SELECTION EXAMINATION FOR MD IN GENERAL MEDICINE AND GERIATRIC MEDICINE OCTOBER

2017 – GENERAL MEDICINE

1. Regarding antibody association with diseases,

a. Anti sm antibody – SLE

b. Anti Ro antibody – sjogren’s syndrome
c. Anti scl antibody – scleroderma
d. Anti RNP antibody – mixed connective disease

2. Regarding leukaemias,

a. AML always causes lymphadenopathy and hepatosplenomegaly

b. ALL associated with Philadelphia chromosome has poor prognosis
c. ALL has bimodal presentation
d. CML causes massive splenomegaly

3. A patient presented with haematuria, proteinuria, RBC casts and high serum creatinine.
What are the possible causes would be?

a. PSGN
b. TTP
c. SLE
d. CKDu
e. APCKD

4. Regarding antiepileptics,

a. Carbamazepine – Steven Johnson syndrome

b. Sodium valproate – PCOS
c. Ethosuximide – hirsutism
d. Phenobarbitone – poor social performance
e. Phenytoin – gum hyperplasia

5. True or False,

a. Sarcoidosis causes bilateral hilar lymphadenopathy

b. Leptospirosis is a recognized cause for cholecystitis
c. HSV – 1 is a recognized cause for meningoencephalitis
d. Long-term use of levodopa causes dyskinesia
e. Lead poisoning is a cause for foot drop
6. Dementia differ from Delirium due to presence of,

a. Inattention
b. Memory impairment
c. Insidious onset
d. Altered level of consciousness
e. Disorientation

7. Brain death is confirmed by in presence of,

a. Absent doll’s eye movement

b. Leg extension for pain
c. Positive caloric test
d. Flat line in EEG

8. Regarding gamma GT,

a. Specific to liver
b. Become normal after 01 week of cessation of alcohol
c. Increases in cardiac failure
d. Will increased by Phenytoin
e. Increases in obstructive jaundice

9. Regarding Broncho pulmonary aspergillosis,

a. Causes proximal bronchiectasis

b. Presents as asthma
c. Caused by Aspergillous fumigatous
d. IV Amphotericin used in severe cases

10. Bronchiectasis,

a. Can occur secondary to pneumonia

b. Exacerbations suspected by increased production of sputum
c. Exacerbation caused mostly by pseudomonas
d. Causes finger clubbing

11. Regarding pleural effusion in TB,

a. Mesothelial cells seen

b. Mostly haemorrhagic
c. AFB seen in most effusions’ fluid
 d. High ADA
e. Exudative in nature

12. Ulcerative colitis is more likely than chrons disease if patient have,

a. Adenocarcinoma of the colon

b. Toxic mega colon
c. Sclerosing cholangitis
d. Oral ulcers
e. Perianal fistulas and abscesses

13. Wasting of quadriceps occur in,

a. Becker’s muscular dystrophy

b. Diabetic amyotrophy
c. Meralgia paraesthetica
d. L 3 root compression

14. If a patient presented with central vein occlusion, which of the following investigations are
useful?

a. FBS
b. Lipid profile
c. Carotid duplex
d. 2D Echo
e. Intraocular pressure

15. Regarding Bronchial Asthma,

a. Has genetic predisposition

b. Step 1 consist LABA only
c. Can exclude if spirometry is normal
d. If peak flowmetry is < 33% predicted is known as acute severe asthma

16. Regarding COPD,

a. Can Cause type 2 respiratory failure with O2 treatment

b. BIPAP is a treatment option for type 1 respiratory failure
c. Steroid inhalers reduce exacerbations
d. Every patient should vaccinate for Hib
e. Cigarette smoking cessation will reduce progression of COPD
17. Regarding phaeochromocytoma,

a. Associated with MEN type 2

b. Causes postural hypotension
c. Causes episodic hypertension
d. Elevates urinary VMA level

18. Meningioma,

a. Metastasizes via CSF

b. Well circumscribed
c. Identified histologically by presence of psammoma bodies
d. Causes bony erosions

19. Regarding HIV seroconversion,

a. Occurs after 6- 8 weeks

b. Persistent lymphadenopathy seen
c. Mostly occur without symptoms
d. Typical maculopapular rash occurs

20. Regarding headache,

a. Trigeminal neuralgia is rare in elderly

b. Tension headache is less common in elderly

21. Clostridium deficille,

a. Infection diagnose by serological testing

b. Is a gram positive bacteria
c. Infection is treated by 3rd generation cephalosporin
d. Causes pseudomembranous colitis following metronidazole

22. Skin lesions associated with Diabetes mellitus are,

a. Granuloma annulare
b. Blistering lesions on hands
c. Pityriasis rosea
d. Pruritus nodulare
e. Necrobiosis lipoidica
23. Proven ways to reverse histological appearance of NASH are,

a. Weight reduction
b. Vitamin E
c. Statin
d. Diet control

24. Regarding psoriasis,

a. Guttate psoriasis commonly occur in elderly people

b. Pustular psoriasis is the severe form
c. Arthropathy seen in 50% of patients
d. Causes erythroderma
e. Shows kobner phenomenon

25. A 15 yr old girl presented to a medical ward one hour after paracetomol overdose. Steps of
management of her would be,

a. Give activated charcoal

b. Do gastric lavage
c. Give IV NAC
d. Send blood for serum PCM level after 4 hrs
e. Monitor serum albumin at regular interval

26. Causes for secondary affective disorder are,

a. Infectious mononucleosis
b. Viral hepatitis
c. Cushing syndrome
d. Following steroid therapy
e. Cannabis abuse

27. Regarding resistant hypertension,

a. Obstructive sleep apnoea is a cause

b. ACE inhibitors are indicated
c. Caused by excessive renin mediated pathology
d. Fluid overload is a cause
e. Endovascular denervation of sympathetic nerves has long term benefit
28. Regarding thyroid diseases,

a. Lid retraction is specific to Graves disease

b. Commonest cause is hashimotos thyroiditis
c. To diagnose Graves disease antibody detection is mandatory
d. Pre tibial myxoedema occur in hypothyroidism
e. Hashimotos thyroiditis may lead to lymphoma

29. In organophosphate poisoning atropinisation adequacy detected by,

a. Pulse rate >80bpm

b. Systolic Blood pressure > 100mmHg
c. Dry axillae
d. Dilated pupils

30. Regarding whipple disease,

a. Causes PR bleeding
b. Causes intestinal obstruction