomal dominant trait(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
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Consider the following statements in relation to an adult patient:1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
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Which of the statements given above are correct?
(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
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(d) 1, 2 and 335.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
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(b) Pyelonephritis(c) Renal stone disease
(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
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of sore throat two weeks prior to presentation. Laboratory investigations are remarkable forlow C
3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
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(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
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37.Which one of the following statements is NOT correct regarding the risk factors for
nephrolithiasis?
(a) Higher dietary calcium increases risk
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(b) Higher animal protein intake increases risk(c) Higher dietary potassium intake lowers risk
(d) Lower urine citrate increases the risk
38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
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He has history of fever and headache for the preceding 3 days. The CSF examination isunremarkable. What would be the probable diagnosis?
(a) Multiple sclerosis
(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
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(d) Viral encephalitis39.
Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
(b) Aceclofenac
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(c) Thiamine(d) Prednisdone
40.
Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
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(b) Non dominant parietal lobe(c) Frontal lobe
(d) Non dominant temporal lobe
41.
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Vertical gaze palsy with convergence retraction nystagmus is seen in:(a) Weber syndrome
(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
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42.A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
(a) Left 3
rd
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nerve palsy(b) Left 6
th
nerve palsy
(c) Right 4
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thnerve palsy
(d) Right 3
rd
nerve palsy
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43.All of the following are features of Cauda Equina syndrome EXCEPT:
(a) Low back pain
(b) Lower limb areflexia
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(c) Loss of bladder function(d) Extensor plantar response
44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
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examination, he had resting tremor, bradykinesia, rigidity and postural instability. Thispatient is suffering most likely from:
(a) Parkinson?s disease
(b) Vascular dementia
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(c) Alzheimer?s disease(d) Frunto temporal dementia
45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
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turns. Heal-Shin test is normal. Which one of the following is most likely disorder?(a) Cerebellar ataxia
(b) Sensory ataxia
(c) Frontal gait disorder
(d) Parkinson?s disease
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46.Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
EXCEPT:
(a) Bradycardia
(b) Hypertension
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(c) Irregular respiration(d) Hypothermia
47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
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Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture(LP) and a day later reports worsening of headache. Which one of the following features is
NOT consistent with diagnosis of ?Post-LP? headache?
(a) Post-LP headache usually begins within 48 hours
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(b) Post-LP headache worsens in sitting position(c) Post-LP headache is most severe upon waking up
(d) Post-LP headache may improve with caffeine intake
48.
Which one of the following investigations is NOT appropriate in a case of recurrent
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thrombosis?(a) Antiphospholipid antibodies
(b) Bcr-Abl assay
(c) Protein C and S assays
(d) Antithrombin level
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49.All of the following are causes of reactive thrombocytosis, EXCEPT:
(a) Hemolytic anemia
(b) Megaloblastic anemia
(c) Post splenectomy
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(d) Chronic inflammatory disorders50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
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(a) Von Willebrand disease(b) Hypofibrinogenemia
(c) Hemophilia?B
(d) Hemphilia?A
51.
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Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolyticanaemia. The disorder is inherited as an:
(a) Autosomal recessive trait
(b) X-linked recessive trait
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(c) Autosomal dominant trait(d) X-linked dominant trait
52.
Sickle cell disease may be associated with any of the following EXCEPT:
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(a) Acute chest syndrome(b) Aplastic crisis
(c) Splenic sequestration crisis
(d) Conn?s syndrome
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53.Fever with splenomegaly and lymphadenopathy can be seen in
(a) Infectious mononucleosis
(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
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(d) Neither infectious mononucleosis nor chronic leukaemia54.
Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
(a) Haemoglobin X disease
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(b) Haemoglobin H disease(c) Haemoglobin F disease
(d) Hydrops fetalis
55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
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(a) It is a clonal malignancy of haematopoetic stem(b) Risk of developing CML is increased in monozygotic turns
(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
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56.
Diagnostic criteria of multiple myeloma includes which of the following?
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1. Increased malignant plasma cells in the bone marrow
2. Serum and/or urinary M protein
3. Skeletal lytic lesions
4. Skeletal blastic lesions
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Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1, 3 and 4
(c) 1, 2 and 4
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(d) 2, 3 and 457.
The most predominant type of serum immunoglobulin involved in patients with plasma cell
disorder is:
(a) Ig G
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(b) Ig A(c) Ig D
(d) Light chains
58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
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pregnancy?(a) There is an increase in the metabolism of thyroxine by placenta
(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
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(d) Impaired cognitive impairment may be seen in the offspring of mother withsubclinical hypothyroidism
59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
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(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL(b) HbA1c ? 6.5 %
(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ? 110 mg/dL
60.
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A young lady presents in outdoor clinic with complaints of menstrual irregularity, weightgain, hair loss, tiredness and weakness. What will be the investigation of choice?
(a) FSH & LH level
(b) Estrogen level
(c) Free T
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3and free T
4
level
(d) Free T
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4and TSH level
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61.
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Consider the following statements about erectile dysfunction in diabetic males:1. It affects 60 % of males
2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
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4. Endocrine disorders like hyperprolactinemia may cause itWhich of the statements given above are true?
(a) 1 and 2
(b) 2 and 3
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(c) 2 and 4(d) 3 and 4
62.
All of the following can cause Hyperprolactinemia, EXCEPT:
(a) Craniopharyngioma
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(b) Hyperthyroidism(c) Stress
(d) Chronic renal failure
63.
All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
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(a) Atrial fibrillation(b) Periodic paralysis
(c) Deafness
(d) Osteoporosis
64.
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Which one of the following hormones acts via the receptor tyrosine kinase?(a) FSH
(b) TSH
(c) IGF-1
(d) PTH
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65.Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a
(MEN 2a):
1. Primary Hyperparathyroidism
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2. Pituitary tumours3. Medullary carcinoma of thyroid
4. Pheochromocytoma
Which of the above are correct?:
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(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4
(d) 2, 3 and 4
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66.
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Consider the following statements with regard to Graves? ophthalmopathy :1. Proptosis is often asymmetric and can even appear to be unilateral
2. It is a clinical diagnosis
3. Worsening of symptoms upon glucocorticoid withdrawal is common
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4. Radiation therapy is very effective in treatmentWhich of the above statements are correct?
(a) 1 and 2 only
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(b) 1, 2 and 3(c) 2, 3 and 4
(d) 1 and 4 only
67.
All of the following are common aetiologies of delirium EXCEPT:
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(a) Hyperthyroidism(b) Hypothyroidism
(c) Hyperparathyroidism
(d) Hypoparathyroidism
68.
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Key anthropometric measurements important for evaluating the degree of obesity are:(a) Weight, height and waist circumference
(b) Weight, height and hip circumference
(c) Weight, height and mid-thigh circumference
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(d) Weight, height and chest circumference69.
What is the minimum BMI (Body Mass Index) recommended for considering adjuvant
pharmacologic treatment in obesity with comorbidity?
(a) 23 kg/m
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2(b) 25 kg/m
2
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(c) 27 kg/m2
(d) 30 kg/m
2
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70.
A young medical student while working in HIV ward got pricked accidently on the finger by
a syringe needle which was used to draw blood from a patient. Patient?s infection status is not
known. Which one of the following therapeutic interventions will be the best interest of this
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student?(a) To start Dolultegravir immediately
(b) To wash wound with soap and water and start Emtricitabine
(c) To give Dolutegravir + Tenofovir + Emtricitabine
(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin
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71.Cryptococcal infection is acquired through:
(a) Inhalation route
(b) Bite of Culex mosquito
(c) Direct skin contact
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(d) Ingestion of spores72.
Which one of the following is NOT appropriate treatment for Echinococcus granulosus and
hydatid disease?
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(a) Albendazole 400 mg twice in a day for 3 months(b) Diethylcarbamazine 2 mg/kg thrice in a day for 12 days
(c) PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)
(d) Praziquantel (20 mg/kg twice daily for 14 days)
73.
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Which one of the following infections is NOT amenable to post-exposure prophylaxis withspecific immunoglobulins?
(a) Hepatitis B
(b) HIV
(c) Tetanus
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(d) Rabies74.
Echinocandins are a class of:
(a) Antiviral agents
(b) Antiparasitic agents
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(c) Antitubercular agents(d) Antifungal agents
75.
Recommended first time drug for initial treatment of tuberculosis include all EXCEPT:
(a) Isoniazid
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(b) Rifampin(c) Ethambutol
(d) Ethionamide
76.
The most frequent adverse reaction of significance among people treated for drug-susceptible
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tuberculosis is:(a) Colitis
(b) Hepatitis
(c) Cystitis
(d) Enteritis
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77.All adult patients in whom anti-tubercular treatment is being started should undergo baseline
assessment of:
(a) Complete blood count
(b) Liver function test
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(c) Lipid profile(d) Pulmonary function test
78.
A 30 year old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea.
On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative
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bradycardia and rose spots rash. The most likely diagnosis is:(a) Malaria fever
(b) Enteric fever
(c) Leptospirosis
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(d) Dengue fever79.
The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:
(a) Lymph node TB
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(b) Genitourinary TB(c) Skeletal TB
(d) Skull TB
80.
Which of the following is NOT a clinical feature of Botulism?
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(a) Impaired alertness(b) Dysphagia
(c) Diplopia
(d) Ptosis
81.
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Post exposure prophylaxis (PEP) for HIV should contain:(a) 2 antiretroviral drugs administered for 4 weeks
(b) 2 antiretroviral drugs administered for 6 weeks
(c) 3 antiretroviral drugs administered for 4 weeks
(d) 3 antiretroviral drugs administered for 6 weeks
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82.Paralytic rabies is characterized by:
(a) Maculopapular rash
(b) Flaccid muscle weakness
(c) Spastic muscle weakness
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(d) Hyperexcitability and facial weakness83.
All of the following are seen in Marasmus EXCEPT:
(a) Reduced triceps skinfold
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(b) Reduced mid arm circumference(c) Protein wasting
(d) Decreased body mass index
84.
A 20 year young lady presents with high grade fever for five days and palpable purpura over
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extremities. She is found to be confused, with presence of neck stiffness. Which of thefollowing is the most likely diagnosis?
(a) Disseminated intravascular coagulation
(b) Acute meningococcemia
(c) Antiphospholipid antibody syndrome
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(d) Thrombotic thrombocytopenic purpura85.
Fibroblast Growth Factor 23 (FGF 23) is increased in which one of the following conditions?
(a) Osteomalacia
(b) Osteoporosis
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(c) Paget?s disease(d) Renal Osteodystrophy
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86.
Which of the following crystals are deposited in a case of pseudogout?
(a) Monosodium urate
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(b) Calcium phosphate(c) Cholestrol crystals
(d) Calcium pyrophosphate dehydrate (CPPD)
87.
Which of the following features are associated with poor prognosis in Diffuse Cutaneous
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Systemic Sclerosis?1. Older age
2. A high gas transfer factor for carbon monoxide (TLCO)
3. Proteinuria
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4. Diffuse skin diseaseSelect the correct answer using the code given below:
(a) 1, 2 and 4
(b) 3 and 4 only
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(c) 1, 3 and 4(d) 1, 2 and 3
88.
Which of the following statements regarding pegloticase are correct?
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1. It is enzyme conjugate
2. It is useful in chronic Gout management
3. The main adverse effects are infusion reactions and development of antibodies
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Select the correct answer using the code given below:(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
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89.The most common cause of sensorineural hearing loss in adults is:
(a) Otosclerosis
(b) Meniere?s disease
(c) Presbycusis
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(d) Meningitis90.
A 50-year old male presents with dizziness. Which one of the following clinical findings does
NOT favour a central cause?
(a) Poor saccades
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(b) Gaze evoked nystagmus(c) Inhibition by visual fixation
(d) Presence of diplopia, dysarthria
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91.
A young primigravida with 11 weeks pregnancy presents with sudden onset pain and
swelling of left lower limb. Homan?s sign is positive. Duplex ultrasonogram shows non-
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compressibility of veins in the affected region, with absent flow. The drug of choice fortreatment is:
(a) Enoxaparin
(b) Amoxycillin?Clavulanic acid
(c) Warfarin
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(d) Limb elevation only92.
All of the following are clinical features of hypovolaemic shock EXCEPT:
(a) Cold clammy skin
(b) Bradycardia
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(c) Hypotension(d) Oliguria
93.
Which one of the following is most appropriate to describe classic heat stroke?
(a) Patients core body temperature rises above 44?C with headache, nausea and loss of
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consciousness(b) Patients core body temperature rises above 40 ?C with muscle tremors, confusion,
loss of consciousness and loss of sweating
(c) Patients core body temperature rises above 38 ?C with increased sweating,
tachypnoea, tachycardia and loss of consciousness
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(d) Patients core body temperature is above 40 ?C with disorientation, increasedsweating, peripheral vasodilation, tachycardia and loss of consciousness
94.
Which of the following is NOT a priority in the initial management of shock from venomous
snake?
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(a) Aggressive volume resuscitation
(b) Vasopressor support
(c) Anti-venom administration
(d) All of these are undertaken simultaneously
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95.
Which one of the following is NOT an appropriate criterion for diagnosis of Systemic
Inflammatory Response Syndrome (SIRS)?
(a) Respiratory rate > 20/mm
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(b) Heart rate > 90/min(c) Total leucocyte count > 16 ? 10
9
per Litre
(d) Temperature > 38
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0C
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96.All of the following predispose to Acute Respiratory Distress Syndrome EXCEPT:
(a) Acute Pancreatitis
(b) Toxic gas inhalation
(c) Aspiration of gastric contents
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(d) Severe Bronchial asthma97.
An 8 year old child has consumed a few tablets of a drug that were being taken by his mother
on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and
hepatic necrosis. Which is the most likely drug?
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(a) Multivitamins(b) Calcium carbonate
(c) Folic acid
(d) Iron
98.
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A newborn weighing 1.5 kg at birth presents at 6 hours of age with lethargy, weak and highpitched cry and difficulty in feeding. What is the next step in management?
(a) Estimation of blood sugar
(b) Estimation of serum calcium
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(c) Supplementary oxygen(d) Bedside electrocardiogram
99.
In a child with acute organophosphorus poisoning, which one of the following drugs will act
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as anti-sialogogue and peripheral parasympatholytic agent?(a) Carbamates
(b) Atropine
(c) Benzodiazepine
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(d) Pralidoxime100.
A 6-year old child needs to undergo a central Catheter placement for total parental nutrition.
The procedure is likely to evoke pain and anxiety. Which of the following is the most
appropriate drug for sedation and analgesia in this child?
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(a) Chloral hydrate
(b) Midozolam
(c) Propofol
(d) Ketamine
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101.Which one of the following is the drug of choice in a child presenting with supraventricular
tachycardia?
(a) Atropine
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(b) Lidocaine(c) Adenosine
(d) Nalaxone
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102.Which one of the following drugs is used in cardiopulmonary resuscitation for pulseless
ventricular fibrillation?
(a) Atropine
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(b) Adenosine(c) Lidocaine
(d) Amiodarone
103.
Which one of the following is a sign of good attachment during breastfeeding?
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(a) The baby?s nose is at the level of the nipple(b) The baby?s chin touches the breast
(c) Most of the nipple is in the mouth and the lower areola is visible
(d) The baby?s lower lip is inverted
104.
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Which one of the following signs is NOT included as an indicator of a vigorous babyimmediately after delivery of an infant born through meconium strained liquor?
(a) Pink colour
(b) Strong respiratory efforts
(c) Good muscle tone
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(d) Active movements of the baby105.
All are true for a Cephalohematoma in a newborn EXCEPT:
(a) It is located over the parietal bones in the subcutaneous plane
(b) It may be associated with hyperbilirubinemia
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(c) It increases in size in the first 12?24 hours(d) It can take 3?6 weeks to resolve
106.
Which of the following sick neonates can be started on ?Minimal Enteral Feeding?, if
hemodynamically stable?
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(a) Septic neonate with sclerema(b) Neonate with necrotizing enterocolitis (NEC)
(c) Neonate on mechanical ventilation
(d) Symptomatic hypoglycaemia
107.
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Which one of the following drugs is contraindicated in a mother who is breastfeeding herinfant?
(a) Bromocriptine
(b) Chlorpromazine
(c) Acyclovir
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(d) Morphine108.
A term neonate presents with tachypnea on day 1 after birth. The chest X-ray reveals
hyperexpanded lung fields, prominent vascular markings, and prominent interlobar fissure.
Which of the following is the most probable diagnosis?
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(a) Congenital lobar emphysema(b) Diaphragmatic hernia
(c) Transient tachypnea of the newborn
(d) Tracheoesophageal fistula
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FirstRanker.com - FirstRanker's ChoiceCombined Medical Services Examination-2020
Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
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following Arrhythmia is most likely?(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
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2.An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
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(b) Glimepiride(c) Enalapril
(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
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chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of bodyhabitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
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(b) Raynaud?s syndrome(c) Marfan?s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
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(a) To confirm the diagnosis of angina(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
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Kussmaul?s sign is present in all of the following conditions, EXCEPT:(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
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(d) Right Ventricular Infarction6.
Which one of the following is NOT a common cause of atrial fibrillation?
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(a) Mitral regurgitation(b) Hypothyroidism
(c) Hypertension
(d) Acute myocardial infarction
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7.In an ECG recording, P wave is produced by:
(a) Atrial depolarisation
(b) Atrial repolarisation
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(c) Ventricular depolarisation(d) Ventricular repolarisation
8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
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(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
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9.Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
(b) Azilsartan
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(c) Aliskiren(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
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(a) Aortic regurgitation(b) Thyrotoxicosis
(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
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Signet-ring sign on CT-chest is suggestive of:(a) Bronchiectasis
(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
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12.Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it
is:
(a) Mild persistent
(b) Moderate persistent
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(c) Severe persistent(d) Very severe persistent
13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
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(a) 24 hour fecal fat-estimation(b) CT-chest
(c) Lung biopsy
(d) DNA sequencing study
14.
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Which one of the following antigens is commonly associated with causation of Farmer?slung?
(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
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(d) Candida15.
The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
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(a) INH resistance(b) Rifampicin resistance
(c) Multi drug resistance
(d) Ethambutol resistance
16.
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The most common cause of chronic type II respiratory failure is:(a) Severe pneumonia
(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
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17.The most frequent symptom in respiratory diseases is:
(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
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(d) Cough18.
A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
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(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
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19.Consider the following statements with regard to respiratory examination:
1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
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2. Whispered pectoriloquy is characteristic of lung consolidation3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
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(a) 1 and 3(b) 2 and 4 only
(c) 1, 2 and 4
(d) 2, 3 and 4
20.
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All of the following are the causes of exudative Pleural Effusion, EXCEPT:(a) SVC obstruction
(b) Fungal infection
(c) SLE
(d) Meig syndrome
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21.Which one of the following is NOT true about Ghrelin?
(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
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(d) Fasting increases its secretion22.
Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
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(c) Bile acid secretory defects(d) Pancreatic dysfunction
23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
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(b) APACHE score(c) MELD score
(d) Metavir score
24.
The blood supply of liver consists of:
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(a) 50 % hepatic artery and 50 % portal vein(b) 80 % portal vein and 20 % hepatic artery
(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
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All of the following conditions are associated with Glomerulonephritis with low complementlevel, EXCEPT:
(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
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(d) Cryoglobulinaemia--- Content provided by FirstRanker.com ---
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26.
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Consider the following statements with regard to oral aphthous ulcers:1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
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4. They are pre-malignant and progress over few years to squamous cell carcinoma ofthe oral cavity
Which of the above statements are correct?
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(a) 1 and 4 only(b) 2 and 3 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
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Which one of the following statements about Barrett?s Oesophagus is NOT correct?(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
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(c) Normal columnar cells lining the lower oesophagus are replaced by squamouscells
(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
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The most common cause of acute hepatitis outbreaks in India is:(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
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(d) Hepatitis A29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
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(a) Menetrier?s disease
(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
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30.Eradication of helicobacter pylori infection may prove beneficial in the following extra-
gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
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(b) Idiopathic thrombocytopenic purpura(c) Iron deficiency anaemia without gastro-intestinal bleeding
(d) Acute glomerulonephritis
31.
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What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidneydisease patient?
(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
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(d) 13 to 14 gm/dL32.
Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
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(b) Tumoral calcinosis(c) Osteitis fibrosa cystic
(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
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(a) It is inherited as autosomal dominant trait(b) It is usually associated with marked proteinuria
(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
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Consider the following statements in relation to an adult patient:1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
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Which of the statements given above are correct?
(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
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(d) 1, 2 and 335.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
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(b) Pyelonephritis(c) Renal stone disease
(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
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of sore throat two weeks prior to presentation. Laboratory investigations are remarkable forlow C
3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
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(a) Renal biopsy is rarely required for making diagnosis
(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
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37.Which one of the following statements is NOT correct regarding the risk factors for
nephrolithiasis?
(a) Higher dietary calcium increases risk
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(b) Higher animal protein intake increases risk(c) Higher dietary potassium intake lowers risk
(d) Lower urine citrate increases the risk
38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
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He has history of fever and headache for the preceding 3 days. The CSF examination isunremarkable. What would be the probable diagnosis?
(a) Multiple sclerosis
(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
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(d) Viral encephalitis39.
Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
(b) Aceclofenac
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(c) Thiamine(d) Prednisdone
40.
Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
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(b) Non dominant parietal lobe(c) Frontal lobe
(d) Non dominant temporal lobe
41.
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Vertical gaze palsy with convergence retraction nystagmus is seen in:(a) Weber syndrome
(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
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42.A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
(a) Left 3
rd
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nerve palsy(b) Left 6
th
nerve palsy
(c) Right 4
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thnerve palsy
(d) Right 3
rd
nerve palsy
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43.All of the following are features of Cauda Equina syndrome EXCEPT:
(a) Low back pain
(b) Lower limb areflexia
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(c) Loss of bladder function(d) Extensor plantar response
44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
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examination, he had resting tremor, bradykinesia, rigidity and postural instability. Thispatient is suffering most likely from:
(a) Parkinson?s disease
(b) Vascular dementia
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(c) Alzheimer?s disease(d) Frunto temporal dementia
45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
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turns. Heal-Shin test is normal. Which one of the following is most likely disorder?(a) Cerebellar ataxia
(b) Sensory ataxia
(c) Frontal gait disorder
(d) Parkinson?s disease
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46.Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the following
EXCEPT:
(a) Bradycardia
(b) Hypertension
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(c) Irregular respiration(d) Hypothermia
47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
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Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture(LP) and a day later reports worsening of headache. Which one of the following features is
NOT consistent with diagnosis of ?Post-LP? headache?
(a) Post-LP headache usually begins within 48 hours
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(b) Post-LP headache worsens in sitting position(c) Post-LP headache is most severe upon waking up
(d) Post-LP headache may improve with caffeine intake
48.
Which one of the following investigations is NOT appropriate in a case of recurrent
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thrombosis?(a) Antiphospholipid antibodies
(b) Bcr-Abl assay
(c) Protein C and S assays
(d) Antithrombin level
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49.All of the following are causes of reactive thrombocytosis, EXCEPT:
(a) Hemolytic anemia
(b) Megaloblastic anemia
(c) Post splenectomy
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(d) Chronic inflammatory disorders50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
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(a) Von Willebrand disease(b) Hypofibrinogenemia
(c) Hemophilia?B
(d) Hemphilia?A
51.
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Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolyticanaemia. The disorder is inherited as an:
(a) Autosomal recessive trait
(b) X-linked recessive trait
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(c) Autosomal dominant trait(d) X-linked dominant trait
52.
Sickle cell disease may be associated with any of the following EXCEPT:
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(a) Acute chest syndrome(b) Aplastic crisis
(c) Splenic sequestration crisis
(d) Conn?s syndrome
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53.Fever with splenomegaly and lymphadenopathy can be seen in
(a) Infectious mononucleosis
(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
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(d) Neither infectious mononucleosis nor chronic leukaemia54.
Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
(a) Haemoglobin X disease
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(b) Haemoglobin H disease(c) Haemoglobin F disease
(d) Hydrops fetalis
55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
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(a) It is a clonal malignancy of haematopoetic stem(b) Risk of developing CML is increased in monozygotic turns
(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
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56.
Diagnostic criteria of multiple myeloma includes which of the following?
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1. Increased malignant plasma cells in the bone marrow
2. Serum and/or urinary M protein
3. Skeletal lytic lesions
4. Skeletal blastic lesions
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Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1, 3 and 4
(c) 1, 2 and 4
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(d) 2, 3 and 457.
The most predominant type of serum immunoglobulin involved in patients with plasma cell
disorder is:
(a) Ig G
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(b) Ig A(c) Ig D
(d) Light chains
58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
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pregnancy?(a) There is an increase in the metabolism of thyroxine by placenta
(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
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(d) Impaired cognitive impairment may be seen in the offspring of mother withsubclinical hypothyroidism
59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
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(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL(b) HbA1c ? 6.5 %
(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ? 110 mg/dL
60.
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A young lady presents in outdoor clinic with complaints of menstrual irregularity, weightgain, hair loss, tiredness and weakness. What will be the investigation of choice?
(a) FSH & LH level
(b) Estrogen level
(c) Free T
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3and free T
4
level
(d) Free T
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4and TSH level
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61.
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Consider the following statements about erectile dysfunction in diabetic males:1. It affects 60 % of males
2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
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4. Endocrine disorders like hyperprolactinemia may cause itWhich of the statements given above are true?
(a) 1 and 2
(b) 2 and 3
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(c) 2 and 4(d) 3 and 4
62.
All of the following can cause Hyperprolactinemia, EXCEPT:
(a) Craniopharyngioma
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(b) Hyperthyroidism(c) Stress
(d) Chronic renal failure
63.
All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
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(a) Atrial fibrillation(b) Periodic paralysis
(c) Deafness
(d) Osteoporosis
64.
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Which one of the following hormones acts via the receptor tyrosine kinase?(a) FSH
(b) TSH
(c) IGF-1
(d) PTH
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65.Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a
(MEN 2a):
1. Primary Hyperparathyroidism
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2. Pituitary tumours3. Medullary carcinoma of thyroid
4. Pheochromocytoma
Which of the above are correct?:
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(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4
(d) 2, 3 and 4
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66.
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Consider the following statements with regard to Graves? ophthalmopathy :1. Proptosis is often asymmetric and can even appear to be unilateral
2. It is a clinical diagnosis
3. Worsening of symptoms upon glucocorticoid withdrawal is common
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4. Radiation therapy is very effective in treatmentWhich of the above statements are correct?
(a) 1 and 2 only
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(b) 1, 2 and 3(c) 2, 3 and 4
(d) 1 and 4 only
67.
All of the following are common aetiologies of delirium EXCEPT:
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(a) Hyperthyroidism(b) Hypothyroidism
(c) Hyperparathyroidism
(d) Hypoparathyroidism
68.
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Key anthropometric measurements important for evaluating the degree of obesity are:(a) Weight, height and waist circumference
(b) Weight, height and hip circumference
(c) Weight, height and mid-thigh circumference
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(d) Weight, height and chest circumference69.
What is the minimum BMI (Body Mass Index) recommended for considering adjuvant
pharmacologic treatment in obesity with comorbidity?
(a) 23 kg/m
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2(b) 25 kg/m
2
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(c) 27 kg/m2
(d) 30 kg/m
2
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70.
A young medical student while working in HIV ward got pricked accidently on the finger by
a syringe needle which was used to draw blood from a patient. Patient?s infection status is not
known. Which one of the following therapeutic interventions will be the best interest of this
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student?(a) To start Dolultegravir immediately
(b) To wash wound with soap and water and start Emtricitabine
(c) To give Dolutegravir + Tenofovir + Emtricitabine
(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin
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71.Cryptococcal infection is acquired through:
(a) Inhalation route
(b) Bite of Culex mosquito
(c) Direct skin contact
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(d) Ingestion of spores72.
Which one of the following is NOT appropriate treatment for Echinococcus granulosus and
hydatid disease?
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(a) Albendazole 400 mg twice in a day for 3 months(b) Diethylcarbamazine 2 mg/kg thrice in a day for 12 days
(c) PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)
(d) Praziquantel (20 mg/kg twice daily for 14 days)
73.
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Which one of the following infections is NOT amenable to post-exposure prophylaxis withspecific immunoglobulins?
(a) Hepatitis B
(b) HIV
(c) Tetanus
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(d) Rabies74.
Echinocandins are a class of:
(a) Antiviral agents
(b) Antiparasitic agents
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(c) Antitubercular agents(d) Antifungal agents
75.
Recommended first time drug for initial treatment of tuberculosis include all EXCEPT:
(a) Isoniazid
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(b) Rifampin(c) Ethambutol
(d) Ethionamide
76.
The most frequent adverse reaction of significance among people treated for drug-susceptible
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tuberculosis is:(a) Colitis
(b) Hepatitis
(c) Cystitis
(d) Enteritis
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77.All adult patients in whom anti-tubercular treatment is being started should undergo baseline
assessment of:
(a) Complete blood count
(b) Liver function test
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(c) Lipid profile(d) Pulmonary function test
78.
A 30 year old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea.
On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative
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bradycardia and rose spots rash. The most likely diagnosis is:(a) Malaria fever
(b) Enteric fever
(c) Leptospirosis
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(d) Dengue fever79.
The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:
(a) Lymph node TB
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(b) Genitourinary TB(c) Skeletal TB
(d) Skull TB
80.
Which of the following is NOT a clinical feature of Botulism?
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(a) Impaired alertness(b) Dysphagia
(c) Diplopia
(d) Ptosis
81.
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Post exposure prophylaxis (PEP) for HIV should contain:(a) 2 antiretroviral drugs administered for 4 weeks
(b) 2 antiretroviral drugs administered for 6 weeks
(c) 3 antiretroviral drugs administered for 4 weeks
(d) 3 antiretroviral drugs administered for 6 weeks
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82.Paralytic rabies is characterized by:
(a) Maculopapular rash
(b) Flaccid muscle weakness
(c) Spastic muscle weakness
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(d) Hyperexcitability and facial weakness83.
All of the following are seen in Marasmus EXCEPT:
(a) Reduced triceps skinfold
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(b) Reduced mid arm circumference(c) Protein wasting
(d) Decreased body mass index
84.
A 20 year young lady presents with high grade fever for five days and palpable purpura over
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extremities. She is found to be confused, with presence of neck stiffness. Which of thefollowing is the most likely diagnosis?
(a) Disseminated intravascular coagulation
(b) Acute meningococcemia
(c) Antiphospholipid antibody syndrome
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(d) Thrombotic thrombocytopenic purpura85.
Fibroblast Growth Factor 23 (FGF 23) is increased in which one of the following conditions?
(a) Osteomalacia
(b) Osteoporosis
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(c) Paget?s disease(d) Renal Osteodystrophy
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86.
Which of the following crystals are deposited in a case of pseudogout?
(a) Monosodium urate
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(b) Calcium phosphate(c) Cholestrol crystals
(d) Calcium pyrophosphate dehydrate (CPPD)
87.
Which of the following features are associated with poor prognosis in Diffuse Cutaneous
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Systemic Sclerosis?1. Older age
2. A high gas transfer factor for carbon monoxide (TLCO)
3. Proteinuria
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4. Diffuse skin diseaseSelect the correct answer using the code given below:
(a) 1, 2 and 4
(b) 3 and 4 only
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(c) 1, 3 and 4(d) 1, 2 and 3
88.
Which of the following statements regarding pegloticase are correct?
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1. It is enzyme conjugate
2. It is useful in chronic Gout management
3. The main adverse effects are infusion reactions and development of antibodies
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Select the correct answer using the code given below:(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
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89.The most common cause of sensorineural hearing loss in adults is:
(a) Otosclerosis
(b) Meniere?s disease
(c) Presbycusis
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(d) Meningitis90.
A 50-year old male presents with dizziness. Which one of the following clinical findings does
NOT favour a central cause?
(a) Poor saccades
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(b) Gaze evoked nystagmus(c) Inhibition by visual fixation
(d) Presence of diplopia, dysarthria
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91.
A young primigravida with 11 weeks pregnancy presents with sudden onset pain and
swelling of left lower limb. Homan?s sign is positive. Duplex ultrasonogram shows non-
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compressibility of veins in the affected region, with absent flow. The drug of choice fortreatment is:
(a) Enoxaparin
(b) Amoxycillin?Clavulanic acid
(c) Warfarin
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(d) Limb elevation only92.
All of the following are clinical features of hypovolaemic shock EXCEPT:
(a) Cold clammy skin
(b) Bradycardia
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(c) Hypotension(d) Oliguria
93.
Which one of the following is most appropriate to describe classic heat stroke?
(a) Patients core body temperature rises above 44?C with headache, nausea and loss of
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consciousness(b) Patients core body temperature rises above 40 ?C with muscle tremors, confusion,
loss of consciousness and loss of sweating
(c) Patients core body temperature rises above 38 ?C with increased sweating,
tachypnoea, tachycardia and loss of consciousness
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(d) Patients core body temperature is above 40 ?C with disorientation, increasedsweating, peripheral vasodilation, tachycardia and loss of consciousness
94.
Which of the following is NOT a priority in the initial management of shock from venomous
snake?
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(a) Aggressive volume resuscitation
(b) Vasopressor support
(c) Anti-venom administration
(d) All of these are undertaken simultaneously
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95.
Which one of the following is NOT an appropriate criterion for diagnosis of Systemic
Inflammatory Response Syndrome (SIRS)?
(a) Respiratory rate > 20/mm
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(b) Heart rate > 90/min(c) Total leucocyte count > 16 ? 10
9
per Litre
(d) Temperature > 38
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0C
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96.All of the following predispose to Acute Respiratory Distress Syndrome EXCEPT:
(a) Acute Pancreatitis
(b) Toxic gas inhalation
(c) Aspiration of gastric contents
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(d) Severe Bronchial asthma97.
An 8 year old child has consumed a few tablets of a drug that were being taken by his mother
on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and
hepatic necrosis. Which is the most likely drug?
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(a) Multivitamins(b) Calcium carbonate
(c) Folic acid
(d) Iron
98.
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A newborn weighing 1.5 kg at birth presents at 6 hours of age with lethargy, weak and highpitched cry and difficulty in feeding. What is the next step in management?
(a) Estimation of blood sugar
(b) Estimation of serum calcium
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(c) Supplementary oxygen(d) Bedside electrocardiogram
99.
In a child with acute organophosphorus poisoning, which one of the following drugs will act
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as anti-sialogogue and peripheral parasympatholytic agent?(a) Carbamates
(b) Atropine
(c) Benzodiazepine
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(d) Pralidoxime100.
A 6-year old child needs to undergo a central Catheter placement for total parental nutrition.
The procedure is likely to evoke pain and anxiety. Which of the following is the most
appropriate drug for sedation and analgesia in this child?
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(a) Chloral hydrate
(b) Midozolam
(c) Propofol
(d) Ketamine
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101.Which one of the following is the drug of choice in a child presenting with supraventricular
tachycardia?
(a) Atropine
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(b) Lidocaine(c) Adenosine
(d) Nalaxone
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102.Which one of the following drugs is used in cardiopulmonary resuscitation for pulseless
ventricular fibrillation?
(a) Atropine
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(b) Adenosine(c) Lidocaine
(d) Amiodarone
103.
Which one of the following is a sign of good attachment during breastfeeding?
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(a) The baby?s nose is at the level of the nipple(b) The baby?s chin touches the breast
(c) Most of the nipple is in the mouth and the lower areola is visible
(d) The baby?s lower lip is inverted
104.
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Which one of the following signs is NOT included as an indicator of a vigorous babyimmediately after delivery of an infant born through meconium strained liquor?
(a) Pink colour
(b) Strong respiratory efforts
(c) Good muscle tone
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(d) Active movements of the baby105.
All are true for a Cephalohematoma in a newborn EXCEPT:
(a) It is located over the parietal bones in the subcutaneous plane
(b) It may be associated with hyperbilirubinemia
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(c) It increases in size in the first 12?24 hours(d) It can take 3?6 weeks to resolve
106.
Which of the following sick neonates can be started on ?Minimal Enteral Feeding?, if
hemodynamically stable?
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(a) Septic neonate with sclerema(b) Neonate with necrotizing enterocolitis (NEC)
(c) Neonate on mechanical ventilation
(d) Symptomatic hypoglycaemia
107.
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Which one of the following drugs is contraindicated in a mother who is breastfeeding herinfant?
(a) Bromocriptine
(b) Chlorpromazine
(c) Acyclovir
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(d) Morphine108.
A term neonate presents with tachypnea on day 1 after birth. The chest X-ray reveals
hyperexpanded lung fields, prominent vascular markings, and prominent interlobar fissure.
Which of the following is the most probable diagnosis?
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(a) Congenital lobar emphysema(b) Diaphragmatic hernia
(c) Transient tachypnea of the newborn
(d) Tracheoesophageal fistula
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109.A pre-school boy can go upstairs on alternate feet and has also started copying a circle. How
many blocks should he be able to build a tower with, without toppling over?
(a) 5
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(b) 7(c) 9
(d) More than 10
110.
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Which one of the following drugs is the antidote for benzodiazepine poisoning?(a) Flumazenil
(b) Atropine
(c) Naloxone
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(d) Pralidoxime aldoxime methiodide111.
A 3-year old child develops severe respiratory distress after inhalation of fumes arising from
burning plastic. The child is started on supportive ventilation. Which one of the following
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antidotes needs to be given?(a) Hydroxycobalamin
(b) Amylnitrate
(c) Sodium nitrite
(d) N-acetyl cysteine
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112.A child has an incurving of the little finger. What is this condition known as?
(a) Camptodactyly
(b) Brachydactyly
(c) Partial cutaneous syndactyly
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(d) Clinodactyly113.
A 4-week old infant presents with repeated episodes of non-bilious vomiting since 7 days.
The infant seems active and hungry after the vomiting. Examination reveals an olive-shaped
mass in the epigartrium. Which metabolic abnormality is expected in this infant?
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(a) Hyperchloremia(b) Metabolic alkalosis
(c) Hyperkalemia
(d) Hyponatramia
114.
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Which one of the following is the correct dose and route of administration of hepatitis Bvaccine in children?
(a) 0.5 mL dose with 10 microgram of antigen subcutaneously
(b) 0.5 mL dose with 10 microgram of antigen intramuscularly
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(c) 1 mL dose with 5 microgram of antigen subcutaneously(d) 1 mL dose with 5 microgram of antigen intramuscularly
FirstRanker.com - FirstRanker's Choice
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Combined Medical Services Examination-2020Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
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(a) Ventricular fibrillation(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
2.
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An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes forfollow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
(b) Glimepiride
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(c) Enalapril(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
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habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu?s arteritis
(b) Raynaud?s syndrome
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(c) Marfan?s syndrome(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
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(b) To evaluate stable angina(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul?s sign is present in all of the following conditions, EXCEPT:
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(a) Massive Pulmonary Embolism
(b) Restrictive Cardiomyopathy
(c) Hypertrophic Cardiomyopathy
(d) Right Ventricular Infarction
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6.
Which one of the following is NOT a common cause of atrial fibrillation?
(a) Mitral regurgitation
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(b) Hypothyroidism(c) Hypertension
(d) Acute myocardial infarction
7.
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In an ECG recording, P wave is produced by:(a) Atrial depolarisation
(b) Atrial repolarisation
(c) Ventricular depolarisation
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(d) Ventricular repolarisation8.
Which one of the following modalities is NOT used in the treatment of ventricular
tachycardia?
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(a) DC Cardioversion(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
9.
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Which one of the following drugs is a Direct Renin Inhibitor?(a) Benedipine
(b) Azilsartan
(c) Aliskiren
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(d) Lisinopril10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Aortic regurgitation
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(b) Thyrotoxicosis(c) Patent ductus arteriosus
(d) Aortic stenosis
11.
Signet-ring sign on CT-chest is suggestive of:
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(a) Bronchiectasis(b) Active alveolitis
(c) Aspergilloma
(d) Sarcoidosis
12.
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Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when itis:
(a) Mild persistent
(b) Moderate persistent
(c) Severe persistent
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(d) Very severe persistent13.
An 18-year old male has insulin dependent diabetes, with malabsorption syndrome and
bilateral upper lobe bronchiectasis. A diagnostic work-up will include all EXCEPT:
(a) 24 hour fecal fat-estimation
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(b) CT-chest(c) Lung biopsy
(d) DNA sequencing study
14.
Which one of the following antigens is commonly associated with causation of Farmer?s
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lung?(a) Penicillium
(b) Actinomycetes
(c) Aspergillus
(d) Candida
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15.The Gene X-pert test used for MTB detection has the additional advantage of detection of
which of the following?
(a) INH resistance
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(b) Rifampicin resistance(c) Multi drug resistance
(d) Ethambutol resistance
16.
The most common cause of chronic type II respiratory failure is:
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(a) Severe pneumonia(b) Severe COPD
(c) Severe bronchial asthma
(d) Severe pulmonary thromboembolism
17.
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The most frequent symptom in respiratory diseases is:(a) Breathlessness
(b) Chest pain
(c) Hemoptysis
(d) Cough
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18.A 26-year old young lady attends medical emergency and is labelled as acute severe asthma
by the emergency physician. Which one of the following is unlikely to be a part of the
prescription?
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(a) Albuterol(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
19.
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Consider the following statements with regard to respiratory examination:1. Change in note, when patient phonates ?EEE? (Egophony) is characteristic of
interstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
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3. Monophonic wheeze is characteristic of asthma4. Hyper-resonant note on percussion is characteristic of pnemothorax
Which of the above statements are correct?
(a) 1 and 3
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(b) 2 and 4 only(c) 1, 2 and 4
(d) 2, 3 and 4
20.
All of the following are the causes of exudative Pleural Effusion, EXCEPT:
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(a) SVC obstruction(b) Fungal infection
(c) SLE
(d) Meig syndrome
21.
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Which one of the following is NOT true about Ghrelin?(a) It stimulates appetite
(b) It decreases gastric emptying
(c) It increases acid secretion
(d) Fasting increases its secretion
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22.Fecal elastase test is used for diagnosing which one of the following conditions?
(a) Lactose intolerance
(b) Mucosal inflammation
(c) Bile acid secretory defects
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(d) Pancreatic dysfunction23.
The recent classification system for listing a patient as a candidate for liver transplantation is:
(a) Child Pugh score
(b) APACHE score
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(c) MELD score(d) Metavir score
24.
The blood supply of liver consists of:
(a) 50 % hepatic artery and 50 % portal vein
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(b) 80 % portal vein and 20 % hepatic artery(c) 80 % hepatic artery and 20 % portal vein
(d) 70 % hepatic artery and 30 % portal vein
25.
All of the following conditions are associated with Glomerulonephritis with low complement
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level, EXCEPT:(a) Subacute bacterial endocarditis
(b) IgA nephropathy
(c) Systemic lupus erythematosus
(d) Cryoglobulinaemia
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26.
Consider the following statements with regard to oral aphthous ulcers:
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1. They are superficial and painful
2. They may occur in women just prior to menstruation
3. Oral glucocorticoids may be needed for the treatment of severe, recurrent cases
4. They are pre-malignant and progress over few years to squamous cell carcinoma of
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the oral cavityWhich of the above statements are correct?
(a) 1 and 4 only
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(b) 2 and 3 only(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4
27.
Which one of the following statements about Barrett?s Oesophagus is NOT correct?
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(a) It is a pre-malignant condition
(b) Normal squamous cells lining the lower oesophagus are replaced by columnar
cells
(c) Normal columnar cells lining the lower oesophagus are replaced by squamous
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cells(d) It is an adaptive response to chronic gastro-oesophageal reflux
28.
The most common cause of acute hepatitis outbreaks in India is:
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(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
(d) Hepatitis A
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29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
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(a) Menetrier?s disease(b) Boerhaave?s syndrome
(c) Achalasia of the oesophagus
(d) Barrett?s oesophagus
30.
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Eradication of helicobacter pylori infection may prove beneficial in the following extra-gastric disorders EXCEPT:
(a) Unexplained vitamin B12 deficiency
(b) Idiopathic thrombocytopenic purpura
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(c) Iron deficiency anaemia without gastro-intestinal bleeding(d) Acute glomerulonephritis
31.
What is the target blood Hemoglobin level when treating anaemia in Stage-4 chronic kidney
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disease patient?(a) 8 to 10 gm/dL
(b) 10 to 12 gm/dL
(c) 12 to 13 gm/dL
(d) 13 to 14 gm/dL
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32.Which one of the following complications of chronic kidney disease is observed in patients
with low parathyroid hormone levels?
(a) Adynamic bone disease
(b) Tumoral calcinosis
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(c) Osteitis fibrosa cystic(d) Calciphylaxis
33.
All of the following statements about adult polycystic kidney disease are true, EXCEPT:
(a) It is inherited as autosomal dominant trait
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(b) It is usually associated with marked proteinuria(c) It is usually associated with systematic hypertension, from young age
(d) It is associated with Berry aneurysm
34.
Consider the following statements in relation to an adult patient:
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1. Oliguria is defined as passage of urine less than 300 ml per day
2. Anuria is said to exist when less than 50 ml urine is passed per day
3. Polyuria is defined as urine volume in excess of 3 litre per day
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Which of the statements given above are correct?(a) 1 and 3 only
(b) 2 and 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
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35.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
(b) Pyelonephritis
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(c) Renal stone disease(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
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low C3
and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
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(a) Renal biopsy is rarely required for making diagnosis(b) Antibiotic treatment is given for streptococcal infection
(c) Treatment is largely supportive
(d) Immunosuppressants are to be used for crescentic glomerulonephritis
37.
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Which one of the following statements is NOT correct regarding the risk factors fornephrolithiasis?
(a) Higher dietary calcium increases risk
(b) Higher animal protein intake increases risk
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(c) Higher dietary potassium intake lowers risk(d) Lower urine citrate increases the risk
38.
A 60-year old patient is admitted in emergency with seizure, aphasia and altered sensorium.
He has history of fever and headache for the preceding 3 days. The CSF examination is
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unremarkable. What would be the probable diagnosis?(a) Multiple sclerosis
(b) Tubercular meningitis
(c) Pyogenic (bacterial) meningitis
(d) Viral encephalitis
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39.Drug of choice for the treatment of Trigeminal Neuralgia is:
(a) Carbamazepine
(b) Aceclofenac
(c) Thiamine
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(d) Prednisdone40.
Constructional skills is a function of which lobe?
(a) Dominant temporal lobe
(b) Non dominant parietal lobe
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(c) Frontal lobe(d) Non dominant temporal lobe
41.
Vertical gaze palsy with convergence retraction nystagmus is seen in:
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(a) Weber syndrome(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
42.
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A patient on looking forward was found to have his right eye deviated downwards andoutwards with pupil dilated. He is suffering from:
(a) Left 3
rd
nerve palsy
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(b) Left 6th
nerve palsy
(c) Right 4
th
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nerve palsy(d) Right 3
rd
nerve palsy
43.
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All of the following are features of Cauda Equina syndrome EXCEPT:(a) Low back pain
(b) Lower limb areflexia
(c) Loss of bladder function
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(d) Extensor plantar response44.
A 68-year old male presented in OPD with complaints of progressive small handwriting. On
examination, he had resting tremor, bradykinesia, rigidity and postural instability. This
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patient is suffering most likely from:(a) Parkinson?s disease
(b) Vascular dementia
(c) Alzheimer?s disease
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(d) Frunto temporal dementia45.
An elderly patient presents with abnormal gait. He has a wide base freezing gait with
imbalance, comprising short strides, shuffling along the floor and difficulty with starts and
turns. Heal-Shin test is normal. Which one of the following is most likely disorder?
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(a) Cerebellar ataxia(b) Sensory ataxia
(c) Frontal gait disorder
(d) Parkinson?s disease
46.
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Cushing reflex, seen in conditions of raised intra cranial pressure includes all of the followingEXCEPT:
(a) Bradycardia
(b) Hypertension
(c) Irregular respiration
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(d) Hypothermia47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
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(LP) and a day later reports worsening of headache. Which one of the following features isNOT consistent with diagnosis of ?Post-LP? headache?
(a) Post-LP headache usually begins within 48 hours
(b) Post-LP headache worsens in sitting position
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(c) Post-LP headache is most severe upon waking up(d) Post-LP headache may improve with caffeine intake
48.
Which one of the following investigations is NOT appropriate in a case of recurrent
thrombosis?
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(a) Antiphospholipid antibodies(b) Bcr-Abl assay
(c) Protein C and S assays
(d) Antithrombin level
49.
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All of the following are causes of reactive thrombocytosis, EXCEPT:(a) Hemolytic anemia
(b) Megaloblastic anemia
(c) Post splenectomy
(d) Chronic inflammatory disorders
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50.
Cryoprecipitate cannot be used for treatment of which one of the following conditions?
(a) Von Willebrand disease
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(b) Hypofibrinogenemia(c) Hemophilia?B
(d) Hemphilia?A
51.
Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic
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anaemia. The disorder is inherited as an:(a) Autosomal recessive trait
(b) X-linked recessive trait
(c) Autosomal dominant trait
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(d) X-linked dominant trait52.
Sickle cell disease may be associated with any of the following EXCEPT:
(a) Acute chest syndrome
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(b) Aplastic crisis(c) Splenic sequestration crisis
(d) Conn?s syndrome
53.
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Fever with splenomegaly and lymphadenopathy can be seen in(a) Infectious mononucleosis
(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
(d) Neither infectious mononucleosis nor chronic leukaemia
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54.Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
(a) Haemoglobin X disease
(b) Haemoglobin H disease
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(c) Haemoglobin F disease(d) Hydrops fetalis
55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
(a) It is a clonal malignancy of haematopoetic stem
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(b) Risk of developing CML is increased in monozygotic turns(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
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56.
Diagnostic criteria of multiple myeloma includes which of the following?
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1. Increased malignant plasma cells in the bone marrow2. Serum and/or urinary M protein
3. Skeletal lytic lesions
4. Skeletal blastic lesions
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Select the correct answer using the code given below:(a) 1, 2 and 3
(b) 1, 3 and 4
(c) 1, 2 and 4
(d) 2, 3 and 4
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57.The most predominant type of serum immunoglobulin involved in patients with plasma cell
disorder is:
(a) Ig G
(b) Ig A
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(c) Ig D(d) Light chains
58.
Which one of the following statements is NOT true regarding the thyroid function/disorder in
pregnancy?
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(a) There is an increase in the metabolism of thyroxine by placenta(b) Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy
(c) Levothyroxine replacement therapy dose should be decreased by 30?50% early in
pregnancy
(d) Impaired cognitive impairment may be seen in the offspring of mother with
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subclinical hypothyroidism59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
(a) Symptoms of diabetes and random plasma sugar concentration ? 200 mg/dL
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(b) HbA1c ? 6.5 %(c) 2-hours plasma glucose ? 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ? 110 mg/dL
60.
A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight
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gain, hair loss, tiredness and weakness. What will be the investigation of choice?(a) FSH & LH level
(b) Estrogen level
(c) Free T
3
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and free T4
level
(d) Free T
4
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61.
Consider the following statements about erectile dysfunction in diabetic males:
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1. It affects 60 % of males
2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
4. Endocrine disorders like hyperprolactinemia may cause it
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Which of the statements given above are true?
(a) 1 and 2
(b) 2 and 3
(c) 2 and 4
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(d) 3 and 462.
All of the following can cause Hyperprolactinemia, EXCEPT:
(a) Craniopharyngioma
(b) Hyperthyroidism
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(c) Stress(d) Chronic renal failure
63.
All of the following can be seen in a case of thyrotoxicosis, EXCEPT:
(a) Atrial fibrillation
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(b) Periodic paralysis(c) Deafness
(d) Osteoporosis
64.
Which one of the following hormones acts via the receptor tyrosine kinase?
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(a) FSH(b) TSH
(c) IGF-1
(d) PTH
65.
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Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a(MEN 2a):
1. Primary Hyperparathyroidism
2. Pituitary tumours
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3. Medullary carcinoma of thyroid4. Pheochromocytoma
Which of the above are correct?:
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(a) 1, 2 and 4(b) 1, 2 and 3
(c) 1, 3 and 4
(d) 2, 3 and 4
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66.
Consider the following statements with regard to Graves? ophthalmopathy :
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1. Proptosis is often asymmetric and can even appear to be unilateral
2. It is a clinical diagnosis
3. Worsening of symptoms upon glucocorticoid withdrawal is common
4. Radiation therapy is very effective in treatment
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Which of the above statements are correct?
(a) 1 and 2 only
(b) 1, 2 and 3
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(c) 2, 3 and 4(d) 1 and 4 only
67.
All of the following are common aetiologies of delirium EXCEPT:
(a) Hyperthyroidism
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(b) Hypothyroidism(c) Hyperparathyroidism
(d) Hypoparathyroidism
68.
Key anthropometric measurements important for evaluating the degree of obesity are:
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(a) Weight, height and waist circumference
(b) Weight, height and hip circumference
(c) Weight, height and mid-thigh circumference
(d) Weight, height and chest circumference
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69.What is the minimum BMI (Body Mass Index) recommended for considering adjuvant
pharmacologic treatment in obesity with comorbidity?
(a) 23 kg/m
2
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(b) 25 kg/m
2
(c) 27 kg/m
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2(d) 30 kg/m
2
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70.A young medical student while working in HIV ward got pricked accidently on the finger by
a syringe needle which was used to draw blood from a patient. Patient?s infection status is not
known. Which one of the following therapeutic interventions will be the best interest of this
student?
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(a) To start Dolultegravir immediately(b) To wash wound with soap and water and start Emtricitabine
(c) To give Dolutegravir + Tenofovir + Emtricitabine
(d) To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin
71.
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Cryptococcal infection is acquired through:(a) Inhalation route
(b) Bite of Culex mosquito
(c) Direct skin contact
(d) Ingestion of spores
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72.
Which one of the following is NOT appropriate treatment for Echinococcus granulosus and
hydatid disease?
(a) Albendazole 400 mg twice in a day for 3 months
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(b) Diethylcarbamazine 2 mg/kg thrice in a day for 12 days(c) PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)
(d) Praziquantel (20 mg/kg twice daily for 14 days)
73.
Which one of the following infections is NOT amenable to post-exposure prophylaxis with
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specific immunoglobulins?(a) Hepatitis B
(b) HIV
(c) Tetanus
(d) Rabies
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74.Echinocandins are a class of:
(a) Antiviral agents
(b) Antiparasitic agents
(c) Antitubercular agents
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(d) Antifungal agents75.
Recommended first time drug for initial treatment of tuberculosis include all EXCEPT:
(a) Isoniazid
(b) Rifampin
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(c) Ethambutol(d) Ethionamide
76.
The most frequent adverse reaction of significance among people treated for drug-susceptible
tuberculosis is:
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(a) Colitis(b) Hepatitis
(c) Cystitis
(d) Enteritis
77.
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All adult patients in whom anti-tubercular treatment is being started should undergo baselineassessment of:
(a) Complete blood count
(b) Liver function test
(c) Lipid profile
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(d) Pulmonary function test78.
A 30 year old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea.
On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative
bradycardia and rose spots rash. The most likely diagnosis is:
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(a) Malaria fever
(b) Enteric fever
(c) Leptospirosis
(d) Dengue fever
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79.
The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:
(a) Lymph node TB
(b) Genitourinary TB
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(c) Skeletal TB(d) Skull TB
80.
Which of the following is NOT a clinical feature of Botulism?
(a) Impaired alertness
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(b) Dysphagia(c) Diplopia
(d) Ptosis
81.
Post exposure prophylaxis (PEP) for HIV should contain:
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(a) 2 antiretroviral drugs administered for 4 weeks(b) 2 antiretroviral drugs administered for 6 weeks
(c) 3 antiretroviral drugs administered for 4 weeks
(d) 3 antiretroviral drugs administered for 6 weeks
82.
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Paralytic rabies is characterized by:(a) Maculopapular rash
(b) Flaccid muscle weakness
(c) Spastic muscle weakness
(d) Hyperexcitability and facial weakness
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83.All of the following are seen in Marasmus EXCEPT:
(a) Reduced triceps skinfold
(b) Reduced mid arm circumference
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(c) Protein wasting(d) Decreased body mass index
84.
A 20 year young lady presents with high grade fever for five days and palpable purpura over
extremities. She is found to be confused, with presence of neck stiffness. Which of the
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following is the most likely diagnosis?(a) Disseminated intravascular coagulation
(b) Acute meningococcemia
(c) Antiphospholipid antibody syndrome
(d) Thrombotic thrombocytopenic purpura
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85.Fibroblast Growth Factor 23 (FGF 23) is increased in which one of the following conditions?
(a) Osteomalacia
(b) Osteoporosis
(c) Paget?s disease
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(d) Renal Osteodystrophy--- Content provided by FirstRanker.com ---
86.
Which of the following crystals are deposited in a case of pseudogout?
(a) Monosodium urate
(b) Calcium phosphate
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(c) Cholestrol crystals(d) Calcium pyrophosphate dehydrate (CPPD)
87.
Which of the following features are associated with poor prognosis in Diffuse Cutaneous
Systemic Sclerosis?
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1. Older age
2. A high gas transfer factor for carbon monoxide (TLCO)
3. Proteinuria
4. Diffuse skin disease
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Select the correct answer using the code given below:
(a) 1, 2 and 4
(b) 3 and 4 only
(c) 1, 3 and 4
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(d) 1, 2 and 388.
Which of the following statements regarding pegloticase are correct?
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1. It is enzyme conjugate2. It is useful in chronic Gout management
3. The main adverse effects are infusion reactions and development of antibodies
Select the correct answer using the code given below:
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(a) 1 and 2 only(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
89.
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The most common cause of sensorineural hearing loss in adults is:(a) Otosclerosis
(b) Meniere?s disease
(c) Presbycusis
(d) Meningitis
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90.A 50-year old male presents with dizziness. Which one of the following clinical findings does
NOT favour a central cause?
(a) Poor saccades
(b) Gaze evoked nystagmus
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(c) Inhibition by visual fixation(d) Presence of diplopia, dysarthria
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91.
A young primigravida with 11 weeks pregnancy presents with sudden onset pain and
swelling of left lower limb. Homan?s sign is positive. Duplex ultrasonogram shows non-
compressibility of veins in the affected region, with absent flow. The drug of choice for
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treatment is:(a) Enoxaparin
(b) Amoxycillin?Clavulanic acid
(c) Warfarin
(d) Limb elevation only
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92.All of the following are clinical features of hypovolaemic shock EXCEPT:
(a) Cold clammy skin
(b) Bradycardia
(c) Hypotension
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(d) Oliguria93.
Which one of the following is most appropriate to describe classic heat stroke?
(a) Patients core body temperature rises above 44?C with headache, nausea and loss of
consciousness
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(b) Patients core body temperature rises above 40 ?C with muscle tremors, confusion,loss of consciousness and loss of sweating
(c) Patients core body temperature rises above 38 ?C with increased sweating,
tachypnoea, tachycardia and loss of consciousness
(d) Patients core body temperature is above 40 ?C with disorientation, increased
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sweating, peripheral vasodilation, tachycardia and loss of consciousness94.
Which of the following is NOT a priority in the initial management of shock from venomous
snake?
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(a) Aggressive volume resuscitation(b) Vasopressor support
(c) Anti-venom administration
(d) All of these are undertaken simultaneously
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95.Which one of the following is NOT an appropriate criterion for diagnosis of Systemic
Inflammatory Response Syndrome (SIRS)?
(a) Respiratory rate > 20/mm
(b) Heart rate > 90/min
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(c) Total leucocyte count > 16 ? 109
per Litre
(d) Temperature > 38
0
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C--- Content provided by FirstRanker.com ---
96.
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All of the following predispose to Acute Respiratory Distress Syndrome EXCEPT:(a) Acute Pancreatitis
(b) Toxic gas inhalation
(c) Aspiration of gastric contents
(d) Severe Bronchial asthma
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97.An 8 year old child has consumed a few tablets of a drug that were being taken by his mother
on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and
hepatic necrosis. Which is the most likely drug?
(a) Multivitamins
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(b) Calcium carbonate(c) Folic acid
(d) Iron
98.
A newborn weighing 1.5 kg at birth presents at 6 hours of age with lethargy, weak and high
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pitched cry and difficulty in feeding. What is the next step in management?(a) Estimation of blood sugar
(b) Estimation of serum calcium
(c) Supplementary oxygen
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(d) Bedside electrocardiogram99.
In a child with acute organophosphorus poisoning, which one of the following drugs will act
as anti-sialogogue and peripheral parasympatholytic agent?
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(a) Carbamates
(b) Atropine
(c) Benzodiazepine
(d) Pralidoxime
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100.A 6-year old child needs to undergo a central Catheter placement for total parental nutrition.
The procedure is likely to evoke pain and anxiety. Which of the following is the most
appropriate drug for sedation and analgesia in this child?
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(a) Chloral hydrate(b) Midozolam
(c) Propofol
(d) Ketamine
101.
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Which one of the following is the drug of choice in a child presenting with supraventriculartachycardia?
(a) Atropine
(b) Lidocaine
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(c) Adenosine(d) Nalaxone
102.
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Which one of the following drugs is used in cardiopulmonary resuscitation for pulselessventricular fibrillation?
(a) Atropine
(b) Adenosine
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(c) Lidocaine(d) Amiodarone
103.
Which one of the following is a sign of good attachment during breastfeeding?
(a) The baby?s nose is at the level of the nipple
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(b) The baby?s chin touches the breast(c) Most of the nipple is in the mouth and the lower areola is visible
(d) The baby?s lower lip is inverted
104.
Which one of the following signs is NOT included as an indicator of a vigorous baby
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immediately after delivery of an infant born through meconium strained liquor?(a) Pink colour
(b) Strong respiratory efforts
(c) Good muscle tone
(d) Active movements of the baby
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105.All are true for a Cephalohematoma in a newborn EXCEPT:
(a) It is located over the parietal bones in the subcutaneous plane
(b) It may be associated with hyperbilirubinemia
(c) It increases in size in the first 12?24 hours
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(d) It can take 3?6 weeks to resolve106.
Which of the following sick neonates can be started on ?Minimal Enteral Feeding?, if
hemodynamically stable?
(a) Septic neonate with sclerema
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(b) Neonate with necrotizing enterocolitis (NEC)(c) Neonate on mechanical ventilation
(d) Symptomatic hypoglycaemia
107.
Which one of the following drugs is contraindicated in a mother who is breastfeeding her
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infant?(a) Bromocriptine
(b) Chlorpromazine
(c) Acyclovir
(d) Morphine
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108.A term neonate presents with tachypnea on day 1 after birth. The chest X-ray reveals
hyperexpanded lung fields, prominent vascular markings, and prominent interlobar fissure.
Which of the following is the most probable diagnosis?
(a) Congenital lobar emphysema
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(b) Diaphragmatic hernia(c) Transient tachypnea of the newborn
(d) Tracheoesophageal fistula
109.
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A pre-school boy can go upstairs on alternate feet and has also started copying a circle. Howmany blocks should he be able to build a tower with, without toppling over?
(a) 5
(b) 7
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(c) 9(d) More than 10
110.
Which one of the following drugs is the antidote for benzodiazepine poisoning?
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(a) Flumazenil
(b) Atropine
(c) Naloxone
(d) Pralidoxime aldoxime methiodide
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111.
A 3-year old child develops severe respiratory distress after inhalation of fumes arising from
burning plastic. The child is started on supportive ventilation. Which one of the following
antidotes needs to be given?
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(a) Hydroxycobalamin(b) Amylnitrate
(c) Sodium nitrite
(d) N-acetyl cysteine
112.
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A child has an incurving of the little finger. What is this condition known as?(a) Camptodactyly
(b) Brachydactyly
(c) Partial cutaneous syndactyly
(d) Clinodactyly
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113.A 4-week old infant presents with repeated episodes of non-bilious vomiting since 7 days.
The infant seems active and hungry after the vomiting. Examination reveals an olive-shaped
mass in the epigartrium. Which metabolic abnormality is expected in this infant?
(a) Hyperchloremia
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(b) Metabolic alkalosis(c) Hyperkalemia
(d) Hyponatramia
114.
Which one of the following is the correct dose and route of administration of hepatitis B
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vaccine in children?(a) 0.5 mL dose with 10 microgram of antigen subcutaneously
(b) 0.5 mL dose with 10 microgram of antigen intramuscularly
(c) 1 mL dose with 5 microgram of antigen subcutaneously
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(d) 1 mL dose with 5 microgram of antigen intramuscularly115.
Which one of the following statements is correct for approved acellular pertussis vaccine?
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(a) It contains at least 3 IU of inactivated pertussis toxin(b) It contains at least 3 pathogenic pertussis antigens
(c) It?s efficacy is superior to the whole cell pertussis vaccine
(d) Presence of nonfimbrial protein is a mandatory component
116.
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Which of the following is recommended in the follow up health visits of a child with Downsyndrome?
(a) Growth assessment twice a year in the first year and annually till 5 years
(b) Annual auditory screening from 1 to 5 years
(c) Screening for refractory error if visual impairment is suspected
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(d) Annual thyroid function test from birth to 2 years117.
A 12 year old child presents with delayed puberty and delayed bone age. His growth records
reveal that he was growing normally till 1 year of age, after which both his height and weight
fell to below the third centile for age. Subsequently, he continued to grow below the third
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centile with normal height velocity. What is the most likely diagnosis?(a) Familial short stature
(b) Constitutional growth delay
(c) Growth hormone deficiency
(d) Skeletal dysplasia
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118.According to the ?Integrated Management of Neonatal and Childhood Illnesses? (IMNCI)
classification of young infants upto 2 months, which one of the following signs is NOT
included in ?Possible Serious Bacterial Infection?
(a) Fast breathing (50 breaths or more per minute)
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(b) Severe chest indrawing(c) Axillary temperature less than 36.5
0
C
(d) Movement only when stimulated or no movement at all
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119.Neonatal tetanus elimination in India is defined as less than one case per:
(a) 100 live births per year
(b) 1000 live births per year
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(c) 10000 live births per year(d) 100000 live births per year
120.
Which one of the following facilities has been established at district hospitals in India to
strengthen the care of low birth weight babies and sick newborns?
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(a) Special Newborn Care Units (SNCU)(b) Newborn Treatment Units (NTU)
(c) Newborn Stabilization Units (NSU)
(d) Shishu Suraksha Units (SSU)
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