MCQs Mastery Q

AMC-MCQs Mastery Questions

1. An anxious patient presents with status asthmaticus. Best acute treatment:

a. Parenteral steroids, inhaled B agonist, sedation
b. Theophyline, B agonist, hydration
c. Hydration, B agonist, iv steroids
d. B agonist, hydration, ipratropium
e.

2. An elderly man presents with hematemesis. He has lost 1 litre of blood and has
two episodes of melaena. After resuscitation, next management is:
a. Omeprazol
b. Gastroscopy
c. H. pylori eradication
d. Surgery
e. Cimetidine should be attempted first

3. A 22 yrs old man had an appendicectomy 5 days ago. Now he has tachycardia and
fever. The most likely is:
a. Wound infection
b. Lung infection
c. UTI
d. Pelvic abscess
e. Subphrenic abscess

4. Hypokalaemic alkalosis presents most commonly with:

a. Intestinal obstruction
b. Pyloric stenosis
c. Colonic obstruction
d. Volvulus
e. Renal failure

5. A child with IDDM collapses at his school in the playground. The most
appropriate first action would be:
a. Assess his neurological status
b. Do a glycaemia test
c. Iv glucose
d. Test the urine for ketones
e. Insulin injection

6. The most important initial treatment of ketoacidosis is:

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MCQs Mastery Q

a. Inaulin
b. Normal saline
c. Potassium
d. Bicarbonate
e. Diuretics

7. The most common cause of diarrhea in a bed-ridden patient are:

a. Faecal impaction
b. Ca of rectum
c. Lacatives
d.

8. Opening snap indicates

a. Mitral valve
b. Atrial fibrillation cause disappearance of the opening snap
c. Replaces S3
d. Best heard at 2nd right intercostals space
e. Remains unaltered despite progression of the disease

9. Which of the following conditions is most likely to become chronic?

a. HAV
b. HBV
c. HCV
d. EBV
e. Cholecystitis

10. A 70 yrs old woman complains of fatigue. The blood picture shows MCV 118, Hb
is decreased, WBC decreased, platelets decreased and hypersegmented polymorphs are
present. The most likely diagnosis is:
a. Autoimmune haemolytic anaemia
b. Pernicious anemia
c. Anaemia of chronic disease
d. Anaemia due to silent gastrointestinal bleeding
e. CML

11. A woman brings her husband who has recently lost interest in supervising his
work mates. He eats less and lost weight. He is restless at night and wanders on the lawn.
What do you think is the treatment of choice?
a. Antidepressant
b. Antipsychotic
c. Antianxiolytics

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d. Sedatives
e. Stimulants

12. A panic attack

a. Presents in 2% of the population
b. Comes in mid twenties
c. Is equal in men and women without aqoraphobia
d. Trigger stimuli should always be avoided
e.

13. A 45 yrs old man was hospitalized after a motorcycle accident where he hit a
lamp post. He has fracture of the femur and bruises over the chest. There is no apparent
injury on the head. On the 3rd day he became suddenly confused and disoriented and his
chest x-ray show bilateral infiltrates. What is the treatment
a. Steroids
b. In mannitol
c. Antibiotic
d. Intubation and O2 inhalation
e.

14. A 50 yrs old man presents with confusion and pain in the RUQ. Liver is not
palpable. His gait is ataxic and has nystagmus in all directions. His lateral eye movements
are restricted and so is the upward gaze. What is the likely cause?
a. Wernickes encephalopathy
b. Subdural haematoma
c. Alcohol cerebellar degeneration
d.

15. Which of the following is the prodomal feature of schizophrenic patient at risk?
a. Ideas of reference
b. Unemployment
c. Dysfunctional parenting
d. H/O of childhood abuse
e. Parietal lobe tumour

16. All of the following can cause serotonin syndrome when given alone with
fluxotene, except:
a. 1- tryptophan
b. Haloperidol
c. Chlomiphramine

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d. Moclobrmide
e. Dextromethorpan

17. A 60 yrs old man with wernickes encephalopathy presents to casualty. O/E he is
found to be hypoglycaemic, has nystagmus, drinks 6 gms of alcohol per day. What is
your initial management?
a. Normal saline (0.9%) and dextrose solution
b. Glucagons iv
c. 505 dextrose iv
d. Iv thiamine followed by dextrose solution
e. Insulin and dextrose iv

18. Which of the following would be a better prognosis for schizophrenia?

a. No precipitating features
b. Abrupt onset
c. Schizoid personality
d. Drug abuse
e. With affective symptoms

19. All of the following cause breast cancer, except:

a. Early onset of menopause
b. Having first child after 35 years
c. Nulliparous
d. Carcinoma of other breast
e. Family history of breast Ca

20. A woman presents with 3 miscarriage in the 8-10 weeks gestation. Prior of this
she had two pregnancies terminated at 10 weeks and has history of chlamydial
salphingitis. What is the cause of her miscarriages?
a. Chromosomal abnormality
b. Cervical dystocia
c. Diabetes mellitus
d. Hypothyroidism
e. Foetal infection

21. A pregnant woman at 34 weeks-gestational age, presents with antepartum

haemorrhage. You diagnose abruption placenta. All of the following are possible seen,
except:
a. Tense and tender uterus
b. BP of 180/11 mm Hg
c. Shock out of proportion with bleeding

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d. Foetal head mobile above the pelvic brim

e. Dead foetus

22. Which of the following is not true for a woman having antenatal care?
a. Presence of anti-Rho means that the baby can have permanent heart block
b. A platelet count of 100,000 is a risk for developing intracranial bleed in
infant
c. The presence of ANA could cause growth retardation of the foetus
d.

23. A young woman pregnant for 14 weeks, uterine size corresponding to 16 weeks,
now presents with bleeding and passing pout grape like material through a dilated cervix.
WOF is the best follow-up?
a. Weekly monitoring of urine HCG, until it comes to normal level
b. Ultrasound
c. Chest x-ray for metastasis
d. Check placenta for signs of malignancy
e. Observation and reassurance

24. A mother brings her baby who is babbling and squeaking and is able to hold his
head and move from prone to supine position and is able to sit unsupported and can reach
for objects with palmer grasp. When supported can stand and bounce. What is the
possible age of this child?
a. 5 weeks
b. 2 weeks
c. 7 months
d. 10 months
e. 12 months

25. A 15 month old child is brought to you by his parents. He was born at 36 weeks
by normal vaginal delivery and his birth weight was 2500 gms. At 8 months a mother and
child health centre test for hearing was done, which was normal. The parents say that he
babbles but does not speak any words yet. On P/E, the child appears normal. What will
you suggest?
a. Reassure the parents that this is a normal variant
b. Reassess at 18 months
c. Repeat mother child test for hearing
d. Arrange for audiometry testing
e.

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26. A 4 yrs old child presents with sudden onset of cough, unilateral wheeze and
decreased respiratory movement on one side. There is no family history of atopy. What is
the appropriate management?\
a. Chest x-ray
b. Full blood examination
c. CT of chest
d. Ultrasound
e. Inspiratory and expiratory chest x-ray

27. A neonate was born at full term with a birth weight of 1500 gms, was jittery on
handling and noticed to have cyanosis on the hands and feet. The infant had normal
temperature, respiratory rate 40/min and lung and heart were normal on examination. The
neonate has been given oxygen. Which of the following is your next step in management?
a. Reassure the infants mother and check the infant later
b. Check blood calcium
c. Give high concentration of oxygen via mask
d. Take blood sample for blood sugar test
e. Take blood for full blood examination

28. A child with periorbital oedema and anasarca, BP is normal. All of the following
are true, except:
a. Steroids are useful in treatment
b. Focal glomerulonephritis is the commonest cause
c. Proteinuria more than 3 gms/day is usual
d. This is commonest between 1 and 4 yrs of age
e.

29. A child with profuse diarrhea for 5 days develops convulsions. WOF blood test
results would most likely to cause convulsion?
a. K 2.2
b. K 2.6
c. Na 132
d. Na 156
e. Cl 100

30. WOF is least likely to cause of iron deficiency anaemia in children?

a. Cows milk
b. Thalassemia
c. Prematurity
d. Celiac disease
e. Multiple pregnancy

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31. A 72 yrs old woman presents with confusion and O/E she was found to be afebrile
and nothing abnormal was detected. She has an ulcer on the lower part of her leg, which
has been treated by the community nurse for several months. What will assist in the
diagnosis?
a. Urine test
b. Swab of the wound
c. Blood culture
d. CT scan
e. Lumbar puncture

32. GCS score of an unconscious man who responds to pain with limb movement and
opening of the eyes as well as speaking incoherently:
a. 8
b. 10
c. 6
d. 4
e.

33. You are performing external cardiac massage on a patient who has just suffered a
cardiac arrest. Which of the following provides best indication that resuscitation is
effective?
a. ECG
b. Palpation of the radial pulse
c. Colour of the skin and mucous membrane
d. Size and reaction of pupils
e. Response to stimuli

34. A 65 yrs old woman develops acute abdominal pain with distension. there is a
history of 12 hours of vomiting and cramping pain. O/E, irregular pulse at 120/min, BP
100/60 mm Hg, abdomen is tender with guarding and bowel sounds are absent. Rectal
examination reveals a dark bloodstain on the finger. Which of the following is most
likely?
a. Perforated peptic ulcer
b. Mesenteric arterial occlusion
c. Diverticullosis
d. Ca of the colon

35. Which of the following is not a feature of uncomplicated haemorrhoids?

a. Bright red bleeding
b. Prolapse of mucosa
c. Pruritus
d. Pain

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e. Mucous

36. A 21 yrs old man presents with increasing dyspnea, tachynoea and hyper inflated
left hemithorax with evidence of a mediastinal shift. Your immediate management would
be:
a. Insert a water sealed chest drain
b. Intubate
c. Insert a venflon into the 4th intercostals space, midaxilary line
d. Insert a venflon into the 2nd intercostals space, midclavicular
e.

37. All of the following are risk factors for breast cancer, except:
a. Early artificial menopause
b. First pregnancy after 35 years of age
c. Early menarche
d. No breast feeding
e. Cancer of the other breast

38. Most common cause of death in severe burns in Australia is:

a. Irreversible shock
b. Septicaemia
c. Respiratory failure due to respiratory tract burns
d. Unable to maintain positive nitrogen balance
e.

39. The most common cause of diarrhea in bedridden elderly patient are:
a. Ca colon
b. Crohns disease
c. Ulcerative colitis
d. Diverticulosis
e. Faecal impaction

40. A 35 yrs old woman having severe sudden abdominal pain throughout the night
wakes up and passes dark urine in the bathroom. She immediately goes to see the doctor.
Investigation showed:
Bilirubin: 5x the normal
Alkaline phosphatase: 4x the normal
AST and ALT: 4x the normal
S. amylase: 2x the normal
What is most likely diagnosis?
a. acute cholelithiasis

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b. acute cholecystitis
c. Ca gall bladder
d. Acute choledocholelithiasis

41. A middle aged male, cough of 2 weeks, with runny nose, sore throat, the cough
persist, especially at night and in the morning, with small amount of yellow sputum.
Picture: chest x-ray. What is the diagnosis?
a. Bronchitis
b. Lung TB
c. Silicosis
d. Mycoplasma pneumonia
e.

42. Which is the lowest prevalence of finding hepatitis C antibody?

a. Post transfusion hepatitis
b. Iv drug users
c. Haemophilia
d. Haemodialysis patients
e. Homosexual

43. In heparin induced thrombocytopaenia, WOF is typically seen?

a. Petechiae of the skin
b. Bleeding
c. Thrombosis
d. Haematuria
e.

44. A 24 yrs old male presented with fever, malaise, and sore throat for last 12 days.
Examination showed white tonsillar exudates, generalized lymphadenopathy,
maculopapular rash (not vesicular), rash on palms and soles and excoriating lesions
around anus. Which of the following is the likely diagnosis?
a. Glandular fever
b. Secondary syphilis
c. Pemphigus
d. Steven Hohnsons syndrome
e. Herpes simplex infection

45. A 29 yrs old male presented with nausea, malaise and upper abdominal
discomfort. Laboratory findings were: AST/ALT bilirubin-raised, Anti HAV Ig-G
positive, Hbs-AG negative, Anti HBc IgM positive, anti HBc IgG negative, and anti HCV
antibodies negative. What is the diagnosis?

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MCQs Mastery Q

a. Acute hepatitis A
b. Acute hepatitis B
c. Alcohol induced hepatitis
d. Cholecystitis
e. Chronic hepatitis B

46. An elderly woman presented with chest pain for several hours. On examination
her BP was 98/50, pulse irregular 120 beats per minute, ECG: ST segment elevation in
V2-V4, what is your initial management?
a. Cardioversion
b. Thrombolyis with TBA
c. Lidocaine
d. Amiodarone
e.

47. WOF is most likely in heart and lung resuscitation?

a. Iv lidocaine should be routinely given
b. When cardioversion is not available, every 3 minutes iv adrenalin should
be given
c. Iv atropine should be given
d. Before resuscitation, ECG should be done
e.

48. An elderly patient presents with pallor and tired, blood picture shows that MCV is
110/dl, Hb 9 mg/dl, wbc_, pl_. what is the most likely diagnosis?
a. CLL
b. ALL
c. Iron deficiency anaemia
d. Pernicious anaemia
e. Autoimmune haemolytic anaemia

49. A 21 yrs old girl had kidney transplantation one year ago. Now develops headache
and mildly neck stiffness. CSF done shows: monocyte 70%, glucose 1.2, protein 1.8.
What of the following investigation you would like to do nest?
a. Immuno-fluorescence assay of HSV
b. Zieh-neelsen stain
c. Cryptococcus assay
d. Virus culture
e. Bacterial culture

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50. A 12 yrs old boy came with the complaint of hip pain for 4 weeks. Mother noticed
that he has been limping for the same duration. On examination, the boy is on 90tt
percentile of weight and height. What is the diagnosis?
a. Perthes disease
b. Transient synovitis
c. Slipped upper femoral impede
d. Osteochondritis
e. osteoarthritis

51. A mother came with 6 weeks old boy C/O no passing stool for 4 days. The child
look well, O/E normal. What would you advise?
a. Reassure that this is a normal variant
b. Hirschprungs disease
c. Anal fissure with foecal impede
d. Anal atresia
e.

52. A 4 yrs old child presents with suddenly onset of unilateral wheeze and decreased
respiratory movement on one side. What is the appropriate management?
a. Chest x-ray
b. FBE
c. CT of the chest
d. Ultrasound
e. Inspiratory and expiratory chest x-ray

53. A newborn baby was not well, vomiting, difficulty in feeding. Urinary analysis
shows leucocytes 100,000. What is the most appropriate management?
a. Amocycillin
b. Suprapublic aspiration
c. MSU
d. Sulphonamide
e.

54. A 42 yrs old nulliparous woman, her uterus was enlarged up to 8 weeks. She is
complaining of heavy period over 2 years time. The most likely cause of bleeding is
a. Adenomyosis
b. Endometriosis
c. Submucosal fibroids
d. Disturbance of hormonal regulation of endometrium
e. Intramural fibroids

55. All are side effects of DEP-PROVERA, except:

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a. Increase weight
b. Amenorrhea
c. Infertility for 6-9 months after the 3rd shot
d. Increase BP
e. Irregular bleeding

56. A pregnant woman who is at 26 weeks of gestation. Has spot bleeding, abdominal
cramp, examination shows 2 contractions during the last 10 minutes, the cervix dilated to
3cms, 80 effaced. Which of the following you cant do?
a. Glucoccorticosteroid
b. Test foetal fibronection
c. USG
d. Cervix cerclage
e.

57. WOF is least useful for prevention o fosteoporosis in postmenopausal woman?

a. HRT
b. Tamoxifen
c. Alendronate
d. Calcium
e. Regular exercise

58. Methotrexate can be used in ectopic pregnancy, except:

a. Foetus is alive
b. HCG level is less than 3000 IU
c. Within 6 weeks after LMP
d.

59. About the corticosteroid and psychiatric side effects, which is correct?
a. Patients with history of psychiatric disorders are more prone to psychiatric
side effects
b. More severe side effects are those of hypomania
c. Less severe side effects are those of depression
d. On withdrawal cause delirium
e. It doesnt depend on the previous psychiatric illness of the patient

60. WOF is the characteristic of ADHD?

a. Primary onset in school age (5-7 yrs old)
b. Equal incidence in sex
c. Reading difficulty
d. Treatment with sedatives is effective

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e. Excellent improvement with behavioural treatment

61. About highest risk of suicide in depression:

a. When the depression is getting worst
b. On beginning of the treatment
c. On improvement with treatment
d. On discharge from the hospital
e. On admission in hospital

62. A young man brought in by his girlfriend. He was very agitated and his speech
was like this: I love you, you lovely girl, the is swirl, vekematba, I do, I do love you.
WOF is the most probable type of disorder?
a. Schizophrenia
b. Mania
c. Histrionic personality disorder
d. Factious illness
e. Schizoaffective disorder

63. WOF is associated with depression:

a. It can occur in the young adolescents
b. If there is suicide risk, ask a psychiatrist for a second opinion
c. 100% of the patients attending general practice have depressive disorders
d.

64. Three days after cholecystectomy, a man develops confusion and irritability. He
had the history of alcohol intake. You diagnose him to have electrolyte imbalance, hepatic
failure and alcohol withdrawal. You find all of the following except:
a. Asterixis
b. sun downing effect
c. Ability to give informed consent
d. Hallucination
e. Fluctuating consciousness

65. Distorted body image is found in all except:

a. Acromegaly
b. Hypochondriasis
c. Limb amputation
d. Anorexia nervosa
e.

66. WOF is the most important initial aspect in psychotherapy?

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a. Establish good relationship

b. A good assessment and complete history
c. Graded exposure
d.

67. A 35 yrs old man who is frightened of flying in airplane. He fells nauseated and
dizzy when he thinks about flying. Because of this, he is afraid to leave home and works
close to his home, he refused to take any oversea assignment from his boss. What is the
most probable diagnosis?
a. Panic attack with agoraphobia
b. Panic attack
c. Agoraphobia
d. Simple phobia
e. Social phobia

68. Alcoholic patient admitted with epigastric pain, on taking history he says he
drinks 3 bottles/week Bobourn whisky. On counseling him what will be your important
initial point?
a. Advise for controlled drinking
b. Give him docacard (drug)
c. Discuss about safe level of drinking
d. Refer him for detoxification
e.

69. 12 days after CABG. A 70 yrs old DM presents with weakness of her right leg,
O/E: weakness of dorsiflixion and evertion, plantar flexion and inversion are preserved,
knee jerk and ankle jerk are normal, WOF is affected?
a. L4 nerve root
b. L5 nerve root
c. Common peroneal nerve
d. Sciatic nerve
e. Tibial nerve

70. Anthology picture: page 197. Supracondylar fracture x-ray. A child presents with
swollen elbow after fallen with an outstretched arm. P/E shows pale, pallor and painful
forearm. What would be the next management:
a. Neurovascular assessment in every 4 hours
b. Close reduction and reassess the neurovascular status urgently
c. Immediate open reduction and neurolysis
d.

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71. What is the most important thing to look for in ultrasound in a jaundiced patient?
a. Gallstone
b. Head of the pancreas
c. Dilatation of the bile duct
d. Liver mass
e.

72. What is the most common cause of intestinal obstruction in an abdomen without
any previous abdominal surgery in Australia?
a. Internal hernia
b. Groin hernia
c. Malignancy
d. Volvulus
e. Intussusception

73. WOF is the most important association cancer colon?

a. Tubular adenoma
b. Villous adenoma
c. Familiar adenomatous polyposis (FAP)
d. Diverticulosis
e. Ulcerative colitis

74. WOF is the most important sign of head injury?

a. Retrograde amnesia
b. Anterograde amnesia
c. Focal neurlogic deficit
d. Iv nerve palsy
e. Level of consciousness

75. A 50 yrs old man presented with suddenly onset of varicocoele in the left scrotum
most likely underlying condition is?
a. Femoral hernia
b. Testicular tumour
c. Benign varicocoele
d. Inguinal hernia
e. Left renal carcinoma

76. Colles fracture the dislocation of the distal fragment. WOF is correct:
a. Forward dislocation with ulnar deviation
b. Forward dislocation with radial deviation
c. Backward dislocation with radial deviation

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d. Backward dislocation with ulnar deviation

e. No displacement

77. What is the first step in the management of tension pneumothorax?

a. Intercostals drainage
b. Thoracostomy
c. Insert a large bore needle in the second IC space
d. Insert chest tube into the 5th IC space in the axillary line
e. Chest x-ray

78. What is the most common site affected leading to intermittent claudication?
a. Popliteal artery
b. Internal ileac artery
c. Superficial femoral
d. Profunda femoris artery
e. Common femoral artery

79. The dilatation of the common bile duct (CBD) is most clearly shown by?
a. CT
b. ERCP
c. US
d. Oral cholecystogram

80. A 35 yrs old lady complains of mastalgia for the last 1 year. Conservative
management failed. How would you manage this patient?
a. Bromocoriptine
b. Clomiphene
c. OCP
d. Danazole
e. NSAID

81. A 21 yrs old girl presented with enlarged cervical lymph node. Biopsy showed
thyroid glandular tissue. What is the most likely cause?
a. Metastasis from thyroid carcinoma
b. Adenoma of the thyroid
c. Thyroglossal duct cyst
d. Lymphadenoid thyroid

82. Regarding diabetic neuropathy, WOF is least likely?

a. Among the diabetes related complications, diabetic foot ulcer is the most
common cause of prolonged hospital stay

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b. 50% of the patient with diabetic neuropathy die within 3 yerars

c. If diabetes is under good control amputation can be reduced by 50%
d. If untreated 1/3 of the patients will have amputation due to diabetic
neuropathy
e. With the presence of normal pedal pulse the development of ulcer is
unlikely

83. What is not true about snake bite in Australia?

a. Anti venom most dangerous side effect is anaphylaxis
b. Tourniguet should be applied to prevent venom from spreading
c. Most of the snakes are non poisonous
d. Snake bites can cause coagulation problems
e. Most snake bites cause only superficial abrasion

84. WOF is best diagnostic of tubal pregnancy?

a. Empty uterus on ultrasound
b. Negative pregnancy urine test
c. Ultrasound evidence of tubal mass
d. Bimanual examination
e. Beta HCG

85. A 28 yrs old woman at 39 weeks of pregnancy is found to have transverse lie. She
is not in labour. There are no other abnormalities. What is your next step in management?
a. Immediate ultrasound
b. P/V examination
c. External cephalic version
d. LS caesarian section
e. Tell her to come to see you again in two weeks

86. A pregnant woman in 1st trimester is found to have CIN III. What is your next
step?
a. Terminate the pregnancy
b. Cone biopsy
c. Hysterectomy
d. Colposcopy
e. Observe

87. WOF is the negative symptom of schizophrenia?

a. Blunt affect
b. Auditory hallucinations
c. Catatonia

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d. Formal thought disorders

e. Visual hallucinations

88. WOF will cause serotonin syndrome if given together with SSRI like fluoxetine
except?
a. 1-tryptophan
b. Haloperidol
c. Moclobemide
d. Chlormipramine
e. Citalopram

89. WOF is damaged in mid humerus fracture

a. Axillary nerve
b. Radial nerve
c. Median nerve
d. Chlormipramine
e. Citalopram

90. You are in a rural area with no major emergency medical facilities. A man
presents to you with snakebite. Examination shows only scratch mark on his lower limb
without any marked necrosis. You dont find any other abnormal signs and patient feels
normal. What is your next step in management of this patient?
a. Arrange for air ambulance to transport to a city hospital
b. Do a swab and apply a pressure bandage
c. Amputate his lower limb
d. Give anti venom immediately
e. Send him home as there is only a scratch mark and no other signs of a
snake bite.

91. An x-ray showing dislocation of the shoulder. WOF is correct?

a. Posterior dislocation of the shoulder
b. Sensory loss of the lateral aspect of the arm
c. Weakness of the hand
d. Sensory loss of the medial aspect of the hand
e. Fracture of the humerus

92. WOF makes you suspect delayed development of a child?

a. Smile for the first time after 3 months
b. Walked for the first time holding the furniture at 7 months
c. Says 3 words at 10 months for the first time
d. Sits without support at six months

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e. The child is dry in bed for the first time at 5 years

93. A 13 yrs old boy has height equal to 50th percentile for 9 years. WOF is best
prognostic?
a. Bone age is equal to 13 years
b. Bone age is equal 9years
c. Bone age is equal to 15 ears
d. Bone age is equal to 10 ears

94. A neonate with cough and fever is found to be grunting. Chest x-ray shows round
lesions with little pleural effusion. WOF is the best treatment?
a. Crystalline penicillin
b. Gentamycin
c. Amoxicillin
d. Flucloxacillin

95. Pictures showing a rash on the body of a girl. The rash is typical of
meningococcal septicaemia. WOF is the next step in the management of this patient
a. Iv amoxicillin
b. Iv ceftriaxone
c. Oral steroids
d. Lumbar puncture
e. Reassurance

96. ECG given. A 65 yrs old lady has emphysema for many years and presents with
dyspnoea and chest pain. ECG shows: bradycardia with variable rates (40-70
beats/minute), no p waves, normal axis, raised ST segment in leads II and AVF, with ST
segment depression in leads I and AVL, V2-V4 with slopping S waves and inverted T
waves. QRS complex normal, right bundle branch block (RSR in V1 and V2). WOF
statements is trur?
a. She has ischaemic heart disease
b. She has right ventricular hypertrophy
c. Right bundle branch block is diagnostic of emphysema
d. She has evidence of dignoxin toxicity
e. She has WPW syndrome

97. All of the following can lower the level of potassium in the treatment of
hyperkalaemia except:
a. Sodium bicarbonate
b. Glucose and insulin
c. Calcium gluconate

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d. Resonium
e. Haemodialysis

98. An elderly lady presented with chest pain for several hours. On examination her
BP was 98/50, pulse irregular at 120 beats/min, ECG given: ST segment elevation in V2-
V4. what is your initial management?
a. Cardioversion
b. Thrombolysis with TPA
c. Lidocaine
d. Verapamil

99. A sweating patient presented with tachycardia, palpitations and shortness of

breath. ECG given: wide slurred QRS and short PR interval, delta waves. What is most
likely diagnosis?
a. Multiple ventricular ectopic beats
b. WPW syndrome
c. Atrial fibribblation
d. Sinus tachycardia
e. Myocardial infarction

100. A 55 yrs old lady develops sudden left sided weakness and right eye blindness.
What is the most likely diagnosis?
a. Vertebro-basilar insufficiency
b. Carotid artery stenosis
c. Pituitary tumour
d. Cerebellar lesion
e. Trauma of head

101. You are examining a man in coma who was brought in the emergency department.
The patient withdraws his hands on painful stimulus and opens his eyes in respond to
pain but shows no verbal response. What is his score on Glasgow coma scale?
a. 0-3
b. 4-6
c. 7-9
d. 10-12
e. 13-15
102. A man presents with suddenly onset of IX and Xth cranial nerves palsy and the
loss of touch and sensation on the opposite side of the body. He has also ipsilateral
Horners syndrome. Where is the lesion?
a. Carotid artery
b. Middle cerebral artery
c. Vertebral artery

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MCQs Mastery Q

d. Basilar artery
e. Posterior cerebral artery

103. WOF is the most characteristic of tuberculosis pleural effusion?

a. Heavily blood stained
b. Contains mononuclear cells predominantly
c. Very low or absent glucose
d. Acid fast bacilli found in culture

104. WOF is incorrect regarding snakebite in Australia?

a. No marked skin necrosis
b. Most of the snakes are not venomous
c. Causes coagulation disorders
d. Tourniquet should be applied so that nenom stays in that area
e. Affects cranial nerves

105. All of the following cause drug interactions except:

a. Erythromycin-theophylline
b. Digoxin-warfarin
c. ACE inhibitors-diuretics
d. Amiodoarone-B. blockers

106. A 28 yrs old male patient presents with distal weakness and atrophy of small
muscles of both hands. What is the most likely diagnosis?
a. Multiple sclerosis
b. Bilateral median nerve palsy
c. Syringomyelia
d. Bilateral unlnar nerve palsy
e. Brainstem infarction

107. A 35 yrs old male with history of sore throat presents with a puffy face, oliguria,
blood pressure reading of 160/120 and some pulmonary crepitations. WOF is correct?
a. Haematuria is a grave prognostic symptoms
b. He is at immediate risk of death from left ventricular failure
c. Increase in oral fluid intake result in diuresis
d. If there is renal tenderness, a renal biopsy should be done
e. Dialysis is contraindicated during the acute phase of illness

108. A given chest x-ray of a 45 yrs old male who had a severe cold 2 weeks ago now
presents to you with complaints of cough during night and early morning which produces

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small amount of yellow sputum especially when he wakes up in the morning. What is the
most likely diagnosis?
a. Chronic bronchitis
b. Tuberculosis
c. Bronchiectasis
d. Pulmonary fibrosis
e. Carcinoma of the bronchus

109. A 23 yrs old male student comes to see you with complaints of sore throat and
fever with malaise for the last 12 days. On examination you find tonsillar exudates,
generalized lymphadenopathy and maculo-papular rash on his palms and soles of the feet.
He also has excoriating lesions around the anus. What is the most likely diagnosis?
a. Glandular fever
b. Syphilis
c. Hepatitis B
d. Hepatitis A

110. 7 yrs old lady presents with chest pain. She was on nitroglycerine, diltiazem
60mg, digoxin 0.125mg, enalapril xxx. On examination she is found with biventricular
enlargement. ECG: (seem to be grade II A-V block & T wave inversions, ventricular
entopic, HR: 50-65/ min). what is the best management?
a. Stop all medications and review in 12 hours
b. Increase the dose of digoxin
c. Commence of colvexin
d. Infusion of potassium
e. Commence on frusemide

111. WOF is the least likely characteristic of pulmonary embolism?

a. Decreased second heart sound
b. Tachycardia
c. Dyspnoea
d. Pleural rub
e. Bronchial breath sound

112. A 54 yrs old lady has rheumatoid arthritis for 10 yrs and is taking naproxen,
prednisolone 5mg daily. Now she complains of pain in the right knee. On examination,
she has low-grade fever, pulse rate 118/min, the right knee is swollen, red. What is your
most appropriate next step in management?
a. Reassure her
b. Injection of corticosteroids into the affected joint
c. Increase the dose of naproxen
d. Oral corticosteroids

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MCQs Mastery Q

e. Aspiration of the affected joint and blood culture, start a course of

antibiotics based on the result of blood culture.

113. What is the best follow up investigation for patient with duodenal ulcer due to
helicobacter pylori infection?
a. Endoscopy
b. C 13 urea breath test
c. Serology
d. Culture
e. Histological examination

114. WOF is most likely occur in the 24 hours of acute pancreatitis?

a. Heart failure
b. Renal failure
c. Lung failure
d. Pseudocyst
e. Pancreatic disease

115. WOF drug can cause gynaecomastia except:

a. Methyldopa
b. Digoxin
c. Cimetidine
d. Omeprazole
e. Frusemide

116. WOF is least likely effective in treatment of paracetamol poisoning within 8 hours
ingestion?
a. Charcoal
b. Oral NAC
c. Iv NAC
d. Oral methinoine
e. Peritoneal dialysis

117. All of the following can lower the level of potassium in the treatment of
hyperkalaemia, except:
a. Bicarbonate
b. Glucose and insulin
c. Calcium
d. Resonium
e. Dialysis

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118. A 65 yrs old lady presents with right upper quadrant pain, jaundice and dark urine.
She has cholecystectomy 7 yrs ago. What is your next appropriate investigation?
a. Ultrasound
b. CT
c. Abdominal x-ray
d. Oral cholecystogram
e. Laparoscopy

119. A 35 yrs old lady presented with fever and painful neck. Thyroid scan showed low
uptake of radioiodine. On examination, she was found to have tachycardia and tremor.
What is your management?
a. Paracetamol and propranolol
b. Iodine
c. Thyroxine
d. Corticosteroid

120. WOF is the most important finding for the diagnosis of gout?
a. Finding of birefringement crystals on arthroscopy
b. Increased neutrophil count
c. Increased serum uric acid
d. Increased urinary acid

121. 30 yrs old man presented with malaise, nauseated, upper abdominal discomfort,
laboratory: ALP mildly increased, AST 200 (3-35), ALT 630 (3-35), total bilirubin 200
(3017), anti HAV-IgG +, HBS-Ag - , anti HBV-IgM+, anti HBC-IgG
a. Acute hepatitis B
b. Acute hepatitis A
c. Alcohol hepatitis
d. Cholecystitis
e. Chronic hepatitis B

122. 55 yrs old man 3 days after abdominal aortic surgery complains of dyspnoea, PR
150/min, BP 85/60 mmHg, ECG: atrial fibrillation with V2, V3, V4 ST elevation. What is
your diagnosis?
a. Leaking aortic aneurysm
b. Pulmonary embolism
c. Atrial fibrillation with anterior myocardial infarction
d. WPW

123. A 43 yrs old lady presented with coital bleeding. What is most likely cause?

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MCQs Mastery Q

a. Submucous myomata
b. Endometrial carcinoma
c. Cervix polyp
d. Intramural myomata
e. Thrush

124. A newborn baby presents jaundice within 24 hours after birth. The baby is Rh -
and blood group type A, the mother is Rh and blood type O, the coombs test weakly +,
what is the most likely diagnosis?
a. Immune incompatibility
b. ABO incompatibility
c. Rh incompatibility
d. Physiological jaundice

125. WOF is the most common type of hiatus hernia?

a. Paraoesophageal hiatus hernia
b. Sliding hiatus hernia
c. Congenital hernia

126. A 50 yrs old man presents with suddenly onset of varicocoele in the left scrotum,
the most likely underlying condition is:
a. Femoral hernia
b. Left renal carcinoma
c. Testicular tumour
d. Benign varicocoele
e. Normal condition

127. 50 yrs old man presented with 5 days vomiting of food taken 24 hours ago.
Reduced skin turgor, oliguria. Which fluid replacement regimen is most appropriate?
a. Hartmann solution
b. Dextrose
c. 0.9% NaCl
d. dextrose 5% + isotonic NaCl
e. NaHCO3

128. 50 yrs old lady presents with bloody discharge from nipple, what is your
diagnosis?
a. Pagets disease of the nipple
b. Ductal papilloma
c. Breast abscess
d. Eczema of the nipple

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MCQs Mastery Q

e. Fat necrosis

129. About tension pneumothorax, what is your first step of management?

a. Intercostals drainage
b. Insert a large bore needle into the second intercostals space
c. Thoracostomy
d. Insert a chest tube into the 5th intercostals space at the axillary line
e. Chest x-ray urgently

130. Picture, antology page 197. supracondylo-humeral fracture: 15 yrs old girl has
right humeral fracture, which of the following is the most correct statement?
a. Neurological and circulation assessment is essential
b. Nerve repair after 1 month
c. Reduction and reassess the circulation urgently
d. Neurological and circulation record 4 hourly is required
e. Open reduction

131. What is the most common site affected leading to intermittent claudication?
a. Superficial femoral artery
b. Popliteal artery
c. External iliac artery
d. Profunda femur artery
e. Common femoral artery

132. WOF carries the most fatal outcome in a 5 months old baby?
a. Bruise on the left cheek
b. Blue spots on the buttocks
c. Diamond shaped peeling lesion on the top of the head
d. Bold area on the occiput
e. Nasty looking rash in the napkin area

133. A six months old infant was brought in by his mother, who said that he passed the
last stool 4 days ago. The breast fed infant appeared well within normal weight gain. The
mother is concerned. What is your management?
a. Reassure that the stool is within normal variations
b. Use stool softeners
c. Use of extra fluid
d. Loperamide
e. Advise to start weaning

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MCQs Mastery Q

134. A 2 yrs old boy has had one side nasal purulent discharge since 2 weeks ago. He
has had a course of antibiotics but his condition had not been improved. On examination
he is very irritable and does not let you examine his nostril. What is your management?
a. Repeat antibiotics
b. Use topical antibiotics
c. Carefully examine the nose under general anesthesia
d. CT scan
e. MRI

135. WOF is true regarding iron deficiency anaemia?

a. Premature newborns are more likely to develop iron deficiency anaemia
b. Reticulocyte increase
c. Peak time is the first 4-6 months old
d. Bleeding tendency
e. Haptoglobin decrease

136. What is not a feature of autosomal resessive disease?

a. If the genes can be passed on silently from generation to generation
b. If both parents are carrier, they dont present with the disease themselves
c. If both parents are carriers, they will have 1:4 chance of having a child
with the disease
d. If a woman is a carrier, the woman will have 50% chance of having child
with the disease
e. The offspring may present with the disease

137. A young school teacher who complains of inability to fall asleep in the night as he
gets repeated thoughts of what happened during the day. He knows its not correct and
tries to resist the thoughts. What is the most useful management for this patient?
a. SSRI
b. Behaviour therapy
c. Benzodiazepines

138. A 40 yrs old man presents with inguinal scrotal swelling which of the following is
consistent with the diagnosis of inguinal hernia?
a. Swelling of the posterior part of the scrotum
b. The examiners hand cant go over the scrotum
c. The swelling is transilluminable
d. Painful scrotum

139. Picture: shows an acute perianal haematoma. A 27 yrs old female, a basketball
player, presented with perianal pain over 10 hours, what is the management?

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MCQs Mastery Q

a. Incision under local anaesthetics

b. Haemorrhoidectomy under GA
c. Drainage abscess
d. Give antibiotics
e. Haemorrhoidectomy under LA

140. In WOF prophylactic antibiotic use is least needed:

a. Surgery on prosthetic heart valve
b. Gastric resection
c. Fundoplication
d. Hemicolectomy
e. Haemorrhoidectomy

141. A patient presents to the A&E department with shortness of breath. On

examination his BP is 90/50 mmHg, pulse rate 96/min and central venous pressure
measured along the anterior axillary line is 0.5. most likely diagnosis is:
a. Cardiogenic shock
b. Hypovolaemic shock
c. Vasovagal syncope
d. Cardiac failure
e. Septic shock

142. A 55 yrs old man presents to your surgery with the complains of difficulty in
swallowing solids for the past 3 months. His past history reveals he had suffered from
heartburn particularly on stooping forward for many years but this problem has settled
and he is no more trouble. He has lost weight of more than 1kg in the last 3 months. Most
likely diagnosis?
a. Achlasia cardia
b. Oesophageal cancer
c. Strictures of oesophagus
d. Oesophageal web
e. Zenkers diverticulum

143. ECG interpretation: classical S1Q3T3, sinus tachycardia. A 50 yrs old

businessman presents with severe chest pain and shortness of breath. He is pale and
sweating. He has returned home after a business trip to Europe 7 days back. He was a
very healthy man and no significant past history. Most likely diagnosis is:
a. Left bundle branch block
b. Pulmonary embolism
c. Acute inferior wall MI
d. Acute anterior wall MI

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MCQs Mastery Q

144. The correct combination of pulmonary embolism is:

a. Normal CXR, decreased ventilation, decreased perfusion
b. Normal CXR, increased ventilation, decreased perfusion
c. Abnormal CXR, decreased ventilation, decreased perfusion
d. Normal CXR, normal ventilation, decreased perfusion
e. Normal CXR, decreased ventilation, increased perfusion

145. A 55 yrs old man presents to the A&E department with acute hemiplegia of 4
hours duration. CT scan is normal. The most appropriate management at this time would
be:
a. Oral aspirin
b. Iv thrombolytic therapy
c. Iv anticoagulatnt therapy
d. Antibiotica
e. No active agents

146. The most appropriate investigation in a diabetic patient with haemochromtaosis

is:
a. Transferring saturation
b. Serum iron
c. Serum ferritin
d. Blood glucose
e. Haemoglobin

147. A 24 yrs old lady presents to your surgery with amenorrhea, galactorrhea and
decreased libido for the last 6 months. Which investigation will be most appropriate to
arrive at diagnosis?
a. Serum FSH
b. Serum LH
c. Serum prolactin
d. T3, T4 and TSH
e. CT scan of the brain

148. Topical corticosteroids are best avoided in:

a. Discoid eczema
b. Atopic eczema
c. Peri-oral dermatitis
d. SLE
e. Psoriasis

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MCQs Mastery Q

149. A know diabetic man takes lispro (fast acting) and protophane (intermediate
acting) insulin for his blood glucose control before breakfast and also before supper now
presents to your surgery with complaints of feeling weal, night sweats, palpitations and
tremor. What is the most appropriated action in this case?
a. Decrease the dose of protophane
b. Decrease the dose of lispro
c. Change the long acting insulin
d. Increase the dose of lispro
e. Increase the dose of protophane

150. The most likely cause of non healing ulcer on the head of third metatarsal bone in
a diabetic man is:
a. Macrobascular disease
b. Neuropathy
c. Ill fitting shoes
d. Poor glucose control
e. Infection

151. After accident, a person got severe trauma, present with distended neck vein,
massive chest injury, shocked. What is the most diagnosis?
a. Tension pneumothorax
b. Cardiac tamponade

152. 50 yrs old patienst presented with several attacks of blurring of vision (both eyes),
hypertension. The probable cause is:
a. Hypertensive retinopathy
b. Vertebro-basilar embolism
c. Carotid stenosis

153. TPA is administered in WOF?

a. All second MI
b. All inferior MI
c. All anterior MI
d. In selected anterior MI
e. In non-ST depression MI

154. A man with severe attacks of memory loss and blurred vision:
a. Internal carotid stenosis
b. Vertebro basilar insufficiency
c. transient global amnesia
d. Mid cerebral artery infarct

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MCQs Mastery Q

155. A young lady with history of asthma, irresponsive to steroids, presents to the ED
with acute attack, WOF will make you think that the fatal outcome is possible?
a. Peanuts intake regularly
b. History of smoking
c. Family history of cardiac disease
d. Previous episodes of intubation due to asthma attack
e. Previous treatment with steroids

156. ACE inhibitors are first line of treatment in all of the following, except:
a. Aortic stenosis
b. Essential hypertension
c. Left anterior infarct
d. CCF
e. Hypertension in diastolic

157. All are true about B-thalassaemia, except:

a. Heterozygote have severe anaemia, requiring frequent transfusion
b. If both parents are with thalassaemia minor, 25% of children will have
thalassaemia major
c. If the father is with thalassaemia major, but mother is normal. All the
children will be with thalassaemia major
d. Homozygote have severe disease

158. A child presents with a lump in his posterior cervical triangle of the neck. On
examination the lump was soft, transilluminated. What is the most likely diagnosis|?
a. Branchial cyst
b. Lipoma
c. Cystic hygroma
d. Thyroglossal duct cyst
e. Enlarged lymph nodes

159. A 3 yrs old girl presents with 3x3cm erythematous area on the upper eyelid, Lid
oedema, congestion of conjuctiva and normal eye movement. What is the correct
treatment?
a. Iv flucloxacillin and cephalosphorin
b. Topical chloramphenicol and cephalosporin
c. Topical steroids
d. Surgical intervention
e. Topical gentamycin

160. A child with helitrope rash and muscle weakness, what is the diagnosis?

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MCQs Mastery Q

a. Dermatomyositis
b. RA
c. Guillain-barre syndrome.

161. The most common cause of blood stained stool in an otherwise normal infant is:
a. Anal fistula
b. Anal fissure
c. Haemorrhoids
d. Meckels divertiulum
e. Intussusception

162. A 65 yrs old lady presents to you regarding her belief her husband suffers from an
incurable cancer for 10 yrs, although her husband is perfectly healthy. She also thinks that
he is a member of the world security organization and the plane flying above their house
and trying to get some important information from her. When asked about her belief, she
remains vague and cant give you any logical explanation. What is most likely diagnosis?
a. Paranoid schizophrenia
b. Delusional disorder
c. Dementia
d. Alcohol disorder
e. Schizoid personality disorder
163. A 24 yrs old mother who gave birth to baby boy complaints of insomnia and
irritability. She also at times has suicidal ideas after the child birth. What is true regarding
this patient?
a. Onset is characteristically within 12 hours
b. ECT is the treatment of choice
c. Mothers bonding towards baby will be affected
d. Separating mother and baby will help
e. This is normal after giving birth and dont need any intervention

164. A 19 yrs old university student who failed mid year exam. She thinks that
something bad is going to happen to her. She is anxious. She felt she isnt herself. She has
no thought disorder. She cant concentrate on study. WOF best describe her problem?
a. Cannabis abuse
b. Bipolar disorder type 2
c. Adjustment disorder with atypical syndrome
d. Post traumatic disorder
e. Personal disorder

165. A pregnant woman had CTG at 32 weeks gestation. WOF will be the sign of
hypoxia?
a. No accelerations for 20 minutes

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MCQs Mastery Q

b. Beat to beat variability of 5 beats per 5 minutes

c. Foetal heart rate of 40 beats per minute associated with uterine
contractions
d. Decelerations occurring after the uterine contractions and coming back to
the base line after the completion of the contraction is a sign of severe hypoxia
e. No variability in beats per minute

166. 16 weeks pregnant lady diagnosed with DVT. Before commencement of the
treatment you want to check her on disorders of coagulation and immune system that
cause DVT. You check all of the following except:
a. Anticardiolipin antibodies
b. Factor V
c. Factor VIII
d. INR
e. Protein

167. The most common cause of jaundice in third trimester in pregnant woman in
Australia is:
a. Cholestasis
b. Acute fatty liver of pregnancy
c. Hepatitis A
d. Gall stones
e. Acute cholecystitis

168. WOF is true matching pairs except:

a. Anticardiolipin antibody-IUGR
b. Lupus anticoagulant-pulmonary embolism and thrombosis
c. Anti Rho antibody-heart block
d. Platelet count < 100,000 foetal intracerebral haemorrhage

169. All of the following is the cause of acute urinary retention in female, except:
a. Spinal tumour
b. Fibroid
c. Human papilloma virus
d. Herpes simplex virus
e. Retroverted gravid uterus

170. A 26 yrs old primigravid patient at 39 weeks gestation was found to have
transverse lie. She is not in labour. She comes to see you. Best management is:
a. External cephalic version
b. Caesarian section

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MCQs Mastery Q

c. Ask her to come and see you in two weeks time

d. Do immediate USG
e. Induction of labour after ECV

171. 26 yrs old primi, 150cm tall with vertex presentation, head at 0 station, cervix
effaced completely and dilated to 4cm with intact membranes at 37 weeks. She is in
labour. Proper management includes:
a. Caesarian section
b. Trial of labour
c. X-ray pelvimetry
d. Ultrasound to detect foetal abnormality
e. Oxytocin to induce labour

172. WOF is least likely to present with a supraclavicular swelling?

a. Subclavian vein thrombosis
b. Cervical rib
c. Carcinoma of the breast
d. Carcinoma of the stomach
e. Subclavian artery aneurysm

173. A patient with chromic ulcer of the limb, which becomes worse when the limb is
elevated. What type of ulcer?
a. Ischaemic
b. Venous
c. Streptococcus infection
d. Diabetic

174. What is the commonest site of atherosclerosis in the lower limb?

a. Superficial femoral artery
b. Common femoral artery
c. Popliteal artery
d. External iliac artery
e. Profunda femoris artery

175. A pregnant woman had CTG at 32 weeks. WOF will be a sign of hypoxia?
a. No accelerations for 20 minutes.

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